ABSTRACT
The school environment is of great relevance in the prevention of drug use in students because it is where they spend most of their time and, since education is compulsory until upper secondary school in Spain, interventions in this area can reach the majority of children up to that stage. The objective of this systematic review is to determine the level of efficacy of the school preventive programs that have been implemented in Spain. Following the PRISMA recommendations, a systematic literature search was carried out in the Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases. The search yielded 274 studies, of which 29 studies were selected. It was found that 48 drug addiction prevention programs have been implemented in Spanish school context, of which only 18 (37.5%) had an evaluation of their effectiveness following the criteria and standards of effective prevention. Conversely, the programs that were not evaluated are far from these standards in their design. It is concluded that there are two models of school prevention of drug addiction in Spain: a model that meets this description; and another model classified as "pseudo-prevention", since its design does not meet the standards of effective prevention nor has its preventive efficacy been demonstrated.
El ámbito escolar adquiere una gran relevancia en la prevención del consumo de drogas en estudiantes, ya que es donde pasan una mayor parte del tiempo y, puesto que en España la enseñanza es obligatoria hasta los 16 años, las intervenciones en este ámbito pueden alcanzar a la mayoría de niños en esa etapa. El objetivo de esta revisión sistemática fue determinar qué nivel de eficacia presentan los programas preventivos escolares que se han implementado en España. Siguiendo las recomendaciones PRISMA, se llevó a cabo una búsqueda bibliográfica sistemática en las bases de datos Web of Science, PubMed/MEDLINE, Embase, Scopus y Cochrane Library. La búsqueda arrojó 274 estudios, de los cuales fueron seleccionados 29 estudios. Se ha identificado que en España se han implementado 48 programas preventivos en drogodependencias en el contexto escolar, de los cuales tan solo 18 (37,5%) cuentan con evaluación de su eficacia siguiendo los criterios y estándares de una prevención eficaz. Por el contrario, los programas que no han sido evaluados distan en su diseño de estos estándares. Se concluye que en España conviven dos modelos de prevención escolar de las drogodependencias: un modelo que responde a esta denominación; y otro modelo calificado como "pseudo-prevención", dado que su diseño no se ajusta a los estándares de la prevención eficaz ni su eficacia preventiva ha sido demostrada.
ABSTRACT
Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population.
ABSTRACT
BACKGROUND: Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities. OBJECTIVE: To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system. METHODS: Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines. INCLUSION CRITERIA: Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage. RESULTS: A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care. CONCLUSIONS: LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.
