Browsing by Author "Guajardo, Viviana"
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- ItemA collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care: protocol for a cluster randomized controlled trial(2021) Rojas Castillo, María Graciela; Martínez, Pablo; Guajardo, Viviana; Campos Romero, Solange; Herrera Salinas, Pablo; Vöhringer, Paul; Gómez, Víctor; Szabo, Wilsa; Araya, RicardoAbstract Background Depression and chronic diseases are frequently comorbid public health problems. However, clinical guidelines often fail to consider comorbidities. This study protocol describes a cluster randomized trial (CRT) aimed to compare the effectiveness of a collaborative, computer-assisted, psycho-educational intervention versus enhanced usual care (EUC) in the treatment of depressed patients with hypertension and/or diabetes in primary care clinics (PCC) in Santiago, Chile. Methods Two-arm, single-blind, CRT carried out at two municipalities in Santiago, Chile. Eight PCC will be randomly assigned (1:1 ratio within each municipality, 4 PCC in each municipality) to the INTERVENTION or EUC. A total of 360 depressed patients, aged at least 18 years, with Patient Health Questionnaire-9 Item [PHQ-9] scores ≥15, and enrolled in the Cardiovascular Health Program at the participating PCC. Patients with alcohol/substance abuse; current treatment for depression, bipolar disorder, or psychosis; illiteracy; severe impairment; and resident in long-term care facilities, will be excluded. Patients in both arms will be invited to use the Web page of the project, which includes basic health education information. Patients in the INTERVENTION will receive eight sessions of a computer-assisted, psycho-educational intervention delivered by trained therapists, a structured telephone calls to monitor progress, and usual medical care for chronic diseases. Therapists will receive biweekly and monthly supervision by psychologist and psychiatrist, respectively. A monthly meeting will be held between the PCC team and a member of the research team to ensure continuity of care. Patients in EUC will receive depression treatment according to clinical guidelines and usual medical care for chronic diseases. Outcome assessments will be conducted at 3, 6, and 12 months after enrollment. The primary outcome will be depression improvement at 6 months, defined as ≥50% reduction in baseline PHQ-9 scores. Intention-to-treat analyses will be performed. Discussion This study will be one of the first to provide evidence for the effectiveness of a collaborative, computer-assisted, psycho-educational intervention for depressed patients with chronic disease at primary care in a Latin American country. Trial registration retrospectively registered in ClinicalTrials.gov , first posted: November 3, 2020, under identifier: NCT04613076 .
- ItemA Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavior and Obesity Markers in Adults: A Multi-National Cross-Sectional Study(2022) Ferrari, Gerson; Herrera-Cuenca, Marianella; Zalcman Zimberg, Iona; Guajardo, Viviana; Gomez, Georgina; Quesada, Dayana; Rigotti, Attilio; Yadira Cortes, Lilia; Yepez Garcia, Martha; Pareja, Rossina G.; Peralta, Miguel; Marques, Adilson; Leme, Ana Carolina B.; Kovalskys, Irina; Rollo, Scott; Fisberg, MauroThe purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.
- ItemAccelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study(2021) Ferrari, Gerson; Marques, Adilson; Barreira, Tiago V.; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Cecilia Yepez; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Guajardo, Viviana; Leme, Ana Carolina B.; Guzman Habinger, Juan; Valdivia-Moral, Pedro; Suarez-Reyes, Monica; Ihle, Andreas; Gouveia, Elvio R.; Fisberg, MauroThe aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18-65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = -0.17; p < 0.05) and waist circumference (r = -0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (beta: -0.054; 95%CI: -0.077; -0.012) and waist circumference (-0.098; -0.165; -0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (-0.075; -0.119; -0.031) and waist circumference (-0.140; -0.233; -0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.
- ItemAgreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS(2021) Ferrari, Gerson; Werneck, Andre O.; Silva, Danilo R.; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Garcia, Martha Yepez; Liria, Maria; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Cristi-Montero, Carlos; Marques, Adilson; Peralta, Miguel; Bolados, Cristian Cofre; Leme, Ana Carolina B.; Rollo, Scott; Fisberg, MauroThe purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
- ItemAlcohol Contribution to Total Energy Intake and Its Association with Nutritional Status and Diet Quality in Eight Latina American Countries(2021) Brenes, Juan Carlos; Gomez, Georgina; Quesada, Dayana; Kovalskys, Irina; Rigotti, Attilio; Cortes, Lilia Yadira; Yepez Garcia, Martha Cecilia; Liria-Dominguez, Reyna; Herrera-Cuenca, Marianella; Guajardo, Viviana; Fisberg, Regina Mara; Leme, Ana Carolina B.; Ferrari, Gerson; Fisberg, Mauro; ELANS Study GrpAlcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemographic levels. Data from 9218 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela participating in "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study, were used. Dietary intake was collected through two, 24 h recalls. Participants were classified into consumers (n = 1073) and non-alcohol consumers (n = 8145) using a cut-off criterium of >= 15 g/day of alcohol consumption calculated from the estimation of their usual daily intake. Among alcohol consumers, the mean alcohol consumption was 69.22 +/- 2.18 grams (4.6. beverages/day), contributing to 484.62 kcal, which corresponded to 16.86% of the total energy intake. We found that the risk of alcohol consumption was higher in young and middle-aged men from low and middle socioeconomic status. Argentine, Brazil, and Chile had the highest percentage of consumers, while Ecuador showed the highest alcohol consumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrients providing relatively less energy at the expense of the energy derived from alcohol. Alcohol drinkers showed lower and higher consumptions of healthy and unhealthy food groups, respectively. In addition, adequacy ratios for all micronutrients assessed were lower in alcohol consumers. All these deleterious effects of alcohol on nutritional and anthropometric parameters increased with the number of alcoholic beverages consumed daily. Altogether, these findings suggest that limiting alcohol consumption can contribute to reducing the risk of obesity, metabolic syndrome, and diet-related diseases.
- ItemAssociation between built environment and physical activity in Latin American countries: a multicentre cross-sectional study(2021) Barreno, Mishell; Sisa, Ivan; Garcia, Martha Cecilia Yepez; Shen, Hua; Villar, Monica; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Cortes, Lilia Yadira; Pareja, Rossina G.; Herrera-Cuenca, Marianella; Guajardo, VivianaObjective To assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA).
- ItemBreakfast in Latin America: Evaluation of Nutrient and Food Group Intake Toward a Nutrient-Based Recommendation(2022) Kovalskys, Irina; Fisberg, Mauro; Previdelli, Agatha Nogueira; Pereira, Jaqueline Lopes; Zimberg, Iona Zalcman; Guajardo, Viviana; Fisberg, Regina; Ferrari, Gerson; Gomez, Georgina; Rigotti, Attilio; Cortes Sanabria, Lilia Y.; Yepez Garcia, Martha C.; Herrera-Cuenca, Marianella; Liria Dominguez, Maria ReynaBackground Little is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region.
- ItemBreakfast skipping, nutritional status, and physical activity in a middle-aged Latin American population: a population-based study from Ecuador(2019) Lara, Melissa; Sisa, Ivan; Cecilia Yepez, Martha; Fisberg, Mauro; Kovalskys, Irina; Salas, Georgina Gomez; Rigotti, Attilio; Sanabria, Lilia Yadira Cortes; Garcia, Martha Cecilia Yepez; Torres, Rossina Gabriella Pareja; Herrera-Cuenca, Marianella; Koletzko, Berthold; Moreno, Luis A.; Pratt, Michael; Tucker, Katherine L.; Guajardo, Viviana; Zalcman Zimberg, Iona; Paz Amigo, Maria; Janezic, Ximena; Cardini, Fernando; Echeverria, Guadalupe; Landaeta, Leslie; Castillo, Oscar; Cortes Sanabria, Lilia Yadira; Nayibe Vargas, Luz; Fernanda Tobar, Luisa; Milena Castillo, Yuri; Gomez, Georgina; Monge Rojas, Rafael; Chinnock, Anne; Cecilia, Martha; Garcia, Yepez; Villar Caceres, Monica; Belen Ocampo, Maria; Pareja Torres, Rossina; Reyna Liria, Maria; Meza, Krysty; Abad, Mellisa; Penny, Mary; Landaeta, Maritza; Mendez, Betty; Vasquez, Maura; Ramirez, Guillermo; Hernandez, Pablo; Chiavegatto Filho, Alexandre D. P.; Bezerra Goncalves, Priscila; Alberico, Claudia; Ferrari, Gerson Luis de Moraes; Previdelli, Agatha Nogueira; Aparecida Grande de Franca, NatashaIntroduction: the failure to eat breakfast has been associated with weight gain, a lower level of physical activity, and poor diet quality.
- ItemCommunity-Based Prevention of Substance Use in Adolescents: Outcomes Before and During the COVID-19 Pandemic in Santiago, Chile(2024) Libuy, Nicolas; Ibanez, Carlos; Araneda, Ana Maria; Donoso, Paula; Contreras, Lorena; Guajardo, Viviana; Mundt, Adrian P. P.A primary community prevention approach in Iceland was associated with strong reductions of substance use in adolescents. Two years into the implementation of this prevention model in Chile, the aim of this study was to assess changes in the prevalence of adolescent alcohol and cannabis use and to discuss the impact of the COVID-19 pandemic on the substance use outcomes. In 2018, six municipalities in Greater Santiago, Chile, implemented the Icelandic prevention model, including structured assessments of prevalence and risk factors of substance use in tenth grade high school students every 2 years. The survey allows municipalities and schools to work on prevention with prevalence data from their own community. The survey was modified from an on-site paper format in 2018 to an on-line digital format in a shortened version in 2020. Comparisons between the cross-sectional surveys in the years 2018 and 2020 were performed with multilevel logistic regressions. Totally, 7538 participants were surveyed in 2018 and 5528 in 2020, nested in 125 schools from the six municipalities. Lifetime alcohol use decreased from 79.8% in 2018 to 70.0% in 2020 (X-2 = 139.3, p < 0.01), past-month alcohol use decreased from 45.5 to 33.4% (X-2 = 171.2, p < 0.01), and lifetime cannabis use decrease from 27.9 to 18.8% (X-2 = 127.4, p < 0.01). Several risk factors improved between 2018 and 2020: staying out of home after 10 p.m. (X-2 = 105.6, p < 0.01), alcohol use in friends (X-2 = 31.8, p < 0.01), drunkenness in friends (X-2 = 251.4, p < 0.01), and cannabis use in friends (X-2 = 217.7, p < 0.01). However, other factors deteriorated in 2020: perceived parenting (X-2 = 63.8, p < 0.01), depression and anxiety symptoms (X-2 = 23.5, p < 0.01), and low parental rejection of alcohol use (X-2 = 24.9, p < 0.01). The interaction between alcohol use in friends and year was significant for lifetime alcohol use (beta = 0.29, p < 0.01) and past-month alcohol use (beta = 0.24, p < 0.01), and the interaction between depression and anxiety symptoms and year was significant for lifetime alcohol use (beta = 0.34, p < 0.01), past-month alcohol use (beta = 0.33, p < 0.01), and lifetime cannabis use (beta = 0.26, p = 0.016). The decrease of substance use prevalence in adolescents was attributable at least in part to a reduction of alcohol use in friends. This could be related to social distancing policies, curfews, and homeschooling during the pandemic in Chile that implied less physical interactions between adolescents. The increase of depression and anxiety symptoms may also be related to the COVID-19 pandemic. The factors rather attributable to the prevention intervention did not show substantial changes (i.e., sports activities, parenting, and extracurricular activities).
- ItemDeveloping a cooperative multicenter study in Latin America: Lessons learned from the Latin American Study of Nutrition and Health Project(2017) Fisberg, Mauro; Kovalskys, Irina; Gomez Salas, Georgina; Pareja Torres, Rossina Gabriella; Yepez Garcia, Martha Cecilia; Cortes Sanabria, Lille Yadira; Herrera-Cuenca, Marianella; Rigotti, Attilio; Guajardo, Viviana; Zimberg, Ione Zalcman; Previdelli, Agatha Nogueira; Moreno, Luis A.; Pratt, Michael; Koletzko, Berthold; Tucker, Katherine L.This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15-65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status.
- ItemDiet Quality and Diet Diversity in Eight Latin American Countries : Results from the Latin American Study of Nutrition and Health (ELANS)(2019) Gómez, Georgina; Fisberg, Regina Mara; Nogueira Previdelli, Agatha; Hermes Sales, Cristiane; Kovalskys, Irina; Fisberg, Mauro; Herrera Cuenca, Marianella; Cortés Sanabria, Lilia Yadira; Yépes García, Martha Cecilia; Rigotti Rivera, Attilio; Pareja Torres, Rossina Gabriela; Guajardo, Viviana; Zimberg, Ioná Zalcman; Chinnock, Anne; Murillo, Ana Gabriela; Brenes, Juan Carlos
- ItemDietary Diversity and Micronutrients Adequacy in Women of Childbearing Age: Results from ELANS Study(2020) Gomez, Georgina; Previdelli, Agatha Nogueira; Fisberg, Regina Mara; Kovalskys, Irina; Fisberg, Mauro; Herrera-Cuenca, Marianella; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Rigotti, Attilio; Reyna Liria-Dominguez, Maria; Guajardo, Viviana; Quesada, Dayana; Murillo, Ana Gabriela; Carlos Brenes, JuanDietary diversity, an important component of diet quality, is associated with an increased probability of adequate micronutrient intake. Women of childbearing age (WCA) are particularly vulnerable to micronutrient inadequacy. The Minimum Dietary Diversity for Women (MDD-W) has been used widely as a proxy measurement of micronutrient adequacy. This study aimed to assess the association between MDD-W and nutrients adequacy among WCA of eight Latin American countries. Nutrient intakes from 3704 WCA were analyzed with two 24-hour dietary recalls. Dietary diversity was calculated based on ten food groups with a cut-off point of intake >= 5 groups. The mean dietary diversity score was 4.72 points, and 57.7% of WCA achieved MDD-W. Vitamin D and E showed a mean Nutrient Adequacy Ratio (NAR) of 0.03 and 0.38, respectively. WCA with a diverse diet (MDD-W > 5) reported a significantly higher intake of most micronutrients and healthy food groups with less consumption of red and processed meats and sugar-sweetened beverages. MDD-W was significantly associated with the mean adequacy ratio (MAR) of 18 micronutrients evaluated. Nevertheless, even those women with a diverse diet fell short of meeting the Estimated Average Requirements (EAR) for vitamins D and E. MDD-W is an appropriate tool to evaluate micronutrients adequacy in WCA from Latin America, showing that women who achieved the MDD-W reported higher adequacy ratios for most micronutrients and an overall healthier diet.
- ItemFacilitating Factors and Barriers to the Implementation of the Icelandic Prevention Model of Adolescent Substance Use in Chile: A Focus Group Study(2024) Sepulveda, Carolina; Ibanez, Carlos; Libuy, Nicolas; Guajardo, Viviana; Araneda, Ana Maria; Contreras, Lorena; Donoso, Paula; Mundt, Adrian P.The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile.
- ItemLatin American consumption of major food groups: Results from the ELANS study(2019) Kovalskys, Irina; Rigotti, Attilio; Koletzko, Berthold; Fisberg, Mauro; Gomez, Georgina; Herrera-Cuenca, Marianella; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja, Rossina G.; Zimberg, Iona Zalcman; Del Arco, Ana; Zonis, Luciana; Previdelli, Agatha Nogueira; Guajardo, Viviana; Moreno, Luis A.; Fisberg, ReginaBackground
- ItemMain foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)(2021) Fisberg, Mauro; Kovalskys, Irina; Gomez, Georgina; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Gabriela Pareja, Rossina; Herrera-Cuenca, Marianella; Koletzko, Berthold; Moreno Aznar, Luis A.; Mara Fisberg, Regina; Hermes Sales, Cristiane; Nogueira Previdelli, Agatha; Guajardo, VivianaThis study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, crosssectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15-65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors. Arch Latinoam Nutr 2021; 71(3): 164-177.
- ItemMethodological design for the assessment of physical activity and sedentary time in eight Latin American countries - The ELANS study(2020) de Moraes Ferrari, Gerson Luis; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Pareja Torres, Rossina Gabriella; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Scholes, Shaun; Goncalves, Priscila Bezerra; Sole, DirceuWorldwide studies of physical activity and sedentary time have historically under-represented low- and middle-income countries due to the lack of surveillance data. The purpose of this paper is to describe the methods and procedures used for the assessment of physical activity and sedentary time in the Latin American Study of Nutrition and Health (Estudio Latinoamericano de NutriciOn y Salud; ELANS). ELANS is a multicentre, cross-sectional and surveillance study of a nationally representative sample from eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Two instruments were used to evaluate different domains and intensities of physical activity and sedentary time: self-reported data and a triaxial accelerometer (model GT3X+). ELANS will generate important self-reported and objective information for the Latin American populations, namely:
- ItemParental practices and their association with alcohol and cannabis use among adolescents in Chile(2023) Libuy, Nicolas; Guajardo, Viviana; Ibanez, Carlos; Araneda, Ana Maria; Contreras, Lorena; Donoso, Paula; Gaete, Jorge; Mundt, Adrian P.BackgroundAdolescent alcohol and cannabis use are common in Chile. The present study aimed to assess the relationship between perceived parenting practices and alcohol and cannabis use among adolescents in a Latin American context.MethodsWe adapted and implemented a substance use prevention strategy in Chile, which included surveys of tenth-grade students from six municipalities in the Metropolitan Region of Greater Santiago. We assessed the reliability and factorial structure of the parenting scale with 16 items, which formed part of the survey. We dichotomized parenting scores into high (above the median) and low. The association of parenting practices with alcohol and cannabis use in adolescents was assessed using multivariate multilevel regression models.ResultsA total of 7,538 tenth-grade students from 118 schools were included in the study. The 16-item scale of parenting practices showed good internal consistency (Omega total = 0.84), and three factors representing Relationship between parents and adolescents, Norms and monitoring, and Parents knowing their children's friends and the parents of their children's friends. High total scores of parenting were associated with lower odds of lifetime alcohol use (OR 0.57; 95% CI: 0.49-0.65), past-month alcohol use (OR 0.63; 95% CI: 0.57-0.70), lifetime drunkenness (OR 0.64; 95% CI: 0.58-0.72), and lifetime cannabis use (OR 0.54; 95% CI: 0.47-0.61). Above median scores on each parenting subscale were associated with significantly lower odds of substance use. The strongest associations were observed for the subscale Norms and monitoring. Interactions between parenting and gender showed a significantly stronger effect of parenting practices on alcohol and cannabis use among girls.ConclusionDifferent types of parenting practices were associated with a lower prevalence of adolescent alcohol and cannabis use. Improving parenting practices has the potential to prevent adolescent substance use in Chile, especially among girls.
- ItemSocio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: Findings from the ELANS study(2020) Ferrari, Gerson Luis de Moraes; Kovalskys, Irina; Fisberg, Mauro; Gomez, Georgina; Rigotti, Attilio; Sanabria, Lilia Yadira Cortes; Garcia, Martha Cecilia Yepez; Torres, Rossina Gabriella Pareja; Herrera-Cuenca, Marianella; Zimberg, Iona Zalcman; Guajardo, Viviana; Pratt, Michael; Cristi-Montero, Carlos; Rodriguez-Rodriguez, Fernando; Scholes, Shaun; Celis-Morales, Carlos A.; Chaput, Jean-Philippe; Sole, DirceuPhysical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America. Highlights Worldwide studies of physical activity (PA) and sedentary behaviours (SB) have historically under-represented Latin American countries due to the lack of surveillance data. Across eight Latin American countries, the ELANS study collected data on PA and SB using an objective method (accelerometers) which we have analysed to quantify and characterise socio-demographic patterns. Over four-in-ten participants were physically inactive (40.6%); with a gender gap (47.7% women; 33.0% men); and striking differences between countries (47% Costa Rica and Venezuela; 26.9% Chile). In all countries, levels of moderate-to-vigorous physical activity (MVPA) were lowest, and levels of SB were highest, among participants in the higher education groups. Our findings on the unequal distribution of PA and SB increases the evidence base and can help to inform future intervention strategies in Latin America.
- ItemSocioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results(2021) Gomez, Georgina; Kovalskys, Irina; Leme, Ana Carolina B.; Quesada, Dayana; Rigotti, Attilio; Cortes Sanabria, Lilia Yadira; Yepez Garcia, Martha Cecilia; Reyna Liria-Dominguez, Maria; Herrera-Cuenca, Marianella; Fisberg, Regina Mara; Previdelli, Agatha Nogueira; Guajardo, Viviana; Ferrari, Gerson; Fisberg, Mauro; Brenes, Juan CarlosPoor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.
- ItemTechnology-Assisted Collaborative Care Program for People with Diabetes and/or High Blood Pressure Attending Primary Health Care: A Feasibility Study(2021) Martinez, Pablo; Guajardo, Viviana; Gomez, Victor E.; Brandt, Sebastian; Szabo, Wilsa; Soto-Brandt, Gonzalo; Farhang, Maryam; Baeza, Paulina; Campos, Solange; Herrera, Pablo; Rojas, GracielaThe comorbidity of depression with physical chronic diseases is usually not considered in clinical guidelines. This study evaluated the feasibility of a technology-assisted collaborative care (TCC) program for depression in people with diabetes and/or high blood pressure (DM/HBP) attending a primary health care (PHC) facility in Santiago, Chile. Twenty people diagnosed with DM/HBP having a Patient Health Questionnaire-9 score & GE; 15 points were recruited. The TCC program consisted of a face-to-face, computer-assisted psychosocial intervention (CPI, five biweekly sessions), telephone monitoring (TM), and a mobile phone application for behavioral activation (CONEMO). Assessments of depressive symptoms and other health-related outcomes were made. Thirteen patients completed the CAPI, 12 received TM, and none tried CONEMO. The TCC program was potentially efficacious in treating depression, with two-thirds of participants achieving response to depression treatment 12 weeks after baseline. Decreases were observed in depressive symptoms and healthcare visits and increases in mental health-related quality of life and adherence to treatment. Patients perceived the CPI as acceptable. The TCC program was partially feasible and potentially efficacious for managing depression in people with DM/HBP. These data are valuable inputs for a future randomized clinical trial.