The objective of the Every Walk You Take initiative was to co-design and test, in a pilot study, a sustainable mHealth intervention prototype (mobile app) to promote physical activity. This prototype would help to identify the barriers to and facilitators of active living in individuals older than 55 years. A prototype of the intervention was co-designed by a community of stakeholders in Barcelona who were familiar with the social and economic burden of aging in high-income societies. The app’s functionalities included recommendations for healthy routes in the city (parks, pedestrian lanes, and streets) according to environmental variables (air quality and climate) and personal preferences (route difficulty, distance, and geolocation), and ecological momentary assessments (pictures and voice notes) were collected to identify the barriers to and facilitators of performing these routes. To test the app, a pilot study was conducted over two 7-day cycles with citizen scientists recruited at the life-long learning centers of two deprived neighborhoods in Barcelona. A total of 21 citizen scientists (mean age = 67 (standard deviation = 7)), 86% of them female, collected 112 comments and 48 pictures describing their perceived barriers to and facilitators of active living. Every Walk You Take is a new, validated, and sustainable mHealth intervention that is directly involved in health promotion, as it empowers the citizens of Barcelona to play an active role in their own healthcare. This intervention has the potential to be implemented in different cities around the world to collect information on the community determinants of health and health assets.

Physical inactivity, highly dependent on community and environmental conditions, is the fourth leading cause of death worldwide. The objective of Every Walk You Take initiative was to co-design and test a mHealth intervention prototype (mobile app) to promote active living, and to identify barriers and facilitators for active living in individuals older than 55 years. Community stakeholders that included citizen scientists, teachers, researchers, health professionals and policy makers, familiar with the social and economic burden of aging in developed societies, codesigned the prototype. The app functionalities included recommendations on healthy routes in the city (parks, pedestrian lanes and streets) according to environmental variables (air quality and climate) and personal preferences (route difficulty, distance and geolocalization); and the collection of ecological momentary assessments (pictures and voice notes) to identify the barriers and facilitators to perform the routes. The prototype was tested in a pilot study in two deprived neighbourhoods of Barcelona. A total of 21 citizen scientists [mean age=67 (standard deviation=7)], 86% of them female collected, during two 7-day cycles, 112 comments and 48 pictures describing the barriers and facilitators for active living. The negative impact of dirty or damaged roads on citizen scientists’ motivation to engage in physical activity was highly reported as a barrier indicating that city infrastructure directly influences the public's inclination towards adopting active lifestyles. However, citizen scientists highlighted murals and urban green spaces they encountered, which made their walks more enjoyable and stimulating, as facilitators for active living. Every Walk You Take initiative constitutes the foundation for the development of novel models of health surveillance to address gaps in the current research landscape of active living. Moreover, the increased health literacy of the individuals ensures that they are more conscious about the role of physical activity in healthy ageing.

Background/Objectives: The study’s goal is to assess the association between long-term statin therapy and influenza incidence, influenza severity, and all-cause mortality. Methods: Two population-based dynamic cohorts (exposed and unexposed to statins) were followed from 2010 to 2019. Participants were 60 years or older; frail patients were excluded. The primary outcomes were influenza incidence, influenza-related intensive care unit (ICU) admission as a proxy for severity, and all-cause mortality. The exposed cohort comprised new statin users with a minimum of two pharmacy invoices within 90 days of enrollment. Adjusted risk ratios (aRRs) for influenza incidence, ICU admission, and mortality rate were calculated using Poisson regression. Results: The initial study population of 639,564 individuals was evenly split into exposed (319,782) and unexposed (319,782) cohorts; mean age was 71 years (standard deviation: 8 years), and 57% were women. Compared to non-users, new statin users showed a higher influenza incidence [9.39 (95% confidence interval: 9.36–9.42) vs. 7.64 (7.61–7.66) per 1000 person-years], ICU admission [1.65 (1.65–1.66) vs. 1.36 (1.35–1.36) per 1000 person-years], and overall mortality rate [97.09 (96.75–97.43) vs. 94.15 (93.82–94.47) per 1000 person-years]. Adjusted analysis revealed no significant association between statin use and influenza incidence [aRR: 1.04 (0.98–1.10)] or influenza-related ICU admission [aRR: 1.03 (0.89–1.19)] and shifted the effect on mortality from harmful to beneficial [aRR: 0.88 (0.87–0.89)]. Conclusions: Despite new users’ greater vulnerability at the start of treatment, our findings indicate that statins do not influence influenza incidence or severity but reduce all-cause mortality, warranting further exploration of their anti-inflammatory properties.

Background: Waiting times for elective surgery are widely used as indicators of health system performance, particularly following the disruption caused by COVID-19. The objective of this study is to compare the waiting times for major elective surgeries in the Southern Barcelona Metropolitan Area before (2018–2019) and after (2022–2023) the pandemic, examining differences according to sociodemographic characteristics. Methods: A retrospective comparative study was conducted using data from the Southern Barcelona Metropolitan Area between 2018 and 2023. Adults registered on the waiting list for major elective surgical procedures were included. All analyses were stratified by sex. A stratified pre–post pandemic analysis was conducted to examine differences in waiting times by Socioeconomic Index. Waiting times were modelled using generalized linear models with a Gamma distribution and log link, adjusting for age and Socioeconomic Index quartiles. Interaction between period and Socioeconomic Index was tested. Results: The analysis included 73,055 individuals (50.5% women). Median waiting time decreased after the COVID-19 pandemic for both sexes (women: 128 to 121 days; men: 99 to 94 days). This reduction showed an inverse socioeconomic gradient. Adjusted analyses showed longer waits in the lowest versus highest Socioeconomic Index quartile after the pandemic (women: RR = 1.23; men: RR = 1.30). Conclusions: Waiting times for major elective surgery decreased after COVID-19. An exclusive focus on waiting time indicators may conceal structural barriers to access and contribute to inequalities. Equity-sensitive monitoring of elective care is essential to ensure a fair recovery of surgical services.