The methodological quality of primary studies is an important issue when performing meta-analyses or systematic reviews. Nevertheless, there are no clear criteria for how methodological quality should be analyzed. Controversies emerge when considering the various theoretical and empirical definitions, especially in relation to three interrelated problems: the lack of representativeness, utility, and feasibility. In this article, we (a) systematize and summarize the available literature about methodological quality in primary studies; (b) propose a specific, parsimonious, 12-items checklist to empirically define the methodological quality of primary studies based on a content validity study; and (c) present an inter-coder reliability study for the resulting 12-items. This paper provides a precise and rigorous description of the development of this checklist, highlighting the clearly specified criteria for the inclusion of items and a substantial inter-coder agreement in the different items. Rather than simply proposing another checklist, however, it then argues that the list constitutes an assessment tool with respect to the representativeness, utility, and feasibility of the most frequent methodological quality items in the literature, one that provides practitioners and researchers with clear criteria for choosing items that may be adequate to their needs. We propose individual methodological features as indicators of quality, arguing that these need to be taken into account when designing, implementing, or evaluating an intervention program. This enhances methodological quality of intervention programs and fosters the cumulative knowledge based on meta-analyses of these interventions. Future development of the checklist is discussed.

Background: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. Methods: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). Results: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. Conclusions: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic.

BACKGROUND Physical inactivity is a main risk factor of death worldwide, and contributes to psychological and physical problems, including obesity. Physical activity (PA) is critical to preventing health deterioration. Many technological interventions designed to promote PA have limited efficacy as some critical variables affecting PA are not considered. This study aims to understand the variables affecting PA, including barriers or facilitators for doing PA to facilitate the design of effective interventions OBJECTIVE (1) To investigate the mediating non-demographic variables of physical (in)activity, with emphasis on psychological variables, (2) to study which PA variables are considered in the design of intervention technologies to promote PA, (3) to provide a tool – a questionnaire- that allows the identification of PA variables when exploring the design space, (4) to investigate the relationship of PA variables with individuals' weight and actual PA level. METHODS We conducted two literature reviews on PA barriers/facilitators, using PsycINFO and ACM Digital Libraries. The PsycINFO literature search yielded 470 articles of which 50 articles were finally selected; PA barriers/facilitators were studied from these articles and used to design the Barriers Questionnaire for PA (BQPA) with 63 items. The ACM literature search yielded 123 articles, of which 15 articles were finally selected and used to evaluate the attention given to the PA variables in the design of technologies for PA. We then conducted a survey study using the BQPA, the International Physical Activity Questionnaire and demographic questions. The survey was filled out by a representative sample of the Spanish population (N=1012), including participants from all PA and weight levels. RESULTS 38 variables were identified as PA barriers/facilitators. Few studies evaluate their relationship with the actual PA level, and most lack an actual PA measure. The same barriers are reported for the overweight/obese and the normal-weight population, but some barriers are stronger in the obese. Only 17 out of the 38 variables were considered when developing PA technologies. On the survey data, we related the item scores with the participant’s PA level and weight. We found significant correlations between PA level and 62 BQPA items (all P<=.027) and between weight group and 35 BPQA items (all P<=.049). CONCLUSIONS Our contribution is three-fold. First, the literature reviews provide an in-depth account of barriers to PA in normal-weight, overweight and obese populations, and illustrate the lack of consideration of these in the design of PA technologies. Second, we propose a novel questionnaire on barriers to PA, specifically designed to ensure consideration of factors identified in the literature review. Third, we show high correlations between many identified variables and PA participation, and demonstrate how actual PA levels and body weight must also be considered. These results can guide future work on technological interventions for PA.

The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ) evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI), and the 12-Item Short Form Health Survey (SF-12v.2). Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83). Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well-being and adherence after liver transplantation.

Background: Emotional exhaustion causes adverse effects in those who suffer from it. Housewives are not excluded. Domestic and care chores, which are considered to be sources of stress, increase when taking on the role of caregiver for a family member with Alzheimer’s disease. Objective: To analyse the influence of emotional exhaustion, somatic symptoms and social dysfunction, based on the activity they carry out. Methodology: Cross-sectional survey. 193 women participated, of which: housewives (HWs) (n = 97), and Alzheimer’s patient caregiver-housewives (CHWs) (n = 96). The evaluation tools were: sociodemographic/working data questionnaire (ad hoc), Maslach Burnout Inventory (MBI) and Goldberg General Health Questionnaire (GHQ-28). Results: High rates of emotional exhaustion are observed, as well as an existing positive link between chronic diseases, somatic symptoms and social dysfunction. The structural model indicates that emotional exhaustion predicts the amount and extent of diseases, somatic symptoms and social dysfunction. The influence is higher in CHWs. Limitations: Sample procedure implemented at convenience; the variable of the grade of dependence of the Alzheimer’s patient caregiver was not included in the study. Conclusions: The domestic and care chores that HWs and CHWs carry out affect their health. Hence the need to develop psychoeducative programmes that are adapted to the particular needs of these women and focused on the different areas of their everyday lives.

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