Abstract About 75% of the population of Metlatónoc, Guerrero, México, lives in extreme poverty (ENSANUT, 2012), which increases the probability of having health problems, regarding their hygiene and nutrition. In order to facilitate tools which can allow this population to improve their control over their decisions with respect to their health and disease prevention, a community-based program based on life skills and the Framework for Enabling Intrinsic Empowerment (Pick y Sirkin, 2010) was implemented. Thirty five promoters were trained through an experiential workshop, who replicated it with 4,728 people -mostly women-. To evaluate the program effect, a self-report questionnaire was applied; a longitudinal design (pre, post and follow-up) was used with the promoters and a pre-post with control group with the target population. With both groups, positive statistically significant effects were found in most of the variables: knowledge, attitudes and target behaviors, life skills, psychosocial barriers, personal agency and intrinsic empowerment. Findings are discussed in light of their contribution to diminish the vulnerability of this population, and strengthen their potential for development.

Resumen Alrededor del 75% de los habitantes de Metlatónoc, Guerrero, viven en pobreza extrema (ENSANUT, 2012), lo que aumenta sus probabilidades de padecer problemas de salud, fundamentalmente en materias de higiene y nutrición. Para proporcionar a esta población herramientas que mejoren el control sobre la toma de decisiones que afectan su salud y prevenir enfermedades, se implementó un programa comunitario basado en habilidades para la vida y en el Marco para Facilitar el Empoderamiento Intrínseco (Pick y Sirkin, 2010). Se impartió un taller para formar a 35 promotores, quienes lo replicaron con la población meta siguiendo una metodología participativa y vivencial, llegando a 4,728 personas -casi todas mujeres-. Para evaluar el efecto del programa se aplicó un cuestionario de autorreporte; con los promotores se utilizó un diseño longitudinal: pre, post y seguimiento, y con la población meta un diseño pre-post con grupo control. Se encontraron efectos favorables y significativos en gran parte de las variables evaluadas (conocimientos, actitudes y conductas meta, habilidades para la vida, barreras psicosociales, agencia personal y empoderamiento intrínseco), en ambos tipos de participantes. Los hallazgos se discuten a la luz de su contribución para disminuir la vulnerabilidad de las personas y potenciar su desarrollo.

Con el propósito de modificar conductas alimentarias y sanitarias en los habitantes de comunidades marginadas, a través del desarrollo de conocimientos y habilidades psicosociales encaminadas a promover agencia personal y empoderamiento intrínseco, se desarrolló e instrumentó en México un modelo piloto basado en el programa "Yo quiero, yo puedo... mejorar mi salud y ejercer mis derechos. La evaluación de dicho programa mostró un efecto sobre conocimientos, comunicación asertiva, agencia personal y equidad de género en el personal de los almacenes que surten las tiendas rurales, así como en conocimientos, comunicación asertiva, toma de decisiones y agencia personal en la población meta. Las habilidades psicosociales, los conocimientos y la agencia personal ofrecen oportunidades para superar la pobreza.

Based on the program "Yo quiero, yo puedo... mejorar mi salud y ejercer mis derechos" [I want to, I can...improve my health and exercise my rights], a pilot model was designed and implemented in three States of Mexico. This model aims to change nutrition and hygiene behaviors in the inhabitants of marginalized communities, through knowledge and psychosocial skills development facilitating personal agency and intrinsic empowerment. Evaluation of the program showed an effect on knowledge, assertive communication, personal agency and gender equity among the personnel in charge of the warehouses that provide the rural stores, and on knowledge, assertive communication, decision making and personal agency in the target population. Life skills training, knowledge and personal agency promotion enhance opportunities for poverty reduction.

In recent years, the number of women who use tobacco has increased rapidly. Among youngsters, gender gap is closing, and the proportion of girls who smoke is already very similar to that of boys, with the added complication that the girls are more vulnerable to addiction, and tobacco use has severe consequences for their health and the well-being of their future children. The key to facing tobacco epidemic is prevention by strengthening protective factors and reducing risk factors that lead to smoking onset. School environment is the most valuable resource for anti-smoking programs. These efforts are commonly focused on elementary and secondary students because experimentation with tobacco and adoption of smoking behavior occur at this stage. There are three intervention models in schools: 1. Information model (or rational), 2. Social skills model (or affective), and 3. Social influence model, which emphasizes social environment as a critical factor in tobacco use. In this model the children are informed about the immediate negative effects of smoking (unfavorable effects on appearance, economic costs and social consequences such as rejection by others). The model also conveys a positive image of non-smokers as rational people, and a negative one of a smoker as someone vulnerable to advertising tricks. It uses the peer group for showing resistance to pressure and how to adopt and to maintain the decision not to smoke, and it teaches how to identify influences from tobacco advertising, peers and family. The social influence programs tend to be the most effective strategy for achieving at least some delay in onset of tobacco use. It is necessary to develop appropriate programs for each age and for a specific gender. Recently, researchers have begun using programs based on computer systems and Internet to prevent teen smoking. The aim of this study was to design, implement and evaluate two different types of tobacco prevention programs, tailored specifically for teenage girls. The programs were computer games and an interactive workshop, as well as the combination of both of them (games plus workshop). It was suggested that in treatment groups versus control group, smoking susceptibility scores (i.e., lack of a firm commitment to not smoke) would be lower in post test. It was also hypothesized that the games plus workshop group would affect the scores of the associated variables with susceptibility, and that changes would remain in the follow-up. Material and methods 537 student girls in the three grades of secondary school were asked to answer the Smoking Susceptibility Scale. Out of this group, 160 girls that obtained the highest scores were selected, because they were considered at risk of becoming regular smokers. Six variables related with smoking susceptibility were also measured: Belief in the addictive property of tobacco, beliefs in smoking benefits, empathy with smoking victims, negative attitudes toward tobacco industry, skills rejecting social pressure to smoke, and identification of diseases associated with smoking in women. The Smoking Susceptibility Scale was applied at three moments of the measurement: A pretest (one week before programs starting), a post test (the last day of the program or programs), and a follow-up (four months after implementing the post test). In the last two occasions, the instruments of variables related with susceptibility were also applied. The two types of prevention programs (computer games and interactive workshop) were based on the social influence model. The purpose of the games was that the girls acquire skills to recognize and resist social pressures to smoke exerted by both the tobacco industry through advertising strategies, and their peers. The interactive workshop was designed according to the strategies of anti-smoking messages that have proved to be effective in order to prevent smoking; the immediate negative consequences suffered by smokers and the physical and psychological vulnerability of women produced by smoking were also highlighted. A mixed 4 inter-groups X 3 intra-groups design was applied (4 treatments: Computer games, interactive workshop, games plus workshop, control, X 3 measurement times: Pretest, post test, follow-up). The 160 participants were randomly assigned to one of the four treatment groups. The study consisted of four phases: pre test, treatment (one week later), post test (on completion of program implementation) and follow-up (four months after the post test). Results There was an immediate effect of the three treatments on the smoking susceptibility by contrasting pre test versus post test, but games plus workshop group had more effect than games or workshop ones. When comparing post test and follow-up measurements in the games plus workshop group versus the control group, it was found that smoking susceptibility scores of the treatment group stayed unchanged. For related variables, the girls who participated in the games plus workshop group had higher scores than the control group in the belief of tobacco addictive property, in empathy with smoking victims, in the negative attitude toward the tobacco industry, in the refusal skills towards social pressure to smoke, and in the identification of diseases associated with smoking in women, and lower scores on beliefs in the benefits of smoking (attractive appearance, emotional well-being, popularity and social acceptance). At the follow-up, it was observed that attitudes toward tobacco companies became even more negative and that participants identified more diseases caused by smoking in women than in the post test, i.e., the treatment effect was strengthened. Discussion The main guideline in the construction of smoking behavior prevention programs evaluated in this study was its focus on adolescent girls. Furthermore, they were only addressed to those adolescents with high scores on smoking susceptibility, due to the intention of using the available resources more efficiently. Another criterion taken into a count in order to build these programs was the shortness of the intervention. The results showed that smoking susceptibility on the participants of each one of the three treatment groups decreased from the pre test to the post test, but the decline was even greater in the games plus workshop group. The smoking susceptibility of the games plus workshop group remained low in the follow-up after four months of its implementation, which did not occur with the workshop or games groups alone. It appears that the more elements used in the prevention programs the greater their impact will be. Compared with the control group, the majority of variables related with smoking susceptibility were affected by the games plus workshop treatment. In conclusion, the combination of preventive programs for smoking addiction constructed in this study specifically for girls with the implementation of psychosocial principles and the use of computer technology decreased the smoking susceptibility on participants, as well as most of the related variables. Moreover, their effects persisted at least for a period of four months. Computer games, which were of interest to participants, could be easily installed on computer rooms of secondary schools, and even uploaded in the Internet, and its effects could be enhanced by an interactive workshop, which promotes interpersonal contact and discussion of false beliefs regarding tobacco use that girls support. The girls at risk who change their smoking susceptibility as a result of their participation in these smoking prevention programs will avoid the severe consequences of using tobacco and will gain years of healthy life for themselves and their descendants.

El consumo de tabaco en las mujeres se ha incrementado aceleradamente. Entre los adolescentes, la brecha de género se está estrechando, ya que el porcentaje de fumadoras es ya muy similar al de los varones, con el agravante de que ellas son más vulnerables a la adicción al tabaco y su consumo tiene serias consecuencias para su salud y la de sus futuros hijos. La principal alternativa para enfrentar la epidemia de tabaquismo es la prevención. Existen básicamente tres modelos de intervención antitabaco en las escuelas: modelo de información, modelo de habilidades sociales y modelo de influencia social, el cual ha mostrado ser el más efectivo para lograr, al menos, retrasar el inicio del consumo. Se ha señalado que es necesario desarrollar programas adecuados específicos para cada edad y género. El propósito de la presente investigación fue construir, aplicar y evaluar dos diferentes tipos de programas de prevención del tabaquismo (juegos de computadora y taller interactivo) y la combinación de ambos (¡uegos+taller), dirigidos específicamente a mujeres adolescentes. Material y métodos De las 537 mujeres estudiantes de secundaria que contestaron la Escala de Susceptibilidad Tabáquica, las 160 adolescentes que obtuvieron los puntajes más altos fueron asignadas aleatoriamente a uno de cuatro grupos de tratamiento: Juegos de computadora, Taller interactivo, Juegos+taller y Control. Los programas se desarrollaron con base en el modelo de influencia social. El estudio constó de cuatro fases: premedición, tratamiento, pos-medición y seguimiento (cuatro meses después). Se evaluaron además seis variables precurrentes de la susceptibilidad tabáquica: creencia en la propiedad adictiva del tabaco, creencias en los beneficios de fumar, empatia hacia las víctimas del tabaco, actitud negativa hacia las tabacaleras, habilidades de rechazo ante la presión social para fumar e identificación de enfermedades asociadas con el tabaco en las mujeres. Resultados La susceptibilidad tabáquica de las participantes en los tres grupos de tratamiento disminuyó significativamente de la premedición a la post-medición, pero los efectos persistieron en el seguimiento sólo en el grupo de Juegos+taller. Respecto de las variables precurrentes, quienes participaron en el grupo Juegos+taller obtuvieron puntajes más altos que las del grupo control en la creencia en la propiedad adictiva del tabaco, en la empatia hacia las víctimas del tabaco, en la actitud negativa hacia las tabacaleras, en las habilidades de rechazo a la presión social para fumar y en la identificación de las enfermedades asociadas con el tabaco en las mujeres, y menores puntajes en las creencias en los beneficios de fumar (apariencia atractiva, bienestar emocional, popularidad y aceptación social). En el seguimiento se observó que las actitudes hacia las tabacaleras se hicieron aún más negativas y las participantes señalaron más enfermedades causadas por el tabaco en las mujeres, que en la posmedición, es decir, se reforzó el efecto del tratamiento. Discusión La combinación de los programas preventivos de la adicción al tabaco para mujeres adolescentes construidos en este estudio con la aplicación de principios psicosociales y la utilización de tecnología computacional, disminuyeron la susceptibilidad tabáquica de las participantes, así como la mayoría de las variables precurrentes. Además, sus efectos persistieron durante un periodo de cuatro meses. Los programas podrían aplicarse fácilmente en el ámbito escolar: los juegos de computadora podrían instalarse en los salones de cómputo o colocarse en Internet, y su efecto se reforzaría con el taller interactivo, el cual es de intervención breve y propicia el contacto interpersonal y la discusión de las creencias falsas respecto del consumo de tabaco que sostienen las adolescentes. Las chicas en riesgo tabáquico que cambien su susceptibilidad como consecuencia de su participación en estos programas evitarán las serias consecuencias del consumo de tabaco y ganarán años de vida sana para ellas y sus descendientes.

Introduction Dating violence, a recent topic in scientific investigation, has an incidence ranging from 22% to 33% among young people. These findings are supported by a previous study that showed that about one third of high school and college students have experienced physical violence from a dating partner. Similarly, National and international studies (e.g. National Survey on Family Relations Dynamics and the International Dating Violence Study) found an incidence of violence between dating partners ranging from 10% to 45% among college students worldwide. Although there is evidence that men also experience violence perpetrated by women and that violence occurs in same sex relationships, the research continues to show that violence is usually perpetrated by men against women. However, past studies have focused on the occurrence of physical violence which signals the possibility that other types of violence, such as emotional or social, have a higher incidence. Their incidence varies and the harmful physical, emotional, and social consequences that they imply point to the need of creating prevention programs targeted at youth populations. It is important to prevent violence in a first stage by raising youth's awareness of this problem and, ideally, also by achieving a change in their behaviors and attitudes as well as in the social norms that promote its occurrence. In order to address all of these components of prevention, programs have been developed that do not only inform youth about violence, but also facilitate the formation of social skills through active participation and role playing which allows individuals to practice new models of interaction that are violence free. In addition, programs have to consider that many schools lack the disposition or the resources to impart long prevention workshops. For this reason, the development of brief prevention strategies has become imperative. The program «I want to, I can… prevent violence: Raising awareness of dating violence through a brief intervention» was developed, implemented, and evaluated with the objective of raising youth's awareness and increasing their knowledge about dating violence, its precursors related to gender and cultural norms and its physical, emotional, and social consequences. Materials and method The program consisted of eight interactive conferences imparted at different public high schools in Mexico. The conferences reached a total of 2250 participants in four different urban areas in the country. The conferences consisted of a presentation and different interaction exercises with a total duration of two hours and thirty minutes. The topics covered in each conference were: life skills (assertive communication, negotiation, decision-making), differentiation of the concepts of sex, sexuality and gender and how these are related to violence, what is and how to recognize violence, types of violence, gender roles and stereotypes, how to recognize violence in a dating relationship, and how to express love in a healthy way. A questionnaire, which included the following sections, was developed to assess participants' attitudes toward violence: a) Ability to recognize violence in everyday interactions: Identifying signs of violence in the behaviors and attitudes of characters presented in eight different cases of interactions between dating partners. b) Attitudes toward violence: Rating levels of agreement with statements that promote or discourage violence. c) Causes of violence: Ten causes of violence related to social norms that encourage men's aggression and promote gender inequality are presented; participants must identify the five that are false and the five that are true. d) Healthy ways of expressing love: Recognition of behaviors and signs in a dating relationship that imply the presence or the lack of love. The impact of the conference was evaluated by applying this brief questionnaire to a random sample of participants before and after the conferences. Across all high schools, a total number of 311 questionnaires were completed by participants before the conferences and 184 were completed after the conferences. Ideally, there should have been a longer term follow-up for which no funds were available. An explanatory model within the framework of the Item Response Theory (IRT) was used to analyze collected data. Results The results showed that the conference improved the participants' ability to identify violence and its causes as well as their understanding of healthy ways of expressing love. Responses also indicated favorable attitudes toward nonviolence both before and after the conference. The findings also suggest that participants might require more time to learn how to fully recognize assertive and violent communication as well as false causes of violence and that, ideally, programs should be undertaken to change behaviors not only create awareness and thus be carried out in smaller groups. An analysis of gender differences in responses to the questionnaire shows that women where better able to recognize violence, its causes, and healthy ways of expressing love. Women also had more favorable attitudes toward nonviolence. Discussion The findings show that raising awareness about dating violence through an interactive conference is an efficient brief first stage prevention strategy because it can promote important changes in participants' attitudes through a brief intervention. Participating adolescents showed an increase in their knowledge and awareness about the subject which allowed them to improve their recognition of violence in everyday life. The increase in their ability to recognize healthy ways of expressing love also points to an understanding of romantic relationships that does not exclude autonomy, assertiveness, and honesty. These changes could facilitate the participants' ability to identify myths and misinformation related to the causes of violence. In addition, awareness-raising can initiate a process of questioning and changing social norms that promote gender inequality, jealousy, and control as acceptable forms of violence within dating relationships. Gender differences in the findings suggest that men might need more time than women to fully understand the problem of dating violence which can be attributed to traditional gender role expectations related to violence and gender relationships. This signals the need to increase prevention programs' focus on masculinity, male roles in dating relationships, and how they can express feelings without violence and without limits related to gender stereotypes. The program's achievements indicate the importance of finding strategies that allow large audiences to learn about dating violence, recognize violence in everyday social interactions and understand how to ask for help. The interactive nature of the program goes beyond giving information to a large number of people as it allows participants to practice relationship skills and promotes reflection on the subject of violence. Throughout the program's implementation, schools demonstrated a great interest in raising awareness about dating violence. It would be convenient to utilize their interest in order to further implement prevention programs. The interactive and brief nature of our program allows schools to resolve the problem of lack of time and resources that might deter their participation. Preventing intimate partner violence must begin during adolescence in order to impede the development of unhealthy patterns of interaction that may become harder to change in adulthood.

Introducción La violencia en el noviazgo es un tema reciente en la investigación científica, cuya incidencia en personas jóvenes va de 22 a 33%. Aun cuando hay evidencias de mujeres que agreden a sus parejas masculinas y también existe violencia entre parejas del mismo sexo, la violencia de pareja sigue siendo predominantemente de control del hombre hacia la mujer. La incidencia de este tipo de violencia y sus consecuencias físicas, emocionales y sociales señalan la necesidad de crear programas de prevención en poblaciones jóvenes. Sin embargo, también debe tomarse en cuenta que en muchas escuelas no existe aún la disposición o los recursos para ofrecer talleres de prevención de larga duración enfocados a esta problemática. Por ello, resulta imperioso contar con estrategias breves que lleven a largo plazo a cambios de conductas en los jóvenes. El primer paso para lograr la prevención es la sensibilización en torno a esta problemática, lo cual permite empezar un proceso de cambio de normas sociales sobre el tema. El programa «Yo quiero, yo puedo… prevenir la violencia: Programa breve de sensibilización sobre violencia en el noviazgo» se desarrolló, instrumentó y evaluó con el objetivo de sensibilizar e incrementar la información que tienen las y los jóvenes sobre los antecedentes culturales y de género relacionados con la violencia en el noviazgo y sus consecuencias a nivel físico, emocional y social. Material y métodos Se impartieron ocho conferencias en preparatorias públicas en México; el total de participantes fue de 2250. Se elaboraron una presentación y un guión para impartir conferencias interactivas con duración de dos horas y treinta minutos dirigidas a jóvenes de nivel medio superior. Algunos de los temas incluidos en las conferencias fueron: habilidades para la vida, qué es y cómo reconocer la violencia, tipos de violencia, su relación con estereotipos de género y formas saludables de expresar el amor. Asimismo, se desarrolló un instrumento para evaluar conocimientos sobre y actitudes hacia la violencia, dividido en cuatro secciones. El impacto de la conferencia interactiva se evaluó mediante la aplicación de este instrumento antes y después de la conferencia impartida a una muestra al azar de la población beneficiada. Aunque idealmente se recomienda hacer un seguimiento del impacto del programa a largo plazo, la falta de recursos no lo permitió en este caso. Para el análisis de datos optamos por la aplicación de un modelo explicativo dentro del marco de la Teoría de Respuesta al Ítem (TRI). Resultados Se logró que los participantes tuvieran un mayor reconocimiento de la violencia y de sus causas. También se logró que los participantes identificaran formas saludables de expresar el amor. Asimismo, los resultados demuestran que los alumnos entendieron que en las relaciones de noviazgo se pueden dar situaciones violentas. Discusión Los hallazgos muestran que la estrategia de sensibilización sobre el tema de la violencia, por medio de una conferencia interactiva, es eficiente ya que logra el objetivo planteado. Una conferencia de corta duración puede promover cambios importantes respecto a un mayor conocimiento y sensibilización frente a la problemática de la violencia. Ello facilita la identificación de situaciones de violencia en la vida cotidiana y el abandono de mitos y creencias falsas relacionadas con las causas de la violencia. Este tipo de programas interactivos y breves, que promueven la reflexión y la aplicación de habilidades relacionales, permite resolver problemas de falta de tiempo para la sensibilización en torno a la violencia en el noviazgo. Asimismo, hacerlo con grandes números de alumnos aumenta el beneficio a un menor costo. Las conferencias interactivas como la aplicada en este estudio abren canales de comunicación sobre el tema en los ambientes escolares y propician la formación de redes de ayuda al respecto.

En este trabajo se analizan los resultados de la aplicación del programa educacional Porque me quiero, me cuido, denominado actualmente Yo quiero, yo puedo. . . prevenir el cáncer, en poblaciones rurales e indígenas de Valles Centrales, estado de Oaxaca, una de las regiones más pobres de México. Este programa está dirigido a promover el uso de servicios de tamizaje y la prevención del cáncer cervicouterino mediante el cambio de conducta de las personas y la comunidad. Para ello se realizaron talleres interactivos enfocados al desarrollo de habilidades y conocimientos en las mujeres de 15 a 64 años de edad. Estos talleres se complementaron con campañas en la comunidad y talleres para hombres con el fin de conseguir su apoyo. Se cuantificaron las pruebas de Papanicolau realizadas en las 10 poblaciones intervenidas y en 6 poblaciones con características similares empleadas como control. Además se evaluó mediante un cuestionario los cambios en la conducta, los conocimientos y las actitudes. Se observó un numero significativamente mayor de pruebas de Papanicolau realizadas en las poblaciones intervenidas con respecto a las de control (P = 0,02). Se comprobaron cambios positivos en el nivel de conocimientos de las mujeres respecto a las causas del cáncer cervical y las medidas para prevenirlo.