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Rodríguez-Barragán M, Fernández-San-Martín MI, Clavería-Fontán A, Aldecoa-Landesa S, Casajuana-Closas M, Llobera J, Oliván-Blázquez B, Peguero-Rodríguez E. Validation and Psychometric Properties of the Spanish Version of the Hopkins Symptom Checklist-25 Scale for Depression Detection in Primary Care. Int J Environ Res Public Health 2021; 18:ijerph18157843. [PMID: 34360136 PMCID: PMC8345472 DOI: 10.3390/ijerph18157843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/18/2021] [Accepted: 07/22/2021] [Indexed: 11/22/2022]
Abstract
Depression constitutes a major public health problem due to its high prevalence and difficulty in diagnosis. The Hopkins Symptom Checklist-25 (HSCL-25) scale has been identified as valid, reproducible, effective, and easy to use in primary care (PC). The purpose of the study was to assess the psychometric properties of the HSCL-25 and validate its Spanish version. A multicenter cross-sectional study was carried out at six PC centers in Spain. Validity and reliability were assessed against the structured Composite International Diagnostic Interview (CIDI). Out of the 790 patients, 769 completed the HSCL-25; 738 answered all the items. Global Cronbach’s alpha was 0.92 (0.88 as calculated for the depression dimension and 0.83 for the anxiety one). Confirmatory factor analysis (CFA) showed one global factor and two correlated factors with a correlation of 0.84. Area under the curve (AUC) was 0.89 (CI 95%, 0.86–0.93%). For a 1.75 cutoff point, sensibility was 88.1% (CI 95%, 77.1–95.1%) and specificity was 76.7% (CI 95%, 73.3–79.8%). The Spanish version of the HSCL-25 has a high response percentage, validity, and reliability and is well-accepted by PC patients.
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Affiliation(s)
- María Rodríguez-Barragán
- Primary Health Centre La Mina, Gerència Territorial de Barcelona, Institut Català de la Salut, 08930 Barcelona, Spain
- Faculty of Medicine, Autonomous University of Barcelona, 08193 Bellaterra, Spain;
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08007 Barcelona, Spain; (M.I.F.-S.-M.); (E.P.-R.)
- Correspondence: ; Tel.: +34-933-811-593
| | - María Isabel Fernández-San-Martín
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08007 Barcelona, Spain; (M.I.F.-S.-M.); (E.P.-R.)
- Gerència Territorial de Barcelona, Institut Català de la Salut, 08007 Barcelona, Spain
| | - Ana Clavería-Fontán
- I-Saúde Group, Galicia Sur Health Research Institute SERGAS-UVIGO, Servicio Galego de Saúde, 36201 Galicia, Spain; (A.C.-F.); (S.A.-L.)
- Primary Care Prevention and Health Promotion Research Network RedIAPP, 28001 Madrid, Spain; (J.L.); (B.O.-B.)
| | - Susana Aldecoa-Landesa
- I-Saúde Group, Galicia Sur Health Research Institute SERGAS-UVIGO, Servicio Galego de Saúde, 36201 Galicia, Spain; (A.C.-F.); (S.A.-L.)
- Primary Health Centre Beiramar, Área de Xestión Integrada de Vigo, SERGAS, 36201 Vigo, Spain
| | - Marc Casajuana-Closas
- Faculty of Medicine, Autonomous University of Barcelona, 08193 Bellaterra, Spain;
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08007 Barcelona, Spain; (M.I.F.-S.-M.); (E.P.-R.)
| | - Joan Llobera
- Primary Care Prevention and Health Promotion Research Network RedIAPP, 28001 Madrid, Spain; (J.L.); (B.O.-B.)
- Institut d’Investigació Sanitària Illes Balears, 07120 Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Service, 07120 Palma, Spain
| | - Bárbara Oliván-Blázquez
- Primary Care Prevention and Health Promotion Research Network RedIAPP, 28001 Madrid, Spain; (J.L.); (B.O.-B.)
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Eva Peguero-Rodríguez
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08007 Barcelona, Spain; (M.I.F.-S.-M.); (E.P.-R.)
- Primary Health Centre El Castell, Institut Català de la Salut, 08860 Barcelona, Spain
- Faculty of Medicine, University of Barcelona, 08007 Barcelona, Spain
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Zabaleta-Del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vicens C, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Correction to: Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:1004. [PMID: 30103723 PMCID: PMC6088411 DOI: 10.1186/s12889-018-5905-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 07/26/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Edurne Zabaleta-Del-Olmo
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain. .,Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007, Barcelona, Spain. .,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. .,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain.
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014, Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.,Faculty of Nursing, Universitat de Girona, Carrer d'Emili Grahit, 77, 17003, Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005, Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022, Barcelona, Spain.,Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/ Padilla 326-332, 08025, Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Alfonso Leiva
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Caterina Vicens
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Clara Vidal
- Gerènciad'AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca, Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023, Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023, Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain.,Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003, Salamanca, Spain.,Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla, 23, Málaga, Spain.,Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla, 23, Málaga, Spain.,El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018, Málaga, Spain.,Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071, Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla, 23, Málaga, Spain.,Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla, 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201, Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201, Vigo, Spain.,Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201, Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009, Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Zabaleta-del-Olmo E, Pombo H, Pons-Vigués M, Casajuana-Closas M, Pujol-Ribera E, López-Jiménez T, Cabezas-Peña C, Martín-Borràs C, Serrano-Blanco A, Rubio-Valera M, Llobera J, Leiva A, Vidal C, Campiñez M, Martín-Álvarez R, Maderuelo JÁ, Recio JI, García-Ortiz L, Motrico E, Bellón JÁ, Moreno-Peral P, Martín-Cantera C, Clavería A, Aldecoa-Landesa S, Magallón-Botaya R, Bolíbar B. Complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in primary health care (EIRA study): study protocol for a hybrid trial. BMC Public Health 2018; 18:874. [PMID: 30005705 PMCID: PMC6045838 DOI: 10.1186/s12889-018-5805-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: 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 the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.
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Affiliation(s)
- Edurne Zabaleta-del-Olmo
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Luis Power Kalea 18, 48014 Bilbao, Spain
| | - Mariona Pons-Vigués
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Marc Casajuana-Closas
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Gerència Territorial de Barcelona, Institut Català de la Salut, c/Balmes 22, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Faculty of Nursing, Universitat de Girona, Carrer d’Emili Grahit, 77, 17003 Girona, Spain
| | - Tomás López-Jiménez
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Carmen Cabezas-Peña
- Deputy Directorate of Health Promotion, Public Health Agency, Department of Health, Goverment of Catalonia, Roc Boronat, 81-95 (Edifici Salvany), 08005 Barcelona, Spain
| | - Carme Martín-Borràs
- Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, C/Císter 34, 08022 Barcelona, Spain
- Faculty of Health Sciences (FCS) Blanquerna, Ramon Llull Univesity, C/Padilla 326-332, 08025 Barcelona, Spain
| | - Antoni Serrano-Blanco
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Rubio-Valera
- Parc SanitariSant Joan de Déu, Institut de Recerca Sant Joan de Déu, C/Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Llobera
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Alfonso Leiva
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Clara Vidal
- Gerènciad’AtencióPrimària de Mallorca, Institut de InvestigacióSanitària de les Illes Balears IdISBa, C/Escola Graduada 3, 07002 Palma, Mallorca Spain
| | - Manuel Campiñez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - Remedios Martín-Álvarez
- Primary Health Centre Vallcarca, Edificio Pedraforca, Av. Vallcarca 169-205, 08023 Barcelona, Spain
| | - José-Ángel Maderuelo
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
| | - José-Ignacio Recio
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Luis García-Ortiz
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Avda. Comuneros 27-31, 37003 Salamanca, Spain
- Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, c/Energía Solar 1, Sevilla, Spain
| | - Juan-Ángel Bellón
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
- El Palo Health Center, Andalusian Health Service (SAS), Av. Salvador Allende 159, 29018 Málaga, Spain
- Department of Public Health and Psychiatry, University of Malaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Patricia Moreno-Peral
- Research Unit, Primary Care District of Málaga-Guadalhorce, c/ Sevilla 23, Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), c/ Sevilla 23, Málaga, Spain
| | - Carlos Martín-Cantera
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Ana Clavería
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Susana Aldecoa-Landesa
- Grupo I-Saúde, Instituto de Investigación Sanitaria Galicia-Sur (IISGS), Xerencia de Xestión Integrada de Vigo, ServizoGalego de Saúde (SERGAS), Universidade de Vigo, Avda Rosalía Castro 21, 36201 Vigo, Spain
- Primary Health Centre Beiramar, Xerencia de Xestión Integrada Vigo, Servizo Galego de Saúde (SERGAS), Avda Rosalía Castro 21, 36201 Vigo, Spain
| | - Rosa Magallón-Botaya
- Instituto de Investigación Sanitaria Aragón, Avda. San Juan Bosco 13, 50009 Zaragoza, Spain
| | - Bonaventura Bolíbar
- Institut Universitarid’Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Gran Via Corts Catalanes 587 àtic, 08007 Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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