Person: Castillo-Laborde, Carla
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Castillo-Laborde
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Carla
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Publication Exposure of 4- year to 24- year olds to tobacco imagery on prime- time Chilean television(2023) Peruga, Armando; Oscar Urrejola; Delgado, Iris; Matute, MarĆa Isabel; Castillo-Laborde, Carla; Molina, Xaviera; Hirmas Adauy, Macarena; Olea, Andrea; GonzĆ”lez, Claudia; Aguilera, Ximena; Sargent, JamesIntroduction: The extent of the population's exposure to tobacco imagery across all genres of regular TV programming and the contribution of each of these genres is unknown, except for UK broadcast channels. The objective of this study is to estimate the exposure of young people to tobacco imagery on Chilean prime-time television and the programme source contributing to such exposure. Methods: Programmes aired during 3 weeks in 2019 from the 15 highest audience channels in Chile were content-analysed for the occurrence of tobacco categorised as actual use, implied use, tobacco paraphernalia, tobacco brand appearances and whether they violated Chilean smoke-free law for each 1 min interval (92 639). The exposure of young people to tobacco content was estimated using media viewership figures. Results: Young people received 29, 11 and 4 million tobacco impressions of any type, explicit use and smoke-free violation, respectively, at a rate of 21.8, 8.0 and 2.1 thousand impressions per hour of TV viewing. The main sources of exposure to tobacco impressions were feature films and animated productions, which were almost entirely non-Chilean. Finally, young people were exposed to tobacco brand impressions primarily through films, effectively circumventing the advertising ban in Chile. Discussion: Television programming is a source of significant youth exposure to tobacco imagery, including branding impressions. To conform to the WHO FCTC, Chile should prohibit tobacco branding in any TV programme and require strong anti-tobacco advertisements prior to any TV programme portraying tobacco.Publication Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review(2022) Castillo-Laborde, Carla; Hirmas Adauy, Macarena; Matute, MarĆa Isabel; Jasmen, Anita; Urrejola, Oscar; Molina, Xaviera; Awad, Camila; Frey, Catalina; Pumarino, Sofia; Descalzi, Fernando; Ruiz, TomĆ”s; Plass, BarbaraObjective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed. Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients' education. Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers' role bringing medicines closer; and patients' health education and disease management.Publication Access to medicines for the treatment of chronic diseases in Chile: qualitative analysis of perceived patient barriers and facilitators in five regions of the country(2024) Castillo-Laborde, Carla; Matute, MarĆa Isabel; Sgombich, Ximena; JofrĆ©, DanielBackground Access to medicines is one of the most serious public health problems globally, and Chile is not an exception. The aim of this study was to explore patientsā perceptions, beneficiaries of both public and private health sectors, of barriers and facilitators in access to medicines in general, and those associated with the treatment of diabetes, dyslipidemia and hypertension. Methods Ten focus groups of patients with these diseases, diagnosed for at least six months and with prescribed medication, were carried out in five regions of Chile: Arica (north), AysĆ©n (south), and ValparaĆso, Metropolitan, and Maule (center). Results The experience of access to medicines is determined by the insurance system, the experience of care with public or private providers, and geographical-administrative difference between capital and other regions. Beneficiaries of public sector value territorial coverage of primary care, which guarantees access in isolated areas and, despite their greater socioeconomic vulnerability, perceive greater protection in access (access conditions, delivery reliability and adherence to pharmacological treatment). The main problem observed is the financing of treatments not covered by the system. Beneficiaries of private sector perceive that they have access to medicines of better qual ity than those provided free of charge by public sector, but raise fears associated with the inability to afford them and distrust in the market process. Regarding the type of provider, public sector shows greater capacity for user loyalty, which is expressed in regular visits and follow-up, unlike discontinuous examinations among private sector beneficiaries. Conclusions Different access conditions both at the territorial level and in the health subsystems are evident. It s necessary to make progress in addressing the problem of access to medicines in a comprehensive manner.Publication Exposure to tobacco impressions during prime-time TV among Chilean minors by sex and socioeconomic status(2022) Peruga, Armando; Castillo-Laborde, Carla; Matute, MarĆa Isabel; Molina, Xaviera; Urrejola, Oscar; Aguilera, XimenaIntroduction: We tested if tobacco impressions were delivered differentially to prime-time TV watching minors by sex and socioeconomic status. Methods: Programs aired during prime-time for three random weeks in 2019 from the 15 highest audience channels in Chile were content-analyzed for the occurrence of tobacco for each one-minute interval of 92639 recorded. Such occurrences were categorized as actual use and whether they violated Chilean smoke-free law or tobacco brand appearances. We estimated the number of persons per hour (p/h) exposed to tobacco impressions for the 4 to 17 years age group by sex and socioeconomic status (SES). Results: Minors spent over a billion p/h watching TV during the observation period. Minors were exposed to tobacco explicit use, branding and smoke-free violation impressions for 9.7 million, 1.2 million, and 1.0 million p/h, respectively. The odds ratios (OR) of exposure to total tobacco impressions were always greater among boys with higher SES compared to boys with low SES. However, they were greater among girls of low SES compared to those of high SES for all types of impressions. The OR of exposure to tobacco branding was higher among girls of any SES compared to boys of any SES. Conclusions: Minors need protection from tobacco imagery on television, particularly girls of low SES. To that end, new legislation should implement all measures to counter depictions of tobacco in entertainment media, as recommended in the WHO FCTC Article 13 guidelines. This should require strong anti-tobacco advertisements before any TV program portraying tobacco targeting minor audiences, particularly girls of low SES. Given that Chile has one of the highest prevalences in the world of current cigarette smoking among young females, the potential contribution of tobacco impressions on TV to smoking differentials across female socioeconomic groups should be further studied.Publication Prescription drug coverage and effective coverage of three chronic conditions of high prevalence in Chile: Hypertension, diabetes and dyslipidemia(2024) Matute, MarĆa Isabel; Castillo-Laborde, CarlaBackground: Access to medicines is a serious problem globally and in Chile. Despite the creation of coverage policies, part of the population with chronic conditions of high prevalence, still does not have access to the medicines it requires and disease control continues to be low. The objective of the study was to estimate the medication use and effective coverage for diabetes, dyslipidemia and hypertension in Chile, analyzing them according to sociodemographic variables and social determinants of health. Methods: Cross-sectional analytical study with information from the 2016-2017 National Health Survey (sample = 6,233 people aged 15 years or older, expanded = 14,518,969). Descriptive analyses of medication use and effective coverage for hypertension, diabetes and dyslipidemia were carried out, and multivariate logistic regression models were developed to analyze possible associations with variables of interest. Results: 60% of people with hypertension or diabetes use medications and only 27.7% in dyslipidemia. While 54.2% of those with diabetes have their glycemia controlled, in hypertension and dyslipidemia the effective coverage drops to 33.3% and 6.6%, respectively. There are no differences in use by health system, but there are differences in the control of hypertension and diabetes, favoring beneficiaries of the private subsystem. Effective coverage of dyslipidemia and hypertension also increases in those using medications. The drugs coincide with the established protocols, although beneficiaries of the private sector report greater use of innovative drugs. Conclusion: A significant proportion of Chileans with hypertension, diabetes or dyslipidemia still do not use the required medications and do not control their conditions.