Miquel Bennasar-Veny

Night shift work has been associated with adverse health effects, although findings remain inconsistent. This study aimed to analyze the association between night shift work and sleep quality, chronotype, cardiometabolic parameters, and behavioral factors among hospital workers. A cross-sectional study was conducted among 225 normoglycemic workers at Son Llàtzer University Hospital (Mallorca, Spain). Sociodemographic and occupational data were collected through a structured questionnaire. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ), adherence to Mediterranean diet with the 14-item PREDIMED tool, sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and chronotype with the Morningness-Eveningness Questionnaire (MEQ). Clinical parameters, including fasting plasma glucose, lipid profile, blood pressure, body mass index (BMI), waist circumference, and cardiovascular risk, were obtained from standardized health assessments. Associations with night shift work were examined using bivariate analyses and general linear models adjusted for age, sex, BMI, and physical activity. Night shift work was not significantly associated with fasting plasma glucose, triglycerides, HDL cholesterol, sleep quality, or chronotype. Compared with day workers, night shift workers showed lower levels of total and LDL cholesterol, blood pressure, BMI, and waist circumference, lower smoking rates, lower cardiovascular risk, and higher physical activity levels. No significant differences were observed in adherence to the Mediterranean diet. After adjustment for age and sex, only the association between night shift work and physical activity remained significant. Overall, night shift work was not associated with poorer health status or increased cardiovascular risk. Instead, no consistent evidence of a less favourable lifestyle was observed among night shift workers.

Health interventions for individuals with prediabetes are essential to prevent or delay progression to type 2 diabetes. Adherence to lifestyle modification is complex and influenced by social determinants that act as barriers or facilitators. Gender, social class, social support, and the patient-professional relationship may shape individuals' capacity to adopt and maintain behavioural changes. This study aimed to explore how these factors influence adherence to lifestyle modification among people with prediabetes. Ethnomethodological study with a critical social perspective. Data were collected through fifteen semi-structured interviews, one focus group, and a support network mapping exercise. Analysis combined thematic content analysis and critical discourse analysis. Rigour was ensured through data saturation, investigator triangulation, and reflexivity. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Women across social classes reported significant barriers, including work overload, caregiving responsibilities, and weaker support networks, whereas men often benefited from stronger family support. Participants from lower socioeconomic backgrounds faced additional challenges, such as financial limitations affecting healthy food choices and lack of time for exercise. Trust-based and supportive relationships with healthcare professionals emerged as important facilitators of sustained lifestyle change. Gender and social class play a key role in prediabetes management. These findings highlight the importance of personalised, equity-focused interventions that address social determinants to improve prevention strategies. The research protocol was registered in a clinical trial registry prior to data collection (registration number: NCT06488677 on July 5, 2024).

Background/Objectives: Mobile health (mHealth) interventions can enhance chronic disease management, but their integration into public healthcare systems remains complex. DiabeText is the first SMS-based intervention in Spain delivering personalized diabetes self-management support using electronic health record data. This study explored perceived barriers and facilitators to the implementation of DiabeText in the Spanish public health context from the perspective of key stakeholders. Methods: A qualitative study was conducted using semi-structured interviews with 14 purposively selected stakeholders involved in digital health, diabetes care, data protection, and healthcare management across several Spanish regions. Interviews were thematically analyzed using Braun and Clarke’s approach and guided by the Implementation Research Logic Model. Results: Participants reported several barriers, including concerns regarding data protection, uncertainty about long-term sustainability, insufficient training and engagement of healthcare professionals and low digital literacy among certain patient groups. Facilitators included favorable institutional momentum for digital innovation, funding availability, perceived clinical utility and scalability of DiabeText, and growing patient familiarity with digital tools. Recommended strategies included integration into existing healthcare systems and workflows, professional training and use of familiar communication platforms. Conclusions: Effective implementation of DiabeText requires addressing regulatory, organizational, and equity-related barriers while leveraging institutional support and readiness for innovation. Early involvement of healthcare professionals, robust data governance, and investment in digital literacy are essential to ensure sustainable and equitable adoption. These findings provide actionable insights to support the integration of mHealth tools into chronic disease care in Spain and similar settings.

Aim: To explore the relationship between social determinants of health and adherence to lifestyle recommendations, and how these determinants can help explain contextual and interpersonal factors contributing to adherence among individuals with prediabetes. Design: Explanatory sequential mixed methods study integrating a cross‐sectional quantitative analysis with an ethnomethodological qualitative approach grounded in critical social paradigm. Methods: The quantitative phase used data from the intervention arm ( n = 86) of the PREDIPHONE trial, a randomised controlled study evaluating the effectiveness of a nurse‐led telephone intervention for lifestyle changes in glycaemic control. Adherence was measured using a composite index, analysed as both a continuous and categorical variable. Correlation analysis examined adherence and age. Chi‐square and ANOVA tests were used to analyse differences in participant characteristics across adherence quartiles. The qualitative phase included individual semi‐structured interviews and a focus group with participants showing high or low adherence. Thematic content and discourse analysis were employed, ensuring validity through triangulation, reflexivity and discourse saturation. Results: Employment status was identified as a significant factor, with unemployed or retired participants showing better adherence. Although no statistical differences in adherence were found by social class or gender, lower social class participants reported financial barriers to healthy eating and time constraints limiting physical activity (PA). Women reported facing greater challenges due to caregiving responsibilities, whereas men benefited from household support. Conclusions: Employment status emerged as a determinant of time availability for self‐care, alongside social class and gender in adherence to lifestyle modifications. Women, especially those from lower social classes, experienced heightened barriers to adherence, underscoring the need for tailored, gender‐sensitive and equity‐focused interventions. Implications: Addressing social determinants is essential for effective lifestyle advice among individuals with prediabetes. Impact: The study highlights the role of social class and gender in adherence. Reporting Method: STROBE and COREQ guidelines. Patient Contribution: Through interviews and focus group.

Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625 International Registered Report Identifier (IRRID): RR2-10.3390/ijerph192214706

BACKGROUND Depression is a prevalent and disabling mental health disorder that significantly affects quality of life and remains a leading global contributor to disability. Although pharmacological and psychological interventions are effective, many patients fail to achieve complete remission of depressive symptoms. Current evidence suggests that lifestyle-related interventions may offer a promising strategy as an adjuvant treatment for depression. OBJECTIVE To evaluate the effectiveness of lifestyle-based interventions in reducing depressive symptoms in adults. METHODS An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating lifestyle-based interventions for adults with depression was conducted. The literature search was conducted in Medline/PubMed, PsycINFO, Web of Science, Cochrane Library, and Scopus from inception to March 2025. The review followed the PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD42024420246). Two reviewers independently screened titles and abstracts, reviewed full texts for eligibility, extracted data and evaluate the methodological quality of included reviews using AMSTAR-2. Discrepancies were resolved through discussion with a third author. A narrative synthesis of findings was conducted. RESULTS A total of 46 systematic reviews were included, of which 32 incorporated meta-analysis. Aerobic and resistance exercise showed moderate-to-large effects, particularly when delivered in supervised settings. Mind-body therapies achieved similar benefits and were associated with high adherence rates. Multicomponent interventions showed small-to-moderate effect, although their effectiveness was limited by heterogeneity and follow-up decline. CONCLUSIONS Lifestyle-based interventions are safe, scalable, and effective adjuvant treatments for depression. However, further high-quality, standardized trials are needed to optimize intervention protocols and confirm their long-term benefits. CLINICALTRIAL The protocol for this umbrella review was prospectively registered in the PROSPERO database (International Prospective Register of Systematic Reviews, under registration number CRD42024420246.