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
• kojenec MeSH
• lidé MeSH
• longitudinální studie MeSH
• předškolní dítě MeSH
• průzkumy a dotazníky MeSH
• psychometrie metody   MeSH
• rizikové faktory MeSH
• rodičovství psychologie   MeSH
• Romové * MeSH
• sociální determinanty zdraví MeSH
• vývoj dítěte * MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Intestinal parasitic infections remain a significant global health issue, particularly affecting poor and marginalised populations. These infections significantly contribute to children's diseases, malnutrition, poor school performance, cognitive disorders, and future economic losses. This study aimed to explore and compare the occurrence of intestinal parasites in early childhood among the group of infants from the Slovak majority population and from marginalised Roma communities (MRCs). Furthermore, it aimed to explore the health complaints of children with and without intestinal parasitic infection in the past month and assess the effect of various risk factors on the occurrence of intestinal parasitic infection in infants from MRCs. METHODS: We obtained cross-sectional data from mothers and stool samples of their children aged 13-21 months using the first wave of the longitudinal RomaREACH study. A total of 181 stools from infants were analysed: 105 infants from the Slovak majority population and 76 from MRCs. RESULTS: Infants from MRCs are significantly more often infected by Ascaris lumbricoides, Trichuris trichiura and Giardia duodenalis than their better-off peers from the majority population. Infection rates are 30% in infants from MRCs vs. 0% in the majority population (p < 0.001). Single and mixed infections were observed in children from MRCs. Infants with intestinal parasitic infections suffer significantly more often from various health complaints, particularly cough, stomach ache, irritability, and diarrhoea. Within MRCs, the risk of parasitic infections in infants is significantly increased by risk factors such as the absence of flushing toilets in households (OR = 4.17, p < 0.05) and contact with un-dewormed animals (OR = 3.61, p < 0.05). Together with the absence of running water in the household, these three factors combined increase the risk more than ten times (p < 0.01). CONCLUSION: Maintaining hygienic standards in conditions of socioeconomic deprivation in MRCs without running water and sewage in the presence of un-dewormed animals is problematic. These living conditions contribute to the higher prevalence of parasitic infections in children from MRCs, causing various health complaints and thus threatening their health and healthy development.

• Klíčová slova
• Early childhood, Health complaints, Hygienic standards, Marginalised Roma communities, Parasitic infections, Risk factors, Un-dewormed animals,
• MeSH
• feces * parazitologie   MeSH
• kojenec MeSH
• lidé MeSH
• parazitární nemoci střev * epidemiologie   MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• Romové * statistika a číselné údaje   MeSH
• zvířata MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

This study aimed to explore the effect of socioeconomic disadvantage accumulated in marginalised Roma communities (MRCs) on early childhood development and to assess the role of selected socioeconomic indicators in the association between belonging to MRCs vs. the majority and early childhood development. We obtained cross-sectional data from 232 mother-child dyads from MRCs and the majority population. The differences in early childhood development and background variables between the two groups were tested using chi-square and Mann-Whitney U tests. The moderated mediation was tested using PROCESS Macro in SPSS Model 14 on 5000 bootstrap samples. Statistically significant differences between children from MRCs and the majority were found in terms of maternal age, parental education, household equipment, as well as early childhood development. Household equipment moderated the indirect effect of being from MRCs vs. the majority on early childhood development through parental education. The indirect effect through parental education was high at a low household equipment level, reduced at an average level and non-significant at a high level of household equipment. Our study uncovered disparities in early childhood development between children from MRCs and the majority population. Parental education significantly influenced developmental outcomes, while household equipment mitigated its impact.

• Klíčová slova
• development, disadvantage, early childhood, household equipment, marginalised Roma communities, parental education,
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Roma living in marginalized communities often face poor living conditions and material deprivation, which may negatively impact parenting. Our aim is to compare the parenting behavior (support, harsh discipline, and stimulation) of mothers from marginalized Roma communities and the majority population in Slovakia. We also examine the role of socioeconomic disadvantage and related worries in the differences in parenting behavior between these groups. METHODS: We obtained cross-sectional data from mothers of children aged 14-18 months using the first wave of the longitudinal RomaREACH study dataset. Two groups were included in the sample: 93 mothers from MRCs and 102 mothers from the majority. We performed multiple regression and mediation analyses to assess whether the educational level of mothers, the degree of poverty, and poverty-related feelings of stress and worries explain parenting behavior differences between the groups of mothers. RESULTS: We found significant differences in parenting, especially in harsh disciplining and stimulation. These two domains were significantly associated with maternal education, degree of poverty, and poverty-related stress and worries. The degree of poverty partially mediated stimulation differences between the two groups of mothers. CONCLUSION: Parenting in MRCs seems harsher and less stimulative than parenting in the Slovak majority. These differences are associated with the socioeconomic disadvantage of mothers. The degree of poverty partially explains why parenting in MRCs is less stimulative. These results may inform intervention efforts aimed at disadvantaged families.

• Klíčová slova
• early childhood, marginalized Roma community, mothers, parenting, socioeconomic disadvantage, stress and worries,
• Publikační typ
• časopisecké články 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.

• Klíčová slova
• early childhood, health, health risks, marginalized Roma communities, poverty,
• MeSH
• dieta MeSH
• hodnocení výsledků zdravotní péče MeSH
• lidé MeSH
• předškolní dítě MeSH
• průřezové studie MeSH
• Romové * MeSH
• společenská třída MeSH
• Check Tag
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH

Objectives: This study aims to compare the early childhood mental health of children from marginalized Roma communities (MRCs) in Slovakia with that of the majority and explore possible mediating pathways of mothers' perceived stress and harsh discipline practices. Methods: We used data from the first wave of the longitudinal RomaREACH study collected in 2021-2022. Two populations were included in the sample: 94 mother-child dyads from MRCs and 79 from the majority population (children aged 14-18 months). Data were analysed using linear regression, and mediation was tested using PROCESS Macro in SPSS. Results: Belonging to MRCs vs. the majority, perceived stress of mothers and harsh discipline were found to be associated with early mental health problems in children. Perceived stress of mothers partially mediates the relationship between belonging to MRCs vs. majority and harsh discipline and harsh discipline partially mediates the relationship between perceived stress of mothers and the mental health of children. Conclusion: Mothers from MRCs perceive more stress, which is associated with more frequent use of harsh discipline practices having a negative impact on the mental health of young children.

• Klíčová slova
• early childhood, harsh discipline, marginalized Roma communities, mental health, perceived stress, poverty,
• MeSH
• duševní zdraví MeSH
• lidé MeSH
• matky psychologie   MeSH
• předškolní dítě MeSH
• průřezové studie MeSH
• psychický stres epidemiologie   MeSH
• rodičovství * psychologie   MeSH
• Romové * MeSH
• Check Tag
• lidé MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: This study aims to assess which measures could improve the healthy early childhood development of children from marginalized Roma communities and to identify priority measures. METHODS: Concept mapping approach was used, using mixed methods. In total 54 professionals, including social workers, educators, health care providers, municipality representatives, and project managers participated in our study. RESULTS: Four distinct clusters of measures targeting living conditions, public resources, healthcare and community interventions, and 27 individual priority measures of highest urgency and feasibility were identified. The cluster 'Targeting living conditions', was rated as the most urgent but least feasible, whereas the cluster 'Targeting health care', was considered least urgent but most feasible. Among the 27 priority measures, 'Planning parenthood' and 'Scaling up existing projects' had the highest priority. CONCLUSION: Our results reflect the public and political discourse and indicate significant barriers to implementation. Reducing inequalities in early childhood needs to be addressed through coordinated efforts.

• Klíčová slova
• Early childhood development, Inequalities, Marginalized Roma communities,
• MeSH
• dítě MeSH
• lidé MeSH
• poskytování zdravotní péče MeSH
• předškolní dítě MeSH
• Romové * MeSH
• sociální pracovníci MeSH
• zdravotní stav MeSH
• zdravotnický personál MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Publikační typ
• časopisecké články MeSH

• Publikační typ
• úvodníky 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.

• Klíčová slova
• Adherence, Ethnographic study, Health inequality, Roma health, Slovakia,
• MeSH
• chudoba MeSH
• kulturní antropologie MeSH
• lidé MeSH
• průřezové studie MeSH
• rasismus MeSH
• Romové psychologie   MeSH
• rozhovory jako téma MeSH
• společenské stigma MeSH
• zdravotní stav * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH