Reclaiming the streets for people: Insights from Ciclovías Recreativas in Latin America.

The Ciclovías comprise worldwide programs in which streets are closed to motor-vehicles and open to individuals for leisure activities. Currently, 93% of the regular programs are in Latin American countries (LAC). The aims of this study were to describe the characteristics of regular Ciclovías in 7 LAC and to analyze the factors that influence the sustainability and scaling-up of five case studies. We conducted a survey of 67 Ciclovías in 2014-2015. In addition, we conducted semi-structured interviews with current and former program coordinators and reviewed policy documents from Ciclovías in 5 LAC. The greatest expansion of Ciclovías has occurred since 2000. The number of participants per event ranged from 40 to 1,500,000 (mean 41,399±193,330; median 1600), and the length ranged from 1 to 113.6km (mean 9.1±16.4; median 3). Ciclovía routes connect low-middle and high income neighborhoods (89.3%), and include the participation of minority populations (61.2%). The main complementary activity offered was physical activity (PA) classes (94.0%), and 80.0% of the programs included strategies to promote biking. All five case studies met definitions for sustainability and scaling-up. All programs shared some level of government support, alliances, community appropriation, champions, compatibility with the mission of the host organization, organizational capacity, flexibility, perceived benefits, and funding stability. However, they differed in operational conditions, political favorability, sources of funding, and number of alliances. The Ciclovías of LAC showed heterogeneity within their design and sustainability factors. Both their heterogeneity and flexibility to adjust to changes make them promising examples of socially inclusive programs to promote PA.

Start small, dream big: Experiences of physical activity in public spaces in Colombia.

Multi-sectoral strategies to promote active recreation and physical activity in public spaces are crucial to building a "culture of health". However, studies on the sustainability and scalability of these strategies are limited. This paper identifies the factors related to the sustainability and scaling up of two community-based programs offering physical activity classes in public spaces in Colombia: Bogotá's Recreovía and Colombia's "Healthy Habits and Lifestyles Program-HEVS". Both programs have been sustained for more than 10years, and have benefited 1455 communities. We used a mixed-methods approach including semi-structured interviews, document review and an analysis of data regarding the programs' history, characteristics, funding, capacity building and challenges. Interviews were conducted between May-October 2015. Based on the sustainability frameworks of Shediac-Rizkallah and Bone and Scheirer, we developed categories to independently code each interview. All information was independently analyzed by four of the authors and cross-compared between programs. Findings showed that these programs underwent adaptation processes to address the challenges that threatened their continuation and growth. The primary strategies included flexibility/adaptability, investing in the working conditions and training of instructors, allocating public funds and requesting accountability, diversifying resources, having community support and champions at different levels and positions, and carrying out continuous advocacy to include physical activity in public policies. Recreovía and HEVS illustrate sustainability as an incremental, multi-level process at different levels. Lessons learned for similar initiatives include the importance of individual actions and small events, a willingness to start small while dreaming big, being flexible, and prioritizing the human factor.

Testigos modestos y poblaciones invisibles en la cobertura de la genética humana en los medios de comunicación colombianos / Modest witnesses and invisible populations in media coverage of human genetics in Colombia / Testemunhas modestas e populações invisíveis na cobertura da genética humana na mídia colombiana

En este artículo exploramos cómo los medios de comunicación colombianos configuran la práctica de la genética humana, reproduciendo ciertos discursos estandarizados sobre ciencia que se encuentran atravesados por el género y la raza. Para este fin llevamos a cabo un análisis etnográfico de la cobertura de la genética humana (poblacional y forense) en dos de los medios de mayor penetración en el país en los periodos de 1992-2006 (periódico) y 2009-2010 (periódico y noticiero). Nuestro argumento es que por una parte, los medios de comunicación presentan a la ciencia genética como única/uniforme/objetiva/neutra/heroica. Por otro lado, presenta sujetos que son simultáneamente marcados y desmarcados en términos de raza, género, clase y geografía. Concluimos que este último mecanismo reproduce y moviliza la idea del mestizaje como una ideología de construcción de nación.

In this paper we explore the ways in which mass media present -and co-produce- human genetic research in Colombia, reproducing certain standardized discourses about science which are cross-cut by gender and race. For this, we conducted an ethnographic analysis of media coverage of human genetics (both population and forensic) in two of the major media in Colombia between 1992-2006 (newspaper) and 2009-2010 (TV news). Our argument is two-fold. First we show that media present genetic science as unique/uniform/objective/neutral/heroic. Second, media present subjects as simultaneously marked and unmarked in terms of race, gender, class, and geography. We conclude by arguing that this mechanism reproduces and mobilizes the ideal of mestizaje as a nation-building ideology in Colombia.

Neste artigo apresenta-se a forma como a mídia colombiana configura a prática da genética humana por meio da reprodução de discursos padronizados de ciência que são atravessados pelo gênero e a raça. Para isso, realizamos uma análise etnográfica da cobertura da genética humana (de populações e forense) no principal jornal impresso e no maior telejornal do país nos períodos 1992-2006 (jornal) e 2009-2010 (jornal e telejornal). Nosso argumento é de que, por um lado, a mídia apresenta a ciência da genética como única/uniforme/objetiva/neutra/heróica. Do outro, apresenta sujeitos que são marcados e desmarcados em termos de raça, gênero, classe e geografia. Como conclusão, aponta-se que o último mecanismo reproduz e mobiliza a ideia da mestiçagem como uma ideologia de construção da nação.

Social representations of human papillomavirus in Bogotá, Colombia.

Identifying DNA of Human papillomavirus (HPV) has been proposed as a new screening method for cervical cancer control. Conventionally, health education for screening programs is based on scientific information without considering any community cognitive processes. We examine HPV social representations of 124 men and women from diverse educational status living in Bogotá, Colombia. The social representation of HPV involves a series of figurative nuclei derived from meanings linked to scientific information. While women focused on symbols associated to contagion, men focused on its venereal character. Figurative nuclei also included long-term uncertainty, need or urgent treatment, and feelings of imminent death associated with cancer and chronic sexually transmitted infections. The social representation of HPV impeded many participants from clearly understanding written information about HPV transmission, clearance, and cancer risk; they are built into a framework of values, which must be deconstructed to allow women full participation in HPV screening programs.

Translating evidence to policy: urban interventions and physical activity promotion in Bogotá, Colombia and Curitiba, Brazil.

The growing evidence of the influence of urban environment on physical activity (PA) underscore the need for novel policy solutions to address the inequality, lack of space, and limited PA resources in rapidly growing Latin American cities. This study aims to better understand the PA policy process by conducting two case studies of Bogotá's Ciclovía and Curitiba's CuritibAtiva. Literature review of peer- and non-peer-reviewed documents and semi-structured interviews with stakeholders was conducted. In the cases of Ciclovía and CuritibAtiva, most policies conducive to program development and sustainability were developed outside the health sector in sports and recreation, urban planning, environment, and transportation. Both programs were developed by governments as initiatives to overcome inequalities and provide quality of life. In both programs, multisectoral policies mainly from recreation and urban planning created a window of opportunity for the development and sustainability of the programs and environments supportive of PA.

Quality of life, physical activity, and built environment characteristics among colombian adults.

BACKGROUND: Studies assessing the association between health-related quality of life (HR-QOL) with physical activity (PA) and built environment (BE) characteristics are limited. METHODS: A cross-sectional study was conducted among 1,334 adults from Bogotá, to assess the associations between HR-QOL with PA and BE characteristics. HR-QOL was measured using the World Health Organization and the Centers for Disease Control and Prevention instruments. PA was measured using the International PA Questionnaire. BE characteristics included the dimensions of density, diversity, design, and access to mass-transit. Analysis included multilevel modeling. RESULTS: Adults who reported meeting PA recommendations and participating in the Ciclovía were more likely to have a high mean score of HR-QOL and were more likely to perceive their health status as good/excellent. Adults who reported biking for transportation were more likely to have a high mean score of HR-QOL. Regarding BE characteristics, land-use heterogeneity was associated with HR-QOL, perceived good health status and being positive about the future. Park density was associated with HR-QOL, perceived health status good/excellent and being positive about the future. Mass-transit stations availability was negatively associated with HR-QOL. CONCLUSION: This study provides preliminary evidence that HR-QOL is associated with PA and BE characteristics among adults in an urban setting of the developing world.

Efectos psicológicos y sociales que genera la prueba del virus del papiloma humano: un estudio exploratorio / An Exploratory Study of the Psychological and Social Effects of the Human Papilloma Virus Test

Objetivo: Presentar los efectos psicológicos y sociales que tuvieron las mujeres, residentes en Bogotá, sometidas a la prueba de ADN del VPH, y la manera como los médicos comunican los riesgos a sus pacientes. Métodos: Estudio cualitativo fenomenológico. Se realizaron 10 entrevistas semiestructuradas con mujeres que se practicaron la prueba ADN-VPH. Así mismo, se hicieron dos grupos focales: uno con médicos generales y otro con ginecólogos. Finalmente se hizo un análisis de contenido. Resultados: El impacto psicosocial se ha clasificado en tres categorías: en la esfera emocional, en la vida sexual y de pareja y en el comportamiento. Se diseñó un modelo de los determinantes de la magnitud de los efectos. Este modelo está determinado por la forma y el contenido de la información que suministra el médico y por las características biográficas de la mujer. Los efectos encontrados fueron ansiedad, rabia, vergüenza, culpa, zozobra por la demora de los resultados, miedo al cáncer y temor a tener relaciones sexuales. Conclusiones: La razón para practicar la prueba no debe ser promovida por el miedo al cáncer, sino por las características de la infección y la convicción sobre los beneficios de la prueba. Se debe promover una reflexión anticipada de la trayectoria de riesgos que se pueden presentar en el futuro utilizando como técnica de comunicación la toma de decisiones de manera concertada.

Objective: To present the psychological and social effects of DNA and HPV exams among women resident in Bogotá; and, the means by which physicians communicate risks to patients. Ten, semi-structured interviews were carried out among women who underwent HPV-DNA examination. Simultaneously, two focus groups were set up: one with general practitioners and the other with gynecologists. Content analysis took place. Methods: Qualitative study with a phenomenological perspective. Ten semi-structured interviews were conducted with women who underwent HPV testing. Two focus groups were carried out with gynecologists and medical practitioners. A content analysis was performed. Results: Psychosocial impact has been classified into three categories: emotional; sex life and partner relationship; and, behavior. A model was designed to measure the magnitude of the effects of these determinants. This model is based upon the form and content of the information provided by physicians and by women´s biographical data. The effects encountered included: anxiety, rage, shame, guilt, panic at delayed results, fear of cancer, and fear of sexual relations. Conclusions: The reasoning to undergo examination should not be based upon fear, but rather on knowledge of infection symptoms and the conviction that the examination is beneficial. Thinking about risk trajectories should play a relevant part in the communication process based on the concept of concerted decision-making.

Prevalence of multiple sclerosis in Bogotá, Colombia.

Among Latin American countries, Colombia is considered a low-risk area for multiple sclerosis (MS) and no studies on MS prevalence have been conducted in any of the country's large urban settings. To fill this gap and assess the prevalence of MS in Bogotá as of December 31, 2002, this study reviewed the clinical records of patients diagnosed with MS in most Bogotá hospitals. This review produced a sample of 296 patients with an MS diagnosis whose reliability was verified by a neurologist with expertise in MS. The total prevalence rate identified for December 2002 was 4.41/100,000 inhabitants (95% CI 3.9-4.9), including a rate of 5.98/100,000 (95% CI 5.2-6.8) for women and 2.71/100,000 (95% CI 2.2-3.3) for men (differences measured at p < 0.001). The prevalence estimates for Bogotá, confirm the city's status as a low-risk area for MS.