Implementation and evaluation of an educational intervention to prevent risk factors for the development of non-communicable diseases in Mexican families of suburban communities.

Non-communicable diseases (NCD), are not transmitted from person to person, are long-lasting and usually of slow evolution. Worldwide cause 71% deaths, in Mexico during 2016 were the cause of 80% of registered deaths; population in socioeconomic disadvantage is more vulnerable. It is urgent to develop strategies that can prevent NCD, thus, the objective of this study was to design, implement and evaluate an educational intervention strategy (EI), to prevent and control risk factors for the development NCD in families of two vulnerable communities. The research design was mixed, the stages were developed based on a risk communication (RC) model and was performed in three stages: 1) EI Design, 2) Implementation and 3) Evaluation of the intervention. In the contextualization, risk factors were found in the participants who were integrated in the design of the educational strategy. The EI implemented was effective in increasing knowledge about NCD and practice of healthy habits, such as increasing the consumption of fruits and vegetables. Additionally, the guidance of EI at the family level has the advantage of creating a support network for these changes. However, pending issues remain, such as the design of effective strategies to reduce the consumption of sugars and sugary drinks.

Neck Circumference and Its Association with Cardiometabolic Risk Factors in Pediatric Population.

Background and objectives: To identify the relationship between neck circumference (NC) and cardiometabolic risk factors in children. Materials and Methods: Children and adolescents 6-18 years old (n = 548) from five counties of San Luis Potosí, México were included. Data was collected for biological markers (glucose and lipid profile) and anthropometric and clinical measurements-weight, height, NC, waist circumference (WC), and blood pressure (BP). Body mass index (BMI) was calculated using Quetelet formula (kg/m2). Descriptive analysis, correlation tests, and receiver operating characteristic (ROC) analysis were performed. Results: NC was highly correlated with BMI and WC in both genders (p <0.0001). The most frequent risk factor was high BMI (38.7%). Sensitivity and specificity analysis of NC and high BMI showed an area under the ROC curve of 0.887. Conclusions: According to our findings, NC is a simple, low-cost, and non-invasive measurement, which has a high association with high BMI and increased WC.

[Health diagnosis and risk perception: key elements of a proposed intervention for indigenous communities in Mexico]. / Diagnóstico de salud y percepción de riesgos, elementos clave para una propuesta de intervención en comunidades indígenas en México.

Objective To carry out a diagnosis of children's environmental health and an analysis of risk perception in indigenous communities of the Huasteca Sur region of San Luis Potosí, Mexico, in order to design an intervention strategy in line with their needs. Methods The study used mixed methods research, carried out in two phases. It was conducted in three indigenous communities of Tancanhuitz municipality from January 2005 to June 2006. In the adult population, risk perception was analyzed through focus groups, in-depth interviews, and questionnaires. In the child population, analysis of children's drawings was used to study perception. An assessment of health risks was carried out through biological monitoring and environmental monitoring of water and soil. Results The three communities face critical problems that reveal their vulnerability. When the results were triangulated and integrated, it was found that the principal problems relate to exposure to pathogenic microorganisms in water and soil, exposure to indoor wood smoke, exposure to smoke from the burning of refuse, use of insecticides, exposure to lead from the use of glazed ceramics, and alcoholism. Conclusions To ensure that the intervention strategy is adapted to the target population, it is essential to incorporate risk perception analysis and to promote the participation of community members. The proposed intervention strategy to address the detected problems is based on the principles of risk communication, community participation, and interinstitutional linkage.

Diagnóstico de salud y percepción de riesgos, elementos clave para una propuesta de intervención en comunidades indígenas in México / Health diagnosis and risk perception: key elements of a proposed intervention for indigenous communities in Mexico

Objetivo. Realizar un diagnóstico de salud ambiental infantil y un análisis de percepción de riesgos en comunidades indígenas de la Región Huasteca Sur de San Luis Potosí, México, para diseñar una estrategia de intervención acorde a sus necesidades. Métodos. La investigación siguió un enfoque mixto realizado en dos fases de estudio. Se desarrolló en tres comunidades indígenas del municipio de Tancanhuitz, desde enero de 2005 hasta junio de 2006. En la población adulta, se analizó la percepción de riesgos mediante grupos focales, entrevistas a profundidad y cédulas de entrevistas. En la población infantil, para el análisis de percepción se utilizó la técnica de dibujo. Se realizó una evaluación de riesgos a la salud a través de un monitoreo biológico y un monitoreo ambiental de agua y suelo. Resultados. Las tres comunidades enfrentan problemas críticos que hacen evidente su vulnerabilidad. Al realizar la triangulación e integración de resultados, se halló que las principales problemáticas se relacionan con la exposición a microorganismos patógenos en el agua y el suelo, la exposición a humo de leña en interiores, la exposición al humo por quema de basura, el uso de insecticidas, la exposición a plomo por uso de barro vidriado y el alcoholismo. Conclusiones. Para que la estrategia de intervención sea acorde a la población que será intervenida, es fundamental incorporar el análisis de percepción de riesgos y fomentar la participación de sus integrantes. La estrategia de intervención que se propone para atender las problemáticas detectadas se basa en los principios de comunicación de riesgo, la participación comunitaria y la vinculación interinstitucional.

Objective. To carry out a diagnosis of children’s environmental health and an analysis of risk perception in indigenous communities of the Huasteca Sur region of San Luis Potosí, Mexico, in order to design an intervention strategy in line with their needs. Methods. The study used mixed methods research, carried out in two phases. It was conducted in three indigenous communities of Tancanhuitz municipality from January 2005 to June 2006. In the adult population, risk perception was analyzed through focus groups, in-depth interviews, and questionnaires. In the child population, analysis of children’s drawings was used to study perception. An assessment of health risks was carried out through biological monitoring and environmental monitoring of water and soil. Results. The three communities face critical problems that reveal their vulnerability. When the results were triangulated and integrated, it was found that the principal problems relate to exposure to pathogenic microorganisms in water and soil, exposure to indoor wood smoke, exposure to smoke from the burning of refuse, use of insecticides, exposure to lead from the use of glazed ceramics, and alcoholism. Conclusions. To ensure that the intervention strategy is adapted to the target population, it is essential to incorporate risk perception analysis and to promote the participation of community members. The proposed intervention strategy to address the detected problems is based on the principles of risk communication, community participation, and interinstitutional linkage.

Diagnóstico de salud y percepción de riesgos, elementos clave para una propuesta de intervención en comunidades indígenas en México / Health diagnosis and risk perception: key elements of a proposed intervention for indigenous communities in Mexico

RESUMEN Objetivo Realizar un diagnóstico de salud ambiental infantil y un análisis de percepción de riesgos en comunidades indígenas de la Región Huasteca Sur de San Luis Potosí, México, para diseñar una estrategia de intervención acorde a sus necesidades. Métodos La investigación siguió un enfoque mixto realizado en dos fases de estudio. Se desarrolló en tres comunidades indígenas del municipio de Tancanhuitz, desde enero de 2005 hasta junio de 2006. En la población adulta, se analizó la percepción de riesgos mediante grupos focales, entrevistas a profundidad y cédulas de entrevistas. En la población infantil, para el análisis de percepción se utilizó la técnica de dibujo. Se realizó una evaluación de riesgos a la salud a través de un monitoreo biológico y un monitoreo ambiental de agua y suelo. Resultados Las tres comunidades enfrentan problemas críticos que hacen evidente su vulnerabilidad. Al realizar la triangulación e integración de resultados, se halló que las principales problemáticas se relacionan con la exposición a microorganismos patógenos en el agua y el suelo, la exposición a humo de leña en interiores, la exposición al humo por quema de basura, el uso de insecticidas, la exposición a plomo por uso de barro vidriado y el alcoholismo. Conclusiones Para que la estrategia de intervención sea acorde a la población que será intervenida, es fundamental incorporar el análisis de percepción de riesgos y fomentar la participación de sus integrantes. La estrategia de intervención que se propone para atender las problemáticas detectadas se basa en los principios de comunicación de riesgo, la participación comunitaria y la vinculación interinstitucional.

ABSTRACT Objective To carry out a diagnosis of children’s environmental health and an analysis of risk perception in indigenous communities of the Huasteca Sur region of San Luis Potosí, Mexico, in order to design an intervention strategy in line with their needs. Methods The study used mixed methods research, carried out in two phases. It was conducted in three indigenous communities of Tancanhuitz municipality from January 2005 to June 2006. In the adult population, risk perception was analyzed through focus groups, in-depth interviews, and questionnaires. In the child population, analysis of children’s drawings was used to study perception. An assessment of health risks was carried out through biological monitoring and environmental monitoring of water and soil. Results The three communities face critical problems that reveal their vulnerability. When the results were triangulated and integrated, it was found that the principal problems relate to exposure to pathogenic microorganisms in water and soil, exposure to indoor wood smoke, exposure to smoke from the burning of refuse, use of insecticides, exposure to lead from the use of glazed ceramics, and alcoholism. Conclusions To ensure that the intervention strategy is adapted to the target population, it is essential to incorporate risk perception analysis and to promote the participation of community members. The proposed intervention strategy to address the detected problems is based on the principles of risk communication, community participation, and interinstitutional linkage.

[Designing and application of a Risk Communication Program for children environmental health on a lead and arsenic contaminated location]. / Diseño y aplicación de un Programa de Comunicación de Riesgos para la salud ambiental infantil en un sitio contaminado con plomo y arsénico.

A metallurgical industry in San Luis Potosí city, México, has contaminated the zone by lead (Pb) and arsenic (As). Since 1989 were reported by our group high concentrations of Pb in blood (PbB) and As in urine (AsU) in the local children. In present work, a Risk Communication Program (RCP) was generated to inform the children about the environmental risks of the site where they live, and to change conducts to diminish the exposure to Pb and As. We worked with 170 children (5 to 7 years) of the zone. The RCP was applied and the evaluation was realized by means of analysis of drawings, questionnaires and biological monitoring. In drawings of the children appeared toxic elements such as Pb, contaminated soil, cigarettes, among others. In the questionnaires applied to the children and family parents it was possible to estimate a change in the knowledge and in some conducts with regard to the pollutants, their effects and their exposure. There was not a decrease in the levels of PbB and in the levels of AsU. These were due probably because the principal route of exposure is not only the soil that had been contemplated previously.

Diseño y aplicación de un Programa de Comunicación de Riesgos para la salud ambiental infantil en un sitio contaminado con plomo y arsénico / Designing and application of a Risk Communication Program for children environmental health on a lead and arsenic contaminated location

Una industria metalúrgica en la ciudad de San Luis Potosí, México ha contaminado el sitio con plomo (Pb) y arsénico (As) principalmente. Desde 1989 se han reportado por nuestro grupo altas concentraciones de Pb en sangre (PbS) y As en orina (AsO) en los niños del lugar. En el presente estudio se generó un Programa de Comunicación Riesgos (PCR) para informar a los niños sobre los riesgos ambientales del sitio donde viven y que cambiaran conductas para disminuir la exposición al Pb y al As. Se trabajó con 170 niños (5 a 7 años) de la zona. Se aplicó el PCR y se realizó la evaluación mediante análisis de dibujos, cuestionarios y monitoreo biológico. En los dibujos de los niños se encontraron elementos tóxicos tales como el Pb, la tierra contaminada, entre otros. En los cuestionarios aplicados a los niños y a los padres de familia se pudo apreciar un cambio en los conocimientos y en algunas conductas respecto a los contaminantes, sus efectos y su exposición. No se encontró una disminución en los niveles de PbS ni de AsO. Esto quizás porque la principal ruta de exposición no es únicamente el suelo, como se había contemplado anteriormente.

A metallurgical industry in San Luis Potosí city, México, has contaminated the zone by lead (Pb) and arsenic (As). Since 1989 were reported by our group high concentrations of Pb in blood (PbB) and As in urine (AsU) in the local children. In present work, a Risk Communication Program (RCP) was generated to inform the children about the environmental risks of the site where they live, and to change conducts to diminish the exposure to Pb and As. We worked with 170 children (5 to 7 years) of the zone. The RCP was applied and the evaluation was realized by means of analysis of drawings, questionnaires and biological monitoring. In drawings of the children appeared toxic elements such as Pb, contaminated soil, cigarettes, among others. In the questionnaires applied to the children and family parents it was possible to estimate a change in the knowledge and in some conducts with regard to the pollutants, their effects and their exposure. There was not a decrease in the levels of PbB and in the levels of AsU. These were due probably because the principal route of exposure is not only the soil that had been contemplated previously.

Análisis de la percepción de la exposición a riesgos ambientales para la salud, en dos poblaciones infantiles, mediante la elaboración de dibujos / Analysis of the exposure perception to environmental health risks, in two children populations, by means of the elaboration of drawings

La exposición a contaminantes ambientales implica un riesgo para la salud, principalmente para la población infantil. Una estrategia de intervención puede ser un Programa de Comunicación de Riesgos (PCR). Para que un PCR sea efectivo es necesario conocer la percepción de la comunidad sobre la exposición a riesgos ambientales. El conocer la percepción de los niños es fundamental para el diseño de los PCR que serán implementados en cada comunidad. En este trabajo se utilizó el dibujo como una herramienta para conocer la percepción de los niños de una comunidad rural-indígena y de niños de una comunidad urbano-marginada. La actividad consistió en la formulación de dos preguntas, las cuales respondieron los niños por medio de la elaboración de un dibujo. Las preguntas se formularon para conocer la percepción en los escenarios dentro y fuera de la casa. Los resultados obtenidos indicaron que los niños perciben la mayoría de las problemáticas ambientales detectadas con anterioridad por nuestro grupo y se encontraron diferencias por comunidad. Además se encontró que algunos niños percibieron problemáticas que no habían sido detectadas por los investigadores.

The exposure to environmental pollutants implies a risk for health, mainly for the children population. A strategy of preventive intervention may be a Risks Communication Program (RCP). In order for a RCP to be carried out in an effective form, it is necessary to know the perception of the community about the exposure to environmental risks. Knowing children perception is essential for designing PCR to be implemented in each community. In this work the drawing was used as a tool to understand the perception of the children from a rural-indigenous community and from a marginalized urban community. The activity consisted on the formulation of two questions, which children answered sketching a drawing. The questions were formulated to know their perception in two sceneries: inside and outside their home. The obtained results indicated that the children perceive most of the environmental issues previously detected by our group and there were some differences between communities. In addition, it was found that some children perceived problems that had not been identified by the researchers.