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Article ; Online: Determinants of self-reported health status during COVID-19 lockdown among surveyed Ecuadorian population: A cross sectional study.

Dueñas-Espín, Iván / Jacques-Aviñó, Constanza / Egas-Reyes, Verónica / Larrea, Sara / Torres-Castillo, Ana Lucía / Trujillo, Patricio / Peralta, Andrés

PloS one

2023 Volume 18, Issue 3, Page(s) e0275698

Abstract: Objective: To examine the associations of sociodemographic, socioeconomic, and behavioral factors with depression, anxiety, and self-reported health status during the COVID-19 lockdown in Ecuador. We also assessed the differences in these associations ... ...

Abstract	Objective: To examine the associations of sociodemographic, socioeconomic, and behavioral factors with depression, anxiety, and self-reported health status during the COVID-19 lockdown in Ecuador. We also assessed the differences in these associations between women and men. Design, setting, and participants: We conducted a cross-sectional survey between July to October 2020 to adults who were living in Ecuador between March to October 2020. All data were collected through an online survey. We ran descriptive and bivariate analyses and fitted sex-stratified multivariate logistic regression models to assess the association between explanatory variables and self-reported health status. Results: 1801 women and 1123 men completed the survey. Their median (IQR) age was 34 (27-44) years, most participants had a university education (84%) and a full-time public or private job (63%); 16% of participants had poor health self-perception. Poor self-perceived health was associated with being female, having solely public healthcare system access, perceiving housing conditions as inadequate, living with cohabitants requiring care, perceiving difficulties in coping with work or managing household chores, COVID-19 infection, chronic disease, and depression symptoms were significantly and independently associated with poor self-reported health status. For women, self-employment, having solely public healthcare system access, perceiving housing conditions as inadequate, having cohabitants requiring care, having very high difficulties to cope with household chores, having COVID-19, and having a chronic disease increased the likelihood of having poor self-reported health status. For men, poor or inadequate housing, presence of any chronic disease, and depression increased the likelihood of having poor self-reported health status. Conclusion: Being female, having solely public healthcare system access, perceiving housing conditions as inadequate, living with cohabitants requiring care, perceiving difficulties in coping with work or managing household chores, COVID-19 infection, chronic disease, and depression symptoms were significantly and independently associated with poor self-reported health status in Ecuadorian population.
MeSH term(s)	Male ; Adult ; Humans ; Female ; COVID-19/epidemiology ; Cross-Sectional Studies ; Ecuador/epidemiology ; Self Report ; Persistent Infection ; Communicable Disease Control ; Health Status
Language	English
Publishing date	2023-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0275698
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador.

Rivadeneira, María F / Salvador, Carmen / Araujo, Lorena / Caicedo-Gallardo, José D / Cóndor, José / Torres-Castillo, Ana Lucía / Miranda-Velasco, María J / Dadaczynski, Kevin / Okan, Orkan

Frontiers in public health

2023 Volume 10, Page(s) 1052423

Abstract: Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young ... ...

Abstract	Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students. Methods: A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed. Results: Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, Conclusion: Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.
MeSH term(s)	Male ; Adolescent ; Humans ; COVID-19/epidemiology ; Cross-Sectional Studies ; Health Literacy ; Pandemics ; Universities ; Ecuador/epidemiology ; Students/psychology
Language	English
Publishing date	2023-01-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.1052423
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Article ; Online: Access to health services for chronic disease care during the COVID-19 pandemic in Ecuador: A qualitative analysis using a Social Determinants of Health approach.

Puig-García, Marta / Rivadeneira, María Fernanda / Peralta, Andrés / Chilet-Rosell, Elisa / Benazizi-Dahbi, Ikram / Hernández-Enríquez, María / Torres-Castillo, Ana Lucía / Caicedo-Montaño, Cintia / Parker, Lucy Anne

Global public health

2023 Volume 18, Issue 1, Page(s) 2224859

Abstract: This qualitative study aims to explore how the COVID-19 pandemic impacted healthcare access for patients with chronic conditions in Ecuador from the patient's perspective. We interviewed 19 patients diagnosed with arterial hypertension or type 2 diabetes ...

Abstract	This qualitative study aims to explore how the COVID-19 pandemic impacted healthcare access for patients with chronic conditions in Ecuador from the patient's perspective. We interviewed 19 patients diagnosed with arterial hypertension or type 2 diabetes in rural and urban areas of Ecuador during August and September 2020. We used the Framework Method to analyse the interview transcripts with ATLAS.Ti 8.4 and organised the ideas discussed using categories from the World Health Organization Commission on the Social Determinants of Health conceptual framework. Reorganization of health services during the pandemic meant that patients with arterial hypertension or diabetes could no longer attend face-to-face appointments for disease follow-up. System failures related to medication supply led to increased out-of-pocket payments, which, together with reduced or absent earnings, and in a context with limited social protection policies, meant that patients frequently went for prolonged periods without medication. Rural health initiatives, support from family and use of traditional medicine were reported as ways to manage their chronic condition during this time. Barriers to disease management disproportionately affected individuals with low socioeconomic positions. Stock shortages, lack of protective labour policies and limited reach of anticipatory policies for health emergencies likely worsened pre-existing health inequities in Ecuador.
MeSH term(s)	Humans ; Pandemics ; Ecuador/epidemiology ; COVID-19/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Social Determinants of Health ; Health Services ; Health Services Accessibility ; Chronic Disease ; Hypertension
Language	English
Publishing date	2023-06-21
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2234129-8
ISSN	1744-1706 ; 1744-1706
ISSN (online)	1744-1706
ISSN	1744-1706
DOI	10.1080/17441692.2023.2224859
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Article ; Online: Prevalence and gender disparities of type 2 diabetes mellitus and obesity in Esmeraldas, Ecuador: a population-based survey in a hard-to-reach setting.

Puig-García, Marta / Caicedo-Montaño, Cintia / Márquez-Figueroa, Mónica / Chilet-Rosell, Elisa / Montalvo-Villacis, Gregorio / Benazizi-Dahbi, Ikram / Peralta, Andrés / Torres-Castillo, Ana Lucía / Parker, Lucy Anne

International journal for equity in health

2023 Volume 22, Issue 1, Page(s) 124

Abstract: Background: Type 2 Diabetes (T2DM) prevalence is increasing in low- and middle-income countries along with high levels of obesity which vary according to socioeconomic and contextual characteristics. We aim to estimate the prevalence of T2DM and obesity ...

Abstract	Background: Type 2 Diabetes (T2DM) prevalence is increasing in low- and middle-income countries along with high levels of obesity which vary according to socioeconomic and contextual characteristics. We aim to estimate the prevalence of T2DM and obesity in men and women in a hard-to-reach rural area in northern Ecuador considering socio-demographic characteristics. Methods: Cross-sectional descriptive study based on a population-based survey in the Eloy Alfaro health district of Esmeraldas between October 2020 and January 2022. We collected sociodemographic information and risk factors for non-communicable diseases with an adapted version of the STEPS survey, performed oral glucose tolerance tests, biochemistry and took physical measurements. We estimated the prevalence of T2DM, obesity, and calculated Odds Ratios (OR) with confidence intervals by logistic regression in Stata v.15. Results: The overall prevalence of T2DM was 6.8% (CI95%: 4.9-8.7), markedly higher among women compared to men (10.4%, CI95% 7.3-13.4%, compared 2.0%, CI95% 0.4-3.7% respectively). The risk of having T2DM in women was 5 times higher than in men adjusting for age, ethnicity, employment, household earnings and obesity (OR: 5.03; 95%CI: 1.68-15.01). Regarding age, the risk of T2DM increased by 6% per year (adjusted OR: 1.06; 95%CI: 1.03-1.08). Obesity prevalence was 30.8% (CI95%: 27.3-34.3), in women was nearly three times higher than in men (43.2% CI95%: 38.2-48.2, compared to 14.7% prevalence, CI95%: 10.6-18.8). Indigenous women had a lower prevalence of obesity compared with the Afro-Ecuadorian women (OR: 0.05; 95%CI: 0.02-0.18) after adjusting for age, employment status, household earnings and setting. Conclusion: We found alarming differences between the prevalence of T2DM and obesity in women and men that may be explained by gender roles, exacerbated in the rural context. Health promotion measures with a gender perspective should be adapted according to the characteristics of isolated rural contexts.
MeSH term(s)	Male ; Humans ; Female ; Diabetes Mellitus, Type 2/epidemiology ; Ecuador/epidemiology ; Cross-Sectional Studies ; Prevalence ; Obesity/epidemiology
Language	English
Publishing date	2023-07-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2092056-8
ISSN	1475-9276 ; 1475-9276
ISSN (online)	1475-9276
ISSN	1475-9276
DOI	10.1186/s12939-023-01939-x
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Article ; Online: Social Inequalities in Mental Health and Self-Perceived Health in the First Wave of COVID-19 Lockdown in Latin America and Spain: Results of an Online Observational Study.

Salas Quijada, Carmen / López-Contreras, Natalia / López-Jiménez, Tomás / Medina-Perucha, Laura / León-Gómez, Brenda Biaani / Peralta, Andrés / Arteaga-Contreras, Karen M / Berenguera, Anna / Queiroga Gonçalves, Alessandra / Horna-Campos, Olivia Janett / Mazzei, Marinella / Anigstein, Maria Sol / Ribeiro Barbosa, Jakeline / Bardales-Mendoza, Olga / Benach, Joan / Borges Machado, Daiane / Torres Castillo, Ana Lucía / Jacques-Aviñó, Constanza

International journal of environmental research and public health

2023 Volume 20, Issue 9

Abstract: COVID-19 lockdowns greatly affected the mental health of populations and collectives. This study compares the mental health and self-perceived health in five countries of Latin America and Spain, during the first wave of COVID 19 lockdown, according to ... ...

Abstract	COVID-19 lockdowns greatly affected the mental health of populations and collectives. This study compares the mental health and self-perceived health in five countries of Latin America and Spain, during the first wave of COVID 19 lockdown, according to social axes of inequality. This was a cross-sectional study using an online, self-managed survey in Brazil, Chile, Ecuador, Mexico, Peru, and Spain. Self-perceived health (SPH), anxiety (measured through GAD-7) and depression (measured through PHQ-9) were measured along with lockdown, COVID-19, and social variables. The prevalence of poor SPH, anxiety, and depression was calculated. The analyses were stratified by gender (men = M; women = W) and country. The data from 39,006 people were analyzed (W = 71.9%). There was a higher prevalence of poor SPH and bad mental health in women in all countries studied. Peru had the worst SPH results, while Chile and Ecuador had the worst mental health indicators. Spain had the lowest prevalence of poor SPH and mental health. The prevalence of anxiety and depression decreased as age increased. Unemployment, poor working conditions, inadequate housing, and the highest unpaid workload were associated with worse mental health and poor SPH, especially in women. In future policies, worldwide public measures should consider the great social inequalities in health present between and within countries in order to tackle health emergencies while reducing the health breach between populations.
MeSH term(s)	Male ; Humans ; Female ; COVID-19/epidemiology ; COVID-19/psychology ; Mental Health ; Latin America/epidemiology ; Spain/epidemiology ; Cross-Sectional Studies ; Communicable Disease Control ; Socioeconomic Factors ; Anxiety/epidemiology ; Health Status ; Depression/epidemiology
Language	English
Publishing date	2023-05-04
Publishing country	Switzerland
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20095722
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Article ; Online: Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part-II, Strengthening the Health System: A Mixed-Methods Study Protocol.

Bernal-Soriano, Mari Carmen / Barrera-Guarderas, Francisco / Alonso-Jaquete, Alfonso / Chilet-Rosell, Elisa / Benazizi, Ikram / Caicedo-Montaño, Cintia / Márquez-Figueroa, Mónica / Puig-García, Marta / Lumbreras, Blanca / Hernández-Aguado, Ildefonso / Torres-Castillo, Ana Lucía / Parker, Lucy Anne

International journal of environmental research and public health

2021 Volume 18, Issue 7

Abstract: Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes ... ...

Abstract	Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings in Ecuador and to stimulate context-led health systems innovations to improve diabetes care and reduce inequity. The mixed-methods approach includes a 24-month retrospective study to assess the current level of implementation of comprehensive diabetes care and participants will be followed up prospectively for two years to assess changes in healthcare and clinical outcomes from the outset of the research. We will include individuals diagnosed with type-2 diabetes aged over 18 years, who are accessing diabetes care in health facilities in the study districts. Varied stakeholders (patients and family members, community members, healthcare workers and decision-makers) will interpret the underlying causes of the observed weaknesses and propose solutions to strengthen diabetes-related healthcare in focus group discussions (FG). A second set of FG will analyze perceived improvements in healthcare based on prospective cohort findings and consider the success/failure of any context-led innovations occurring throughout the research. Our study will demonstrate how evidence can be contextualized to stimulate local innovations and overcome weaknesses of diabetes-related healthcare in low resource settings.
MeSH term(s)	Adult ; Delivery of Health Care ; Diabetes Mellitus/therapy ; Ecuador ; Government Programs ; Humans ; Middle Aged ; Prospective Studies ; Retrospective Studies
Language	English
Publishing date	2021-03-25
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18073391
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Article ; Online: Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part I: A Mixed-Methods Study Protocol.

Chilet-Rosell, Elisa / Piay, Nora / Hernández-Aguado, Ildefonso / Lumbreras, Blanca / Barrera-Guarderas, Francisco / Torres-Castillo, Ana Lucía / Caicedo-Montaño, Cintia / Montalvo-Villacis, Gregorio / Blasco-Blasco, Mar / Rivadeneira, María Fernanda / Pastor-Valero, María / Márquez-Figueroa, Mónica / Vásconez, Juan Francisco / Parker, Lucy Anne

International journal of environmental research and public health

2020 Volume 17, Issue 2

Abstract: Challenges remain for policy adoption and implementation to tackle the unprecedented and relentless increase in obesity, diabetes and other non-communicable diseases (NCDs), especially in low- and middle-income countries. The aim of this mixed-methods ... ...

Abstract	Challenges remain for policy adoption and implementation to tackle the unprecedented and relentless increase in obesity, diabetes and other non-communicable diseases (NCDs), especially in low- and middle-income countries. The aim of this mixed-methods study is to analyse the contextual relevance and applicability to low-resource settings of a sample of evidence-based healthy public policies, using local knowledge, perceptions and pertinent epidemiological data. Firstly, we will identify and prioritise policies that have the potential to reduce the burden of diabetes in low-resource settings with a scoping review and modified Delphi method. In parallel, we will undertake two cross-sectional population surveys on diabetes risk and morbidity in two low-resource settings in Ecuador. Patients, community members, health workers and policy makers will analyse the contextual relevance and applicability of the policy actions and discuss their potential for the reduction in inequities in diabetes risk and morbidity in their population. This study tackles one of the greatest challenges in global health today: how to drive the implementation of population-wide preventative measures to fight NCDs in low resource settings. The findings will demonstrate how local knowledge, perceptions and pertinent epidemiological data can be used to analyse the contextual relevance and applicability of potential policy actions.
MeSH term(s)	Clinical Studies as Topic/methods ; Cost of Illness ; Cross-Sectional Studies ; Diabetes Mellitus/therapy ; Ecuador ; Humans ; Morbidity ; Risk Assessment
Language	English
Publishing date	2020-01-16
Publishing country	Switzerland
Document type	Journal Article
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph17020569
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Article ; Online: Determinants of self-reported health status during COVID-19 lockdown among surveyed Ecuadorian population: A cross sectional study.

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Article ; Online: Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador.

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Article ; Online: Access to health services for chronic disease care during the COVID-19 pandemic in Ecuador: A qualitative analysis using a Social Determinants of Health approach.

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Article ; Online: Prevalence and gender disparities of type 2 diabetes mellitus and obesity in Esmeraldas, Ecuador: a population-based survey in a hard-to-reach setting.

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Article ; Online: Social Inequalities in Mental Health and Self-Perceived Health in the First Wave of COVID-19 Lockdown in Latin America and Spain: Results of an Online Observational Study.

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Article ; Online: Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part-II, Strengthening the Health System: A Mixed-Methods Study Protocol.

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Article ; Online: Contextualizing Evidence for Action on Diabetes in Low-Resource Settings-Project CEAD Part I: A Mixed-Methods Study Protocol.

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Inter-library loan at ZB MED