Acceptability, feasibility and fidelity of the culturally adapted version of Unplugged ("Yo Se Lo Que Quiero"), a substance use preventive program among adolescents in Chile: a pilot randomized controlled study.

INTRODUCTION: The consumption of alcohol, tobacco, and cannabis is a public health problem that impacts the cognitive, social, and emotional development of adolescents. Prevention strategies such as the "Unplugged" program are effective in delaying the progression of daily smoking and episodes of drunkenness among adolescents. "Yo Se Lo Que Quiero" (YSLQQ) corresponds to the adaptation of this program to the Chilean context. This study assesses the acceptability and feasibility of implementing this program to the local reality. MATERIAL AND METHODS: This was a cluster-randomized controlled pilot study conducted on six public schools. All consented students attending 6th, 7th, and 8th grades (n = 1,180) participated in the study. The schools were randomly assigned to one of two conditions in a 1:1 ratio: (1) the "YSLQQ" intervention group (n = 526), and (2) the Control group (n = 654). The program consisted of a 12-hour class-based curriculum based on a comprehensive social-influence approach delivered by a trained facilitator. The acceptability and feasibility were assessed in the intervention group at the end of the intervention using questionnaires answered by students and facilitators. The quality and fidelity of the program were evaluated during the implementation using self-ported surveys answered by the facilitators and the assessment of video-recorded sessions rated by external observers. Finally, a pre-test and a post-test survey assessing past and current substance use and risk and protective factors were conducted before and immediately after the program's implementation. RESULTS: A high proportion of students (49.6%) liked the sessions. 79.2% reported that the YSLQQ helped them learn about the dangers of substances, while 65.8% reported having more skills to avoid substance use in the future. Regarding students' satisfaction with YSLQQ, 62.9% reported being happy or very happy with the program. Facilitators reported implementing the intervention according to the manual in 73.9% of sessions. Regarding substance use, students who participated in the intervention groups reported a significant reduction in drunkenness in the last year and last 30-day prevalence and also a significant reduction in a lifetime and 30-day prevalence of cannabis use when compared with those students in the control group. CONCLUSIONS: Our results suggest that YSLQQ has adequate acceptability and feasibility to be implemented in the Chilean context, and there were promising results in reducing drunkenness and cannabis use. Future research should confirm these results in a larger RCT study. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov, NCT04566627; registration date: 01/03/2019.

Differences in mental health problems in LGBT+ first year college students in Chile during the pandemic.

PURPOSE: To examine the differences in mental health problems by sexual orientation and gender identity in first-year university students in Chile during the pandemic. METHODS: 7,213 first-year students aged 18 years and older from five universities participated as part of the World Mental Health - International College Student initiative in Chile. Students completed an online self-report survey between 2020 and 2021 that included measures of lifetime and 12-month major depressive episode, generalized anxiety disorder, panic disorder, bipolar disorder, drug abuse/dependence, alcohol dependence, non-suicidal self-injuries, and suicidal risk. Prevalence of mental health problems were estimated and the differences by sexual orientation and gender identity were examined using logistic and multinomial logistic regression models. RESULTS: Between 84.1% and 98% of lesbian, gay, bisexual, trans, and other sexual and gender minority (LGBT+) students screened positive for at least one lifetime mental health problem and between 67.6% and 90.6% for two or more problems. For most outcomes, non-heterosexual (Odds Ratio [OR] between 1.25 and 7.00) and trans and gender nonconforming students (OR between 1.72 and 5.81) had significantly higher odds of positive screening for lifetime mental health problems than heterosexual and cisgender students, respectively. Similar results were observed for 12-month mental health problems. CONCLUSION: The results show differences in the prevalence of mental health problems in LGBT+ university students in Chile, which are consistent with those found in other countries. These results may be useful for planning interventions to improve the mental health of LGBT+ students.

Psychometric evidence of the Acceptance and Action Questionnaire-II (AAQ-II): an item response theory analysis in university students from Chile.

BACKGROUND: Experiential avoidance (EA) is a psychological mechanism associated with several mental health disorders and is regarded as a relevant target by third-generation cognitive behavioral therapies. It has been mainly assessed through self-report questionnaires, and the AAQ-II is the most used tool. Its psychometric evidence has been mostly tested through the classical test theory (CTT) and very scarcely assessed through Item Response Theory (IRT). METHODS: We used the Graded Response Model to examine its psychometric properties in Spanish-speaking university students (n = 1503; women = 995 (66.2%), mean age = 19.29, SD = 2.45). We tested whether the empirical data fit the model's predictions and estimated the dispersion of persons and items along the experiential avoidance continuum. Moreover, we examined category probability curves to identify the response probability of each answer. Likewise, an item-person map was made where the measurement of persons and items, both on the same scale and along the experiential avoidance continuum, could be observed jointly. Finally, we tested the gender invariance of the scale. RESULTS: We found that the values of the individuals and the items were in the established range to be considered an adequate measure of EA. Additionally, we observed high discrimination indices for all items. The current version with seven answer options could not be optimal and should be tested in future studies. Finally, we found evidence of differential functioning by gender in one of the seven items of the instrument. CONCLUSIONS: Our results indicate that the AAQ-II is a suitable tool for measuring EA and accurately classifying and differentiating EA levels in university students.

Psychotic symptoms with and without a primary psychotic disorder in children requiring inpatient mental health admission.

Psychotic symptoms are relatively common in children and adolescents attending mental health services. On most occasions, their presence is not associated with a primary psychotic disorder, and their clinical significance remains understudied. No studies to date have evaluated the prevalence and clinical correlates of psychotic symptoms in children requiring inpatient mental health treatment. All children aged 6 to 12 years admitted to an inpatient children's unit over a 9-year period were included in this naturalistic study. Diagnosis at discharge, length of admission, functional impairment, and medication use were recorded. Children with psychotic symptoms without a childhood-onset schizophrenia spectrum disorder (COSS) were compared with children with COSS and children without psychotic symptoms using Chi-square and linear regressions. A total of 211 children were admitted during this period with 62.4% experiencing psychotic symptoms. The most common diagnosis in the sample was autism spectrum disorder (53.1%). Psychotic symptoms were not more prevalent in any diagnosis except for COSS (100%) and intellectual disability (81.8%). Psychotic symptoms were associated with longer admissions and antipsychotic medication use. The mean length of admission of children with psychotic symptoms without COSS seems to lie in between that of children without psychotic symptoms and that of children with COSS. We concluded that psychotic symptoms in children admitted to the hospital may be a marker of severity. Screening for such symptoms may have implications for treatment and could potentially contribute to identifying more effective targeted interventions and reducing overall morbidity.

The Coronavirus Anxiety Scale: Cross-national measurement invariance and convergent validity evidence.

Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirus-related anxiety. In a large-scale collaboration spanning 60 countries (Ntotal = 21,513), we examined the CAS's measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Visualizing Monocarboxylates and Other Relevant Metabolites in the Ex Vivo Drosophila Larval Brain Using Genetically Encoded Sensors.

The high energy requirements of brains due to electrical activity are one of their most distinguishing features. These requirements are met by the production of ATP from glucose and its metabolites, such as the monocarboxylates lactate and pyruvate. It is still unclear how this process is regulated or who the key players are, particularly in Drosophila. Using genetically encoded Förster resonance energy transfer-based sensors, we present a simple method for measuring the transport of monocarboxylates and glucose in glial cells and neurons in an ex-vivo Drosophila larval brain preparation. The protocol describes how to dissect and adhere a larval brain expressing one of the sensors to a glass coverslip. We present the results of an entire experiment in which lactate transport was measured in larval brains by knocking down previously identified monocarboxylate transporters in glial cells. Furthermore, we demonstrate how to rapidly increase neuronal activity and track metabolite changes in the active brain. The described method, which provides all necessary information, can be used to analyze other Drosophila living tissues.

Delays in the vaccination of infants between 2 and 18 months of age: associated factors in Chile.

INTRODUCTION: Infant vaccination has significantly reduced the morbidity and mortality of transmittable diseases worldwide. Its coverage is high (85%); however, partial or suboptimal vaccination has been an important public health problem. This study aimed (1) to design and explore the psychometric features of a questionnaire to determine the reasons for this partial or suboptimal vaccination; and 2) to determine the factors associated with delaying Diphtheria, Tetanus, Poliomyelitis (DTaP) vaccination. MATERIAL AND METHODS: This study contained two parts. In Part One, a questionnaire was created by the research team and then validated by a committee of experts in the field and a group of parents. It included the following contents: sociodemographic variables, features of the vaccination services, history of vaccination, and attitudes and perceptions about vaccination. Part Two was a cross-sectional study, recruiting private and public healthcare centers to explore the psychometrics features of the instrument, performing exploratory factor analysis, and determining the associated factors with DTaP vaccination delay throughout multivariable regression models. RESULTS: Initially, six experts validated the questionnaire. For instance, on a scale of 1 to 5, the general evaluation of the questionnaire was ≥ 4 for all the experts. Additionally, five experts considered that most of the questions were easy to understand, and all thought the questionnaire had a clear and logical organization. The resulting questionnaire included the "Trust and positive attitude towards vaccination" scale, which had a good structure of items and internal consistency (α = 0.7918). Six healthcare centers were recruited in the second part of the study, and 715 people answered the questionnaire. Not being the mother who brings the child to the health center, having more than one child, and having a history of previous vaccination delays increased the risk of delaying vaccination. Attending the healthcare center for a reason other than only vaccination, obtaining information about vaccines from the Internet, and having higher trust and positive attitudes to vaccination reduced the risk of delay. CONCLUSIONS: First study during the pandemic to explore the role of different factors on the risk of DTaP vaccination delay in Latin America. The findings highlighted the importance of trust in the vaccination system. The instrument presented in this article may help the scientific community evaluate future interventions to increase trust and positive attitudes toward the vaccination process.

Parental practices and their association with alcohol and cannabis use among adolescents in Chile.

Background: Adolescent alcohol and cannabis use are common in Chile. The present study aimed to assess the relationship between perceived parenting practices and alcohol and cannabis use among adolescents in a Latin American context. Methods: We adapted and implemented a substance use prevention strategy in Chile, which included surveys of tenth-grade students from six municipalities in the Metropolitan Region of Greater Santiago. We assessed the reliability and factorial structure of the parenting scale with 16 items, which formed part of the survey. We dichotomized parenting scores into high (above the median) and low. The association of parenting practices with alcohol and cannabis use in adolescents was assessed using multivariate multilevel regression models. Results: A total of 7,538 tenth-grade students from 118 schools were included in the study. The 16-item scale of parenting practices showed good internal consistency (Omega total = 0.84), and three factors representing Relationship between parents and adolescents, Norms and monitoring, and Parents knowing their children's friends and the parents of their children's friends. High total scores of parenting were associated with lower odds of lifetime alcohol use (OR 0.57; 95% CI: 0.49-0.65), past-month alcohol use (OR 0.63; 95% CI: 0.57-0.70), lifetime drunkenness (OR 0.64; 95% CI: 0.58-0.72), and lifetime cannabis use (OR 0.54; 95% CI: 0.47-0.61). Above median scores on each parenting subscale were associated with significantly lower odds of substance use. The strongest associations were observed for the subscale Norms and monitoring. Interactions between parenting and gender showed a significantly stronger effect of parenting practices on alcohol and cannabis use among girls. Conclusion: Different types of parenting practices were associated with a lower prevalence of adolescent alcohol and cannabis use. Improving parenting practices has the potential to prevent adolescent substance use in Chile, especially among girls.

Initial validation of the Multidimensional Adolescent Functioning Scale (MAFS) in Spanish-speaking students from Chilean secondary schools.

INTRODUCTION: Psychosocial functioning is closely associated with psychopathology and wellbeing in different populations, particularly adolescents. Despite its relevance, measures assessing psychosocial functioning in healthy adolescents are scant as most focus on adults or clinical populations. We evaluated the psychometric properties of the Multidimensional Adolescent Functioning Scale (MAFS), a self-report questionnaire created to assess three dimensions of psychosocial functioning ('general functioning', 'family-related functioning', and 'peer-related functioning') in adolescents from the general population. METHODS: After translation and cultural adaptation, we administered the Spanish MAFS to 619 adolescents aged 14 to 19. We assessed the factor structure, internal consistency, and associations with depressive symptoms, suicidal ideation, cognitive-behavioral skills, cognitive reappraisal (CR), and expressive suppression (ES). We additionally tested for measurement invariance based on biological sex. RESULTS: The original three-factor structure showed the best fit. Internal consistency was good for the total scale (ω = 0.874; α = 0.869; GLB = 0.939, rM=0.216) and for all subscales (ω = 0.806-0.839; α = 0.769 to 0.812; GLB = 0.861-0.873). Correlations between all three MAFS subscales were significant, ranging between 0.291 and 0.554. All MAFS subscales correlated positively and significantly with cognitive-behavioral skills and adaptive regulatory strategies and negatively with depressive symptoms and suicidal ideation. CONCLUSION: The Spanish MAFS translation is a valid and reliable self-report measure to assess three domains of psychosocial functioning in adolescents aged 14-19 from the general population.

Validation of the Spanish version of the Pediatric Symptom Checklist (PSC) to identify and assess psychosocial problems among early adolescents in Chile.

BACKGROUND: The high prevalence of mental disorders in early adolescents, and their consequences, encourage the need for validated instruments to identify and assess psychosocial problems. OBJECTIVES: i) To evaluate the psychometric properties of the Spanish version of the Pediatric Symptom Checklist (PSC) questionnaires (PSC-Y, 35 items, and PSC-17-Y) and its subscales (Attention, Internalizing and Externalizing subscales), including the assessment of the item structure, concurrent validity, and reliability; and ii) To assess possible associations between bullying experiences, school climate and school membership with psychological problems identified by the PSC questionnaire. METHODS: A cross-sectional study was carried out in 39 schools in Santiago, Chile. The sample consisted of 3,968 adolescents aged between 10 and 11 years. A descriptive analysis of the Pediatric Symptom Checklist was performed along with measures of dimensionality, reliability, and correlations with a validated questionnaire exploring similar constructs, the Strengths and Difficulties Questionnaire. Finally, associations of bullying, school climate, and school membership with the three subscales of the PSC were explored. RESULTS: Both versions of PSC had problems with item #7 (Act as if driven by motor), which did not load in any of the latent factors. It was removed from later analyses. The three-factor structure of PSC was confirmed. All remaining items had high factor loadings in their corresponded latent factors, and the reliability was high for the total scales (PSC-34-Y, ω = 0.78; PSC-16-Y, ω = 0.94) and the subscales of PSC-16-Y (Attention, ω = 0.77; Internalizing, ω = 0.79; Externalizing, ω = 0.78). The goodness of fit was adequate, and the correlation between PSC subscales and SDQ subscales was high. Victimization and perpetration were associated with all PSC subscales, and higher school climate and stronger school memberships were negatively associated with PSC symptoms. CONCLUSIONS: The current findings seem to demonstrate that the Spanish version of the PSC is a valid and reliable instrument for identifying and assessing psychosocial problems in early adolescents.

Building bridges through cultural adaptation: Examining the initial impact of a culturally adapted parent training intervention for the Chilean context.

Child exposure to maltreatment and neglect constitutes a significant public health problem throughout Latin American and Caribbean (LAC) countries. Although evidence-based parent training (PT) interventions constitute an empirically demonstrated alternative to prevent child maltreatment and neglect, multiple implementation barriers have prevented the large-scale dissemination of evidence-based PT interventions across LAC countries. This selective prevention study consisted of an exploratory quasi-experimental design implemented in Chile, aimed at examining the initial impact of a culturally adapted version of the evidence-based PT intervention known as GenerationPMTO©. The parenting intervention was adapted in a previous pilot study, according to a rigorous model of cultural adaptation. Based on self-reports completed by 281 caregivers, when compared to baseline measurements, significant improvements at intervention completion were observed in the majority of caregivers' parenting practices, as well as child internalizing and externalizing problematic behaviors. This study provides promising initial empirical evidence that efficacious PT interventions developed in the US can be transported to Latin American contexts, as long as they are thoroughly adapted to achieve high contextual and cultural relevance. The rates of child maltreatment across LAC countries constitute an urgent and permanent call for strongly promoting this line of prevention research.

Experience of stigmatization in children receiving inpatient and outpatient mental health treatment: a longitudinal study.

Mental health-related stigma is poorly understood, and minimal research has focused on the experience of stigma from children's perspectives. We sought to investigate whether children treated as inpatients and outpatients had different experiences of stigma over time and whether stigma is linked to global functioning cross-sectionally and longitudinally. Children, aged 8-12 years, receiving treatment within a national specialist mental health inpatient unit were matched for age, gender and diagnosis with children receiving outpatient treatment (N = 64). Validated measures of stigma, global functioning and symptom severity were collected at the start of treatment and upon discharge from the ward for inpatients, and a similar timeframe for their individually matched outpatients. Latent change score models and partial correlation coefficients were employed to test our hypotheses. No differences in most aspects of stigma between children treated as inpatients and outpatients were observed, except for personal rejection at baseline and self-stigma at follow-up favouring outpatients. A reduction in stigma was observed in societal devaluation, personal rejection and secrecy for inpatients, and self-stigma and secrecy for outpatients between the two assessments. Societal devaluation declined at a higher rate among inpatients compared to outpatients, albeit reductions in stigma were comparable for all remaining measures. No association was found between the change in stigma and change in global functioning. Future research may offer further insights into the development and maintenance of stigma and identify key targets for anti-stigma interventions to reduce its long-term impact.

Space Analysis of School Violence in the Educational Setting of Peru, 2019.

BACKGROUND: Schools are increasingly experiencing physical, psychological, and sexual violence, which impacts students' academic achievement and physical and emotional health. Our objective was to identify regional prevalence rates, average prevalence by aggressor type, and provincial spatial conglomerates with higher rates for each type of school violence reported in educational settings in Peru during 2019. METHODS: An analysis was made of 12,132 cases reported through Peru's Specialized School Violence System (SíseVe). The Moran indices were calculated using provincial prevalence rates to identify conglomerates with high prevalence. RESULTS: In the coast region, the Department of Tacna reported the highest prevalence rates for physical (99.7) and psychological (107); the Department of Amazonas, which is in the jungle, reported the highest prevalence rate for sexual violence (74.6), with teachers in public schools accounting for the majority of sexual assaults against students (56%). CONCLUSIONS: Sexual violence predominated in the jungle zone, with a significant percentage of teachers participating in violence with sexual connotations. Physical and psychological violence prevailed in the coastal region.

Brief Report: The Association of Adverse Childhood Experiences and Suicide-Related Behaviors Among 10th-Grade Secondary School Students.

The association between adverse childhood experiences and suicide-related behaviors (SRB) of adolescents has been widely studied in Western high-income countries, but not yet in Latin America. The aim of this study was to determine this association and to explore a dose-response relationship between adverse childhood experiences and SRB in Chile. We conducted a cross-sectional survey to assess adverse childhood experiences up to 1 year prior to the survey and SRB (suicide ideation and attempts) in a sample of secondary school students. Multilevel and multivariable logistic regressions were run with SRB as dependent and adverse childhood experiences as independent variables, adjusted by self-esteem, general mental health, friend and parental support, and the age at onset of cannabis and alcohol use. We included 7,458 adolescents (48.7% girls), mean age = 16.0 (SD = 0.7), and found a prevalence of 78.1% for at least one adverse childhood experience. The 6-month prevalence of suicidal ideation was 18.1% (95% confidence interval [CI]: 17.2%-19.0%), and the prevalence of suicide attempts was 5.0% (95% CI: 4.6-5.6). Among all adverse childhood experiences, only sexual abuse was a risk factor for both SRB. We also found an independent effect of the total number of adverse childhood experiences on suicidal ideation (p < .001) and on suicide attempts (p < .001). Additionally, ages at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively. This is the first study exploring the influence of adverse childhood experiences on suicide-related behaviors in adolescents from Latin America.HIGHLIGHTSSexual abuse is associated with suicidal ideation and suicide attempts in 10th-grade secondary school studentsThere is a dose-response effect between adverse childhood experiences and suicide-related behaviorAges at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively.

The effectiveness of a tablet-based video game that stimulates cognitive, emotional, and social skills in developing academic skills among preschoolers: study protocol for a randomized controlled trial.

BACKGROUND: Evidence suggests that children from low-income families begin the preschool stage with less academic and non-academic skills development compared to higher-income families. There are several successful experiences of early stimulation of cognitive and social-emotional skills; however, there is scarce evidence of the effectiveness of a video game that incorporates the stimulation of these skills simultaneously. This study aims to evaluate the effectiveness of a video game in stimulating cognitive, emotional, and social competence skills in developing academic skills in socioeconomically disadvantaged preschool children. METHODS: A cluster-randomized controlled trial design will be used. A tablet-based video game that stimulates cognitive and socio-emotional skills to improve the development of academic skills is compared with a tablet-based game where students draw and paint with no explicit stimulation of cognitive and socio-emotional skills. Eighteen schools and 750 Chilean preschool students will be recruited. The effectiveness of the intervention will be assessed using a direct evaluation of children on literacy learning and pre-calculation skills at baseline, immediately after stimulation, and at 6, 12, 18, and 24 months post-intervention. The mediating effect of working memory, inhibitory control, emotion recognition, and prosocial behaviours will be assessed on the effectiveness of the intervention. DISCUSSION: The proposed study will be the first to test the effectiveness of a tablet-based video game stimulating cognitive and social-emotional skills to improve academic skills in socioeconomically disadvantaged preschool children in Chile, controlling for gender, age (in months), mental health, and baseline conditions of stimulated skills. TRIAL REGISTRATION: ClinicalTrials.gov NCT05224700. Registered on February 2022.

Effectiveness of the KiVa Antibullying Program with and without the Online Game in Chile: a Three-Arm Cluster Randomized Controlled Trial.

Bullying is a major health problem. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on self-reported bullying victimization and perpetration. No evaluations of this program have been conducted in Latin America. A cluster randomized controlled trial was conducted at socially vulnerable schools in Santiago, Chile, to assess the effectiveness of the KiVa antibullying program in grades 5 and 6 (aged 10-12 years). Schools were randomly assigned (1:1:1) to three groups: the full KiVa group (including the online game), the partial KiVa group (did not include the online game), and the control group in which the regular school curriculum was implemented. The primary outcome was self-reported bullying victimization, assessed before the intervention (baseline) at the end of the academic year (November 2016) and post-intervention, 12 months after the baseline assessment (November 2017). This trial is registered with ClinicalTrials.gov, number NCT02898324. A total of 39 schools (13 in each group) were included; no schools withdrew. The baseline survey included 5923 participants, and the endpoint survey included 3968 participants. Participants in the partial KiVa group had lower bullying victimization at the endpoint survey than those in the control group (OBVQ-R adjusted mean difference - 0.14; 95% CI, - 0.26 to - 0.01; effect size - 0.13, 95% CI - 0.24 to - 0.01, p = 0.035). There was no effect of the full KiVa group for bullying victimization compared with the control and partial KiVa groups. Compared to the control group, participants in the partial KiVa group had lower witnessing bullying at school (adjusted mean difference = - 0.25; 95% CI - 0.45 to - 0.05; effect size - 0.18, 95% CI, - 0.32 to - 0.04, p = 0.013). No effects were found for other secondary outcomes, including bullying perpetration in any comparisons between arms. The implementation of the KiVa antibullying program had mixed results in Chile. There was only a small effect on bullying victimization and witnessing when KiVa was delivered without the online game.

The Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile ("Mi Mejor Plan") for substance use prevention among early adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Substance use is highly prevalent among children and adolescents in Chile, and it is known how it impacts their health and social adjustment. The call for effective prevention of substance use among children adolescents has resulted in numerous school-based programs, and particularly, the Social Competence Promotion Program among Young Adolescents (SCPP-YA) has been proved to be successful for promoting social and problem-solving skills in addition to preventing substance abuse in the US population. The purpose of this study is to test the effectiveness of the Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile ("Mi Mejor Plan"). METHODS: This is a cluster randomized controlled trial, parallel-group type, where "Mi Mejor Plan" is compared to standard school preventive curricula in control schools. A total of 10 schools and 600 adolescents are expected to be recruited and randomized with 1:1 allocation. During formative work, the SCPP-YA program was culturally adapted to Chile. The effectiveness of this program will be assessed using the European Drug Addiction Prevention Trial Questionnaire (EU-Dap), measuring substance use prevalence and risk and protective factors in baseline, post-intervention, and 4 months after the end of the intervention. DISCUSSION: The proposed study will be the first to test the effectiveness of the Social Competence Promotion Program among Young Adolescents (SCPP-YA) in Chile in a cluster randomized control trial and also the first study evaluating this program in Spanish-speaking Latin America. SCPP-YA has been implemented successfully in the USA. Thus, if the effects of the program are positive, wide implementation in Chile and Latin American countries is possible soon. TRIAL REGISTRATION: Clinical Trials NCT04236947 . Registered on January 22, 2020.

Mental Health and Related Factors Among Undergraduate Students During SARS-CoV-2 Pandemic: A Cross-Sectional Study.

Background: Mental health problems among undergraduates are a significant public health concern. Most studies exploring mental health in this population during the pandemic have been conducted in high-income countries. Fewer studies come from Latin American countries. The aim of this study was to determine the prevalence of depression, anxiety, stress, insomnia, and suicide risk, and explore the association with several relevant variables in personal, family, university, and SARS-CoV-2 pandemic domains. Methods: A cross-sectional study was conducted in Chile in a medium-size private University. Outcome variables were explored with valid instruments: Depression, Anxiety, and Stress Scale (DASS-21), Insomnia Severity Index (ISI), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Independent variables from personal (e.g., sex, age, sexual orientation, history of mental health problems, substance use), family (e.g., parental educational background, family history of mental health problems, family functioning), university (e.g., course year, financial support, psychological sense of university belonging, history of failing subjects) and SARS-CoV-2 domains (e.g., history of personal and family contagion, fear of contracting SARS-CoV-2, frequency of physical activity, keeping routines and social contact). Multivariable logistic regression models were conducted for each outcome, after univariable and domain-specific multivariable models. The significant variable at each step was selected if the p-value was ≤ 0.05. Results: A total of 5,037 students answered the survey-the global response rate of 63.5%. Most of the students were females (70.4%) and freshmen students (25.2%). The prevalence of mental health problems was high: depression (37.1%), anxiety (37.9%), and stress (54.6%). Insomnia was reported in 32.5% of students, and suicide risk in 20.4% of students. The associated variables at personal domain were history of mental health problems, substance use, and sexual orientation; at family domain, family functioning and family history of mental health problems; at university domain, violence victimization and sense of belonging; and in SARS-CoV-2 domain, having a daily routine and fear to contracting SARS-CoV-2 by students themselves or others. Conclusions: The prevalence of mental health problems is high among undergraduate students and some of the associated factors, such as victimization and a sense of belonging can be used in preventive interventions.

Testing the Effectiveness of a Blended Intervention to Reduce Suicidal Ideation among School Adolescents in Chile: A Protocol for a Cluster Randomized Controlled Trial.

Suicidal ideation is prevalent in adolescents and is a marker for subsequent psychiatric vulnerability and symptom severity. Literature shows that blended care (integrating online and offline components in a treatment process) could improve the effectiveness and adherence of interventions targeting suicidal ideation in adolescents, but the evidence is inconclusive. Thus, we will test the effectiveness of a blended intervention to reduce suicidal ideation (primary outcome) in school settings using a single-blind two-armed cluster randomized controlled trial (cRCT). The internet-based component corresponds to the Reframe-IT, a program encompassing eight online sessions based on cognitive-behavioral therapy (CBT) principles. The face-to-face intervention will be delivered through four CBT sessions. Additionally, we will assess the effect of the intervention on the following secondary outcomes: suicidal attempts, depressive symptoms, hopelessness, emotional regulation, and problem-solving skills. Primary and secondary outcomes will be assessed at post-intervention, 3-month, 6-month, and 12-month follow-up. Finally, we will explore the mediation role of cognitive, emotional, and behavioral correlates of suicide on the effect of the intervention. Results will inform whether the intervention can reduce suicide among school adolescents and be implemented on a large scale in Chile.

The Unplugged program in Chile ("Yo Sé Lo Que Quiero") for substance use prevention among early adolescents: study protocol for a randomized controlled trial.

BACKGROUND: Substance use is among the main contributors to disease among children and adolescents in the Americas region. The call for effective prevention of substance use among adolescents has resulted in numerous school-based programs, and particularly the Unplugged program has been proved to be successful in reducing the prevalence of different substances in seven European countries. The purpose of this study is to test the effectiveness of the Unplugged program in Chile ("Yo Sé Lo Que Quiero"). METHODS: This is a cluster randomized controlled trial, parallel-group type, where "Yo Sé Lo Que Quiero" is compared to standard school preventive curricula in control schools. A total of 70 schools and 8400 adolescents are expected to be randomized with 1:1 allocation. During formative work, the Unplugged program was culturally adapted to Chile, and the instrument to assess the primary and secondary outcomes was validated. The effectiveness of this program will be assessed using the European Drug Addiction Prevention Trial Questionnaire (EU-Dap), measuring substance use prevalence and risk and protective factors in baseline, post-intervention, and four months after the end of the intervention. DISCUSSION: The proposed study will be the first to test the effectiveness of a school-based substance use prevention program in Chile in a cluster randomized control trial and the first study evaluating the Unplugged program in Spanish-speaking Latin America. A model for disseminating the Unplugged program inside Europe already exists and has been implemented successfully in several countries. Thus, if the effects of the program are positive, wide implementation in Chile and Latin American countries is possible soon. TRIAL REGISTRATION: ClinicalTrials.gov NCT04236999 . Registered on January 17, 2020.