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Sánchez-Aragón A, Valls-Fonayet F, Pastor-Gosálbez I, Anleu-Hernández CM, Belzunegui-Eraso A. [Motivations for alcohol consumption in schooled adolescents: analysis of discussion groups]. Aten Primaria 2024; 56:102931. [PMID: 38603940 PMCID: PMC11015495 DOI: 10.1016/j.aprim.2024.102931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE To find out the motivations of adolescents for alcohol consumption. DESIGN Qualitative methodology with discussion groups. PARTICIPANTS AND CONTEXT 131 adolescents (15-17 years old) enrolled in nine schools in Tarragona (Spain). METHOD Systematic coding strategy, adapted to focus groups. Educational centers were selected through a stratified purposive sampling by educational levels (segmentation criterion) and ownership of the center (public or private). Participants within the educational levels were randomly selected for the groups. Content analysis was conducted using an open and flexible coding strategy. RESULTS Motivations for alcohol consumption were identified, revolving around six fundamental dimensions: a) seeking fun and new sensations, b) alleviating discomfort, c) consumption due to social contagion and group pressure, d) consumption as a rite of passage into adulthood, e) environmental availability of alcohol, and f) low perception of risk. This motivation varied according to the adolescent's gender. In girls, drinking behavior appeared related to overcoming negative emotional states, while for boys, belonging to the peer group took precedence: drinking reinforces hegemonic masculinity and ensures complicity among peers. Adolescents considered that the information they receive from educational centers is sufficient, but it does not motivate change. CONCLUSIONS Public health strategies focused on preventing alcohol consumption in adolescents should incorporate their motivations to achieve greater efficiency, paying due attention to sex/gender variables.
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Affiliation(s)
- Anna Sánchez-Aragón
- Social & Business Research Laboratory (SBRlab), Universidad Rovira i Virgili, Tarragona, España.
| | | | - Inma Pastor-Gosálbez
- Social & Business Research Laboratory (SBRlab), Universidad Rovira i Virgili, Tarragona, España
| | | | - Angel Belzunegui-Eraso
- Social & Business Research Laboratory (SBRlab), Universidad Rovira i Virgili, Tarragona, España
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de Andrés-Sánchez J, Belzunegui-Eraso A, Valls-Fonayet F. The significance of information variables in polydrug use by adolescents: insights from a cross-sectional study in Tarragona (Spain). PeerJ 2024; 12:e16801. [PMID: 38259667 PMCID: PMC10802159 DOI: 10.7717/peerj.16801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Substance use, especially among adolescents, is a significant public health concern, with profound implications for physical and psychological development. This study aimed to evaluate the quantity and sources of information available to adolescents regarding polydrug use. A cross-sectional survey was conducted in Tarragona involving adolescents with an average age of 16.44 years. This study assessed the number of substances used (alcohol, cigarettes, and cannabis) in the past month, along with information sources related to substance use. Monitored sources (e.g., schools, parents, and mass media) and unmonitored sources (e.g., peers, siblings, internet) were distinguished. In addition, four individual and four environmental control variables were considered. Multinomial logistic regression analysis revealed that incorporating variables related to adolescents' substance use information and its sources enhanced the explanatory model, surpassing control variables. The degree of information about substance use did not significantly explain consumption patterns, but the number of information sources, both monitored and unmonitored, did. The unmonitored sources were associated with increased polydrug use. Conversely, greater reliance on supervised sources for information was linked to reduced single-substance and polydrug use. This protective effect increased with an increase in the number of substances used. In conclusion, information obtained from monitored sources acts as a deterrent to substance consumption, consistent with findings suggesting that greater health literacy among adolescents discourages substance use. Conversely, this study suggests that information from more informal sources may encourage heavier polydrug use, aligning with reports indicating that adolescents with a more comprehensive understanding of substance use consequences tend to engage in heavier drug use.
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de Molina-Fernandez MI, Reyes-Martí L, De la Flor-López M, Aguarón-García MJ, Roca-Biosca A, Rubio-Rico L, Raventós Torner RD, Valls-Fonayet F. Medication Adherence and Contraceptive Counseling. Healthcare (Basel) 2023; 11:healthcare11091304. [PMID: 37174846 PMCID: PMC10178153 DOI: 10.3390/healthcare11091304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Combined oral contraceptives (COC) are a very popular form of birth control. Incorrect use and lack of adherence to treatment reduce the effectiveness of this method. Having a standard tool to identify poor-adherence profiles quickly and objectively can be helpful for midwives and potentially for COC users. The MMAS-4 adherence scale has been used in various medical fields, but there is little evidence of its potential in contraceptive consultation. This paper presents a piece of multicenter observational research based on a sample of 327 women who had attended contraceptive counselling in Spain and were COC users or had informed the midwife that they want to start to use this method. Two interviews were conducted: at the time of consultation and after one year. In our research, the MMAS-4 identified high-risk behaviors: during the 1-year follow-up period, COC users classified as poorly adherent had a significantly higher risk of missed contraceptive pills, more incidents and problems related to the method of contraception, as well as a lower degree of satisfaction with the contraceptive method. One case of unplanned pregnancy and two cases of emergency contraception were identified, all of them corresponding to poorly adherent women. The use of MMAS-4 in consultation can improve midwives' contraceptive counselling.
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Affiliation(s)
| | - Laura Reyes-Martí
- Nursing Department, Universitat Rovira i Virgili, 43002 Tarragona, Spain
| | | | | | - Alba Roca-Biosca
- Nursing Department, Universitat Rovira i Virgili, 43002 Tarragona, Spain
| | - Lourdes Rubio-Rico
- Nursing Department, Universitat Rovira i Virgili, 43002 Tarragona, Spain
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Reyes-Martí L, Rubio-Rico L, Ortega-Sanz L, Raigal-Aran L, de la Flor-López M, Roca-Biosca A, Valls-Fonayet F, Moharra-Francés M, Escuriet-Peiro R, de Molina-Fernández MI. Contraceptive counselling experiences in Spain in the process of creating a web-based contraceptive decision support tool: a qualitative study. Reprod Health 2021; 18:237. [PMID: 34838040 PMCID: PMC8626746 DOI: 10.1186/s12978-021-01254-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background The choice of contraceptive method is a complex decision, and professionals should offer counselling based on the preferences, values and personal situation of the user(s). Some users are unsatisfied with the counselling received, which may, among other consequences, adversely affect method use adherence. In view of this situation, we propose exploring the experiences and needs of users and professionals for contraceptive counselling, in the context of creating a web-based contraceptive decision support tool. Methods/design Qualitative research was conducted through focus group discussions (64 users split into eight groups, and 19 professionals in two groups, in Tarragona, Spain) to explore the subjects’ experiences and needs. The data were categorized and the categories were defined and classified based on the three-step protocol or framework for Quality on Contraceptive Counseling (QCC), created by experts, which reviews the quality of interactions between user and professional during the counselling process. Results In counselling, users demand more information about the different methods, in an environment of erroneous knowledge and misinformation, which lead to false beliefs and myths in the population that are not contrasted by the professional in counselling. They complain that the method is imposed on them and that their views regarding the decision are not considered. Professionals are concerned that their lack of training leads to counselling directed towards the methods they know best. They acknowledge that a paternalistic paradigm persists in the healthcare they provide, and decision support tools may help to improve the situation. Conclusions Users feel unsatisfied and/or demand more information and a warmer, more caring approach. Professionals are reluctant to assume a process of shared decision-making. The use of a contraception DST website may solve some shortcomings in counselling detected in our environment. In Spain, individuals can use a variety of contraceptive methods. Professionals involved in contraceptive counselling should help users to choose and properly use the method that best suits their preferences, personal situation and health status. However, there is a high number of unplanned pregnancies and the population feels dissatisfied with the counselling received. In the context of creating a website dealing with contraceptive methods, we wished to find out how counselling was taking place, giving voice those directly concerned. A qualitative study was proposed to explore the experiences and needs of users and professionals during counselling. Ten focus groups were conducted involving 64 users and 19 professionals from Tarragona (Spain). The results were ordered based on the Quality on Contraceptive Counseling (QCC) framework, created by experts, which determines what the relationship between user and professional should be like during the counselling process. Our analysis highlighted users’ little knowledge and false beliefs concerning contraception who, moreover, complained of receiving little information during counselling. They expressed their discontent with methods being imposed on them by the professional without exploring their preferences or needs. Meanwhile, the professionals argued that they often prescribe the method with which they are most familiar due to the lack of time during consultations at their office and/or because they are unfamiliar with other methods. These results, among others, offer the possibility of improving contraceptive counselling in Spain, if solutions to the difficulties and/or barriers detected are posed and implemented.
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Affiliation(s)
- Laura Reyes-Martí
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Lourdes Rubio-Rico
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain.
| | - Laura Ortega-Sanz
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Laia Raigal-Aran
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Miriam de la Flor-López
- Medicine Department, Universitat Rovira i Virgili, C/Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Alba Roca-Biosca
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Francesc Valls-Fonayet
- Nursing Department, Universitat Rovira i Virgili, Av/Catalunya, 35, 43002, Tarragona, Spain
| | - Montse Moharra-Francés
- Agency for Health Quality and Assessment of Catalonia (AQuAS) of the Catalan Ministry of Health, Carrer de Roc Boronat, 81, 08005, Barcelona, Spain
| | - Ramon Escuriet-Peiro
- Catalan Health Service of the Catalan Ministry of Health, Travessera de Les Corts, 131-159 - Edifici Olímpia. Població, 08028, Barcelona, Spain
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Fernández-Aliseda S, Belzunegui-Eraso A, Pastor-Gosálbez I, Valls-Fonayet F. Compulsive Internet and Prevalence Substance Use among Spanish Adolescents. Int J Environ Res Public Health 2020; 17:ijerph17238747. [PMID: 33255602 PMCID: PMC7728152 DOI: 10.3390/ijerph17238747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/24/2022]
Abstract
This paper analyses compulsive Internet use among Spanish adolescents as measured by the Compulsive Internet Use Scale (CIUS) of the ESTUDES 2016 survey (national survey on drug use in secondary schools), which was recently added to the statistical programme of the Spanish National Plan on Drugs. We examined two subsamples of Spanish adolescents (those who suffer from compulsive Internet use and those who do not) while taking into account gender and age. Our general hypothesis was that adolescents who suffer from compulsive Internet use have a greater prevalence of alcohol, tobacco, cannabis, sedative, and new substance consumption as well as a greater prevalence of modes of consumption such as getting drunk, drinking with friends in public places (botellón), and binge drinking. While our results confirm these assumptions, they also suggest that gender and age play an ambivalent role in these associations.
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Affiliation(s)
- Sonia Fernández-Aliseda
- History Department (Sociology Section), Universitat Rovira i Virgili, 43002 Tarragona, Spain; (S.F.-A.); (I.P.-G.)
| | - Angel Belzunegui-Eraso
- Medical Anthropology Research Centre, Universitat Rovira i Virgili, 43002 Tarragona, Spain
- Faculty of Nursing, Universitat Rovira i Virgili, 43002 Tarragona, Spain;
- Correspondence:
| | - Inma Pastor-Gosálbez
- History Department (Sociology Section), Universitat Rovira i Virgili, 43002 Tarragona, Spain; (S.F.-A.); (I.P.-G.)
- Medical Anthropology Research Centre, Universitat Rovira i Virgili, 43002 Tarragona, Spain
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Belzunegui-Eraso A, Pastor-Gosálbez I, Raigal-Aran L, Valls-Fonayet F, Fernández-Aliseda S, Torres-Coronas T. Substance Use among Spanish Adolescents: The Information Paradox. Int J Environ Res Public Health 2020; 17:E627. [PMID: 31963717 PMCID: PMC7013889 DOI: 10.3390/ijerph17020627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 02/07/2023]
Abstract
This aim of this paper is to determine the relationship between the consumption of tobacco, cannabis, and alcohol (including drunkenness and binge drinking consumption patterns) in the previous 30 days by Spanish adolescents and the information that is available to adolescents on drug consumption. This cross-sectional study employed data from the Survey on Drug Use in Secondary Education in Spain (ESTUDES 2016), which was conducted on students aged 14 to 18 (n = 35,369). Contingency tables, mean comparison tests, and logistic regression analyses were conducted and prevalence ratios (PR) were obtained. The results show that the probability that an adolescent will smoke tobacco is associated with whether their mother and/or father smoke (PR: 1.30), whether some of their friends smoke (PR: 14.23), whether the majority of their friends smoke (PR: 94.05) and how well informed they perceive themselves to be (PR: 1.30). Cannabis use is mainly associated with whether most of their friends also use cannabis (PR: 93.05) and whether they are sufficiently informed regarding this consumption (PR: 1.59). Alcohol consumption is associated with whether their mothers drink regularly (PR: 1.21), whether most of their friends drink (PR: 37.29), and whether they are well informed (PR: 1.28). Getting drunk and binge drinking are associated with whether their friends have these behaviors (PR: 44.81 and 7.36, respectively) and whether they are sufficiently informed (PR: 1.23 for both behaviors). In conclusion, the consumption of these substances is more frequent among Spanish adolescents who believe that they are better informed and whose friends have similar patterns of consumption.
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Affiliation(s)
- Angel Belzunegui-Eraso
- Social Inclusion, Rovira i Virgili University, 43002 Tarragona, Spain; (S.F.-A.); (T.T.-C.)
| | - Inma Pastor-Gosálbez
- Medical Anthropology Research Center, Rovira i Virgili University, 43002 Tarragona, Spain;
| | - Laia Raigal-Aran
- Department of Nursing, Rovira i Virgili University, 43002 Tarragona, Spain; (L.R.-A.); (F.V.-F.)
| | - Francesc Valls-Fonayet
- Department of Nursing, Rovira i Virgili University, 43002 Tarragona, Spain; (L.R.-A.); (F.V.-F.)
| | | | - Teresa Torres-Coronas
- Social Inclusion, Rovira i Virgili University, 43002 Tarragona, Spain; (S.F.-A.); (T.T.-C.)
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de Molina-Férnandez MI, Raigal-Aran L, de la Flor-Lopez M, Prata P, Font-Jimenez I, Valls-Fonayet F, March-Jardi G, Escuriet-Peiro R, Rubio-Rico L. The effectiveness of a digital shared decision-making tool in hormonal contraception during clinical assessment: study protocol of a randomized controlled trial in Spain. BMC Public Health 2019; 19:1224. [PMID: 31484579 PMCID: PMC6727535 DOI: 10.1186/s12889-019-7572-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 08/29/2019] [Indexed: 11/23/2022] Open
Abstract
Background Decision-making tools represent a paradigm shift in the relationship between the clinician and the user/patient. Some of their advantages include patient commitment, the promotion of preferences and values, and increased treatment adherence. This study protocol aims to assess the effectiveness of a decision-making tool in contraception (SHARECONTRACEPT) concerning: a) Improvement in counselling on hormonal contraception at the medical consultation, measured in terms of decreasing decisional conflict and improving knowledge of available contraceptive options; b) Improvement in adherence to treatment measured in terms of: persistence in the chosen treatment, compliance with dose or procedure of use, and ability to deal with incidents related to the use of the contraceptive method; and decreasing unwanted pregnancies and voluntary interruption of pregnancy. The SHARECONTRACEPT tool, developed by previous phases of this project, is available at: http://decisionscompartides.gencat.cat/en/decidir-sobre/anticoncepcio_hormonal/ Methods/design A longitudinal, prospective-type, randomized, controlled community clinical trial, carried out in the clinical contraceptive counselling units of 6 autonomous regions in Spain, with an experimental group and a control group. Description of the intervention: The health professionals participating will be randomly assigned to one of the two groups. Clinicians assigned to the experimental group will perform contraceptive counselling assisted by SHARECONTRACEPT, and those of the control group will follow the conventional contraceptive counselling provided in their clinical unit. It is planned to study 1708 users (control group n = 854 and intervention group n = 854), recruited from women who attend the consultations of the health professionals. The selected users will be followed up for one year. The data will be collected through ad-hoc questionnaires, and validated instruments for measuring decisional conflict and adherence to treatment. Discussion The results of this study protocol will offer evidence of the effectiveness of a shared decision-making tool, SHARECONTRACEPT, which may prove a useful tool for users and professionals to promote adherence to contraceptive methods. Trial registration Clinical Register number ISRCTN5827994. Date: 15/04/2019 (Retrospectively registered)
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Affiliation(s)
| | - Laia Raigal-Aran
- Nursing Department, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002, Tarragona, Spain.
| | - Miriam de la Flor-Lopez
- Medicine Department, Universitat Rovira i Virgili, C/ Dr. Mallafrè Guasch, 4, 43005, Tarragona, Spain
| | - Paula Prata
- Escola Superior de Enfermagem do Porto, Portugal, Rua Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Isabel Font-Jimenez
- Nursing Department, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002, Tarragona, Spain
| | - Francesc Valls-Fonayet
- Universitat Rovira i Virgili, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002, Tarragona, Spain
| | - Gemma March-Jardi
- Institut Català de la Salut, Primary Care Unit. CAP Jaume I, C/ Jaume i, 45-49, 43005, Tarragona, Spain
| | - Ramon Escuriet-Peiro
- Àrea d'Atenció Sanitària. Gerència de Salut i Atenció Integrada, Servei Català de la Salut
- Generalitat de Catalunya, Travessera de les Corts, 131-159
- Pavelló Ave Maria,
- 08028, Barcelona, Spain
| | - Lourdes Rubio-Rico
- Nursing Department, Campus Catalunya, Universitat Rovira i Virgili, Av/ Catalunya, 35, 43002, Tarragona, Spain
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Belzunegui-Eraso A, Pastor-Gosálbez I, Puig-Andreu X, Valls-Fonayet F. Risk of Exclusion in People with Disabilities in Spain: Determinants of Health and Poverty. Int J Environ Res Public Health 2018; 15:ijerph15102129. [PMID: 30262774 PMCID: PMC6210139 DOI: 10.3390/ijerph15102129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/23/2018] [Accepted: 09/25/2018] [Indexed: 11/16/2022]
Abstract
In this paper, we analyze data from the 2012 Encuesta de Integración Social y Salud (Social Integration and Health Survey) of the Instituto Nacional de Estadística (Spanish National Institute of Statistics) to obtain profiles created by combining disability, poverty and social exclusion. We hypothesize that the probability that people will experience social exclusion increases if they have a disability, chronic illness or limitation in conducting everyday activities, and that this probability is greater for women than for men. To conduct our analysis, we constructed a social exclusion model based on a series of social determinants that acts as a dependent variable. In this context, social exclusion is understood to go beyond the concept of financial poverty. We performed bivariate analyses, in which we calculated the Odds Ratios (OR) for certain variables considered to be predictors of social exclusion. We also performed a means comparison test and an ANOVA test to observe differences between individuals with recognized disability and those without. Finally, we conducted logistic regression analysis to determine which vulnerability profiles are most likely to experience a situation of social exclusion. We also discuss the limitations of our study, and suggest areas in, which the relationships between health, social exclusion and disability can be further investigated.
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Affiliation(s)
| | - Inma Pastor-Gosálbez
- Medical Anthropology Research Center, Rovira i Virgili University, 43002 Tarragona, Spain.
| | - Xavier Puig-Andreu
- Social Inclusion Chair, Rovira i Virgili University, 43002 Tarragona, Spain.
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