Revista Panamericana De Salud Publica-pan American Journal of Public Health最新文献

{"title":"Accelerating actions in primary health care.","authors":"Silvana Luciani, Anselm Hennis, Jonas Gonseth-Garcia, Irene Agurto, Carlos Santos-Burgoa, Graciela Abriata, Patricia J Garcia","doi":"10.26633/RPSP.2025.80","DOIUrl":"https://doi.org/10.26633/RPSP.2025.80","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e80"},"PeriodicalIF":2.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerating integration of noncommunicable diseases into primary health care.","authors":"Jarbas Barbosa da Silva","doi":"10.26633/RPSP.2025.79","DOIUrl":"https://doi.org/10.26633/RPSP.2025.79","url":null,"abstract":"","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e79"},"PeriodicalIF":2.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing for ICD-11 transition: lessons from case studies in Argentina and Mexico.","authors":"Carmen L Ballester-Otero, Maryam Tavakkoli, Katri Kontio, Jenna Thelen, Olga Helena Joos, Carlos Gustavo Guevel, Manuel Yáñez, Rebeca Revenga Becedas, Carmen Sant Fruchtman, Andrea Gerger, Keith Denny, Daniel Cobos Munoz","doi":"10.26633/RPSP.2025.95","DOIUrl":"10.26633/RPSP.2025.95","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the early stages of the International Classification of Diseases 11th Revision (ICD-11) implementation in Argentina and Mexico, focusing on mortality coding, to identify essential elements and key considerations for successful adoption.</p><p><strong>Methods: </strong>Qualitative analysis was conducted using case studies from Argentina and Mexico. Data were collected through interviews, workshops, and document analysis to uncover opportunities, challenges, and strategic decisions in ICD-11 implementation.</p><p><strong>Results: </strong>Key findings highlight the critical role of comprehensive system assessments, strategic partnerships, financial planning, technological readiness, targeted training initiatives, and structured evaluation mechanisms. Both countries emphasized the importance of tailored strategies aligned with their unique contexts and highlighted the need for collaboration across sectors and the establishment of national task forces. Challenges included navigating the complexities of integrating ICD-11 within existing systems and enhancing interoperability through accelerated development of tools and establishment of expert networks.</p><p><strong>Conclusions: </strong>Tailored strategies are essential for integrating ICD-11 into national health information systems. Greater collaboration, establishment of national task forces, and clear monitoring frameworks are crucial for successful implementation. Guided by digital health and health informatics expertise, countries can overcome challenges and align with broader health care objectives, thereby ultimately enhancing global health outcomes through effective ICD-11 adoption. By learning from early adopters such as Argentina and Mexico, other countries can better prepare for their own transitions to ICD-11.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e95"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Digital health and its impacts on the access of minority groups to primary care: a systematic reviewLa salud digital y su impacto en el acceso a la atención primaria de salud en grupos minoritarios: revisión sistemática].","authors":"Gabriela de Oliveira Laguna Silva, Gabriel Ricardo Fernandes, Jacqueline Castro da Rocha, Gabriela Tizianel Aguilar, Isadora D'Avila Lottici, Andressa Dutra Dode, Felipe Cezar Cabral, Taís de Campos Moreira, Maria Eulália Vinadé Chagas","doi":"10.26633/RPSP.2025.96","DOIUrl":"10.26633/RPSP.2025.96","url":null,"abstract":"<p><strong>Objective: </strong>To identify digital interventions applied in the context of primary health care (PHC) and assess their impact on access to health care by minority population groups.</p><p><strong>Methods: </strong>We performed a systematic review of randomized clinical trials evaluating digital interventions in PHC settings, with health care access as the primary outcome. Searches were carried out in the PubMed, Scopus, and LILACS databases up to January 2025, with no restrictions regarding language, country, or year. The interventions were further analyzed using the PROGRESS-Plus framework to identify the social vulnerability markers addressed in the studies.</p><p><strong>Results: </strong>Six studies were included, all conducted in the United States, focusing on populations vulnerable due to race (Black and Hispanic/Latino individuals), gender (women), education level (individuals with low educational attainment), and socioeconomic status (low-income individuals). Most participants (adults aged 30 to 60 years) were overweight or obese and had chronic comorbidities. In all studies, digital solutions were integrated into interprofessional practices involving dietitians, nurses, pharmacists, physicians, and/or psychologists, and were successful in improving clinical outcomes and expanding access to care. However, barriers related to digital and health literacy were reported, as well as difficulties using digital tools, particularly among participants with lower educational levels.</p><p><strong>Conclusion: </strong>Realizing the equity potential of digital interventions requires overcoming barriers such as limited literacy, low connectivity, and social inequality through participatory design approaches and public policies guided by principles of social justice.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e96"},"PeriodicalIF":2.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of and support for banning e-cigarettes and heated tobacco products among Mexicans who smoke.","authors":"Lizeth Cruz-Jiménez, Inti Barrientos-Gutiérrez, Katia Gallegos-Carrillo, Rosibel Rodríguez-Bolaños, Dèsirée Vidaña-Pérez, Edna Arillo-Santillán, James W Hardin, James F Thrasher","doi":"10.26633/RPSP.2025.91","DOIUrl":"10.26633/RPSP.2025.91","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates awareness of and support for Mexico's bans on e-cigarettes and heated tobacco products among adults who smoke.</p><p><strong>Methods: </strong>Data were analyzed from a 2020 survey of adult Mexicans who exclusively smoked cigarettes (<i>n</i> = 1 324) or smoked cigarettes and used e-cigarettes (<i>n</i> = 654). Weighted multilevel mixed-effects logistic regression models estimated crude and adjusted odds ratios (AORs) for awareness of and support for bans on each product, regressing these outcomes on variables for sociodemographic characteristics, product use, perceptions of harms, norms and exposure to advertising.</p><p><strong>Results: </strong>Weighted results indicated that 27.2% of respondents were aware of the e-cigarette ban and 15.5% supported it. Among the 805 respondents who had heard of heated tobacco products, 32.5% were aware of the ban on them, and 18.8% expressed support. Awareness of the e-cigarette ban was correlated with the frequent use of cigarettes (AOR: 2.15), while awareness of heated tobacco products was associated with current use of them (AOR: 2.36). Awareness of the bans was positively associated with support for them (AOR for e-cigarettes: 1.73; AOR for heated tobacco products: 2.17). Lower support was found among those who perceived the banned product as less harmful than cigarettes (AOR for e-cigarettes: 0.51; AOR for heated tobacco products: 0.32) or perceived information about the banned product as positive (i.e. in contrast to negative or neutral; AOR for e-cigarettes: 0.21; AOR for heated tobacco products: 0.43).</p><p><strong>Conclusions: </strong>Awareness of and support for bans on e-cigarettes and heated tobacco products were low among Mexicans who smoke, especially among those who use these products or had favorable perceptions of the products and information about them.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e91"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluation of knowledge about childhood cancer among health professionals in five cities of ColombiaAvaliação do conhecimento sobre o câncer infantil entre profissionais de saúde de cinco cidades da Colômbia].","authors":"María Lourdes Calderón Mendoza, Yefferson Enciso Rodríguez, Devi Puerto Jiménez","doi":"10.26633/RPSP.2025.93","DOIUrl":"10.26633/RPSP.2025.93","url":null,"abstract":"<p><strong>Objective: </strong>To assess primary health care professionals' knowledge regarding the timely detection of childhood cancer in five priority cities in Colombia.</p><p><strong>Methods: </strong>Descriptive cross-sectional study with an analytical component, of 141 nursing, general medicine, family medicine, and pediatrics professionals in five of the Colombian cities with the highest rates of mortality due to this cause. A multivariate analysis was performed to predict the percentage of success obtained on each section of the test and overall.</p><p><strong>Results: </strong>There is variability in childhood cancer knowledge among cities and professions. Fifty percent of the participants showed a good level of knowledge. The nursing group exhibited the lowest average score relative to the other participants. The lowest scores were observed in the city of Valledupar.</p><p><strong>Conclusions: </strong>An association was found between profession and knowledge about childhood cancer. Although there is an adequate level of knowledge about this disease in the five cities evaluated, areas of opportunity were identified to improve training on the early identification of cancer, especially in the group of nurses.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e93"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Implementation of a multilevel course to strengthen surveillance of ESAVI in NicaraguaImplementação de um curso multinível para fortalecer a vigilância de ESAVI na Nicarágua].","authors":"Ana Yoe-Cheng Chang, Nadia Romualdo, Patricia Arce, Jazmina Umaña, Leonardo Peralta, Cristhian Toledo","doi":"10.26633/RPSP.2025.94","DOIUrl":"10.26633/RPSP.2025.94","url":null,"abstract":"<p><strong>Objective: </strong>To describe the adaptation, preparation, and implementation of a multilevel course to strengthen health personnel capacity related to the surveillance cycle for events supposedly attributable to vaccination or immunization (ESAVI) in Nicaragua.</p><p><strong>Methods: </strong>A descriptive study was developed based on the implementation of a multilevel course aimed at national and municipal managers of the Expanded Program on Immunization and Epidemiology. The educational strategy included virtual learning, peer-to-peer learning, and pedagogical mediation with certified tutors. The process was structured in three phases: organization (definition of educational aspects), preparation (training of tutors and development of didactic material), and implementation. It was divided into two editions: the first included virtual seminars and practical classes with case-problems, while the second condensed the content and applied peer-to-peer learning. Perceptions were assessed through an online survey.</p><p><strong>Results: </strong>A total of 88% (184 participants) completed all course activities. The survey results reflected positive perceptions of different aspects of the course that facilitated learning and communication: topics (97%, n= 156), case studies (96%, n= 155), practical classes (95%, n= 153), teaching resources (92%, n= 148), evaluation (89%, n= 143), and the use of Zoom (87.7%, n=141) and WhatsApp (92.5%, n= 149). The main strengths mentioned were useful information, professional growth, and the relevance of the topics. The main difficulties mentioned were the schedule for the course activities and Internet access and quality.</p><p><strong>Conclusions: </strong>The Nicaraguan experience contextualizes the multilevel educational strategy through case studies and the use of available technology, highlighting the virtual modality and pedagogical mediation as key elements for capacity building in municipalities.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e94"},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of second round of HPV-based screening for cervical cancer in programmatic contexts in Argentina.","authors":"Pilar Barcena Barbeira, Melisa Paolino, Fernando Binder, Maribel Almonte, Armando Baena, Juan David Mazzadi, Silvina Arrossi","doi":"10.26633/RPSP.2025.92","DOIUrl":"10.26633/RPSP.2025.92","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate implementation of the second round of human papillomavirus (HPV)-based cervical screening, introduced in Argentina in 2012-2014 through the Jujuy Demonstration Project for women 30 years and older, and describe the characteristics of women who adhere to the recommended five-year rescreening interval.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted based on the data of two rounds of screening. All women aged 30 years or older who had been HPV-tested during the Jujuy Demonstration Project and had a negative result were included. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to evaluate implementation. Multivariable regression was used to examine factors associated with adherence to rescreening.</p><p><strong>Results: </strong>Of 42 307 HPV-negative women, 47.9% (<i>n</i> = 20 285) were rescreened in the second round (Reach); 69.2% of health centers provided at least one HPV test at second-round screening (Adoption); and 13.3% (<i>n</i> = 5 639) of women were rescreened within the recommended five-year interval. Among the total rescreened, 9.3% (<i>n</i> = 1 888) were HPV-positive, of which 95.0% underwent triage Pap and 79.2% of the HPV-positive/abnormal Pap women had colposcopy. Considering women rescreened at five years, the second-round detection rate was 5.3/1 000 screened women. Rescreening at five years was significantly higher among women aged 30-44, with public health insurance, and those living in the provincial capital.</p><p><strong>Conclusions: </strong>Rescreening of HPV-negative women faced challenges linked to its reduced reach, especially if we consider the recommended five-year interval. Our findings suggest that we need to devise specific strategies to increase second-round screening rates.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e92"},"PeriodicalIF":2.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spatial and spatiotemporal inequalities in premature mortality due to cervical cancer in Argentina (2001-2020)Desigualdades espaciais e espaço-temporais na mortalidade prematura por câncer do colo do útero na Argentina (2001-2020)].","authors":"Gisel L Fattore, Natalia Aráoz Olivos, Carlos M Leveau, Christian Ballejo, Ana Laura Delgado, María Verónica Pesce, María Jimena Marro","doi":"10.26633/RPSP.2025.90","DOIUrl":"10.26633/RPSP.2025.90","url":null,"abstract":"<p><strong>Objective: </strong>To estimate years of life lost (YLL) due to cervical cancer (CC) at the subnational level in Argentina from 2001 to 2020 and identify spatial and spatiotemporal clusters of CC mortality.</p><p><strong>Methods: </strong>Ecological time-series study. Mortality data were obtained from the Directorate of Health Statistics and Information, and population data, from the censuses conducted by the National Statistics and Census Institute and intercensal projections. Crude and age-adjusted YLL rates, grouped into five-year periods, were estimated for each province of Argentina. Spatial autocorrelation techniques were applied, namely Moran's index, local indicators of spatial association and space-time scan statistics, to detect spatiotemporal clustering.</p><p><strong>Results: </strong>In the period 2001-2020, 37 265 deaths due to cervical cancer were recorded, corresponding to 1 398 661 YLL. The adjusted YLL rate showed a significant increase between the first five-year period (5.42 per 1000; 95%CI, 5.40-5.44) and the last (5.75 per 1000; 95%CI, 5.73-5.76). All provinces exhibited stable or rising rates, except for Jujuy and Santa Cruz, both of which had significant reductions in YLL. Persistence of a spatial cluster over time was observed in the North of the country, and spatiotemporal clustering of high rates was detected in the Northwest region (Salta/Jujuy) during the years 2001-2009 and in the Northeast region in 2011-2020.</p><p><strong>Conclusions: </strong>Premature mortality due to cervical cancer in Argentina showed a rising trend over the study period, with a greater concentration in northern provinces. The decline observed in some provinces could be attributed partly to differences in the implementation of prevention programs.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e90"},"PeriodicalIF":2.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Distribution of the COVID-19 vaccine: experience in EcuadorOperacionalização da vacinação contra a COVID‑19: experiência no Equador].","authors":"José Ruales, Ximena Garzón, Cristina Aldaz, Nancy Vásconez, Fernando Jácome, Jacqueline Cevallos, Jackeline Pinos, Francisco Pérez-Tasigchana, Adrián Díaz, Alvaro Whittembury","doi":"10.26633/RPSP.2025.89","DOIUrl":"10.26633/RPSP.2025.89","url":null,"abstract":"<p><p>In Ecuador, the health emergency caused by COVID-19 required the State's concerted effort to provide safe, effective, and free vaccines. At the start of 2022, the country reached broad vaccination coverage, placing it among the countries in the Americas with the strongest achievements in this area.To systematize and analyze the lessons learned from the introduction of the COVID-19 vaccine, the country and the Pan American Health Organization/World Health Organization (PAHO/WHO) implemented an intra-action review (IAR) during the application of the measures adopted, which presented the lessons learned and corrective measures to strengthen the deployment of vaccination.This article describes, based on the authors' experience and the results of the IAR, the introduction of vaccination in Ecuador, the timely response mechanisms, and the difficulties encountered in deploying vaccination in accordance with the national plan and in achieving the proposed objectives.</p>","PeriodicalId":21264,"journal":{"name":"Revista Panamericana De Salud Publica-pan American Journal of Public Health","volume":"49 ","pages":"e89"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}