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Ukraine faced significant fluctuations in COVID-19 morbidity and mortality, alongside an escalating HIV epidemic. This mixed-methods study, conducted between February and August 2022, employed a sequential explanatory design combining a quantitative analysis of national data and qualitative interviews to investigate the pandemic's effects on HIV services in Ukraine. The observed trends confirmed that the pandemic significantly disrupted facility-based HIV testing due to logistical challenges, an increased burden on healthcare workers, and supply shortages. Meanwhile, community-based testing showed resilience, largely attributed to programmatic adjustments rather than the pandemic itself. The initiation of antiretroviral therapy declined, especially during initial lockdowns, reflecting diminished treatment capacities. Despite these challenges, telemedicine and home medication delivery innovations supported antiretroviral therapy adherence. Furthermore, improvements in viral load testing and suppression rates showed healthcare resilience. The study highlights the critical need for adaptable, sustainable healthcare strategies in crises, emphasized during the war with Russia. Plain Language Summary: How COVID-19 Changed HIV Care in Ukraine: Challenges, Adaptations, and Innovations In recent times, Ukraine, like many other countries, has been dealing with two big health problems: the COVID-19 pandemic and the ongoing HIV epidemic. With over 104 million cases of COVID-19 reported in Europe by early 2022, Ukraine faced the coronavirus as well as an increasing HIV crisis, especially among older adults and through various ways of spreading. This study, done between February and August 2022, aimed to understand how the COVID-19 pandemic affected the HIV services in Ukraine. By using numbers and in-depth interviews with health officials, service providers, and community members, we looked into the state of HIV care during this challenging period. Our findings show that the effects of the pandemic on HIV services were mixed. While HIV testing done in the community managed to adjust and keep going despite the changes, services in healthcare facilities ran into many problems. Lockdowns and restrictions made it hard for people to get to these places, leading to a big drop in HIV testing and the start of antiretroviral therapy, a key treatment for managing HIV. Despite these challenges, there were important changes and new ideas. Services such as telemedicine and delivering medication were started to make sure patients could continue their antiretroviral therapy without any breaks. The testing for viral load, which is important for checking how well HIV treatment is working, slowly went up, showing a system that could adapt to the pressures of the pandemic. The ability to adjust and keep going shown by some HIV services in Ukraine during the COVID-19 pandemic highlights the need for healthcare delivery methods that can change as needed and last over time. This study points out the importance of ongoing efforts to support people living with HIV, especially when facing big challenges, and gives valuable lessons for managing healthcare services during difficult times like the conflict with Russia. [ABSTRACT FROM AUTHOR]

Emergency and critical care services inevitably expose their staff to potential work stressors and traumatic events, which can cause emotional, behavioral, and physical reactions. The literature presents a wide range of evidence-based knowledge on the effectiveness of interventions to promote mental health after traumatic events. However, little is known about the effectiveness of prevention programs. In this study, we sought to improve the empirical understanding of the potential of a combination of psycho-educational-defusing training for trauma prevention. We employed a mixed methods approach using statistical modeling and content/focus group analysis to describe the sample of investigation and the effectiveness of the prevention training. A retrospective quantitative chart measured and evaluated the psychological state of physicians, nurses, and registered nurses (N = 222). A retrospective qualitative chart examined staff accounts of traumas and their coping strategies via autobiographies (n = 26). Prospective focus groups examined participants of the psycho-educational defusing intervention administered (n = 61). Findings revealed different forms of experiencing grief and trauma. Prospective analysis of the training effectiveness revealed favorable perceptions by participants. Results support the formal implementation of continuous prevention, building relational support, and coping strategies as keys to recovery and preventing traumas. [ABSTRACT FROM AUTHOR]

Abstract Introduction This study reports the evaluation of the short-term effects of the Strengthening Families Program (SFP 10–14), adapted as Famílias Fortes (Strong Families) in Brazil, on preventing adolescent drug use and improving parenting behaviors. Methods A two-arm, parallel cluster randomized controlled trial was conducted in 60 Social Assistance Reference Centers (SARC) from 12 Brazilian municipalities. In each city, the SARC were randomly assigned to the intervention or control group. A total of 805 families participated in the study, each contributing data from one parent or legal guardian and one adolescent totaling 1,610 participants. Data collection occurred before intervention implementation and 6 months after baseline collection. Data were analyzed using multilevel mixed-effects modeling with repeated measures in two different paradigms: Intention to Treat (ITT) and Per protocol (PP). The study was registered in the Brazilian Ministry of Health Register of Clinical Trials (REBEC), under protocol no. RBR-5hz9g6z. Results Considering the ITT paradigm, the program reduced the chance of parents and legal guardians being classified as negligent by 60% (95%CI 0.21; 0.78), increased the use of nonviolent discipline by caregivers (Coef 0.33, 95%CI 0.01; 0.64) and decreased the chance of adults exposing adolescents to their drunken episodes by 80% (95%CI 0.06; 0.54). No program effects were observed on outcomes related to adolescent drug use. Similar results were found for the PP paradigm. Conclusion The positive effects on family outcomes suggest preventive potential of the program among the Brazilian population. Long-term evaluations are necessary to verify if the program can also achieve the drug use reduction goals not observed in the short term.

Introduction: This study reports the evaluation of the short-term effects of the Strengthening Families Program (SFP 10–14), adapted as Famílias Fortes (Strong Families) in Brazil, on preventing adolescent drug use and improving parenting behaviors. Methods: A two-arm, parallel cluster randomized controlled trial was conducted in 60 Social Assistance Reference Centers (SARC) from 12 Brazilian municipalities. In each city, the SARC were randomly assigned to the intervention or control group. A total of 805 families participated in the study, each contributing data from one parent or legal guardian and one adolescent totaling 1,610 participants. Data collection occurred before intervention implementation and 6 months after baseline collection. Data were analyzed using multilevel mixed-effects modeling with repeated measures in two different paradigms: Intention to Treat (ITT) and Per protocol (PP). The study was registered in the Brazilian Ministry of Health Register of Clinical Trials (REBEC), under protocol no. RBR-5hz9g6z. Results: Considering the ITT paradigm, the program reduced the chance of parents and legal guardians being classified as negligent by 60% (95%CI 0.21; 0.78), increased the use of nonviolent discipline by caregivers (Coef 0.33, 95%CI 0.01; 0.64) and decreased the chance of adults exposing adolescents to their drunken episodes by 80% (95%CI 0.06; 0.54). No program effects were observed on outcomes related to adolescent drug use. Similar results were found for the PP paradigm. Conclusion: The positive effects on family outcomes suggest preventive potential of the program among the Brazilian population. Long-term evaluations are necessary to verify if the program can also achieve the drug use reduction goals not observed in the short term. [ABSTRACT FROM AUTHOR]

While scholars have extensively studied rape myth acceptance, less is known about these myths within hypermasculine environments and among women within these environments. One hypermasculine environment in which rape myth acceptance remains understudied is the United States Air Force Academy, which is characterized by the hypermasculinity that is often found in military environments and is an academic institution prone to high levels of sexual assault like most college campuses. Indeed, a top priority at the Air Force Academy is lowering sexual assault rates. This paper analyzes the hypermasculine environment found at the Air Force Academy and examines rape myth acceptance among female cadets. Specifically, this study investigates the impact of the Enhanced Access, Acknowledge, Act (EAAA) Sexual Assault Resistance training program in reducing acceptance of rape myths by female cadets. Using survey data from the Illinois Rape Myth Acceptance Scale and the Perceived Causes of Rape Scale, we find that the program was effective in reducing rape myth adherence overall, which is consistent with other studies measuring the effectiveness of the EAAA program. Further, a more granular examination of the surveys revealed changes to specific rape myth beliefs within the unique context of the military academy's hypermasculine environment. Implications for sexual assault prevention programs in hypermasculine environments such as military settings are discussed. [ABSTRACT FROM AUTHOR]

School violence remains a major concern for scholars, policymakers, and the public in the United States. Despite the implementation of various school violence prevention programs, information regarding their effectiveness in the United States is outdated and limited. This systematic review identified current elementary school programs that effectively reduce school violence in the United States and determined the types of elementary school violence prevention programs implemented, their effectiveness, and the types of tools used to enhance such programs. A qualitative methodological approach was employed, and four databases were searched. English articles published between 2012 and 2023 were selected. Furthermore, data involving elementary school education, school personnel, teachers, and children (5–12-year-old) in the United States were included in the thematic analysis. Results confirmed that the school-wide Positive Behavior Interventions and Supports program effectively decreases violence, suspensions, office referrals, and disruptive behaviors, whereas positive action effectively reduces negative violent behaviors. Social–emotional learning (SEL) implementation also reduced behavioral issues. The findings of this study are relevant for guiding teachers, school administrators, policymakers, teacher education preparation programs, and health professionals in constructing evidence-based violence prevention programs with an added SEL component for elementary schools. [ABSTRACT FROM AUTHOR]

Educational institutions record an increase in behavioral disorders in children and adolescents every day, with severe symptoms that result in hospitalization or the imposition of criminal sanctions for juvenile delinquents. Behavioral disorders of children and young people stand out as one of the primary problems of today's society. The purpose of this paper is to give a detailed insight into the state of emotional and behavioral disorders, from those that are hidden such as withdrawal, apprehension, fear,anxiety to behavior that children and young people come into conflict with others, even committing acts that are legally recordable as punishable. It has been proven in various studies that early diagnosis and preventive interventions in working with children give the best results. The hypothesis that behavioral disorders and emotional problems among children and young people in primary and secondary schools are present and require the application of appropriate preventive and treatment programs has been confirmed. Through the presentation of modern approaches to the detection, prevention and diagnosis of behavioral problems, this work shows the relationship between biological factors, parental qualities, education, the influence of peers, school and socialnorms, and the way in which they become risky for the development of problematic behavior. Detecting risk factors and stopping the action of risk processes, which have been proven to have a positive correlation with the occurrence of aggressive behavior in children, leads to a decrease in the rate of its occurrence. It has been observed that there are several successful ways of working with children that result in a reduction in the rate of behavioral disorders, even in provoking situations. Communication and problem-solving skills training can successfully reduce inappropriate child behaviors.Teaching social-emotional skills, in addition to reducing behavioral disorders, also results in higher self-esteem and more positive attitudes in children.Schoolshave a need for continuous implementation of science-based prevention programs that include interventions aimed at children and work with parents.

IntroductionSuicide is a significant public health problem, impacting individuals, families and communities worldwide. Effective suicide prevention requires a comprehensive approach with diverse integrated interventions and collaboration across sectors, stakeholders and professions. This study aims to identify challenges, gaps and success factors in current suicide prevention efforts in Germany, Austria and Switzerland, providing specific recommendations for advancement.MethodsWe conducted online, semi-structured interviews with 36 suicide prevention experts from Germany, Austria and Switzerland, incorporating perspectives from policy, science and practice. Interviews were conducted between September 2022 and February 2023, audio-recorded, transcribed verbatim and analyzed using the Framework method.ResultsDespite progress in national strategies and coordinated efforts for suicide prevention, challenges such as resource scarcity, stigma and structural issues in psychiatric and psychotherapeutic care persist. The interviewees identified several areas for advancement, including developing targeted prevention measures for men and older people, strengthening collaboration across sectors, stakeholders and professions, and increasing the involvement of individuals with lived experience. While the COVID-19 pandemic has exacerbated challenges in psychiatric and psychotherapeutic care, it has concurrently strengthened interest in suicide prevention among policymakers and the media.DiscussionNational suicide prevention strategies play a crucial role in setting priorities, raising public awareness, and guiding action. However, since most suicide prevention efforts are still predominantly health sector-driven, a more comprehensive approach is needed to promote the involvement of all relevant actors and address suicidality as a collective societal responsibility. Tailoring prevention programs for risk groups like older people and men is important, as these populations show high suicide rates and face a lack of targeted interventions. Our study underscores the importance to continuously monitor, refine and strengthen collaborative and evidence-based suicide prevention efforts.

This systematic review critically evaluates 21 grandparent-focused prevention programs designed to benefit grandparent caregivers or target grandparent caregivers as agents of change for grandchild development. These grandparent programs were published in 35 peer-reviewed articles in the last 31 years. For each program, we described the phase of development of program (i.e., feasibility, pilot, and efficacy), delivery characteristics, and adaptations of existing evidence-based programs to meet the needs of grandparent caregivers in diverse sociocultural backgrounds. For programs tested under a controlled trial design, we evaluated core components and preliminary effects on targeted outcomes. Most studies targeted grandparents who served as primary or custodial caregivers in the USA, while limited studies targeted supplementary grandparent caregivers. Thirteen programs which were evaluated using pretest–posttest designs demonstrated feasibility and acceptability of the grandparent programs. Moreover, eight programs which were evaluated using randomized-controlled trials (RCTs; 5 pilot and 3 full-scale efficacy trials) demonstrated promising outcomes. Additionally, we identified six core components and 17 specific elements in eight programs evaluated using RCT designs. Overall, we provide a comprehensive critique of this body of literature as well as directions for future studies, including the need to develop programing tailored to grandparent caregivers with unique needs. [ABSTRACT FROM AUTHOR]

Child sexual abuse (CSA) is a worldwide public health concern. With the widespread dissemination of prevention approaches to end CSA, numerous CSA prevention programs exist in developed countries, but there is little evidence on how these programs are performing in Mainland China. The aim of this study was to review the existing research focusing on CSA prevention programs in Mainland China. Studies of CSA prevention programs were identified by conducting a comprehensive search of major academic databases for Chinese and English research. Articles were retained if they were original empirical studies that conducted programs to prevent CSA in Mainland China and measured related outcomes. Twelve studies met the inclusion criteria. A child-targeted, universally focused, and school-based educational program was the most common (n = 7), followed by specifically focused programs that covered migrant and left-behind children using group-based intervention strategies (n = 2) and ordinary parents with self-learning strategies (n = 2); one study delivered agency-based face-to-face education to parents with disabled children. However, the shortcomings in research design limited its replication to the broader population. CSA prevention program research in Mainland China is in an early stage due to the limited target populations, lack of large-scale government-led initiatives, and low involvement of multicomponent collaboration. We provide suggestions for conducting future research involving more inclusive programs for other populations, comprehensive programs with multiple targets and stakeholders, large-scale evidence-based research, culturally tailored and contextual adaptation programs. [ABSTRACT FROM AUTHOR]

This study examined if culturally and linguistically adapted versions of a US-developed adolescent substance use prevention intervention, keepin' it REAL (kiREAL), for Mexico increases the use of drug resistance strategies and if increased use of resistance strategies subsequently leads to a reduction in the frequency of substance use (i.e., alcohol, cigarette, marijuana, and inhalants). Students (N = 5,522, 49% female, age range = 11–17) in 36 middle schools across three cities in Mexico were randomized into three conditions: (1) Mantente REAL (MREAL), the culturally adapted version, (2) kiREAL-S, the linguistically adapted version, and (3) Control. Using survey data collected at four time points, random intercept cross-lagged path analyses tested the direct and indirect effects of MREAL and kiREAL-S compared to Control. At time 2, the number of drug resistance strategies used by students increased in both MREAL (β = 0.103, p =.001) and kiREAL-S (β = 0.064, p =.002) compared to Control. However, only MREAL lead to less frequent use of alcohol (β = −0.001, p =.038), cigarettes (β = −0.001, p =.019), marijuana (β = −0.002, p =.030), and inhalants (β = −0.001, p =.021) at time 4, mediated through increased use of drug resistance strategies. This study provides evidence that MREAL and kiREAL-S are successful in spurring use of the drug resistance strategies that are the core component of the intervention. Only MREAL achieved long-term effects on substance use behaviors, the ultimate objective of these interventions. These findings provide support for the value and importance of rigorous cultural adaptation of efficacious prevention programs as a necessary condition for enhancing prevention benefits for participating youth. [ABSTRACT FROM AUTHOR]

Purpose: This paper examines implementation fidelity (IF) and the underpinning conceptual framework drawing on the evaluation of a UK-wide, manualized child abuse and neglect prevention program for elementary schools. We describe and assess our approach to assessing IF and consider how IF can inform program development. Method: We drew on the literature on program fidelity and critical components of the program evaluated to identify three dimensions of IF: Coverage, Quality and Context. Data was collected through external observations using systemized observation schedules which were extracted to be scored using scoring protocols for each intervention type. Scores were calculated by two researchers with a random sample cross-checked by a third member of the research team. Results: Observation analysis demonstrated consistency in the coverage of content when delivering assemblies for both younger and older children with at least 76% coverage of content across the assemblies. However, observation analysis revealed greater levels of variability in the delivery of workshops. Material on sexual abuse was less fully covered and children reported that some facilitators lacked confidence and clarity in delivering this material (Stanley et al., 2023). Conclusion: Our results indicate the usefulness of systemized observations in capturing coverage of content, these findings underscore the importance of developing scoring protocols and training observers prior to evaluating program delivery. We highlight the significance of integrating implementation fidelity training for program facilitators and implementers to both assist with monitoring and to maintain quality, despite variations in the actual delivery and setting of the program. [ABSTRACT FROM AUTHOR]

The Brazilian version of the prevention program Unplugged, #Tamojunto, has had a positive effect on bullying prevention. However, the curriculum has recently been revised, owing to its negative effects on alcohol outcomes. This study evaluated the effect of the new version, #Tamojunto2.0, on bullying. For adolescents exposed to the school-based program #Tamojunto2.0, we investigated (1) whether the prevalence of bullying victimization and perpetration was reduced, (2) whether this reduction was moderated by gender, and (3) whether the program's effect on bullying was mediated by adolescents' alcohol use. A cluster randomized controlled trial was conducted using 5,208 eighth-grade students from 73 Brazilian public schools. Baseline data were collected before program implementation, and follow-up data were collected nine months later. We used a multilevel mixed-effects model to examine the effect of #Tamojunto2.0 on bullying, and a moderation model to test the moderating effect of gender on program outcomes. A mediation analysis was performed to determine lifetime alcohol use as a mediator of the intervention effect on bullying. We found that the positive effect of #Tamojunto2.0 on bullying victimization (β = −0.019, 95% confidence interval = −0.035; −0.002) and perpetration (β = −0.027, 95% confidence interval = −0.051; −0.004) was mediated by a decrease in alcohol use, but not moderated by gender. #Tamojunto2.0 program can be indirectly effective in the prevention of bullying by decreasing adolescents' alcohol use. Moreover, alcohol and drug use prevention programs might also affect bullying outcomes through mediation, and we suggest that future studies consider this. [ABSTRACT FROM AUTHOR]

Early treatment of behavioral problems can prevent their progression into intractable disorders. This study examined the impact of a multiple family group (MFG) intervention for children with behavior symptoms and their families. Fifty-four (n = 54) caregiver/child dyads with sub-clinical levels of oppositional defiant disorder (ODD) participated in a 16-week MFG. Child, caregiver, and family outcomes were assessed at baseline, post-treatment, and at 6 months follow-up. Significant decreases in impairment with parents, family members, and peers, and improvements in child self-esteem were found from baseline to follow-up. Caregiver stress increased; no significant changes in depression or perceived social support were found over time. The effectiveness of MFG as a preventive approach and areas of future research are discussed. [ABSTRACT FROM AUTHOR]

Introduction Health behaviors play an important role in preserving, maintaining and improving health. These are actions and behaviors selected by humans, which, based on specific knowledge, remain in a significant relationship with health. Nursing staff, due to their knowledge, skills and duties enshrined in the Act on the Professions of Nurses and Midwives, through their own model of behavior and actions, should encourage appropriate health attitudes. Aim of the study The aim of the study was to learn about selected health behaviors in the use of preventive programs, coping with stress and the impact of additional workload among the nursing staff employed at the Railway Hospital in Wilkowice. Material and methods: The research was carried out using the diagnostic survey method and a standardized scale - Juczyński's Health Behavior Inventory on a group of 100 nurses. Results: The group of surveyed nurses was characterized by the highest health behaviors in terms of positive mental attitude and proper eating habits, lower in terms of preventive behaviors and health practices. Only 63% of the respondents used prevention programmes. In addition, it was observed that abnormal health behaviors were more common among nurses working additionally in another health care facility. Conclusions: The surveyed nurses used preventive programs on average and manifested health practices at an average level, which was influenced by the burden of additional work. They chose various ways of coping with stress, which were not always pro-health, therefore postgraduate education should emphasize the development of these skills, and nurses should be able to use psychologists employed in hospitals.

Objective: This systematic review evaluates and summarizes existing eating disorder (ED) prevention programs in Latin American countries. Methods: A systematic literature search was conducted using the Cochrane Controlled Trial Register, PubMed, and Virtual Health Library databases up to and including July 31, 2022. All ED prevention studies published in English, Spanish or Portuguese were eligible, regardless of the study design, sample characteristics, and type of prevention programs. The Cochrane Collaboration Risk of Bias criteria were used to evaluate the quality of the included studies. Results: Twenty‐two studies were included. Most were pilot studies that were nonrandomized, had a high risk of bias, were from Mexico and Brazil, and employed selective interventions. Dissonance‐based programs and social cognitive theory were the commonly used approaches in interventions, and most of them were tested in adolescent girls and women. Short follow‐ups were used, varying from 1 to 6 months. Many found significant decreases after the intervention and/or at follow‐up in ED/disordered eating risk behaviors/symptoms, negative affect, body‐ideal internalization, and body image disturbances. Conclusions: This review highlights promising efforts to prevent EDs among Latin American countries. Some barriers in conducting research include funding restrictions, laws that do not allow remuneration or compensation for participants, and high costs of training. Nonetheless, the outcomes of the programs developed and evaluated so far are positive enough to merit further work on ED prevention. Efforts for future researchers should recruit samples with diverse characteristics, use robust designs and data analysis techniques, and expand the accessibility of prevention programs. Public Significance Statement: The development of effective eating disorder (ED) prevention programs that can be broadly implemented is a public health priority. Nevertheless, there is limited evidence regarding the characteristics of ED prevention programs and their efficacy among Latin American countries. In the present study, we reviewed existing ED prevention programs adopted in Latin America, described their characteristics and outcomes, noted the limitations of available programs, and discussed the implications of these findings for efforts to prevent the development of EDs in Latin America. The outcomes of the programs developed and evaluated so far are positive enough to merit the development and rigorous evaluation of future programs and their broad dissemination in Latin American countries. PROSPERO registration number CRD42021275245. [ABSTRACT FROM AUTHOR]

Research on battering intervention programs (BIPs) has expanded significantly in the last several years to include qualitative measures of men's experiences in such programs. This research has provided useful insights into what gains men who perpetrate violence may take away from BIPs. However, to expand our definition of success for BIPs and better understand the full range of potential benefits to clients of such programs, more research is needed that seeks to describe clients' perspectives on what they learned from a BIP. The present study uses clients' written reflections on their experience with a community-based BIP to understand what gains clients described making during the BIP process. We analyzed a random sample of 555 exit letters collected from a participating BIP to understand what clients felt they had learned during their time in the program. Analysis was conducted using a three-coder iterative approach, which focused on content and global coding of broad thematic and subthematic categories. Our findings suggest that BIP clients leave programs with both didactic or psychoeducational and interpersonal and intrapersonal gains that may need to be considered as alternative measures of success for such programs. This study is important for identifying ways to increase the understanding of BIP "success" by suggesting potential outcomes that could be measured in future evaluation research. [ABSTRACT FROM AUTHOR]

This paper describes the development and impact of an underage drinking reduction program designed and implemented by a South Carolina county sheriff's office with assistance from the county coalition. In December 2017, high school surveys identified family and friends as the alcohol source 82.2% of the time. In Summer 2018, sheriff deputies began visiting with almost all high school seniors, i.e., 1,352 high school senior visits. Deputies reminded parents to not provide alcohol to anyone under 21 years old. School surveys were conducted pre-program (December 2017), during (April 2018 and September 2018) and post-program (April 2020). Comparing the pre-effort results with post surveys found a 22.8% decline in 30-day drinking (p=.01) and a 23.5% decrease in binge drinking (p=.07). As described by Holder et al., the results provide the foundation for replication under controlled research conditions. [ABSTRACT FROM AUTHOR]

Digital media has become part of our everyday life in recent years, and this applies especially to school-age students. The COVID- 19 pandemic and the transition to distance learning have raised the level of student exposure to the Internet, including its dangers. Aiming to examine the impact of preventive programs for safe Internet practices on the media literacy of children in primary school, we conducted an empirical study among 267 students. Media literacy was analysed in terms of the ways of using digital media as well as in terms of safe Internet practices, and comparisons were made by student gender and age.

Since 2001, attacks attributed to extremist movements or “lone actors” have intensified and spread around the world, prompting governments to invest significant sums of money into preventing violent radicalization. Nonetheless, knowledge regarding best practices for prevention remains disparate, and the effectiveness of current practices is not clearly established. Consequently, we conducted a systematic review on the outcomes of primary and secondary prevention programs in the field of violent radicalization. Of the 11,836 documents generated, 33 studies published between 2009 and 2019 were eligible for inclusion as they comprised an empirical (quantitative or qualitative) evaluation of a prevention initiative using primary data. The majority of these studies evaluated programs targeting violent Islamist or “general” radicalization. Negative or iatrogenic effects mostly stemmed from programs aimed at specific ethnic or religious groups or focusing on surveillance and monitoring. Positive effects were noted in programs aimed at improving potential protective factors against violent radicalization. However, the reviewed studies had numerous limitations (i.e., weak experimental designs, small/biased samples, unclear definitions, incomplete methodological sections, and conflicts of interests) that hinder one’s confidence in their conclusions. Also, many studies lacked a logic model, failed to differentiate between intermediate and final outcomes, and often did not assess for negative outcomes. Encouragingly, however, some of the most methodologically sound studies contained results attesting to the effectiveness of improving protective factors against violent radicalization.

To identify factors independently associated with program participation and knowledge of campus processes to address sexual assault and harassment complaints. 1,182 undergraduates who completed the University of Michigan's 2015 campus climate survey on topics of sexual assault and harassment (67% response rate). We analyze survey responses to estimate multivariable models that identify subgroups of the student population least likely to have participated in programs or to know campus processes. Students living off campus, not involved in major organizations, and males are less likely to report attending programming. Students not involved in major organizations and females are less likely to report knowing campus processes. Specific student subpopulations are more difficult to engage in programs designed to reduce sexual assault and harassment. Targeting additional effort to these groups may improve campus sexual climate. Careful analyses of campus climate survey data can help construct campus-specific priorities for these interventions. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate if attitudes toward drug use, decision-making, communication, and alcohol resistance skills act as predictors of alcohol use and binge drinking initiation among Brazilian students, considering the sex differences., Methods: We used a longitudinal sample of 1,103 seventh-grade students from 15 Brazilian public schools. We explored if attitudes toward drug use, decision-making, communication, and alcohol resistance skills at baseline predicted alcohol outcomes nine months later., Results: We found that lower levels of resistance skills (i.e., ORboys=0.29, 95% CI: 0.12; 0.70) and positive attitudes toward drugs (i.e., ORgirls:=1.41, 95% CI: 1.02; 1.94) are predictors of alcohol use onset and binge drinking, independently of sex. Decision-making predicts binge drinking initiation only for girls (OR=0.73, 95% CI: 0.59; 0.91). Negative attitudes toward drugs are a risk factor for alcohol use initiation only for boys (OR=0.78, 95% CI: 0.64; 0.95)., Conclusion: Our findings highlighted the importance of understanding the predictors of adolescents' alcohol outcomes to inform the key components that preventive programs should address in their activities to achieve the expected preventive outcomes., Competing Interests: The authors report no conflicts of interest.

Modern, systemic understanding of resilience as the ability of the individual, but also the community and other systems to select and provide the resources needed for positive functioning despite risk exposure, has opened space for designing programs that will provide the same resources. A review of the literature shows that experts and scientists have successfully directed the results of practice, which refer to the positive systems functioning despite the presence of risk, to create recommendations for designing programs that will help individuals, communities and other systems to build resilience. Such programs are of particular importance for victim empowerment. This paper aims to explain the basic assumptions of the effectiveness of programs aimed at building system resilience, which relate to the elements of assessment, design principles and key characteristics of resilience-building programs.

The paper investigates the role of the internal asset (IA), perceived external resources (PER) of resilience, and the school-based universal prevention program known as ‘Unplugged’ in explaining persistent healthy behavior among early adolescence. A sample of 425 adolescents was collected in a repeated measure design study with a baseline (T1) and a six-month follow-up (T2) after the Unplugged implementation. Persistent healthy behavior was assessed by a change in the cumulative index of substance use created by combining alcohol use and cigarette smoking in the past 30 days and their change between T1 and T2. Four categories were created: non-users, permanent users, new users and ex-users. A multinominal logistic regression revealed that non-users were more likely to show higher self-esteem when compared to permanent users. Females had a higher probability of being non-users than either being permanent users or new users. Moreover, Unplugged intervention increased the probability of being a non-user rather than a new user. Regarding PER of resilience, non-users were more likely to have higher home support, prosocial peers, and school connectedness compared to permanent users. Non-users were also more likely to have higher levels of prosocial peers compared to new users. In summary, higher self-esteem, home support, prosocial peers and school connectedness are associated with persistent healthy behavior. To maintain this persistent healthy behavior, the school-based universal prevention program Unplugged has been effective; thus internal assets and external resources of resilience, and prevention program Unplugged, play an important role in the absence of alcohol or cigarette use in early teenage years.

(1) Background: It is essential to focus attention on sex-specific factors which are clinically relevant in pain management, especially with regards to opioid use disorder (OUD) risk. The aim of this study was to explore potential sex-differences in chronic non-cancer pain (CNCP) outpatients. (2) Methods: An observational cross-sectional study was conducted under CNCP outpatients with long-term prescribed opioids (n = 806), wherein 137 patients had an OUD diagnosis (cases, 64% females) and 669 did not (controls, 66% females). Socio-demographic, clinical, and pharmacological outcomes were analyzed. (3) Results: Female controls presented an older age and less intensive pain therapy but higher psychotropic prescriptions and emergency department visits compared to male controls. Meanwhile, cases demonstrated a younger age, higher work disability, double morphine equivalent daily dose, and benzodiazepine use compared with controls. Here, female cases showed an 8% greater substance use disorder (OR 2.04 [1.11–3.76]) and 24% lower tramadol use, while male cases presented a 22% higher fentanyl use (OR 2.97 [1.52–5.81]) and reported the highest number of adverse drug reactions (24%, OR 2.40 [1.12–5.16]) compared with controls. (4) Conclusions: An OUD individual risk profile was evidenced with sex-differences to take into consideration to design equal prevention programs. [ABSTRACT FROM AUTHOR]

Background: Rural populations face significant health disparities (e.g., high rates of chronic diseases) and unique accessibility barriers (e.g., limited healthcare facilities). Training higher education students to serve as facilitators for chronic disease prevention programs may address rural health promotion needs. Purpose: The purpose of this pilot, exploratory study was to create an experiential learning opportunity for students and examine their experiences. Methodology/Approach: Project leaders completed a Diabetes Prevention Program Lifestyle Coach training and, based on their experiences, created training program goals, content, and schedule. Undergraduate students in health-related programs or courses were recruited to participate. Four students completed a 4-week experiential training program and, at the end of the program, participated in an individual qualitative interview for researchers to understand their experiences. Findings/Conclusions: Data were analyzed through a qualitative-descriptive approach. The main theme, experiential learning, branched into two subthemes: (a) professional development and (b) program implementation and future program directions. Students’ experiential learning influenced their personal and programmatic views of prevention training. Implications: The benefits of experiential learning in prevention will enhance students’ education and future employment experiences. Future studies should improve upon training delivery and examine the acceptability of this method of delivery in the rural population. [ABSTRACT FROM AUTHOR]

To examine the associations of basic demographics (age, race, and gender identity) on alcohol consumption among college students at a mid-sized university.To evaluate the drinking habits of students using the survey tool that will measure basic demographics to collect data.A cross-sectional study that included college students ages 17-21 at Columbus State University in the fall of 2021.Columbus, Georgia.University students (n = 260, mean age 20.5 ± 3.8).One-way ANOVA and independent t-tests were used to test differences in age on alcohol consumption and binge drinking. Chi-Square tests and Fisher’s Exact were used to estimate differences in proportions of binge drinking for race and gender.Underage students (57.7%) reported having consumed alcohol in the past. Frequency of alcohol consumption increased with age (P = 0.004). Caucasian students reported drinking most frequently, with 14.8% (n = 12) drinking at least once a week, compared to 0 African American students reporting they drank at least once per week (P < 0.001). There were no significant findings when examining differences in binge drinking for demographics assessed in this sample (P > 0.05).and Relevance: In this cross-sectional research study, the prevalence of underage drinking among college-aged students, there is a need for targeted prevention methods to reduce adverse health outcomes among this vulnerable population. [ABSTRACT FROM AUTHOR]

Substance abuse in adolescents has been recognized as a public health problem at the national and global levels. Adolescents are at risk for experimenting with substances. School nurses in secondary schools are well positioned to screen and counsel students on substance use. In this project, school nurses' self-efficacy levels increased in using the Screening, Brief Intervention, and Referral to Treatment (SBIRT) process posteducation, and SBIRT was integrated into school nurses' practice. Initiatives aimed at stopping or preventing substance use are beneficial for a healthy society. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Elementary Education / Revija za Elementarno Izobraževanje is the property of University of Maribor, Faculty of Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is the responsibility of adults to protect children from sexual abuse. Thus, raising parents' awareness is particularly important since they are the ones who take care of the child and support his/her development in every field. Parents need to acquire information from authentic sources in terms of sexual education of children and protection of them from sexual abuse. That parents have limited knowledge on this subject, feel anxious, or do not know how to talk may prevent them from talking to their kids about sexual abuse. Thus, children's awareness about protection is postponed until they enter an educational institute. It may also become difficult for children to talk to their parents in case of possible sexual abuse. Therefore, it is crucial for parents to increase their awareness through training prepared by experts. In these training programs, awareness of parents can be raised about topics like what sexual abuse is, how to approach a child who experienced sexual abuse, creating an intrafamilial safety plan, and intrafamilial open communication. This review study includes issues of what sexual abuse is, the importance of parents in prevention studies, and sexual abuse prevention programs in which parents take part. As a conclusion, it is thought that awareness can be raised about the importance of parents to prevent sexual abuse and what can be included in programs designed for them. [ABSTRACT FROM AUTHOR]

Abstract Background Intensified preventive regimen based on a ‘high-risk’ approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children. Methods The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups. Results The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups at the end of our study (p = 0.709). Conclusions The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost. Trial registration Thai Clinical Trials Registry (TCTR), TCTR20180124001 . Registered 24 January 2018 - Retrospectively registered.

BackgroundOpioid overdose related injury or death can be prevented by bystander naloxone administration. For naloxone to be present when and where overdoses occur, opioid prevention education and naloxone distribution (OPEND) must be established on a broad level. This is the 30-month follow-up of the first multi-site naloxone project in Sweden, implemented at 31 sites in the County of Skåne 2018.AimTo address participant characteristics and factors associated with returning for naloxone refill and with having used naloxone for overdose reversal. An additional aim was to describe self-reported reasons for naloxone refill and overdose experiences.MethodsData were collected during June 2018—December 2020 through questionnaires at baseline and upon naloxone refill of the initial and subsequent naloxone kit. Descriptive statistics was used to address participant characteristics, those returning for naloxone refill and reporting overdose reversal. Chi-2 test was used for variable comparison between groups. Factors associated with overdose reversals were examined by logistic regression analysis. Reasons for naloxone refill, overdose situation and management were presented descriptively.ResultsAmong 1,079 study participants, 22% (n = 235) returned for naloxone refill, of which 60% (n = 140) reported a total of 229 overdose reversals. Reversals were more likely to be reported by participants trained at needle exchange programs (NEPs) [adjusted odds ratio (AOR) = 5.18, 95% Confidence interval (CI) = 3.38–7.95)], with previous experience of own (AOR = 1.63, 95% CI = 1.03–2.58) or witnessed (AOR = 2.12, 95% CI = 1.05–4.29) overdose, or who had used sedatives during the last 30 days before initial training (AOR = 1.56, 95% CI = 1.04–2.33). A majority of overdoses reportedly occurred in private settings (62%), where the victim was a friend (35%) or acquaintance (31%) of the rescuer.ConclusionParticipants with own risk factors associated with overdose (e.g., injection use, concomitant use of benzodiazepines and previous experience of own overdose) were more likely to report administering naloxone for overdose reversal. Overdose management knowledge was high. The findings indicate that implementation of multi-site OPEND reaches individuals at particularly high risk of own overdose in settings with limited previous harm reduction strategies and favors a further scaling up of naloxone programs in similar settings.

The fast-increasing obesity prevalence rates in children, youths, and adults in the last decade have made obesity prevention a global public health priority. The primary objective of this study is to evaluate the various obesity prevention strategies and guidelines implemented in the United States and Canada. Thus, for this study, a systematic review was performed on various online databases including PubMed, Scopus, Google Scholar, and MEDLINE. The decision to study the obesity prevention strategies in Canada and the United States is a result of the high prevalence rates of obesity in the two countries, alongside the numerous prevention interventions that have been executed to prevent obesity. Additionally, the systematic review used robust methodology that followed the Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies published between 2014 and 2024, drawn from listed databases, were included in this systematic review. The quality of the included studies was evaluated using the appraisal tool for cross-sectional studies, with the studies being rated moderate to high quality. Therefore, a total of 15 studies met the inclusion criteria and were reviewed. The findings indicate that various obesity prevention interventions have been implemented across the United States and Canada, with diverse degrees of success in obesity prevention and management. Food labeling, regular exercises, portion size regulation, school-based intervention strategies, early childhood Intervention programs, and sugar-sweetened beverage taxation were found to be effective interventions for preventing obesity in children and adults. Based on the findings, there is a need to ensure full execution of the different interventions to ensure significant reduction in obesity prevalence, as well as prevention of obesity in different populations., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ijoma et al.)

Objective: To estimate the economic cost of GBV from the perspective of a women survivor who sought help from two identified programs (Makueni GBVRC and Life Bloom Services International [LBSI])., Design: A mixed method research design combining qualitative and quantitative approaches. SITE: Makueni GBVRC in Makueni County, overseen by the Makueni County government, and LBSI in Naivasha, Nakuru County, a non-profit organization devoted to serving local communities., Participants: Study participants include women survivors of GBV, aged 18 and above, actively seeking services at Makueni GBVRC and LBSI., Interventions: The study adopts a qualitative approach to delve into the intricate economic costs of GBV on survivors. Additionally, quantitative data analysis employs an accounting model to ascertain the financial implications., Main Measurements: The costs analyses were done from the perspective of the women survivors. An accounting model was utilized to evaluate the cost of GBV on selected survivors. Furthermore, the research explores the enduring consequences for survivors, including psychological trauma and susceptibility to stress-related diseases., Results: The findings reveal substantial economic costs linked to GBV, adversely affecting survivors, their children, and society at large. These costs encompass direct expenditures on medical care, legal representation, and counseling, as well as indirect costs, such as lost productivity., Conclusions: Beyond immediate and indirect costs, the study underscores the existence of opportunity costs-what survivors and affected children could attain in the absence of GBV., (Copyright © 2023 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)

PRO-Mueve Relaciones Sanas (PRO-Mote Healthy Relationships) is a gender-based violence and dating violence prevention program targeted at adolescents. The program has been designed to be implemented during three consecutive courses [from the first to third year of Spanish mandatory secondary education (ESO)] in 8 annual sessions, imparted by university students who have been previously trained and supervised by university professors. The present study evaluates the effects of the program after the first year of implementation through a quasi-experimental design (Intervention Group N = 181; Quasi-control group N = 62; Mage = 12.11; SDage = 0.57; 54.7% girls) and assesses whether there are gender differences in the outcomes. The results obtained evidenced a significant reduction in benevolent sexism in the intervention group compared to the quasi-control group. Regarding hostile sexism, it was found to increase significantly in the quasi-control group, while it remained stable in the intervention group. Thus, there were significant differences between both groups after the intervention. Likewise, romantic love myths were found to decrease significantly, and knowledge about gender-based violence increased significantly in the intervention group between the two time points assessed, although there were no significant differences with the quasi-control group. No gender differences in the outcomes of the program were observed. The obtained results supported the efficacy of the program during the first year of intervention in the first course of the ESO and laid the foundation for the following phases of intervention.

The paper investigates the role of the internal asset (IA), perceived external resources (PER) of resilience, and the school-based universal prevention program known as ‘Unplugged’ in explaining persistent healthy behavior among early adolescence. A sample of 425 adolescents was collected in a repeated measure design study with a baseline (T1) and a six-month follow-up (T2) after the Unplugged implementation. Persistent healthy behavior was assessed by a change in the cumulative index of substance use created by combining alcohol use and cigarette smoking in the past 30 days and their change between T1 and T2. Four categories were created: non-users, permanent users, new users and ex-users. A multinominal logistic regression revealed that non-users were more likely to show higher self-esteem when compared to permanent users. Females had a higher probability of being non-users than either being permanent users or new users. Moreover, Unplugged intervention increased the probability of being a non-user rather than a new user. Regarding PER of resilience, non-users were more likely to have higher home support, prosocial peers, and school connectedness compared to permanent users. Non-users were also more likely to have higher levels of prosocial peers compared to new users. In summary, higher self-esteem, home support, prosocial peers and school connectedness are associated with persistent healthy behavior. To maintain this persistent healthy behavior, the school-based universal prevention program Unplugged has been effective; thus internal assets and external resources of resilience, and prevention program Unplugged, play an important role in the absence of alcohol or cigarette use in early teenage years. [ABSTRACT FROM AUTHOR]

The aim of the article is to present the assumptions of the prevention of sexual violence against children in the school environment. Child sexual abuse has become a global problem that affects not only the family environment, but educational institutions as well. One example of such an institution is a school where, under the guise of upbringing, there may be numerous abuses committed by people who are an authority in the child’s life. School staff members are often unaware of institutional grooming and its perpetrators, which means that the entire institution may unknowingly contribute to promoting child sexual abuse. The author first presents the methods of grooming used by perpetrators, pointing to activities aimed at children and the mechanisms of institutional grooming that may create a specific culture that makes it difficult to protect children. The author then presents the standards and strategies for prevention in schools, paying attention to the need to involve the entire community: conducting proper recruitment and training of employees and constructing preventive programs adapted to the age and development of children and their proper implementation.

Few studies so far have analysed the potential role of mentoring in decreasing hyperactivity and inattention problems. The aim of the current study is to investigate the impact of the Italian Mentor-UP mentoring program on hyperactivity and inattention problems in a non-clinical sample of mentees. “Mentor-UP” is a weekly school- and community-based mentoring program implemented in northern Italy over a period of 8 months. The sample included 468 students, 65 from the experimental group (mentees) and 403 as comparison group. Participants’ age ranged between 8 and 14 years (M = 11.31, SD = 1.40), 46% were females and 20% were non-Italian youths. Students reported their levels of hyperactivity and inattention problems at the beginning and at the end of the program. A significant interaction between time and group revealed a significant effect of the program on hyperactivity and inattention problems (B = −0.10, t (450) = −2.00, p = 0.04), which decreased in mentees (Cohen’s d = −0.21) but not in the comparison group. Results supported the effectiveness of Mentor-UP in decreasing youths’ hyperactivity and inattention. This might be due to the structural characteristics of the mentoring relationships established in the context of Mentor-UP.

Background: Violent workplace deaths among health care workers (HCWs) remain understudied in the extant literature despite the potential for serious long-term implications for staff and patient safety. This descriptive study summarized the number and types of HCWs who experienced violent deaths while at work, including the location in which the fatal injury occurred. Methods: Cases were identified from the Centers for Disease Control and Prevention's National Violent Death Reporting System between 2003 and 2016. Coded variables included type of HCW injured, type of facility, and location within the facility and perpetrator type among homicides. Frequencies were calculated using Excel. Findings: Among 61 HCW deaths, 32 (52%) were suicides and 21 (34%) were homicides; eight (13%) were of undetermined intent. The occupations of victims included physicians (28%), followed by nurses (21%), administration/support operations (21%), security and support services (16%), and therapists and technicians (13%). Most deaths occurred in hospitals (46%) and nonresidential treatment services (20%). Within facility, locations included offices/clinics (20%) and wards/units (18%). Among homicide perpetrators, both Type II (perpetrator was client/patient/family member) and Type IV (personal relationship to perpetrator) were equally common (33%). Conclusion/ Applications to Practice: Suicide was more common than homicide among HCW fatal injuries. Workplace violence prevention programs may want to consider both types of injuries. Although fatal HCW injuries are rare, planning for all types of violent deaths could help minimize consequences for staff, patients, and visitors. [ABSTRACT FROM AUTHOR]

Research in the United States has shown that youth mentoring is a promising strategy for increasing self-esteem and school connectedness in at-risk youth. There has been little confirmation of those findings internationally. The current study evaluates the impact of mentoring by trained university students on children’s self-esteem and school connectedness compared to schoolmates not involved in the program. Mentor-UP is a school- and community-based weekly mentoring program implemented in northern Italy over a period of seven months. Participants (209 students – 34 in the experimental group and 175 in the comparison group – aged between 11 and 13, 56% male, 27% immigrants) reported their levels of self-esteem and school connectedness at the beginning and at the end of the program. Results showed a significant increase in mentees’ self-esteem compared to the control group, while the difference in school-connectedness was nonsignificant. The findings support the effectiveness of Mentor-UP in nurturing youth’s self-esteem.

Abstract Background Overdose education and naloxone distribution programs decrease opioid overdose deaths. However, no studies of such programs have been carried out in Denmark. The aim of this study was to evaluate the feasibility and the effect of a broader “training-the-trainers” model in low-threshold settings after participation in the “Danish Save Lives” [SL] program. Methods Between May 2013 and November 2015, 552 participants from four municipalities took part in the SL program. The program is built on the train-the-trainers model where a central trainer trains others (trainers), who in turn train others (helpers). Participants were 30 police officers (5%), 188 people who use opioids (34%), 23 significant others (4%), and 217 social workers (39%). Ninety-four participants could not be classified (17%). At follow-up, participants were interviewed to determine the number and outcomes of opioid overdoses. Logistic regression was used to assess predictors of treating an overdose. Results In all, 37 (7%) participants had intervened in 45 opioid overdose events (two trainers and 35 helpers). Detailed descriptions of the overdose event were available from 32 follow-up interviews (70%). In 16 cases, the person who intervened was already present at the site when the overdose occurred, and in 17 cases, the overdose victim recovered without complications. All overdose victims survived except one. People who used opioids were more likely to have treated an overdose than other participants (adjusted odds ratio [AOR] = 8.50, p = 0.001), and the likelihood of treating and overdose declined over time AOR = 0.37 (0.13, 0.93), p = 0.034). Conclusions Prevention programs that target people who use opioids are more likely to be effective than programs that target professionals, especially in high-risk settings that can be hard for paramedics to reach. A future goal is to explore how prevention programs can be adapted to new user groups. Trial registration The Danish Data Protection Agency, 2015-57-0002, Aarhus University, 2016-051-000001, 184, retrospectively registered

Abstract Background The European school-based drug addiction prevention program Unplugged was adapted to the Brazilian context by the Ministry of Health and renamed #Tamojunto. Its first implementations, in the form of a public policy in Brazil, showed contradictory and different effects from those observed in Europe. Adaptations were made to #Tamojunto in 2018 to reintroduce the essential content of the original program. Methods A parallel, two-arm, randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the new version of the school-based government program #Tamojunto2.0 for the prevention of drug use among 8th grade middle school students from 70 public schools in three Brazilian cities, totaling approximately 6.300 participating students distributed in 210 classes. For intervention, the experimental group will receive the 12 lessons of the #Tamojunto2.0 program under the supervision of a Brazilian Ministry of Health team. The control group will not receive any intervention. Information will be collected from the students at three time points: preintervention and 9 and 18 months postintervention. Multilevel analyses will be performed using the Gllamm Stata program to assess simultaneous differences in prevalence, in time and among groups for the outcomes of interest. Structural equation modeling will be used to evaluate the effectiveness of the intervention in changing the behavioral patterns of the adolescents through latent transition analysis. The effect of the mediators involved in the program effectiveness outcomes will also be analyzed. The program doses applied in all classes of the intervention group will be collected using a form completed by the teacher at the end of each lesson, indicating the activities taught and not taught in each lesson. Discussion This study will show whether the #Tamojunto2.0 program can be expanded as a public policy for all schools with the aim of preventing drug use among Brazilian students. Trial registration Brazilian Clinical Trials Registry (RBR-8cnkwq) under the name “Avaliação do Efeito do Programa de Prevenção Escolar ao Uso de Drogas #Tamojunto2.0, Versão 2018”, on August 30th, 2018 (http://www.ensaiosclinicos.gov.br/rg/RBR-8cnkwq/).

(1) Background: It is essential to focus attention on sex-specific factors which are clinically relevant in pain management, especially with regards to opioid use disorder (OUD) risk. The aim of this study was to explore potential sex-differences in chronic non-cancer pain (CNCP) outpatients. (2) Methods: An observational cross-sectional study was conducted under CNCP outpatients with long-term prescribed opioids (n = 806), wherein 137 patients had an OUD diagnosis (cases, 64% females) and 669 did not (controls, 66% females). Socio-demographic, clinical, and pharmacological outcomes were analyzed. (3) Results: Female controls presented an older age and less intensive pain therapy but higher psychotropic prescriptions and emergency department visits compared to male controls. Meanwhile, cases demonstrated a younger age, higher work disability, double morphine equivalent daily dose, and benzodiazepine use compared with controls. Here, female cases showed an 8% greater substance use disorder (OR 2.04 [1.11–3.76]) and 24% lower tramadol use, while male cases presented a 22% higher fentanyl use (OR 2.97 [1.52–5.81]) and reported the highest number of adverse drug reactions (24%, OR 2.40 [1.12–5.16]) compared with controls. (4) Conclusions: An OUD individual risk profile was evidenced with sex-differences to take into consideration to design equal prevention programs.

Research indicates that mental health disorders can occur in children as young as 4 years of age, prompting the need for prevention programs for young children. The ability to use healthy strategies to cope with emotions is a protective factor against mental health disorders that can be effectively taught to children from an early age. The current study used a pre-test post-test cluster randomized controlled trial to test the efficacy of the new Aussie Optimism: I Spy Feelings Program. The aim of the study was to investigate the effects of the program on children’s emotional coping. The program included content on emotion regulation strategies, focusing on the emotions of happiness, sadness, anger, fear, and worry. The participants were 73 children (intervention = 33; control = 40) from pre-primary classes. Four schools were cluster randomized to the intervention or control group, resulting in two schools in each condition. Parents completed measures of their children’s emotional coping with sadness, anger and worry. Children in the intervention group participated in ten sessions of the I Spy Feelings Program, spread over 5 weeks. The results indicated a significant, small to moderate intervention effect for coping with anger. Children in the control group decreased in their ability to cope with anger, while children in the intervention group remained stable. No intervention effects were found for coping with sadness or worry, with results for these emotions staying stable across time for both groups. This pilot study will inform the further development of the program. The effects of the program on coping with anger provide support for the use of emotion regulation strategies in intervention programs to maintain healthy emotional coping, which is a protective factor against internalizing and externalizing disorders in childhood.

Research indicates that mental health disorders can occur in children as young as 4 years of age, prompting the need for prevention programs for young children. The ability to use healthy strategies to cope with emotions is a protective factor against mental health disorders that can be effectively taught to children from an early age. The current study used a pre-test post-test cluster randomized controlled trial to test the efficacy of the new Aussie Optimism: I Spy Feelings Program. The aim of the study was to investigate the effects of the program on children's emotional coping. The program included content on emotion regulation strategies, focusing on the emotions of happiness, sadness, anger, fear, and worry. The participants were 73 children (intervention = 33; control = 40) from pre-primary classes. Four schools were cluster randomized to the intervention or control group, resulting in two schools in each condition. Parents completed measures of their children's emotional coping with sadness, anger and worry. Children in the intervention group participated in ten sessions of the I Spy Feelings Program, spread over 5 weeks. The results indicated a significant, small to moderate intervention effect for coping with anger. Children in the control group decreased in their ability to cope with anger, while children in the intervention group remained stable. No intervention effects were found for coping with sadness or worry, with results for these emotions staying stable across time for both groups. This pilot study will inform the further development of the program. The effects of the program on coping with anger provide support for the use of emotion regulation strategies in intervention programs to maintain healthy emotional coping, which is a protective factor against internalizing and externalizing disorders in childhood. [ABSTRACT FROM AUTHOR]

BACKGROUND: Universal prevention approaches that target the general population can be effective for promoting children's health. This overview aims to summarize evidence presented in existing reviews of school‐based interventions. METHODS: We present an overview of evidence sourced from Campbell and Cochrane systematic reviews. These reviews examined randomized controlled trials concerning school‐based health‐promotion programs for children (mostly aged 4‐18 years) in the general population. RESULTS: We identified 56 high‐quality reviews. The reviews focused on emotional and behavioral outcomes, infectious diseases, injury reduction, mental health, nutrition intake, oral health, physical and developmental changes, sense‐organ diseases, sexual‐health outcomes, and substance use/abuse. Positive evidence—such as vision screening plus provision of free spectacles for spectacle wear increase and a combination of social competence and social‐influence approaches for preventing illicit drug use—were considered high certainty. CONCLUSIONS: Of the various interventions implemented in school settings that involved people from various occupations, some positive effects were found. In most cases, evidence certainty was negatively affected by a high risk of bias within studies, inconsistencies within the estimates, and insufficient sample sizes. Further primary studies in these areas would be helpful for accumulating evidence to promote stronger cooperation between health and education stakeholders. [ABSTRACT FROM AUTHOR]