David Cantarero-Prieto

FUNDAMENTOS // La prevalencia de exceso de peso en población infantil española es del 36,1%, pero la diferencia entre quienes pertenecen a familias de renta baja y alta es del 16%, por lo que reducirla es una prioridad. El objetivo de la acción conjunta Health4EUKids es la implementación de buenas prácticas de promoción de la salud y prevención de la obesidad. El objetivo de este trabajo fue replicar y contextualizar una buena práctica basada en intervenciones en el entorno donde se vive que contribuya a reducir la obesidad infantil en población vulnerable en seis comunidades autónomas. MÉTODOS // Se adaptó la metodología original de investigación al contexto real de la práctica y posibilidades del proyecto. Se identificaron determinantes del entorno obesogénico y se utilizaron, a través de una herramienta participativa, para sistematizar las conversaciones con diferentes grupos sociales de los barrios. Se constituyeron el grupo motor y la red de salud, se realizaron análisis de situación, se priorizaron acciones y se realizaron los mapas de activos. Con toda esta información el grupo motor diseñó un conjunto de acciones. RESULTADOS // La guía se organizó en seis pasos y se armonizó la metodología en los ocho pilotos. La participación comunitaria y las herramientas participativas fueron fundamentales para la contextualización a las características locales. Se llevaron a cabo doce estructurales, diecinueve de Participación y Capacitación Comunitaria y catorce programáticas. CONCLUSIONES // Con este proyecto se visibiliza y consigue, en varios contextos locales, implicar a la población para contribuir a mejorar la alimentación y la actividad física a través del conocimiento, las habilidades, la práctica y la optimización de los entornos donde se vive.

I. Partnership and family-formation patterns in Europe have changed substantially over recent decades, with declining marriage rates, increasing cohabitation, and greater diversity in partnership h...

ProArt is a co-designed humanization programme that uses artistic activities and environmental transformation to enhance the experience of patients and families in a palliative care unit. This study evaluates its social impact through a Social Return on Investment (SROI) approach including patients, relatives, professionals and volunteers. The programme generated measurable improvements in emotional well-being, communication, personal relationships and the overall care environment, as reported by all stakeholder groups. The total social value created amounted to €1,076,855.42 compared with an investment of €129,405.78, yielding an SROI of €8.32 for each €1 invested. A comprehensive sensitivity analysis varying proxy values and attribution parameters confirmed the robustness of the findings, with SROI ratios ranging from €6.51 to €10.64. These results indicate that art-based humanization strategies can deliver substantial social value in palliative care and may represent an effective approach to improving the quality of end-of-life care.

Background: Cardiac rehabilitation (CR) programs have shown promising results in tertiary prevention. However, achieving sustained behavioral changes remains a challenge. Objective: The TIMELY project aims to develop and evaluate a personalized, artificial intelligence–driven eHealth platform and app to support sustainable behavior change during phase-3 CR, subsequently reducing cardiac risk scores. Methods: An international, multicenter, randomized controlled trial will be conducted to evaluate the effectiveness of the TIMELY integrated platform and app. A total of 360 patients with cardiac conditions will be approached to participate in the study across Germany, Spain, and the Netherlands. Patients will be randomly assigned (1:1) to either the intervention group or the control group (care as usual). The intervention group will receive fully web-based, behavior change support through the TIMELY app, with personalized exercise prescription, chatbot assistance, and monitoring devices (eg, activity watch). Both groups will continue to receive care as usual, complete validated questionnaires, undergo physical tests, and provide blood samples. Assessments will be conducted at baseline and at 3, 6, and 12 months. Results: Trial recruitment has been finalized in July 2024. A total of 358 patients have been recruited and randomly assigned to the intervention (n=180, 50.1%) or care-as-usual (n=178, 49.7%) condition. As of January 2025, the 6-month follow-up has been completed for all participants. Follow-up data collection will be completed in May 2025. Results regarding the primary and secondary objectives are expected in September 2025. Conclusions: This project will test a personalized platform and app, supported by artificial intelligence and designed to support health behavior change during phase-3 CR. It will target multiple health behaviors, with a primary focus on physical activity and fitness levels, using an integrated approach. Trial Registration: ClinicalTrials.gov NCT05955625; https://clinicaltrials.gov/ct2/show/NCT05955625 International Registered Report Identifier (IRRID): DERR1-10.2196/66283

This study examines the relationship between unmet healthcare needs and employment status, with a focus on how this relationship was influenced by the Spanish economic recession of 2008-2012. Data were obtained from the Spanish National Health Survey for 2006 and 2011-2012. The outcome variable was the presence of unmet healthcare needs, describing its reasons. The analysis included the period (pre-crisis/crisis), demographic variables (sex, age, Spanish citizenship), employment status, social factors (level of education, marital status, social-class), and health indicators (self-assessed health, chronic conditions, and limitations). Logistic regression was used to predict unmet health needs based on the period, employment status, and control variables. The frequency of unmet healthcare needs was low and decreased further during the crisis (5% pre-crisis vs 3% during the crisis). Unmet healthcare needs were more strongly associated with health status than with employment status. However, among the unemployed, unmet healthcare needs increased during the crisis compared to the pre-crisis. The most vulnerable groups, characterized by higher unmet healthcare needs, included women, individuals with lower levels of education, and those in poorer health. These groups may require more targeted attention. These findings should be interpreted in the context of the Spanish National Health System, which is fully decentralized and provides healthcare and protection to all residents.

In current times, we coexist with technology, using it every day. However, in older people, the use and employability of technology on a day-to-day basis is often more complicated or even null due to a lack of knowledge. Background/Objectives: The youngest generation were born surrounded by technology, which has given them superior capabilities when it comes to handling technology compared to elderly people. In short, older people have grown up without technology and only later in life have they crossed paths with it. Therefore, these circumstances can produce what is known as a “digital divide”, an unequal distribution in the access, use, or impact of information and communication technologies among social groups. Thus, the aim of this study is to examine whether there is a digital divide among European older adults and to show its effect on the mental health of individuals. In this way, we analyze how technological characteristics (digital divide) cause worsen mental health. Additionally, we examine whether, over time, the digital divide has had a greater impact on the mental health of older adults. Methods: For this purpose, recently published data from the Survey on Health, Aging, and Retirement in Europe are used. Results: Our analysis has revealed that the digital divide, driven by age, negatively affects the mental health of older adults in Europe. Thus, we have analyzed how technological characteristics related to the digital divide lead to poorer mental health among this population. Additionally, we have examined whether the digital divide has increasingly impacted older adults’ mental health over time. Conclusions: These findings highlight the need to address the digital divide as a public health issue, promoting greater digital inclusion to improve the psychological well-being of older adults.

La irrupción del SARS-CoV-2 o COVID-19, supuso un cambio importante en la población mundial. En España, las medidas de contención y erradicación del virus interpuestas por el Gobierno, contemplaron largos periodos de confinamiento domiciliario que tuvieron importantes consecuencias para la salud y en los hábitos de la población infanto-juvenil. Estas medidas, que se prolongaron entre marzo y junio de 2020, provocaron modificaciones en los hábitos alimentarios, el descenso de la práctica deportiva y actividades físicas recreacionales así como un incremento de actividades sedentarias. Sin embargo, años después del fin de esta pandemia, todavía existen importante secuelas en la población directamente relacionadas con la salud mental, el bienestar emocional y los estados de ánimo. El objetivo de este estudio fue determinar el impacto en el estado de ánimo de una muestra de niños y niñas a causa del confinamiento domiciliario relacionado con la práctica de actividad física. Método: Participaron 50 niños de la Comunidad de Cantabria (España) entre 11-12 años (n = 50; M = 11,40; SD = 0,50), 33 (66%) niños y 17 (34%) niñas. Se ha utilizado el cuestionario Profile of Mood States (POMS) y un cuestionario ad hoc para datos sociodemográficos y otra información relevante. Resultados: El análisis comparativo de los estados de ánimo preconfinamiento y durante el confinamiento, evidenció un descenso en sus valores en todos los estados de ánimo evaluados por el POMS: tensión, depresión, ira, confusión, fatiga y vigor. No existieron diferencias estadísticamente significativas entre niños y niñas. Conclusiones: El estudio evidencia que el confinamiento domiciliario provocó cambios en los estados de ánimo en niños y niñas entre 11 y 12 años en relación con la práctica de actividad física.

Most part of the literature has highlighted the detrimental effects of discrimination on health. However, the influence of past and perceived discrimination on older workers’ self-assessed health has been understudied. Firstly, we aim at studying whether reported discrimination is associated with self-assessed health among adults of working ages (50–65 years of age). Secondly, we analyze the existence of differences by gender. Data was retrieved from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to obtain the regular panel of questions, and the third and seventh waves of the SHARELIFE questionnaire, that includes information about discrimination (n = 30,019). We develop logistic regression models to determine the relationship of discrimination on male and female workers’ self-assessed health separately. Our results show that 49.0% of our sample was composed of highly discriminated women, while the remaining percentage covered men and women (42.3% males and 8.7% females) that reported lower levels of discrimination. Our estimations reveal a significant association between discrimination and poor health status, especially in the case of men ranging from OR = 1.802 (95% CI 1.502–2.163) to OR = 1.565 (95% CI 1.282–1.910). In the case of women our results range from OR = 1.728 (95% CI 1.463–2.040) to OR = 1.196 (95% CI 0.992–1.442). These findings are essential to highlight the importance of tackling discrimination as a determinant of health that negatively affects both sexes, men and women.

Lone parenthood is one of the multiple accepted family types that make up today’s societies. In Europe, 3.2% of total households were single adults with children in 2019. Understanding the socioeconomic and demographic transformations that have led to the relatively high rates of single-parent families have attracted the attention and concern of researchers and policy makers. This study contributes to the literature by exploring trends in and predictors of health outcomes, lifestyle factors (obesity, smoking and alcohol) and social support among single-parent families and cohabiting couples in 20 European countries. To do so, microdata from the European Health Interview Survey-EHIS (2013–2015 and 2018–2020) is used. Running multivariate logistic regressions, we estimate the impact of individual factors associated with single parents’ health status, lifestyle factors and social support, adjusting by demographic characteristics and stressors. Our analysis suggests that both single mothers and fathers are left behind in several respects compared to their couple counterparts: lower education levels, lower income and worse economic conditions, worse physical health, and poorer social support relationships. Differences in health status, lifestyle factors and social support between single and couple parents, both mothers and fathers could be associated with the unequal distribution of demographic and stress factors found in this article. Understanding these characteristics of single-parent families could enable the establishment of community-level interventions to mitigate the adverse effects of lone parenthood and their children.