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.

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.

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.

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.

Spanish validation of the Spence Preschool Anxiety Scale.

BACKGROUND: The Preschool Anxiety Scale (PAS) is a 28-item measure designed to assess anxiety symptoms in preschoolers aged 31 to 83 months. METHODS: The present study aims to extend the literature by examining the psychometric properties and factorial structure of the PAS in a Spanish community sample of 274 preschoolers aged 3 to 7 years. RESULTS: Factor analysis confirmed the five-factor original model after removing eight items, suggesting a shorter 20-item version for the Spanish preschoolers. The scale demonstrated to have good internal consistency (Cronbach's α = 0.84). Moderate but significant correlations with a measure of health-related quality of life supported the convergent validity of the PAS. CONCLUSIONS: The Spanish version of the PAS demonstrated to have good psychometric properties, providing these results initial support to its use for assessing a broad range of anxiety symptoms in Spanish-speaking preschoolers.

Testing the nicotine dependence measure mFTQ for adolescent smokers: A multinational investigation.

BACKGROUND AND OBJECTIVES: As a measure of nicotine dependence among adolescent smokers, the modified Fagerström Tolerance Questionnaire (mFTQ; seven items), has been successfully used in the United States (USA). Nonetheless, the validity and reliability of mFTQ at the international level is still needed. The current study is the first to test the validity and reliability of mFTQ in four countries: Thailand, Spain, the USA, and Russia. METHODS: In a cross-sectional survey, mFTQ, risk factors of nicotine dependence, and sociodemographic characteristics were assessed. Risk factors included age of first cigarette, frequency of alcohol use, frequency of marijuana use, and number of cigarettes smoked yesterday. Salivary cotinine was also obtained in Thailand and Spain. RESULTS: For all four countries, mFTQ exhibited a single factor structure, as supported by previous work in the USA. For all studied countries except Thailand, mFTQ presented acceptable internal reliability. Overall, risk factors of nicotine dependence have predicted mFTQ scores across countries. Frequency of alcohol use in the USA and frequency of marijuana use in Thailand and Spain were not associated with mFTQ scores. DISCUSSION AND CONCLUSIONS: mFTQ is a single-factor measure of nicotine dependence that shows acceptable internal consistency and validity across countries. Further work can advance the scale and tailor it to different cultures. SCIENTIFIC SIGNIFICANCE: mFTQ can be a clinically practical international measure of nicotine dependence. This study provides initial support for the utility of the mFTQ among Thai, Spanish, American, and Russian adolescents. Further research is needed to test and advance mFTQ across cultures. (Am J Addict 2017;26:689-696).

Problem video game playing is related to emotional distress in adolescents. / El uso problemático de videojuegos está relacionado con problemas emocionales en adolescentes.

Problem use of video games is an increasing risk behaviour. High exposure of adolescents to video games has been linked to a variety of disorders, but the relationship between problem video game playing and emotional welfare is unknown. The aim of the study is to analyse problem video game playing in a sample of adolescents and to determine whether there are differences between online and offline players, in addition to examining its relationship with anxiety and depressive symptomatology. A sample of adolescents (N = 380) completed self-reports measuring video game use and symptoms of anxiety and depression. We found that 7.4% of females and 30% of males can be considered as playing at problem levels. Online players were almost 12 times more likely to play at high frequency than offline players (χ2 (1, 267) = 72.72, p < .001, OR = 11.63, 95% CI [6.31, 21.43]). Males play more frequently, and play more online (χ2 (1, 267) = 50.85, p < .001, OR = 6.74, 95% CI [3.90, 11.64]), with a clear relationship between problem video game playing and anxiety (r = .24; p < .001). In females, there is a relationship between problem video game playing and depression (r = .19; p < .05). Our findings contribute to a better understanding of the psychological variables involved in problem video game playing. The implementation of strategies is suggested in order to prevent pathological gaming and associated problems.

El uso problemático de los videojuegos es una conducta de riesgo cada vez más frecuente. La alta exposición de los adolescentes a los videojuegos se ha relacionado con una variedad de trastornos, pero se desconoce la relación entre el uso problemático de videojuegos y el bienestar emocional. El objetivo del estudio es analizar el uso problemático de videojuegos en una muestra de adolescentes y determinar si existen diferencias entre jugadores online y offline, además de examinar su correlación con sintomatología ansiosa y depresiva. Una muestra de adolescentes (N = 380) completó autoinformes que medían el uso de videojuegos y sintomatología ansiosa y depresiva. El 7,4% de las chicas y el 30% de los chicos pueden considerarse jugadores problemáticos. Jugadores online tienen casi 12 veces más probabilidad de jugar con alta frecuencia en comparación con jugadores offline (χ2 (1, 267)= 72,72, p < ,001, RM = 11,63, 95% IC [6,31, 21,43]). Los chicos juegan con mayor frecuencia y lo hacen en mayor medida online (χ2 (1, 267)= 50,85, p < ,001, RM= 6,74, 95% IC [3,90, 11,64]), con una clara relación entre el uso problemático de los videojuegos y la ansiedad (r =.24; p < ,001). En las chicas existe relación entre el uso problemático de videojuegos y bajo estado de ánimo (r = ,19; p < ,05). Los hallazgos contribuyen a una mejor comprensión de las variables psicológicas relacionadas con el uso problemático de videojuegos, consolidando la idea de instaurar programas educativos para prevenir el abuso de los videojuegos y sus problemas asociados.

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.

Prevalence and Co-Occurrence of Addictive Behaviors Among Russian and Spanish Youth: A Replication Study.

Recently, an addiction matrix measure was assessed among U.S. former alternative high school youth. This presentation seeks to examine the generalizability of findings using this measure among Russian and Spanish high school adolescents. Latent class analysis was used to explore addiction subgroups among adolescents in Russia (average age = 16.27; n = 715) and Spain (average age = 14.9; n = 811). Last 30-day prevalence of one or more of 11 addictions reviewed in the previous work was the primary focus (i.e., cigarettes, alcohol, hard drugs, eating, gambling, Internet, love, sex, exercise, work, and shopping) among Russian youth, and last-30 prevalence of one or more of 8 addictions among Spanish youth (the three drug use items had not been included in the questionnaire for these youths). Results confirmed a two-class model (addicted class and non-addicted class) among both Russian and Spanish adolescents. The mean number of addictions reported was 1.39 (SD = 1.78) addictions among Russian youth and 1.56 (SD = 1.68) addictions among Spanish youth. The prevalence of the sample that constituted the "addicted group" in Russia and Spain was 32.2% and 28.6%, respectively. The most prevalent addictions (i.e., love, Internet, exercise) were similar. These results are similar to the findings previously reported for U.S. sample. Latent class structures for addictive behaviors are similar across international adolescent populations. Our results highlight the need to address multiple addictions in health education programming.

Association between personality traits and substance use in Spanish adolescents. / Asociación entre rasgos de personalidad y consumo de sustancias en adolescentes españoles.

Substance use is considered one of the most frequent risk behaviors during adolescence. Personality factors are linked to consumption during adolescence. Although there are studies on personality and consumption among Spanish adolescents, some outcomes are contradictory, and more studies including larger samples and using validated measures are needed. The aim of this study is to analyze the relationship between different personality factors and substance use among Spanish adolescents. Participants were 1,455 students aged between 13-18 years. The adaptation of the 16PF-IPIP Personality Inventory was applied to assess Warmth, Stability, Gregariousness, Friendliness, Sensitivity, Trust, Openness to experience, Sociability, Perfectionism, and Calmness. Participants were asked about their different consumption substances during their lifetime. Results provide evidence for a relationship between personality factors and psychoactive substance use. There are different distributions of alcohol use regarding personality traits. Furthermore, personality factors have some influence on consumption of alcohol, cannabis, and cocaine.Trust and Calmness influence average alcohol, cannabis, and cocaine consumption, whereas Sociability had no statistically significant influence on any of the three substances. The results from this study are highly useful in the design of preventive programs, as they provide more evidence of the role of personality traits as a risk factor.

El consumo de sustancias está considerado como una de las conductas de riesgo más frecuentes durante la adolescencia. Los factores de personalidad están relacionados con el consumo en la adolescencia.Aunque existen estudios sobre personalidad y consumo en adolescentes españoles, algunos resultados son contradictorios y son necesarios más estudios con muestras de mayor tamaño y que utilicen medidas validadas.El objetivo de este estudio es analizar la relación entre los diferentes factores de personalidad y el consumo de sustancias en adolescentes españoles. Participaron 1,455 estudiantes de secundaria entre 13 y 18 años. Se aplicó la adaptación del Inventario de Personalidad 16PFIPIP para evaluar Calidez, Estabilidad, Gregarismo, Amigabilidad, Sensibilidad, Confianza, Apertura, Sociabilidad, Perfeccionismo y Calma.Se preguntó a los participantes acerca de las diferentes sustancias que habían consumido a lo largo de su vida. Los resultados evidencian la relación entre las variables de personalidad y el consumo de sustancias psicoactivas. El consumo de alcohol presenta diferentes distribuciones con respecto a los rasgos de personalidad. Por otra parte, los factores de personalidad tienen cierta influencia en el consumo de alcohol, cannabis y cocaína. Confianza y Calma tienen influencia en el consumo de alcohol, cannabis y cocaína, mientras que Sociabilidad no presenta ninguna influencia estadísticamente significativa en ninguna de las tres sustancias.Los resultados de este estudio son de gran utilidad a la hora de diseñar programas preventivos, ya que proporcionan mayor evidencia sobre el papel de los rasgos de personalidad como factores de riesgo.

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.

Perceived quality of the parental relationship and divorce effects on sexual behaviour in Spanish adolescents.

Parental divorce has been linked to some risky sexual behaviour in previous studies. Here we examine whether the sexual behaviour of adolescents is related more to the perceived quality of the interparental relationship or to the parents' divorce in a sample from Spain, the country that has experienced the greatest recent increase in marital break-ups in the European Union. Participants were 801 adolescents aged between 14 and 17, who completed questionnaires anonymously. Adolescents who perceive high conflict in their parents' marriages have more sexual activity and engage in more risk practices in some sexual behaviours compared to adolescents with divorced parents and low interparental conflict. When adolescents perceive low conflict, those with divorced parents are more sexually active than adolescents with married parents, but they do not engage in more risk practices. The perceived quality of the parental relationship has a greater negative impact on adolescents than does the type of family structure. The study highlights the need to address the parents' marital relationship in the implementation of prevention programmes of sexual risk behaviours in Spanish adolescents.

Spanish version of the Children's Somatization Inventory: factorial structure and psychometric properties in a community sample.

BACKGROUND: The Children's Somatization Inventory (CSI) has proved to be a suitable measure to assess somatic symptoms in pediatric patients, but additional research was needed to evaluate its psychometric properties in community populations. PURPOSE: The objective of the present study was to examine psychometric properties and factorial structure of the instrument among a nonclinical sample of Spanish children. METHOD: The 24-item version of the CSI and two self-report measures of anxiety and depression were administered to 1,111 Spanish children aged 8 to 12. RESULTS: Exploratory analysis suggested a factorial structure composed of three factors: pseudoneurologic symptoms, gastrointestinal symptoms, and pain. Due to confirmatory analysis indicating a poor fit for the three-factor model, two alternative models were tested. A six-item single factor identified in a previous study with an American community sample showed the best fit (RMSEA = 0.04; GFI = 0.99; AGFI = 0.98; CFI = 0.98; χ(2)/gl = 2.71). The internal consistency for the six-item version was acceptable (ω = .71), and the construct validity with anxiety (r = .53) and depression (r = .38) measures was adequate. CONCLUSION: The six-item version of the CSI demonstrated to be a reliable measure for assessing somatization symptoms in Spanish children.

Psychometric properties and factorial structure of the Spence Children's Anxiety Scale (SCAS) in Spanish adolescents.

The Spence Children's Anxiety Scale is an instrument widely applied in the assessment of the most common anxiety disorders in children and adolescents. This study examines its psychometric properties and the factorial structure in a large community sample of Spanish-speaking adolescents (N = 1,374) aged 13 to 17 years. The scale demonstrated strong internal consistency and good convergent and discriminant validity. Factor analysis confirmed the 6-factor original model, providing a good fit of the data for the Spanish sample. The good psychometric properties support its use by clinicians and researchers, adding evidence to the international empirical support for this measure.

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.

Daily Activities in European Children and Adolescents During COVID-19 School Closure: A Longitudinal Study Exploring Physical Activity, Use of Screens, and Sleep Patterns.

This longitudinal study aimed to analyze the evolution of patterns of daily activities (physical activity time, screen usage time, and sleep hours) in European youth during school closure due to the COVID-19 health crisis. Participants were 624 caregivers of children and adolescents aged 3-18 from Italy, Spain, and Portugal. Evaluations were online, and four time-points were considered: retrospective measurement of daily activities before confinement (T1), and two (T2), five (T3), and eight (T4) weeks after starting the lockdown. Generally accepted international guidelines on physical activity time, screen usage time, and hours of sleep by age group were used to determine whether the pattern might increase the risk for ill health or not. To estimate the evolution of daily activities, generalized estimating equations (GEE) were used. The percentage of children who practiced less than 60 min of daily exercise increased significantly from before home confinement (47.8%) to T2 (86.4%); it slightly decreased at T3 (79.8%), and remained stable at T4 (76.1%). The percentage of children who made excessive use of screens (according to their age group) significantly increased from T1 to T2 and remained stable and high in the rest of the evaluations. The percentage of children who slept fewer or more hours than recommended for their age group remained stable between T1 and T4, although there was a significant increase at T3. In general, results found unhealthier behaviors as confinement was extended. Results are discussed in order to find strategies for promoting healthy daily activities for future pandemics.