Jaime Jiménez Pernett

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.

Introduction. The COVID-19 pandemic exposed fragilities and inequities in Ibero-American health systems, underscoring the need to set research priorities that strengthen resilience, innovation, and equity in the post-syndemic period.Objectives. To identify, through expert consensus, research priorities in health systems and services in Ibero-America after the COVID-19 syndemic.Methods. A modified eDelphi (electronic Delphi) was conducted from September 2022 to March 2023. A total of 228 invitations were issued; 167 individuals agreed to participate (73,2 %). In Round 1, 99 experts (43,7 %) generated 164 proposals, which were grouped into six domains. In Round 2, 66 panelists (39,5 %) rated the importance of topics using a 1–5 Likert scale. In Round 3, 66 specialists (39,5 %) completed the final assessment. Topics were deemed priorities if scored 4 or 5 by at least 70% of panelists; the interquartile range (IQR) was used to quantify consensus.Results. Fifty-nine priority topics were identified and organized into six thematic domains: (1) organizational models and planning for health crises; (2) responses to environmental threats using a One Health approach; (3) equity and ethics in resource allocation; (4) surveillance, prevention, and control of communicable diseases and zoonoses; (5) citizen and patient participation; and (6) innovation and technologies in public health emergencies. The IQR indicated high consensus for most topics.Conclusions. This Ibero-American consensus provides a strategic framework to guide the post-syndemic research agenda in health systems and services. It informs policy, funding, and international cooperation, strengthening systems’ resilience and promoting regional equity.

In health policy-making, various deliberative mechanisms can be used to engage the members of the public in exploring what might be a reasonable course of action. Scurr et al take power dynamics into consideration to analyse a deliberative dialogue involving stakeholders with diverse points of view. Given such asymmetries at play, the conclusions of deliberations could be biased. Scholars would benefit from guidance on designing and evaluating deliberative processes. This commentary aims to broadly reflect on the possible sources of power and information asymmetries in deliberative dialogues, and to bring the biographical resources approach to deal with such asymmetries.

Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers’ personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the association between different network characteristics and self-perceived health among caregivers. We performed a social network analysis study using a convenience sample of 25 female and 25 male caregivers. A descriptive analysis of the caregivers and bivariate analyses for associations with self-perceived health were performed. The structural metrics analyzed were density; degree centrality mean; betweenness centrality mean; and number of cliques, components, and isolates. The variability observed in the structure of the networks was not explained by gender. Some significant differences between men and women were observed for network composition and function. Women received help mainly from women with a similar profile to them. Men’s networks were broader and more diverse and they had more help from outside family circles, although these outcomes were not statistically significant. Our results indicate the need to develop strategies that do not reinforce traditional gender roles, but rather encourage a greater sharing of responsibility among all parties.

Using a combination of videos and online short stories, we conducted four face-to-face deliberative workshops in Montreal (Quebec, Canada) with members of the public who later joined additional participants in an online forum to discuss the social and ethical implications of prospective technologies. This paper presents the participants’ appraisal of our intervention and provides novel qualitative insights into the use of videos and online tools in public deliberations. We applied a mixed-method study design. A self-administered survey contained open- and close-ended items using a 5-level Likert-like scale. Absolute frequencies and proportions for the close-ended items were compiled. Qualitative data included field notes, the transcripts of the workshops and the participants’ contributions to the online forum. The qualitative data were used to flesh out the survey data describing the participants’ appraisal of: 1) the multimedia components of our intervention; 2) its deliberative face-to-face and online processes; and 3) its perceived effects. Thirty-eight participants contributed to the workshops and 57 to the online forum. A total of 46 participants filled-in the survey, for a response rate of 73 % (46/63). The videos helped 96 % of the participants to understand the fictional technologies and the online scenarios helped 98 % to reflect about the issues raised. Up to 81 % considered the arguments of the other participants to be well thought-out. Nearly all participants felt comfortable sharing their ideas in both the face-to-face (89 %) and online environments (93 %), but 88 % preferred the face-to-face workshop. As a result of the intervention, 85 % reflected more about the pros and cons of technology and 94 % learned more about the way technologies may transform society. This study confirms the methodological feasibility of a deliberative intervention whose originality lies in its use of videos and online scenarios. To increase deliberative depth and foster a strong engagement by all participants, face-to-face and online components need to be well integrated. Our findings suggest that online tools should be designed by considering, one the one hand, the participants’ self-perceived ability to share written comments and, on the other hand, the ease with which other participants can respond to such contributions.