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Objectives: To determine risk factors associated with presence of depression in young adults (20-35 years). Methods: Case-control design in 6 health centers. Subjects: Young adult, visited in the past two years in primary health care. Cases: Diagnosis of depression <12 months. Controls: no diagnosis of depression or related treatment. Diagnosis confirmed by CIDI questionnaire. Random selection of controls. Measurements: Personal interview. Dependent variable: depressive syndrome present or absent. Independent: demographic, labor, economic, social, health, drug abuse and life events. Results: 95 cases and 93 controls. Response rate 57.7% and 45.0% respectively. Variables associated with depression: being female, being separated/divorced/widow, income <1000 €/month, difficulties at work, spending free time alone, have problems getting or maintaining relationships, sexual dissatisfaction, worse perceived health status, marijuana use, sedentary lifestyle, having suffered some form of discrimination, child abuse, a family member with serious psychological problems (last year). Conclusions: The risk factors found are similar to those of other studies with wide age range. Differentiating factors are abuse in childhood, spending time alone, problems with relationships. [ABSTRACT FROM AUTHOR]

The thirteenth SESPAS (Spanish society of public health and health management) report is structured in three blocks Who, How and What about community health and local governance. In the who block the main agents working in community health are described: communities, health care system, and local government; and how their relations and implication in community health have evolved; which concepts are used; what is the current situation and which challenges they have. The How block contains methodological views, oriented towards implementation of community interventions, based upon participatory tools, development of networks and review of evidence and evaluations to build a National Strategy of Health Promotion of the Spanish Ministry of Health, welfare and consumers affairs including suitable deontologic principles. Finally, the what block refers to a wide range of experiences of community health at the local level as well as training in community health, urbanism, gender, neighborhoods, healthy universities. Additionally, besides regular papers, we show dialogs including debates to further develop community health. It contains 18 papers, without taking into account this introduction, authored by 40 men and 49 women., (Copyright © 2018. Publicado por Elsevier España, S.L.U.)

This article argues for the need to implement community healthcare promotion initiatives in medical practice. Some of the community initiatives introduced in primary care, as well as scientific evidence and associated implementation factors are described. The need for effective coordination between primary care and public health services, working with the community, is underlined. Two specific coordination initiatives are explained by way of example. The first is a project to develop healthcare plans in health centres in the Balearic Islands, by means of a participatory process with the collaboration of citizens, local organisations and the town council (urban planning, mobility, social services, etc.). The second is the Interdepartmental Public Health Plan of Catalonia, which was established to coordinate cross-sectoral healthcare. A specific part of this plan is the COMSalud project, the purpose of which is to introduce a community perspective to health centres and which is currently being piloted in 16 health areas. We review the proposals of a 2008 research study to implement healthcare promotion in primary care, assessing its achievements and shortfalls. The Disease Prevention and Health Promotion Strategy of the Spanish Ministry of Health is recognised as an opportunity to coordinate primary and public health. It is concluded that this change of mentality will require both financial and human resources to come to fruition., (Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To assess the knowledge, perceptions, expectations and attitudes of Primary Care (PC) professionals in Mallorca on managerial autonomy., Design: Cross-sectional study based on an ad hoc, anonymous questionnaire, distributed online, from June-July 2013., Location: PC Mallorca., Participants: PC healthcare professionals (n=1,097)., Measurements: Knowledge of self-management skills, requirements, and future scenarios of the centers with management autonomy (CMA); impact of self-management, commitment and willingness to take risks, and to become a CMA., Results: Response rate: 49.8% (546/1097), with 10.9% showing a high level of knowledge of self-management. The core competencies of a CMA were internal organizational capacity (87.5%) and selection of staff (81.1%). The CMA future was envisaged with motivated and involved professionals (72.6%), efficient results (66%), better quality of care (59.4%), and better training (52.8%). The benefits of self-management were considered important, for individual practitioners and for the improvement of PC in Mallorca (46.8%). The main requirements of the CMA were to have: trained managers (92.6%), budget allocation systems (87.5%), and appropriate management contracts (86.1%). They preferred that the CMA should depend on the Administration (62.7%), and had a personal interest in becoming a CMA (56.9%), but without taking on excessive commitments (waiving statutory regime, financial risk)., Conclusions: These data provide hitherto unknown information of great importance, which could contribute to a more rational planning and participatory implementation of CMA in our midst., (Copyright © 2014 Elsevier España, S.L.U. All rights reserved.)

Objective: To describe the health-promoting community activities developed in primary health care and compare types of activities and how they are performed among autonomous regions., Methods: A descriptive multicenter study was carried out in primary care in 5 Spanish regions. We included community activities consisting of non-sporadic activities, carried out in the previous year, with the participation of the primary care team, and the active participation of the community or as a cross-sector activity. The persons responsible for each of the 194 teams were asked if the team participated in community activities and, if so, a questionnaire was completed by the person responsible for each activity. The variables consisted of the topic addressed, the target population, the professionals involved, the time and scope of implementation, evaluation, theoretical perspectives, network registration, the involvement of the community and other agents, and evaluation of this involvement. A descriptive analysis was performed, stratified by region., Results: We identified 183 community activities in 104 teams. Although there was wide variability among regions, most activities were related to general health, nutrition and emotional-sexual health and targeted the general population, children or parents and were carried out in educational or health centers. Participating professionals had a median of 4 years of experience and a median of 2.8 professionals were involved in each activity. A total of 72.5% of the activities were performed during working hours, 75% were evaluated, and 70% were supported by theoretical and methodological perspectives. Non-health sectors were involved in 65%, local government in 60%, and nongovernmental organizations in 58.5%. Nurses were involved in 85.8% of the activities, physicians in 38.5%, and social workers in 35%. Substantial variability was detected among regions., Discussion: Wide variability was found in the types of activities and their application among the community activities developed by primary care, as well as in institutional recognition and community involvement in the development and evaluation of these activities., (Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.)

Objectives: To determine risk factors associated with presence of depression in young adults 20 to 35., Methods: Case-control design in 6 health centers., Subjects: Young adult, visited in the past two years in primary health care., Cases: Diagnosis of depression <12 months., Controls: no diagnosis of depression or related treatment. Diagnosis confirmed by CIDI questionnaire. Random selection of controls., Measurements: Personal interview. Dependent variable: depressive syndrome present or absent. Independent: demographic, labor, economic, social, health, drug abuse and life events., Results: 95 cases and 93 controls. Response rate 57.7% and 45.0% respectively. Variables associated with depression: being female, being separated/divorced/widow, income <1000 euros/month, difficulties at work, spending free time alone, have problems getting or maintaining relationships, sexual dissatisfaction, worse perceived health status, marijuana use, sedentary lifestyle, having suffered some form of discrimination, child abuse, a family member with serious psychological problems (last year)., Conclusions: The risk factors found are similar to those of other studies with wide age range. Differentiating factors are abuse in childhood, spending time alone, problems with relationships.

Objective: Describe the community activities (CA) published or registered in health promotion networks in which Primary Health Care (PHC) has taken part., Design: Descriptive study, by documental review of experiences., Data Source: articles, activities in exchange networks, presentations and funded projects. SELECTED EXPERIENCES: The AC included were those where PHC and the local community were involved in its inception, development and/or evaluation, but not solitary actions with no continuity., Data Extraction: The following variables were collected: Source and year of the document; region; municipality; name and number of health centres involved; target population; objectives; involvement of the community, the health and the non-health sectors; theoretical perspective and evaluation methods., Results: A total of 472 activities were found that met criteria, involving 300 health centres in most of the autonomous regions. Of those, 71.8% were registered in networks, and 19.3% were registered in articles. The most frequent target populations were: the general population (22.2%), youth (18.2%) and parents (10.2%). More than half (58.2%) had one or more of the following objectives: to empower the community to choose healthy behaviours; transmit health information to the population, or encourage self-care. In 33.3% of the activities there were no other sectors involved besides Primary Care. Of the remainder, non-health sectors participated in 53.8%, civic bodies in 26.9%, and government administration in 24.2%., Conclusions: Most of the CA are documented in networks and their presence is uneven by region. The involvement of sectors other than PHC in the activities identified is low., (Copyright © 2009 Elsevier España, S.L. All rights reserved.)