Substance use disorder is one of the most stigmatized health conditions. Stigma internalization is one of the main consequences of the stigmatization process, and it is associated with lower self-esteem and self-efficacy and worse recovery prospects. It may also bring guilt, hopelessness, anxiety, self-devaluation, and depression. This study investigated self-stigma among substance dependents who sought treatment, testing the construction of a psychosocial model for understanding this phenomenon. Individual interviews were conducted at the Psychosocial Care Center for Alcohol and Drugs at Juiz de Fora, Brazil. Data were subjected to exploratory statistical analysis, using descriptive and standard deviation. Three explanatory models of self-stigma were tested: the sociodemographic model, including variables such as gender, religious practice, education, marital status, employment status, and involvement in illicit activities; the psychological model, with variables related to symptoms of depression, self-esteem, and hope; and the psychosocial model, which included all sociodemographic and psychological variables. The sample was composed by 461 individuals. The results supported the hypothesis that the psychosocial model would have greater explanatory power of self-stigma among substance dependents. An association between self-stigma and the sociodemographic variables and the type of substance used was confirmed. Depressive symptoms contributed to higher scores on self-stigma. Stigma may be a barrier to access to health care, treatment, social research, social inclusion, and recovery opportunities. Interventions and treatment models that are able to reduce self-stigma would have the potential to contribute toward a reduction in the negative impacts associated with substance use disorder.

Acervo disponível em www.scielo.br/epsic Curso de prevenção ao uso de drogas: Descrição e avaliação de satisfação

A Patient-Reported Outcome (PRO) measure titled Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral (acronym CEAT-VIH) is currently available in paper-and-pencil and digital (online assessment) formats. Due to the advantages of online assessment, the main objective of this work was to evaluate psychometric properties of the online version, in an international sample, to accumulate evidence of its validity and provide score norms for the questionnaire. A psychometric study was performed with an international sample of 1,470 participants, from 30 countries, to accumulate evidence of CEAT-VIH validity regarding internal structure and related external criterion (e.g., viral load, number of pills, and AIDSrelated symptoms). Descriptive statistics and normative data for scores are also presented. The majority of participants were men (72.4%), aged 15 to 78 years old (M = 39.3, SD = 12.6). A unidimensional model with five facets occurred as the observed variables converged, which presented a good model fit (comparative fit index [CFI] = 1.000; Tucker-Lewis index [TLI] = 0.999; standardized root mean square residual [SRMR] = 0.027; and root mean square error of approximation [RMSEA] [90% confidence interval, CI] = 0.009 [0.000, 0.038], p = .995). There was a weak invariance for the CEAT-VIH structure for language versions and countries. Cronbach's alpha values for the instrument (17 items) were acceptable across language versions (.88-.96). Evidence of validity related to external criteria was achieved by associations (e.g., Spearman and Mann-Whitney) between CEAT-VIH scores and relevant clinical (e.g., CD4+ cells, viral load, number of pills, and AIDSrelated symptoms) and sociodemographic (e.g., gender, age, employment status, education level, place of residence, and participation at local AIDS association) variables. In conclusion, the overall data on the evaluated psychometric properties allow recommendation of the use of this instrument in research and applied settings.

O estudo visa analisar os conteúdos divulgados pelas principais revistas de circulação na mídia digital brasileira acerca do consumo de crack. Pesquisa documental, exploratório-descritiva, com abordagem qualitativa das três revistas semanais com maior circulação no país. O acesso foi através dos sites das revistas, as palavras-chave: "crack", "óxi" e "merla" foram utilizadas e apenas a categoria de notícias foi incluída. As 661 notícias encontradas foram analisadas em relação a duplicação, quando "crack" não foi utilizado como droga e quando não era o tema central na notícia. Restando assim, 559 notícias. A análise de conteúdo temática identificou os principais temas presentes. A maior parte das notícias é permeada pela criminalização e moralização dos usuários de crack, relacionando-se principalmente ao tratamento, bem como o tráfico, com reportagens de ações policiais e ao enfrentamento do fenômeno, através de iniciativas de combate. Compreende-se a mídia enquanto formadora de opinião, mas também como produto sócio-histórico que reflete posições e visões de mundo. Observa-se a necessidade de modificação da abordagem ao fenômeno do crack pelos meios de comunicação analisados, na tentativa de estimular um debate ampliado e realista sobre a temática, em detrimento dos correntes discursos maniqueístas, estigmatizantes e de sobreposição de racionalidades.

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Background: Interpersonal and technical skills are required for the care of people living with substance use disorders. Considering the applicability and usability of online courses as continuing professional education initiatives, this study aimed to describe the content design process of an introductory-level healthcare-centered Massive Open Online Course (MOOC). Methods: The content of the course was informed through needs assessment, by using three sources: (a) narrative literature review, (b) Delphi health experts panel consensus, and (c) focus groups conducted with people living with substance use disorders. The data from the empirical research phases were analyzed through qualitative Thematic Analysis. Results: The product of this research project is the introductory-level Massive Open Online Course "Healthcare: Developing Relational Skills for the Assistance of People Living with Substance Use Disorders" which approaches health communication and empathetic relational professional skills as a means of reducing stigmatization of people living with substance use disorders. Conclusions: Diverse strategies for designing distance education initiatives have to consider different views on the subject being approached in such courses. The product presented in this paper has the potential to be an educational tool for topics traditionally not addressed in Brazilian continuing education and can be used as a model to the design of online courses directed to the development of work-related skills for the healthcare professions.

In the Brazilian context, the Prevention Course to Drug Use for Public School Educators is developed. This study seeks to identify factors cited by the educators as favorable or unfavorable to the implementation of prevention projects. Data collection was carried out in three stages: in the first stage (T0), a sample consisted of 1494 course participants, in the second stage (T1), 2153 teachers participated and in the third stage (T2), 1017 educators answered the questions. Text mining techniques and content analyses were used. The results were categories proposed for the axes barriers and favorable aspects: training of school team, students and school community relationship and participation of the community and perceived dysfunctional family aspects, violence and drug trafficking, personal characteristics of adolescents and the school environment, respectively. The identification of these aspects is relevant to the development of prevention programs, allowing barriers to be anticipated and solutions to be proposed.

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