This article is guided by several premises. First, community coalitions fit with a social ecology perspective of health promotion because they work with multiple domains and promote community change. Second, the community context affects the functioning of coalitions. Third, key leaders are an important part of the social fabric of a community and influence the social ecology of a community; therefore a coalition should include key leaders and influence them and their organizations. The purpose of this article is to advance an understanding of the social ecology of coalitions by describing concepts, variables and results from two national studies and by providing anecdotal evidence and a measure of key leaders from our own work. After briefly defining and describing community coalitions, we: (1) review literature on contextual variables and community coalitions, (2) provide examples of contextual variables influencing community coalition development, and (3) discuss the relationship of key leaders in multiple domains and community coalitions. The article concludes with a discussion of the need for a framework of contextual variables and a promising next step.
We report three simultaneous measles outbreaks with 112 confirmed cases in three Health Regions of Portugal, from February to April 2018. The mean age of cases was 30 years, 79% worked in a healthcare setting and 87% were vaccinated. Genotype B3 was identified in 84 cases from the three outbreaks. Primary cases in each outbreak were imported. Several cases presented with modified measles, highlighting the importance of rethinking the measles case definition for vaccinated cases.
Background: This paper aims to discuss how physical activity (PA) brief assessment, brief counseling, and self-monitoring tools were designed and implemented in the Portuguese National Health Service (NHS), and to report on their current use by health professionals and citizens. Methods: Three digital tools to facilitate PA promotion in primary health care (PHC) were developed: 1) a PA brief assessment tool was incorporated in the electronic health record platform “SClínico Cuidados de Saúde Primários“; 2) a brief counseling tool was developed in the software “PEM—Prescrição Eletrónica Médica” (electronic medical prescription); and 3) a “Physical Activity Card” was incorporated in an official NHS smartphone app called “MySNS Carteira”. Results: From September 2017 to June 2019, 119,386 Portuguese patients had their PA assessed in PHC. Between December 2017 and June 2019, a total of 7957 patients received brief intervention for PA by a medical doctor. Regarding the app “MySNS Carteira”, 93,320 users activated the “Physical Activity Card”, between February 2018 and December 2018. Conclusions: These tools represent key actions to promote PA among Portuguese citizens using PHC as a priority setting. Further initiatives will follow, including proper assessment of their clinical impact and training programs for health care professionals on PA promotion.
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