Effect of spiritual intelligence and employment status on the association between education and depressive symptoms among adults in rural Puducherry, India: A mediation analysis.

BACKGROUND: Depression is a major global health concern, particularly in India, where it significantly impacts the population's well-being. The interplay of various factors, including education, employment status, and spiritual intelligence, contributes to the complex landscape of depressive symptoms among adults. METHODOLOGY: A community-based cross-sectional study was conducted in the rural service areas of a tertiary care medical institution in rural India from March 2021 to September 2022. The study employed structured questionnaires and validated scales to assess depressive symptoms, spiritual intelligence, educational status, and occupational status among participants. Structural equation modelling was used for mediation analysis to evaluate the effect of spiritual intelligence and employment status on the association between education and depressive symptoms. RESULTS: The study included 381 participants, with a prevalence of depressive symptoms at 14.4%. Higher educational attainment was associated with lower odds of depressive symptoms (aOR = 0.34, 95% CI [0.17, 0.67]). Employment status mediated the relationship between education and depression, with employed individuals exhibiting lower odds of depressive symptoms (aOR = 0.42, 95% CI [0.22, 0.82]). While spiritual intelligence was higher among those with formal education, its direct impact on depression was not statistically significant. The mediation analysis revealed that a significant portion (77.5%) of the total effect of education on depression was mediated through employment status and spiritual intelligence. CONCLUSION: The study underscores the importance of education and employment opportunities in mitigating depressive symptoms among rural adults. It suggests targeted interventions that promote education and employment support to enhance mental health resilience. While spiritual intelligence may influence mental health outcomes, its exact role requires further investigation.

'I was scared I will end up in another abortion': a mixed-methods study assessing the impact of COVID-19 pandemic and lockdown on the antenatal care of pregnant women in Puducherry, South India.

BACKGROUND: As a mitigation measure for COVID-19 pandemic, lockdown was implemented in India for a period of 2 months (24 March-31 May 2020). Disruption in antenatal care (ANC) provisions during lockdown is expected due to diversion of public health facilities on pandemic. OBJECTIVE: To assess the proportion of pregnant women who had not completed the ideal number of antenatal visits, availability of iron-folic acid (IFA) supplements and challenges in availing health services during the period of lockdown. METHODS: A concurrent mixed-methods study was conducted among pregnant women in Puducherry, India. Information on obstetric characteristics and details regarding antenatal visits were collected through telephonic interviews. In-depth interviews were conducted to understand the perceived challenges in availing health services during the lockdown period. RESULTS: Out of 150 pregnant women, 62 [41.3%; 95% confidence interval (CI) 33.6-49.3] did not complete the ideal number of visits and 61 (40.7%, 95% CI 32.7-49.0) developed health problems. Out of 44 women who received medical care for health problems, 11 (25%) used teleconsultation. Of all the women, 13 (8.7%, 95% CI 4.9-14.0) had not taken the IFA supplements as prescribed by the health provider. Economic hardship, restricted mobility, lack of information about the health system changes and psychological stress due to the fear of COVID were the challenges in accessing care. CONCLUSIONS: Two out of five pregnant women did not complete the ideal number of visits and developed health problems during the lockdown period.

Is a smartphone application effective in improving physical activity among medical school students? Results from a quasi-experimental study.

INTRODUCTION: Physical activity (PA) is proven to be an effective strategy to avert the life threatening cardiovascular diseases. There is need for developing feasible aids to improve compliance to PA. Hence, we conducted a study among medical college students a) to assess the prevalence of recommended PA level and b) to assess the effectiveness of installing a smartphone application (app) in improving PA. METHODOLOGY: A quasi-experimental study was conducted among medical college students in Puducherry, India. The baseline PA was assessed using the Global Physical Activity Questionnaire (GPAQ) and anthropometric measurements such as height and weight were measured as per World Health Organization (WHO) standards. A smartphone app (Runtastic) was installed on the mobile phones of all study participants. At the end of 1 month, the end line PA and anthropometric measurements were captured using same scales. RESULTS: Of the total 350 students who were included, the mean age of the participants was 18.9 (0.9) years and 58% of them were male. The proportion of participants with the WHO recommended level of PA increased from 81% at the baseline to 91% after 1 month of installation of the mobile app (p < 0.001). There was also a statistically significant increase in the leisure time PA [median (interquartile range - IQR) of metabolic equivalents (METS): 0 (0-1600) vs. 1260.0 (0-1920)]. Clinically significant change was not seen in body mass index (BMI) though the reduction was statistically significant [(mean (standard deviation - SD) of BMI: 22.54 (2.49) vs. after intervention 22.46 (2.47); p = 0.018]. CONCLUSION: This quasi-experimental study conducted among medical college students reported significant improvement in total and leisure time PA.

Prevalence and associated factors for social phobia among school-going adolescents in a rural area of Puducherry, South India.

BACKGROUND: The World Health Organisation has reported that mental disorders are one of the leading causes of disability worldwide. Social phobia is one such mental disorder that can have significant impact on the livelihood of adults if not detected at an early stage. There have been very few studies done on social phobia among adolescents in South India. Hence, this study was done to determine the prevalence of social phobia and factors associated with it among the school-going adolescents in rural Puducherry. METHODOLOGY: A community-based cross-sectional study was conducted among 1018 school going adolescents from December 2017 to January 2018 in rural Puducherry. Information on socio-demographic characteristics was collected by a pre-tested semi-structured questionnaire and social phobia was assessed using the validated Social Phobia Inventory (SPIN) questionnaire. RESULTS: Among 1018 participants, 738 (72.5%) belonged to early adolescence (10-13 years); 520 (51.1%) were boys; 557 (54.7%) were studying in a middle class; 931 (91.5%) were Hindus; 978 (96.1%) had siblings.The prevalence of social phobia among adolescents was found to be 22.9% (95% CI: 20.4-25.5%). The prevalence of mild social phobia was 18% [95% confidence interval (CI): 15.7-20.4%], moderate social phobia was 4% (95% CI: 2.9-5.4%), severe social phobia was 0.7% (95% CI: 0.3-1.3%) and very severe social phobia was 0.2% (95% CI: 0.03-0.64%). Higher age, female gender, lack of counselling services and specialist visits at school were found to be determinants of social phobia. CONCLUSION: The current study showed that one in every five adolescents was at risk of developing social phobia. Health education for students, teachers and family members needs to be given to make them aware of the importance of social phobia.