RESUMO
BACKGROUND: Mental health care is a top clinical concern for modern Puerto Rico, especially given a dramatically changing economic landscape paired with recurrent natural disasters. Youth are particularly at-risk due to long-term impacts of toxic stress and adverse childhood experiences on health and development. OBJECTIVES: Here we present a novel clinician-community-educator-scientist partnership to address Puerto Rican youth mental well-being and wellness. We deployed pilot health workshops within the Boys & Girls Clubs of Puerto Rico to build youth mental health conceptual understanding and competencies in stress recognition and management. The work in progress herein evaluates acceptability and feasibility of our curricular model. METHODS: Dialogue with community stakeholders guided curricular design of workshops for youth ages 6 to 13 and older. Prior to implementation, educators and volunteers attended a 1-day training on educational strategies. Workshop success was evaluated using qualitative approaches (i.e., narrative feedback, educator and volunteer reflections, youth Talking Drawings) to assess youth engagement, youth conceptual health understanding, and educator/volunteer impressions of feasibility and impact. RESULTS: Initial findings indicate high acceptability and feasibility of our curricular model. Youth engagement and enthusiasm were noted in educator feedback and continue to be sustained post-workshop. Preliminary analysis shows accompanying increases in youth conceptual mental health understanding, particularly for 6- to 12-year-olds in recognition of stress and healthy coping mechanisms. Reciprocal gains were observed for volunteers. CONCLUSIONS: Activities have evolved into a formal partnership called Semilla, which features expanded analysis of mental well-being and wellness outcomes. Our collaborative model continues to engage Puerto Rican youth in the science of their well-being.
Assuntos
Pesquisa Participativa Baseada na Comunidade , Saúde Mental , Masculino , Feminino , Adolescente , Humanos , Porto Rico , Bem-Estar Psicológico , Nível de SaúdeRESUMO
Hurricane Maria was the worst recorded natural disaster to affect Puerto Rico. Increased stress in pregnant women during and in the aftermath of the hurricane may have induced epigenetic changes in their infants, which could affect gene expression. Stage of gestation at the time of the event was associated with significant differences in DNA methylation in the infants, especially those who were at around 20-25 weeks of gestation when the hurricane struck. Significant differences in DNA methylation were also associated with maternal mental status assessed after the hurricane, and with property damage. Hurricane Maria could have long lasting consequences to children who were exposed to this disaster during pregnancy.
Assuntos
Tempestades Ciclônicas , Desastres , Desastres Naturais , Lactente , Humanos , Criança , Feminino , Gravidez , Metilação de DNA , Porto RicoRESUMO
El objetivo de este estudio fue conocer el nivel de desarrollo en la etapa pre-escolar de un grupo de niños nacidos prematuramente y con bajo peso. Se evaluó un grupo 20 niños de cuatro años nacidos prematuramente y con bajo peso y un grupo de 20 niños nacidos luego de gestación completada y peso deseado utilizando la prueba de integración visual-motora Beery-Buktenica. Además, se administró el cuestionario del desarrollo Ages and Stages (ASQ-3) a las 40 madres. El análisis estadístico se llevó a cabo mediante una prueba t de studentpara grupos independientes. El grupo de niños nacidos prematuramente obtuvo puntuaciones significativamente inferiores en las pruebas que medían las habilidades de percepción visual (µ1 83.65 ; µ2 93.7) (p=0.0001), integración visual-motora (µ1 93.6 ; µ2 104.8) (p=0.001) y motor fina (µ1 36.00 ; µ2 44.25) (p=0.033) al ser comparados con el grupo de niños nacidos luego de una gestacióncompletada.El estudio sugiere que los niños nacidos prematuramente y con bajo peso presentan menor ejecución en el desarrollo sensorio-motor durante la etapa pre-escolar. Estas desventajas pasan desapercibidas y pueden representar rezago en las tareas escolares futuras que requieren de dichas habilidades. Es importante fomentar la evaluación y estimulación ambiental temprana en esta población aún en ausencia de indicadores de riesgo.
The purpose of this study was to evaluate the development among a group of pre-school children born premature and with low weight. We evaluated a group of four years old children; 20 children born prematurely and 20 children born after a full gestation and desired weight, using the Beery-Buktenica visual-motor integration test. We also administered the Ages and Stages Questionnaire (ASQ-3) development test to all 40 mothers. Statistical analysis was performed using student t test for independent groups. The group of children born prematurely scored significantly lower on tests measuring visual perception skills (µ1 83.65 ; µ2 93.7) (p = 0.0001), visual-motor integration (µ1 93.6 ; µ2 104.8) (p = 0.001) and fine motor (µ1 36.00 ; µ2 44.25) (p=0.033) (p = 0.033), when compared to the group of children born after a full term. This study suggests that premature low weight born children have lower performance in the sensory-motor development during the preschool years. These disadvantages go unnoticed and may represent future delays on school tasks that require these skills. It is important to promote an early assessment and environmental stimulation among this population even in the absence of risk indicators