When More is More: Do Non-Restricted Goals Benefit Employers and the Environment Too?

Prior research on goal self-concordance (GSC) and goal attainment (GA) has studied these dimensions as transversal sections through a person’s life domains. Blending the recent developments in self-determination theory and pro-environmental behavior literature, the current study introduced the concept of non-restricted goals and explored whether work climate (WCQ) and environmental identity (EID) impact GA and, through it, in-role job performance (IRB), organizational citizenship behaviors (OCB) and wellbeing, as well as organizational citizenship behaviors for the environment (OCBE). It also explored GSC along with basic psychological needs’ satisfaction (BPNS) and GA, as explanatory mechanisms. The study relied on data collected at two different moments in time, with a retained sample of 201 employees from different organizations. Results confirmed that WCQ and EID are relevant antecedents for IRB, OCB and wellbeing, as well as OCBE. Except for the direct relationship between EID and OCB/OCBE, most of these impacts were indirect, through BPNS, GSC or GA. The current study did not find a significant relationship between GSC and GA, adding to the line of mixed results regarding their relationship. The findings inform pro-environmental interventions in the workplace, as well as human resource management practices that foster employee wellbeing, work-life balance, and job performance. (AU)

Yo soy Polígono. Proceso de intervención comunitaria intercultural y salud en el barrio del Polígono de Toledo / I Am Polygon. Intercultural and health community process in the Toledo polygon district

INTRODUCCIÓN: En julio de 2014 se inició en el barrio del Polígono de Toledo un proceso comunitario en las áreas de salud y educación. OBJETIVO: Exponer los resultados que diferentes estrategias de salud comunitaria han obtenido en la capacitación territorial y la mejora de la convivencia ciudadana del barrio del Polígono de Toledo. MÉTODOS: El proceso supone la aplicación de un modelo científico de trabajo para la mejora de la convivencia y la cohesión social en territorios de alta diversidad; partiendo de una monografía comunitaria y diagnósticos compartidos, se llega a una programación comunitaria, en donde instituciones, profesionales y ciudadanía acuerdan trabajar por los mismos retos. RESULTADOS: En estos años de desarrollo, se ha podido dotar al barrio de una estructura de participación propia para estos tres protagonistas. Al entrar en escena diferentes actores con relevancia en el enfoque promocional de la salud, se ha llegado a conformar una mesa técnica de salud desde donde se han ido dando forma a iniciativas que apuestan por una ciudadanía más activa en el manejo de su propio bienestar. DISCUSIÓN: Para poder desarrollar estrategias sólidas de promoción y prevención, es necesario implicar a todos los actores relacionados de un territorio, traducir sus potenciales en términos de salud y articular nuevos espacios de relación y coordinación sanitaria a través de procesos comunitarios sostenibles en el tiempo

INTRODUCTION: A community process in the health and education areas began in the Polígono de Toledo neighbourhood in July 2014. OBJECTIVE: To present the results that different community health strategies have obtained in territorial training and improved citizen coexistence in the Polígono de Toledo neighbourhood. METHODS: The process entails application of a scientific work model to improve coexistence and social cohesion in high diversity territories. Departing from a Community Monograph and Shared Diagnostics, Community Programming is attained where institutions, professionals and citizens agree to work on the same challenges. RESULTS: In these years of development, it has been possible to provide the neighbourhood with its own participation structure for these three protagonists. As different actors with a role to play in promoting healthcare entered the scene, a Technical Healthcare Roundtable was created, from where initiatives that went for citizens being more active in managing their own well-being were devised. DISCUSSION: In order to develop solid promotion and prevention strategies, all related actors in a region need to be involved. Their potential in terms of health must become a reality and new spaces for health relationship and coordination have to be articulated by means of sustainable community processes over time

Diálogo intercultural como herramienta de construcción en políticas de salud. Amazonía Colombiana / Intercultural dialogue as a tool for construction in health policies. Colombian Amazon

OBJETIVO: Describir el diálogo intercultural como herramienta para la construcción de políticas públicas de salud que respondan a la diversidad cultural indígena colombiana. MÉTODOS: Investigación cualitativa: observación participante, entrevistas en profundidad y análisis documental durante 2010 a 2019, desde la experiencia en la Asociación Indígena Zonal de Arica (AIZA) en la Amazonía colombiana. RESULTADOS: El diálogo intercultural en la construcción de las políticas públicas en salud relativas a los pueblos indígenas se describe a nivel comunitario, departamental y nacional. En AIZA, el diálogo se realiza entre las etnias muina, p++nemina e inga de manera constante y fluida, promoviendo el desarrollo de un proceso de salud que tiene como meta el fortalecimiento de la medicina tradicional y complementarla con la occidental. A nivel departamental, el diálogo entre las asociaciones indígenas es constructivo y colaborativo; entre asociaciones e instituciones gubernamentales, el diálogo depende de la voluntad de los funcionarios de turno. A nivel nacional, el diálogo entre las asociaciones e instituciones nacionales es precario. Las instituciones tienen objetivos de corto plazo; no comprenden que se requieren metas de largo plazo, y ello dificulta la construcción de políticas en salud pertinentes con la diversidad cultural. DISCUSIÓN: El diálogo intercultural como herramienta avanza en cada nivel, bien sea comunitario, departamental y nacional, de manera distinta y única, confluyendo diferentes factores

OBJECTIVE: Intercultural dialogue is reported as a tool to devise public health policies that respond to the indigenous cultural reality of Colombia. METHODS: Qualitative research strategies involving participant observation, in-depth interviews and documentary analysis over the period 2010 to 2019; from the experience in the Arica Zonal Indigenous Association (AIZA) in the Colombian Amazon. RESULTS: Intercultural dialogue in the drawing up of public health policies related to indigenous peoples at community, departmental and national level. In AIZA dialogue between the muina, p++ nemina and inga ethnic groups is constant and fluid. This enables developing a healthcare process whose aim is to strengthen traditional medicine complementary to its western counterpart. At departmental level, dialogue with indigenous associations is constructive and collaborative. However, dialogue between governmental associations and institutions depends on the will of the officials on duty. At national level dialogue between national associations and institutions is precarious. Institutionalism has short term aims and there is no understanding that long term goals are required. This hinders building health policies relevant to cultural diversity. DISCUSSION: Intercultural dialogue as a tool advances at each level, be it community, departmental and national in a different and unique way where different factors converge

Concept analysis of nursing activism.

Nursing history is firmly rooted in social and political activism; however, both the word activism and its defined actions have been minimized in modern nursing practice. This paper seeks to define activism, its uses, and importance to the nursing discipline. A concept analysis using the Walker and Avant (2019) method was conducted. Literature sources were identified through a search of PubMed, CINAHL, and PsycINFO along with hand searches of reference lists. Nursing activism is a concept that extends from within the discipline's ethical responsibilities and social contract with humanity. Activism differs from advocacy or engagement as it requires the expenditure of energy including personal, social, and/or political capital. Nursing activism is a necessary response to health inequities, social accountability, and advancement of the nursing profession.

The use of community advisory boards in pragmatic clinical trials: The case of the adult day services plus project.

Community advisory boards (CABs) have become increasingly common and important in translational research in health care including studies focusing on home and community-based services. CABs are composed of stakeholders who share interest in research projects and typically include patients/clients, practitioners, community members, policymakers, and researchers. CABs advise researchers on issues ranging from research design and recruitment to implementation and dissemination. In this article, the researchers detail their experiences with the CAB for a pragmatic clinical trail of Adult Day Services (ADS) Plus, an education and support intervention for family caregivers of older adults with dementia using adult day services. Lessons learned, guidelines, and best practices are then presented for developing and working with a CAB in healthcare research.

Análisis descriptivo de la formación en participación comunitaria en salud en España / Descriptive analysis of training in community health engagement in Spain

OBJETIVO: Describir las actividades formativas en participación comunitaria en salud que se realizan en España. MÉTODO: Identificación y análisis descriptivo de las acciones formativas en el periodo 2017-2018 en los ámbitos de la universidad, la Administración pública y las unidades docentes de medicina y enfermería familiar y comunitaria. RESULTADOS: Se incluyeron 28 actividades formativas en el análisis descriptivo de ocho comunidades autónomas diferentes y dos de ámbito nacional. La mayoría de las actividades formativas son presenciales e impartidas por unidades docentes de formación especializada para profesionales de medicina y enfermería de atención familiar y comunitaria, con una duración de entre 10 y 25 horas, y sin coste de matriculación. CONCLUSIÓN: Existe un vacío formativo en la mayoría de las comunidades autónomas que evidencia que la formación en participación comunitaria en salud es escasa y está poco integrada. Las actividades formativas analizadas están incluidas principalmente en la formación de especialistas de medicina y enfermería de familia y comunitaria, si bien esta formación no está unificada ni se incorpora en todos los planes docentes. Para una mirada integral sobre la salud de las personas es esencial incluir la participación comunitaria en salud en la formación de grado y posgrado, tanto del ámbito sanitario como de otras disciplinas. Las instituciones responsables de la formación en los diferentes niveles deben incluir la participación comunitaria en salud en los itinerarios formativos de los profesionales

OBJECTIVE: To describe the professional training health professionals receive in community health engagement in Spain. METHOD: The identification and descriptive analysis of trainings developed between 2013-2018 offered by public universities, public administrations and the teaching units for the specialization of family and community health doctors and nurses. RESULTS: Twenty eight trainings were included in the descriptive analysis. Most of them had been organized during 2018 in eight Autonomous Communities. Two of them were organized at a national level. Most trainings were attendance based and have been developed by teaching units in charge of training doctors and nurses specializing in family and community health, with an average duration of 10-25hours and no enrolment costs. CONCLUSION: There is a lack of training in community health engagement in the majority of autonomous communities in Spain which shows that it is scarce and not yet fully integrated in the training of health professionals. The trainings that have been analyzed are mainly part of wider specialization programs for doctors and nurses specializing in family and community health, and even so this training is not standardized and included in the specialization programs of all the Spanish regions. To develop a comprehensive health approach it is key to include community health engagement as part of the trainings professionals receive during their University degree, and to extend it to other health professions. The institutions responsible for the training of health professionals should include community health engagement as part of the different training itineraries of professionals

Ciudadanía activa y personas mayores: viejos conceptos, nuevos abordajes. Una revisión sistemática y metasíntesis cualitativa / Being an active citizen and the elderly: old concepts, new approaches. A systematic review and qualitative meta-synthesis

Las políticas de envejecimiento activo presentan el concepto de «ciudadanía activa» como un desafío clave en el ámbito del envejecimiento para los próximos años. La ciudadanía activa ha sido definida de diferentes maneras, en la mayoría de los casos de forma complementaria, describiendo un eclecticismo de actividades participativas que incluye la política, el mercado y la acción comunitaria y voluntaria. El término se sitúa en diferentes contextos como la política formal, el trabajo remunerado, la sociedad civil y el hogar. Este trabajo, a partir de una revisión sistemática, identifica el contexto en el que emerge este concepto en relación con las personas mayores y las personas con demencia, analizando las diferentes expresiones de ciudadanía activa utilizadas y aportando elementos clave a tener en cuenta en la formulación de políticas en un contexto de acelerado envejecimiento demográfico y donde la demencia es una prioridad de salud pública. La noción de ciudadanía activa en la vejez supone un paso adelante que parte del envejecimiento activo a un concepto más amplio que integra el principio de igualdad entre las personas con independencia del género, edad y necesidad de apoyos

The politics of active ageing present active citizenship of the elderly as a key challenge for the coming years. Active citizenship has been defined in different ways (as complimentary in most cases), outlining an eclecticism of participatory activities that includes political engagement in a participatory and deliberative manner, as well as community and voluntary action. This term is found in different contexts such as formal politics, work, civil society, and the home. This paper, based on a systematic review, identifies the context in which this concept emerges in relation to older people and people with dementia. It also analyses the different expressions of active citizenship used, and provides key elements to be taken into account in the formulation of policies in a context of accelerated demographic ageing and where dementia is a public health priority. The notion of active citizenship in old age is a step forward from active ageing to a broader concept that integrates the principle of equality between people irrespective of gender, age and the need for support

Aproximación a la respuesta comunitaria a la pandemia por COVID-19 de los equipos de Atención Primaria de Salud aragoneses / Approach to the community response to the COVID-19 pandemic of Aragonese Primary Healthcare Teams

INTRODUCCIÓN: ¿cómo seguir trabajando la orientación y participación comunitaria en Atención Primaria durante la pandemia por COVID-19?. OBJETIVOS Y MÉTODOS: observar, describir, reflexionar y documentar aspectos relativos a la atención comunitaria en el momento actual de pandemia por COVID-19 en los equipos de Atención Primaria (EAP) de Aragón. Estudio exploratorio-descriptivo observacional transversal con enfoque cualitativo, con dos fases. 1ª: recopilación de experiencias comunitarias y localización de informantes clave. 2ª: descripción de acciones comunitarias. Análisis descriptivo y tipo DAFO. RESULTADOS: se detectaron 47 iniciativas. Participaron 11 expertas y 54 informantes clave. El 66,6% consideró el rol de los EAP como consultores/colaboradores. El 64,9% de las iniciativas contempló la diversidad. El 49,1% no sabía si valoraron diferencias por género. Destacaron la importancia de lo comunitario para superar la crisis y la cooperación y coordinación con la comunidad e instituciones locales. DISCUSIÓN: protocolos con orientación biomédica, miedo e incertidumbre por la COVID-19 dificultaron el desarrollo de iniciativas comunitarias; frente a esto, fue clave la trayectoria comunitaria previa de los EAP, el trabajo en equipo, con especial relevancia el de las trabajadoras sociales, y su motivación. La participación del EAP como colaborador refuerza la importancia del liderazgo compartido. Son necesarios espacios colaborativos, apoyo institucional y coordinación intersectorial. CONCLUSIÓN: durante la pandemia, las comunidades deben ser parte de la respuesta; la orientación comunitaria de los EAP es clave. Es preciso visibilizar, acompañar y reforzar el trabajo comunitario y estimular la coordinación con Salud Pública

INTRODUCTION: How to continue working on community guidance and participation in Primary Care during the COVID-19 pandemic?. OJECTIVES AND METHODS: To observe, report, reflect and document autonomous community experiences of Aragonese Primary Care Teams (PCT) during the COVID-19 pandemic. A two-phase exploratory-descriptive observational, cross-sectional study with a qualitative approach. Phase 1: compilation of experiences in community health and location of key informants. Phase 2: description of community actions. Descriptive and SWOT analysis. RESULTS: A total of 47 initiatives were detected; 11 experts and 54 key informants took part. A total of 66.6% considered the role of the PCT as consultants or collaborators; 64.9% of initiatives considered diversity. A total of 49.1% did not know whether they evaluated differences by sex. They highlighted the importance of the community to overcome the crisis, and cooperation and coordination with community and local institutions. DISCUSSION: Protocols with biomedical guidance, fear and uncertainty due to COVID-19 hindered development of community initiatives. In light of this, the previous community trajectory of PCTs, teamwork with special relevance of social workers and their motivation were fundamental. PCT involvement as a partner strengthens the importance of shared leadership. Collaborative spaces, institutional support and intersectoral coordination are all necessary. CONCLUSION: During the pandemic, communities must be part of the response; PCT community guidance is essential. Visibility, working alongside and strengthening community work and stimulating public health coordination are all necessary requirements

"Hay que seguir en la lucha": An FQHC's Community Health Action Approach to Promoting Latinx Immigrants' Individual and Community Resilience.

Latinx immigrants have poorer access to health care, compared to non-Latinx Whites. Federally-Qualified Health Centers (FQHCs) provide clinical and community programing to address their clients' health needs. One mechanism by which FQHC's may strengthen Latinx immigrant well-being is by promoting their individual and community resilience. We partnered with La Clínica del Pueblo (La Clínica), an FQHC serving Latinx immigrants in Washington, DC and Prince George's County, Maryland. We conducted in-depth interviews in Spanish with 30 La Clínica clients to explore the daily adversities they faced, how they coped, and how La Clínica helped them cope. We conducted thematic analysis using Dedoose software. All participants were from Central America; 37% were undocumented. Participants were 18-78 years old, 70% cis-females, 23% cis-males (10% gay men), and 7% transgender. 57% reported a serious health issue, including diabetes. Participants identified three main adversities: immigration legal status, language, and isolation/depression. Residents of Prince George's, compared to DC, as well as sexual/gender minorities, reported more barriers to accessing health care. Sources of individual resilience for participants included fighting to improve their children's lives, relying on supportive networks, and using La Clínica as a safety net to overcome health access barriers. Sources of community resilience included La Clínica's safe spaces, support groups, referrals to outside legal service providers, and health promoter training. Latinx immigrants face multiple daily adversities, but we find evidence that La Clínica's community health action approach promotes their resilience. We offer a conceptual model for how FQHCs can foster resilience and strengthen immigrant health.

La teoría del cambio: una herramienta para la planificación y la evaluación participativa en salud comunitaria / Theory of change: a tool for participatory planning and evaluation in community health

Existe un creciente interés por encontrar respuestas innovadoras para evaluar intervenciones complejas en salud pública. En esta nota metodológica, se presenta la teoría del cambio como una herramienta útil para facilitar tanto la planificación como la evaluación de intervenciones en promoción de la salud comunitaria. Una teoría del cambio es una representación visual de cómo funciona un programa o una intervención, en la que se identifican sus diferentes componentes y cómo cada elemento se vincula con otro: cuáles son sus objetivos, los resultados esperados y a través de qué acciones se pretenden alcanzar. Es una herramienta de investigación aplicada a la práctica que se desarrolla mediante métodos participativos con las diferentes personas implicadas en la intervención, para identificar y decidir conjuntamente qué es lo que hay que evaluar y cómo evaluarlo

There is a growing interest in finding innovative approaches to the evaluation of complex interventions in public health. This methodological note presents the theory of change as a useful tool to facilitate both the planning and the evaluation of community health promotion interventions. A theory of change is a visual representation of how a programme or intervention works, in which its different components can be identified, together with how they relate to each other: what its objectives are, its expected results and through which actions they are expected to be achieved. It can be an applied research tool, developed using participatory approaches together with all relevant stakeholders, who can identify and jointly decide what to evaluate and how to

PAHO COVID19 Virtual Media Briefing March 31st 2020

PAHO COVID19 Virtual Media Briefing March 31st 2020

Participación pública en los proyectos de investigación: formas de crear conocimiento colectivo en salud / Public participation in research projects: ways of creating collective knowledge in health

La participación pública en los proyectos de investigación es un ámbito emergente en España y en los países latinoamericanos. Existen cinco tipos de proyectos según el grado de implicación que las personas participantes tienen en los procesos: contributivos, colaborativos, cocreados, contractuales e independientes. Para promover la participación pública en los equipos de investigación del ámbito de la salud es necesario redefinir sus prácticas y sus competencias. Para ello, puede ser útil formularse preguntas en las diferentes fases de la investigación, así como desarrollar estrategias que incluyan audiencias que cuenten con menos canales de participación en pro de favorecer la equidad en salud. Esta forma de hacer ciencia permite reunir experiencia y experticia priorizando y adecuando la investigación a las necesidades de la población, lo que aumenta su capacidad transformadora y el impacto social de sus resultados

Public participation in research projects is an emerging area in Spain and Latin American countries. There are five types of projects according to the degree of involvement that the participants have in the processes: contributory, collaborative, co-created, contractual and independent. In order to promote public participation in health research teams, their practices and competencies need to be redefined. To this end, it may be useful to ask questions in the different phases of the research, as well as to develop strategies that include audiences that have fewer channels of participation in favour of favouring equity in health. This way of doing science allows gathering experience and expertise prioritizing and adapting the research to the needs of the population, which increases its transforming capacity and the social impact of its results

Assessing the Development of Collective Impact Initiatives Addressing Maternal and Child Health.

PURPOSE: To examine the extent to which communities participating in the Collective Impact Learning Collaborative (CILC) increased capacity to create conditions for collective impact (CI) to address racial disparities in maternal and child health (MCH) and align local efforts with state MCH priorities over a 12-month period. DESCRIPTION: Eight communities participated in a learning collaborative that involved the provision of technical assistance via webinars, monthly team calls, and site visits to facilitate the development of a collective impact initiative. A Ready-Set-Go approach to technical assistance was used to guide the communities through each phase of development while also providing individual assistance to teams based on their capacity at the start of participation. ASSESSMENT: A pre/post design measured change in capacity to engage in CI efforts over time. A survey designed to assess the completion of core tasks related to early indicators of CI was completed at baseline and 12 months later. Wilcoxon Signed Ranks Test and Mann-Whitney test determined statistically significant progress towards outcomes over 12 months and differences in progress between high- and low- capacity teams. CONCLUSION: In 12 months, teams with little established groundwork made significant progress, in some ways exceeding progress of more established teams. Statistically significant progress was achieved in eleven of fourteen outcomes measured. Five teams aligned local efforts with state priorities after 12 months. Findings suggest technical assistance to establish conditions for collective impact can support progress even when pre-conditions for collective impact are not previously established.

Urban organic community gardening to promote environmental sustainability practices and increase fruit, vegetables and organic food consumption / Prácticas agrícolas ecológicas urbanas para promover la sostenibilidad ambiental y aumentar el consumo de frutas, verduras y alimentos orgánicos

OBJECTIVE: To describe the environmental practices of participants in an urban organic community garden at the beginning of their gardening experience and after a period of six months, and to discover their opinion about how this activity influenced the consumption of vegetables, fruits and organic food. METHOD: Interviews using structured questionnaires were conducted twice with 115 city dwellers: when they started in the vegetable garden and about 6 months later. The questionnaire included questions related to environmental practices. The second evaluation also included questions related to the consumption of organic food, vegetables and fruit. RESULTS: This research showed significant behavioural transformation, including positive outcomes in environmental practices such as recycling and trying to persuade friends or family to recycle, compost leftovers or choose to walk/bike to save petrol. In the opinion of the participants, activities in the organic community garden helped to increase consumption of fruits, vegetables and organic food. CONCLUSIONS: The study results reinforce the hypothesis that an organic community vegetable garden can induce significant, positive behavioural changes among its users. In particular this research suggests horticulture is associated with positive improvements in personal environmental behaviours, awareness of the environment's high social priority and increased consumption of organic food, fruit and vegetables

OBJETIVO: Caracterizar las prácticas ambientales de los participantes de un jardín comunitario orgánico urbano al inicio de su experiencia en prácticas agrícolas y después de 6 meses, así como conocer su opinión sobre cómo esta actividad influyó en el consumo de verduras, frutas y alimentos orgánicos. MÉTODO: Las entrevistas con cuestionarios estructurados se realizaron dos veces a 115 habitantes de la ciudad: cuando comenzaron en la huerta y unos 6 meses después. El cuestionario incluyó preguntas relacionadas con las prácticas ambientales. La segunda evaluación incluyó también preguntas sobre el consumo de alimentos orgánicos, verduras y frutas. RESULTADOS: Se observó una transformación conductual significativa, incluidos resultados positivos en prácticas ambientales como el reciclaje e intentar que amigos o familiares reciclen, la composta de sobras o elegir caminar o ir en bicicleta para ahorrar gasolina. En opinión de los participantes, las prácticas agrícolas de la comunidad orgánica contribuyeron a aumentar el consumo de frutas, verduras y alimentos orgánicos. CONCLUSIÓN: Los resultados del estudio refuerzan la hipótesis de que un huerto comunitario orgánico puede inducir cambios conductuales significativos entre sus usuarios. En particular, esta investigación sugiere que la horticultura se asocia con mejoras positivas en los comportamientos ambientales y la conciencia de la alta prioridad social del medio ambiente y un mayor consumo de alimentos orgánicos, frutas y verduras

Tradução para portuguêse validação cultural da Empowerment Assessment Rating Scale / Translation to Portuguese and cultural validation of the Empowerment Assessment Rating Scale

Introduction: To assess the level of community empowerment, Laverack proposes an instrument called the Empowerment Assessment Rating Scale (EARS), which has nine assessment domains related to community empowerment. Objectives: Translate to Portuguese and culturally validate the EARS for an ACeS community, a hospital community, a business community, and a school community. A review of the Portuguese translation was developed, a review group was set up to analyze the resulting document, by consensus a new scale called the Escala de Avaliação do Empoderamento Comunitário (EAvEC) was developed, and the retroversion was developed. Same review group conducted a new evaluation of the resulting version, comparing them with the original in English. The study was carried out at a Hospital in the Azores Archipelago, three Health Centers Organizations in the North of Portugal, an Education-oriented Company in Greater Porto and a School Community in Mozambique, where the focus group scale was applied based on a problematic chosen for intervention. Results: EVaEC retained the nine evaluation domains of the original scale and its translated version did not change after its cultural adaptation. The level of community empowerment was identified in each of the communities, analyzed in the form of a radar chart, with the clustered image of all domains. Discussion / Conclusions: EVaEC is a useful tool for community intervention and is being used to assess community empowerment in the MAIEC project of theCentre for Interdisciplinary Research in Health at Universidade Católica Portuguesa

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Changes in Sugary Beverage Consumption and Public Perceptions in Upstate New York After Implementation of a Community Awareness Campaign and Healthier Vending Strategies.

OBJECTIVE: We evaluated the impact of a community-based healthy beverage procurement and serving practices program, and educational media campaign, on residents' behaviors and beliefs regarding sugary beverages. DESIGN: Repeated cross-sectional population surveys in 2013 and 2014 were conducted, as well as semistructured interviews with key informants. We employed multivariate differences-in-differences regression analysis, adjusting for demographics and weight status, using the survey data. Key informant interviews were reviewed for common themes. SETTING: Three rural counties in upstate New York with high prevalence of children living in poverty and childhood obesity. PARTICIPANTS: Residents of Broome, Cattaraugus, and Chautauqua, with Chemung as a control, reached through cross-sectional random-digit-dial landline and cellular telephones, and practitioners involved in intervention implementation. INTERVENTION: Community organizations were encouraged through presentations to leadership to adopt healthier vending policies, providing more low- and no-sugar options, and were provided assistance with implementation. In addition, a media campaign supported by presentations to the public aimed to educate residents regarding the health consequences of sugary beverage consumption. OUTCOME MEASURES: The survey measured population demographics and sugary beverage consumption frequency, availability, beliefs about harmfulness, and support for regulation, pre- and postintervention. Key informant interviews elicited perceived program challenges and successes. RESULTS: Compared with temporal trends in the control county, availability of regular soda in the intervention counties decreased (differences-in-differences estimator: ß = -.341, P = .04) and support for regulation increased (differences-in-differences estimator: ß = .162, P = .02). However, there were no differences regarding beliefs about harmfulness or consumption. Practitioners confirmed that the intervention increased awareness but was insufficient to spur action. CONCLUSION: Although public education on the harmfulness of sugary beverages and provision of healthier options in some vending machines successfully impacted soda availability and support for regulation, it did not reduce consumption. This intervention seems promising but should be paired with other community-based interventions for a more comprehensive approach.