Validación del test Nuevo Signo Vital para la medición de la alfabetización en salud

Background: Health literacy is a determinant, powerful predictor of health. The Newest Vital Sign test (NVS) evaluates health literacy assessing the capacity of participants to understand the nutrition information label of an ice cream. Aim: To validate The NVS test for its application in the sociocultural context on primary care patients in Chile. Material and Methods: In a descriptive cross-sectional study, 1,117 people aged 58 ± 14 years (70% women) registered in the Cardiovascular Health Program of different Family Health Centers, answered the NVS test. They also answered the Test of Functional Health Literacy for Adults (TOFHLA) and the Health Literacy Survey, European Union (HLS-EU-32). An exploratory analysis was carried out. In addition, the Kuder-Richarson-20 reliability coefficient and Item-Test Point Biserial Correlations were calculated. The construct validity of the NVS was obtained using the Item Response Theory. The sensitivity and specificity of NVS were estimated using receiver operating characteristic curves using the TOFHLA score as gold standard. To establish the cutoff points, the Stratum-Specific Likelihood Ratio analysis was used. Results: The reliability of the test was adequate (KR-20 = 0.7478) and the values of the two logistic parameters model confirmed that the NVS items account for the health literacy construct. Conclusions: The NVS test turned out to be a valid and reliable instrument, and its application is recommended to measure the level of health literacy.

Efectividad de intervenciones basadas en Mindfulness para mejorar el control de la Diabetes Mellitus tipo 2: una revisión sistemática e integración metanalitica preliminar / Effectiveness of Mindfulness-based interventions to improve control of type 2 diabetes mellitus: a systematic review and preliminary meta-analytic integration

Resumen El propósito de este trabajo fue estudiar la efectividad de intervenciones basadas en Mindfulness sobre el nivel de hemoglobina glicada —HbA1c— en pacientes con diabetes mellitus tipo 2 —DM2—. Se realizó una revisión sistemática e integración metanalítica preliminar. La búsqueda de los estudios se realizó en las siguientes bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Se identificaron 10 artículos: cuatro fueron llevados a cabo en Estados Unidos, dos en Irán, uno en Alemania, uno en Australia, uno en Tailandia y uno en Inglaterra. Se observó una reducción en los niveles de la HbA1c utilizando Mindfulness en comparación a los grupos controles (p < 0,02). Además, se observó un efecto diferenciado al analizar según número de participantes, sexo y tiempo de seguimiento. Se concluyó que el uso de intervenciones basadas en Mindfulness tendría un efecto indirecto sobre la reducción de la hemoglobina glicada.

Abstract The purpose of this paper was to study the effectiveness of Mindfulness-based interventions on the level of glycated hemoglobin —HbA1c— in patients with type 2 diabetes mellitus —DM2—. A systematic review and preliminary meta-analytic integration was performed. The search of the studies was carried out in the following bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Ten articles were identified: four were published in the United States, two in Iran, one in Germany, one in Australia, one in Thailand and one in England. A reduction in HbA1c levels was observed using Mindfulness compared to control groups (p <0,02). In addition, according to the number of participants, sex and time of follow-up a differentiated effect was found. It was concluded that the use of interventions based on Mindfulness would have an indirect effect on the reduction of glycated hemoglobin (HbA1c).

Diabetes Mellitus tipo 2: desafíos para los modelos de cuidados crónicos en Chile / Type 2 diabetes mellitus as a challenge for chronic disease care models in Chile

The increase in chronic noncommunicable diseases is one of the main concerns worldwide. Therefore, it is pertinent to ask how care system organizations responded to the requirements currently being posed by chronic diseases, specifically type 2 diabetes mellitus (T2DM). In the world, different models have been developed considering elements that transcend the biological stability of the disease. Chile has the great challenge of exploring new models that emphasize the promotion and prevention of health rather than the management of the disease. The impact of variables such as health literacy, self-efficacy and subjective well-being on T2DM should be explored. In addition, it is necessary to validate and implement guidelines and protocols of care that incorporate the aforementioned variables.

Percepción de stakeholders de Chile Crece Contigo, acerca de su implementación en la comuna de Concepción, Chile / Perception of Chile Crece Contigo stakeholders on its implementation in the Commune of Concepción, Chile

RESUMEN Objetivo Explorar la percepción de los stakeholders vinculados al subsistema de protección de la infancia "Chile Crece Contigo" en lo que respecta a su implementación en la comuna de Concepción, Chile. Métodos Estudio cualitativo. Se utilizaron entrevistas semiestructuradas y un focus group como técnicas de recolección de información. Se realizó un muestreo teórico en base a la representación de los niveles de decisión y poder respecto a la implementa-ción de Chile Crece Contigo en la comuna de Concepción. Los datos fueron analizados con el software ATLAS.ti 6.2. Resultados Destacaron como logros la alta valoración de Chile Crece Contigo, junto con, la capacidad de instalar temas tan relevantes como el cuidado de la primera infancia. El aspecto no logrado más importante fue el aprovechamiento de los beneficios entregados y la difusión de la política. El mayor facilitador de la implementación fue el compromiso con el Chile Crece Contigo, mientras la mayor barrera, la situación contractual de los profesionales. Finalmente, como aspectos a mejorar se apuntaron la infraestructura, la articulación de la red Chile Crece Contigo y los recursos asociados a la política. Conclusión La implementación de Chile Crece Contigo en la comuna de Concepción ha alcanzado una alta valoración y reconocimiento en la comunidad, sin embargo, aún se requiere trabajar en el logro de aspectos relacionados con la articulación de los distintos stakeholders que componen la red Chile Crece Contigo, la difusión de la política en todos los niveles y el mejor aprovechamiento de los beneficios entregados a la población.(AU)

ABSTRACT Objective To explore the perception of stakeholders on the implementation policy of the childhood protection subsystem "Chile Crece Contigo" in the Commune of Concepción, Chile. Materials and Methods Qualitative study. Semi-structured interviews and a focus group were used as information gathering techniques. A theoretical sampling was carried out based on the representation of decision and power levels with regard to the implementation of Chile Crece Contigo in the Commune of Concepción. The data were analyzed with the ATLAS.ti 6.2 software. Results The most notable achievements highlighted by interviewees were the high valuation of Chile Crece Contigo, along with the possibility of placing relevant subjects such as first childhood care into the agenda. On the contrary, taking advantage of benefits delivered by the program and the dissemination of the policy were deemed as not achieved. The main facilitator of the implementation was the commitment of the beneficiaries to Chile Crece Contigo, while the most important barrier identified was the contract modality of professionals. Finally, aspects to be improved included infrastructure of facilities, the Chile Crece Contigo network articulation and the funds to secure sustainability of the program over time. Conclusion The implementation of Chile Crece Contigo in the Commune of Concepción has achieved high recognition in the community, however, it is still necessary to work on the achievement of aspects related to the articulation of the different stakeholders that make up the Chile Crece Contigo network, the diffusion of politics at all levels, and the best use of the benefits delivered to the population.(AU)