¿Cómo mejoramos la participación comunitaria en salud? Análisis de las acciones propuestas tras la aplicación de una herramienta de evaluación / How to improve community engagement in health: Analysis of proposed actions following the implementation of a community engagement assessment tool

Objetivo Analizar las líneas de acción propuestas por los proyectos de promoción de la salud participantes en el proyecto de investigación EvaluAGPS, y su relación con las puntuaciones obtenidas con EvalGuía, una herramienta para evaluar la participación comunitaria basada en la evidencia. Diseño Estudio multicéntrico cuali-cuantitativo. Emplazamiento Proyectos de atención primaria o de red intersectorial de atención primaria y municipalidades de 5 comunidades autónomas en España. Participantes Personas que trabajan en 10 proyectos de promoción de la salud, seleccionados con muestreo intencional según criterios de inclusión (proyectos con un mínimo de participación comunitaria centrados en la salud comunitaria). Método Se recogieron los datos mediante cuestionarios (herramienta EvalGuía) y talleres participativos. Los datos cuantitativos se analizaron con estadística descriptiva, los datos cualitativos se analizaron utilizando el análisis de matriz. Resultados Tras pasar la herramienta EvalGuía, las puntuaciones más bajas estaban en la evaluación de resultados, conocimiento de leyes relacionadas con participación comunitaria, diversidad en el grupo motor, medidas de conciliación, recursos financieros y devolución de resultados. Las líneas de acción planteadas eran heterogéneas y no siempre coinciden con las priorizadas. Las líneas priorizadas giraban en torno a la organización del proyecto y a la comunicación. Conclusiones La herramienta EvalGuía puede ser útil para diseñar planes de acción en proyectos de promoción de la salud. La implementación de medidas en 12 meses para aumentar la diversidad del grupo motor, incorporar medidas de conciliación o mejorar la evaluación es difícil. Se requiere más tiempo para implementar este tipo de medidas. (AU)

Objective To analyse the lines of action identified in the health promotion projects participating in the EvaluA GPS research, and their relationship with the scores assigned in EvalGuia, a tool for evaluating evidence-based community participation. Design Qualitative-quantitative multicentre study. Setting Primary care or intersectoral network of primary care and municipalities in five autonomous communities in Spain. Participants Participants of 10 health promotion projects, selected with convenience sampling, following inclusion criteria (projects with a minimum of community engagement and centred on community health). Method Data were collected through questionnaires (EvalGuía tool) and participatory workshops. Quantitative data were analysed with descriptive statistics, qualitative data were analysed using matrix analysis. Results After implementing the EvalGuide tool, the lowest scores were assigned in outcome evaluation, knowledge of policies related to community participation, diversity in the core working group, inclusivity policies, financial resources and diffusion of results. The lines of action proposed were heterogeneous and did not always match with those prioritised as lower score. The prioritised lines revolved around project organisation and communication. Conclusions The EvalGuide tool can be helpful to design action plans in Health Promotion projects. The implementation of measures in 12 months to increase the diversity of the core working group, to incorporate work–life balance measures or to improve evaluation is difficult. More time is needed to implement such measures. (AU)

[How to improve community engagement in health: Analysis of proposed actions following the implementation of a community engagement assessment tool]. / ¿Cómo mejoramos la participación comunitaria en salud? Análisis de las acciones propuestas tras la aplicación de una herramienta de evaluación.

OBJECTIVE: To analyse the lines of action identified in the health promotion projects participating in the EvaluA GPS research, and their relationship with the scores assigned in EvalGuia, a tool for evaluating evidence-based community participation. DESIGN: Qualitative-quantitative multicentre study. SETTING: Primary care or intersectoral network of primary care and municipalities in five autonomous communities in Spain. PARTICIPANTS: Participants of 10 health promotion projects, selected with convenience sampling, following inclusion criteria (projects with a minimum of community engagement and centred on community health). METHOD: Data were collected through questionnaires (EvalGuía tool) and participatory workshops. Quantitative data were analysed with descriptive statistics, qualitative data were analysed using matrix analysis. RESULTS: After implementing the EvalGuide tool, the lowest scores were assigned in outcome evaluation, knowledge of policies related to community participation, diversity in the core working group, inclusivity policies, financial resources and diffusion of results. The lines of action proposed were heterogeneous and did not always match with those prioritised as lower score. The prioritised lines revolved around project organisation and communication. CONCLUSIONS: The EvalGuide tool can be helpful to design action plans in Health Promotion projects. The implementation of measures in 12 months to increase the diversity of the core working group, to incorporate work-life balance measures or to improve evaluation is difficult. More time is needed to implement such measures.

Implementación de un protocolo de recomendación formal de activos para la salud en los equipos de atención primaria aragoneses / Implementation of a social prescribing protocol in Aragon's primary care teams

Objetivo: Analizar la implementación de la «Guía de recomendación de activos para la salud en atención primaria Aragón». Diseño: Estudio observacional, descriptivo, transversal. Emplazamiento: Ciento veintitrés equipos de atención primaria aragoneses. Participantes: Recomendaciones de Activos para la Salud realizadas con el protocolo «Recomendación Activos-AP» de historia clínica electrónica de atención primaria Aragón desde septiembre de 2018 a marzo de 2021. Mediciones principales: Se describieron las variables más relevantes del protocolo: edad, sexo, provincia, sector sanitario, zona básica de salud, problema de salud, aspecto a potenciar, activo para la salud recomendado, tipo de profesional, grado de asistencia, satisfacción y mejoría. Resultados: El protocolo fue utilizado 2.109 veces y se realizaron 1.482 recomendaciones y 428 seguimientos. El uso del protocolo fue aumentando progresivamente hasta marzo de 2020. A 1.431 personas se les realizó una recomendación y a 51 más de una. La edad media de las personas beneficiarias fue de 67,9años. El 74,8% de recomendaciones se dirigieron a mujeres. Diagnósticos relacionados con problemas sociales y psicológicos fueron los más vinculados a recomendaciones, y la esfera física fue el aspecto más potenciado. Los activos más recomendados se vinculaban con actividad física y recursos de promoción de la autonomía personal. Más del 90% de las personas asistieron con regularidad al activo. La satisfacción media fue de 4,8 (0/5) y el grado de mejoría de 4,3 (0/5). Conclusiones: La implementación de recomendación de activos para la salud dentro la Estrategia de Atención Comunitaria Aragón está funcionando. Sin embargo, es necesario revisar algunos aspectos. Es preciso continuar generando evidencia para poder adecuar y hacer más eficiente este proceso.(AU)

Objective: To analyze the implementation of social prescribing guideline in primary care Aragón. Design: Observational, descriptive, cross-sectional study. Location: One hundred twenty-three primary care teams of Aragón. Participants: Social prescribing made with the protocol «Recomendación Activos - AP» of electronic health record of primary care Aragón from September 2018 to March 2021. Main measurements: The most relevant variables of the protocol were described: age, sex, province, health sector, basic health area, health problem, aspect to be enhanced, asset for health recommended, type of professional, degree of assistance, satisfaction and improvement. Results: The protocol was used 2109 times, 1482 recommendations were made and 428 follow-ups were performed. The use of the protocol increased progressively until March 2020. A total of 1431 people received one recommendation and 51 received more than one recommendation. The average age of the beneficiaries was 67.9years. 74.8% of recommendations were addressed to women. Diagnoses related to social and psychological problems were the most frequently recommended, and the physical sphere was the aspect most promoted. Most social prescribing was linked to physical activity and resources for the promotion of personal autonomy. More than 90% of the people regularly attended the activity, the average satisfaction was 4.8 (0/5) and the degree of improvement 4.3 (0/5). Conclusions: The implementation of asset for health recommended within the Aragon community care strategy is working, however, some aspects need to be reviewed. It is necessary to continue generating evidence to be able to adapt and make this process more efficient.(AU)

[Implementation of a social prescribing protocol in Aragon's primary care teams]. / Implementación de un protocolo de recomendación formal de activos para la salud en los equipos de atención primaria aragoneses.

OBJECTIVE: To analyze the implementation of social prescribing guideline in primary care Aragón. DESIGN: Observational, descriptive, cross-sectional study. LOCATION: One hundred twenty-three primary care teams of Aragón. PARTICIPANTS: Social prescribing made with the protocol «Recomendación Activos - AP¼ of electronic health record of primary care Aragón from September 2018 to March 2021. MAIN MEASUREMENTS: The most relevant variables of the protocol were described: age, sex, province, health sector, basic health area, health problem, aspect to be enhanced, asset for health recommended, type of professional, degree of assistance, satisfaction and improvement. RESULTS: The protocol was used 2109 times, 1482 recommendations were made and 428 follow-ups were performed. The use of the protocol increased progressively until March 2020. A total of 1431 people received one recommendation and 51 received more than one recommendation. The average age of the beneficiaries was 67.9years. 74.8% of recommendations were addressed to women. Diagnoses related to social and psychological problems were the most frequently recommended, and the physical sphere was the aspect most promoted. Most social prescribing was linked to physical activity and resources for the promotion of personal autonomy. More than 90% of the people regularly attended the activity, the average satisfaction was 4.8 (0/5) and the degree of improvement 4.3 (0/5). CONCLUSIONS: The implementation of asset for health recommended within the Aragon community care strategy is working, however, some aspects need to be reviewed. It is necessary to continue generating evidence to be able to adapt and make this process more efficient.

Baja concordancia entre la información clínica de atención primaria y hospital / Low concordance between primary care and hospital clinical information

OBJETIVOS: Medir la concordancia respecto a las enfermedades crónicas registradas en atención primaria (AP) y hospitalaria, y valorar la utilidad de sus registros asistenciales con fines de investigación. Emplazamiento: Estudio transversal retrospectivo integrando información diagnóstica de AP y hospitalaria de la población de Aragón ingresada en 2010. PARTICIPANTES: Se analizó a 75.176 pacientes INTERVENCIONES: Se analizaron coincidencias, divergencias e índice kappa de los diagnósticos registrados en AP y hospital, estratificando por grupos de edad y sexo. MEDICIONES PRINCIPALES: Enfermedades estudiadas: EPOC, diabetes, hipertensión, enfermedad cerebrovascular, cardiopatía isquémica, asma, epilepsia e insuficiencia cardiaca. RESULTADOS: La concordancia fue mayor en hombres y entre los 45-64 años. Diabetes fue el diagnóstico más concordante (índice kappa: 0,75) mientras que asma obtuvo los valores más bajos (índice kappa: 0,34). CONCLUSIONES: La baja concordancia de la información diagnóstica contenida en AP y hospital obliga a adoptar medidas que permitan a los profesionales sanitarios a conocer el conjunto de problemas de salud que presenta un paciente

OBJECTIVES: To measure the diagnostic agreement between Primary Care (PC) and hospital information systems, in order to assess the usefulness of health care records for research purposes. SETTING: Cross-sectional retrospective study integrating PC and hospital diagnostic information for the Aragon population admitted to hospital in 2010. PARTICIPANTS: 75.176 patients were analysed. INTERVENTIONS: Similarities, differences and the kappa index were calculated for each of the diagnoses recorded in both information systems. MAIN MEASUREMENTS: The studied diseases included COPD, diabetes, hypertension, cerebrovascular disease, ischaemic heart disease, asthma, epilepsy, and heart failure. RESULTS: Diagnostic concordance was higher in men and between 45 and 64 years. Diabetes was the condition showing the highest concordance (kappa index: 0.75), while asthma had the lowest values (kappa index: 0.34). CONCLUSIONS: The low concordance between the diagnostic information recorded in PC and in the hospital setting calls for urgent measures to ensure that healthcare professionals have a comprehensive picture of patient's health problems

[Low concordance between primary care and hospital clinical information]. / Baja concordancia entre la información clínica de atención primaria y hospital.

OBJECTIVES: To measure the diagnostic agreement between Primary Care (PC) and hospital information systems, in order to assess the usefulness of health care records for research purposes. SETTING: Cross-sectional retrospective study integrating PC and hospital diagnostic information for the Aragon population admitted to hospital in 2010. PARTICIPANTS: 75.176 patients were analysed. INTERVENTIONS: Similarities, differences and the kappa index were calculated for each of the diagnoses recorded in both information systems. MAIN MEASUREMENTS: The studied diseases included COPD, diabetes, hypertension, cerebrovascular disease, ischaemic heart disease, asthma, epilepsy, and heart failure. RESULTS: Diagnostic concordance was higher in men and between 45 and 64 years. Diabetes was the condition showing the highest concordance (kappa index: 0.75), while asthma had the lowest values (kappa index: 0.34). CONCLUSIONS: The low concordance between the diagnostic information recorded in PC and in the hospital setting calls for urgent measures to ensure that healthcare professionals have a comprehensive picture of patient's health problems.