A systematic scoping review of peer support interventions in integrated primary youth mental health care.

Peer support, defined as the social and emotional support offered and received by individuals with a shared experience of mental health difficulties, is gaining popularity in youth mental health settings. This systematic scoping review aimed to collate and synthesise the evidence on key aspects of peer support interventions within integrated youth services and educational settings. Specifically, it synthesised evidence on the (1) assessed mental health outcomes in peer support interventions, (2) key characteristics and associated roles of peer support workers (PSWs) and (3) barriers and facilitators to implementation. A search of peer reviewed articles from January 2005 to June 2022 across five electronic databases (PsychINFO, Pubmed, Scopus, ERIC and CINAHL) was conducted. A total of 15 studies retrieved in the search met the inclusion criteria and were included in the review. This review supports previous research indicating that peer support has potential for improving recovery related outcomes. While a variety of interventions and PSW roles were reported, studies could be strengthened by providing more in-depth information on intervention content. Examples of barriers to implementation included staff concerns around confidentiality of peer support relationships as well as PSWs' confidence in their roles. Facilitators included positive support from staff members and role clarity.

Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents.

BACKGROUND: Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context. METHODS: We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up. CONCLUSION: This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools. TRIAL REGISTRATION: The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .

A cluster analysis of health behaviours and their relationship to mental health difficulties, life satisfaction and functioning in adolescents.

Research has documented relationships between individual health behaviours and mental health, but few studies have examined patterns of health behaviours (i.e., health lifestyles) and mental health outcomes. This study investigated the relationship between health lifestyles and mental health and psychological wellbeing in adolescents. Data from the My World Survey 2 - Second Level (MWS2-SL), a random national sample of 9493 adolescents (44.2% male) aged 12-18 years (M = 14.8, SD = 1.66) in second level education in Ireland were used. TwoStep cluster analysis identified clustering of health behaviours (sleep, alcohol use, cannabis use, social media use, sport and hobby participation). ANOVA and Chi Square tests identified potential differences in demographic characteristics (age, gender, socioeconomic status, ethnicity) and psychological outcomes (anxiety, depression, life satisfaction, daily functioning) across clusters. Three clusters were identified; 1. Low (22.0%), 2. Moderate-high (41.5%) and 3. High (36.5%), health promoting. The 'Low' health-promoting cluster, characterised by high alcohol, cannabis and social media use, moderate sport and hobby participation, and low sleep duration, demonstrated the highest levels of anxiety and depression and the lowest levels of life satisfaction, self-esteem and daily functioning. The 'High' health-promoting cluster reported the most favourable psychological outcomes. Cluster 1 were more likely to be older and male, Cluster 3 were more likely to be younger and female. Findings demonstrate the potential for health promotive lifestyles to mitigate mental health difficulties and promote life satisfaction and daily functioning in adolescents. Health lifestyles represent important indicators of mental health and targets for prevention/promotion efforts.

Adolescents' Experiences of Idiopathic Scoliosis in the Presurgical Period: A Qualitative Study.

OBJECTIVE: Adolescent idiopathic scoliosis (AIS) is a sideways curvature of the spine that can progress severely during adolescent development and require surgical intervention. This qualitative study was conducted to explore the psychosocial experiences of adolescents with idiopathic scoliosis during the presurgical stage of treatment. METHODS: Fourteen adolescents with moderate-to-severe AIS aged 12-17 years participated in semistructured interviews and data were analyzed using inductive reflexive thematic analysis. RESULTS: Four key themes were generated from the analysis. "Proceeding with Caution" described adolescents' adaptation to the physical impact of their AIS, while "Am I Different?" encompassed adolescents' perceptions of their changing appearance and visibility of their condition. "An Emotional Journey" captured the rollercoaster of emotions from shock at diagnosis to the daunting realization of the severity of their condition, while knowing others with AIS could ease the emotional burden. Finally, adolescents' concerns and expectations about their prospective surgery were captured by the theme "No Pain, No Gain", whereby they were often keen to put surgery behind them. CONCLUSIONS: Understanding and addressing adolescents' psychosocial support needs as they manage the challenges associated with idiopathic scoliosis is a key component of promoting better outcomes among this patient group. Clinical implications and opportunities for support provision are discussed.

Measuring goal progress using the goal-based outcome measure in Jigsaw - A primary care youth mental health service.

BACKGROUND: Jigsaw is a primary care youth mental health service designed to increase access to and utilisation of mental health supports for 12- to 25-year-olds. Effectiveness in community youth mental health services is typically assessed using standardised instruments. The aim of this study was to examine the effectiveness of Jigsaw's brief intervention model of support using an idiographic tool, the goal-based outcome (GBO) measure. The study also aimed to explore the type of goals set by young people engaging with this service. METHOD: The study sample consisted of a secondary dataset of 4839 young people aged 12-25 years (63.5% female, 36.5% male) who engaged with one of Jigsaw's 13 brief intervention services. Overall, 7366 goals set using the GBO were examined. Inductive thematic analysis was conducted to examine the type of goals set by young people, and inferential analyses were used to examine statistical and reliable changes in goal progress. RESULTS: The goals young people set focused on developing coping mechanisms and personal growth and managing interpersonal difficulties. Mean scores for progress towards goals improved significantly from pre- to postintervention. The reliable change index (RCI) indicated that change greater than 2.82 points represents reliable change on the GBO, with 78.6% of young people showing reliable improvement. Demographic characteristics did not impact goal progress. CONCLUSION: These findings suggest Jigsaw's brief intervention model of support is effective in assisting young people reach their goals and that the GBO is a suitable measure for young people attending a community-based youth mental health service.

Interpreting ambiguous emotional information: Convergence among interpretation bias measures and unique relations with depression severity.

This study aimed to examine the convergence among interpretation bias measures and their associations with depressive symptom severity. Research into interpretation biases employs measures of interpretation bias interchangeably, however, little is known about the relationship between these measures. Participants (N = 82 unselected undergraduate students; 59 female) completed four computer-based interpretation bias tasks in a cross-sectional design study. Indirect measures, based on participants' reaction times, were not correlated with each other and had poor split-half reliability. Direct measures were more strongly correlated with depressive symptoms than indirect measures, but only the Scrambled Sentences Task explained a reliable unique portion of the variance in depressive symptoms. Interpretation bias tasks may not measure the same cognitive process and may differ in the extent to which they are a cognitive marker of depression-linked interpretation bias. These findings help to improve the measurement of and theory underlying interpretation bias and depressive symptoms.

Investigating the psychometric properties of the revised child anxiety and depression scale (RCADS) in a non-clinical sample of Irish adolescents.

Background: The psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS) have been established cross-culturally, yet psychometric evidence is lacking for an English-speaking European population. Aim: This research sought to further cross-validate the measure in a non-clinical Irish adolescent sample, and to test for gender and age-based differential item functioning in depression and anxiety. Method: Participants were Irish second-level school students (N = 345; 164 male; 12-18 years, M =14.97, SD = 1.44). Confirmatory factor analysis for categorical data (confirmatory item factor analysis) and multiple-indicator multiple-cause (MIMIC) modelling to identify items displaying possible metric invariance were conducted. Results: A six-factor model fit the data well in both gender samples and both school cycles, as a proxy for age samples. Gender-based metric invariance for 5 of 47 items and age-based metric invariance for three items were identified. However, the magnitudes were small. Internal consistency and validity were also established. Conclusions: While, a number of items demonstrated minor metric invariance, there was no evidence that they influenced overall scores meaningfully. The RCADS can reasonably be used without adjustment in male and female, younger and older, adolescent samples. Findings have implications for the use of the RCADS in an English-speaking European population.

Association between attention bias to threat and anxiety symptoms in children and adolescents.

BACKGROUND: Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. METHODS: A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. RESULTS: Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P = .004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P = .008) and school phobia (ß = 0.076, P = .006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. CONCLUSIONS: These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.

The Relationship Between Perceived Family Support and Depressive Symptoms in Adolescence: What is the Moderating Role of Coping Strategies and Gender?

This study examined the moderating role of gender and coping strategies in the relationship between perceived family support, self-esteem and depressive symptoms. Data were used from the My World Survey Second Level (MWS-SL), a national survey of mental health among 6062 young people aged 12-19 years. Conditional process analyses indicated that planned coping moderated the relationship between perceived family support and depressive symptoms for those engaging in low-moderate levels but not high levels of planned coping, and this moderating role was stronger for females than males. Avoidance coping was a moderator for those engaging in moderate-high but not low levels of avoidance coping, and gender also moderated this relationship. Support-focused coping only moderated the perceived family support/depressive symptoms relationship for females. Findings suggest that the strength of the relationship between perceived family support and depressive symptoms depends on level of engagement with a particular coping strategy, and this engagement is a consistently stronger moderator for females.

Weight concerns among adolescent boys.

OBJECTIVE: To investigate weight concerns among adolescent boys and relationships with health indicators and family factors. DESIGN: Analysis of the 2010 Health Behaviour in School-aged Children survey of 10-17-year-olds. SETTING: Schools in the Republic of Ireland. RESULTS: Among 6187 boys, 25.1% reported a desire to lose weight (weight 'loss' concern) and 7.7% reported a desire to gain weight (weight 'gain' concern). Both types of weight concerns were associated with poor self-rated health, life satisfaction and happiness, and with more frequent emotional and physical symptoms. Family factors were associated with boys' weight concerns. In adjusted analyses, the risk of weight 'loss' concerns decreased with daily family breakfasts (OR=0.80; 95% CI 0.66, 0.97). The risk of weight 'gain' concerns decreased with frequent family evening meals (OR=0.77; 95% CI 0.60, 0.99). Ease of communication with mother was associated with a decreased risk of weight 'loss' and weight 'gain' concerns among boys (OR=0.74; 95% CI 0.60, 0.90 and OR=0.61; 95% CI 0.44, 0.82, respectively). An open father-son relationship and having a father present in the home decreased the risk of weight 'loss' concerns (OR=0.69; 95% CI 0.57, 0.82 and OR=0.81; 95% CI 0.67, 0.98, respectively). CONCLUSIONS: Body weight concerns were reported by a sizeable minority of boys and were associated with negative health outcomes. The findings support the need to promote frequent family meals and facilitate open communication in families.

Modeling problem behaviors in a nationally representative sample of adolescents.

Research on multiple problem behaviors has focused on the concept of Problem Behavior Syndrome (PBS). Problem Behavior Theory (PBT) is a complex and comprehensive social-psychological framework designed to explain the development of a range of problem behaviors. This study examines the structure of PBS and the applicability of PBT in adolescents. Participants were 6062 adolescents; aged 12-19 (51.3% female) who took part in the My World Survey-Second Level (MWS-SL). Regarding PBS, Confirmatory Factor Analysis established that problem behaviors, such as alcohol and drug use loaded significantly onto a single, latent construct for males and females. Using Structural Equation Modeling, the PBT framework was found to be a good fit for males and females. Socio-demographic, perceived environment system and personality accounted for over 40% of the variance in problem behaviors for males and females. Our findings have important implications for understanding how differences in engaging in problem behaviors vary by gender.

Substance Misuse and Behavioral Adjustment Problems in Irish Adolescents: Examining Contextual Risk and Social Proximal Factors.

BACKGROUND: Using an ecological perspective to examine the roles of contextual factors and proximal social processes, the current study examined problem behavior among adolescents. OBJECTIVE: The study examined how family, peer, and school processes mediate the relationship between cumulative contextual risk and problem behavior, and whether these mediating relationships are moderated by gender. METHOD: Data were obtained from the My World Survey Second Level, a cross-sectional national survey assessing risk and protective factors of mental health among 6062 adolescents aged 12-19 years (M = 14.93, SD = 1.62). Using risk factors from socioeconomic, community, and family levels, a cumulative contextual risk index (CCRI) was created to identify adolescents at increased risk of problem behavior in Ireland. Conditional process analysis examined whether gender moderated the relationship between the CCRI and problem behaviors (alcohol behavior, poorer behavioral adjustment, and problematic substance use) as mediated by five proximal social variables, family cohesion, mother criticism, father criticism, peer connectedness, and school connectedness. RESULTS: Using Hayes' (2013) SPSS macro for conditional process analyses, with age as a covariate, gender was shown to moderate the mediated relationships between CCRI and problem behaviors, via mother criticism and peer connectedness. Of note, a positive association was observed between high peer connectedness and alcohol risk behavior, highlighting the need to examine additional aspects of peer context including group norms and peer pressure. CONCLUSION: The study provides valuable and practical implications for informing research, interventions, and social policy at family, peer, and school levels.

Bisphenol A and Related Alkylphenols Exert Nongenomic Estrogenic Actions Through a G Protein-Coupled Estrogen Receptor 1 (Gper)/Epidermal Growth Factor Receptor (Egfr) Pathway to Inhibit Meiotic Maturation of Zebrafish Oocytes.

Xenobiotic estrogens, such as bisphenol A (BPA), disrupt a wide variety of genomic estrogen actions, but their nongenomic estrogen actions remain poorly understood. We investigated nongenomic estrogenic effects of low concentrations of BPA and three related alkylphenols on the inhibition of zebrafish oocye maturation (OM) mediated through a G protein-coupled estrogen receptor 1 (Gper)-dependent epidermal growth factor receptor (Egfr) pathway. BPA (10-100 nM) treatment for 3 h mimicked the effects of estradiol-17beta (E2) and EGF, decreasing spontaneous maturation of defolliculated zebrafish oocytes, an effect not blocked by coincubation with actinomycin D, but blocked by coincubation with a Gper antibody. BPA displayed relatively high binding affinity (15.8% that of E2) for recombinant zebrafish Gper. The inhibitory effects of BPA were attenuated by inhibition of upstream regulators of Egfr, intracellular tyrosine kinase (Src) with PP2, and matrix metalloproteinase with ilomastat. Treatment with an inhibitor of Egfr transactivation, AG1478, and an inhibitor of the mitogen-activated protein kinase (MAPK) 3/1 pathway, U0126, increased spontaneous OM and blocked the inhibitory effects of BPA, E2, and the selective GPER agonist, G-1. Western blot analysis showed that BPA (10-200 nM) mimicked the stimulatory effects of E2 and EGF on Mapk3/1 phosphorylation. Tetrabromobisphenol A, 4-nonylphenol, and tetrachlorobisphenol A (5-100 nM) also inhibited OM, an effect blocked by cotreatment with AG1478, as well as with the GPER antagonist, G-15, and displayed similar binding affinities as BPA to zebrafish Gper. The results suggest that BPA and related alkylphenols disrupt zebrafish OM by a novel nongenomic estrogenic mechanism involving activation of the Gper/Egfr/Mapk3/1 pathway.

Socioecological Risk and Protective Factors for Sexual Victimization in Post-Secondary Students in Ireland: A Brief Report.

Although numerous predictors of sexual violence (SV) have been identified, there is a need to further explore protective factors and examine the nature and strength of associations between predictors and SV outcomes using a hierarchical predictive model. Cross-sectional data from the My World Survey Post-Second Level (2019) in Ireland were used. The sample contained 8, 288 post-secondary students, 69% female, aged 18 to 25 years (M = 20.25, SD = 1.85). Univariate and multivariate binary logistic regression analyses were conducted to identify correlates of two SV outcomes (i.e., forced/pressured to have sex and being touched in a sexual manner without consent) across societal, community, relationship, and individual levels. Approximately 25% of females and 10% of males reported being forced/pressured to have sex, whereas 55% of females and 23% of males reported being touched in a sexual manner without consent. Key predictors of SV in multivariate analyses included being female and experiencing violence in a romantic relationship, whereas discrimination, living on campus or in rented accommodation (compared with living at home) were also significant predictors of both SV outcomes. Parental conflict, sexual initiation, depressive symptoms, older age, and an avoidant coping style significantly predicted being forced/pressured to have sex, whereas being bullied and engaging in problem drinking were unique predictors of being touched sexually without consent. Findings highlight the importance of considering salient risk and protective factors at the individual, relationship, community and societal level to predict SV and effectively guide the delivery of interventions and support services for post-secondary students affected by SV.

Exploring changing trends in depression and anxiety among adolescents from 2012 to 2019: Insights from My World repeated cross-sectional surveys.

AIM: Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in mental health difficulties remain poorly understood. This study examines psychological, social and environmental risk and protective factors that may explain changes in depression and anxiety among adolescents. METHODS: Data were taken from two nationally representative My World Surveys of adolescents aged 12-19 years in 2012 (N = 5,490) and 2019 (N = 9,844). Survey data on depression and anxiety and a range of potential risk (e.g., alcohol use, psychotic symptoms) and protective factors (e.g., resilience, self-esteem) were assessed at both time points. Multiple group analyses assessed whether the predictive ability of risk/protective factors changed from wave 1 to wave 2. RESULTS: Results showed that the prevalence of depression and anxiety increased significantly between 2012 and 2019, particularly among females. Predictors accounted for between 37% and 61% of the variance in outcomes across waves. While some risk/protective factors were consistent predictors of depression and anxiety at both waves (e.g., bullying, discrimination, optimism), reporting female gender and having higher formal help-seeking tendencies more strongly predicted anxiety at wave 2, while lower self-esteem and lower resilience (personal competence) strongly predicted both depression and anxiety at wave 2. CONCLUSION: Findings highlight the need to prioritize adolescent mental health service provision, especially in females. Self-esteem and resilience are potentially important targets for supporting adolescent mental health. Further research is required to understand the causal factors associated with increases in anxiety and depression.

Making it relevant: A codesign and cultural acceptability study of Be Real's BodyKind Ireland body image programme for older adolescents.

Body image is an established public health concern and there is a pressing need for evidence-informed universal programmes for older adolescents. To ensure high standard, quality programmes, there have been calls to adapt existing programmes to different contexts in ways that ensure materials are relevant, but still aligned with their theoretical foundations. This study outlines the cultural adaptation of the BodyKind programme in Ireland, which was initially developed in the USA, to address an unmet need to provide an inclusive, strengths-focused, school-based body image intervention for older adolescents. After receiving BodyKind, codesign workshops were conducted with 12 adolescents aged 15-16 years, who provided feedback and designed content (examples/scenarios) to increase the programme's relevance for adolescents. Feedback on cultural appropriateness of programme materials were obtained via interviews with six female post-primary teachers and one mental health clinician. Qualitative data were analysed using thematic analysis. BodyKind was perceived as highly acceptable by stakeholders who offered suggestions for programme refinement. Themes included 1.) Programme acceptability, 2.) Implementation considerations, 3.) Programme refinement. This study used multi-stakeholder feedback to engage in cultural adaptation of BodyKind prior to further evaluation, thereby informing efforts to implement sustainable and scalable programmes in schools.

Self-efficacy for healthy eating and peer support for unhealthy eating are associated with adolescents' food intake patterns.

Adolescence, with its change in dietary habits, is likely to be a vulnerable period in the onset of obesity. It is considered that peers have an important role to play on adolescents' diet, however, limited research has examined the role of peers in this context. This study examined the relationship between self-efficacy for healthy eating, parent and peer support for healthy and unhealthy eating and food intake patterns. Participants were 264 boys and 219 girls (N=483), aged 13-18years, recruited from post-primary schools in Ireland. Self-report measures assessed self-efficacy, parent and peer support for healthy eating, and for unhealthy eating. Dietary pattern analysis, a popular alternative to traditional methods used in nutritional research, was conducted on a FFQ to derive food intake patterns. Two patterns were identified labelled 'healthy food intake' and 'unhealthy food intake'. Multi-group modelling was used to evaluate whether the hypothesized model of factors related to dietary patterns differed by gender. The multi-group model fit the data well, with only one path shown to differ by gender. Lower self-efficacy for healthy eating and higher peer support for unhealthy eating were associated with 'unhealthy food intake'. Higher self-efficacy was associated with 'healthy food intake'. Prevention programs that target self-efficacy for eating and peer support for unhealthy eating may be beneficial in improving dietary choices among adolescents.

Interpersonal relationships and emotional distress in adolescence.

The aim of this study was to examine positive and negative qualities in adolescents' interpersonal relationships and their relative importance in predicting emotional distress. Participants were 260 students from three schools in the Dublin area (119 girls; 141 boys), aged 12-18 years (M = 15.32, SD = 1.91). Students completed questionnaires assessing qualities in important interpersonal relationships in their lives and emotional distress. Girls reported more positive qualities in their relationships with mothers and best friends than boys. Younger students reported more positive qualities in their relationships with parents than older students. Stepwise multiple regression analysis revealed high levels of satisfaction in interpersonal relationships were predictive of low levels of emotional distress whereas high levels of criticism and exclusion were predictive of high levels of distress. High levels of support and disclosure were also linked to emotional distress. These findings and their implications are discussed in detail.

Mental, physical and sexual health in sexual minority third-level students: Findings from My World Survey 2.

AIMS: Sexual minority youth experience health disparities across mental, physical and sexual domains. However, little is known about the extent to which mental health overlaps with sexual and physical health to compound health problems among sexual minority youth. This study examined risky health behaviours, adverse health outcomes, and their overlap across mental, physical and sexual domains, in lesbian, gay, bisexual, questioning (LGBQ) and heterosexual third-level students in Ireland. METHOD: Cross-sectional data from the My World Survey 2-Post Second Level (MWS2-PSL) were used. Analyses were conducted on data from N = 7950 18-25-year-old students, of which 6204 (78%) identified as heterosexual, 910 (11.4%) bisexual, 412 (5.2%) lesbian/gay and 424 (5.3%) questioning. Risky health behaviours (e.g., self-harm), adverse outcomes (e.g., mental health difficulties, physical health conditions) and their overlap across mental, physical and sexual domains were compared across heterosexual and LGBQ students using Chi-square tests. Clustering of health behaviours/outcomes within and between domains were examined. RESULTS: LGBQ students were more likely to exhibit a greater number of risky mental and sexual health behaviours and outcomes. Sexual, physical and mental health behaviours and outcomes overlapped to a greater extent in LGBQ versus heterosexual students. Distinct health outcomes were observed across sexual minority subgroups (e.g., bisexual women reported greater mental health difficulties). CONCLUSION: Findings demonstrate health inequalities experienced by LGBQ students, particularly across mental and sexual domains. Holistic integrated approaches that consider multiple health domains simultaneously and the distinct health needs of sexual minority subgroups are needed to promote greater health equity.

Quality Appraisal of Research Reporting for Aromatherapy and Essential Oil Studies in Humans: Proposed Checklist for "Transparent Reporting for Essential oil and Aroma Therapeutic Studies".

Introduction: Reporting of aromatherapy-focused research often lacks sufficient quality and detail for replication and subsequent application of results. To our knowledge currently, no quality appraisal tool exists for aromatherapy research reporting. To address this gap, the Aromatic Research Quality Appraisal Taskforce (ARQAT) composed of aromatherapy professionals with varied expert backgrounds came together. Presented here is the Transparent Reporting for Essential oil and Aroma Therapeutic Studies (TREATS) checklist, which is a result of this collaborative effort. Methods: Creation of TREATS followed a three-stage process, including determination of interest/need, development, and dissemination. The shortcomings of existing aromatherapy research reporting quality were evaluated and responses to address these shortcomings were used to create checklist items that were then grouped into sections. Items for each section were brain-stormed with reference to the aromatherapy literature and ARQAT's expert knowledge, and the development of each section followed an iterative process until agreement was reached. An explanatory document was also created to assist more accurate use of the tool; it and the checklist were reviewed by a group of aromatherapy experts. Results: The TREATS checklist with 38 items in four sections was developed along with the explanatory document. The ARQAT and a global group of aromatherapy experts reviewed the TREATS. Their results and comments assisted development of the current version. The TREATS identifies key components of research involving essential oils, their application, and olfactory considerations that ARQAT considers the minimum necessary for high-quality aromatherapy research. Conclusion: The TREATS, explanatory document, and associated website (www.arqat.org) contribute to thorough aromatherapy research critique. The TREATS checklist aids appraisal of quality and can be used with any study design. It lays the foundation for the future development of aromatic research reporting guidelines.