[Lights and shadows in the implementation of community action for health]. / Luces y sombras en la implementación de la acción comunitaria para la salud.

OBJECTIVE: To explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities. METHOD: Qualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach. RESULTS: The prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment. CONCLUSIONS: Participatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment.

Luces y sombras en la implementación de la acción comunitaria para la salud / Lights and shadows in the implementation of community action for health

Objetivo Explorar las experiencias de personas que desarrollan proyectos e intervenciones en los que la participación-acción comunitaria constituye una herramienta estratégica para reducir las desigualdades en salud. Método Estudio cualitativo basado en entrevistas en profundidad semiestructuradas realizadas en línea a personas consideradas expertas en el desarrollo de estrategias de promoción de la salud con participación comunitaria. Se seleccionaron 12 personas de los ámbitos sanitario, sociosanitario, académico y asociativo. Los textos se analizaron siguiendo el enfoque de análisis temático del contenido. Resultados La fortaleza destacada de los procesos en los que están involucradas las personas entrevistadas es su enfoque participativo. Sin embargo, no existe una apuesta real por promover la participación comunitaria desde la atención primaria de salud, y la precariedad ha sido señalada como la gran debilidad en el desarrollo de proyectos de promoción de la salud participativos. La sostenibilidad de los procesos participativos se basa en la transferencia de conocimiento hacia la comunidad y en su empoderamiento. Conclusiones Los procesos participativos han demostrado su capacidad para resituar a la comunidad como parte esencial que es del sistema sanitario. Sería interesante utilizar una herramienta de medición de la participación en toda acción comunitaria para la salud, tanto para orientar su diseño y planificación como para evaluar la profundidad de la participación y su impacto en el proceso. Mejorar las expectativas de la acción comunitaria para la salud en un futuro próximo pasa por potenciar una orientación comunitaria de la atención primaria y la intersectorialidad, lo que implica una gran apuesta institucional y política. (AU)

ObjectiveTo explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities.MethodQualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach.ResultsThe prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment.ConclusionsParticipatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment. (AU)

"Como eu fui me transformando": juventude, prevenção do HIV e a contribuição de projetos sociais comunitários no Rio de Janeiro, RJ, Brasil / "How I transformed myself": youth, HIV prevention and the contribution of community-based social projects in Rio de Janeiro, Brazil / "Como me fui transformando": juventud, prevención de VIH y la contribución de proyectos sociales comunitarios en Río de Janeiro, RJ, Brasil

O artigo analisa os possíveis efeitos de projetos sociais desenvolvidos na década de 2000, em uma favela do Rio de Janeiro, na trajetória de vida e cuidado da saúde sexual e reprodutiva dos participantes. Foram entrevistados cinco mulheres e cinco homens egressos/as dessas intervenções. Segundo os resultados, a abordagem dos direitos humanos e desigualdades sociais e de gênero somada à participação juvenil e parcerias institucionais, assim como à expansão de políticas públicas para jovens no país, colaboraram para que seus integrantes tivessem relações de gênero mais igualitárias, postergassem a maternidade/paternidade e adotassem práticas preventivas ao HIV/IST. Ademais, favoreceram o acesso ao Ensino Superior, a melhoria das condições socioeconômicas e influenciaram suas escolhas profissionais. Tais resultados podem orientar a implementação de ações diante do aumento de casos de HIV/Aids entre jovens e do desmonte de políticas públicas para saúde sexual e reprodutiva.

This article analyzes the effects of social projects developed in a favela in Rio de Janeiro in the 2000s on the life trajectory and sexual and reproductive health care of the participants. Five female and male participants were interviewed. The results show that the rights-based and social and gender equality approach, combined with youth participation and institutional partnerships, as well as the expansion of public policies for youth in the country, helped participants have more equal gender relations, postpone motherhood/fatherhood and adopt HIV/STI prevention practices. Furthermore, the approach helped promote access to higher education and improve participant socioeconomic status and influenced career choices. These results can help guide the implementation of actions in the face of an increase in cases of HIV/AIDS among young people and the dismantling of sexual and reproductive health policies.

El artículo analiza los posibles efectos de proyectos sociales desarrollados en la década de 2000 en una favela de Río de Janeiro en la trayectoria de vida y cuidado de la salud sexual y reproductiva de los participantes. Se entrevistaron cinco mujeres y cinco hombres egresados/as de esas intervenciones. De acuerdo con los resultados, el abordaje de los derechos humanos y las desigualdades sociales y de géneros, sumadas a la participación juvenil y alianzas institucionales, así como la expansión de políticas públicas para jóvenes en el país, colaboraron para que sus integrantes tuvieran relaciones de género más igualitarias, postergaran la maternidad/paternidad y adoptasen prácticas preventivas al VIH/ITS. Además, favoreció el acceso a la enseñanza superior, la mejora de las condiciones socioeconómicas e influyó en sus elecciones profesionales. Tales resultados pueden orientar la implementación de acciones frente al aumento de casos de VIH/SIDA entre jóvenes y el desmantelamiento de políticas públicas para salud sexual y reproductiva.

Diagnóstico inicial de salud desde la farmacia comunitaria en el barrio de San Isidro de Granadilla de Abona (Tenerife) / Initial health diagnosis from the community pharmacy in the neighbourhood of San Isidro de Granadilla de Abona (Tenerife)

Introducción: Este diagnóstico comunitario de salud surge de la necesidad de un conocimiento compartido del territorio, sus recursos, sus retos, con el objetivo de desarrollar una acción comunitaria para la salud desde una farmacia.Métodos. Se ha realizado un inventario de recursos comunitarios categorizados en: territoriales, sanitarios, sociales, económicos, educativos, culturales y de ocio y asociativos; y 31 entrevistas semiestructuradas a 68 personas que integran instituciones, ONG o asociaciones vecinales.Resultados. Se presenta resumen de la guía de recursos, que tienden a concentrarse en torno a la avenida Santa Cruz. Los resultados iniciales del diagnóstico comunitario presentados muestran un barrio donde las desigualdades en salud tienen un peso importante, con problemas estructurales en relación con distintos determinantes de la salud.Discusión. El proceso ha generado relaciones de colaboración en materia de promoción de la salud en el territorio. El Ayuntamiento de Granadilla de Abona ha mostrado su voluntad de extender la iniciativa al resto del municipio. Es necesario mejorar la participación en salud de los y las pacientes en espacios de construcción compartida e incluir técnicas como el análisis del discurso y análisis de contenido. (AU)

Diagnóstico inicial de salud desde la farmacia comunitaria en el barrio de San Isidro de Granadilla de Abona (Tenerife) / Health mapping and diagnosis from the community pharmacy. Initial results of an experiment in San Isidro

Introducción: Este diagnóstico comunitario de salud surge de la necesidad de un conocimiento compartido del territorio, sus recursos, sus retos, con el objetivo de desarrollar una acción comunitaria para la salud desde una farmacia. Métodos: Se ha realizado un inventario de recursos comunitarios categorizados en: territoriales, sanitarios, sociales, económicos, educativos, culturales y de ocio y asociativos; y 31 entrevistas semiestructuradas a 68 personas que integran instituciones, ONG o asociaciones vecinales. Resultados: Se presenta resumen de la guía de recursos, que tienden a concentrarse en torno a la avenida Santa Cruz. Los resultados iniciales del diagnóstico comunitario presentados muestran un barrio donde las desigualdades en salud tienen un peso importante, con problemas estructurales en relación con distintos determinantes de la salud. Discusión: El proceso ha generado relaciones de colaboración en materia de promoción de la salud en el territorio. El Ayuntamiento de Granadilla de Abona ha mostrado su voluntad de extender la iniciativa al resto del municipio. Es necesario mejorar la participación en salud de los y las pacientes en espacios de construcción compartida e incluir técnicas como el análisis del discurso y análisis de contenido. (AU)

Introduction: This community health diagnosis arises from the need for a shared knowledge of the region, its resources and challenges. The aim is to develop community health action from a Pharmacy. Methods. An inventory of community resources has been made, categorized as: territorial, health, social, economic, educational, cultural and leisure and associative; and 31 semi-structured interviews with 68 people comprising institutions, NGOs or community associations. Results. A summary of the community resources, which tend to be concentrated around Avenida Santa Cruz, is presented. The initial results of the community diagnosis presented reveals a neighbourhood where health inequalities play an important role with structural problems in relation to different health determinants. Discussion. The process has generated collaborative relationships in the area of health promotion in the territory. The City Council of Granadilla de Abona has shown its willingness to extend the initiative to the rest of the municipality. It is necessary to improve the participation of patients in health within spaces of shared construction and to include techniques such as discourse analysis and content analysis. (AU)

Intervención comunitaria en salud bucal en la población de San Pablo de Pillao, Perú, 2018 / Community oral health intervention in the population of San Pablo de Pillao, Peru, 2018

RESUMEN Introducción. Las intervenciones comunitarias permiten promover la salud y prevenir enfermedades en el poblador. Objetivo. Describir los diagnósticos y tratamientos realizados por estudiantes de odontología en el Campamento Universitario Multidisciplinario de Investigación y Servicio. Métodos. Se diseñó un estudio epidemiológico, con el enfoque cuantitativo en el distrito de San Pablo de Pillao, provincia Huánuco, Perú. Participaron docentes y estudiantes de la Facultad de Medicina, Humana, Odontología, Nutrición y Psicología. De un total de 250 asistentes a las sesiones, 95 adultos fueron atendidos en la consulta odontológica. Se realizaron sesiones educativas referidas a "anemia y desnutrición", "enfermedades diarreicas", "infecciones respiratorias", "alcoholismo y violencia", "crecimiento y desarrollo", "lactancia materna" y "salud bucal", así como una campaña de diagnóstico y tratamiento de efecciones bucodentales. Se utilizó el programa Excel para el análisis de datos. Resultados. Se atendieron 95 pobladores adultos. El 6,3 por ciento correspondió a edéntulos totales y el 40 por ciento a edéntulos parciales. De los dentados, el 97,3 por ciento presentó caries dental con un promedio de índice CPOD (suma de los dientes cariados + dientes perdidos + dientes obturados, en la dentición pemanente) de 2,08 ± 1,56. Con respecto al estado periodontal, el 38,9 por ciento presentó inflamación gingival severa. En los adultos se realizó 35 restauraciones, 28 exodoncia y 8 ajustes de prótesis. En adultos y niños se realizaron fluorizaciones y cinco actividades educativas de promoción de la salud. Conclusiones. La presencia de caries y enfermedad gingival fue altamente prevalente; las principales actividades terapéuticas realizadas en el campamento fueron las restauraciones y exodoncia(AU)

ABSTRACT Introduction: Community interventions make it possible to promote health and prevent disease in the population. Objective: Describe the diagnoses and treatments made by dental students at the Multidisciplinary Research and Service University Camp. Methods: A qualitative epidemiological study was designed for the district of San Pablo de Pillao, Huánuco province, Peru. The participants were teachers and students from the School of Human Medicine, Dentistry, Nutrition and Psychology. Of the total 250 subjects attending the sessions, 95 adults were cared for at the dental service. The educational sessions conducted dealt with the topics of "anemia and malnutrition", "diarrheal diseases", "respiratory infections", "alcoholism and violence", "growth and development", "breastfeeding" and "oral health", as well as a campaign about diagnosis and treatment of oral disorders. Data analysis was performed on Microsoft Excel. Results: Of the total 95 adult residents cared for, 6.3 percent were totally edentulous and 40 percent were partially edentulous. Of the dentate subjects, 97.3 percent had dental caries with a mean DLRP index (sum total of decayed + lost + restored permanent teeth) of 2.08 ± 1.56. As to periodontal status, 38.9 percent had severe gingival inflammation. A total 35 restorations, 28 exodontias and 8 prosthesis adjustments were performed on adult patients. Adults and children alike received fluoridation and attended five educational health promotion sessions. Conclusions: Dental caries and gingival disease were highly prevalent. The main therapeutic actions performed in the camp were restorations and exodontia(AU)

[Descriptive analysis of training in community health engagement in Spain]. / Análisis descriptivo de la formación en participación comunitaria en salud en España.

OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals.