Effective interventions targeting the mental health of children and young adults: A scoping review.

Aims: Children and young adults are in general characterised by good health, but evidence shows increasing mental-health problems. Numerous interventions have been developed to target their mental health, but the effectiveness of these interventions remains varied. In this scoping review, we investigated factors associated with the effectiveness of interventions. Methods: A scoping review based on a three-block search strategy was performed to review the current literature of effective interventions. Each block (interventions, mental health and children and young adults) were operationalised to search terms. Systematic searches were conducted in three electronic databases and supplemented with citation searches, resulting in 51 studies in total. All studies were critically analysed, and a standardised extraction chart was used to systemise the data. Results: Our scoping review revealed a range of factors influencing the effectiveness of interventions. These factors were (a) characteristics of the target group (age, sex and level of baseline symptoms), (b) factors linked to implementation (use of manuals, training of implementers and context) and (c) characteristics of the interventions (universal versus indicated delivery, multiple-domain approaches, level of theory and adjustment to age and socio-economic status). Elements are discussed for each factor. Conclusions: Based on this review, it can be concluded that the use of stepwise, multi-domain approaches incorporating the social networks of the target group, adjusting activities to specific age groups and the social context, training implementers well and using stringent implementation manuals will improve the effectiveness of interventions targeting the mental health of children and young adults.

Governance for public health and health equity: The Tröndelag model for public health work.

BACKGROUND: Multi-sectoral governance of population health is linked to the realization that health is the property of many societal systems. This study aims to contribute knowledge and methods that can strengthen the capacities of municipalities regarding how to work more systematically, knowledge-based and multi-sectoral in promoting health and health equity in the population. METHODS: Process evaluation was conducted, applying a mixed-methods research design, combining qualitative and quantitative data collection methods. RESULTS: Processes strengthening systematic and multi-sectoral development, implementation and evaluation of research-based measures to promote health, quality of life, and health equity in, for and with municipalities were revealed. A step-by-step model, that emphasizes the promotion of knowledge-based, systematic, multi-sectoral public health work, as well as joint ownership of local resources, initiatives and policies has been developed. CONCLUSIONS: Implementation of systematic, knowledge-based and multi-sectoral governance of public health measures in municipalities demand shared understanding of the challenges, updated overview of the population health and impact factors, anchoring in plans, new skills and methods for selection and implementation of measures, as well as development of trust, ownership, shared ethics and goals among those involved.

Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level.

BACKGROUND: Health promotion, with a focus on multidimensional upstream factors and an ecological, life-course approach, is establishing itself as the guiding philosophy for addressing public health. Action at the political and programmatic level on the Social Determinants of Health has proven effective for promoting and building public health at all levels but has been particularly evident at the national and international levels - due in large part to available documents and guidelines. Although research and experience establish that health promotion is most effective when settings-based, the development of health promoting policies and programs at the local level is still difficult. This study intended to investigate available knowledge on the development and implementation of health promoting policies and programs at the local level and identify factors most important for facilitating capacity building and outcome achievement. METHODS: We used a scoping review in order to review the current literature on local policy development and program implementation. Keywords were chosen based on results of a previous literature review. A total of 53 articles were divided into two categories: policy and implementation. Critical analysis was conducted for each article and a summary assembled. Data was charted with specific focus on the aims of the study, data acquisition, key theories/concepts/frameworks used, outcome measures, results, and conclusions. RESULTS: The articles included in this study primarily focused on discussing factors that facilitate the development of health promoting policy and the implementation of health promotion programs. Most significant facilitators included: collaborative decision-making, agreement of objectives and goals, local planning and action, effective leadership, building and maintaining trust, availability of resources, a dynamic approach, a realistic time-frame, and trained and knowledgeable staff. Within each of these important facilitating factors, various elements supporting implementation were discussed and highlighted in this study. CONCLUSION: Our results indicate that clear and consistent facilitators exist for supporting health promoting policy development and program implementation at the local level. These results offer a starting point for local action on the Social Determinants of Health and have the potential to contribute to the development of a framework for improving action at the local level.

Everyday life in breast cancer survivors experiencing challenges: A qualitative study.

BACKGROUND: Early diagnosis and treatment of breast cancer results in an increasing number of survivors, some of whom face new challenges in their transition to daily life. AIM: Based on these experiences, the aim of this study was to describe the everyday life in breast cancer survivors experiencing challenges. MATERIAL AND METHOD: Eleven women recruited from a follow-up study of breast cancer patients participated in qualitative interviews about their everyday occupations seven years after ending treatment. The inductive analysis revealed ten categories that were organized into five subthemes under the two main themes 'bodily and mental loneliness' and 'new center of gravity in everyday life'. RESULTS: Findings showed how relevant information and guidance; active support to the client and their relatives; and a balance between occupations at home and at work were important matters to handle their everyday life challenges. CONCLUSION AND SIGNIFICANCE: By assisting these women in finding new patterns of meaningful occupations that positively affect their everyday life, the study suggests some central elements to be included in future follow-up practice for breast cancer survivors. Approaching this goal, occupational therapists should contribute to more involvement assisting cancer survivors and their partners in finding new patterns of meaningful occupations that positively affect their everyday life.

The Search Conference as a Method in Planning Community Health Promotion Actions.

Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives.