Barriers and facilitators for safe sex behaviors in students from universidad de Santiago de Chile (USACH) through the COM-B model.

BACKGROUND: Unsafe sex is one of the main morbidity and mortality risk factors associated with sexually transmitted infections (STIs) in young people. Behavioral change interventions for promoting safe sex have lacked specificity and theoretical elements about behavior in their designs, which may have affected the outcomes for HIV/AIDS and STI prevention, as well as for safe sex promotion. This study offers an analysis of the barriers and facilitators that, according to the university students who participated in the focus groups, impede or promote the success of interventions promoting healthy sexuality from the perspective of the actions stakeholders should undertake. In turn, this study proposes intervention hypotheses based on the Behavior Change Wheel which appears as a useful strategy for the design of intervention campaigns. METHODS: Two focus groups were organized with students from Universidad de Santiago de Chile (USACH). The focus groups gathered information about the perceptions of students about sex education and health, risk behaviors in youth sexuality, and rating of HIV/AIDS and STI prevention campaigns. In the focus groups, participants were offered the possibility of presenting solutions for the main problems and limitations detected. After identifying the emerging categories related to each dimension, a COM-B analysis was performed, identifying both the barriers and facilitators of safe sex behaviors that may help orient future interventions. RESULTS: Two focus groups were organized, which comprised 20 participants with different sexual orientations. After transcription of the dialogues, a qualitative analysis was performed based on three axes: perception about sex education, risk behaviors, and evaluation of HIV/AIDS and STI prevention campaigns. These axes were classified into two groups: barriers or facilitators for safe and healthy sexuality. Finally, based on the Behavior Change Wheel and specifically on its 'intervention functions', the barriers and facilitators were integrated into a series of actions to be taken by those responsible for promotion campaigns at Universidad de Santiago. The most prevalent intervention functions are: education (to increase the understanding and self-regulation of the behavior); persuasion (to influence emotional aspects to promote changes) and training (to facilitate the acquisition of skills). These functions indicate that specific actions are necessary for these dimensions to increase the success of promotional campaigns for healthy and safe sexuality. CONCLUSIONS: The content analysis of the focus groups was based on the intervention functions of the Behavior Change Wheel. Specifically, the identification by students of barriers and facilitators for the design of strategies for promoting healthy sexuality is a useful tool, which when complemented with other analyses, may contribute improving the design and implementation of healthy sexuality campaigns among university students.

Identifying Activities from an Intervention to Promote Sleep in Hospitalised Patients Using the Focus Mapping Technique.

BACKGROUND: Sleep is an essential element for patients' recovery during a period of hospitalisation. Hospital Clínic de Barcelona has developed the ClíNit project to promote patients' sleep by identifying elements that affect the quality of sleep and implementing actions to improve rest at night. OBJECTIVE: Our aim is to select actions to improve sleep quality. METHODS: The study population included night-shift nurses from two clinical units where the pilot actions were to be carried out (n: 14). The nurses prioritised actions to improve sleep quality using the methodology proposed by Fogg: clarification, magic wand, crispification, and the focus-mapping technique. RESULTS: Two sessions were organised for each unit and 32 actions considered high impact and easy to implement were proposed, of which 43.75% (14/32) were directly dependent on nurses. It was then agreed to implement four of these pilot studies. CONCLUSIONS: One aspect worth highlighting is that using prioritization techniques such as the Fogg technique is a good strategy to implement the general objectives of intervention programmes in large organizations in an easy way.

The experience of parents of children with rare diseases when communicating with healthcare professionals: towards an integrative theory of trust.

BACKGROUND: Given the inherent complexity of rare paediatric diseases and the sensitive emotional context of the situations they create (due to the patients' age and the tense uncertainty surrounding the progression of the disease), communication between the adults involved is a key tool in the efforts to provide these children and youths a better quality of life. We conducted ten interviews with families of children with rare diseases, in the aim of exploring how communication between doctors and patients affect their daily lives. All participants, members of FEDER (a Spanish federation of associations of patients with rare diseases) were invited by phone or email to participate in a semi-structured interview including questions on clinical information, communication experiences with healthcare professionals, and the impact these had on the interviewees' relationships with them. To analyse these interviews, we used the 'grounded theory' methodology and open and axial text coding techniques, in addition to those identifying the properties and dimensions of the categories formulated. RESULTS: The core category we have proposed is 'adjustment of mutual trust', with said category describing the attitude and behaviour of doctors who inspire trust in the parents of paediatric patients diagnosed with a rare disease. More specifically, said behaviours or sources of trust are: appearing human, sensitive and empathetic; showing transparency and communicative openness; being supportive of parental proactivity; and being available to families at all times. CONCLUSIONS: Trust is the cornerstone of parent-doctor communication in the field of children with rare diseases. If the sources of trust are present, they create a degree of trust that bolsters both parties in the search for a common goal: providing the child with the best possible care.