ABSTRACT A scoping review of systematic reviews was carried out to identify evidence of efficacy, effectiveness, and costeffectiveness of universal and selective suicide prevention programs among university students worldwide. Five databases were reviewed using terms in English, Spanish, and Portuguese. The following were the inclusion criteria: systematic review or meta-analysis or meta-synthesis, suicide prevention in college students, evaluation of the efficacy, effectiveness and/or cost-effectiveness of interventions, and peer-reviewed studies. The quality of reviews was assessed. The field of study features three decades of publication in high-income countries. The strategy used, the components of the program, and the target audience to which they are delivered interfere with efficacy. In the psychoeducation strategy, the experiential and didactic components are more efficacious in the knowledge about suicide. And the motivational enhancement component promotes greater self-efficacy in suicide prevention. Programs that take a multimodal approach are effective in increasing short-term attitudes related to suicide and reducing rates of completed suicide. The gatekeeper strategy delivered to peer counselors is the most effective one in the outcomes, including short-term and long-term knowledge about suicide and its prevention and self-efficacy in suicide prevention. A greater number of evaluated studies of gatekeeper interventions were identified, indicating a trend in this research field. No review addressed the effects on subgroups that were classified based on sex, racial or sexual minorities, and special (indigenous) populations. Only one study addressed cost-effectiveness, pointing out that the psychoeducation and gatekeeper strategies have relevant net benefit rates, but the gatekeeper strategy has a higher cost–benefit ratio compared to the psychoeducation strategy. The findings indicate that psychoeducation and gatekeeper interventions tend to be more efficacious when they combine education and skills training to intervene in suicidal behavior. The components of the intervention and the target audience to which it is delivered influence efficacy. Multimodal interventions evaluate completed suicide outcomes, but require greater implementation efforts, in terms of human and financial resources and more time for the evaluation.

Resumo As ações voltadas à saúde integral dos adolescentes por vezes assumem um caráter moral e regulador sem levar em conta as visões dos próprios adolescentes sobre seu desenvolvimento. O objetivo foi compreender as significações sobre adolescência e saúde, na perspectiva de 10 adolescentes de ambos os sexos, entre 13 e 19 anos de um programa de atenção integral à saúde do DF. Foram realizados seis grupos temáticos, com periodicidade quinzenal e duração de duas horas por encontro. A metodologia grupal foi baseada no método sociodramático que facilitou a participação, reflexão e compreensão dos temas abordados pelos participantes. A Epistemologia Qualitativa foi adotada para a análise das informações e possibilitou a construção de indicadores de saúde na adolescência, a partir de cinco zonas de sentido: Adolescência é mais do que sexo, drogas erock and roll; Porque a família tem que adolescer com a gente; O projeto de vida começa agora, agora?; Em busca de um ideal de saúde; e Porque sexualidade, antes de tudo, se expressa. Conclui-se que é necessário superar a visão estereotipada da adolescência pelo paradigma do risco e ampliar a reflexão sobre os modos de vida do adolescente considerando os contextos para o desenvolvimento de sua subjetividade.

Abstract Sometimes, the actions addressing health care of adolescents assume a moral and regulatory character without taking into account the views of adolescents on their own development. The purpose was to understand the meanings of adolescence and health from the perspective of 10 teens of both sexes aged between 13 and 19 years from a comprehensive health attention program located in Distrito Federal. Six thematic group sessions were conducted bimonthly, with two-hour meetings. The group methodology was based on the sociodramatic method, which facilitated participation, reflection, and understanding of the topics discussed by the participants. Qualitative epistemology was adopted for the information analysis, and this enabled the construction of indicators about adolescence and health, emerging from five indicators of meaning costructed by researchers: (1) adolescence is more than sex, drugs, and rock and roll; (2) the family must “grow up” with us; (3) must the life plan begin now?; (4) seeking ideal health; and (5) first of all, sexuality is expressed. It follows that we must overcome the stereotypical views of adolescence present in the paradigm of risk discourse and extend our thinking about adolescents’ way of life by considering the contexts for the development of their subjectivity.

Resumen Las acciones dirigidas a la salud integral de los adolescentes a veces asumen un carácter moral y regulador, sin tener en cuenta las opiniones de los adolescentes sobre su propio desarrollo. El objetivo fue comprender los significados de la adolescencia y de la salud desde la perspectiva de 10 adolescentes de ambos sexos, entre 13 y 19 años de un programa de atención integral de salud del DF. Se realizaron seis grupos temáticos, cada 15 días y con duración de dos horas por sesión. La metodología de grupo se basó en el método sociodramático que facilitó la participación, la reflexión y la comprensión de los temas tratados por los participantes. Se adoptó la Epistemología Cualitativa para el análisis de las informaciones, que a su vez permitió la construcción de los indicadores de salud en la adolescencia, a partir de cinco zonas de sentido: La adolescencia es más que sexo, drogas y rock and roll; Porque la familia tiene que “adolecer” con nosotros; El proyecto de vida empieza ahora, ¿ahora?; En busca de un ideal de salud; y Porqué la sexualidad, antes que nada, se expresa. Se concluye que hay que superar la visión estereotipada de la adolescencia basada en el paradigma del riesgo y extender la reflexión sobre las formas de vida de los adolescentes, considerando los contextos para el desarrollo de su subjetividad.