Validation of the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services among Colombian adolescents. / Validación de la versión en español del Rapid Assessment for Adolescent Preventive Services en adolescentes colombianos.

Seventy percent of adolescent morbidity and mortality is related to six risky behaviors. The Rapid Assessment for Adolescent Preventive Services is a screening questionnaire consisting of 21 questions but there is not a validated Spanish-language version. The obj ective of this study was to validate the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services in two Colombian cities: Bucaramanga and Medellin. The questionnaire was administered to 270 randomly selected adolescent students aged between 11 and 19 years old. Its internal consistency measured using Cronbach's alpha was 0.7207. The factor analysis showed that two factors accounted for 84.5% of variance, but factor loading indicates that only one of these is valid in Colombia: substance use (tobacco, alcohol, narcotics, and psychoactive substances).

La morbilidad y mortalidad en adolescentes, en un 70%, está relacionada con seis comportamientos de riesgo. El Rapid Assessment for Adolescent Preventive Services es un cuestionario de pesquisa, que consta de 21 preguntas, del que existe una versión en español, no validada. El objetivo de este trabajo fue validar la versión en español del Rapid Assessment for Adolescent Preventive Services en dos ciudades colombianas (Bucaramanga y Medellin). Se aplicó el cuestionario a 270 adolescentes escolarizados de 11-19 años seleccionados al azar. El alfa de Cronbach de fiabilidad interna fue de 0,7207. En el análisis de factores, se encontraron dos, que explican el 84,5% de la varianza, pero la carga factorial señala que solo uno de ellos es válido en Colombia, el consumo de sustancias (tabaco, alcohol, narcóticos y sustancias psicoactivas).

Type of Insurance and Use of Preventive Health Services Among Older Adults in Mexico.

OBJECTIVE: The main purpose of this article was to assess the differences between Seguro Popular (SP) and employer-based health insurance in the use of preventive services, including screening tests for diabetes, cholesterol, hypertension, cervical cancer, and prostate cancer among older adults at more than a decade of health care reform in Mexico. METHOD: Logistic regression models were used with data from the Mexican Health and Nutrition Survey, 2012. RESULTS: After adjusting for other factors influencing preventive service utilization, SP enrollees were more likely to use screening tests for diabetes, cholesterol, hypertension, and cervical cancer than the uninsured; however, those in employment-based and private insurances had higher odds of using preventive care for most of these services, except Pap smears. DISCUSSION: Despite all the evidence that suggests that SP has increased access to health insurance for the poor, inequalities in health care access and utilization still exist in Mexico.

Colorectal cancer screening in the framework of the medical home model: findings from focus groups and interviews.

A recent report from a survey of 15 primary care practices revealed considerable variability and much room for improvement in aspects of primary care practice that are associated with increased colorectal cancer screening rates. There was low utilization of patient reminders, tracking of test completion, rescheduling of missed appointments, and inconsistent follow-up of positive stool blood tests. Qualitative data collected in the same study provide insights into how the practices operated. Focus group discussions with the clinicians and staff of the practices and key informant interviews with office managers support the survey findings by shedding light on a lack of office policies and systems. Many practices lacked a systematic way to identify patients who were not up to date on screening while they were visiting the practice, thereby passing up the best opportunity to reach them. These findings are not consistent with the patient-centered medical home model.