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The availability of medications to induce abortion, especially in contexts of restricted access, has transformed practices and allowed women and/or their community organizations to assist other women in obtaining abortions, whether or not they interact with the healthcare system. This study recovers the experience of a feminist community organization that, from the province of Neuquén, extends throughout the country, creating a network of community care. An exploratory descriptive study with a qualitative approach was conducted to analyze the experiences of women who facilitate access to permitted abortion in Argentina. Through in-depth interviews with three leaders of the feminist collective La Revuelta and semi-structured interviews with 33 members of the socorrista groups, conducted between November 2019 and December 2020, we describe their history and processes of work and growth; we explore their motivations and feelings and characterize the interactions of these organizations with public and private health systems. The results of this work align with the international conversation and bibliographic production about these organizations and their particularities, and with the need to incorporate these forms of care into institutional health systems.
La disponibilidad de medicamentos para producir un aborto, sobre todo en contextos de acceso restringido, transformó las prácticas y permitió que las propias mujeres y/o sus organizaciones comunitarias ayuden a otras mujeres a abortar, interactuando o no con el sistema de salud. Este estudio recupera la experiencia de una organización feminista de la comunidad que, desde la provincia de Neuquén, se extiende a todo el país, generando una red de cuidados comunitarios. Se realizó un estudio exploratorio descriptivo, con enfoque cualitativo con el propósito de analizar las experiencias de las mujeres que facilitan el acceso al aborto permitido en Argentina. A través de entrevistas en profundidad a tres líderes de la colectiva feminista La Revuelta y de entrevistas semiestructuradas a 33 integrantes de las grupas socorristas, realizadas entre noviembre de 2019 y diciembre de 2020, describimos su historia y los procesos de trabajo y crecimiento; exploramos sus motivaciones y sentimientos y caracterizamos las interacciones de dichas organizaciones con los sistemas de salud público y privado. Los resultados de este trabajo coinciden con la conversación y la producción bibliográfica internacional acerca de estas organizaciones y sus particularidades y con la necesidad de incorporar estos cuidados a los sistemas de salud institucionales.
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Aborto Inducido , Investigación Cualitativa , Humanos , Argentina , Femenino , Embarazo , Accesibilidad a los Servicios de Salud , Feminismo , Redes Comunitarias , Automanejo , Entrevistas como Asunto , AdultoRESUMEN
Social capital, defined as the nature of the social relationship and the resources embedded within the social network of an individual or community, influences how individuals within a group interact and collaborate within their communities or organizations. While it is acknowledged that social capital can be drawn from as a coping strategy to mitigate financial stress, there is a notable absence of the lived experience in the literature on how social capital influences households to tap resources from their social network. We have investigated the role of social capital in healthcare financing in rural Uttar Pradesh, India, highlighting the challenges faced by households in managing healthcare expenses. We took a qualitative research approach, conducting in-depth interviews with 24 households in the Hardoi District of Uttar Pradesh in August 2017 to explore participants' lived experience of accruing support from their community during their healthcare crisis. Data analysis followed a thematic content analysis approach. The study finds that households leverage social capital for both financial and non-financial support during health crises. Social networks, trust, and community cohesion play critical roles in resource acquisition. However, overreliance on social capital can be coercive, leading to inequity, privacy invasion, and dependency. Though social capital serves as a crucial resource of support in healthcare emergencies, its unequal distribution and potential for misuse highlight the need for more structured health financing policies in India. The findings underscore the importance of integrating community-driven resources into broader health financing strategies, considering local social structures and community dynamics.
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Financiación de la Atención de la Salud , Investigación Cualitativa , Población Rural , Capital Social , Humanos , India , Población Rural/estadística & datos numéricos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Apoyo SocialRESUMEN
Introduction This investigation explores the influence of community dialogue on loneliness within rural Japanese communities amidst the backdrop of globalization, urbanization, and technological shifts. Highlighting the significance of both informal and formal community dialogues, the study aims to bridge the gap in empirical evidence regarding the role of these interactions in enhancing social cohesion and mitigating loneliness, particularly in rural areas facing demographic changes and privacy concerns. Method A cross-sectional study was performed in Unnan City, Japan, targeting individuals over 40 who regularly visited a local rural hospital. The study employed the Japanese version of the University of California, Los Angeles (UCLA) Loneliness Scale and questionnaires regarding the frequency of community dialogue, alongside examining participants' health and demographic details from hospital records. Analysis methods included t-tests, Mann-Whitney U tests, and multivariate logistic regression to examine the association between community dialogue frequency and loneliness. Results Among the 647 respondents, the participants' mean age was 71.26 years, with a male rate of 46.3%. The multivariate logistic regression analysis revealed that higher frequencies of community dialogue significantly reduce the odds of experiencing loneliness. Specifically, compared to individuals with the least frequency of community dialogue, those with more frequent and most frequent dialogues were significantly more likely to report higher loneliness levels, with odds ratios of 2.62 (95% CI: 1.60-4.29, p<0.01) and 4.11 (95% CI: 2.47-6.85, p<0.01), respectively. Additionally, an increase in BMI was inversely related to loneliness (OR: 0.95, 95% CI: 0.91-0.99, p=0.023), and individuals with a higher comorbidity index (CCI≥5) showed a decreased likelihood of reporting higher loneliness (OR: 0.64, 95% CI: 0.43-0.96, p=0.031). Conclusion This study shows compelling evidence that more frequent community interactions are inversely associated with feelings of loneliness. These findings suggest that initiatives to increase community dialogue need a nuanced approach to mental health and social cohesion in rural settings. The research further reveals an intriguing relationship between body mass index, the severity of comorbidities, and loneliness, offering insights into the complex interplay between physical health and social well-being. The importance of this study lies in its potential to inform policies and programs designed to foster social connections respecting rural contexts, thereby addressing the challenge of loneliness in rural communities.
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Telemedicina , Humanos , Enfermedad Crónica , Dermatología , Enfermería de Práctica Avanzada , Heridas y Lesiones , Femenino , MasculinoRESUMEN
Based on the need to implement strategies to reduce recovery gaps in mental health with the community as axes of recovery, the objective of the present study was to assess the impact on psychosocial disability and care continuity in individuals with suicidal behavior, of the clinical and community components of the Mental Health Gap Action Program (mhGAP), versus exclusive psychiatric care. For this, a controlled community trial carried out in 2023 was conducted, comprising intervention groups: Support Group (SG), mhGAP Group (mhGAPG) and a Control Group (CG). Self-report measurements were collected pretest and posttest, utilizing the Psychosocial Disability Scale and the Alberta Continuity of Care Scale. The study involved the participation of 94 individuals with a history of suicidal behavior, with 30 individuals in the SG, 34 in the mhGAP group, and 30 in the CG. Categorical variables were summarized using frequency distribution tables. Descriptive statistics were used to examine participants' characteristics at the study outcome and estimate treatment compliance. The Mann-Whitney U Test examined differences in sociodemographic variable frequencies. The Jarque-Bera test confirmed a normal distribution for psychological variables, warranting the use of parametric tests. Differences in mean values across groups, each with two measurements per individual, were assessed using a type II repeated measures ANOVA. There were significant differences based on the intervention, with the effect being greater in the SG across all domains. Significant improvement was observed in all domains of the disability and continuity of care scale within the intervention groups. Both groups showed improvement, with better results for the SG. In conclusion, a methodology is proposed for implementing support groups based on core components, which effectively enhances psychosocial disability and the continuity of mental health care, especially in suicidal behavior.
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Introduction Loneliness among adults is a critical public health issue, particularly in rural areas where social isolation can be more pronounced. Understanding the factors that influence loneliness can guide the development of effective interventions. This study explores the impact of demographic, health-related, and social participation factors on loneliness among rural Japanese adults, focusing on the role of community participation. Method This cross-sectional study was conducted with rural Japanese adults who regularly visited rural community hospitals. Data were collected on participants' demographic characteristics, health status, and social participation and analyzed using a multivariate logistic regression model to identify factors associated with higher levels of loneliness. The covariates included age, sex, body mass index (BMI), chronic health conditions, and community participation. Results The study found that community participation had a significant negative association with loneliness, with an odds ratio (OR) of 0.46 (p < 0.01), indicating that individuals engaged in community activities were substantially less likely to experience higher levels of loneliness. Higher BMI was associated with lower odds of loneliness (OR = 0.93, p < 0.02), suggesting a protective effect against loneliness. Conclusion The findings highlight the paramount importance of community engagement in mitigating loneliness among rural Japanese adults. The inverse relationship between BMI and loneliness suggests that BMI and social participation influence loneliness. These insights underscore the need for comprehensive interventions that promote community participation and address the multifaceted nature of loneliness. Future research should further explore the mechanisms through which community engagement and BMI impact loneliness to develop targeted strategies for improving the well-being of rural adults.
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Background: Health inequalities in African American communities have been further exacerbated by COVID-19. Public health departments and other safety-net providers across the United States have partnered with community-based organizations to address barriers to COVID-19 testing in disproportionately impacted communities. This narrative review summarizes lessons learned from published examples of these community-based COVID-19 testing efforts. Methods: We searched online databases for peer-reviewed articles on community-based COVID-19 testing interventions in the United States aimed at increasing COVID-19 testing among African American populations. We abstracted information about each example and synthesized the primary lessons learned and key aspects that contributed to their success. Results: Seven examples of community-based COVID-19 testing aimed at increasing testing among African Americans and other underserved populations were identified and described, across various U.S. locations and involving multiple types of partners (1) St. Paul, MN (faith, health centers, Mayo Clinic); (2) Chicago, IL (university hospital and health centers); (3) NC (health centers, Community Advisory Board); (4) Baltimore, MD (hospitals, community clinic, mobile clinic); (5) Marion County, FL (health department and community partners); (6) New Orleans, LA (health department and health system); and (7) New York City, NY health and hospital system, mobile clinic). Discussion: Several key aspects of the COVID-19 testing models included the following: (1) close proximity of the testing site to affected communities and availability of walk-up and drive-through testing options; (2) partnerships between safety-net providers and broad community networks, which facilitated outreach and trust; (3) increased resources for safety-net providers; and (4) the use of data to identify areas of need and track impact. The merging of resources and relationships among well-equipped, safety-net providers and other health care institutions and culture-rich, community-centered organizations, to jointly address structural and systemic inequities, is key to cultivating health equity in the distribution of COVID-19 testing and other essential public health services.
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Introducción. En Asunción existe una zona geográfica llamada Bañados, en esta zona se conforman los llamados «cinturones de pobreza», donde el trabajo informal se impone como principal medio de sustento. El oficio del reciclaje corresponde a uno de los trabajos informales más practicados. Objetivos. Describir aspectos de la zona donde desarrollan su vida trabajadora de la recolección. Incorporar elementos de resignificación positiva acerca del trabajo de reciclaje a mujeres recicladoras organizadas o no del Bañado Sur de la ciudad de Asunción, Paraguay. Material y métodos. Se realizaron 28 encuentros con 153 mujeres agrupadas en 7 grupos, durante el período del 2019 al 2022. La muestra fue seleccionada fue por conveniencia. Se eligió la modalidad de «taller» debido a las prácticas ya conocidas y aceptadas por la comunidad. Resultados. Se realizó conjuntamente la clasificación de la basura o residuos urbanos en sus categorías orgánica/inorgánica/tóxica, pero también en una clasificación más cercana a su realidad concreta. Se identificó cómo son las relaciones familiares y comunitarias, las preocupaciones por los hijos e hijas, el cambio climático, las inundaciones, las viviendas precarias, el acceso al agua, la inseguridad en el barrio y la problemática de drogas en la comunidad. Conclusión. Las jornadas se desarrollaron con mujeres recicladoras organizadas, miembros de una organización civil, que residen en el Bañado Sur Tacumbú, Asunción (Paraguay). Durante el proceso se logró acercar a los grupos de mujeres que han podido participar de la experiencia, una resignificación positiva del trabajo y su rol en la sociedad, mediante el diálogo. (AU)
Introduction. In Asunción there is a geographic area called Bañados. They make up the so-called poverty belts, where informal work is laid down as the main means of support. The job of recycling is one of the most performed informal jobs. Aims. To report aspects of the area where collection workers go about their lives. Incorporate elements of positive new meaning about the recycling work to organized or disorganized women recyclers from Bañado Sur in the city of Asunción, Paraguay. Methods. In total 28 meetings were held with 153 women grouped into seven groups, during the period from 2019 to 2022. The sample was selected by convenience. The workshop modality was chosen due to the practices already known and accepted by the community. Results. Garbage or urban waste could be classified together in its organic/inorganic/toxic categories but also in a classification more akin to its specific reality. Family and community relationships, concerns for children, climate change, floods, precarious housing, access to water, insecurity in the neighbourhood and drug problems in the community were all identified. Conclusion. The sessions were held with organized women recyclers, members of a civil organization residing in Bañado Sur Tacumbú, Asunción, Paraguay. During the process, it was possible to bring together the groups of women who were able to take part in the experience, a positive new meaning for work and their role in society, by means of dialogue. (AU)
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Humanos , Femenino , Reciclaje , Planificación Social , Grupos de Riesgo , Redes Comunitarias , Salud PúblicaRESUMEN
We consider the looming threat of bad actors using artificial intelligence (AI)/Generative Pretrained Transformer to generate harms across social media globally. Guided by our detailed mapping of the online multiplatform battlefield, we offer answers to the key questions of what bad-actor-AI activity will likely dominate, where, when-and what might be done to control it at scale. Applying a dynamical Red Queen analysis from prior studies of cyber and automated algorithm attacks, predicts an escalation to daily bad-actor-AI activity by mid-2024-just ahead of United States and other global elections. We then use an exactly solvable mathematical model of the observed bad-actor community clustering dynamics, to build a Policy Matrix which quantifies the outcomes and trade-offs between two potentially desirable outcomes: containment of future bad-actor-AI activity vs. its complete removal. We also give explicit plug-and-play formulae for associated risk measures.
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AIMS: To develop and validate an instrument to identify the core components of community strategies for mental health, especially mutual aid groups: The Mutual Aid Scale . METHODS: 135 community strategies leaders participated in the study. The core components are active agency, coping strategies, recognition, and management of emotions, problem-solving strategies, supportive interaction, trust, self-identity construction, and strengthening of social networks. With these components a scale was designed. Content validity was carried out in addition to an exploratory factor analysis. RESULTS: Two dimensions resulted, strengthening of agency capacity and Coping strategies, and the internal consistency of both factors was acceptable, with a Cronbach's alpha of 0.722 and 0.727, respectively. The Kaiser-Meyer-Olkin (KMO) statistic was used with a score of 0.831 and the Barlett Sphericity Test, with a significant value of 265.175. CONCLUSION: This scale identifies the components of community interventions for mental health and can contribute to a better implementation of these strategies. It also articulates autonomous community processes with strategies developed in health services.
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Salud Mental , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Análisis FactorialRESUMEN
Strengthening interorganizational collaboration is critical to mitigate the impact of adverse childhood experiences (ACEs) and improve community health. We examined change in interorganizational collaboration around ACEs within Peace4Tarpon's network and investigated factors influencing collaboration. We conducted a community-wide social network analysis among 32 trauma-informed organizations in 2016 and 2018, using network analysis methods to examine interorganizational cohesion (density, transitivity, triad census) over time, and multiple regression quadratic assignment procedure to investigate factors influencing collaboration. Network cohesion measures indicated small increases in collaboration level and greater network cohesion over time. Conducting ACEs screenings was a significant factor (b = 0.237; p < 0.01) predicting likelihood of interorganizational collaboration in 2016. No assessed ACEs practices predicted collaboration in 2018, suggesting variables assessed predicted a small proportion of variance in collaboration change. Results provide a foundation for understanding how ACEs/trauma-informed practices influence collaboration and highlight implications of interorganizational collaboration. Peace4Tarpon's 2-year progress provides insights for other trauma-informed communities.
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Experiencias Adversas de la Infancia , Salud Pública , HumanosRESUMEN
AIMS: The study aims to identify and compare health indicators collected by national research in Spain and in Brazil that can generate action strategies for health promoting universities. METHODS: This is an epidemiological, descriptive, cross-sectional study that uses the database of the Secretariat of Health Surveillance of the Brazilian Ministry of Health and the database of the National Statistics Institute of Spain. Based on the National Health Promotion Policy, the analyzer axis prioritizes defined themes; percentage of physical exercise, daily smokers, sedentary lifestyle, obesity and self-perception of health status were evaluated. The data were collected from 2014 to 2020. RESULTS: In Brazil, physical exercise is the highest percentage indicator, whereas in Spain, sedentary lifestyle is the highest. Regarding the age group, Brazil presented the lowest prevalence of daily smokers in the age group from 18 to 24, with little increase in older age groups; in Spain, older age groups presented the highest rates of sedentary lifestyle and obesity. In 2020, 4.5% of Brazilians reported a negative self-perception of health and in Spain 6.6%. CONCLUSION: The indicators 'physical exercise', 'daily smokers' and 'sedentary lifestyle' presented better results in Brazil than in Spain. Brazil presents a better perspective on health when compared with Spain, as the results showed that older ages present higher rates of sedentary lifestyle and obesity. Our study results also show that Brazilians report better self-perception in health, which can be interpreted by health promotion strategies.
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Background: The core to successful advance care planning (ACP) facilitation is helping people determine their values, beliefs and wishes, and understand substitute decision-making. Recognizing the potential for community members to support public awareness and education we developed a model of ACP education, whereby peer facilitators associated with community organizations host workshops that educate and assist members of the public with ACP. Objectives: Describe the development and evaluation of the model for community-led peer-facilitated ACP workshops for the public. Design: Descriptive mixed methods. Methods: A training curriculum and program model were co-developed with two community organizations that had been successful in delivering ACP workshops independently in their communities. Herein we describe a mixed-methods evaluation of three cycles of implementation and improvement of the model. Results: The model centers on three key concepts; the right content (based around three steps Think, Talk, Plan), the right facilitator, and the right approach. A suite of tools was designed to support the three groups involved in the delivery of the ACP workshops: the public participants, the peer facilitators, and the community-based organizations. The peer-facilitator training addresses the facilitator's learning needs of ACP content knowledge, facilitation skills, and understanding change behavior. Training evaluation data from 106 facilitators confirmed that the curriculum prepared them to facilitate the workshops. Qualitative data revealed that support from organizations with established reputations in their community is critical, with mentoring from more experienced facilitators beneficial. Conclusion: Our model demonstrates the potential of community-led, peer-facilitated ACP initiatives to enhance the capacity of community to upstream ACP conversations. Reaching a broader audience and creating a supportive, inclusive environment for individuals to comfortably learn about ACP can drive the much-needed culture shift to normalize ACP. Meaningful community engagement, empowerment, and partnerships are essential for the successful development and widespread impact of these initiatives.
A model for community-led peer-facilitated advance care planning workshops for the public Why was this study done? Advance care planning (ACP) allows people to reflect on and share their personal values, goals and preferences as they relate to their future healthcare. Despite the benefits of doing ACP, the number of people who have engaged in ACP remains low. Traditionally, most ways of supporting people to engage in ACP have involved healthcare providers. In British Columbia, two community-based organizations had developed successful peer-facilitated workshops to engage and educate the public. In these workshops, non-expert members of the community (peer-facilitators) conduct interactive workshops that help members of the public understand and begin ACP. What did the researchers do? We partnered with these two organizations to develop a training curriculum and other materials required to spread this approach to other community organizations throughout the province. The model is based on three key concepts: the right content, the right facilitator, and the right approach. The materials include a suite of tools for three groups: the public participants, the peer-facilitators and the organizations. What did the researchers find? The training and suite of tools we developed successfully prepared community members ("peers") associated with community organizations to facilitate ACP workshops for the public. Support from community organizations is essential, and mentoring from more experienced facilitators is beneficial. What do the findings mean? As a provincial organization we were able to successfully partner with community organizations to develop a model and spread the workshops provincially and confirm they were acceptable and effective, improving public access to information about advance care planning.
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BACKGROUND: Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. METHODS: In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. DISCUSSION: Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.
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Prescripciones , Atención Primaria de Salud , Humanos , España , Servicios de Salud Comunitaria , Investigación CualitativaRESUMEN
Objetivo: evaluar el aprendizaje y la metodología de un trabajo académico sobre el diseño de una actividad comunitaria local.Método: estudio evaluativo mixto realizado en estudiantes de Enfermería. Tras una introducción teórica a 144 estudiantes sobre acción comunitaria se formaron equipos que, durante dos meses, realizaron un análisis de población parcialmente real, mapeo de activos, búsqueda bibliográfica para conocer los estilos de vida, búsqueda y análisis crítico de experiencias comunitarias anteriores y diseño de una propuesta de actividad. El profesorado la calificó mediante rúbrica (0 a 10 puntos) y se ofreció al alumnado evaluarla mediante cuatro preguntas abiertas y dos cerradas (interés suscitado y necesidad de mantener la actividad formativa -escalas Likert de 1 mín. a 5 máx.-). Se llevaron a cabo índices estadísticos descriptivos y análisis de contenido.Resultados: realizaron la actividad 27 grupos que obtuvieron una calificación mediana de 8,17 puntos. La evaluaron 96 estudiantes que consideraron que era interesante (x= 4,29) y debía mantenerse (x= 4,17). Identificaron como necesarios e importantes los proyectos de promoción de la salud en la comunidad local y el trabajo compartido con ella. Reflejaron haber descubierto otro campo de acción profesional. Apenas reflejaron visión salutogénica y encontraron dificultades para enfocar la tarea, en la búsqueda de bibliografía y de experiencias previas.Conclusión: la actividad fue resuelta con éxito por los estudiantes y logró en el corto plazo la familiarización con el trabajo comunitario que buscaba. El alumnado encontró dificultades para desarrollar la metodología, pero percibieron la actividad como interesante y relevante. (AU)
Objective: to evaluate the level of learning and the methodology of an academic paper on the design of a local community activity.Method: a mixed evaluative study conducted on Nursing students. After a theoretical introduction on community action, 144 students formed teams and, during two months, conducted a partially real population analysis, article mapping and bibliographic search in order to understand the lifestyles, search and critical analysis of previous community experiences, and design a proposal of activity. Professors graded it through signature (0 to 10 scores), and students were offered an evaluation through four open questions and two closed-ended questions (interest generated and the need to maintain the training activity, Likert scales with min. 1 to max. 5). Descriptive statistical analyses were conducted, as well as content analysis.Results: the activity was conducted by 27 groups, who achieved a median score of 8.17. It was then evaluated by 96 students, who considered that it was interesting (x= 4.29) and should be maintained (x= 4.17). They identified as necessary and important the health promotion projects in the local community and the work shared with it. They showed that they had discovered another area of professional action. They scarcely showed salutogenic vision and had difficulties to focus the task on a search for bibliography and previous experiences.Conclusion: the activity was successfully conducted by students, and the desired familiarity with the community work was achieved at short term. Students met difficulties to develop the methodology but perceived the activity as interesting and relevant. (AU)
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Humanos , Educación en Enfermería/métodos , Estudiantes del Área de la Salud , Estudiantes de Enfermería , Aprendizaje Basado en Problemas , Participación de la ComunidadRESUMEN
Introducción. Salubrízate es un grupo de procesos y activos comunitarios que realiza intervenciones de educación y promoción de la salud para el bienestar colectivo, en Ourense y alrededores desde el año 2018. Objetivo. El objetivo principal es conocer y responder a las inquietudes de salud de la ciudadanía. Métodos. Esta experiencia se basa en un modelo abierto a la participación, intersectorial y multidisciplinar, que tiene la capacidad de adaptarse a diversas circunstancias sanitarias o sociales, como la COVID. Se trabaja en cuatro áreas: hábitos saludables, bienestar emocional y social, entornos saludables y seguridad ciudadana. Tiene como recursos principales a las personas, los medios de comunicación colectiva como la radio y las redes sociales y diversas instituciones tanto sanitarias como sociales. Resultados. La repercusión de Salubrízate se está midiendo a través del alcance de cada uno de los proyectos llevados a cabo por el grupo, analizando también las debilidades que limitan el proyecto y sus fortalezas. (AU)
Introduction. Salubrízate is a group of community processes and assets that has been implementing health education and promotion interventions for collective well-being in Ourense and its surroundings since 2018.Aim. The main purpose is to be aware of the health concerns of citizens and respond to them.Methods. This experience is based on an intersectoral and multidisciplinary model open to participation, which can adapt to various health or social circumstances, such as COVID-19. The programme works on four areas: healthy habits, emotional and social well-being, healthy environments and citizen safety. Its key resources are people, mass media such as radio and social media and various health and social institutions.Results. The impact, strengths and limiting weaknesses of Salubrízate are being analysed by means of the scope of each project conducted by the group.
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Humanos , Educación en Salud/métodos , Agentes Comunitarios de Salud/tendencias , Medicina Comunitaria/métodos , Participación de la Comunidad/métodos , Redes Comunitarias , Pandemias , Infecciones por Coronavirus/epidemiologíaRESUMEN
Objective: Despite recognized benefits, engagement in Advance Care Planning (ACP) remains low. Research into peer-facilitated, group ACP interventions is limited. This study investigated the acceptability of community-led peer-facilitated ACP workshops for the public and whether these workshops are associated with increased knowledge, motivation and engagement in ACP behaviors. Methods: Peer-facilitators from 9 community organizations were recruited and trained to deliver free ACP workshops to members of the public with an emphasis on conversation. Using a cohort design, workshop acceptability and engagement in ACP behaviors was assessed by surveying public participants at the end of the workshop and 4-6 weeks later. Results: 217 participants returned post-workshop questionnaires, and 69 returned follow-up questionnaires. Over 90% of participants felt they gained knowledge across all 6 learning goals. Every ACP behavior saw a statistically significant increase in participant completion after 4-6 weeks. Almost all participants were glad they attended (94%) and would recommend the workshop to others (95%). Conclusion: This study revealed an association of peer-facilitated ACP workshops and completion of ACP behaviors in public participants. Innovation: This innovative approach supports investment in the spread of community-based, peer-facilitated ACP workshops for the public as important ACP promotion strategies.
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The increasing frequency and cost of zoonotic disease emergence due to global change have led to calls for the primary surveillance of wildlife. This should be facilitated by the ready availability of remotely sensed environmental data, given the importance of the environment in determining infectious disease dynamics. However, there has been little evaluation of the temporal predictiveness of remotely sensed environmental data for infection reservoirs in vertebrate hosts due to a deficit of corresponding high-quality long-term infection datasets. Here we employ two unique decade-spanning datasets for assemblages of infectious agents, including zoonotic agents, in rodents in stable habitats. Such stable habitats are important, as they provide the baseline sets of pathogens for the interactions within degrading habitats that have been identified as hotspots for zoonotic emergence. We focus on the enhanced vegetation index (EVI), a measure of vegetation greening that equates to primary productivity, reasoning that this would modulate infectious agent populations via trophic cascades determining host population density or immunocompetence. We found that EVI, in analyses with data standardised by site, inversely predicted more than one-third of the variation in an index of infectious agent total abundance. Moreover, in bipartite host occupancy networks, weighted network statistics (connectance and modularity) were linked to total abundance and were also predicted by EVI. Infectious agent abundance and, perhaps, community structure are likely to influence infection risk and, in turn, the probability of transboundary emergence. Thus, the present results, which were consistent in disparate forest and desert systems, provide proof-of-principle that within-site fluctuations in satellite-derived greenness indices can furnish useful forecasting that could focus primary surveillance. In relation to the well-documented global greening trend of recent decades, the present results predict declining infection burden in wild vertebrates in stable habitats; but if greening trends were to be reversed, this might magnify the already upwards trend in zoonotic emergence.
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Ecosistema , Roedores , Animales , Animales Salvajes , BosquesRESUMEN
Se expone el desarrollo de un proceso territorial de acción comunitaria para la salud basada en activos, que tuvo como objetivo generar estrategias concretas para combatir el hambre y la malnutrición en un barrio popular de la ciudad de Tunja (Colombia) con altas brechas de desigualdad económica y fragmentación social. A partir de la identificación y la dinamización de diversas iniciativas de autonomías alimentarias se generó una red comunitaria que facilitó la utilización colectiva de recursos, saberes y prácticas propias alrededor del proceso agroalimentario. Con ello se promovió la accesibilidad a alimentos saludables y culturalmente legítimos, a la vez que se configuró un espacio vincular de autonomía, organización, participación y cooperación solidaria entre vecinos. Esto demuestra la potencialidad salutogénica de las acciones locales en salud y de abordar la alimentación de manera participativa, hecho que señalamos como una propuesta político-popular y académica para la promoción de la salud colectiva.(AU)
This paper presents the development of a territorial process of community action for health based on assets. Its objective was to generate concrete strategies to combat hunger and malnutrition in a working-class neighbourhood of the Colombian city of Tunja where there are significant gaps in terms of economic inequality and social fragmentation. Through the identification and dynamization of diverse initiatives of food autonomy, a community network was created which facilitated the collective use of their own resources, knowledge, and practices around the agri-food process. This promoted access to healthy and culturally accepted foods and a space where autonomy, organisation, participation, and cooperation among neighbours converged. The above shows the salutogenic potentiality of local actions in health and of approaching food in a participative way, something that we point out as a political-popular and academic proposal for the promotion of collective health.(AU)