José Manuel Granada-López

Background: Health misinformation has intensified worldwide, especially in digital environments, where low health and media literacy increase vulnerability. Thus, the MEDIATICH program of the University of Zaragoza launched OCODES (Observatorio Contra la Desinformación en Salud), a participatory digital initiative designed to promote health media literacy and provide evidence-based information through a web platform and social media channels. Objective: This study describes the co-design and development of the OCODES strategy using 2 sequential nominal group technique (NGT) sessions, and assesses its preliminary usability, preliminary user perception, and user engagement after 6 months of activity as a digital initiative developed in response to health misinformation. Methods: NGT1 (n=15) aimed to identify and prioritize interventions to strengthen health literacy through an individual yes or no prioritization process, while NGT2 (n=18) translated selected priorities into concrete digital products, including website structure, social media selection, content lines, and interaction mechanisms. In addition, routine user feedback and website analytics data generated through the OCODES digital channels during the first 6 months of activity were retrospectively examined. Usability was explored using the System Usability Scale (SUS), while preliminary user perception was described through 2 study-specific indicators available in the public feedback tools: perceived usefulness (1‐5 Likert scale) and willingness to recommend the website. Google Analytics provided complementary website engagement metrics. Results: NGT-1 generated 11 interventions grouped into four categories. Digital actions were prioritized as the core strategy: a health dissemination portal and social media interventions in the context of health misinformation each achieved 93.3% (14 of the 15 participants) agreement. NGT-2 defined the digital architecture of OCODES, including a central website and presence on LinkedIn (Meta), X (formerly known as Twitter; X Corp), and Instagram (Meta), and established guiding principles such as transparency, scientific rigor, accessibility, and clear communication. A total of 99 adults provided routine usability feedback (65/99, 65.7% women; mean age 44.7, SD 12.54 y). The mean SUS score was 83.10 (SD 10.09), with 94.9% (94/99) achieving adequate usability (SUS ≥68). Perceived usefulness scored 4.52 (SD 0.71), and 97.9% (97/99) of users who provided feedback indicated that they would recommend the site. Web metrics showed 5769 new users, 1935 returning users, 19,003 page views, a bounce rate of 53.32%, a total of 3.28 pages per active user, and 4.95 events per session, indicating strong initial engagement. Conclusions: OCODES is a feasible and well-received digital strategy developed through a participatory, consensus-driven process. Its favorable usability indicators, positive preliminary user perception, and encouraging early engagement metrics support its feasibility. However, the current findings do not provide evidence of effectiveness in reducing health misinformation or improving health media literacy. Future efforts should focus on reaching vulnerable populations, expanding evaluation approaches, and assessing long-term impact.

Recent studies suggest that only 27.6% of cancer survivors meet PA guidelines. This could partially be attributed to the limited knowledge reported by healthcare professionals (HCP) regarding the appropriate timing, methodology, and suitability of referring cancer survivors to exercise programs or professionals. In this commentary, we aim to acknowledge the challenges that HCP may face in prescribing exercise and propose potential solutions to facilitate their efforts in this regard.

Objective: to determine the prevalence of anxiety and depression symptoms, as well as their association with screen time, diet and physical activity, in a cohort comprised by nursing students. Method: a descriptive and cross-sectional study conducted with a sample of 648 Nursing students. The instruments used were the Hospital Anxiety and Depression Scale, the short version of the International Physical Activity Questionnaire and the Spanish Healthy Eating Index (Índice de Alimentación Saludable Español, IASE). Different multiple linear regression models were performed to analyze the association between anxiety/depression symptoms and screen time, diet and physical activity. Results: the prevalence values for anxiety and depression symptoms were 24.1% and 3.7%, respectively. Prolonged screen times (>6 hours a day), low levels of physical activity and inadequate diet were independently and significantly associated with deeper psychological symptoms. Conclusion: Nursing students’ mental health might benefit from the implementation of initiatives promoting healthy lifestyles.

Objetivo: determinar a prevalência de sintomas de ansiedade e depressão e sua associação com tempo de tela, dieta e atividade física em uma coorte de estudantes de enfermagem. Método: estudo descritivo transversal com amostra de 648 estudantes de enfermagem. Utilizou-se a Hospital Anxiety and Depression Scale, a versão curta do International Physical Activity Questionnaire e o Índice Espanhol de Alimentação Saudável. Foram realizados diferentes modelos de regressão linear múltipla para analisar a associação entre sintomas de ansiedade e depressão e tempo de tela, dieta e atividade física. Resultados: a prevalência de sintomas de ansiedade e depressão foi de 24,1% e 3,7%, respectivamente. O tempo prolongado de tela (>6 horas por dia), a baixa atividade física e a dieta inadequada foram associados de forma independente e significativa ao aumento da sintomatologia psicológica. Conclusão: a saúde mental dos estudantes de enfermagem pode ser beneficiada com a implementação de iniciativas que promovam estilos de vida saudáveis.

Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy. Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables. Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain

Objetivo: descrever os padrões de atividade física de uma coorte de gestantes em nosso meio e explorar sua associação com o ganho de peso em cada um dos trimestres de gestação. Método: estudo descritivo longitudinal com uma amostra de 151 mulheres. O Questionário Internacional de Atividade Física foi utilizado para avaliar a atividade física durante a gestação de acordo com o volume, intensidade e escopo do desempenho. Diferentes modelos de regressão linear múltipla foram utilizados para analisar a associação entre atividade física e ganho de peso gestacional. Resultados: a atividade física diminuiu durante a gestação, tanto em tempo quanto em intensidade. O índice de massa corporal pré-gestacional foi o principal fator associado ao menor ganho de peso ao longo da gestação. A influência da atividade física no ganho de peso gestacional limitou-se ao terceiro trimestre de gestação, no qual foi observada associação inversa entre ambas as variáveis. Conclusão: os resultados deste estudo mostram uma diminuição significativa da atividade física no momento da gravidez e sugerem uma influência limitada desta no ganho de peso gestacional.

Objetivo: determinar la prevalencia de síntomas de ansiedad y depresión, al igual que su asociación con el tiempo de pantalla, la dieta y la actividad física, en una cohorte de estudiantes de enfermería. Método: estudio descriptivo y transversal sobre una muestra de 648 estudiantes de enfermería. Se utilizaron la Hospital Anxiety and Depression Scale, la versión corta del International Physical Activity Questionnaire y el Índice de Alimentación Saludable español. Se llevaron a cabo diferentes modelos de regresión lineal múltiple para analizar la asociación entre los síntomas de ansiedad y depresión, y el tiempo de pantalla, la dieta y la actividad física. Resultados: la prevalencia de síntomas de ansiedad y depresión fue de 24,1% y 3,7%, respectivamente. El tiempo de pantalla prolongado (>6 horas por día), baja actividad física y dieta inadecuada se asociaron de manera independiente y significativa con una mayor sintomatología psicológica. Conclusión: la salud mental de los estudiantes de enfermería podría beneficiarse de implementarse iniciativas que promuevan estilos de vida saludables.

Objetivo: describir los patrones de actividad física de una cohorte de gestantes de nuestro medio y explorar su asociación con la ganancia de peso en cada uno de los trimestres del embarazo. Método: estudio descriptivo longitudinal sobre una muestra de 151 mujeres. Se utilizó el Cuestionario Internacional de Actividad Física para evaluar la actividad física durante el embarazo en función del volumen, intensidad y ámbito de realización. Se llevaron a cabo diferentes modelos de regresión lineal múltiple para analizar la asociación entre actividad física y ganancia de peso gestacional. Resultados: la actividad física disminuyó durante el embarazo, tanto en tiempo como en intensidad. El índice de masa corporal pre-gestacional fue el principal factor asociado con una menor ganancia de peso a lo largo de todo el embarazo. La influencia de la actividad física sobre la ganancia de peso gestacional se limitó al tercer trimestre del embarazo en el que se observó una asociación inversa entre ambas variables. Conclusión: los resultados de este estudio muestran un importante descenso de la actividad física en la época del embarazo y sugieren una influencia limitada de ésta sobre la ganancia de peso gestacional.

While it has long been recognized that diet is a leading behavioral risk factor for human health, recent scientific findings have also suggested that diet and sleep quality may be connected. The purpose of the present study is to evaluate the association between diet and sleep quality among a group of Spanish university students. To do so, a cross-sectional study of 868 students was carried out. Sleep quality was assessed using the Spanish version of the Pittsburgh Sleep Quality Index (PSQI), while diet was assessed using the Spanish Healthy Eating Index (SHEI). The study revealed a noteworthy rate of bad sleepers (51.6%) and students whose diet needed modifications (82.2%). Unhealthy eaters were more likely to have poor sleep quality (aOR = 4.20; CI 95%: 2.07–8.52). The unbalanced intake of vegetables (aOR = 1.63; CI 95%: 1.14–2.34), fruits (aOR = 4.08; CI 95%: 2.90–5.74), dairy products (aOR = 1.96; CI 95%: 1.41–2.72), lean meats (aOR = 1.82; CI 95%: 1.19–2.78), legumes (aOR = 1.43; CI 95%: 1.00–2.02), sweets (aOR = 1.60; CI 95%: 1.13–2.25) and sugary soft drinks (aOR = 1.46; CI 95%: 1.07–1.99) was associated with lower sleep quality.

Given that there is only a limited body of evidence available concerning the dietary habits of Spanish university students, the present study assesses the quality of this group’s diet, their adherence to the National Food-Based Dietary Guidelines, and the predictive factors of their diet quality. To do so, a cross-sectional study was performed on a sample of 1055 students. The quality of the participants’ diets was then analysed by using the Spanish Healthy Eating Index, and then their level of compliance was assessed in light of the dietary recommendations put forth by the Spanish Society for Community Nutrition. According to these standards, only 17.4% of the participants had a healthy diet. The level of compliance with the recommendations was poor, highlighting especially the low levels of “fruit” and “vegetables” that they consumed as well as high levels of “cold meats and cuts” and “sweets”. The factors that predicted a worse diet are being male, living alone, low levels of physical activity, smoking, high alcohol intake, leading a sedentary lifestyle, psychological distress, and insomnia (p < 0.005). Furthermore, participants with low or high body weights showed signs of a higher quality diet (p < 0.001). The present findings suggest that a significant proportion of university students ought to change their dietary habits; these also attest to the importance of developing strategies that are directly targeted at university students in order to promote a healthy diet.