title: Adult community health-promoting interventions in primary health care: A systematic review.
abstract: OBJECTIVE
  To examine evidence on the effectiveness of health-promoting community interventions carried out in primary health care.
  
  
  METHODS
  Systematic review of originals and systematic reviews of health-promoting community interventions with the participation of primary health care. A working definition of community activities was used in the inclusion criteria. Databases searched up to 2013: PUBMED, EMBASE, CINHAL, Web of SCIENCE, IBECS, IME, and PSICODOC. No restrictions on year of publication or design. Articles were reviewed by separate researchers to identify risks of bias.
  
  
  RESULTS
  Fifty-one articles published between 1966 and 2013 were included: 11 systematic reviews and 40 originals that described 39 community interventions. There is evidence on the effectiveness of community interventions in reducing cardiovascular risk factors, encouraging physical exercise, preventing falls and improving self-care among chronic patients compared with usual individual care. The effectiveness of some interventions increases when the community is involved in their development. Most assessments show positive results despite design limitations.
  
  
  CONCLUSIONS
  The community approach may be more effective than the individual in usual preventive interventions in primary care. There is a lack of evidence on many community interventions in primary care and further research is needed.
authors.affiliation: Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain. Electronic address: smarch@ibsalut.caib.es.
authors.forename: Sebastià
authors.initials: S
authors.lastname: March
authors.affiliation: Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain. Electronic address: elenatorres@ibsalut.caib.es.
authors.forename: Elena
authors.initials: E
authors.lastname: Torres
authors.affiliation: IUNICS-IdISPa, UIB, 07010 Palma, Spain; Registro de Cáncer, Servicio de Epidemiología, Dirección General de Salud Pública y Consumo, Conselleria de Salut, Família i Benestar Social, Camí de Jesús 38 A, 07010 Palma, Spain. Electronic address: mramos@dgsanita.caib.es.
authors.forename: María
authors.initials: M
authors.lastname: Ramos
authors.affiliation: Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain. Electronic address: jripoll@ibsalut.caib.es.
authors.forename: Joana
authors.initials: J
authors.lastname: Ripoll
authors.affiliation: Mallorca Primary Care, Ib-Salut Balears, Centro de Salud Coll d'en Rabassa, Guayaquil Street, 9, 07006 Palma, Spain. Electronic address: agarciapineda@ibsalut.caib.es.
authors.forename: Atanasio
authors.initials: A
authors.lastname: García
authors.affiliation: Mallorca Primary Care, Ib-Salut Balears, Centro de Salud Son Pisà, Vicens Joan Rosselló Ribas Street, 65, 07011 Palma, Spain. Electronic address: obulilete@ibsalut.caib.es.
authors.forename: Oana
authors.initials: O
authors.lastname: Bulilete
authors.affiliation: IUNICS-IdISPa, UIB, 07010 Palma, Spain; Mallorca Primary Care, Ib-Salut Balears, Centro de Salud de Manacor, Central Street, 1, Son Macià, 07509 Manacor, Spain. Electronic address: dmedina@ibsalut.caib.es.
authors.forename: David
authors.initials: D
authors.lastname: Medina
authors.affiliation: Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain. Electronic address: mcvidal@ibsalut.caib.es.
authors.forename: Clara
authors.initials: C
authors.lastname: Vidal
authors.affiliation: IUNICS-IdISPa, UIB, 07010 Palma, Spain; Dirección General de Salud Pública y Consumo, Conselleria de Salut, Família i Benestar Social, Camí de Jesús 38 A, 07010 Palma, Mallorca, Spain. Electronic address: cabezaelena@gmail.com.
authors.forename: Elena
authors.initials: E
authors.lastname: Cabeza
authors.affiliation: Mallorca Primary Care, Ib-Salut Balears, Centro de Salud Sant Agustí, Plaça Pça, Sant Salvador, 2, 07015 Gènova, Spain. Electronic address: mllull@ibsalut.caib.es.
authors.forename: Micaela
authors.initials: M
authors.lastname: Llull
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain. Electronic address: ezabaleta@idiapjgol.org.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-del-Olmo
authors.affiliation: Grupo de Investigación en Salud Mental, Servicios y Atención Primaria (SAMSERAP), Centro de Salud San Andres Torcal, C/José Palanca, s/n, 29003 Málaga, Spain. Electronic address: regules11@gmail.com.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Aranda
authors.affiliation: Mallorca Primary Care, Ib-Salut Balears, Biblioteca Virtual de Ciencias de la Salud de las Islas Baleares, Reina Esclaramunda Street, 9, 07003 Palma, Spain. Electronic address: ssastre@bibliosalut.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sastre
authors.affiliation: Research Unit, Mallorca Primary Care, Ib-Salut Balears, Reina Esclaramunda Street, 9, 07003 Palma, Spain; IUNICS-IdISPa, UIB, 07010 Palma, Spain. Electronic address: jllobera@ibsalut.caib.es.
authors.forename: Joan
authors.initials: J
authors.lastname: Llobera
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003153:Community Health Services; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors
keywords: Ageing; Assessment programmes; Community interventions; Health education; Health promotion; Primary care