The Role of Personalized Normative Feedback in the Efficacy of Brief Intervention Among Argentinian University Students: A Randomized Controlled Trial.

Background: Personalized Normative Feedback (PNF) aims to modify misperceptions about peer consumption that influence one's drinking. PNF is usually a component in Brief Interventions delivered to university students. Despite this, whether PNF contributes to improving the effect of brief interventions is unclear. Objectives: This randomized controlled trial aimed to determine the role of PNF as an active ingredient in a face-to-face motivational brief intervention. Results: Participants were students from an Argentinian university (n=806; M=20.14; SD=3.17; 63.2% women) who presented at least one binge drinking episode in the last 12 months. Students were randomly assigned to 1) a Brief Intervention, 2) a Brief Intervention with PNF, or 3) an evaluation-only control group. The follow-up was three months later. After controlling sex and age, General Linear Models showed that both the brief intervention and the brief intervention with PNF reduced the quantity and frequency of alcohol consumption, binge drinking, and alcohol problems compared to the control condition. No differences were found between the brief intervention and the brief intervention with PNF. Also, treating eight students with brief intervention and 10 with brief intervention with PNF was necessary to benefit one student. Conclusions: In conclusion, this study demonstrates that brief intervention reduces alcohol consumption among Latin American university students and that PNF might not be an active ingredient of its effectiveness in this population. However, PNF could benefit students with specific characteristics, like those who overestimate their peers' drinking, highlighting the need to study moderators of effectiveness further.

[Detection of alcohol consumption at the first level of care in Mexico during the COVID-19 pandemicDetecção do consumo de álcool no nível da atenção primária no México durante a pandemia de COVID-19]. / Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19.

Objective: To measure the impact of the COVID-19 pandemic on the implementation of a program for timely detection, brief intervention, and referral for treatment of alcohol consumption in health centers at the first level of care in Mexico City. Methods: The data were collected at 18 health centers in Mexico City between 2019 and 2021, as part of a larger study. A total of 287 participating health professionals measured their patients' alcohol consumption using the AUDIT-C test. The patients' demographic aspects and consumption patterns were analyzed, as well as care actions (detection, brief intervention, provision of leaflets, monitoring, and referral) at three points in time: before the COVID-19 pandemic, during confinement, and after confinement. Parametric and nonparametric tests were performed to identify the relationship and differences between the variables at the three points. Results: A total of 9090 people who consumed alcohol were identified; detection of consumption fluctuated in the three periods studied (26%, 53%, and 37%, respectively). Medium- and high-risk consumption was more frequent among young men with higher schooling during and after confinement. In the post-confinement period, monitoring and referral actions increased. Conclusions: Measuring the impact of the pandemic on the implementation of a program for timely detection of alcohol consumption, brief intervention, and referral for treatment in health centers helps to develop health policies by age, gender, schooling, and type of consumption at the first level of care.

Objetivo: Medir o efeito da pandemia de COVID-19 na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento pelo consumo de álcool em centros de saúde no nível da atenção primária na Cidade do México. Métodos: Foram coletados dados em 18 centros de saúde na Cidade do México entre 2019 e 2021, como parte de um estudo mais amplo. Participaram 287 profissionais de saúde, que mediram o consumo de álcool de seus pacientes com o teste AUDIT-C. Foram analisados aspectos demográficos e o padrão de consumo dos pacientes, bem como as medidas em termos de atendimento (triagem, intervenção breve, entrega de folhetos, monitoramento e encaminhamento) em três momentos: antes da pandemia de COVID-19, durante o confinamento e após o confinamento. Foram feitos testes paramétricos e não paramétricos para identificar a relação e as diferenças entre as variáveis nos três períodos. Resultados: Foram identificadas 9.090 pessoas com consumo de álcool, sendo que a porcentagem de consumo detectada flutuou nos três períodos estudados (26%, 53% e 37%, respectivamente). O consumo de médio e alto risco foi mais prevalente entre homens jovens e com nível maior de escolaridade durante e após o confinamento. No período posterior ao confinamento, as medidas de monitoramento e encaminhamento aumentaram. Conclusões: Medir o impacto da pandemia na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento do consumo de álcool em centros de saúde ajuda na formulação de políticas de saúde por idade, gênero, escolaridade e tipo de consumo para o primeiro nível de atenção.

Detección del consumo de alcohol en el primer nivel de atención en México durante la pandemia de COVID-19 / Detection of alcohol consumption at the first level of care in Mexico during the COVID-19 pandemic / Detecção do consumo de álcool no nível da atenção primária no México durante a pandemia de COVID-19

RESUMEN Objetivo. Medir el efecto de la pandemia de COVID-19 en la implementación de un programa de detección oportuna, intervención breve y referencia para tratamiento por consumo de alcohol en centros de salud del primer nivel de atención de la Ciudad de México. Métodos. Se recopilaron los datos en 18 centros de salud de la Ciudad de México entre 2019 y 2021, como parte de un estudio más amplio. Participaron 287 profesionales de la salud, quienes midieron el consumo de alcohol de sus pacientes con la prueba AUDIT-C. Se analizaron aspectos demográficos y patrones de consumo de los pacientes, así como las acciones de atención (detección, intervención breve, entrega de folletos, monitoreo y referencia) en tres momentos: antes de la pandemia de COVID-19, durante el confinamiento y luego del confinamiento. Se realizaron pruebas paramétricas y no paramétricas para identificar la relación y las diferencias entre las variables en los tres períodos. Resultados. Se identificaron 9 090 personas con consumo de alcohol; el porcentaje de detección del consumo tuvo fluctuaciones en los tres períodos estudiados (26%, 53% y 37%, respectivamente). El consumo de riesgo medio y alto fue más frecuente entre hombres jóvenes y con mayor escolaridad durante y después del confinamiento. En el período posconfinamiento aumentaron las acciones de monitoreo y referencia. Conclusiones. La medición del impacto de la pandemia en la implementación de un programa de detección oportuna, asesoramiento breve y referencia para el tratamiento del consumo de alcohol en centros de salud ayuda a elaborar políticas en salud por edad, género, escolaridad y tipo de consumo para el primer nivel de atención.

ABSTRACT Objective. To measure the impact of the COVID-19 pandemic on the implementation of a program for timely detection, brief intervention, and referral for treatment of alcohol consumption in health centers at the first level of care in Mexico City. Methods. The data were collected at 18 health centers in Mexico City between 2019 and 2021, as part of a larger study. A total of 287 participating health professionals measured their patients' alcohol consumption using the AUDIT-C test. The patients' demographic aspects and consumption patterns were analyzed, as well as care actions (detection, brief intervention, provision of leaflets, monitoring, and referral) at three points in time: before the COVID-19 pandemic, during confinement, and after confinement. Parametric and nonparametric tests were performed to identify the relationship and differences between the variables at the three points. Results. A total of 9090 people who consumed alcohol were identified; detection of consumption fluctuated in the three periods studied (26%, 53%, and 37%, respectively). Medium- and high-risk consumption was more frequent among young men with higher schooling during and after confinement. In the post-confinement period, monitoring and referral actions increased. Conclusions. Measuring the impact of the pandemic on the implementation of a program for timely detection of alcohol consumption, brief intervention, and referral for treatment in health centers helps to develop health policies by age, gender, schooling, and type of consumption at the first level of care.

RESUMO Objetivo. Medir o efeito da pandemia de COVID-19 na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento pelo consumo de álcool em centros de saúde no nível da atenção primária na Cidade do México. Métodos. Foram coletados dados em 18 centros de saúde na Cidade do México entre 2019 e 2021, como parte de um estudo mais amplo. Participaram 287 profissionais de saúde, que mediram o consumo de álcool de seus pacientes com o teste AUDIT-C. Foram analisados aspectos demográficos e o padrão de consumo dos pacientes, bem como as medidas em termos de atendimento (triagem, intervenção breve, entrega de folhetos, monitoramento e encaminhamento) em três momentos: antes da pandemia de COVID-19, durante o confinamento e após o confinamento. Foram feitos testes paramétricos e não paramétricos para identificar a relação e as diferenças entre as variáveis nos três períodos. Resultados. Foram identificadas 9.090 pessoas com consumo de álcool, sendo que a porcentagem de consumo detectada flutuou nos três períodos estudados (26%, 53% e 37%, respectivamente). O consumo de médio e alto risco foi mais prevalente entre homens jovens e com nível maior de escolaridade durante e após o confinamento. No período posterior ao confinamento, as medidas de monitoramento e encaminhamento aumentaram. Conclusões. Medir o impacto da pandemia na implementação de um programa de detecção oportuna, intervenção breve e encaminhamento para tratamento do consumo de álcool em centros de saúde ajuda na formulação de políticas de saúde por idade, gênero, escolaridade e tipo de consumo para o primeiro nível de atenção.

Effectiveness of a Brief Group Intervention for Harmful Alcohol Use in Men at a Primary Health Care Facility in Brazil: A Randomized Clinical Trial.

To evaluate the effectiveness of a brief group intervention (BGI) in reducing the use of alcohol and increasing the readiness to change in men with risky and harmful alcohol use. A randomized clinical trial with follow-ups at 30 and 90 days that was conducted in a primary health care (PHC) facility in the central region of São Paulo (Brazil). A total of 112 men were randomized to the experimental group (EG) (n = 55) or the control group (CG) (n = 57). To identify the pattern of alcohol use and the readiness to change, the Alcohol Use Disorders Identification Test (AUDIT) and the readiness to change (RTC) rule were used. The EG received a BGI session applied by nurses using the Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy (FRAMES) model. The CG was instructed to continue with the standard service of the unit after an initial interview. Intergroup analyses using the generalized equation estimation (GEE) method were performed. A significant difference in the pattern of use was observed between the EG and CG at follow-up evaluated (EG T1 (7.73 ± 5.14), CG T1 (12, 48 ± 5.62)) and EG T2 (6.65 ± 4.83), CG T2 (11.68 ± 6.65)). When compared the baseline (T0) measures (13.04) with the last time (T2) (6.65) at EG, it was identified a reduction of 6.39 in the AUDIT score. Differences between groups were found for readiness to change at follow-up ((EG T1 (8.50 ± 2.44) and CG T1 (5.67 ± 3.10) and (EG T2 (8.80 ± 1.73) and CG T2 (5.36 ± 3.33)), when contrasting with the baseline. The data suggest that the BGI was effective when compared to the control condition, as there was a reduction in risky and harmful use of alcohol for low-risk use, according to the alcohol use scores, and an increase in the stages of readiness to change.

Efficacy of Brief Intervention for Alcohol Consumption during Pregnancy in Argentinean Women: A Randomized Controlled Trial.

INTRODUCTION: Although Brief Intervention (BI) has proven to reduce alcohol consumption during pregnancy in high income countries, there is no evidence from the Southern Cone of America. Thus, we conducted a study to assess BI efficacy among Argentinean pregnant women. METHOD AND MATERIALS: We collected data on pregnant women receiving prenatal care at the public health system in Mar del Plata, Argentina. Women with less than 26 weeks of gestation (n = 486) were randomized to brief advice (BA) or BI. Three months later they were re-assessed; women with more than 26 weeks of gestation constituted a screening only control group (SC) (n = 154). Self-reported quantity and frequency of alcohol consumption, frequency of binge drinking, and related problems after three months were used as outcomes. We performed generalized estimating equations and clinical significance analyses. Also, we obtained newborn health indicators from the city's health system database to use as objective outcomes. Women who did not participate in any of the three former conditions were randomly selected to constitute a non-screening control group (NSC) (n = 150). We compared objective outcomes among BI, BA, and NSC groups using the Wilcoxon rank test. RESULTS: In comparison with SC, BI and BA reduced alcohol consumption, without differences between the latter two. Newborns of women who received BI and BA had better health indicators compared with the NSC group. CONCLUSIONS: performing either a BI or BA reduces alcohol consumption among Argentinean pregnant women and might lead to healthier newborns.

Reducing women's alcohol use: a brief intervention pilot study at a primary health care service in Brazil.

This study assesses the feasibility of a brief intervention among women with hazardous alcohol use at a primary health care service in Brazil. A two-arm randomized pilot study was carried out from July 2017 to January 2018 with 44 women aged 18 years or older with hazardous alcohol use. The intervention group completed a brief intervention in a single session lasting 20 to 30 minutes. The control group received five minutes of brief advice. Alcohol use was assessed by the Alcohol Use Disorders Identification Test (AUDIT), and the frequency and quantity of alcohol consumed in the previous month were assessed at baseline and the first and third months of follow-up in both groups. The AUDIT score was decreased in both groups at baseline (intervention group 12.89, control group 10.64), the 1st month (intervention group 12.78 p = .9; control group 7.9 p = .01) and the 3rd month (intervention group 10.11 p = .13; control group 7.09 p < .01). The intervention group continued using alcohol after the brief intervention, although the quantity of alcohol consumed was reduced compared with that at baseline (p < .01). Finally, the brief intervention delivered in a primary health care service in Brazil showed the potential to reduce women's pattern of alcohol consumption.

A Health Technician-delivered Brief Intervention linked to AUDIT for reduction of alcohol use in Chilean primary care: a randomized controlled trial.

BACKGROUND: Because of the shortage of health professionals in Chilean primary care, Health Technicians (HT) are providing Brief Interventions (BI) for risky alcohol consumption. We compared the efficacy of two AUDIT-linked interventions provided by HTs: an informative leaflet and a BI plus leaflet. METHODS: This is a parallel-group randomized controlled trial with 1:1 randomization. Participants were identified through screening with the Alcohol Use Disorders Identification Test (AUDIT) at five primary care centers between March 2016 and July 2017. People older than 18 years at intermediate-risk (AUDIT score 8 to 15, inclusive) were randomized to receive either an HT-delivered BI (n = 174) or an informative leaflet (n = 168). Only data from participants (n = 294) who completed the 6-month assessment were analyzed. The leaflet was delivered without further advice. It contains alcohol consumption limits, a change planner, and strategies to decrease drinking. The BI was a 5-min discussion on the leaflet´s content plus normative feedback, tailored information on alcohol and health, and a change plan. The change in the AUDIT risk category six months after randomization (primary outcome) was compared among groups with a Chi-squared test. Changes in the secondary outcomes, which were scores on the AUDIT and the AUDIT´s consumption items (AUDIT-C), were compared with T-tests. Mixed-effects linear models adjusted for potential confounders. Outcome adjudicators were blinded to group assignment. RESULTS: At 6-month follow-up, low-risk alcohol consumption was observed in 119 (80%) participants in the BI group, and in 103 (71%) in the leaflet group, with no difference among groups ([Formula: see text] [1, N = 294] = 2.6, p = 0.1; adjusted odds ratio 0.6; 95% confidence interval [CI] 0.34, 1.05). The mean AUDIT score decreased by 5.76 points in the BI group, and by 5.07 in the leaflet group, which represents a 0.86 AUDIT point reduction attributable to the BI (secondary outcome) (T = 2.03, p = 0.043; adjusted mean difference 0.86 CI 0.06, 1.66). CONCLUSIONS: The AUDIT-linked BI delivered by HTs was not associated with a greater reduction of risky alcohol consumption than an informative leaflet. Delivering a leaflet could be more efficient than a BI when provided by HTs; however, more research on the effectiveness of the leaflet is needed. Trial registration ClinicalTrials.gov NCT02642757 (December 30, 2015) https://clinicaltrials.gov/ct2/show/NCT02642757 .

Orientação a práticas parentais: descrição de um programa de intervenção individual breve / Parenting practices orientation: description of a brief individual intervention program / Orientación a prácticas parentales: descripción de un breve programa de intervención individual

A orientação a práticas parentais visa modificar o contexto no qual as crianças estão inseridas como forma de potencializar mudanças em seu comportamento. Esse artigo descreve uma intervenção breve de sete encontros em modalidade individual. O programa teve como finalidades principais auxiliar os cuidadores a identificar e estimular comportamentos adequados em seus filhos; ensinar novos comportamentos; incentivar a autonomia das crianças; encontrar abordagens não-agressivas para lidar com maus comportamentos; e auxiliar na organização da rotina. Como metodologia, realizou-se a descrição de três casos, exemplificando as estratégias adotadas em cada um. A análise dos casos permitiu o delineamento de características comuns entre as práticas parentais dos pais ou cuidadores. Os casos relatados neste estudo evidenciam que as famílias utilizam punição corporal, apresentam dificuldade de empatizar com a criança, possuem um estilo parental autoritário e expectativas incompatíveis com a idade das crianças. Além disso, a infância dos pais ou cuidadores apresentou forte influência no desenvolvimento de suas práticas parentais. A sobrecarga na figura materna também ficou evidente nos casos de famílias intactas. Por fim, a intervenção pode estabelecer um contato inicial da família com um serviço de psicologia, incentivando contato posterior com serviços que possam atender às demais dificuldades. A partir dos resultados examinados, conclui-se que a intervenção breve apresentou resultados positivos na mudança das relações familiares. Porém, o estudo precisa estabelecer uma medição quantitativa antes e depois da intervenção, além de uma sessão de seguimento para verificar se as mudanças são de longo prazo.(AU)

Orientation to parenting practices aims to modify the context in which children are inserted as a means to induce changes in their behavior. This article describes a brief seven-session individual intervention program aimed to help guardians identifying and encouraging appropriate behavior in their children, teaching new behaviors, encouraging autonomy, finding non-aggressive approaches to dealing with bad behavior, and assisting in the routine organization. The study describes three cases, exemplifying the strategies adopted in each of them. The analysis allowed the delineation of common characteristics among parental practices, indicating that families use corporal punishment, struggle in empathizing with the child, and have an authoritarian parental style and expectations that are incompatible with children's age. The results indicate that the childhood of parents and guardians had a strong influence on the development of their parental practices. Moreover, intact families presented an overload in the maternal figure. In this scenario, the intervention can bridge an initial contact between the family and a psychology service, encouraging later contact that can attend to other family difficulties. Despite the positive changes in family relationships enabled by this brief intervention, the study requires a pre- and post-intervention quantitative measurement and a follow-up session to verify whether these changes are long-term.(AU)

La orientación a prácticas parentales tiene por objetivo modificar el contexto en el que viven los niños como forma de potenciar cambios en su comportamiento. Este artículo describe una intervención breve de siete encuentros individuales. El programa tuvo como finalidades principales: auxiliar a los cuidadores en la identificación y estimulación de comportamientos adecuados en sus hijos; enseñar nuevos comportamientos; fomentar la autonomía de los niños; encontrar enfoques no agresivos para manejar malos comportamientos; y ayudar en la organización de la rutina. Para ello, se describió tres casos, ejemplificando las estrategias adoptadas en cada uno. El análisis de los casos permitió el delineamiento de características comunes entre las prácticas parentales de los padres/cuidadores. Los casos reportados en este estudio evidencian que las familias utilizan castigo corporal, presentan dificultad para tener empatía con el niño, poseen un estilo parental autoritario y expectativas incompatibles con la edad de los niños. Además, la infancia de los padres/cuidadores presentó una fuerte influencia en el desarrollo de sus prácticas parentales. La sobrecarga en la figura materna también estuvo evidente en los casos de familias intactas. Por último, la intervención puede establecer un contacto inicial de la familia con un servicio de psicología, incentivando un contacto posterior con servicios que puedan atender las demás dificultades de la familia. La intervención breve presentó resultados positivos en el cambio de las relaciones familiares, pero el estudio necesita establecer una medición cuantitativa pre- y posintervención y una sesión de seguimiento para verificar si los cambios son a largo plazo.(AU)

Because of the baby: reduction on drug use during pregnancy / Por causa do bebê: redução do uso de drogas por gestantes

Abstract Objectives: evaluate changes in the use of psychoactive substances (PAS) throughout pregnancy. Methods: longitudinal study, with pregnant women users of PAS at a prenatal follow-up. Results: 76 pregnant women used: tobacco (84.2%, n=64), alcohol (73.7%, n=56), cocaine (27.6%, n=21), marijuana (26.3%, n=20) and crack (13.1%, n=10). Spontaneous interruption had occurred in 60% (n=6) of crack users, 57.1% (n=12) of cocaine and 50% (n=28) of alcohol. After the Brief Intervention, 78.9% (15 of the total of 19) of alcohol users and 70% (7 of the total of 10) of marijuana users discontinued the consumption and there was a reduction in smoking cigarettes. Conclusions: the spontaneous reduction in the consumption of PAS and after the interventions, pregnancy is a window of opportunity to reduce the use of drugs.

Resumo Objetivos: avaliar mudanças no uso de substâncias psicoativas (SPA) durante a gravidez. Métodos: estudo longitudinal, com gestantes usuárias de SPA em seguimento pré-natal. Resultados: 76 gestantes, que utilizavam: tabaco (84,2%, n=64), álcool (73,7%, n=56), cocaína (27,6%, n=21), maconha (26,3%, n=20) e crack (13,1%, n=10). Houve interrupção espontânea em 60% (n=6) das usuárias de crack, 57,1% (n=12) de cocaína e 50% (n=28) de álcool. Após Intervenção Breve, cessaram o consumo 78,9% (15 do total de 19) das usuárias de álcool e 70% (7 do total de 10) de maconha, e as tabagistas diminuíram o número de cigarros. Conclusões: a redução do consumo de SPA espontânea e após intervenções reforçam a gravidez como janela de oportunidade para abordagem do uso de drogas.

Conhecimento, atitudes e práticas dos profissionais da equipe de saúde da família na atenção aos usuários de substâncias psicoativas / Knowledge, attitudes and practice of family health team professionals in the attention to psychoactive substances users

O abuso do álcool e outras drogas é um problema de saúde pública, e as equipes de saúde da família devem estar capacitadas e qualificadas para cuidar dessa população. Desse modo, o presente estudo teve como objetivo geral: Avaliar o conhecimento, as atitudes e as práticas dos profissionais que integram as Equipes de Saúde da Família na atenção à saúde dos usuários com problemas relacionados ao uso de substâncias psicoativas; e teve como objetivos específicos: Descrever o conhecimento, as atitudes e as práticas frente ao uso de substâncias psicoativas dos profissionais de saúde que integram as Equipes de Saúde da Família; Realizar capacitação em serviço sobre as substâncias psicoativas baseadas na Intervenção Breve par aos profissionais da Equipe de Saúde da Família; Analisar o impacto da capacitação em serviço sobre o conhecimento dos profissionais das Equipes de Saúde da Família nas perspectivas da Intervenção Breve. Metodologia: Trata-se de uma pesquisa seccional do tipo inquérito Conhecimento, Atitudes e Práticas, seguido de um estudo quase- experimental. Para o estudo seccional foram entrevistados 318 profissionais que atuavam nas Equipes de Saúde da Família em uma área de planejamento do município do Rio de Janeiro. O instrumento de coleta de dados foi um questionário autoaplicável com questões referentes a perfil sociodemográfico, conhecimento, atitudes e práticas relacionadas à atenção à saúde dos usuários de substâncias psicoativas. Para o desenho quase-experimental foi realizada uma capacitação em serviço com 17 profissionais das Equipes de Saúde da Família, sendo utilizado um questionário autoaplicável antes e após a intervenção. Todos os dados foram analisados pelo programa Statistical Package for the Social Sciences (IBM SPSS, v. 23,0). Resultados: Evidenciou-se que a maior parte dos entrevistados foram do sexo feminino, adultos (mediana= 38), cristãos, agentes comunitários de saúde e que trabalhavam na Estratégia de Saúde da Família de 1 a 5 anos. Houve predomínio de conhecimento, atitudes e práticas não adequadas relacionadas à atenção à saúde dos usuários de substâncias psicoativas, houve diferença estatística significativa entre atitudes não adequadas e práticas não adequadas. Após a capacitação em serviço observou-se melhora no conhecimento adequado. Conclusão: Observou-se que ainda existe fragilidade no conhecimento, nas atitudes e nas práticas ofertadas pelos profissionais da Estratégia de Saúde da Família para as pessoas com uso/abuso de substâncias psicoativas. Desse modo, recomenda-se maior oferta de cursos de capacitação em serviço sobre álcool e outras drogas para que o mesmo possa influenciar em atitudes e práticas adequadas.

The abuse of alcohol and other drugs is a public health problem, which family health teams must be trained and qualified for the care of this population. Thus, the present study had the general objective of: Assessing the knowledge, attitudes and practices of the professionals who are part of the Family Health Teams in the health care of users with problems related to the use of psychoactive substances; and had as specific objectives: To describe the knowledge, attitudes and practices regarding the use of psychoactive substances by health professionals who are part of the Family Health Teams; Conduct in-service training on psychoactive substances based on Brief Intervention for professionals in the Family Health Team; To analyse the impact of in-service training on the knowledge of the professionals of the Family Health Teams in the perspective of Brief Intervention. Methodology: This is a Knowledge, Attitudes and Practices sectional survey followed by a quasi-experimental study. For the sectional study, 318 professionals who worked in Family Health Teams in a planning area in the city of Rio de Janeiro were interviewed. The data collection instrument was a self- administered questionnaire with questions related to the socio-demographic profile, knowledge, attitudes and practices related to the health care of psychoactive substances users. For the quasi-experimental design, in-service training was carried out with 17 professionals from the Family Health Teams, using a self-administered questionnaire before and after the intervention. All data was analysed using the Statistical Package for the Social Sciences program (IBM SPSS, v.23.0). Results: It was evident that most of the interviewees were female, adults (median = 38), Christians, community health workers and who worked on the Family Health Strategy for 1 to 5 years. There was a predominance of inappropriate knowledge, attitudes and practices related to the health care of psychoactive substances users, there was a statistically significant difference between inappropriate attitudes and inappropriate practices. After in-service training, there was an improvement in adequate knowledge. Conclusion: It was observed that there is still a weakness in the knowledge, attitudes and practices offered by professionals of the Family Health Strategy for people with use/abuse psychoactive substances. Thus, a greater offer of in-service training courses on alcohol and other drugs is recommended so that it can influence appropriate attitudes and practices.

El abuso de alcohol y otras drogas es un problema de salud pública en el que los equipos de salud familiar deben estar capacitados y calificados para atender a esta población. Por lo tanto, el presente estudio tuvo el objetivo general de: evaluar los conocimientos, las actitudes y las prácticas de los profesionales que forman parte de los Equipos de Salud Familiar en la atención de la salud de los usuarios con problemas relacionados con el uso de sustancias psicoactivas; y tenía como objetivos específicos: describir el conocimiento, las actitudes y las prácticas con respecto al uso de sustancias psicoactivas por parte de los profesionales de la salud que forman parte de los Equipos de Salud Familiar; Realizar capacitación en el servicio sobre sustancias psicoactivas basada en la Intervención Breve para profesionales del Equipo de Salud Familiar; Analizar el impacto de la capacitación en el servicio sobre el conocimiento de los profesionales de los Equipo de Salud Familiar en la perspectiva de la intervención breve. Metodología: Esta es una encuesta seccional Conocimiento, Actitudes y Prácticas seguida de un estudio cuasi-experimental. Para el estudio seccional, se entrevistó a 318 profesionales que trabajaron en Equipos de Salud Familiar en un área de planificación en la ciudad de Río de Janeiro. El instrumento de recopilación de datos fue un cuestionario autoadministrado con preguntas sobre el perfil sociodemográfico, el conocimiento, las actitudes y las prácticas relacionadas con la atención de la salud de los usuarios de sustancias psicoactivas. Para el diseño cuasiexperimental, se llevó a cabo capacitación en el servicio con 17 profesionales de los equipos de salud familiar, utilizando un cuestionario autoadministrado antes y después de la intervención. Todos los datos se analizaron utilizando el Paquete Estadístico para el programa de Ciencias Sociales (IBM SPSS, v.23.0). Resultados: fue evidente que la mayoría de los entrevistados eran mujeres, adultos (mediana = 38), cristianos, trabajadores de salud comunitarios y que trabajaron en la Estrategia de Salud Familiar hace de 1 a 5 años. Predominaran el conocimiento, las actitudes y las prácticas inapropiadas relacionadas con la atención de la salud de los usuarios de sustancias psicoactivas, hubo una diferencia estadísticamente significativa entre las actitudes inapropiadas y las prácticas inapropiadas. Después de la capacitación en servicio, hubo una mejora en el conocimiento adecuado. Conclusión: se observó que todavía existe debilidad en el conocimiento, las actitudes y las prácticas ofrecidas por los profesionales de la Estrategia de Salud Familiar para las personas con uso/abuso de substancias psicoactivas. Por lo tanto, se recomienda mayor oferta de cursos de capacitación en servicio sobre alcohol y otras drogas para que pueda influir en las actitudes y prácticas apropiadas.

Rastreio e intervenção breve para mulheres que fazem uso de risco e nocivo de álcool atendidas em serviço de atenção primária à saúde / Screening and Brief Intervention for women who are on risk/harmful use of alcohol attended at Primary Health Care

Introdução: Parcela significativa de mulheres atendidas em serviços de Atenção Primária á Saúde (APS) faz uso de risco e nocivo de álcool, e a prevalência desse padrão de consumo vem aumentando nessa população nos últimos anos, gerando incontáveis prejuízos sociais e de saúde. Estratégias de enfrentamento e prevenção no contexto da APS vem sendo sugeridas, dentre elas, destaca-se se a Intervenção Breve (IB), que tem demonstrado resultados satisfatórios quando realizada com mulheres. Objetivo: Verificar a efetividade da IB no padrão de consumo de álcool e na motivação para mudança de comportamento em mulheres que fazem uso de risco ou nocivo de álcool atendidas em um serviço de APS. Método: Ensaio clínico randomizado em que 20 mulheres atendidas em um serviço de APS que faziam um consumo de risco ou nocivo de álcool foram rastreadas utilizando-se o instrumento Alcohol Use Disorder Identification Test (AUDIT), e divididas aleatoriamente entre dois grupos; o Grupo Intervenção (GI) que participou da IB (sessão individual de 20 a 30 minutos, utilizando-se de técnicas motivacionais) o Grupo Controle (GC) que recebeu o Aconselhamento Breve (AB) (feedback sobre o padrão de consumo de álcool). Os desfechos foram avaliados na linha de base, no primeiro e no terceiro mês de seguimento, sendo eles: padrão de consumo de álcool, prontidão para mudança de comportamento, frequência e quantidade de álcool consumido no último mês. Para a análise intragrupo e intergrupo foi utilizado o modelo linear generalizado e para todos os testes foi considerado como significativo um valor de p 0,05. Resultados: Houve diminuição no escore AUDIT em ambos os grupos nos dois seguimentos, na linha de base (GI 12,89; GC 10,64), no 1º mês (GI 12,78 p=0,9; GC 7,9 p=0,01) e no 3º mês (GI 10,11 p=0,13; GC 7,09 p<0,00). Embora o GI tenha mantido o padrão de uso de risco de álcool após a IB, houve redução do número de doses ingeridas em relação a avaliação inicial (p<0,00) e menor quando comparado ao número de doses ingeridas pelo GC no mesmo período (p=0,07). Os resultados também sugerem a efetividade da IB nos estágios de prontidão para mudança do padrão do uso de álcool em mulheres que fazem uso de risco e nocivo de álcool, (antes da IB 4,89; após 1ºmês de IB 6,67, p=0,12). Conclusão: A Intervenção Breve aplicada no contexto da APS é efetiva na diminuição do consumo de álcool em mulheres que fazem uso de risco ou nocivo desta substância, e tem potencial para influenciar positivamente nos estágios de prontidão para mudança do hábito de beber

Introduction: A significant number of women attended at Primary Health Care (PHC) services is on risk/harmful use of alcohol, and the prevalence of consumption pattern has been increasing in this population recently, with countless social and health losses. Coping strategies and prevention in PHC settings have been suggested, highlighting the Brief Intervention (BI), which has shown satisfactory results when performed with women. Objective: To verify the IB effectiveness in the pattern of alcohol consumption and in the motivation to change women behavior who are on risk/harmful use of alcohol attended in an PHC service. Methods: Randomized clinical trial in which 20 women attended at a PHC service who are on risk/harmful alcohol intake were screened using the Alcohol Use Disorder Identification Test (AUDIT) and randomly divided into two groups; the Intervention Group (IG) who participated in the IB (20 to 30 minutes individual session, by motivational techniques), the Control Group (CG) who received the Brief Advice (BA) (feedback on the pattern of alcohol consumption). Outcomes were assessed at the baseline, in the first and third month of follow-up, being: pattern of alcohol consumption, readiness to change behavior, frequency and amount of alcohol consumed in the last month. For the intragroup and intergroup analysis, the generalized linear model was used and for all tests, a p0.05 value was considered significant. Results: There was a decrease in the AUDIT score in both groups in two segments: the first month (IG 12.78 p=0.9, CG 7.9 p=0.01) and in the third month (IG 10.11 p=0.13, CG 7.09, p<0.00). Although IG maintained the alcohol risk pattern after IB, the number of doses ingested was lower than the baseline (p<0.00) and lower when compared to the number of doses ingested by CG during the same period (p=0.07). The data suggest the effectiveness of IB in the stages of readiness to change the alcohol ingestion pattern (before BI 4.89, after 1st BI 6.67, p=0.12). Conclusions: Brief Intervention applied in PHC setting is effective in reducing alcohol consumption in women who are on risk/harmful use of this substance which has the potential to influence positively in the stages of readiness to change drinking habits

Web-Based Intervention to Reduce Substance Abuse and Depression: A Three Arm Randomized Trial in Mexico.

BACKGROUND: Web-based cognitive-behavioral interventions to reduce substance use can be a useful low-cost treatment for a large number of people, and an attractive option in countries where a greater availability of treatment is needed. OBJECTIVE: To evaluate the feasibility and initial effectiveness of a web-based cognitive-behavioral intervention for the reduction of substance use and depression compared with treatment as usual, with and without a printed self-help manual. METHOD: Individuals seeking outpatient treatment for substance use were randomly assigned to one of the following: (1) the web-based Help Program for Drug Abuse and Depression (n = 23); (2) an in-person session with an addiction therapist and use of the Alcohol, Smoking, and Substance Involvement Screening Test Self-Help Strategies guide, followed by treatment as usual (n = 25), or (3) treatment ordinarily offered in the participating treatment centers (n = 26). The study took place in 2013-2014 (trial registration: ISRCTN25429892), and participants completed baseline, posttreatment, and 1-month follow-up evaluation interviews. RESULTS: Treatment retention and data availability were comparable in all three conditions. A reduction was observed from baseline to follow-up in average days of use [F(1,28) = 29.70, p < 0.001], severity of use [F(2,28) = 143.66, p < 0.001], and depressive symptomatology [F = (4)16.40, p < 0.001], independent of the type of treatment provided. CONCLUSIONS: The findings suggest that the web-based intervention to reduce substance abuse is feasible, although it is not more effective than other intervention modalities; its effectiveness must be evaluated in a larger sample. Attrition was a main limitation; future studies must improve retention and assess cost-effectiveness.

When and How Do Brief Alcohol Interventions in Primary Care Reduce Alcohol Use and Alcohol-Related Consequences among Adolescents?

OBJECTIVE: To systematically describe when and how brief alcohol interventions delivered to adolescents in primary care settings reduce alcohol use and alcohol-related consequences among adolescents, using realist review methodology. STUDY DESIGN: Eleven electronic databases, gray literature, and reference screening were searched up to June 2016; 11 brief interventions published in 13 studies met inclusion criteria. Intervention design components (delivery context and intervention mechanisms) underlying brief alcohol interventions for adolescents were extracted and linked to alcohol use and related consequences. RESULTS: Brief interventions had either an indicated context of delivery (provided to adolescent patients with low-to-moderate risk for alcohol problems) or universal context of delivery (provided to general adolescent patient population). Interventions that used motivational interviewing in an indicated delivery context had 2 potential mechanisms-eliciting and strengthening motivation to change and providing direction through interpretation. These interventions resulted in clinically significant reductions in alcohol use and associated consequences. Peer risk also was identified among universal and indicated brief interventions as a potential mechanism for changing alcohol-related outcomes among adolescents who received the intervention. None of the studies tested the processes by which interventions were expected to work. CONCLUSIONS: The current evidence base suggests that both indicated and universal delivery of brief alcohol interventions to adolescents in primary care settings can result in clinically important changes in alcohol-related outcomes. Studies that test brief intervention processes are now necessary to better understand how brief interventions work with adolescents in primary care settings.

Evaluation of the Implementation of Brief Interventions to Substance Abuse in a Socieducative Context / Avaliação da Implementação de Intervenções Breves no Uso de Substâncias em Contexto Socioeducativo

Objetivo: Avaliar o conhecimento e dificuldades dos profissionais de centros socioeducativos na realização triagem e intervenção breve (TIB) em adolescentes em conflito com a Lei. Método: 102 profissionais que participaram ou não de capacitações responderam a um questionário específico referente a TIB. Resultados: A falta de tempo na aplicação da TIB e o perfil do adolescente da Fundação Casa foram as principais crenças/dificuldades detectadas. Aqueles que realizaram um curso prévio de capacitação na área de álcool/drogas apresentaram menores chances de adesão e as dificuldades encontradas na aplicação da TIB reduziram a motivação dos profissionais para sua aplicação. Conclusão: Estes dados indicam necessidade na atualização da formação profissional a partir de um ambiente para o diálogo e supervisão dos procedimentos.

Objective: To evaluate the knowledge and the difficulties of professionals who work in socio-educational contexts on the performing of screening and brief intervention (SBI) with youth in conflict with the law. Method: One hundred two professionals filled a specific questionnaire regarding SBI. Results: lack of time for application of SBI as well as the belief that this procedure is not efficient for these youths were the main difficulties observed. Those who concluded a prior course about substance abuse had fewer chances of adherence. Besides, the difficulties observed for applying SBI reduced their motivation to perform it. Conclusion: These data indicate the necessity to change some components of these training programs by introducing an environment for dialogue as well as supervision of all procedures adopted.

The Effectiveness of a Brief Intervention for Reducing Adolescent Alcohol Consumption / Efectividad de una intervención breve para reducir el consumo de alcohol en adolescentes / Efetividade de uma Intervenção breve para reduzir o consumo de álcool em adolescentes

Abstract Introduction: Although alcohol consumption affects more than half of all adolescents, there are no known studies to assess the effectiveness of interventions to prevent or reduce consumption at a local level. The aim of this randomized clinical trial was to determine the effectiveness and clinical significance of a brief intervention program to reduce the consumption of alcohol and related problems in an educational setting in Argentina. Materials and methods: Systematically selected high school students (N = 167) were randomly assigned to one of three conditions: two control groups (screening, screening and evaluation) and one experimental group (screening, assessment and intervention). With the approval of an Ethics Committee, we implemented a protocol based on international guidelines. The effectiveness measures used were reduction in usual quantity, in high-risk alcohol drinking or in alcohol-related problems. We performed descriptive analyses, linear and logistic regressions, estimates of relative and absolute risk reduction, and the number of patients needed to reduce an event. In the follow-up (N = 150), the quantity of consumption and high-risk consumption were higher in the control groups. Results: The intervention effectively reduced alcohol consumption and related problems in about one out of seven adolescents, with a minimal investment in training and implementation. However, we did not find significant differences in alcohol-related problems among the groups, which decreased under all conditions. Conclusion: Long-term studies could determine whether this change primarily affects the intervention group.

Resumen Introducción: A pesar de que el consumo de alcohol afecta a más de la mitad de los adolescentes, se desconoce la efectividad de intervenciones para evitarlo o reducirlo a nivel local. Este ensayo clínico aleatorizado se propuso determinar la efectividad y significancia clínica de un programa de intervención breve para reducir el consumo de bebidas alcohólicas y problemas relacionados en un contexto educativo de Argentina. Materiales y métodos: Los participantes, estudiantes de educación media seleccionados sistemáticamente (N = 167) fueron asignados aleatoriamente a una de tres condiciones: dos grupos control (tamizaje, tamizaje y evaluación) y uno experimental (tamizaje, evaluación e intervención). Con el aval de un Comité de Ética, se implementó un protocolo basado en lineamientos internacionales. Las medidas de efectividad utilizadas fueron disminución de la cantidad habitual, del consumo de alto riesgo, y de los problemas relacionados con el alcohol. Se realizaron análisis descriptivos, regresiones lineales y logísticas, y estimaciones de reducción relativa y absoluta del riesgo y del número de pacientes a tratar para reducir un evento. En la etapa de seguimiento (N = 150), la cantidad y el consumo de alcohol de alto riesgo fueron mayores en los grupos control. Resultados: la intervención redujo efectivamente el consumo de alcohol y sus problemas en aproximadamente uno de cada siete adolescentes, con una mínima inversión en entrenamiento y aplicación. Sin embargo, no se encontraron diferencias significativas en los problemas relacionados, que disminuyeron en todas las condiciones. Conclusión: Estudios a largo plazo podrían dilucidar si el cambio se sostiene mayormente en el grupo de intervención.

Resumo Introdução: A pesar de que o consumo de álcool afeta a mais da metade dos adolescentes, desconhece-se a efetividade de intervenções para evitá-lo ou reduzi-lo no nível local. Este ensaio clínico aleatorizado se propôs determinar a efetividade e significância clínica de um programa de intervenção breve para reduzir o consumo de bebidas alcoólicas e problemas relacionados em um contexto educativo da Argentina. Materiais e métodos: Os participantes, estudantes de educação média selecionados sistematicamente (N = 167) foram assignados aleatoriamente a três condições: dois grupos controle (peneiração, peneiração e avaliação) e um experimental (peneiração, avaliação e intervenção). Com o aval de um Comitê de Ética, se implementou um protocolo baseado em diretrizes internacionais. As medidas de efetividade utilizadas foram diminuição da quantidade habitual, do consumo de alto risco, e dos problemas relacionados com o álcool. Realizaram-se análises descritivas, regressões lineais e logísticas e estimações de redução relativa e absoluta do risco e do número de pacientes a tratar para reduzir um evento. Na etapa de seguimento (N = 150), a quantidade e o consumo de álcool de alto risco foram maiores nos grupos controle. Resultados: A intervenção reduziu efetivamente o consumo de álcool e seus problemas em aproximadamente um de cada sete adolescentes, com um mínimo investimento em treinamento e aplicação. No entanto, não se encontraram diferenças significativas nos problemas relacionados, que diminuíram em todas as condições. Conclusão: Estudos a longo prazo poderiam dilucidar se a mudança se sustenta maiormente no grupo de intervenção.

Brief interventions to promote behavioral change in primary care settings, a review of their effectiveness for smoking, alcohol and physical inactivity. / Intervenciones breves para promover cambios conductuales en el ámbito de la atención primaria: revisión de su efectividad en consumo de tabaco, alcohol y sedentarismo.

The brief intervention is a therapeutic strategy suggested to address behavioral changes associated with risk factors for chronic non-communicable diseases and there is ample evidence of its effectiveness. However, this evidence is sustained by various definitions of “brief intervention”, a fact that makes the clinical application of this strategy difficult. This literature review article aimed to conduct a search for systematic reviews in the Epistemonikos database in order to identify common factors in the definition of “brief intervention” and summarize some brief intervention strategies frequently used in primary health care. It also seeks to describe their effectiveness, for three risk factors: tobacco, alcohol and physical activity, within this clinical context.

La intervención breve en salud es una estrategia terapéutica, sugerida para abordar cambios conductuales asociados a factores de riesgo de enfermedades crónicas no transmisibles. Existe amplia evidencia sobre su efectividad. Sin embargo, esta evidencia se sustenta en distintas definiciones de intervención breve, lo que dificulta su aplicación clínica. Este artículo de revisión de literatura, se propuso realizar una búsqueda de revisiones sistemáticas en la base de datos Epistemonikos con el fin de identificar factores comunes en su definición y resumir algunas estrategias de intervención breve usadas con frecuencia en la atención primaria de salud. Asimismo, se busca describir su efectividad en este contexto clínico, para tres factores de riesgo: tabaco, alcohol y actividad física.

Impact of a brief intervention programs in clinical practice: Barriers and adaptations.

INTRODUCTION: The present study analyzes the main barriers and adaptations to brief interventions that focus on addictive behavior treatments carried out in clinical settings by 756 health professionals during their adoption process in 350 Primary Attention Units in Mexico. METHOD: A descriptive cross-sectional study was conducted and consisted in the application of an instrument that explored diverse aspects, such as knowledge about evidence based brief intervention (BI) programs, barriers during the execution, and adaptations of the BI. RESULTS: the main barriers were related to the implementation of sessions and the user's characteristics such as educational level. As a consequence, the main adaptations were related to the increase in the number of sessions, modifying their length and changing the sequence as well as the proposed material in the manuals. CONCLUSIONS: We discuss the possibility of systematizing the adaptations made by health professionals in order to evaluate their effectiveness.

INTRODUCCIÓN: Este estudio analiza las barreras y adaptaciones realizadas en la práctica por 756 profesionales de la salud a Intervenciones breves para conductas adictivas durante el proceso de transferencia y adopción en 350 Unidades de Atención Primaria de México. MÉTODO: Estudio descriptivo transeccional en el cual se aplicó un instrumento que exploró los conocimientos sobre las IB basadas en evidencia, barreras en la implementación y adaptaciones realizadas a las IB. RESULTADOS: las principales barreras son las relacionadas con la impartición de las sesiones y características de los usuarios como el nivel de escolaridad y por tanto, las principales adaptaciones tienen que ver con mayor número de sesiones, cambios en la duración y en el orden de las mismas así como en los materiales que se proponen en los manuales. CONCLUSIÓN: Se analiza la posibilidad de sistematizar las adaptaciones realizadas por los profesionales de la salud para evaluar su eficacia.

Country-wide distance training for delivery of screening and brief intervention for problematic substance use: A pilot evaluation of participant experiences and patient outcomes.

BACKGROUND: In this study, the authors evaluated if the 120-hour distance learning (DL) course SUPERA (an acronym in Portuguese meaning "System for detection of excessive use or dependence on psychoactive substances: brief Intervention, social reinsertion and follow-up") was an effective way to train health professionals and social workers to apply screening and brief intervention (SBI) for patients with substance use disorders. METHODS: In the first phase, 2420 health professionals or social workers, who had completed the course, answered an online survey about their use of the SBI. In the second phase, 25 of those professionals applied the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) followed by a brief intervention (BI) to patients with substance use disorders. Three months after the SBI delivery, independent researchers followed up 79 patients who had received SBI, reapplying the ASSIST and a questionnaire to evaluate the patients'/clients' satisfaction with the intervention they received. RESULTS: In the first phase, it was found that most health professionals and social workers who completed the course applied the SBI in their work and felt very motivated to do it. In the second phase of the study, at a 3-month follow-up, most patients had significantly reduced their ASSIST scores in respect of alcohol and cocaine/crack in relation to their baseline levels. Those patients classified by their ASSIST score as "suggestive of dependence" presented a significant reduction in their scores regarding alcohol, tobacco, and cocaine/crack, whereas those classified as "at risk" presented a reduction in respect of alcohol problems only. Patients associated changes in their substance use with the SBI received. CONCLUSIONS: A reduction in substance use-related problems was associated with the SBI applied by the health professionals or social workers trained by the DL course SUPERA. Two significant limitations of this study were the small number of participants (professionals and patients in the follow-up) and the absence of a control group in the second phase of the study.

Intervenciones breves para promover cambios conductuales en el ámbito de la atención primaria: revisión de su efectividad en consumo de tabaco, alcohol y sedentarismo / Brief interventions to promote behavioral change in primary care settings, a review of their effectiveness for smoking, alcohol and physical inactivity

La intervención breve en salud es una estrategia terapéutica, sugerida para abordar cambios conductuales asociados a factores de riesgo de enfermedades crónicas no transmisibles. Existe amplia evidencia sobre su efectividad. Sin embargo, esta evidencia se sustenta en distintas definiciones de intervención breve, lo que dificulta su aplicación clínica. Este artículo de revisión de literatura, se propuso realizar una búsqueda de revisiones sistemáticas en la base de datos Epistemonikos con el fin de identificar factores comunes en su definición y resumir algunas estrategias de intervención breve usadas con frecuencia en la atención primaria de salud. Asimismo, se busca describir su efectividad en este contexto clínico, para tres factores de riesgo: tabaco, alcohol y actividad física.

The brief intervention is a therapeutic strategy suggested to address behavioral changes associated with risk factors for chronic non-communicable diseases and there is ample evidence of its effectiveness. However, this evidence is sustained by various definitions of "brief intervention", a fact that makes the clinical application of this strategy difficult. This literature review article aimed to conduct a search for systematic reviews in the Epistemonikos database in order to identify common factors in the definition of "brief intervention" and summarize some brief intervention strategies frequently used in primary health care. It also seeks to describe their effectiveness, for three risk factors: tobacco, alcohol and physical activity, within this clinical context

Consumo de substâncias psicoativas por pacientes com tuberculose: interface entre a adesão ao tratamento e intervenção breve / Consumption of psychoactive substances in tuberculosis patients: interface to adherence to treatment and brief intervention

Introdução: o consumo de substâncias psicoativas associado à terapêutica da tuberculose (TB) estabelece uma urgente questão de saúde pública no mundo contemporâneo. O aumento da morbimortalidade, pertinente à incidência e prevalência da tuberculose, e o consumo indevido de substâncias psicoativas, tem refletido em resultados negativos, relacionados à saúde e questões sociais, para indivíduos e seus familiares (CASSIANO, 2014). Objetivos: identificar o perfil e o padrão de consumo de substâncias psicoativas por pacientes em tratamento da tuberculose, na Unidade de Atenção Primária à Saúde; analisar a adesão ao tratamento desses pacientes que fazem consumo de substâncias psicoativas e realizar a Intervenção Breve nessa clientela, na perspectiva da adesão ao tratamento da tuberculose. Método: estudo seccional, realizado em unidades de atenção primária à saúde, na modalidade da Estratégia Saúde da Família, na cidade do Rio de Janeiro, com 114 pacientes em tratamento da tuberculose, utilizando o questionário ASSIST. Foram incluídos na amostra todos os pacientes em tratamento de tuberculose. A variável de exposição foi o consumo de substâncias psicoativas, e a de desfecho, a adesão ao tratamento. Na primeira fase, realizou-se a Intervenção Breve, na etapa do feedback. Na segunda fase, após dois meses, foi realizada a busca no prontuário para confirmação ou não da adesão. Resultados: prevalência da população masculina 71,1%, idade mediana de 39 anos, escolaridade fundamental incompleta 52,6%, cor da pele parda 42,1%, renda familiar > 1 salário mínimo 74,5%, e vivia com familiares. Prevalência para tabaco 28,0%, bebidas alcoólicas 12,3%, maconha 5,4% e cocaína /crack 3,5%. Em relação à adesão, observou-se, após dois meses da Intervenção, em levantamento realizado nos prontuários dos pacientes, prevalência da população masculina, maiores de 40 anos, escolaridade médio/superior, casados e que viviam em união, brancos, recebiam até 1 salário mínimo, viviam com parentes; estes aderiram ao tratamento de tuberculose. Conclusão: esses resultados demonstram a importância da Intervenção Breve, realizada pelos profissionais de saúde com essa clientela, diminuindo a incidência de pacientes bacilíferos, propensos à disseminação da doença.

Introduction: The consumption of psychoactive substances associated with tuberculosis (TB) therapy establishes an urgent public health issue in the contemporary world. The increase in morbidity and mortality, pertinent to the incidence and prevalence of tuberculosis and the misuse of psychoactive substances, has reflected in negative results related to health and social issues for individuals and their families (CASSIANO, 2014). The objectives of this study were: To identify the profile and the pattern of consumption of psychoactive substances of patients undergoing tuberculosis treatment in the network of basic health services; to analyze the adherence to the treatment of patients of tuberculosis who consume these substances and perform brief intervention in this clientele from the perspective of the adherence to the tuberculosis treatment. Materials and Methods: Sectional study, carried out in primary care units in the modality of the Family Health Strategy, in the city of Rio de Janeiro, with n sample of 114 patients in the treatment of tuberculosis using the ASSIST questionnaire. All patients undergoing tuberculosis treatment were included in the sample. The exposure variable was the consumption of psychoactive substances and the outcome variable adherence to treatment. In the first phase the brief intervention was carried out, in the stages of feedback, due guidance and empathically. In the second phase after two months, a search was performed on the medical record for confirmation or non-compliance. Results: Prevalence in the male population71,1%, median age 39 years, incomplete primary schooling 52,6%, brown skin color 42,1%, family income > 1 minimum wage, 74,5% lived with relatives. Prevalence for tobacco 28,0%, alcoholic beverages 12,3%, marijuana 5,4% and cocaine / crack 3,5%. Regarding adherence, after two months of Brief Intervention, with a survey in the patients' charts, a higher prevalence of adherence was observed in the male population, over 40 years old, with medium / high school education, married and living in union, whites received up to 1 minimum wage, live with relatives, adhered to the treatment of tuberculosis. Conclusions: These results demonstrate the importance of brief interventions applied by health professionals with these patients, decreasing the incidence of bacilliferous patients, prone to the spread of the disease.

Introduction: la consommation de substances psychoactives associées au traitement de la tuberculose (TB) établit un problème urgent de santé publique dans le monde contemporain. L'augmentation de la morbidité et de la mortalité, qui est pertinente pour l'incidence et la prévalence de la tuberculose et l'abus de substances psychoactives, s'est traduite par des résultats négatifs liés aux problèmes de santé et sociaux pour les individus et leurs familles (CASSIANO,2014). Buts: identifier le profil y le schéma de consommation de substances psychoactives des patients en traitement contre la tuberculose, dans le Centre de Soins de Santé Primaires; analyser l'adhésion au traitement concernant ces patients qui font usage de substances psychoactives et réaliser une Intervention brève chez cette clientèle, dans le contexte de l'adhésion au traitement de la tuberculose. Méthode : étude sectionnelle, mise en marche dans des centres de Soins de Santé Primaires dans la modalité de la Stratégie sur la Santé de la Famille à Rio de janeiro, auprès de 114 patients en traitement contre la tuberculose, par le moyen du questionnaire ASSIST. Tous les patients en traitement contre la tuberculose y ont été inclus. La variable d'exposition fut la consommation de substances psychoactives et celle de résultat l'adhésion au traitement. Dans la première phase, une intervention brève a été mise en marche, à l'étape du feedback. Dans la deuxième phase, après deux mois, fur réalisée la recherche du dossier médical pour confirmer ou pas l'adhésion. Résultats: prévalence chez la population masculine - 71,1%, âge moyen - 39 ans, scolarité primaire incomplète - 52,6%, couleur de peau brune - 42,1%, revenu familial > 1 SMIC - 74,5% et habite avec la famille. Prévalence pour tabac - 28,0%, boissons alcoolisées - 12,3%, cannabis - 5,4% et cocaïne/crack - 3,5%. Concernant l'adhésion, après deux mois de l'Intervention, au moyen d'un relevé des dossiers médicaux des patients, on a observé une plus grande prévalence d'adhésion chez la population masculine, ayant plus de 40 ans, enseignement secondaire et universitaire, mariés en cohabitation, blancs, recevant jusqu'à un SMIC, ne vivant pas avec les familiers. Ceux-ci ont adhéré au traitement contre la tuberculose. Conclusion: ces résultats démontrent l'importance de l'Intervention brève mise en marche par les professionnels de la santé, auprès de cette clientèle, ce qui diminue l'incidence de patients frottis positif enclins à la dissémination de la maladie.

Introducción: el consumo de sustancias psicoactivas asociadas a la terapia contra la tuberculosis (TB) establece un problema urgente de salud pública en el mundo contemporáneo. El aumento de la morbilidad y mortalidad, pertinente a la incidencia y prevalencia de la tuberculosis y al uso indebido de sustancias psicoactivas, se ha reflejado en los resultados negativos relacionados con la salud y las cuestiones sociales de las personas y sus familiares (CASSIANO, 2014). Objetivos: identificar el perfil y el patrón de consumo de sustancias psicoactivas de los pacientes en tratamiento contra la tuberculosis, en el Centro de Atención Primaria de Salud; analizar la adhesión al tratamiento de esos pacientes que consumen sustancias psicoactivas y realizar Intervención Breve junto a esa clientela, en el contexto de la adhesión al tratamiento de la tuberculosis. Método: estudio seccional, realizado en centros de atención primaria en la modalidad de la Estrategia Salud de la Familia en la ciudad del Rio de janeiro, junto a 114 pacientes en tratamiento contra la tuberculosis, utilizando el cuestionario ASSIST. Se han incluido en el muestreo a todos los pacientes en tratamiento contra tuberculosis. La variable de exposición fue el consumo de sustancias psicoactivas y, la de resultado, adhesión al tratamiento. En la primera fase se realizó la Intervención Breve, en la etapa del feedback. En la segunda fase, después de dos meses, se realizó la búsqueda en la historia clínica para confirmar o no la adhesión. Resultados: prevalencia en la población masculina -71,1%, promedio de edad - 39 años, enseñanza primaria incompleta - 52,6%, color de piel pardo - 42,1%, ingresos familiares > 1 salario mínimo - 74,5% y viviendo con familiares. Prevalencia para tabaco - 28,0%, bebidas alcohólicas - 12,3%, marihuana -5,4% y cocaína /crack - 3,5%. Respecto a la adhesión, tras dos meses de la Intervención, con relevamiento en las historias clínicas de los pacientes, se observó mayor prevalencia en la adhesión en la población masculina, mayores de 40 años, con escolaridad secundaria/universitaria, casados y que vivían en unión estable, blancos, recibían hasta 1 salario mínimo, no vivían con parientes. Estos adhirieron al tratamiento de tuberculosis. Conclusión: esos resultados demuestran la importancia de la Intervención Breve realizada por los profesionales de salud, con esa clientela, disminuyendo la incidencia de pacientes bacilífero propensos a la diseminación de la enfermedad.