Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case-control studies

Atenció Primària de Salut; Salut Comunitària; Promoció de la SalutAtención Primaria de Salud; Salud Comunitaria; Promoción de la SaludPrimary Health Care; Community Health; Health PromotionOBJECTIVE: Spanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities. DESIGN: Two case-control studies. SETTING: Performed in primary care of five Spanish regions. SUBJECTS: In the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not. MAIN OUTCOME MEASURES: Team, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources. RESULTS: The first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1). CONCLUSIONS: Professional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs

Guía educativa para trabajar con grupos de padres y madres

Dirigido y coordinado por la Sección de Promoción de la Salud. Instituto de Salud Pública. Departamento de SaludGuía dirigida a profesionales de los Equipos de Atención Primaria de Salud, Equipos de Salud Mental, Servicios Sociales de Base y otros organismos que quieran llevar a cabo intervenciones educativas con grupos de padres o madres con distintos tipos de finalidades: educar mejor a sus hijas e hijos, promoción de la salud de sus hijos e hijas, prevención de drogodependencias, accidentes, embarazos no deseados, etc. Aunque dirigido principalmente a padres y madres de adolescentes se puede trabajar tambien con padres y madres de niños y niñas que estan en guardería o en educación infantil o primaria. Es un instrumento abierto que permite llevar a cabo un conjunto de sesiones de duración variable y con un grupo de padres y madres, en un espacio de tiempo corto o de forma continuada. La guía se estructura en un apartado, Antes de empezar, que fundamenta, explica y proporciona algunas orientaciones básicas sobre el contenido y tratamiento educativo de la guía, y otro apartado, Centros de Interes, que agrupa diversas unidades didácticas: 1. Ser padre y madre hoy, 2. ¿La edad del pavo? 3. Educando 4. Relacionarnos mejor 5. La salud de nuestros hijos e hijas.NavarraBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

Programa de ayuda para dejar de fumar en Navarra: 25 años de andadura

In Navarre, the Smoking Cessation Program (PAF) was launched in 1994, result of the collaboration between Public Health and Primary Care. In 2001 it was integrated into the Tobacco Regional Action Plan, together with the other two lines of action: prevention of smoking initiation and promo- tion of smoke-free spaces. PAF includes two levels of in- tervention, a basic and an intensive one, with programmed educational support, individual and group. Medications for smoking cessation have been intermittently subsidized by the Health Department of Navarre. In December 2017, fun- ding of medications for smoking cessation was reintroduced, in the same conditions of any other medication. Treatments are limited to one per patient and year, always including edu- cational support. In 2018, 6139 people benefited from this funding, 50% women and 60% with yearly income lower than 18000 euros. We carried out a preliminary evaluation through a telephone survey. Overall, 35% of participants reported to keep abstinent after one year, 40% among those who also received intensive educational support.En Navarra el Programa de Ayuda a Dejar de Fumar (PAF) nace en 1994 fruto de la colaboración entre Salud Pública y Atención Primaria y desde 2001 se integra en el Plan Foral de Acción sobre el Tabaco, junto con otras dos líneas de actuación: prevención al inicio y espacios sin humo. El PAF incluye dos niveles de intervención, básico e intensivo, con apoyo educativo programado individual y grupal y periodos de financiación farmaco- lógica. En diciembre de 2017 se reintrodujo la financia- ción de los fármacos para la deshabituación tabáquica en las mismas condiciones que el resto de medicamentos, limitada a un tratamiento por paciente y año, siempre en el contexto de un programa de apoyo educativo. En 2018 se beneficiaron de la financiación 6.139 personas, la mitad mujeres y 6 de cada 10 con rentas inferiores a 18.000 euros. Los resultados de la evaluación preli- minar, realizada mediante encuesta telefónica, muestran una tasa declarada de abandono al año del 35%, que as- ciende al 40% si se recibe apoyo educativo

Observatorio de Salud Comunitaria de Navarra: Puesta en marcha y primeras experiencias

Background: The Community Health Observatory of Navarre (Observatorio de Salud Comunitaria de Navarra) was created in 2016 to study health determinants, results and inequalities. The objective of this article was to describe the methodology and the process followed to launch it, and to analyse the variation of the selected indicators among Basic Health Zones. Methods: The observatory configuration was specified and the selected indicators and their variation among zones were described. Results: During the period under consideration, the observatory interacted with many institutions, some of them provide information and others receive it. One of the main outcomes was the Profile Reports by Basic Health Zone, which included a selection of 21 indicators by zone related to socio-demographic factors, lifestyles, morbidity, Health System and mortality. The coefficients of variation among zones ranged between 0.01 and 0.7, showing the socio-demographic factors the greatest variation. Conclusions: This project, in line with other observatories, sets a system of comparison with health determinants and results in small areas. The selected indicators capture variation among zones, generating specific pictures. This is the starting point for future interventions in coordination with Primary Health Care, social agents and health assets.Fundamentos: El Observatorio de Salud Comunitaria de Navarra se creó en 2016 para estudiar los determinantes, resultados y desigualdades en salud. El objetivo de este artículo fue describir la metodología y el proceso seguidos para su puesta en marcha, así como analizar la variabilidad de los indicadores seleccionados entre Zonas Básicas de Salud. Métodos: Se especificó la configuración del observatorio y se describieron estadísticamente los indicadores seleccionados y su variabilidad entre zonas. Resultados: Durante el periodo considerado, el observatorio interactuó con diferentes instituciones, unas como proveedoras de información y otras como usuarias de la misma. Uno de sus principales productos fueron los Informes de Perfil de Zona Básica de Salud, que incluyeron para cada zona una selección de 21 indicadores agrupados en: factores sociodemográficos, estilos de vida, morbilidad, sistema de salud y mortalidad. Los coeficientes de variación entre zonas de los indicadores se encontraron entre 0,01 y 0,7, siendo los que aluden a factores sociodemográficos los de mayor variabilidad. Conclusiones: Esta experiencia comparte con otras similares el establecimiento de un sistema de comparación de determinantes y resultados de salud en áreas pequeñas. Los indicadores seleccionados captan la variabilidad entre zonas, devolviendo una imagen específica de las mismas. A partir de sus productos se abren posibilidades de intervención en coordinación con Atención Primaria, los agentes sociales y los activos de salud

Factors related to the development of health-promoting community activities in Spanish primary healthcare: two case-control studies

Atenció Primària de Salut; Salut Comunitària; Promoció de la SalutAtención Primaria de Salud; Salud Comunitaria; Promoción de la SaludPrimary Health Care; Community Health; Health PromotionOBJECTIVE: Spanish primary healthcare teams have the responsibility of performing health-promoting community activities (CAs), although such activities are not widespread. Our aim was to identify the factors related to participation in those activities. DESIGN: Two case-control studies. SETTING: Performed in primary care of five Spanish regions. SUBJECTS: In the first study, cases were teams that performed health-promoting CAs and controls were those that did not. In the second study (on case teams from the first study), cases were professionals who developed these activities and controls were those who did not. MAIN OUTCOME MEASURES: Team, professional and community characteristics collected through questionnaires (team managers/professionals) and from secondary sources. RESULTS: The first study examined 203 teams (103 cases, 100 controls). Adjusted factors associated with performing CAs were percentage of nurses (OR 1.07, 95% CI 1.01 to 1.14), community socioeconomic status (higher vs lower OR 2.16, 95% CI 1.18 to 3.95) and performing undergraduate training (OR 0.44, 95% CI 0.21 to 0.93). In the second study, 597 professionals responded (254 cases, 343 controls). Adjusted factors were professional classification (physicians do fewer activities than nurses and social workers do more), training in CAs (OR 1.9, 95% CI 1.2 to 3.1), team support (OR 2.9, 95% CI 1.5 to 5.7), seniority (OR 1.06, 95% CI 1.03 to 1.09), nursing tutor (OR 2.0, 95% CI 1.1 to 3.5), motivation (OR 3.7, 95% CI 1.8 to 7.5), collaboration with non-governmental organisations (OR 1.9, 95% CI 1.2 to 3.1) and participation in neighbourhood activities (OR 3.1, 95% CI 1.9 to 5.1). CONCLUSIONS: Professional personal characteristics, such as social sensitivity, profession, to feel team support or motivation, have influence in performing health-promoting CAs. In contrast to the opinion expressed by many professionals, workload is not related to performance of health-promoting CAs