Back to school after the pandemic: Adjustment of Spanish children and adolescents / La vuelta al colegio tras la pandemia: Adaptación de los niños y adolescentes españoles

Para frenar la propagación del COVID-19, el gobierno español aplicó medidas restrictivas, como el cierre escolar. Aunque los efectos de la pandemia en el bienestar emocional de los niños han sido estudiados, faltan estudios que examinen la adaptación escolar tras la pandemia y el papel que la infección ha tenido en el proceso de adaptación. El objetivo es analizar la relación entre los eventos estresantes relacionados con la escuela y la adaptación escolar después del confinamiento, incluyendo la ansiedad como mediadora. Los participantes fueron 219 padres de niños y adolescentes españoles de entre 3 y 18 años que completaron encuestas sobre la ansiedad de sus hijos (Spanish Brief Child Version of the Spence Children's Anxiety Scale), los eventos estresantes vividos relacionados con la escuela (Stressful Eventos relacionados con el Inventario de Pandemia), y la adaptación escolar (Escala de Ajuste de los Niños después del Cierre Escolar de la Pandemia). Los resultados mostraron mayor prevalencia en el evento estresante distancia social (87%). Tener COVID-19 y sufrir acoso escolar se relacionó directamente con una mayor ansiedad. Los niños que disminuyeron el contacto social y sufrieron acoso escolar mostraron peor adaptación escolar, siendo la ansiedad un mediador indirecto. Los hallazgos destacan la importancia de supervisar la adaptación escolar y promover estrategias para prevenir problemas emocionales en jóvenes expuestos a situaciones estresantes.(AU)

Aiming to mitigate the COVID-19 spread, the government of Spain applied restrictive measures, like schools’ closure. Although the ef-fects of the pandemic on children's emotional well-being have been stud-ied, there is a lack of studies examining school adjustment following the pandemic and the role that the infection has played in the adjustment pro-cess. The objective is to analyze the relationship between stressful events related to school experienced by children and their adjustment to school after the home confinement, including anxiety as a mediator variable. Par-ticipants were the parentsof 219 Spanish children and adolescents aged 3 and 18 years who completed a survey about their children’s anxiety (Span-ish Brief Child Version of the Spence Children’s Anxiety Scale), the stress-ful events experienced related to school (Stressful Events related to Pan-demic Inventory), and the adjustment to school (Adjustment of Children after Pandemic School Closure Scale). Results showed that social distance was the most reported stressful event (87%). Having COVID-19 and expe-riencing bullying were directly related to a high level of anxiety. Children ́s who decreased social contact and experienced bullying showed a worse ad-justment to school. Anxiety was an indirect mediator of this relationship. Findings highlight the importance of supervising school adaptation and promoting strategies to prevent emotional problems when the youths are exposed to stressful situations.(AU)

Effectiveness of a transdiagnostic computerized self-applied program targeting children with emotional problems: A randomized controlled trial.

BACKGROUND: Super Skills for Life (SSL) is an eight-session transdiagnostic program based on cognitive-behavioral therapy (CBT), aimed at the indicated prevention of childhood emotional problems, which has been implemented with positive short- and long-term results. The present study aimed to examine the effects of a self-applied computerized program based on SSL that maintains the same objectives and contents as the face-to-face program. METHODS: In this randomized controlled study, 75 children (49.3 % female) aged 8-12 years (Mage = 9.45, SD = 1.31), selected for exhibiting emotional symptoms, were randomly assigned to either the intervention (n = 35) or the waiting list control (WLC) group (n = 40). Pre- and post-intervention data were collected through self-reports and the report of parents who completed parallel versions of the same measures of emotional and behavioral problems. RESULTS: Overall, compared to the WLC group, the intervention group showed positive effects on targeted emotional symptomatology in the short term. Based on parents' reports, a significant reduction was found in outcomes such as anxiety, depression, emotional symptoms, and internalizing problems, while self-reported results were similar except for anxiety. In addition, a positive impact was found on symptoms related to other types of difficulties (e.g., externalizing problems and general difficulties measured). LIMITATIONS: Small sample size, non-inclusion of follow-up assessment and other informants (e.g., teachers). CONCLUSIONS: In conclusion, this research provides novel and promising data on the self-applied computerized adapted version of the SSL program, within a multi-informant approach, suggesting that it may be a useful tool for the indicated prevention of childhood emotional problems.

Nighttime coping response in children: Development and validation of a new scale.

Coping strategies can play an important role in dealing with nighttime fears and related anxiety problems in school-aged children, but well-established self-reporting tools are lacking, and research in this area is limited. The aim of this study was to develop a new self-report instrument assessing coping strategies in school-aged children when facing nighttime fears, the Nighttime Coping Response Scale (NCRS), and to examine its psychometric properties. Participants were 786 children (48.7% boys) aged 8-12 years, who completed the NCRS and other measures related to anxiety and behavioral problems. The construction of the NCRS was based on relevant prior literature and experts' criteria. Exploratory and confirmatory analyses supported a three-factor structure, comprising 15 items measuring coping strategies related to self-control, social support seeking, and avoidance. The NCRS was shown to have good internal consistency, test-retest reliability, and convergent and divergent validity. This research found preliminary support for the use of the NCRS, suggesting the potential suitability of this brief tool to be used by clinicians and researchers to identify and address the use of children's maladaptive coping strategies when dealing with nighttime fears. The NCRS could also be important to enable the development of further research in this field.

COVID-19: Psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents.

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.

Improving Social Performance Through Video-feedback with Cognitive Preparation in Children with Emotional Problems.

Anxious children report a more negative perception of their social performance and increased nervous behaviors. The video-feedback with cognitive preparation allows children to contrast and modify their negative social self-image, increasing their self-confidence and decreasing anxiety behaviors. This study aimed to examine the effectiveness of the Super Skills for Life (SSL) program in improving social performance in a sample of children with emotional symptoms. Results indicated that both objective and subjective evaluation showed positive effects of the SSL program on the children's social performance, enhancing their social skills and reducing anxiety behaviors in social situations, both during the program and in the last session. Girls felt more comfortable and showed better speech and social performance than boys. Our findings increase the evidence about the short-term effects of the video-feedback with cognitive preparation of the SSL program and provide a useful transdiagnostic protocol for application in the clinical setting.

Who benefits most from an evidence-based program to reduce anxiety and depression in children? A latent profile analysis.

Comorbidity between anxiety and depression symptoms is often high in children. Person-oriented statistical approaches are useful to detect heterogeneity of individuals and diverse patterns of response to treatment. This study aimed to explore the different profiles in a sample of Spanish children who received the Super Skills for Life (SSL) transdiagnostic program, to identify which profile of individuals benefited most from the intervention and the likelihood of transition of symptom patterns over time. Participants were 119 children (42.9% were female) aged 8-12 years old (M = 9.39; SD = 1.26). Children completed anxiety and depression measures at the baseline, postintervention, and 12-months follow-up. Results from latent transition analysis (LTA) revealed two groups depending on the severity of the anxiety and depression symptoms: low symptoms (LS) and high symptoms (HS). LS group remained stable and HS decreased by 25%, switching to the LS group. Children with greater social anxiety benefited most from the program over time. Furthermore, older children were more likely to improve rapidly one year after the intervention compared to younger children. This study provides information to consider when implementing preventive interventions for schoolchildren and to tailor them according to the target population characteristics to increase their effectiveness.

Corrigendum: Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

[This corrects the article DOI: 10.3389/fpsyg.2021.565657.].

Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date. Children and adolescents' behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: (1) to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, (2) to analyze the differences in these behaviors in three countries, and (3) to examine the relationship between different coping modalities and adaptation. Participants were 1,480 parents of children aged 3-18 years from three European countries (n Spain = 431, n Italy = 712, and n Portugal = 355). The children's mean age was 9.15 years (SD = 4.27). Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening (58.9%), collaborating with quarantine social activities (e.g., drawings on the windows, supportive applauses) (35.9%), acting as if nothing is happening (35.5%), highlighting the advantages of being at home (35.1%), and not appearing to be worried about what is happening (30.1%). Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries. Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep, behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation (considered a low presence of psychological symptoms). Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children.

"Who Are at Higher Sexual Risk?" Latent Class Analysis of Behavioral Intentions among Spanish Adolescents.

Consistent condom use tends to be limited in youth, which makes this group especially vulnerable for sexually transmitted infections (STIs) and unplanned pregnancies. It is known that sexual risk may vary as a function of behavioral intentions (e.g., condom use intention or having sex under the influence of alcohol), but no studies have yet characterized the sexual risk profiles considering behavioral intentions. This study utilizes latent class analysis (LCA) to explore the subtyping of behavioral intentions related to sexual risk in a community-based sample of adolescents aged 14 to 16 years from Spain. Multinomial logistic regression was used to assess the association between class membership and participants' sociodemographic variables (sex, age, educational level, socioeconomic status, and family situation), and behavioral variables (sexual experience and percentage of condom use). Among the 1557 participants, four latent classes of risk were identified: "Condom + drugs", "abstinent", "condom + no drugs", and "no condom + drugs". Differences in adolescents' sex, age, educational level, sexual experience, and condom use across latent classes were found. Findings highlight opportunities for psychologists, educators, and health-care providers to promote condom use in adolescents with differing sexual risk profiles. Increased understanding of behavioral intentions among adolescents may help to reduce sexual risk behaviors in this group.

Anxiety and depressive symptoms in children and adolescents during covid-19 pandemic: a transcultural approach / Ansiedad y Síntomas Depresivos en Niños y Adolescentes durante la Pandemia de la COVID-19: un enfoque transcultural

BACKGROUND: Despite being necessary to delay the spread of COVID-19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people's psychological problems related to lockdown as early as possible. This cross-sectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic. METHOD: The parents of 515 children, aged 3-18 years old, completed an online survey. Children's anxiety symptoms were assessed using the Spence Children's Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version. RESULTS: We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress. CONCLUSIONS: These findings are discussed in the light of detecting and supporting affected children as early as possible

ANTECEDENTES: a pesar de ser necesario para retrasar la propagación del COVID-19, el confinamiento podría haber afectado al bienestar emocional de niños y adolescentes. Conocer qué variables están involucradas en la ansiedad y depresión podría ayudar a prevenir en los niños los problemas psicológicos asociados al confinamiento lo antes posible. Este estudio transversal tiene como objetivo examinar la sintomatología ansiosa y depresiva en niños y adolescentes italianos, españoles y portugueses, para detectar qué variables están relacionadas con un peor bienestar durante la pandemia. MÉTODO: los padres de 515 niños de 3 a 18 años completaron una evaluación online. Los síntomas de ansiedad de los niños se evaluaron con la Spence Children's Anxiety Scale-Parent Version, y los síntomas depresivos con el Short Mood and Feelings Questionnaire-Parent Version. RESULTADOS: se hallaron diferencias en la ansiedad y la depresión entre países, con mayor ansiedad en los niños españoles, y mayor sintomatología depresiva en los niños españoles e italianos, en comparación con los portugueses. Los síntomas de ansiedad y depresión eran más probables en niños cuyos padres informaron de un mayor nivel de estrés. CONCLUSIONES: estos hallazgos se discuten con el propósito de detectar y apoyar a los niños afectados lo antes posible

How does depression facilitate psychological difficulties in children? The mediating role of cognitive emotion regulation strategies.

Knowing the processes of emotion regulation that children use to respond to stressful situations is essential to analyse the development of psychopathology. The objectives of this research were to study the use of nine cognitive emotion regulation strategies (CERS) in depressed children, compared with nondepressed children, and to analyse their possible mediating effects on the relationship between childhood depression and several areas related to child psychological adjustment. The sample comprised 336 children (46.7% girls) aged 8-12 years. Participants completed measures on depression symptoms (Child Depression Inventory), psychological strengths and difficulties (Strengths and Difficulties Questionnaire) and CERS (Cognitive Emotion Regulation Questionnaire for Spanish kids). Correlations and multiple regression analyses were conducted to test whether CERS and child gender and age predicted child depression. Mediation analyses were run to identify the CERS that mediate the relationship between depression and daily psychological adjustment. On multiple regression, children who score higher in self-blame (ß = .18, p < .01), catastrophizing (ß = .24, p < .001), and other-blame (ß = .14, p ≤ .01) but lower in positive reappraisal (ß = -.15, p ≤ .01) and females (ß = .10, p < .05) were more likely to present higher scores in depression. The maladaptive CERS "other-blame" mediated a positive relationship between depression and conduct problems and between depression and peer problems. Other-blame mediated a negative relationship between depression and prosocial behaviour. In conclusion, this research provides evidence of which specific CERS mediate the emergence of psychopathology in vulnerable children, and provides clues for the proper orientation of psychological interventions in childhood.

Colombian Adaptation of the HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI) in an Adolescent Population.

Colombia has one of the highest rates of sexually transmitted infections (STIs) and teenage pregnancies among Latin American countries. Knowledge about HIV/AIDS and other STIs has been identified as a factor in promoting healthy sexual behavior. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI) is an instrument created in Spain to assess sexual health knowledge in adolescents. In view of the lack of scales that measure this construct in Colombia, this study aims to culturally adapt and validate the KSI for the Colombian adolescent population. The sample was comprised of 866 adolescent school children (458 females and 408 males) aged between 14 and 19 years (M = 15.97, SD = 1.36) from 12 schools in the cities of Bogotá (n = 467) and Barranquilla (n = 400). Results showed good item psychometric properties and adequate discrimination and difficulty indices. Factorial analysis confirmed a five-dimensional factor structure. The indicators of validity showed significant correlations with constructs related on theoretical grounds. In sum, the study presents a valid and reliable scale for evaluating knowledge about HIV and other STIs in Colombian adolescent population.

Psychological Symptoms and Behavioral Changes in Children and Adolescents During the Early Phase of COVID-19 Quarantine in Three European Countries.

The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.

Spanish Adaptation and Psychometric Properties of the Parent Version of the Short Mood and Feelings Questionnaire (SMFQ-P) in a Non-Clinical Sample of Young School-Aged Children.

The parent version of the Short Mood and Feelings Questionnaire (SMFQ-P) is a brief 13-item tool for the screening of depression in children from the age of 6 years. Despite the wide use of the SMFQ-P, its psychometric properties and factor structure remain understudied, with few data available for young school-aged children. The objective of this study was to examine for the first time the factorial structure and psychometric properties of the SMFQ-P in a non-clinical sample of Spanish-speaking children aged 6-8 years. Participants were 181 children whose parents completed the Spanish-adapted version of the SMFQ-P along with the parent version of other measures of anxiety and general difficulties and positive attributes. The SMFQ-P demonstrated adequate internal consistency (α = .83) and test-retest reliability over an eight-week period (ICC = .80), and good convergent and divergent validity. Factor analysis confirmed the original 13-item model, thus supporting the unidimensionality of the measure in the Spanish sample. Overall, this study provides initial empirical evidence for the utility of the SMFQ-P with Spanish-speaking children from early school ages, and extends the international support of the measure.

The Psychological Consequences of COVID-19 and Lockdown in the Spanish Population: An Exploratory Sequential Design.

The objectives of this study were to analyze the psychological impact of the COVID-19 pandemic and the lockdown in the Spanish population and to identify what population profiles were most affected. The study used a sequential exploratory design. In the qualitative phase, 40 participants were recruited based on theoretically relevant criteria and the saturation of the information provided by the interviews. In the quantitative phase, a large representative sample was applied. The universe considered was the adult population of Spain. A total of 6789 surveys were conducted. Both the analysis of the narratives of the interviews and the responses to the panel survey showed relevant changes in attitudes and mood swings compared to the period prior to lockdown. These changes include dysphoric moods (i.e., experiences of distress such as sadness/depression, anxiety, rage, feeling of unreality, worry, etc.) and also some euphoric moods (i.e., feelings of well-being, happiness, etc.). A higher number of women were affected than men and a greater increase was observed in younger people. The findings of the study may serve as a basis for detecting needs and providing psychological support, as the symptoms detected as the most common are key for the processes of screening at-risk individuals.

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.

How Does Perfectionism Influence the Development of Psychological Strengths and Difficulties in Children?

This study aimed to examine differences in gender, age, and psychopathology, according to the perfectionism level, and to analyze how perfectionism dimensions contribute to the development of psychological strengths and difficulties in children. Participants were 319 Spanish students (52.4% girls) between 7 and 11 years old (M = 9.38, SD = 1.15). Children completed self-reported measures of perfectionism and psychological strengths and difficulties. The sample was divided into groups based on the perfectionism level (high, medium, and low). A one-way ANOVA (Analysis of variance), t-test, Pearson correlations, and 3-step hierarchical regression analyses were run. Results showed that 27.6% of the children belonged to the high perfectionism group, characterized by an elevated Socially Prescribed Perfectionism (SPP). Compared to girls, boys presented higher scores in all perfectionism measures. The younger children presented higher SPP and lower Self-oriented Perfectionism-Critical (SOP-Critical) than the older group. High perfectionism was related to psychological problems. The SOP-Critical increased the likelihood of developing emotional symptoms and total difficulties, and SPP was associated with behavioral and peer problems. In contrast, Self-oriented Perfectionism-Striving (SOP-Striving) was related to greater prosocial behavior. This research has important implications for the design of transdiagnostic strategies targeting the prevention and intervention of psychological difficulties in schoolchildren.

How does a CBT-based transdiagnostic program for separation anxiety symptoms work in children?: effects of Super Skills for Life / ¿Es eficaz un programa transdiagnóstico basado en TCC para los síntomas de ansiedad por separación infantil? Resultados del programa Super Skills

Super Skills for Life (SSL) is a transdiagnostic program of Anglo-Saxon origin based on cognitive behavioural therapy, aimed at treating emotional problems in children. It has been translated and implemented in the Spanish population, achieving significant reductions in anxious and depressive symptoms. The objective of the current study was to examine the short- and long-term efficacy of SSL in schoolchildren with separation anxiety. The program was attended by 86 Spanish-speaking children aged 8-12 years, who were evaluated before receiving the intervention, immediately after and 12 months later. Results indicated statistically significant improvements both in the main problem, separation anxiety and other comorbid symp-toms or problems (depression, behaviour problems, problems with peers, interference of anxiety in daily life, etc.). Overall, the results show that the program was more effective in the long-term than in the short-term. The findings of the study suggest that SSL can be useful for treating emotional problems in children with separation anxiety. Clinical implications of these findings are discussed

Super Skills for Life (SSL) es un programa transdiagnóstico de origen anglosajón basado en la terapia cognitiva conductual, dirigido a tratar problemas emocionales infantiles. Se ha traducido e implementado en población española, logrando reducciones significativas en síntomas de ansiedad y depresión. El objetivo del presente estudio fue examinar la eficacia a corto y largo plazo de SSL en escolares con ansiedad por separación. Participaron 86 niños hispanohablantes de 8 a 12 años, que fueron evaluados antes de recibir la intervención, inmediatamente después y 12 meses después. Los resultados indicaron mejoras estadísticamente significativas tanto en el problema principal, la ansiedad por separación, como en otros síntomas o problemas comórbidos (depresión, problemas de comportamiento, problemas con los compañeros, interferencia de ansiedad en la vida diaria, etc.). En general, los resultados muestran que el programa fue más efectivo a largo plazo que a corto plazo. Los hallazgos del estudio sugieren que SSL puede ser útil para tratar problemas emocionales en niños con ansiedad por separación. Se discuten las implicaciones prácticas de estos hallazgos

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.