Total and temporal patterning of physical activity in adolescents and associations with mental wellbeing.

BACKGROUND: There is limited understanding of the extent to which differences in physical activity across the day and week may be associated with mental wellbeing. Such an understanding is needed for better targeting of interventions. In this study, we describe total and temporal patterning of physical activity across the week in adolescents (age 13-14y) and assess their prospective associations with mental wellbeing. METHODS: 1,983 13-14-year-old adolescent participants based in Cambridgeshire and Essex, recruited between 2016 and 2017 into the Get Others Active Trial provided data at baseline and 4 months. Physical activity was measured at baseline using wrist-worn accelerometers across different time segments (whole week, weekday schooltime, weekday out of school, and weekend), and operationalized as average movement-related acceleration for each time segment. Mental Wellbeing at baseline and 4 months was measured using the Warwick Edinburgh MentalWellbeing Scale. Associations between physical activity across different time segments (whole week, weekday schooltime, weekday out of school, and weekend) and mental wellbeing at 4 months were investigated using sex-stratified multi-level regression models, adjusted for covariates, and both adjusted and unadjusted for baseline mental wellbeing. RESULTS: Our analyses found positive associations between physical activity and mental wellbeing at 4 months, unadjusted for baseline wellbeing. Among girls, positive associations were shown when considering physical activity across the whole week 0.07 (95% CI, 0.03-0.12), and across all separate time periods studied: weekday schooltime 0.07 (95% CI, 0.02-0.11), weekday out-of-school time 0.07 (95% CI, 0.03-0.12), and weekend 0.07 (95% CI, 0.02-0.11). For boys, similar associations were observed for activity across the week 0.07 (95% CI, 0.03-0.11), during weekday schooltime 0.08 (95% CI, 0.04-0.12), and weekday out-of-school time 0.07 (95% CI, 0.03-0.11), but not the weekend 0.01 (95% CI, -0.03-0.05). For both girls and boys, associations were attenuated below significance after adjusting for baseline wellbeing. CONCLUSIONS: This longitudinal analysis showed positive associations between physical activity and later mental wellbeing in both male and female adolescents across most time segments. Higher physical activity throughout the week may be associated with better mental wellbeing in the adolescent population. Further research is required to understand determinants of change in wellbeing over time. TRIAL REGISTRATION: Registration Number: ISRCTN31583496. Registered: 18/02/2014.

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.

MHQ: constructing an aggregate metric of population mental wellbeing.

BACKGROUND: According to the World Health Organization (WHO), mental health is 'a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community'. Any population metric of mental health and wellbeing should therefore not only reflect the presence or absence of mental challenges but also a person's broad mental capacity and functioning across a range of cognitive, social, emotional and physical dimensions. However, while existing metrics of mental health typically emphasize ill health, existing metrics of wellbeing typically focus on happiness or life satisfaction, indirectly infer wellbeing from a selection of social and economic factors, or do not reflect a read out of the full spectrum of mental functioning that impacts people's everyday life and that spans the continuum from distress and the inability to function, through to the ability to function to one's full potential. METHODS: We present the Mental Health Quotient, or MHQ, a population metric of mental wellbeing that comprehensively captures mental functioning, and examine how it relates to functional productivity. We describe the 47-item assessment and the life impact rating scale on which the MHQ metric is based, as well as the rationale behind each step of the nonlinear algorithm used to construct the MHQ metric. RESULTS: We demonstrate a linear relationship between the MHQ metric and productive life function where movement on the scale from any point or in any direction relates to an equivalent shift in productive ability at the population level, a relationship that is not borne out using simple sum scores. We further show that this relationship is the same across all age groups. Finally, we demonstrate the potential for the types of insights arising from the MHQ metric, offering examples from the Global Mind Project, an initiative that aims to track and understand our evolving mental wellbeing, and since 2020 has collected responses from over 1 million individuals across 140 + countries. CONCLUSION: The MHQ is a metric of mental wellbeing that aligns with the WHO definition and is amenable to large scale population monitoring.

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.

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.

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.

Gaining consensus on emotional wellbeing themes and preferences for digital intervention type and content to support the mental health of young people with long-term health conditions: A Delphi study.

BACKGROUND: Young people (YP) with long-term conditions (LTCs) are at greater risk of psychological distress than those without LTCs. Despite this, there is a scarcity of quality digital interventions designed to help improve mental wellbeing in this population. The aim of this study was to determine what YP, parents and health professionals preferred for future interventions. METHODS: Twenty-six YP with asthma, diabetes and/or epilepsy (the three most common LTCs in YP), 23 parents of YP with LTCs and 10 health professionals mainly in paediatric specialisms (total n = 59) took part in an online Delphi study to gain consensus (set at 75% agreement) on four questions across three rounds. Participants ordered psychological themes that may be experienced by YP with LTCs by importance and ranked digital intervention types and delivery modes by importance or usefulness. The most common results were reported if no consensus was reached by round 3. RESULTS: Participants preferred a mobile phone app (73% agreement) and a mixture of one-on-one and group support for an intervention (75% agreement). The two highest ranked psychological themes were anxiety (44%) and wanting to appear 'normal' (38%), and the top intervention type was 'general counselling' (54% agreement). CONCLUSION: There was a clear desire for an app to help with the psychological aspects of living with LTCs and for a combination of one-to-one and group intervention elements. Anxiety and wanting to appear 'normal' might be two closely linked psychological challenges that could be addressed by a single intervention. IMPLICATIONS: The results will be important to consider for a future intervention, although further consultation will be needed for app development. PATIENT OR PUBLIC CONTRIBUTION: Two YP with a LTC provided feedback on the study protocol including the aims and procedures of the project. Another six YP with LTCs were consulted on an early draft of the study questionnaire (the four questions), which was subsequently revised. Once the project began, a patient and public involvement group consisting of two YP with LTCs and one parent of a YP with an LTC gave feedback on the research process, lay report of the results and dissemination plan.

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.

Screen viewing patterns and their association with mental wellbeing and psychological distress: a cross-sectional study amongst university students.

BACKGROUND: Dependency on screen viewing (SV) has reached unprecedented levels, and mental health issues are becoming a major public health concern. However, the associations between SV, including variations in purposes, devices, and timing, and mental health remain unclear. This study aims to provide insights into these associations among university students. METHODS: This analysis used baseline data from a longitudinal cohort study among first-year university students matriculating in the 2021-2022 academic year. Self-reported data on sociodemographics, health behaviors and mental health outcomes alongside anthropometric measurements were collected. Unadjusted and adjusted logistic regression analyses were conducted. RESULTS: The average age of the 997 valid students was 20.2 years, with 59.6% being female and 41.4% male. Students spent 14.3 h daily on SV, with females reporting higher SV than males. Daily SV was predominant for study purposes (7.6 h/day). Computer usage was the highest (7.0 h/day), while TV usage was the lowest (1.7 h/day). Poor mental wellbeing was reported by 33.6% of students, while 13.9% experienced psychological distress. Compared to students with low total SV, those with high levels were more likely to have poor mental wellbeing [OR (95% CI): 1.40 (0.99, 1.98)] and psychological distress [1.56 (1.00, 2.44)]. High levels of recreational and study related SV were significantly associated with poor mental wellbeing [1.81 (1.27, 2.56)] and psychological distress [1.75 (1.11, 2.83)], respectively. Those with high levels of computer time were more likely to have poor mental wellbeing [1.44 (1.01, 2.06)], and high weekend day SV was associated with greater odds of psychological distress [2.16 (1.17, 4.06)]. CONCLUSIONS: SV among university students was high, as was the high prevalence of poor mental wellbeing and psychological distress. Greater SV was associated with poor mental wellbeing and psychological distress. Differences according to purpose of SV were noted. Although recreational SV was associated with poor mental wellbeing, study related SV was associated with psychological distress. Variations across different devices and timing were also noted. This highlights the need for further longitudinal research to understand the impact of SV on mental health and to guide interventions for promoting mental health of university students globally.

Prevalence and nature of workplace bullying and harassment and associations with mental health conditions in England: a cross-sectional probability sample survey.

BACKGROUND: Evidence on workplace bullying and harassment (WBH) in the UK has not used probability-sample surveys with robust mental health assessments. This study aimed to profile the prevalence and nature of WBH in England, identify inequalities in exposure, and quantify adjusted associations with mental health. METHODS: Data were from the 2014 Adult Psychiatric Morbidity Survey, a cross-sectional probability-sample survey of the household population in England. Criteria for inclusion in the secondary analysis were being aged 16-70 years and in paid work in the past month (n = 3838). Common mental disorders (CMDs) were assessed using the Clinical Interview Schedule-Revised and mental wellbeing using the Warwick-Edinburgh Mental Wellbeing Scale. Analyses were weighted. We examined associations between past-year WBH and current CMD using multivariable regression modelling, adjusting for sociodemographic factors. Interaction terms tested for gender differences in associations. The study received ethical approval (ETH21220-299). RESULTS: One in ten employees (10.6%, n = 444/3838) reported past-year experience of WBH, with rates higher in women (12.2%, n = 284/2189), those of mixed, multiple, and other ethnicity (21.0%, n = 15/92), and people in debt (15.2%, n = 50/281) or living in cold homes (14.6%, n = 42/234). Most commonly identified perpetrators of WBH were line managers (53.6%, n = 244/444) or colleagues (42.8%, n = 194/444). Excessive criticism (49.3%, n = 212/444), verbal abuse (42.6%, n = 187/444), and humiliation (31.4%, n = 142/444) were the most common types. WBH was associated with all indicators of poor mental health, including CMD (adjusted odds ratio [aOR] 2.65, 95% CI 2.02-3.49), and 11 of 14 mental wellbeing indicators, including lower levels of confidence (aOR 0.57, 0.46-0.72) and closeness to others (aOR 0.57, 0.46-0.72). Patterns of association between WBH and mental health were similar in men and women. CONCLUSIONS: These findings reinforce a need for more cohesive UK legislation against WBH; guidance on recognition of bullying behaviours for employees, managers, and human resources, focusing on prevention and early intervention, and increased awareness of the impact of WBH on mental health among health service practitioners. Limitations include reliance on cross-sectional data collected before pandemic-related and other changes in workplace practices. Longitudinal data are needed to improve evidence on causality and the longevity of mental health impacts.

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.

Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health.

BACKGROUND: We have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period. METHODS: Teams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models. RESULTS: Participants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (ß = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (ß = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress. CONCLUSIONS: The multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components. TRIAL REGISTRATION: ISRCTN92968402 (27 February 2018).

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.

Exploring the Relationship Between Instagram Use and Self-Criticism, Self-Compassion, and Body Dissatisfaction in the Spanish Population: Observational Study.

BACKGROUND: The widespread use of online social networks, particularly among the younger demographic, has catalyzed a growing interest in exploring their influence on users' psychological well-being. Instagram (Meta), a visually oriented platform, has garnered significant attention. Prior research has consistently indicated that Instagram usage correlates with heightened levels of perfectionism, body dissatisfaction, and diminished self-esteem. Perfectionism is closely linked to self-criticism, which entails an intense self-scrutiny and is often associated with various psychopathologies. Conversely, self-compassion has been linked to reduced levels of perfectionism and stress, while fostering greater positive affect and overall life satisfaction. OBJECTIVE: This study investigates the relationship between Instagram usage (time of use and content exposure) and users' levels of self-compassion, self-criticism, and body dissatisfaction. METHODS: This study comprised 1051 adult participants aged between 18 and 50 years, either native to Spain or residing in the country for at least a decade. Each participant completed a tailored questionnaire on Instagram usage, along with abbreviated versions of the Self-Compassion Scale, the Body Shape Questionnaire, and the Depressive Experiences Questionnaire, spanning from January 23 to February 25, 2022. RESULTS: A positive correlation was observed between daily Instagram usage and self-criticism scores. Participants of all age groups who spent over 3 hours per day on Instagram exhibited higher self-criticism scores than users who spent less than 1 hour or between 1 and 3 hours per day. Contrary to previous findings, no significant relationship was detected between Instagram usage time and levels of self-compassion or body dissatisfaction. Furthermore, content centered around physical appearance exhibited a positive correlation with self-criticism and body dissatisfaction scores. Among younger participants (aged 18-35 years), those who primarily viewed beauty or fashion content reported higher self-criticism scores than those consuming science-related content. However, this association was not significant for participants aged 35-50 years. Conversely, individuals who predominantly engaged with sports or fitness or family or friends content exhibited higher levels of body dissatisfaction than those focusing on science-related content. No significant associations were observed between self-compassion scores and daily Instagram usage or most-viewed content categories. CONCLUSIONS: The findings of this study underscore the considerable impact of Instagram usage on self-criticism and body dissatisfaction-2 variables known to influence users' psychological well-being and be associated with various symptoms and psychological disorders.

Battling on two fronts: The mental wellbeing of war zone medics.

The essential roles and responsibilities of healthcare professionals commissioned on the frontlines of active war zone/s are indispensible, wherein they are explicitly exposed to detrimental conditions due to conflicting situations. With compromised healthcare infrastructure in active war zones, the role of healthcare workers becomes fundamental in delivering urgent medical care while facing significant risks. Beyond instantaneous availability of medication, healthcare workers manoeuvre through the psychological trauma of war, addressing prevalent ordeal and inadequate mental health support. They appear as supporters for peace, documenting rampant atrocities and contribute actively to post-war revival by rebuilding healthcare infrastructure, providing psychosocial support and participation in public health initiatives. This viewpoint highlights the comprehensive impact of conflicting situations on healthcare infrastructure, thus underscoring the necessity for cooperation required for safeguarding of mental wellbeing of healthcare professionals required at the intersection of health and war.

'My parkrun friends.' A qualitative study of social experiences of men at parkrun in Ireland.

Social support is a well-established determinant of mental wellbeing. Community initiatives, which combine a purposeful activity with social connection, may be appropriate to promote the mental wellbeing of middle-aged men in Ireland-a group at risk of poor mental wellbeing due to social isolation. parkrun offers free, weekly, 5km run or walk events in 22 countries. This study aims to explore the social experience of parkrun participation for middle-aged men in Ireland and considers how social connections made at parkrun relate to mental wellbeing. Online semi-structured interviews were conducted in 2022/23 with 39 men aged 45-64 years, who run, walk or volunteer at parkrun in Ireland, recruited purposively in rural and urban communities. Men with a range of parkrun experience gave interviews lasting a mean of 32 minutes. Interviews were recorded and transcribed verbatim. Reflexive thematic analysis resulted in three themes and ten subthemes. The men described parkrun as offering a welcoming and supportive environment (Theme 1). Men at parkrun could choose the level of social connections, building strong or weak social ties to provide social support and improve mental wellbeing (Theme 2). Social engagement with parkrun evolved following repeated participation (Theme 3). The results suggest that parkrun is a suitable community initiative for middle-aged men at risk of poor mental wellbeing due to social isolation. Social connections were developed after repeated participation in parkrun and these connections improved subjective mental wellbeing. The findings from this study could be used to design new initiatives for mental health promotion.

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.