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Introduction: Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. Objectives: To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. Methods and analysis: This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba’s criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. Discussion: This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role.

Antecedentes: La proliferación de intervenciones e investigaciones psicológicas realizadas a través de internet ha fomentado la aplicación de cuestionarios online para evaluar trastornos mentales comunes como la ansiedad perinatal. Este estudio analiza la validez y fiabilidad de la versión online de la Escala de Ansiedad Generalizada (GAD-7) en una muestra de mujeres españolas embarazadas y puérperas. Método: 3082 mujeres embarazadas (n = 1260) y puérperas (n = 1822) fueron reclutadas por internet y seguidas durante seis meses en tres momentos de tiempo. Resultados: El Análisis Factorial Exploratorio aportó una solución unifactorial que se confirmó mediante Análisis Factorial Confirmatorio en embarazadas (CFI = 0.998; RMSEA = 0.035) y puérperas (CFI = 0.998; RMSEA = 0.038). Este modelo mostró invarianza estricta por grupo. La validez se confirmó evaluando las correlaciones entre GAD-7 con la Escala de Depresión Postnatal de Edimburgo y los 10 ítems de la lista de verificación del Trastorno de Estrés Postraumático en los tres momentos evaluados. El coeficiente de fiabilidad fue .92 para ambos grupos. Conclusiones: Este estudio muestra que la versión online en español del GAD-7 tiene buenas propiedades psicométricas y puede ser utilizada para evaluar síntomas de ansiedad durante el período perinatal., Background: The use of online questionnaires to assess common mental disorders such as perinatal anxiety has spread due to the proliferation of Internet-based psychological interventions and research. This study analyses the validity and reliability of the online version of the Generalized Anxiety Disorder-7 (GAD-7) in a sample of pregnant and postpartum Spanish women. Method: A total of 3082 pregnant (n = 1260) and postpartum (n = 1822) women were recruited via the Internet and underwent three follow-up evaluations during a six-month period. Results: A one-factor solution was assigned by Exploratory Factor Analysis and confirmed by Confirmatory Factor Analysis for both pregnant (CFI = 0.998; RMSEA = 0.035) and postpartum(CFI = 0.998; RMSEA = 0.038) women. The one-factor model showed strict invariance across groups. Validity was confirmed by assessing correlations between GAD-7, the Edinburgh Postnatal Depression Scale, and the 10-item Posttraumatic Stress Disorder checklist at three time points. The reliability coefficient was .92 for the two groups. Conclusions: This study shows that the Spanish online GAD-7 version has good psychometric properties and can be used to assess anxiety symptoms during the perinatal period.

It is necessary to continue identifying the predictors of anxiety symptoms in men and women undergoing assisted reproductive technology (ART), especially from a psychosocial perspective. For this reason, this study evaluated a mediation model that demonstrates the effect of various stressors related to infertility, as well as the variables of sex, age, social support, and sexist beliefs, on anxiety symptoms. The sample of this cross-sectional study consisted of 215 infertility patients (146 women and 69 men) undergoing ART and residing in Spain. The Inventory of Infertility Problems (FPI) was used, which measures five stressors related to infertility (social, sexual and relationship concerns, rejection of a child-free lifestyle and need for parenthood). The Hospital Anxiety and Depression Scale (HADS) and the Ambivalent Sexism Inventory (ASI) were also used. Being women and perceiving less social support was associated with higher anxiety symptoms, due to the mediated effect of social, sexual and relationships concerns. Higher levels of sexist beliefs were related to greater concern about the relationship, greater rejection of a childless lifestyle and greater need for parenting. This pioneering research in Spain identifies factors predisposing to anxiety in ART patients. This evidence should be considered in infertility research and clinical practice.

Background: We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research. Methods/design: The scoping review process will be guided by the methodological framework of Arksey and O’Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles. Discussion: A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed.

Background Empirical evidence has shown that cardiac rehabilitation programs are effective in reducing morbidity and mortality, improving quality of life in patients with cardiovascular disease. Despite the benefits, women have a high cardiac rehabilitation dropout rate. Our aim was to explore women’s perceptions about the reasons they faced for dropout from these programs. Methods Semi-structured interviews were conducted with women (n = 10) after dropping out from three different cardiac rehabilitation centers in Spain. In addition, a focus group and a semi-structured interview with cardiovascular professionals were conducted. From a grounded theory perspective, thematic analysis was used to derive themes from interview transcripts. Results The women were between 41 and 70 years. We identified five general themes that illustrated reasons for cardiac rehabilitation dropout: intrapersonal reasons (self-reported health, self-reported mental health, health beliefs); interpersonal reasons (family caregiver role, work conflicts); logistical reasons (transport, distance); cardiac rehabilitation program characteristics (perception of the objective of cardiac rehabilitation, exercise component, inconvenient timing, cardiac rehabilitation equipment); and health system reasons (financial assistance for transport, long waiting list). The cardiovascular professionals found barriers to cardiac rehabilitation completion similar to those found by the women. Conclusions In order to prevent cardiac rehabilitation dropout in women, modular and flexible programs are needed. In addition, the inclusion of primary care centers or community resources could improve cardiac rehabilitation completion in women. Psychological assessment and counseling during cardiac rehabilitation should be included as an essential part of the programs and recommended for those women with depressive symptoms. Finally, improved financial assistance for transport from the health system is essential.

IntroductionAlthough evidence exists for the efficacy of psychosocial interventions in preventing depression, little is known about its prevention through online interventions. The objective of this study is to conduct a systematic review and meta-analysis of randomised controlled trials assessing the effectiveness of online interventions in preventing depression in heterogeneous populations.Methods and analysisWe will conduct a systematic review and meta-analysis of randomised controlled trials that will be identified through searches of PubMed, PsycINFO, WOS, Scopus, OpenGrey, Cochrane Central Register of Controlled Trials, ClinicalTrials. gov and Australia New Zealand Clinical Trials Register . We will also search the reference lists provided in relevant studies and reviews. Experts in the field will be contacted to obtain more references. Two independent reviewers will assess the eligibility criteria of all articles, extract data and determine their risk of bias (Cochrane Collaboration Tool). Baseline depression will be required to have been discarded through standardised interviews or validated self-reports with standard cut-off points. The outcomes will be the incidence of new cases of depression and/or the reduction of depressive symptoms as measured by validated instruments. Pooled standardised mean differences will be calculated using random-effect models. Heterogeneity and publication bias will be estimated. Predefined sensitivity and subgroup analyses will be performed. If heterogeneity is relevant, random-effect meta-regression will be performed.

Background:Health promotion is a key process of current health systems. Primary Health Care (PHC) is the idealsetting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority ofthe adult population engages two or more risk behaviours, that is why a multiple intervention might be moreeffective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness andan implementation strategy of a complex multiple risk intervention to promote healthy behaviours in peoplebetween 45 to 75 years attended in PHC.Methods:This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing acomplex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. Thestudy focuses on people between 45 and 75 years who carry out two or more of the following unhealthybehaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level.The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in theroutine care of PHC practices according to the conceptual framework of the“5A’s”. It will have a maximum durationof 12 months and it will be carried out to three different levels (individual, group and community). Incremental costper quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. Theimplementation strategy is based on the“Consolidated Framework for Implementation Research”, a set of discreteimplementation strategies and an evaluation framework. Discussion:EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple riskintervention and will provide a better understanding of implementation processes of health promotioninterventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriersthat affect implementation of t

Objetivo: Este estudio pretende identificar y analizar los instrumentos de evaluación de los eventos vitales estresantes creados/adaptados para su uso con población española adulta, publicados en la literatura nacional e internacional, con especial atención en sus propiedades psicométricas y en su asociación con medidas de problemas de salud. Métodos: Se llevó a cabo una revisión sistemática de la literatura de todos los instrumentos publicados a través de los buscadores MEDLINE; ProQuest Health y Medical Complete ProQuest Psychology Journals PsycARTI-CLES PsycINFO Psicodoc OpenSIGLE desde la fecha de inicio hasta el 31 de enero de 1026. Dos investigadores independientes evaluaron la elegibilidad de todos los artículos, extrajeron los datos y evaluaron sus propiedades psicométricas. Resultados: Se seleccionaron 12 instrumentos que cumplían los criterios de inclusión en el estudio. Las medidas presentaron una gran heterogeneidad. La mayoría no incluían información sobre sus propiedades psicométricas o necesitaban aportar más datos, ya que eran pocas los que evaluaban su estabilidad test-retest y/o su estructura interna. Los cuestionarios creados o adaptados por González de Rivera y Morena(1983), Sandín y Chorot (1987), Fernández y Mielgo (1992), Gracia y Herrero (2004) y Motrico et al. (2013) mostraron asociaciones significativas con variables de problemas de salud. Discusión: Se requieren más estudios sobre la asociación de los instrumentos con variables de problemas de salud mental y física, lo que facilitaría su aplicación clínica. Estos resultados tienen una gran utilidad a la hora de seleccionar un instrumento de evaluación de eventos vitales estresantes en el ámbito clínico y de investigación en España, Objective: The aim of this research is to identify and analyze the measures for the assessment of stressful life events created/adapted for its use in Spanish adult population, published in national and international literature, with a focus on psychometric properties and its association with health measures. Methods: A systematic review was carried out to identify all instruments identified through searches of MEDLINE; ProQuest Health and Medical Complete; ProQuest Psychology Journals; PsycAR-TICLES; PsycINFO; Psicodoc; OpenSIGLE from inception until 31 January 2016. Two independent researchers assessed the eligibility criteria of all articles, subtracted data and assessed its psychometric properties. Results: Twelve measures, which satisfied the inclusion criteria, were selected. The measures showed a large heterogeneity. Most of them did not include any information on its psychometric properties or needed to provide fur-ther data, since a few of them assessed its test-retest stability and/or internal structure. The questionnaires created or adapted by González de Rivera y Morena (1983), Sandín y Chorot (1987), Fernández y Mielgo (1992), Gracia y Herrero (2004), and Motrico et al. (2013) showed significant associations with health variables. Discussion: Further research is needed to clarify the association of these instruments with mental and physical health measures, which would facilitate its clinical application. These results are very useful in order to select a measure for the assessment of stressful life events in clinical practice and research in Spain.

Background: The predictD study developed and validated a risk algorithm for predicting the onset of major depression in primary care. We aimed to explore the opinion of patients about knowing their risk for depression and the values and criteria upon which these opinions are based. Methods: A maximum variation sample of patients was taken, stratified by city, age, gender, immigrant status, socioeconomic status and lifetime depression. The study participants were 52 patients belonging to 13 urban health centres in seven different cities around Spain. Seven Focus Groups (FGs) were given held with primary care patients, one for each of the seven participating cities. Results: The results showed that patients generally welcomed knowing their risk for depression. Furthermore, in light of available evidence several patients proposed potential changes in their lifestyles to prevent depression. Patients generally preferred to ask their General Practitioners (GPs) for advice, though mental health specialists were also mentioned. They suggested that GPs undertake interventions tailored to each patient, from a ‘‘patient-centred’’ approach, with certain communication skills, and giving advice to help patients cope with the knowledge that they are at risk of becoming depressed. Conclusions: Patients are pleased to be informed about their risk for depression. We detected certain beliefs, attitudes, values, expectations and behaviour among the patients that were potentially useful for future primary prevention programmes on depression.