Knowledge and attitudes regarding contraceptive methods and sex education in students and parents of eight Colombian schools 2020-2021: a mixed methods study.

Background: In Colombia, the average age of first sexual intercourse is between 14 and 15, and it has one of the highest fertility rates among adolescents in Latin America, which reflects poor access to health services and a lack of knowledge about contraception. Some laws support comprehensive sex education as a learning process that families and schools should provide. The objective of this work was to assess the frequency of adequate knowledge and attitudes of acceptance towards contraception in students, their associated factors, sexual behaviours in sexually active students, and experiences with sex education. Methods: Mixed methods study consisting of an analytical cross-sectional study and a qualitative hermeneutic phenomenological study. The former included students who completed a questionnaire with sociodemographic variables, surveys on knowledge and attitudes toward contraception, and questions about sexual behaviour. Focus groups were used in the qualitative study to evaluate students' and parents' sex education experiences. Findings: 827 students were surveyed, of whom 52.3% had adequate knowledge about contraceptives and 80.1% had attitudes of acceptance. Talking with parents about sex education, receiving sex education, and being in the eleventh grade increased the likelihood of having adequate knowledge. Each year of age, being male, being a victim of forced displacement, and studying in a public school were associated with lower possibilities of attitudes of acceptance. Using condoms, compared to other contraceptives, was associated with less adequate knowledge and attitudes of acceptance (p < 0.05). Experiences with sex education, contraception, and sexual and reproductive rights were three emerging categories in the focus groups. Interpretation: In a group of Colombian high school students, half of them had adequate knowledge, eight out of 10 had attitudes of acceptance about contraception, and both were associated with having received sex education. Nevertheless, different types of barriers to sexual education were identified at home and in schools. The results will allow the generation of educational policies that modify the educational model as well as new strategies by health professionals to raise awareness about responsible sexuality. Funding: This project was financed by internal research of the Fundación Universitaria de Ciencias de la Salud-FUCS (DI-I-0392-20).

Evaluación pre- y postaller de sexualidad en estudiantes de un colegio secundario / Before and after assessment of a sexuality workshop in high-school students

Objetivo. Evaluar aspectos de la percepción sobre sexualidad de los estudiantes antes y después de un taller. Población y métodos. Estudio descriptivo cualicuantitativo de intervención antes-después sin grupo control. Se analizó año escolar, condición percibida en relación con la sexualidad, dispositivos preferidos para recibir información y percepción sobre el cuidado de su sexualidad. Resultados. Se completaron 272 encuestas pretaller y 259 postaller. Aumentó la percepción acerca de un mejor nivel de información (el 72,3 % vs. el 90,7 %) y disminuyeron las dudas, miedos y vergüenza. Aumentó la preferencia por el dispositivo taller (el 49,1 % vs. el 69,9 %), mejoró la percepción del uso adecuado del preservativo (el 66,8 % vs. el 81,1 %), pastillas anticonceptivas (el 20,3 % vs. el 42,5 %) y anticoncepción de emergencia (el 18,5 % vs. el 40,9 %). Conclusión. Los estudiantes aumentaron la información y percepción sobre el cuidado de su sexualidad.

Objective. To assess different aspects of the perception of sexuality among students before and after a workshop. Population and methods. Descriptive, qualitative, and quantitative before and after intervention study without a control group. School year, status in relation to sexuality, preferred sources of information, and perception of self-care in relation to sexuality care were analyzed. Results. A total of 272 surveys were completed before the workshop and 259, after the workshop. The perception about a better level of information increased (72.3 % versus 90.7 %), and doubts, fears, and embarrassment decreased. The preference for the workshop as an information source increased (49.1 % versus 69.9 %), and an improvement was observed in the perception of a correct use of condoms (66.8 % versus 81.1 %), birth control pills (20.3 % versus 42.5 %), and emergency contraception (18.5 % versus 40.9 %). Conclusion. Students' information and perception of self-care in relation to sexuality increased.

Before and after assessment of a sexuality workshop in high-school students. / Evaluación pre- y postaller de sexualidad en estudiantes de colegios secundarios.

OBJECTIVE: To assess different aspects of the perception of sexuality among students before and after a workshop. POPULATION AND METHODS: Descriptive, qualitative, and quantitative before and after intervention study without a control group. School year, status in relation to sexuality, preferred sources of information, and perception of self-care in relation to sexuality care were analyzed. RESULTS: A total of 272 surveys were completed before the workshop and 259, after the workshop. The perception about a better level of information increased (72.3 % versus 90.7 %), and doubts, fears, and embarrassment decreased. The preference for the workshop as an information source increased (49.1 % versus 69.9 %), and an improvement was observed in the perception of a correct use of condoms (66.8 % versus 81.1 %), birth control pills (20.3 % versus 42.5 %), and emergency contraception (18.5 % versus 40.9 %). CONCLUSION: Students' information and perception of self-care in relation to sexuality increased.

Objetivo. Evaluar aspectos de la percepción sobre sexualidad de los estudiantes antes y después de un taller. Población y métodos. Estudio descriptivo cualicuantitativo de intervención antes-después sin grupo control. Se analizó año escolar, condición percibida en relación con la sexualidad, dispositivos preferidos para recibir información y percepción sobre el cuidado de su sexualidad. Resultados. Se completaron 272 encuestas pretaller y 259 postaller. Aumentó la percepción acerca de un mejor nivel de información (el 72,3 % vs. el 90,7 %) y disminuyeron las dudas, miedos y vergüenza. Aumentó la preferencia por el dispositivo taller (el 49,1 % vs. el 69,9 %), mejoró la percepción del uso adecuado del preservativo (el 66,8 % vs. el 81,1 %), pastillas anticonceptivas (el 20,3 % vs. el 42,5 %) y anticoncepción de emergencia (el 18,5 % vs. el 40,9 %). Conclusión. Los estudiantes aumentaron la información y percepción sobre el cuidado de su sexualidad.

Adaptación transcultural y validación del test CRAFFT como prueba de pesquisa para consumo problemático, abuso y dependencia de alcohol y otras sustancias en un grupo de adolescentes argentinos / Transcultural adaptation and validation of the CRAFFT as a screening test for problematic alcohol and substance use, abuse and dependence in a group of Argentine adolescents

Introducción. El consumo de sustancias de abuso y sus consecuencias son una problemática importante en adolescentes. La pesquisa de consumo problemático, abuso y dependencia (CPAD) de alcohol y otras sustancias debe formar parte de la consulta con adolescentes. El cuestionario POSIT (Problem Oriented Screening Instrument for Teenagers; Pesquisa orientada a los problemas, para adolescentes) y el cuestionario CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble; Auto, relax, solo, olvido, amigos/familia, problema; CRAFFT, por sus siglas en inglés) son para tal fin. POSIT: 17 ítems corresponden al área del uso y abuso de sustancias (POSITuas); ha sido validado en español. CRAFFT: consta de 6 preguntas; no ha sido validado en Argentina. Objetivo. Evaluar la validez de una versión adaptada del CRAFFT al castellano en un grupo de adolescentes argentinos tomando como referencia la pesquisa realizada con POSITuas. Población y métodos. Se realizaron CRAFFT y POSITuas a adolescentes de 14 a 20 años. Se asignó 1 a la respuesta afirmativa y 0 a la respuesta negativa. Individuo con riesgo aumentado de CPAD, el que puntúe >2 en CRAFFT y en POSITuas. Resultados. Se incluyeron 286 adolescentes; 52% fueron mujeres; edad media: 16,6 años. 29% obtuvo puntaje CRAFFT > 2, y 37%, puntaje POSITuas > 2. Sensibilidad del CRAFFT: 59%; y especificidad: 88%. Valor predictivo positivo CRAFFT : 0,74; y valor predictivo negativo: 0,78. El área bajo la curva fue 0,73. En la regresión lineal, el R² para las 6 preguntas CRAFFTa fue 0,60. Sexo y edad no modifican los resultados. El alfa de Cronbach fue 0,64. Conclusión. La sensibilidad del CRAFFTa fue del 59% y la especificidad, del 88%, comparadas con POSITuas para pesquisar CPAD de alcohol y otras drogas en adolescentes de nuestro medio.

Introduction. Substance use and abuse and their consequences are a major problem among adolescents. The screeningfor problematic alcohol and substance use, abuse and dependence should be part of the case-taking process for adolescents. The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Car, Relax, Alone, Forget, Family/Friends, Trouble questionnaire (CRAFFT) are used to this end. POSIT: 17 items corresponding to substance use and abuse (POSITsua); it has been validated in Spanish. CRAFFT: six questions; it has not been validated in Argentina. Objective. To assess the validity of a version of the CRAFFT screening test adapted to Spanish in a group of Argentine adolescents using the POSITsua test as reference. Population and Methods. The CRAFFTa and the POSITsua tests were administered to 14-20 year-old adolescents. An affirmative answer was scored as 1, and a negative answer, as 0. An individual was considered to have an increased risk of problematic use, abuse and dependence if he/she scored >2 in the CRAFFTa and POSITsua tests. Results. Two hundred and eighty-six adolescents were included; 52% were female; mean age: 16.6 years old. The CRAFFTa score was >2 for 29%, while the POSIT score was >2 for 37%. CRAFFTa sensitivity: 59%; specificity: 88%. CRAFFTa positive predictive value: 0.74; negative predictive value: 0.78. The area undej; the curve was 0.73. In the linear regression, the R for the six CRAFFT questions was 0.60. Gender and age did not modify results. Cronbach's alpha was 0.64. Conclusion. CRAFFTa sensitivity was 59%, and its specificity was 88%, compared to the POSITsua test as a screening tool for problematic alcohol and substance use, abuse and dependence among Argentine adolescents.

Adaptación transcultural y validación del test CRAFFT como prueba de pesquisa para consumo problemático, abuso y dependencia de alcohol y otras sustancias en un grupo de adolescentes argentinos / Transcultural adaptation and validation of the CRAFFT as a screening test for problematic alcohol and substance use, abuse and dependence in a group of Argentine adolescents

Introducción. El consumo de sustancias de abuso y sus consecuencias son una problemática importante en adolescentes. La pesquisa de consumo problemático, abuso y dependencia (CPAD) de alcohol y otras sustancias debe formar parte de la consulta con adolescentes. El cuestionario POSIT (Problem Oriented Screening Instrument for Teenagers; Pesquisa orientada a los problemas, para adolescentes) y el cuestionario CRAFFT (Car, Relax, Alone, Forget, Family/Friends, Trouble; Auto, relax, solo, olvido, amigos/familia, problema; CRAFFT, por sus siglas en inglés) son para tal fin. POSIT: 17 ítems corresponden al área del uso y abuso de sustancias (POSITuas); ha sido validado en español. CRAFFT: consta de 6 preguntas; no ha sido validado en Argentina. Objetivo. Evaluar la validez de una versión adaptada del CRAFFT al castellano en un grupo de adolescentes argentinos tomando como referencia la pesquisa realizada con POSITuas. Población y métodos. Se realizaron CRAFFT y POSITuas a adolescentes de 14 a 20 años. Se asignó 1 a la respuesta afirmativa y 0 a la respuesta negativa. Individuo con riesgo aumentado de CPAD, el que puntúe >2 en CRAFFT y en POSITuas. Resultados. Se incluyeron 286 adolescentes; 52% fueron mujeres; edad media: 16,6 años. 29% obtuvo puntaje CRAFFT > 2, y 37%, puntaje POSITuas > 2. Sensibilidad del CRAFFT: 59%; y especificidad: 88%. Valor predictivo positivo CRAFFT : 0,74; y valor predictivo negativo: 0,78. El área bajo la curva fue 0,73. En la regresión lineal, el R² para las 6 preguntas CRAFFTa fue 0,60. Sexo y edad no modifican los resultados. El alfa de Cronbach fue 0,64. Conclusión. La sensibilidad del CRAFFTa fue del 59% y la especificidad, del 88%, comparadas con POSITuas para pesquisar CPAD de alcohol y otras drogas en adolescentes de nuestro medio.(AU)

Introduction. Substance use and abuse and their consequences are a major problem among adolescents. The screeningfor problematic alcohol and substance use, abuse and dependence should be part of the case-taking process for adolescents. The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Car, Relax, Alone, Forget, Family/Friends, Trouble questionnaire (CRAFFT) are used to this end. POSIT: 17 items corresponding to substance use and abuse (POSITsua); it has been validated in Spanish. CRAFFT: six questions; it has not been validated in Argentina. Objective. To assess the validity of a version of the CRAFFT screening test adapted to Spanish in a group of Argentine adolescents using the POSITsua test as reference. Population and Methods. The CRAFFTa and the POSITsua tests were administered to 14-20 year-old adolescents. An affirmative answer was scored as 1, and a negative answer, as 0. An individual was considered to have an increased risk of problematic use, abuse and dependence if he/she scored >2 in the CRAFFTa and POSITsua tests. Results. Two hundred and eighty-six adolescents were included; 52% were female; mean age: 16.6 years old. The CRAFFTa score was >2 for 29%, while the POSIT score was >2 for 37%. CRAFFTa sensitivity: 59%; specificity: 88%. CRAFFTa positive predictive value: 0.74; negative predictive value: 0.78. The area undej; the curve was 0.73. In the linear regression, the R for the six CRAFFT questions was 0.60. Gender and age did not modify results. Cronbachs alpha was 0.64. Conclusion. CRAFFTa sensitivity was 59%, and its specificity was 88%, compared to the POSITsua test as a screening tool for problematic alcohol and substance use, abuse and dependence among Argentine adolescents.(AU)

Transcultural adaptation and validation of the CRAFFT as a screening test for problematic alcohol and substance use, abuse and dependence in a group of Argentine adolescents.

INTRODUCTION: Substance use and abuse and their consequences are a major problem among adolescents. The screening for problematic alcohol and substance use, abuse and dependence should be part of the case-taking process for adolescents. The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Car, Relax, Alone, Forget, Family/Friends, Trouble questionnaire (CRAFFT) are used to this end. POSIT: 17 items corresponding to substance use and abuse (POSITsua); it has been validated in Spanish. CRAFFT: six questions; it has not been validated in Argentina. OBJECTIVE: To assess the validity of a version of the CRAFFT screening test adapted to Spanish in a group of Argentine adolescents using the POSITsua test as reference. POPULATION AND METHODS: The CRAFFTa and the POSITsua tests were administered to 14-20 year-old adolescents. An affirmative answer was scored as 1, and a negative answer, as 0. An individual was considered to have an increased risk of problematic use, abuse and dependence if he/she scored >2 in the CRAFFTa and POSITsua tests. RESULTS: Two hundred and eighty-six adolescents were included; 52% were female; mean age: 16.6 years old. The CRAFFTa score was >2 for 29%, while the POSIT score was >2 for 37%. CRAFFTa sensitivity: 59%; specificity: 88%. CRAFFTa positive predictive value: 0.74; negative predictive value: 0.78. The area under the curve was 0.73. In the linear regression, the R for the six CRAFFT questions was 0.60. Gender and age did not modify results. Cronbach's alpha was 0.64. CONCLUSION: CRAFFTa sensitivity was 59%, and its specificity was 88%, compared to the POSITsua test as a screening tool for problematic alcohol and substance use, abuse and dependence among Argentine adolescents.

[The choking game in adolescence, between experimentation and risk]. / El juego de la asfixia en la adolescencia: entre la experimentación y el riesgo.

In the last year there was happened a series of adolescent deaths in the province of Salta that might be related to a dangerous game known as "the choking game". It has been practiced over many years in different countries around the world and consists of provoking brain hypoxia for some seconds by different techniques to obtain an instant of ecstasy and pleasure. We consider relevant that health providers know about this practice and so be able to recognize through signs and symptoms when an adolescent might be playing this game.

El juego de la asfixia en la adolescencia: entre la experimentación y el riesgo / The choking game in adolescence, between experimentation and risk

En el último año ha tenido lugar una serie de muertes de adolescentes en Salta que podrían estar relacionadas con un peligrosojuego llamado “juego de la asfixia”. Se lo practica desde hace muchos años en varios países del mundo y consiste en provocar hipoxia cerebral por algunos segundos, mediante diferentes técnicas, para obtener un instante de éxtasis y placer.Consideramos relevante que el equipo de salud conozca esta práctica y pueda identificar, a través de signos y íntomas, cuando un adolescente pueda estar jugando al juego de la asfixia.

El juego de la asfixia en la adolescencia: entre la experimentación y el riesgo / The choking game in adolescence, between experimentation and risk

En el último año ha tenido lugar una serie de muertes de adolescentes en Salta que podrían estar relacionadas con un peligrosojuego llamado ¶juego de la asfixia÷. Se lo practica desde hace muchos años en varios países del mundo y consiste en provocar hipoxia cerebral por algunos segundos, mediante diferentes técnicas, para obtener un instante de éxtasis y placer.Consideramos relevante que el equipo de salud conozca esta práctica y pueda identificar, a través de signos y íntomas, cuando un adolescente pueda estar jugando al juego de la asfixia.(AU)