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RESUMEN Objetivo: Colombia cuenta con una legislación de control del tabaco desde 2009 sin embargo, no existe una regulación específica sobre los Sistemas Electrónicos de Administración de Nicotina (SEAN), por lo tanto, es vital caracterizar las dimensiones cualitativas de consumo. El objetivo de este estudio fue identificar las prácticas y representaciones de los consumidores de SEAN con el fin de obtener elementos para orientar las acciones necesarias para prevenir su consumo. Materiales y métodos: Este artículo presenta los resultados identificados en el componente cualitativo de una investigación macro sobre la prevalencia del uso de SEAN entre estudiantes universitarios. Se realizaron 14 entrevistas individuales y 1 grupo focal, analizados con el software NVivo10®. Resultados: Se presentan como resultados principales la identificación de las prácticas de consumo, de las cuales se derivó que el núcleo central de la representación social sobre SEAN es no autónomo, lo que posibilita un cambio que desincentive su consumo; el sistema periférico de la representación está conformado por tres elementos: la dimensión social, el consumo de SEAN como estilo de vida y la dimensión corporal y emocional. Conclusiones: Se concluye que las acciones de prevención de consumo de SEAN deben partir de la identificación de características particulares y exclusivas del consumo de SEAN y la incorporación de los elementos del sistema periférico que permitan abordar un consumo que no se basa en la toma de decisiones informadas.
ABSTRACT Objective: Colombia has had a tobacco control legislation since 2009, however there is no specific regulation on Electronic Nicotine Delivery Systems (ENDS). Therefore, it is crucial to characterize the qualitative dimensions of consumption. The study aimed to answer the question: What are the representations and practices of the university population regarding the consumption of SEAN? The objective of the study is to identify the practices and representations of ENDS consumers in order to obtain elements to guide the necessary actions to prevent their consumption. Methods: This paper presents the results identified in the qualitative component of a main study on the prevalence of ENDS use among university students. 14 individual interviews and 1 focus group were conducted and analyzed with the NVivo10® software. The corpus consisted of the transcripts of the 14 interviews and 1 focus group, which constitutes a total of 116 pages of raw data. The techniques used were semi-structured interviews and focus groups, using the Microsoft Teams platform. Taking into account ethical aspects, in each interview and in the focus group the informed consent was read and authorization was requested for the interview to be recorded. The average duration of each interview was one hour and forty-five minutes and the focus group lasted a total of 120 minutes. The capture of practices and representation related to the use/non-use of SEAN was achieved by incorporating two phases of analysis: a)Inductivephase: it was developed with an ordered matrix on the theoretical categories of the project, b)Phase of deductive analysis was carried out based on processes typical of the founded theory that allowed expanding the analytical framework having as its axis the identification of consumption practices and the elements that make up the central core and the peripheral system of representation. Results: The main results are the identification of consumption practices, from which it was derived that the central nucleus of the social representation of SEAN is non-autonomous, which enables a change that discourages its consumption. The reasons and practices for consuming ENDS are closely related to conventional cigarette consumption, which corresponds to the fact that 11 of the 14 interviewees who identify themselves as consumers have consumed conventional cigarettes and only two have been exclusive ENDS consumers. The following practices were identified: a) The consumption motivations were grouped like social, economic and socio-emotional; b) Three types of consumption spaces: prohibited, exclusive and recovered spaces. These last ones are places where you couldn't smoke cigarettes and now they feel empowered to vape; c) There are forms of differential consumption and access to ENDS related to the quality, price, exclusivity and adherence; d) Habits and rituals are not related to moments of daily life, as with cigarettes, but to practices such as searching for and mixing "salts" to obtain flavors, cleaning and maintaining the device, smoking tricks; e) About information channels among the interviewees it was noted that the practice of informed consumption is not frequent and that there are few sources of information that offer low confidence. Finally, the peripheral system of representation is made up of three elements: social dimension, the consumption of SEAN as a lifestyle, bodied and emotional dimension. Conclusion : It is concluded that the actions to prevent the consumption of ENDS should start from the identification of particular and exclusive characteristics of the consumption of ENDS and the incorporation of the elements of the peripheral system that allow addressing a consumption not based on making informed decisions. The main finding is the identification of a non-autonomous representation that stems from the difficulty of establishing notable differentiations between conventional cigarette consumption and e-cigarettes. Therefore, the main vein of research that opens up is to delve into the particular and exclusive characteristics of this consumption. It is essential to incorporate bodily, emotional, and especially social (interpersonal) dimensions as important variables in understanding the practices and representations of e-cigarettes through complex approaches that can break the solid elements on which conventional cigarette consumption is anchored, as it continues to define dynamics of electronic device consumption. It is important at this point to recognize that emotions can be understood as the intermediary between the lived experience in the body and everything that happens in the environment. Thus, it is not possible to think of this representation without recognizing that consumption is an embodied exercise, and the absence of the body in discourses about e-cigarettes can be a revealing element of a disconnection between practices and meanings that are reinforced in the insistence on an action (smoking is smoking) despite the recognition of its negative effects on health (even though it should not be). The understanding of the social representation of e-cigarette consumption in relation to specific practices related to it provides some clues on which to work on processes of information, communication, prevention, and regulation to discourage this consumption that appears relatively new.
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Young people in Colombia present high rates of mental health problems, to which the country's history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people's help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen's 'capabilities approach' to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme 'Jovenes en Acción' (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on 'community competencies' as complementary to and interrelated with individual competencies would strengthen young people's individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.
Asunto(s)
Entrevistas como Asunto , Servicios de Salud Mental , Investigación Cualitativa , Estigma Social , Humanos , Colombia , Adolescente , Femenino , Masculino , Adulto Joven , Conflictos Armados , Salud Mental , Trastornos MentalesRESUMEN
Background: Colombia has endured more than five decades of internal armed conflict, which led to substantial costs for human capital and mental health. There is currently little evidence about the impact of incorporating a mental health intervention within an existing public cash transfer program to address poverty, and this project aims to develop and pilot a mental health support intervention embedded within the human capital program to achieve better outcomes among beneficiaries, especially those displaced by conflict and the most socioeconomically vulnerable. Methods: The study will consist of three phases: semi-structured one-to-one interviews, co-design and adaptations of the proposed intervention with participants and pilot of the digital intervention based on cognitive behavioral therapy and transdiagnostic techniques to determine its feasibility, acceptability, efficacy, and usefulness in 'real settings'. Results will inform if the intervention improves clinical, educational and employment prospects among those who use it. Results: Knowledge will be generated on whether the mental health intervention could potentially improve young people's mental health and human capital in conflict-affected areas? We will evaluate of the impact of potential mental health improvements on human capital outcomes, including educational and employment outcomes. Conclusion: Findings will help to make conclusions about the feasibility and acceptability of the intervention, and it will assess its effectiveness to improve the mental health and human capital outcomes of beneficiaries. This will enable the identification of strategies to address mental health problems among socioeconomically vulnerable young people that can be adapted to different contexts in in low and middle-income countries.
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BACKGROUND: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. AIMS: Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. METHODS: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents (N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict. RESULTS: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85-0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86-0.97]), non-specific violence and harm (OR 0.91 [0.86-0.97]) and social capital variables (OR 0.91 [0.85-0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. CONCLUSIONS: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.