Listening to stakeholders in the prevention of gender-based violence among young people in Spain: a qualitative study from the positivMasc project.

OBJECTIVE: This study seeks to deepen current knowledge of the phenomenon of gender-based violence (GVB) among young people in Spain, identifying the main challenges in terms of prevention from the perspective of key stakeholders in the field. METHODS: 23 semi-structured qualitative interviews were performed with professionals whose work involves youth and comes from different areas: social work, policy making, youth education, feminist and LGBTQ activism and anti-violence masculinities engagement (13 women and 10 men). RESULTS: Among the main challenges identified by stakeholders in relation to GBV preventive strategies in young populations there is a need to focus on transformative programmes within educational settings. The findings indicate that specific programs and interventions in this area may not be yielding the expected effectiveness. This outcome could be attributed less to a lack of resources and more to a failure to address the core issues and challenges adequately. Thus, the results underline that intervention programmes should emphasise equitable gender norms and gender relations and incorporate content on anti-violence masculinities. Finally, a pivotal aspect seen by professionals to facilitate GBV prevention is the design and development of interventions based on participatory and active approaches, close to young people's everyday situations. The results also draw attention to the need to analyse the impact of new forms of violence in greater depth, especially those that occur through information and communication technologies. CONCLUSION: Among other implications for policy and practice, the study points to the need to articulate interventions designed to work simultaneously at different levels of influence acting on people.

Modelo sinérgico de salud: una integración de la salutogénesis y el modelo de activos para la salud.

Se propone un "modelo sinérgico" para avanzar en la integración de elementos clave de la salutogénesis y el modelo de activos para la salud, utilizando como marco para esta articulación la teoría bioecológica de Bronfenbrenner. El sentido de coherencia es clave para facilitar la transformación de recursos potenciales en activos disponibles, produciendo un desarrollo positivo de la salud. El modelo sinérgico puede aportar a la contextualización de las ideas en políticas y prácticas de salud pública, fortaleciendo la dimensión salud-bienestar y contribuyendo al desarrollo de modelos de salud más integrados y colectivos.

Positive Masculinities and Gender-Based Violence Educational Interventions Among Young People: A Systematic Review.

BACKGROUND: Hegemonic masculinity has been recognized as contributing to the perpetration of different forms of gender-based violence (GBV). Abandoning hegemonic masculinities and promoting positive masculinities are both strategies used by interventions that foreground a "gender-transformative approach." Preventing GBV among young people could be strengthened by engaging young men. In this article, we aim to systematically review the primary characteristics, methodological quality, and results of published evaluation studies of educational interventions that aim to prevent different forms of GBV through addressing hegemonic masculinities among young people. MAIN BODY: We conducted a systematic review of available literature (2008-2019) using Medline (PubMed), Scopus, Web of Science, PsycInfo, the CINAHL Complete Database, and ERIC as well as Google scholar. The Template for Intervention Description and Replication was used for data extraction, and the quality of the selected studies was analyzed using the Mixed Method Appraisal Tool. More than half of the studies were conducted in Africa (n = 10/15) and many were randomized controlled trials (n = 8/15). Most of the studies with quantitative and qualitative methodologies (n = 12/15) reported a decrease in physical GBV and/or sexual violence perpetration/victimization (n = 6/15). Longitudinal studies reported consistent results over time. CONCLUSIONS: Our results highlight the importance of using a gender-transformative approach in educational interventions to engage young people in critical thinking about hegemonic masculinity and to prevent GBV.

Promoción de salud más allá de los estilos de vida saludables: propuestas de actuación en una universidad chilena.

Las intervenciones centradas en cambios de conducta, sumadas a la escasa evidencia de mapeo y dinamización de activos en Universidades Promotoras de Salud (UPS), hacen necesario potenciar enfoques integrales y sistémicos que contribuyan al bienestar y empoderamiento de sus integrantes. El objetivo de este artículo es explorar propuestas de acción que contribuyan a fortalecer activos en una comunidad universitaria chilena. Se desarrolló un estudio cualitativo con 72 hombres/77 mujeres (estudiantes, trabajadores, jubilados y exestudiantes). Se realizaron 48 entrevistas individuales y 14 grupos focales. Se efectuó un análisis de contenido utilizando el software QRS NVivo 12. Las propuestas identificadas se agruparon en: desarrollo de la participación e inclusión, promoción de la salud mental, mantenimiento y mejora de áreas verdes e infraestructura, y fortalecimiento del acceso a actividades deportivas, culturales y de extensión universitaria. Las mujeres valoraron la difusión de activos comunitarios y el cuidado de las personas y el entorno. Y los hombres, el fortalecimiento del capital social, la docencia y la transferencia de conocimiento. Las propuestas de acción tienen una orientación colectiva que favorece el vínculo de las personas con su entorno y el desarrollo del sentido de comunidad. Desde una perspectiva de género, se observa reproducción de roles y estereotipos arraigados en el sistema patriarcal. Esto constituye un desafío para potenciar las UPS en tanto política pública, considerando los principios de participación, justicia social y equidad.

Gender Equality and the Global Gender Gap in Life Expectancy: An Exploratory Analysis of 152 Countries.

When looking at life expectancy (LE) by sex, women live longer than men in all countries. Biological factors alone do not explain gender differences in LE, and examining structural differences may help illuminate other explanatory factors. The aim of this research is to analyse the influence of gender inequality on the gender gap in LE globally. We have carried out a regression analysis between the gender gap in relativised LE and the UN Gender Inequality Index (GII), with a sensitivity analysis conducted for its three dimensions, stratified by the six World Health Organization (WHO) regions. We adjusted the model by taking into consideration gross national income (GNI), democratic status and rural population. The results indicated a positive association for the European region (ß=0.184) and the Americas (ß=0.136) in our adjusted model. Conversely, for the African region, the relations between gender equality and the LE gender gap were found to be negative (ß=-0.125). The findings suggest that in the WHO European region and the Americas, greater gender equality leads to a narrowing of the gender LE gap, while it has a contrary relationship in Africa. We suggest that this could be because only higher scores in the GII between men and women show health benefits.

Asset map in a Chilean Health Promoting University: 'a strategy for revitalization'.

Health Promoting Universities (HPUs) are more likely to perform actions intended to change habits and increase personal empowerment, than they are to develop community actions. The objective of this research is to create an asset map to visualize collective actions in a Chilean HPU. A qualitative study, based on the ABCD model was conducted. There were 149 people, distributed into 48 semi-structured interviews and 14 focus groups, who participated in this study (students, employees, ex-students and retirees). An asset map was elaborated, identifying the contributions of residents, associations and organizations, local institutions, physical resources, economic assets and local culture and with a new category, 'connecting assets'. These categories show the range of resources in a university. According to the participants, the questions on asset identification were a tool for reflection, and by giving their opinions and discovering or drawing attention to new resources, they gained a better understanding of the assets in the university. Several participants stated that these talks could generate a positive emotional environment, which boosted their wellbeing. There were gender- and group-based differences in how the assets were valued. Students stressed assets related to services and benefits from the institution, green areas, and collective spaces. Employees, retirees and ex-students emphasized assets related to belonging, identity and traditions. Men appreciated openness and privacy in physical spaces. Women highlighted assets related to the institution. The resulting map, displays a range of resources that can help the university develop new possibilities for comprehensive and collective actions that would revitalize the HPU strategy.

Childhood, families and the Internet: a qualitative approach on health assets / Infancia, familias e Internet: un enfoque cualitativo sobre activos para la salud

Objective: To explore the views of the Internet in childhood, identifying both health assets and risks. Method: A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings in Andalusia (Spain). Teachers in these schools were also asked to complete an online questionnaire using LimeSurvey. This study involved 114 individuals: 64 pupils (33 girls and 31 boys), 28 parents (18 mothers and 10 fathers), and 22 teachers (14 women and 8 men). Analysis of manifest content and underlying meanings was carried out. QSR NVivo 9 software was used to facilitate analysis and make it systematic. Results: Our findings show how the differences in the way parents and children understand health and wellbeing affect the way they discuss the Internet and health. The discussion of results looks at the implications of computer literacy for public health and wellbeing, particularly with regard to health assets. Conclusions: Parents and children understand the contribution of the Internet to health and wellbeing differently. Whilst parents emphasize the risks (unsafe environment, relationships and quality of information, social networks, physical problems and addiction), the children emphasize the assets offered by the Internet. (AU)

Objetivo: Explorar la visión de Internet en la infancia, identificando riesgos y activos para la salud. Método: Estudio cualitativo con 14 grupos focales: ocho con niños y niñas, cuatro con familias y dos mixtos con niños/as y familias en centros de educación primaria de los ámbitos rural y urbano en Andalucía (España). También se aplicó un cuestionario on-line al profesorado de los centros educativos. En total participaron 114 personas (33 chicas y 31 chicos; 18 madres y 10 padres; 14 maestras y 8 maestros). Se llevó a cabo un análisis de contenido manifiesto y contenido latente, utilizando el software QSR NVivo 9 para facilitar dicho análisis y hacerlo más sistemático. Resultados: Los resultados ponen de manifiesto cómo la forma diferencial de entender la salud y el bienestar entre padres/madres e hijos/as influye en la orientación de los discursos sobre Internet y salud. Los resultados son discutidos ampliando el debate existente en torno a las implicaciones en salud pública de la alfabetización digital y su conexión con el enfoque de activos para la salud. Conclusión: Las familias y la infancia entienden la contribución de Internet a la salud y al bienestar de manera muy diferente. Mientras los padres y las madres enfatizan los riesgos (ambiente inseguro, relaciones y calidad de la información, redes sociales, problemas físicos y adicciones), los/las niños/as se centran en enfatizar las potencialidades de Internet, descritas como activos. (AU)

'A synergy model of health': an integration of salutogenesis and the health assets model.

This article proposes to advance the connections between salutogenic theory and assets models for health improvement. There is a need to integrate their use in public health and health promotion so that their respective potentials can be fully developed. This requires their synergies to be made more explicit so that a more coherent approach can be taken to their utilization. A mechanism is therefore needed that helps to raise awareness of them and their value as a resource together. Bronfenbrenner's bioecological theory provides one framework that can support better integration of salutogenesis with the applied nature of assets-based models. This paper proposes a new 'synergy model for health' that integrates key concepts associated with salutogenic theory-generalized and specific resistance resources (GRRs/SRRs) and generalized and specific resistance deficits and the sense of coherence (SOC). In doing so, it highlights those GRRs and SRRs which are assets that, either individually or collectively, help to develop a stronger SOC. Higher levels of SOC can then support the transformations of potential resources into available assets (that people can understand, manage and make sense of), capable of producing positive health development. The proposed 'Synergy model of health' aims to contribute to a deeper theoretical understanding of health and development through the integration of the key elements of both salutogenesis and assets models. This can facilitate a better contextualization of the ideas into public health policy and practice by making the salutogenic theory more action-oriented and the assets model more theoretical.

Childhood, families and the Internet: a qualitative approach on health assets.

OBJECTIVE: To explore the views of the Internet in childhood, identifying both health assets and risks. METHOD: A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings in Andalusia (Spain). Teachers in these schools were also asked to complete an online questionnaire using LimeSurvey. This study involved 114 individuals: 64 pupils (33 girls and 31 boys), 28 parents (18 mothers and 10 fathers), and 22 teachers (14 women and 8 men). Analysis of manifest content and underlying meanings was carried out. QSR NVivo 9 software was used to facilitate analysis and make it systematic. RESULTS: Our findings show how the differences in the way parents and children understand health and wellbeing affect the way they discuss the Internet and health. The discussion of results looks at the implications of computer literacy for public health and wellbeing, particularly with regard to health assets. CONCLUSIONS: Parents and children understand the contribution of the Internet to health and wellbeing differently. Whilst parents emphasize the risks (unsafe environment, relationships and quality of information, social networks, physical problems and addiction), the children emphasize the assets offered by the Internet.

Advancing gender equ(al)ity, lifting men's health: dealing with the spirit of our time.

In this paper, we jointly address two connected issues that should be addressed together more purposefully within both public health policies and programmes: the health and well-being of men and boys, and the focus on equity versus equality from a gender perspective. Awareness of these issues has boosted the debate on the impacts of gender inequality on health and men's role within it. Although this essay is not intended as an in-depth review on the subject, we provide a brief approach to some critical factors interwoven in the process of achieving greater gender equality. We identify some of the challenges that may arise for both policy and new research that seek to assume a relational gender approach that also pays greater attention to men's health.

Evidence for deprescription in primary care through an umbrella review.

BACKGROUND: There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care, and to describe the barriers and enablers of the process from the point of view of patients and healthcare professionals. METHODS: We designed an umbrella review which includes nine systematic reviews. More than 50% of included studies were performed with adults in primary care. Two reviewers independently performed data extraction and analysis. RESULTS: In considering studies of the effectiveness of interventions, it can be observed that the educational component of deprescription procedures is a key factor, whilst procedures tailored towards the patient's situation offer better results. With regards to studies involving healthcare professionals, the main explored areas were the balance between risks and benefits, and the need to improve communication with patients as well as other colleagues involved in patient care. Amongst the identified barriers we found lack of time, inability to access all information, being stuck in a routine, resistance to change and a lack of willingness to question the prescription decisions made by healthcare colleagues. With regards to patients, it is clear that they have worries and doubts. In order to overcome these issues, a good relationship with healthcare professionals and receipt of their support is required during the process. CONCLUSIONS: Optimizing medication through targeted deprescribing is an important part of managing chronic conditions, avoiding adverse effects and improving outcomes. The majority of deprescription interventions in primary care are effective. Good communication between healthcare professionals is a key element for success in the deprescription process.

[The study of health in men from a gender perspective: where we come from, where are we going]. / El estudio de la salud de los hombres desde una perspectiva de género: de dónde venimos, hacia dónde vamos.

Comprehensive and in-depth analyses of differences and inequalities in health require a broad-based approach to the study of masculinities and men's health. Interest in this issue has grown in parallel to increased concern over specific risks and vulnerabilities faced by men, but also due to the need to involve them in programs capable of promoting progress towards gender-based health equity. This article attempts to reframe these issues from the perspective of public health, providing a wider viewpoint on men's health situated within debates on the social determinants of health and the analysis of health inequalities. Based on a relational gender approach, we formulate some recommendations regarding policy and research agendas, which we argue can contribute to advancing the study and development of programs from a gender-based perspective in health.

Llevar a cabo un análisis más integral y profundo de las diferencias y desigualdades en salud requiere de una aproximación más amplia al estudio de las masculinidades y la salud de los hombres en el momento actual. Estamos ante un tema cuyo interés ha ido a la par de la creciente preocupación por los riesgos y vulnerabilidades específicas de los hombres, pero también de la necesidad de involucrarlos en programas con capacidad de promover cambios positivos en el orden de género hacia la equidad en salud. Este artículo resitúa este campo dentro de la salud pública, proporcionando una visión amplificada sobre la salud de los hombres dentro del debate de los determinantes sociales de la salud y el análisis de las desigualdades. Sobre la base de un enfoque relacional de género, se formulan una serie de recomendaciones orientadas a las políticas y la investigación, que consideramos pueden contribuir a avanzar en el estudio y el desarrollo de programas desde una perspectiva de género en salud.

["Here (in Sydney) we are lost:" An ethnographic study of life satisfaction among urban aboriginal Australians participating in a community outreach program]. / "Aquí (en Sídney) estamos perdidos": estudio etnográfico de la satisfacción vital de aborígenes urbanos australianos participantes en un programa sociocomunitario.

This ethnographic study was designed to explore living conditions among a group of aboriginal families residing in an urban context, who participated in a recreational social program. The aim of the study was to explore life satisfaction by analyzing their living conditions and cultural capital inscribed in established attitudes, perceptions, and lay knowledge. Fieldwork was carried out in two complementary phases: phase 1, between May 2008 and December 2010, began when the first listed author initiated volunteer work with the organization responsible for the program; in phase 2, which extended from January 2011 to February 2013, participant observation was intensified and semi-structured interviews were carried out. The results indicate that the process of cultural uprooting underscores the experience of social inequality, and suggest a cohort effect that continues to this day. This process of cultural (in)consonance must be taken into account as a key factor when analyzing the living conditions and well-being of ethnic minorities, as well as when developing programs and interventions.

Este estudio etnográfico fue diseñado para explorar las condiciones de vida de un grupo de familias aborígenes residentes en un contexto urbano, beneficiarias de un programa sociorecreativo en Sídney, Australia. El objetivo fue explorar la satisfacción vital mediante el análisis de sus condiciones de vida y del capital cultural inscrito en sus actitudes, percepciones y conocimientos establecidos. El trabajo de campo se estructuró en dos fases complementarias: en la fase 1, entre mayo de 2008 y diciembre de 2010, se inició con el ingreso del primer autor como voluntario en la asociación responsable del programa y, en la fase 2, entre enero de 2011 y febrero de 2013 se intensificó el proceso de observación participante y las entrevistas semiestructuradas. Los resultados muestran que el proceso de desarraigo cultural está en la base de las experiencias vitales de desigualdad social experimentadas y apunta a un efecto de cohorte que llega hasta nuestros días. Dicho proceso de (des)consonancia cultural debe ser tenido en cuenta como un factor clave a la hora de analizar las condiciones de vida y bienestar de estas minorías étnicas, así como a la hora de desarrollar programas e intervenciones.

Aquí (en Sídney) estamos perdidos: estudio etnográfico de la satisfacción vital de aborígenes urbanos australianos participantes en un programa sociocomunitario / Here (in Sydney) we are lost: An ethnographic study of life satisfaction among urban aboriginal Australians participating in a community outreach program

RESUMEN Este estudio etnográfico fue diseñado para explorar las condiciones de vida de un grupo de familias aborígenes residentes en un contexto urbano, beneficiarias de un programa sociorecreativo en Sídney, Australia. El objetivo fue explorar la satisfacción vital mediante el análisis de sus condiciones de vida y del capital cultural inscrito en sus actitudes, percepciones y conocimientos establecidos. El trabajo de campo se estructuró en dos fases complementarias: en la fase 1, entre mayo de 2008 y diciembre de 2010, se inició con el ingreso del primer autor como voluntario en la asociación responsable del programa y, en la fase 2, entre enero de 2011 y febrero de 2013 se intensificó el proceso de observación participante y las entrevistas semiestructuradas. Los resultados muestran que el proceso de desarraigo cultural está en la base de las experiencias vitales de desigualdad social experimentadas y apunta a un efecto de cohorte que llega hasta nuestros días. Dicho proceso de (des)consonancia cultural debe ser tenido en cuenta como un factor clave a la hora de analizar las condiciones de vida y bienestar de estas minorías étnicas, así como a la hora de desarrollar programas e intervenciones.

ABSTRACT This ethnographic study was designed to explore living conditions among a group of aboriginal families residing in an urban context, who participated in a recreational social program. The aim of the study was to explore life satisfaction by analyzing their living conditions and cultural capital inscribed in established attitudes, perceptions, and lay knowledge. Fieldwork was carried out in two complementary phases: phase 1, between May 2008 and December 2010, began when the first listed author initiated volunteer work with the organization responsible for the program; in phase 2, which extended from January 2011 to February 2013, participant observation was intensified and semi-structured interviews were carried out. The results indicate that the process of cultural uprooting underscores the experience of social inequality, and suggest a cohort effect that continues to this day. This process of cultural (in)consonance must be taken into account as a key factor when analyzing the living conditions and well-being of ethnic minorities, as well as when developing programs and interventions.