Henrique Pinto Gomide

Web-based self-help intervention reduces alcohol consumption in both heavy-drinking and dependent alcohol users: A pilot study.

As part of a multicenter project supported by the World Health Organization, we developed a web-based intervention to reduce alcohol use and related problems. We evaluated the predictors of adherence to, and the outcomes of the intervention. Success was defined as a reduction in consumption to low risk levels or to <50% of the baseline levels of number of drinks. From the 32,401 people who accessed the site, 3389 registered and 929 completed the full Alcohol Use Disorders Identification Test (AUDIT), a necessary condition to be considered eligible to take part in the intervention. Based on their AUDIT scores, these participants were classified into: low risk users (LRU; n=319) harmful/hazardous users (HHU; n=298) or suggestive of dependence users (SDU; n=312). 29.1% of the registered users (LRU=42; HHU=90; SDU=82) completed the evaluation form at the end of the six-week period, and 63.5% reported low-risk drinking levels. We observed a significant reduction in alcohol consumption in the HHU (62.5%) and SDU (64.5%) groups in relation to baseline. One month after the intervention, in the follow-up, 94 users filled out the evaluation form, and their rate of success was similar to the one observed in the previous evaluation. Logistic regression analyses indicated that HHU participants presented higher adherence than LRU. Despite a relatively low adherence to the program, its good outcomes and low cost, as well as the high number of people that can be reached by a web-based intervention, suggest it has good cost-effectiveness.

Revisão sistemática da literatura sobre estigma social e alcoolismo

Systematic literature review about social stigma and alcoholism. A large number of studies have focused on stigma and its health consequences. Drugs related disorders are pointed as the most stigmatized conditions in Latin America. Thus this paper aims to review the scientific literature about social stigma and alcoholism. A systematic review of literature was accomplished among four databases: LILACS (Latin American and Caribbean Center on Health Sciences Information), PsycInfo, PubMed and SciELO between 1997 and 2007 with these following keywords: stigma, stereotyped attitudes, stereotyping and alcoholism. Nine articles remained after exclusion and inclusion criteria application and were analyzed. In sum, the studies had no objectives, instruments and population convergence, illustrating an absence of a clear stigma measure method. Moreover the number of studies is not increasing as expected. As a public health concern, more funding and research is needed to development of prevention and rehabilitation procedures.

Moralização sobre o uso de álcool entre estudante de curso de saúde

Alcohol use is one of the major conditions that display a worldwide moralizing connotation. The objective of this present article was to investigate the stereotypes and the moral attribution of the Health College Students (HCS) about the dependence of alcohol. 138 HCS enrolled on undergraduate health courses participated of the study. Three instruments were used: questionnaire about the personal characteristics of the professionals, Evaluation questionnaire about stereotypes and moralization of the use of alcohol. Was verified that for the use of alcohol, the perception model of the HCS was moral and one of the biggest difficulties for them dealing with the patients referred to the alcoholics.

Capacitação em álcool e outras drogas para profissionais da saúde e assistência social: relato de experiência

Como alternativa ao panorama deficitario de formacao profissional para atuacao na area do uso de alcool e outras drogas, e visando a incorporacao de mudancas praticas, sao criados os Centros Regionais de Referencia sobre Drogas (CRRs). Faz-se necessario compreender e refletir sobre o papel dos CRRs nos cenarios de formacao e atuacao sobre a tematica. A partir disso, o presente artigo pretende discutir aspectos sobre a capacitacao de profissionais do Sistema Unico de Saude e Assistencia Social, por meio do relato de experiencia de um CRR de Minas Gerais. A implantacao do presente CRR possibilitou a qualificacao de profissionais em direcao a abordagens integrais e reflexivas sobre a tematica. Contudo, sao necessarias reformulacoes sobre o seu modelo, com uma posicao mais bem definida e atuante dentro das politicas sobre drogas, garantindo continuidade nas acoes e auxiliando na reformulacao das praticas.

É hora de investirmos em intervenções comportamentais computadorizadas no Brasil

Studies have shown that computer-based interventions are effective treatment modality for many health conditions such as anxiety disorders, depression, alcohol abuse, and nicotine dependence. Although these interventions have shown small effect sizes, they could reach a large number of people. This study aims to analyze critically the efficacy evidence of computer-based interventions in scientific literature, evaluate their potential utilization in Brazil, describe the current regulation, and introduce some development tools. To reach these aims, a narrative review of literature was performed. The computer-based interventions are configured as a potential tool for public health due to the growing use of computers and Internet in Brazil and the low cost of development.Studies have shown that computer-based interventions are effective treatment modality for many health conditions such as anxiety disorders, depression, alcohol abuse, and nicotine dependence. Although these interventions have shown small effect sizes, they could reach a large number of people. This study aims to analyze critically the efficacy evidence of computer-based interventions in scientific literature, evaluate their potential utilization in Brazil, describe the current regulation, and introduce some development tools. To reach these aims, a narrative review of literature was performed. The computer-based interventions are configured as a potential tool for public health due to the growing use of computers and Internet in Brazil and the low cost of development.

Depression among smokers of a web-based intervention to quit smoking: a cross-sectional study

Introduction. Web-based interventions for smoking cessation are an innovative strategy to reduce the burden of smoking. Although many web-based interventions are freely available in many languages and have proven to be effective, so far no study has covered in detail the association between depression and smoking. Objective. The aim of this study was to evaluate the prevalence of depression among users of the Viva sem Tabaco, a web-based intervention for smoking cessation. Method. This was a retrospective cross-sectional study. In the internet-based intervention participated 1 433. Inclusion criteria were: being 18 years or older and a smoker; exclusion criteria were: omitting to fill out two questions of the screening depression questionnaire PHQ-2 and having made multiple accesses within a limited time span, characterizing invalid access. At the end, the sample had 461 participants. Participants answered questions related to sociodemographic characteristics, tobacco history, depression (PHQ-2 and PHQ-9), alcohol use, and intervention use. Results. Participants average age was 42.3 years (SD = 12.1). Most participants were female (67%), and 70% were employed during the time of the study. From the total sample, 36.4% of the participants presented depression according to PHQ-2. Being screened with depression was associated with tobacco dependence (OR = 1.10; 95% CI = 1.00, 1.20), and associated with not having a job (OR = .53; 95% CI = .29, .97). Discussion and conclusion. Depression may be a factor to be considered in programs that offer support to quit smoking through the internet for Portuguese Speakers.

Prevalence and correlates of light and non-daily smoking in Brazil: Results from a nationwide representative survey

BACKGROUND The research of light (≤10 cigarettes per day) and non-daily smokers in developing countries including Brazil is scarce despite the high prevalence of these groups among smokers and health risks associated to low-level smoking. OBJECTIVE To describe health and smoking characteristics of Brazilian adult light and non-daily smokers. METHODS We analyzed data from the 2013 Brazilian National Health Research survey (n=48,282). RESULTS The prevalence of current manufactured cigarette smoking in the total sample was 12.4%. Among these smokers, 12.8% were non-daily smokers (NDS), 47.4% were light smokers (LS) and 39.8% were moderate/heavy smokers (MHS). Bivariate analysis showed that non-daily smoking was associated with higher odds of poor self-rated health, binge drinking and lung diseases compared to never smokers (ORs=1.2; 5.9 and 1.9). Light smoking was associated with higher odds of poor self-rated health, binge drinking, depression, use of sleeping pills and lung diseases (ORs=1.3; 4.3; 1.4; 1.2 and 2.0). After controlling for sex and age, non-daily smoking was associated with lung disease (OR=2.2) and light smoking with depression and lung diseases (ORs=1.3 and 1.8). Smoking levels were associated with living with same-level smokers in bivariate and multivariate analyses. CONCLUSION A large proportion of smokers in Brazil are light and non-daily smokers, carrying substantial health risks related to tobacco use. Longitudinal research is needed to provide further evidence of associations found in this study. Public health policies must take the different smoking patterns into consideration to effectively target all smokers and reduce the harmful consequences of tobacco worldwide.

Curso de prevenção ao uso de drogas: Descrição e avaliação de satisfação

Drug abuse prevention course: Description and evaluation of satisfaction. Considering the substance use by children and adolescents, it is important to implement preventive actions in the school environment. Among them, there is the use of online courses to train the various actors who can be protagonists of the planed activities. This study presented and evaluated the Drug Use Prevention Course for Public School Educators. A total of 4,960 educators from Minas Gerais, Rio de Janeiro, and Paraná participated and the sociodemographic characteristics of these, in addition to evaluation of aspects of satisfaction with the course and access to virtual learning tools were investigated. The profile of the participants was predominantly composed of women (85.8%) with a postgraduate degree (64.8%) and 35.2% reported having contact with the alcohol and drugs theme in the school context. Most participants approved the course (98.1%), indicating that the teaching method and strategies used were suitable to the qualified public.

Development of an open-source web-based intervention for Brazilian smokers – Viva sem Tabaco

BackgroundWeb-based interventions for smoking cessation available in Portuguese do not adhere to evidence-based treatment guidelines. Besides, all existing web-based interventions are built on proprietary platforms that developing countries often cannot afford. We aimed to describe the development of “Viva sem Tabaco”, an open-source web-based intervention.ResultsThe development of the intervention included the selection of content from evidence-based guidelines for smoking cessation, the design of the first layout, conduction of 2 focus groups to identify potential features, refinement of the layout based on focus groups and correction of content based on feedback provided by specialists on smoking cessation. At the end, we released the source-code and intervention on the Internet and translated it into Spanish and English.ConclusionsThe intervention developed fills gaps in the information available in Portuguese and the lack of open-source interventions for smoking cessation. The open-source licensing format and its translation system may help researchers from different countries deploying evidence-based interventions for smoking cessation.

Capacitación sobre alcohol y otras drogas para profesionales de la salud y asistencia social: relato de experiencia

Como alternativa ao panorama deficitario de formacao profissional para atuacao na area do uso de alcool e outras drogas, e visando a incorporacao de mudancas praticas, sao criados os Centros Regionais de Referencia sobre Drogas (CRRs). Faz-se necessario compreender e refletir sobre o papel dos CRRs nos cenarios de formacao e atuacao sobre a tematica. A partir disso, o presente artigo pretende discutir aspectos sobre a capacitacao de profissionais do Sistema Unico de Saude e Assistencia Social, por meio do relato de experiencia de um CRR de Minas Gerais. A implantacao do presente CRR possibilitou a qualificacao de profissionais em direcao a abordagens integrais e reflexivas sobre a tematica. Contudo, sao necessarias reformulacoes sobre o seu modelo, com uma posicao mais bem definida e atuante dentro das politicas sobre drogas, garantindo continuidade nas acoes e auxiliando na reformulacao das praticas.