A Qualitative Investigation of Older Adults' Conceptualization of Quality of Life and a Think-Aloud Content Validation of the EQ-5D-5L, SF-12v2, Warwick Edinburgh Mental Wellbeing Scale, and Office of National Statistics-4.

OBJECTIVES: Old age is characterized by declining health, comorbidities, and increasing health and social care service use. Traditionally, patient-reported outcome measures (PROMs) including the EQ-5D-5L and SF-12v2 have focused on health. Nevertheless, aged care often aims to improve broader elements of quality of life (QoL), captured by well-being measures, such as the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and Office of National Statistics-4 (ONS-4). This study investigates older adults' conceptualization of QoL and the content validity of the EQ-5D-5L, SF-12v2, WEMWBS, and ONS-4 in measuring their QoL. METHODS: Qualitative cognitive think-aloud interviews were undertaken with older adults aged 75+, exploring their views on what was important to QoL and, for each measure, the relevance, acceptability, and interpretation of items; suitability of response options; and the comprehensiveness of the measure. Conceptualization of QoL was analyzed thematically and content validity using framework analysis. RESULTS: Twenty interviews were undertaken. Older adults' conceptualization of QoL centered on health, ability to perform usual activities, social contact, and emotional functioning. Possible response shift was observed, as older adults assessed their health relative to lower health expectations at their age or to people in worse states. Participants questioned the relevance of negatively phrased mental items and often preferred the functioning-focused EQ-5D-5L to more subjective ONS-4 and WEMWBS items. Domains suggested to improve comprehensiveness included social contact, coping, security, dignity, and control. CONCLUSIONS: These findings are useful to researchers developing new PROMs for older adults or for the developers of included PROMs considering permanently adapting or bolting-on domains to improve content validity in older adults.

Measuring mental well-being in Sri Lanka: validation of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) in a Sinhala speaking community.

BACKGROUND: Well-being is an important aspect of people's lives and can be considered as an index of social progress. The Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed to capture subjective mental well-being. It is a widely tested measure of mental well-being at the population level and has 14 items and a short-form with 7 items. This study was carried out to culturally validate and adapt the WEMWBS among a Sinhala speaking population in Sri Lanka. METHODS: A forward and backward translation of the scale into Sinhala was done followed by a cognitive interview. The translated and culturally adapted scale and other mental health scales were administered to a sample of 294 persons between the ages of 17-73 using a paper-based version (n = 210) and an online survey (n = 84). Internal consistency reliability and test-retest reliability were tested. Construct validity, and convergent and discriminant validity were assessed using the total sample. RESULTS: The translated questionnaire had good face and content validity. Internal consistency reliability was 0.91 and 0.84 for the 14-item and 7-item scales, respectively. Test-retest reliability over two weeks was satisfactory (Spearman r = 0.72 p < 0.001). Confirmatory factor analysis supported a one factor model. Convergent validity was assessed using WHO-5 well-being index (Spearman r = 0.67, p < 0.001), Patient Health Questionnaire (PHQ-9) (Spearman r = (-0.45), p < 0.001) and Kessler psychological distress scale (K10) (Spearman r = (-0.55), p < 0.001). CONCLUSIONS: The translated and culturally adapted Sinhala version of the WEMWBS has acceptable psychometric properties to assess mental well-being at the population level among the Sinhala speaking population in Sri Lanka.

Mental well-being of the general population: direct and indirect effects of socioeconomic, relational and health factors.

PURPOSE: The aim of this study was to analyse the association between individual mental well-being and social, economic, lifestyle and health factors. METHODS: Cross-sectional study on a representative sample of 13,632 participants (> 15y/o) from the Catalan Health Interview Survey 2013-2016 editions. Mental well-being was assessed with the Warwick-Edinburg Mental Well-being Scale (WEMWBS). Linear regressions were fitted to associate well-being and sociodemographic, relational, lifestyle and health variables according to minimally sufficient adjustment sets identified using directed acyclic graphs. Predictors entered the model in blocks of variable types and analysed individually. Direct and total effects were estimated. RESULTS: Health factors significantly contributed to mental well-being variance. Presence of a mental disorder and self-reported health had the largest effect size (eta2 = 13.4% and 16.3%). The higher individual impact from a variable came from social support (ß = - 12.8, SE = 0.48, eta2 = 6.3%). A noticeable effect gradient (eta2 = 4.2%) from low to high mental well-being emerged according to economic difficulties (from ß = 1.59, SE = 0.33 for moderate difficulties to ß = 6.02 SE = 0.55 for no difficulties). Younger age (ß = 5.21, SE = 0.26, eta2 = 3.4%) and being men (ß = 1.32, SE = 0.15, eta2 = 0.6%) were associated with better mental well-being. Direct gender effects were negligible. CONCLUSIONS: This study highlights health and social support as the most associated factors with individual mental well-being over socioeconomic factors. Interventions and policies aimed to these factors for health promotion would improve population mental well-being.

Self-reported well-being and the importance of green spaces - A comparison of garden owners and non-garden owners in times of COVID-19.

This study focuses on the effects of the use of green spaces on the self-reported well-being measures of life satisfaction and mental well-being during the COVID-19 pandemic. We compare two distinct groups of people: garden owners and non-garden owners. We collected quantitative data and data from an open-ended question online from 495 people living in all regions of Germany in May 2020. To analyze our quantitative data, we used a combination of descriptive statistics and hierarchal regressions. Here, results indicated that garden owners had substantially greater life satisfaction and mental well-being than non-garden owners. Additionally, the two groups differed statistically significant in many socioeconomic factors (e.g., income, age, fear of job loss), in the context of time spent outside, as well as personality traits. Our analyses suggest that these differences are valuable for understanding differences between the two groups' self-reported well-being. To analyze the open-ended question, we followed the main steps of a qualitative content analysis. Here, we found that the vast majority of participants associated positive meanings (e.g., freedom and joy) with private gardens and public green spaces during the pandemic. Our findings have implications for policies to promote and support the design and use of public green spaces. Overall, our findings support governmental decisions in Germany (as elsewhere) to keep public green spaces open during the first wave of the outbreak of COVID-19, suggesting that green spaces provide valuable support for self-reported well-being in these difficult times of COVID-19 contagion.

Psychometric evaluation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) with Chinese University Students.

BACKGROUND: The aim of this study was to assess the validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the SWEMWBS, the shortened version of the WEMWBS, and conduct a preliminary evaluation of the metric properties of these scales by using a sample of university students in mainland China. METHODS: Nine-hundred and three students from a Chinese university participated in the cross-sectional study. The internal consistency, convergent validity, factorial validity and construct validity of the scales were examined. RESULTS: The Chinese versions of the WEMWBS and SWEMWBS showed high internal consistency, with Cronbach's alpha values of 0.930 and 0.884, respectively. The results of the exploratory factor analysis suggested that the 14-item WEMWBS and 7-item SWEMWBS were suitable for a single scale. The WEMWBS and SWEMWBS also showed significant moderate to strong correlations with the other major subjective hedonic and eudemonic scales. Both scales showed good model fit in the confirmatory factor analysis, after reorganising several types of error covariance between the items. However, some items in WEMWBS recorded low validity in the evaluation of internal consistency, convergent validity and factorial validity. CONCLUSIONS: This study demonstrated that the SWEMWBS had high validity, internal consistency and psychometric properties when applied to the sample of Chinese students. Further studies should apply this promising scale to samples of other Chinese populations.

Validation of two versions of the Warwick-Edinburgh Mental Well-Being Scale among Norwegian adolescents.

AIM: This study aimed to examine the psychometric properties of the original 14-item version of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and the short 7-item version (SWEMWBS) to validate these scales for use among Norwegian adolescents. METHOD: Cross-sectional data were collected by distributing questionnaires among students in five upper secondary schools in Norway with a net sample of n = 1814. Exploratory- and confirmatory factor analyses (CFA) and a reliability analysis were conducted and possible floor and ceiling effects were examined to evaluate the scales. A correlation analysis was conducted to examine criterion-related validity. RESULTS: The preliminary exploratory factor analysis gave strong indications of a one-dimensional solution for both versions of the scale. Furthermore, both scales showed high internal consistency (Cronbach's α = .93 for the WEMWBS and α = .88 for the SWEMWBS). The SWEMWBS showed the best fit in the CFA and a strong correlation with the WEMWBS ( r = .94). The score distributions of both scales indicated the possibility of a small ceiling effect. Both scales showed high correlations with related constructs in the expected direction. CONCLUSIONS: In our study, based on the CFA results and the high correlation between the original scale and the short version, the SWEMWBS was found to be most suitable for use among Norwegian adolescents.

Where's WALY? : A proof of concept study of the 'wellbeing adjusted life year' using secondary analysis of cross-sectional survey data.

BACKGROUND: The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE ( https://www.nice.org.uk/process/pmg9/ ). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. METHODS: Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson's and Spearman's correlations, linear regression, and receiver operating characteristic curves. RESULTS: Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R(2) being 0.104 for the index and 0.141 for the visual analogue scale). CONCLUSION: The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure - a Wellbeing Adjusted Life Year - is needed.

Veterinarian-Chasing A Dream Job? A Comparative Survey on Wellbeing and Stress Levels among European Veterinarians between 2018 and 2023.

Whilst recognizing the abundantly positive aspects within the different domains of the veterinary profession, the challenging socio-economic and cultural working climate has been identified as a source of veterinary mental wellbeing issues. This mixed methods study provides an overview of the mental state of veterinarians across Europe via two cross-sectional surveys in 2018/2019 (n = 14,559 veterinarians) and in 2022/2023 (n = 12,393 veterinarians). Mental wellbeing was assessed using 3 indicators: self-reported stress levels, the need for medical leave due to reduced mental wellbeing (22% and 23%, resp., in 2018/2019 and 2022/2023) and the seven-question Warwick-Edinburgh Mental Wellbeing Scale (2018/2019: 25, 2022/2023: 24.8). In both surveys, important differences were spotlighted between countries, but early-career veterinarians and female veterinarians were most at risk of decreased mental wellbeing all over Europe for all indicators. In conclusion, stress levels and need for medical leave due to reduced mental wellbeing remained at comparatively high levels across the two surveys and standardized mental wellbeing scores remained equally low. Notwithstanding the increased attention given to veterinary wellbeing in the last decade, our results underline that major efforts remain necessary, by creating more supportive and attractive workplaces that prioritize wellbeing, a good work/life balance, and providing job satisfaction.

A validation study of the Arabic version of the Warwick-Edinburgh Mental Well-being scale among undergraduate students.

BACKGROUND: The main aim of this study was to assess the validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and the short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) and to evaluate the metric properties of both versions by using a sample of undergraduate students from three Gulf Cooperation Council (GCC) countries (Oman, Qatar, and Saudi Arabia). METHODS: Six hundred ninety undergraduate students (340 M and 350 F; mean age = 21.16 ± 2.44) from Oman, Qatar, and Saudi Arabia (NOM = 238, NQA = 215, NSA = 237), voluntarily participated in this cross-section study. All of them responded to the WEMWBS, Basic Psychological Needs Satisfaction Frustration (BPNSFS), and Beck Depression Inventory (BDI-II). The methodology involved utilizing descriptive statistics to understand the data's characteristics, internal consistency analysis for reliability, correlation analysis for convergent validity, confirmatory factor analysis to validate the scales, and measurement invariance testing to ensure cross-group comparability. Model fit indices were employed to gauge the goodness of fit. RESULTS: The translated Arabic versions of the WEMWBS and SWEMWBS showed good reliability, with Cronbach's alpha values of 0.867 and 0.772, respectively. The findings of confirmatory factor analysis asserted the one-factor solution to interpret the item variances of the 14-item WEMWBS and 7-item SWEMWBS. The WEMWBS and SWEMWBS also showed significant positive relationships with need satisfaction and negative relationship with need frustration, and depression. Moreover, the SWEMWBS showed partial scalar invariance across genders and countries, while the WEMWBS showed only partial metric invariance across the three countries and partial scalar invariance across genders. CONCLUSIONS: Our study highlights the appropriateness of both versions of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in assessing the psychological well-being of Arab undergraduate students. The employment of these tools is strongly encouraged for the assessment of mental well-being within a comparable adult population.

The mental wellbeing of female prisoners in Chile.

OBJECTIVE: To measure and understand mental wellbeing among women prisoners in Chile, as part of a larger study. RESULT: Sixty-eight sentenced prisoners in a women's prison participated in a survey, giving a response rate of 56.7%. Using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the mean wellbeing score of participants was 53.77 out of maximum score of 70. Whilst 90% of the 68 women felt useful at least some of the time, 25% rarely felt relaxed, close to others or able to make up their own minds about things. Data generated from two focus groups attended by six women offered explanations for survey findings. Thematic analysis identified stress and loss of autonomy due to the prison regime as factors which negatively affect mental wellbeing. Interestingly, whilst offering prisoners an opportunity to feel useful, work was identified as a source of stress. Interpersonal factors linked to a lack of safe friendships within the prison and little contact with family had an adverse impact on mental wellbeing. The routine measurement of mental wellbeing among prisoners using the WEMWBS is recommended in Chile and other Latin American countries to identify the impact of policies, regimes, healthcare systems and programmes on mental health and wellbeing.

Status of mental health among college and university students during first and second wave of COVID-19 outbreak in India: A cross-sectional study.

Background: India has been badly affected by Covid-19 not only in terms of human lives but also has a long-term effect on mental health of the population. This paper is an attempt to understand the psychological effects of the pandemic on the college and university students in India after the second wave of COVID-19 outbreak and its associated factors. Method: A web-based survey was conducted to collect information from the students both at individual and household level. The study applied binary and multivariate logistic regression to estimate the adjusted and unadjusted marginal effects of the predictor variables. Result: Results show a significant increase in mental health concerns during the second wave of the pandemic, as compared to the first year. The key factors contributing to the higher prevalence of depression, anxiety, and stress are the difficulties faced in the adaptation to the new way of learning, fear of discontinuation of education due to financial constraints faced by household, limited physical interaction, and prolonged screen-time during the pandemic. Limitation: The study has some limitations regarding selection of the sample as the survey was web-based. Also, the mental health situation of the students is self-reported and the study does not consider the prevailing mental health issues before the pandemic. Conclusion: The study recommends initiatives like offering counselling classes and strategies to cope up with mental health disorders. Further, there is a need to conduct follow-up studies to assess the long-term impacts of prolonged home quarantine on the mental health of the students.

Mental wellbeing in bereaved carers: A Health Survey for England population study.

OBJECTIVES: The experience of caregiving may affect carers' well-being into bereavement. We explored associations between mental well-being and previous experience of bereavement of, and caring for, someone close at the end-of-life. METHODS: An end-of-life set of questions was included in population-based household survey administered to adults (age 16 years and above). We used univariable regression to explore the cross-sectional relationship between our primary outcome (Warwick-Edinburgh Mental Well-being Scale (WEMWBS)) and possible explanatory variables: sociodemographic; death and bereavement including ability to continue with their life; disease and carer characteristics; service use and caregiving experience. RESULTS: The analysis dataset included 7606 of whom 5849 (77%) were not bereaved, 1174 (15%) were bereaved but provided no care and 583 (8%) were bereaved carers. WEMWBS was lower in the oldest age class (85 years and above) in both bereaved groups compared with not bereaved (p<0.001). The worst WEMWBS scores were seen in the 'bereaved but no care' group who had bad/very bad health self-assessed general health (39.8 (10.1)) vs 41.6 (9.5)) in those not bereaved and 46.4 (10.7) in bereaved carers. Among the bereaved groups, those who would not be willing to care again had lower WEMWBS scores than those who would (48.3 (8.3) vs 51.4 (8.4), p=0.024). CONCLUSION: Mental well-being in bereavement was worse in people with self-reported poor/very poor general health and those with a worse caregiving experience. Although causality cannot be assumed, interventions to help people with worse mental and physical health to care, so that their experience is as positive as possible, should be explored prospectively.

Lifestyle Habits and Wellbeing Among Physicians in Pakistan: A Cross-Sectional Study.

Introduction Physicians' attitude towards a healthy lifestyle is important as it determines their extent of acceptance of these habits leading to overall well-being. Physicians with healthy lifestyle habits are more confident in advocating the same to their patients and their patients are keener in adopting lifestyle modifications. This study aimed to evaluate the lifestyle habits, wellbeing, and mental health of physicians in Pakistan. Methods A multi-center, cross-sectional survey was conducted with physicians across Pakistan from August to October 2020. A total of 1406 participants were gathered by the non-probability convenient sampling technique. Data were collected physically from the participants. A semi-structured, self-administered questionnaire comprising socio-demographic information, lifestyle habits, mental well-being, and well-being, in general, was filled. Mental wellbeing was assessed using the Warwick Edinburg Mental Wellbeing Scale (WEMWBS) comprising 14-positive items scored on a 1-5 point Likert scale where 1 corresponds to "none of the time" and 5 corresponds to "all of the time." The score ranges from a minimum of 14 to a maximum of 70 points. Higher scores are associated with higher levels of mental wellbeing. Data were stored and analyzed using IBM-SPSS v.23 (IBM Corp., Armonk, NY). Results In this survey, there were 1284 (91.3%) males and 122 (8.7%) females with a mean age of 44.09 ± 11.18 years. More than half (n=768; 53.0%) of the physicians reported their general health as "good," 1045 (73%) were satisfied with their work-life balance, 206 (14%) had seen a physician for their health in the last six months, and 358 (25%) never had a routine medical checkup. When WEMWBS was applied, participants ≤40 years scored significantly higher than the older age group (p<0.01). Male physicians also scored significantly higher on WEMWBS (52.35 ± 8.78) as compared to their female counterparts (p<0.01). WEMWBS scores also varied significantly across various levels of expertise - with consultants scoring the highest (52.67 ± 9.02) and others scoring the lowest (48.63 ± 8.58; p=0.02). Physicians practicing in the public hospitals only (53.05 ± 9.02), scored higher on WEMWBS as compared to those in the private hospitals (51.28 ± 8.12) as well as those practicing in private clinics only (49.57 ± 8.82; p<0.01). Physicians who perceived their health as excellent scored highest on WEMWBS (53.55 ± 9.31), than those who considered their health good (51.68 ± 8.40), poor (50.71 ± 9.27), or fair (48.70 ± 8.15; p<0.01). The correlation analysis showed a significant negative correlation of WEMWBS scores with health in general (2.5% variation) and age (0.92% variation; p<0.01). Conclusion Physicians in our study were mostly satisfied with their general health and work-life balance. Nevertheless, their mental health well-being was not satisfactory, as assessed by WEMWBS. There is a dire need for lifestyle modifications among the medical practitioners who may improve their mental and physical well-being subsequently allowing them to cater to their patients more effectively. It is recommended that physician-patient-specific interventions should be developed to target the health status and mental well-being of a physician and to encourage the physicians especially the fresh medical graduates and young doctors to indulge in healthy activities.

Examining the effectiveness of Gateway-an out-of-court community-based intervention to reduce recidivism and improve the health and well-being of young adults committing low-level offences: study protocol for a randomised controlled trial.

BACKGROUND: Young adult offenders represent a third of the UK prison population and are at risk of poor health outcomes including drug and alcohol misuse, self-harm and suicide. Court diversion interventions aim to reduce the negative consequences of formal criminal justice sanctions and focus resources on addressing the root causes of offending. Although diversions are widely used, evidence of their effectiveness has not yet been established. Hampshire Constabulary, working together with local charities, have developed the Gateway programme, an out-of-court intervention aimed at improving the life chances of young adults. Issued as a conditional caution, participants undertake a health and social care needs assessment, attend workshops encouraging analysis of own behaviour and its consequences and agree not to re-offend during the 16-week caution. METHODS: This is a pragmatic, multi-site, parallel-group, superiority randomised controlled trial with a target sample size of 334. Participants are aged 18-24, reside in Hampshire and Isle of Wight and are being questioned for an eligible low-level offence. Police investigators offer potential participants a chance to receive the Gateway caution, and those interested are also invited to take part in the study. Police officers obtain Stage 1 consent and carry out an eligibility check, after which participants are randomised on a 1:1 basis either to receive Gateway or follow the usual process, such as court appearance or a different conditional caution. Researchers subsequently obtain Stage 2 consent and collect data at weeks 4 and 16, and 1 year post-randomisation. The primary outcome is the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes include health status, alcohol and drug use, recidivism and resource use. The primary analysis will compare the WEMWBS score between the two groups at 12 months. DISCUSSION: This pioneering trial aims to address the evidence gap surrounding diversion in 18-24-year-olds. The findings will inform law enforcement agencies, third sector organisations, policymakers and commissioners, as well as researchers working in related fields and with vulnerable target populations. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Register ( ISRCTN 11888938 ).

What Is the Health and Well-Being Burden for Parents Living With a Child With ADHD in the United Kingdom?

Objective: To explore the burden associated with childhood ADHD in a large observational study. Methods: We recruited familes with at least one child (6-18 years) with ADHD via 15 NHS trusts in the UK, and collected data from all family members. We made careful adjustments to ensure a like-for-like comparison with two different control groups, and explored the impact of controlling for a positive parental/carer ADHD screen, employment, and relationship status. Results: We found significant negative impacts of childhood ADHD on parents'/carers' hours and quality of sleep, satisfaction with leisure time, and health-related quality of life (measured by the EuroQol-5D [EQ-5D]). We found a decrement in life satisfaction, mental well-being (as measured by the Short-Warwick Edinburgh Mental Well-Being Scale [S-WEMWBS]), and satisfaction with intimate relationships, but this was not always robust across the different control groups. We did not find any decrement in satisfaction with health, self-reported health status, or satisfaction with income. Conclusion: The study quantifies the impact on the health and well-being of parents living with a child with ADHD using a survey of families attending ADHD clinics in the United Kingdom.

Socio-demographic predictors of well-being in United Kingdom adolescents, and the impact of well-being on a range of health-related outcomes.

The deleterious impact of low mental well-being, and higher levels psychological symptoms (collectively well-being), on concurrent and prospective health outcomes has elsewhere been demonstrated. Further, variables such as conurbation and deprivation have been found to be related to mental and physical heath. This study used data from a longitudinal study to examine which demographic predicted well-being scores, and how scores on these constructs were related to six health-related outcomes. Participants were adolescents (N = 4,956; Male = 2376[48%]), from 72 High Schools in Northern Ireland. Three waves of data were gathered on mental well-being, psychological symptoms, subjective life expectancy (living to age 35 and age 75 years), self-rated health, frequency of physical exercise, and lifetime use of cigarettes and cannabis. Results showed that both well-being scores were significantly associated with gender cross-sectionally, but demographic variables did not predict changes in well-being longitudinally. Both well-being measures were significantly associated with health outcomes cross-sectionally, with mental well-being (over time) predicting life subjective life expectancy, self-rated health, and addictive behaviors, while psychological symptoms (over time) predicted the former two, but not addictive behaviors. Overall, the relationship between mental well-being, psychological symptoms, and the health outcomes assessed, was small in terms of effect size.

The Influence of the COVID-19 Pandemic on Mental Well-Being and Psychological Distress: Impact Upon a Single Country.

The COVID-19 pandemic is likely to have affected the psychological well-being and mental health of many people. Data on prevalence rates of mental health problems are needed for mental health service planning. Psychological well-being and prevalence of clinically significant mental distress were measured in a large sample from Wales 11-16 weeks into lockdown and compared to population-based data collected in 2019 before the COVID-19 pandemic. Data were collected using an online survey disseminated across Wales and open to adults (age 16+) from 9th June to 13th July 2020. Psychological well-being was indexed via the Warwick-Edinburgh Mental Well-being Scale, and psychological distress was indexed via the K10. Data from 12,989 people who took part in this study were compared to that from April 2018 - March 2019, gathered by the National Survey for Wales (N = 11,922). Well-being showed a large decrease from 2019 levels. Clinically significant psychological distress was found in around 50% of the population (men = 47.4%, women = 58.6%), with around 20% showing "severe" effects (men = 17.0%, women = 20.9%): a 3-4-fold increase in prevalence. Most affected were young people, women, and those in deprived areas. By June-July 2020 the COVID-19 pandemic had dramatic effects on the mental health of people living in Wales (and by implication those in the UK and beyond). The effects are larger than previous reports. This probably reflects that the current data were taken deeper into the lockdown period than previous evaluations. Mental health services need to prepare for this wave of mental health problems with an emphasis on younger adults, women, and in areas of greater deprivation.

Naturalistic evaluation of a sport-themed mental health and wellbeing app aimed at men (MindMax), that incorporates applied video games and gamification.

INTRODUCTION: While men display lower help-seeking rates than women, there is a lack of mental health interventions targeting men. To address this issue, we developed a smartphone app named MindMax, an Australian Football League (AFL)-themed app containing psychoeducational modules teaching strategies derived from positive psychology and acceptance and commitment therapy. MindMax also incorporates gamification, casual video games, and social connection and is intended to appeal to male Australians interested in AFL. This study reports results from a naturalistic trial intended to investigate whether using MindMax was associated with improved wellbeing, resilience, and help-seeking intentions. METHODS: We conducted a naturalistic trial from July 2017 to May 2018, where participants were given access to MindMax to use as they wished, and asked to answer wellbeing surveys at multiple time points. As we employed a customised version of the General Help-Seeking Questionnaire (GHSQ), we conducted an exploratory factor analysis and extracted two factors that we interpreted as 'personal help-seeking' and 'impersonal help-seeking'. Mixed design MANOVAs were conducted with flourishing, resilience, personal help-seeking, impersonal help-seeking, relatedness, and sense of connection (self-group overlap) to the MindMax community to assess change between Day 1-30 and Day 1-60. RESULTS: 313 participants (174/313, 55.6% female; 131/313, 41.9% male) completed the survey at baseline and at least one follow-up survey. We observed significant 30-day and 60-day increases in impersonal help-seeking intentions and sense of connection to the MindMax community, and 60-day increases in flourishing. 30-day increases in sense of connection were highest in our male participants with high base wellbeing, present in our female participants, and not present in our male participants with low base wellbeing. 60-day increases in sense of connection were higher in high-wellbeing participants than in low-wellbeing participants. DISCUSSION/CONCLUSION: Our findings are encouraging as they could be attributed to participants' exposure to MindMax. However, they could also be attributed to other factors that may also have motivated trial participation. Future research can consider investigating more explicitly the role of conformity to masculine norms and how that may affect uptake of mHealth technologies and help-seeking behaviour.

Evidence for the Psychometric Validity, Internal Consistency and Measurement Invariance of Warwick Edinburgh Mental Well-being Scale Scores in Scottish and Irish Adolescents.

Mental well-being is an important indicator of current, but also the future health of adolescents. The 14-item Warwick Edinburgh Mental Well-being Scale (WEMWBS) has been well validated in adults world-wide, but less work has been undertaken to examine the psychometric validity and internal consistency of WEMWBS scores in adolescents. In particular, little research has examined scores on the short 7-item version of the WEMWBS. The present study used two large samples of school children in Scotland and Northern Ireland and found that for both forms of the WEMWBS, scores were psychometrically valid, internally consistent, factor saturated, and measurement invariant by country. Using the WEMWBS full form, males reported significantly higher scores than females, and Northern Irish adolescents reported significantly higher scores than their Scottish counterparts. Last, the lowest overall levels of well-being were observed among Scottish females.

Diet, exercise and mental-wellbeing of healthcare professionals (doctors, dentists and nurses) in Pakistan.

Background. "Health is wealth" is a time tested adage. Health becomes more relevant when it comes to professionals whose job is to provide people with services that maintain an optimum state of mental, physical and social well-being. Healthcare professionals (HCP) differ from general population in regards to the nature of their work, stress, burnout etc. which begs the need to have a robust state of health for the ones who provide it to others. We initiated this study to see if healthcare professionals "practice what they preach others." Methods. We employed a cross-sectional study design with convenience-sampling technique. Questionnaires were administered directly to the three groups of healthcare professionals (Doctors, Dentists and Nurses) across the province Punjab after their consent. 1,319 healthcare professionals took part in the study (response rate of 87.35). Warwick Edinburg Mental Wellbeing Scale (WEMWBS) was used to assess mental wellbeing. USDA Dietary Guidelines-2010 were employed to quantify diet. American Heart Association (AHA) guidelines were employed for the analysis of exercise. Results. A total of 1,190 healthcare professionals formed the final sample with doctors and nurses forming the major proportion. Out of 1,190 participants only one healthcare professional was found to eat according to USDA Dietary Guidelines; others ate more of protein group and less of fruits, dairy and vegetable groups. 76% did not perform any exercise. 71.5% worked >48 h/week. More than 50% of healthcare professionals were sleeping <7 h/day. WEMWBS score of the entire sample was 47.97 ± 9.53 S.D. Conclusion. Our findings suggest that healthcare professionals do not practice what they preach. Their mental wellbeing, diet and exercise habits are not up to the mark and should be improved to foster the whole healthcare system for individual and community benefits.