Development and validation of a questionnaire for assessing the determinants that predict household recycling (ReDom Questionnaire).

The growing tendency towards 'urbanization' is promoting an increase in resource consumption and waste generation, which requires proper waste separation management with active participation of the population. To this end, it is essential to know the personal modifiable factors that predict recycling. The primary aim of the present study is to develop and evaluate the psychometric properties of a Spanish language questionnaire designed to measure determinants of household waste separation for recycling purposes (ReDom Questionnaire). A cross-cultural adaptation, translation and psychometric evaluation was undertaken of an extant questionnaire originally developed in Swedish, and the resultant Spanish questionnaire was then subjected to reliability and validity testing. The questionnaire was developed using survey data from 759 respondents and 33 participants performed the retest to assess reliability. The resultant 'ReDom Questionnaire' is composed of three factors that draw on relevant elements of the COM-B framework: motivation (seven items), physical opportunity (three items) and social opportunity (three items). The accuracy of the scores is adequate both in terms of internal consistency (factorial weights >0.60; comparative fit index = 0.994; root mean square error of approximation = 0.049; root mean square residual (RMSR) = 0.053) and reliability (Pearson correlation >0.65; Cronbach's alpha >0.75). In conclusion, the Spanish ReDom Questionnaire showed adequate psychometric properties and appears useful for assessing the determinants of household waste separation.

Young Women's Needs Regarding Sexual Preventive Behaviours and Unwanted Pregnancies.

Unwanted pregnancies are considered a public health problem that affects women's mental health and quality of life. The aim of this paper was to access university students' understanding and behaviours regarding unwanted pregnancies and identify their needs to prevent them. Qualitative descriptive design was used, and 13 semi-structured interviews were carried out. Women between 18 and 20 years old participated. They discussed a lack of training for themselves, their partners, and their families, their desire to have access to non-in-person health care resources, and their belief that contraception was expensive. Emotional aspects were relevant, affecting the way communication is established with those close to them and with health professionals. Despite the existence of access to sexual health resources, the findings show the existence of needs related to the prevention of unwanted pregnancies. The findings are presented grouping the main identified needs as "related to capability", "related to opportunity", and "related to motivation". Among the aspects to consider when designing interventions to prevent unwanted pregnancies are the feelings shown by these women, the inclusion of couples and family members in educational programs, and access to non-face-to-face health resources and less expensive contraceptive methods. Interventions for social support and understanding of women are necessary both to prevent unwanted pregnancies and to support adolescents with unwanted pregnancies by avoiding criminalization or blame.

Research on missed nursing care during the COVID-19 pandemic: A scoping review.

BACKGROUND: Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM: This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS: This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS: We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION: Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.

The "Breast-4Y" web app for breast cancer prevention at young age: Development, evaluation, and validation.

Background: Improving knowledge of risk factors, signs and symptoms positively influence an individual's intention to acquire healthy lifestyle behaviors to prevent breast cancer, to identify breast cancer risk early and seek health advice early. The aim of the present study was to develop and to assess the usability and quality of a web-app (Breast-4Y) designed specifically for younger women to improve their knowledge about breast cancer risk factors and symptoms as well as protective behaviors to reduce their risk. Methods: The development of the Breast-4Y web-app, based on Health Belief Model and the Behaviour Change Wheel, comprised four steps: i) analysis of scientific literature regarding breast cancer risk factors, symptoms and preventive lifestyle behaviors; ii) design of web-app; iii) content review by experts; iv) quality and usability assessment by the end-users (n = 20). Web-app usability was evaluated using the Spanish version of the System Usability Scale for the Assessment of Electronic Tools and the quality using the Spanish version of uMARS. Results: The contents were rated 4.25 or above, indicating high content quality. The mean usability score was 84.9 (SD 12.4), the mean rating for objective quality and subjective quality dimensions mean were 4.2 (SD 0.4) and 3.4 (0.777) respectively, indicating excellent usability and quality. Positive associations (p < .05) were observed between numbers of app used and attitudes to change (r = 0.479), and intention to change (r = 0.539). Strong positive associations (p < .001) were also observed between usability satisfaction and attitudes to change (r = 0.584), intention to change (r = 0.656), and help-seeking (r = 0.656). Conclusions: This study provided evidence that Breast-4Y has adequate contents, high quality, and usability. Breast-4Y can be tested in pragmatic trials to assess their effectiveness to reduce the risk of breast cancer, raise women's awareness of breast cancer risk factors, increase women's knowledge of breast cancer symptoms, and adopt protective lifestyle behaviors.

Assessment of content, behavior change techniques, and quality of unintended pregnancy apps in Spain: Systematic search on app stores.

Objective: Unintended pregnancies are a public health problem that represents 48% of global pregnancies. Despite the proliferation of smartphones there is limited data on the app's features on unintended pregnancy. The purpose of this research was to identify free apps available in Spanish, in the iOS Store and Google Play, which can be recommended to prevent unintended pregnancies in adolescents. Methods: A systematic search to identify apps was performed in the iOS App Store and in Google Play aiming to replicate the way a patient might access an "unintended pregnancy prevention" app. Additionally, the quality, using the Mobile Application Rating Scale, and content were assessed. Results: A total of 4614 apps were identified, of which 8 were retrieved for assessment (0.17%). The mean for objective and subject quality was 3.39 (standard deviation (SD) = 0.694) and 1.84 (SD = 0.626), respectively. A total of 16 thematic categories were identified. The mean of topics covered in the apps was 5.38 (SD = 2.925) being those related to contraception the more frequent. Conclusion: The results of the present study suggest that only a small percentage of free pregnancy prevention apps in Spanish should be recommended. The contents of the apps retrieved meet the potential necessities of adolescents.

Association between neighborhood physical characteristics and mental health among older adults in Spain.

The aim was to assess the impact of neighborhood physical environment on mental health among non-institutionalized older adults. A cross-sectional analysis was conducted over a representative sample of 5,071 people ≥65 years from the Spanish National Health Survey. The survey included nine items addressing the self-perceived degree of discomfort due to neighborhood physical problems. Participants were categorized into groups with "no problems", "some problems" (somewhat discomfort on 1-4 items) and "many problems" (somewhat discomfort on ≥5 items or very much discomfort on ≥1 item). Mental health status was assessed using the General Health Questionnaire, consisting of 12 items assessing the severity of a psychological distress over the past few weeks. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regressions. A dose-response association (p-trend<0.001) was found between living in neighborhoods with some (OR: 1.41; 95% CI: 1.14-1.75) or many problems (OR: 1.93; 95% CI: 1.55-2.42) affecting the physical environment with poor mental health of community dwelling older adults. Integrating and articulating health considerations into public policymaking regarding housing and the residential environment can have broad implications for healthy aging.

Nutritional content and quality of processed foods and beverages advertised near schools in three cities in the north of Spain.

The advertisement of food and beverages on television and social media has been widely assessed, evidencing its powerful influence on children's dietary patterns and the development of childhood obesity. However, there is a gap in the evidence about advertisements near schools. The aim of this study was to describe and classify the nutritional quality and information of processed foods and alcoholic and non-alcoholic beverages advertised near schools in three cities in the north of Spain. A descriptive analysis was performed from September to December 2021 in the cities of Oviedo, Gijón and Avilés in the Principality of Asturias (Spain). The nutritional quality and information of processed foods or beverages advertised within a 500 m radius of schools were assessed. The Nutri-Score system was used for the classification of the nutritional quality of products and nutritional information, calories, fat, saturated fat, carbohydrates, sugars, protein and salt in 100 g or ml of each product was calculated. A total of 73.5% of the products were classified as "foods to eat less often and in small amounts," and 22.6% and 46.3% were classified as D or E, respectively, according to the Nutri-Score system. Finally, 57.5%, 56.4% and 78.5% of the products showed a medium to high content of fat, saturated fat and sugar, respectively. In conclusion, the food and drink advertisements surrounding schools in the assessed cities promote many products of low nutritional value, rich in fat, saturated fat and sugars, which have high obesogenic potential.

Use a web-app to improve breast cancer risk factors and symptoms knowledge and adherence to healthy diet and physical activity in women without breast cancer diagnosis (Precam project).

PURPOSE: This study aimed to evaluate the preliminary effectiveness of an educational intervention using a web-app to improve knowledge of breast cancer risk factors and symptoms and adherence to healthy eating and physical activity among women without breast cancer diagnosis in Asturias (Spain). METHODS: A pragmatic randomized pilot trial was conducted to evaluate the impact of a web-app-based intervention for women without breast cancer diagnosis. Women in the intervention group participated in a 6-month intervention web-app based on the Behaviour Change Wheel Model. The web-app includes information about breast cancer risk factors, early detection, physical activity and diet. RESULTS: Two hundred and eighty-fifth women aged 25-50 were invited to join the study. Two hundred and twenty-four were randomly assigned to either the intervention group (IG = 134) or control group (CG = 90) according to their place of residence. Adherence among women in the IG increased significantly from pre- to post-intervention for eight of the 12 healthy behaviors and for the identification of six risk factors and six symptoms compared to women in the CG and, among whom adherence only increased for two behaviors, the identification of one risk factor and 0 symptoms. The intervention significantly improved the mean number of risk factors + 1.06 (p < 0.001) and symptoms + 1.18 (p < 0.001) identified by women in the IG. CONCLUSIONS: The preliminary results of this study suggest that an educational intervention using a web-app and based on the Behaviour Change Wheel model could be useful to improve knowledge of breast cancer risk factors and symptoms and to improve adherence to a healthy diet and physical activity in women without a previous breast cancer diagnosis.

Evaluation of Water Intake in Spanish Adolescent Soccer Players during a Competition.

An optimal state of hydration is essential to maintaining health. The objective of this cross-sectional study was to evaluate the water intake of adolescents aged 12 to 16 years and their hydration level during an official soccer match. Three hundred and six players participated in the study (N = 306). Their water intake was recorded and the level of hydration was evaluated using the density of urine as an indicator. Weight measurements were made before and after the match. Water intake control, urine collection and analysis, and the recording of minutes played were carried out after the match. The average weight loss was 746.2 g (SD: 474.07; p < 0.001), with 36.5% with less than 1% loss and 23.3% with more than 2% loss. The mean volume of water ingested was 229.35 ml (SD: 211.11) and a significant correlation was observed between minutes of activity (ρ-value = 0.206; p < 0.001), environmental humidity (ρ-value = - 0.281; p < 0.001), and temperature (ρ-value = 0.200; p < 0.001). The sweat rate was 0.69 l/h (SD: 0.56) and it was significantly associated with playing time (ρ-value = -0.276; p < 0.001). The mean urine density was 1.019 (SD: 0.007), with 64.9% of youth athletes showing dehydration (≥ 1.020). An association was observed between dehydration and activity time (U- value = 4.124; p < 0.001). Approximately 10% of the participants stated that they had not drunk any water during the match. In conclusion, it is necessary to establish individual hydration guidelines based on personal, environmental and activity-related factors, as well as establish a minimum volume of fluids to consume.

Mapping of Outdoor Food and Beverage Advertising around Spanish Schools.

Overweight and obesity rates have increased worldwide in the last decades. The marketing strategies of food considered to be unhealthy significantly exacerbate the childhood obesity dilemma. Studies typically analyze the content of advertisement in television, movies, or social media, but there is a gap in the assessment of the real-life promotion of food and beverages around the schools. The primary aim of the study was to assess the products advertised around public and concerted schools in three cities in the north of Spain, and to categorize them as healthy (core) or unhealthy (discretionary). The secondary aim was to describe the types of food and beverages in advertisements, as well as to determine the density of core and discretionary product advertisements. A cross-sectional descriptive study was carried out between September and December 2021. The units of analysis were outdoor food and beverage advertisements that were located around public and concerted schools of three cities in the north of Spain. We found 104 schools that met the criteria. We identified 6469 products advertised, 35.1% core and 61.2% discretionary, observing significant differences (p < 0.001) among the cities. Fruit (core) and alcohol (discretionary) were the most heavily advertised products. In conclusion, children attending schools located in the assessed cities are currently exposed to a significant amount of discretionary product advertisement, a situation that should be regulated.

Psychometric Properties of the Spanish Version of Breast Cancer and Lymphedema Symptom Experience Index.

BACKGROUND: Lymphedema is a common late and chronic adverse effect of breast cancer treatment. This study aimed to translate and evaluate the psychometric properties of the BCLE-SEI Spanish version with Spanish-speaking breast cancer patients. METHOD: 286 patients were recruited (2018 to 2020), from the Hospital Universitario Central de Asturias. Data analysis included descriptive statistics; internal consistency and test-retest reliability; principal component analysis and exploratory factor analysis; average variance extracted; and receiver operating characteristic curves. RESULTS: No semantic modifications to items were needed. The scores of the instrument demonstrated excellent internal consistency (Cronbach´s alpha = .95-.97; McDonald´s omega = .96-.98) and test-retest reliability (r = .78-.87, n = 29). A significant difference was observed between the lymphedema group and non-lymphedema group (p < .001) in terms of total scale, symptom occurrence (p < .001), symptom distress in the physical-functional (p < .001), and psychosocial dimension (p < .001). Principal component analysis for symptom occurrence revealed a unidimensional factor and two factors were identified for symptom distress via exploratory factor analysis, the two of which explained 45.71% and 54.77% of the total sample variance, respectively. CONCLUSIONS: This study provided initial evidence to support the psychometric properties of the BCLE-SEI Spanish version.

Content, Behavior Change Techniques, and Quality of Pregnancy Apps in Spain: Systematic Search on App Stores.

BACKGROUND: Women consult information in mobile apps (apps) during pregnancy, and even obstetrics specialists highlight that pregnancy is the ideal moment for the use of apps as consultation sources. However, the high number of apps designed for pregnancy requires a careful assessment to determine their suitability before recommendation. OBJECTIVE: The aim of this study is to identify the apps available in Spanish that can be recommended based on their content, behavior change techniques (BCTs), and quality as a complementary tool during pregnancy. METHODS: A systematic search on app stores to identify apps was performed in the Apple App Store and Google Play with the subject term "pregnancy." The apps meeting the following criteria were chosen: pregnancy-related content, free, and available in Spanish. An app was excluded if it was classified as a game or entertainment and thus lacking an educational or health aim and if it did not target the population under study. The selected apps were downloaded, and their quality was assessed using the Mobile Application Rating Scale (MARS), with the BCTs included evaluated using the BCT taxonomy version 1 and its content. RESULTS: A total of 457 apps were identified, 25 of which were downloaded for assessment (5.6%). The median for objective and subjective quality was 2.94 (IQR 2.71-3.46) and 1.75 (IQR 1.25-2.25), respectively. Regarding content, the median of topics included in the apps was 23 (IQR 16-23), with weight gain, nutrition, fetal development, and physical activity being the most common. The median number of BCTs was 12 (IQR 0.5-3.5). The most frequently identified BCTs in the apps were "Self-Monitoring of Outcomes," followed by "Goal Behavior" and "Instructions." Statistically significant correlations were observed between objective quality and content (ρ=0.624; P=.001), subjective quality and content (ρ=0.638; P=.001), objective quality and BCTs (ρ=0.672; P<.001), subjective quality and BCTs (ρ=0.623; P<.001), and BCTs and content (ρ=0.580; P=.002). CONCLUSIONS: The results of this study suggest that only a small percentage of free pregnancy apps available in Spanish should be recommended. The apps with the best MARS scores were those that addressed a higher number of topics and included a higher number of BCTs. Those with the best content and quality, and a higher number of BCTs included could be recommended by health professionals.

Spanish adaptation and validation of the User Version of the Mobile Application Rating Scale (uMARS).

OBJECTIVE: While the professional version of the Mobile App Rating Scale (MARS) has already been translated, and validated into the Spanish language, its user-centered counterpart has not yet been adapted. Furthermore, no other similar tools exist in the Spanish language. The aim of this paper is to adapt and validate User Version of the MARS (uMARS) into the Spanish language. MATERIALS AND METHODS: Cross-cultural adaptation, translation, and metric evaluation. The internal consistency and test-retest reliability of the Spanish version of the uMARS were evaluated using the RadarCovid app. Two hundred and sixteen participants rated the app using the translated scale. The app was then rated again 2 weeks later by 21 of these participants to measure test-retest reliability. RESULTS: No major differences were observed between the uMARS original and the Spanish version. Discrimination indices (item-scale correlation) obtained appropriate results for both raters. The Spanish uMARS presented with excellent internal consistency, α = .89 and .67 for objective and subjective quality, respectively, and temporal stability (r > 0.82 for all items and subscales). DISCUSSION: The Spanish uMARS is a useful tool for health professionals to recommend high-quality mobile apps to their patients based on the user's perspective and for researchers and app developers to use end-user feedback and evaluation, to help them identify highly appraised and valued components, as well as areas for further development, to continue ensuring the increasing quality and prominence of the area of mHealth. CONCLUSION: uMARS Spanish version is an instrument with adequate metric properties to assess the quality of health apps from the user perspective.

Development and validation of the MARA scale in Spanish to assess knowledge and perceived risks and barriers relating to breast cancer prevention.

OBJECTIVE: The aim of this study was to develop a measurement instrument for assessing knowledge of breast cancer and perceived risk of developing the disease (MARA). METHODS: 641 women with a mean age of 36.19 years (SD = 7.49) participated in the study. Data collection took place during 2019 and included sociodemographic data, data on history of cancer and breast cancer, perceived risk, and feelings of concern about developing breast cancer. Internal consistency, test-retest reliability, convergent validity, and structural validity were tested. RESULTS: The questionnaire items comprise 4 subscales: risk factors (9 items), signs and symptoms (9 items), perceived risk (6 items), barriers (7 items). A factor analysis revealed that the first two subscales had two dimensions each, whereas the other two subscales had one dimension each. Each subscale was shown to have adequate reliability (α = 0.74-0.92) and temporal stability (r = 0.201-0.906), as well as strong evidence of validity in relation to a questionnaire on breast cancer knowledge (r = 0.131-0.434). In addition, the subscales were shown to have high discriminatory power in terms of the presence or absence of a history of cancer or breast cancer, perceived risk, and feelings of concern. CONCLUSION: The MARA questionnaire represents a valid, reliable tool for assessing Spanish women's knowledge, risks, perceptions, and barriers regarding breast cancer.

Evaluación de la calidad de la dieta y de la actividad física en jugadores de fútbol, de 13 a 16 años, del Principado de Asturias / Assessment of diet quality and physical activity of soccer players aged 13 to 16, from the Principality of Asturias, Spain

Introducción: La dieta y la actividad física son 2conductas que juegan un papel clave en la aparición de sobrepeso y la obesidad infantil. Es una tarea esencial en salud pública el análisis de su prevalencia en diferentes contextos.Objetivo: Describir la composición corporal, el nivel de actividad física y la adherencia a la dieta mediterránea de jugadores de fútbol de 13 a 16 años de Asturias. Secundariamente, determinar la relación entre dieta, actividad física, composición corporal y variables personales.Métodos: Estudio descriptivo transversal. Participaron 303 niños, con una edad media de 14,15 años (DE=1,06). Se analizaron la adherencia a la dieta mediterránea y el nivel de actividad física con los cuestionarios KIDMED y PAQ-A, respectivamente, y se estableció su composición corporal de acuerdo con su índice de masa corporal.Resultados: Un 23,1% de los participantes presentó exceso de peso. El 54,8% y el 8,9% tenían una adherencia media o baja, respectivamente, a la dieta mediterránea. La puntuación media del PAQ-A fue de 2,69 (DE=0,47). El exceso de peso se asoció con jugar de portero (p=0,001), mayor puntuación de PAQ-A (p=0,011) y menor de KIDMED (p=0,032). El análisis de correlación presentó una asociación inversa entre edad y puntuación de PAQ-A (r=−0,122) y directa entre las puntuaciones de KIDMED e PAQ-A (r=0,152).Conclusiones: Los participantes en el estudio mostraron un adecuado nivel de actividad física. Sin embargo, presentaron un perfil obesogénico similar al de la población de su edad y una potencial necesidad de mejora sobre la adherencia a las recomendaciones de la dieta saludable. (AU)

Introduction: Diet and physical activity are factors that have key roles in childhood overweight and obesity prevention. Appropriate assessment of these factors is an essential task in public health.Objective: The main aims of the study are to assess body composition, physical activity, and adherence to Mediterranean diet of soccer players, aged 13 to 16 years old in Asturias, Spain. It also aims to evaluate the relationships between diet, physical activity, body composition, and personal characteristics.Methods: A cross-sectional descriptive survey approach was used involving children (n=303) with a mean age of 14.15 years (SD=1.06), and using the KIDMED and PAQ-A questionnaires to assess adherence to Mediterranean diet and level of physical activity, respectively. Body composition was represented using the participants’ body mass index.Results: Approximately 23.1% of the participants were overweight or obese. With regards to adherence to Mediterranean diet, 54.8% of the participants had medium adherence, while 8.9% had low adherence. PAQ-A mean score was 2.69 (SD=0.47). Excess weight was associated with being a goalkeeper (P=.001), higher PAQ-A (P=.011), and lower KIDMED scores (P=.032). Correlation analysis showed an inverse association between age and PAQ-A score (r=−0.122), and a direct association between KIDMED and PAQ-A scores (r=0.152).Conclusion: Participants had an adequate level of physical activity. However, they had an obesogenic profile similar to that of their age population, who were not soccer players. Actions to improve adherence to healthy diet practices are highly recommended. (AU)

Assessment of diet quality and physical activity of soccer players aged 13 to 16, from the Principality of Asturias, Spain.

INTRODUCTION: Diet and physical activity are factors that have key roles in childhood overweight and obesity prevention. Appropriate assessment of these factors is an essential task in public health. OBJECTIVE: The main aims of the study are to assess body composition, physical activity, and adherence to Mediterranean diet of soccer players, aged 13 to 16 years old in Asturias, Spain. It also aims to evaluate the relationships between diet, physical activity, body composition, and personal characteristics. METHODS: A cross-sectional descriptive survey approach was used involving children (n = 303) with a mean age of 14.15 years (SD = 1.06), and using the KIDMED and PAQ-A questionnaires to assess adherence to Mediterranean diet and level of physical activity, respectively. Body composition was represented using the participants' body mass index. RESULTS: Approximately 23.1% of the participants were overweight or obese. With regards to adherence to Mediterranean diet, 54.8% of the participants had medium adherence, while 8.9% had low adherence. PAQ-A mean score was 2.69 (SD = 0.47). Excess weight was associated with being a goalkeeper (P = .001), higher PAQ-A (P = .011), and lower KIDMED scores (P = .032). Correlation analysis showed an inverse association between age and PAQ-A score (r = -0.122), and a direct association between KIDMED and PAQ-A scores (r = 0.152). CONCLUSION: Participants had an adequate level of physical activity. However, they had an obesogenic profile similar to that of their age population, who were not soccer players. Actions to improve adherence to healthy diet practices are highly recommended.

[Improvement of flu vaccination coverage in people over 65 years old. Strategy developed in a health area of Asturias.] / Mejora de la cobertura de vacunación antigripal en persona mayores de 65 años. Estrategia desarrollada en un área de salud de Asturias.

OBJECTIVE: Influenza vaccination rates among adults over 65 years have not reached the minimum levels recommended by the health authorities in Asturias during previous vaccination campaigns. The objective of this study is to describe the characteristics of an influenza vaccination strategy and its effectiveness. METHODS: Strategy developed during the 2019-2020 influenza vaccination campaign in the Área Sanitaria VII in the Servicio de Salud of the Principado de Asturias. The target population were people over 65 years. The strategy consisted of training sessions for professionals and the general population, information dissemination through the media, overt recommendations for the vaccination of hospital personnel and social recognition of the professionals involved. The vaccination rates were described and a two-tailed hypothesis test was used to determine the differences in the vaccination percentages. RESULTS: The percentage of vaccination in the Área Sanitaria VII went from 56.29% in the 2018-2019 campaign to 65.82% in the 2019-2020 campaign (+9.53; p<0.001). During the same campaign, the percentage of vaccination in Asturias was 57,38%, that is, 8,44% less than in the intervened Área Sanitaria. CONCLUSIONS: The strategy proved effective in increasing the rates of influenza vaccination among adults over 65 years in the Área Sanitaria VII of the Principado de Asturias.

OBJETIVO: La vacunación de la gripe en población mayor de 65 años en Asturias no ha alcanzado el mínimo recomendado por las autoridades sanitarias españolas en las últimas campañas de vacunación. El objetivo de este trabajo consistió en presentar las características de una estrategia de vacunación frente a la gripe y su efectividad. METODOS: Estrategia desarrollada en la campaña de vacunación 2019-2020, en el Área Sanitaria VII del Servicio de Salud del Principado de Asturias. Su población objeto fueron las personas mayores de 65 años. Incluyó sesiones formativas a profesionales y población, información a la población a través de medios de comunicación, recomendación activa de la vacunación en el ámbito hospitalario y reconocimiento social a los profesionales implicados. Se realizó la descripción de las tasas de vacunación y, para determinar las diferencias en los porcentajes de vacunación, se utilizó un contraste de hipótesis para proporciones de dos colas. RESULTADOS: El porcentaje de vacunación en el Área Sanitaria VII pasó de un 56,29% en la campaña 2018-2019 a un 65,82% en la 2019-2020 (+9,53; p<0,001). Esa misma campaña el porcentaje de vacunación en Asturias fue 57,38%, es decir un 8,44% menor que en Área Sanitaria intervenida. CONCLUSIONES: La estrategia ha mostrado ser efectiva para aumentar el porcentaje de vacunación frente a la gripe en población mayor de 65 años en el Área Sanitaria VII del Principado de Asturias.

Apps for individuals diagnosed with breast cancer: a preliminary assessment of the content and quality of commercially available apps in Spanish.

BACKGROUND: many apps are directly related to health issues. Recent studies show that apps are widely accepted by the population and contribute to the modernization of the healthcare system. However, before recommendation, their contents and quality should be assessed, as well as the behavioral change techniques they include. In Spain, no study has been found to determine which apps are aimed at addressing any aspect of breast cancer. The objective of this study was to identify and describe the contents and analyze the quality and behavior change strategies of the free applications available in the online stores of Android and Apple whose main purpose is related to some aspect of breast cancer. METHODS: Searches were conducted in the Apple App and Google Play stores in Spain, between October 2018 and February 2019, using an Apple iPad Pro and a Samsung Galaxy Tab A6. The Spanish search terms used were: "cáncer de mama" [breast cancer], "cáncer de pecho" [breast cancer], "cáncer de seno" [breast cancer], "tumor de mama" [breast tumor], "tumor de pecho" [breast tumor], "tumor de seno" [breast tumor], "neoplasia de mama" [breast neoplasm], "neoplasia de pecho" [breast neoplasm], and "neoplasia de seno" [breast neoplasm]. After screening, contents related to breast cancer, quality, and behavioral change were assessed. RESULTS: The contents of the 6 selected apps were related to breast self-examination and to the signs and symptoms that may warn the woman of the presence of a breast tumor. The MARS objective and subjective quality scores were 4.11 (SD =0.59) and 3.07 (SD =0.91), respectively. The mean number of BCTs included in the apps was 2.83 (SD =3.040). The app with the highest number of BCTs was APP1, with a total of 9 techniques. CONCLUSIONS: Few free apps are specifically designed for breast cancer in Spanish. Their content and quality, as well as the number of BCTs they include, should be improved.

Concordance Between the Weight of Spanish Adolescent Soccer Players, Their Self-Perceived Weight, and Their Weight as Perceived by Their Parents.

PURPOSE: In the context of soccer clubs, to analyze the concordance between players' actual weight, their self-perceived weight, and their weight as perceived by their parents; to determine which variables might explain the presence of concordance between parents' perception of adolescents' weight and their actual weight. Design and study: A cross-sectional study involving 330 soccer players aged between 13 and 16. Data on personal characteristics of adolescents and parents were analyzed, as well as parents' perceptions of adolescents' weight status and their self-perception. A descriptive analysis of the personal characteristics of the sample (adolescents and parents) and an analysis of the variables explaining the presence of concordance between the parents' perception of adolescents' weight and their actual weight were performed. RESULTS: 19% of the adolescents were overweight and 3.4% were obese. The concordance between parents' perceptions of players' weight and players' actual weight was weak. The concordance between adolescents' self-perceived weight and their actual weight was moderate. The difference in BMI scores according to presence or absence of concordance was statistically significant: these scores were higher in the absence of concordance. Discordance between adolescents' weight and their parents' perception of their weight was associated with parents having lower levels of education. CONCLUSION: A high percentage of parents and players misperceived their actual weight. This discrepancy was associated with higher BMI scores for adolescents. PRACTICE IMPLICATIONS: Nurses should include promotion of accurate weight perception in educational interventions on excess weight.

Feasibility Study of an Educational Intervention to Improve Water Intake in Adolescent Soccer Players: A Two-Arm, Non-Randomized Controlled Cluster Trial.

This study aimed to assess the feasibility of an educational intervention on hydration behavior in adolescent soccer players. A pilot study of a two-arm, non-randomized controlled cluster trial was conducted. A total of 316 players aged 13-16 agreed to participate. The response variables were the players' participation in the intervention, their perception of the knowledge acquired, the usefulness and the overall assessment of the intervention. Hydration patterns and acquisition of knowledge on hydration behavior were also assessed. The intervention involved two elements: posters and a web app. A total of 259 adolescents completed the study (intervention group (IG) = 131; control group (CG) = 128). 80.6% of the players responded to the survey assessing the feasibility of the intervention. The mean number of correct answers regarding behavior was significantly higher in the IG (3.54; SD = 1.162) than in the CG (2.64; SD = 1.174) (p < 0.001). The water consumption pattern at all the clubs was ad libitum. Of the players, 10% did not drink any water at all during the game. In conclusion, this intervention has been shown to be feasible for implementation with adolescent soccer players. It suggests that hydration guidelines should be informed by personal factors and that ad libitum water consumption should be avoided.