Urge capacitar a los gobiernos locales para la intersectorialidad por la salud: un policy brief / Capacity building for intersectoral action for health by local governments is needed: a policy brief

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Los retos de la promoción de la salud en una sociedad multicultural: revisión narrativa de la literatura / The challenges of health promotion in a multicultural society: a narrative review

La realidad multicultural en la que vivimos hoy en día, hace que los profesionales de la salud interactúen a diario con personas y familias de culturas diversas. La interacción entre una persona o familia y un profesional de la salud de una cultura diferente se denomina «encuentro cultural». Los encuentros no van a estar exentos de dificultades a las que los profesionales van a tener que hacer frente para poder proporcionar un buen cuidado y promover estilos de vida saludables. En la revisión narrativa llevada a cabo se han observado que las dificultades están relacionadas con factores culturales y linguísticos, la alfabetización en salud, las desventajas en el estado socio-económico y los prejuicios y estereotipos de los profesionales de la salud. Las estrategias sugeridas para vencer esas dificultades son: el desarrollo de programas culturalmente adaptados; utilizar una pedagogía y recursos apropiados, y materiales cultural y lingüísticamente adaptados; el uso de intérpretes y la organización de cursos para aprender el idioma mayoritario. Además de esas estrategias, la bibliografía enfatiza la necesidad de un cambio de enfoque en el que el objetivo sea la formación de los profesionales de la salud para el desarrollo de lo que los autores denominan «competencia cultural». La formación en competencia cultural está orientada a favorecer que los profesionales ofrezcan y promuevan cuidados congruentes y adaptados a los valores culturales, creencias y prácticas de cualquier persona, familia o grupo sin caer en prejuicios ni estereotipos (AU)

Nowadays multicultural reality leads health professionals to interact in their daily work with individuals and families from diverse cultures. The interaction between a person or family and a health professional from a different culture is called «cultural encounter». These encounters involve difficulties, complications and barriers, which health professionals will have to face in order to provide good care and promote healthy lifestyles. This narrative review shows that the difficulties are related to cultural and linguistic factors, health literacy, disadvantages in socio-economic status and the prejudices and stereotypes of healthcare professionals. Different strategies are described in the literature that could help health professionals to overcome these difficulties, namely: the development of culturally appropriate programmes; appropriate pedagogy and resources, and the use of culturally and linguistically sensitive materials; the use of interpreters and the organization of courses to learn the most widely spoken language. In addition to these strategies, the need is underscored for a change of approach in which the objective should be training health professionals to achieve «cultural competence». Training in cultural competence would encourage professionals to offer tailored care plans, taking into account the cultural values, beliefs and practices of any person or family, and would help them to avoid stereotypes and prejudices (AU)

School children's own views, roles and contribution to choices regarding diet and activity in Spain.

BACKGROUND: Behaviours regarding food and activity are learned during childhood and continue throughout life. Children can be very important agents in making decisions concerning their own well-being and care and their perspective is essential to understanding how they and/or others make choices for them to achieve a healthy lifestyle. However, their perspectives remain under-researched. This study provides an insight into school children's own perspectives, behaviours and contribution to food and activity choices. METHODS: The paper reports on the findings from an ethnographic study with 38 Spanish children aged 5-7 years. Information was obtained through participant observations, diaries kept by children and group interviews. Data were analysed using techniques of analytical induction and constant comparison. RESULTS: The children who took part in this study described choices about activities with enthusiasm. Children saw activity as a way of learning new things, mastering skills and socializing. They were willing to try and experience new activities and games. However, the activities performed depended on parents' agendas and security issues. In contrast, children reported less interest in and active involvement in food choices. They contributed to family food choices indirectly through the expression of their preferences, not wanting to eat what they disliked or tasting new foods. CONCLUSION: Children had strong preferences and motivations, particularly about activities which could be harnessed in interventions to prevent obesity and promote healthy diet and activity. Parental involvement and commitment is also important both to encourage exercise according to children's interests and active informed food choices, including introduction to unfamiliar foods.

El comienzo de la lactancia: experiencias de madres primerizas / Initiating breastfeeding: experiences of first-time mothers

Fundamento. La lactancia materna es importante para promover el desarrollo saludable del recién nacido. A pesar de sus beneficios, el abandono es masivo durante el primer trimestre de vida. El objetivo de esta investigación fue explorar cómo las madres primerizas percibían y experimentaban la lactancia materna para poder identificar así los aspectos que influyen en su instauración. Material y métodos. Se llevó a cabo un estudio cualitativo con un enfoque fenomenológico descriptivo, en el que participaron 12 madres primíparas que fueron entrevistadas en profundidad en dos ocasiones, una los primeros días tras el parto y otra al mes de haber dado a luz. Los datos obtenidos se grabaron y transcribieron para analizarlos con el método de Giorgi. Resultados. El significado esencial de la experiencia vivida por las madres que participaron en este estudio se puede resumir en los cinco temas que se detallan a continuación: la idealización de la lactancia; la incertidumbre ante las dificultades; el deseo de privacidad durante las tomas; la responsabilidad compartida con el niño para lograr el éxito; y finalmente, la desorganización en sus vidas y la modificación del rol de la mujer. Conclusiones. Conocer las experiencias de las madres primíparas en la etapa de instauración de la lactancia, permitirá a los profesionales diseñar intervenciones específicas adaptadas a ellas. Los profesionales deberían tener en cuenta las expectativas de cada madre y cómo hace frente al nuevo rol, la necesidad de proporcionar apoyo práctico y emocional con unanimidad de criterios y la importancia del apoyo del padre (AU)

Background. Breastfeeding is important for promoting the healthy development of the new born. Despite its benefits, the abandonment of breastfeeding is massive in the first three months of life. The aim of this research was to explore how first-time mothers perceived and experienced breastfeeding in order to identify issues affecting its establishment Methods. A qualitative study with a descriptive phenomenological approach was used. Twelve first-time mothers were interviewed in-depth on two occasions: once a few days after childbirth, and another time one month from giving birth. The data were recorded and transcribed verbatim. Giorgi’s method was used for the analysis. Results. The essential meaning of the experience undergone by the mothers who took part in this study can be described by the following five themes: an idealization of breastfeeding; uncertainty over the difficulties; a desire for privacy during breastfeeding; shared responsibility with the child for breastfeeding to succeed; and, finally, disruption to the women’s lives and changes in their role. Conclusions. This study allowed access to the experiences of first-time mothers during the establishment of breastfeeding. This information will facilitate the design of tailored interventions taking into account the mothers’ reports. Health professionals should: consider women’s expectations and how they face their new role, provide practical and emotional support, be consistent and avoid giving conflicting advice, and a know ledge the importance of the fathers’ support (AU)

[Initiating breastfeeding: experiences of first-time mothers]. / El comienzo de la lactancia: experiencias de madres primerizas.

BACKGROUND: Breastfeeding is important for promoting the healthy development of the newborn. Despite its benefits, the abandonment of breastfeeding is massive in the first three months of life. The aim of this research was to explore how first-time mothers perceived and experienced breastfeeding in order to identify issues affecting its establishment. METHODS: A qualitative study with a descriptive phenomenological approach was used. Twelve first-time mothers were interviewed in-depth on two occasions: once a few days after childbirth, and another time one month from giving birth. The data were recorded and transcribed verbatim. Giorgi's method was used for the analysis. RESULTS: The essential meaning of the experience undergone by the mothers who took part in this study can be described by the following five themes: an idealization of breastfeeding; uncertainty over the difficulties; a desire for privacy during breastfeeding; shared responsibility with the child for breastfeeding to succeed; and, finally, disruption to the women's lives and changes in their role. CONCLUSIONS: This study allowed access to the experiences of first-time mothers during the establishment of breastfeeding. This information will facilitate the design of tailored interventions taking into account the mothers' reports. Health professionals should: consider women's expectations and how they face their new role, provide practical and emotional support, be consistent and avoid giving conflicting advice, and acknowledge the importance of the fathers' support.