Impact of a Digital Atopic Dermatitis Educational Intervention on Hispanic Patients and Family Members.

With the increasing incidence of atopic dermatitis (AD) in the U.S., the highest prevalence of AD being found in Hispanic countries, and the rising Hispanic-American population, educational resources on eczema focused on Spanish-speaking populations are needed more than ever. As such, the primary goal of this project was to assess the beneficial impact of an educational intervention conducted through a virtual platform for Hispanic individuals living with atopic dermatitis. Utilizing WhatsApp, the study enrolled 55 participants diagnosed with AD and/or parents of children diagnosed with AD. Participants were enrolled in a seven-day educational module with daily topics on AD health knowledge. A health knowledge survey was administered before the educational program, upon completion of the program, and one month after completion. The program found a 14% increase in AD health knowledge upon completion of the program (p < 0.001). Most importantly, there was no significant difference found between the health knowledge survey submitted at program completion and one month after completion, signaling that health knowledge taught through the course was successfully retained by participants (p = 0.29). Qualitative themes involving atopic disease were additionally explored through group discussions, including mental health and peer stigma. This study is the first of its kind in dermatology utilizing the WhatsApp format. The success of retained health knowledge regarding AD demonstrates that future virtual endeavors can be effective and accessible methods of patient education overall for populations that might not have ease of access to major medical centers.

O papel dos atores na formulação e implementação de políticas públicas: dinâmicas, conflitos e interesses no Programa Mais Médicos / The role of actors in the formulation and implementation of public policies: dynamics, conflicts and interests in Program More Doctors

Diversos atores participam dos processos de formação de políticas públicas: indivíduos, grupos ou organizações que exercem influência diretaou indireta, em diferentes momentos. Dessa forma, buscou-se mapear os atores envolvidos na formulação e implementação do ProgramaMais Médicos e compreender as dinâmicas e contribuições desses atores. Para análise dessa política pública, adotou-se um estudo teóricoempíricocom abordagem qualitativa e método de estudo de caso. Identificou-se como atores centrais o Governo Federal, os movimentossociais, a mídia de massa, as redes sociais e os conselhos de medicina. No que se refere à análise do ciclo do programa, verificou-se que seusprocessos não foram contínuos, mas, sim, permeados por relações assimétricas e conflitantes. Na análise observou-se que as Jornadas deJunho constituíram uma janela de oportunidade para o Programa Mais Médicos; no entanto, houve diversos posicionamentos contrários aele. Os movimentos de oposição enfeixaram-se em dinâmicas, conflitos e coalizões tanto no âmbito de atores governamentais como de atoresda sociedade civil – com destaque para a relação da base aliada com os partidos contrários ao programa, em que houve processos conflituosose recuos de ambos os lados. Conclui-se que os diversos atores participaram dos processos motivados por interesses, ideologias eobjetivos diversificados. Dessa forma, os conflitos permearam todo o processo, desde a proposta do programa, o anúncio, a aprovação dalei, a chegada dos diversos médicos, até o início de suas atividades por todo o país.

Many different actors take part in the process of formulating public policies, which includes individuals, groups and organizations that exert adirect or indirect influence at different times. Thus, the specific purpose of this article has been to map the actors involved in the formulationand implementation of the ‘Mais Médicos’ Program and to understand the dynamics and contributions of these actors. In order to analyze thisparticular public policy, a theoretical and empirical study has been adopted with a qualitative approach and case study method. Among thekey players in this process were the federal government, social movements, the mass media, and social networks, as well as the Councils ofMedicine. With regard to the analysis of the program cycle, it was found that its processes were not continuous, but rather asymmetrical andpermeated by conflicting relations. This same analysis showed that the June 2013 protests provided a window of opportunity for the ‘MaisMédicos’ Program, but that nevertheless, there was still considerable opposition to the program. The opposition movements involved werebound by a series of different dynamics, conflicts and coalitions that applied to both government actors as well as those from civil society. Oneshould highlight, for example, the relationship between those parties for and those against the ‘Mais Médicos’ Program, in which there wereconflicts and setbacks on both sides. The conclusion is, therefore, that the different actors involved in the process were motivated by a varietyof different interests, ideologies and goals. Thus, conflict permeated the entire process, from the program’s initial proposal, its announcement,the enactment of the Law governing it and the arrival of the different doctors to the start of their activities in hospitals throughout the country.

Diversos actores participan en los procesos de formación de políticas públicas: individuos, grupos u organizaciones que ejercen influenciadirecta o indirecta, en diferentes momentos. De esta forma, se buscaron mapear los actores implicados en la formulación e implementacióndel Programa Más Médicos y comprender las dinámicas y aportaciones de dichos actores. Para análisis de esta política pública, se adoptó unestudio teórico-empírico con abordaje cualitativo y método de estudio de caso. Se identificaron como actores centrales el Gobierno Federal,los movimientos sociales, los medios de comunicación, las redes sociales y los consejos de medicina. En lo que respecta al análisis del ciclodel programa, se constató que sus procesos no han sido continuos, sino impregnados de relaciones asimétricas y conflictivas. En el análisisse observó que las Jornadas de Junio constituyeron una ventana de oportunidad para el Programa Más Médicos; sin embargo, hubo muchosposicionamientos contrarios a ello. Los movimientos de oposición se empaquetaron en dinámicas, conflictos y coaliciones tanto en el ámbitode actores gubernamentales como de actores de la sociedad civil – con destaque para la relación de la base aliada con los partidos contrariosal programa, en el que hubo procesos conflictivos y retrocesos de ambos lados. Se concluye que los diversos actores participaron en los procesosmotivados por intereses, ideologías y objetivos diversificados. De esta forma, los conflictos impregnaron todo el proceso, desde la propuestadel programa, el anuncio, la aprobación de la ley, la llegada de los diversos médicos, hasta el inicio de sus actividades en todo el país.