The findings suggest the scale is useful as a generic self-rated clinical tool for assessing self-management in a range of chronic conditions, and provides an outcome measure for comparing populations and change in patient self-management knowledge and behaviour. The authors recommend validating the scale in other Latin-American settings with more research into the effect of gender on self- management.

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Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands.

Objective: To assess the effectiveness of a Spanish-language version of the Stanford Chronic Disease Self-management Program among adults who received medical care in community health centers in Mexico. Methods: This was a prospective, randomized study with Mexican users of community health centers in Tampico, Mexico, conducted between September 2015 and July 2016. A total of 120 adults aged 18 years or older were randomly assigned to intervention (n=62) and control (n=58) groups. Data were collected at baseline and at 3 and 6 months post intervention using a structured questionnaire. A repeated measures ANOVA was used for data analysis. Results: Statistically significant differences were found in intervention participants at 3 and 6 months post intervention compared to baseline and the control group for self-management behaviors, including: social activity limitation, quality of life perception, depression, stress, physical activity, communication with physicians, adherence to physician visits, and self-management behaviors. Conclusions: Chronic disease self-management programs (CDSMP) with Mexican adults in community settings are effective in improving their health and self-management behaviors. Further research is needed to assess CDSMP in Mexico and Latin America using objective measurements and examining health outcomes and self-management maintenance over longer periods of time.

Of the numerous instruments available to detect nutritional risk, the most widely used is the Mini Nutritional Assessment (MNA), but it takes 15–20 min to complete and its systematic administration in primary care units is not feasible in practice. We developed a tool to evaluate malnutrition risk that can be completed more rapidly using just clinical variables. Between 2008 and 2013, we conducted a cross-sectional study of 418 women aged ≥60 years from Mexico. Our outcome was positive MNA and our secondary variables included were: physical activity, diabetes mellitus, hypertension, educational level, dentition, psychological problems, living arrangements, history of falls, age and the number of tablets taken daily. The sample was divided randomly into two groups: construction and validation. Construction: a risk table was constructed to estimate the likelihood of the outcome, and risk groups were formed. Validation: the area under the ROC curve (AUC) was calculated and we compared the expected and the observed outcomes. The following risk factors were identified: physical activity, hypertension, diabetes, dentition, psychological problems and living with the family. The AUC was 0.77 (95% CI [0.68–0.86], p < 0.001). No differences were found between the expected and the observed outcomes (p = 0.902). This study presents a new malnutrition screening test for use in elderly women. The test is based on six very simple, quick and easy-to-evaluate questions, enabling the MNA to be reserved for confirmation. However, it should be used with caution until validation studies have been performed in other geographical areas.