BACKGROUND: The period of early childhood bears significant importance from the lifespan perspective. Children from marginalized Roma communities face several risk factors that endanger their early development. Based on the gaps in available evidence, the aim of the RomaREACH research project (Research on Early Childhood in marginalized Roma communities) is, therefore, to explore the complex mechanisms influencing psychomotor development in the first 3 years of a child's life in marginalized Roma communities, and to translate and adapt instruments for measuring development and parenting in marginalized Roma communities and assess their psychometric qualities and suitability METHODS: The project comprises two parts. The first part is a validation study of the translated Caregiver-Reported Early Development Instrument (CREDI) and the Comprehensive Early Childhood Parenting Questionnaire (CECPAQ), tools for the assessment of early development and of parenting strategies and practices. The second part is a longitudinal cohort study, in which the relationships of risk and protective factors with development are explored. DISCUSSION: The RomaREACH project is a multicomponent study of social determinants of health and development in early childhood that can provide new evidence on the relationship of risk and protective factors with early development. Such young children from difficult-to-reach marginalized Roma communities are rarely included in research, and information about the scope and the extent of inequities in health and development in the period of early childhood is scarce. The expected results of the RomaREACH project have the potential to influence policy and practice by providing validated tools and evidence-based insights that can help mitigate the developmental risks faced by children in marginalized Roma communities and contribute to improving developmental outcomes and equity.

• MeSH
• Infant MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Child, Preschool MeSH
• Surveys and Questionnaires MeSH
• Psychometrics methods   MeSH
• Risk Factors MeSH
• Parenting psychology   MeSH
• Roma * MeSH
• Social Determinants of Health MeSH
• Child Development * MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: This study aims to compare selected early childhood health risks and health outcomes of children from marginalized Roma communities (MRCs) in Slovakia with those of the majority. METHODS: We obtained cross-sectional data from mother-child dyads from the majority (N = 109) and MRCs (N = 143) via questionnaires and from medical records. Socioeconomic status, health risks and health outcomes were compared using chi-square and Mann-Whitney U tests in SPSS. RESULTS: Mothers from MRCs reported significantly worse socioeconomic status. Air quality in the households in MRCs was significantly worse, affected by heating with stoves, burning fresh wood and indoor smoking. The diet composition of children from MRCs was characterized by shorter breastfeeding and unhealthy diet composition less fresh fruits and vegetables, more processed meat products, and sweet and salty snacks. Children from MRCs more often suffered from respiratory and diarrheal diseases, used antibiotics and were hospitalized. CONCLUSION: The health and healthy development of children living in MRCs is endangered by various poverty-related factors. Persistent differences in exposures and health in early childhood should be a priority goal of the state's social and health policies.

• Keywords
• early childhood, health, health risks, marginalized Roma communities, poverty,
• MeSH
• Diet MeSH
• Outcome Assessment, Health Care MeSH
• Humans MeSH
• Child, Preschool MeSH
• Cross-Sectional Studies MeSH
• Roma * MeSH
• Social Class MeSH
• Check Tag
• Humans MeSH
• Child, Preschool MeSH
• Publication type
• Journal Article MeSH

According to the general public in Slovakia, compliance with the law is problematic when it comes to Roma and health. Roma compliance with laws has not yet been studied. The aim of this is study was to explore the determinants of Roma behavior in the field of health laws. We used the concept of a semi-autonomous field proposed by Moore (1973) and the theory of planned behavior by Ajzen (1985). We found that Roma (non-)compliance with health laws was influenced by many different factors, such as beliefs, traditions, living conditions and culture. Group beliefs overrule national laws and also individual preferences, which tend to be subordinate to the group view. The less contact Roma from settlements have with non-Roma, the stronger their own rules are in the field of health. Roma health status is influenced by many factors: group beliefs and community traditions are stronger and overrule individual and state behavioral influence. A community-based participatory approach together with improvement of living conditions in cooperation with Roma is desirable.

• Keywords
• Roma health, Slovakia, non-compliance,
• MeSH
• Patient Compliance * MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Roma * MeSH
• Health Policy * MeSH
• Health Status MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Slovakia MeSH

OBJECTIVES: The health status of segregated Roma is poor. To understand why segregated Roma engage in health-endangering practices, we explored their nonadherence to clinical and public health recommendations. METHODS: We examined one segregated Roma settlement of 260 inhabitants in Slovakia. To obtain qualitative data on local-level mechanisms supporting Roma nonadherence, we combined ethnography and systematic interviewing over 10 years. We then performed a qualitative content analysis based on sociological and public health theories. RESULTS: Our explanatory framework summarizes how the nonadherence of local Roma was supported by an interlocked system of seven mechanisms, controlled by and operating through both local Roma and non-Roma. These regard the Roma situation of poverty, segregation and substandard infrastructure; the Roma socialization into their situation; the Roma-perceived value of Roma alternative practices; the exclusionary non-Roma and self-exclusionary Roma ideologies; the discrimination, racism and dysfunctional support towards Roma by non-Roma; and drawbacks in adherence. CONCLUSIONS: Non-Roma ideologies, internalized by Roma into a racialized ethnic identity through socialization, and drawbacks in adherence might present powerful, yet neglected, mechanisms supporting segregated Roma nonadherence.

• Keywords
• Adherence, Ethnographic study, Health inequality, Roma health, Slovakia,
• MeSH
• Poverty MeSH
• Anthropology, Cultural MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Racism MeSH
• Roma psychology   MeSH
• Interviews as Topic MeSH
• Social Stigma MeSH
• Health Status * MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Slovakia MeSH