Promotion of mental health in young adults via mobile phone app: study protocol of the ECoWeB (emotional competence for well-being in Young adults) cohort multiple randomised trials.

BACKGROUND: Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence (EC) skills via a mobile app may be an effective, scalable and acceptable way to do this. However, few large-scale controlled trials have examined the efficacy of mobile apps in promoting mental health in young people; none have tailored the app to individual profiles. METHOD/DESIGN: The Emotional Competence for Well-Being in Young Adults cohort multiple randomised controlled trial (cmRCT) involves a longitudinal prospective cohort to examine well-being, mental health and EC in 16-22 year olds across 12 months. Within the cohort, eligible participants are entered to either the PREVENT trial (if selected EC scores at baseline within worst-performing quartile) or to the PROMOTE trial (if selected EC scores not within worst-performing quartile). In both trials, participants are randomised (i) to continue with usual practice, repeated assessments and a self-monitoring app; (ii) to additionally receive generic cognitive-behavioural therapy self-help in app; (iii) to additionally receive personalised EC self-help in app. In total, 2142 participants aged 16 to 22 years, with no current or past history of major depression, bipolar disorder or psychosis will be recruited across UK, Germany, Spain, and Belgium. Assessments take place at baseline (pre-randomisation), 1, 3 and 12 months post-randomisation. Primary endpoint and outcome for PREVENT is level of depression symptoms on the Patient Health Questionnaire-9 at 3 months; primary endpoint and outcome for PROMOTE is emotional well-being assessed on the Warwick-Edinburgh Mental Wellbeing Scale at 3 months. Depressive symptoms, anxiety, well-being, health-related quality of life, functioning and cost-effectiveness are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. CONCLUSIONS: The trial aims to provide a better understanding of the causal role of learning EC skills using interventions delivered via mobile phone apps with respect to promoting well-being and preventing poor mental health in young people. This knowledge will be used to develop and disseminate innovative evidence-based, feasible, and effective Mobile-health public health strategies for preventing poor mental health and promoting well-being. TRIAL REGISTRATION: ClinicalTrials.gov ( www.clinicaltrials.org ). Number of identification: NCT04148508 November 2019.

Somatic complaint differences between Turkish immigrants and Belgians: do all roads lead to Rome?

OBJECTIVE: Turkish immigrants have been found to report more somatic complaints compared to western majority groups. The present study investigates the combination of two cultural explanations (somatization versus psychologization and emotion mediation) with two acculturative explanations (acculturative stress versus acculturative transition) to explain these differences. DESIGN: In total, 144 Turkish immigrants, 353 Belgian majority members, and 222 Turkish majority members were asked to report the last three emotional episodes they encountered and to rate them on 24 emotion terms and 17 somatic sensations. RESULTS: Turkish majorities scored higher on all somatic factors, anxiety-sadness, and self-conscious emotions followed by Turkish immigrants and Belgian majorities. Furthermore, path analysis showed (partial) mediation effects of anxiety-sadness and self-conscious factors on the differences in the somatic factors between Belgian and Turkish majorities. CONCLUSION: These results indicate that the somatic differences do not result from a trade-off between somatization and psychologization, but that emotions mediate differences in somatic processes to a large extent. It was also found that differences between Turkish immigrants and Belgian majority members are to be attributed to acculturative transition, rather than to acculturative stress.