Sónia F Dias

National School of Public Health NOVA Lisboa

A change in the research paradigm towards a method that more readily allows the translation of scientific knowledge into more community-oriented health actions and policies has been advocated in the field of public health. Special attention has been paid to community-based participatory research, which has the potential to allow the production of d...

Migration has been associated with a greater vulnerability in health. Migrants, especially women, go through several experiences during the migration process and in the host countries that ultimately put their health at risk. This study examines self-reported health status and preventive behaviors among female and male immigrants in Portugal, and i...

The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from immigrant groups. Structured interviews were conducted with 15 he...

Health workers' attitudes toward immigrant patients influence behaviour, medical decisions, quality of care and health outcomes. Despite the increasing number of immigrant patients in health services and the potential influence of health workers' attitudes, there is little research in this area. This study aimed to examine attitudes of different he...

Purpose: While there has been systematic research on the experiences of immigrant patients in mental health services within certain European countries, little research has explored the experiences of mental health professionals in the delivery of services to immigrants across Europe. This study sought to explore professionals' experiences of deliv...

The School Health Program aims to build healthy schools. This qualitative case study aimed to identify and understand how professionals involved in the School Health Program behave in the integration based on their inclusion in the recommended activities. The consensus was reached with experts to develop a matrix of indicators after building the Pr...

The School Health Program aims to build healthy schools. This qualitative case study aimed to identify and understand how professionals involved in the School Health Program behave in the integration based on their inclusion in the recommended activities. The consensus was reached with experts to develop a matrix of indicators after building the Pr...

Background Multidrug-resistant tuberculosis (MDR-TB) is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perceptions of health professionals about MDR-TB, their strategies to ensure adherence to treatment and their challenges in the context of the COVID-19 pandemic in a priority mu...

RESUMO A saúde sexual e reprodutiva representa uma das principais preocupações da Saúde Pública, pois afeta a saúde e o bem-estar dos indivíduos e compromete o nível social e econômico das sociedades. Muitos problemas relacionados a este tema são acentuados em grupos socialmente desfavorecidos, como os imigrantes. Esta investigação, portanto, aprof...

O Programa Saúde na Escola é uma política intersetorial, resultado do trabalho entre o Ministério da Saúde e o Ministério da Educação, cuja finalidade é ampliar as ações de saúde aos escolares da rede pública. As escolas participantes devem incluir no projeto político pedagógico escolar os temas das atividades em saúde desenvolvidas no Programa, de...

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) itself is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perception of health professionals about multidrug-resistant tuberculosis, their strategies to ensure adherence to treatment and the challenges in the context of the COV...

Depressive symptoms display heterogeneous trajectories across adolescence, which can lead to different consequences. This study aimed to identify trajectories of depressive symptoms from adolescence to young adulthood, assessing the association with social and health outcomes at young adulthood. Adolescents born in 1990, enrolled in schools of Port...

Investigar os fatores associados à prática do sexo sob o efeito de drogas (chemsex) entre homens que fazem sexo com homens (HSH) durante período de isolamento social, no contexto da pandemia da COVID-19. Inquérito multicêntrico online, aplicado aos territórios de Brasil e Portugal em abril de 2020, enquanto os dois países vivenciavam medidas sanitá...

The economic evaluation has gained popularity in recent years but, to be useful, it must be conducted and reported accurately. The aim of this study was to perform a mapping review identifying published articles about economic evaluation of school health programmes, characterizing and qualifying what has been published, and discussing how these stu...

Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevent...

Migrants often travel back to the origin countries and to other European states after settling in the residence country. Mobility along with structural vulnerabilities may increase HIV acquisition risk. Knowledge on HIV risk exposure when traveling is limited, yet crucial to inform prevention. This study aims to explore risky sexual behaviors and a...

High circular mobility creates vulnerability and elevates risk for sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV). We aim to explore knowledge, perceptions of risk, and sexual behaviors in relation to STIs/HIV, in Mozambican women involved in an informal cross border trade (ICBT) and residing in South Mozambique...

Migration to the European Union (EU)/European Economic Area (EEA) affects the epidemiology of infectious diseases, including tuberculosis (TB), HIV, hepatitis B/C, and parasitic diseases. Some sub-populations of migrants are also considered to be an under-immunised group and thus at risk of vaccine-preventable diseases. Providing high-risk migrants...

Background Migrants from high endemic countries accounted for 18% of newly diagnosed HIV infections in Europe in 2017. Knowledge on the link between HIV risk and post-migration travels and their impact on HIV acquisition is scarce, but critical to inform prevention. This study aims to explore risky sexual behaviour and HIV-acquisition among sub-Sah...

The national HIV/AIDS Programme has been a core health programme in Portugal, and has led the country's response to the HIV epidemics since the 1980s. In 2011, the Portuguese Government reorganised central services and reformed all vertical programmes, including the HIV/AIDS Programme. This paper describes the main features of that reform and analy...

Background: Sexual and gender based violence (SGBV) is a major public health problem and a violation of human rights. Refugees, asylum seekers and migrants are exposed to a constant risk for both victimization and perpetration. Yet, in the context of European asylum reception centers (EARF) professionals are also considered to be at risk. Our stud...

Background The HIV/AIDS Programme has been a core health programme in Portugal leading the country’s response to the HIV epidemics since the 1980s. In 2011, the severe financial and economical context forced the government to reorganize central services, including the Ministry of Health, aiming to improve efficiency and reduce costs. All vertical p...

Data for MSM continue to show a high risk of acquiring HIV-STIs. Within this population, outness seems to have an impact on both risk-taking and on health seeking behaviors. The objective of this study was to assess the relationship between socio-demographic, behavioral characteristics, testing behaviors, and outness level among MSM using data from...

Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs complete...

Background: Relationship status is an important factor associated with condomless anal intercourse (CAI) amongst men who have sex with men (MSM). Methods: A multi-centre bio-behavioural survey with MSM was conducted in 13 European cities (n = 4901) exploring factors associated with CAI via bivariate and multivariate multilevel logistic regressio...

This study identified patterns of sexual risk behavior among a sub-Saharan African migrant (SAM) population in Portugal and examined its associations with human immunodeficiency virus (HIV) prevalence, sociodemographics, use of sexual health services, and HIV testing. A cross-sectional biobehavioral survey was conducted with a venue-based sample of...

Background Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explor...

In Portugal, a mental health reform process is in place aiming to redefine the model of service provision. In 2008, a National Mental Health Plan (NMHP) was approved to provide policy guidance over the transition period. The NMHP intended, among others, to develop community‐based services, with a specific focus on rehabilitation and deinstitutional...

Background WhatsApp (WA) is the most recent and attractive applicative among Smartphone users. The use of WA in healthcare environment has been shown of multiple benefices. Mozambique team involved in 2017 bed nets universal coverage campaign (UCC) implemented a distant mentoring strategy using WA. This study aims to perform a descriptive analysis...

The book was inadvertently published with an incorrect affiliation for the author Tina Cook on page iv of the front matter.

The role of critical reflection as a key ongoing element of participatory research is explored with reference to previous chapters. The power of critical reflection to encourage learning and change is discussed alongside the formalization of reflection as evaluation: as a way of recognizing and capturing change. Participatory evaluation and its ben...

Participatory research is dependent on a number of factors, but perhaps most important is the relationship that develops between the research partners. This chapter focuses on a number of factors that impact on the sustainability of research partnerships, including the challenges posed by undertaking time-limited research projects. These factors in...

This final Chapter sheds light on the reasons why participatory research is so worth all the effort. It comes back to the essence of participatory research: the communicative focus, the relational, the reflexivity, the co-labouring, the critical and the creative dimensions. Participatory research is also a research approach that addresses tradition...

In this chapter you will be shown the collaborative process and steps that need to be taken to frame the research. Framing is essentially a way of looking at the world; a frame is a lens of understanding. Frameworks are critical for the interpretation and understanding of practices and lives. The process of framing consists of exploring various, so...

In this chapter you will be led step-by-step in the process of defining the focus of the research, together with your local research team comprised of key stakeholders (community members, service providers, decision-makers, academics, etc.). This consists of formulating research questions and goals which take into account the various perspectives o...

In this chapter you will be led step-by-step in how to analyze the data generated in the research process. The focus is on how to organize a group process to make sense out of the data, taking into account various data forms and the different competencies and skills of the various participants and community members. Principles to guide the quality...

The process of engaging people in the research of their lives or work involves a participatory approach to data collection, or what is often understood in participatory research as “data generation.” Engaging people in data collection or generation requires the creation of “communicative space”, and the use of methods that facilitate learning and m...

In this chapter we will consider the collaborative steps that need to be taken to narrate the participatory research process and findings. Telling and showing, often called dissemination, is about sharing knowledge with others. This may include searching for useful “evidence” generated by the research, deciding what audience groups should be reache...

Participatory Research is orientated towards change. This chapter explores the types of actions that generate change in the research process both during and after a research project has finished. It covers the conditions that need to be nurtured to encourage action and some of the impediments to that action. Purpose Developing insights into unders...

This chapter discusses what to consider at the start of a process of participatory research. This includes clarifying what different parties understand by “research”, what type of research they want to undertake for what purpose, and the value of making a “working agreement” based on discussions about how to conduct research in a way that is fair,...

In this chapter you will be led step-by-step in how to organize a participatory research project. This includes identifying the various tasks and roles within the project, estimating the resources needed, matching the strengths of the participants to the tasks at hand, and planning how the project will be done. Issues of capacity building and susta...

This chapter introduces the pleasure and the challenges of doing participatory research. It covers the origins and background to participatory research for health and social well-being, the underpinning paradigm and underlying principles and values. It introduces the notion of participatory research as a process dependent on context rather than a t...

This textbook is a comprehensive guide for students interested in using participatory research to improve people’s health and well-being. It is especially designed for those working in the fields of health and social welfare who are embarking on participatory research for the first time. It covers all phases in participatory research from “getting...

Background: The uptake of findings from sexual and reproductive health and rights research into policy-making remains a complex and non-linear process. Different models of research utilisation and guidelines to maximise this in policy-making exist, however, challenges still remain for researchers to improve uptake of their research findings and for...

Introduction: The HIV epidemic represents an impor- tant public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic. Methods: The Sialon II study, imp...

Introduction: The HIV epidemic represents an important public health issue in Europe particularly among men who have sex with men (MSM). Global AIDS Monitoring indicators (GAM) have been widely and jointly promoted as a set of crucial standardised items to be adopted for monitoring and responding to the epidemic. Methods: The Sialon II study, impl...

This study aims to compare adequate fruit and vegetable (F&V) intake between immigrants and natives in Portugal, and to analyse factors associated with consumption of F&V among immigrants. Data from a population based cross-sectional study (2014) was used. The final sample comprised 17,410 participants (≥20 years old), of whom 7.4% were immigrants....

Resumo Cabo Verde é um dos Pequenos Estados Insulares em Desenvolvimento do mundo, com especificidades e desafios próprios. Independente há 43 anos, com meio milhão de habitantes, a formação dos seus médicos tem sido feita no exterior, incrementando a força de trabalho do país, mas não o suficiente, em número e diferenciação, para sustentar os desa...

Resumo O Programa Saúde na Escola é uma política intersetorial brasileira, sendo resultado da parceria entre os Ministérios da Saúde e da Educação, com a finalidade de ampliar as ações de saúde aos alunos da rede pública, com vistas à formação integral dos estudantes da Educação Básica. Estudo qualitativo realizado em 2016, com o objetivo de invest...

The Health at School Programme is a Brazilian inter-sector policy resulting from a partnership between the Ministries of Health and Education to expand health actions to public school students, with a view to the comprehensive education of primary and lower middle school students. This qualitative study was carried out in 2016 to investigate Brazil...

Migrants, defined as individuals who move from their country of origin to another, account for 40% of newly-diagnosed cases of human immunodeficiency virus (HIV) in the European Union/European Economic Area (EU/EEA). Populations at high risk for HIV include migrants, from countries or living in neighbourhoods where HIV is prevalent, and those parti...

Background: Reducing the number of people with undiagnosed HIV infection is a major goal of HIV control and prevention efforts in Europe and elsewhere. We analysed data from a large multi-city European bio-behavioural survey conducted among Men who have Sex with Men (MSM) for previously undiagnosed HIV infections, and aimed to characterise undiagn...

Depression is the most important source of disability in adolescents, partially due to its recurrence. There is a lack of studies on population-based samples investigating the continuity of depressive symptoms during adolescence. This study evaluates depressive symptoms at early adolescence as predictors of depressive symptoms later in adolescence....

A participatory HIV research project was conducted with sex workers (SW) and men who have sex with men (MSM) to understand epidemiological HIV dynamics and associated sociobehavioural factors among these vulnerable groups. We examine the impact of this project, critically analysing the processes undertaken and focusing on the advantages and the cha...

Background: Sexual and gender-based violence (SGBV) is a widespread public health problem and a violation of human rights rooted in gender and power inequities. Refugees, asylum-seekers and migrants living in European asylum reception facilities (EARF) are especially vulnerable to SGBV. To contribute to closing the gap on systematic and accurate e...

Primary health care (PHC) should be a preferential way to access healthcare. Access to PHC is fundamental in terms of preventive medicine and an important health equity indicator. In Portugal, PHC has been continuously strengthened with an ongoing reform initiated in 2006. Although migrants are recognized as a group that tend to underuse preventive...

Objective: Immigrants tend to receive a lower quality of healthcare, which can be a sign of healthcare bias. We examined whether this bias in medical care is associated with a legitimizing process involving two psychosocial factors: threat perception and level of intergroup contact. Method: One hundred eighty six Portuguese health professionals...

Background: Substance use has been consistently reported to be more prevalent amongst Men who have Sex with Men (MSM) compared to the general population. Substance use, in particular polydrug use, has been found to be influenced by social and contextual factors and to increase the risk of unprotected intercourse among MSM. The objective of this ana...

Objective: Since physicians play an important role on antibiotic usage, it is vital to understand their antibiotic-prescribing behaviour and knowledge on antimicrobial resistance, in order to develop and implement effective antibiotic stewardship interventions. The aim of this study was to evaluate Portuguese physicians' knowledge, and understand...

The use of population-based survey data together with sound statistical methods can enhance better estimation of HIV risk factors and explain variations across subgroups of the population. The distribution and determinants of HIV infection in populations must be taken into consideration. We analysed data from the HIV Prevalence and Behaviour Survey...

Focus groups have been widely used in health research to explore the perspectives and experiences of individuals regarding health, illness and the health system, and to understand its sociocultural and contextual factors. Migrant health is increasingly a research topic of interest nationwide. Immigrants are recognized as a group that tends to under...

Background Knowledge of HIV status can be important in reducing the risk of HIV exposure. In a European sample of men-who-have-sex-with-men (MSM), we aimed to identify factors associated with HIV serostatus disclosure to the most recent anal intercourse (AI) partner. We also aimed to describe the impact of HIV serostatus disclosure on HIV exposure...

Background International human migration has been rapidly growing. Migrants coming from low and middle income countries continue to be considerably vulnerable and at higher risk for infectious diseases, namely HIV (Human Immunodeficiency Virus) and tuberculosis (TB). In Europe, the number of patients with HIV-TB co-infection has been increasing and...

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