Evaluation of the effectiveness of a cardiac rehabilitation program in lifestyle modification and treatment adherence
Authorship
E.F.C.
Master's Degree in Public Health
E.F.C.
Master's Degree in Public Health
Defense date
02.13.2026 09:00
02.13.2026 09:00
Summary
Introduction: Ischemic heart disease represent the primary cause of mortality and disability worldwide. Cardiac rehabilitation programs (CRP) have evolved toward comprehensive, multidisciplinary interventions aimed at optimizing patients' physical, mental, and social health. The Hospital Clínico Universitario de Santiago de Compostela (CHUS) features an advanced CR unit that applies this contemporary approach within its CRP. Objective: To evaluate the effectiveness of the CHUS CRP in terms of lifestyle modification and treatment adherence among its participants. Material and Methods: A single-arm prospective observational study was conducted, including 1,379 patients who participated in the CHUS CRP between 2015 and 2020. The intervention included health education, supervised physical training, pharmacological adjustment, and reinforcement of treatment adherence. Sociodemographic data and the following variables were collected at both the initial visit (IV) and final visit (FV): clinical data, functional capacity (using metabolic equivalents (METs) and predicted maximum oxygen consumption percentage (VO2)), and validated questionnaires to assess changes in diet (Predimed Test), physical activity (IPAQ9 Questionnaire), therapeutic compliance (Morisky-Green Test), quality of life (EuroQol-5D), and anxiety and depression (HADS). Results: Significant changes were obtained between IV and FV in the following variables: decrease in Body Mass Index (28.20 vs 27.90 kg/m2), improvement in glycemic control (Glycated Hemoglobin 5.80% vs 5.70%), improvement in functional capacity (percentage of patients with good functional capacity in METs 45.23% vs 53.35% and in VO2 11.69% vs 24.07%), adherence to the Mediterranean diet (9.00 (7.00-9.00) vs 11.00 (10.00-12.00)), increase in daily time dedicated to exercise (60.00 (30.00-60.00) vs 60.00 (45.00-60.00) min/day), increase in patients with moderate physical activity (75.65% vs 80.95%) and high physical activity (3.06% vs 8.50%), decrease in anxiety levels (5.00 (2.00-8.00) vs 4.00 (2.00-7.00)) and depression (3.00(1.00-6.00) vs 3.00(1.00-5.00)), and a slight improvement in pharmacological adherence (98.09% vs 98.24%). Conclusions: The CHUS CRP significantly improved physical activity, functional capacity, mental health, and adherence to both the Mediterranean diet and pharmacological treatment in patients with cardiovascular disease. Despite the study's limitations, the large sample size and the use of validated scales confirm the program's effectiveness in lifestyle modification.
Introduction: Ischemic heart disease represent the primary cause of mortality and disability worldwide. Cardiac rehabilitation programs (CRP) have evolved toward comprehensive, multidisciplinary interventions aimed at optimizing patients' physical, mental, and social health. The Hospital Clínico Universitario de Santiago de Compostela (CHUS) features an advanced CR unit that applies this contemporary approach within its CRP. Objective: To evaluate the effectiveness of the CHUS CRP in terms of lifestyle modification and treatment adherence among its participants. Material and Methods: A single-arm prospective observational study was conducted, including 1,379 patients who participated in the CHUS CRP between 2015 and 2020. The intervention included health education, supervised physical training, pharmacological adjustment, and reinforcement of treatment adherence. Sociodemographic data and the following variables were collected at both the initial visit (IV) and final visit (FV): clinical data, functional capacity (using metabolic equivalents (METs) and predicted maximum oxygen consumption percentage (VO2)), and validated questionnaires to assess changes in diet (Predimed Test), physical activity (IPAQ9 Questionnaire), therapeutic compliance (Morisky-Green Test), quality of life (EuroQol-5D), and anxiety and depression (HADS). Results: Significant changes were obtained between IV and FV in the following variables: decrease in Body Mass Index (28.20 vs 27.90 kg/m2), improvement in glycemic control (Glycated Hemoglobin 5.80% vs 5.70%), improvement in functional capacity (percentage of patients with good functional capacity in METs 45.23% vs 53.35% and in VO2 11.69% vs 24.07%), adherence to the Mediterranean diet (9.00 (7.00-9.00) vs 11.00 (10.00-12.00)), increase in daily time dedicated to exercise (60.00 (30.00-60.00) vs 60.00 (45.00-60.00) min/day), increase in patients with moderate physical activity (75.65% vs 80.95%) and high physical activity (3.06% vs 8.50%), decrease in anxiety levels (5.00 (2.00-8.00) vs 4.00 (2.00-7.00)) and depression (3.00(1.00-6.00) vs 3.00(1.00-5.00)), and a slight improvement in pharmacological adherence (98.09% vs 98.24%). Conclusions: The CHUS CRP significantly improved physical activity, functional capacity, mental health, and adherence to both the Mediterranean diet and pharmacological treatment in patients with cardiovascular disease. Despite the study's limitations, the large sample size and the use of validated scales confirm the program's effectiveness in lifestyle modification.
Direction
VARELA LEMA, MARIA LEONOR (Tutorships)
Alonso Vázquez, Marta (Co-tutorships)
VARELA LEMA, MARIA LEONOR (Tutorships)
Alonso Vázquez, Marta (Co-tutorships)
Court
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)
Childhood obesity in health plans in Spain: analysis of regional and national health planning
Authorship
E.A.R.M.
Master's Degree in Public Health
E.A.R.M.
Master's Degree in Public Health
Defense date
02.13.2026 09:20
02.13.2026 09:20
Summary
Introduction: Childhood obesity constitutes one of the main public health challenges of the 21st century, with a growing impact on morbidity, equity, and the sustainability of healthcare systems. In Spain, decentralized health planning generates a wide diversity of health plans that constitute fundamental instruments for articulating preventive policies on childhood obesity, although their quality and effectiveness are not systematically analyzed. Objective: To evaluate the approach to childhood obesity in regional general health plans and in specific plans on obesity and childhood obesity at regional and national levels in Spain. Methods: A scoping review was conducted by searching for health plans and strategies on the official websites of Spanish health administrations up to June 2025. General health plans and specific obesity plans for the general and child population at regional and national levels were included. Six dimensions were defined for evaluation: analysis and diagnosis, objectives, programs, financing, execution, and evaluation, including 24 items derived from Spanish health regulations: Law 14/1986 and Royal Decree 938/1989. A qualitative synthesis of plans addressing childhood obesity was developed. Results: Twenty-two health plans were identified. An absence of plans was evident in the Community of Madrid, Ceuta, and Melilla. Specific childhood obesity plans showed higher technical quality than general ones. Only 15 plans included childhood obesity prevalence indicators. Only 14 plans established specific objectives aimed at reducing excess weight. Regarding the identification of programs related to childhood obesity, 11 plans met this criterion. The allocation of financial resources was identified in barely five plans. Evaluation mechanisms were present in 12 plans. Analysis of socioeconomic inequalities was practically non-existent, present in only 6 plans. Conclusions: Spanish health planning against childhood obesity shows significant progress but also structural limitations that reduce its potential impact. It is a priority to develop integrated monitoring systems, strengthen inter-institutional coordination, systematically incorporate the equity approach, and guarantee the technical and financial sustainability of interventions. The prevention of childhood obesity is an unavoidable responsibility of healthcare systems to ensure public health, equity, and social justice.
Introduction: Childhood obesity constitutes one of the main public health challenges of the 21st century, with a growing impact on morbidity, equity, and the sustainability of healthcare systems. In Spain, decentralized health planning generates a wide diversity of health plans that constitute fundamental instruments for articulating preventive policies on childhood obesity, although their quality and effectiveness are not systematically analyzed. Objective: To evaluate the approach to childhood obesity in regional general health plans and in specific plans on obesity and childhood obesity at regional and national levels in Spain. Methods: A scoping review was conducted by searching for health plans and strategies on the official websites of Spanish health administrations up to June 2025. General health plans and specific obesity plans for the general and child population at regional and national levels were included. Six dimensions were defined for evaluation: analysis and diagnosis, objectives, programs, financing, execution, and evaluation, including 24 items derived from Spanish health regulations: Law 14/1986 and Royal Decree 938/1989. A qualitative synthesis of plans addressing childhood obesity was developed. Results: Twenty-two health plans were identified. An absence of plans was evident in the Community of Madrid, Ceuta, and Melilla. Specific childhood obesity plans showed higher technical quality than general ones. Only 15 plans included childhood obesity prevalence indicators. Only 14 plans established specific objectives aimed at reducing excess weight. Regarding the identification of programs related to childhood obesity, 11 plans met this criterion. The allocation of financial resources was identified in barely five plans. Evaluation mechanisms were present in 12 plans. Analysis of socioeconomic inequalities was practically non-existent, present in only 6 plans. Conclusions: Spanish health planning against childhood obesity shows significant progress but also structural limitations that reduce its potential impact. It is a priority to develop integrated monitoring systems, strengthen inter-institutional coordination, systematically incorporate the equity approach, and guarantee the technical and financial sustainability of interventions. The prevention of childhood obesity is an unavoidable responsibility of healthcare systems to ensure public health, equity, and social justice.
Direction
PEREZ RIOS, MONICA (Tutorships)
GARCIA , GUADALUPE (Co-tutorships)
PEREZ RIOS, MONICA (Tutorships)
GARCIA , GUADALUPE (Co-tutorships)
Court
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)
Sociodemographic and clinical factors associated with depressive symptomatology in children and adolescents with Autism Spectrum Disorder.
Authorship
M.B.V.R.
Master's Degree in Public Health
M.B.V.R.
Master's Degree in Public Health
Defense date
02.13.2026 09:40
02.13.2026 09:40
Summary
Introduction: Autism Spectrum Disorder (ASD) presents a high comorbidity with mental health issues, particularly anxiety and depression. In Spain, ASD prevalence is estimated to be between 0.59% and 2.4%, with a significant increase in the number of enrolled students with this diagnosis. Despite its major impact on quality of life, depressive symptomatology is often underdiagnosed in the ASD population due to atypical clinical presentation and the limited availability of validated instruments. Objectives: The general objective was to identify the sociodemographic and clinical factors associated with the emergence of anxiety and depression symptoms in minors with ASD aged 6 to 18 years, analyzing the influence of the type of schooling, age, gender, comorbidities such as ADHD and intellectual disability (ID). Methodology: A retrospective analysis was conducted on a sample of 222 minors with ASD in Galicia (Spain). The response variable was the presence of clinical symptoms of depression/anxiety, assessed using the Anxiety/Depression scale (1T) of the Child Behavior Checklist (CBCL/6-18), considering a T-score greater than or equal to 70 as clinically significant. Descriptive analyses and bivariate and multivariate logistic regression models were performed. Results: The overall prevalence of clinically significant depressive symptomatology was 22.5%. In the bivariate analysis, the probability of suffering from depression in the group attending mainstream schools was significantly higher compared to participants attending special education centers (OR=0.10 p=0.003). In the multivariate model, mainstream schooling increased the probability of presenting depression symptoms 4.8 times compared to special education (OR=4.8 95% CI: 1.0-23.7), reaching borderline significance. Furthermore, intellectual disability acted as a protective factor against depression (OR=0.2 95% CI=0.0-0.9), with an 80% reduction in the probability of reaching clinical depression symptoms compared to those without intellectual disability, adjusted for all other variables. The presence of ADHD, frequent impulsivity, and self-harming behaviors showed trends toward higher risk, although none reached statistical significance. Comorbidities such as ADHD lost statistical significance in the multivariate model. Conclusions: The results suggest that the educational environment is a determining factor in the emotional well-being of students with ASD. The high prevalence of depression in mainstream schooling (32.7%) compared to special education (4.8%) highlights the need to transform the current inclusion model by implementing protection mechanisms and early intervention models to ensure safe environments and reduce the vulnerability of the ASD population.
Introduction: Autism Spectrum Disorder (ASD) presents a high comorbidity with mental health issues, particularly anxiety and depression. In Spain, ASD prevalence is estimated to be between 0.59% and 2.4%, with a significant increase in the number of enrolled students with this diagnosis. Despite its major impact on quality of life, depressive symptomatology is often underdiagnosed in the ASD population due to atypical clinical presentation and the limited availability of validated instruments. Objectives: The general objective was to identify the sociodemographic and clinical factors associated with the emergence of anxiety and depression symptoms in minors with ASD aged 6 to 18 years, analyzing the influence of the type of schooling, age, gender, comorbidities such as ADHD and intellectual disability (ID). Methodology: A retrospective analysis was conducted on a sample of 222 minors with ASD in Galicia (Spain). The response variable was the presence of clinical symptoms of depression/anxiety, assessed using the Anxiety/Depression scale (1T) of the Child Behavior Checklist (CBCL/6-18), considering a T-score greater than or equal to 70 as clinically significant. Descriptive analyses and bivariate and multivariate logistic regression models were performed. Results: The overall prevalence of clinically significant depressive symptomatology was 22.5%. In the bivariate analysis, the probability of suffering from depression in the group attending mainstream schools was significantly higher compared to participants attending special education centers (OR=0.10 p=0.003). In the multivariate model, mainstream schooling increased the probability of presenting depression symptoms 4.8 times compared to special education (OR=4.8 95% CI: 1.0-23.7), reaching borderline significance. Furthermore, intellectual disability acted as a protective factor against depression (OR=0.2 95% CI=0.0-0.9), with an 80% reduction in the probability of reaching clinical depression symptoms compared to those without intellectual disability, adjusted for all other variables. The presence of ADHD, frequent impulsivity, and self-harming behaviors showed trends toward higher risk, although none reached statistical significance. Comorbidities such as ADHD lost statistical significance in the multivariate model. Conclusions: The results suggest that the educational environment is a determining factor in the emotional well-being of students with ASD. The high prevalence of depression in mainstream schooling (32.7%) compared to special education (4.8%) highlights the need to transform the current inclusion model by implementing protection mechanisms and early intervention models to ensure safe environments and reduce the vulnerability of the ASD population.
Direction
VARELA LEMA, MARIA LEONOR (Tutorships)
FERNANDEZ PRIETO, MONSERRAT (Co-tutorships)
VARELA LEMA, MARIA LEONOR (Tutorships)
FERNANDEZ PRIETO, MONSERRAT (Co-tutorships)
Court
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)
RUANO RAVIÑA, ALBERTO (Chairman)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Secretary)
Rodríguez Loureiro, Lucía (Member)