Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study.

BACKGROUND: Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS: A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS: The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS: Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.

[SBIRT model as a prevention strategy against addiction with and without substance in teenagers.] / El modelo SBIRT como estrategia de prevención de las adicciones con y sin sustancia en adolescentes.

A high prevalence of adolescent substance use, risky consumption patterns and the decrease in the age of initiation, together with the growth of non-substance addictions, represent a huge challenge for Public Health. This suggests the need for a change of focus in the work of the primary care settings, which must be more proactive in the early detection and intervention. Although there are some previous experiences in Spain, we do not have a duly standardised system, based on clinical practice and validated in consulting rooms, which could be used in a general, simple, and guaranteed manner. The SBIRT (Screening, Brief Intervention and Referral to Treatment) model, developed in the United States and conceived from a Public Health perspective, might represent such a paradigm shift. The aim of this paper was to provide researchers and professionals with a review of the available evidence in different countries, with a view to implementing it in Spain, where SBIRT remains a challenge. In addition, theoretical and technical foundations, and potential of the SBIRT are described. Not only its possible benefits and opportunities are put on the table, but also the shortcomings, limitations and needs that must be overcome for SBIRT implementation to be possible.

La alta prevalencia del consumo de sustancias entre los adolescentes, los preocupantes patrones de consumo y el descenso de las edades de inicio, junto al crecimiento de las adicciones sin sustancia, suponen uno de los grandes desafíos actuales en materia de Salud Pública. Ello sugiere la necesidad de un cambio de enfoque en la labor de los dispositivos de Atención Primaria (AP), que han de ser más proactivos en la detección e intervención precoz. Aunque en España existen algunas experiencias previas, no disponemos de una sistemática debidamente protocolizada, fundamentada clínicamente y validada en las consultas, que pueda ser utilizada de forma generalizada, sencilla y con garantías por los profesionales. El modelo SBIRT (Screening, Brief Intervention and Referral to Treatment), desarrollado en Estados Unidos y concebido desde un enfoque de Salud Púbica, representa ese cambio de paradigma. El objetivo de este trabajo, además de dar a conocer los fundamentos teóricos, técnicos y potencialidades del SBIRT, fue poner a disposición de investigadores y profesionales una revisión de la evidencia disponible en diferentes países, de cara a su posible implantación en España, donde a pesar de la existencia de experiencias precedentes puntuales, constituye todavía una cuenta pendiente. Se ponen sobre la mesa no sólo los posibles beneficios y oportunidades, sino también las carencias, limitaciones y necesidades que han de superarse para que la implementación del SBIRT sea posible.

PIUS-a: Problematic Internet Use Scale in adolescents. Development and psychometric validation.

Adolescents' use of the Internet is becoming a matter of great concern for different sectors of society. The psychological and behavioural consequences of problematic Internet use in young people demands quick and effective answers. One of the major challenges in this context is the development of empirically validated tools, which would facilitate early detection and screening for potential risk cases. This is precisely the aim of this paper. Based on a sample of 1,709 secondary-school students from Galicia (a region in northern Spain) aged 11 to 17 (M = 13.74, SD = 1.43), the analysis carried out permitted us to present a brief and simple tool (with just 11 items). It has substantial theoretical support, since both the existing background information and the views of experts from the academic and professional spheres were taken into account in the course of its development. The scale is adapted to the Spanish cultural context and to the language of young people. It has satisfactory psychometric properties in terms of reliability of the scores (α = .82), evidence of its internal structure (tested via a Confirmatory Factorial Analysis), sensitivity (81%), and specificity (82.6%). Moreover, its use enables the gradation of adolescents on a risk or problematic Internet use continuum. In our view, all of this lends it enormous applied potential in both the educational and clinical contexts.

Evaluation and early detection of problematic Internet use in adolescents.

BACKGROUND: Problematic Internet use in adolescents has become an issue of concern for a growing number of researchers and institutions over the past years. Behavioural problems, social isolation, school failure and family problems are some of the consequences of psychological and behavioural impact on teenagers. Taking into account the interest that this issue has generated at many levels, the aim of this paper is to develop a screening tool for early detection of problematic Internet use in teenagers. METHOD: A survey of Compulsory Secondary School students from Galicia involving a total of 2,339 individuals was carried out. RESULTS: The results obtained allow (1) gauging the magnitude of the problem, establishing the risk levels among the adolescents, and (2) presenting a new, simple and short screening instrument. CONCLUSIONS: The present scale has sufficient theoretical and empirical support, including good psychometric properties (a = .83; specificity = .81; sensitivity = .80; ROC curve = .90), making it an interesting applied tool.