Responding to STI epidemics among young people: a characterization of the language employed in educational materials. / Enfrentamento de epidemias de ISTs em população jovem: caracterização da linguagem dos materiais educativos.

This article aims to characterize the language employed in educational and communications materials about STIs, HIV/AIDS and viral hepatitis produced by the Ministry of Health between 2010 and 2019, identifying elements related to health promotion and disease prevention. We conducted an exploratory descriptive study. The materials were selected by performing a systematic search of the Ministry of Health website focusing on the period 2010-2019. The materials were analyzed to determine the educational approaches adopted. The preventive, educational and personal development approaches were identified in 100% (201), 24.87% (50) and 7.96% (16) of the materials, respectively. The radical and popular education for health approaches were not observed. The almost exclusive focus on the preventive approach reveals that promoting changes in individual habits and behavior alone is not sufficient to combat and solve the problem of STIs, HIV/AIDS and viral hepatitis in Brazil.

O objetivo do artigo é caracterizar a linguagem utilizada nos materiais educativos e comunicacionais vinculados à temática das IST, do HIV/Aids e hepatites virais produzidos e veiculados pelo Ministério da Saúde no período de 2010 a 2019, identificando elementos de promoção à saúde e de prevenção de doenças. Metodologia descritiva exploratória para a caracterização da linguagem utilizada nos materiais educativos e comunicacionais sobre as IST, do HIV/Aids e hepatites virais. Para a seleção dos materiais educativos, adotou-se a estratégia de busca sistemática realizada no site do Ministério da Saúde do Brasil por um período de dez anos: de 2010 a 2019. Os materiais foram observados por meio dos enfoques educativos. O enfoque preventivo foi identificado em 100% dos materiais analisados (201). O enfoque educativo foi encontrado em 24,87% (50) dos materiais, e o enfoque de desenvolvimento pessoal foi encontrado em 7,96% (16). Os enfoques radical e da educação popular em saúde não foram observados. A atenção quase exclusiva ao enfoque preventivo revela que cuidados individuais isoladamente não são suficientes para combater e sanar o problema das IST, do HIV/Aids e das hepatites virais no Brasil.

Enfrentamento de epidemias de ISTs em população jovem: caracterização da linguagem dos materiais educativos / Responding to STI epidemics among young people: a characterization of the language employed in educational materials

Resumo O objetivo do artigo é caracterizar a linguagem utilizada nos materiais educativos e comunicacionais vinculados à temática das IST, do HIV/Aids e hepatites virais produzidos e veiculados pelo Ministério da Saúde no período de 2010 a 2019, identificando elementos de promoção à saúde e de prevenção de doenças. Metodologia descritiva exploratória para a caracterização da linguagem utilizada nos materiais educativos e comunicacionais sobre as IST, do HIV/Aids e hepatites virais. Para a seleção dos materiais educativos, adotou-se a estratégia de busca sistemática realizada no site do Ministério da Saúde do Brasil por um período de dez anos: de 2010 a 2019. Os materiais foram observados por meio dos enfoques educativos. O enfoque preventivo foi identificado em 100% dos materiais analisados (201). O enfoque educativo foi encontrado em 24,87% (50) dos materiais, e o enfoque de desenvolvimento pessoal foi encontrado em 7,96% (16). Os enfoques radical e da educação popular em saúde não foram observados. A atenção quase exclusiva ao enfoque preventivo revela que cuidados individuais isoladamente não são suficientes para combater e sanar o problema das IST, do HIV/Aids e das hepatites virais no Brasil.

Abstract This article aims to characterize the language employed in educational and communications materials about STIs, HIV/AIDS and viral hepatitis produced by the Ministry of Health between 2010 and 2019, identifying elements related to health promotion and disease prevention. We conducted an exploratory descriptive study. The materials were selected by performing a systematic search of the Ministry of Health website focusing on the period 2010-2019. The materials were analyzed to determine the educational approaches adopted. The preventive, educational and personal development approaches were identified in 100% (201), 24.87% (50) and 7.96% (16) of the materials, respectively. The radical and popular education for health approaches were not observed. The almost exclusive focus on the preventive approach reveals that promoting changes in individual habits and behavior alone is not sufficient to combat and solve the problem of STIs, HIV/AIDS and viral hepatitis in Brazil.

Investigating the nature of interprofessional collaboration in primary care across the Western Health Region of Brasília, Brazil: A study protocol.

Primary care can provide a supportive context for the development of interprofessional collaborative practice owing to its nature and dynamics. In Brazil, a number of practice changes have already occurred to primary care, notably the implementation of the Family Health Strategy which promoted interprofessional collaboration (IPC). In Brasilia, a new arrangement was implemented in 2016 that focused on an expansion of primary healthcare. However, it is not clear how these reforms will affect the nature of IPC or the delivery of patient care. The article presents a study protocol which describes a study that aims to explore the nature of IPC in the context of primary care in the Western Health Region of Brasilia. A sequential mixed methods design will be used to gather both quantitative and qualitative data. Initially, we will translate, cross-culturally adapt, and validate an IPC scale for a survey of primary care teams. We will then undertake a series of focus groups with a purposeful sample of team members to explore the results from the survey. Quantitative data will be analysed with descriptive and multivariate statistics. A content analysis will be undertaken with the focus group data. We expect that the results will illuminate a range of elements linked to IPC in primary care as well as identify areas for improving IPC skills, patient safety, quality of care, and healthcare outcomes in this clinical context.

Dimensões do trabalho interprofissional e práticas colaborativas desenvolvidas em uma unidade básica de saúde, por equipe de Saúde da Família / Dimensions of interprofessional work and of collaborative practices developed at a primary care unit by a Family Health team

Resumo Este artigo tem como objetivo identificar as dimensões do trabalho interprofissional e das práticas colaborativas desenvolvidas por uma equipe de saúde da família em uma unidade básica de saúde. Trata-se de pesquisa qualitativa realizada mediante observação participante do trabalho desenvolvido por profissionais de saúde. O estudo realizado evidenciou avanços na incorporação de práticas colaborativas no âmbito da atenção primária e na criação de espaços mais favoráveis ao diálogo e ao estabelecimento de consensos que resultam em cuidado integral e segurança do paciente, a despeito dos conflitos e das tensões próprias do processo de trabalho em saúde.(AU)

Resumen El objetivo de este artículo es identificar las dimensiones del trabajo interprofesional y de las prácticas colaborativas desarrolladas por un equipo de salud de la familia en una unidad básica de salud. Se trata de investigación cualitativa realizada mediante observación participativa del trabajo desarrollado por profesionales de la salud. El estudio realizado mostró avances en la incorporación de prácticas colaborativas en el ámbito de la atención primaria y en la creación de espacios más favorables al diálogo y al establecimiento de consensos que resultan en cuidado integral y seguridad del paciente, a pesar de los conflictos y de las tensiones propias del proceso del trabajo en salud.(AU)

Abstract This article aims at identifying the dimensions of interprofessional work and of collaborative practices developed by a family health team at a primary care unit. This qualitative research was conducted through participant observation of the work developed by health professionals. The study evidenced advances in the incorporation of collaborative practices in primary healthcare and in the creation of spaces that favor dialogs and the establishment of a consensus that result in comprehensive care and patient safety, despite conflicts and tensions inherent to the health work process.(AU)

Saúde e cultura da paz

Esse módulo pretende abrir espaço para uma discussão a respeito da importância de se criar cultura de paz baseada na relação com o desenvolvimento humano. É dividido é dividido em quatro lições que visam possibilitar ao especializando: refletir sobre sua rotina (pessoal, familiar, profissional e comunitária); relacionar violência, saúde e contextos sociais; discutir conceitos de cidadania, equidade, justiça social, conflitualidade, não-violência e cultura de paz; refletir sobre as implicações da violência como problema de saúde; identificar ações necessárias ao enfrentamento dos agravos da violência com foco na atenção básica; enfatizar a necessidade da construção de Cultura da Paz a ser assumida como ação de Saúde Publica.

Formação dos Agentes Comunitários de Saúde na cidade de São Paulo: ação civilizatória na construção de Ambientes Verdes e Saudáveis / Training of Community Health Workers in São Paulo: civilizing action in the construction of Green and Healthy Environments

RESUMO Procura-se analisar a atuação dos Agentes Comunitários de Saúde no Projeto Ambientes Verdes e Saudáveis quanto à construção de políticas públicas integradas na cidade de São Paulo, uma articulação entre as Secretarias do Verde e do Meio Ambiente, da Saúde, da Assistência e Desenvolvimento Social, e da Educação. Busca-se articular a integração das políticas públicas para a inclusão das questões ambientais nas ações de promoção da saúde desenvolvidas nos territórios nas 31 subprefeituras, das cinco regionais de saúde. Evidencia-se que o trabalho dos seis mil Agentes vem contribuindo com novas práticas efetivas, de criação de oportunidades para a incorporação e abordagem de questões ambientais nas ações de promoção da saúde.

ABSTRACT The work of the Community Health Agents in the Project Green and Healthiness environments: building integrated publie politics in São Paulo. Proposal from a joint within the Green and the Environment, Health, Assistance and Social Development and Education Departments. The objective is integrate of the publie politics towards the inclusion of environmental issues of the actions to the advancement in health developed in the area of 31 subcities halls, in five regional of health in the district. The work of 6000 Agents have been contributing with new effective know-how, developing opportunities to the incorporation and the boarding of environment issues of health advancement.

Formação dos Agentes Comunitários de Saúde na cidade de São Paulo: ação civilizatória na construção de Ambientes Verdes e Saudáveis / Training of Community Health Workers in São Paulo: civilizing action in the construction of Green and Healthy Environments

RESUMO Procura-se analisar a atuação dos Agentes Comunitários de Saúde no Projeto Ambientes Verdes e Saudáveis quanto à construção de políticas públicas integradas na cidade de São Paulo, uma articulação entre as Secretarias do Verde e do Meio Ambiente, da Saúde, da Assistência e Desenvolvimento Social, e da Educação. Busca-se articular a integração das políticas públicas para a inclusão das questões ambientais nas ações de promoção da saúde desenvolvidas nos territórios nas 31 subprefeituras, das cinco regionais de saúde. Evidencia-se que o trabalho dos seis mil Agentes vem contribuindo com novas práticas efetivas, de criação de oportunidades para a incorporação e abordagem de questões ambientais nas ações de promoção da saúde.

ABSTRACT The work of the Community Health Agents in the Project Green and Healthiness environments: building integrated publie politics in São Paulo. Proposal from a joint within the Green and the Environment, Health, Assistance and Social Development and Education Departments. The objective is integrate of the publie politics towards the inclusion of environmental issues of the actions to the advancement in health developed in the area of 31 subcities halls, in five regional of health in the district. The work of 6000 Agents have been contributing with new effective know-how, developing opportunities to the incorporation and the boarding of environment issues of health advancement.

Ambientes verdes e saudáveis: formação dos agentes comunitários de saúde na Cidade de São Paulo, Brasil / Green, healthy environments: training of community health agents in the city of São Paulo, Brazil

Este artigo tem por objetivo descrever a experiência de formação dos agentes comunitários de saúde (ACS) no contexto do Projeto Ambientes Verdes e Saudáveis: Construindo Políticas Públicas Integradas na Cidade de São Paulo (PAVS). A execução do PAVS foi conduzida pelas secretarias do Verde e Meio Ambiente, de Saúde, de Assistência e Desenvolvimento Social e de Educação, em colaboração com as 31 subprefeituras da Cidade e as cinco coordenadorias regionais de saúde. Além do setor público municipal, foi constituída, para cogestão do PAVS, uma rede de parceiros, entre os quais instituições de cooperação técnica internacional multilateral e acadêmicas. A formação e qualificação de ACS e agentes de proteção social e o desenvolvimento de projetos comunitários que levem em conta as potencialidades e especificidades locais foram os objetivos centrais dessa rede. A gestão localmente integrada para o desenvolvimento de uma agenda de proteção e de promoção de ambientes verdes e saudáveis configurou-se no contexto das redes já existentes nos territórios de atuação da Estratégia Saúde da Família (ESF), junto às Unidades Básicas de Saúde. Os 705 projetos atualmente em funcionamento são evidência dos resultados positivos, em nível local, da gestão intersetorial.

The aim of this article is to describe the training of community health agents (ACSs) in the context of an intersectorial initiative (Green, Healthy Environments Project: Building Integrated Public Policies in the City of São Paulo). The initiative was developed by four city departments-Environment, Health, Social Support and Development, and Education-in collaboration with the city's 31 superintendencies and five regional health administrations. In addition to these municipal bodies, a network of partners was established, including institutions involved in multilateral international technical cooperation and academic institutions. The training of ACSs and social support agents, and the development of community programs that take into account local potential and characteristics was the main objective of the network. The locally integrated management for the development of an agenda of protection and promotion of green, healthy environments was carried out inside the previously existing networks operating in the territories close to public primary care health units serving populations covered by the Family Health Strategy. There currently are 705 programs created by the Green, Healthy Environments Project. These programs serve as evidence of the positive results obtained locally through intersectorial management efforts.

[Green, healthy environments: training of community health agents in the city of São Paulo, Brazil]. / Ambientes verdes e saudáveis: formação dos agentes comunitários de saúde na Cidade de São Paulo, Brasil.

The aim of this article is to describe the training of community health agents (ACSs) in the context of an intersectorial initiative (Green, Healthy Environments Project: Building Integrated Public Policies in the City of São Paulo). The initiative was developed by four city departments--Environment, Health, Social Support and Development, and Education--in collaboration with the city's 31 superintendencies and five regional health administrations. In addition to these municipal bodies, a network of partners was established, including institutions involved in multilateral international technical cooperation and academic institutions. The training of ACSs and social support agents, and the development of community programs that take into account local potential and characteristics was the main objective of the network. The locally integrated management for the development of an agenda of protection and promotion of green, healthy environments was carried out inside the previously existing networks operating in the territories close to public primary care health units serving populations covered by the Family Health Strategy. There currently are 705 programs created by the Green, Healthy Environments Project. These programs serve as evidence of the positive results obtained locally through intersectorial management efforts.

Analyzing the outcomes of health promotion practices.

This article focuses on health promotion (HP) outcomes, illustrated through evaluation of case studies and identification of strategies which have contributed to their success and sustainability. Evaluation research and practice in three distinct sceneries are discussed: (i) institutional and governmental agencies; (ii) communities in the "Manguinhos Complex" and Nova Iguaqu Municipality, and (iii) building of potentially healthy municipality networks. The effectiveness of a social program in a health promotion perspective was based in the "School for Parents" program, undertaken by the First Court of Childhood and Youth of Rio de Janeiro, between 2001 and 2004. The analysis was grounded in the monitoring of 48 parents in charge of children under 18, who were victims of abuse, violence or negligence, and social exclusion, most of all. The study's objectives were: illustrating the evidence of effectiveness of health promotion, discussing the concept of HP effectiveness under macro unfavorable conditions, and identifying strategies that foster sustainability of results. Institutional resources included a multi-professional staff, multidisciplinary approaches, participatory workshops, family case management, partnership with public and private institutions, and volunteer and civil society sponsorship of the families. Evaluation was based on social impact indicators, and psychosocial and contextual determinants. Evaluation methods included program monitoring and quantitative-qualitative methods, through a longitudinal evaluation of 3 years, including one year post program. The evaluation showed highly favorable results concerning "family integration', "quality of family relations" and "human rights mobilization". Unsatisfactory results such as "lack of access to formal employment" are likely related to structural factors and the need for new public policies in areas such as education, professional training, housing, and access to formal employment. The training process of social actors in environmental management and housing, supported by the Public Health Technology Development Project of the Oswaldo Cruz Foundation, was employed as a tool of environmental education and healthy housing. The purpose of this study was to construct an integrated and participatory model of environment management. The methodology included training, research and evaluation of participants, from 21 to 50 years of age, who participated in building Thematic Learning Books and Community Guides about water quality monitoring. Participants'evaluations emphasized the training process, encouraging them to become multiplier agents of environmental education in their communities and to continue learning how to bring together sectors for problems solving. The Potentially Healthy Districts' Network (RMPS) aimed at increasing knowledge and building capacity to develop actions which originate from each of the local units, based on their characteristics and practices. Developed by the Preventive and Social Department of Campinas State University with PAHO/WHO and the Society Special Research Institute (IPES), RMPS's mission was to cooperate in the construction of healthy public policies in a participatory and articulated way through different municipal representatives. The network offered tools to municipal administrations to develop integrated projects that brought together government, managers, technicians, academy and organizations for the construction of public policies aimed at health promotion and quality of life. The methodology is based in the construction of knowledge and action networks by social actors, stimulating trans-sectorial and inter-district actions. The outcome evaluation is based on case studies, focus groups, oral stories, documents and image analyses.

Analyzing the outcomes of health promotion practices

El artículo trata de los resultados de la promoción de la salud, ilustrándolo con la evaluación de casos prácticos y la identificación de las estrategias que han contribuido al éxito y a la sostenibilidad. Se aborda la evaluación tanto de la teoria como de la práctica en tres escenarios diferentes: (i) agencias institucionales y gubernamentales; (ii) comunidades del Complejo Manguinhos y del Municipio de Nova Iguaçu, y (iii) construcción de redes de municipios potencialmente saludables. La efectividad de un programa social desde la perspectiva de la promoción de la salud se basaba en el programa Escuelas para Padres, aprendido por el Primer Juzgado Especial para Niños y Jóvenes de Rio de Janeiro, entre 2001 y 2004. El análisis realizó en base al seguimiento de 48 padres que tenían a su cargo niños menores de 18 años, víctimas de abusos, violencia o negligencia, y casi todos ellos, tambén de exclusión social. Los objetivos del estudio eran: ilustrar con ejemplos la efectividad de la promoción de la salud, debatir el concepto de efectividad de la promoción de la salud en macrocondiciones desfavorables y definir estrategias que favorecerian la sostenibilidade de los resultados...(AU)