Examining the barriers encountered by irregular immigrants in accessing the public health system is crucial for the continuity of healthcare processes. This approach not only heightens patient-centered care but also fosters long-term public health preparedness and social cohesion. The aim of this review was to examine the existing barriers to accessing the Spanish healthcare system for the immigrant population. A systematic review of original articles was conducted based on the PRISMA methodology. Studies registered in PubMed, Scopus, CINAHL, LILACS, Web of Science, and Enfispo were analyzed. A total of 4773 articles were identified, of which 15 were selected for review. Among the selected articles, 10 employed qualitative methodologies, 1 utilized a mixed methodology, and 4 used quantitative methodologies. A variety of access barriers related to communication, administrative issues, and misinformation about legal aspects were identified. It was noted that one in five immigrants has experienced at least one barrier to accessing the Spanish healthcare system. Barriers to access to the health system are clearly shared by both immigrants and healthcare professionals. Barriers to access to the health system are a result of the coalition of organizational factors, cultural experiences, and socioeconomic and educational determinants. Access to healthcare for irregular migrants in Spain is hindered by language barriers, misinformation, and administrative obstacles, exacerbated by the COVID-19 pandemic. Policies are needed to ensure equitable care, enhance communication, streamline procedures, and strengthen collaboration with non-governmental organizations and cultural mediators to optimize healthcare responses.

The presence of playful elements in learning environments is increasingly frequent in university settings. The objective of this study was to evaluate the gaming experience of the participants of an escape room activity developed in the second year of the Bachelor of Science in Nursing program. An escape room activity was carried out, based on 10 tasks, on the thematic content of the subject ‘History, Theory and Methods of Nursing II’, with students in the second year. After the game experience, the Gameful Experience Scale (GAMEX) questionnaire of 27 items in the validated version in Spanish and for nursing students was applied. An open-ended question was also included to allow the students to give their opinion on aspects of improvement, or their feelings during their performance, and a thematic analysis was utilized for this qualitative approach. A total of 107 students participated in the escape room activity, and 75 individuals acceded to the request to be surveyed. The results in the Enjoyment dimension showed that five of the six questions were assessed with the maximum score by the majority of respondents. In the Absorption dimension, between 15% and 25% of the sample did not manage to abstract themselves from the real world. In the dimensions of Creative Thinking and Activation, up to 70% managed to feel imaginative, creative, or exploratory, feeling active and excited. Nearly 85% of the sample reported the Absence of Negative Affect (hostility, annoyance, or frustration) during the game. In the Dominance dimension, up to 70% of the sample considered feeling influential during the game. Two categories were identified after analyzing the participants’ responses: room for improvement in the activity and feelings during the activity. In conclusion, the escape room is positioned as a useful tool for university teaching in nursing. This didactic game allows students to have fun while learning, and to value the knowledge and techniques provided by the subject while being able to work as a team.

The purpose of this paper is to describe the protocol for the design, implementation, and evaluation of an animation- versus text-based computer tailoring game intervention aimed at preventing alcohol consumption and binge drinking (BD) in adolescents. A cluster-randomized controlled trial (CRCT) is carried out in students aged 14–19 enrolled in 24 high schools from Andalusia (Spain), which are randomized either to experimental (EC-1, EC-2) or waiting-list control conditions (CC). EC-1 receives an online intervention (Alerta Alcohol) with personalized health advice, using textual feedback and several gamification techniques. EC-2 receives an improved version (Alerta Alcohol 2.0) using animated videos and new gamification strategies. Both programs consist of nine sessions (seven taking place at high school and two at home): session 1 or baseline, sessions 2 and 3 that provide tailored advice based on the I-Change Model; sessions 4, 5, 7, and 8 are booster sessions, and sessions 6 and 9 are follow-up questionnaires at six and twelve months. The CC completes the baseline and the evaluation questionnaires. The primary outcome is BD within 30 days before post-test evaluations, and as secondary outcomes we assess other patterns of alcohol use. The findings should help the development of future alcohol drinking prevention interventions in adolescents.

The aim of this study was to explore the perceptions and satisfaction of last-year nursing students with the Self-Learning Methodology in Simulated Environments (MAES©). As a learning method, clinical simulation uses elements that replicate real clinical practice scenarios and facilitates the acquisition of competencies and learning objectives. Simulations promote critical thinking, knowledge, techniques and teamwork in nursing students. The Self-Learning Methodology in Simulated Environments (MAES©) is a method that integrates problem-based learning with realistic clinical simulation. A cross-sectional mixed-method study implemented a simulation learning method as part of the mandatory nursing training practice; that was registered in Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/R89PZ). Students were invited to complete a cross-sectional questionnaire about satisfaction with the simulation and were asked to participate in an interview about their perceptions on the simulation. All data were collected in December 2023 in a mid-sized southern Spanish university. A total of 69 last-year nursing students were enrolled in the simulation course and were selected using eligibility criteria. Satisfaction measures showed no significant differences across gender, university access, or age (p>0.05 each). However, strong correlations were found between students' preference for the simulation method and perceived effort value (p<0.001 each). Qualitative analysis identified key themes in different stages of simulation (prebriefing, scenario, briefing, debriefing), simulation benefits (learning, usefulness, positive emotions) and challenges (difficulty, realism, time constraints). Despite some realism concerns, overall, students viewed the methodology positively. The findings of this study underscore the vital role of simulation-based learning in nursing education. As the field of nursing continues to evolve, so too must the educational methods we employ, with simulation-based learning standing at the forefront of this transformative journey.

Objectives: This study aimed to enhance the understanding of factors influencing changes in binge drinking (BD) behavior during the COVID-19 pandemic, with a particular focus on its impact on the health of individuals aged 12 to 25 years. Methods: A systematic review was conducted, encompassing studies published between January 2020 and September 2024. Articles were retrieved from PubMed, Web of Science, and Scopus, following PRISMA guidelines and the Joanna Briggs Institute (JBI) review protocols. Inclusion criteria targeted studies focusing on BD during the COVID-19 pandemic in adolescents or school-aged individuals without specific medical conditions. Exclusions included studies limited to a single gender, ethnicity, or profession, as well as doctoral theses and editorials. JBI tools were used to assess the quality of the selected studies. Results: From 33 studies (19 cross-sectional and 14 longitudinal), trends in BD during the pandemic varied: 2 studies reported an increase, while 21 indicated a decrease. Key factors linked to increased BD included pandemic stressors (e.g., isolation, social disconnection and non-compliance with restrictions), psychosocial issues (e.g., depression, anxiety, boredom, and low resilience), prior substance use, and sociodemographic variables (e.g., low education, economic extremes, living arrangements, and limited family support). Female gender and academic disengagement were also risk factors. Conversely, factors like stay-at-home orders, fear of contagion, family support, studying health sciences, and resilient coping strategies contributed to reduced BD. Other variables, such as pandemic stress and self-efficacy, had inconsistent effects. Conclusions: Factors contributing to increased BD included pandemic-related stress, mental health conditions, and unhealthy habits, while protective factors included stay-at-home orders, social support, and resilient coping. The study highlights the need for effective prevention and intervention strategies, emphasizing a holistic approach in healthcare, early detection, and tailored interventions, particularly for vulnerable groups such as adolescents.

School-based health interventions can help prevent adolescent substance use, but their success depends on various factors affecting planning and evaluation. This study examines the factors that facilitate or hinder the success of school-based digital health interventions. A systematic review was conducted in September–October 2024, following PRISMA guidelines, using PubMed, Scopus, Web of Science, CINAHL, and PsycINFO databases. From a total of 2530 studies, after removing duplicates and screening titles and abstracts, 51 full-text articles were assessed and 12 met the inclusion criteria. Data were extracted using an adapted tool for systematic reviews applying the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The methodological quality was assessed with Joanna Briggs Institute tools. The studies included cluster-randomized controlled trials, quasi-experimental designs, and one cross-sectional study, primarily targeting adolescents aged 11.9–17.4 years, with sample sizes ranging from 90 to nearly 5000 participants. Most interventions were implemented in schools in the USA, Europe, and Taiwan, with balanced gender distribution. Many studies reported on reach and effectiveness in reducing substance use, particularly alcohol. However, adoption and implementation factors influencing school participation were less frequently addressed, and maintenance was not mentioned. To maximize impact, future efforts should focus on enhancing sustainment and participation by leveraging emerging technologies for personalization.