Salud comunitaria

Salud comunitaria
  • 文章类型: English Abstract
    目的:评估干预措施的有效性,以在卫生区域的所有基本卫生区(ZBS)中持续纳入团体和社区活动。
    方法:在2019年1月和2月期间,研究小组的两名成员前往每个ZBS采访了先前通过电子邮件收到临时初始评估问卷(QAI)的医疗和护理协调员。
    方法:范围是健康区域的11ZBS。
    方法:研究人群是ZBS和由医疗和护理协调员代表的各自团队。
    方法:促进社区卫生委员会,开展培训行动,记录临床病史中的活动,并纳入管理目标。
    方法:在干预的第一年后进行定量和定性分析。
    结果:在预评估中:6个初级保健团队(EAP)报告有小组活动,4人参加了地方行动项目,4有一个专业的社区活动推荐人,3人参加了弱势群体的项目,4人表示有关于社区卫生的具体会议。干预后:11个EAP进行了小组活动,8有参考专业人士,6人参加了地方行动项目,4次与弱势群体合作开展项目,5次举行社区健康会议。
    结论:干预措施在实施第一年后被证明是有效的,由于所有EAP都开展了小组活动,并与该地区的地方议会合作;大多数都有社区护理方面的领先专业人员,在较小程度上,对地方行动项目和弱势群体的参与增加。
    OBJECTIVE: Evaluate the effectiveness of an intervention to incorporate group and community activities on a sustained basis in all the Basic Health Zones (ZBS) of a health area.
    METHODS: During January and February 2019, two members of the research team traveled to each ZBS to interview the medical and nursing coordinators who had previously received an ad hoc initial assessment questionnaire (QAI) by email.
    METHODS: The scope is the 11 ZBS of a health area.
    METHODS: The study population is the ZBS and the respective teams represented by the medical and nursing coordinations.
    METHODS: Promote a community health commission, carry out training actions, record activities in clinical history and incorporate management objectives.
    METHODS: Quantitative and qualitative analysis was carried out pre and post after the first year of intervention.
    RESULTS: In the pre-evaluation: 6 primary care teams (EAP) reported having group activities, 4 were participating in local action projects, 4 had a professional referent for community activities, 3 participated in projects with populations in vulnerable situations and 4 stated have specific meetings on community health. After the intervention: 11 EAPs had group activities, 8 had a reference professional, 6 were participating in local action projects, 4 collaborated in projects with vulnerable populations and 5 held meetings on community health.
    CONCLUSIONS: The intervention proved effective after its first year of implementation, since all the EAPs carried out group activities and collaborated with the local councils in the area; the majority had leading professionals in community care and, to a lesser extent, participation in local action projects and in vulnerable populations increased.
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  • 文章类型: Journal Article
    目的:分析参与EvaluAGPS研究的健康促进项目中确定的行动路线,以及它们与EvalGuia分配的分数的关系,评估基于证据的社区参与的工具。
    方法:定性定量多中心研究。
    方法:西班牙五个自治社区的初级保健或初级保健和市政当局的部门间网络。
    方法:10个健康促进项目的参与者,通过方便的抽样选择,遵循纳入标准(社区参与最少且以社区健康为中心的项目)。
    方法:通过问卷调查(EvalGuía工具)和参与式研讨会收集数据。定量数据采用描述性统计分析,定性数据采用矩阵分析。
    结果:实施EvalGuide工具后,在结果评估中分配了最低的分数,了解与社区参与有关的政策,核心工作组的多样性,包容性政策,财政资源和成果扩散。提议的行动路线是不同的,并不总是与优先考虑的较低分数相匹配。优先事项围绕项目组织和沟通。
    结论:EvalGuide工具有助于在健康促进项目中设计行动计划。在12个月内采取措施,增加核心工作组的多样性,纳入工作与生活平衡的措施或改善评估是困难的。需要更多的时间来执行这些措施。
    OBJECTIVE: To analyse the lines of action identified in the health promotion projects participating in the EvaluA GPS research, and their relationship with the scores assigned in EvalGuia, a tool for evaluating evidence-based community participation.
    METHODS: Qualitative-quantitative multicentre study.
    METHODS: Primary care or intersectoral network of primary care and municipalities in five autonomous communities in Spain.
    METHODS: Participants of 10 health promotion projects, selected with convenience sampling, following inclusion criteria (projects with a minimum of community engagement and centred on community health).
    METHODS: Data were collected through questionnaires (EvalGuía tool) and participatory workshops. Quantitative data were analysed with descriptive statistics, qualitative data were analysed using matrix analysis.
    RESULTS: After implementing the EvalGuide tool, the lowest scores were assigned in outcome evaluation, knowledge of policies related to community participation, diversity in the core working group, inclusivity policies, financial resources and diffusion of results. The lines of action proposed were heterogeneous and did not always match with those prioritised as lower score. The prioritised lines revolved around project organisation and communication.
    CONCLUSIONS: The EvalGuide tool can be helpful to design action plans in Health Promotion projects. The implementation of measures in 12 months to increase the diversity of the core working group, to incorporate work-life balance measures or to improve evaluation is difficult. More time is needed to implement such measures.
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  • 文章类型: English Abstract
    The objective of this study was to know the evolution of the COVID-19 pandemic in the school setting, and the effect of the new variants on it.
    It is an observational longitudinal descriptive study during the first term of the academic year 21/22. SITE: Community health services.
    Preschool, elementary, secondary, and high school students.
    none.
    We calculated cumulative incidence stratified by grade, source of infection and follow-up period, percentage of vaccinated cases and correlation between cumulative incidence in schooled children per week and cumulative incidence in the general population.
    1526 cases were reported, and the cumulative incidence was 3,17% and 0,48% in within-school acquired cases. 20,9% were vaccinated. During follow-up, there was an important change in incidence from weeks 49/21 on, at the time Omicron began to appear in Spain, with an increase in secondary cases, mostly high school students. We found a high correlation between general population and schooled children\'s cumulative incidence (R2 = 0,59).
    SARS-CoV-2 transmission in school settings has been affected by new circulating variants. Two propagation scenarios were identified, and they were like the community propagation pattern. This supports the hypothesis that school settings reflect the transmission in the community. Reinforcement of preventive measures and surveillance would have a positive effect on school settings.
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  • 文章类型: Journal Article
    Los procesos participativos permiten analizar, comprender, debatir y promover la acción colectiva en asuntos significativos para una comunidad. Estas metodologías activas favorecen la identificación de necesidades y activos en salud para elaborar un diagnóstico de salud comunitaria y promover acciones colectivas. En este sentido, la aplicación de los procesos participativos en el contexto universitario resulta de gran interés para el fortalecimiento de las universidades como comunidades promotoras de la salud. En este trabajo se describe el desarrollo del proceso participativo #beUMHealthy, cuyo objetivo principal fue potenciar el debate sobre la salud y las iniciativas de promoción de la salud en el alumnado de la Universidad Miguel Hernández (UMH). El proyecto se desarrolló entre mayo y noviembre del 2019. Se recogieron 22 participaciones mediante WhatsApp y 173 cuestionarios diligenciados en línea. Este proceso permitió identificar necesidades y activos en salud en el alumnado de la UMH y obtener propuestas para su mejora. Esta información se usará para promover acciones futuras que incrementen la salud de la comunidad universitaria.
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  • 文章类型: Case Reports
    This is a report about the experience on redefining the health asset mapping methodology. The aim of this experience consisted of making an analysis on health inequalities, as well as of using it as a tool in decision-making participative processes in the local administration area. Thus, a replicable procedure for all ages and groups was designed. Besides this, assets have been widely classified, in accordance with the territorial distribution, people\'s profiles and asset features. Both the upload of data to a geographical information system and the large amount of data gathered allowed us to enlarge the common interpretation of data and present the information in a dynamic way.
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  • 文章类型: Journal Article
    The objective of this article is to critically reflect on the participation in community of people with a diagnosis of mental disorder from a human rights and community health perspective. Firstly, we review basic concepts such as community mental health and the meaning of participation, which is understood as an end and not as a mean. It is important to increase the participation of people with a diagnosis in community spaces beyond the classic circuit of mental health care. This implies to create and share knowledge in a collective, horizontal and consensual way among all the people involved, especially the diagnosed people themselves. Secondly, the experience of the group of women of Radio Nikosia is narrated in first person by the participants themselves. The main highlights of the group are its horizontality, flexibility, and that is a self-organized space outside the health system where it is possible to express oneself without fear of being judged. Processes of trust, recognition, joy, social support and health are generated. Members of the group meet fortnightly and discuss on different topics chosen by them, and take part in political actions for women\'s own rights such as participation in the media, in feminist calls, in training and talks. We exemplify that other ways of doing community mental health are possible. The challenges are to make them visible, to systemize them and to be able to assess the impact they have on the health not only of the participants, but also the community.
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  • 文章类型: Journal Article
    Community health can reduce inequalities in health and improve the health of the most disadvantaged populations. In 2007, Barcelona Salut als Barris (Barcelona Health in the Neighbourhoods) was launched, a community health programme to reduce social inequalities in health. In 2018, this programme reached the 25 most disadvantaged neighbourhoods of the city. This article shares the lessons learned after 12 years of work. The programme was initially funded by a research grant and the funds were maintained during the economic crisis and were tripled when the programme became a political priority in the last municipal government. During the 12-year period, partnerships with stakeholders were generally stable and productive. Maximum community participation was obtained in the detection of health assets and needs and in action plans. During 2018, Barcelona Salut als Barris worked with more than 460 agents that co-produced 183 interventions involving more than 13,600 people. Most of the interventions assessed showed improvements in the health of participants, which could help to reduce health inequalities. The greatest difficulties were: a) citizen participation, b) the sustainability of working groups over the years, c) conflicts of interest, d) the sustainability of interventions, e) reaching certain minority groups and f) evaluation. The increase in resources in the last period contributed to the maturity and expansion of the programme. Key factors in its scope and results were political will, strong technical capacity and methodology, strong intersectoral partnerships and continued community work.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Case Reports
    Health depends mostly on factors that lay outside the health system, such as socioeconomic determinants. Intersectorality and participation are key elements for an integrated care person and community centred. In Catalonia, the National Primary Health and Community Strategy aims to reinforce primary health care, so that it becomes the backbone of the health system and with a strong community orientation. To deploy a community oriented primary health care it is important to count with reliable and robust data by small areas. Thirty-eight basic indicators were selected for each of the 370 primary health care in Catalonia. Indicators were calculated and presented following the social determinants model: demographic (4), socioeconomic (3), morbidity (9), mortality (6), lifestyles (4), preventive practices (1), resources and use of health services (9) and physical environment (2). These indicators will allow health professionals to carry out local health assessments in a fast and systematic manner.
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  • 文章类型: Journal Article
    Scientific studies showing how regular contact and physical activity in natural environments result in health benefits are increasingly precise and conclusive, and include many aspects related to physical and mental health. Starting from protected areas departments, many initiatives have appeared to incorporate health in the planning and management of these natural spaces, with successful results both for the improvement of the health and well-being of the people and for the conservation of the natural heritage. In recent years, numerous projects have arisen in different autonomous communities and local administrations, which show the potential of this line of collaborative work. It would be desirable to develop a joint strategy between the departments of health and nature conservation in order to enhance the indicated benefits through common projects at different scales.
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