Priorización de intervenciones sanitarias. Revisión de criterios,enfoques y rol de las agencias de evaluación

Objective

This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting.

Evaluación de la efectividad de los programas de vacunación

Vaccines have contributed enormously to reducing the incidence of many communicable diseases. The protective efficacy of a vaccine refers to the health effects of the vaccine applied in optimal, ideal conditions, whereas the effectiveness of a vaccination program refers to the health effects of vaccination in the vaccinated individuals in clinical practice or within public health programs, which may differ widely from optimal conditions. Vaccine efficacy is estimated by randomized clinical trials. In contrast, effectiveness can be measured by various types of epidemiological studies: randomized community trials, in which the target vaccine is randomly assigned to a group and disease incidence in this group is compared with that of an unvaccinated group; cohort studies, which are observational epidemiological studies in which the vaccination status is known in healthy vaccinated (vaccinated cohort) and unvaccinated (unvaccinated cohort) people and the occurrence of the disease in the two groups is studied; and observational case-control studies, in which two groups are selected; one with the disease under investigation (cases) and the other without (controls), and vaccination histories are investigated in the two groups. Vaccine effectiveness may also be estimated by comparing attack rates in epidemic outbreaks or secondary attack rates in the home, or by screening.     

Implantación de un programa de promoción de la salud de las mujeres en zonas de exclusión social de la ciudad de Sevilla

Health promotion can contribute towards reducing inequality and ensuring equal opportunities, providing the means to enable the entire population to develop its maximum health possibilities. Women living in areas with social transformation needs (ASTN) are an especially vulnerable group due to the situation of material deprivation and social exclusion in which they live. Health promotion programmes for this group can bring about an improvement in their health. This paper describes the health promotion programme Socio-educational Groups of Primary Care for Women (SEGPC-W), and evaluates its implementation in ASTN in the city of Seville (Spain), as well as the benefits and difficulties of its development through a documentary analysis and interviews with participating professionals.     

Pautas de alimentación de la población gitana y la población general de España

ObjectiveThe NAOS (Nutrición, Actividad Física y Prevención de la Obesidad) strategy implemented by Spanish Ministry of Health proposes a range of healthy dietary guidelines. The objective of this article is to analyze the degree these nutritional patterns are monitored by the Roma population, compared to the rest of the population, compared to the total Spanish population.MethodsData from the 2012 National Health Survey and the 2014 Roma Health Survey were compared. Sex, age and socio-occupational scale were used as independent variables, applying a logistic regression analysis to assess their degree of influence.ResultsThere was less monitoring carried out by the Roma population of the dietary plans recommended by the Ministry of Health and differences of more of 20 percentage points were found in some of them. In both populations, age was the variable with the greatest influence, but even more so in the Roma population, while sex did not show statistical among Roma people. The follow-up data of these dietary patterns in the Roma population were lower in comparison with any of the socio-occupational groups of the rest of the population.ConclusionsThe Roma population is in a situation of inequality as regards the levels of adherence of the healthy dietary guidelines proposed by the Spanish NAOS strategy. The distance from these healthy eating habits is even greater among the younger Roma population.     

Percepción del riesgo de contraer una enfermedad de transmisión sexual en población joven

ObjectiveTo find out the perception of the risk of adquire a sexually transmitted disease (STD) in young people (15–21 years), and their attitudes and behaviour to adopt protective measures in sexual relationships.DesignSocioconstructive qualitative study performed between the years 2006 and 2008SettingTwo Primary Care Centres in the city of Girona.ParticipantsA total of 34 young people selected from lists provided by doctors and key informers.MethodsTheoretical sample from different designed profiles. The data was obtained and saturated by performing 5 group interviews. A thematic content analysis of the narrative data was made of the categorical subject.ResultsThey had partial knowledge on AIDS and very little on other STD. The risk of pregnancy has the most influence on adopting protective measures. Despite easy access and knowledge of condoms, in some cases they are not used either in stable relationships or in sporadic ones, with different reasons for having this risk behaviour. They have limited contact with the health services, and when they do it is mainly to ask for emergency contraception.ConclusionsHealth strategies should be directed towards adolescents, taking into account what they need from the health services as regards sexual health, in a different context from the health centre. Information should be focused on combating erroneous beliefs, such as AIDS is a disease of “others” and not “ours”, and address these actions, not only to improve knowledge and attitudes but also changes in behaviour.     

Evaluación,corrección e impacto de la no respuesta en estudios de obesidad infantil

Objective

To evaluate and correct the impact of non-response in the prevalence of underweight, overweight and obesity in children aged 6 to 15 years old using silhouette scales.

La acreditación de los comités de ética de la investigación

Objective

According to Law 14/2007 and Royal Decree 1090/2015, biomedical research must be assessed by an Research Ethics Committee (REC), which must be accredited as an Research ethics committee for clinical trials involving medicinal products (RECm) if the opinion is issued for a clinical trial involving medicinal products or clinical research with medical devices. The aim of this study is to ascertain how IEC and IECm accreditation is regulated.

La participación ciudadana en la investigación desde la perspectiva de investigadores de atención primaria

ObjectiveExplore the strengths, weaknesses, opportunities and threats (SWOT) for development of public involvement in research by Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol) according to primary health care researchers in Catalonia (Spain).MethodsCross-sectional study carried out in 2017 with 36 primary health care research teams accredited by IDIAPJGol and its management staff. An open questionnaire (paper and online) was designed and piloted to develop a SWOT technique, and 65 answers were obtained (14 in paper and 51 online). A thematic content analysis was carried out.ResultsMost informants consider public involvement in research a useful, innovative, viable and essential strategy, but it requires a change of mentality and a move away from the hierarchical paradigm. It can be difficult to execute and can complicate studies. They are concerned about which citizens should be involve, how to select them, possible conflicts of interest and training needs. The main proposals for its implementation are to disseminate previous strategies, encourage motivation and synergies among citizens, researchers and institutions, and to clarify the roles of the actors involved. IDIAPJGol should develop recommendations for the public involvement in research, encourage their inclusion, have a mentor and advise the research teams.ConclusionsDespite the challenges, developing public involvement in research in primary health care is essential and feasible, what it is more should be based on a participatory strategy with all actors. The citizens can participate in any kind of design and phase of the research, adapting each project, being the primary health care a privileged area to develop the public involvement in research.