Perceived Safety, Not Perceived Legality, Mediates the Relationship Between Cannabis Legalization and Drugged Driving.

Cannabis legalization has rapidly spread throughout the United States and is associated with multiple public health outcomes, including driving under the influence of cannabis (DUIC). To improve understanding of the relationship between legalization and DUIC, we tested two potential mediators of this relationship: perceived safety and perceived legality of driving high. We analyzed data from 1,236 current (past 30-day) cannabis users who were recruited from states with recreational, medical only, or no legal cannabis between 2016 and 2017 using address-based and social media samples. Using a generalized linear model and adjusting for cannabis legalization, demographics, living in a state with a cannabis-specific drugged driving law, frequency of cannabis use, and weights, we found that perceived safety (risk ratio [RR] = 2.60, 95% CI [1.88, 3.58]), but not perceived legality (RR = 0.96, 95% CI [0.67, 1.37]), was significantly associated with DUIC. Perceived safety mediated the relationship between legalization and DUIC (Coeff: -0.12, 95% CI [-0.23, -0.01]). Models stratified by frequency of cannabis use yielded results consistent with those of pooled models except that, for frequent users, cannabis-specific driving laws were associated with a significantly lower risk of DUIC (RR = 0.64, 95% CI [0.44, 0.92]). Agencies developing cannabis-focused drugged driving educational campaigns should consider the potential role of perceived safety of driving high in DUIC campaigns.

Histórias de vidas de universitários e uso de substâncias psicoativas / Life stories of college students and use of psychoactive substances / Historias de vida de estudiantes universitarios y uso de substancias psicoactivas

O objetivo deste estudo foi compreender, por meio das histórias de vidas, aspectos relacionados ao uso de substâncias psicoativas por estudantes universitários. Participaram 15 estudantes de ambos os gêneros e com idades entre 18 e 28 anos, de diferentes cursos de graduação que já fizeram uso de alguma substância psicoativa. Foi aplicado um questionário sócio demográfico e um relato autobiográfico; na sequência, as entrevistas narrativas foram realizadas. Para análise dos dados utilizou-se da análise temática que identificou quatro categorias: Conflitos familiares na infância e adolescência; Experiências com o uso de drogas na adolescência e na vida universitária; Formas de tratamento; e Prevenção na educação. Foi observado que os fatores comportamentais, ambientais, sociais e familiares, demonstram estar associados ao uso de drogas. Este estudo traz dados relevantes que podem contribuir no planejamento de ações preventivas sobre o uso de drogas no âmbito universitário (AU).

The aim of this study was to understand, through life stories, aspects related to the use of psychoactive substances by university students.The study included 15 students of both genders and aged between 18 and 28 years, from different undergraduate courses who have already used some psychoactive substanceA sociodemographic questionnaire and an autobiographical report were applied; then, narrative interviews were carried out.For data analysis, the thematic category analysis was used, four categories wereidentified: Family conflicts in childhood and adolescence;Experiences with drug use in adolescence and university life;Forms of treatment;and Prevention in education. It was observed in this study that behavioral, environmental, social and family factors, demonstrate to be associated with drug use. This study provides relevant data that can contribute to the planning of preventive actions on drug use at the university level (AU).

El objetivo de este estudio fue comprender, a través de historias de vida, aspectos relacionados con el uso de sustancias psicoactivas por parte de estudiantes universitarios.El estudio incluyó a 15 estudiantes de ambos sexos y con edades comprendidas entre los 18 y los 28 años, de diferentes cursos de grado que ya han consumido alguna sustancia psicoactiva. Se aplicó un cuestionario sociodemográfico y un informe autobiográfico; luego, se realizaron entrevistas narrativas. Para el análisis de los datos se utilizó el análisis de categorías temáticas, se identificaron cuatro categorías: Conflictos familiares en la infancia y la adolescencia; Experiencias con el consumo de drogas en la adolescencia y la vida universitaria;Formas de tratamiento;y Prevención en la educación. Se observó en este estudio que factores conductuales, ambientales, sociales yfamiliares demuestran estar asociados con el consumo de drogas. Este estudio aporta datos relevantes que pueden contribuir a la planificación de acciones preventivas sobre el consumo de drogas a nivel universitario (AU).

Evaluation of the Implementation Process of the Tamojunto 2 0 Prevention Program in Brazilian Schools / Avaliação do Processo de Implementação do Programa Preventivo # Tamojunto 2 0 em Escolas Brasileiras / Evaluación del Proceso de Implementación del Programa Preventivo # Tamojunto 2. 0 en Escuelas Brasileñas

Abstract The #Tamojunto2.0 program (Unplugged) has been evaluated in Brazil in order to support its implementation as a national public policy. The aim of this study was to evaluate the implementation process of the #Tamojunto2.0 school-based program, disseminated by the Ministry of Health, in the prevention of alcohol and other drug use among adolescents. This is a mixed-methods study. The sample consisted of 13 teachers and eight managers of 8th grade classes of elementary education public schools located in two cities, and a training provider professional for the program's application. Observation, evaluation and semi-structured interview forms were used. Descriptive and thematic analyses were performed. The results indicate low implementation fidelity, good quality in the application of the program, and high student absenteeism. Aspects which facilitate or hinder implementation of the program are also presented. Such results are relevant for the large-scale implementation of #Tamojunto2.0.

Resumo O programa #Tamojunto2.0 (Unplugged) tem sido avaliado no Brasil com vistas a subsidiar sua implantação como política pública nacional. O objetivo deste estudo foi avaliar o processo de implementação do programa escolar #Tamojunto2.0, disseminado pelo Ministério da Saúde, na prevenção do uso de álcool e outras drogas entre adolescentes. Trata-se de estudo de métodos mistos. A amostra constituiu-se de 13 professores e oito gestores de turmas de 8º ano do ensino fundamental de escolas públicas localizadas em duas cidades, e uma profissional ministrante da formação para aplicação do programa. Foram utilizados formulários de observação, avaliação e roteiro de entrevista semiestruturada, os dados coletados foram submetidos às análises descritiva e temática. Os resultados indicam baixa fidelidade de implementação, boa qualidade na aplicação do programa, alto absenteísmo dos estudantes. São também apresentados aspectos que facilitam ou dificultam sua implementação. Tais resultados são relevantes para a implementação do #Tamojunto2.0 em larga-escala.

Resumen El programa # Tamojunto2.0 (Unplugged) ha sido evaluado en Brasil con miras a subsidiar su implementación como política pública nacional. El objetivo del estudio fue evaluar el proceso de implementación del programa escolar #Tamojunto2.0, difundido por el Ministerio de Salud, en la prevención del consumo de drogas en adolescentes. Es un estudio de métodos mixtos. La muestra se constituyó de 13 maestros y ocho directores de clases del 8º grado de Enseñanza Fundamental en escuelas públicas de dos ciudades, y un profesional provedor de capacitación para la aplicación del programa. Se utilizaron formularios de observación, evaluación y entrevista semiestructurada. Los datos se sometieron a análisis descriptivo y temático. Los resultados indican baja fidelidad en la implementación, buena calidad en la aplicación del programa, alto ausentismo estudiantil. También se presentan aspectos que facilitan o dificultan la implementación del programa. Estos resultados son relevantes para la implementación a gran escala de #Tamojunto2.0.

Beyond effectiveness of the Strengthening Families Program (10-14): a scoping RE-AIM-based review.

A scoping review, based on the RE-AIM framework, was conducted to analyze evidence of reach, effectiveness, adoption, implementation, and maintenance of the Strengthening Families Program (10-14), a preventive family-based substance abuse program for adolescents. Sixty-five articles were included. The results disclosed that effectiveness, implementation, and maintenance at the individual-level were the most evaluated aspects, while reach, maintenance at the setting-level, and adoption were the least investigated aspects. Positive effects on drug abuse prevention and protective parenting factors were found in the U.S. studies. Likewise, Latin American studies have shown the improvement of parenting practices. However, European studies have produced mixed results, with predominantly null effects on substance abuse. The implementation quality was high. There is no available evidence of adoption and maintenance at the setting-level by the organizations that implemented it. New studies must examine the reach, adoption, and sustainability of the program to lay foundations for its future use as an instrument of public policies.

Uso de álcool e outras substâncias psicoativas por estudantes universitários de psicologia / Use of alcohol and other psychoactive substances by psychology students / Uso de alcohol y otras sustancias psicoactivas por estudiantes universitarios de psicología

O consumo de substâncias psicoativas (SPAs) cresce em escala global, especialmente entre universitários. Este estudo tem como objetivo avaliar o padrão de uso de álcool e outras SPAs em estudantes universitários. A amostra foi composta por 180 graduandos de Psicologia que preencheram um questionário sociodemográfico e instrumentos de rastreamento do uso de SPAs validados para o contexto brasileiro. Os resultados evidenciaram maior prevalência do uso de álcool: 81,7% na vida, 67,6% nos últimos três meses e 55% no padrão binge. Dentre os motivos endossados para o consumo destaca-se o convívio universitário, porém o fator mais valorizado foi o álcool como potencializador do desejo de fumar, seguido de sua percepção como fator gregário em festas/reuniões sociais e como facilitador do enfrentamento de estresse. As pressões da vida universitária geram insegurança e instabilidade que deixam os jovens universitários mais suscetíveis à influência dos pares e à busca de diversão e descontração em ambientes de festas, nas quais o consumo é estimulado e facilitado, o que pode favorecer o beber em quantidade excessiva. Esse padrão de consumo pode se associar a outros comportamentos de risco, como dirigir sob efeito do álcool, manter relações sexuais sem proteção ou envolver-se em distúrbios da ordem pública e infrações à lei. Considerando que os jovens fazem uso em excesso de SPAs sem um suporte social comunitário adequado, é necessário investir em programas de prevenção e políticas públicas guiadas pelas noções de autocuidado, protagonismo e participação ativa na própria reabilitação...(AU)

The consumption of psychoactive substances (SPAs) grows worldwide, especially among university students. This study evaluated the pattern of alcohol use and other SPAs in psychology students. The sample consisted of 180 Psychology undergraduates who filled out a sociodemographic questionnaire and instruments for tracking the use of SPAs validated for the Brazilian context. The results showed a higher prevalence of alcohol use: 81.7% in life, 67.6% in the last three months and 55% following a binge pattern. Among the reasons endorsed for the consumption stand out university conviviality, but the most valued factor was alcohol as a potentiator of the desire to smoke, followed by its perception as a gregarious factor in parties/social gatherings and as a facilitator to cope with stress situations. The pressures of university life create insecurity and instability, which make university students more susceptible to peer influence and the search for fun and relaxation in party environments where drinking is stimulated and facilitated, which may favor binge drinking. This pattern of consumption may be associated to other risk behaviors, such as driving under the influence of alcohol, having unprotected sex, or engaging in public order disturbances and infractions of the law. Considering that these young people make excessive use of SPAs without adequate social and community support, it is necessary to invest in prevention programs and public policies guided by the notions of self-care, protagonism and active participation in self rehabilitation...(AU)

El consumo de sustancias psicoactivas (SPA) crece a escala global, especialmente entre universitarios. Este estudio tuvo como objetivo evaluar el patrón de uso de alcohol y otras SPA por estudiantes universitarios. Compusieron la muestra 180 estudiantes de graduación en Psicología, que respondieron a un cuestionario sociodemográfico e instrumentos de rastreo del uso de SPA validados para el contexto nacional. Los resultados evidenciaron mayor prevalencia del uso de alcohol: el 81,7% en la vida, el 67,6% en los últimos tres meses y el 55% en el patrón binge. Entre los motivos endosados para el consumo se destaca la convivencia universitaria, pero el factor más valorado fue el alcohol como potenciador del deseo de fumar, seguido de su percepción como factor gregario en fiestas/reuniones sociales y como facilitador del enfrentamiento de situaciones de estrés. Las presiones de la vida universitaria generan inseguridad e inestabilidad que dejan a los jóvenes universitarios más susceptibles a la influencia de los pares y a la búsqueda de diversión y relajación en fiestas y discotecas donde se estimula y facilita el consumo de alcohol, lo que puede favorecer la costumbre de beber en cantidad excesiva. Ese patrón de consumo puede asociarse a otros comportamientos de riesgo, como conducir bajo el efecto del alcohol, mantener relaciones sexuales sin protección o involucrarse en disturbios del orden público e infracciones a la ley. Considerando que estos jóvenes hacen uso excesivo de SPA sin un soporte social-comunitario adecuado, son necesarios programas de prevención y políticas públicas guiadas por las nociones de autocuidado, protagonismo y participación activa en la propia rehabilitación...(AU)

Randomized effectiveness trial of a parent and youth combined intervention on the substance use norms of Latino middle school students.

This article advances knowledge about the effectiveness of applying a community-based efficacious parenting intervention in parallel with an efficacious preadolescent intervention in changing substance abuse norms among preadolescent Latino youth. The study employed a longitudinal, randomized control group design comparing three groups: (1) Parent intervention combined with a Youth intervention: Parent/Youth; (2) Parent intervention without a Youth intervention: Parent Only; and (3) Treatment as usual: Comparison. In the comparison group, parents participated in a standard parenting program delivered by the community partner, and the youth received the usual drug use prevention programming offered in their schools. Data from both parents and youth at the19 participating schools were collected at pre-test, immediate post-test (4 months after pre-test), and two follow-up (8 & 20 months after the pre-test). The total sample includes 532 families (parent-child dyads). The parent-child dyads consisted of one parent and one youth ages 12-14. The retention rates for both parents and preadolescent were high across the different waves of data collection (79%-96%). Regression results of youth substance use norms were calculated based on three permutations of data: (a) original data, with no imputation and no propensity score matching; (b) imputed data but no propensity score matching; and (c) imputed data plus propensity score matching. Compared to the Comparison group, the Parent/Youth condition was the most effective in changing youth's norms, closely followed by the Parent Only condition. These findings make a significant contribution in advancing knowledge on family/youth substance use prevention for Latinos in a community environment. Although the study took place in a specific urban center in the Southwest US, its findings can be generalized to other urban communities of similar characteristics across the country.

Almost Everything We Need to Better Serve Children of the Opioid Crisis We Learned in the 80s and 90s.

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US history of drug dependence crises and research from the 1980s and 1990s, a range of "tried and true" family, school, and community interventions centered on children. We already know that these children are at high risk of maladjustment and early onset of drug dependence; early intervention is critical; multiple risk factors are likely to occur simultaneously; comprehensive strategies are optimal; and multiple risk-focused strategies are most protective. Where we need now to turn our efforts is on how to effectively implement and disseminate best practices, many of which we learned in the 1980s and 1990s. The greatest opportunity in both changing the nature of the opioid epidemic at scale and influencing rapid translation of existing research findings into policy and practice is not in asking what to do, but in asking how to do the right things well, and quickly.

[Effect of Non-alcoholic Beverage Intake in Children on Alcoholic Beverage Drinking and Smoking].

　The early intake of alcohol and/or nicotine in childhood or adolescence is one of risk factors for alcohol and/or nicotine dependence in adult. Recently, non-alcoholic beverages with less than 0.00% alcohol are on sale for adults as substitutes for alcoholic beverages without strict legal limitations. However, it is unclear whether non-alcoholic beverages could be a risk factor in drinking and smoking in childhood or adolescence. The purpose of the present survey is to clarify the effect of non-alcoholic beverage intake in children on alcoholic beverage drinking and smoking. We examined as follows: the experience of alcoholic or non-alcoholic beverage intake, and of smoking in elementary school pupils and/or their family members, and interest in or motivation for drinking and smoking in the pupils. As a result, the percentage of alcoholic or non-alcoholic beverage intake, and of smoking in the pupils were 16.8% or 21.9%, and 0.3%, respectively. The number of family members took the alcoholic or non-alcoholic beverage was larger in the pupils took it compared to the pupils did not take it. In the pupils who experienced the non-alcoholic beverage intake, interest in or motivation for drinking alcoholic beverages and/or smoking is higher than in those who did not. These findings indicate that non-alcoholic beverage intake is related to drinking and smoking. We will introduce drug abuse prevention education on the risk of drug dependence among childhood or adolescents based on the findings of this survey.

Percepções da comunidade escolar sobre a implantação do programa unplugged em escolas / School community perceptions on implementation of the unplugged program in schools / Percepciones de la comunidad escolar sobre la implantación del programa unplugged en escuelas

O objetivo do presente estudo foi investigar as percepções da comunidade escolar sobre o programa Unplugged, implantado pelo Ministério da Saúde em escolas públicas brasileiras de ensino fundamental II. A metodologia utilizada foi a qualitativa e envolveu coleta de dados através de 11 grupos focais de professores (n=13), alunos (n=54) e administradores escolares (n=11) em 8 escolas de 3 cidades brasileiras. Análise de conteúdo permitiu a identificação de 3 eixos temáticos. As facilidades identificadas estiveram relacionadas com o suporte técnico para implantação da metodologia, como a formação e supervisão recebida, além do suporte dos administradores das escolas. As dificuldades apontadas estiveram relacionadas ao tempo das aulas, a obtenção de materiais de suporte para as aulas e ao cumprimento adequado do currículo regular. Como potencialidade, identificou-se a melhoria das relações de convivência. Os resultados aqui alcançados permitem o aprimoramento da implantação do programa Unplugged nas escolas brasileiras.

The aim of the present study was to investigate the perceptions of the school community about the Unplugged program, implemented by the Ministry of Health in Brazilian public elementary school. The methodology used was qualitative and involved data collection through 11 focus groups of teachers (n = 13), students (n = 54) and school administrators (n = 11) in 8 schools in 3 Brazilian cities. The content analysis allowed the identification of 3 thematic axes. The facilities identified were related to the technical support for the implementation of the methodology, such as the training and supervision received, and the support of the school administrators. The difficulties pointed out were related to class time, obtaining support materials for classes and adequate fulfillment of the regular curriculum. As potentiality, the improvement of the relations of coexistence was identified. The results obtained here allow the improvement of the implementation of the Unplugged program in Brazilian schools.

El objetivo del presente estudio fue investigar las percepciones de la comunidad escolar sobre el programa Unplugged, implantado por el Ministerio de la Salud en escuelas públicas brasileñas de enseñanza primaria II. Se utilizó la metodología cualitativa e involucró recolecta de datos por intermedio de 11 grupos focales de profesores (n=13), alumnos (n=54) y administradores escolares (n=11) en 8 escuelas de 3 ciudades brasileñas. El análisis de contenido permitió la identificación de 3 ejes temáticos. Las facilidades identificadas estuvieron relacionadas con el soporte técnico para implantación de la metodología, como la formación y supervisión recibida, además del soporte de los administradores de las escuelas. Las dificultades apuntadas estuvieron relacionadas al tiempo de las clases, la obtención de materiales de soporte para las clases y al cumplimiento adecuado del currículo regular. Como potencialidad, se identificó la mejora de las relaciones de convivencia. Los resultados aquí alcanzados permiten el perfeccionamiento de la implantación del programa Unplugged en las escuelas brasileñas.

Barriers and Facilitators to Implement Preventive Practices to Drug Abuse / Barreiras e Facilitadores para Implementação de Práticas Preventivas ao Abuso de Drogas / Barreras y Facilitadores para la Aplicación de Prácticas Preventivas al Abuso de Drogas

Abstract In the Brazilian context, the Prevention Course to Drug Use for Public School Educators is developed. This study seeks to identify factors cited by the educators as favorable or unfavorable to the implementation of prevention projects. Data collection was carried out in three stages: in the first stage (T0), a sample consisted of 1494 course participants, in the second stage (T1), 2153 teachers participated and in the third stage (T2), 1017 educators answered the questions. Text mining techniques and content analyses were used. The results were categories proposed for the axes barriers and favorable aspects: training of school team, students and school community relationship and participation of the community and perceived dysfunctional family aspects, violence and drug trafficking, personal characteristics of adolescents and the school environment, respectively. The identification of these aspects is relevant to the development of prevention programs, allowing barriers to be anticipated and solutions to be proposed.

Resumo No contexto brasileiro, desenvolve-se o Curso de Prevenção ao Uso de Drogas para Educadores de Escolas Públicas. O presente estudo teve por objetivo identificar fatores citados pelos educadores-cursistas como favoráveis ou desfavoráveis à implementação de projetos de prevenção. A coleta de informações foi realizada em três momentos: no primeiro momento (T0), a amostra foi composta por 1494 cursistas. No segundo momento (T1), 2153 cursistas participaram e no terceiro momento (T2), 1017 educadores responderam às questões. Foram utilizadas técnicas de mineração de texto e análise de conteúdo. Como resultados foram propostas as categorias barreiras e aspectos favoráveis, sendo essas: capacitação da equipe escolar, relação entre alunos, comunidade escolar e participação da comunidade, aspectos familiares disfuncionais, violência e tráfico de drogas, características pessoais dos adolescentes e o ambiente escolar, respectivamente. A identificação destes aspectos é relevante ao desenvolvimento de programas de prevenção, permitindo que barreiras sejam antecipadas, propondo-se soluções para elas.

Resumen En el contexto brasileño, se desarrolla el Curso de Prevención de Consumo de Drogas para Educadores Públicos. Se busca identificar los factores citados por los educadores como favorables o desfavorables para la realización de proyectos de prevención. La recolección de datos se sucedió en tres etapas: la primeira (T0), con 1494 participantes, en la segunda etapa (T1), 2153 educadores participaron y en la tercera etapa (T2), con 1017 educadores. Se utilizaron técnicas de minería de texto y análisis de contenido. Se propusieron categorías para barreras y aspectos favorables: la formación del personal escolar, relación entre estudiantes y la comunidad escolar, la participación de la comunidad y, aspectos disfuncionales de la familia, la violencia y el tráfico de drogas, las características personales de los adolescentes y el entorno escolar, respectivamente. Esta identificación es relevante para el desarrollo de programas de prevención, permitiendo que las barreras sean anticipadas, proponiéndose soluciones a ellas.

Preventing Adolescent Substance Use Through an Evidence-Based Program: Effects of the Italian Adaptation of Life Skills Training.

Evidence-based preventive interventions for adolescent substance use, violence, and mental health issues are increasingly being adapted and disseminated internationally. In the present paper, we report the results of an effectiveness study that was part of a comprehensive initiative by a coalition of health promotion organizations in the Lombardy region of Italy to select, culturally adapt, implement, evaluate, and sustain an evidence-based drug abuse prevention program developed in the USA. Findings are presented from a large-scale effectiveness study of the Life Skills Training prevention program among over 3000 students attending 55 middle schools in Italy. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills. Relative to comparison group students, students who received the prevention program were less likely to initiate smoking at the post-test and 2-year follow-up, and less likely to initiate weekly drunkenness at the 1-year follow-up. The program had direct positive effects on several cognitive, attitudinal, and skill variables believed to play a protective role in adolescent substance use. The findings from this study show that a drug abuse prevention program originally designed for adolescents in the USA is effective in a sample of Italian youth when a rigorous and systematic approach to cultural adaptation is followed that incorporates the input of multiple stakeholders.

Awareness Survey of Drug Abuse among Paramedical Students / 社会薬学

The use of illicit drugs among young people is a growing social problem in Japan. All healthcare professionals are expected to play a role in preventing drug abuse; thus, it is important to give lectures to paramedical students not only to acquire accurate knowledge about illicit drugs but also to promote their self-awareness as future health care workers. To evaluate effective education for drug abuse prevention, we conducted an awareness survey of students in the Faculty of Pharmaceutical Sciences, Kyushu University and the College of Healthcare Management, Fukuoka. Over 90% of students were affected by drug abuse resistance education in elementary, junior high, and high schools. According to this, most of the students tended to have an understanding of health hazards such as central nervous system toxicity. A normative consciousness of avoiding drug usage was high but in response to dealing with friends involved in drug abuse, 14.5% of students answered “it depends on their decision” and 9.1% answered “no idea.” The reasons for drug abuse given included easy availability (63.6%), fear of exclusion from the group (60.0%), and escaping distress (41.8%). The nature of this problem in young people might be attributed to their relationship with family or friends. In this survey, we obtained information regarding knowledge and awareness of drug abuse among paramedical students. We think that it is necessary to focus the education on understanding of factors leading to the use of illicit drugs, such as psychological problems, rather than their harmful effects on health.

Curso de prevenção ao uso de drogas: Descrição e avaliação de satisfação / Drug abuse prevention course: Description and evaluation of satisfaction / Curso de prevención del consumo de drogas: Descripción y evaluación de satisfacción

Resumo Diante do cenário de uso de substâncias por crianças e adolescentes, é relevante implementar ações de prevenção no ambiente escolar. Dentre elas, cita-se a utilização de cursos online para capacitar os diversos atores que podem ser protagonistas das atividades propostas. O presente estudo apresentou e avaliou o Curso de Prevenção do Uso de Drogas para Educadores de Escolas Públicas. Participaram 4.960 educadores de Minas Gerais, Rio de Janeiro e Paraná e foram investigadas as características sociodemográficas destes, além da avaliação de aspectos de satisfação com o curso e sobre o acesso às ferramentas virtuais de aprendizagem. O perfil dos participantes foi composto predominantemente por mulheres (85,8%) com pós-graduação (64,8%) e 35,2% afirmaram possuir contato com a temática álcool e drogas no contexto escolar. A maioria dos participantes aprovou o curso (98,1%), indicando que o método de ensino e estratégias utilizados se mostraram adequados ao público capacitado.

Abstract Considering the substance use by children and adolescents, it is important to implement preventive actions in the school environment. Among them, there is the use of online courses to train the various actors who can be protagonists of the planed activities. This study presented and evaluated the Drug Use Prevention Course for Public School Educators. A total of 4,960 educators from Minas Gerais, Rio de Janeiro, and Paraná participated and the sociodemographic characteristics of these, in addition to evaluation of aspects of satisfaction with the course and access to virtual learning tools were investigated. The profile of the participants was predominantly composed of women (85.8%) with a postgraduate degree (64.8%) and 35.2% reported having contact with the alcohol and drugs theme in the school context. Most participants approved the course (98.1%), indicating that the teaching method and strategies used were suitable to the qualified public.

Resumen En el contexto del uso de sustancias por niños y adolescentes, es importante implementar acciones preventivas en el ámbito escolar. En este estudio se presentó y evaluó el Curso de Prevención del uso de drogas a Educadores de Escuelas Públicas. En total participaron 4960 educadores de Minas Gerais, Río de Janeiro y Paraná. La investigación se centró en: las características sociodemográficas de estos, la evaluación y el nivel de satisfacción con el curso; y el acceso a las herramientas virtuales de aprendizaje. El perfil de los participantes estaba compuesto predominantemente por mujeres (85,8%) con un título de postgrado (64,8%). El 35,2% informó "haber desarrollado el tema de alcohol y otras drogas en el contexto escolar. La mayoría de los participantes aprobaron el curso (98,1%), lo que indica que el método de enseñanza y las estrategias utilizadas fueron adecuados para el público especializado.

Emotional and Behavioral Problems in Children Living With Addicted Family Members: Prevention Challenges in an Underprivileged Suburban Community / Problemas Emocionais e Comportamentais de Crianças que Convivem com Familiares Dependentes Químicos: Desafios de Prevenção em uma Comunidade Suburbana Desfavorecida / Problemas Emocionales y de Comportamiento en Niños que Viven con Familiares Adictos: Desafios de Prevención en una Comunidad Suburbana Desfavorecida

Abstract Children living with substance abusers are more likely to experience negative outcomes. Our goal was to compare caregivers' reports on the Child Behavior Checklist (CBCL) and a socioeconomic and risk form of psychological aspects of children exposed to substance abuse assisted versus not assisted by a preventive intervention program in an underprivileged community. This observational intervention study was conducted with 66 caregivers of children who attended the program and 35 caregivers of children from the same community who did not attend. Ages ranged between six and 11 years old. Chi-square and logistic regression tests indicate that children exposed to substance abusers have more mental health problems than the general population and those who did not participate in the preventive intervention program presented worse outcomes, with higher rates of behavioral/emotional problems and exposure to risk situations. Results suggest that preventive actions might be helpful to promote the mental health of children at risk, validating the need for public policies and services.(AU)

Resumo Crianças que convivem com usuários de substâncias psicoativas são mais propensas a apresentar problemas. O objetivo deste estudo foi comparar, a partir dos relatos dos cuidadores no Child Behavior Checklist (CBCL) e numa ficha de dados sociodemográficos e de fatores de risco, aspectos psicológicos de crianças expostas ao abuso de substâncias assistidas e não assistidas por um programa de intervenção preventiva, em uma comunidade desfavorecida. O estudo observacional de intervenção foi conduzido com 66 cuidadores de crianças que passaram pela intervenção e 35 da mesma comunidade que não foram atendidas. A faixa etária era de seis a 11 anos. Os testes qui-quadrado e regressão logística indicaram que as crianças expostas ao abuso de substâncias apresentaram mais problemas de saúde mental do que a população geral e que aquelas que não participaram do programa preventivo apresentaram desfechos piores, com escores mais elevados de problemas emocionais/comportamentais e maior exposição a situações de risco. Sugere-se que ações preventivas podem contribuir para a promoção de saúde mental em crianças em situação de risco, validando a necessidade de políticas e serviços públicos.(AU)

Resumen Los niños que viven con consumidores de drogas son más propensos a tener problemas. Nuestro objetivo fue comparar, a partir de los informes de los cuidadores en el Child Behavior Checklist (CBCL) y en una hoja de datos sociodemográficos y de factores de riesgo, aspectos psicológicos de niños expuestos al abuso de sustancias, con y sin la asistencia de un programa de intervención preventiva en una comunidad desfavorecida. Este estudio de intervención observacional fue realizado con 66 cuidadores de niños que pasaron por la intervención y 35 de la misma comunidad que no fueron atendidos. Las idades oscilaran entre seis y 11 años. Las pruebas de chi-cuadrado y regresión logística indicaron que los niños expuestos al abuso de sustancias tenían más problemas de salud mental en comparación con la población general y que aquellos que no participan del programa de prevención tuvieron peores resultados, con una puntuación más alta de problemas emocionales y de conducta y una mayor exposición al riesgo. Se sugiere que las acciones preventivas puedan contribuir a la promoción de la salud mental en los niños en situación de riesgo y se valida la necesidad de políticas y servicios públicos.(AU)

Emotional and behavioral problems in children living with addicted family members: prevention challenges in an underprivileged suburban community / Problemas emocionais e comportamentais de crianças que convivem com familiares dependentes químicos: desafios de prevenção em uma comunidade suburbana desfavorecida / Problemas emocionales y de comportamiento en niños que viven con familiares adictos: desafios de prevención en una comunidad suburbana desfavorecida

Children living with substance abusers are more likely to experience negative outcomes. Our goal was to compare caregivers' reports on the Child Behavior Checklist (CBCL) and a socioeconomic and risk form of psychological aspects of children exposed to substance abuse assisted versus not assisted by a preventive intervention program in an underprivileged community. This observational intervention study was conducted with 66 caregivers of children who attended the program and 35 caregivers of children from the same community who did not attend. Ages ranged between six and 11 years old. Chi-square and logistic regression tests indicate that children exposed to substance abusers have more mental health problems than the general population and those who did not participate in the preventive intervention program presented worse outcomes, with higher rates of behavioral/emotional problems and exposure to risk situations. Results suggest that preventive actions might be helpful to promote the mental health of children at risk, validating the need for public policies and services

Crianças que convivem com usuários de substâncias psicoativas são mais propensas a apresentar problemas. O objetivo deste estudo foi comparar, a partir dos relatos dos cuidadores no Child Behavior Checklist (CBCL) e numa ficha de dados sociodemográficos e de fatores de risco, aspectos psicológicos de crianças expostas ao abuso de substâncias assistidas e não assistidas por um programa de intervenção preventiva, em uma comunidade desfavorecida. O estudo observacional de intervenção foi conduzido com 66 cuidadores de crianças que passaram pela intervenção e 35 da mesma comunidade que não foram atendidas. A faixa etária era de seis a 11 anos. Os testes qui-quadrado e regressão logística indicaram que as crianças expostas ao abuso de substâncias apresentaram mais problemas de saúde mental do que a população geral e que aquelas que não participaram do programa preventivo apresentaram desfechos piores, com escores mais elevados de problemas emocionais/comportamentais e maior exposição a situações de risco. Sugere-se que ações preventivas podem contribuir para a promoção de saúde mental em crianças em situação de risco, validando a necessidade de políticas e serviços públicos.

Los niños que viven con consumidores de drogas son más propensos a tener problemas. Nuestro objetivo fue comparar, a partir de los informes de los cuidadores en el Child Behavior Checklist (CBCL) y en una hoja de datos sociodemográficos y de factores de riesgo, aspectos psicológicos de niños expuestos al abuso de sustancias, con y sin la asistencia de un programa de intervención preventiva en una comunidad desfavorecida. Este estudio de intervención observacional fue realizado con 66 cuidadores de niños que pasaron por la intervención y 35 de la misma comunidad que no fueron atendidos. Las idades oscilaran entre seis y 11 años. Las pruebas de chi-cuadrado y regresión logística indicaron que los niños expuestos al abuso de sustancias tenían más problemas de salud mental en comparación con la población general y que aquellos que no participan del programa de prevención tuvieron peores resultados, con una puntuación más alta de problemas emocionales y de conducta y una mayor exposición al riesgo. Se sugiere que las acciones preventivas puedan contribuir a la promoción de la salud mental en los niños en situación de riesgo y se valida la necesidad de políticas y servicios públicos.

Improving substance use prevention efforts with executive function training.

BACKGROUND: Executive function (EF) includes emotional regulation, planning and decision-making, and behavioral impulse control. Improving youth substance use (SU) prevention by targeting EF poses challenges including determining whether specific sub-domains of EF are more associated with SU than others, whether EF is related to some types of SU more than others, and whether EF programs might be enhanced by inclusion of mindfulness training. METHODS: Data were drawn from two studies from the Pathways to Health project: a randomized controlled trial of 4th-6th graders and a cross-sectional pilot study of the relationship of EF to specific types of SU in a sample of 7th graders. Survey measures included assessment of the EF subdomains of inhibitory control (IC), emotional control, working memory, organization/planning, lifetime SU (tobacco and alcohol use), and mindfulness. Analyses included multivariate and multiple group path analysis. RESULTS: Results suggested that the EF sub-domain of IC was the strongest and most consistent predictor of SU, particularly cigarette and e-cigarette use, though emotional control was predictive of alcohol use among late-elementary school students. In the 7th grade sample, IC was predictive of alcohol, cigarette, and e-cigarette use only among students in the low 75% of mindfulness. CONCLUSIONS: Findings from the present studies suggest that improvements in SU prevention efforts may result from increased curricular emphasis on IC and its application to multiple substance use prevention, and systematically integrating mindfulness with EF skills training. Future research should examine whether EF-SU relationships vary across patterns of SU and types of measures used to assess EF.

Percepções e Práticas dos Profissionais da Atenção Primária à Saúde na Abordagem sobre Drogas / Perceptions and Practices of Professionals in Primary Health Care in the Approach of Drug Use

RESUMO Este estudo teve como objetivo analisar as percepções dos profissionais da Atenção Primária à Saúde (APS) em relação às práticas de prevenção e à abordagem ao usuário de álcool e outras drogas, levantando desafios e possibilidades da APS. Através de grupos focais, participaram 18 profissionais da APS de um município de pequeno/médio porte do estado de Minas Gerais, Brasil. Os resultados sugerem que há um discurso a favor das práticas preventivas, mas enfoque no curativismo; limitada participação dos usuários nas atividades preventivas; dificuldade na abordagem aos usuários de drogas; sobrecarga de trabalho; ausência de engajamento dos médicos; cobertura assistencial insuficiente; falta de suporte da gestão, entre outros fatores que obstaculizam o desenvolvimento das ações preventivas e interferem na abordagem aos usuários de drogas.

ABSTRACT This study aimed to analyze the perceptions of the professionals of Primary Health Care (PHC) in relation to prevention practices and the approach to users of alcohol and other drugs, raising challenges and possibilities of PHC. Through focus groups, 18 PHC practitioners of a city of small / medium-sized state of Minas Gerais, Brazil, participated. The results suggest that there is a general opinion in favor of preventive practices, but the focus is on curative practices; limited user participation in preventive activities; difficulties in approaching drug users; work overload, lack of engagement of doctors; insufficient health care coverage; lack of support management, among other factors that hinder the development of preventive actions and the approach of drug users.

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers.

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort.

Consultório na rua: atenção a pessoas em uso de substâncias psicoativas / Street outreach office: attention to people on psychoactive drug/substance / Consultorio en la calle: atención a las personas en el uso de substancias psicoactivas

O estudo objetivou investigar os modos de atuação e as características do trabalho de intervenção com adultos jovens em situação de rua e usuários de substâncias psicoativas, segundo percepções de profissionais do Consultório na Rua (CR) do município de Goiânia (GO) e de pessoas atendidas pelo mesmo. Os participantes foram nove profissionais de diferentes categorias com idades entre 24 e 64 anos e quatro usuários beneficiários do CR com idades entre 23 e 37 anos. A metodologia foi qualitativa com aplicação de roteiros semiestruturados de entrevista e realização de análise de conteúdo. Os resultados, a partir dos relatos dos profissionais, configuraram eixos temáticos, tais como: atuação profissional no CR; aspectos facilitadores e dificultadores e apoio necessário para o trabalho. Para os usuários, os eixos foram: primeiro contato com a equipe; atuação dos profissionais do CR e o mais interessante nesse trabalho. Observou-se consonância entre as percepções e predomínio de aspectos positivos nos relatos dos profissionais e dos usuários acerca da atuação do CR, caracterizada por acolhimento, escuta e vínculo. Quanto às dificuldades, foram citados: preconceito e falta de aceitação do usuário pela sociedade civil; atuação agressiva da Polícia Militar e da Guarda Municipal e falta de insumos para o trabalho. O estudo indicou que os modos de atuação do CR vão ao encontro daqueles preconizados nas políticas públicas de álcool e outras drogas do país, pautados no respeito aos direitos humanos, ampliação do acesso a ações e serviços e redução de danos à saúde da população usuária em situação de rua.

The present study aimed at investigating professional practices and characteristics of intervention with young adults living in the streets who make use of psychoactive substances (PAS), according to perceptions of Street Outreach Office (SOO) professionals in the city of Goiânia and of people served by the SOO. Participants were nine different categories of professionals, aged between 24 and 64 years old, four PAS users aged between 23 and 37 years old, alcohol and crack users. The methodology was of qualitative type with semi-structured interviews and used content analysis. The results based on reports from professionals configured the following theme axes: professional work at the SOO; facilitating aspects; difficulties; support needed for the work. The users’ themes were: first contact with the team, the work of the SOO professionals, the most interesting thing about this work. There was consistency between the perceptions and positive aspects in the reports from professionals and PAS users about the work of the SOO, characterized by listening, reception and bond. The difficulties cited were: prejudice and lack of acceptance from civil society towards users; aggressive actions by the Military Police and the Municipal Guard; and lack of provisions for the work. The study indicated that the governing principles of the actions of the SOO are in accordance with those recommended by the public policy in the area of alcohol and other drugs in Brazil, based on respect for human rights, expansion of access to actions and services, and harm reduction to the users’ health.

El estudio tuvo el objetico de investigar los modos de actuación y las características del trabajo de intervención con adultos jóvenes habitantes de la calle y usuarios de sustancias psicoactivas, según percepciones de profesionales del Consultorio en la Calle (CC) del municipio de Goiânia (GO) y de personas atendidas por el CC. Los participantes fueron nueve profesionales de diferentes categorías con edades entre 24 y 64 años, y cuatro usuarios beneficiarios de CC con edades entre 23 y 37 años. Fue utilizada la metodología cualitativa con aplicación de guiones semiestructurados de entrevista y la realización de análisis de contenido. Los resultados, a partir de los relatos de los profesionales, se configuraron en ejes temáticos, tales como: actuación profesional en el CC; aspectos facilitadores y dificultadores; apoyo necesario para el trabajo. Para los usuarios, los ejes fueron: primer contacto con el equipo; actuación de los profesionales del CC; lo más interesante en ese trabajo. Se observó una coherencia entre las percepciones y el predominio de aspectos positivos en los relatos de los profesionales y de los usuarios, respecto a la actuación del CC, caracterizada como acogida, escucha y vínculo. En cuanto a las dificultades, fueron citados: prejuicio y falta de aceptación del usuario por la sociedad civil; acciones agresivas de la Policía Militar y Guardia Municipal; y la falta de insumos para el trabajo. El estudio indicó que los modos de actuación del CC cumplen aquellos preconizados en las políticas públicas de alcohol y otras drogas de Brasil, basados en el respeto a los derechos humanos, ampliación del acceso a acciones y servicios y la reducción de daños a la salud de esta población usuaria.

Pharmaceutical Students’ Awareness of Drug Abuse and Assessment of the Effects of Education / 医薬品情報学

<b>Objective: </b>In this study, we evaluated to examine the short-term educational effects for drug abuse prevention, including lectures and students’ awareness of drug abuse.<br><b>Method: </b>A questionnaire consisting of eleven items and SD method-based image survey were conducted three times, prior to and following the lectures and after the summer vacation for first-year students of the Department of Pharmacy.<br><b>Results: </b>The numbers of responses to the questionnaire surveys conducted prior to and following the summer vacation were 323 (response rate: 95.8%) and 332 (response rate: 97.9%), respectively.  When asked: “Do you think that people should be allowed to use cannabis (illegal herbal drugs) as long as they do not cause any trouble to others”, 2.8 (3.4) and 6.9 (6.6)% of students answered “Yes” after the lectures prior to the summer vacation and following it, respectively; there were both increased.  Following the summer vacation, 28.6% of students answered “Yes” to the question: “Have you ever seen or heard of people using cannabis or illegal herbal drugs ?”  A total of 2.1% of students had been “solicited to use cannabis or illegal herbal drugs”, and all of them stated that it would be “easy to obtain illegal herbal drugs”.  As the reason for drug abuse by young people, 140 students (42.2%) cited “curiosity”, and 81.6%, or 271 students, stated that they would “refuse” to use any illegal drugs even if they were asked to do so.  The results of the SD method-based image survey suggested significant changes in students’ awareness of drug abuse during the summer vacation; they had the image of little risk on drug abuse prevention following the vacation.<br><b>Conclusion: </b>The effects of learning were not maintained in some first-year students because they faced a variety of temptations during the short summer vacation and their normative consciousness and images of drug abuse easily changed.  Therefore, it is necessary to provide lectures for new students to help them acquire accurate knowledge of drug abuse, enhance their normative consciousness, and increase their self-awareness as health care professionals, develop curriculums on a continuing basis, and deploy specialists so that students with psychological problems as identified by the survey, including stress, escapism, mental weakness, and anxiety, can consult them.