Preventive Psychosocial Interventions Research Articles

Psychosocial Problems and Coping Methods Experienced By The Nurses Working In Pandemic Clinics

Aim: This study was designed as a descriptive study using the "in-depth interview technique" to determine psychosocial problems and coping methods experienced by nurses working in Covid 19 pandemic clinics. Materials and Methods: The universe of the study consisted of 871 nurses working in pandemic clinics of a city hospital in the western part of Turkey between September 2021 and October 2021; and the sample consisted of 21 nurses working in pandemic clinics. "Personal Information Form" and "Psychosocial Health Evaluation Form in Nurses" were used as data collection tools in the study. Data were analyzed by using content analysis. Results: Mean age of the nurses participated in the study was 31.85 years old; and 76.20% were women. A total of five main themes and subthemes for each theme were identified at the end of data analysis. Five main themes identified were “Emotional Problems”, “Behavioral Problems”, “Coping Strategies”, “Occupational Changes” and “An Isolated Life”. Conclusion: Nurses experienced various psychosocial problems in their working environment during the pandemic. It is suggested to plan preventive psychosocial interventions in order to decrease and prevent psychosocial problems experienced by the nurses under challenging conditions.

Children of South Asian-Origin Parents in the Diaspora: Dance, Resilience, and Prosociality

ABSTRACT Diaspora children of South Asian-origin immigrant parents experience issues of acculturation, identity concerns and general wellbeing that influence their psychosocial development. Within the domain of culturally-attuned interventions for immigrant children, art forms are gaining prominence. This article reports a study on the impact of customized dance lessons for children (aged 10–13-years) of South Asian-origin parents in the diaspora on resilience and prosocial behaviors, compared to a waitlist control group. The dance lessons were effective and female children, participants whose primary caregivers had postgraduate or professional degrees, who were familiar with at least one language other than English, who attended 21–40 (>50%) dance lessons, and who completed 21–40 (>50%) dance homework lessons, gained more on resilience and prosociality outcomes. The need for promotive and preventive psychosocial interventions for immigrant children, and particularly those from low- and middle-income or crisis-prone geographies to high-income destination lands, is highlighted.

The School Preparedness Toolkit: Building Systemic Resilience in Ukrainian Schools Through a Self-Assessment Digital Platform

During the COVID-19 outbreak, schools around the world faced major challenges and were required to adapt to new educational practices while supporting students’ learning and well-being. This study outlines the development of School Preparedness Toolkit (SPT), an online interactive checklist launched from January to March 2021 among 273 Ukrainian schools. SPT was a dual-use tool, aiming to inform and support efforts of school administrations in implementing effective strategies to address challenges arising from COVID-19 and to inform related public health and educational policies at regional and national levels. The toolkit focused on resilience against COVID-19 challenges across five main domains: Access to Education Provision of Quality and Inclusive Learning, Well-Being, Safety, Nutrition, and School Feeding. Completion of SPT was a collaborative process among school administrators. Chi-square tests were conducted to examine differences across schools’ geographical locations and between urban and rural areas. Results indicated that most schools were already adapting to the challenges, to the extent of implementing mandated safety and online education protocols, communicating these with families, and providing a psychosocial safety net for children in extreme distress. However, resilience could be further strengthened through a greater emphasis on school cohesion, connectedness, and solidarity, as well as on preventive psychosocial interventions. The SPT methodology was shown to be a promising approach in assisting schools to reflect and plan for greater resilience, not just in the context of the COVID-19 pandemic but also in other extreme adversities that school systems—in Ukraine and around the world—might be facing.

Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis.

to assess the efficacy of psychosocial interventions delivered through task-sharing approaches for preventing perinatal common mental disorders among women in low- and middle-income countries. We conducted a systematic review of randomized controlled trials following a prespecified protocol registered in the Open Science Framework (osf.io/qt4y3). We searched MEDLINE, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) through June 2022. Two reviewers independently extracted the data and evaluated the risk of bias of included studies using the Cochrane risk of bias tool. We performed random-effects meta-analyses and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We included 23 studies with 24,442 participants. At post-intervention, task-shared psychosocial interventions, were effective in preventing the development of mental disorders in general (RR 0.57, 95% CI [0.35, 0.91]), and specifically depression (RR 0.51, 95% CI [0.35, 0.75]), but not anxiety disorders (RR 0.46, 95% CI [0.06, 3.33]). Similarly, psychosocial interventions reduced psychological distress (SMD -1.32, 95% CI [-2.28, -0.35]), and depressive symptoms (SMD -0.50, 95% CI [-0.80, -0.16]), and increased parenting self-efficacy (SMD -0.76, 95% CI [-1.13, -0.38]) and social support (SMD -0.72, 95% CI [-1.22, -0.22]). No effect was detected for anxiety symptoms at post-intervention. At follow-up the beneficial effects of interventions progressively decreased. Psychosocial interventions delivered through the task-sharing modality are effective in preventing perinatal common mental disorders and fostering positive mental health among women in low- and middle-income countries. However, our findings are tentative, due to the low number of preventative intervention strategies considering outcomes as the incidence of mental disorders, especially in the long-term. This evidence supports calls to implement and scale up psychosocial prevention interventions for perinatal common mental disorders in low- and middle-income countries.

How can resilience moderate the effects of the COVID-19 pandemic on mental health?

IntroductionThe COVID-19 pandemic represents a new form of trauma, which is impacting on the mental health of the general population. However, the effects of this new trauma are variable, being mediated by individual factors such as the levels of resilience and the coping strategies.ObjectivesThe aims of the present study are: 1) describe the levels of resilience and the type of coping strategies adopted by the Italian general adult population during the first wave of the pandemic; 2) evaluate the protective role of coping strategies and resilience on the levels of depressive, anxiety and stress symptoms.MethodsAn online survey has been developed, which includes several validated self-reported questionnaires for the evaluation of participants’ mental health condition, coping strategies and levels of resilience. The main outcome measure is the Depression Anxiety and Stress Scale-21 (DASS-21).ResultsThe finale sample consists of 20,720 participants, more than half reported low levels of resilience, which were not associated with age or gender. The levels of resilience did not differ among the general population, patients with pre-existing mental disorders and those infected by COVID-19. People with low levels of resilience rarely used adaptive coping strategies. The levels of resilience did not have any influence on stress, depressive or anxiety symptoms.ConclusionsThe presence of low levels of resilience in the general population may be the missing link between the pandemic and increasing concerns on mental health problems. This could be important for the development of ad-hoc supportive and preventive psychosocial interventions.DisclosureNo significant relationships.

Effectiveness of Promotive and Preventive Psychosocial Interventions on Improving the Mental Health of Finnish-Born and Immigrant Adolescents.

Background: Schools are considered natural environments in which to enhance students’ social–emotional skills and mental health in general, but they can be especially important for students with refugee and immigrant backgrounds. The current study tested the effectiveness of two school-based interventions in enhancing the mental health and wellbeing of adolescents of native, refugee, and immigrant backgrounds. It further analyzed the role of age, gender, daily stressors, and discrimination in affecting the interventions’ effectiveness. Methods: A three-arm cluster RCT with parallel assignment was applied among the 16 schools. Schools were randomized to three conditions of two active interventions and a waiting-list control condition. Students (n = 1974) filled in an online questionnaire at baseline before the interventions, after the interventions, and at follow-up an average of 9 months after the interventions. The effectiveness criteria were internalizing and externalizing problems, resilience, and prosocial behavior. Results: Interventions were generally not effective in decreasing mental health problems and increasing psychosocial resources. The expected positive intervention effects were dependent on students’ age and gender and exposure to socioeconomic daily stressors. Conclusion: Interventions enhancing teacher awareness and peer relationships at school should be carefully tailored according to the strengths and vulnerabilities of participating students, especially their daily stress exposure, but also age and gender.

Social features in internet-based programs to prevent alcohol consumption among adolescents: a scoping review.

Alcohol consumption among adolescents is a social and public health issue. School-based programs are needed to prevent the onset of alcohol consumption during adolescence. Information and communication technologies offer new promising approaches to deliver preventive programs to these populations. The most traditional, successful programs use group dynamics within the classroom. However, the usefulness of social interaction features (SIF) within internet-based interventions remains unclear. The current scoping review aims to identify and evaluate the effectiveness of online and mobile psychosocial preventive interventions that use SIF, and that target adolescents. Web of Science, Scopus and Google Scholar were electronically searched for all articles published between January 2011 and December 2020. Articles reporting on school-based, web-based interventions for adolescents to prevent alcohol consumption and that encouraged any kind of interaction between users ('social interactions') were eligible for inclusion. Fourteen articles were included in the review. These articles assessed eight preventive programs. Six programs showed positive results on outcome variables. In two of them, it was possible to determine that their success was partially due to the SIF. SIF seem to be useful to enhance the receptivity and usefulness of web-based prevention programs, but the current evidence of their effectiveness is scarce. More evidence is required to assess the effectiveness of these features and to improve programs having the objective of preventing the consumption of alcohol among young people.

The effect of preventive psychosocial interventions directed towards mothers and children on children's knowledge about protection from sexual abuse

Sexual abuse is a multidimensional public health problem that concerns all communities. Primary-level preventive approaches in the fight against sexual abuse have an important place. However, research involving parents in sexual abuse prevention interventions with children is limited. The aim of this study is to determine the effect of preventive psychosocial interventions directed towards mothers and their children on children's knowledge about protection from sexual abuse. The study has a quasi-experimental, comparative design with a control group and a pretest/posttest. The participants were assigned into four groups; namely, control, mother psychoeducation, child psychoeducation and mother-child psychoeducation. Significant difference was determined within and between the groups in the mean scores of the Good Touch Bad Touch Curriculum test (p < 0.001). The preventive psychosocial intervention simplemented to mothers and their children increase children's knowledge about protection from sexual abuse.

A Live Video Program to Prevent Chronic Pain and Disability in At-Risk Adults With Acute Orthopedic Injuries (Toolkit for Optimal Recovery): Protocol for a Multisite Feasibility Study.

BackgroundDespite the pivotal role of psychosocial factors in pain and disability after orthopedic injury, there are no evidence-based preventive interventions targeting psychosocial factors in patients with acute orthopedic injuries. We developed the first mind-body intervention focused on optimizing recovery and improving pain and disability in patients with acute orthopedic injuries who exhibit high levels of catastrophic thinking about pain and/or pain anxiety (Toolkit for Optimal Recovery [TOR] after orthopedic injury). In a pilot single-site randomized controlled trial (RCT), the TOR met a priori set benchmarks for feasibility, acceptability, and satisfaction. The next step in developing TOR is to conduct a multisite feasibility RCT to set the stage for a scientifically rigorous hybrid efficacy-effectiveness trial.ObjectiveThe objective of this study is to conduct a rigorous multisite feasibility RCT of TOR to determine whether the intervention and study methodology meet a priori set benchmarks necessary for the successful implementation of a future multisite hybrid efficacy-effectiveness trial. In this paper, we describe the study design, manualized treatments, and specific strategies used to conduct this multisite feasibility RCT investigation.MethodsThis study will be conducted at 3 geographically diverse level 1 trauma centers, anonymized as sites A, B, and C. We will conduct a multisite feasibility RCT of TOR versus the minimally enhanced usual care (MEUC) control (60 patients per site; 30 per arm) targeting a priori set feasibility benchmarks. Adult patients with acute orthopedic injuries who endorse high pain catastrophizing or pain anxiety will be recruited approximately 1-2 months after injury or surgery (baseline). Participants randomized to the TOR will receive a 4-session mind-body treatment delivered via a secure live video by trained clinical psychologists. Participants randomized to the MEUC will receive an educational booklet. Primary outcomes include feasibility of recruitment, appropriateness, feasibility of data collection, acceptability of TOR (adherence to sessions), and treatment satisfaction across all sites. We will also collect data on secondary implementation outcomes, as well as pain severity, physical and emotional function, coping skills, and adverse events. Outcomes will be assessed at baseline, posttreatment, and at the 3-month follow-up.ResultsEnrollment for the RCT is estimated to begin in June 2021. The target date of completion of the feasibility RCT is April 2024. The institutional review board approval has been obtained (January 2020).ConclusionsThis investigation examines the multisite feasibility of TOR administered via live videoconferencing in adult patients with acute orthopedic injuries. If feasible, the next step is a multisite, hybrid efficacy-effectiveness trial of TOR versus MEUC. Preventive psychosocial interventions can provide a new way to improve patient and provider satisfaction and decrease suffering and health care costs among patients with orthopedic injuries who are at risk for chronic pain and disability.International Registered Report Identifier (IRRID)PRR1-10.2196/28155

Impact of maternal age on infants' emotional regulation and psychomotor development.

Maternal age has progressively increased in industrialized countries. Most studies focus on the consequences of delayed motherhood for women's physical and mental health, but little is known about potential effects on infants' neurodevelopment. This prospective study examines the association between maternal age and offspring neurodevelopment in terms of both psychomotor development (Ages & Stages Questionnaires-3) and emotional competences (Early Childhood Behavior Questionnaire). We evaluated a cohort of healthy pregnant women aged 20-41 years and their offspring, assessed at 38 weeks gestation (n = 131) and 24 months after birth (n = 101). Potential age-related variables were considered (paternal age, education level, parity, social support, maternal cortisol levels, and maternal anxiety and depressive symptoms). Bayesian ordinal regression models were performed for each neurodevelopmental outcome. Maternal age was negatively associated with poor child development in terms of personal-social skills [odds ratio (OR) -0.13, 95% confidence interval (CI) 0.77-0.99] and with difficult temperament in terms of worse emotional regulation (OR -0.13, 95% CI 0.78-0.96) and lower positive affect (OR 0.16, 95% CI 0.75-0.95). As for age-related variables, whereas maternal anxiety symptoms and cortisol levels were also correlated with poor child development and difficult temperament, maternal social support and parental educational level were associated with better psychomotor and emotional competences. Increasing maternal age may be associated with child temperament difficulties and psychomotor delay in terms of social interaction skills. Early detection of neurodevelopment difficulties in these babies would allow preventive psychosocial interventions to avoid future neuropsychiatric disorders.

Genotype–environment correlation by intervention effects underlying middle childhood peer rejection and associations with adolescent marijuana use

Aggressive behavior in middle childhood can contribute to peer rejection, subsequently increasing risk for substance use in adolescence. However, the quality of peer relationships a child experiences can be associated with his or her genetic predisposition, a genotype-environment correlation (rGE). In addition, recent evidence indicates that psychosocial preventive interventions can buffer genetic predispositions for negative behavior. The current study examined associations between polygenic risk for aggression, aggressive behavior, and peer rejection from 8.5 to 10.5 years, and the subsequent influence of peer rejection on marijuana use in adolescence (n = 515; 256 control, 259 intervention). Associations were examined separately in control and intervention groups for children of families who participated in a randomized controlled trial of the family-based preventive intervention, the Family Check-Up . Using time-varying effect modeling (TVEM), polygenic risk for aggression was associated with peer rejection from approximately age 8.50 to 9.50 in the control group but no associations were present in the intervention group. Subsequent analyses showed peer rejection mediated the association between polygenic risk for aggression and adolescent marijuana use in the control group. The role of rGEs in middle childhood peer processes and implications for preventive intervention programs for adolescent substance use are discussed.

Association Between Chronic Medical Conditions and Acute Perinatal Psychiatric Health-Care Encounters Among Migrants: A Population-Based Cohort Study.

To examine the relationship between prepregnancy chronic medical conditions (CMCs) and the risk of acute perinatal psychiatric health-care encounters (i.e., psychiatric emergency department visits, hospitalizations) among refugees, nonrefugee immigrants, and long-term residents in Ontario. We conducted a population-based study of 15- to 49-year-old refugees (N = 29,189), nonrefugee immigrants (N = 187,430), and long-term residents (N = 641,385) with and without CMC in Ontario, Canada, with a singleton live birth in 2005 to 2015 and no treatment for mental illness in the 2 years before pregnancy. Modified Poisson regression was used to estimate the relative risk of a psychiatric emergency department visit or hospitalization from conception until 1 year postpartum among women with versus without CMC, stratified by migrant status. An unstratified model with an interaction term between CMC and migrant status was used to test for multiplicativity of effects. The association between CMC and risk of a psychiatric emergency department visit or hospitalization was stronger among refugees (adjusted relative risk [aRR] = 1.87; 95% confidence interval [CI], 1.36 to 2.58) compared to long-term residents (aRR = 1.39; 95% CI, 1.30 to 1.48; interaction P = 0.047). The strength of the association was no different in nonrefugee immigrants (aRR = 1.26; 95% CI, 1.05 to 1.51) compared to long-term residents (interaction P = 0.45). Our study identifies refugee women with CMC as a high-risk group for acute psychiatric health care in the perinatal period. Preventive psychosocial interventions may be warranted to enhance supportive resources for all women with CMC and, in particular refugee women, to reduce the risk of acute psychiatric health care in the perinatal period.

Psychosocial interventions for preventing and treating depression in dialysis patients.

Psychosocial interventions for preventing and treating depression in dialysis patients.

Typology of Social Network Structures and Late-Life Depression in Low- and Middle-Income Countries.

Background:Rapid social changes and youth migration ensures a continuous drain on the social networks of the elderly in Low- and Middle-Income Countries (LMICs).Objective:We reviewed available literature on the relationship between social network structures and depression among community dwelling older persons in LMICs with a view to identifying patterns that might provide information for designing preventive psychosocial interventions.Methods:We searched the MEDLINE database through Pubmed, extracted information on the typologies of social network structures in LMICs and identified dimensions with the strongest systematic association with late-life depression, by weight, using the inverse of variance method. All analyses were conducted using the Cochrane review manager version 5.3.Results:Fourteen community-based surveys drawn from 16 LMIC contexts met criteria for syntheses. They included a total of 37,917 mostly female (58.8%) participants with an average age of 73.2 years. Social network size, contact with network, diversity of network, co-residency with own child, having more friends than family in the network, and prestigious standing of persons in the social network were protective structures against late-life depression. Conversely, low network diversity contributed 44.2% of the weight of all social network structures that are predictive of late-life depression.Conclusion:Recommendations are made for the design of new measures of social network structures in LMICs that captures the key dimensions identified. Epidemiological studies using such tools will provide more precise information for planning and prioritization of scarce resources for the prevention of late-life depression in LMICs.

A Smart Toy Intervention to Promote Emotion Regulation in Middle Childhood: Feasibility Study.

BackgroundA common challenge with existing psycho-social prevention interventions for children is the lack of effective, engaging, and scalable delivery mechanisms, especially beyond in-person therapeutic or school-based contexts. Although digital technology has the potential to address these issues, existing research on technology-enabled interventions for families remains limited. This paper focuses on emotion regulation (ER) as an example of a core protective factor that is commonly targeted by prevention interventions.ObjectiveThe aim of this pilot study was to provide an initial validation of the logic model and feasibility of in situ deployment for a new technology-enabled intervention, designed to support children’s in-the-moment ER efforts. The novelty of the proposed approach relies on delivering the intervention through an interactive object (a smart toy) sent home with the child, without any prior training necessary for either the child or their carer. This study examined (1) engagement and acceptability of the toy in the homes during 1-week deployments, and (2) qualitative indicators of ER effects, as reported by parents and children.In total, 10 families (altogether 11 children aged 6-10 years) were recruited from 3 predominantly underprivileged communities in the United Kingdom, as low SES populations have been shown to be particularly at risk for less developed ER competencies. Children were given the prototype, a discovery book, and a simple digital camera to keep at home for 7 to 8 days. Data were gathered through a number of channels: (1) semistructured interviews with parents and children prior to and right after the deployment, (2) photos children took during the deployment, and (3) touch interactions automatically logged by the prototype throughout the deployment.ResultsAcross all families, parents and children reported that the smart toy was incorporated into the children’s ER practices and engaged with naturally in moments the children wanted to relax or calm down. Data suggested that the children interacted with the toy throughout the deployment, found the experience enjoyable, and all requested to keep the toy longer. Children’s emotional connection to the toy appears to have driven this strong engagement. Parents reported satisfaction with and acceptability of the toy.ConclusionsThis is the first known study on the use of technology-enabled intervention delivery to support ER in situ. The strong engagement, incorporation into children’s ER practices, and qualitative indications of effects are promising. Further efficacy research is needed to extend these indicative data by examining the psychological efficacy of the proposed intervention. More broadly, our findings argue for the potential of a technology-enabled shift in how future prevention interventions are designed and delivered: empowering children and parents through child-led, situated interventions, where participants learn through actionable support directly within family life, as opposed to didactic in-person workshops and a subsequent skills application.

Prevalence and multi-morbid correlates of homelessness among veterans with HIV infection nationally in the veterans health administration

ABSTRACTThis study sought to evaluate the risk of homelessness among HIV positive users of Veterans Health Administration (VHA) services. National VHA administrative data from Fiscal Year (FY) 2012 (N = 5.4 million) were used to: (1) evaluate the unadjusted risk of homelessness among veterans with HIV; (2) identify common multi-morbid correlates of both HIV diagnosis and homelessness; and (3) to assess the independent risk of homelessness among veterans with HIV after adjusting for risk factors common to both conditions. Veterans with HIV were at substantial risk of homelessness (OR = 4.23 (95% CI 4.07–4.39)). However, with adjustment for shared co-variates (especially black race, low income, substance use, and psychiatric disorders) this risk declined substantially to 1.41 (95% CI 1.35–1.48). The high risk of homelessness among HIV positive veterans is largely attributable to multi-morbid risk factors common to both HIV and homelessness rather than to an independent effect of HIV, and requires multi-dimensional preventive psychosocial interventions.

Psychosocial interventions for prevention of depression in older people

Psychosocial interventions for prevention of depression in older people

Children Affected by Trauma in Conflict Areas and Need for School-based Psycho-social Intervention

An established fact is that in any armed conflict the bulk of the sufferers include women and children world-wide. The experience and exposure of children to violent incidents hampers their well being. Trauma caused by such violent incidents becomes threatening if not addressed properly and on timely basis. The role of family, community and other stake holders to relieve traumatized children in strengthening their coping mechanism is imperative. Teachers including school personnel usually develop trusting relationships with children and parents .Teachers may allocate time to deal with traumatic experiences, model the children’s responses, reinforce emerging coping skills and help children to resume normal life. Committed and trained teachers may turn out to be excellent mediators to provide mental health relief to large groups of children affected by trauma. This literature review analyses the importance and effectiveness of teacher-mediated psychosocial preventive interventions among children traumatized in the context of armed conflicts (war, military violence, and terrorism). Each child reacts differently to the impact of armed conflict. Their response depends on their age, gender, personality type, personal and family history, cultural background and experience, as well as on the nature and duration of the event. Stress can reveal itself in a wide range of symptoms, including increased separation anxiety, developmental delays, sleep disturbances, nightmares, flashbacks, decreased appetite, withdrawn behavior, and a lack of interest in play. Younger children can have learning difficulties; older children and adolescents can show anxious or aggressive behavior and depression. Parents, teachers and community networks must be mobilized to provide the continuity, trust and stability children need for recovery. This paper explains how important is the teacher mediated intervention in reaching out to children affected by trauma in conflict situations. Methodologically: Apart from the related literature review, the paper contains inferences from authors experience while working as mental health counselor in Kashmir, India.

An update on postpartum depression

Postpartum depression (PPD) is a common condition worldwide and most of the available information is about treatment rather than prevention. This paper is an update on prevention and treatment of PPD. A simple review of the literature and a critical review of papers' methodology and conclusions was carried out. There is a consensus of the preeminence of psychosocial factors in the genesis of PPD. Considering the complications when the condition is not treated, it is of the utmost importance to implement early detection and management strategies. The use of psychosocial preventive interventions is an alternative that has support in the literature and should be seriously considered.

Programa psicopreventivo de educación para la vida : efectividad en adolescentes. UTEC-PGR

Con el objetivo de analizar la intervención preventiva psicosocial implantada por la Procuraduría General de la Republica (PGR), a través de la ejecución de un programa psicoeducativo en centros escolares como respuesta a los planes institucionales que buscan proteger a la niñez y la adolescencia, se plantea, específicamente, identificar los elementos que fortalecen y obstaculizan el logro de los resultados del proyecto, analizar su efectividad a través del cumplimiento de los objetivos diseñados y proponer un programa psicopreventivo de educación para la vida. Se seleccionó un diseño ex post facto, en una muestra de 305 estudiantes de noveno grado que recibieron el programa durante tres años, en temas distribuidos anualmente. Se realizaron análisis descriptivos e inferenciales no paramétricos. Se validó la eficacia del programa a través del impacto que tiene sobre la población beneficiaria atendida. Los estudiantes que recibieron el programa presentaron cambios perceptivos sobre los temas abordados e identificaron los riesgos de vida a los cuales tienen la probabilidad de ser expuestos en su adolescencia. Una de las implicaciones en el estudio es que las diferencias encontradas podrían estar intervenidas por factores sociales del entorno, de la familia y de la escuela. Sin embargo, podemos inferir que existen variables psicosociales que significan riesgos y que cambios se han generado en el grupo que ha estado recibiendo la intervención de la institución.