Peru’s recent national mental health (MH) reforms aim to decentralise care and expand access to MH services for rural populations by integrating services into primary healthcare through the expansion of Community Mental Health Centres (CMHCs). Evidence on the implementation of these reforms at the local level remains limited. This qualitative study aimed to (i) describe the structure and implementation framework of MH services, (ii) analyse local understandings of MH; and (iii) examine pathways to care and identify barriers and facilitators to MH service implementation from both the supply (service providers) and demand (users and community members) perspectives. MH services were mapped across three provinces of northern Peru using a review of national MH policies, 2 focus group discussions, and 31 semi-structured interviews. Data were analysed thematically to explore local understandings of MH, pathways to care, and health system barriers. Local understandings of MH are shaped by cultural beliefs, social norms, and economic conditions, with many individuals experiencing distress initially relying on family networks or traditional healers. Stigma and expectations of a quick recovery hinder engagement with formal services. While the expansion of CMHCs has improved geographical access to specialised care in rural areas through proximity and being patient-centred, the implementation of respectful provider interactions remains uneven. Weak referral pathways and limited coordination between primary care centres and CMHCs frequently shift the responsibility for navigating care onto users and their families. Family involvement and culturally sensitive practices foster trust and support continued engagement. Persistent challenges include the limited capacity of service providers, high staff turnover, and the follow-up mechanisms, stigma, and tensions between cultural and biomedical understandings of MH. Peru’s expansion of CMHCs represents a significant health system reform to improve equitable access for rural populations. To sustain these gains, it will be necessary to strengthen workforce stability, clarify referral processes, and integrate culturally responsive approaches within primary care systems, offering lessons for similar resource-constrained contexts.

INTRODUCTION:In 2019, Peru implemented the first phase of a front-of-package warning label (FOPWL) policy requiring packaged foods and beverages exceeding thresholds for total sugars, sodium, saturated fats or containing trans fats to display warning labels. While intended to inform consumers, such policies may also incentivise product reformulation. This study assessed differences in the proportion and nutrient content of regulated ('high in') products in the Peruvian food supply after FOPWL policy implementation. METHODS:Product-level nutritional information was collected from packaged foods and beverages during two periods: pre-implementation (T0: March-June 2019; n=2481) and post implementation (T1: March 2020-February 2021; n=3018). The proportion of products exceeding thresholds for nutrients of concern (sugars, sodium and saturated fats) and shifts in nutrient distributions across quartiles were compared pre-implementation and post implementation of the law in repeated cross-sectional samples and a longitudinal subsample (products collected in both periods, n=1694). Generalized estimating equations and logistic regression assessed differences in the proportion of 'high in' products, while quantile regression evaluated shifts in nutrient distributions. RESULTS:In cross-sectional analyses over T1-T0 period, the proportion of 'high in' products declined by 6 percentage points (61% to 55%) among foods and by 11 percentage points (31% to 19%) among beverages. Relative reductions were observed in products 'high in' sugars (10% among foods; 37% among beverages), sodium (16% among foods) and saturated fats (7% among foods). Reductions varied across product categories and were greatest in those where thresholds were set below the prepolicy 75th percentile of baseline nutrient distributions. Longitudinal results were largely consistent with cross-sectional findings. CONCLUSION:Peru's first FOPWL policy phase was associated with reductions in the proportion of products 'high in' nutrients of concern, suggesting reformulation occurred across diverse product categories. These findings highlight the potential of mandatory FOPWL policies to improve the nutritional quality of the food supply and support efforts to reduce diet-related diseases.

Objectives. To describe the availability and advertising of beverages and foods with front- of-package warning labels in kiosks and cafeterias and in school environments in public and private schools in Metropolitan Lima. Materials and methods. A cross-sectional study was conducted in 45 schools in Metropolitan Lima between March and May 2023. The availability and advertising of beverages and foods were observed in school kiosks during the school day and by street vendors located at school exits. Results. Fifty-seven school kiosks and cafeterias in 45 schools were analyzed. Processed and ultra-processed beverages and foods were observed in 96.5% of them, and at least one beverage or food with a front-of-package warning label (octagon) was observed in 89.5%. Street vendors were found in 41 schools, totaling 148 vendors. In 77.7% of the samples, processed and ultra-processed foods and beverages were observed, and in 48.6%, at least one food or beverage with an octagonal warning label was found. Advertising for processed and ultra-processed foods was observed in 57.9% of school kiosks and cafeterias and in 27.7% of street vendors. Conclusions. This demonstrates the exposure of schoolchildren to unhealthy food environments and the non-compliance with regulations prohibiting the sale of foods with octagonal warning labels both in and around schools. Strengthening information, awareness campaigns, and monitoring within the educational community is necessary to ensure the effectiveness of these policies in protecting the health of schoolchildren.

Introduction. Growing evidence suggests that social capital is protective against common mental disorders, but how this affects adolescents and young adults living in highly deprived contexts outside of the Global North has received less attention. We investigated whether cognitive (i.e. trust, values) and structural (i.e. networks, support) social capital were associated with depression and anxiety in young people growing up in the poorest half of three cities in South America. Methods. In this case-control study, we recruited young people, 15-16 and 20-24 years old, from the most deprived half of Bogotá (Colombia), Lima (Peru) and Buenos Aires (Argentina), who did and did not meet threshold criteria for depression and/or anxiety. Following multiple imputation for missing data, we used multivariable logistic regression to test whether cognitive and structural social capital were associated with case-control status, and we examined whether these were modified by socioeconomic status (SES). Results. Amongst 2,402 young people (59.8% cases, 65.0% female), those with depression and/or anxiety were about half as likely to report living in areas with high cognitive social capital compared with controls (OR: 0.51; 95% CI: 0.39, 0.66), with a trend in this direction for high versus low structural social capital (OR: 0.78; 95% CI: 0.59-1.03; p=.079). We did not observe effect modification by SES. Conclusion. Higher cognitive social capital was associated with reduced odds of depression and/or anxiety amongst youth in economically deprived, urban contexts in South America. This may offer an important community-based resource to promote youth mental health.

Objectives:To describe the supply and advertising of food and beverages with front-of-package warning labeling in kiosks and cafeterias, and in school environments of public and private schools in Metropolitan Lima. Materials and methods:A cross-sectional study was conducted in 45 schools in Metropolitan Lima between March and May 2023. The supply and advertising of food and beverages were observed in school kiosks during the school day and among street vendors located at the school exit gates. Results:A total of 57 school kiosks and cafeterias from 45 schools were analyzed. Processed and ultra-processed foods and beverages were observed in 96.5% of them, and at least one product with front-of-package warning labeling (octagon) was identified in 89.5%. Street vendors were found at 41 schools, totaling 148 vendors. Processed and ultra-processed food and beverages were observed in 77.7% of them, and at least one food or beverage with an octagon was observed in 48.6%. Advertising for processed and ultra-processed foods was observed in 57.9% of school kiosks and cafeterias and in 27.7% of street vendors. Conclusions:Evidence shows the exposure of schoolchildren to unhealthy food environments and non-compliance with regulations prohibi-ting the sale of foods with octagons both inside and around schools. It is necessary to reinforce information, awareness, and monitoring of the educational community to ensure the effectiveness of these policies in protecting the health of schoolchildren.

Objective To explore how experiences of sexual harassment influence the progression of depressive symptoms over one year in young people, and whether resilience moderates this association. Method Participants were young people aged 15–16 and 20–24 from deprived neighbourhoods in Buenos Aires, Bogotá, and Lima. Sexual harassment was assessed at baseline (yes/no), capturing experiences within the past year and more than a year ago. Depressive symptoms (PHQ-8) were measured at baseline and one-year follow-up. Multilevel mixed-effects linear regression tested associations between harassment and symptom change. Resilience (CD-RISC-10), measured at baseline, was explored as a potential effect modifier. Results Among 1260 participants, those reporting sexual harassment showed higher depressive symptoms over time (β=1.02; p<.001). Resilience moderated this association (χ2=316.13; p<.001). Predicted margins indicated that participants with high resilience showed a greater reduction in depression symptom scores (−3.35 points without harassment; −2.79 points with harassment) compared with those with low resilience (−2.48 and 2.65, respectively). However, mean scores in all groups remained above the clinical threshold. Conclusion Resilience alone cannot protect young people from the emotional impact of sexual harassment. Addressing this issue requires institutional commitment and structural policy reforms.

Introducción: El consumo de productos ultraprocesados ha aumentado en América Latina y su promoción en redes sociales representa un desafío para la salud pública. En Perú, la Ley N.º 30021 establece el uso de advertencias nutricionales en productos que superan ciertos parámetros, incluyendo su difusión en medios digitales. Sin embargo, el cumplimiento de estas disposiciones en publicaciones de influencers no ha sido evaluado. El objetivo del estudio fue describir el contenido de publicaciones en Instagram relacionadas con productos ultraprocesados de los 50 influencers más populares en Perú y evaluar el cumplimiento de la normativa vigente. Metodología: Estudio descriptivo de corte transversal. Se seleccionaron los 50 macroinfluencers con mayor número de seguidores en Perú mediante la base de datos en línea Influencity. Se analizaron todas las publicaciones realizadas durante 12 meses en Instagram. Las variables del análisis de contenido incluyeron tipo de formato (post/foto, carrusel, video corto y video largo), presencia de alimentos o bebidas, clasificación según NOVA (preparaciones y productos ultraprocesados), presencia visible de octógonos en el envase y ubicación de la advertencia en la esquina superior derecha conforme a la Guía del Instituto Nacional de Defensa de la Competencia y de la Protección de la Propiedad Intelectual (INDECOPI). Resultados: De 5547 publicaciones analizadas, 1232 incluyeron alimentos o bebidas; de estas, 19,2% correspondieron a productos ultraprocesados. Entre las publicaciones con ultraprocesados, 22,4% mostraban octógonos visibles y, de estas 15,1% los ubicaban conforme a la recomendación normativa. En términos acumulados, solo 3,4% cumplía completamente con la normativa. Conclusión: Se evidencia una presencia relevante de productos ultraprocesados en publicaciones de influencers y un bajo nivel de cumplimiento de las disposiciones sobre advertencias nutricionales en entornos digitales, lo que subraya la necesidad de fortalecer los mecanismos de supervisión y adaptación regulatoria frente al marketing digital de alimentos. Financiación: Bloomberg Philanthropies (46129 y 2019-71181).

INTRODUCTION:We explored how people with dementia (PwD) and their carers navigate Peru's health system for diagnosis and treatment. METHODS:We interviewed PwD (n = 4), carers (n = 18), and healthcare workers (n = 17) from four sites. We developed a patient journey map using thematic analysis and participant validation. RESULTS:Three journey stages emerged. Pre-diagnosis: Families seek care across different sub-health systems and facilities 2-4 years after symptom onset. DIAGNOSIS:Specialist consultation is sought in major cities and diagnosis occurs in hospitals based on clinical presentation. Continuity of care: Care focuses on controlling behavioral and psychological symptoms, with limited access to dementia-specific drugs and non-pharmacological interventions, and heavy reliance on carers' resources. Community mental health centers (CMHCs) are preferred facilities due to geographical and specialist accessibility and perceived care quality. DISCUSSION:Without a formal entry point to dementia care, families navigate fragmented pathways, whereas CMHCs emerge as facilities with adequate care procedures for PwD.

Improving youth mental health is a major societal challenge. In low-income urban areas in South America, this cohort study explored rates and predictors of recovery among young people with depression and/or anxiety symptoms over two years. Adolescents (15–16 years old) and young adults (20–24 years old) with depression and/or anxiety symptoms (≥ 10 on Patient Health Questionnaire-8 and/or Generalised Anxiety Disorder-7) from low-income areas in Bogotá, Buenos Aires and Lima, were recruited from community organisations and educational institutions between April 2021 and November 2022 and reassessed after 6, 12 and 24 months. Sociodemographic characteristics, substance use, stressful life events, resilience, coping strategies, social capital, perceived social support, sports and arts activities, and social media engagement were explored as predictors of recovery. We recruited 1437 young people. Overall recovery rates were 30.3

This study aims to identify, describe and analyze the policies enacted by the Peruvian health authorities to address the population mental health needs and adequate health services in the context of the COVID-19 pandemic. We conducted an scoping review of mental health-related policies published between 6 March 2020 (first case of COVID-19 in Peru) and 31 May 2023. The official websites of the Peruvian Government, the Social Security Health System (EsSalud), and the LILACS scientific database were used. Data was analyzed using content and thematic analysis. Eighty-two documents were included. Policies contents were divided into three main categories. First, the governance of mental health care, which portrays the principles guiding policies and those seeking to strengthen mental health services by increasing the allocation of budget, use technology to provide remote care, enhance infrastructure, equipment and materials, hiring and training staff, and assure biosafety measures. Second, service delivery of mental health care, including policies aimed to detect and provide specialized mental health care to different groups of the population. Third, some policies focused on community engagement, promotion, and prevention in mental health, such as reducing misinformation, promoting self-care, community participation, and working with local organizations. We found that Peru included most of the international recommendations, but some important weaknesses were found, such as the lack of indicators to assess their completion or procedures on how to adapt these policies to routine practices. Peru designed several policies to attend to the mental health of its population during the COVID-19 pandemic, specifically on the principles for the provision of mental health care, the strengthening of these services, detection of mental disorders, provision of mental health care, and care at the community level. This study will inform other countries on their design of mental health policies, especially those with a community model-of-care.

Introduction: Ultra-processed food consumption has increased in Latin America, and its promotion on social media represents a growing public health concern. In Peru, Law No. 30021 mandates the use of front-of-package warning labels for products exceeding established nutritional thresholds, including in digital media. However, compliance with these provisions in influencer-generated content has not been evaluated. This study aimed to describe Instagram posts related to ultra-processed products published by the 50 most popular influencers in Peru and to assess compliance with current regulations. Methods: A cross-sectional descriptive study was conducted. The 50 macroinfluencers with the highest number of followers in Peru were selected using the Influencity database. All Instagram posts published over 12 months were analyzed. Content analysis variables included post format (single image, carousel, short video, long video), presence of food or beverages, classification according to NOVA (culinary preparations and ultra-processed products), visibility of warning labels on product packaging, and placement of the warning label in the upper-right corner of the post in accordance with the INDECOPI guidelines. Results: Of 5,547 posts analyzed, 1,232 included food or beverages; 19.2% of these featured ultra-processed products. Among posts displaying ultra-processed products, 22.4% showed visible warning labels on the packaging, and of those, 15.1% placed the label according to the recommended guideline. Overall, only 3.4% of posts featuring ultra-processed products fully complied with the regulation. Conclusion: Ultra-processed products are present in influencer-generated content on Instagram, with limited adherence to digital warning label requirements. These findings highlight the need to strengthen monitoring mechanisms and regulatory adaptation in the context of digital food marketing.

Objetivo: Describir las experiencias y las valoraciones por parte de los trabajadores de los Centros de Salud Mental Comunitaria (CSMC) del Perú respecto a la capacitación y el acompañamiento recibidos para el uso del módulo de salud mental del Sistema de Información de Historia Clínica Electrónica (SIHCE). Materiales y métodos: Estudio descriptivo transversal aplicado durante la implementación del SIHCE en los CSMC. Los participantes fueron facilitadores y trabajadores de 55 CSMC priorizados a nivel nacional. Se capacitó presencial y virtualmente a facilitadores que replicaron posteriormente el conocimiento adquirido a los trabajadores de sus respectivos centros. Las variables de interés, recogidas en encuestas y analizadas descriptivamente, incluyeron valoraciones de los procesos de capacitación y asistencia. Resultados: Se analizó la información recogida de 96 facilitadores (clínicos y no clínicos) y de 53 trabajadores de los CSMC. La mayoría de los facilitadores calificó las capacitaciones virtuales y presenciales como regulares e insuficientes, y valoraron la fase de acompañamiento o asistencia como buena (54,2 % de los clínicos) o regular (52,2 % de los no clínicos). El 83,3 % de los facilitadores clínicos y el 73,9 % de los no clínicos consideraron que el entrenamiento fue necesario, aunque insuficiente (58,3% y 65,2%, respectivamente) para un uso eficiente del SIHCE. Con respecto al apoyo brindado a los trabajadores de sus centros, fue mejor valorado por los clínicos (62,5 %), mientras que menos de la mitad de ambos grupos (37,5 % de los clínicos y 43,5 % de los no clínicos) consideró que la capacitación fue suficiente para la mayoría de los trabajadores. Conclusiones: Los resultados indican que la capacitación y la asistencia docente para el uso del SIHCE en CSMC del Perú necesitan mejoras para asegurar la escalabilidad de los centros a nivel nacional.

Objectives. To describe the availability and advertising of beverages and foods with front-of-package warning labels in kiosks and cafeterias and in school environments in public and private schools in Metropolitan Lima. Materials and methods. A cross-sectional study was conducted in 45 schools in Metropolitan Lima between March and May 2023. The availability and advertising of beverages and foods were observed in school kiosks during the school day and by street vendors located at school exits. Results. Fifty-seven school kiosks and cafeterias in 45 schools were analyzed. Processed and ultra-processed beverages and foods were observed in 96.5% of them, and at least one beverage or food with a front-of-package warning label (octagon) was observed in 89.5%. Street vendors were found in 41 schools, totaling 148 vendors. In 77.7% of the samples, processed and ultra-processed foods and beverages were observed, and in 48.6%, at least one food or beverage with an octagonal warning label was found. Advertising for processed and ultra-processed foods was observed in 57.9% of school kiosks and cafeterias and in 27.7% of street vendors. Conclusions. This demonstrates the exposure of schoolchildren to unhealthy food environments and the non-compliance with regulations prohibiting the sale of foods with octagonal warning labels both in and around schools. Strengthening information, awareness campaigns, and monitoring within the educational community is necessary to ensure the effectiveness of these policies in protecting the health of schoolchildren.

PURPOSE:While the protective role of neighborhood social cohesion against mental disorders is well-documented in high-income countries, evidence from resource-constrained settings remains scarce. This study evaluated the cross-sectional and longitudinal associations between neighborhood social cohesion and depressive symptoms in a Peruvian cohort. METHODS:Data from the CRONICAS Cohort Study were analyzed. The primary outcomes were the prevalence and incidence of depressive symptoms, assessed via the Center for Epidemiologic Studies Depression Scale (CES-D). Neighborhood social cohesion, conceptualized through trust, reciprocity, and solidarity, was measured using a 4-item scale and categorized into tertiles. Single variable and multivariable-adjusted Poisson regression models were used to estimate incidence rate ratios (IRR) and 95% confidence intervals (95% CI). RESULTS:Among 3533 participants (mean age 55.8 ± 12.7 years; 51.5% female), baseline prevalence of depressive symptoms was 18.6% (95%CI: 17.3%-19.9%). Middle and high levels of social cohesion were associated with a 27% (95% CI: 13%-38%) and 47% (95% CI: 19%-66%) lower prevalence of symptoms at baseline. We identified 221 incident cases (4.0 cases per 100 person-years, 95% CI: 3.5-4.6). High social cohesion was associated with an adjusted 46% (95% CI: 9%-68%) reduction in the risk of developing depressive symptoms over 30 months. DISCUSSION:Higher neighborhood social cohesion was significantly associated with a reduced prevalence and a lower incidence of developing depressive symptoms. These findings suggest that interventions aimed at fostering community trust and social capital may represent a viable strategy for mental health prevention in resource-constrained environments.

Objectives This study aims to explore the association between reported financial hardship and the presence of comorbid depression and anxiety symptomatology and to identify whether resilience modifies this relationship. Methods This is a case–control study with 1705 adolescents and young adults from deprived urban areas in Bogota (Colombia), Buenos Aires (Argentina), and Lima (Peru). Cases of comorbid depression and anxiety symptomatology were defined when the score of PHQ-8 and GAD-7 was higher than 9. The self-report questionnaire asked whether their family had experienced financial hardship and if it was more than a year ago, in the last year, or both periods. The association of financial hardship with comorbid depression and anxiety symptomatology was explored using logistic regressions. We assessed the possible effect modification of resilience (CD-RISC-10). Results Financial hardship was associated with comorbid depression and anxiety symptomatology, with the highest odds ratios for hardship reported in the last year and for hardship reported both more than a year ago and in the last year. High resilience was associated with a lower chance of comorbid depression and anxiety symptomatology, especially among participants who reported financial hardship more than a year ago. Conclusions This study reinforces the need for financial support programmes and community-based interventions targeting economically vulnerable youth to prevent adverse mental health outcomes.

Objective Assess the association between experiencing parental alcohol misuse with depression, anxiety and frequency of alcohol use among young people, and evaluate participants’ coping strategies as effect modifiers. Methods Participants were adolescents and young adults from deprived Bogotá, Buenos Aires, and Lima areas. We evaluated the relationship between experiencing parental alcohol misuse and presence of depression (PHQ-8), anxiety (GAD-7), and frequency of alcohol use (ASSIST), and examined the modifying effect of coping (CCSC-R1). Results Young people who experienced parental alcohol misuse in the last year had 2.41 and 2.30 times higher odds of having depression and anxiety, respectively, and 1.91 and 2.49 times higher odds of drinking monthly and weekly, compared to those who did not. Those who experienced it more than a year ago had 1.60 and 1.58 times higher odds of having depression and anxiety, respectively, compared to participants who did not. Coping strategies were not significant effect modifiers. Conclusions Parental alcohol misuse is associated with emotional distress and frequency of alcohol use in young people. Family-based interventions should address youth drinking and promote positive parenting practices.

From the outset of the pandemic there were calls to ensure people with disabilities were included in prevention and response measures, given their increased risk of health consequences from COVID-19 infection. This study sought to explore people with disabilities’ experiences of inclusion in the response to the COVID-19 pandemic, to understand how such responses can be more inclusive in the future. Qualitative interviews were conducted with 372 people with disabilities and their caregivers in Bangladesh, Ghana, India, Peru, Thailand, Türkiye (with Syrian refugees), Viet Nam, and Zimbabwe between 1 December 2020 and 28 February 2023, and analysed using thematic analysis. The study found that people with disabilities demonstrated high levels of knowledge about COVID-19 and were willing to adhere to prevention measures. However, participants noted that countries’ COVID-19 responses were largely not inclusive of people with disabilities; that pandemic information was seldom available in accessible formats; and that adhering to social distancing and other mandates was challenging and incurred personal and economic costs. Consequently, the pandemic compounded existing barriers and inaccessibility experienced by people with disabilities and contributed to inequality.

Introduction Mental disorders, including depression and anxiety, present a substantial burden for adolescents and young adults in Latin America, where socio-economic challenges hinder recovery. Perceived social support (PSS) is a potential protective factor, yet its role in the recovery of common mental disorders in this population is underexplored. Methods A prospective cohort study (2021–2024) followed adolescents (15–16 years) and young adults (20–24 years) in disadvantaged neighborhoods of Bogotá, Buenos Aires, and Lima. Depression and anxiety symptoms (PHQ-8, GAD-7) and PSS (Multidimensional Scale of Perceived Social Support) were assessed at baseline, 12, and 24 months. A longitudinal multivariable model using Generalized Estimating Equations (GEE) examined associations between PSS and recovery, adjusting for sociodemographic and psychosocial factors. Results Among 1437 participants, 70.5% completed the 24-month follow-up. Higher PSS was associated with greater recovery. Recovery for depressive and anxiety symptoms was statistically significantly higher among participants reporting medium (adjusted Odds Ratio (aOR): 2.77; 95% CI: 1.70–4.51) and high (aOR: 5.05; 95% CI: 3.03–8.43) levels of total PSS compared with those with low PSS. Support from family and friends were both statistically significantly associated with recovery. After adjustment, the odds of recovery were elevated for people with medium (aOR: 2.58; 95% CI: 1.71–3.89) and high (aOR: 3.13; 95% CI: 2.06–4.74) levels of support from friends. Interaction analyses revealed that age, resilience and employment modified these associations; with stronger effects in younger participants (15–16 vs. 20–24 years), those employed, and those with high levels of resilience (≥28). Conclusion Social support, especially from family and friends, enhances recovery from depression and anxiety, with resilience, employment and age modulating these effects. Strengthening support networks and resilience-building interventions may improve mental health outcomes in vulnerable youth.

Antecedentes La mejora de la salud mental en jóvenes de zonas desfavorecidas es crucial para la salud pública, dada la prevalencia de ansiedad y depresión en estos contextos. Objetivo Este estudio investigó la relación entre estrategias de afrontamiento y los niveles de ansiedad y depresión en jóvenes de barrios urbanos de bajos recursos en Bogotá, Buenos Aires y Lima. Metodología Se incluyeron 2.395 adolescentes y jóvenes de 15-16 años y 20-24 años, respectivamente. Se evaluaron estrategias como el afrontamiento centrado en el problema, la reestructuración cognitiva, la búsqueda de apoyo social, la distracción y la evitación mediante cuestionarios estandarizados. Resultados Las estrategias centradas en el problema, la reestructuración cognitiva y la búsqueda de apoyo social mostraron asociaciones negativas y moderadas con la ansiedad y la depresión, al igual que la evitación y la distracción, aunque de manera más débil. Estos hallazgos fueron consistentes entre diferentes grupos de edad y género. Conclusiones Los resultados evidencian la importancia de promover estrategias de afrontamiento activas y sociales para mitigar la ansiedad y depresión en jóvenes de entornos desfavorecidos. Se recomienda implementar intervenciones dirigidas a fortalecer estas habilidades como parte de programas de salud mental comunitarios..