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1.
BMJ Open ; 14(3): e078545, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38479737

RESUMO

INTRODUCTION: A trauma-informed approach (TIA) means working with awareness that people's histories of trauma may shape the way they engage with services, organisations or institutions. Young people with adverse childhood experiences may be at risk of retraumatisation by organisational practices in schools and universities and by employers and health agencies when they seek support. There are limited evidence-based resources to help people working in the public sector to work with adolescents in trauma-informed ways and the needs of adolescents have not been central in resource development. This study contributes to public sector capacity to work in trauma-informed ways with adolescents by codesigning and evaluating the implementation of a youth-informed organisational resource. METHODS AND ANALYSIS: This is an Accelerated Experience-based Co-design (AEBCD) Study followed by pre-post evaluation. Public sector organisations or services, and adolescents connected with them, will collaboratively reflect on lived experience data assembled through creative arts practice, alongside data from epidemiological national data sets. These will present knowledge about the impact of adverse childhood experiences on adolescents' mental health (stage 1). Collaboratively, priorities (touch points) for organisational responses will be identified (stage 2), and a low-burden resource will be codesigned (stage 3) and offered for implementation (stage 4) and evaluation (stage 5) in diverse settings. The study will provide insights into what adolescents and public sector organisations in the UK want from a TIA resource, the experience of services/organisations in implementing this and recommendations for resource development and implementation. ETHICS AND DISSEMINATION: The UK National Health Service Health Research Authority approved this study (23/WM/0105). Learning will be shared across study participants in a workshop at the end of the study. Knowledge products will include a website detailing the created resource and a youth-created film documenting the study process, the elements of the codesigned resource and experiences of implementation. Dissemination will target academic, healthcare, education, social care, third sector and local government settings via knowledge exchange events, social media, accessible briefings, conference presentations and publications.


Assuntos
Setor Público , Medicina Estatal , Humanos , Adolescente , Atenção à Saúde , Saúde Mental , Reino Unido
2.
J Adolesc ; 96(2): 337-349, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38013246

RESUMO

INTRODUCTION: The INSCHOOL project aimed to understand the school experiences and unmet needs of young people across a diversity of long-term physical health conditions. METHODS: Young people aged 11-18 years, in mainstream secondary school in the United Kingdom, with one of 11 physical health conditions were invited to unique participant-driven interviews, focus groups, or written activities. Creative preparation activities were provided to give participants increased control over the data collection and prioritize their voices. A needs analysis, in combination with participatory analysis sessions with young people, identified the common needs of participants in relation to their school lives. RESULTS: Eighty-nine young people participated from April 2022 to 2023. Analysis of their transcripts defined six common needs across all the health conditions: Need to safely manage my health at school; need for a flexible education pathway; need to be acknowledged and listened to in the right way; need to be included in and supported by the school community; need to build toward my future; need to develop attitudes and approaches to help me cope in school. CONCLUSIONS: This study has generated new, actionable knowledge by identifying six major needs that young people have in relation to the intersection of their health condition and their school life. This paper shows that a commonalities approach to research and policy development is warranted given the similarities in experiences and needs. The common needs identified in the INSCHOOL project highlight six areas where future interventions could be targeted to begin making meaningful changes for all young people with long-term health conditions.


Assuntos
Instituições Acadêmicas , Humanos , Adolescente , Pesquisa Qualitativa , Reino Unido
3.
J Child Psychol Psychiatry ; 64(12): 1735-1764, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37859504

RESUMO

BACKGROUND: Participatory arts-based (PAB) programmes refer to a diverse range of community programmes involving active engagement in the creation process that appear helpful to several aspects of children's and young people's (CYP) mental health and well-being. This mixed-methods systematic review synthesises evidence relating to the effectiveness and mechanisms of change in PAB programmes for youth. METHOD: Studies were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. Eleven electronic databases were searched for studies of PAB programmes conducted with CYP (aged 4-25 years), which reported mental health and well-being effectiveness outcomes and/or mechanisms of change. A mixed-methods appraisal tool assessed study quality. A narrative synthesis was conducted of effectiveness and challenges in capturing this. Findings relating to reported mechanisms of change were integrated via a metasummary. RESULTS: Twenty-two studies were included. Evidence of effectiveness from quantitative studies was limited by methodological issues. The metasummary identified mechanisms of change resonant with those proposed in talking therapies. Additionally, PAB programmes appear beneficial to CYP by fostering a therapeutic space characterised by subverting restrictive social rules, communitas that is not perceived as coercive, and inviting play and embodied understanding. CONCLUSIONS: There is good evidence that there are therapeutic processes in PAB programmes. There is a need for more transdisciplinary work to increase understanding of context-mechanism-outcome pathways, including the role played by different art stimuli and practices. Going forward, transdisciplinary teams are needed to quantify short- and long-term mental health and well-being outcomes and to investigate optimal programme durations in relation to population and need. Such teams would also be best placed to work on resolving inter-disciplinary methodological tensions.


Assuntos
Arte , Saúde Mental , Adolescente , Criança , Humanos , Pré-Escolar , Adulto Jovem
4.
Res Involv Engagem ; 9(1): 91, 2023 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-37828630

RESUMO

BACKGROUND: Evidence suggests resources and services benefit from being developed in collaboration with the young people they aim to support. Despite this, patient and public involvement and engagement (PPIE) with young people is often tokenistic, limited in engagement and not developmentally tailored to young people. Our paper aims to build knowledge and practice for meaningfully engaging with young people in research design, analysis and as research participants. METHODS: We report the participatory processes from the INSCHOOL project, examining long-term health conditions and schooling among 11-18 year olds. Young people were consulted at the inception of the project through a hospital-based youth forum. This began a partnership where young people co-designed study documents, informed the recruitment process, developed creative approaches to data collection, participated in pilot interviews, co-analysed the qualitative data and co-presented results. RESULTS: PPIE advisors, participants and researchers all benefitted from consistent involvement of young people throughout the project. Long-term engagement allowed advisors and researchers to build rapport and facilitated openness in sharing perspectives. PPIE advisors valued being able to shape the initial aims and language of the research questions, and contribute to every subsequent stage of the project. Advisors co-designed flexible data collection methods for the qualitative project that provided participants with choices in how they took part (interviews, focus groups, written tasks). Further choice was offered through co-designed preparation activities where participants completed one of four creative activities prior to the interview. Participants were therefore able to have control over how they participated and how they described their school experiences. Through participatory analysis meetings advisors used their first-hand experiences to inform the creation of themes and the language used to describe these themes. PPIE in every stage of the process helped researchers to keep the results grounded in young people's experience and challenge their assumptions as adults. CONCLUSIONS: Young people have much to offer and the INSCHOOL project has shown that researchers can meaningfully involve young people in all aspects of research. Consistent PPIE resulted in a project where the voices of young people were prioritised throughout and power imbalances were reduced, leading to meaningful participant-centred data.


BACKGROUND: Young people's voices are often overlooked in research about long-term health conditions, but evidence suggests involving young people improves research quality, usefulness and impact. Despite the benefits, young people are not involved in research as often or as well as they could be. METHODS: Young people were consulted during the early planning of the INSCHOOL project and began a long-term co-production partnership. Through a series of meetings, young advisors helped to design project methods, took part in pilot interviews, analysed interview data, and presented results. Co-designed activities helped participants prepare for their interviews, which was a key part in helping participants tell their own stories. RESULTS: Having young advisors throughout the research added significant value to the project design and helped the results remain grounded in young people's experiences. The co-designed methods gave participants time to prepare for interviews, which allowed them to feel more comfortable and in control of the interview process. This reduced the amount of influence the researchers had over the content of the interviews and gave young people an opportunity to describe experiences of school life that were meaningful to them. PPIE advisors, participants and researchers all benefitted from consistent involvement of young people throughout the project. Long-term engagement allowed advisors and researchers to build rapport and facilitated openness in sharing perspectives. CONCLUSIONS: Researchers should aim to engage with young people at an early stage of research to develop partnerships that allow them to shape the direction and content of the research, and how the information is analysed and presented. Co-designing methods that offer flexibility and make it easy for young people to have more control over the research process can lead to more meaningful and valuable results.

5.
Glob Ment Health (Camb) ; 10: e39, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37854399

RESUMO

Experiencing mental health stigma during adolescence can exacerbate mental health conditions, reduce quality of life and inhibit young people's help-seeking for their mental health needs. For young people, education and contact have most often been viewed as suitable approaches for stigma reduction. However, evidence on the effectiveness of these anti-stigma interventions has not been consistent. This systematic review evaluated the effectiveness of interventions to reduce mental health stigma among youth aged 10-19 years. The review followed Cochrane and PRISMA guidelines. Eight databases were searched: PubMed, PsycINFO, MEDLINE, Web of Science, Scopus, EMBASE, British Education Index and CNKI. Hand searching from included studies was also conducted. Randomised controlled trials and experimental designs that included randomised allocation to interventions and control groups were included in the review. Narrative synthesis was employed to analyse the results. A meta-analysis was conducted to determine the effectiveness of included interventions. Twenty-two studies were included in the review. Eight studies reported positive effects, 11 studies found mixed effects and 3 studies reported no effect on indicators of mental health stigma among youth. Seven of the effective studies were education-based. Eleven studies were suitable for meta-analysis, and the multivariate meta-analytic model indicated a small, significant effect at post-intervention (d = .21, p < .001), but not at follow-up (d = .069, p = .347). Interventions to reduce stigma associated with mental health conditions showed small, short-term effects in young people. Education-based interventions showed relatively more significant effects than other types of interventions.

6.
Appetite ; 187: 106591, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37187446

RESUMO

Snacking is prevalent in adolescents and can have significant health impacts, but there is considerable individual and cross-country variation in determinants on adolescent snacking. The present study examined the role of eating styles (i.e. restrained eating, emotional eating, external eating, mindful eating) and the constructs of an extended Theory of Planned Behaviour (TPB) (i.e. attitudes, subjective norms, perceived behavioural control, habit strength) in predicting adolescent snacking, and the moderating effects of country. A survey was completed by adolescents aged 16-19 years from China (N = 182; mean age = 16.13, SD = 0.87) and England (N = 96; mean age = 17.04, SD = 0.74). Compared to British adolescents, Chinese adolescents showed higher restrained eating (p = .009), lower external eating (p = .004), less positive attitudes (p < .001) and subjective norms (p = .007) to, and less strong habit strength (p = .005) for unhealthy snacking. Mindful eating significantly predicted lower consumption of unhealthy snacks (p = .008) and beverages (p = .001), while restrained eating predicted higher consumption of fruit (p < .001) and vegetables (p < .001), regardless of country. Country showed significant moderating effects of TPB constructs on unhealthy beverages (p = .008) and fruit (p < .001) consumption, and effects on unhealthy snack (p = .023) and vegetable (p = .015) consumption approaching significance. Subjective norms predicted unhealthy snacking frequency regardless of country (p = .001). Habit strength predicted consumption of beverages (p < .001) and fruit (p < .001) only in English adolescents. Mindful eating may be a positive intervention approach to help reduce adolescent unhealthy snacking. TPB-based snacking interventions should carefully consider the country context. Acknowledging country-specific determinants of snacking are recommended.


Assuntos
População do Leste Asiático , Lanches , Adolescente , Humanos , Comportamento Alimentar/psicologia , Frutas , Lanches/psicologia , Teoria do Comportamento Planejado , Verduras
7.
Appl Psychol Health Well Being ; 15(2): 516-535, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35860947

RESUMO

The prevalence of obesity among Chinese adolescents is rising rapidly, and theoretically informed, scalable weight management interventions are needed. We developed and evaluated the feasibility and preliminary effects of an mHealth nutrition education and mindful snacking intervention for weight loss and improved dietary practices among Chinese adolescents with overweight. We examined whether including implementation intention formation (using if-then plans) improved outcomes. With user consultation, we created a 3-week mindful eating intervention delivered as 10 videos to user smartphones. Participants (n = 55) were randomly assigned to mindful eating or mindful eating + planning. Forty-six (83.6%) participants (age = 16.35 ± 0.48 years; body mass index [BMI] = 25.79 ± 2.05 kg/m2 ) completed the intervention. Both groups exhibited significant pre- to post-intervention weight loss (M = 1.42 and 1.79 kg, respectively); decreases in snacking frequencies, emotional eating, external eating, and trait craving; and significant increases in mindful eating and eating self-efficacy. No significant intervention group differences were observed. User experience data (n = 16) indicated acceptability and meaningful behavior change. Findings suggest that a smartphone-delivered mindfulness-based intervention for Chinese adolescents living with overweight is feasible and efficacious.


Assuntos
Atenção Plena , Sobrepeso , Adolescente , Humanos , Sobrepeso/terapia , Sobrepeso/psicologia , Comportamento Alimentar/psicologia , Estudos de Viabilidade , Projetos Piloto , População do Leste Asiático , Redução de Peso
8.
Health Expect ; 26(1): 318-328, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36349556

RESUMO

INTRODUCTION: There are global calls for better understanding of substance use disorder (SUD) to inform prevention, risk reduction and treatment of this relapse-prone disorder. Our aim in this article is to understand the pathways to recovery of youth in Assam, India who have suffered SUD. METHODS: We recruited 15 participants (11 men and 4 women) via two rehabilitation facilities. All are addicts-in-recovery aged 19-24 years. Material was generated through photo-led interviews, analysed using an inductive variant of thematic analysis and the resulting model refined through expert and participant checks. RESULTS: We present a multiroute, multidirectional pathway to recovery model. It has three phases, Recreational Use, Addiction (Relaxed, Chaotic, Strategic) and Supported Recovery, each phase consisting of cycling between, or transitioning through, a series of stages. CONCLUSIONS: The model enhances psycho-socio-cultural insights into the experience of risk and recovery, and informs prevention and treatment for youth substance misuse in Assam. This is the first model of its kind and an important public health resource. We discuss the possible transferability of the model to a wider range of contexts. PATIENT OR PUBLIC CONTRIBUTION: The model presented was generated through analysis of interviews with addicts-in-recovery. Four of these addicts-in-recovery, and two mental health and rehabilitation service providers, conducted participant and expert checks of the model leading to its improvement.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Masculino , Humanos , Feminino , Adolescente , Transtornos Relacionados ao Uso de Substâncias/terapia , Saúde Mental , Índia
9.
Int J Obes (Lond) ; 46(12): 2120-2127, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36104431

RESUMO

BACKGROUND: Increased weight-related stigma during the COVID-19 pandemic has amplified the need to minimise the impacts on mental wellbeing. We investigated the relationship between the perceived changes in the representation of obesity in the media and mental wellbeing during the pandemic in a sample of people with obesity across 10 European countries. We also investigated the potential moderating effect of loneliness. METHODS: Between September to December 2020 during the COVID-19 pandemic, participants reported data on demographics, mental wellbeing (measured by World Health Organisation Five Wellbeing Index and Patient Health Questionaire-4), loneliness (measured by De Jong Gierveld short scale), and perceived change in the representation of obesity in media (measured by a study-specific question) using the online, cross-sectional EURopean Obesity PatiEnt pANdemic Survey (EUROPEANS). Data were analysed using linear mixed-effects models, controlling for age, gender, body mass index, and shielding status, with random incept for country. RESULTS: The survey was completed by 2882 respondents. Most identified as female (56%) and reported their ethnicity as White or White-mix (92%). The total sample had a mean age of 41 years and a BMI of 35.4 kg/m2. During the peak of the pandemic, compared to pre-pandemic, perceiving more negative representation of people with obesity on social media was associated with worse psychological distress, depression, and wellbeing. Perceiving more positive representation, compared to no change in representation, of people with obesity on television was associated with greater wellbeing, yet also higher psychological distress and anxiety. Loneliness, as a moderator, explained ≤0.3% of the variance in outcomes in any of the models. CONCLUSIONS: Perceiving negative representation of obesity on social media was associated with poorer mental wellbeing outcomes during the pandemic; positive representation on television was associated with both positive and negative mental wellbeing outcomes. We encourage greater media accountability when representing people with obesity.


Assuntos
COVID-19 , Adulto , Feminino , Humanos , COVID-19/epidemiologia , Estudos Transversais , Solidão/psicologia , Obesidade/epidemiologia , Pandemias , Masculino
10.
Appetite ; 176: 106097, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35654223

RESUMO

Overweight and obesity are major public health challenges in China, and increasingly among young people. Valid measures are needed to examine the relationship between eating styles and weight to advance understanding and intervention. Mindful approaches show promise in weight management. This study aimed to investigate the psychometric properties of a Chinese version of Mindful Eating Questionnaire (C-MEQ). Study 1 used a think aloud methodology to examine Chinese young adults' (n = 7) and adolescents' (n = 10) comprehension of C-MEQ items. Findings informed revision of problematic items before a full validation study (Study 2) of the revised C-MEQ (C-MEQ-R) in a sample of 430 Chinese young adults. In Study 1, both groups misinterpreted ten items as asking about noticing about whether behaviour ever occurred rather than noticing experience, indicating the lack of content validity of the C-MEQ. Ten items were rephrased to emphasise mindful (intentional) noticing in the moment. In Study 2, confirmatory factor analysis revealed an inadequate fit to the original MEQ structure. Exploratory Structural Equation Model of the C-MEQ-R revealed five distinct domains. The C-MEQ-R showed better psychometric properties than the C-MEQ, and significant associations with mindfulness, emotional eating, external eating and BMI in expected directions. However, psychometric limitations including low internal reliability, inadequate coherence of the subscales and limited construct validity were identified. These findings contribute to the progress in the measurement of mindful eating by highlighting the weaknesses of the MEQ. Further research is called to adopt and validate alternative mindful eating measurements to assess mindful eating in Chinese adolescents and young adults.


Assuntos
Atenção Plena , Adolescente , Comportamento Alimentar/psicologia , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
11.
BMJ Open ; 12(4): e054897, 2022 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-35379625

RESUMO

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences.


Assuntos
Depressão , Saúde Mental , Adolescente , Ansiedade/epidemiologia , Ansiedade/prevenção & controle , Depressão/epidemiologia , Depressão/prevenção & controle , Estudos de Viabilidade , Humanos , Índia/epidemiologia
12.
Appl Psychol Health Well Being ; 14(4): 1291-1313, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35040529

RESUMO

We explore if there is potential to embed psychosocial well-being impact in global challenges research where the primary aims are not mental health related. We are interested in the use of material practices to deliver impact through routine project activities of working with concrete things together. The UK Research and Innovation (UKRI) gateway to research was searched for information on Global Challenges Research Fund (GCRF) grants from 2015 to May 2020. Analysis shows that only 3 per cent of projects self-categorise as engaging with mental health. Thirty-six non-mental health GCRF grants were purposefully sampled for diversity, and each was coded independently by two researchers for relevant information. Findings suggest that 50-70 per cent of non-mental health GCRF projects already engage implicitly, but nonstrategically, with psychosocial well-being impact; opportunities for psychosocial well-being impact, from most to least frequent, are community mobilisation, community building, skills development, positive sense of self, positive emotions and sociocultural identity; the presence of material practice from most to least frequent is as follows: (i) interactions between or enactments upon people, (ii) written materials or images, and (iii) objects; when a material practice was present, it was usually considered usable as a focus to enhance psychosocial well-being. Our study provides evidence that there are low hanging fruit opportunities to impact psychosocial well-being across Sustainable Development Goals (SDGs) through routine project activities.


Assuntos
Saúde Global , Saúde Mental , Humanos
13.
Appetite ; 165: 105308, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34010725

RESUMO

Overweight and obesity remain serious public health concerns. Outcomes from community based commercial weight management programmes vary, relapse is common and drop out is high. Outcomes could be improved by better understanding experiences on these programmes. The aim of our study was to generate accounts of people's experience on a commercial weight-management program to identify what experiences were perceived as facilitating, and what posed risks, to programme effectiveness and compliance. We conducted individual, semi-structured interviews with eighteen Caucasian women (mean age 45.4y) who were members of nation-wide UK commercial, fee-paying, community weight management programme. Interview data was analysed via framework analysis. Participants' experiences indicated that the programme helped by triggering several intra- and interpersonal processes that catalysed change across psychological, physiological, dietary and behavioural areas of their life. Risks to program adherence and effectiveness spanned well-known risks such as self-regulation fatigue and the difficulty of recovering from negative self-criticism, as well as new factors such as the confusing nature of weight change, the relatively powerful impact of everyday events, and the difficulty in getting the balance right between personalised support vs. intrusion. The complexity of reported experiences challenges the linear, predictive pathways of change proposed by many health behaviour models of weight management. To improve effectiveness, programmes need to go well beyond behavioural and dietary support. It is recommended that community, commercial programmes educate people about the physiological and psychological tensions they will encounter, why people lose weight at different rates, the likelihood of weight relapse and strategies to manage these, including evidence-based support for managing self-criticism.


Assuntos
Obesidade , Percepção , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Pesquisa Qualitativa , Fatores de Risco , Reino Unido
14.
Eur Child Adolesc Psychiatry ; 30(6): 849-860, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32535656

RESUMO

Anxiety disorders are among the most common youth mental health disorders. Early intervention can reduce elevated anxiety symptoms. School-based interventions exist but it is unclear how effective targeted approaches are for reducing symptoms of anxiety. This review and meta-analysis aimed to determine the effectiveness of school-based indicated interventions for symptomatic children and adolescents. The study was registered with PROSPERO [CRD42018087628]. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library for randomised-controlled trials comparing indicated programs for child and adolescent (5-18 years) anxiety to active or inactive control groups. Data were extracted from papers up to December 2019. The primary outcome was efficacy (mean change in anxiety symptom scores). Sub-group and sensitivity analyses explored intervention intensity and control type. We identified 20 studies with 2076 participants. Eighteen studies were suitable for meta-analysis. A small positive effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test (g = - 0.28, CI = - 0.50, - 0.05, k = 18). This benefit was maintained at 6 (g = - 0.35, CI = - 0.58, - 0.13, k = 9) and 12 months (g = - 0.24, CI = - 0.48, 0.00, k = 4). Based on two studies, > 12 month effects were very small (g = - 0.01, CI = - 0.38, 0.36). No differences were found based on intervention intensity or control type. Risk of bias and variability between studies was high (I2 = 78%). Findings show that school-based indicated programs for child and adolescent anxiety can produce small beneficial effects, enduring for up to 12 months. Future studies should include long-term diagnostic assessments.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Psicoterapia/métodos , Adolescente , Criança , Feminino , Humanos , Masculino
15.
BMC Health Serv Res ; 20(1): 133, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32087729

RESUMO

BACKGROUND: Preventing the onset of poor mental health in adolescence is an international public health priority. Universal, whole school preventative approaches are valued for their reach, and anti-stigmatising and resilience building principles. Mindfulness approaches to well-being have the potential to be effective when delivered as a whole school approach for both young people and staff. However, despite growing demand, there is little understanding of possible and optimal ways to implement a mindfulness, whole school approach (M-WSA) to well-being. This study aimed to identify the determinants of early implementation success of a M-WSA. We tested the capacity of the Consolidated Framework for Implementation Research (CFIR), to capture the determinants of the implementation of a mental health intervention in a school setting. METHODS: Key members of school staff (n = 15) from five UK secondary schools attempting to implement a M-WSA were interviewed at two-time points, 6 months apart, generating a total of 30 interviews. Interviews explored participants' attitudes, beliefs and experiences around implementing a M-WSA. Interview data were coded as CFIR constructs or other (non CFIR) factors affecting implementation. We also mapped school-reported implementation activity and perceived success over 30 months. RESULTS: The CFIR captured the implementation activities and challenges well, with 74% of CFIR constructs identifiable in the dataset. Of the 38 CFIR constructs, 11 appeared to distinguish between high and low implementation schools. The most essential construct was school leadership. It strongly distinguished between high and low implementation schools and appeared inter-related with many other distinguishing constructs. Other strongly distinguishing constructs included relative priority, networks and communications, formally appointed implementation leaders, knowledge and beliefs about the intervention, and executing. CONCLUSIONS: Our findings suggest key implementation constructs that schools, commissioners and policy makers should focus on to promote successful early implementation of mental health programs. School leadership is a key construct to target at the outset. The CFIR appears useful for assessing the implementation of mental health programs in UK secondary schools.


Assuntos
Atenção Plena , Serviços de Saúde Escolar/organização & administração , Adolescente , Pesquisa sobre Serviços de Saúde , Humanos , Desenvolvimento de Programas , Pesquisa Qualitativa , Reino Unido
16.
Appetite ; 148: 104608, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31935423

RESUMO

Mothers' responsiveness to hunger and fullness cues has been implicated in the development of infant overweight, and baby led weaning (BLW) is argued to be one way to protect against overfeeding. Whilst studies have examined maternal perceptions of hunger, fullness and adequate intake to some degree in traditional weaning (TW) contexts, less is known about this in BLW. This study therefore aimed to understand and compare maternal perceptions of cues and intake in BLW and TW. Eleven mothers of infants (7-24m) participated in semi-structured interviews based on discussions of short videos featuring participants feeding their infants. Interviews were read and transcribed in full. Data were selected for coding which addressed mothers' perceptions of infant hunger, fullness and sufficient consumption and subsequently subjected to template analysis. A sample of data was coded to produce an initial template which was applied to all interviews and revised in an iterative process to produce a final template for interpreting findings. Mothers in the study were adept at recognising fullness cues and gauging feeding state. Both groups perceived similar hunger cues although TW mothers reported a wider range of fullness cues. Both groups used numerous strategies for judging the adequacy of their babies' intake. These included the use of infant cues, however perceived adequacy of intake was also influenced by factors such as infant tiredness and maternal worries about over and under-eating. Findings have implications for the development of responsive feeding interventions while also highlighting the utility of video elicited interviews for understanding feeding interactions.


Assuntos
Sinais (Psicologia) , Comportamento Alimentar , Fome , Julgamento , Comportamento Materno , Saciação , Desmame , Adulto , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Comportamento do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Comportamento Materno/psicologia , Relações Mãe-Filho , Mães , Necessidades Nutricionais , Estado Nutricional , Percepção , Inquéritos e Questionários
17.
Nutrients ; 11(11)2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31683892

RESUMO

High whole grain intake is beneficial for health. However, adolescents consume low levels of whole grain and the understanding of the underpinning reasons for this is poor. Using a visual, participatory method, we carried out a pilot feasibility study to elicit in-depth accounts of young people's whole grain consumption that were sensitive to their dietary, familial and social context. Furthermore, we explored barriers and suggested facilitators to whole grain intake and assessed the feasibility of using SenseCam to engage adolescents in research. Eight British adolescents (aged 11 to 16 years) wore a SenseCam device which auto-captured images every twenty seconds for three consecutive days. Participants then completed traditional 24-hour dietary recalls followed by in-depth interviews based on day three SenseCam images. Interview data were subjected to thematic analysis. Findings revealed that low adolescent whole grain intake was often due to difficulty in identifying whole grain products and their health benefits; and because of poor availability in and outside of the home. The images also captured the influence of parents and online media on adolescent daily life and choices. Low motivation to consume whole grains, a common explanation for poor diet quality, was rarely mentioned. Participants proposed that adolescent whole grain consumption could be increased by raising awareness through online media, improved sensory appeal, increased availability and variety, and tailoring of products for young people. SenseCam was effective in engaging young people in dietary research and capturing data relevant to dietary choices, which is useful for future research.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Dieta , Fibras na Dieta/administração & dosagem , Preferências Alimentares , Grãos Integrais , Adolescente , Conscientização , Criança , Registros de Dieta , Inquéritos sobre Dietas , Ingestão de Energia , Estudos de Viabilidade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Rememoração Mental , Reino Unido
18.
Eur J Oncol Nurs ; 39: 28-34, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30850135

RESUMO

PURPOSE: Young people (YP) returning to school after a cancer diagnosis and treatment have to decide who has the right to know about their cancer experiences and how to distribute this information to peers. Young people face unique challenges in this area because of their life stage, their need to reintegrate with peers, and their own approach to their disease and treatment. This paper explores the perspectives of young people as they return to school during and after curative cancer treatment. METHOD: 12 young people (6 females, 6 males) from the north of England (aged 13-16 years at time of recruitment) took part in photo elicitation interviews conducted at three time points during the year following a diagnosis of lymphoma, Hodgkin's lymphoma, osteosarcoma, A-plastic anaemia or acute lymphoblastic leukaemia. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). RESULTS: Three main themes emerged: 'approaches to telling', 'lives becoming public property'; and 'owning the story'. Within these themes participants experienced stressors related to altered peer group dynamics, being propelled into the foreground of the school environment, being responsible for the feelings and needs of others, and conflicts between their perception of coping and the reactions of others. CONCLUSIONS: Re-entering school following a diagnosis of cancer can result in challenging dynamics for a young person, which they are not always equipped to manage. Participants displayed individual differences in their approaches and preferences, but inevitably all had to cope with their lives becoming public property and managing the narrative of their cancer experience.


Assuntos
Comunicação , Choro , Neoplasias/psicologia , Adaptação Psicológica , Adolescente , Emoções , Inglaterra , Feminino , Humanos , Masculino , Grupo Associado , Percepção
19.
J Adolesc Young Adult Oncol ; 8(2): 157-164, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30300045

RESUMO

BACKGROUND: Being diagnosed with cancer during the teenage years can be significant given that young people are at a key developmental, educational, and future-planning stage. Little is known about young people's attitude toward and engagement with school postdiagnosis, nor how this changes over time. We adopted a novel qualitative approach to examine accounts over time of young people recently diagnosed with cancer. METHODS: Twelve teenagers (13-16 years), recently diagnosed with cancer, participated in photo-elicitation interviews at three time points (∼2, 6, and 9 months postdiagnosis), generating 30 interviews in total. Photo-elicitation interviews center around images that participants bring to represent key experiences and issues that matter to them. Transcripts were analyzed using interpretative phenomenological analysis. RESULTS: Seven themes were generated, representing experiences over time. Themes convey how significant school was to the young people postdiagnosis, principally because it mattered to them to maintain a normative educational pathway. Young people felt tension between wanting to be the same as their peers but feeling distinctly changed. Keeping ownership and control of their cancer story within school was challenging. Survivorship brought, for some, a legacy of missed schooling. CONCLUSION: Support for young people and reintegration plans for school need to be tailored to the young person's emerging way of understanding their cancer and recovery, and their orientation to coping. Young people need help to understand that schoolwork exemptions/extensions do not implicate academic deficiency, and how they could accept a "same but different" position as they continue to develop personally and educationally with their peers.


Assuntos
Adaptação Psicológica , Neoplasias/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Grupo Associado , Qualidade de Vida , Instituições Acadêmicas/estatística & dados numéricos , Estresse Psicológico/prevenção & controle , Adolescente , Educação , Feminino , Seguimentos , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prognóstico , Pesquisa Qualitativa
20.
Appetite ; 133: 353-361, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30502439

RESUMO

Infant gaze serves as a measure of attention to food cues in adults and children and may play a role in signalling infant hunger and satiation. Maternal responsiveness to infant satiation cues, including gaze, supports healthy appetite development and may reduce obesity risk. However, mothers often experience difficulty in interpreting feeding cues, and there have been few attempts to study cues systematically. This study aimed to develop a reliable coding scheme for categorising and tracking infant gaze behaviours during complementary feeding (CF). Twenty infants aged between six and eighteen months were filmed during typical meals on two occasions at home. The Infant Gaze at Mealtime (IGM) coding scheme was devised from the analysis of a sample of videos, a piloting and testing process, and the feeding cues and developmental psychology literature. Inter and intra-rater reliability tests of the scheme with 20% of the study videos revealed high levels of reliability. When applied to the full sample of 225 video clips, the IGM coding scheme revealed a significant decrease over time in the frequency of infants gazing at food and a significant increase in exploratory gaze behaviour within a meal. These changes were consistent across main and dessert courses, suggesting they may be indicative of changes in infant feeding state. The results suggest that infant gaze may offer a means of identifying infant hunger and satiation and, as an easily observed behaviour, an effective tool for mothers and professionals for promoting responsive feeding.


Assuntos
Comportamento Alimentar/psicologia , Fixação Ocular , Fome , Comportamento do Lactente , Saciação , Sinais (Psicologia) , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Refeições , Mães , Reprodutibilidade dos Testes , Gravação em Vídeo
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