Global Health Promotion最新文献

Objetivo: identificar las características sociodemográficas y/o sociosanitarias comunes de quienes solicitaron prestaciones para la interrupción voluntaria del embarazo (IVE) en Chile mediante un análisis de clases latentes, con el fin de examinar la relación entre estos patrones y la decisión de interrumpir el embarazo.Métodos:análisis de clases latentes a partir de una cohorte retrospectiva basada en registros anonimizados a nivel nacional. Gestantes que solicitaron las prestaciones contempladas en la Ley 21.030 de la red sanitaria pública en Chile, entre los años 2018 y 2022 (N = 3789).

Resultados: modelo de cinco clases latentes: C1 "Extranjeras con alta vulnerabilidad que ingresan por violación" (4.3 %), C2 "Chilenas con baja vulnerabilidad" (11.8 %), C3 "Extranjeras con alta vulnerabilidad que ingresan por inviabilidad fetal o riesgo de vida para la persona gestante" (13.3 %), C4 "Chilenas con vulnerabilidad media" (55.6 %) y C5 "Chilenas con alta vulnerabilidad" (15.1 %). Las gestantes pertenecientes a las C3 (OR = 0.91, IC 95 % [0.88, 0.95]) y C4 (OR = 0.87, IC 95 % [0.84, 0.90]) tienen menores probabilidades de interrupción en comparación con las que pertenecen a la C2. Las gestantes C3 (0.94 [IC 95 % = 0.88, 0.99]) son quienes presentan mayores probabilidades de solicitar IVE, seguidas por C2 (0.93 [IC 95 % = 0.90, 0.97]) y C5 (0.92 [IC 95 % = 0.89, 0.95]).

Conclusiones: los perfiles sociodemográficos de las personas solicitantes de la IVE revisten de complejidad y presentan características heterogéneas. En Chile, los patrones distintivos identificados en las personas gestantes que solicitaron la IVE durante el periodo de estudio apuntan a vulnerabilidades sociales que pueden limitar los derechos sexuales y reproductivos de las personas gestantes. Las políticas públicas debieran poner foco en personas migrantes que solicitan prestaciones IVE.

With the 40th anniversary of the Ottawa Charter approaching, it is worth reflecting on its legacy in health promotion, particularly in schools. This short yet aspirational text marked a turning point by establishing the basis for a new public health system that takes a comprehensive, intersectoral approach to social determinants. Rather than being merely an awareness-raising tool, the Charter promotes health education as a means of emancipation and of acting on living conditions, notably enabling the fight against cancers. This article provides a critical analysis of developments in health promotion research in schools. First, it identifies the initial challenge of moving beyond isolated interventions towards comprehensive, integrated and participatory approaches. It then explores the obstacles and incentives associated with the transferability of interventions and the development of implementation science. The third axis calls for the research field to be structured, with clear objectives, shared indicators and greater consideration given to practical knowledge. Finally, it stresses the need to place the reduction of social inequalities in health at the heart of interventions, adopting methodologies that are sensitive to the differentiated effects according to social contexts. In conclusion, research into health promotion in school settings must evolve towards a transdisciplinary systemic approach that is grounded in practice. Such an approach plays a strategic role in building truly equitable schools that promote the health and well-being of all by taking action to reduce cancers from an early age.

Health mediation, similar to health navigation in the United States or Canada, is known by various terms worldwide. In France, health mediation has historically been implemented by civil society organizations to support hard-to-reach populations. Health mediation is increasingly considered by health authorities as a valuable tool for health promotion to reduce health inequalities. However, systematic evaluations of its effects are scarce, making it difficult for decision-makers to generalize health mediation as a health policy. Our study aims to bridge this gap, by framing a research protocol to evaluate a health mediation intervention. The intervention consists of setting up a biweekly mobile booth using an 'outreach' approach at the base of a social housing complex in 12 neighborhoods of Seine-Saint-Denis with marked indicators of social deprivation. We chose a realistic evaluation approach and a mixed-methods methodology, which is the best fit for assessing complex interventions such as the one we aim to assess. Realistic evaluation is a relatively new approach, and sharing studies based on this type of epistemological and methodological approach is required. This study aims to contribute to the reflection on and the production of standard tools to ensure that the use of this evaluation approach is improved.

Non-communicable diseases (NCDs) account for 74% of all deaths globally. The growing health inequities related to NCDs stem from social determinants of health (SDOH). Targeting SDOH could reduce NCDs substantially. To achieve this, implementing complex health promotion and prevention programmes in schools, including but not limited to developing life skills, seems paramount. However, the evaluation of such endeavours remains critical but challenging. To our knowledge, few complex health promotion school programmes integrating health education and environmental improvement have been evaluated. The present study is part of a French intervention-research project evaluating a three-year programme for 4th graders (ages 8-10) from schools with marked social inequalities. The aim is to develop life skills and promote healthy environments. Validated scales measuring life skills, health literacy, self-efficacy, and life satisfaction were used with 631 pupils from six pilot regions. This study presents the baseline scores for French pupils to detect early disparities and determine potential associations with SDOH, such as gender or socioeconomic status. Our results show that girls scored higher than boys on all scales except self-efficacy. Discrepancies between regions were noted, suggesting the potential need for adjustments to educational programmes to address specific regional differences in life skills outcomes. Further studies will be needed to assess the effectiveness of the programmes in other areas of its target goals.