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Introduction: The COVID-19 pandemic has had a direct impact on mental health. Inter national organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treat ment option for common mental health problems. However, the evidence regarding these ap proaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-as sessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous pop ulation. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Introducción: La pandemia de COVID-19 tuvo impacto directo en la salud mental. Organizaciones internacionales han enfatizado la vulnerabilidad de los pueblos indígenas. Los enfoques de salud mental digital brindan terapia en línea como una opción de tratamiento basada en evidencia, efectiva y accesible; sin embargo, los datos son limitados en población indígena. El objetivo de este estudio fue describir el diseño, desarrollo y evaluación de la eficacia de una intervención en línea autoaplicada sobre síntomas psicológicos de depresión, ansiedad y miedo al COVID-19 en una muestra de población maya. Método: Se diseñó un es tudio cuantitativo longitudinal prospectivo, donde se midió a un solo grupo antes y después de recibir la intervención en línea, implementada de abril a septiembre de 2021, que constó de seis sesiones impartidas vía WhatsApp, en español y maya. Resultados: La evaluación inicial se implementó con 82 participantes que fueron evaluados mediante el Cuestionario de Salud del Paciente, Escala para el Trastorno de Ansiedad Generalizada y Escala de Miedo al COVID-19; 18 participantes permanecieron para la evaluación posterior. Se observaron di ferencias estadísticas en las medidas pre- y post- de depresión y ansiedad, pero no miedo al COVID-19. Conclusiones: Este estudio arrojó resultados positivos de la primera intervención de salud mental en línea implementada en la población indígena latinoamericana. Estudios futuros podrían considerar el desarrollo de intervenciones similares para otras comunidades indígenas en América Latina.

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BACKGROUND: The outbreak of the COVID-19 pandemic in 2020 aggravated already existing difficulties and added new challenges for students. Owing to the gap between needed and available psychological services, group interventions may offer a helpful strategy for student mental health promotion. OBJECTIVE: This study aimed to investigate the acceptability and feasibility of a 4-week online support group program designed for mental health promotion tailored to graduate students at a Brazilian public university in the context of the COVID-19 pandemic (May 2022 to June 2022). METHODS: Participants in the program took part in online support groups based on a pilot group facilitated by a trained clinical psychologist. Self-administered, standardized web-based questionnaires were assessed at the baseline (T0; before the intervention), postintervention (T2), and follow-up (T3; after 4-6 weeks) time points. We measured sociodemographic variables, treatment credibility and expectancy (Credibility and Expectancy Questionnaire), satisfaction (Client Satisfaction Questionnaire), negative effects of the intervention (Negative Effects Questionnaire), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and participants' quality of life (abbreviated World Health Organization Quality of Life assessment). A 9-answer option questionnaire and open-ended questions also assessed the group's perceived positive and negative outcomes. RESULTS: The total sample comprised 32 participants. Most (23/32, 72%) were doctoral students. Credibility and expectancy scores were high. Participants' satisfaction (Client Satisfaction Questionnaire) with the program was high at the postintervention (T2) and follow-up (T3) evaluations (T2: mean 28.66, SD 3.02; T3: mean 27.91, SD 3.02). Most participants reported that they could learn from other participants' experiences (T2: 29/32, 91%; T3: 27/32, 84%) and felt encouraged to take better care of themselves (T2: 22/32, 69%; T3: 24/32, 75%). None of the participants reported that they had no benefits from the program. The PHQ-9 scores showed mild to moderate depressive symptoms (mean 9.59, SD 6.34), whereas the answers of 9% (3/32) of the participants to the PHQ-9 item 9 indicated suicidality at baseline (T0). Finally, the 4 domains of quality of life (physical: P=.01; psychological: P=.004; social: P=.02; and environmental: P<.001) showed a slight and statistically significant improvement at the postintervention evaluation (T0: mean 57.03, SD 15.39 to 59.64, SD 17.21; T2: mean 64.32, SD 11.97 to 68.75, SD 8.87). CONCLUSIONS: Online support groups for the mental health promotion of graduate students are feasible and can be especially useful for universities with students allocated to different cities. They are also satisfactory and may positively influence participants' quality of life. Therefore, they can be considered a helpful mental health promotion strategy in the educational context. Further studies could evaluate these (or similar) programs under nonpandemic circumstances.

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OBJECTIVES: Self-guided, asynchronous, online interventions may provide college students access to evidence-based care, while mitigating barriers like limited hours of service. Thus, we examined the preliminary effectiveness of a 45-minute, self-guided, asynchronous, online, dialectical behavior therapy (DBT)-informed stress and anxiety management workshop. College undergraduates (n = 131) were randomized to either workshop (n = 65) or waitlist control (n = 66) conditions. METHODS: Participants in the workshop condition completed baseline measures of depression, stress, and anxiety, before completing the workshop. Participants in the waitlist control condition only completed the baseline measures. All participants were reassessed at 1-week follow-up. RESULTS: Controlling for baseline measures, students in the workshop condition experienced significantly less stress and greater self-efficacy to regulate stress and anxiety at follow-up, compared to waitlist controls. CONCLUSION: A 45-minute, self-guided, asynchronous, online DBT skills-informed stress and anxiety management workshop may reduce stress and improve self-efficacy to regulate stress and anxiety.

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RESUMO O presente estudo teve como objetivo explorar de que modo o sociopsicodrama, conduzido na modalidade online, pode contribuir para reflexões críticas a respeito das vivências afetivo-sexuais na contemporaneidade. Trata-se de relato de experiência, com a apresentação de um ato sociopsicodramático online com direção focada na protagonização. A discussão dos resultados foi feita a partir das categorias: reflexões sobre o amor na contemporaneidade, interlocuções entre o público e o privado e a direção socionômica online. Foi possível concluir que o sociopsicodrama é um instrumento capaz de contribuir para a reflexão crítica de seus/suas participantes a respeito das vivências afetivo-sexuais na contemporaneidade, pela ampliação do campo da intervenção, do individual para o social. A direção online se mostrou efetiva e inovadora.

ABSTRACT The purpose of this study is to explore how sociopsychodrama, conducted online, can contribute to critical reflections about the affective-sexual experiences in contemporaneity. It is an experiment report, presenting an online sociopsychodrama act focusing on protagonization. The result discussion was done based on categories: reflections about love in contemporaneity, interlocutions between public and private and the online socionomic direction. It was possible to conclude that sociopsychodrama is an instrument which is able to contribute to the critical reflection of its participants about the affective-sexual experiences in contemporaneity, by the enlargement of the intervention field, from individual to social. The online direction proved to be effective and innovative.

RESUMEN El presente estudio objetivó explorar cómo el sociopsicodrama, realizado en línea, puede contribuir con reflexiones críticas sobre las experiencias afectivo-sexuales en esta época contemporánea. Se trata de un relato de experiencia, con la presentación de un acto sociopsicodramático en línea cuya dirección se centra en la protagonización. La discusión de los resultados se basó en las siguientes categorías: reflexiones sobre el amor en la contemporaneidad, interlocuciones entre lo público y lo privado y dirección socionómica en línea. Fue posible concluir que el sociopsicodrama se reveló un instrumento capaz de contribuir, con los participantes, para una reflexión crítica sobre las experiencias afectivo-sexuales en la contemporaneidad, por la ampliación del campo de intervención, de lo individual a lo social. La opción en línea demostró ser efectiva e innovadora.

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Abstract Objectives Self-guided, asynchronous, online interventions may provide college students access to evidence-based care, while mitigating barriers like limited hours of service. Thus, we examined the preliminary effectiveness of a 45-minute, self-guided, asynchronous, online, dialectical behavior therapy (DBT)-informed stress and anxiety management workshop. College undergraduates (n = 131) were randomized to either workshop (n = 65) or waitlist control (n = 66) conditions. Methods Participants in the workshop condition completed baseline measures of depression, stress, and anxiety, before completing the workshop. Participants in the waitlist control condition only completed the baseline measures. All participants were reassessed at 1-week follow-up. Results Controlling for baseline measures, students in the workshop condition experienced significantly less stress and greater self-efficacy to regulate stress and anxiety at follow-up, compared to waitlist controls. Conclusion A 45-minute, self-guided, asynchronous, online DBT skills-informed stress and anxiety management workshop may reduce stress and improve self-efficacy to regulate stress and anxiety.

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BACKGROUND: The Barbados Diabetes Remission Study-2 reported that a low-calorie diet for weight loss and diabetes remission implemented within the community and supported by trained community health advocates was both an acceptable implementation strategy and a clinically effective intervention. This study aimed to examine the adaptability of the face-to-face protocol into an online modality. METHODS: The Iterative Decision-making for Evaluation of Adaptations (IDEA) framework guides researchers in examining the necessity of the adaptation and the preservation of core intervention elements during the adaptation process. Adaptation outcomes were documented using the Framework for Reporting Adaptations and Modifications to Evidence-Based Implementation Strategies (FRAME-IS). Implementation outcome was determined by fidelity to core elements. Intervention effectiveness was determined from the analysis of clinical data. RESULTS: We decided that an adaptation was needed as COVID-19 control measures prohibited in-person interactions. The core elements-i.e. 12-week intervention duration, daily 840-kcal allowance, and weekly monitoring of weight and blood glucose-could be preserved during the adaptation process. Adaptations were made to the following: (1) the context in which data were collected-participants self-measured at home instead of following the original implementation strategy which involved being measured by community health advocates (CHA) at a community site; (2) the context in which data were entered-participants posted their measurements to a mobile application site which was accessible by CHAs. As with the original protocol, CHAs then entered the measurements into an online database; (3) the formulation of the low-calorie diet-participants substituted the liquid formulation for a solid meal plan of equivalent caloric content. There was non-inferiority in fidelity to attendance with the online format (97.5% visit rate), as compared to the face-to-face modality (95% visit rate). One participant deviated from the calorie allowances citing difficulty in estimating non-exact portion sizes and financial difficulty in procuring meals. Weight change ranged from - 14.3 to 0.4 kg over the 12-week period, and all group members achieved induction of diabetes remission as determined by a FBG of < 7mmol/l and an A1C of < 6.5%. CONCLUSION: The results suggest that this adapted online protocol-which includes changes to both the implementation strategy and the evidence-based practice-is clinically effective whilst maintaining fidelity to key elements. Utilization of the IDEA and FRAME-IS adaptation frameworks add scientific rigour to the research. TRIAL REGISTRATION: ClinicalTrials.gov NCT03536377 . Registered on 24 May 2018.

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Background: COVID-19 has taken many lives worldwide and due to this, millions of persons are in grief. When the grief process lasts longer than 6 months, the person is in risk of developing Complicated Grief Disorder (CGD). The CGD is related to serious health consequences. To reduce the probability of developing CGD a preventive intervention could be applied. In developing countries like Mexico, the psychological services are scarce, self-applied interventions could provide support to solve this problem and reduce the health impact even after the pandemic has already finished. Aims: To design and implement a self-applied intervention composed of 12 modules focused on the decrease of the risk of developing CGD, and increasing the life quality, and as a secondary objective to reduce the symptomatology of anxiety, depression, and increase of sleep quality. The Intervention Duelo COVID (Grief COVID) follows the principles of User Experience (UX) and is designed according to the needs and desires of a sample of the objective participants, to increase the adherence to the self-applied intervention, considered one of the main weaknesses of online interventions. Methods: A Randomized Controlled Trial will be conducted from the 22nd of December of 2020 to the first of June 2021. The participants will be assigned to an intervention with elements of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Mindfulness and Positive Psychology. The control group will be a wait-list condition, that will receive the intervention 1.5-2 months after the pre-measurement were taken. The Power Size Calculation conducted through G*Power indicated the need for a total of 42 participants, which will be divided by 21 participants in each group. The platform will be delivered through responsive design assuring with this that the intervention will adapt to the screen size of cellphones, tablets, and computers. Ethics and Dissemination: The study counts with the approval of the Research Ethics Committee of the Autonomous University of Ciudad Juárez, México, and it is registered in Clinical Trials (NCT04638842). The article is sent and registered in clinical trials before the recruitment started. The results will be reported in future conferences, scientific publications, and media.

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O mundo encontra-se em uma crise sanitária causada pela pandemia da Covid-19 que requer cuidados em todos os âmbitos: social, econômico, ambiental, político, educacional e de saúde, inclusive saúde mental. Por meio de um relato de experiência, este artigo objetivou evidenciar os alcances e limites do uso da tecnologia na oferta do serviço de Plantão Psicológico on-line da Clínica Psicológica da Universidade Estadual de Londrina. Os alcances desta prática se mostraram importantes para a escuta e o acolhimento do sofrimento psíquico ocasionado pela pandemia, principalmente aos estudantes da universidade que estão lidando com inseguranças e frustrações, tendo seus projetos de vida atravessados pelo novo cenário mundial. Alguns limites do Plantão Psicológico on-line foram elencados, principalmente em relação às intercorrências tecnológicas. Espera-se que esta experiência narrada inspire outros serviços a ofertarem esse tipo de atendimento, ou aprimorarem sua oferta, em tempos pandêmicos, a fim contribuir com a saúde mental da população.(AU)

The world is in a health crisis caused by the Covid-19 pandemic that requires care in all areas: social, economic, environmental, political, educational and health, including mental health. Through an experience report, this article aimed to highlight the scope and limits of the use of technology in offering the online Psychological Emergency Attendance service of the Psychological Clinic of the State University of Londrina. The scope of this practice proved to be important for listening to and welcoming the psychological suffering caused by the pandemic, especially to university students who are dealing with insecurities and frustrations, with their life projects crossed by the new world scenario. Some service limits were listed, mainly in relation to technological complications. It is hoped that this experience will inspire other services to offer this type of care, or improve their offer, in times of pandemic, in order to contribute to the mental health of the population.(AU)

El mundo se encuentra en una crisis de salud provocada por la pandemia de Covid-19 que requiere atención en todos los ámbitos: social, económico, ambiental, político, educativo y sanitario, incluida la salud mental. A través de un relato de experiencia, este artículo tuvo como objetivo resaltar los alcances y límites del uso de la tecnología en la oferta del servicio de Guardia Psicológica en línea de la Clínica Psicológica de la Universidad Estatal de Londrina. El alcance de esta práctica resultó ser importante para escuchar y acoger el sufrimiento psicológico provocado por la pandemia, especialmente a los universitarios que enfrentan inseguridades y frustraciones, con sus proyectos de vida atravesados por el nuevo escenario mundial. Se enumeraron algunos límites de la Guardia Psicológica en línea, principalmente con relación a las complicaciones tecnológicas. Se espera que esta experiencia narrada inspire a otros servicios a ofrecer este tipo de atención, o mejorar su oferta, en tiempos de pandemia, con el fin de contribuir a la salud mental de la población.(AU)

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Abstract Nearly 50% of the college population struggles with academic procrastination, which is an impulsivity problem that often leads to emotional difficulties and college dropout. This study aimed to assess whether an online intervention on clarification of academic goals could reduce impulsivity and academic procrastination in college students. Forty-eight participants were assigned to three different types of interventions: (a) SMART-type goal clarification treatment (setting specific, measurable, agreed upon, realistic and time-based goals); (b) instructional intervention for the abandonment of procrastination (conventional self-help type intervention); and (c) a waiting list. Only SMART intervention produced a statistically signif icant decrease in impulsivity (measured in terms of a hyperbolic discounting test; Whelan & McHugh, 2009), and academic procrastination (measured with the Procrastination Assessment Scale-Student --- PASS), in both cases with small-to-moderate treatment effects. In conclusion, the study showed that online SMART-type goal clarification led to positive changes in impulsive ness and academic procrastination of college students, whereas a self-help protocol failed to produce similar effects. Potential reasons for reduced treatment effects of the SMART interven tion are examined (e.g., experimental control). Also, prospective lines of research are discussed in view of the scarcity of experimental studies in this area.

Resumen Cerca del 50% de la población universitaria experimenta procrastinación académica, un problema asociado con impulsividad, dificultades emocionales y deserción. El estudio evaluó si una intervención en línea en clarificación de metas académicas reduce la impulsividad y la procrastinación académica de estudiantes universitarios. Cuarenta y ocho estudiantes fueron distribuidos en tres tipos de intervención: (a) clarificación de metas tipo SMART (estable cer metas específicas, acordadas en colaboración, medibles, realistas, y basadas en criterios temporales); (b) seguimiento de instrucciones para abandonar la procrastinación (protocolo convencional de tipo autoayuda), y (c) lista de espera. La intervención SMART fue la única que produjo una disminución estadísticamente significativa en impulsividad -medida en términos de descuento hiperbólico (Whelan & McHugh, 2009)- y procrastinación académica -medida a través del Procrastination Assessment Scale-Student (PASS)---- , en ambos casos con efectos de tratamiento de pequeños a moderados. En conclusión, el estudio demostró la efectividad de un protocolo en línea de clarificación de metas tipo SMART para reducir la impulsividad y la procrastinación académica de estudiantes universitarios, efectos que no fueron encontrados con la implementación de un protocolo de tipo autoayuda. Se discuten posibles razones por las cuales los efectos del tratamiento SMART no fueron mayores (e.g., control experimental), y líneas potenciales de investigación a futuro, esto especialmente considerando los escasos estudios experimentales en esta área.

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ANTECEDENTES: Los efectos del estrés dependen de la percepción de los estresores y de las habilidades para afrontar situaciones estresantes. OBJETIVO: Evaluar una intervención interactiva para desarrollar recursos y habilidades para un manejo adecuado del estrés en profesionales de la salud. MÉTODO: Esta intervención se probó utilizando un Cédula diseñada para evaluar componentes de Conocimientos, Habilidades y Actitudes sobre manejo del estrés, conformada por 17 afirmaciones para dimensión de Conocimientos, 11 sobre Habilidades para manejo del estrés; y 20 sobre Actitudes para reaccionar ante el estrés. Participaron 165 profesionales y pasantes de carreras afines. Se hicieron análisis estadísticos para comparar los puntajes de los tres componentes antes y después de la intervención utilizando la prueba t de Student, se aplicó la prueba de McNemar para comparar los resultados. RESULTADOS: Sobre la efectividad de la intervención, en los análisis de comparación de los puntajes, se encontraron diferencias estadísticamente significativas a favor de la intervención en los tres componentes: Conocimientos (t = -9.77, gl = 164, p = .000), Habilidades (t = -10.19, gl = 164, p = .000) y Actitudes (t = -4.80, gl = 164, p = .000).Los análisis por reactivo mostraron incrementos estadísticamente significativos en el número de respuestas correctas después de la intervención en los tres componentes. DISCUSIÓN Y CONCLUSIÓN: Los resultados de esta intervención interactiva fueron estadísticamente significativos en Conocimientos, Habilidades y Actitudes para manejo del estrés. Además de ser una intervención innovadora, breve, basada en la traslación del conocimiento (4 semanas), y disponible en Internet, la evidencia de su efectividad hace que se perfile como una herramienta válida para el manejo adecuado del estrés.

BACKGROUND: The effects of stress depend on the perception of stressors and a person's skills for coping with stressful situations. OBJECTIVE: Evaluate an interactive intervention to develop resources and skills for proper stress management among healthcare professionals. METHOD: This intervention was tested using a chart designed to evaluate the knowledge, skills and attitudes components of stress management, consisting of 17 statements about Knowledge, 11 about Stress management; 20 about Attitudes for reacting to stress. A total of 165 professionals and interns from related careers participated. Statistical analyses were conducted to compare the scores of the three components before and after the intervention using the Student's t test. McNemar's test was used to compare the results. RESULTS: In regard to the effectiveness of the intervention, an analysis of the comparison of scores found statistically significant differences in favor of intervention in the three components: Knowledge (t = -9.77, df = 164, p = .000), Skills (t = -10.19, df = 164, p = .000) and Attitudes (t = -4.80, df = 164, p = .000). The item analysis showed statistically significant increases in the number of correct answers after the intervention in the three components. DISCUSSION AND CONCLUSION: The results of this interactive intervention were statistically significant in Knowledge, Skills and Attitudes for stress management. In addition to being a brief, innovative intervention, based on knowledge translation (4 weeks) and available on the Internet, the evidence of its effectiveness suggests it is a valid tool for proper stress management.