Sánchez Urbano Raúl E, Paredes Ariel, Vargas Chambi Frank R, Guedes Ruela Pedro, Olivares David E V, Souza Pereira Benicio T, Pacheco Sandaly O S, Pacheco Fabio J
Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata, Libertador San Martín, Argentina.
Institute for Food Science and Nutrition, Universidad Adventista del Plata, Libertador San Martín, Argentina.
Front Nutr. 2021 Jan 27;8:622543. doi: 10.3389/fnut.2021.622543. eCollection 2021.
An effective way to address risk factors for non-communicable chronic diseases (NCD) and reduce healthcare costs is by using sound health-related advice (HRA) to promote healthy lifestyle habits. In Argentina, however, few studies have examined the context in which HRA is communicated and undertaken by patients at the primary care level. In this study, we assessed the reception of HRA using a mixed-method approach in a central area of Argentina. A total of 1,044 participants from the community were contacted and sociodemographic characteristics, health-related lifestyle factors, and medical history were collected. A calendar with health messages was provided to participants and its usage was assessed after 1 year. Additionally, semi-structured interviews were conducted with 34 patients attending a local primary healthcare center. The results show that HRA was given more frequently to individuals with higher mean age, lower educational level, and to females. Participants with a chronic health condition are at a higher chance of receiving advice to reduce salt intake and maintain a healthy weight. Dietary advice is offered along with other lifestyle recommendations. The use of alcohol and tobacco is usually addressed together. HRA was primarily received in the context of an NCD diagnosis and advice was directed, especially, to risky behaviors. The HRA to increase the intake of fruits and vegetables was mentioned less frequently. Patients at the healthcare center greatly appreciated receiving an HRA, especially when given in a tailored, written, and detailed form, and acknowledged its importance to prevent or control a chronic health condition as part of the medical treatment but showed concern regarding the ability to fully incorporate the advice. Lifestyle recommendations are highly appreciated by patients but are still underutilized since they are offered mostly in the context of illness. The health calendar was shown to be useful to complement health intervention programs at the community level. The findings of our study underscore the acknowledged value of HRA by participants to tackle the risk factors of chronic diseases. If properly used HRA constitutes a simple and highly valued tool to help address patient's needs to prevent and control NCD in Argentina.
应对非传染性慢性病（NCD）风险因素并降低医疗成本的有效方法是运用合理的健康相关建议（HRA）来促进健康的生活方式习惯。然而，在阿根廷，很少有研究考察初级保健层面患者接受和采纳HRA的情况。在本研究中，我们在阿根廷一个中心地区采用混合方法评估了HRA的接受情况。共联系了1044名社区参与者，收集了他们的社会人口学特征、与健康相关的生活方式因素和病史。向参与者提供了一本带有健康信息的日历，并在1年后评估其使用情况。此外，还对当地一家初级医疗保健中心的34名患者进行了半结构化访谈。结果表明，HRA更频繁地提供给平均年龄较高、教育水平较低的个体以及女性。患有慢性健康状况的参与者更有可能收到减少盐摄入和保持健康体重的建议。饮食建议与其他生活方式建议一同提供。饮酒和吸烟问题通常一并提及。HRA主要在NCD诊断的背景下提供，且建议尤其针对危险行为。增加水果和蔬菜摄入量的HRA提及较少。医疗保健中心的患者非常感激收到HRA，特别是以量身定制、书面且详细的形式提供时，并认可其作为医疗治疗一部分对预防或控制慢性健康状况的重要性，但对能否完全采纳这些建议表示担忧。患者高度赞赏生活方式建议，但由于这些建议大多在患病背景下提供，仍未得到充分利用。健康日历被证明有助于补充社区层面的健康干预项目。我们的研究结果强调了参与者认可HRA在应对慢性病风险因素方面的价值。如果正确使用，HRA是帮助满足阿根廷患者预防和控制NCD需求的一种简单且备受重视的工具。
