Post-migration Factors Research Articles

Post-Migration Stress and Mental Health Outcomes: A Comparative Study of Syrian Refugee Women in Houston and Jordan

This study aims to examine context-specific post-migration stress factors and their differential impacts on the mental health of Syrian refugee women resettled in Houston, Texas, and urban communities in Jordan. A cross-sectional survey investigated sociodemographic and health-related conditions, psychological distress and coping (Perceived Stress Scale [PSS]), mental health-related symptomatology (Self-Report Questionnaire [SRQ]), conflict-related psychological distress (Afghan Symptom Checklist [ASC]), and post-migration stress (Refugee Post-Migration Stress Scale [RPMS]). Linear regression models examined factors associated with post-migration stress and mental health outcomes. A total of 127 Syrian refugee women participated in the study. Participants were in their mid-30s (mean age = 34.79 ± 11.2 years), married (66.9%), and reported low levels of education (44.8% below high school), low employment (27.2%), and elevated financial strain (91% below the poverty line). Jordan-based refugees exhibited higher scores on mental distress measures compared to their Houston-based counterparts; specifically more elevated psychological distress (p < 0.001), symptomatology (p < 0.001), and conflict-related distress (p < 0.001). Syrian refugee women in Houston reported higher social strain, while those in Jordan experienced greater financial hardship and barriers to accessing healthcare services. Mental distress among Syrian refugee women is influenced by specific post-migration stressors that vary by resettlement location. Targeted interventions are necessary to improve mental health outcomes in this population.

Displacement Stressors, Trauma Exposure, and Mental Health: A Survey of Asylum Seekers and Refugees.

The mental health of asylum seekers and refugees (ASRs) is a pressing global concern, with complex trauma histories and environmental stressors contributing to heightened vulnerability. This study investigates the mental health and service utilization patterns of ASRs in Hong Kong, where unique policy landscapes pose additional challenges to this population. A cross-sectional survey was conducted with 100 ASRs in Hong Kong. Participants completed measures assessing displacement-related stressors, trauma exposure, mental health symptoms (depression, anxiety, stress, PTSD/CPTSD), and mental health service utilization. Participants reported high levels of displacement-related stressors and trauma exposure. The majority exhibited symptoms of depression, anxiety, and stress, with a significant proportion screening positive for PTSD/CPTSD. Despite high mental health needs, their service utilization rates were low. Trauma exposure and displacement-related stressors were significantly associated with poorer mental health outcomes, but not with service utilization. ASRs in Hong Kong face significant mental health challenges, influenced by both pre- and post-migration factors. Findings underscore higher rates of mental distress in the present sample compared to prior studies in ASRs and other local surveys. While trauma-informed care is crucial, efforts to improve mental health service access and reduce systemic barriers are needed with targeted strategies and policy changes.

Pre-and post-migration factors associated with sleep health among Latin American immigrants in the United States: A systematic review.

Immigrants face unique challenges and stressors before leaving their country of origin and upon arrival to their host country, all of which may impair their sleep health. We synthesized the literature on pre-and-post migration factors predicting sleep outcomes among foreign-born Latin American immigrants to the United States. Following PRISMA guidelines, we searched three electronic databases: PubMed, PsycINFO, and Web of Science. We supplemented our search using Google Scholar and by manually reviewing reference lists from all included studies and four reviews on similar topics. Out of 2581 references screened, 12 peer-reviewed studies met our inclusion criteria. All studies but one were quantitative. Most were cross-sectional, consisted of adults, relied on self-reported measures of sleep, and had a low risk of bias. Acculturation stress, perceived discrimination and racism, working multiple jobs, as well as poor physical and mental health were the most consistent predictors of poorer sleep health in this population. Being born in Mexico and greater biculturalism were predictors of better sleep health. We discuss gaps in the literature, highlight opportunities for future research, and argue for a more comprehensive examination of how pre-migration experiences impact post-migration sleep health.

Determinants of health among Ukrainian refugees in Germany: comparison with other refugee groups

Abstract Background 6.5 million Ukrainian refugees have been displaced globally since 2022, with 1 million seeking asylum in Germany. Little is known about the health determinants for this group, limiting the evidence base for policy intervention. Methods We use a nationally representative survey of adult Ukrainian refugees in Germany (IAB-BiB/FReDA-BAMF-SOEP study; n = 5943), conducted in 2023, to analyse the effect of sociodemographic, pre-migration (experienced war intensity, traumatic experiences) and post-migration factors (time since arrival, accommodation, social networks) on self-rated health using multiple logistic regression. We contrast these findings with estimates of identical models obtained from a subset of the IAB-BAMF-SOEP-sample of non-Ukrainian refugees within one year of arrival (n = 1195). Results In the Ukrainian sample, post-migration factors are particularly critical for health, with those experiencing discrimination (OR 1.83; 95%CI: 1.51,2.21) and social isolation (OR: 2.70; 95%CI: 2.23, 3.28) affected by ill health, while those with high German proficiency (OR 0.34; 95%CI: 0.18, 0.64) and contact with Germans (OR: 0.66; 95%CI: 0.53,0.83) are protected. Pre-migration factors do not affect self-rated health. Among refugees from other countries of origin, post-migration factors are not associated with health within the first year of arrival, with exception of social isolation (OR: 2.03; 95%CI: 1.32,3.13). Discussion Despite the EU Temporary Protection Directive, the health of Ukrainian refugees in Germany is shaped by adverse post-migration circumstances. While other refugee groups may have had riskier escape journeys and worse arrival conditions, this is unrelated to self-rated health in the first year. This underscores the importance of considering pre-migration contexts when evaluating subjective health. Outreach services, communication campaigns and the expansion of medical interpreting services are needed to ensure access to the health system. Key messages • Despite the EU Temporary Protection Directive, the health of Ukrainian refugees in Germany is shaped by adverse post-migration circumstances. • Outreach services, communication campaigns and the expansion of medical interpreting services are needed to ensure access to the health system.

The impact of temporary residence permit on symptom severity and treatment outcome among refugees with PTSD

Despite an increased focus on the impact of post-migratory factors on the health of trauma-affected refugees, research on the influence of residence permit is limited. This influence may manifest on the outcome of psychiatric treatment. Accordingly, the aim of this study was to examine the role of temporary residence permit on symptom severity and treatment outcome among trauma-affected refugees in PTSD treatment. The sample consisted of 897 patients, who were allocated into three groups based on their residence permit: temporary residence permit, permanent residence permit, and Danish citizenship. The outcome measures were symptoms of PTSD (Harvard Trauma Questionnaire), depression and anxiety (Hopkins Symptom Checklist-25 and Hamilton Depression and Anxiety Rating Scales), quality of life (WHO-5 Well-being Index), and functioning (The Sheehan Disability Scale), evaluated before and after psychiatric treatment. Temporary residents tended to have less severe symptoms prior to treatment. Overall, no significant differences were observed between the three groups on treatment outcome. However, Danish citizens had a poorer treatment outcome on Hamilton Depression Scale compared with temporary residents. This study is one of the first to investigate treatment implications of residence permit in a clinical setting. The interactions between mental health and individual post-migratory factors are complex. Further research is still needed to understand how residence status affects mental health and treatment outcomes for refugees.

Trajectories of mental health problems in unaccompanied young refugees in Germany and the impact of post-migration factors - a longitudinal study.

Unaccompanied young refugees (UYRs) are at an elevated risk of continuing psychological distress, including posttraumatic stress symptoms (PTSS), depression, and anxiety. The post-arrival situation in a host country plays an important role in increasing or reducing mental health risks for UYRs. This study aimed to examine the trajectory of psychological distress and post-migration factors experienced by UYRs in Germany with five assessments every six months over a two-year period.Standardised self-report questionnaires were used to assess PTSS (CATS-2), depression (PHQ-9), and anxiety (GAD-7) symptoms. Material and social stressors (DSSYR), sociocultural adjustment (BSAS), frequency of contact with family members, and distress regarding asylum status were included as post-migration factors. N = 131 UYRs (Mage = 17.04; SDage = 1.46; 81.1% male) living in residential care facilities in Germany were included in this study. There was a significant loss to follow up with n = 77 after 12 months at T2 (59% attrition), and n = 37 after 24 months at T4 (28% attrition).At baseline, clinically relevant symptom scores were found in 48.1% for PTSS, 42.0% for depression, and 22.9% for anxiety. Analysis of latent growth curve models revealed that the symptom severity of depression and anxiety did not change substantially over one year, but PTSS showed a significant decline. The number of traumatic events affected initial levels of mental health problems but not their trajectory over time. The impact of post-migration factors varied between measurement points and outcome measures and did not result in a homogeneous pattern.Despite limitations, this study demonstrated the persistence of high levels of psychological distress in UYRs. Effective interventions are required at an early stage to prevent chronic trajectories and support systems should adapt to constantly changing circumstances.Trial registration number/date of registration: DRKS00017453/11th December 2019.

Post-traumatic stress disorder among long-term resettled Syrian refugees in Turkey: a comprehensive analysis of pre- and post-migratory factors.

After the war in Syria, many people were forcibly displaced, and many others migrated to foreign countries. Many Syrians have been exposed to traumatic negative lifeexperiences during this process. In this context, this study was carried out to investigate the effects of pre- and post-migration traumatic experiences and living difficulties on the development of post-traumatic stress disorder (PTSD) in Syrian refugees who have been residing in Turkey for more than five years. The sample size of this cross-sectional study consisted of 200 Syrian refugees. Research data were collected using a self-report questionnaire. Refugees' depression and anxiety levels were assessed with The Hopkins Symptom Checklist-25 (HSCL-25), and post-traumatic stress disorder (PTSD) symptoms were assessed with the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (PCL-5). Logistic regression models were created to assess the effects of pre- and post-migration traumas, adverse events, and other sociodemographic variables, including age and gender, on PTSD. The study unveiled a high prevalence of PTSD (55.5%), depression (33.5%), and anxiety(4.5%) among participants. Notably, male refugees and those exposed to armed conflict exhibited a significantly higher frequency of PTSD. In contrast, depression was more prevalent among female participants. Pre-migration traumatic experiences, especially near-death situations, were identified as significant predictors of PTSD. Interestingly, while pre-migration traumatic experiences were higher, post-migration living difficulties also emerged as a concern, with factorslike "inability to return home in emergencies" and "worries about losing ethnic identity" beinghighlighted. Path analysis further revealed that pre-migration traumatic experiences indirectly contributed to PTSD by exacerbating post-migration living difficulties. Syrian refugees in Turkey, even after long-term residence, exhibit high rates of PTSD, depression, and anxiety. While pre-migration traumas play a pivotal role, post-migration challenges further compound their mental health issues. These findings underscore the need for holistic, long-term mental health interventions that address both past traumas and current living difficulties.

Neighborhood social composition and refugee mental health - quasi-experimental evidence of associations from a Danish population register study.

Refugees are at an elevated risk of some mental disorders with studies highlighting the contributing role of post-migration factors. Studies of migrant groups show neighborhood social composition, such as ethnic density, to be important. This is the first longitudinal study to examine this question for refugees and uses a novel quasi-experimental design. We followed a cohort of 44 033 refugees from being first assigned housing under the Danish dispersal policy, operating from 1986 to 1998, until 2019. This comprised, in effect, a natural experiment whereby the influence of assigned neighborhood could be determined independently of endogenous factors. We examined three aspects of neighborhood social composition: proportion of co-nationals, refugees, and first-generation migrants; and subsequent incidence of different mental disorders. Refugees assigned to neighborhoods with fewer co-nationals (lowest v. highest quartile) were more likely to receive a subsequent diagnosis of non-affective psychosis, incident rate ratio (IRR) 1.25 (95% confidence interval (CI) 1.06-1.48), and post-traumatic stress disorder (PTSD), IRR 1.21 (95% CI I.05-1.39). A comparable but smaller effect was observed for mood disorders but none observed for stress disorders overall. Neighborhood proportion of refugees was less clearly associated with subsequent mental disorders other than non-affective psychosis, IRR 1.24 (95% CI 1.03-1.50). We found no statistically significant associations with proportion of migrants. For refugees, living in a neighborhood with a lower proportion of co-nationals is related to subsequent increased risk of diagnosed mental disorders particularly non-affective psychosis and PTSD.

International Migration and Cardiovascular Health: Unraveling the Disease Burden Among Migrants to North America and Europe.

Europe and North America are the 2largest recipients of international migrants from low-resource regions in the world. Here, large differences in cardiovascular disease (CVD) morbidity and death exist between migrants and the host populations. This review discusses the CVD burden and its most important contributors among the largest migrant groups in Europe and North America as well as the consequences of migration to high-income countries on CVD diagnosis and therapy. The available evidence indicates that migrants in Europe and North America generally have a higher CVD risk compared with the host populations. Cardiometabolic, behavioral, and psychosocial factors are important contributors to their increased CVD risk. However, despite these common denominators, there are important ethnic differences in the propensity to develop CVD that relate to pre- and postmigration factors, such as socioeconomic status, cultural factors, lifestyle, psychosocial stress, access to health care and health care usage. Some of these pre- and postmigration environmental factors may interact with genetic (epigenetics) and microbial factors, which further influence their CVD risk. The limited number of prospective cohorts and clinical trials in migrant populations remains an important culprit for better understanding pathophysiological mechanism driving health differences and for developing ethnic-specific CVD risk prediction and care. Only by improved understanding of the complex interaction among human biology, migration-related factors, and sociocultural determinants of health influencing CVD risk will we be able to mitigate these differences and truly make inclusive personalized treatment possible.

Acculturative stress and psychological distress during COVID-19, among racial-ethnic minority immigrants in the US

ABSTRACT Guided by Berry’s conceptualization of acculturative stress and Hovey’s acculturative stress framework, this cross-sectional study examines the relationship between migratory acculturative stress and psychological distress among racial-ethnic minority US immigrants (n = 202). The multiple linear regression indicated that respondents reported moderate psychological distress, acculturative stress, social support, and COVID impact. Pre-migration and post-migration acculturative stress factors predicted higher psychological distress; however, only the subscale of socioeconomic stressors remained statistically significant once the COVID impact scale was also modeled. Future research and practice efforts need to attend to the cumulative impact of acculturative stress and pandemic disruptions inhibiting the psychological well-being of racially minoritized immigrants.

Social Determinants of Mental Health among Refugees in Germany - The Influence of Postmigratory Social Isolation and Resources on Psychopathology and Utilization Behavior

The mental health of refugees is influenced by a variety of pre-, peri- and postmigratory factors. It remains largely unclear how social determinants influence the utilization of psychiatric-psychotherapeutic treatment. We applied a questionnaire survey to 189 refugees from a clinical sample in a psychiatric hospital and from a control sample, which was not in treatment. The influence of social factors on psychopathology and utilization of care was analyzed by means of a CHAID algorithm. The total sample was highly stressed (54% PTSD and 41.4% depression symptoms). Patients were more severely affected in all psychometric scales as well as in traumatization and they were less able to draw on resources such as a social network or residence permit. The strongest predictor for psychotherapeutic-psychiatric treatment was social isolation in the living environment. For patients, the lack of a work permit was the strongest predictor of depression symptoms. The results point to the importance of postmigratory social determinants for the mental health of refugees. In particular, stable social relationships, together with formal factors such as work permit and residence title, should help to reduce mental distress and the need for psychiatric treatment.

Social Determinants and Mental Health in Newly Arrived Young Migrants in Spain

IntroductionResearch has shown that factors related with the migratory process (such as travelling alone, living away from family, and discrimination after arrival) considerably increase the risk of mental health problems in young migrants. Moreover, they are among the most vulnerable migration groups with a high risk of social exclusion.ObjectivesTo identify coping strategies and behavioural changes used to deal with perceived discrimination and its impact on the emotional well-being and mental health of newly arrived young migrants in Spain.MethodsA subsample of 15 audio-recorded in-depth qualitative interviews were analysed from the national action-research Migrasalud project (II IN 190517 EN 162 FA 01). The interviews were transcribed, translated from Arabic to Spanish, and analysed through content analysis.ResultsMost participants were males (93.3%; n=14), ranging from 18 to 20 years, and from Morocco (93.3%; n=14). All participants were from foster care placements in Barcelona and arrived to Spain as minors. Newly arrived young migrants reported that they perceived themselves as being healthy before the migratory process. Adverse experiences during the journey and discrimination after arrival impacted their well-being and mental health. Specifically, they reported perceived discrimination in their daily life due to culture, language, or origin. This negatively impacted their well-being and mental health, increasing their emotional distress response and ‘undervalued or inferior’ and ‘vulnerable’ feelings about themselves. Concerning coping with discrimination, they reported using internalised coping strategies such as ‘ignoring’ or ‘not responding’ for fear of having their legal documents revoked or not obtaining them. Their behavioural changes often occurred when they perceived unfair treatment or prejudice towards their migrant status or their socioeconomics, culture or religion. These changes were motivated by being more accepted by the local community by ‘westernisation or cultural assimilation’ and by ‘creating a good image’ of oneself and its culture.ConclusionsFindings establish that the cumulative experience of post-migration stressors (such as discrimination) negatively impacts their mental health and well-being in the long term. This suggests the need for specific policies and services to address this population’s effects of post-migration risk factors. Further research is needed to explore the causes and effects of perceived discrimination on mental health more closely and to develop more targeted and effective interventions.Disclosure of InterestNone Declared

Adversarial Growth among Refugees: A Scoping Review

Background: The main aims of this scoping review are to provide a comprehensive overview of the existing knowledge about adversarial growth among refugees, and to gain insight into the complexity of post-trauma development. Methods: We applied a systematic search strategy resulting in the inclusion of 43 quantitative and qualitative empirical studies. Our findings underscore the prevalence of growth as a common phenomenon among refugees, emphasizing the positive associations with problem-focused coping, optimism, positive reappraisal, religiosity, and social support. Additionally, this review sheds light on the qualitative experiences and outcomes of growth, particularly pro-social outcomes, and the cultural and religious aspects of growth processes. Findings concerning the role of time and post-migration factors on growth processes highlight the need for more studies among established refugees. In sum, the findings supplement and lend nuance to pathology-oriented research, while acknowledging the severity of suffering and trauma and their consequences for individuals. We suggest that further research should focus on existential aspects and theories of growth: compassion, altruism, and pro-sociality following trauma, and the importance of religious and cultural elements in growth processes.

Prevalence and associated factors for poor mental health among young migrants in Sweden: a cross-sectional study

ABSTRACT Background Young migrants face multiple challenges that can affect their mental, sexual and reproductive health. Objective To assess the prevalence of self-reported poor mental health and its associated demographic, post-migration and sexual risk behaviour factors among young migrants (aged 15–25) in Sweden. Methods Data were drawn from a cross-sectional survey conducted with migrants aged 15–65 years old in Sweden between December 2018 and November 2019 (n = 6449). Among these, 990 participants aged 15–25 were eligible for the study. Mental health was measured using the Refugee Health Screener-13. Missing data indicator analysis and multivariable logistic regression models were conducted to estimate the association between mental health, sexual risk behaviour, demographic and migration-related variables. Results Of the 990 participants, 59% reported poor mental health. Participants reporting poor mental health were more likely to be female (AOR:1.63, 95% CI:1.18–2.25), to have lived in Sweden more than three years (AOR:2.16, 95% CI:1.17–3.97), to engage in any sexual risk behaviour (AOR:1.99, 95% CI:1.25–3.17), and to live alone (AOR:1.95, 95% CI:1.25–3.03) or with friends they already knew (AOR:1.60, 95% CI:1.37–4.91). People arriving from the Americas (AOR:0.54, 95% CI:0.33–0.88), Asia (AOR:0.44, 95% CI:0.22–0.86), Europe (AOR:0.30, 95% CI:0.14–0.61) and Africa (AOR 0.37, 95% CI: 0.23–0.60) had lower odds of poor mental health than those arriving from Syria. Conclusion The prevalence of poor mental health among young migrants in Sweden was high, with specific subgroups (women, asylum seekers, people arriving from Syria, and those residing longer in Sweden) being particularly vulnerable. Our results indicate the interconnectedness between poor mental health and sexual risk behaviour in this population. Thus, policies targeting young migrants should ensure that healthcare services screen for both poor sexual and mental health at the same time.

Research breakdowns: A constructive critique of research practice involving grief, trauma and displaced people.

Impactful research on refugee mental health is urgently needed. To mitigate the growing refugee crisis, researchers and clinicians seek to better understand the relationship between trauma, grief and post-migration factors with the aim of bringing better awareness, more resources and improved support for these communities and individuals living in host countries. As much as this is our intention, the prevailing research methods, that is, online anonymous questionnaires, used to engage refugees in mental health research are increasingly outdated and lack inclusivity and representation. With this perspective piece, we would like to highlight a growing crisis in global mental health research; the predominance of a Global North-centric approach and methodology. We use our recent research challenges and breakdowns as a learning example and possible opportunity to rebuild our research practice in a more ethical and equitable way.

Is self-compassion relevant for refugees? A cross-sectional study of the relationship between self-compassion and depression among Kurdish refugees in Norway

Extensive research presents self-compassion as beneficial for mental health in a wide range of samples. However, knowledge about the role of self-compassion for mental health in refugee population is scarce. The purpose of this exploratory cross-sectional study was to explore the association between self-compassion and depression in a sample of Kurdish refugees in Norway (N = 106, 59.4% women). An online survey including questions about post-migration work-related stress, the Self-Compassion Scale Short-Form (SCS-SF), and Major Depressive Inventory (MDI) was distributed. The results showed that self-compassion was strongly associated with depressive symptoms (r = −0.61, p < .01). In a multiple regression analysis, work-related stress (β = −0.24, p < .001) and negative subscale of self-compassion compassion (β = .54, p < .001) predicted unique variance in depression. A moderation analysis using Hayes “Power” macro showed that level of self-compassion did not moderate the effects of post-migration work-related stress on depressive symptoms. The results indicate that even though self-compassion contributed significantly to levels of depression, it could not fully protect against post-migration risk factors. The study may provide a useful framework for guiding research, clinical practice, and mental health prevention in refugee populations.

라이프코스 관점으로 본 한국 고등교육 진학 성인이주민의 특성에 관한 연구

[Purpose] This study aims to understand the characteristics of adult immigrants who aspire to enter or have entered higher education institutions in South Korea from a lifecourse perspective.&#x0D; [Methods] Through an online survey, we collected data from 407 adult immigrants residing across the nation, seeking to explore the intricate interplay of pre-migration and post-migration factors that shape their educational aspiration and access to higher education.&#x0D; [Results] Our analysis revealed that pre-migration factors, such as prior education and job experiences, played a significant role, as did post-migration factors like participation in Korean language education programs. Additionally, we found that post-migration life conditions, such as current household income, marital status, and nationality significantly influenced adult immigrants' access to higher education.&#x0D; [Conclusion] These findings highlight the importance of understanding adult immigrants' educational aspirations or access within the broader context of their own lifecourse trajectory. By adopting a lifecourse perspective, we shed light on the multifaceted nature of the factors that influence adult immigrants' pursuit of higher education in South Korea.

Insomnia and post-migration stress among resettled Syrian refugees: a cross-sectional survey

PurposePost-migration stress is an important aspect of refugees’ mental health, but little is known about the relationship with insomnia. The purpose of this study was to investigate the assication between different post-migration stress factors and insomnia among Syrian refugees living in Norway.Design/methodology/approachThe authors analysed survey data from the REFUGE study with 873 Syrian adults who resettled in Norway between 2015 and 2017. Potential participants were randomly selected from The Norwegian Population Register. Insomnia was measured using the Bergen Insomnia Scale. Perceived-discrimination, navigation difficulties, financial strain and loss of social status were measured via the refugee post-migration stress scale. The authors ran logistic regression analyses, controlling for socio-demographics, potentially traumatic experiences and symptoms of post-traumatic stress.FindingsOverall, 59% (95% CI, 56%–62%) of the sample reported experiencing insomnia. In the fully-adjusted model, only financial strain and navigation difficulties were significantly associated with increased odds of insomnia. Loss of social status was also related to insomnia but only before adjusting for symptoms of post-traumatic stress.Originality/valueFinancial strain and navigation difficulties appear to be the most important post-migration stress factors in terms of insomnia among Syrian refugees living in Norway. Ameliorating these difficulties could potentially reduce insomnia among refugees. Since insomnia is a risk factor for the subsequent development of post-traumatic stress and depression, it is important to prevent or improve symptoms of insomnia among Syrian refugees, especially considering the high prevalence found in this study.

Diversity competence training for health professionals in Europe: a modified delphi study investigating relevant content for short or online courses

BackgroundDiversity is a reality in our societies, requiring health professionals to adapt to the unique needs of all patients, including migrants and ethnic minorities. In order to enable health professionals to meet related challenges and reduce health disparities, long and demanding training courses have been developed. But due to busy schedules of professionals and often scarce resources, a need for shorter training courses exists. This study aims to investigate which topics and methods should be prioritised in designing basic diversity training courses that provide health professionals the opportunity to foster this competence.MethodsThe study provided an expert panel of 31 academic and clinical migrant health experts with the content and methods of an existing diversity training course. The panel was asked to prioritise training topics and teaching methods in a two-stage process, using an adapted Delphi method. In the first stage, experts rated 96 predefined items, commented on those items, provided answers to eight open-ended questions and suggested additional content for a short course. In the second stage, they commented on the ratings from Round 1, and rated new suggested content. Consensus for training topics was set to 80% and for teaching methods 70%.ResultsThe entire panel deemed ‘health effects of migration (pre-, during- and post-migration risk factors)’ to be important or very important to include in a short/online, basic diversity training (100% consensus). Other high-scoring items and therefore topics to be included in trainings were ‘social determinants of health’ (97%) and ‘discrimination within the healthcare sector’ (also 97%). A general trend was to focus on reflective practice since almost all items regarding reflection reached consensus. ‘Reflection on own stereotypes and prejudices’ (97%) was the highest-rated reflection item. ‘Opportunities and best practices in working with interpreters’ was the highest-scoring skills item, both on consensus (96%) and mean value (5.77).ConclusionsExperts’ prioritizations of teaching content and methods for diversity training can help the design of short (online) trainings for health professionals and reduce unnecessary course content, thereby fostering professional development and enabling diversity competence trainings to be implemented also when time and/or financial resources are limited.

The Well-Being of Undocumented Migrants in The Netherlands: Learning about Post-Migration Experiences

In this contribution we will shed light on how individual and social post-migration factors affect the well-being of undocumented migrants. Using retrospective interviews, this study involves undocumented migrants who live in the Netherlands and have received psychosocial support. The stories of these undocumented migrants demonstrate that individual and social post-migration factors (such as health and social contacts) are closely entangled. These pathways are not often considered by mental health and psychosocial support organizations. A better understanding of these pathways will strengthen support for as yet untapped factors of change, and be effective in improving the well-being of undocumented migrants.