SP project among migrants in primary healthcare units in Lisbon: Challenges and Lessons learned

Abstract Background SP in Lisbon, Portugal, was first piloted in two primary healthcare units covering migrant populations. We aim to present findings on migrant patients’ non-clinical needs, SP uptake, trajectories and challenges in SP implementation. Methods A mixed-methods approach was used. Data from registries of migrant patients referred to the SP program in 2018-2023 was analysed, including sociodemographic and health characteristics, referral details, adherence to SP and trajectories. A logistic regression analysis was used to identify factors associated with SP uptake. Barriers to SP implementation were explored through semi-structured interviews with stakeholders involved. Results Of the 456 migrants referred to SP, 61.2% were female, 53% 26-50 years old, 54% from Asian countries and 27% from Portuguese-speaking African countries. Most common reasons for referral to SP related to social/financial support (74%), social integration (42%), unemployment (34%) and mental health (17%). Overall, 55% of referred migrants attended an SP appointment. Factors significantly associated with SP uptake were older age (≥75 years), multimorbidity condition and referral for social/financial support. SP users integrated social inclusion and wellbeing activities, as well as services for financial and employment support. Perceived challenges to SP implementation included patients’ low SP awareness and adherence, lack of preparedness for intersectoral action, limited community resources addressing migrants’ needs and uneven partner's capacity for data collection on activities acceptance and progress. Conclusions SP is a promising approach to foster migrants’ integration. Challenges include understand the complexity of migrants’ needs, explore acceptability of SP, and identify how best to promote awareness and adherence to expand SP positive effects in migrants’ health.