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Active citizen participation in research is important to generate societal impact of outcomes. Even so, many times, the community input in these processes is limited or non-existent, and co-creation processes are often not documented. This paper describes a structured and systematised protocol to co-create a nature-based social prescribing intervention addressed to face loneliness in urban deprived neighbourhoods. As a result, a nature-based social prescription menu was co-developed with stakeholders from health, social prescription, nature, associative, and research sectors. The menu consists of open spaces and nature activities and will be offered to the participants of a randomised controlled trial to test actions for social prescribing in natural spaces. [ABSTRACT FROM AUTHOR]

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross‐sectional study on the validation of two stigma scales with a 1‐month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5‐month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish‐speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies. [ABSTRACT FROM AUTHOR]

There is overwhelming consensus among policy makers, academics, and professionals about the need to support families in their childrearing tasks. Consequently, European countries have been encouraged to develop family support interventions aimed at guaranteeing children's rights, targeting particularly those children in situations of psychosocial risk. While a certain amount of evidence exists regarding how family support is generally delivered in certain European countries, with a particular focus on parenting initiatives, this paper aims to take existing evidence one step further by providing an updated review focusing on two core components of the Council of Europe's Recommendation on Positive Parenting: families at psychosocial risk as the target population, and family education and support initiatives as the delivery format. The scope of the study was therefore broad, in both geographical and conceptual terms. An online survey was conducted with experts from 19 European countries to gather information regarding how they perceive family education and support initiatives for families at psychosocial risk. Both quantitative and qualitative data were analysed by computing frequencies/percentages and by following a thematic synthesis method, respectively. The results revealed both similarities and disparities as regards provider profiles, intervention characteristics, and quality standards. Practical implications are discussed, such as the need to diversify initiatives for at‐risk families in accordance with the tenets of progressive universalism, the ongoing need for an evidence‐based, pluralistic approach to programmes, and the skills and qualifications required in the family support workforce. This study constitutes a first step towards building a common family support framework at a European level, which would encompass family support and parenting policies aimed at families at psychosocial risk. [ABSTRACT FROM AUTHOR]

This paper aims to identify the inter-relationships between the social factors that influence epidemiological patterns in the city neighbourhood of Casablanca, Zaragoza (Spain). Data for a cross-sectional survey were collected between January 2008 and April 2008 from a representative random sample of 1032 residents aged more than 15 years. The study interview contained information scales on healthcare behaviours, treatment evaluation, the number of medical consultations in the weeks pervious to the interview and the perceived health status of the respondents, using The Health Perception Questionnaire. The global index (continuous variable) allowed inferences to be made on the individual's perception of his/her own health. The assessment of social vulnerability was based on the occupational, educational and economic conditions of the interviewees. An individual was considered to belong to a vulnerable subeconomic group if he/she had a personal income of 6000 euros or less; or had no formal education or had been educated up to primary school level only; or was not in paid employment at the time of the interview. A descriptive and comparative analysis of the vulnerable and non-vulnerable population groups for perceived and diagnosed health variables was undertaken using parametric and non-parametric tests. A total of 550 interviewees (53.3%) were considered vulnerable people. Low level of instruction (primary or no education) was the main characteristic of this group (356 subjects, 64.7% of those identified as vulnerable). Binary logistic regression was used to analyse the association between belonging to the vulnerable group and a number of health variables adjusted for gender, age and area of residence. The vulnerable group had worse levels of perceived health even when controlled for gender and area of residence. In Casablanca, the place of residence is an important social stratification indicator reflected in the characteristics of the vulnerable population group and its perceived health. [ABSTRACT FROM AUTHOR]

Despite the increase in sexual violence (SV) amongst young people, the use of formal services is poor. Effective coverage of health services is related to a satisfactory and quality care for the people who need a specific intervention. The aim of this study is to identify the factors that influence effective coverage of SV services from the perspective of young people and professionals in Spain. A qualitative study was conducted using an inductive thematic analysis approach based on 38 semistructured interviews with young people and professionals working in SV resource services and/or youth services in Spain, from September 2020 to October 2021. A content analysis was carried out. Both the professionals and young people referred to the fact that effective coverage is limited by the factors related to SV normalization and stigma, the lack of training of professionals, and the lack of human and economic resources. Furthermore, the young interviewees perceive sexual education as more biological and not focused on SV, as well as excessive bureaucracy, medicalization of processes, and the lack of trust in resources. However, the professionals mentioned the excessive specialization of psychological recovery accompaniment programmes and the lack of specialization of judicial institutions. To conclude, both the young people and professionals identified factors that reduce effective coverage of the services related to the social construction of the problem, training, and availability of resources. The young people also perceive other factors related to care and services, while the professionals place more emphasis on factors related to the user population. [ABSTRACT FROM AUTHOR]

Professional residential care providers face several stressors due to the burden of caring for dependent people. This burden may affect the way in which care is carried out. Resilience, as personal strengths, may help them to be more effective in their workplace and in their interaction with patients, and this may be related to the development of participation skills and prosocial behaviours. A total of 125 professional's caregivers from Spain responded to the Connor‐Davidson Resilience Scale Resilience Scale and the PB new Prosocial Conduct Scale over the years 2018 and 2019. We checked the predictive power of resilience as well as other predictors (sex, type of contract and total months worked in professional caregiving) on prosocial behaviour in caregivers' professionals with multiple regression analysis. Results showed resilience as the only significant predictor, explaining 21% of the variance in prosocial behaviour (R2 = 0.21, F(5, 115) = 6.16, p < 0.001). This indicates that resilience is a variable prediction of prosocial behaviour in health and social professionals. Resilience gets in the individual the capacity to be attentive to give answers in certain situations, being a predictor of great relevance of the prosocial behaviours. Thus, it is necessary to deepen the research on professional caregivers to be able to train and empower them in skills that improve their quality of life and by strength, that of dependent people. [ABSTRACT FROM AUTHOR]

Previous studies on palliative care have assessed the phenomenon of Information Concealment (IC), confirmed its relevance and emphasised the need to have a scale for its assessment. The aim of this study was to design and validate such an instrument. The sample comprised 150 palliative caregivers (23 men and 127 women). The dimensionality of the items of the Information Concealment Scale for Caregivers (ECOI) was assessed using Exploratory Factor Analysis and an optimal implementation of parallel analysis. Reliability and criterion validity were analysed using sample data. The ECOI comprises three factors: Concealment or dissimulation about the disease, misrepresentation of the real situation and control of the information. The scale has excellent reliability and shows criterion validity. Therefore, the ECOI is a reliable and valid instrument to objectively measure IC among Spanish caregivers in palliative care settings. [ABSTRACT FROM AUTHOR]

To reduce the spread of COVID‐19, governments initiated lockdowns, limiting mobility and social interaction of populations. Lockdown is linked to health issues, yet the full impact on health remains unknown, particularly in more vulnerable groups. This study examined the impact on frailty and outcomes in high and low COVID‐19 risk older adults. We examined health‐related behaviours and support resources participants used during lockdown(s). Lockdown impacts in two countries were compared across four time points to examine impacts of different rules. We recruited 70 participants (aged >70 years) in England and Spain. Participants were allocated to higher or lower COVID‐19‐risk groups based on UK NHS guidelines. They completed assessments for frailty, quality‐of‐life, loneliness, exercise frequency and social interaction, coping resources and perception of age‐friendliness of their environment. The four assessments took place over a 7‐month period. Frailty was highest at Time 1 (most severe lockdown restrictions) and significantly higher in the Spanish group. It was lower at Time 3 (lowest restrictions), but did not continue to reduce for the English participants. Perceptions of the age friendliness of the environment matched these changes. Coping resources did not mitigate changes in frailty and outcomes over time, but more frequent physical activity predicted more reduction in frailty. Lockdown had a negative impact on frailty, increasing risk of adverse events for older people, but recovery once lockdowns are eased is evidenced. Further research is required to consider longer term impacts and methods to mitigate effects of lockdown on health. [ABSTRACT FROM AUTHOR]

Chronic diseases show a significant limitation on the quality of life and functional status, as patients as also their caregivers. The objective of this study is to analyse the quality of life of patients diagnosed with chronic obstructive pulmonary disease and stroke and their caregivers, and to find out if there is a relationship between the caregiver's overload and the quality of life of the patient, as well as to determine whether the functional status of the patients is related to the quality of life of the caregiver. Quantitative, observational, descriptive, cross‐sectional and prospective study, performed at Primary Health Care Centres of the northwest Area of Murcia Region (Spain), between January and May 2018, with 131 patients, 79 with stroke, 48 with chronic obstructive pulmonary disease (4 of them with both diseases), and 110 caregivers. The EuroQol scale, Zarit's questionnaire and Barthel's index and an ad hoc questionnaire of sociodemographic variables developed for this study were used. We found a positive and significant correlation between the scores of the caregiver's overload scale and those of the caregiver's health status (r = −0.425; p = 0.001), and a negative and also significant correlation between the overload and quality of life of the patients (r = −0.297; p = 0.002) and their inability (r = 0.189; p = 0.048). The more the overload we find the worse quality of life of the caregiver, but better quality of life of the patient. The physical inability of the patients also influences on the caregiver's level of overload, but not in his health status. Intervention programmes are needed to improve the quality of life of family members as they are the best patient support and the best help for healthcare professionals. [ABSTRACT FROM AUTHOR]

Compassion has been suggested as a relevant variable for understanding dementia caregivers' psychological distress. The objectives were to analyse the psychometric properties of the Caregiving Compassion Scale (CCS) and to explore the association between caregivers' compassion and their emotional health. Two hundred and thirty‐six dementia caregivers were evaluated for compassion, depressive symptoms, guilt, ambivalence, care‐recipient's functional and cognitive status, frequency of behavioural problems and desire to institutionalise the care‐recipient. Exploratory factor analyses, correlations and regression analyses were done. Two factors were obtained. The factor labelled "Distress from witnessing the care recipient suffering" was associated with higher stress linked to witness depressive problems in the care‐recipient and with caregivers' ambivalence and guilt levels. The factor labelled "Motivation/disposition for helping" was associated with less desire for institutionalisation, and it showed a negative association with ambivalence and guilt feelings. The CCS seems to be a valid and reliable scale for assessing compassion in dementia caregivers. [ABSTRACT FROM AUTHOR]

Although aquatic‐based interventions are increasingly used in the psychiatric rehabilitation services, the effects of this type of community program as an adjuvant therapy for psychosocial problems of people with serious mental illness (SMI) have been under‐explored. This research evaluated the feasibility and outcomes of an occupational therapy program consisting of aquatic‐based activities (AA‐OT program) in the community in Spain. This study is the first randomized controlled trial (RCT) on this topic. This pilot trial was conducted with a sample of 16 adults with SMI who were randomly allocated to the AA‐OT program plus treatment as usual or treatment as usual alone (eight in each group). The AA‐OT program included activation of daily living skills, warm‐up, group activities/tasks, and relaxation. It consisted of two sessions per week over 12 weeks. Outcomes were evaluated at week 0 and 12. A total of 14 participants (87.5%) completed the trial. No adverse events or side‐effects were noted. Comparisons between the two groups on change scores showed that participants in the intervention group showed significant improvements in several outcome measures: psychosocial problems (HoNOS), two health‐related quality of life scales (SF‐36: Physical Functioning and Mental Health), and performance of social activities (Activity and Social Relations scale). Satisfaction with the program was high. In conclusion, the results support the feasibility and potential benefits of this occupational therapy program. 12 weeks of aquatic‐based activities in a group intervention may enhance the outcomes of psychiatric rehabilitation improving the severity of psychosocial problems, patient‐reported health status, and social relations. This community‐based program may be beneficial as a non‐pharmacologic method in the illness management and recovery of people with SMI. The findings from this pilot trial need to be confirmed in a large, fully‐powered RCT. [ABSTRACT FROM AUTHOR]

Baby‐led weaning or self‐regulated small chunk feeding by the baby has emerged as an alternative to the traditional method of complementary feeding. Parents and healthcare professionals often differ in the benefits and drawbacks about it. The research aims were to describe the knowledge of health professionals about complementary feeding and baby‐led weaning (BLW) method and the attitudes towards its recommendation, and to explore the knowledge, experiences and attitudes of parents who have used this method to feed their children. A mixed methods research was carried out. A questionnaire was completed by 38 health professionals and 10 interviews were conducted with participating mothers. A total of 52.6% of health professionals recommended initiating complementary feeding at 6 months of age, a guideline followed by the mothers who used BLW. Some 86.8% of the professionals knew the BLW method and 76.3% knew its benefits, but the mothers consulted mainly informal sources of information sources to learn about and implement it. The health professionals stated that it facilitated family transition, enabled the infant to adapt better to flavours and textures, promoted chewing and the development of fine motor skills, improved growth and might also be a protective factor against obesity. The mothers noted that the method was natural, encouraged infant autonomy and promoted healthy eating habits. The health professionals expressed varied opinions concerning the risks entailed in the method. The main conclusions are that the majority of health professionals participating in the study know the BLW method, its benefits; however, they do not recommend it in all cases. Mothers listen to the advice of professionals but continue to rely on other informal sources of information. [ABSTRACT FROM AUTHOR]

The treatment of the mentally ill people is a challenge across the world, and different professionals, such as doctors, social workers, psychologists, or nurses, take care of this group. Nonetheless, mental health is not a vocational sector preferred by students and professionals of many of these careers. Research has proposed that professional preference for a patient group would be positively influenced by intergroup contact (quantity and quality) and empathy (perspective‐taking), and negatively associated with intergroup anxiety and social distance. However, the evidence testing this proposal was partial and mainly referring to other patient groups such as minorities or immigrants. The major aim of this cross‐sectional study was to clarify two research questions referring to mentally ill persons: Do contact and empathy protect undergraduates from intergroup anxiety and social distance and promote professional preference? Do intergroup anxiety and social distance predict professional preference and mediate the influence of contact and empathy in professional preference? A convenience sample of 409 Social Work undergraduates (81% females) from three Spanish universities completed a questionnaire between February and June 2020. Concerning direct relationships, the structural equation model showed that the quantity of contact only predicted intergroup anxiety negatively; quality of contact and empathy negatively predicted intergroup anxiety and social distance; intergroup anxiety positively predicted social distance; intergroup anxiety and social distance negatively predicted professional preference. Concerning mediated relationships, the influence of quality of contact and empathy on social distance was mediated by intergroup anxiety; social distance mediated the relationship of intergroup anxiety with professional preference; both anxiety and distance mediated the influence of quality of contact and empathy in professional preference. These results encourage interventions aimed at enhancing professional preference for mental illness by improving contact, knowledge, and empathy and reducing stigma in students and workers from diverse mental health careers. [ABSTRACT FROM AUTHOR]

The present study is aimed at exploring the role of loneliness in the healthcare professionals' mental health during the COVID‐19 outbreak in Spain. A total of 1,421 healthcare professionals who were in contact with at least one positive COVID‐19 patient participated in a cross‐sectional online survey from April to June 2020. Mental health was measured with the General Health Questionnaire‐12, and loneliness was assessed with the 3‐item UCLA Loneliness Scale. More than 80% of participants showed a certain prone to experience mental health problems, and 90% felt that they had not enough workplace protective measures to manage COVID‐19 patients. Presence of loneliness was positively related to higher mental health problems after controlling for other covariates. Other factors related to higher mental health problems were a higher COVID‐19 risk perception, being in quarantine, checking COVID‐19‐related news several times a day and having a lower training on managing infectious diseases. Neither living alone, nor supervisor social support, were related to healthcare professionals' mental health. Results suggest that the impact of COVID‐19 in terms of mental health in the healthcare professionals could be more related to subjective appraisals of social isolation rather than to be physically alone. There were also a variety of cognitive, behavioural and training‐related factors that were associated with the healthcare professionals' mental health, and that should be potentially managed in the mental healthcare interventions. [ABSTRACT FROM AUTHOR]

The burnout syndrome has traditionally been identified in the service sector professions, among which is Social Work. In order to determine this syndrome, different measuring instruments have emerged, including the Maslach Burnout Inventory. The main objective of this study was to evaluate the psychometric properties of this instrument and to find evidence of its validity (corroborating the original factorial structure and its convergent validity) and reliability (internal consistency). The Spanish adapted version of the Maslach Burnout Inventory was used. Four hundred social workers participated, randomly divided into two samples of 200 individuals (Sample 1: M = 43.06, SD = 9.04 and Sample 2: M = 40.89, SD = 8.78). We carried out principal components exploratory factor analysis with Varimax rotation. The results identified a factorial structure with four factors (Emotional Exhaustion, Depersonalization, Personal Realization, and Interpersonal Psychological Stress) (χ2/df = 1.73, CFI = 0.929, NNFI = 0.859, SRMR = 0.069, RMSEA = 0.061), different from that of the original questionnaire, which indicated three dimensions. The data also show a high internal consistency (α = 0.882). The four factors were directly and moderately associated with each other (r between 0.328 and 0.534). In conclusion, this study provides new data of a valid and reliable tool for evaluating professional burnout or exhaustion. [ABSTRACT FROM AUTHOR]

We explore, from the perspective of primary care health professionals, the motivations that lead patients to not initiate prescribed treatments, by developing a qualitative study in Spanish primary care. Six focus groups (N = 46) were conducted with general practitioners, nurse practitioners, social workers and community pharmacists and carried out in primary care (PC) of Barcelona Province, from April to July of 2018. The 46 participants were identified by three general practitioners and two pharmacists. In the interviews, the reasons for non‐initiation of PC patients' medication were explored. Triangulated content analysis was performed. Patients' perspective, analysed in a previous study, and professionals' perspective agree on most of the factors that affect non‐initiation. New factors were categorized into existent categories, confirming, and supplementing the model developed with patients. Health professionals identified some new factors which were not present in the patients' discourse, such as stigma related to the drug, hidden reasons for consultation, the role of nurses in prescription and support, the role of the pharmacy technician, illiteracy and lack of social support. The professionals confirm and expand on the Theoretical Model of Medication Non‐Initiation. Primary care professionals should consider the factors described when prescribing a new medication. Knowledge contributed by the model should guide the design of interventions to improve initiation. [ABSTRACT FROM AUTHOR]

Nursing home workers have been exposed to great physical and mental burdens during the COVID‐19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID‐19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross‐sectional study was conducted in Spain between March and May 2020. Three hundred and thirty‐five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open‐ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID‐19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post‐crisis resilience. [ABSTRACT FROM AUTHOR]

As people age, they tend to increase their use of health services. For this, the aims of this study were to analyse the frequency and variability in the use of different health services by people over 65 years, their evolution from 2009 to 2017 and the factors associated it. We carried out a cross‐sectional study with 25,465 people over 65 years who participated in the National Health Survey in Spain in 2011/2012 and 2017 and the European Health Survey in Spain in 2009 and 2014. A descriptive analysis was performed using the attendance records of family/general physicians, nurse consultations, or both over the last 12 months as well as these data over the following years of study. Our findings show that approximately 93.2% of the participants had consulted with a family/general physician over the last year, and women were almost twice as likely to do so compared with men (61.2% vs. 38.8%). The use of health services gradually increased from 2009 to 2017, being the visits to nursing that more increased their frequency. Being a woman and a widower as well as having no higher education, a low social class, a serious or long‐term illness, obesity and bed restraint were associated with a greater use of health services. Findings suggested that the increased health services due to ageing and comorbidities associated with it present new challenges. It is necessary to determine realistic plans that can meet future healthcare demands and not lead to a collapse of the health system. For this it is very important the primary prevention of chronic diseases, functional limitations, obesity and disability. [ABSTRACT FROM AUTHOR]

Perceived health in caregivers is related to caregiver burden, psychological well‐being and social support. Women perceive poorer health and are more likely than men to experience caregiver overload. The objectives of this study were to analyse perceived health, perceived social support and caregiver overload in family caregivers of patients with Alzheimer's disease, as well as to study the effect of the perceived social support as a mediating variable between perceived health and caregiver overload was also analysed, taking into account the caregivers' gender. A cross‐sectional descriptive design was used. The sample consisted of 255 family caregivers of individuals with Alzheimer's disease in the Almería Health District (Spain). This study was conducted from January to December 2015. The caregivers' mean age was 55.35 years (SD = 12.35), with 85.5% (n = 218) being women and 14.5% (n = 37) being men. The following questionnaires were administered: Goldberg's General Health Questionnaire‐28; the Caregiver Strain Index, measuring caregiver overload; and the Duke‐UNC‐11 functional social support questionnaire. Poor perceived health, high caregiver overload and high perceived social support were found. Differences in perceived health and perceived social support were significantly higher in women than in men. In women, perceived social support was a mediating variable between perceived health and family caregiver overload. This mediation was not observed in men. This study suggests that perceived social support influences the emotional well‐being and the caregiver overload of family caregivers of patients with Alzheimer's. However, its effect differs according to gender. It would, therefore, be necessary to have an in‐depth understanding of the variables determining these differences in family caregivers. [ABSTRACT FROM AUTHOR]

Few studies have examined the differences between immigrant and native‐born homeless populations. Our aim was to conduct an exploratory study to examine the differences in health status, health behaviour and healthcare utilisation in a sample of Spanish immigrant and native homeless people. Study was conducted in eight different temporary accommodations in the Valencia region in August 2018. Overall, 86 participants were included in the analysis who answered questionnaires concerning socio‐demographic characteristics, immigration status, health status and behaviour, healthcare utilisation and experienced discrimination in healthcare and health literacy. In total, 76.7% were men with a mean age of 41.91 (14.17) years, with 60.4% having immigration background with an average of 4.8 (4.2) years since arrival in Spain. No differences were found in the subjective health status, however, native homeless participants reported significantly higher prevalence of heart disease (87.5% vs. 12.5%), hypertension (84.6% vs. 15.4%), psychological illness (63.6% vs. 36.4%) and were also more often smokers (73.5% vs. 28.8%), reported smoking more cigarettes per day (12.0 vs. 7.4) and were more often illegal drug users (17.6% vs. 2.0%). Immigrant participants were significantly more often not insured, reported more problems in healthcare access and had lower rates of visits to general practitioners and less hospital admissions. Differences were also observed in social status with the native homeless more often reporting receiving income, and living in less crowded accommodations. Our results show a variety of issues that the immigrant homeless population in Spain is confronted with that also prevents adequate social inclusion and achieving good health. However, the immigrant population engaged less often in risky health behaviour. More, and continuous, monitoring of social, mental and physical health of the homeless population is necessary. Public health interventions aiming at health promotion in the immigrant homeless populations need to focus on increasing overall social integration. [ABSTRACT FROM AUTHOR]

Study of the long‐term impact of economic recession on lifestyle according to socioeconomic groups is scarce. This study examines health‐related lifestyle and preventive medical attendance in different socioeconomic groups in the Spanish adult population (18–64 years of age) before, during and after an economic recession. Data were collected from three waves of the Spanish National Health Survey (2006, 2012 and 2017). Self‐perceived health, health‐related lifestyle and common preventive medical attendance were evaluated by means of multivariate logistic models. The increase in good self‐perceived health in 2006–2012 was 7.1%, 6.9% and 8.3% for the high, middle and low group, respectively, and 5.2%, 5.9% and 7.9% for the high, middle and low group, respectively, in 2006–2017. In 2006–2012 and 2006–2017, the gap increased between people of the high and low groups in smoking prevalence (2.8%–4.7%), physical activity (2.0%–4.0%), daily fruit (1.0%–6.3%) and vegetable intake (2.5%–6.1%). The probability of women´s gynaecological attendance increased statistically significant for cytology in three groups in 2006–2012 and 2006–2017 (OR = 1.35, 95% CI = 1.08–1.67; OR = 1.42, 95% CI = 1.18–1.7; OR = 1.34, 95% CI = 1.21–1.47 for the high, middle and low groups, respectively, in 2006–2012 and OR = 1.34, 95% CI = 1.08–1.67; OR = 1.62, 95% CI = 1.35–1.95; OR = 1.51, 95% CI = 1.37–1.66 for the high, middle and low groups, respectively, in 2006–2017), but not for mammography. This study reveals long‐term socioeconomic inequalities in lifestyle behaviours after the economic recession. Health policies must be emphasised in these population subgroups and in more disadvantaged populations. [ABSTRACT FROM AUTHOR]

We aimed to determine the sociodemographic and psychosocial profile, and the associated subclinical affective symptomatology of users above the 95th percentile in the distribution of patient self‐initiated, face‐to‐face consultations. Additionally, we sought to determine the contribution of subclinical symptomatology in differentiating between the groups above or below this cut‐off point. A total of 16,803 users who self‐initiated at least one face‐to‐face consultation with a GP at any of 13 PHC practices over 1 year, were eligible. After discarding those fulfilling exclusion criteria, 129 cases and 109 controls, matched by gender and age, answered the Family APGAR, the Duke‐UNC and the Goldberg Anxiety‐Depression scale. Both groups did not differ significantly on any of the sociodemographic and psychosocial variables recorded showing a similar percentage distribution. However, users with high self‐initiated consultation rates obtained lower scores on the affective social support subscale from the Duke‐UNC. Regarding Goldberg scale, the two groups differed significantly on the likelihood of displaying depression and/or anxiety symptoms. Users with a high probability of suffering from depression and/or anxiety were more prevalent among users on the top 5% in the distribution. Altogether, results indicate that these users report a lack of affective social support and have a higher probability of suffering from subclinical depression and/or anxiety. Early detection and treatment of affective symptomatology would temperate this excess in consultation. General practitioners, social workers and psychologists could act as gatekeepers, preventing this overuse of medical services and in turn lowering economical costs, professional burnout and patients' suffering and discontent. [ABSTRACT FROM AUTHOR]

Ageing well involves individuals continuing participating in personal, social and civic affairs even in older age. From this standpoint, limitations in individual's functioning (beyond the mere absence of disease) may drastically impact on how well people becoming older. This study aimed to identify functional status profiles in a nationally representative sample of older adults, using latent class analysis methods. Moreover, it intended to study the how identified classes would be related to health‐related outcomes later in life, as a way to provide some evidence on predictive validity. Data from a nationally representative sample of Spanish older adults (N = 2,118; 56.18% women; M = 71.50 years, SD = 7.76), were used. Profiles were identified according to a large set of functioning indicators from multiple domains using latent class analysis. Outcomes were studied over a 3‐year follow‐up, considering both the individual (quality of life, well‐being and mortality) and institutional level (health service utilisation). As a result, seven profiles were identified: normative profile (showed by most participants), limited cognitive functioning class, limited global functioning class, limited mental and mobility functioning class, poor self‐reported health class, limited sensory functioning class and limited objective functioning class. All the profiles with limitations across domains showed poor outcomes. Multidimensional limitations were related to the worst outcomes, especially when psychosomatic complaints and high feelings of loneliness were reported. To sum up, latent class analysis constitutes a suitable alternative to study population heterogeneity, providing relevant evidence to help making decision in public and community health. [ABSTRACT FROM AUTHOR]

With the start of the great economic recession in 2007, homelessness increased fivefold in some regions of southern Europe. Larger numbers of people experiencing homelessness, compounded by a lowered capacity for social and health services to respond to their needs, precipitated an increase in so‐called 'chronic homelessness'. The aim of this study was to establish the presence of chronic homelessness in a defined geographical area of Spain, and to determine the prevalence of diagnosed mental disorders within both the chronic and non‐chronic homeless population. A prospective and descriptive study was designed to monitor a cohort of 826 individuals experiencing homelessness who constituted the entire identified homeless population in the relevant territory in 2006. This sample was followed until 2016 and sociodemographic as well as clinical information was collected, including the time spent homeless. The results obtained indicated that one in 10 participants met the criteria for chronic homelessness, a rate that is lower than in the US, where the definition of chronicity that was applied originates from. Alcohol use disorder was the most common mental health disorder that contributed to the chronicity associated with homelessness. Being born in the country (Spain) where the study was conducted and being older were the main other variables associated with chronicity. People defined as chronically homeless in Spain were on average younger than in the US, but women were present in the chronic subgroup at a similar rate. We also reflect on the limitations of the study and in particular the appropriateness of the concept of chronicity as applied to homelessness. [ABSTRACT FROM AUTHOR]

This study analyses participants' and coordinators' perceptions of the implementation process and perceived benefits of a community‐based intervention to reduce social isolation among older adults. The 'School of Health for Older People' is a weekly community intervention that promotes resources among individuals and communities in order to enhance their ability to identify problems and activate solutions, encouraging participation in the community. A qualitative approach was employed, based on semi‐structured interviews and focus groups (FGs). This study was carried out in Barcelona. Two coordinators (community nurses) and 26 community‐dwelling people aged 65 and over who attended the School of Health for Older People in the neighbourhoods of Besòs and Guineueta, participated in in‐depth interviews and FGs between January and February 2016. Views and experiences about the intervention were explored. The main perceived effects of the intervention were expanding knowledge of health issues and of community activities, encouraging participants to go out, giving them a feeling of being heard, and peer relationships, increasing participants' contacts and knowledge while the main negative features were related to repetition of certain contents. The benefits identified included learning something about health and their own neighbourhood and breaking the habit of staying at home. Social isolation might be prevented by increasing the number of contacts with peers and sharing a common interest, since it could help to give them a sense of belonging to a community. [ABSTRACT FROM AUTHOR]

Children with autism spectrum disorder (ASD) experience moderate to profound challenges in relation to the skills required for social participation. Animal‐assisted intervention (AAI) is increasingly used within early community care. However, the results of its early application in this population group are not known. This pilot study aimed to explore the feasibility of an early intervention based on the use of therapy dogs and to examine their impact on communication and social interaction skills. A within‐subject quasi‐experimental longitudinal design was used. The instruments for measuring results were the Assessment of Communication and Interaction Skills (ACIS) and Animal‐assisted Therapy Flow Sheet, both based on observation. A total of 19 children with confirmed or probable ASD (with mean age of 46.2 months), cared for in a Spanish therapeutic unit, participated in a median of nine AAI sessions, with a mean duration of 19.9 min per session. The total ACIS score increased significantly between the initial and final assessments of the study, with communication and social interaction skills improving with a large effect size. In the Animal‐assisted Therapy Flow Sheet instrument, statistically significant improvements were found in most of the items that evaluate the frequency of child–dog social relationships (look at the dog, touch it, talk to it and get involved in an activity with the animal) and child–therapist relationships (look at the therapist and talk to him/her); the effect sizes ranged from medium to large. In conclusion, the early application of an AAI is feasible and seems to improve communication and social interaction skills, both essential elements for social participation. The results suggest that this intervention may be a beneficial non‐pharmacological therapy as a complementary approach within community care for children with ASD in the early years of their life. [ABSTRACT FROM AUTHOR]

Various international organisations have identified the development of programmes that mitigate the negative impact that forced displacement has on refugees' mental health as a priority intervention area. From this perspective, this study seeks to lend empirical support to a community‐based pilot intervention aimed at promoting posttraumatic growth (PTG) among refugee adults arrived to Seville, the capital of Andalucía (southern Spain). PTG constitutes a mental health indicator that refers to the positive personal transformations refugees undergo as a consequence of experiencing forced displacement. This concept does not negate the undeniable personal suffering forced displacement causes for refugees; rather, it focuses on the positive changes this event has the potential to bring about. Forty‐seven individuals (age, M = 33 years; 20 women) from several countries in conflict participated in the intervention over 15 weeks (March–June 2017). The implementation process comprised two phases: (a) training a group of settled refugees to become peer mentors; and (b) holding cultural peer‐support group sessions made up of newly arrived refugees led by the mentors. Following quantitative and qualitative data collection (using the 'Posttraumatic Growth Inventory' (PTGI; Tedeschi & Calhoun, Journal of Traumatic Stress, 1996, 9, 455) and participants' written evaluations and comments, respectively), and adopting a pretest‐posttest evaluation design, significant improvements were found in four of the five PTG factors: 'appreciation of life', 'personal strength', 'relating to others' and 'new possibilities'. However, no significant differences were observed for 'spiritual change'. We also documented implementation outcomes which revealed high intervention acceptability, appropriateness and feasibility. This study highlights how PTG shown by the refugee population can be actively improved through a community‐based intervention, specifically by creating supportive community settings that adopt a mentorship and peer‐based approach. The limitations and contributions of this research that address the current challenges behind promoting the mental health of refugees in places of settlement are discussed. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to analyse health inequalities in the immigrant population in Spain in 2014, while differentiating between immigrant and native‐born men and women. We have designed a cross‐sectional study on the population aged over 15 years resident in Spain and the data were obtained from the 2014 European Health Survey in Spain (n = 22,842). Among immigrant men and women, we observed a lower risk of having a Chronic Physical Problem (CPP) or a Mental Health Problem (MHP) and a lower consumption of psychiatric drugs. We also observed a higher risk of lack of medical care in immigrant men compared to native‐born. The country of origin was not significantly related to self‐perception of health or use of Primary Care (PC) and Emergency Care services. In conclusion, we observed that now that the peak of the crisis has passed it seems that the “healthy immigrant” effect is being recovered, although the gender inequalities observed in the general population are transferred to the immigrant population. We need to approach the feminisation of migration from a new perspective and understand how inequalities affect immigrant women. [ABSTRACT FROM AUTHOR]

Abstract: Nonpharmacologic therapies such as occupational therapy (OT) are promising for people with Alzheimer's disease (AD). However, more research is needed to better understand the effectiveness of home‐based OT programs. This pilot study aimed to assess the effects of a home‐based, high‐intensity and multicomponent OT intervention on the activities of daily living of people with AD in Spain. The secondary objective was to examine its impact on the cognitive functions. A multiple‐baseline intrasubject design was used. Twenty‐one community‐dwelling older adults with mild AD (mean age 78.6 years) and their primary caregivers participated in a 12‐week home‐based OT program. This intervention was replicated for 8 weeks after a 1.5‐month intervention withdrawal period. The intervention followed a holistic, biopsychosocial and client‐centred approach and consisted of the following components: meaningful activities/tasks, cognitive stimulation, activation of psychomotor and sensory skills, home modification, caregiver counselling and training in daily living skills. Functional independence was the primary outcome (Barthel Index). The cognitive functions were assessed by the Loewenstein Occupational Therapy Cognitive Assessment‐Geriatric (LOTCA‐G). Data were analysed using nonparametric tests. Main results showed that after completing the OT program, 6.5 months after the moment of inclusion, the level of functional independence improved significantly and the effect size was large. Moreover, there was a significant moderate‐to‐substantial improvement in several cognitive functions after each of the two intervention periods: place orientation, time orientation and attention/concentration. In summary, the findings give a great deal of information as a basis for further research. This study provides evidence that an intensive home‐based OT intervention has a positive influence on daily activities and some cognitive functions, suggesting that this program may be beneficial as a nonpharmacological supplementary tool in health and social care for people with AD living in the community. [ABSTRACT FROM AUTHOR]