Perceived barriers and facilitators to healthy eating among Pakistani women participating in the PakCat program in Catalonia: A qualitative approach.

Immigrant women of Pakistani origin are among the most at-risk groups for type 2 diabetes, obesity, and heart failure in Catalonia. As the incidence of these diseases is associated with lifestyle factors, we approached this community with participatory research and conducted six focus groups (N = 36) among Pakistani women participating in the PakCat Program. The research process of this paper adhered to the COREQ checklist. Through the thematic analysis, we identified six main themes: social beliefs and attitudes, family environment, personal factors, dietary acculturation, traditional dietary patterns, and economic factors. We discovered both facilitators and barriers associated with each theme, but the findings indicated that Pakistani women encounter more inhibitors than enablers to following a healthy diet. The determination of these factors can facilitate the reinforcement of the aspects that help Pakistani women to follow a healthy diet and provide adequate tools to overcome the barriers.

Measurement of availability and accessibility of food among youth: a systematic review of methodological studies.

BACKGROUND: Comprehensive and psychometrically tested measures of availability and accessibility of food are needed in order to explore availability and accessibility as determinants and predictors of dietary behaviors. The main aim of this systematic review was to update the evidence regarding the psychometric properties of measures of food availability and accessibility among youth. A secondary objective was to assess how availability and accessibility were conceptualized in the included studies. METHODS: A systematic literature search was conducted using Medline, Embase, PsycINFO and Web of Science. Methodological studies published between January 2010 and March 2016 and reporting on at least one psychometric property of a measure of availability and/or accessibility of food among youth were included. Two reviewers independently extracted data and assessed study quality. Existing criteria were used to interpret reliability and validity parameters. RESULTS: A total of 20 studies were included. While 16 studies included measures of food availability, three included measures of both availability and accessibility; one study included a measure of accessibility only. Different conceptualizations of availability and accessibility were used across the studies. The measures aimed at assessing availability and/or accessibility in the home environment (n = 11), the school (n = 4), stores (n = 3), childcare/early care and education services (n = 2) and restaurants (n = 1). Most studies followed systematic steps in the development of the measures. The most common psychometrics tested for these measures were test-retest reliability and criterion validity. The majority of the measures had satisfactory evidence of reliability and/or validity. None of the included studies assessed the responsiveness of the measures. CONCLUSIONS: The review identified several measures of food availability or accessibility among youth with satisfactory evidence of reliability and/or validity. Findings indicate a need for more studies including measures of accessibility and addressing its conceptualization. More testing of some of the identified measures in different population groups is also warranted, as is the development of more measures of food availability and accessibility in the broader environment such as the neighborhood food environment.

[Design and validation of a questionnaire to assess the level of general knowledge on eating disorders in students of Health Sciences]. / Diseño y validación de un cuestionario para evaluar el nivel de conocimientos generales en trastornos del comportamiento alimentario en estudiantes de ciencias de la salud.

OBJECTIVE: To design and validate a questionnaire to assess the level of knowledge regarding eating disorders in college students. DESIGN: Observational, prospective, and longitudinal study, with the design of the questionnaire based on a conceptual review and validation by a cognitive pre-test and pilot test-retest, with analysis of the psychometric properties in each application. LOCATION: University Foundation of Bages, Barcelona. Marco community care. PARTICIPANTS: A total of 140 students from Health Sciences; 53 women and 87 men with a mean age of 21.87 years; 28 participated in the pre-test and 112 in the test-retests, 110 students completed the study. MAIN MEASUREMENTS: Validity and stability study using Cronbach α and Pearson product-moment correlation coefficient statistics; relationship skills with sex and type of study, non-parametric statistical Mann-Whitney and Kruskal-Wallis tests; for demographic variables, absolute or percentage frequencies, as well as mean, central tendency and standard deviation as measures of dispersion were calculated. The statistical significance level was 95% confidence. RESULTS: The questionnaire was obtained that had 10 questions divided into four dimensions (classification, demographics characteristics of patients, risk factors and clinical manifestations of eating disorders). The scale showed good internal consistency in its final version (Cronbach α=0.724) and adequate stability (Pearson correlation 0.749). CONCLUSIONS: The designed tool can be accurately used to assess Health Sciences students' knowledge of eating disorders.

Effectiveness of Culinary Nutrition Workshops on the Mood and Nutritional Interest of Inpatients With Mental Disorder.

Background Promoting healthy eating habits through nutrition education programs is crucial to improving the overall health of people with mental disorders. This study aims to assess the effectiveness of culinary nutrition workshops on the mood and nutritional interest of hospitalized adults with mental disorders (MD) from the acute psychiatric unit of two general hospitals in Catalonia, Spain. Methods A pilot randomized control trial (RCT) was conducted with MD inpatient. Participants were randomly assigned to two groups: the intervention group received weekly culinary nutrition workshops with flexible participation and the control group continued routinary care. The interest in nutrition was analysed with an ad hoc item pre and post-intervention period. Mood changes were studied with a visual analog scale and analysed pre- and post-intervention periods as well as before and after every session. An ad hoc questionnaire was also used to assess the satisfaction of participants with the intervention. The obtained data were analysed at both descriptive and inferential levels. Results We included 81 participants, with a mean age of 45.3 (SD: 17.0); 66.7% were women, with 41 assigned to the intervention group and 40 to the control group. At the end of every culinary nutrition workshop, a statistically significant improvement in mood was observed in the intervention group (5.9 vs. 7.4 points, p<0.001). However, there were no significant differences in mood changes between the control and intervention groups after the intervention period (control group: 1.0 vs. intervention group: 1.5, p=0.473), while the nutritional interest was significantly improved after the intervention period intergroups (control group: 4.1 vs. intervention group: 37.2, p<0.001). The intervention was excellently valued by the participants regarding content, space, and health professionals, and generated interest and motivation, with scores above 9 on all these items. Conclusion The improvement of interest in nutrition and the satisfaction of hospitalised people with MD with the nutrition culinary workshops emphasize the need to design more comprehensive RCTs in hospitals and rehabilitation centers.

The relationship between subjective well-being and food: a qualitative study based on children's perspectives.

PURPOSE: Despite the lack of consensus regarding which life satisfaction domains should be included in the study of children's subjective well-being (SWB), some domains are frequently considered, such as satisfaction with health. However, some others, such as satisfaction with food, are barely taken into account, despite the impact eating habits have on children's health and well-being. We adopt a qualitative approach to explore the role food plays in children's SWB, providing for a more in-depth analysis of children's perceptions and evaluations on a still insufficiently known domain of life satisfaction. METHOD: Sixteen discussion groups were held with 112 Spanish students (10-12 years old) from six schools. The transcripts were analy sed and themes reflecting the key concepts were defined using reflexive thematic analysis. RESULTS: Five themes emerged from the children's discourses on the relationship between food and SWB: health, pleasure, emotions, commensality-i.e., eating together-and food-empowerment-thus offering new insights from children's perspectives. CONCLUSION: Almost all of the participants established a relationship between their SWB and their eating behaviour, meaning that, within the challenges facing public health, SWB must be taken into account when promoting healthy eating programmes for children. Also, group discussion is found to be a very powerful tool for exploring topics with subjective connotations among child populations.

Design of Culturally and Linguistically Tailored Nutrition Education Materials to Promote Healthy Eating Habits among Pakistani Women Participating in the PakCat Program in Catalonia.

(1) Background: Pakistani women are among one of Catalonia's most affected groups by obesity and cardiovascular disease. The design of health education strategies for them has become a compelling need. This paper aims to enlighten the elaboration and evaluation procedure of culturally and linguistically tailored nutrition education materials for Pakistani women participating in the PakCat Program, which aims to evaluate the efficacy of a nutrition education strategy allowing the participants to become ambassadors of healthy eating habits for their community. (2) Methods: In this Randomised Control Trial (RCT), 137 Pakistani women (70 from the intervention and 67 from the control group) took part. We conducted 10 sessions for the intervention group and 3 sessions for the control group in the form of small groups. The sessions were conducted in Urdu and Punjabi, and the material was translated into Urdu, Catalan, Spanish and English. For some sessions, we elaborated on new materials and for others, we adapted them from the existing nutrition material in aspects of language and culture. We evaluated the nutritional material from the observation carried out by the dietician who developed the sessions, participants' feedback at the end of the sessions and a satisfaction questionnaire. (3) Results: We summarised the elaborated material in form of two multilingual nutritional guidelines about portion size and heart-healthy foods. We also registered several materials generated for the PakCat program such as an infographic about myths and beliefs related to food, a booklet to read and interpret the food labels, a recipe book for healthy snacks, and an infographic of 10 tips for healthy eating. We also organised a PhotoVoice exhibition of 70 healthy plates elaborated by the intervention group participants. The participants highly appreciated the material in terms of visualization, cultural and linguistic adequacy, and level of comprehension through all three evaluation methods. (4) Conclusions: The design of culturally and linguistically tailored nutrition education material for Pakistani women living in Catalonia is attainable and effective to meet their specific needs. The healthy dietary recommendation can be adapted to them preserving their traditional dietary pattern, and they acquire the confidence to start following a healthy diet.

Pakistani Women: Promoting Agents of Healthy Eating Habits in Catalonia-Protocol of a Culturally and Linguistically Appropriate Randomized Control Trial (RCT) Based on the Transtheoretical Model.

(1) Introduction: Dietary and lifestyle changes along with the cultural and linguistic barriers convert the immigrant women of Pakistani origin into a risk population for developing metabolic syndrome (MetS) and cardiovascular diseases (CVD). The objective of this project is to evaluate the efficacy of a culturally and linguistically appropriate food education program based on the Transtheoretical model that will allow the participants to become ambassadors of healthy eating habits for their community. (2) Methods: In this community-based RCT, any Pakistani adult woman with residence in Badalona and Santa Coloma de Gramenet will be able to participate. We will use a mixed model approach. From the quantitative perspective, the participants will answer a survey accompanied by a multilingual nutritionist that will help us to determine the sociodemographic, clinical, anthropometric, dietary data, and quality of life. From the qualitative perspective, we will conduct 6 focus groups (3 in each municipality) to determine the cultural and religious beliefs with the aim of tailoring the intervention to the target population. Hereafter, the participants from one municipality will randomly become the control group and from the other, the intervention group. The intervention group will participate in 10 weekly food education sessions based on the Transtheoretical model while the control group will receive 3 general educational sessions on food and health. During the evaluation procedure, we will assess the impact of the intervention considering the outcomes of the study. (3) Discussion: This study will establish intercultural bridges between health professionals and the Pakistani community living in Catalonia. The project will open the door for future interventions, and it will be sustainable in time as the participating women will become health promotion agents for the rest of their community.

Metabolic impact of a nutrition education program for the promotion of fruit and vegetable consumption with people with severe mental disorders (DIETMENT).

OBJECTIVES: The aim of this study is to determine the metabolic impact of a nutrition education program on metabolic parameters and the presence of metabolic syndrome (MetS). RESULTS: Seventy-four patients were included (mean age, 48.7 years [Standard deviation, SD: 10.8], 55.4% men). The diagnoses of SMD were 37.8% schizophrenia and related disorders; 29.7% bipolar disorder; 25.7% depressive disorder; 4.1% personality disorders; and 2.7% obsessive compulsive disorders. Thirty-seven individuals were distributed in both the intervention group (IG) and the control group (CG). In the IG the presence of MetS was 56.3% and in the CG 46.7%, with no statistically significant difference (p = 0.309). At the end of the study, glomerular filtrate decreased in the IG, body mass index and abdominal perimeter increased in both groups, and there were no changes in metabolic parameters between the groups. Between the baseline and the end of the study, there was no increase in the number of patients diagnosed with MetS (14 at both points); and in the CG the increase was from 8 to 12 (p = 0.005). An intervention based on fruit and vegetable intake could prevent progression to MetS in individuals with SMD, decreasing the likelihood of cardiovascular disease. Trial registration The trial was retrospectively registered on International Standard Randomised Controlled Trial Number (ISRCTN) Register on 11 March 2022 (ISRCTN12024347).

Applying the Stages of Change Model in a Nutrition Education Programme for the Promotion of Fruit and Vegetable Consumption among People with Severe Mental Disorders (DIETMENT).

Despite growing evidence of the benefits of adequate intake of fruit and vegetables (F&V) and the recommendation to consume five servings daily, the adoption of these habits is poor among people with severe mental disorder (SMD). The main aim of the present study is to determine changes in the intake of F&V and motivation to do so among people with SMDs after participating in a food education programme. A community-based randomized controlled trial was conducted in Spain, with the intervention group (IG) participating in a food education programme based on the stages of change model to promote consumption of F&V and the control group (CG) receiving three informative sessions on basic healthy eating. The main outcomes were related to the intake of F&V and stages of change. Data collection was performed at baseline, post intervention, and 12-month follow-up. Seventy-four participants enrolled in the study and sixty completed the 12-month follow-up. An increase in motivation towards the intake of F&V was observed in the IG but not in the CG (McNemar's test p = 0.016, p = 0.625). No significant difference was observed for the intake of fruit, vegetables, or F&V. Basing food education strategies on the stages of change model shows positive results, increasing the awareness and disposition of people with SMD towards the intake of F&V. More research is needed to identify the most appropriate eating intervention to increase the intake of F&V.

[Cardiac insufficiency-failure and life quality]. / Insuficiencia cardiaca y calidad de vida.

Cardiac insufficiency-failure is a chronic cardiovascular disease whose prevalence, incidence, mortality rate and health system costs are increasing. Patients suffering from cardiac insufficiency-failure have co-life-threatening risks which lead to severe limitations in daily activities and decrease their perception of living a quality lifestyle. Their evaluation helps to plan out future treatment and serves to predict their response to treatment. Many patients give more importance to their lifestyle quality rather than their lifespan. In this review, the authors describe the variables which affect the life quality of patients who suffer cardiac insufficiency-failure and what are the instruments more commonly employed. The authors ran a bibliographical search on Medline and Cuiden. The authors analyze five articles; they prioritize publication date, distinct magazines, study sector source of each article and the diverse profession the authors of each article has.

Is the integration of nutritional care in the different assistance levels possible? The Catalan experience. Clinical perspective / ¿Podemos integrar la asistencia nutricional en los distintos niveles asistenciales? La experiencia catalana. Visión del clínico.

Disease-related malnutrition is highly prevalent in pathologies commonly integrating care complexity. Healthcare models for complexity must include malnutrition detection and approaches, since it is a key factor which has great impact on the patient's evolution and the consumption of healthcare resources. Malnourished patients present higher hospitalization, complication and mortality rates, higher demand of post-discharge social resources and higher hospital readmission frequency. Detecting malnutrition is necessary to implement a nutritional care program which might be used in any assistance level. The integration of health and social care and the development of information tools which are shared by the different assistance agents has allowed the development of a program for the management of disease-related malnutrition in patients with clinical complexity in Catalonia.