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BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.

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Objectives: To evaluate the structure and operation of national immunization technical advisory groups (NITAGs) in Latin America and the Caribbean and to make recommendations for improvement. Methods: A convenience sample of six current and eight former NITAG members representing 12 countries in the region were invited in 2022 to answer a web-based questionnaire on NITAG structure, organization, and procedures. The questionnaire used indicators similar to those in the Joint Reporting Form on Immunization. Participants were also asked about the role their NITAGs played in coronavirus disease 2019 (COVID-19) immunization policies. Results: Brazil, Dominican Republic, and Venezuela (Bolivarian Republic of) reported not having an active NITAG. The nine active NITAGs are structured and organized according to World Health Organization and Pan American Health Organization recommendations, with variations between countries. Most NITAGs include representatives of the five recommended medical specialties with the participation of additional members possible. Only Bolivia (Plurinational State of) and Mexico have no explicit policy for managing members' potential conflicts of interest. All NITAGs have an exclusively technical advisory role and generally meet once a quarter. Usually, NITAGs are asked by health ministries to analyze issues and make recommendations. All NITAGs, except for Peru's, actively participated in supporting decision-making for immunization policy on COVID-19. Conclusions: NITAGs have successfully supported vaccine policy-making through evidence-based recommendations. However, improvement in their structure, operation, and transparency is needed to help them keep up with the rapidly evolving field of immunization. Research on the impact of NITAGs is important to support the development of recommendations for improvement.

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Introducción: Colombia es uno de los países con mayor número de casos de COVID-19 en América Latina y el Caribe. Los gobiernos no pueden trabajar solos en una crisis de gran intensidad, por lo que las alianzas y la colaboración Gobierno-academia toman un valor preponderante. Objetivo: Sistematizar la experiencia del trabajo colaborativo que se realizó entre actores académicos de la región y las autoridades de salud del departamento de Santander, Colombia, en el marco de la emergencia sanitaria por COVID-19 durante 2020-2021. Metodología: A partir de la sistematización de experiencias y desde el enfoque crítico social se realizó un abordaje cualitativo con ocho actores clave del sector académico y de la autoridad en salud que participaron activamente en la alianza. Se hizo una revisión documental y se realizaron entrevistas semiestructuradas. Resultados: Una vez declarada la emergencia sanitaria, de manera rápida se conformaron dos grupos de trabajo colaborativo, uno entre academia y actores gubernamentales del municipio de Bucaramanga y otro entre academia y actores gubernamentales departamentales; ambos grupos se conformaron de manera voluntaria, pero se diferenciaron en su forma de organización. El trabajo colaborativo y voluntario brindó apoyo a las autoridades en salud, principalmente en la fase de preparación para afrontar la pandemia, traducción y difusión del conocimiento, vigilancia epidemiológica y actividades de fortalecimiento de la capacidad de respuesta. Conclusiones: El apoyo brindado por el equipo colaborativo fue muy proliferativo en actividades e intervenciones, no obstante, se presentaron dificultades y una de ellas fue que un número importante de sus recomendaciones no fueron atendidas por las autoridades sanitarias. Las dificultades presentadas no son diferentes a las ya reportadas en otras emergencias de salud pública, por lo que se requiere continuar fortaleciendo las relaciones Gobierno-academia para que se pueda trazar de manera proactiva una agenda que contribuya a superar las limitaciones que se reportan en este trabajo.

Introduction: Colombia is one of the countries with the highest number of COVID-19 cases in Latin America and the Caribbean. In a health crisis of high intensity, governments cannot work alone, so alliances and collaboration between Government and academia take on a preponderant value. Objective: Systematize the experience of the collaborative work carried out between academic actors in the region and the health authorities from the Department of Santander, Colombia in the framework of the health emergency due to COVID-19 during 2020-2021. Methods: Based on the systematization of experiences and from the critical social approach, a qualitative approach was carried out with eight key actors from the academic sector and the health authority that actively participated in the alliance. Documentary review and semi-structured interviews were conducted. Results: Once the health emergency was declared, two collaborative working groups were quickly formed, one between academia and government actors of the municipality of Bucaramanga and another between academia and departmental government actors; both groups were formed voluntarily but differed in their form of organization. The collaborative and voluntary work provided support to health authorities mainly in the preparation phase to face the pandemic, knowledge translation and dissemination, epidemiological surveillance, and response capacity-building activities. Conclusions: The support provided by the collaborative team was very proliferative in activities and interventions; however, difficulties occurred and one of them was that a significant number of their recommendations were not addressed by the health authorities. The difficulties presented are not different from those already reported in other public health emergencies, so it is necessary to continue strengthening the relations between Government-Academia, so that they can proactively draw up an agenda that contributes to overcoming the limitations that are reported in this work.

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In their study of sustaining knowledge translation (KT) practices, Borst et al found that this process is an interplay of: (i) constructing and extending networks, (ii) creating contexts that support KT practices, and (iii) understanding how actors create, maintain, and disrupt institutions. Their article is an important contribution to the body of research promoting KT. In this commentary we reflect on the convergences and differences between the concepts of 'sustaining' and 'institutionalizing' KT, highlighting domains and processes related to the institutionalization, providing an analysis of KT landscape in Brazil and making a case for the need to increase countries' routine use of evidence.

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Objective: To identify strategies to increase adherence to systemic arterial hypertension (SAH) treatment and describe the barriers and facilitators for implementing these strategies in primary health care (PHC). Method: A rapid evidence review was performed. We included systematic reviews with or without meta-analyses, published in English, Spanish or Portuguese, covering adults (age 18 to ≤ 60 years) with SAH followed in the PHC. Searches were performed in nine databases in December 2020 and updated in April 2022. The systematic reviews were assessed for methodological quality using the AMSTAR 2 tool. Results: Fourteen systematic reviews on treatment adherence strategies and three on barriers and facilitators for implementation were included. Regarding methodological quality, one systematic review was classified as moderate, four as low, and the others as critically low. Four strategies were identified as options for health policies: actions performed by pharmacists; actions performed by non-pharmaceutical health professionals; self-monitoring, use of mobile apps, and text messages; and subsidies for the purchase of medicines. Low digital literacy, limited access to the internet, work process and incipient training were barriers for professionals. The users' educational and health literacy levels, accessibility to health services and good relationships with professionals were facilitators. Conclusions: Positive effects of strategies related to pharmaceutical care, self-monitoring, and the use of cell phone applications and text messages were identified to increase adherence to the treatment of SAH in the context of PHC. However, for implementation purposes, it is necessary to consider barriers and facilitators, in addition to the methodological limitations of the analyzed systematic reviews.

Objetivo: Buscar estrategias para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica y describir las barreras y los elementos facilitadores para la implementación de esas estrategias en el ámbito de la atención primaria de salud. Métodos: Se realizó una revisión rápida de la evidencia. Se incluyeron revisiones sistemáticas, con o sin metaanálisis, publicadas en español, inglés o portugués, en las cuales se evaluaban a personas adultas (de 18 a ≤ 60 años) con hipertensión arterial sistémica observadas en el ámbito de la atención primaria de salud. Las búsquedas se realizaron en nueve bases de datos en diciembre del 2020 y se actualizaron en abril del 2022. Se evaluó la calidad metodológica de las revisiones sistemáticas incluidas con la herramienta AMSTAR 2. Resultados: Se incluyeron 14 revisiones sistemáticas sobre estrategias de adhesión al tratamiento y tres sobre obstáculos y elementos facilitadores para la implementación. La calidad metodológica fue moderada en una revisión sistemática, baja en cuatro y críticamente baja en las demás. Se identificaron cuatro estrategias como opciones para las políticas de salud: medidas tomadas por farmacéuticos; medidas tomadas por profesionales no farmacéuticos; autocontrol, uso de aplicaciones para teléfonos celulares y mensajes de texto; y oferta de subvenciones para la compra de medicamentos. La escasa alfabetización digital, el acceso limitado a internet y los procesos de trabajo y formación incipiente fueron obstáculos para los profesionales. Los elementos facilitadores fueron el nivel de educación y de conocimientos de los usuarios en materia de salud, la accesibilidad a los servicios de salud y las buenas relaciones con los profesionales. Conclusiones: Se observaron efectos positivos de las estrategias relacionadas con la atención farmacéutica, el autocontrol y el uso de aplicaciones de telefonía celular y mensajería de texto para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica en el ámbito de la atención primaria de salud. Sin embargo, para fines de implementación, es necesario considerar los obstáculos y los elementos facilitadores, además de las limitaciones metodológicas de las revisiones sistemáticas analizadas.

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BACKGROUND: Evidence-informed policy-making (EIPM) requires a set of individual and organizational capacities, linked with background factors and needs. The identification of essential knowledge, skills and attitudes for EIPM can support the development of competency profiles and their application in different contexts. PURPOSE: To identify elements of competency (knowledge, skills and attitudes) for EIPM, according to different professional profiles (researcher, health professional, decision-maker and citizen). METHODS: Rapid umbrella review. A structured search was conducted and later updated in two comprehensive repositories (BVSalud and PubMed). Review studies with distinctive designs were included, published from 2010 onwards, without language restrictions. Assessment of the methodological quality of the studies was not performed. A meta-aggregative narrative synthesis was used to report the findings. RESULTS: Ten reviews were included. A total of 37 elements of competency were identified, eight were categorized as knowledge, 19 as skills and 10 as attitudes. These elements were aggregated into four competency profiles: researcher, health professional, decision-maker and citizen. The competency profiles included different sets of EIPM-related knowledge, skills and attitudes. STRENGTHS AND LIMITATIONS: This study is innovative because it aggregates different profiles of competency from a practical perspective, favouring the application of its results in different contexts to support EIPM. Methodological limitations are related to the shortcuts adopted in this review: complementary searches of the grey literature were not performed, and the study selection and data extraction were not conducted in duplicate. FINAL CONSIDERATIONS: CONCLUSIONS AND IMPLICATIONS OF THE FINDINGS: EIPM requires the development of individual and organizational capacities. This rapid review contributes to the discussion on the institutionalization of EIPM in health systems. The competency profiles presented here can support discussions about the availability of capacity and the need for its development in different contexts.

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Objective: To assess the legislative frameworks concerning childhood vaccination in the English- and Dutch-speaking Caribbean and propose a model legislative framework for Caribbean countries. Methods: This study included a survey of 22 countries and territories in the Caribbean regarding legal vaccination mandates for school entry, budget allocations, sanctions, or exemptions. A legal consultant conducted a comprehensive search and analysis of legislation regarding vaccination among 13 Caribbean countries/territories. A comparative analysis of the legislation under five themes-legislative structure, mandatory vaccination, national immunization schedule, sanctions, and exemptions-formed the basis for the proposed model legislation. Results: Among the 22 Caribbean countries/territories, 17 (77%) had legislation mandating vaccination, 16 (94%) mandated vaccination for school entry, 8 (47%) had a dedicated budget for immunization programs, and 13 (76%) had no legislated national schedules. The source of legislation includes six (35%) using the Education Act, eight (47%) the Public Health Act, and five (29%) a free-standing Vaccination Act. Three countries/territories-Jamaica, Montserrat, and Saint Lucia-had immunization regulations. In 12 (71%) of the 17 countries with legislation, sanctions were included, and 10 (59%) permitted exemptions for medical or religious/philosophical beliefs. Conclusions: Several countries in the Caribbean have made failure to vaccinate a child an offense. By summarizing the existing legislative frameworks and approaches to immunization in the Caribbean, the analysis guides policymakers in making effective changes to immunization legislation in their own countries.

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Resumo A fim de identificar e discutir opções informadas por evidências para abordar a judicialização da saúde no Brasil, utilizou-se as Ferramentas SUPPORT (Supporting Policy Relevant Reviews and Trials). A busca foi realizada nas bases PubMed; Health Systems Evidence; Campbell Collaboration; Cochrane Library; Rx for Change Database e PDQ-Evidence. A seleção e avaliação da qualidade metodológica foi feita por dois revisores independentes. Os resultados foram apresentados numa síntese narrativa. Dezenove revisões sistemáticas apontam quatro opções: 1) Serviço de respostas rápidas; 2) Programa de educação permanente; 3) Serviço de mediação entre as partes envolvidas; e 4) Adoção de ferramenta online (baseada em computador) de suporte à decisão e de intervenções mediadas por pacientes. Conclusões: Apresentamos e caracterizamos quatro opções que podem ser consideradas para abordar a judicialização da saúde. A implementação dessas opções deve garantir a participação de diferentes atores, refletindo sobre variados contextos. Recursos humanos e financeiros, capacitação das equipes, são os principais pontos críticos.

Abstract This article seeks to identify and discuss evidence-informed options to address the judicialization of health. The Supporting Policy Relevant Reviews and Trials Tools were used to define the problem and the search strategy, which was carried out in the following databases: PubMed, Health Systems Evidence, Campbell, Cochrane Collaboration, Rx for Change Database, and PDQ-Evidence. Selection and assessment of methodological quality was performed by two independent reviewers. The results were presented in a narrative synthesis. This study selected 19 systematic reviews that pointed out four strategies to address the judicialization of health in Brazil: 1) Rapid response service, 2) Continuous education program, 3) Mediation service between the parties involved, and 4) Adoption of a computer-based, online decision-making support tool and patient-mediated interventions. This study therefore presented and characterized four options that can be considered to address the judicialization of health. The implementation of these options must ensure the participation of different actors, reflecting on different contexts and the impact on the health system. The availability of human and financial resources and the training of teams are critical points for the successful implementation of the options.

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ABSTRACT Objective. To assess the legislative frameworks concerning childhood vaccination in the English- and Dutch-speaking Caribbean and propose a model legislative framework for Caribbean countries. Methods. This study included a survey of 22 countries and territories in the Caribbean regarding legal vaccination mandates for school entry, budget allocations, sanctions, or exemptions. A legal consultant conducted a comprehensive search and analysis of legislation regarding vaccination among 13 Caribbean countries/territories. A comparative analysis of the legislation under five themes—legislative structure, mandatory vaccination, national immunization schedule, sanctions, and exemptions—formed the basis for the proposed model legislation. Results. Among the 22 Caribbean countries/territories, 17 (77%) had legislation mandating vaccination, 16 (94%) mandated vaccination for school entry, 8 (47%) had a dedicated budget for immunization programs, and 13 (76%) had no legislated national schedules. The source of legislation includes six (35%) using the Education Act, eight (47%) the Public Health Act, and five (29%) a free-standing Vaccination Act. Three countries/territories—Jamaica, Montserrat, and Saint Lucia—had immunization regulations. In 12 (71%) of the 17 countries with legislation, sanctions were included, and 10 (59%) permitted exemptions for medical or religious/philosophical beliefs. Conclusions. Several countries in the Caribbean have made failure to vaccinate a child an offense. By summarizing the existing legislative frameworks and approaches to immunization in the Caribbean, the analysis guides policymakers in making effective changes to immunization legislation in their own countries.

RESUMEN Objetivo. Evaluar los marcos legislativos relativos a la vacunación infantil en el Caribe de habla inglesa y neerlandesa y proponer un modelo de marco legislativo para los países del Caribe. Métodos. En este estudio se incluyó una encuesta en 22 países y territorios del Caribe sobre los requisitos legales de vacunación para el ingreso escolar, asignaciones presupuestarias, sanciones o exenciones. Un consultor jurídico realizó una búsqueda y un análisis exhaustivos de la legislación relativa a la vacunación en 13 países y territorios del Caribe. Un análisis comparativo de la legislación dividido en cinco temas (estructura legislativa, vacunación obligatoria, calendario nacional de vacunación, sanciones y exenciones) formó la base del modelo de legislación propuesto. Resultados. Entre los 22 países y territorios del Caribe, 17 (77%) contaban con leyes sobre vacunación obligatoria, 16 (94%) exigían la vacunación para el ingreso escolar, 8 (47%) tenían un presupuesto dedicado a los programas de vacunación y 13 (76%) no disponían de calendarios nacionales estipulados por ley. Entre las fuentes de la legislación, seis países y territorios (35%) empleaban la ley de educación, ocho (47%) la ley de salud pública y cinco (29%) una ley independiente de vacunación. Tres países y territorios —Jamaica, Montserrat y Santa Lucía— disponían de regulaciones sobre vacunación. Doce (71%) de los 17 países con legislación tenían sanciones y 10 (59%) permitían exenciones por creencias médicas o religiosas o filosóficas. Conclusiones. Varios países del Caribe han tipificado como delito el no vacunar a un niño o niña. Al resumir los enfoques y marcos legislativos existentes para la vacunación en el Caribe, este análisis ofrece orientaciones a los responsables de formular las políticas para que realicen modificaciones efectivas en la legislación relativa a la vacunación en sus propios países.

RESUMO Objetivo. Avaliar as estruturas da legislação relativas à vacinação em crianças no Caribe de língua inglesa e holandesa e propor um modelo de legislação para os países caribenhos. Métodos. Este estudo incluiu uma pesquisa relativa à exigência legal em 22 países e territórios do Caribe de vacinação para admissão em escolas, alocações orçamentárias, sanções ou isenções. Um consultor jurídico realizou ampla pesquisa e análise da legislação relativa à vacinação em 13 países/territórios do Caribe. Uma análise comparativa da legislação referente a cinco temas - estrutura legislativa, vacinação obrigatória, cronograma nacional de imunização, sanções e isenções - formou a base para o modelo de legislação proposto. Resultados. Entre os 22 países/territórios caribenhos, 17 (77%) tinham legislação que exigia a vacinação; em 16 (94%), a vacinação era obrigatória para admissão na escola; 8 (47%) tinham orçamento exclusivo para programas de imunização; e em 13 (76%), a legislação não contemplava cronogramas nacionais. Com relação à fonte da legislação, seis (35%) países usavam a legislação de educação; oito, (47%) a Legislação de Saúde Pública; e cinco (29%), legislação de vacinação independente. Três países/territórios - Jamaica, Montserrat e Santa Lúcia - tinham regulamentações para imunização. Dos 17 países com legislação, 12 (71%) incluíam sanções e 10 (59%) permitiam isenções por crenças médicas ou religiosas/filosóficas. Conclusões. Diversos países do Caribe estabelecem que não vacinar uma criança é violação da lei. Ao resumir as estruturas de legislação existentes e as abordagens da imunização no Caribe, a análise orienta os formuladores de políticas a realizar mudanças efetivas na legislação de imunização em seus próprios países.

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RESUMO Objetivo. Identificar estratégias para aumentar a adesão ao tratamento de hipertensão arterial sistêmica (HAS) e descrever as barreiras e os facilitadores para implementação dessas estratégias na atenção primária à saúde (APS). Métodos. Foi realizada uma revisão rápida de evidências. Foram incluídas revisões sistemáticas, com ou sem metanálises, publicadas em inglês, espanhol ou português, que avaliaram adultos (18 a ≤ 60 anos) com HAS acompanhados na APS. As buscas foram realizadas em nove bases de dados em dezembro de 2020 e atualizadas em abril de 2022. As revisões sistemáticas incluídas foram avaliadas quanto à qualidade metodológica por meio da ferramenta AMSTAR 2. Resultados. Foram incluídas 14 revisões sistemáticas sobre estratégias de adesão ao tratamento e três sobre barreiras e facilitadores para implementação. A qualidade metodológica foi moderada em uma revisão sistemática, baixa em quatro e criticamente baixa nas demais. Quatro estratégias foram identificadas como opções para políticas de saúde: ações realizadas por farmacêuticos; ações realizadas por profissionais não farmacêuticos; automonitoramento, uso de aplicativos de celular e mensagens de texto; e oferta de subsídios para aquisição de medicamentos. O baixo letramento digital, o acesso limitado à internet, processos de trabalho e formação incipiente foram barreiras para os profissionais. Foram facilitadores o nível educacional e de letramento em saúde dos usuários, a acessibilidade aos serviços de saúde e o bom relacionamento com os profissionais. Conclusões. Identificaram-se efeitos positivos de estratégias relacionadas à atenção farmacêutica, automonitoramento e uso de aplicativos de celular e mensagem de texto para aumentar a adesão ao tratamento da HAS no âmbito da APS. Porém, para fins de implementação, é preciso considerar barreiras e facilitadores, além das limitações metodológicas das revisões sistemáticas analisadas.

ABSTRACT Objective. To identify strategies to increase adherence to systemic arterial hypertension (SAH) treatment and describe the barriers and facilitators for implementing these strategies in primary health care (PHC). Method. A rapid evidence review was performed. We included systematic reviews with or without meta-analyses, published in English, Spanish or Portuguese, covering adults (age 18 to ≤ 60 years) with SAH followed in the PHC. Searches were performed in nine databases in December 2020 and updated in April 2022. The systematic reviews were assessed for methodological quality using the AMSTAR 2 tool. Results. Fourteen systematic reviews on treatment adherence strategies and three on barriers and facilitators for implementation were included. Regarding methodological quality, one systematic review was classified as moderate, four as low, and the others as critically low. Four strategies were identified as options for health policies: actions performed by pharmacists; actions performed by non-pharmaceutical health professionals; self-monitoring, use of mobile apps, and text messages; and subsidies for the purchase of medicines. Low digital literacy, limited access to the internet, work process and incipient training were barriers for professionals. The users' educational and health literacy levels, accessibility to health services and good relationships with professionals were facilitators. Conclusions. Positive effects of strategies related to pharmaceutical care, self-monitoring, and the use of cell phone applications and text messages were identified to increase adherence to the treatment of SAH in the context of PHC. However, for implementation purposes, it is necessary to consider barriers and facilitators, in addition to the methodological limitations of the analyzed systematic reviews.

RESUMEN Objetivo. Buscar estrategias para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica y describir las barreras y los elementos facilitadores para la implementación de esas estrategias en el ámbito de la atención primaria de salud. Métodos. Se realizó una revisión rápida de la evidencia. Se incluyeron revisiones sistemáticas, con o sin metaanálisis, publicadas en español, inglés o portugués, en las cuales se evaluaban a personas adultas (de 18 a ≤ 60 años) con hipertensión arterial sistémica observadas en el ámbito de la atención primaria de salud. Las búsquedas se realizaron en nueve bases de datos en diciembre del 2020 y se actualizaron en abril del 2022. Se evaluó la calidad metodológica de las revisiones sistemáticas incluidas con la herramienta AMSTAR 2. Resultados. Se incluyeron 14 revisiones sistemáticas sobre estrategias de adhesión al tratamiento y tres sobre obstáculos y elementos facilitadores para la implementación. La calidad metodológica fue moderada en una revisión sistemática, baja en cuatro y críticamente baja en las demás. Se identificaron cuatro estrategias como opciones para las políticas de salud: medidas tomadas por farmacéuticos; medidas tomadas por profesionales no farmacéuticos; autocontrol, uso de aplicaciones para teléfonos celulares y mensajes de texto; y oferta de subvenciones para la compra de medicamentos. La escasa alfabetización digital, el acceso limitado a internet y los procesos de trabajo y formación incipiente fueron obstáculos para los profesionales. Los elementos facilitadores fueron el nivel de educación y de conocimientos de los usuarios en materia de salud, la accesibilidad a los servicios de salud y las buenas relaciones con los profesionales. Conclusiones. Se observaron efectos positivos de las estrategias relacionadas con la atención farmacéutica, el autocontrol y el uso de aplicaciones de telefonía celular y mensajería de texto para aumentar la adhesión al tratamiento de la hipertensión arterial sistémica en el ámbito de la atención primaria de salud. Sin embargo, para fines de implementación, es necesario considerar los obstáculos y los elementos facilitadores, además de las limitaciones metodológicas de las revisiones sistemáticas analizadas.

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Resumo A Tradução do Conhecimento (TC) disponibiliza tecnologias que podem ser empregadas na operacionalização da integração entre universidade e sociedade, para a formulação de políticas informadas por evidências, em resposta a necessidades em saúde. A partir da formação de um grupo de trabalho - uma das tecnologias de TC disponíveis - e para compreender as necessidades em saúde dos trabalhadores inseridos na Atenção Básica (AB), este estudo objetivou relatar a experiência de problematização e instrumentalização realizada com pesquisadores, gestores e trabalhadores da AB no município de São Paulo. O referencial do Materialismo Histórico e Dialético conduziu o processo de realização de oficinas emancipatórias com os participantes. Dessa forma, foram levantados problemas enfrentados pelos trabalhadores, e realizados workshops e seminários de instrumentalização, de acordo com as necessidades do grupo de participantes. No processo de compreensão das necessidades em saúde dos trabalhadores da AB, os participantes relacionaram as formas de organização do trabalho aos desgastes dos trabalhadores, o que foi enfatizado pelo grupo. A formação do grupo foi estratégica para alcançar o objetivo, bem como direcionar a pesquisa sobre as respostas às necessidades em saúde dos trabalhadores na área, etapa seguinte da TC.

Abstract Knowledge Translation (KT) provides technologies that can be used to operationalize the collaboration between university and society for evidence-informed policy-making in response to health needs. Based on the formation of a working group (one of the available KT technologies) and to understand the health needs of Primary Health Care (PHC) workers in the city of São Paulo, this study aimed to report the experience of problematization and instrumentalization carried out with researchers, managers and PHC workers of the city of São Paulo. The Historical and Dialectical Materialism oriented the process of emancipatory workshops with the participants. The problems faced by the workers were raised and workshops and seminars were held to provide knowledge according to the needs of the group of participants. In the process of understanding the health needs of PHC workers the participants related the forms of work organization to the workers' wear out, which was emphasized by the group. The formation of the group was strategic to reach the objective and also to direct the research on the answers to the health needs of workers in the area, the next stage of the KT.

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Resumo Introdução: Alimentação e estado nutricional inadequados são importantes fatores de risco para doenças crônicas não transmissíveis (DCNT). No Brasil, a cidade do Rio de Janeiro (RJ) tem se destacado pela elevada prevalência de obesidade. Objetivo: Avaliar a evolução temporal de indicadores de consumo alimentar e de estado nutricional, relacionados às DCNT, em adultos da cidade do Rio de Janeiro e das demais capitais brasileiras. Método: Utilizou-se dados do Vigitel de 2006 a 2019. Modelos de regressão de Prais-Winsten foram empregados para avaliar a variação na prevalência dos indicadores de interesse. Esses foram definidos com base nas metas do Plano Nacional de Segurança Alimentar e Nutricional (2016-19) e do Plano de Ações Estratégicas para o Enfrentamento das DCNT no Brasil (2011-22). Resultados: Não houve variação significativa no consumo regular e recomendado de frutas e hortaliças, assim como no consumo regular de doces. O consumo regular de refrigerantes diminuiu no RJ e nas demais capitais no período. A prevalência de excesso de peso e de obesidade aumentou significativamente no RJ e nas demais capitais do país. Conclusões: A evolução dos indicadores revela um cenário desfavorável para a saúde da população e para o alcance das metas dos planos nacionais.

Abstract Background: Inadequate diet and nutritional status are important risk factors for noncommunicable diseases (NCDs). In Brazil, the city of Rio de Janeiro (RJ) has stood out for its high prevalence of obesity. Objective: To evaluate the temporal trend of indicators of food consumption and nutritional status related to NCDs in the adult population of the city of RJ and other Brazilian capitals. Method: Vigitel data between 2006 and 2019 were used. Prais-Winsten regression was used to evaluate the variation in the prevalence of interest indicators. These were defined based on the goals of the National Plan for Food and Nutritional Security (Plano Nacional de Segurança Alimentar e Nutricional - 2016-19) and the Strategic Action Plan to Tackle NCDs in Brazil (Plano de Ações Estratégicas para o Enfrentamento das DCNT no Brasil - 2011-22). Results: Regular and recommended consumption of fruits and vegetables and regular consumption of sweets did not present significant variation, while the regular consumption of soft drinks decreased in RJ and other capitals during the period. The prevalence of excess weight and obesity increased significantly in RJ and in other capitals. Conclusions: The trend of the indicators reveals an unfavorable scenario for the health's population and to achieve the goals proposed in the national plans.

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Objectives: To identify evidence-based strategies to improve adherence to the preventive measures against the coronavirus disease (COVID-19) at the community level. Method: This is an evidence brief for policy, combining research evidence specific to contextual knowledge from stakeholders. A systematic search was performed in 18 electronic databases, gray literature, and a handle search, including only secondary and tertiary studies that focused on the adherence of the general population to COVID-19 preventive measures in the community. Two reviewers, independently, performed the study selection, data extraction, and assessment of the quality of the studies. Relevant evidence has been synthesized to draft evidence-based strategies to improve adherence. These strategies were circulated for external endorsement by stakeholders and final refinement. Endorsement rates >80%, 60-80% and <60% were considered high, moderate, and low respectively. Results: Eleven studies, with varying methodological qualities were included: high (n = 3), moderate (n = 3), low (n = 1), and critically low (n = 4). Three evidence based strategies were identified: i. Risk communication; ii. Health education to the general public, and iii. Financial support and access to essential supplies and services. The rates of endorsement were: 83% for risk communication, 83% for health education, and 92% for financial support and access to essential supplies and services. The evidence showed that an increase in knowledge, transparent communication, and public awareness about the risks of COVID-19 and the benefits of adopting preventive measures results in changes in people's attitudes and behavior, which can increase adherence. In addition, the guarantee of support and assistance provides conditions for people to adopt and sustain such measures. Conclusions: These strategies can guide future actions and the formulation of public policies to improve adherence to preventive measures in the community during the current COVID-19 pandemic and other epidemics.

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Objective: To contextualize a synthesis of evidence on interventions in student mental health during the COVID-19 pandemic through a deliberative dialogue with Ibero-American universities. Methods: An evidence synthesis and synchronous dialogues were previously conducted, consisting of subgroup discussions about the design and implementation of mental health interventions. An analysis of dialogic data was conducted, then organized by topic. Results: Fifty-seven representatives of 17 public and private Ibero-American universities participated in the meeting. In terms of the design of interventions, mental health is perceived as neglected, although its profile was raised by the pandemic. Interventions are guided by detection of needs; scientific evidence is rarely used to design them. Importance was given to forming an interdisciplinary team with continuous training in order to design a specific program that also covers families and teaching/administrative staff. In terms of implementation, problems include saturation of services due to high demand and lack of basic resources among students. Regarding the provision of resources, the influence of the broader context, including the institutional context, is undeniable. The dialogues were perceived as an opportunity to build a new set of interventions. Conclusions: These dialogues enriched the description of interventions already described in the literature on student mental health during the COVID-19 pandemic. However, implementing such interventions in the region means addressing previous neglect and a high level of unmet basic needs.

Objetivo: Contextualizar uma síntese de evidências sobre intervenções em saúde mental de estudantes universitários na pandemia de COVID-19, por meio do diálogo deliberativo com universidades ibero-americanas. Métodos: A partir de uma síntese de evidências previamente elaborada, o diálogo síncrono foi conduzido por meio de discussões em subgrupos sobre o planejamento e a implementação de intervenções em saúde mental. Os dados obtidos foram analisados e resumidos por área temática. Resultados: Cinquenta e sete integrantes de 17 universidades ibero-americanas públicas e privadas participaram do encontro. Os participantes indicaram que a saúde mental é negligenciada no planejamento das intervenções, mas ganhou visibilidade na pandemia. As intervenções são direcionadas às necessidades identificadas e raramente planejadas com base em evidências científicas. Disseram considerar importante formar uma equipe interdisciplinar com capacitação contínua para planejar um programa específico que englobe também familiares e o corpo docente e administrativo. Implementar intervenções é complicado porque os serviços estão sobrecarregados devido à grande demanda e à falta de recursos básicos para os estudantes. O contexto macro e institucional claramente influencia a disponibilização de recursos. O diálogo foi visto como uma oportunidade para consolidar um novo conjunto de intervenções. Conclusões: O presente diálogo contribuiu para enriquecer a literatura de intervenções de saúde mental para estudantes universitários na pandemia de COVID-19. Implementar intervenções no nosso contexto requer sanar as falhas por negligência passada e as enormes necessidades básicas não atendidas.

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Resumo A resistência aos antimicrobianos é um problema mundial que põe em risco a segurança da saúde da população. O objetivo deste artigo é identificar e avaliar estratégias para prevenção e controle de resistência microbiana, bem como barreiras para sua implementação em serviços de Atenção Primária à Saúde (APS). Realizou-se uma síntese de evidências para políticas. As buscas de evidências foram realizadas entre novembro/dezembro de 2018, em 13 bases de dados. Um diálogo deliberativo foi realizado para validação dos resultados e levantamento de barreiras e facilitadores para implementação das estratégias. As 13 revisões sistemáticas incluídas mostraram que intervenções com foco em educação, uso de sistemas eletrônicos e biomarcadores reduziram o consumo e prescrição de antimicrobianos. É um obstáculo à implementação a expectativa de usuários/cuidadores em receber prescrição de antibióticos, e são facilitadores as ações educativas que envolvem profissionais de saúde. O uso racional de medicamentos se impõe na APS com vistas à prevenção da resistência dos microrganismos aos antibióticos. As intervenções identificadas neste estudo podem ser implementadas isoladamente ou em conjunto, conforme o contexto local.

Abstract Antimicrobial resistance is a global problem that puts the population's health at risk. This paper aims to identify and evaluate strategies for the prevention and control of antimicrobial resistance, and barriers to their implementation in Primary Health Care (PHC) services. We developed an evidence brief for policies. The search for evidence occurred in 13 databases from November to December 2018. A deliberative dialogue was performed to validate the results and we identified barriers and facilitators to implementing the strategies. The 13 systematic reviews included evidenced that the interventions focused on education, use of electronic systems and biomarkers reduced antimicrobial consumption and prescription. User/caregiver's expectation to receive antibiotic prescriptions was the main obstacle to implementing strategies, while education actions involving health professionals were facilitators. The rational use of medications in the PHC services is crucial to prevent antimicrobial resistance to antibiotics. The interventions identified in this study can be implemented alone or combined, according to local context.

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Resumo Objetivo validar indicadores para o monitoramento da qualidade da assistência pré-natal. Método estudo metodológico, com 11 especialistas da Linha de Cuidado à Saúde Materna e Infantil do Paraná, realizado em 2020. Os indicadores foram organizados em domínios de um modelo lógico e na tríade estrutura, processo e resultado. Analisado Taxa de Concordância, Razão de Validade de Conteúdo, Índice de Validade de Conteúdo e confiabilidade pelo Alfa de Cronbach. Resultados elaboração de 35 indicadores e, após os procedimentos de validação foram readequados quanto a clareza, dois foram excluídos. Apresentaram confiabilidade excelente para clareza e relevância da estrutura (0,94), do processo (0,98) e do resultado (0,94); bem como, em relação aos domínios do modelo lógico de entradas (0,96), atividades (0,86), saídas (0,98), resultados (0,86) e impacto (0,96). Conclusão os indicadores apresentam validade e confiabilidade para da qualidade do pré-natal, sob a ótica do monitoramento e da qualidade em saúde. Implicações para a Prática o constructo apresenta flexibilidade de aplicação para diversas dimensões territoriais como municípios, regionais de saúde e estado.

Resumen Objetivo validar indicadores para el seguimiento de la calidad de la atención prenatal. Método estudio metodológico, con 11 especialistas de la Línea de Atención Materno infantil de Paraná, indicadores organizados en dominios de un modelo lógico y en la organización de la tríada estructura, proceso y resultado, realizado en 2020. Tasa de Concordancia Calculada, Razón de Validez de Contenido, Índice de Validez de Contenido; y confiabilidad por Alfa de Cronbach. Resultados Se elaboraron 35 indicadores, que luego de reajustar los procedimientos de validación para mayor claridad, se excluyeron dos. Mostró una excelente confiabilidad para la claridad y relevancia de la estructura (0.94), el proceso (0.98) y el resultado (0.94); así como en relación con los dominios del modelo lógico de insumos (0,96), actividades (0,86), productos (0,98), resultados (0,86) e impacto (0,96). Conclusión los indicadores son válidos y confiables para evaluar la calidad de la atención prenatal, reflejando el impacto de esta atención en la gestión de la calidad. Implicaciones para la práctica El constructo presenta flexibilidad de aplicación para varias dimensiones territoriales como municipios, salud regional y estadual.

Abstract Objective to validate indicators for monitoring the quality of prenatal care. Method methodological study conducted in 2020 with 11 specialists of the maternal and child health care line of Paraná. The indicators were organized in domains of a logical model and in the triad structure, process, and result. The calculated agreement rate, content validity ratio, content validity index, and Cronbach's alpha reliability were analyzed. Results 35 indicators were elaborated, which after the validation procedures were readjusted for clarity, two were excluded. It showed excellent reliability for clarity and relevance of the structure (0.94), process (0.98), and result (0.94), as well as in relation to the domains of the logical model of inputs (0.96), activities (0.86), outputs (0.98), results (0.86), and impact (0.96). Conclusion the indicators are valid and reliable for evaluating the quality of prenatal care, reflecting the impact of this care on quality management. Implications for Practice The construct presents flexibility of application for several territorial dimensions such as municipalities, regional health, and state.

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Resumo As taxas mundiais de cirurgia cesariana têm crescido há 30 anos, correspondendo a mais de 56% dos nascimentos no Brasil. Considerando os agravos ocasionados por cesáreas eletivas na saúde materna e infantil, esta revisão buscou apresentar uma estratégia para a redução dessas taxas. Para realizar a síntese das melhores evidências, adotou-se a metodologia SUPPORT. Foram incluídas revisões sistemáticas publicadas em inglês, português ou espanhol sobre intervenções não clínicas. As buscas resultaram em quatro estudos, que em metanálise associaram o apoio contínuo durante o parto à redução de 25% a 51% nas taxas de cesárea. Igualmente, o apoio contínuo reduziu a duração e as intervenções clínicas desnecessárias durante o trabalho de parto e a probabilidade de bebê com baixo escore de Apgar aos cinco minutos. Além disso, proporcionou melhoria na amamentação e na recuperação da mulher, aumento da satisfação com o processo de nascimento e maiores chances de parto vaginal espontâneo. O apoio contínuo foi benéfico para a gestante e o recém-nascido. A intervenção garante respeito, segurança e qualidade durante o parto, bem como reduz custos hospitalares. Portanto, é uma estratégia efetiva que deve ser adotada nos serviços de saúde para ampliar o acesso das mulheres aos seus direitos.

Abstract Cesarean section rates have increased globally in the last 30 years, representing more than 56% of total births in Brazil. Considering the impacts of elective cesarean sections in maternal and child health, this review aimed to present an option to reduce these rates. We used the SUPPORT tools to summarize the best evidence. We included systematic reviews published in English, Portuguese, or Spanish, which focused on non-clinical interventions. Continuous support during labor and birth was described in four systematic reviews as an option to reduce cesarean rates (down to -51%). It also decreased unnecessary clinical interventions during labor, the duration of labor, and the likelihood of delivering a baby with a low Apgar score at five minutes. Moreover, continuous support improved breastfeeding, postpartum recovery of women during the puerperium period, and increased women's satisfaction with the birth experience and the possibility of spontaneous vaginal deliveries. The continuous support was beneficial for women and newborns. The intervention fosters respect, safety, and quality during birth, besides reducing hospital costs. Therefore, it is an effective strategy that should be adopted in hospitals and other health services to improve women's access to their rights.

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RESUMEN Objetivo. Contextualizar una síntesis de evidencia sobre intervenciones en salud mental estudiantil durante la pandemia de la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) por medio de un diálogo deliberativo con universidades iberoamericanas. Métodos. Se realizó previamente una síntesis de evidencia y un diálogo sincrónico, que consistió en la discusión en subgrupos acerca del diseño y aplicación de las intervenciones en salud mental. Se realizó un análisis de datos dialógicos y se sintetizó por temas. Resultados. Cincuenta y siete miembros de 17 universidades iberoamericanas públicas y privadas participaron en el encuentro. En el diseño de las intervenciones, se percibe la salud mental como desatendida, y visibilizada con la pandemia. La detección de necesidades es la que orienta las intervenciones y rara vez se utiliza evidencia científica para diseñarlas. Se considera importante conformar un equipo interdisciplinario con capacitación continua para diseñar un programa específico, que cubra también familias y personal docente y administrativo. En la aplicación, existen problemas como la saturación de los servicios por la alta demanda y la falta de recursos básicos de los estudiantes. Es innegable la influencia del contexto macro e institucional por la disposición de recursos. El diálogo fue percibido como oportunidad para construir un consolidado nuevo de intervenciones. Conclusiones. Este diálogo permitió enriquecer la descripción de intervenciones en salud mental estudiantil durante la pandemia de COVID-19 ya descritas en la literatura, aunque llevarlas a la práctica en nuestro contexto supone hacer frente a la deuda por la desatención previa y las altas necesidades básicas insatisfechas.

ABSTRACT Objective. To contextualize a synthesis of evidence on interventions in student mental health during the COVID-19 pandemic through a deliberative dialogue with Ibero-American universities. Methods. An evidence synthesis and synchronous dialogues were previously conducted, consisting of subgroup discussions about the design and implementation of mental health interventions. An analysis of dialogic data was conducted, then organized by topic. Results. Fifty-seven representatives of 17 public and private Ibero-American universities participated in the meeting. In terms of the design of interventions, mental health is perceived as neglected, although its profile was raised by the pandemic. Interventions are guided by detection of needs; scientific evidence is rarely used to design them. Importance was given to forming an interdisciplinary team with continuous training in order to design a specific program that also covers families and teaching/administrative staff. In terms of implementation, problems include saturation of services due to high demand and lack of basic resources among students. Regarding the provision of resources, the influence of the broader context, including the institutional context, is undeniable. The dialogues were perceived as an opportunity to build a new set of interventions. Conclusions. These dialogues enriched the description of interventions already described in the literature on student mental health during the COVID-19 pandemic. However, implementing such interventions in the region means addressing previous neglect and a high level of unmet basic needs.

RESUMO Objetivo. Contextualizar uma síntese de evidências sobre intervenções em saúde mental de estudantes universitários na pandemia de COVID-19, por meio do diálogo deliberativo com universidades ibero-americanas. Métodos. A partir de uma síntese de evidências previamente elaborada, o diálogo síncrono foi conduzido por meio de discussões em subgrupos sobre o planejamento e a implementação de intervenções em saúde mental. Os dados obtidos foram analisados e resumidos por área temática. Resultados. Cinquenta e sete integrantes de 17 universidades ibero-americanas públicas e privadas participaram do encontro. Os participantes indicaram que a saúde mental é negligenciada no planejamento das intervenções, mas ganhou visibilidade na pandemia. As intervenções são direcionadas às necessidades identificadas e raramente planejadas com base em evidências científicas. Disseram considerar importante formar uma equipe interdisciplinar com capacitação contínua para planejar um programa específico que englobe também familiares e o corpo docente e administrativo. Implementar intervenções é complicado porque os serviços estão sobrecarregados devido à grande demanda e à falta de recursos básicos para os estudantes. O contexto macro e institucional claramente influencia a disponibilização de recursos. O diálogo foi visto como uma oportunidade para consolidar um novo conjunto de intervenções. Conclusões. O presente diálogo contribuiu para enriquecer a literatura de intervenções de saúde mental para estudantes universitários na pandemia de COVID-19. Implementar intervenções no nosso contexto requer sanar as falhas por negligência passada e as enormes necessidades básicas não atendidas.

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BACKGROUND: The use of research evidence as an input for health decision-making is a need for most health systems. There are a number of approaches for promoting evidence use at different levels of the health system, but knowledge of their effectiveness is still scarce. The objective of this overview was to evaluate the effectiveness of knowledge communication and dissemination interventions, strategies or approaches targeting policy-makers and health managers. METHODS: This overview of systematic reviews used systematic review methods and was conducted according to a predefined and published protocol. A comprehensive electronic search of 13 databases and a manual search in four websites were conducted. Both published and unpublished reviews in English, Spanish or Portuguese were included. A narrative synthesis was undertaken, and effectiveness statements were developed, informed by the evidence identified. RESULTS: We included 27 systematic reviews. Three studies included only a communication strategy, while eight only included dissemination strategies, and the remaining 16 included both. None of the selected reviews provided "sufficient evidence" for any of the strategies, while four provided some evidence for three communication and four dissemination strategies. Regarding communication strategies, the use of tailored and targeted messages seemed to successfully lead to changes in the decision-making practices of the target audience. Regarding dissemination strategies, interventions that aimed at improving only the reach of evidence did not have an impact on its use in decisions, while interventions aimed at enhancing users' ability to use and apply evidence had a positive effect on decision-making processes. Multifaceted dissemination strategies also demonstrated the potential for changing knowledge about evidence but not its implementation in decision-making. CONCLUSIONS: There is limited evidence regarding the effectiveness of interventions targeting health managers and policy-makers, as well as the mechanisms required for achieving impact. More studies are needed that are informed by theoretical frameworks or specific tools and using robust methods, standardized outcome measures and clear descriptions of the interventions. We found that passive communication increased access to evidence but had no effect on uptake. Some evidence indicated that the use of targeted messages, knowledge-brokering and user training was effective in promoting evidence use by managers and policy-makers.

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Background: The deinstitutionalization process is complex, long-term and many countries fail to achieve progress and consolidation. Informing decision-makers about appropriate strategies and changes in mental health policies can be a key factor for it. This study aimed to develop an evidence brief to summarize the best available evidence to improve care for deinstitutionalized patients with severe mental disorders in the community. Methods: We used the SUPPORT (Supporting Policy Relevant Reviews and Trials) tools to elaborate the evidence brief and to organize a policy dialogue with 24 stakeholders. A systematic search was performed in 10 electronic databases and the methodological quality of systematic reviews (SRs) was assessed by AMSTAR 2. Results: Fifteen SRs were included (comprising 378 studies and 69,736 participants), of varying methodological quality (3 high-quality SRs, 2 moderate-quality SRs, 7 low-quality SRs, 3 critically low SRs). Six strategies were identified: (i). Psychoeducation; (ii). Anti-stigma programs, (iii). Intensive case management; (iv). Community mental health teams; (v). Assisted living; and (vi). Interventions for acute psychiatric episodes. They were associated with improvements on a global status, satisfaction with the service, reduction on relapse, and hospitalization. Challenges to implementation of any of them included: stigma, the shortage of specialized human resources, limited political and budgetary support. Conclusions: These strategies could guide future actions and policymaking to improve mental health outcomes.