Global Health Promotion最新文献

Objectives: In order to prevent people from taking up smoking on a daily basis, the P2P program has been developed based on the Theory of Planned Behavior (TPB) and relying on the peer-to-peer method. A cluster randomized controlled trial involving 1573 high school students in the Occitanie region of France showed a reduction in the increase in daily smoking. Given the effectiveness observed, the aim was to assess the transferability of P2P to two other French regions (Ile-de-France and Auvergne).

Method: The RE-AIM (Recruitment, Effectiveness, Adoption, Implementation, Maintenance) methodology was used. A total of 190 interviews were conducted with school referents, peer educators, peer receivers and regional coordinators. A self-questionnaire (before and after the intervention) assessed changes in daily smoking habits.

Results: P2P has been implemented faithfully in 29 vocational high schools, with adaptations to suit different contexts and actors. The main obstacles were organizational (timetable and school career). The levers are the support provided by prevention structures. Recruiting pairs of nurse referents and improving the pedagogical guide, which is recognized as a support tool, will be necessary. In terms of effectiveness, more than 3229 students in 10th Grade in vocational high schools were followed for 1 year. The prevalence rates of daily smoking changed by -1.6%, +2.9% and +0.7%, respectively, showing no significant difference between these regions, with no difference in effect depending on the place of implementation.

Discussion: The P2P program is transferable to other regions despite differences in how the organizations and high schools involved operate, and differences in the characteristics of the high school students targeted. It is also reproducible, maintaining a beneficial effect in preventing increased daily smoking among vocational high school students.

Social norms, the informal rules that influence behavior, play essential roles in shaping people's behavior. Community-based norms-shifting interventions (NSIs) identify gender and other social norms linked to unhealthy behaviors and implement activities to promote collective change by encouraging communities to reflect on and question these norms. Though NSIs are gaining international traction in social and behavior change programming for health promotion, how change occurs needs to be clearly understood in African and other contexts. To build understanding and guidance for future NSI design, the applied-research Passages Project and collaborating non-governmental organizations in West and Central Africa conducted realist evaluations of four NSIs focused on adolescent/youth sexual and reproductive health, operating in Democratic Republic of Congo, Niger, and Senegal. The evidence base for the realist synthesis came from four quasi-experimental outcome evaluations and 19 rapid implementation studies, which confirmed the four program Theories of Change. The synthesis findings identified eight norms-shifting mechanisms common across NSIs: information provision; dialogical, experiential approaches; role modeling; safe spaces; within-community meetings; planned diffusion; cross-community meetings of change agents; and community-service linkages. NSIs directly, at times indirectly, engaged reference groups that uphold norms, explaining their theoretical roles operationally. These findings led to middle-range theory showing how NSI activities, mechanisms, and reference group engagement should, over time, lead to norms-shifting outcomes. Design implications include developing a fuller understanding of how program components, as norms-change mechanisms, lead to effects; being deliberate about when and how to engage reference groups; and recognizing systems complexity and the subsequent need for NSI implementation elasticity.

Introducción:la pandemia de la COVID-19 expuso a los profesionales sanitarios a circunstancias que incrementaron su estrés, recurriendo al consumo de sustancias como estrategia de afrontamiento.

Objetivos: conocer el patrón de consumo de alcohol, tabaco y cannabis en profesionales sanitarios españoles en el periodo prepandemia y durante la fase pandémica aguda (FPA), diferenciando en función de la profesión y estableciendo si hubo diferencias entre ambos periodos.Métodos:estudio descriptivo no probabilístico con muestreo por conveniencia. Participaron 630 profesionales sanitarios. Se utilizó una encuesta en línea con categorización de la profesión sanitaria, AUDIT-C para consumo de alcohol, preguntas ad hoc para tabaco, y CAST para cannabis. Se realizó análisis de frecuencia y diferencia de medias (t de Student, Z Wilcoxon), reportando el tamaño del efecto y Phi.

Resultados: el 57.1 % de los profesionales sanitarios mostró consumo de la riesgo de la alcohol antes de la FPA; disminuyendo al 42.4 % en la FPA. Entre los consumidores, la proporción de consumidores de riesgo previa a la FPA fue del 95 % en todas las profesiones sanitarias y superior al 65 % durante la FPA. Entre ambos periodos, únicamente hubo un descenso significativo en médicos/as (χ² MN = 8.108; p < 0.004). Respecto al tabaco, el 14.1 % afirmó consumirlo, observándose un incremento significativo del consumo medio de cigarrillos entre ambos periodos (t(80) = -3.994; p < 0,001), explicado por el incremento entre psicólogos/as (t(42) = -3.245; p < 0.002). Respecto al cannabis, el 2.7 % afirmó haberlo consumido, presentando el 14.3 % adicción moderada y el 7.1 % dependencia.

Conclusiones: durante la crisis sanitaria se produjo una reducción del consumo de alcohol, tabaco y cannabis entre profesionales sanitarios, siendo desigual por categoría profesional. Sin embargo, se detectaron incrementos del consumo y consumos de riesgo en algunos colectivos, señalándose las implicaciones para su salud y labor sanitaria. Se propone impulsar medidas de promoción de la salud mental en los centros sanitarios que incorporen estrategias de abordaje de sustancias.

Context: Food literacy encompasses the knowledge, skills and attitudes necessary to choose, prepare and enjoy a healthy diet. Understanding the factors influencing children's food literacy is essential for guiding efforts to prevent overweight and obesity, as well as other food-related health outcomes.

Objective: In this context, this study aimed to describe the level of food literacy and its associated factors in a sample of 1187 children aged 8 to 11 years in France.

Methods: We conducted a cross-sectional study in CM1-CM2 classes (equivalent to 4th and 5th grades) across 31 schools in the Essonne department of France during the 2022-2023 school year. Data on food literacy, age, gender, family composition and lifestyle factors were collected through questionnaires completed by each child during class. Schools were characterized by their average social position index, which is derived from parents' professional categories and includes information on education, housing and culture. Factors associated with the food literacy score (ranging from 0 to 25, with higher scores indicating better food literacy) were identified in multivariate linear regression models that accounted for both individual and class levels.

Results: Among the 1187 children included in the study, the mean food literacy score was 17.0 ± 3.4. After adjustment, food literacy levels were significantly higher among girls, 5th graders, children engaged in regular physical activity and those with lower screen time. Conversely, food literacy levels were lower in larger families and in schools situated in priority education areas. A gradient in food literacy was observed according to the quintile of the school's social position index, with a difference of 2.17 points between the lowest and highest quintiles.

Conclusion: This study provides insights into the attributes of food literacy among a large sample of children and highlights the roles of social, family and individual factors in shaping food literacy.