http://repositorio.cedes.org/handle/123456789/2348 Wed, 22 Apr 2026 06:57:37 GMT 2026-04-22T06:57:37Z http://repositorio.cedes.org/handle/123456789/4827 Título : Bending the curve: Modeling the impact of reducing risk factors for noncommunicable diseases to control future health expenditures in Latin America and the Caribbean Autor : López-Hernández, Angelica; Prado, Andrea; Metivier, Charmaine; Laptiste, Christine; La Foucade, Althea; Rao, Krishna D; Vega Landaeta, Angela P; Flores, Yvonne N; Beharry, Vyjanti; Giusti, Paulina; Machado, Carla; Noonan, Caitlin M; Roberton, Timothy; Mora-García, Claudio A; Maceira, Daniel; Vecino-Ortiz, Andres I; Samuels, T Alafia; Palacio-Martínez, Natalia Resumen : [ABSTRACT]: Addressing the World Health Organization's noncommunicable disease (NCD) "best buys" is key to reducing the disease burden in Latin America and the Caribbean (LAC). Yet, the potential impact of addressing NCD risk factors on current health expenditures (CHE) in LAC countries is unknown. This study uses both Global Burden of Disease (GBD) data and administrative information to model the impact of addressing four risk factors on CHE trends for 24 LAC countries. A comparative risk assessment model estimates changes in CHE associated with reducing five NCDs. Reducing the prevalence of the four risk factors by 10% could save $ 185 billion in cumulative expenditure by 2050 (1.32% of cumulative expenditure from 2020 to 2050) for all LAC countries assessed, with substantial heterogeneity across risk factors. Reducing the prevalence of high blood pressure had the largest impact. On average, a reduction of 10% in high blood pressure, tobacco use, high blood glucose, and alcohol use would reduce cumulative CHE by US$59bn (0.4% of the cumulative CHE by 2050), US$68bn (0.5%), US$46bn (0.3%), and US$12bn (0.1%), respectively for all LAC countries. While addressing NCD risk factors is a key step to improving health in LAC countries, the impact on CHE is relatively small though meaningful in absolute terms, and additional strategies need to be implemented to control increasing CHE levels that threaten health systems' sustainability Descripción : Fil: Vecino-Ortiz AI. Department of International Health, Health Systems program, Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland, United States of America; Fil: Roberton T. Faculty of Health and Medical Sciences, School of Population and Global Health, University of Western Australia; Perth, Australia; Fil: López-Hernández A. Department of International Health, Health Systems program, Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland, United States of America; Fil: Noonan CM. Department of International Health, Health Systems program, Johns Hopkins Bloomberg School of Public Health; Baltimore, Maryland, United States of America; Fil: Vega Landaeta AP. Pontificia Universidad Javeriana, Instituto de Salud Pública; Bogotá, Colombia; Fil: Maceira D. University of Buenos Aires, Economics Department; National Council for Scientific and Technical Research (CONICET); Center for the Study of State and Society (CEDES); Buenos Aires, Argentina; Fil: Flores YN. Unidad de Investigación Epidemiológica y en Servicios de Salud, Morelos, Instituto Mexicano del Seguro Social; Cuernavaca, Morelos, México; Fil: Mora-García CA. Business School, INCAE University; San Jose, Costa Rica; Fil: Giusti P. Instituto de Análisis y Gestión; Lima, Perú; Fil: Samuels TA. Caribbean Institute for Health Research, The University of the West Indies; Kingston, Jamaica; Fil: Palacio-Martínez N. Departamento Administrativo Nacional de Estadística, Bogota, Colombia; Fil: Prado A. Business School, INCAE University; San Jose, Costa Rica; Fil: Machado C. School of Medicine, Universidade Federal de Minas Gerais; Belo Horizonte, Brazil; Fil: Metivier C. HEU, Centre for Health Economics, The University of the West Indies, St. Augustine Campus; St. Augustine, Trinidad and Tobago; Fil: Laptiste C. HEU, Centre for Health Economics, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago; Fil: La Foucade A. HEU, Centre for Health Economics, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago; Fil: Beharry V. HEU, Centre for Health Economics, The University of the West Indies, St. Augustine Campus; St. Augustine, Trinidad and Tobago Fri, 18 Jul 2025 00:00:00 GMT http://repositorio.cedes.org/handle/123456789/4827 2025-07-18T00:00:00Z http://repositorio.cedes.org/handle/123456789/4826 Título : Effectiveness of an mHealth Intervention to Increase Participation in Breast Cancer Screening (Breast Cancer ATICA Study): A Pragmatic Randomized Controlled Trial Autor : Arrossi, Silvina; Paolino, Melisa; Orellana, Liliana C; Sánchez Antelo, Victoria; Mazzadi, Juan David; Strochero, María Eugenia; López De Degani, Graciela; Correa, Silvina; Furia, Anabel Resumen : [ABSTRACT]: Implementation of invitation systems has been shown to increase breast cancer screening rates. However, implementation of active outreach strategies in Latin American programs is limited. We conducted a pragmatic randomized controlled trial-the breast cancer ATICA study-to evaluate the effectiveness and implementation of a digital messaging-based intervention to increase breast cancer screening. A total of 248 Argentinian women ages 50+ years were recruited from 10 health care centers in Santa Fe, Argentina, and randomly assigned (1:1) to the intervention (n = 123) or control group (n = 125). The intervention included up to four Short Message Service (SMS) messages inviting participants to schedule an appointment for mammography through WhatsApp or the usual care control group (n = 125). Effectiveness outcomes were the proportion of women who underwent mammography within 105 or 45 days of enrollment. The reach, effectiveness, adoption, implementation, and maintenance framework was used to evaluate the implementation of the intervention. Our results showed that women in the intervention group (n = 123) were significantly more likely than women in the control group (n = 125) to undergo a mammography within 105 days (23.6% vs. 6.4%, difference 17%, 95% confidence interval, 7.7%-27.0%) and within 45 days (15.4% vs. 3.2%; difference 12%, 95% confidence interval, 4.3%-20.0%; P = 0.02). Our results also showed high acceptability and appropriateness of the intervention. Our study demonstrates that sending consecutive SMS messages, including a WhatsApp number to ask for an appointment, effectively increased breast cancer screening. This mobile health intervention could be an excellent option to improve access to breast cancer screening in low- and middle-resource settings in which active invitation systems are challenging to implement. PREVENTION RELEVANCE: Breast cancer remains a significant public health concern, and strategies to improve access to screening are urgently needed. This study is one of the first pragmatic randomized controlled trials in Latin America that demonstrate the effectiveness and real-world implementation of an SMS-based intervention to increase participation in breast cancer screening. Descripción : Fil: Paolino M. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Buenos Aires, Argentina; Fil: Sánchez Antelo V. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Buenos Aires, Argentina; Fil: Orellana L. Biostatistics Unit, Faculty of Health, Deakin University; Geelong, Australia; Fil: Correa S. Agencia del Control del Cáncer de Santa Fe, Ministerio de salud Santa Fe; Santa Fe, Argentina; Fil: Mazzadi JD. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina; Fil: Furia A. Ministerio de Salud de Santa Fe, Hospital Gral. Especializado en Oncología J. B. Iturraspe; Santa Fe, Argentina; Fil: Strochero ME. Agencia del Control del Cáncer de Santa Fe, Ministerio de salud Santa Fe; Santa Fe, Argentina; Fil: López De Degani G. Asociación Argentina para el Estudio del Climaterio; Santa Fe, Argentina; Fil: Arrossi S. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Buenos Aires, Argentina Tue, 02 Dec 2025 00:00:00 GMT http://repositorio.cedes.org/handle/123456789/4826 2025-12-02T00:00:00Z http://repositorio.cedes.org/handle/123456789/4825 Título : Similarities and differences in international clinical practice guidelines for preeclampsia diagnosis and diagnostics: a scoping review Autor : Ábalos, Edgardo; Diaz, Virginia; Chamillard, Monica; Gialdini, Celina; Portela, Anayda; Pasquale, Julia Resumen : [ABSTRACT]: INTRODUCTION: Preeclampsia is a leading cause of maternal and newborn deaths. Traditionally characterized by high-blood pressure and proteinuria, organ and placental dysfunction were later proposed in some clinical practice guidelines as additional components for its definition. Variability in diagnostic criteria across international guidelines could be a barrier to harmonized and equitable care in different settings. METHODS: We reviewed current relevant clinical practice guidelines to identify similarities and differences in recommendations related to the definition and diagnosis of preeclampsia, and their supporting evidence. We also reviewed additional systematic reviews related to the diagnosis of preeclampsia. We searched different databases and websites of international and professional organizations for guidelines published or updated from 2014 to 2024. We searched databases to identify additional systematic reviews on preeclampsia diagnosis. RESULTS: Fifteen guidelines from 11 organizations were identified with 11 systematic reviews supporting evidence on the diagnosis of preeclampsia. We found 21 additional systematic reviews, not included in these guidelines. DISCUSION: There is agreement for hypertension and proteinuria for the diagnosis of preeclampsia, without a uniform consensus on methods and devices for their assessment. Organ dysfunction is considered in eight guidelines and placental dysfunction in four, with some disagreements on their usefulness, and the methods and tools for their measurement. Few guidelines support their recommendations on preeclampsia diagnosis with systematic reviews. CONCLUSION: Consensus in preeclampsia definition is needed to guide not only clinical practice but also future research and policy, particularly in global health contexts. Descripción : Fil: Abalos E. Centro de Estudios de Estado y Sociedad (CEDES); Buenos Aires, Argentina; Fil: Díaz V. Centro Rosarino de Estudios Perinatales (CREP); Rosario, Santa Fe, Argentina; Fil: Chamillard M. Centro Rosarino de Estudios Perinatales (CREP); Rosario, Santa Fe, Argentina; Fil: Gialdini C. Centro Rosarino de Estudios Perinatales (CREP); Rosario, Santa Fe, Argentina; Fil: Portela A. Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization; Geneva, Switzerland; Fil: Pasquale J. Centro Rosarino de Estudios Perinatales (CREP); Rosario, Santa Fe, Argentina Mon, 01 Dec 2025 00:00:00 GMT http://repositorio.cedes.org/handle/123456789/4825 2025-12-01T00:00:00Z http://repositorio.cedes.org/handle/123456789/4824 Título : Analysis of roll-your-own tobacco pack design and warning compliance in Argentina Autor : Mejía, Raúl M; Arnaudo, Belén; Alexandrou, Georgia; Elicabe, Emilia; Moodie, Crawford Resumen : [ABSTRACT]: INTRODUCTION: Packaging is a key marketing tool for tobacco companies and an important means of communicating product-related risks to governments. While research has explored promotional characteristics of cigarette packs and compliance with warnings on cigarette packs, studies on roll-your-own (RYO) tobacco packaging are limited. METHODS: We purchased a convenience sample of unique RYO packs (n=116) between November 2022 and May 2024 in five cities in Argentina, where RYO tobacco has increased in popularity. We developed a checklist to examine the presence of pack design features and compliance with on-pack warnings and conducted a descriptive analysis. RESULTS: The sample included 50 brands. Most packs were pouches (94.0%) and contained 30 g of tobacco (74.1%). About half (51.7%) were flavoured, most commonly fruit (43.3%), vanilla (21.7%) and chocolate (15.0%). Unflavoured packs frequently featured 'natural' or 'additive-free' descriptors (51.8%) and light colours (48.2%), while flavoured packs predominantly used flavour descriptors (88.3%) and bright colours (86.7%). Nearly half the packs (46.6%) were locally produced, with 48.1% highlighting their Argentinian origin. In terms of warning compliance, 47.4% of packs failed to display a warning image covering 50% of the front of the pack. The warning image (90.5%) and message (81.9%) were frequently obscured by a tax stamp. CONCLUSIONS: The findings help understand how tobacco companies promote RYO via the packaging. Additionally, this exploratory study could serve as a template for other studies on RYO tobacco. Descripción : Fil: Elicabe E. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina; Fil: Arnaudo MB. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina.; Fil: Mejia R. Centro de Estudios de Estado y Sociedad; Buenos Aires, Argentina.; Fil: Alexandrou, G. Institute for Social Marketing and Health, University of Stirling; Stirling, United Kingdom; Fil: Moodie C. Institute for Social Marketing and Health, University of Stirling; Stirling, United Kingdom Tue, 05 Aug 2025 00:00:00 GMT http://repositorio.cedes.org/handle/123456789/4824 2025-08-05T00:00:00Z