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      Reception of Dietary and Other Health-Related Lifestyle Advice to Address Non-communicable Diseases in a Primary Care Context: A Mixed-Method Study in Central Argentina

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          Abstract

          An effective way to address risk factors for non-communicable chronic diseases (NCD) and reduce healthcare costs is by using sound health-related advice (HRA) to promote healthy lifestyle habits. In Argentina, however, few studies have examined the context in which HRA is communicated and undertaken by patients at the primary care level. In this study, we assessed the reception of HRA using a mixed-method approach in a central area of Argentina. A total of 1,044 participants from the community were contacted and sociodemographic characteristics, health-related lifestyle factors, and medical history were collected. A calendar with health messages was provided to participants and its usage was assessed after 1 year. Additionally, semi-structured interviews were conducted with 34 patients attending a local primary healthcare center. The results show that HRA was given more frequently to individuals with higher mean age, lower educational level, and to females. Participants with a chronic health condition are at a higher chance of receiving advice to reduce salt intake and maintain a healthy weight. Dietary advice is offered along with other lifestyle recommendations. The use of alcohol and tobacco is usually addressed together. HRA was primarily received in the context of an NCD diagnosis and advice was directed, especially, to risky behaviors. The HRA to increase the intake of fruits and vegetables was mentioned less frequently. Patients at the healthcare center greatly appreciated receiving an HRA, especially when given in a tailored, written, and detailed form, and acknowledged its importance to prevent or control a chronic health condition as part of the medical treatment but showed concern regarding the ability to fully incorporate the advice. Lifestyle recommendations are highly appreciated by patients but are still underutilized since they are offered mostly in the context of illness. The health calendar was shown to be useful to complement health intervention programs at the community level. The findings of our study underscore the acknowledged value of HRA by participants to tackle the risk factors of chronic diseases. If properly used HRA constitutes a simple and highly valued tool to help address patient's needs to prevent and control NCD in Argentina.

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          Most cited references64

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            Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and health behaviors, known as the education gradient. We show that income, health insurance, and family background can account for about 30 percent of the gradient. Knowledge and measures of cognitive ability explain an additional 30 percent. Social networks account for another 10 percent. Our proxies for discounting, risk aversion, or the value of future do not account for any of the education gradient, and neither do personality factors such as a sense of control of oneself or over one's life. Copyright 2009 Elsevier B.V. All rights reserved.
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              Understanding associations among race, socioeconomic status, and health: Patterns and prospects.

              Race/ethnicity and socioeconomic status (SES) are social categories that capture differential exposure to conditions of life that have health consequences. Race/ethnicity and SES are linked to each other, but race matters for health even after SES is considered. This commentary considers the complex ways in which race combines with SES to affect health. There is a need for greater attention to understanding how risks and resources in the social environment are systematically patterned by race, ethnicity and SES, and how they combine to influence cardiovascular disease and other health outcomes. Future research needs to examine how the levels, timing and accumulation of institutional and interpersonal racism combine with other toxic exposures, over the life-course, to influence the onset and course of illness. There is also an urgent need for research that seeks to build the science base that will identify the multilevel interventions that are likely to enhance the health of all, even while they improve the health of disadvantaged groups more rapidly than the rest of the population so that inequities in health can be reduced and ultimately eliminated. We also need sustained research attention to identifying how to build the political support to reduce the large shortfalls in health. (PsycINFO Database Record
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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                27 January 2021
                2021
                : 8
                : 622543
                Affiliations
                [1] 1Center for Health Sciences Research, School of Medicine and Health Sciences, Universidad Adventista del Plata , Libertador San Martín, Argentina
                [2] 2Institute for Food Science and Nutrition, Universidad Adventista del Plata , Libertador San Martín, Argentina
                Author notes

                Edited by: Joan Sabate, Loma Linda University, United States

                Reviewed by: Ángela Hernández-Ruiz, Fundación Iberoamericana de Nutrición (FINUT), Spain; Diego A. Moreno, Spanish National Research Council, Spain

                *Correspondence: Fabio J. Pacheco fabio.pacheco@ 123456uap.edu.ar

                This article was submitted to Nutritional Epidemiology, a section of the journal Frontiers in Nutrition

                Article
                10.3389/fnut.2021.622543
                7873357
                62bfff42-3e67-4503-bc77-d2a1a2a6f71b
                Copyright © 2021 Sánchez Urbano, Paredes, Vargas Chambi, Guedes Ruela, Olivares, Souza Pereira, Pacheco and Pacheco.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 October 2020
                : 04 January 2021
                Page count
                Figures: 0, Tables: 7, Equations: 0, References: 67, Pages: 12, Words: 10594
                Categories
                Nutrition
                Original Research

                health-related advice,non-communicable diseases,diet,lifestyle habits,mixed- method study,primary health care,argentina

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