Los consejos de salud como instrumento de participación comunitaria en La Rioja

Objective

To describe the functioning and regulations of health councils in La Rioja (Spain) as vehicles for citizen participation in health management.

Educación popular en salud para la educación en sexualidad en un movimiento social rural brasileño

Based on the ideas of Paulo Freire, the methodological framework of Popular Education for Health (PEH) provides a more adaptable method for sex education, including societal participation as well as the social, historical and cultural dimensions of the population. The purpose of this work is to relate one such PEH experience in sex education, which took the form of a community project with a group of students from 10 to 28 years of age attending Itinerant Schools and with groups from the Landless Rural Workers Movement (MST) in the state of Parana, Brazil. This work provides knowledge of certain elements that may help in developing similar projects, not only for sex education but also education for other public health issues. PEH demonstrates a method of ensuring socially effective participation in the different dimensions of health-promotion strategies     

Implementación del mapa de la vulnerabilidad en salud en la Comunidad de Madrid

The Public Health General Directorate of Madrid has developed a health vulnerability mapping methodology to assist regional social health teams in health planning, prioritisation and intervention based on a model of social determinants of health and an equity approach. This process began with the selection of areas with the worst social indicators in health vulnerability. Then, key stakeholders of the region jointly identified priority areas of intervention and developed a consensual plan of action. We present the outcomes of this experience and its connection with theoretical models of asset-based community development, health-integrated georeferencing systems and community health interventions.     

Effectiveness of a brief intervention for acceptance of influenza vaccine in reluctant primary care patients

ObjectiveTo determine the effectiveness of a brief intervention in increasing influenza vaccination coverage compared with the usual advice in people who refuse it, and to record the main reasons for refusing to be vaccinated.MethodA cluster randomized clinical trial was conducted in which the study population was individuals with high risk factors who initially had refused to be vaccinated against influenza. Professionals (doctors and nurses) who voluntarily accepted to participate were assigned randomly to the intervention group (brief intervention) and the control group (usual advice).Results57 professionals recruited 524 people who had previously declined the influenza vaccination (271 in the control group and 253 in the intervention group). Brief intervention showed its effectiveness with an odds ratio of 2.48 (1.61-3.82; p < 0.001), in individuals aged 60 or over, both healthy or with risk factors. The most frequent reasons for rejection of vaccination were the belief that there was no risk of getting sick (53.0%) and the fear of the side effects (33.3%).ConclusionsBrief intervention is an effective tool in improving vaccination coverage in people who have initially rejected it.     

Unravelling salutogenic mechanisms in the workplace: the role of learning

Objective

To explore the moderating and mediating role(s) of learning within the relationship between sense of coherence (SOC) and generalized resistance resources.

Monitoring sedentary patterns in office employees: validity of an m-health tool (Walk@Work-App) for occupational health

ObjectiveThis study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping.MethodsThe W@W-App was installed on the smartphones of office-based employees (n = 17; 10 women; 26 ± 3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker).ResultsDuring the protocol, agreement between self-paced walking (ICC = 0.85) and active working tasks step counts (ICC = 0.80) was good. The smallest median difference was for sitting time (1.5 seconds). During free-living conditions, sitting time (ICC = 0.99) and stepping (ICC = 0.92) showed excellent agreement, with a difference of 0.5 minutes and 18 steps respectively.ConclusionsThe W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness.     

"Community ambassadors" for South Asian elder immigrants: Late-life acculturation and the roles of community health workers

Elder immigrants face multiple barriers to accessing health care and other basic services. The Community Ambassador Program for Seniors (CAPS), based in Fremont, California, trains volunteer "ambassadors" from several ethnic and faith communities to perform information and referral services for elders, particularly immigrants. The purpose of this study is to examine the roles of ambassadors in ecologic context as community health workers (CHWs) for clients undergoing late-life acculturation. Ambassadors from three different communities, all of South Asian heritage, were interviewed using a semi-structured guide. 20 out of 23 ambassadors from these communities participated, from December 2008 to December 2009. Data collection and analysis followed grounded theory methodology. Results are presented as an integrated explanatory model, with three major components: (1) acculturative stress, particularly within elders' families; (2) polygonal relationships, a construct that includes elders, their caregivers, CHWs, and service providers, and builds on the notion of a "geriatric triad" (Adelman, Greene, & Charon, 1987); and (3) role hybridity, a novel explanation for CHWs' social niche. Ambassadors mediated elder clients' acculturation both inside and outside elders' families. As such, ambassadors worked in polygonal relationships with elder clients and elders' children, rather than simply working in dyads with elder clients themselves. In the CAPS context, this polygonal framework integrates intra-familial and extra-familial acculturative dynamics into a single relational model. Within these relationships, CHWs exhibited hybridity of social roles, integrating familial and professional attributes, but fully achieving neither familial nor professional status. Practical implications, including importance of outreach to elders' children, accessibility of social programs, and the consequences of role hybridity as a property of CHW identity and function, are discussed.     

Salutogenic interventions and health effects: a scoping review of the literature

ObjectiveTo explore the typology of implemented salutogenic interventions and the health effects described by the authors.MethodA scoping review of the literature published (PubMed, Embase, Web of Science and Scopus) over the last ten years (2007-2016) was conducted. Articles that included interventions with assessments of health outcomes were selected for this review. The kappa index (86.4%) was calculated for the classification and extraction of information.Results61 papers were selected out of the 676 works identified. These were categorized into individual, grouped, mixed and intersectoral interventions. A total of 85% of the interventions described positive effects. Adverse effects were not reported. Methodological limitations were identified in 75% of the papers. The interventions addressed a large variety of topics, especially in the field of mental health and chronic diseases. Collective actions described more positive effects. Intersectoral actions were the only type of interventions to have approached the impact of mortality reduction.ConclusionsFindings support the existence of positive health effects of salutogenic approaches. Important methodological limitations were identified, such as biases in the selection of participants and sample sizes. Studies need to be conducted with improved monitoring and evaluation designs. A more robust theoretical framework and tools to evaluate the salutogenic contents are needed.