Designing an Effective Front-of-Package Warning Label for Food and Drinks High in Added Sugar, Sodium, or Saturated Fat in Colombia: An Online Experiment.

Policies to require warnings on the front of food and drinks high in nutrients of concern (e.g., added sugar, sodium, or saturated fat) are becoming increasingly common as an obesity prevention strategy. Colombia, a country with growing prevalence of obesity, is considering implementing a similar policy. The objective of this study was to assess perceptions and reactions to different warning designs. We conducted a randomized experiment in an online panel of adults age > 18y (n = 1997). Participants were randomized to view one of four labels: a control label (barcode), an octagon warning, a circle warning, and a triangle warning. Participants viewed their randomly assigned label on a series of products and answered questions (continuous outcomes ranged from 1-4). Compared to the control, all warnings led to higher perceived message effectiveness (increase in mean from 1.79 in the control to 2.59-2.65 in the warning conditions, p < 0.001), a higher percentage of participants who correctly identified products high in nutrients of concern (from 48% in the control condition to 84-89% in the warning conditions, p < 0.001), and reduced intentions to purchases these products (decrease in mean from 2.59 to 1.99-2.01 in the warning conditions, p < 0.001). Relative to the control, warnings performed similarly across education levels, suggesting this policy would be equitable in Colombia. Looking at differences by warning type, the pattern of results suggested that the octagon warnings performed best. After viewing all label types, 49% of participants selected the octagon warning as the one that most discouraged them from consuming products high in nutrients of concern, while 21% and 27% selected the circle and triangle warning. Colombian policymakers should consider the octagon warning as part of a front-of-package labeling policy to help consumers identify and reduce consumption of foods and drinks high in nutrients of concern.

Propuesta para la formación en Medicina Familiar y Comunitaria, desde la percepción, conceptualización y experiencia práctica de los enfoques de Salud Familiar / Proposal for training in Family and Community Medicine, from the perception, conceptualization and practical experience of Family Health approaches / Proposta de formação em Medicina Familiar e Comunitária, a partir da percepção, conceituação e experiência prática de abordagens de Saúde Familiar

Resumen La existencia de un Plan Decenal de Salud Pública para Colombia y la definición de una Política de Atención Integral en Salud concretaron un nuevo Modelo de Atención basado en la Atención Primaria de la Salud. Esto ubicó a la Salud Familiar y Comunitaria como núcleo fundamental y definió un rol al Médico y al Profesional Familiar y Comunitario, que dimensiona los procesos transdisciplinarios y la articulación de acciones individuales y colectivas, con esquemas pedagógicos holísticos transformadores. Este planteamiento generó un análisis y reflexión de la opinión de una muestra del 14,6% de los clasificados como Salubristas por el Observatorio Laboral del Ministerio de Educación quienes, con la respuesta a 13 preguntas enviadas por vía electrónica, libremente plantearon su percepción, conceptualización y experiencia práctica de los enfoques de Salud Familiar y Comunitaria. Con esta medición se definieron los contenidos básicos que se presentan en este documento con un nuevo enfoque transversal en el Pregrado y los Posgrados, de acuerdo con una propuesta pedagógica transformadora y con visión práctica, encontrándose aquí como destacable, la importante relación entre la educación y la salud integral; el concepto que en el 80% de las observaciones se expresó al denominar el poco compromiso de la comunidad y los profesionales de la salud con una "Cultura de la Salud Integralmente Concebida".

Abstract The existence of a Decennial Public Health Plan for Colombia and the definition of a Comprehensive Health Care Policy concretized a new Model of Care based on Primary Health Care. This placed Family and Community Health as a fundamental nucleus and defined a role for the Family and Community Physician and Practitioner, who dimension the transdisciplinary processes and the articulation of individual and collective actions, with transformational holistic pedagogical schemes. This approach generated an analysis and reflection of the opinion of a sample of 14.6% of those classified as Salubristas by the Labor Observatory of the Ministry of Education who, with the answer to 13 questions sent electronically, freely raised their perception, conceptualization and practical experience of Family and Community Health approaches. With this measurement the basic contents that are presented in this document with a new transversal approach in the Undergraduate and Postgraduates were defined, according to a pedagogical proposal transforming and with practical vision, being here like remarkable, the important relation between the education and integral health; the concept that in 80% of the observations was expressed when denominating the little commitment of the community and the professionals of the health with an "Culture of the Health Integrally Conceived".

Resumo A existência de um Plano de Saúde Pública de dez anos para a Colômbia ea definição de uma Política Integral de Saúde resultou em um novo Modelo de Cuidados Baseado em Atenção Primária à Saúde. Isso colocou a Familia e a Saúde Comunitária como um núcleo fundamental e definiu um papel para o Médico e o Profissional Familiar e Comunitário, que dimensiona os processos transdisciplinares e a articulação de ações individuais e coletivas, com esquemas pedagógicos transformadores holísticos. Esta abordagem gerou uma análise e reflexão da opinião de uma amostra de 14,6% das classificadas como Salubristas pelo Observatório do Trabalho do Ministério da Educação que, com a resposta a 13 questões enviadas eletronicamente, aumentou livremente sua percepção, conceituação e experiência prática de abordagens de saúde familiar e comunitária. Com esta medida, os conteúdos básicos apresentados neste documento foram definidos com um novo foco transversal em Estudos de Graduação e Pós-Graduação, de acordo com uma proposta pedagógica transformadora e com uma visão prática, sendo aqui a relação notável entre educação e saúde abrangente; o conceito de que em 80% das observações foi expressado chamando o pequeno compromisso da comunidade e os profissionais de saúde com uma "Cultura de Saúde Integralmente Concebida".

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia.

The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia / Condiciones sociales y ambientes urbanos asociados con la participación al programa de Ciclovía en adultos en Cali, Colombia / Condições sociais e ambientes urbanos associados à participação no programa Ciclovia entre adultos em Cali, Colômbia

Abstract The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Resumen El programa de Ciclovía (PC) ha surgido como una iniciativa efectiva para promover actividad física en el contexto urbano de América Latina. Este estudio evaluó la asociación entre las condiciones sociales, el ambiente urbano y la participación en el PC en adultos que vivían en Cali, Colombia. Se llevó a cabo un estudio transversal en 2011 y 2012 en 719 adultos de 18 a 44 años. Se obtuvieron medidas del ambiente urbano utilizando Sistemas de Información Geográfica. Un poco más del 7% de las personas participaron en el PC en los últimos 4 fines de semana. Ser hombre y tener un nivel de escolaridad de secundaria se asoció positivamente con la participación en el PC. Así mismo, se encontró una asociación positiva con residir en barrios con existencia de corredores con este programa. Por el contrario, la existencia de muertes por accidentes de tránsito fue negativamente asociada. Este estudio brinda nuevos conocimientos acerca de un programa recreativo que tiene beneficios potenciales para la salud, en una región marcada por desigualdades urbanas relacionadas con actividad física.

Resumo O programa Ciclovia (PC) surgiu como uma iniciativa eficaz para promover a atividade física no contexto urbano da América Latina. Este estudo avaliou a associação entre as condições sociais, o ambiente urbano e participação no PC em adultos que vivem em Cali, Colômbia. Um estudo transversal foi realizado em 2011 e 2012, em 719 adultos com idades entre 18 e 44 anos. Medidas do ambiente urbano utilizando SIG foram obtidos. Pouco mais de 7% das pessoas participaram do PC nos últimos quatro finais de semana. Ser do sexo masculino e ter um nível de ensino médio foi positivamente associado com a participação no PC. Da mesma forma, uma associação positiva com residência em bairros com corredores existência desse programa foi encontrada. Pelo contrário , a existência de mortes no trânsito foi negativamente associado . Este estudo fornece novos conhecimentos sobre um programa de lazer que tem benefícios de saúde potenciais em uma região marcada por desigualdades urbanas em atividade física.