Olga Lopez-Dicastillo

Background: The World Health Organization (WHO) defines health promotion as the process of enabling individuals to gain control over and improve their health. This shifts the focus from lifestyle choices to broader social determinants of health, requiring involvement from healthcare, authorities, industry, civil society, and the media. Civil society engagement in health initiatives offers benefits such as empowerment, service delivery, flexibility, policy participation, and credibility. However, identifying specific health promotion actions for civil society organizations (CSOs) is challenging. The lack of assessment tools for CSOs hinders evaluation and improvement. Objective: To develop a tool, ‘PromoACTIVA-SC’, to assess CSOs’ health promotion practice by identifying essential actions that constitute the health promotion process. Methods: ‘PromoACTIVA-SC’ was developed through documentary analysis and validated by experts. CSOs’ members participated in cognitive interviews for comprehensibility, and the tool was pilot tested for administration and Likert scale evaluation. Results: The final questionnaire, consisting of 8 phases and 40 items, demonstrated good content validity. Its use can help to map CSOs’ practices and identify areas needing improvement. CSOs can use it for self-assessment and in collaborative health promotion and disease prevention efforts. Conclusions: ‘PromoACTIVA-SC’ is the first tool designed to assess civil society’s role in the health promotion process. Its future use will reveal the extent to which civil society organizations actively participate in health promotion. It can also be used to promote CSOs’ involvement in health policy and administration, enhancing public health outcomes through collaborative, cross-sectoral efforts.

This cross-sectional study assessed the global health needs of children aged 2 to 6 years and examined how socio-demographic characteristics influenced children's health needs observed following the COVID-19 pandemic. Cross-sectional study conducted between January and March 2021 in three regions of northern Spain with similar household incomes. Participants were selected through one-stage cluster sampling. A self-reported questionnaire, Necesidades de salud de la Población Infantil, was used to assess children's health needs across seven dimensions and 125 items. A total of 301 parents or caregivers completed the questionnaire. The dimensions parental self-efficacy, professional advice, child socio-emotional aspects, and situational influence were the most frequently reported as significant, while parent socio-emotional aspects, lifestyle, promotion of healthy lifestyles, and influence of significant people were the least emphasized. Life-style-related needs were particularly affected by the limited access to healthcare professionals and were more pronounced when children had a disability. The findings of this study provide valuable insights for the development of strategies, programs, and interventions aimed at promoting children's health by addressing the identified needs.

Being well prepared and feeling confident when working with women who are breastfeeding is a challenge for many health professionals who need to be prepared to manage breastfeeding or any associated problems. The purpose of this study was to explore the changes in students’ breastfeeding professional self-efficacy and knowledge after a workshop on breastfeeding counseling. The counseling workshop increased their knowledge (p≤ .001) and breastfeeding professional self-efficacy (p≤ .001) in the provision of labor support. Counseling skills help students to integrate the knowledge and feel more confident to provide breastfeeding care.

Aims: This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions.Design: A complementary multi‐method study combining survey methods and qualitative interviews will be adopted.Methods: Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed.Discussion: This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building.Impact: Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts.Stakeholder Engagement: Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.

Unwanted pregnancies are considered a public health problem that affects women’s mental health and quality of life. The aim of this paper was to access university students’ understanding and behaviours regarding unwanted pregnancies and identify their needs to prevent them. Qualitative descriptive design was used, and 13 semi-structured interviews were carried out. Women between 18 and 20 years old participated. They discussed a lack of training for themselves, their partners, and their families, their desire to have access to non-in-person health care resources, and their belief that contraception was expensive. Emotional aspects were relevant, affecting the way communication is established with those close to them and with health professionals. Despite the existence of access to sexual health resources, the findings show the existence of needs related to the prevention of unwanted pregnancies. The findings are presented grouping the main identified needs as “related to capability”, “related to opportunity”, and “related to motivation”. Among the aspects to consider when designing interventions to prevent unwanted pregnancies are the feelings shown by these women, the inclusion of couples and family members in educational programs, and access to non-face-to-face health resources and less expensive contraceptive methods. Interventions for social support and understanding of women are necessary both to prevent unwanted pregnancies and to support adolescents with unwanted pregnancies by avoiding criminalization or blame.

At present, more babies are born with neonatal abstinence syndrome due to the increased use of certain substances by their mothers while pregnant. The therapeutic approaches for this syndrome vary in clinical practice, and in some centres, breastfeeding and rooming-in are interrupted. The aim of this work was to analyse the effects of breastfeeding and rooming-in in infants with neonatal abstinence syndrome by conducting a scoping review of the related literature in PubMed and CINAHL. Eleven papers were included, which showed that breastfeeding and rooming-in reduced hospital stay and the need for and duration of pharmacological treatment. In addition, rooming-in decreased the likelihood of admission to the Neonatal Intensive Care Unit, although there was no improvement of the severity of neonatal abstinence syndrome signs. Breastfed infants had milder withdrawal signs and, although they were more likely to be readmitted than formula-fed infants were, there were no statistically significant differences. There was no evidence that rooming-in decreased hospital readmission after discharge. Our findings support the maintenance of cohabitation and breastfeeding whenever possible in the management of this neonatal abstinence syndrome, so as not to worsen the conditions of the neonate, while introducing measures to ensure mother-child safety.

Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness.Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later.Results: The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group.Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics.Trial registration: ClinicalTrials.gov ID: NCT03944642.

Aim: To develop a taxonomy of activities in health prevention and promotion for primary care. Background: Despite health promotion being considered a keystone for population health and health care sustainability, its implementation remains insufficient. Customized evaluation tools are needed to address prevention and promotion omissions in primary care. Method: A taxonomy was designed using documentary analysis. Documents describing frontline primary care professionals' health prevention and promotion activities or omissions were identified and analysed using framework analysis. Results: The 'Taxonomyof Activities in Health Prevention and Promotion for Primary Care' (TaxoPromo) includes 43 activities grouped into eight categories: planification, situational analysis, capacity building, development of awareness/public opinion, advocacy, development of networks, development of partnerships and intervention strategies. Conclusion: By contrasting the usual practices with the activities collected in the TaxoPromo, opportunities for improvement can be unveiled. Implications for Nursing Management: The TaxoPromo can be used at organisational and system levels to identify actions to integrate health prevention and promotion activities into a systematic, data-driven process; design implementation plans and tailor-made strategies for capacity building; enable benchmarking; and address omissions. The TaxoPromo can serve as a catalyst tool for the clarification and expansion of the nursing role in health prevention and promotion.

Aim: To design, implement and evaluate a nurse‐led capacity building intervention (PromoGOB) for intersectoral action for health at local governments.Design: The programme was based on theories of the policy process and organizational change and facilitated by a nurse developing a health broker role. A complex intervention perspective was adopted in carrying out the study. The intervention was evaluated using a mixed method embedded design.Methods: Quantitative component relied on a specific questionnaire. This tool, designed and piloted ad hoc, measured the capacity in terms of knowledge, awareness, resources, skills, and commitment, both at sectoral and government levels. For the qualitative component, semi‐structured interviews were conducted. These explored the perceived capacity and feasibility and acceptability issues. The programme was initiated at the end of October 2019, and it lasted a total of 5 weeks. Nineteen individuals representing various sectors at a local government in northern Spain participated in the study. The data analysis was concluded by the end of March 2020.Findings: PromoGOB positively influenced participants' capacity for addressing health promotion. Awareness component, intersectoral work and the nurse as health broker were essential in the programme. The necessity of political participation was identified as an issue to be prioritized in future studies.Conclusion: This study highlights the relevance of capacity building at local governments and the role that nurses can play in it. Further work should be undertaken to continue developing Health in All Policies approach at local level.Impact: This study offers a starting point for nurses to get involved in the policy process of health promotion, performing a specific role as health brokers, building capacity at local governments for addressing social determinants of health, and delving into theories and concepts of the Health in All Policies field.