Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 178.462
Filtrar
1.
Licere (Online) ; 24(02): 418-436, 20210630.
Artigo em Português | LILACS | ID: biblio-1282959

RESUMO

A eficácia das práticas corporais, atividades físicas e esportivas regulares é cientificamente comprovada como vetor de saúde e devem ser fomentadas em todos os ambientes. O objetivo é investigar se, no Século XXI, o governo federal brasileiro formulou políticas públicas que as contemplem no âmbito da Educação Básica em prol da saúde. Metodologicamente é um estudo exploratório documental. Como resultados, a Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, Pesquisa Nacional de Saúde, Pesquisa Nacional por Amostra de Domicílios Contínua e Pesquisa Nacional de Saúde do Escolar são os inquéritos que subsidiam aspolíticas públicas. Conclui que, alinhado com a Política Nacional de Promoção de Saúde de 2006, 2014 e 2017, Lei do SUS, Lei de Diretrizes e Bases da Educação e a Constituição/1988, o Programa Saúde na Escola é a principal política pública interfederativa que as contemplam.


The effectiveness of body practices, regular physical activity and sports is scientifically demonstrated as a health vector and should be adopted in all environments. The goal is to investigate if, in the 21st Century, the Brazilian federal government created public policies that include these practices and activities in the scope of Basic Education in favor of health. Methodologically it is an exploratory documentary study. As a result, Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey, National Health Survey, National Continuous Household Sample Survey and National School Health Survey are the surveys that support public policy and that, in line with The National Health Promotion Policy of 2006, 2014 and 2017, with the SUS Law, the Education Guidelines and Bases Law and the Federal Constitution / 1988, the Health at School Program is the main interfederative and intersectoral public policy.


Assuntos
Educação , Política Pública
2.
Rev. enferm. UERJ ; 29: e53845, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224571

RESUMO

Objetivo: avaliar o impacto de um programa psicoeducacional nos níveis de autoeficácia, autoestima e sintomas ansiosos e depressivos em estudantes no início da graduação em enfermagem. Método: pesquisa multicêntrica, quase experimental, do tipo tempo-série, desenvolvida em duas instituições de ensino superior públicas, com 82 estudantes, no período de setembro de 2018 a maio de 2019. O programa psicoeducacional foi elaborado com base no construto da autoeficácia, baseando-se nas atividades de enfermagem da intervenção "Fortalecimento da autoestima", proposta pela Nursing Interventions Classification. Os desfechos avaliados foram: autoeficácia, mensurada pela Escala de Autoeficácia Geral e Percebida; autoestima, mensurada pela Escala de Autoestima de Rosenberg; sintomas ansiosos e depressivos, avaliados pela Escala Hospitalar de Ansiedade e Depressão. Resultados: a intervenção psicoeducacional teve efeito positivo na percepção de autoeficácia geral dos estudantes. A autoestima e os sintomas ansiosos e depressivos não foram influenciados. Conclusão: os níveis de autoeficácia foram positivamente impactados pelo programa implementado.


Objective: to evaluate the impact of a psychoeducational program on the levels of self-efficacy, self-esteem, and anxious and depressive symptoms in students starting their undergraduate nursing program. Method: this quasi-experimental, multicenter, time-series type study was conducted with 82 students at two public institutions of higher education, from September 2018 to May 2019. Based on the self-efficacy construct, the psychoeducational program contemplated nursing activities of the "Strengthening self-esteem" intervention proposed by the Nursing Interventions Classification. The outcomes evaluated were self-efficacy, on the General and Perceived Self-Efficacy Scale; self-esteem, on the Rosenberg Self-Esteem Scale; and anxious and depressive symptoms, on the Hospital Anxiety and Depression Scale. Results: the psychoeducational intervention had a positive effect on the students' perception of general self-efficacy. Self-esteem and anxious and depressive symptoms were not influenced. Conclusion: the program impacted levels of self-efficacy positively.


Objetivo: evaluar el impacto de un programa psicoeducativo en los niveles de autoeficacia, autoestima y síntomas ansiosos y depresivos en estudiantes al inicio de sus estudios universitarios en enfermería. Método: investigación multicéntrica, cuasi-experimental, tipo serie temporal, desarrollada en dos instituciones públicas de educación superior, con 82 estudiantes, de septiembre de 2018 a mayo de 2019. El programa psicoeducativo se desarrolló con base en el constructo de autoeficacia y las actividades de enfermería de la intervención "Fortalecimiento de la autoestima", propuesta por la Nursing Interventions Classification. Los resultados evaluados fueron: autoeficacia, medida por la Escala de Autoeficacia General y Percibida; autoestima, medida por la Escala de Autoestima de Rosenberg; síntomas de ansiedad y depresión, evaluados por la Escala Hospitalaria de Ansiedad y Depresión. Resultados: la intervención psicoeducativa tuvo un efecto positivo sobre la percepción de autoeficacia general de los estudiantes. La autoestima y los síntomas de ansiedad y depresión no se vieron afectados. Conclusión: los niveles de autoeficacia fueron impactados positivamente por el programa implementado.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Percepção , Estudantes de Enfermagem/psicologia , Autoeficácia , Educação em Enfermagem/métodos , Ansiedade , Autoimagem , Saúde Mental , Depressão , Promoção da Saúde
3.
Rev. enferm. UERJ ; 29: e52508, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1254203

RESUMO

Objetivo: identificar, na literatura científica, estratégias assistenciais para o controle da tuberculose drogarresistente. Método: revisão integrativa da literatura, com análise de pesquisas relevantes sobre a questão nortedora: Quais são as evidências científicas sobre as estratégias assistenciais para o controle da tuberculose drogarresistente? Busca realizada nas bases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis, Índice Bibliográfico Espanhol em Ciências da Saúde e Banco de Dados em Enfermagem, entre janeiro e março de 2020. Foram incluídos dez artigos para discussão dos resultados que responderam à questão da pesquisa, atendendo aos critérios de inclusão e exclusão. Resultados: nos estudos publicados nos últimos cinco anos, 80% abordaram estratégias assistenciais para o controle da tuberculose drogarresistente e 20% evidenciaram falhas na assistência aos portadores da doença. Conclusão: a revisão da literatura identificou várias estratégias assistenciais para o controle da tuberculose drogarresistente, com destaque para a descentralização do diagnóstico e tratamento compartilhado, possibilitando uma atenção ampliada e integral aos pacientes.


Objective: from the scientific literature, to identify care strategies for controlling drug-resistant tuberculosis. Method: this integrative literature review examined relevant research on the research question ­ What is the scientific evidence on care strategies for controlling drug-resistant tuberculosis? ­ by searching Latin American and Caribbean Health Sciences Information, Medical Literature Analysis, Índice Bibliográfico Español en Ciencias de la Salud and Banco de Dados em Enfermagem, between January and March 2020. Ten articles were included in order to discuss findings that answered the research question, after meeting the inclusion and exclusion criteria. Results: of studies published in the past five years, 80% addressed care strategies for controlling drug-resistant tuberculosis and 20% revealed shortcomings in care for patients with the disease. Conclusion: the literature review identified several care strategies for controlling drug-resistant tuberculosis, particularly by decentralized diagnosis and shared treatment, allowing expanded, comprehensive patient care.


Objetivo: identificar, en la literatura científica, estrategias de asistencia para el control de la tuberculosis farmacorresistente. Método: se trata de una revisión integradora de la literatura, con análisis de investigaciones relevantes sobre la cuestión rectora: ¿Cuáles son las evidencias científicas sobre las estrategias de asistencia para el control de la tuberculosis farmacorresistente? La búsqueda fue realizada en las bases Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Medical Literature Analysis, Índice Bibliográfico Español en Ciencias de la Salud y Banco de Datos en Enfermería, de enero a marzo de 2020. Se incluyeron diez artículos para discutir los resultados que respondieron a la pregunta de la investigación, cumpliendo con los criterios de inclusión y exclusión. Resultados: en los estudios publicados en los últimos cinco años, el 80% abordó estrategias de atención para el control de la tuberculosis farmacorresistente y el 20% mostró fallas en la atención de los pacientes con la enfermedad. Conclusión: la revisión de la literatura identificó varias estrategias asistenciales para el control de la tuberculosis farmacorresistente, con énfasis en la descentralización del diagnóstico y tratamiento compartido, permitiendo una atención ampliada e integral a los pacientes.

4.
Int J Infect Dis ; 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34628022

RESUMO

Coronavirus disease 2019 (COVID-19) protocols has reduced primary and secondary health care for other diseases, such as leishmaniasis, a parasitic, endemic, chronic and persistent disease in Brazil. To ascertain this, we compared the number of leishmaniasis cases diagnosed before and after the COVID-19 pandemic. In 5 regions of Brazil, there was an increase in the mean number of leishmaniasis clinic visits from 2020 pandemic period (over 57%) compared with 2017-2019 years. Interestingly, this increase was due to tegumentary leishmaniasis while visceral leishmaniasis consultations decreased considerably. The increase in clinic visits with a diagnosis of TL in all regions of Brazil during the pandemic period in 2020, shows that the epidemiological surveillance of neglected tropical diseases cannot slowdown in the country. Expanding information can minimize the negative impacts of COVID-19 on health promotion, prevention and monitoring of the most prevalent neglected diseases.

5.
Clin Nurs Res ; : 10547738211051011, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34628952

RESUMO

In this experimental study, 200 cancer patients (100 subject in experimental group and 100 subjects in control group) referred to Amir Oncology Hospital in Shiraz were investigated. Educational intervention for experimental group consisted of 12 educational sessions for 50 to 55 minutes. A questionnaire including demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure health promotion behaviors, patients' hope, and mental health before and 6 months after intervention. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, social supports, health promotion behaviors, patients' hope, and mental health compared to the control group. This study showed the effectiveness of intervention based on PRECEDE constructs in mentioned factors 6 months after intervention. Hence, this model can act as a framework for designing and implementing educational intervention for health promotion behaviors of cancer patients.

6.
Health Promot Pract ; : 15248399211046578, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628964

RESUMO

When embarking on research within a community where little empirical research exists, the inclusion of a structured participant group-such as a steering committee or advisory board-can formalize the participant-research team partnership, increase community buy-in for action items, and reinforce the trustworthiness of research findings. These were among the aims of the multimethod design of the Student Parent Project, a qualitative study to determine the barriers and facilitators of academic achievement and well-being at six community colleges within a large, urban, public university system. The initial step of the study was to create a Student Advisory Board by recruiting one student parent from each of the participating campuses. The Student Advisory Board then met intermittently to review the research approach, data collection instruments, and preliminary findings at different stages. In this article, we describe the process of convening and collaborating with the advisory board and identify key areas in which their participation influenced the study design, findings, and recommendations. Based on lessons learned, we offer recommendations for the design and implementation of a participatory advisory board within qualitative studies.

7.
Health Educ Behav ; : 10901981211046533, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628967

RESUMO

Most actions targeting children's health behaviors have limited involvement of children in the development, potentially contributing to disappointing effectiveness. Therefore, in the 3-year "Kids in Action" study, 9- to 12-year-old children from a lower-socioeconomic neighborhood were involved as coresearchers in the development, implementation, and evaluation of actions targeting health behaviors. The current study describes the controlled trial that evaluated the effects on children's energy balance-related behaviors, physical fitness, and self-rated health, as well as experienced challenges and recommendations for future evaluations. Primary school children from the three highest grades of four intervention and four control schools were eligible for participation. Outcome measures assessed at baseline, and at 1- and 2-year follow-up were as follows: motor fitness by the MOPER test (N = 656, N = 485, N = 608, respectively), physical activity and sedentary behavior by accelerometry (N = 223, N = 149, N = 164, respectively), and consumption of sugar sweetened beverages and snacks and self-rated health by a questionnaire (N = 322, N = 281, N = 275, respectively). Mixed-model analyses were performed adjusted for clustering within schools and relevant confounders. Significant beneficial intervention effects were found on self-reported consumption of energy/sports drinks at T2 versus T0, and on total time and ≥5-minute bouts of moderate-to-vigorous physical activity at T1 versus T0. Significant adverse effects were found on "speed and agility" and "coordination and upper-limb speed." No other significant effects were found. The inconsistent intervention effects may be explained by the dynamic cohort and suboptimal outcome measures. We advise future studies with a similar approach to apply alternative evaluation designs, such as the delayed baseline design.

8.
Health Promot Pract ; : 15248399211046583, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628969

RESUMO

This article focuses on examining the implementation of evidence-based teen pregnancy prevention programming in a select school district. Results are presented based on the following implementation drivers: (1) actions taken by leadership to make decisions, provide guidance, and support how the school site and community-based organizations are functioning in support of implementation; (2) actions taken to ensure competent staff delivery of the curricula; and (3) actions taken to create and sustain a hospitable context in order to implement the interventions at the school site. The need for adolescent sexual health education is evident in this geographic location where Hispanic or Latino teens consistently have higher birth rates among race and ethnicities that are routinely reported. For 2018, when this project started, those rates were 40 births per 1,000 females aged 15 to 19 years. For 2018, the birth rates for African Americans was 31 and for Whites was 17 per 1,000 females aged 15 to 19 years. The project goals were to reduce teen birth rates by (1) providing evidence-based teen pregnancy prevention curricula to youth aged 11 to 19 years over the course of the 5-year project period, (2) training school staff and community members in the curricula, and (3) generating community support of youth access to reproductive health care and education. Despite a funding interruption to implementation of the project and the impact of COVD-19, educational programming was provided to 9,616 youth. The article details the key implementation strategies and solutions so that other practitioners can consider application of these implementation drivers in their own adolescent health education programming.

9.
Health Promot Pract ; : 15248399211045355, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34628971

RESUMO

Rates of diseases and disabilities that are otherwise preventable are higher in low-income communities and communities of color. These disparities are attributed, in large part, to a power imbalance between residents and decision makers, and restoring resident power is necessary to improve health outcomes. A key strategy in many health promotion programs, resident power building is a process by which residents gain necessary skills to improve social conditions through their involvement in community change work. This study is part of a larger evaluation of Building Healthy Communities, a ground-breaking 10-year, $1 billion place-based initiative funded by The California Endowment designed to reverse the historical impact of racial and economic discrimination by advancing statewide policy, changing the narrative around health, and transforming underserved communities to achieve health equity. This article presents the resident power framework and identifies five domains that contributed to resident power building: continuity, culture, context, concrete action, and capacity. Continuity and culture mattered most to residents' ability to organize and to their ability to exercise their voice, respectively. While this study examined resident power building within the context of a large-scale place-based initiative, the domains that the authors identified are salient across health promotion programs that use power building as a key strategy to achieve program outcomes. The domains serve as opportunities to modify power-building strategies and allow program staff to allocate resources to specific activities to achieve program outcomes.

10.
Health Educ Behav ; : 10901981211050571, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34628972

RESUMO

Achieving women's health equity and empowerment is a global priority. In a Western context, women are often disempowered by the value society places on body size, shape or weight, which can create a barrier to health. Health promotion programs can exacerbate women's preoccupations with their bodies by focusing outcomes toward achieving an "ideal" body size. Women's health promotion activities should be empowering if the desired outcomes are to improve their health and well-being long-term. This review sought to identify key elements from health promotion programs that aimed to empower women. A search was conducted in PubMed, MEDLINE, Web of Science, Scopus, CINAHL complete, and Academic Search Premiere databases. The search yielded 27 articles that collectively reported on 10 different programs. Through thematic synthesis, each article was analyzed for (1) key program features employed to empower women and (2) how such programs evaluated women's health. Seven themes resulted, of which five describe key empowering features (active participation, social support, sustainable change, holistic health perspective, strength-based approach) and two evaluation characteristics (assessment across multiple health domains and a mixed-method design). The findings from this review can assist health promoters to design and improve initiatives that aim to empower women.

11.
Health Promot Pract ; : 15248399211048461, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34628977

RESUMO

Young people demand and deserve participation in shaping the health and well-being of their community. Getting to Y: Youth Bring Meaning to the Youth Risk Behavior Survey (GTY) is a positive youth development initiative, whereby students analyze local youth health data and create change. This article adds definitive evidence to support the theoretical foundations of GTY expounded by Garnett et al. (2019). A mixed methods convergent study design, collecting quantitative data from pre- and postintervention surveys and qualitative data from focus groups, was enacted during the 2018-2019 school year. Survey participants were 256 students attending 20 Vermont middle/high schools. Surveys measured self-efficacy, health literacy, civic engagement, resiliency, and knowledge. Focus groups with 50 students solicited open-ended feedback. Wilcoxon signed-rank tests determined student-level change over time. Focus group transcripts were coded using grounded theory and a priori codes from the survey. Statistically significant improvements were seen in average scores from pre- to postintervention surveys in all five domains and differences in effect by gender. Results from the focus group complement the quantitative findings. Participation in GTY positively affected youth participant's understanding of their own health and well-being and increased agency to take action on behalf of themselves and their community. As the Youth Risk Behavior Survey is available nationwide, GTY is poised for replication to critically engage youth with relevant data to inform social change.

12.
Scand J Public Health ; : 14034948211042956, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628984

RESUMO

Aims: This study aims to identify physical inactivity-related challenges and motives, based on reviews and supplemented by expert interviews with Danish national experts on physical inactivity, providing a general discussion of the subject ultimately generating knowledge useable in a Scandinavian context. Methods: This study is framed as a narrative review of scientific review literature on physical inactivity, limited to the general population. The review is supplemented by expert interviews with Danish national experts on physical inactivity. We used thematic coding of the included reviews, while using hermeneutic interpretation analysis for the expert interviews. Results: Based on 11 included reviews, we highlighted four themes based on our analysis of reviews: (a) socioeconomic determinants of physical activity; (b) life-course perspective; (c) physical inactivity and older adults aged 60+ years; and (d) intervention recommendations. The supplementary expert interviews revealed three additional themes: (a) the individual history with physical activity; (b) sporting organisation importance; and (c) society responsibility for physical inactivity. Conclusions: Collectively this study concludes, based on review and expert interviews, that a number of determinants and correlations for physical inactivity affect the individual from various socioecological levels. Based on this review, we suggest moving beyond the 'upstream' public health approach of randomised controlled trials and consider complex interventions targeting physical inactivity from several levels. Physical inactivity should be acknowledged as a 'wicked problem' that requires a systems-based approach instead of a single quick fix. Future work with physical inactivity would profit from focus on the life-course perspective, sporting clubs' responsiveness and physical literacy.

13.
Respir Res ; 22(1): 260, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34615520

RESUMO

BACKGROUND: The "can do, do do" concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily classified with respect to their levels of physical capacity ("can't do" or "can do") and physical activity ("don't do" or "do do"), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the "can do, do do" quadrant concept. METHODS: Within the scope of secondary data analyses of the "Stay Active After Rehabilitation" (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the "don't do" and "do do" groups. RESULTS: Among persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity. CONCLUSION: The findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses. Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561 .

14.
BMC Oral Health ; 21(1): 489, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600520

RESUMO

BACKGROUND: Oral diseases are a public health concern with a significant impact on the quality of life of individuals. Children with special needs face significant challenges in carrying out oral hygiene due to their disability, and they are more prone to poor oral health and illnesses. This study assessed dental health problems and treatment-seeking behaviors of special needs school students in Amhara region, Ethiopia. METHODS: An institution-based cross-sectional study was conducted from November 2020 to April 2021, in eight special needs schools located in the Amhara Regional State, Ethiopia. A total of 443 randomly selected special needs students were included. Data were collected using a structured interview-administered questionnaire. Bivariable and multivariable logistic regression models were fitted to identify factors associated with oral health problems and treatment-seeking behavior. A p-value of less than 0.05 was used to declare statistical significance. RESULTS: The prevalence of self-reported dental health problems and treatment-seeking behaviors among special needs school students was 46.1% (95% CI: 41.4%, 50.7%) and 60.3% (95% CI: 53.4%, 66.8%), respectively. Place of residence, grade level, religious affiliation, years lived with disability, and knowledge of dental health-related risk behaviors were associated with dental health problems. Whereas, place of residence, being hearing impaired, and having prior information about dental health problems were associated with dental treatment-seeking behavior. CONCLUSIONS: A significant number of special needs students reported dental problems and about 40% of them did not seek dental treatment. Oral hygiene practice and access to dental care services are important in the prevention of dental problems. Hence, oral hygiene promotion programs focusing on oral hygiene practice and dental treatment services are needed in special needs schools. It is also strongly suggested to incorporate oral health related information in health-related academic lessons to enhance optimum oral health among special needs students.

15.
Neth Heart J ; 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34606024

RESUMO

The high prevalence and burden of cardiovascular diseases (CVD) is largely attributable to unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity and unhealthy food habits. Prevention of CVD, through the promotion of healthy lifestyles, appears to be a Sisyphean task for healthcare professionals, as the root causes of an unhealthy lifestyle lie largely outside their scope. Since most lifestyle choices are habitual and a response to environmental cues, rather than rational and deliberate choices, nationwide policies targeting the context in which lifestyle behaviours occur may be highly effective in the prevention of CVD. In this point-of-view article, we emphasise the need for government policies beyond those mentioned in the National Prevention Agreement in the Netherlands to effectively reduce the CVD risk, and we address the commonly raised concerns regarding 'paternalism'.

16.
J Phys Act Health ; : 1-10, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627125

RESUMO

BACKGROUND: The purpose of this study was to analyze factors associated with physical activity (PA) and to identify perceived barriers and benefits of PA among patients with hypothyroidism on thyroid hormone therapy. METHODS: This survey-based cross-sectional study was conducted among members of the Dutch thyroid patient organization. Self-reported data on respondents' PA levels and demographic, clinical, and physical health variables were collected. Moreover, perceived barriers and benefits to PA were identified. Respondents were categorized as physically active when meeting the recommended Dutch PA guidelines and physically inactive otherwise. To compare physically active and inactive respondents, potential confounders were entered into univariate analyses. Factors showing significant correlations (P < .20) were added to a multivariate model to determine the associated factors of PA. RESULTS: About 1724 female respondents (mean age 53.0 [11.6] y) were included; 16.1% reported meeting the PA recommendations. Multivariate analysis showed that factors associated with PA included levothyroxine/liothyronine therapy, comorbidities, self-perceived physical fitness, and diminished physical endurance. Overall, physically related barriers to PA were rated highest. CONCLUSIONS: The vast majority of treated hypothyroid respondents are physically inactive and experience long-term exercise intolerance. Considering the health implications of physical inactivity, promotion of regular PA is of key importance in this population.

17.
J Phys Act Health ; : 1-11, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627128

RESUMO

INTRODUCTION: Health care professionals are well-positioned to encourage physical activity. The Clinical Champions Physical Activity Training Program (CCTP) aimed to increase population-level physical activity across England. This study aimed to (1) evaluate CCTP uptake and utilization; (2) explore CCTP fidelity, barriers, facilitators, and satisfaction; and (3) provide recommendations for program improvement. METHODS: Physical Activity Clinical Champions were recruited and trained to deliver training to other health care professionals about physical activity. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to conduct a process evaluation using data collected from CCTP training sessions delivered (often at hospitals and General Practitioner surgeries) between February and December 2018. RESULTS: About 509 training sessions were delivered, with 89% of sessions delivered by doctor/physician and nurse Clinical Champions; 8917 health care professionals attended a training session. Sessions lasted on average 1 hour 28 minutes and core slide sets were used in 65% of sessions. Barriers related to arranging the sessions and time available to deliver sessions. CONCLUSION: The process evaluation demonstrated a national peer-led training program can reach all geographical regions of England; however, barriers need to be addressed. Recommendations include providing more administrative support to the Clinical Champions, improving communication and advertising to raise awareness of the CCTP, and standardizing training session duration and content.

18.
BMC Public Health ; 21(1): 1857, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649535

RESUMO

BACKGROUND: Handwashing with soap is a cost-effective, efficient health behavior to prevent various diseases. Despite its immense health benefits, the lowest prevalence of handwashing is found in low-income countries. Here, its practice is not only determined by individual behavior, but also heavily shaped by deprivations in the social and structural ecology. Moreover, handwashing barriers are not equally experienced as overlapping social identities (e.g., age and gender) intersect and create inequities between members of different social groups. To embrace the complexities of handwashing beyond individual-level behavior and singular social identities, a combined socioecological and intersectional perspective is employed. This multi-level approach with regards to intersecting privileges and disadvantages serves as a basis to promote this highly important health behavior. METHODS: This study used a qualitative, theory-based approach and combined data from two samples: experts in health promotion (n = 22) and local citizens stratified by gender and rural/urban location (n = 56). Data was collected in face-to-face interviews in Sierra Leone between November 2018 and January 2019 and analyzed using thematic analysis and typology of the qualitative data. RESULTS: The conceptualization of multi-level determinants of handwashing within a socioecological model showed the high relevance of inhibiting social and structural factors for handwashing practice. By establishing seven distinguishing social identity dimensions, data demonstrates that individuals within the same social setting yet with distinct social identities experience strikingly differing degrees of power and privileges to enact handwashing. While a local leader is influential and may also change structural-level determinants, a young, rural wife experiences multiple social and structural constraints to perform handwashing with soap, even if she has high handwashing intentions. CONCLUSION: This study provides a holistic analytical framework for the identification of determinants on multiple levels and accumulating intersections of socially produced inequalities for handwashing and is applicable to other health topics. As the exploration of handwashing was approached from a solution-focused instead of a problem-focused perspective, the analysis can guide multi-level intervention approaches (e.g., using low-cost, participatory activities at the community level to make use of the available social capital).

19.
BMJ Open ; 11(10): e050943, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649847

RESUMO

INTRODUCTION: Household contacts of cholera cases are at a greater risk of Vibrio cholerae infection than the general population. There is currently no agreed standard of care for household contacts, despite their high risk of infection, in cholera response strategies. In 2018, hygiene kit distribution and health promotion was recommended by Médecins Sans Frontières for admitted patients and accompanying household members on admission to a cholera treatment unit in the Democratic Republic of Congo. METHODS: To investigate the effectiveness of the intervention and risk factors for cholera infection, we conducted a prospective cohort study and followed household contacts for 7 days after patient admission. Clinical surveillance among household contacts was based on self-reported symptoms of cholera and diarrhoea, and environmental surveillance through the collection and analysis of food and water samples. RESULTS: From 94 eligible households, 469 household contacts were enrolled and 444 completed follow-up. Multivariate analysis suggested evidence of a dose-response relationship with increased kit use associated with decreased relative risk of suspected cholera: household contacts in the high kit-use group had a 66% lower incidence of suspected cholera (adjusted risk ratio (aRR) 0.34, 95% CI 0.11 to 1.03, p=0.055), the mid-use group had a 53% lower incidence (aRR 0.47, 95% CI 0.17 to 1.29, p=1.44) and low-use group had 22% lower incidence (aRR 0.78, 95% CI 0.24 to 2.53, p=0.684), compared with household contacts without a kit. Drinking water contamination was significantly reduced among households in receipt of a kit. There was no significant effect on self-reported diarrhoea or food contamination. CONCLUSION: The integration of a hygiene kit intervention to case-households may be effective in reducing cholera transmission among household contacts and environmental contamination within the household. Further work is required to evaluate whether other proactive localised distribution among patients and case-households or to households surrounding cholera cases can be used in future cholera response programmes in emergency contexts.

20.
BMJ Glob Health ; 6(10)2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34649869

RESUMO

In 2021, many countries have begun distribution of COVID-19 vaccines but are hampered by significant levels of vaccine hesitancy or apathy. Experts recommend that standard health communication campaigns be expanded to include a more holistic approach of behaviourally oriented strategies. We constructed a large-scale Delphi panel of marketing and behavioural science university faculty to assess 12 previously reported US vaccination promotion strategies, asking respondents to assess applicability of the strategy in their country, how efficacy might compare to the USA and recommendations for local adaptations necessary to successful implementation. Separately, we sought to determine whether strategies based on cognitive mechanisms (eg, 'nudges') are more readily generalisable than strategies based on social identity. Ninety-two marketing and behavioural science faculty from universities worldwide participated. Globally, all 12 behavioural strategies were validated; a majority of respondents reported that they would or could work well in their country. While all strategies were strongly validated at a global level, specific need for regional adaptation was identified. Also, open-ended responses suggested the addition of three emergent strategies to a global effort. Finally, we see that strategies based on some types of cognitive mechanisms are more readily generalisable across regions than mechanisms based on social identity, however, this is not always true of 'nudge' strategies. All 12 strategies are robust to global use and consensus exists on adaptation for optimal efficacy in different regions; specific strategy recommendations are posited. Use of these strategies can accelerate individual country efforts to achieve desired vaccination rates to protect global public health.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...