Promoting physical activity through primary health care: the case of Catalonia.

BACKGROUND: In adults, as little as 10 minutes of moderate physical activity (PA) three times a day can help prevent non-communicable diseases and prolong life expectancy. The aim of the study was to evaluate the process and impact of scaling up a complex intervention (PAFES) implemented in Catalonia, aimed to increase the proportion of adults complying with PA recommendations (especially those with cardiovascular risk factors). METHODS: The intervention, piloted in 2005, had three elements: 1) establishing clinical guidelines for PA; 2) identifying local PA resources; 3) PA screening and advice in primary health care (PHC) settings, based on stage of change. Central and local level implementation activities included training, support to municipalities, dissemination through a web page, and promotion of World Physical Activity Day (WPAD). Evaluation followed the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance), identifying 3-6 variables for annual evaluation of each dimension. These included coverage of PA screening and advice and individuals with access to a healthy exercise route (Reach), increased PA level between 2006 and 2010-15 (Effectiveness), PAFES adoption by PHC centres and municipalities (Adoption), process evaluation data (Implementation), and cost (Maintenance). RESULTS: PHC screening coverage increased from 14.4% (2008) to 69.6% (2015) and advice coverage from 8.3% (2012) to 35.6% (2015). In 2015, 82.5% patients had access to a "healthy route" (Reach). The proportion of patients with at least one cardiovascular risk factor who were "sufficiently active" increased from 2006 to 2010-2013 (Effectiveness). By 2015, PAFES was applied by all PHC teams, 8.3% municipalities and 22.7% PHC centres had organized WPAD events (Adoption). The Plan showed good penetration in all health regions by 2013, with relatively low use of resources and estimated cost (Implementation). By 2013 the Plan was embedded within the health system (Maintenance). CONCLUSIONS: In the first application of the RE-AIM framework to evaluate the scaling-up of a PA plan, PAFES showed good results for most RE-AIM indicators. Changes in priority and investment in health promotion programs affect reach, adoption, and effectiveness. It is important to maintain support until programs are strongly embedded into the health system.

Physical activity level and lifestyle-related risk factors from Catalan physicians.

BACKGROUND: Physicians' own Physical Activity (PA) and other health-related habits influence PA promotion. The current study identifies the PA level, according to the current PA recommendations and other health-related habits of physicians from the Catalan Medical Council. METHODS: 2400 physicians (30-55 years) were randomly selected; each received a self-administered mailed questionnaire identifying medical specialization, work setting, health self-perception, body mass index (BMI), PA, and smoking habits. RESULTS: 762 physicians responded (52% female). Almost 1 in 2 (49.3%) exercised sufficiently, nearly all self-perceived good health, while 80.5% were nonsmokers. Almost 6 in 10 males reported overweight or obesity (56.9%) versus 18.2% of females. Active physicians dominated specific groups: (1) aged 45-55 years, (2) specializing either in primary care or surgery, (3) working in the private sector, (4) BMI < 25 kg/m2, (5) perceiving themselves in good health, or (6) having free leisure time. CONCLUSIONS: Only half of Catalan physicians met current PA recommendations; male physicians were particularly at risk for overweight/obesity. Overweight and under-exercise were associated with private workplaces and positive health perceptions, meaning that it is it is now possible to target inactive and/or overweight Catalan physicians in future interventions.

Calidad de las recomendaciones sobre actividad física saludable en la prensa. Análisis del contenido de cinco periódicos españoles / Quality of recommendations on health-enhancing physical activity in the press. Content analysis of five Spanish newspapers

Introducción: La inactividad física es una pandemia que provoca mundialmente millones de muertes prematuras, pero es un hábito que puede modificarse aumentando la cantidad y la calidad de la información disponible. En España y en el mundo, las noticias publicadas en los periódicos sobre salud y actividad física saludable (AFS) han aumentado, pero su calidad es cuestionable, según muestran varios estudios. Metodología: Se utiliza la técnica de análisis del contenido para analizar 12 variables de calidad desde las perspectivas comunicativa y científica en noticias sobre AFS publicadas en los periódicos generalistas con mayor difusión en España (2013-2014): El País, El Mundo, La Vanguardia, ABC y El Periódico. Resultados: La calidad de las noticias (n=100) obtiene una nota media de 6,3 puntos (s=1,9) en una escala de 0 a 10. Las variables satisfacen heterogéneamente la calidad; de mayor a menor: medicalización (96%); objetividad (94%); fuentes (80%); contexto (62%); credibilidad (61%); disponibilidad (54%); novedad (52%); veracidad (43%); alternativas (26%); emoción (20%); lenguaje divulgativo (19%), y magnitud (19%). Conclusiones: Aunque la calidad media de las noticias sobre AFS no es baja, existe un amplio margen de mejora. Sobre todo, en algunas de las variables analizadas para las que se aportan unas recomendaciones para la práctica periodística y para las fuentes de información científicas y profesionales

Introduction: The pandemic of physical inactivity causes millions of early deaths globally. However, inactivity can be reversed if more and better information is made available. While the number of news stories on health and health-enhancing physical activity (HEPA) has increased globally and also in Spain, various studies show that the quality of these articles is often questionable. Methodology: Content analysis was used to analyze twelve quality variables from the scientific and media perspectives and five variables about the themes in news stories on HEPA published in five Spanish general-interest newspapers in the years 2013 and 2014: El País; El Mundo; La Vanguardia; ABC; and El Periódico. Results: The average score of quality of news stories (n=100) is 6.3 (s=1.9) on a scale from 0 to 10. The percentages of satisfactory quality variables are: medicalization (96%); objectivity (94%); sources (80%); context (62%); credibility (61%); availability (54%); novelty (52%); truthfulness (43%); alternatives (26%); emotion (20%); accessible language (19%); and magnitude (19%). Conclusions: The average quality of the newspaper articles on HEPA is intermediate. Further work is required, particularly regarding the following variables: alternatives; emotion; accessible language; and magnitude. Suggestions to improve journalistic practice and scientific dissemination (sources) are accordingly included