¿Cuál es el efecto de las intervenciones implementadas en APS por profesionales de la salud para prevenir la violencia escolar?: síntesis rápida de evidencia / What is the effect of interventions implemented in PHC by health professionals to prevent school violence?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO En el contexto del retorno escolar luego de la suspensión de clases por la pandemia por COVID-19, el Departamento de Salud Mental, Gabinete MINSAL y el Ministerio de Educación, establecieron una mesa de trabajo para hacer frente al aumento de hechos de violencia escolar ocurridos con el retorno presencial a clases desde marzo de 2022. En este contexto el Departamento de Salud Mental de la Subsecretaría de Salud Pública se solicitó el desarrollo de una síntesis rápida de evidencia con el objetivo de conocer la efectividad de las medidas implementadas desde el sector salud para prevenir la violencia escolar. METODOLOGÍA Para la elaboración de esta síntesis rápida de evidencia, el equipo formuló estrategias de búsqueda que fueron utilizadas en 7 bases de datos pertinentes al tema estudiado. Así mismo se recuperaron documentos que fueron filtrados por criterios según tema y tipo de documento, enfocados en revisiones sistemáticas y sus estudios primarios. RESULTADOS Se trabajó con 4 revisiones sistemáticas, de las cuales se recuperaron los siguientes resultados: -No es posible establecer el efecto de las estrategias conductuales en la población escolar, en comparación con el cuidado usual sobre la victimización, la agresión y el apego en la escuela debido a que la certeza en la evidencia existente es muy baja. -No es posible establecer el efecto de la consulta escolar psiquiátrica en la población escolar en comparación con el cuidado usual sobre la victimización. -No es posible establecer el efecto de las estrategias conductuales en población escolar conflictiva, en comparación con el cuidado usual sobre la agresión. -El balance costo-beneficio es favorable para las intervenciones que tienen como objetivo prevenir el abuso escolar. -La medición de resultados de las intervenciones incluidas son a corto plazo, por lo que estos resultados podrían no ser válidos si las mediciones consideran el tiempo para adoptar las nuevas conductas. -En Chile existen programas y asociaciones entre escuelas y centros de salud que favorecerían la implementación de programas desde el sector salud.

Integration of Adverse Childhood Experiences Across Nursing Curriculum.

Adverse childhood experiences (ACEs) devastate the lives of children, families and the community. Nearly 35 million children in the United States (US) have experienced one or more types of childhood trauma and nearly a third of youth between ages 12 and 17 have experienced two or more traumatic events. Adverse childhood experiences place an economic toll in the U.S., costing between $5.8 billion and $12.6 billion annually. Child maltreatment costs $124 billion, conservatively. Health Professionals play a major role to prevent and effectively intervene in ACEs. To this end, building a nursing workforce with necessary ACEs knowledge is critical as nursing graduates can make a sustainable impact as they translate knowledge in practice to improve health and health outcomes for children, families and communities. This paper describes how a College of Nursing initiated a systematic integration of ACEs knowledge across BSN curriculum from designing an ACEs Curriculum Integration Model, engaging and enabling faculty in the integration process and how ACEs concepts and contents were integrated. Suggestions are made for ongoing work and evaluations of the effects of ACEs curriculum integration.

The Case for Including Adverse Childhood Experiences in Child Maltreatment Education: A Path Analysis.

CONTEXT: The lifelong, negative consequences of exposure to adverse childhood experiences (ACEs) for individuals and their families are well established. OBJECTIVE: To demonstrate the importance of including ACE information in child maltreatment education curricula using path analysis. DESIGN: Survey data examined the impact of child maltreatment education programs and knowledge about ACEs on medical practitioners' reporting habits and ability to detect maltreatment. A path diagram distinguished between the direct impact of education programs on outcome measures and the indirect effect that is mediated through knowledge of ACEs. MAIN OUTCOME MEASURES: Medical practitioners' ability to detect child maltreatment and their number of referrals to Child Protective Services (CPS). RESULTS: The optimized path diagram (χ2SB(3) = 3.9, p = 0.27; RMSEA-SB = 0.017; R2 = 0.21, where SB is Satorra-Bentler coefficient and RMSEA is root-mean-square error of approximation) revealed the mediating variable "knowledge about ACEs" as the strongest structural effect (SB-ß = 0.34) on the number of CPS referrals. It was almost twice as high as the second strongest effect of formal education programs (SB-ß = 0.19). For workplace training programs, the total effect when including knowledge of ACEs was almost double as strong as the direct effect alone. Even when previous child maltreatment education was controlled for, practitioners familiar with the consequences of ACEs were significantly more likely to recognize and to report abuse to CPS. CONCLUSION: This study documented the importance of specialized training programs on ACEs, and the essential role ACE knowledge plays in the effectiveness of provider education programs.