Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America

ABSTRACT: Educational interventions designed to promote healthy eating are essential in primary health care. Nevertheless, given the nutrition controversies about what is healthy, the contradictions created by the media, and the situation of users with complex needs, the prioritization of the themes...

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Autores:
Pava Cárdenas, Alexandra
Rosendo Vincha, Kellem Regina
Laudelino Vieira, Viviane
Cervato Mancuso, Ana María
Tipo de recurso:
Article of investigation
Fecha de publicación:
2018
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/23432
Acceso en línea:
http://hdl.handle.net/10495/23432
Palabra clave:
Promoción de la Salud
Health Promotion
Nutrición, Alimentación y Dieta
Diet, Food, and Nutrition
Investigación Cualitativa
Qualitative Research
Atención Primaria de Salud
Primary Health Care
Rights
openAccess
License
http://creativecommons.org/licenses/by/2.5/co/
id UDEA2_eb32dec7ea3d91a0f35e2d22cb9e5054
oai_identifier_str oai:bibliotecadigital.udea.edu.co:10495/23432
network_acronym_str UDEA2
network_name_str Repositorio UdeA
repository_id_str
dc.title.spa.fl_str_mv Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
title Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
spellingShingle Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
Promoción de la Salud
Health Promotion
Nutrición, Alimentación y Dieta
Diet, Food, and Nutrition
Investigación Cualitativa
Qualitative Research
Atención Primaria de Salud
Primary Health Care
title_short Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
title_full Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
title_fullStr Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
title_full_unstemmed Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
title_sort Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America
dc.creator.fl_str_mv Pava Cárdenas, Alexandra
Rosendo Vincha, Kellem Regina
Laudelino Vieira, Viviane
Cervato Mancuso, Ana María
dc.contributor.author.none.fl_str_mv Pava Cárdenas, Alexandra
Rosendo Vincha, Kellem Regina
Laudelino Vieira, Viviane
Cervato Mancuso, Ana María
dc.subject.decs.none.fl_str_mv Promoción de la Salud
Health Promotion
Nutrición, Alimentación y Dieta
Diet, Food, and Nutrition
Investigación Cualitativa
Qualitative Research
Atención Primaria de Salud
topic Promoción de la Salud
Health Promotion
Nutrición, Alimentación y Dieta
Diet, Food, and Nutrition
Investigación Cualitativa
Qualitative Research
Atención Primaria de Salud
Primary Health Care
dc.subject.agrovoc.none.fl_str_mv Primary Health Care
description ABSTRACT: Educational interventions designed to promote healthy eating are essential in primary health care. Nevertheless, given the nutrition controversies about what is healthy, the contradictions created by the media, and the situation of users with complex needs, the prioritization of the themes to be addressed in the services has scarcely been described in the planning process. This study aimed to identify the process of implementing the themes discussed by health professionals in nutrition education groups in two primary health care models. Methods: Our study followed a qualitative comparative approach. It included the systematic observation of nutrition education group meetings to identify the key messages addressed and semi-structured interviews with health professionals in São Paulo, Brazil, and in Bogotá, Colombia. We used thematic networks to classify the messages and the collective subject discourse technique to organize the information obtained from interviews. We observed 28 nutrition education groups in São Paulo, and 13 in Bogotá, and conducted 27 interviews with nutritionists in each city. Results: The messages identified were grouped into four global themes: feeding habits, life cycle, disease, and “being a multiplier”. The process of implementing the themes, understood as identification, selection, consultation, and application of themes, is intermediated by social representations of the health professionals about service requirements, training and professional performance, and the relationship with users. Two notions shape these representations: Control, although the time and the physical space dedicated to health services are restricted to the disease in São Paulo, in Bogotá only limited health promotion is provided; and specificity, which is portrayed as therapeutic support within a more educational model in São Paulo and as health promotion training courses within a prescriptive model in Bogotá. Conclusions: Understanding the process of implementing the themes discussed in nutrition education groups can reveal mechanisms that support the approach to themes on healthy eating, including communicative and educational adaptations of health professionals. This study contributes to the discussion about educational models in health care and their effects on the qualifications of health professionals within the service, especially those included in the context of low- and middle-income settings. Keywords: Nutrition, Health systems and services in low and middle-income settings, Primary care, Health promotion/prevention/screening, Qualitative research
publishDate 2018
dc.date.issued.none.fl_str_mv 2018
dc.date.accessioned.none.fl_str_mv 2021-10-25T16:56:27Z
dc.date.available.none.fl_str_mv 2021-10-25T16:56:27Z
dc.type.spa.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.citation.spa.fl_str_mv Pava-Cárdenas, A., Vincha, K.R.R., Vieira, V.L. et al. Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America. BMC Nutr 4, 34 (2018). https://doi.org/10.1186/s40795-018-0244-9
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10495/23432
dc.identifier.doi.none.fl_str_mv 10.1186/s40795-018-0244-9
dc.identifier.eissn.none.fl_str_mv 2055-0928
identifier_str_mv Pava-Cárdenas, A., Vincha, K.R.R., Vieira, V.L. et al. Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America. BMC Nutr 4, 34 (2018). https://doi.org/10.1186/s40795-018-0244-9
10.1186/s40795-018-0244-9
2055-0928
url http://hdl.handle.net/10495/23432
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournalabbrev.spa.fl_str_mv BMC Nutr.
dc.rights.spa.fl_str_mv info:eu-repo/semantics/openAccess
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eu_rights_str_mv openAccess
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dc.format.extent.spa.fl_str_mv 11
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dc.publisher.spa.fl_str_mv BMC
dc.publisher.group.spa.fl_str_mv GIIESEN Grupo de Investigación Interdisciplinaria en Educación para la Salud y Educación Nutricional
dc.publisher.place.spa.fl_str_mv Londres, Inglaterra
institution Universidad de Antioquia
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spelling Pava Cárdenas, AlexandraRosendo Vincha, Kellem ReginaLaudelino Vieira, VivianeCervato Mancuso, Ana María2021-10-25T16:56:27Z2021-10-25T16:56:27Z2018Pava-Cárdenas, A., Vincha, K.R.R., Vieira, V.L. et al. Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South America. BMC Nutr 4, 34 (2018). https://doi.org/10.1186/s40795-018-0244-9http://hdl.handle.net/10495/2343210.1186/s40795-018-0244-92055-0928ABSTRACT: Educational interventions designed to promote healthy eating are essential in primary health care. Nevertheless, given the nutrition controversies about what is healthy, the contradictions created by the media, and the situation of users with complex needs, the prioritization of the themes to be addressed in the services has scarcely been described in the planning process. This study aimed to identify the process of implementing the themes discussed by health professionals in nutrition education groups in two primary health care models. Methods: Our study followed a qualitative comparative approach. It included the systematic observation of nutrition education group meetings to identify the key messages addressed and semi-structured interviews with health professionals in São Paulo, Brazil, and in Bogotá, Colombia. We used thematic networks to classify the messages and the collective subject discourse technique to organize the information obtained from interviews. We observed 28 nutrition education groups in São Paulo, and 13 in Bogotá, and conducted 27 interviews with nutritionists in each city. Results: The messages identified were grouped into four global themes: feeding habits, life cycle, disease, and “being a multiplier”. The process of implementing the themes, understood as identification, selection, consultation, and application of themes, is intermediated by social representations of the health professionals about service requirements, training and professional performance, and the relationship with users. Two notions shape these representations: Control, although the time and the physical space dedicated to health services are restricted to the disease in São Paulo, in Bogotá only limited health promotion is provided; and specificity, which is portrayed as therapeutic support within a more educational model in São Paulo and as health promotion training courses within a prescriptive model in Bogotá. Conclusions: Understanding the process of implementing the themes discussed in nutrition education groups can reveal mechanisms that support the approach to themes on healthy eating, including communicative and educational adaptations of health professionals. This study contributes to the discussion about educational models in health care and their effects on the qualifications of health professionals within the service, especially those included in the context of low- and middle-income settings. Keywords: Nutrition, Health systems and services in low and middle-income settings, Primary care, Health promotion/prevention/screening, Qualitative researchCOL010333311application/pdfengBMCGIIESEN Grupo de Investigación Interdisciplinaria en Educación para la Salud y Educación NutricionalLondres, Inglaterrainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARTArtículo de investigaciónhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/2.5/co/http://purl.org/coar/access_right/c_abf2https://creativecommons.org/licenses/by/4.0/Promoting healthy eating in primary health care from the perspective of health professionals: a qualitative comparative study in the context of South AmericaPromoción de la SaludHealth PromotionNutrición, Alimentación y DietaDiet, Food, and NutritionInvestigación CualitativaQualitative ResearchAtención Primaria de SaludPrimary Health CareBMC Nutr.BMC Nutrition1114ORIGINALPavaAlexandra_2018_PromotingHealthyEating.pdfPavaAlexandra_2018_PromotingHealthyEating.pdfArtículo de investigaciónapplication/pdf1279307http://bibliotecadigital.udea.edu.co/bitstream/10495/23432/1/PavaAlexandra_2018_PromotingHealthyEating.pdf1c1bd9b6cebda3c975ae5471c0306f05MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8927http://bibliotecadigital.udea.edu.co/bitstream/10495/23432/2/license_rdf1646d1f6b96dbbbc38035efc9239ac9cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/23432/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD5310495/23432oai:bibliotecadigital.udea.edu.co:10495/234322021-10-25 13:40:53.729Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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