Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study.

The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.

Advancing Nutrition and Dietetics Research in Global Food and Nutrition Security: A Roundtable Meeting Report.

Food and nutrition security remains a relevant issue globally, impacting nutritional status and other health outcomes. This is further complicated by various environmental factors that impact stable access to, availability of, and utilization of nutritious foods. Nutrition and dietetics practitioners play an important role in the identification and treatment of food and nutrition security and are also well positioned to advance research that can support food and nutrition security solutions. To address this important issue, the Academy of Nutrition and Dietetics' Council on Research convened a Global Food and Nutrition Security Research Task Force (Task Force). To leverage existing information and expertise in this area and identify the need for future evidence, the Task Force hosted a virtual roundtable with key internal and external stakeholders. This 2-day event included discussions on research gaps, potential entry points for nutrition and dietetics practitioners, and important equity considerations in the area of food and nutrition security research. The identified research gaps included the need for standardized terminology for consistent data collection, the need for validated screening and assessment tools that can be used across settings and also assess diet quality, additional translational and implementation science research, multi-sectoral and multi-pronged approaches, interdisciplinary collaboration with community partners, incorporation of research into policy development, and additional evidence on food systems approaches to target food and nutrition security. To more clearly identify the entry points for practitioners, five examples from various countries were included to identify food and nutrition security issues and how nutrition and dietetics practitioners can be involved in research to address food and nutrition security. The Task Force would like this information to inform a research agenda and be leveraged by the larger scientific community to drive future funding and research opportunities for food and nutrition professionals on this topic.

Professional competences to promote healthy ageing across the lifespan: a scoping review.

As societies age, the development of resources and strategies that foster healthy ageing from the beginning of life become increasingly important. Social and healthcare professionals are key agents in this process; therefore, their training needs to be in agreement with societal needs. We performed a scoping review on professional competences for social and health workers to adequately promote healthy ageing throughout life, using the framework described by Arksey and O'Malley and the Joanna Briggs Institute Guidelines. A stakeholder consultation was held in each of the participating countries, in which 79 experts took part. Results show that current literature has been excessively focused on the older age and that more attention on how to work with younger population groups is needed. Likewise, not all disciplines have equally reflected on their role before this challenge and interprofessional approaches, despite showing promise, have not been sufficiently described. Based on our results, health and social professionals working to promote healthy ageing across the lifespan will need sound competences regarding person-centred communication, professional communication, technology applications, physiological and pathophysiological aspects of ageing, social and environmental aspects, cultural diversity, programs and policies, ethics, general and basic skills, context and self-management-related skills, health promotion and disease prevention skills, educational and research skills, leadership skills, technological skills and clinical reasoning. Further research should contribute to establishing which competences are more relevant to each discipline and at what level they should be taught, as well as how they can be best implemented to effectively transform health and social care systems.

Perspective: Food and Nutrition Insecurity in Europe: Challenges and Opportunities for Dietitians.

In recent years, the interest in food and nutrition insecurity in high-income countries has skyrocketed. However, its recognition in Europe is still developing. This perspective summarizes the evidence on food and nutrition insecurity across Europe in terms of prevalence, consequences, and current mitigation strategies, with the aim of outlining the challenges and opportunities for dietitians. Prevalence in the general population ranges between 5% and 20%, with higher rates identified in women, children, older adults, single-parent households, those with low educational attainment, and on low or unstable income and/or employment. In users of food aid, the prevalence of food insecurity is above 70%. Responses to food and nutrition insecurity include welfare policies and food assistance programs at regional and national levels. However, most current strategies are not successful in tackling the structural drivers of food and nutrition insecurity, nor do they guarantee diet quality. Despite limited involvement to-date, dietitians can play an important role in addressing food and nutrition insecurity across Europe. This narrative identifies 4 areas: 1) create awareness of the existence and severity of food and nutrition insecurity, 2) advocate for comprehensive, robust data on the determinants and prevalence, 3) partner with diverse stakeholders, social assistance providers, local authorities, and nongovernmental organizations in a comprehensive, intersectoral, and integrated manner, 4) participate in the development of political instruments and interventions that ensure equitable access to high-quality safe food.

European dietitians as key agents of the green transition: An exploratory study of their knowledge, attitudes, practices, and training.

Introduction: How food systems are currently provisioning food to the population is a matter of debate worldwide. Food systems, driven by widespread and increasing adherence to a westernized dietary pattern, are failing to meet people's basic needs and are draining natural resources. There is a push to make food systems more healthy, fair, and sustainable. To this end, action from all players is needed to meet the international agenda. In this regard, dietitians play a crucial role, as they can provide advice and promote actions that foster the adoption of more sustainable dietary patterns (SDP) as well as the promotion of sustainable food systems. As an emerging requirement in their training, it is crucial to know what dietitians know about SDP as well as their attitudes and current practices in this field in order to strengthen their competences and be key agents for the green transition. For this reason, the aim of the present study is to explore the knowledge, attitudes, practices, and training (KAPT) of European dietitians on SDP by administering an online survey. Methods: Cross-sectional survey administered between April-August 2021 to dietitians based in the European countries with National Dietetic Associations or Education Associate Members affiliated to the European Federation of Associations of Dietitians (EFAD). Results were analyzed based on European region of professional practice (Northern/Southern/Western/South-East Europe), area of expertise and years of experience. Results: Responses from 2211 dietitians from 25 countries were received, although the analysis was based on those that responded at least 90% of the survey (n=208). European dietitians are lacking training on SDP but are willing to learn more about it. Most dietitians perceive themselves as able to define an SDP, although aspects concerning social and economic sustainability were underestimated. Dietitians concur that barriers exist to the promotion of SDP, such as the lack of updated national food-based dietary guidelines and the absence of support from peers and managers. The country of professional activity seemed to be key to influencing dietitians' KAPT. Discussion: These results emphasize the need to strengthen European dietitians' training in SDP and increase public/private commitment to consider dietitians as key professionals for the transition towards SDP.

Analysis of gender perspective in the use of NANDA-I nursing diagnoses: A systematic review.

AIM: To identify, describe and analyse the gender perspective in the use of the diagnoses contained in the NANDA-I taxonomy in observational studies published in the scientific literature. DESIGN AND METHODS: A systematic review has been conducted spanning from 2002 to 2020. The most frequent NANDA-I nursing diagnoses in care plans reported in observational studies, and the defining characteristics and related factors identified for men and women have been described. The Preferred Reporting Items for Systematic Reviews (PRISMA-P) have guided our research. The main findings have been summarized using a descriptive narrative synthesis approach. RESULTS: Forty-one articles were included in our study. With regard to gender analysis, the percentage of men and women that make up the sample were not specified in all articles, and half of the studies did not identify gender either in the diagnosis label or in their defining characteristics or related factors. Based on the reviewed articles, gender perspectives are not systematically incorporated in the use of the NANDA-I diagnosis. Therefore, gender biases in its use in the scientific literature may exist. This situation poses barriers to determine the health responses that are different and unequal between women and men.

Impact of Health and Social Factors on the Cardiometabolic Risk in People with Food Insecurity: A Systematic Review.

Food plays a key role in people's health and quality of life. Inadequate eating habits or a deficient diet can lead to the development of non-communicable diseases (NCDs). The present review aims to describe the health and social factors related to food insecurity (FI) in adults in high-income countries and evaluate their impact on cardiometabolic risk (CMR). Following the PRISMA procedures, a systematic review was conducted by searching in biomedical databases. Full articles were screened (nf = 228) and critically appraised, and 12 studies met the inclusion criteria. Based on the selected studies, the results grouped information based on (i) the characteristics of the population in FI, (ii) the impact of FI on NCDs, and (iii) the cardiovascular and all-cause mortality risk of the FI population. Considering the minimum and maximum percentage data, people of the categories female sex (46.2-57.6%), education level lower than high school (11-67.46%), non-Hispanic white ethnicity (37.4-58%), single or separated or widowed (45-64.8%), and current smoker (35.5-61.1%) make up the population with FI in high-income countries. All of these factors presented a significant association (p < 0.001) with cardiovascular risk factors. The highest odds ratios (OR) for the FI population are described for obesity (OR = 2.49, 95% CI; 1.16-5.33) and myocardial infarction (OR = 2.19, 95% CI). Interventions that integrate FI screening and the measurement of CMR factors into routine clinical care may be an important step to identify vulnerable populations and subsequently improve and prevent NCDs. Thus, food-diet policies and public-health-based interventions are needed to be included in the measurement of CMR in the assessment of FI.

The association between social capital indicators and psychological distress in Catalan adolescents.

According to the WHO, globally, one in seven adolescents experiences a mental disorder, being in a detrimental situation toward educational achievement, social cohesion, future health and life chances. Calls to identify risk and resilience factors to develop effective preventive actions have been made. Following a systemic approach, we conducted a cross-sectional study on the relationship between social capital and psychological distress in a sample of Catalan adolescents in Barcelona, taking into account a range of other relevant aspects at different levels influencing mental health, including gender, age, migrant status, family background, lifestyle factors, body mass index, and self-rated health. Data were collected through validated questionnaires in December 2016 from 646 of 14- to 18-year-old adolescents from three public and private high schools in Barcelona (Spain). Data analysis included descriptive analysis, a correlational study and logistic regression to obtain the odds ratio for social capital indicators to be associated with psychological distress. Our results suggest that reporting higher levels of family support and higher levels of teacher-student trust reduce the likelihood of suffering psychological distress. Higher levels of neighborhood informal control were associated with mental health, but a possible detrimental effect cannot be ruled out. Being a girl, reporting low self-rated health or higher media use was also associated with higher likelihood of psychological distress. Current results may encourage interventions that focus on social capital as a means to reduce psychological distress and foster well-being in youth.

The Measurement of Food Insecurity in High-Income Countries: A Scoping Review.

The measurement of food insecurity is essential to monitor the prevalence, risk factors, consequences and effects of food insecurity and the interventions and policies implemented to tackle it. Yet, how best to apply it remains an unsettled issue due to the multifaceted and context-dependent nature of food insecurity. We report a scoping review of measures of food insecurity at the individual and household level in high-income countries with the final purpose of facilitating a catalogue of instruments to be used by both researchers and practitioners. The scoping review was conducted following the methodological framework of Arksey and O'Malley and the Joanna Briggs Institute guidelines. We included all types of documents published between 2000-2020 using instruments that estimate food insecurity at both individual and household level in high-income countries, and with respondents including adolescents, adults, and elderly. We identified a total of 23 measurement strategies being used in 33 peer-reviewed publications and 114 documents from the grey literature. Our results show that most measures focus on the access dimension of food insecurity and that further research is required to develop measures that incorporate aspects of quality of dietary intake and relevant individual, household and social conditions related to food insecurity.

Interventions on Food Security and Water Uses for Improving Nutritional Status of Pregnant Women and Children Younger Than Five Years in Low-Middle Income Countries: A Systematic Review.

Malnutrition is a global health issue concerning children and pregnant women in low- and middle-income countries (LMICs). The aim of this review was to assess the health-impact outcomes of interventions addressing food security, water quality and hygiene in order to address the improvement of the nutritional status in children below five years and pregnant women in LMICs. Using PRISMA procedures, a systematic review was conducted by searching in biomedical databases clinical trials and interventions for children and pregnant women. Full articles were screened (nf = 252) and critically appraised. The review included 27 randomized and non-randomized trials and interventions. Based on the analysis, three agents concerning nutritional status were identified. First, exclusive breastfeeding and complementary feeding were fundamental elements in preventing malnutrition. Second, provision of sanitation facilities and the promotion of hygienic practices were also essential to prevent infections spread and the consequent deterioration of nutritional status. Finally, seasonality was also seen to be a relevant factor to consider while planning and implementing interventions in the populations under study. In spite of the efforts conducted over last decades, the improvement in food insecurity rates has remained insufficient. Therefore, the development of global health programs is fundamental to guide future actions.

Interventions across the Retirement Transition for Improving Well-Being: A Scoping Review.

(1) Background: The work-to-retirement transition involves a process of psychologically and behaviorally distancing oneself from the workforce that is often accompanied by other social changes, which can influence health and well-being. However, research on interventions targeting the work-to-retirement transition to improve health status is limited. Our objective was to summarize and describe interventions aiming to improve well-being across the retirement transition; (2) Methods: We conducted a scoping review following the methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the PRISMA-ScR statements; we systematically searched articles and gray literature to identify interventions and policies that aimed to improve well-being across the retirement transition. (3) Results: 15 publications were included, which comprised both experimental designs (n = 10) and systematic reviews (n = 5). (4) Conclusions: More research on how to promote overall well-being during the work-to-retirement transition is needed. The results of this scoping review show that most reported interventions address one single lifestyle behavior, and that relevant social determinants of health have been barely considered in their design. Future investigations need to consider vulnerable groups and country-specific structural conditions. Adopting a patient and public involvement approach will contribute to developing interventions that address the significant needs of those in the transition to retirement.

A comparison of European countries FBDG in the light of their contribution to tackle diet-related health inequalities.

BACKGROUND: The purpose of this article is to report on a comparative analysis of the official food-based dietary guidelines (FBDG) that were applicable in 2015 in 25 EU Member States. We assess FBDG in relation to the main guidelines established by the FAO/WHO, the EURODIET project and the EFSA, with a particular focus on identifying strengths and limitations of current FBDG in Europe towards addressing diet-related health inequalities. METHODS: This is a review research, in which a mixed-methods sequenced procedure was utilized. In each EU country key informants, including sociologists, economists, dietitians and nutritionists were asked to provide data regarding: (i) current dietary guidelines and national health priorities, (ii) model of health promotion currently available, (iii) results of the latest food consumption survey. All documents were reviewed by the coordinating team. Full data were analysed by two nutritionists, using a tabulated sheet to organize and compare the results. RESULTS: While all countries have national FBDG, the level of detail and quality varies substantially with regard to: time of last update; availability of recommendations for specific target groups; specification of frequency and portion size; the graphical representation; recommended amounts and limits of foods consumed; and recommendations regarding physical activity. CONCLUSIONS: European countries have great opportunities to improve FBDG to better serve Public Health policy through a more consistent foundation of how these guidelines are developed, the inclusion of different population subgroups as a target for recommendations and the implementation of monitoring systems.

Interventions across the retirement transition for improving well-being: a scoping review protocol.

INTRODUCTION: The work-to-retirement transition involves a process of psychologically and behaviourally distancing oneself from the workforce that is often accompanied by other social changes. The person is confronted with new social roles, expectations, challenges and opportunities that can influence lifestyle and well-being. In the scientific literature, we find recent reports of interventions aimed at improving health and well-being in people at retirement age. However, there is still a gap of knowledge on how different interventions during retirement might improve health status. We intend to conduct a scoping review with the aim of describing interventions for improving well-being across the retirement transition. METHODS AND ANALYSIS: The methodological framework described by Arksey and O'Malley; the Joanna Briggs Institute guidelines as well as the Preferred Reporting Items for scoping reviews and Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols statements will be followed. Eligibility criteria comprise of: (a) all type of original studies, review articles or reports published on journals as well as grey literature; (b) describing interventions to improve the well-being in adults across their retirement transition; (c) including participants before, during and after retirement; (d) all publications must describe variables associated with participants' physical and/or psychological and/or social well-being and/or perceived quality of life related to these; (e) no language restriction and (f) published from January 2000 to March 2019. The main findings will be summarised using a narrative descriptive synthesis approach and grouped following the population, concept and context principles. A stakeholder meeting will be held to provide feedback on the findings and to develop next steps in research and practice. ETHICS AND DISSEMINATION: Approval from a research ethics committee is not required, as no personal information will be collected. We plan to disseminate our research findings at different levels: scientific community, clinical and social arenas, as well as to healthcare leaders and policymakers and general population. The project has been registered at Open Science Framework with the name TRANSITS: work to retirement transition project.

Development and validation of a questionnaire to measure family social capital.

The development and psychometric validation of instruments to measure social capital remains a priority in the field. The aim of the current study was to develop a Questionnaire on Family Social Capital (FSCQ) for use in an adolescent population and to test its reliability and validity. We followed an exploratory, sequential mixed-methods approach consisting of four steps: (1)item selection based on a conceptual model; (2)expert judgment of the conceptual model; (3)cognitive validation through focus groups; (4)psychometric validation, through principal components analysis (PCA) and confirmatory factor analysis (CFA) to assess construct validity, using Cronbach alpha and ICC to test reliability, and testing rural-urban differences to evaluate discriminant validity. A total of 429 3r and 4th ESO students participated in the study. The resulting 26-item FSCQ demonstrated a second-order model with two dimensions and seven first-order factors. The model showed good internal consistency and reliability, as indicated by the Chi-squared value(χ = 155.834; p = 0.91) and CFI(0.936). Discriminant validity tests showed significantly higher scores for the structural FSC and the total FSC scores for the rural group. We conclude that the instrument is an adequate tool to study family social capital in adolescents.

Food Reference Budgets as a Potential Policy Tool to Address Food Insecurity: Lessons Learned from a Pilot Study in 26 European Countries.

The aim of this article is to present the development of cross-country comparable food reference budgets in 26 European countries, and to discuss their usefulness as an addition to food-based dietary guidelines (FBDG) for tackling food insecurity in low-income groups. Reference budgets are illustrative priced baskets containing the minimum goods and services necessary for well-described types of families to have an adequate social participation. This study was conducted starting from national FBDG, which were translated into monthly food baskets. Next, these baskets were validated in terms of their acceptability and feasibility through focus group discussions, and finally they were priced. Along the paper, we show how that food reference budgets hold interesting contributions to the promotion of healthy eating and prevention of food insecurity in low-income contexts in at least four ways: (1) they show how a healthy diet can be achieved with limited economic resources, (2) they bring closer to the citizen a detailed example of how to put FBDG recommendations into practice, (3) they ensure that food security is achieved in an integral way, by comprising the biological but also psychological and social functions of food, and (4) providing routes for further (comparative) research into food insecurity.

Social influences on adolescents' dietary behavior in Catalonia, Spain: A qualitative multiple-cases study from the perspective of social capital.

Adolescence has been referred to as the last best chance to prevent adult non-communicable diseases. Gaining further evidence on the psychosocial determinants of health behaviors, particularly the impact of peers, social networks and media on diet, is necessary to develop appropriate preventive strategies. Based on a multiple-cases study, our aim was to discuss the social influences on adolescents' dietary behavior from a social capital perspective. Participants were reached through four high-schools in different Catalan rural-urban and socioeconomic contexts. Our results confirm the different layout of social capital in the community, school, peers and family. In our sample, family and peers are the most influent sources of social capital in relation to dietary behaviors, inducing both protective and damaging effects.

Measuring social capital: further insights / La medición del capital social: nuevas perspectivas

Social capital is defined as the resources available to individuals and groups through membership in social networks. However, multiple definitions, distinct dimensions and subtypes of social capital have been used to investigate and theorise about its relationship to health on different scales, creating a confusing picture. This heterogeneity makes it necessary to systematise social capital measures in order to build a stronger foundation in terms of how these associations between the different aspects of social capital and each specific health indicator develop. We aim to provide an overview of the measurement approaches used to measure social capital in its different dimensions and scales, as well as the mechanisms through which it is presumed to influence health. Understanding the mechanisms through which these relationships develop may help to refine the existing measures or to identify new, more appropriate ones (AU)

El capital social se define como los recursos disponibles para individuos y grupos gracias a su membresía en redes sociales. Sin embargo, varias definiciones, dimensiones y subtipos de capital social se han utilizado para investigar y teorizar sobre su relación con la salud a diferentes escalas, lo que genera un panorama confuso. Esta heterogeneidad hace necesario sistematizar las mediciones de capital social con el fin de obtener una base más sólida acerca de cómo se producen estas asociaciones entre los diferentes aspectos del capital y cada indicador específico de salud. Nuestro objetivo es proporcionar una visión general de los métodos de medición utilizados para medir el capital social en sus diversas dimensiones y escalas, así como los mecanismos mediante los cuales se presume que este influye en la salud. La comprensión de los mecanismos por los que esta relación se produce puede orientar el perfeccionamiento de las medidas existentes o la identificación de otras nuevas y más adecuadas (AU)

Measuring social capital: further insights.

Social capital is defined as the resources available to individuals and groups through membership in social networks. However, multiple definitions, distinct dimensions and subtypes of social capital have been used to investigate and theorise about its relationship to health on different scales, creating a confusing picture. This heterogeneity makes it necessary to systematise social capital measures in order to build a stronger foundation in terms of how these associations between the different aspects of social capital and each specific health indicator develop. We aim to provide an overview of the measurement approaches used to measure social capital in its different dimensions and scales, as well as the mechanisms through which it is presumed to influence health. Understanding the mechanisms through which these relationships develop may help to refine the existing measures or to identify new, more appropriate ones.

Development of the Spanish Healthy Food Reference Budget for an adequate social participation at the minimum.

OBJECTIVE: It has been observed that diet quality and food choices vary depending on socio-economic status (SES), especially when measured through income and educational level. Although the reasons behind these differences are multiple, diet cost is a critical determinant in those groups that spend a higher proportion of their budget on food. Reference budgets are priced baskets containing the minimum goods and services necessary for well-described types of families to have an adequate social participation. In the current paper we describe the development and content of the Spanish Healthy Food Basket (SHFB). DESIGN: National dietary guidelines were translated into monthly food baskets. Next, these baskets were validated in terms of acceptability and feasibility through focus group discussions, and finally they were priced. SETTING: The focus group discussions and the pricing were performed in Barcelona, Spain. SUBJECTS: Twenty adults aged 30-50 years from different SES backgrounds and their children aged 2-22 years participated in three discussion groups. RESULTS: The SHFB complies with the dietary recommendations for the Spanish population. The monthly cost of this basket ranges from 131·63 € to 573·80 € depending on the type of family. CONCLUSIONS: The SHFB does not have the purpose of prescribing what people should eat, but of estimating a minimum budget threshold below which healthy eating is not possible for well-described types of families. Thus, the SHFB is an educative guide on how to plan a healthy food budget and orient policies designed to guarantee food access and reduce SES inequalities.