[Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study]. / Impacto psicológico del COVID-19 en los trabajadores sanitarios durante el segundo año de pandemia en Latinoamérica: estudio de encuesta transversal.

Introduction: The coronavirus pandemic continues to affect the mental health of healthcare personnel in Latin America (LA). Objective: To estimate the prevalence of psychological disturbances and associated risk factors for mental health in healthcare personnel in LA during the second year of the COVID-19 pandemic. Method: This multicenter cross-sectional study included a total sample of 5437 healthcare professionals from Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru. The PHQ-9, GAD-7, and a brief demographic questionnaire were used. The prevalence of anxiety and depression was estimated based on the cut-off points of the instruments. Two multivariate logistic regressions were performed. Results: A population burden of anxiety (40.1%) and depression (62.2%) was found in healthcare personnel in LA. Among professionals in Argentina (OR = 1.374; P<.001), those working in state hospitals (OR = 1.536; P<.003), frontline healthcare workers for COVID patients (OR = 1.848; P<.001), general practitioners (OR = 1.335; P<.001), and specialists (OR = 1.298; P<.001), a higher risk of experiencing mental disorders was observed. Among women, younger personnel, and administrative staff, a higher probability of experiencing anxiety and depression was identified. Conclusions: The burden of mental disorders on healthcare personnel in Latin America is alarming. Psychological support services are necessary, aimed at providing measures for professionals to develop healthy coping mechanisms that mitigate the impact of the pandemic on their well-being and facilitate post-crisis adjustment.

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.

Sexual Orientation and Gender Identity Change Efforts and Suicide Morbidity Among Sexual and Gender Minority Adults in Colombia.

Purpose: We assessed the association between sexual orientation and gender identity change efforts (SOGICE) experiences and lifetime suicide morbidity among sexual and gender minority (SGM) groups in Colombia. Methods: A sample of 4160 SGM Colombian adults responded to an online cross-sectional survey. We used binary logistic regression to assess the relationship between SOGICE and suicide morbidity for the overall sample and stratified by SGM group. Results: We found a high prevalence of suicidal ideation (56%), suicide planning (54%), suicide attempt (25%), and SOGICE experiences (22%). There were significant differences in the prevalence of suicide morbidity and SOGICE experiences across SGM groups, with transgender men and gender nonbinary participants being generally most at risk. SOGICE experiences were associated with 69% increased odds of suicidal ideation, 55% increased odds of suicide planning, and 76% increased odds of suicide attempt. Stratified analyses by SGM group showed that the association of SOGICE experiences with suicide morbidity varied by SGM group, and it was particularly detrimental for cisgender sexual minority men. Conclusions: Suicide morbidity among SGM adults in Colombia is high, with rates that are 8-22 times higher than in the general population. SOGICE experiences further exacerbate suicide risk. The study findings highlight the need to design and implement policies affirming diverse sexual orientation and gender identities in Colombia and to ban SOGICE practices. These findings also highlight the importance of recognizing the variability within SGM groups and the need to examine these groups separately rather than treating them as a monolithic group.

Psychometric Properties of the Colombian Version of the HIV Attitudes Scale for Adolescents.

The HIV Attitudes Scale (HIV-AS) evaluates attitudes towards different aspects of HIV. In view of the lack of scales measuring this construct in Colombia, this study sought to validate the HIV-AS test for adolescents from Colombia. A total of 867 Colombian students, aged between 14 and 19 years (M = 15.97 years; SD = 1.37) were evaluated. Participants responded to the HIV-AS test and a set of scales used to assess external validity. Content validity analyses reflected good adequacy indices for the items. Exploratory factor analyses revealed a four-factor structure and reliability indices were satisfactory. The structural equation model showed good levels of fit. Most of the items presented a discrimination index above 0.30 and contributed to the reliability of the scale, except for item 9, which was eliminated. Concurrent validity showed significant correlations among the HIV-AS and other similar constructs. A reliable measurement of attitudes toward HIV allows for an improved assessment of the risk associated with exposure to sexually transmitted infections in adolescent populations.

A text mining approach for adapting a school-based sexual health promotion program in Colombia.

A common practice among clinical psychologists and other health professionals is the use of school-based sexual health promotion programs as a means for preventing sexually transmitted infections. A fundamental criterion for the designing and adaptation of these programs is the age of their target populations because limited education and language are the most relevant factors that limit the efficacy of these programs. The contribution of this paper consists of assessing both the readability of the written materials that accompany the contents of a Spanish-written school-based sexual health promotion program used in Colombia, as well as the words co-occurrence network structure of its contents. The readability of the evaluated program corresponded to its intended target population aged between 14 and 19, with the schooling of 9-13 years of education. The resulting words co-occurrence network structure of the COMPAS program also mirrored its theoretical content. These results all together are deemed as empirical evidence of the adequacy of the program.

Adaptation of an effective school-based sexual health promotion program for youth in Colombia.

RATIONALE: Given the disproportionate impact of HIV and STIs among youth in Latin America, there is a compelling need for effective sex education programs. In particular, Colombia lacks a nationally standardized youth sex education program, despite the fact that 15 to 24-year-olds accounted for the highest incidence and prevalence rates of HIV and STIs in the nation. In an attempt to fill this void, our team adapted COMPAS, a Spanish school-based sexual health promotion intervention, for Colombian adolescents. OBJECTIVE: This study describes the adaptation process that resulted in a modified version of COMPAS for youth in Colombia. METHOD: We employed a systematic cultural adaptation process utilizing a mixed methods approach, including intervention adaptation sessions with 100 young adolescents aged 15-19. The process included six steps: 1) consulting international researchers and community stakeholders; 2) capturing the lived experiences of a diverse sample of colombian youth; 3) identifying priorities and areas in need of improvement; 4) integrating the social cognitive theory, information-motivation-behavioral skills model, and an ecological framework for colombian youth; 5) adapting intervention content, activities, and materials; and 6) quantitative evaluation of COMPAS by Colombian youth. RESULTS: The adapted intervention incorporates elements common to effective youth sex education interventions, including: a solid theoretical foundation, sexual communication skills and social support for protection, and guidance on how to utilize available cultural- and linguistic-appropriate services. In addition, the adapted intervention incorporates cultural and linguistic appropriate content, including an emphasis on tackling machismo to promote risk reduction behaviors. CONCLUSIONS: The systematic adaptation approach to sexual health intervention for youth can be employed by researchers and community stakeholders in low-resource settings for the promotion of health wellness, linkage to care, and STI and unplanned pregnancy prevention for youth.

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.

Cognitive profile and Prevalence of Depression, Hopelessness and Suicide Risk in Youth Linked to the first level of Military Training School / Perfil cognitivo y prevalência de depresión, desesperanza y riesgo suicida en jóvenes vinculados al primer nivel de formación en una escuela militar colombiana

Resumen Este estudio evaluó el perfil cognitivo y los niveles de desesperanza, depresión y riesgo suicida en un grupo de jóvenes vinculados al proceso de formación de una escuela militar colombiana. En total participaron 114 sujetos, militares regulares de primer año (MR-1A), que representan la totalidad de un contingente particular; todos ellos hombres, con edades entre los diecisiete y los veintidós años, provenientes de hogares ubicados en la región Caribe (41%) y el centro del país (12%), sin ningún tipo de diagnóstico médico o mental relevante. Los resultados indican relaciones lineales y directamente promocionales entre todas las variables, con magnitudes significativas en lo referente a las relaciones depresión-desesperanza (rs= 0,295; ρ = 0,01) y depresión-riesgo suicida (rs= 0,478; ρ = 0,01), siendo esta ultima el reporte más elevado.

Abstract This study evaluated the cognitive profile and the levels of Hopelessness, Depression and Suicide Risk in a youth group linked to the process of forming a Colombian military school. A total of 114 subjects participated, regular military freshman, which representing an entire contingent particular; all male, aged between 17 and 22 years, from households in the Caribbean region (41%) and the center of the country (12%), without any relevant medical or mental diagnosis. The results indicate linear and directly promotional relationships between all variables with significant quantities in relation to depression-hopelessness (rs= 0,295; ρ = 0,01) and depression-suicide risk (rs= 0,478; ρ = 0,01) the latter being the highest report.

Escala Multidimensional de trastornos afectivos-EMTA: análisis desde la teoría clásica de los test y la teoría de respuesta al ítem / Multidimensional scale for affective disorders-Msad: analysis from the classic tests theory and the item response theory

La presente investigación responde a una de las fases del proceso de diseño y estandarización de la Escala Multidimensional de Trastornos Afectivos (EMTA), cuyo propósito fue su análisis desde la Teoría Clásica de los Test (TCT) y la Teoría de Respuesta al Ítem (TRI) a partir de una muestra de 384 estudiantes vinculados a tres instituciones de educación superior de Barranquilla, cuyas edades oscilaron entre los 17 y los 26 años de edad. Los datos fueron recolectados a través de la administración de tres instrumentos: la Escala Multidimensional de Trastornos Afectivos, el Inventario de Depresión de Beck (a= .791) y la Escala Autoaplicada de Altman (a= .566). Se reportaron resultados ajustados a los parámetros de ambos modelos. En el análisis desde la TCT, se evidenciaron índices alfa de Cronbach significativos para ambas subescalas (a = .942 para la Subescala de Depresión y a = .864 para la Subescala de Manía), una alta consistencia interna con correlaciones ítem escala superiores a .3 para todos los ítems. Desde la TRI, se reportó una fiabilidad en el caso de la Depresión de .88 (personas) y .99 (ítems), mientras que en lo referente a Manía, los índices fueron de .84 (personas) y .87 (ítems). A lo largo de los resultados se conservó un ajuste monotónico creciente, con lo cual se corrobora el cumplimiento del principio de la invarianza en la medición del rasgo latente.

This research responds to one phase of the process for the design and standarization of the MSAD Multidimentional Scale of Affective Disorders -EMTA in Spanish-, whose purpose was to analyze MSAD, from the Classical Test Theory (CTT) and the Item Response Theory (TRI), from a sample of 384 students enrolled to three universities in Barranquilla, aged between 17 and 26 years. This is considered an instrumental study, due to its purpose. The data were collected through he administration of three instruments: Scale Multidimensional Affective Disorder, The Beck Depression Inventory (a= .791) and the self-administered Altman Scale (a= .566). Finally, results were reported as adjusted to the parameters of both models. Analysis from the TCT showed high Cronbach alpha indexes for both subscales (a= .942 for the Depression Subscale and a= .864 for the Subscale Mania), as well as high internal item-scale correlations above .3 for all items. Since the TRI, reliability in the case of Depression .88 (individuals) and .99 (items) were reported, while rates regarding Mania were .84 (persons) and .87 (items). Results retained an increasing monotonic configuration; thus the principle of invariance in measuring the latent trait is corroborated.