Teoría del cambio aplicada al programa de promoción de la actividad física «La Ribera Camina» / Theory of change implemented in the program to promote physical activity “La Ribera Camina”

Objetivo: Aplicar la teoría del cambio al diseño y la evaluación de un programa para promover la actividad física en 11 zonas básicas de salud. Método: Realización de cuatro grupos focales siguiendo la metodología de la teoría del cambio. Se identifican los cambios (a largo, medio y corto plazo) que se pretende alcanzar con el programa «La Ribera Camina» según la opinión de los agentes de interés: profesionales de atención primaria, concejalas/es y personal técnico municipal deportivo, y ciudadanía participante. A través de un análisis temático se identifican las acciones que se deben realizar para alcanzar estos cambios, y las dificultades y los facilitadores para la sostenibilidad del programa. Resultados: Los cambios identificados se clasificaron en cuatro apartados: 1) cambios en la salud física y social (mejoría en la condición física, hábitos saludables, autoestima y sensación de bienestar); 2) cambios organizativos y relacionales (mejor coordinación entre instituciones); 3) cambios específicos del programa (incorporación de más «activos» y asociaciones, sobre todo de hombres, y ampliación de rutas y horarios); y 4) cambios en el entorno (mejora de infraestructuras y seguridad de las rutas). Conclusiones: La teoría del cambio permite identificar y clasificar los cambios que se esperan, las acciones que deben realizarse y los vínculos entre elementos del programa. Esto servirá de base para la evaluación del programa. Dicha metodología podría aplicarse en otros programas que deseen incorporar la intersectorialidad y la participación comunitaria en su diseño y evaluación. (AU)

Objective: To develop a theory of change of a program to promote physical activity in eleven health districts, in order to improve its design and plan its evaluation. Method: Four focus groups were carried out, to develop a participatory theory of change, to identify the expected changes (long, medium and short term) of “La Ribera Camina” program, according to the following stakeholders: primary healthcare professionals, local government representatives and community members. A thematic analysis was used to identify the actions to be taken to achieve these changes, as well as the difficulties and facilitators to enhance the sustainability of the program. Results: The identified changes were classified into four themes: 1) changes in physical and social health (improved physical condition, healthy habits, self-esteem and perceived well-being); 2) organizational and relational changes (better coordination between institutions); 3) specific changes to the program (incorporation of more “assets” and local associations, especially male participants, more trails and schedules); and 4) changes in the environment (improved trails’ infrastructures and safety). Conclusions: The theory of change allows to identify and classify the changes that are expected, the actions to be carried out and the links between elements of the program. This will serve as the basis for its evaluation. This methodology could be applied to other programs interested in incorporating intersectorality and community engagement in their design and evaluation. (AU)

Self-Care and Sense of Coherence: A Salutogenic Model for Health and Care in Nursing Education.

BACKGROUND: Effective advocacy on self-care and the enhancement of a sense of coherence among nurses don't only benefit control over one's health and personal performance, but it may have a direct impact on clinical care and on the entire healing system. In this regard, nursing curricula grounded on a salutogenic model of health (SMH) operate with strategies to engage students in self-care and contribute to improving their mental health and wellbeing. The aim of this study was to explore the relationships between self-care agency and a sense of coherence as dependent variables and the age and self-reported academic performance as independent variables in nursing assistant students. METHODS: For this cross-sectional study, data were collected from a full sample of 921 Certified Nursing Assistant (CNA) Spanish students. A self-administered questionnaire, including sociodemographic variables, the 'appraisal of self-care agency' (ASA), and the 'sense of coherence' (SOC) constructs, was administered. RESULTS: Older participants presented significantly stronger values of both constructs. Apart from a significant and positive correlation between ASAS and SOC, ANOVA analyses indicate significant differences in terms of academic performance according to different ASAS and SOC degrees. CONCLUSIONS: The findings of this study endorse the assumption that there is a consistent relationship between ASA and SOC constructs that might, indeed, have a potential effect on students' academic performance. In practical terms, it seems relevant to try to recognise the students' self-care agency and the sense of coherence as forceful predictive variables of mental health and wellbeing, in addition to academic success as a strength implied in the future career achievement.

[Theory of change implemented in the program to promote physical activity "La Ribera Camina"]. / Teoría del cambio aplicada al programa de promoción de la actividad física «La Ribera Camina¼.

OBJECTIVE: To develop a theory of change of a program to promote physical activity in eleven health districts, in order to improve its design and plan its evaluation. METHOD: Four focus groups were carried out, to develop a participatory theory of change, to identify the expected changes (long, medium and short term) of "La Ribera Camina" program, according to the following stakeholders: primary healthcare professionals, local government representatives and community members. A thematic analysis was used to identify the actions to be taken to achieve these changes, as well as the difficulties and facilitators to enhance the sustainability of the program. RESULTS: The identified changes were classified into four themes: 1) changes in physical and social health (improved physical condition, healthy habits, self-esteem and perceived well-being); 2) organizational and relational changes (better coordination between institutions); 3) specific changes to the program (incorporation of more "assets" and local associations, especially male participants, more trails and schedules); and 4) changes in the environment (improved trails' infrastructures and safety). CONCLUSIONS: The theory of change allows to identify and classify the changes that are expected, the actions to be carried out and the links between elements of the program. This will serve as the basis for its evaluation. This methodology could be applied to other programs interested in incorporating intersectorality and community engagement in their design and evaluation.

Atención Primaria y redes comunitarias en tiempos COVID-19: una aproximación a lo que está pasando y qué podemos hacer / Primary care and community partnerships during the COVID19 pandemic: an approach to what has been done so far and ways to improve it

Objetivo. Identificar las redes y acciones comunitarias realizadas en la Comunidad Valenciana durante la situación de la pandemia por COVID-19 y describir las fortalezas y amenazas para el desarrollo de la salud comunitaria. Diseño. Estudio cuantitativo descriptivo y cualitativo, incluyendo un cuestionario remitido por correo y análisis DAFO. Emplazamiento. Equipos de Atención Primaria (EAP) de la Comunidad Valenciana. Participantes y contexto. El ámbito de estudio son los miembros de la Societat Valenciana de Medicina Familiar i Comunitària (SoVaMFiC). Método. 1) Constitución de un grupo de trabajo; 2) diseño de un cuestionario ad hoc para la identificación de redes comunitarias, acciones o iniciativas durante la pandemia por COVID-19, y de aspectos positivos y negativos del impacto de la pandemia sobre la salud comunitaria; 3) envío del cuestionario a través de correo electrónico; 4) análisis DAFO, y 5) elaboración de recomendaciones. Resultados. Se obtuvieron un total de 56 respuestas (3,3% de participación) identificándose 32 acciones o redes comunitarias de las cuales, 19 existían previamente a la crisis de la COVID-19. Se realizó un análisis DAFO y se identificaron 6 debilidades, 9 amenazas, 5 fortalezas y 8 oportunidades. Este análisis permitió la elaboración de un decálogo de recomendaciones para promover la atención comunitaria en tiempos de la COVID-19. Conclusiones. Las acciones y redes comunitarias surgidas durante la pandemia tienen como objetivo principal responder a las necesidades que han ido apareciendo. Los EAP han participado poco en estas iniciativas. (AU)

Objective: To identify community partnerships, actions or initiatives carried out in the Valencian Community during the Covid19 pandemic and to describe the strengths and challenges to supporting community health during this situation. Design: Mixed method study using survey with closed and open-ended questions and SWOT analysis. Setting: Primary Health are teams of the Valencian Community. Participants and context: Members of the Valencian Society of Family and Community Medicine (SoVaMFiC). Method: (1) Development of a working group. (2) Design of an ad hoc questionnaire to identify community partnerships, actions or initiatives during the Covid19 pandemic, and positive and negative aspects of the impact of the pandemic on community health. (3) Launch of the questionnaire via email; (4) SWOT analysis and (5) development of recommendations. Results: A total of 56 responses were obtained (3.3% response rate), identifying 32 actions or community networks, of which 19 existed prior to the Covid19 crisis. A SWOT analysis was carried out, and six weaknesses, nine threats, five strengths and eight opportunities were identified. This analysis informed the development of a set of 10 recommendations for community care in the time of Covid19. Conclusions: The community partnerships, actions or initiatives developed during the pandemic have the main objective of responding to the needs that have been emerging. The Primary Health Care teams have shown limited engagement in these initiatives. (AU)

Associations and community health workers: analysis and time trends over ten years of training-action / Asociaciones y agentes de salud de base comunitaria: análisis y tendencias temporales durante diez años de formación-acción

Objective: To analyse the profile of the persons and associations that participated in the course, quantify peer education activities and analyse their evolution. Method: A quantitative study using an analysis of the course records from 2009 to 2018 was designed for this purpose inside mihsalud program designed to promote health amongst persons in vulnerable situations in the city of Valencia (Spain). It offers a yearly training-action course of community health workers (CHW) that is attended by persons who have been proposed by associations. The associations were defined according to their population (immigrant, local or intercultural) and the CHWs according to gender, country of birth, year of course, association and continuity after training. Means and confidence intervals were calculated at 95% and a bivariate analysis was conducted in order to compare the activities that took place in 2009 to 2013 with those of 2014 to 2018. The time trends were analysed by applying linear regression models that included the different years studied as the dependent variable. Results: 201 CHW of 31 nationalities were trained, 81.6% (95% confidence interval [95% CI]: 75.5-86.7] were women. Eighty-two associations participated, 51.2% (95% CI: 39.9-62.4] worked with culturally diverse populations. Participation by associations (p=.017) and CHWs (p=.377) increased in a statistically significant manner over the years. After the course, 35.3% (95% CI: 28.7-42.4] of the CHWs continued to collaborate voluntarily in the associations. (AU)

Objetivo: Analizar el perfil de las personas y asociaciones que participaron en los cursos, cuantificar las actividades de educación entre iguales y analizar su evolución. Método: Se diseñó un estudio cuantitativo utilizando un análisis de los registros del curso de 2009 a 2018, dentro del programa mihsalud diseñado para promover la salud entre las personas en situación de vulnerabilidad en la ciudad de Valencia (España). Anualmente se ofrece un curso de formación-acción para agentes de salud de base comunitaria (ASBC), al que asisten personas propuestas por asociaciones. Las asociaciones se definieron según su población (inmigrantes, locales o interculturales) y los ASBC según el género, el país de nacimiento, el año de curso, la asociación y la continuidad después de la capacitación. Las medias y los intervalos de confianza se calcularon al 95% y se realizó un análisis bivariado para comparar las actividades que tuvieron lugar en 2009 a 2013 con las de 2014 a 2018. Las tendencias temporales se analizaron aplicando modelos de regresión lineal que incluyeron el estudio de diferentes años como la variable dependiente. Resultados: 201 ASBC de 31 nacionalidades fueron entrenados, 81.6% (intervalo de confianza del 95% [IC 95%]: 75,5 a 86,7) eran mujeres. Participaron 82 asociaciones, el 51,2% (IC 95%: 39,9 a 62,4) trabajaron con poblaciones culturalmente diversas. La participación de asociaciones (p = 0,017) y ASBC (p = 0,377) aumentó de manera estadísticamente significativa a lo largo de los años. Después del curso, el 35,3% (IC 95%: 28,7 a 42,4] de los ASBC continuaron colaborando voluntariamente en las asociaciones.(AU)

Associations and community health workers: analysis and time trends over ten years of training-action.

OBJECTIVE: To analyse the profile of the persons and associations that participated in the course, quantify peer education activities and analyse their evolution. METHOD: A quantitative study using an analysis of the course records from 2009 to 2018 was designed for this purpose inside mihsalud program designed to promote health amongst persons in vulnerable situations in the city of Valencia (Spain). It offers a yearly training-action course of community health workers (CHW) that is attended by persons who have been proposed by associations. The associations were defined according to their population (immigrant, local or intercultural) and the CHWs according to gender, country of birth, year of course, association and continuity after training. Means and confidence intervals were calculated at 95% and a bivariate analysis was conducted in order to compare the activities that took place in 2009 to 2013 with those of 2014 to 2018. The time trends were analysed by applying linear regression models that included the different years studied as the dependent variable. RESULTS: 201 CHW of 31 nationalities were trained, 81.6% (95% confidence interval [95% CI]: 75.5-86.7] were women. Eighty-two associations participated, 51.2% (95% CI: 39.9-62.4] worked with culturally diverse populations. Participation by associations (p=.017) and CHWs (p=.377) increased in a statistically significant manner over the years. After the course, 35.3% (95% CI: 28.7-42.4] of the CHWs continued to collaborate voluntarily in the associations. CONCLUSIONS: The results of the CHW training-action course improve over time given that a significant increase in participation by associations and women can be seen, along with a greater number of activities completed during the training. One effect of this is that CHWs are contracted or carry out voluntary activities in the associations.

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

Health Assets, Vocation and Zest for Healthcare work. A Salutogenic Approach to Active Coping among Certified Nursing Assistant Students.

People's health assets (HA) mapping process and design dynamization strategies for it are paramount issues for health promotion. These strategies improve the health heritage of individuals and communities as both the salutogenic model of health (SMH) and health assets model (HAM) defend. Connecting and mobilizing HA and strengthens the 'sense of coherence' (SOC) are both related to enhancing stress active and effective coping strategies. This study aims to describe the HA present in a population of certified nursing assistant students (n = 921) in Spain and then to explore their relationships with the SOC, the motivation to choose healthcare studies and their academic performance. A great variety of HA were identified and mapped. Findings showed that individuals with greater motivation towards self-care and 'caring for others' as internal HA, possessed higher SOC levels and a strong vocation for healthcare work. Differences in HA were identified according to gender, age and employment situation. Consistent connections between the care-relation factor and vocational factor with interpersonal and extrapersonal HA were reported. Evidence and results substantiated the salutogenic and asset-based approach as a proper strategy to strengthen SOC, dynamize their HA map, reinforce the sense of calling and enable Certified Nurse Assistant (CNA) students to buffer against caregiving-related stress and thrive in their profession.

Community engagement to promote health and reduce inequalities in Spain: a narrative systematic review.

OBJECTIVES: Over the past decade, increasing attention has been paid to community engagement in health (CEH) across Europe. This study aimed to identify and review CEH interventions to promote health and reduce inequalities within the Spanish context and the key facilitators for these community processes. METHODS: A systematic search in six databases, followed by a forward citation search, was conducted to identify implementation literature on CEH in Spain. Articles were included when engagement occurred in at least two stages of the interventions and was not limited to information or consultation of stakeholders. RESULTS: A total of 2023 results were identified; 50 articles were reviewed full text. Five articles were finally selected for inclusion. Data were extracted on various factors including details of the interventions, results achieved, stakeholders involved and their relationships. A narrative synthesis was performed to present results and support the discussion. CONCLUSIONS: Three main points are discussed: the role of professionals and citizens in CEH interventions, providing training to enable a reorientation towards a CEH practice and the relevance of contexts as enablers for community engagement processes to thrive.

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

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.

Sense of coherence, academic performance and professional vocation in Certified Nursing Assistant students.

BACKGROUND: The sense of coherence (SOC) of the salutogenic health model explains why people in stressful situations are able to maintain or even improve their health. There are some studies on which measures are more effective to reduce stress in Nursing assistant students. There are no studies that link SOC with the two key aspects in the prevention of stress in Nursing assistant students: the motivation of pursuing this profession and the academic level. OBJECTIVES: To explore the salutogenic paradigm among Nursing assistant students in a region of Spain (Comunitat Valenciana). DESIGN: Cross-sectional, analytical and exploratory study carried out in 2016. METHODS: Students of the first year of Nursing Assistant certification. Self-administered questionnaire to collect the variables: Sense of Coherence (SOC-13 instrument); professional vocation; Self-reported grades of the academic record. RESULTS: The mean score for the total SOC measurement was M = 56.38 (SD = 12.236; 71). Regarding the SOC components, the average score was for Manageability M = 16.45 (SD = 4.53; 24); Comprehensibility M = 19.27 (SD = 5.642; 30) and Meaningfulness M = 20.65 (SD = 4.48; 23). Students who lived in rural environments presented a weaker SOC (M = 54.05), compared to those who were located in urban environments (M = 56.83) and large cities (M = 56.15). The students who reported a choice of studies motivated by professional vocation presented a stronger SOC, scoring also a remarkable academic performance (p < 0.05). CONCLUSIONS: Strong levels of SOC in Nursing assistant students, are related to a greater motivation to study something desirable, and to obtaining high academic performance, despite being a demanding and high-stress profession. Therefore, a strong SOC seems to contribute to being more resistant to stress. The environments that provide and facilitate greater external resources such as health, education, culture, association, leisure and recreation, for the community, have higher global levels of sense of coherence.

Evidencia sobre la participación comunitaria en salud en el contexto español: reflexiones y propuestas. Informe SESPAS 2018 / Evidence of community engagement in health in Spain: thoughts and proposals. SESPAS Report 2018

La participación comunitaria se está convirtiendo en fundamental para desarrollar e impulsar acciones de promoción de la salud de ámbito local. Sin embargo, se necesitan herramientas para la implementación de estrategias e intervenciones con enfoque participativo que estén basadas en la evidencia. El objetivo de este artículo es reflexionar sobre la evidencia existente en España sobre participación comunitaria en salud partiendo de los resultados del Proyecto AdaptA GPS (Adapta y Aplica Guías de Promoción de la Salud), cuyo primer objetivo ha sido la adaptación de la Guía NICE NG44 sobre participación comunitaria para mejorar la salud y el bienestar, y para reducir las desigualdades. Se describe la metodología del proceso de adaptación de dicha guía y se propone una reflexión a partir de los resultados de la revisión de la evidencia en participación comunitaria procedente del contexto español. Nos preguntamos si la limitada evidencia identificada se debe a las dificultades para evaluar esas intervenciones o al limitado interés y la escasez de recursos destinados a ellas. Se proponen dos recomendaciones: promover más y mejores investigaciones, fomentando la formación, la investigación y la evaluación vinculada al desarrollo de intervenciones de participación comunitaria en salud, e impulsar más y mejores intervenciones utilizando herramientas basadas en la evidencia con un mayor esfuerzo en apoyar y mantener en el tiempo estos procesos. Generar mayor evidencia vinculada a la práctica en participación comunitaria en salud en España nos permitirá compartir procesos exitosos de participación comunitaria y fomentar la transferencia de buenas prácticas en diferentes contextos

Community engagement has recently become key in the development of health promotion programmes at a local level. However, evidence-based tools are necessary to implement strategies and interventions with a participatory approach. The objective of this article is to reflect on the existing evidence in Spain about community engagement in health, drawing on the results of the AdaptA GPS Project (Adapt and Apply Health Promotion Guidelines), intended to adapt NICE guideline NG44 on community engagement to improve health and wellbeing, and to reduce inequalities. After describing the methodology for the adaptation process, we discuss some of the findings from the review of the evidence on community engagement in the Spanish context. We ask whether the limited evidence identified is due to the difficulties involved in evaluating these interventions, or to the lack of interest in these programmes and the limited resources and funding dedicated to them. Two recommendations are proposed: to promote more and better research, fostering training, research and evaluation towards the development of community engagement interventions in health, and to promote more and better interventions using evidence-based tools, supporting their long-term sustainability by taking into account the time needed for community engagement programmes to be properly developed. Generating more evidence on community engagement in health in Spain will allow us to learn from successful processes and encourage the transfer of good practice to different contexts

[Evidence of community engagement in health in Spain: thoughts and proposals. SESPAS Report 2018]. / Evidencia sobre la participación comunitaria en salud en el contexto español: reflexiones y propuestas. Informe SESPAS 2018.

Community engagement has recently become key in the development of health promotion programmes at a local level. However, evidence-based tools are necessary to implement strategies and interventions with a participatory approach. The objective of this article is to reflect on the existing evidence in Spain about community engagement in health, drawing on the results of the AdaptA GPS Project (Adapt and Apply Health Promotion Guidelines), intended to adapt NICE guideline NG44 on community engagement to improve health and wellbeing, and to reduce inequalities. After describing the methodology for the adaptation process, we discuss some of the findings from the review of the evidence on community engagement in the Spanish context. We ask whether the limited evidence identified is due to the difficulties involved in evaluating these interventions, or to the lack of interest in these programmes and the limited resources and funding dedicated to them. Two recommendations are proposed: to promote more and better research, fostering training, research and evaluation towards the development of community engagement interventions in health, and to promote more and better interventions using evidence-based tools, supporting their long-term sustainability by taking into account the time needed for community engagement programmes to be properly developed. Generating more evidence on community engagement in health in Spain will allow us to learn from successful processes and encourage the transfer of good practice to different contexts.

[Changes attributed to a program based on the action-training of health agents. What do the associations say?] / Cambios atribuidos a un programa basado en la formación-acción de agentes de salud ¿Qué dicen las asociaciones?

OBJECTIVE: Interventions aimed at improving health must take into account the health inequalities and the target the population in need. The mihsalud program (Women, Children and Men creating health) promotes health in vulnerable populations through engaging and collaborating with the local third sector. The objective of the study was to describe the changes attributed to the mihsalud programme and the process of action-training of community-based health volunteers (ASBC in Spanish) as perceived by the local organizations where they work or volunteer. METHODS: Qualitative descriptive study through semi-structured interviews with representatives of organizations that trained ASBC during 2012 in Valencia. Twelve semi-structured interviews were conducted with representatives of organizations which had trained some of their volunteers to become ASBC during the 2012 action-training session. The interviews were transcribed verbatim and analysed with the programme for qualitative analysis Nvivo. Themathic analysis was performed: transcripts were coded line by line from an inductive perspective. RESULTS: Three main categories were identified: 1) The role of the ASBC: The associations recognise the role of the ASBC among their peers and the importance of the training received in the program; 2) Perceived changes: The associations recognize having a broader vision of health, identify the role of the figure ASBC that coordinates with health professionals in their health area and networking with other associations that were previously unknown; 3) Challenges and opportunities: Lack of support for the continuity of projects with ASBC due to the precariousness of small organisations and coordination with services, recognition at the local level and promotion of participation and interculturality through ASBC and their peers. CONCLUSIONS: The organizations recognize that the program and ASBC have made collaboration with health sector possible, have promoted health among their peers and have encouraged networking with other organizations and areas.

OBJETIVO: Las intervenciones dirigidas a mejorar la salud deben tener en cuenta las desigualdades de la población y orientarse a la población más necesitada. El programa mihsalud (Mujeres, Infancia y Hombres construyendo salud) promueve la salud en poblaciones en situación de vulnerabilidad implicando al ámbito asociativo. El objetivo del estudio fue describir los cambios atribuidos al programa mihsalud y al proceso de formaciónacción de agentes de salud de base comunitaria (ASBC) por parte de las asociaciones a las que pertenecen. METODOS: Estudio descriptivo cualitativo mediante entrevistas semiestructuradas a representantes de asociaciones participantes que formaron ASBC durante 2012 en Valencia. Se realizaron 12 entrevistas semiestructuradas con representantes de asociaciones que formaron ASBC tras 4 años de la formación. Las entrevistas se transcribieron verbatim y se analizaron con el programa para análisis cualitativo "Nvivo (análisis temático)": Las transcripciones se codificaron línea por línea con perspectiva inductiva. RESULTADOS: Se agruparon en tres categorías principales: 1) Reconocimiento del rol del ASBC: Las asociaciones reconocieron el rol del ASBC entre sus iguales y la importancia de la formación recibida; 2) Cambios percibidos: Las asociaciones reconocieron tener una visión más amplia sobre la salud, identificaron el rol del ASBC que se coordina con los profesionales sanitarios de su zona de salud y el trabajo en red con otras asociaciones que antes desconocían; 3) Dificultades y oportunidades: La falta de apoyo para la continuidad de los proyectos vinculados con ASBC por la precariedad de las asociaciones pequeñas; y la coordinación con los servicios, el reconocimiento a nivel local y el fomento de la participación e interculturalidad a través de ASBC y sus iguales. CONCLUSIONES: Las asociaciones reconocen que el programa y ASBC han hecho posible la colaboración con recursos sanitarios, han promocionado la salud entre sus iguales y han fomentado el trabajo en red.

Aplicabilidad y percepción de utilidad del European Quality Instrument for Health Promotion (EQUIHP) en un programa de promoción de la salud / Applicability and perceived utility of the European Quality Instrument for Health Promotion (EQUIHP) in a health promotion programme

Objetivo: Describir los resultados de la aplicación del European Quality Instrument for Health Promotion (EQUIHP) en el Programa MIH salud y la percepción de su utilidad por el equipo ejecutor de este. Método: Estudio de evaluación aplicando EQUIHP a un programa de promoción de la salud. Autocumplimentación de EQUIHP por ocho mujeres y dos hombres del equipo MIH salud, y realización de dos entrevistas grupales con este equipo sobre la percepción de su utilidad. Resultados: El programa ha obtenido una puntuación global de calidad de 6,5 sobre 10. EQUIPH ha permitido identificar los aspectos más débiles dentro del programa, como la falta de un plan de comunicación y las propias evaluabilidad y sostenibilidad; y los más fuertes, como la inclusión de principios de promoción de la salud. Se considera que EQUIPH es un instrumento útil que facilita una valoración exhaustiva de los componentes de un programa desde la práctica profesional de la promoción de salud. Conclusión: La aplicación de EQUIHP ha permitido evaluar la calidad del programa y formular recomendaciones para su mejora. Asimismo, es aplicable a otros programas e intervenciones (AU)

Objective: To describe the results of applying the European Quality Instrument for Health Promotion (EQUIHP) tool in the MIHsalud programme and to discuss its perceived utility by the programme's team members. Method: Evaluation study applying EQUIHP to a health promotion programme. A total of ten MIHsalud staff (eight women and two men) completed the EQUIHP and participated in two group interviews to discuss its perceived utility. Results: The programme obtained a total score of 6.5 points out of 10 in quality. The use of EQUIHP enabled the programme's weaknesses to be identified, such as lack of a communication plan, evaluability and sustainability; as well as its strengths, such as the inclusion of health promotion principles. The MIHsalud team believes that the EQUIHP is a useful tool which can facilitate a comprehensive evaluation of the programme in terms of a health promotion initiative. Conclusion: The use of the EQUIHP has made it possible to evaluate the quality of the programme and to make recommendations for its improvement, and it could be applied to other programmes and activities (AU)

[Applicability and perceived utility of the European Quality Instrument for Health Promotion (EQUIHP) in a health promotion programme]. / Aplicabilidad y percepción de utilidad del European Quality Instrument for Health Promotion (EQUIHP) en un programa de promoción de la salud.

OBJECTIVE: To describe the results of applying the European Quality Instrument for Health Promotion (EQUIHP) tool in the MIHsalud programme and to discuss its perceived utility by the programme's team members. METHOD: Evaluation study applying EQUIHP to a health promotion programme. A total of ten MIHsalud staff (eight women and two men) completed the EQUIHP and participated in two group interviews to discuss its perceived utility. RESULTS: The programme obtained a total score of 6.5 points out of 10 in quality. The use of EQUIHP enabled the programme's weaknesses to be identified, such as lack of a communication plan, evaluability and sustainability; as well as its strengths, such as the inclusion of health promotion principles. The MIHsalud team believes that the EQUIHP is a useful tool which can facilitate a comprehensive evaluation of the programme in terms of a health promotion initiative. CONCLUSION: The use of the EQUIHP has made it possible to evaluate the quality of the programme and to make recommendations for its improvement, and it could be applied to other programmes and activities.

Cambios atribuidos a un programa basado en la formación-acción de agentes de salud ¿Qué dicen las asociaciones? / Changes attributed to a program based on the action-training of health agents. What do the associations say?

Fundamentos: Las intervenciones dirigidas a mejorar la salud deben tener en cuenta las desigualdades de la población y orientarse a la población más necesitada. El programa mihsalud (Mujeres, Infancia y Hombres construyendo salud) promueve la salud en poblaciones en situación de vulnerabilidad implicando al ámbito asociativo. El objetivo del estudio fue describir los cambios atribuidos al programa mihsalud y al proceso de formación-acción de agentes de salud de base comunitaria (ASBC) por parte de las asociaciones a las que pertenecen. Método: Estudio descriptivo cualitativo mediante entrevistas semiestructuradas a representantes de asociaciones participantes que formaron ASBC durante 2012 en Valencia. Se realizaron 12 entrevistas semiestructuradas con representantes de asociaciones que formaron ASBC tras 4 años de la formación. Las entrevistas se transcribieron verbatim y se analizaron con el programa para análisis cualitativo "Nvivo (análisis temático) ": Las transcripciones se codificaron línea por línea con perspectiva inductiva. Resultados: Se agruparon en tres categorías principales: 1) Reconocimiento del rol del ASBC: Las asociaciones reconocieron el rol del ASBC entre sus iguales y la importancia de la formación recibida; 2) Cambios percibidos: Las asociaciones reconocieron tener una visión más amplia sobre la salud, identificaron el rol del ASBC que se coordina con los profesionales sanitarios de su zona de salud y el trabajo en red con otras asociaciones que antes desconocían; 3) Dificultades y oportunidades: La falta de apoyo para la continuidad de los proyectos vinculados con ASBC por la precariedad de las asociaciones pequeñas; y la coordinación con los servicios, el reconocimiento a nivel local y el fomento de la participación e interculturalidad a través de ASBC y sus iguales. Conclusiones: Las asociaciones reconocen que el programa y ASBC han hecho posible la colaboración con recursos sanitarios, han promocionado la salud entre sus iguales y han fomentado el trabajo en red

Background: Interventions aimed at improving health must take into account the health inequalities and the target the population in need. The mihsalud program (Women, Children and Men creating health) promotes health in vulnerable populations through engaging and collaborating with the local third sector. The objective of the study was to describe the changes attributed to the mihsalud programme and the process of action-training of community-based health volunteers (ASBC in Spanish) as perceived by the local organizations where they work or volunteer. Methods: Qualitative descriptive study through semi-structured interviews with representatives of organizations that trained ASBC during 2012 in Valencia. Twelve semi-structured interviews were conducted with representatives of organizations which had trained some of their volunteers to become ASBC during the 2012 action-training session. The interviews were transcribed verbatim and analysed with the programme for qualitative analysis Nvivo. Themathic analysis was performed: transcripts were coded line by line from an inductive perspective. Results: Three main categories were identified: 1) The role of the ASBC: The associations recognise the role of the ASBC among their peers and the importance of the training received in the program; 2) Perceived changes: The associations recognize having a broader vision of health, identify the role of the figure ASBC that coordinates with health professionals in their health area and networking with other associations that were previously unknown; 3) Challenges and opportunities: Lack of support for the continuity of projects with ASBC due to the precariousness of small organisations and coordination with services, recognition at the local level and promotion of participation and interculturality through ASBC and their peers. Conclusions: The organizations recognize that the program and ASBC have made collaboration with health sector possible, have promoted health among their peers and have encouraged networking with other organizations and areas

Salutogénesis y autocuidado comunitario: también responsabilidad enfermera / No disponible

No disponible