Mapeamento de intervenções para redução do estigma da obesidade em profissionais de saúde: desenvolvimento e apresentação da intervenção / Mapping interventions to reduce obesity stigma in healthcare professionals: development and presentation of the intervention

Resumo O estigma da obesidade, também popularmente chamado de gordofobia, é uma realidade atual e sua superação é um desafio complexo. As concepções negativas acerca do excesso de peso também se encontram presentes entre profissionais de saúde, prejudicando a assistência prestada e trazendo danos ainda maiores na saúde de pacientes com obesidade. O objetivo do artigo é apresentar o processo de desenvolvimento de uma intervenção para redução do estigma da obesidade voltada para profissionais de saúde, que utilizou como referencial teórico o protocolo Mapeamento de Intervenções. Descreveu-se como foi realizada a avaliação de necessidades e detalharam-se as etapas referentes ao desenho e à produção da intervenção, tendo como produto final um protocolo de intervenção para redução do estigma da obesidade em profissionais de saúde pronto para ser implementado. O protocolo tem carga horária total de 20h, organizado em dez módulos, cada um com a descrição do formato e duração, objetivo, conteúdo, estratégias pedagógicas, materiais, referências e resultados esperados. O produto final representa uma contribuição para a área de saúde, que tem a intervenção elaborada minuciosamente sobre um arcabouço teórico, passível de ser aplicada e reaplicada em diferentes contextos.

Abstract The stigma of obesity, also popularly called fatphobia, is a current reality and overcoming it is a complex challenge. Negative conceptions about being overweight are also present among health professionals, compromising the care provided and causing even greater damage to the health of obese patients. The article aims to present the process of developing an intervention to reduce the stigma of obesity aimed at health professionals, which used the Intervention Mapping protocol as a theoretical framework. It was described how the needs assessment was carried out and the steps relating to the design and production of the intervention were detailed, with the final product being an intervention protocol to reduce the stigma of obesity in healthcare professionals ready to be implemented. The protocol has a total workload of 20 hours, organized into ten modules, each with a description of the format and duration, objective, content, pedagogical strategies, materials, references and expected results. The final product represents a contribution to the health area, with the intervention being meticulously elaborated on a theoretical framework, capable of being applied and reapplied in different contexts.

Development and validation of a logic model for comprehensive medication management services.

OBJECTIVES: To develop and validate a theoretical logic model for comprehensive medication management (CMM) services. METHODS: The components of a logic model were constructed after a literature review and interviews with 4 CMM professionals. To validate the logic model, a panel of 17 CMM experts participated in three online Delphi method rounds to achieve consensus on the model. The consensus between the experts on each component of the logic model was evaluated using the Content Validity Index and Inter-rater Agreement in each of the rounds. KEY FINDINGS: A logic model for CMM services containing 51 items was constructed and validated. Both the items of each component of the model and the linkage between the main components were agreed upon among the experts. CONCLUSIONS: A logic model for CMM services was developed and validated. It is an innovative tool that, if used as a theoretical framework for the implementation of CMM, can ensure greater reproducibility of CMM services in different scenarios of practice and levels of care.

Logical model of a behavior change program for community intervention ­ Active Life Improving Health ­ VAMOS / Modelo Lógico do programa Vida Ativa Melhorando a Saúde ­ VAMOS

The present study aimed to present a Logic Model (LM) of the "Vida Ativa Melhorando a Saúde" (VAMOS ­ Active Life Improving Health) program for its application in community interventions in adults and old age in Brazil. The VAMOS program purpose is to motivate people to have a healthier lifestyle. It is divided in 12 group meetings usually held weekly, varying from three to five months of duration. VAMOS is guided by specific booklets and conducted by health professionals with prior certification. The LM consists of activities (advertising, meetings, community outreach), products (financial resources, promotion, increase in attendance) and short, medium and long term objectives (adoption of the program, knowledge and empowerment of participants). Participants of the VAMOS program maintained their physical activity levels for longer when compared with traditional and control groups. VAMOS is under expansion in Brazil, supporting behavior changes in order to reach a healthier lifestyle.

O objetivo deste estudo foi apresentar o Modelo Lógico (ML) do programa Vida Ativa Melhorando a Saúde (VAMOS) para sua aplicação em intervenções comunitárias em adultos e idosos com o objetivo de motivá-los a adotarem um estilo de vida saudável. O VAMOS é desenvolvido em 12 encontros presenciais, com apoio de livretos, ocorrendo uma vez por semana, com duração prevista de três a cinco meses e conduzido por profissionais certificados. No ML estão presentes as atividades realizadas (publicidade, reuniões, alcance), os produtos (recursos financeiros, divulgação) e objetivos em curto, médio e longo prazos (adoção do programa, conhecimento e autonomia para um estilo de vida ativo). Os participantes do VAMOS têm mantido os níveis de atividade física por mais tempo quando comparados aos do grupo de exercícios físicos e de controle. O VAMOS está em expansão no país favorecendo mudanças de comportamento em busca de um estilo de vida mais saudável.

Using a participatory evaluation design to create an online data collection and monitoring system for New Mexico's Community Health Councils.

We present the collaborative development of a web-based data collection and monitoring plan for thirty-two county councils within New Mexico's health council system. The monitoring plan, a key component in our multiyear participatory statewide evaluation process, was co-developed with the end users: representatives of the health councils. Guided by the Institute of Medicine's Community, Health Improvement Process framework, we first developed a logic model that delineated processes and intermediate systems-level outcomes in council development, planning, and community action. Through the online system, health councils reported data on intermediate outcomes, including policy changes and funds leveraged. The system captured data that were common across the health council system, yet was also flexible so that councils could report their unique accomplishments at the county level. A main benefit of the online system was that it provided the ability to assess intermediate, outcomes across the health council system. Developing the system was not without challenges, including creating processes to ensure participation across a large rural state; creating shared understanding of intermediate outcomes and indicators; and overcoming technological issues. Even through the challenges, however, the benefits of committing to using participatory processes far outweighed the challenges.