A Comparison of Items and Constructs of Standardized Health-Related Quality of Life and Mental Well-Being Measures.

OBJECTIVES: This study aimed to explore the internal constructs of the concepts being measured by EQ-5D-5L (a health-related quality of life measure that can produce preference-based utility values) and the 12-item General Health Questionnaire (GHQ-12, a mental well-being measure) and to understand to what extent the items of EQ-5D-5L and GHQ-12 associate with each other. METHODS: We used data from 12 701 respondents participating in a Belgian survey in 2022. Correlation coefficients between GHQ-12 and EQ-5D-5L were calculated at both the aggregate and item levels. Multidimensional scaling, exploratory factor analysis, and regression models were performed to investigate the underlying constructs that are associated with the items. RESULTS: Despite a moderate correlation (0.39) between the EQ-5D-5L and GHQ-12 total scores, only a trivial or weak correlation (<0.3) was observed between the first 4 EQ-5D-5L items and any GHQ-12 item. Multidimensional scaling and exploratory factor analysis showed the first 4 EQ-5D-5L dimensions were clustered together with EuroQol visual analog scale and positively phrased GHQ-12 items were close to each other, whereas EQ-anxiety/depression and negatively phrased GHQ-12 items were grouped with overall life satisfaction. In the regression models, not all GHQ-12 items had a significant coefficient to predict EQ-5D-5L responses. CONCLUSIONS: To the best of our knowledge, we present the first comparison of items and underlying constructs of GHQ-12 and EQ-5D-5L. The results showed that GHQ-12 can only partially predict the responses of EQ-5D-5L and the 2 instruments measure different constructs. Researchers should carefully consider conceptual legitimacy while applying the mapping technique and consider sensitivity analyses for the mapping estimates.

Validation and psychometric evaluation of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) among Czech adolescents using Item Response Theory.

BACKGROUND: The topic of adolescent mental health is currently a subject of much debate due to the increasing prevalence of mental health problems among this age group. Therefore, it is crucial to have high-quality and validated mental well-being measurement tools. While such tools do exist, they are often not tailored specifically to adolescents and are not available in Czech language. The aim of this study is to validate and test the Czech version of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) on a large sample of Czech adolescents aged 15 to 18 years. METHODS: The analysis is based on data from the first wave of the Czech Education Panel Survey (CZEPS) and was mainly conducted using Item Response Theory (IRT), which is the most appropriate method for this type of analysis. Specifically, the Graded Response Model (GRM) was applied to the data. This comprehensive validation study also included reliability and three types of validity (construct, convergent and criterion) testing. RESULTS: The study found that the Czech version of the SWEMWBS for adolescents aged 15 to 18 years (N = 22,498) has good quality and psychometric properties. The data was analysed using the GRM model as it met the assumptions for the use of IRT. The estimated parameter values by GRM demonstrated good discriminant and informative power for all items, except for item 7, which showed poorer results compared to the others. However, excluding it from the scale would not enhance the overall quality of the scale. The five-category response scale functions effectively. Additionally, the results demonstrated high reliability, and all types of validity tested were also confirmed. CONCLUSIONS: The Czech version of the SWEMWBS for adolescents has been validated as a psychometrically sound, reliable and valid instrument for measuring mental well-being. It can therefore be used with confidence in future studies.

Validation of the Warwick-Edinburgh Mental Well-Being Scale for the Mental Health Surveillance (MHS) of German adults.

BACKGROUND: Mental health encompasses more than just the absence of mental disorders. Thus, a Mental Health Surveillance (MHS) and reporting system for Germany should monitor mental well-being in addition to psychopathology to capture a more complete picture of population mental health. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) is an internationally established inventory for the integrated assessment of different aspects of mental well-being (i.e., hedonic and eudaimonic) in population samples that has not yet been validated for Germany. METHODS: Using data from a cross-sectional online survey of a convenience sample of N = 1.048 adults aged 18-79 years (51% female) living in Germany, the factorial structure, measurement invariance (age, sex) and psychometric properties of the WEMWBS in its long (14 items) and short (7 items) versions were analyzed. Additionally, correlations to relevant factors (e.g., health-related quality of life, psychological distress) were investigated as indicators of criterion validity. RESULTS: Means of model fit indices did not confirm a unidimensional factor structure for either version. The three-factor-correlative models showed moderate to good fit while the bifactor model with one general mental well-being factor and three grouping factors fitted the data best. The full range of possible responses was used for all items, and the distribution of both scales was approximately normal. Moreover, the results revealed measurement invariance across sex and age groups. Initial evidence of criterion validity was obtained. Internal consistencies were α = 0.95 and α = 0.89, respectively. Average mental well-being was comparable to that of other European countries at 3.74 for the long version and 3.84 for the short version. While there were no differences by sex, comparisons between age groups revealed higher mental well-being among the older age groups. CONCLUSIONS: Both versions of the WEMWBS showed sound psychometric characteristics in the present German sample. The findings indicate that the instrument is suitable for measuring mental well-being at the population level due to its distributional properties. These results are promising, suggesting that the scale is suitable for use in a national MHS that aims to capture positive mental health in the population as a foundation for prevention and promotion efforts within public mental health.

Examining the importance of neighborhood natural, and built environment factors in predicting older adults' mental well-being: An XGBoost-SHAP approach.

BACKGROUND: Previous studies have shown that urban neighborhood environmental factors significantly influence the health outcomes of urban older adults. However, most cross-sectional studies exploring the health effects of these factors have failed to quantify the relative importance of each factor. METHODS: We use XGBoost machine learning techniques and SHAPley Additive Interpretation (SHAP) to rank the importance of urban neighborhood environmental factors in shaping the mental health of urban older adults. To address self-selection bias in housing choice, we distinguish older adults living in private housing from those living in public as residents in private housing have more freedom to choose where to live. RESULTS: The results show that both natural and built environmental factors in urban neighborhoods are important predictors of mental well-being scores. Five natural environmental factors (blue space, perceived greenery quantity, NDVI, street view greenness, aesthetic quality) and three built environmental factors (physical activity facilities quality, physical activity facilities quantity, neighborhood disorder) had considerable predictive power for mental well-being scores in two groups. Among them, blue space, perceived greenery quantity and street view greenness quantity became less important after controlling for self-selection bias, possibly because of the unequal distribution of quantity and quality, and the performance of neighborhood disorder, aesthetic quality and physical activity facilities quality was more sensitive in public housing. CONCLUSIONS: These results highlight the nuanced and differential effects of neighborhood environmental exposures on mental well-being outcomes, depending on housing preferences. The results of this study can provide support for decision makers in urban planning, landscape design and environmental management in order to improve the mental well-being status of urban older adults.

German adult population norm values of the short Warwick Edinburgh mental well-being scale (SWEMWBS).

PURPOSE: The Warwick-Edinburgh Mental Well-Being Scale represents an internationally established inventory to assess population mental well-being. Particularly the short form (SWEMWBS) is recommended for use in Mental Health Surveillance. In the present study, we present normative data of the SWEMWBS for the German adult population. METHODS: Data from the telephone survey German Health Update (GEDA) in 2022 representative of the German adult population (48.9% women, 18-98 years) was processed to estimate SWEMWBS percentile norm values, T-values, z-values and internationally comparable logit-transformed raw scores for the total sample (N = 5,606) as well as stratified by sex, age group and sex with age group combinations. RESULTS: The average mental well-being was comparable to that of other European countries at M = 27.3 (SD = 4.0; logit-transformed: M = 24.79, SD = 3.73). To provide a benchmark, the cut off for low well-being was set at the 15th percentile (raw score: 23; logit-transformed: 20.73), for high well-being at the 85th percentile (raw score: 32; logit-transformed: 29.31). CONCLUSION: The present study provides SWEMWBS norm values for the German adult population. The normative data can be used for national and international comparisons on a population level to initiate, plan and evaluate mental well-being promotion and prevention measures.

Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study.

BACKGROUND: Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. METHODS: A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022-2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). RESULTS: Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help. CONCLUSION: The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

Determinants of the desire to avoid pregnancy after the disaster of the century in Türkiye.

BACKGROUND: After natural disasters, the occurrence of mental health problems and adverse effects on reproductive health in women of reproductive age can be attributed to a multitude of factors, including the deterioration of health facilities, a shortage of qualified health professionals, a lack of socio-economic stability, and a paucity of familial and community support. METHODS: The descriptive correlational study was conducted through social networks with 405 women who had experienced the disaster of the century 8 months after (between November and December 2023) the earthquake. The snowball sampling method was used to obtain the research data. The questionnaire form, developed for the purpose of data collection, was disseminated to women who consented to participate in the study through social networks. The data were evaluated using a variety of statistical techniques, including number, percentage, mean, standard deviation, independent sample t-test, one-way analysis of variance, and structural equation modeling. RESULTS: According to the results of linear regression analysis, these were found to be predictors of the desire to avoid pregnancy: having housing problems (ß-coefficient 0.173; p = .008), having a damaged home (ß-coefficient. 276; p = .009), sleep patterns (ß-coefficient 0.433; p = .022), eating habits (ß-coefficients 0.248, 0.044), use of psychiatric medication (ß-coefficient 0.436, p = .003), and problems related to the food and water supply (ß-coefficient 0.127, p = .003). In addition, a structural equation model (SEM) was established to examine the relationship between these variables and mental well-being and pregnancy avoidance. Only the model constructed with mental well-being demonstrated significance in the SEM analysis. CONCLUSIONS: This study shows that women's mental health is negatively affected in unpredictable emergencies such as earthquakes and that poor mental health negatively affects pregnancy planning. The findings of the study may help to guide health professionals working in the field of women's health to protect women's mental health in emergency situations, to provide counseling about pregnancy planning, and to provide social and psychological support programs.

The effects of a combined physical activity and health education program on health knowledge and well-being of socially vulnerable children.

The purpose of the present study was to evaluate the effects of the football-based health education program "11 for Health" on health knowledge and well-being in the setting of a 10-week residential stay in a Danish charity home for socially vulnerable children. Six hundred and fourteen children participated in the study, of which 305 took part in the standard program plus "11 for Health" (SG+: 12.4 ± 1.4 (mean ± SD) years) and 309 took part in the standard program (SG: 12.4 ± 1.6 years). We used a crossover design over two full years. The study examined changes in health knowledge and well-being through questionnaires. Overall health knowledge increased more in SG+ than SG over 10 weeks (6.6 vs. 3.4%, p < 0.05). The overall well-being scores were markedly improved (p < 0.05) by 4.54 ± 7.17 AU in SG+ and 4.51 ± 7.16 AU in SG, with no between-group differences. Specific improvements (p < 0.05) were seen in all well-being subcategories, raising the well-being scores to the national average. In conclusion, a 10-week stay at a Danish charity home, the Christmas Seal Home, markedly affected health knowledge and well-being of socially vulnerable children. When the football-based health education program-11 for Health-was added, there were additional positive effects on health knowledge.

The impact of the Covid-19 pandemic on mental health in Danish school children in 5th to 7th grade.

AIM: We wanted to examine the impact of the Covid-19 pandemic on mental health in Danish school children in 5th to 7th grade (11 to 15 years), and whether the impact differed across age and sex. METHODS: We included 793 and 391 school children from winter 2020 and winter 2021, respectively. Mental health was measured using the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), Strengths and Difficulties Questionnaire (SDQ), and Brief Resilience Scale (BRS). Data were analyzed by sex using linear regression models adjusting for grade (age), cohabitation, geographical region, employment status of parents, and schools as clusters. RESULTS: Girls in 5th grade and boys in 6th grade during Covid-19 had statistically significant lower well-being (SWEMWBS) compared with before Covid-19. Girls in 5th and 6th grade during Covid-19 had non-statistically significant lower scores on all subscales of SDQ compared with girls before Covid-19. Girls in 7th grade during Covid-19 had statistically significant lower total difficulty score (SDQ) and fewer conduct problems (SDQ) compared with girls before Covid-19. Boys in 5th grade during Covid-19 had statistically significant fewer conduct problems (SDQ) compared with boys before Covid-19. CONCLUSIONS: This study indicates that the Covid-19 pandemic impacted Danish school children differently across sex and grade (age). During Covid-19, mental health tended to be better among the oldest girls and worse among the youngest girls compared with girls before Covid-19. Boys in 6th grade had poorer mental well-being, and boys in 5th grade had fewer conduct problems during Covid-19 compared with before Covid-19.

Associations between eating habits and mental health among adolescents in five nordic countries: a cross-sectional survey.

BACKGROUND: The role of eating habits in adolescent mental health has become a growing area of interest for researchers and health professionals. Recent studies suggest that healthy eating habits may play a role in the development and management of mental health. However, existing literature is largely based on clinical populations, and comparisons are challenged by sociocultural differences and methodological issues. The aim of the present study was to use nationally representative data based on standardized procedures, to explore associations between adolescents eating habits and mental health, considering the importance of age, gender, socioeconomic factors, and country. METHODS: The study was based on data from Nordic adolescents (age 11, 13 and 15 years) who participated in the 2017/2018 Health Behavior in School-aged Children (HBSC) study (n = 22384). General linear modelling and multigroup regression analysis were used to examine the relationship between food habits (intake of fruit, vegetables, sweets, soft drinks), meal habits (intake of breakfast and having family meals together), and mental health (life satisfaction and subjective health complaints). The analyses were weighted and adjusted for age, gender, socio-economic status, and country. RESULTS: Overall, healthier eating habits were associated with better mental health. The strongest associations were found between meal habits (breakfast consumption and having family meals together) and mental health. Gender and country differences were seen, with weaker associations found among Danish boys. CONCLUSION: Eating habits should be considered when promoting mental health in the adolescent population. While gender differences and cross-country variations exist, even minor enhancements in eating behaviors could yield meaningful benefits.

Financial insecurity and mental well-being: experiences of parents amid the lebanese economic crisis.

BACKGROUND: This study investigates the impact of financial insecurity on the mental well-being and stress levels of parents in Lebanon amid the country's severe economic crisis. The context of Lebanon's economic collapse, coupled with the effects of the COVID-19 pandemic and the Beirut port explosion, has exacerbated financial and psychological distress among the population. This research aims to understand the correlation between financial instability and parental stress, identifying key factors contributing to mental health challenges in this demographic. METHODS: Employing a quantitative research approach, data was collected through an online survey from 785 parents from different backgrounds in Lebanon. The survey incorporated sociodemographic questions, the InCharge Financial Distress/Financial Well-Being Scale (IFDFW), and the Arabic version of the Parental Stress Scale (PSS). Data analysis was conducted using SPSS version 25. RESULTS: Findings showed significant correlations between high levels of parental stress and factors such as age (r = 0.071, p = 0.047) and lower education levels. Notably, refugees residing in Lebanon exhibited higher stress levels compared to Lebanese parents (mean stress score: 51.73 vs. 45.71, p < 0.001). Similarly, employed participants exhibited higher stress levels compared to the nonworking (mean stress score: 46.75 vs. 44.60, p = 0.003). A significant inverse association was found between financial well-being and parental stress (r=-0.216, p < 0.001), emphasizing the profound impact of economic instability on mental health. CONCLUSIONS: This study highlights the adverse effects of financial insecurity on parents' mental health, primarily during a period of economic instability, emphasizing the urgent need for targeted support interventions. These findings contribute to the literature on economic crises and mental health, providing a basis for future research and policy development in similar contexts.

Quantifying the relationship between gardening and health and well-being in the UK: a survey during the covid-19 pandemic.

BACKGROUND: Rates of non-communicable diseases, including cardiovascular disease and type 2 diabetes, and mental health problems, such as anxiety and depression, are high and rising in the urbanising world. Gardening could improve both mental and physical health and help prevent a range of conditions by increasing fruit and vegetable (F&V) consumption, promoting physical activity, and reducing stress. However, good quality quantitative research in the area is scarce, and our understanding of the role of allotments and home gardens, and the effects of the level of engagement in gardening and involvement with food production has thus far been limited. METHODS: We quantitatively assess the relationship between home and allotment gardening and various indicators and predictors of health and well-being using an online survey of gardeners (n = 203) and non-gardeners (n = 71) in the UK. The survey was composed of multiple validated questionnaires (including the Short Form Food Frequency Questionnaire (SFFFQ), the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the Physical Health Questionnaire (PHQ) and the Self-Rated Health question (SRH)) and self-defined questions relating to participants' involvement with gardening and food production, and relevant demographic and lifestyle factors. Data were analysed using a series of hierarchical logistic and multiple linear regression models adjusting for socio-demographic variables. RESULTS: After adjusting for relevant socio-demographic factors, gardening related variables were associated with better self-rated health, higher mental well-being, increased F&V consumption. Higher F&V intake was in turn also associated with better self-rated health and decreased odds of obesity. Thus, gardening had a positive association with four different aspects of health and well-being, directly or indirectly via increased F&V consumption. CONCLUSIONS: Our results suggest that gardening in UK allotments and domestic gardens may promote different aspects of health and well-being via multiple mechanisms. Improving access to growing space and promoting regular gardening could provide a range of benefits to public health. More research on how socio-economic factors influence the health and well-being benefits of gardening will help policymakers devise strategies to maximise these benefits.

Collaborative approaches to health education: perspectives of parents and teachers on self-care and managing common health issues in UK primary schools.

BACKGROUND: Health education in primary schools plays a critical role in equipping children with essential self-care skills, fostering health literacy, and addressing social determinants of health. This study explores the perspectives of parents and teachers on teaching self-care and managing common health issues in UK primary schools. Despite the recognized importance of health education, there is limited research on how self-care education is perceived and implemented in the primary school setting. METHODS: A qualitative study was conducted using semi-structured interviews with 18 participants, including 9 generalist primary teachers and 9 parents from diverse educational and socioeconomic contexts in the West Midlands, East Midlands, Northwest, and London of England. Participants were recruited via social media and professional networks, and interviews were conducted via video conferencing platforms. Data were thematically analysed using NVivo 12 to identify recurring themes related to the delivery and impact of self-care education in primary schools. RESULTS: Teachers and parents highlighted key self-care topics, including hygiene, managing common illnesses like colds and cuts, and mental well-being. There was a consensus on the importance of self-care education, but views diverged on whether the responsibility should lie primarily with schools, parents, or a collaborative approach. Teachers expressed concerns about their preparedness to teach sensitive topics, citing a lack of training and resources. Socioeconomic and religious contexts further influenced perceptions, with participants emphasising further importance of school-led self-care education for children from lower socioeconomic backgrounds. Strengths were identified in current self-care education efforts, particularly in practical lessons that empower children with age-appropriate skills. CONCLUSIONS: This study highlights the critical need for comprehensive and collaborative health education in primary schools to promote health literacy and reduce health disparities. Enhancing teacher training, integrating self-care topics into the primary curriculum, and fostering stronger partnerships between schools and families are essential to improving the quality and consistency of self-care education. Policymakers should consider implementing mandatory health education training in teacher education programs and providing ongoing professional development to support teachers. By addressing these gaps, schools can play a pivotal role in preparing children for lifelong health management, reducing the burden on healthcare services, and supporting public health objectives.

Milk fat globule membranes for psychological and physical health: qualitative results from the Employing Milk Phospholipids to Observe Well-being and Emotional Resilience (EMPOWER) randomised trial.

BACKGROUND: Milk fat globule membranes (MFGM) present a nutritional intervention with the potential to improve psychological well-being and mitigate the negative effects of stress on health. The present study aimed to investigate participant's experience of different aspects of health during a trial of MFGM supplementation and determine the effect of MFGM on qualitative measures of psychological and physical well-being. METHODS: Seventy-three adults in New Zealand who were enrolled in a clinical trial to test MFGM supplementation for improvement of psychological well-being took part in a post-intervention interview. Participants and researchers remained blinded to intervention group allocation. Interviews were conducted over the video conferencing platform Zoom and transcribed. A mixed methods analytical approach included thematic analysis to identify emerging themes and χ2 regression models to examine frequency of improvements in different aspects of well-being between the MFGM and placebo groups. RESULTS: There were no significant demographic or psychological differences between interviewees and non-interviewed study participants. Four central themes emerged from the data for all participants: improved well-being, increased ability to cope with stress and improvements in mood, improvement in physical energy or activity, and improved sleep. The frequency of improved ability to cope with stress and improved sleep quality was significantly higher in participants who received MFGM supplementation compared to those receiving the placebo. CONCLUSIONS: Qualitative data may capture aspects of improved sleep or psychological well-being not measured by rating scales. The results suggest that MFGM supplementation may improve the ability to cope with stress and improve sleep quality in healthy adults.

Development and Evaluation of a Smartphone-Based Chatbot Coach to Facilitate a Balanced Lifestyle in Individuals With Headaches (BalanceUP App): Randomized Controlled Trial.

BACKGROUND: Primary headaches, including migraine and tension-type headaches, are widespread and have a social, physical, mental, and economic impact. Among the key components of treatment are behavior interventions such as lifestyle modification. Scalable conversational agents (CAs) have the potential to deliver behavior interventions at a low threshold. To our knowledge, there is no evidence of behavioral interventions delivered by CAs for the treatment of headaches. OBJECTIVE: This study has 2 aims. The first aim was to develop and test a smartphone-based coaching intervention (BalanceUP) for people experiencing frequent headaches, delivered by a CA and designed to improve mental well-being using various behavior change techniques. The second aim was to evaluate the effectiveness of BalanceUP by comparing the intervention and waitlist control groups and assess the engagement and acceptance of participants using BalanceUP. METHODS: In an unblinded randomized controlled trial, adults with frequent headaches were recruited on the web and in collaboration with experts and allocated to either a CA intervention (BalanceUP) or a control condition. The effects of the treatment on changes in the primary outcome of the study, that is, mental well-being (as measured by the Patient Health Questionnaire Anxiety and Depression Scale), and secondary outcomes (eg, psychosomatic symptoms, stress, headache-related self-efficacy, intention to change behavior, presenteeism and absenteeism, and pain coping) were analyzed using linear mixed models and Cohen d. Primary and secondary outcomes were self-assessed before and after the intervention, and acceptance was assessed after the intervention. Engagement was measured during the intervention using self-reports and usage data. RESULTS: A total of 198 participants (mean age 38.7, SD 12.14 y; n=172, 86.9% women) participated in the study (intervention group: n=110; waitlist control group: n=88). After the intervention, the intention-to-treat analysis revealed evidence for improved well-being (treatment: ß estimate=-3.28, 95% CI -5.07 to -1.48) with moderate between-group effects (Cohen d=-0.66, 95% CI -0.99 to -0.33) in favor of the intervention group. We also found evidence of reduced somatic symptoms, perceived stress, and absenteeism and presenteeism, as well as improved headache management self-efficacy, application of behavior change techniques, and pain coping skills, with effects ranging from medium to large (Cohen d=0.43-1.05). Overall, 64.8% (118/182) of the participants used coaching as intended by engaging throughout the coaching and completing the outro. CONCLUSIONS: BalanceUP was well accepted, and the results suggest that coaching delivered by a CA can be effective in reducing the burden of people who experience headaches by improving their well-being. TRIAL REGISTRATION: German Clinical Trials Register DRKS00017422; https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00017422.

Adolescent mental well-being in time of crises: The role of social and residential contexts.

BACKGROUND: The extent of the impact and the interconnections among factors within social and residential contexts during the COVID-19 lockdowns on mental well-being remain to be elucidated. We identified latent classes of each of social and residential context during the lockdown and examined their associations with mental well-being among adolescents in France 1-year after the first lockdown. METHODS: We used data collected in 2021 in a cross-sectional school-based pilot study for EXIST, from 387 participants ages 12-15 years. Participants reported retrospectively on characteristics of their social and residential contexts during the lockdown, and their current mental well-being in self-report questionnaires. We used latent class analysis to identify latent classes of social and residential contexts, and linear regression models to examine the associations between these contexts and mental well-being. RESULTS: Four social context classes were identified: class 1 "Low opportunity for social contact at home," class 2 "Moderate opportunity for social contact at home," class 3 "High opportunity for social contact at home," and class 4 "Very high opportunity for social contact at home." Relative to class 4, lower levels of mental well-being were observed among adolescents in class 1 (b = -4.08, 95% CI [-8.06; -0.10]) 1 year after the lockdown. We identified four residential context classes based on proximity to nature, type of residence (e.g., apartment, house), and level of neighborhood deprivation. No association was detected between residential context during the lockdown and adolescent mental well-being one-year later. CONCLUSION: A limited social context may negatively impact adolescent mental well-being during crises.

Promoting mental well-being in Western Australia: Act Belong Commit® mental health promotion campaign partners' perspectives.

The Act Belong Commit® mental health promotion campaign aims to improve population mental well-being. Based on a social-franchising model, partnerships are sought with organizations offering 'mentally healthy activities' that foster social connectedness and mental well-being. There are four categories of partner organizations sought: Site (government agencies and health services), Associate (organizations with state-wide or national services), Community (local, grass-roots community groups) and Schools. This research explored organizational perceptions of the Act Belong Commit® Partnership Program. A purposive sample of 14 organizational representatives across all four partner categories participated in semi-structured interviews online or face-to-face between July and September 2021. Reflexive thematic analysis was used to identify three main themes: (a) A passion for promoting mental health; (b) Implementation, innovation, adaption and creation (e.g. the ability to adapt, create and deliver activities aligned with the campaign message; and (c) Future sustainability (e.g. recommendations for the sustainability of the programme). The use of reflexive thematic analysis enabled deeper insights into the complexity of the partnerships. Findings describe how the Act Belong Commit® Partnership Program supports mutually desirable objectives and extends the campaign reach. Embedded in a shared belief system that incorporates a passion for good mental health, the model supports the flexibility to adapt, create and deliver fit-for-purpose activities that promote mental well-being in the places where people live, work and play.

A structural equation model of the impacts of nurses' psychological safety and psychological contract breach.

AIM: To investigate the effects of psychological contract breach and psychological safety on health and well-being outcomes among nurses. DESIGN: A cross-sectional study. METHODS: Data were gathered from members of the Finnish social and healthcare workers' trade union (n = 4575) in February 2023. This study focused on data from 3260 nurses. Structural equation modelling was employed to firstly explain burnout and work engagement and subsequently health and well-being outcomes in relation to perceived psychological contract breach and psychological safety. RESULTS: Younger male nurses, those with lower-level university degrees, and nurses employed in public hospitals reported experiencing more psychological contract breaches. Conversely, older nurses and those working in private organizations perceived a higher level of psychological safety. Psychological contract breaches were associated with increased burnout and reduced work engagement, while psychological safety contributed to lower burnout and higher work engagement. Moreover, burnout was linked to health problems and diminished mental well-being, whereas increased work engagement led to fewer health problems and improved mental well-being. The final model demonstrated excellent fit. CONCLUSION: Breaches in the psychological contract, followed by distrust, and anger significantly burden nurses, detrimentally affecting their well-being at work. Psychologically safe working environments, consequently, improve nurses' well-being at work and should be promoted within work teams. IMPLICATIONS FOR THE PROFESSION: Nursing managers could receive training to understand the consequences of, and practices for supporting, a beneficial psychological work climate. IMPACT: The study examined psychological burden and resource factors at work, finding that psychological contract breaches increased burden and led to negative well-being outcomes. In contrast, psychological safety emerged as a positive resource for health and well-being. These results offer benefits for nurses, managers and organizations. REPORTING METHOD: The study was reported following the Strengthening of the reporting of observational studies in epidemiology guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey.

INTRODUCTION: Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression. METHODS: The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA). RESULTS: Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise. CONCLUSIONS: High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.

Building resilience among undergraduate health professions students: identifying influencing factors.

BACKGROUND: Resilience contributes to mental well-being, hence expediting recovery from stressful events. Health professions students, in particular, often experience heightened levels of stress and anxiety due to academic demands and other stressors. This study aimed to explore the factors contributing to resilience and identify support systems that universities can implement to help undergraduate health professions students build resilience and manage their mental well-being. METHODS: A total of 28 students from the fields of Medicine, Dentistry, Pharmacy, and Dietetics and Nutrition participated in semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The interviews were stopped when data saturation was achieved. The data were analysed using thematic analysis. RESULTS: Thematic analysis of the interviews identified five key themes contributing to resilience: life experience, socioeconomic factors, personal attributes, support resources, and role modelling. Universities play a crucial role in fostering resilience among health professions students through soft skills training, workplace-oriented training, mentoring, and extracurricular activities. These opportunities enable students to develop and strengthen resilience in both formal and informal settings. Such initiatives not only equip students to manage future career challenges but also support their overall personal and professional development. CONCLUSIONS: This study provided a comprehensive understanding of the contributing factors to health professions students' resilience. The availability of support resources together with a nurturing environment provided by university are crucial. By fostering resilience, students are better prepared to navigate the challenges of the demanding professions and develop the emotional fortitude necessary for long-term success in healthcare.