Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis.

BACKGROUND: The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence. METHODS: A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs. RESULTS: PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs. CONCLUSIONS: PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs' curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC. TRIAL REGISTRATION: Not applicable.

Validation of the Parent Version of the Nighttime Fears Scale (NFS-P) for Children Aged 3-8 Years.

BACKGROUND: Nighttime fears are highly prevalent in children, ranging from normative fears to triggering fear-related anxiety disorders. The lack of available assessment instruments recently prompted the development of the Nighttime Fears Scale (NFS) for children aged 8-12 years. The present study aimed to adapt and psychometrically evaluate the parent-reported version for children aged 3-8 years (NFS-P) as a complement for younger children. METHODS: Two hundred eighty-four Spanish-speaking parents (47% girls) completed the NFS-P and anxiety measures. RESULTS: Confirmatory factor analyses supported a four-factor structure of the NFS-P. Strong internal consistency and validity evidence were obtained. No significant differences were found in NFS-P scores between sexes and age groups. CONCLUSIONS: The findings offer support for the use of the NFS-P as a valuable instrument in clinical and research settings, supplementing the NFS for older children. Both scales provide an efficient means to comprehensively assess the presence and intensity of typical nighttime fears across preschool and school years.

Benefits of Super Skills for Life in a randomized controlled trial in clinical settings for Spanish children with comorbid conditions.

Emotional disorders in children are often associated with low self-concept and problems with peers, and in many cases externalizing symptoms. Super Skills for Life (SSL) is a transdiagnostic treatment for emotional problems in children that has also shown benefits in other comorbid symptoms. This study aimed to examine, for the first time, the effect of SSL on a clinical sample of Spanish children aged 8-12 years with a major emotional disorder and comorbid externalizing symptoms and low self-concept. A quasi-experimental design with two groups, pretest and posttest, was carried out. Thirty-eight children received the SSL intervention, and 36 children were assigned to a wait-list control (WLC) group. Children in SSL showed statistically fewer posttest emotional symptoms (p < .001), peer problems (p = .002), and overall internalizing and externalizing difficulties (p = .005) compared to children in WLC, in addition to higher posttest self-concept (p = .002). There were no differences in the postinterventional changes between boys and girls in internalizing and externalizing symptoms. However, significant differences were found in some facets of self-concept. The results of this study suggest that the SSL protocol may be useful in Spanish clinical contexts. Still, more research is needed to overcome some of the inherent limitations.

Examining academic self-concept as a mediator of the relationship between anxiety and depression: A longitudinal study.

BACKGROUND: Self-concept plays a role as a mediator in the development and maintenance of internalizing symptoms but mechanisms through which the early presence of anxiety symptoms is associated with the subsequent development of depression is unknown. The aim of this longitudinal study was to analyze the mediating role of different areas of self-concept in the relationship between the early development of anxiety symptoms and the later appearance of depressive symptoms. METHODS: A longitudinal study with 3 time-points was conducted, including baseline, 2 months and 12 months from the baseline assessment. A total of 217 children aged 8-12 years participated. Mediation analyses were conducted using PROCESS Macro for SPSS. RESULTS: Academic self-concept (Time 2) mediated the relationship between Anxiety (Time 1) and Depression (Time 3) when controlling for children's sex and, age, baseline value of the mediator, anxiety (at Times 2 and 3), and depression (at Times 1 and 2). Children with self-reports of higher anxiety symptoms (Time 1) presented lower Academic self-concept (Time 2). Children who reported lower levels of Academic self-concept and Family self-concept (Time 2) were more likely to develop depressive symptoms (Time 3). CONCLUSIONS: Feeling competent in the school environment may be considered a protective factor against the development of depression in childhood. The identification of risk factors facilitates the development and implementation of preventive programs.

Effects of a Sexual Risk-Reduction Intervention for Teenagers: A Cluster-Randomized Control Trial.

This study evaluated the efficacy of the COMPAS program in the short term and 6 months after its application. For the initial sample, 2047 teenagers aged 14-19 years from 14 schools in 11 Colombian cities participated; eight schools were randomly assigned to the experimental condition and six to the control group. The participants completed self-report assessments that evaluated several variables theoretically associated with protective sexual behaviors. In the short term, the experimental group showed increased knowledge about HIV and other STIs, sexual assertiveness, self-efficacy, greater behavioral intention toward condom use, and more favorable attitudes toward HIV and condom use than the control group. After 6 months, most psychological and health variables also showed a significant positive change. In conclusion, the COMPAS program is the first school-based sexuality education program that has been shown to be effective in reducing mediating and behavioral variables associated with sexual risk reduction in Colombia.

RESUMEN: Este estudio evaluó la eficacia del programa COMPAS a corto plazo y a 6 meses después de la aplicación. Para la muestra inicial participaron 2.047 adolescentes de 14 a 19 años provenientes de 12 escuelas en 11 ciudades colombianas; 8 escuelas fueron aleatoriamente asignadas a la condición experimental y 6 al grupo control. Los participantes completaron autoinformes sobre variables teóricamente asociadas con comportamientos sexuales de protección. A corto plazo, el grupo experimental mostró un mayor conocimiento sobre ITS, asertividad sexual, autoeficacia e intención conductual hacia el uso del condón y actitudes más favorables hacia el VIH que el grupo de control. Después de seis meses, la mayoría de las variables psicológicas y de salud también mostraron un cambio positivo. En conclusión, el programa COMPAS es el primer programa de educación sexual que ha demostrado ser efectivo para reducir las variables mediadoras y conductuales asociadas con la reducción del riesgo sexual en Colombia.

Who benefits most from an evidence-based program to reduce anxiety and depression in children? A latent profile analysis.

Comorbidity between anxiety and depression symptoms is often high in children. Person-oriented statistical approaches are useful to detect heterogeneity of individuals and diverse patterns of response to treatment. This study aimed to explore the different profiles in a sample of Spanish children who received the Super Skills for Life (SSL) transdiagnostic program, to identify which profile of individuals benefited most from the intervention and the likelihood of transition of symptom patterns over time. Participants were 119 children (42.9% were female) aged 8-12 years old (M = 9.39; SD = 1.26). Children completed anxiety and depression measures at the baseline, postintervention, and 12-months follow-up. Results from latent transition analysis (LTA) revealed two groups depending on the severity of the anxiety and depression symptoms: low symptoms (LS) and high symptoms (HS). LS group remained stable and HS decreased by 25%, switching to the LS group. Children with greater social anxiety benefited most from the program over time. Furthermore, older children were more likely to improve rapidly one year after the intervention compared to younger children. This study provides information to consider when implementing preventive interventions for schoolchildren and to tailor them according to the target population characteristics to increase their effectiveness.

Psychological Symptoms in Italian, Spanish and Portuguese Youth During the COVID-19 Health Crisis: A Longitudinal Study.

Aiming to slow down the spread of the COVID-19, a lockdown was declared in the first term of 2020 in many European countries, applying different restrictions measures. Although the psychological effects of home confinement in children have been described, there is a lack of longitudinal research examining the impact of the confinement over time. The present study analyzes the evolution of the psychological wellbeing of children and adolescents from three European countries with different restrictions. Parents of 624 Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years old completed the "Impact Scale of COVID-19 and Home Confinement on Children and Adolescents" two, five, and eight weeks after the lockdown. Results show a different pattern for each country. Children from Italy, the first European country that applied a lockdown, were better adapted than Spanish and Portuguese children the first two weeks after confinement but they were more psychologically impacted by home confinement at the eight-week assessment. Portuguese children, who followed a general duty of home confinement, were the best adapted to the situation, with no significant differences over time. A significant change was found in anxiety symptoms in Spanish children, with a decrease at the last assessment. Findings suggest that long confinements and hard restrictions affect children, so prevention measures should be applied during confinements to prevent psychological problems in children.

Validation of the brief version of the Spence Children's Anxiety Scale for Spanish children (SCAS-C-8).

OBJECTIVE: This study aimed to validate the self-reported brief version of the Spence Children's Anxiety Scale-Children (SCAS-C-8) in pre-adolescent Spanish children. METHOD: Participants were 824 children aged 8-12 from a community sample. The results revealed a good fit to the one-factor structure, adequate internal consistency (α = 0.75), and evidence of test-retest reliability (α = 0.77). RESULTS: The strong relationship between the SCAS-C-8 and emotional problems provided evidence of convergent validity. Also, the results showed factorial gender invariance. CONCLUSION: The SCAS-C-8 is a suitable instrument for pre-adolescent Spanish children. The brevity and simplicity of this scale may facilitate early detection and help to narrow the existent gap between the presence of anxiety problems and psychological assistance-seeking.

COVID-19: Psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents.

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.

Rumination, Catastrophizing, and Other-Blame: The Cognitive-Emotional Regulation Strategies Involved in Anxiety-Related Life Interference in Anxious Children.

Childhood anxiety problems have a great impact on the daily functioning of children and their families. The first objective of this study was to compare whether the use of cognitive-emotional regulation strategies differs in children with and without anxious symptomatology. A second objective was to analyze the possible mediating role of regulation strategies in the relationship between the presence of anxious symptomatology and its subsequent interference in children's lives. In total, 315 children (53.7% boys) between 8 and 12 years old participated. Mann-Whitney-Wilcoxon U-test was used to analyze differences in the use of cognitive-emotional regulation strategies between children with and without anxious symptomatology. In order to identify the cognitive-emotional regulation strategies which mediate the relation between anxiety and the consequent interference in children's lives, mediation analyses were carried out. As expected, children with anxious symptomatology used more maladaptive regulatory strategies than those without such symptomatology. Multiple mediation models in parallel showed that catastrophizing, rumination, and other-blame mediated the relationship between anxiety problems and their consequent interference. The identification of functional or dysfunctional patterns of cognitive-emotion regulation may favor the inclusion of new components in the evidence-based interventions currently available, in an attempt to increase rates of remission of anxiety.

Spanish version of Super Skills for Life in individual modality: Improvement of children's emotional well-being from a transdiagnostic approach.

OBJECTIVE(S): This study analyzed the short-term effects of the Super Skills for Life (SSL) program in its individual format from the parents' perspective. METHODS: Parents of 70 Spanish children aged 8-11 years (M = 9.31; SD = 1.16) completed assessment instruments about their children's emotional state at the baseline and postintervention. RESULTS: Analyses revealed significantly lower scores in depression (The Mood and Feelings Questionnaire), anxiety, and specific disorders (The Spence Children's Anxiety Scale) (i.e., panic attack/agoraphobia, separation anxiety, social phobia, and generalized anxiety). Significant improvements were also found in anxiety life interference at home (The Child Anxiety Life Interference Scale), total difficulties, internalized and externalized problems, emotional symptoms, peer problems, and hyperactivity/inattention (The Strengths and Difficulties Questionnaire) at posttest. SSL was effective in reducing psychopathological symptoms similarly in both girls and boys. CONCLUSIONS: These promising results provide preliminary support for the usefulness of the SSL program in individual format for the indicated prevention of children's emotional problems. This study provides a valuable resource for research and clinical practice.

How does depression facilitate psychological difficulties in children? The mediating role of cognitive emotion regulation strategies.

Knowing the processes of emotion regulation that children use to respond to stressful situations is essential to analyse the development of psychopathology. The objectives of this research were to study the use of nine cognitive emotion regulation strategies (CERS) in depressed children, compared with nondepressed children, and to analyse their possible mediating effects on the relationship between childhood depression and several areas related to child psychological adjustment. The sample comprised 336 children (46.7% girls) aged 8-12 years. Participants completed measures on depression symptoms (Child Depression Inventory), psychological strengths and difficulties (Strengths and Difficulties Questionnaire) and CERS (Cognitive Emotion Regulation Questionnaire for Spanish kids). Correlations and multiple regression analyses were conducted to test whether CERS and child gender and age predicted child depression. Mediation analyses were run to identify the CERS that mediate the relationship between depression and daily psychological adjustment. On multiple regression, children who score higher in self-blame (ß = .18, p < .01), catastrophizing (ß = .24, p < .001), and other-blame (ß = .14, p ≤ .01) but lower in positive reappraisal (ß = -.15, p ≤ .01) and females (ß = .10, p < .05) were more likely to present higher scores in depression. The maladaptive CERS "other-blame" mediated a positive relationship between depression and conduct problems and between depression and peer problems. Other-blame mediated a negative relationship between depression and prosocial behaviour. In conclusion, this research provides evidence of which specific CERS mediate the emergence of psychopathology in vulnerable children, and provides clues for the proper orientation of psychological interventions in childhood.

Spanish Validation of the Child Anxiety Life Interference Scale (CALIS-C): Psychometric Properties, Factorial Structure and Factorial Invariance Across Gender.

The Child Anxiety Life Interference Scale (CALIS-C) is a measure created to specifically identify life interference and impairment related to children's anxiety disorders in areas of daily functioning. Despite being a widely used scale, a Spanish version of the CALIS-C is not available. The purpose of this study was to adapt and validate the CALIS-C for Spanish-speaking children. We examined the CALIS-C factorial structure, factorial invariance across gender, and psychometric properties in a community sample of 336 (46.7% girls) Spanish-speaking children aged 8-12 years. Confirmatory factor analysis provided support for the original two-factor model. Excellent internal consistency coefficients were found for the total scale (0.88) and the subscales (0.85 and 0.82). 8-week test-retest reliability was moderate (IC = 0.51). Evidence of convergent and divergent validity was found, and factorial invariance across gender was reached. The current study provides initial support for the use of the CALIS-C with Spanish-speaking children by clinicians and researchers.

Sexual risk among Colombian adolescents: knowledge, attitudes, normative beliefs, perceived control, intention, and sexual behavior.

BACKGROUND: Colombia has one of the highest rates of the human immunodeficiency virus (HIV) and pregnancies - both of which are influenced by lack of condom use -, among adolescent population in Latin America; however, the mechanisms underlying the inconsistent use of condoms in this population are poorly understood. This descriptive and cross-sectional study's purpose was to examine sexual behavior and its precursors using the theory of planned behavior (TPB) and considering gender-based differences. Another objective was to study the mediating effect of intention in the relationship between behavior precursors and condom use based on the TPB. METHODS: We recruited 1100 adolescents aged between 14 and 19 years old (M = 15.94, SD = 1.30, 54.4% female) from Bogotá and Barranquilla, two of the cities with highest adolescent birth rates among adolescents in Colombia. Sociodemographic variables, knowledge on HIV and other sexually transmitted infections (STIs), HIV/AIDS-related attitudes, including attitudes toward the use of condoms, normative beliefs, perceived behavioral control, behavioral intention, and sexual behavior were assessed using self-reports. All analyses were run using SPSS v25. The indirect effect of intention to explain the relationship between precursors and the use of condoms during sexual intercourse was estimated using the PROCESS v3 macro. RESULTS: Descriptive analyses suggest a high risk of contracting sexually transmitted infections and unplanned pregnancies associated to inconsistent condom use, medium-low level of knowledge about sexual health, low normative beliefs regarding peers' condom use, and a certain perceived difficulty for using condoms. Condoms are used 71% of the times they have sex, but only 22% of the participants use them consistently; girls use condoms more consistently than boys. Sexual risk characteristics differed significantly by gender. Mediation analyses indicated that condom use intention mediates the relationship between behavioral precursors and frequency of condom use, according to the TPB. CONCLUSIONS: Findings provide a better understanding of sexual risk and highlight important implications for the sexual and reproductive health of adolescents. There is a need of designing and implementing protocolized sexual health promotion programs in schools with the aim of reducing sexual risk behaviors in Colombian adolescents.

Coupling of Coexisting Noncollinear Spin States in the Fe Monolayer on Re(0001).

Spin-polarized scanning tunneling microscopy is used to investigate the magnetic state of the Fe monolayer on Re(0001). Two coexisting atomic-scale noncollinear spin textures are observed with a sharp transition between them on the order of the atomic lattice spacing. A position correlation between the two spin states is observed both in experiments and in Monte Carlo simulations, demonstrating their coupling behavior.

Predicting condom use in adolescents: a test of three socio-cognitive models using a structural equation modeling approach.

BACKGROUND: The theory of planned behavior (TPB), socio-cognitive model (SCM), and information-motivation-behavioral skills (IMB) model are effective in predicting condom use. However, the adequacy of these three theoretical models in predicting the frequency of condom use (FCU) among young people has not been compared. This cross-sectional study tested the applicability and suitability of these three models in predicting the FCU, and analyzed the relationships among the postulated constructs. METHODS: Sexually experienced adolescents (n = 410) aged 13-18 completed a survey assessing the TPB, SCM, and IMB model constructs. Participants were students recruited from 18 high schools, randomly selected from the north, south, east, and southeast of Spain. A structural equation modelling (SEM) analysis was applied to test TPB, SCM and IBM and constructs relationships of each model using R. RESULTS: The results of SEM demonstrated that behavioral skills predict behavior via motivation as hypothesized by the IMB model, but not directly via knowledge about condom use and sexually transmitted infections (STIs). Cognitive factors, such knowledge about condom use and STIs as well as condom use self-efficacy, directly predicted the FCU when modeled as per the SCM. According to the TPB, condom use intention was the best predictor of the FCU, and condom use intention was predicted by attitudes toward condom use and subjective norms related to condom use, but perceived control was not directly or indirectly related to the FCU. Based on the data, the TPB becomes the best-fit model for predicting the FCU among young people compared to the SCM and IMB model. CONCLUSIONS: From a statistical perspective, the TPB seems to be the most suitable model for predicting the FCU among young people compared to the other models. Overall, key direct predictors of the FCU in adolescents included condom use intention, behavioral skills and cognitive factors, such as STIs knowledge and condom use self-efficacy. The next step should be to test integrative models that include personal, contextual, environmental, and social factors.

A 1-year follow-up evaluation of a sexual-health education program for Spanish adolescents compared with a well-established program.

BACKGROUND: Competencies for adolescents with a healthy sexuality (COMPAS) is the only school-based sexual health promotion program in Spain that has been found to be as effective as an evidence-based intervention (¡Cuídate!) in the short term. This study's aim was to compare data from a 12-month follow-up evaluation on the effects of COMPAS on adolescents' sexual risks (knowledge, attitudes, perceived norms, sexual risk perception and intentions) and sexual behaviours (age of the first sex, consistent condom use and multiple partners) with an evidence-based intervention (¡Cuídate!) and a control group. METHODS: Eighteen schools from five provinces of Spain were randomly assigned to one of three conditions: COMPAS, ¡Cuídate! and a control group. The adolescents (N = 1563; 34% attrition) were evaluated 1 week before and after the program, and 1 year post-program implementation. RESULTS: We found that the COMPAS program was as effective as ¡Cuídate!, the evidence-based program, in increasing the adolescents' knowledge about sexually transmitted infections and in fostering favourable attitudes about condom use and people living with HIV/AIDS. COMPAS was more effective than ¡Cuídate! in increasing the adolescents' perceptions of their peer's consistent condom use and the age delay of their first vaginal intercourse. However, it was less effective in maintaining the adolescents' intentions to use condoms and in delaying the age of their first oral sex experience. CONCLUSION: COMPAS was as effective as ¡Cuídate! in reducing sexual risk among adolescents.

Sexual risk behaviors increasing among adolescents over time: comparison of two cohorts in Spain.

Despite advances in treatment and prevention, HIV/AIDS remains a serious health and social problem. This study's objective is to examine sexual behavior, levels of knowledge, and attitudes toward HIV/AIDS between two cohorts in Spanish adolescents, and to analyze gender differences in these cohorts. Participants were 2132 adolescents between 15 and 18 years of age: 1222 in 2006 (43.2% boys) and 910 in 2012 (54.1% boys). The results indicate lower HIV knowledge and less favorable attitudes about HIV/AIDS in the 2012 cohort. In addition, adolescents from the 2012 cohort had their first sexual intercourse at an earlier age and have more sexual partners than those from the 2006 cohort. Compared to boys, girls engage in fewer risky behaviors, although they did not use condoms with their stable partner; girls tended to use condom less when they were in a stable relationship than boys. This study confirms the insufficiency of prevention campaigns as well as the need to improve the impact from programs that promote healthy sexual habits. Assuming comparability of cohorts, this study suggests increased risk of HIV/AIDS over time.

The short-term impact of peers as co-facilitators of an HIV prevention programme for adolescents: a cluster randomised controlled trial.

BACKGROUND: There is no consensus concerning the most effective type of facilitator to promote healthy sexual behaviours in interventions targeting adolescents. OBJECTIVES: To evaluate the facilitator's effect on the implementation of the COMPAS programme (Spanish acronym for Skills for Adolescents with Healthy Sexuality), a school-based HIV prevention protocol. METHODS: Participants were 832 Spanish scholars aged 14 to 18. Fifteen schools were randomly assigned to one of the three following schemes: COMPAS delivered by experts only; the same programme administered by experts and peers; or a control group, not exposed to any intervention. RESULTS: The experts achieved an improvement in HIV knowledge and attitudes towards HIV and condom use; however, experts associated to peers only succeeded in increasing HIV knowledge. The effect size of the changes indicated a greater positive change in the programme when applied by experts than by experts and peers. CONCLUSIONS: The participation of peers as co-facilitators did not increase the efficacy of a programme delivered by experts to Spanish adolescents. Education delivered by experts was the most effective modality for reducing sexual risk. COMPAS is the only Spanish programme targeting the promotion of safer sex behaviours in adolescents whose efficacy has been evaluated with different health agents in Spain.

[Validation of an HIV and other sexually transmitted infections knowledge scale in an adolescent population]. / Validación de una escala de conocimiento sobre el VIH y otras infecciones de transmisión sexual en población adolescente.

OBJECTIVE: The objective of this research is to determine the validity and reliability of a questionnaire designed to specifically assess the knowledge of HIV and other sexually transmitted infections in a Spanish adolescent population. DESIGN: Cross-sectional study for the validation of a questionnaire. LOCATION: A total of 17 schools in five Spanish provinces. PARTICIPANTS: A total of 1,570 adolescent schoolchildren between 13 and 17 years old. INTERVENTION: A pool of 40 items relating to knowledge about HIV and other sexually transmitted infections was established. This pool was analyzed by an expert panel. It was then administered to a pilot group with the same demographic characteristics of the sample, to ensure comprehension. MAIN MEASUREMENT: Item analysis, internal consistency, test/retest and exploratory factorial analysis. RESULTS: A factor analysis was performed, in which five factors that explained 46% of the total variance were retained: general knowledge about HIV, condom as a protective method, routes of HIV transmission, the prevention of HIV, and other sexually transmitted infections. Reliability measures ranged from 0.66 to 0.88. The test-retest correlation was 0.59. There were gender differences in the knowledge of infections. CONCLUSIONS: These factors have adequate internal consistency and acceptable test-retest correlation. Theoretically, these factors fit properly with the content of the items. The factors have a moderate relationship, indicating that a high degree of knowledge about an aspect, but not a guarantee of general knowledge. The availability of a questionnaire to assess knowledge of sexually transmitted infections is helpful to evaluate prevention programs.