Intervenciones de mHealthpara reducir el impacto del consumo de sustancias en jóvenes: una revisión sistemática / mHealthinterventions to reduce the impact of substance use on youths: a systematic review

El objetivo de la presente revisión sistemática fue examinar las características de las interven-ciones centradas en reducir el consumo de sustancias, sus potenciales consecuencias negativas o incrementar el uso de estrategias de protección en jóvenes impartidas a través de medios tecnológicos. Las intervenciones fueron categorizadas según el formato de implementación (i. e., mensajes, páginas webs o apps). Se identificaron 29 intervenciones. Las intervenciones por mensajes y páginas web impactaron positivamente en las tres variables dependientes analiza-das. Ninguna de las intervenciones por apps mostró cambios significativos. La mayoría de las in-tervenciones estuvieron dirigidas a estudiantes universitarios y centradas en el consumo de al-cohol. Esto destaca la necesidad de desarrollar y evaluar intervenciones dirigidas a población no-universitaria y centradas en sustancias diferentes al alcohol. La síntesis proporcionada po-dría ser útil para guiar el diseño de intervenciones mediadas por tecnologías para reducir el impacto del consumo de sustancias en jóvenes. (AU)

The aim of the present systematic review was to examine the characteristics of mHealth in-terventions focused on reducing substance use, negative consequences or increasing protective behavioural strategies use in young adult population. Interventions were categorized accord-ing to the format of implementation (i. e., messages, web page or apps). We identified 29 in-terventions. Interventions delivered by messages and web pages impacted on the three de-pendent variables analysed. None of the interventions delivered by app showed significant changes. Most of the interventions were intended for college students and focused on alcohol consumption. Our results stand out the need to develop and evaluate interventions for non-college population and focused on substances different to alcohol. The evidence provided could be a useful for designing mHealth interventions focused on reduce substance use among young people. (AU)

Consumo de alcohol durante el embarazo y la lactancia: rol de profesionales de salud / Alcohol use during pregnancy and breastfeeding: health professionals' role

Dada la prevalencia del consumo de alcohol durante el embarazo y la lactancia y la implicancia de esta práctica para la salud de los/as bebés, se indagó sobre la información que comparten profesionales de la salud a mujeres (embarazadas o en período de lactancia) sobre el consumo de alcohol durante el embarazo y la lactancia. Para ello, se llevó a cabo un estudio observacional transversal mediante una encuesta en línea. Completaron la encuesta completa 86 profesionales de la salud (Medad=43.22, DS=9.10) y 32 sólo las preguntas sobre consumo y lactancia (n total para encuesta de lactancia=118 profesionales; Medad=44.5, DS=8.77). Los resultados arrojaron que la mayoría de los/as profesionales destaca la importancia de abordar el consumo de alcohol durante el embarazo y la lactancia, pero hay quienes permiten el consumo de alcohol durante estos períodos, a pesar de considerarse de riesgo entre moderado y alto para el/la bebé. Se concluye, entonces, que hay una necesidad de mayor formación profesional en el tema (AU)

The high prevalence of alcohol consumption during pregnancy and breastfeeding has been reported. The use of alcohol during pregnancy and breastfeeding is prejudicial for babies' health. This study inquired about the information that health professionals share with women about alcohol use during pregnancy and breastfeeding. Therefore, a cross-sectional observational study was conducted using an online survey. 86 health professionals (Mage=43.22, SD=9.10) completed the full survey and 32 health professionals completed only the questions about breastfeeding and alcohol use (total sample for these questions=118, Mage=44.5, SD=8.77). The results showed that almost every professional highlights the importance of approaching alcohol use during pregnancy and breastfeeding, but some allow alcohol use during these periods despite the fact that a large group considered that alcohol use has moderate to high risk for the baby. The conclusions of the study are that results showed the need for more professional training on alcohol drinking risk during pregnancy and breastfeeding (AU)

Tomar alcohol antes de salir: la previa en adolescentes argentinos y su relación con normas sociales y motivos de previa / Drinking before going out: prepartying in Argentinean adolescents and its association with drinking norms and prepartying motives

Resumen La previa (i.e., el consumo de alcohol antes de asistir al evento de la salida en el que puede, o no, consumirse más alcohol) incrementa marcadamente el riesgo de experimentar consecuencias negativas asociadas al consumo de alcohol. Aunque el consumo de alcohol es muy prevalente entre los adolescentes argentinos, son escasos los trabajos centrados en la previa. Este trabajo describe el consumo de alcohol y la conducta de previa en adolescentes argentinos (13 a 18 años), identifica el efecto de las normas descriptivas y los motivos de previa sobre la frecuencia de previa y la cantidad de alcohol consumido durante esta práctica, y examina variaciones en el consumo general de alcohol y en la cantidad de consecuencias negativas derivadas, en función de realizar, o no, la previa. Participaron 402 adolescentes (52.7 % mujeres) que completaron una encuesta sobre consumo de alcohol, consecuencias negativas asociadas, conducta y motivos de previa, y normas descriptivas sobre estos encuentros. El 60 % de los adolescentes reportó conducta de previa en el último año en la que consumieron, en promedio, 70 gramos de alcohol. El 85 % continuó tomando alcohol después de la previa. Quienes exhiben conducta de previa, comparados con quienes beben pero no hacen previa, consumen significativamente más alcohol y experimentan más consecuencias negativas derivadas de este consumo. A nivel multivariado, las normas descriptivas fueron el mejor predictor de los indicadores de previa. Los hallazgos sugieren que la previa sería un factor de riesgo para tener trayectorias de consumo problemático y sería beneficioso prevenir este tipo de prácticas.

Abstract In Argentina, alcohol is the most consumed psychoactive substance among adolescents and, similar to other western countries, rates of alcohol use markedly increase during this developmental stage. Arguably more concerning, heavy episodic drinking (HED, a.k.a. binge drinking) is also highly prevalent. Heavy episodic drinking can be defined as the consumption of a large quantity of alcohol (i.e., ≥ 42/70 g of pure alcohol, depending on sex and age) in one, rather brief, single setting. HED is associated with greater occurrence of a myriad of negative consequences such as alcohol-induced increments in impulsivity and risk-taking behaviors, blackouts, drunk driving, sleep and eating impairments, and the development of tolerance. Prepartying (i.e., the consumption of alcohol before attending a social event where more alcohol might, or might not, be available) is a high-risk drinking practice due to its robust association with alcohol-related negative consequences. Different factors influence alcohol use and preparty behavior. Many adolescents overestimate the drinking behaviors of their peers (descriptive norms) which, in turn, is associated with heavier alcohol use. Additionally, previous work found that one of the main reasons or motives for engaging in preparty behavior is the desire of getting intoxicated. Although alcohol use is highly prevalent among Argentinean adolescents, studies focused on prepartying are very scarce. The present study (i) describes alcohol consumption and prepartying behaviors in Argentinean adolescents (13 to 18 years old), (ii) examines the effect of descriptive norms and prepartying motives on prepartying outcomes (i.e., frequency of prepartying and drinking quantity when prepartying) and (iii) examines variations in alcohol drinking outcomes as a function of prepartying. Participants were 402 adolescents (52.7 % women) that completed a pencil and paper survey that measured alcohol consumption, prepartying outcomes, descriptive norms for prepartying, prepartying motives and alcohol-related negative consequences. Most of the sample (83 %) reported lifetime alcohol use and 64 % reported last-month alcohol use. More than half of the sample (57 %) reported engaging in prepartying behavior within the last year where they consumed an average of 70 grams of alcohol. Most of the adolescents who prepartied (85 %) continued drinking alcohol at the event. Adolescents who engaged in preparty behavior, compared to their drinking peers who did not, consumed significantly more alcohol and experienced more alcohol-related negative consequences. Specifically, 90 % of the adolescents who engaged in preparty behavior reported to engaged in heavy drinking episodes within the previous month while 68 % of drinkers who did not preparty reported to engage in that drinking pattern. At the multivariate level, descriptive norms, but not prepartying motives, were significantly associated with preparty behavior. The present results suggest that prepartying could be a risk factor for the involvement in problematic trajectories of alcohol use and, therefore, it would be beneficial to prevent adolescents from engaging in this type of drinking practice. Additionally, the present findings suggest promising avenues for intervention, such as those aimed at targeting descriptive norms. Adolescents tend to overestimate drinking behaviors among their peers, a bias that is associated with heavier alcohol use. Interventions aimed at correcting these biases have shown promising results at reducing drinking behaviors.

Ethanol-induced autonomic responses and risk taking increase in young adults with a positive family history of alcohol problems.

The mechanisms that underlie the greater prevalence of alcohol use disorders in individuals with a positive family history (FH+) of alcohol abuse are still under investigation. These subjects may exhibit differential sensitivity to alcohol's effects on psychomotor stimulation and impulsivity. Alcohol-induced psychomotor stimulation, measured as the heart rate (HR) response, is a proxy for the positive rewarding effects of the drug. We analyzed alcohol-induced effects on time perception (Time Production Task), risk taking (Balloon Analogue Risk Task [BART]), and HR in FH+ and FH- participants. In the FH+ and FH- groups, women and men received 0.6 and 0.7g/kg alcohol, respectively. The alcohol dose yielded a breath alcohol concentration of 0.08% throughout the experiment. The control groups received placebo, and the subjective perception of alcohol intoxication was assessed. Alcohol intoxication significantly increased HR and the adjusted average number of pumps on the BART (a measure of risk taking) in FH+ men and women but not in FH- participants. Behavioral impulsivity was unaffected by alcohol or a FH of alcohol abuse. FH- but not FH+ participants who received alcohol reported significantly greater subjective perception of alcohol's effects than their placebo counterparts. These results indicate that FH+ individuals presented heightened sensitivity to alcohol-induced HR stimulation and alcohol-induced risk taking compared with their FH- counterparts. FH+ subjects, however, were insensitive to the subjective effects of alcohol. This idiosyncratic response pattern may be a likely pathway by which a FH of alcohol problems promotes alcohol drinking.

Validation of the Spanish Version of the Young Adult Alcohol Consequences Questionnaire (S-YAACQ).

The present work was aimed at analyzing the psychometric properties of a Spanish version of the 48-item Young Adult Alcohol Consequences Questionnaire (YAACQ) by applying the item response theory. Participants were 247 college students (75.7% female) who reported drinking alcohol within the last 3 months. The 48-item YAACQ was translated into Spanish and back to English. The psychometric properties of the Spanish YAACQ (S-YAACQ) were analyzed applying the Rasch model, as well as group difference and correlational analyses. Factor structure of the S-YAACQ was analyzed using confirmatory factor analysis. The verification of the global fit of the data showed adequate indexes for persons and items. The reliability estimates for the items and the persons were both high. Scores on the S-YAACQ were strongly correlated with scores on the Spanish versions of the AUDIT and the RAPI and with frequency of binge drinking. Five of 48 items showed different item functioning (DIF) as a function of gender. These biases were in opposite directions, resulting in DIF cancellation. The item severity continuum was largely similar to that found with the Spanish brief YAACQ and to that found in U.S. and Dutch samples. Overall, results from the present study suggest that this translated full version is better suited than the brief YAACQ for the identification of youth who are experiencing problems with alcohol. Findings suggest that the Spanish version of the full YAACQ may be used to identify a broad diversity of alcohol-related problems in Spanish-speaking college students. (PsycINFO Database Record

The Spanish version of the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ): a Rasch model analysis.

The present work was aimed at analyzing the psychometric properties of the Spanish Brief YAACQ in a sample of Argentinean college students applying the Item Response Theory. Participants were 302 college students (59.9% females) who reported drinking alcohol within the last month. The B-YAACQ was translated into Spanish and the psychometric properties of this Spanish version were analyzed applying the Rasch Model, as well as testing group difference and conducting correlational analyses. The verification of the global fit of the data showed adequate indexes for the persons and items. The reliability estimate of the items was very high (.97), while the reliability estimate of the persons was modest (.65). All but one item had adequate fit indexes. B-YAACQ scores were strongly related to measures of hazardous alcohol drinking, including frequency of drunkenness episodes and frequency of heavy episodic drinking, indicating concurrent validity. The item content along the severity continuum was fairly similar to that found with US and Dutch samples. Three items had a gender bias against men and another three items showed a gender bias against women, indicating the presence of differential item functioning cancellation. The map of items and persons suggests that these 24 items do not provide a full coverage of the continuum of alcohol problems at the lower levels of the continuum. Overall, results from the present study suggest that the Spanish B-YAACQ offers a brief and efficient way to identify alcohol problems in Spanish-speaking college students.

Contribution of time of drinking onset and family history of alcohol problems in alcohol and drug use behaviors in Argentinean college students.

AIMS: The aim of the study was to analyze independent and potential interactive effects of age at drinking onset and family history of alcohol abuse on subsequent patterns of alcohol drinking, alcohol-related problems and substance use. METHODS: Participants were college students (60.3% females, mean age = 20.27 ± 2.54 years) from the city of Córdoba, Argentina. Several measures were used to assess alcohol, tobacco and drug use. The Spanish version of the Brief Young Adult Alcohol Consequences Questionnaire was used to assess alcohol-related problems. Factorial analyses of variance, or its non-parametric equivalent, were performed to explore differences in substance use behaviors and alcohol-related problems in subjects with early or late drinking onset and with or without family history of alcohol abuse. Chi-square tests were conducted to analyze the association between these two risk factors and categorical measures of alcohol, tobacco and drug use. RESULTS: Early onset of drinking was associated with amount of consumption of alcohol including up to hazardous levels, as well as tobacco and drug use. However, the frequency of alcohol problems and frequency of episodes of alcohol intoxication were only related to age of onset in those with a positive family history of alcohol problems. CONCLUSION: Delaying drinking debut is particularly important in the prevention of future alcohol problems in those adolescents who have a family history of such problems.