Coping in the Face of Violence - a Qualitative Study on the Impacts of Stressful Life Events on the Mental Health of Older Adults in Colombia.

BACKGROUND: Many older adults in Colombia have lived through violent and stressful life events, particularly in areas of poverty. The aim of this qualitative study was to understand the impact of stressful life events on the mental health and wellbeing of older Colombians living in areas of relative poverty. METHODS: Older adults (aged 60+) living in the Turbo region in Colombia were interviewed face-to-face between August and December 2021. Transcripts were coded in Spanish and English by at least two researchers, using inductive thematic analysis. RESULTS: Twenty-six older adults participated in the study. Four overarching themes were generated: Living in violent and dangerous communities; Disturbing gender violence and gender roles; Lack of mental health awareness; Coping mechanisms. Older adults experienced a long narrative of stressful life events. Younger generations appeared to disrespect older members of Society. Without any mental health support, older adults coped by accepting the extreme situations or seeking solace in their faith. CONCLUSIONS: The health system and Government need to build up trust and generate an awareness of mental health, as older Colombians will not approach psychological support otherwise. Intergenerational community-based interventions may provide a first avenue of mental health support.

Sistematización de una sistematización: aprendizajes sobre el método / Systematization of a systematization: learning about the method / Sistematização de uma sistematização: aprendizagem sobre o método

Resumen Objetivo: presentar los aprendizajes de una sistematización como método, para la construcción de conocimiento basado en la experiencia vivida por los propios investigadores de varios proyectos sobre la educación en crianza, en el campo de la salud pública, llevado a cabo en la vereda Granizal, Antioquia, durante el período 2013-2019. Materiales y método: se empleó la sistematización de experiencias y los participantes fueron los mismos investigadores. Se inició con la organización de los materiales, los diarios de campo de los círculos de investigación temática y relatorías de las reuniones del equipo de investigación y de los actores comunitarios. Se siguió con la elaboración de una matriz con la recuperación histórica. Y, finalmente, de las reflexiones grupales, surgieron categorías y relaciones para la construcción teórica de visión de conjunto. Resultados: se presenta la propuesta teórica de la sistematización y los procedimientos para implementarla, orientada por cinco momentos: vivir la experiencia, formular un plan de sistematización, recuperar el proceso vivido, las reflexiones de fondo y los puntos de llegada. Se destacan cuatro rasgos de la sistematización: una investigación creativa; basada en un proceso de construcción colectiva; para aprender de la práctica y construir conocimiento; y como escenario transformador de esta y de quienes la realizaron. Conclusión: la "sistematización de la sistematización" permitió hacer conciencia sobre la propia praxis investigativa. Muestra la comprensión del grupo acerca de la conceptualización y metodología de esta perspectiva investigativa. Trasciende la recopilación y organización de la información del proceso vivido en la medida en que la reconstrucción de la experiencia es una comprensión más amplia que transforma la práctica de los sujetos involucrados.

Abstract Objective: to present the learning of a systematization as a method, for the construction of knowledge based on the experience lived by the researchers of several projects on parenting education in the field of public health carried out in the rural settlement of Granizal, Antioquia, during the period 2013-2019. Materials and method: the systematization of experiences was used and the participants were the researchers. It began with the organization of the materials, the field diaries of the thematic research circles and reports of the meetings of the research team and community actors. It was continued with the elaboration of a matrix with the historical recovery. And, finally, reflections, categories and relationships emerged from the group for the theoretical construction of the overall vision. Results: the theoretical proposal of the systematization and the procedures to implement it are presented, guided by five moments: living the experience, formulating a systematization plan, recovering the lived process, the background reflections and the arrival points. Four features of systematization stand out: creative research; research based on a process of collective construction; learning from practice and building knowledge; and as a transforming scenario of this research and of those who carried it out. Conclusion: the "systematization of the systematization" allowed raising awareness of the research praxis itself. It shows the understanding of the group on conceptualization and methodology of this research perspective. It transcends the collection and organization of the information of the process lived to the extent that the reconstruction of the experience is a broader understanding that transforms the practice of the subjects involved.

Resumo Objetivo: apresentar as aprendizagens de uma sistematização como método, para a construção de conhecimento baseado na experiência vivida pelos próprios pesquisadores de vários projetos sobre a educação em criação, no campo da saúde pública, levado a cabo no povoado Granizal, Antioquia, durante o período 2013-2019. Materiais e método: utilizou-se a sistematização de experiências os participantes foram os mesmos pesquisadores. Iniciou-se com a organização dos materiais, os diários de campo dos círculos de pesquisa temática e relatorias das reuniões da equipe de pesquisa e dos atores comunitários. Conseguiu-se com a elaboração de uma matriz com a recuperação histórica. E, finalmente, das reflexões grupais, surgiram categorias e relações para a construção teórica de visão de conjunto. Resultados: apresenta-se a proposta teórica da sistematização e os procedimentos para implementá-la, orientada por cinco momentos: viver a experiência, formular um plano de sistematização, recuperar os processos vividos, as reflexões de fundo e os pontos de chegada. Destacam-se quatro rasgos da sistematização: uma pesquisa criativa; baseada em um processo de construção coletiva; para aprender da prática e construir conhecimento; e como cenário transformador desta e de quem a realizaram. Conclusão: a "sistematização da sistematização" permitiu fazer consciência sobre a própria práxis pesquisaria. Amostra a compreensão do grupo acerca da conceptualização e metodologia desta perspectiva pesquisaria. Trascende a recopilação e organização da informação do processo vivido na medida em que a reconstrução da experiência é uma compreensão mais ampla que transforma a prática dos sujeitos envolvidos.

Una reflexión multimodal sobre los contenidos educativos construidos en imagen y video en el marco de una propuesta educativa para la salud / A Multimodal Reflection on the Educational Contents Constructed in Image and Video within the Framework of an Educational Proposal for Health

Resumen Cuando los procesos de construcción de contenidos digitales se producen con escaza participación de la comunidad, las decisiones sobre el significado pasan por la interpretación de técnicos y profesionales expertos que tienen otra lectura del mundo y en algunos casos se termina en procesos de exclusión desde el mismo significado que se presenta. Debido a la toma de decisiones que surge entre una temática y el modo que se elige, se presenta como reto una participación amplia de las comunidades para crear contenidos formativos en el marco de la Educativos para la Salud (EpS).

Abstract: When the processes of construction of digital contents are produced with little participation of community, decisions about the meaning go through the interpretation of technical and professional experts, who have another reading of the world and, in some cases, end up in processes of exclusion from the same meaning that is presented. Due to the decision making that arises between a theme and the way it is chosen, a broad participation of communities to create formative contents within the framework of Education for Health (EpS) is presented as a challenge.

Understanding post-conflict mental health needs and co-producing a community-based mental health intervention for older adults in Colombia: a research protocol.

BACKGROUND: Older adults in Colombia have seen a number of stressful life events - including the Colombian armed conflict, forced misplacement and recently COVID-19. These events likely have had and are having a substantial impact on people's mental health and well-being, whilst mental health care provision in Colombia is not sufficient and often access is limited and unaffordable. Therefore, the aim of this study is to understand the impact of stressful life events on the mental health of older adults living in Colombia, and co-produce, pilot, and evaluate a community-based mental health intervention in Turbo. METHODS: This 3-year international mixed-methods study comprises of three phases: Phase I will explore the impact of stressful life events on the mental health of older adults living in Colombia, and their mental health needs, via quantitative needs assessments and qualitative interviews and focus groups; Phase II will involve synthesising the findings from Phase I as well as conducting a systematic review and qualitative interviews with experts into implementing mental health interventions in LMICs to co-produce a community-based mental health intervention with older adults and local community group leaders and care providers; Phase III will involve the piloting and evaluation of the mental health intervention via quantitative and qualitative assessments. Co-production and public involvement underpin each element of this project. DISCUSSION: Appropriate mental health care is as important as physical health care, but this study also looks at how we might integrate these findings into community-level public health initiatives for application both within Colombia and more widely in both LMICs and more developed countries. This study protocol will act as a guide for the development and adaptation of psychosocial mental health interventions in different cultures and contexts.

Condiciones socio-habitacionales y morbilidad percibida de desplazados internos residentes en Viviendas de Interés Social en Turbo, Antioquia / Social and Housing Conditions and Perceived Morbidity of Victims of Internal Forced Displacement Living in Public Housing in Turbo, Antioquia / Condições sociais, habitacionais e morbidade percebida das vítimas de deslocamento forçado que residem em moradias de interesse social em Turbo, Antioquia

Resumen Introducción: investigación cuyo objetivo fue explorar las condiciones sociales y habitacionales de las víctimas de desplazamiento forzado que residen en viviendas de interés social y su relación con la morbilidad percibida por enfermedad diarreica aguda e infección respiratoria aguda. Materiales y métodos: componente cuantitativo de un estudio mixto realizado con población desplazada en Turbo, Antioquia. La información fue recolectada mediante encuesta y lista de chequeo aplicadas a una muestra representativa y aleatorizada de 196 viviendas. Los datos fueron analizados con técnicas estadísticas descriptivas, bivariadas y modelos multivariados de regresión binomial para razones de prevalência (RP). Resultados: los niños menores de cinco años mostraron mayor probabilidad de presentar síntomas relacionados con infección respiratoria aguda (IRA) [RP 2.07; IC 95 % 1.60-2.67] y enfermedad diarreica aguda (EDA) [RP 1,90; IC 95 % 1,24-2,91]. La prevalencia de síntomas de IRA fue superior en mujeres [RP 1.24; IC 95 % 1.05-1.47], en viviendas con dos o menos habitaciones para dormir [RP 1.42; IC 95 % 1.05-1.91] y con pisos de tierra y arena [RP 1.42; IC 95 % 1.23-2.29]. La prevalencia de síntomas de EDA se duplicó en viviendas sin cocina separada [RP 2.34; IC 95 % 1.34-4.07] y hogares que no usan detergentes o desinfectantes en el aseo doméstico [RP 2.11; IC 95 % 1.38-3.22]. Conclusión: en las viviendas estudiadas, la población infantil es más propensa a tener síntomas relacionados con IRA y EDA, situaciones que pueden aumentar cuando hay deterioro en pisos, carencia de espacios exclusivos para cocinar y suficientes para dormir, y hábitos de higiene inadecuados.

Abstract Introduction: The research's objective was to explore the social and housing conditions of victims of forced displacement living in public housing and their relationship with the perceived morbidity caused by acute diarrheal disease and acute respiratory infection. Materials and methods: A quantitative component of a mixed method design research developed on forced displaced population living in Turbo, Antioquia. The information was collected through a survey and checklist poll applied to a representative and randomized sample of 196 houses. An analysis of the collected data was conducted through descriptive and bivariate statistical techniques and multivariate binomial regression models for prevalence ratios (PR). Results: Children younger than 5 years were more likely to suffer symptoms related to acute respiratory infection (ARIS) [PR 2.07; CI 95 % 1.60-2.67] and acute diarrheal disease (ADD) [PR 1,90; CI 95 % 1,24-2,91]. The prevalence of symptoms related to ADIS was higher in women [PR 1,24; CI 95 % 1.05-1.47] and were also connected with houses with two or less rooms for resting and sleeping purposes [PR 1,42; CI 95 % 1,05-1,91] and with houses with soil and sand floors [PR 1,42; CI 95 % 1.23-2.29]. The prevalence of symptoms related to ADD doubled in houses where the kitchen is not separated from other domestic areas [PR 2.34; CI 95 % 1,34-4,07] and where no detergents or disinfectants in cleaning tasks are used [PR 2.11; CI 95 % 1.38-3.22]. Conclusions: In the studied public housing, children are more likely to develop symptoms of ARIS and ADD. These conditions may increase when the floor is deteriorated, where exclusive areas exclusively for cooking are lacking, where there are not suitable areas to sleep, and inadequate hygiene habits.

Resumo Introdução: pesquisa cujo objetivo foi explorar as condições sociais e habitacionais das vítimas de deslocamento forçado que residem em moradias de interesse social e sua relação com a morbidade percebida por doença diarreica aguda e infeção respiratória aguda. Materiais e métodos: componente quantitativo de um estudo misto realizado com população deslocada em Turbo, Antioquia. A informação foi recolhida mediante inquérito e lista de checagem aplicada a uma amostra representativa e aleatorizada de 96 moradias. Os dados foram analisados com técnicas estatísticas descritivas, bivariadas e modelos multivariados de regressão binomial para razões de prevalência (RP). Resultados: as crianças menores de cinco anos mostraram maior probabilidade de apresentar sintomas relacionados com infeção respiratória aguda (IRA) [RP 2,07; IC 95 % 1.60-2.67] e doença diarreica aguda (EDA) [RP 1.90; IC 95 % 1.24-2.91]. A prevalência de sintomas de IRA foi superior em mulheres [RP 1.24; IC 95 % 1.05-1.47], em moradias com dois ou menos quartos para dormir [RP 1.42; IC 95 % 1.05-1.91] e com pisos de terra e areia [RP 1.42; IC 95 % 1.23-2.29]. A prevalência de sintomas de EDA se duplicou em moradias sem cozinha separada [RP 2.34; IC 95 % 1.34-4.07] e lares que não usam detergentes ou desinfetantes no asseio doméstico [RP 2.11; IC 95 % 1.38-3.22]. Conclusões: nas moradias estudadas, a população infantil é mais propensa a ter sintomas relacionados com IRA e EDA, situações que podem aumentar quando há deterioro em solos, carência de espaços exclusivos para cozinhar e suficientes para dormir, e hábitos de higiene inadequados.