<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1727-897X</journal-id>
<journal-title><![CDATA[MediSur]]></journal-title>
<abbrev-journal-title><![CDATA[Medisur]]></abbrev-journal-title>
<issn>1727-897X</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas, Provincia de Cienfuegos.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1727-897X2022000601150</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Responsabilidad personal con la salud en Cuba: análisis estructural e identificación de variables estratégicas]]></article-title>
<article-title xml:lang="en"><![CDATA[Personal responsibility with health in Cuba: structural analysis and identification of strategic variables]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Luis Gonzalvez]]></surname>
<given-names><![CDATA[Isabel Pilar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez Pérez]]></surname>
<given-names><![CDATA[Adolfo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres Jiménez]]></surname>
<given-names><![CDATA[Yusdanys]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Higiene, Epidemiología y Microbiología  ]]></institution>
<addr-line><![CDATA[La Habana ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>20</volume>
<numero>6</numero>
<fpage>1150</fpage>
<lpage>1168</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1727-897X2022000601150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1727-897X2022000601150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1727-897X2022000601150&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento: el incremento de la responsabilidad personal con la salud en la población cubana es un resultado esperado del Plan de Desarrollo Socialista hasta el año 2030. Para lograr esta meta se necesita un ejercicio de planificación estratégica cuya primera etapa es el análisis estructural del problema.  Objetivo:  identificar las variables relacionadas con los niveles de responsabilidad personal con la salud en la población cubana, describir las relaciones entre ellas y determinar las que resultan estratégicas para fomentar el cambio.  Métodos:  se realizó un estudio de prospectiva estratégica para el análisis estructural de los niveles de responsabilidad personal con la salud en Cuba. Mediante muestreo no probabilístico de casos críticos se contactó con 24 expertos que elaboraron una lista de variables relacionadas con el problema de estudio y las relaciones entre ellas. Se utilizó el programa Matriz de impactos cruzados- multiplicación aplicada a una clasificación, para el análisis de los datos.  Resultados:  se identificaron 19 variables, de las cuales cinco son variables determinantes, seis variables estratégicas (acción intersectorial, normas sociales y marco jurídico, enfoque paternalista en salud, rendición de cuentas individual y del Estado-Gobierno, alfabetización en salud y apoyo al cuidado y bienestar), dos variables objetivo y tres variables resultados y autónomas respectivamente.  Conclusiones:  el incremento de los niveles de responsabilidad personal con la salud dependerá de la acción intersectorial, la actualización del marco jurídico y formas innovadoras para la rendición de cuenta de todos los actores sociales. Será necesario, además, alcanzar mejoras en la alfabetización en salud, mayor acompañamiento a los esfuerzos de los individuos para el autocuidado y el abandono de prácticas paternalistas que expropien a los ciudadanos de sus responsabilidades.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background:  the increase in personal responsibility for health in the Cuban population is an expected result of the Socialist Development Plan until the year 2030. To achieve this goal, a strategic planning exercise is needed. The structural analysis of the problem is the first stage of this exercise.  Objective:  to identify the variables related to the current and future levels of personal responsibility for health in the Cuban population, to describe the relationships between them and to determine those that, due to their levels of dependency and influence in the system, are strategic for promoting change.  Methods:  a strategic prospective study was carried out for the structural analysis of the levels of personal responsibility for health in Cuba. Through non-probabilistic sampling of critical cases, 24 experts were contacted who drew up a list of related variables to the study problem, assigned them and described the relationships between them. The cross-impact matrix-multiplication program applied to a classification was used for data analysis.  Results:  19 variables were identified, of which five are determining variables, six challenge variables, two target variables and three result and autonomous variables, respectively. Intersectoral action, social norms and legal framework, paternalistic approach to health, individual and State-Government accountability, health literacy and support for care and well-being were considered strategic.  Conclusions:  the increase in the levels of personal responsibility for health will depend on intersectoral action, the updating of the legal framework and innovative forms for the accountability of all social actors. It will also be necessary to achieve improvements in health literacy, greater accompaniment to the efforts of individuals for self-care and the abandonment of paternalistic practices that expropriate citizens from their responsibilities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[estilo de vida saludable]]></kwd>
<kwd lng="es"><![CDATA[salud]]></kwd>
<kwd lng="es"><![CDATA[estudios prospectivos]]></kwd>
<kwd lng="en"><![CDATA[healthy lifestyle]]></kwd>
<kwd lng="en"><![CDATA[health]]></kwd>
<kwd lng="en"><![CDATA[prospective studies]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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