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Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years; 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters—a health-enhancing vs. risky pattern—emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.

Background Interprofessional collaborative practice (ICP) is currently recommended for the delivery of high-quality integrated care for older people. Frailty prevention and management are key elements to be tackled on a multi-professional level. Aim This study aims to develop a consensus-based European multi-professional capability framework for frailty prevention and management. Methods Using a modified Delphi technique, a consensus-based framework of knowledge, skills and attitudes for all professions involved in the care pathway of older people was developed within two consultation rounds. The template for the process was derived from competency frameworks collected in a comprehensive approach from EU-funded projects of the European Commission (EC) supported best practice models for health workforce development. Results The agreed framework consists of 25 items structured in 4 domains of capabilities. Content covers the understanding about frailty, skills for screening and assessment as well as management procedures for every profession involved. The majority of items focused on interprofessional collaboration, communication and person-centred care planning. Discussion This framework facilitates clarification of professionals' roles and standardizes procedures for cross-sectional care processes. Despite a lack of evidence for educational interventions, health workforce development remains an important aspect of quality assurance in health care systems. Conclusions The multi-professional capability framework for frailty prevention and management incorporated interprofessional collaborative practice, consistent with current recommendations by the World Health Organization, Science Advice for Policy by European Academies and the European Commission.

Health literacy entails the knowledge, motivation, and competencies to access, understand, appraise, and apply health information in order to make judgments and decisions in everyday life concerning health care, disease prevention, and health promotion to maintain or improve quality of life throughout the life course. It has become an essential concept in public health. It is considered a modifiable determinant of health decisions, health behaviors, health, and healthcare outcomes. Prior studies suggest highly variable levels of health literacy across European countries. Assessing and monitoring health literacy is critical to support interventions and policies to improve health literacy. This study aimed to describe the process of adaptation to Portugal of the short-form version of the Health Literacy Survey (HLS19-Q12) from the Health Literacy Population Survey Project 2019–2021, also establishing the health literacy levels in the Portuguese population. The sample comprised 1247 valid cases. The survey consisted of a brief questionnaire on the determinants of health literacy, plus the HLS19-Q12 questionnaire and the specific health literacies packages on digital health literacy, navigational health literacy, and vaccination health literacy. The results suggest that 7 out of 10 people in Portugal (mainland) have high health literacy levels and support the results of other studies concerning the main socioeconomic determinants of general health literacy. Furthermore, the results suggest that “navigation in the health system” tasks are the most challenging tasks regarding specific health literacies. The overall data suggest the HLS19-Q12 as a feasible measure to assess health literacy in the Portuguese population. Thus, it can be used in Portugal to assess the population’s needs and monitor and evaluate policies and initiatives to promote health literacy by addressing its societal, environmental, personal, and situational modifiable determinant factors.

Do crisis evolve linearly through sequential one‐directional stages that end with their resolution? Or are crisis, a set of nonlinear events with somewhat a chaotic nature, better represented as multilayer relapse cycles, that is, a series of dynamic processes and templates that evolve at different levels of analysis and can either go forward—achievement—or go back—relapses? Moreover, should crisis always move forward to reach their resolution or should we strive to achieve social systems resilience, grounded on learning and adaptation processes, that is, moving forward and backwards, until achieving it? To argument in favor of achieving crisis resilience, we propose a theoretical model—the crisis layers and thresholds (CLT) model grounded on the following assumptions: (a) individuals' evaluations and responses should be the basis/core of crisis management and crisis communication activities; (b) different concurrent psychosocial and organizational processes occur at different levels of analysis of a crisis, from a microindividual level to a macro organization level; and (c) rather than striving for crisis resolution, we should strive for crisis resilience, preparing the social system for current and future emerging risks and crisis. To implement effective evidence‐based crisis management and crisis communication in line with such assumptions, we also propose the CLT‐ResiliScence approach, an Information and Communication Technology‐mediated crisis sensing approach. This is based on monitoring “social sensors” data, particularly from social media, as an important source of information. Examples of this will be provided based on research on the current COVID‐19 pandemic.

The population aging in Europe imposes challenges to societies that require adaptations and responses at various levels to minimize impacts and figuring out opportunities. Portugal has been committed to the World Health Organization and European Union's values and policy frameworks concerning active and healthy aging. In 2017, an inter-ministerial working group developed the National Strategy for Active and Healthy Aging. In the face of the COVID-19 pandemic that exposed the vulnerabilities of older populations, the launch of the Decade of Healthy Aging 2021–2030 and its baseline report and the 2018 Active Aging Index Analytical Report may constitute an opportunity to strategically think about the aging of the population as a national purpose in Portugal and in the other European countries that face similar challenges.

Applied to health, literacy enhances the capacity to make the decisions that are necessary for autonomous health management. With this position paper, we intend to defend the thesis that the conditions for creating a national strategy for health literacy in Portugal along the life course are strengthened by the modernization of the National Health Service (SNS). First, we conducted a scope review on health literacy, and then we collected data on the National Strategy for Health Literacy and the different actions around it. The Literacy Program in Health and Care Integration, aligned with the modernization program of the National Health Service “SNS + Proximidade,” has been developed based on a life course approach. On the other hand, the National Strategy for Health Literacy, in addition to encompassing different dimensions of health literacy, from the individual and community level to the health systems, also presents strategic opportunities for intervention in contexts associated with different determinants of health. The digital Health Literacy Library of the SNS Portal is the first tool to integrate this strategy, being a digital repository of resources to support the promotion of health literacy, accessible at all times. These resources include interactive digital health books and the “My Health Journal,” encouraging people to organize their health information and take control of their health throughout their lives. The strategy also includes plans to bring these resources to people in various everyday contexts, such as public libraries, schools, and day centers, enabling their activation. At the same time, the digital modernization of the SNS allows health information to be made available in the Citizen Area of the SNS Portal, for example, by facilitating each citizen’s access to their health information in a confidential way. The entire process of implementing the health literacy strategy is dynamic and aims to encourage all citizens to participate in its construction and evaluation, and consequently in its adaptation and continuous improvement.

This study aimed to understand how beliefs and attitudes regarding COVID-19 are associated with self-perceived changes in food consumption during lockdown between March 19 and May 2, 2020. We conducted a cross-sectional study with a non-probabilistic weighted sample of the Portuguese population. Data were collected using an online survey and telephone interviews. The association between agreement with sentences about food and COVID-19 and perceived changes in food consumption were assessed by multinomial logistic regression models. Overall, 5858 citizens were included, with a mean age of 38.2 (17.3) years. Exclusive agreement with the belief “SARS-CoV-2 can be transmitted by food” (27.5%) was associated with decreased odds of perceived positive changes (e.g., increased consumption of fruit and vegetables). Agreement only with the attitudinal sentence “I started to consume foods that may protect against COVID-19” (11.9%) was associated with positive perceived consumption changes (e.g., increasing fruit and vegetables, and decreasing soft drinks and snacks). Cumulative agreement (with both sentences; 10.6%) was also associated with mostly positive food consumption changes. Specific beliefs and attitudes regarding COVID-19 and food are associated with self-perceived changes in food consumption. Longitudinal research is needed to understand how beliefs and/or attitudes about the role of food in infectious diseases act as determinants of eating behavior modification.