Impact on help-seeking behaviours of a campaign perceived to decrease stigma and increase openness around mental health.

ISSUE ADDRESSED: There is considerable evidence that public stigma around mental illness inhibits help-seeking for mental health problems. Hence there have been many interventions and campaigns designed to reduce stigma around mental illness. However, as far as could be ascertained, none of these stigma reduction interventions has reported any substantial impact of reducing stigma on people's mental health help-seeking behaviours. The aim of this paper is to report on the impact of the Act-Belong-Commit positive mental health promotion Campaign on help-seeking via increasing perceived openness around mental health and reducing perceived stigma around mental illness. METHODS: State-wide computer assisted telephone interviews (CATIs) of the general adult population were undertaken in 2018 and 2019 (N = 600 adults per year). The questionnaire included measures of respondents' awareness of the Act-Belong-Commit Campaign, their beliefs about the Campaign's impact on mental illness stigma and openness around mental health issues, and whether they had sought help for or information about a mental health problem as a result of their exposure to the Campaign. RESULTS: Those who believed the Act-Belong-Commit Campaign increased openness around mental health issues were significantly more likely than those not holding this belief to have sought information about mental health and to have sought help for a mental health problem as a result of their exposure to the Campaign. Those who believed the Act-Belong-Commit Campaign decreased stigma around mental illness versus those not holding this belief were significantly more likely to have sought information, and more likely, but not significantly so, to have sought help as a result of their exposure to the Campaign. Overall, the effect was slightly greater for increased openness. CONCLUSION: As far as we are aware, these are the first reported findings of a positive impact on mental health help-seeking behaviours as a result of a population-wide mental health promotion Campaign being seen to have increased openness around mental health and decreased stigma around mental illness. SO WHAT?: These findings suggest that accompanying specific stigma reduction interventions with a broad-based, population-wide, positive mental health promotion Campaign such as the Act-Belong-Commit campaign, could amplify these interventions' impact on help-seeking by increasing openness about mental health issues.

Impact on stakeholders of a cultural adaptation of a social and emotional well-being intervention in an Aboriginal community.

PURPOSE: Australian Indigenous people conceptualise health broadly as situated within a social and emotional well-being (SEWB) framework. A consultation process with an Aboriginal community revealed that the fundamental principles of the population wide, community-based Act-Belong-Commit mental health promotion Campaign were consistent with Aboriginal people's understanding of SEWB and that a cultural adaptation of the Campaign would be welcomed in the community. The purpose of this paper is to present key stakeholders' feedback on the Campaign adaptation. METHODOLOGY: Two years after implementation of the Campaign, individual in-depth interviews were conducted with a purposeful sample of n = 18 Indigenous and non-Indigenous stakeholders to identify ongoing issues in the community and assess their reactions to the Campaign implementation and perceptions of the effects of the Campaign on the community. RESULTS: The two primary factors influencing stakeholder acceptance of the Campaign in the community were (i) the nature of the consultation process that clearly acknowledged that it was for the community to decide whether or not to adopt the Campaign and (ii) the ability of the Aboriginal Project Manager to gain the trust of the community, bring stakeholders together and illustrate the Act-Belong-Commit principles in her actions in the community. Stakeholders reported observing social and emotional well-being benefits for individuals, their families and the whole community. CONCLUSION: Overall, the results suggest that the Act-Belong-Commit mental health promotion Campaign can be successfully culturally adapted as a community-based, social and emotional well-being Campaign in Aboriginal and Torres Strait communities. SO WHAT?: The Act-Belong-Commit cultural adaptation in Roebourne provides an evidence-based best practice model for the development of culturally appropriate mental health promotion campaigns in Indigenous communities around Australia.

Impact of the Act-Belong-Commit campaign on mental health help-seeking behaviour.

ISSUE ADDRESSED: Despite the high prevalence of mental ill-health amongst Australians, many people do not seek help for their mental ill-health. A delay in help-seeking is associated with poorer outcomes. This study investigated the extent to which the Act-Belong-Commit mental health promotion campaign prompted people to seek information or professional help for mental ill-health. METHODS: A sample of 1200 respondents took part in two state-wide surveys (n = 600 each). Participants aware of the Act-Belong-Commit campaign were asked questions related to information-seeking and help-seeking behaviours because of the campaign. RESULTS: Of those aware of the campaign, 8% stated that the campaign prompted them to seek information and 4% stated that the campaign prompted them to seek help for a mental health problem. Those with a mental illness experience (MIE) were significantly more likely than those without to report that the campaign prompted them to look for information (12% vs 6%) and seek help for a mental health problem (9.5% vs 1.2%). Extrapolating these results to the total adult population of Western Australia indicated that around 120 000 adults had sought mental health information, and around 60 000 had sought help as a result of the campaign. CONCLUSIONS: The campaign not only initiated the seeking of information or professional help for a mental health problem amongst those with no prior thoughts of such, but also prompted those who were already thinking about seeking information or getting help to act sooner than they otherwise would. SO WHAT?: Although previous research suggests that mental health literacy interventions have limited impact on help-seeking, the presented data show that the Act-Belong-Commit approach can have a significant impact on help-seeking, particularly amongst those with a MIE, which could yield substantial social and economic return on investment benefits if intensified at both the media and community grass roots levels.

"Respecting our patients' choices": making the organizational decision to participate in voluntary assisted dying provision: findings from semi-structured interviews with a rural community hospice board of management.

BACKGROUND: There is limited literature around how palliative care organizations determine the degree to which they will interface with voluntary assisted dying in jurisdictions where it is legal. The aim of this research was to describe the experience of the board of management of an Australian community-based hospice during their decision-making process around whether to support voluntary assisted dying in the facility, prior to the legislation coming into operation. METHODS: The Board considered this decision over ten meetings in 2020, during which time they received information on the legislation, relevant literature, feedback from workshops which included the community, comment from hospice founders, staff survey results and presentations by clinicians able to discuss the impact of voluntary assisted dying on palliative care services. Members were encouraged to make notes of their own experiences during this time. Following this, semi-structured interviews were conducted with seven of the nine board members. Interviews were audio-recorded and transcribed verbatim and analysed using conventional qualitative content analysis method. RESULTS: The board members experienced a sense of journey in reaching an overall decision, which was to allow full participation in voluntary assisted dying provision for inpatients. Themes based on the journey motif included: starting from a personal view; moving to a hospice perspective; exploring if voluntary assisted dying can be part of end-of-life care; awareness and assessment of risks to the Hospice; arriving at a common platform to vote on; factors facilitating a safe decision-making journey; and personal impact of the journey. CONCLUSIONS: The group highlighted several facilitators of a successful outcome including having adequate time, the availability of useful resources, sound board processes and a trusting culture. The study may provide support to other healthcare organisations as they face similar decisions triggered by legislative change.

A longitudinal study examining uptake of new recreation infrastructure by inactive adults.

BACKGROUND: The built environment is reported to influence physical activity in populations, but longitudinal evidence about the impact of building new physical activity infrastructure is limited. This study aimed to prospectively investigate the uptake and usage of the newly established Peninsula Aquatic and Recreation Centre (PARC), a large multi-purpose recreation facility in Melbourne, Australia. METHODS: Physically inactive adults (n = 549) from the City of Frankston were recruited before the opening of PARC and followed up 12 months later to measure frequency of attendance at the Centre, and the purposes and barriers to use. Multivariable methods were used to identity the demographic, cognitive and social predictors of attendance, and the relationship between PARC use and improvements in leisure-time physical activity. RESULTS: Over 12 months 8.7% of the sampled residents used PARC once per month or more, 17.5% attended less than once per month, and 73.8% did not use the Centre. Lap swimming was the dominant purpose for attendance, and the major barriers were cost of transport and cost of entry. Independent predictors of usage were being female, having children, living within 5 km of the Centre, and expressing strong intentions for use prior to its opening. Use of PARC was not associated with progression to a higher level of total leisure-time physical activity. CONCLUSIONS: While installation of multi-purpose aquatic and recreation facilities may be considered an investment towards physical activity in populations, regular use by inactive people is likely to be low. Strategies to reduce barriers, including cost and transport, and to motivate use should be trialled in order to improve the public health impacts of this form of infrastructure.

Heavy Rydberg states: large amplitude vibrations.

Extremely large vibrational amplitude (≈8700 a.u.) heavy Rydberg levels in the HH[combining macron]1Σ+g state, located only 25 cm-1 below the ion-pair dissociation limit, are reported. The calculations are done using a hybrid log derivative/multichannel quantum defect approach that accounts for predissociation and is capable of dealing with any number of long-range closed channels, and of providing positions and widths for the heavy Rydberg resonances. In this case, resonance positions can be reproduced qualitatively using a simple diabatic model (however, the resonance widths cannot). Absolute quantum defects are derived for the vibrational series ranging from ν = 0 to ν = 2010. The influence of the Coulomb potential and continuity of heavy Rydberg behavior throughout the 1Σ+g manifold of states is demonstrated.

Developing a culturally appropriate branding for a social and emotional wellbeing intervention in an Aboriginal community.

ISSUE ADDRESSED: An initial consultation process to implement a culturally appropriate social and emotional wellbeing campaign in an Aboriginal community indicated that the fundamental principles of the Act-Belong-Commit mental health promotion campaign were acceptable, but that a cultural adaptation of the branding should be sought. METHODS: A competition was held inviting community members to design a brand logo for the campaign in their community. Local judges selected "winners" in various categories, and six of the submissions were selected for testing in the broader community via street intercept interviews. Respondents were asked which logo they liked best, their perceived meanings of the designs and the perceived appropriateness of the designs for a social and emotional wellbeing campaign. RESULTS: A convenience sample of N = 26 local Aboriginal people who lived and/or worked in Roebourne completed the questionnaire. There was a clear majority preference for logo "D," which communicated appropriate meanings of pride and strength in standing together, and reflected the underlying strengths and capacities of Aboriginal people which this project seeks to harness and support. CONCLUSIONS: The approach of using a logo competition to develop the campaign brand was highly successful and enabled further meaningful engagement with the community and other service providers in the town. The success of the competition process resulted from an emphasis on relationship building, listening to the local community and involving the community in decision-making. So what? By conforming to established, but not always adhered to, recommendations for community consultation, successful and more enduring outcomes are likely.

Perioperative Cardiovascular Evaluation for Orthotopic Liver Transplantation.

Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant. Careful screening and rigorous management of cardiovascular risk factors are important to ensure optimal cardiovascular outcomes in the immediate post-transplantation period and in the long term as well.

Adjunctive anticoagulation during peripheral vascular intervention.

Endovascular techniques for the treatment of peripheral arterial disease are becoming an increasingly common alternative to open surgery, yet the degree of anticoagulation and choice of anticoagulant to optimize outcomes in these procedures remain uncertain. To date, few randomized trials have directly compared different anticoagulants for use during peripheral vascular interventions. It is also unclear if the approach to anticoagulation should be individualized to each vascular bed or if common principles are shared among them. This has led practitioners across different specialties to use a variety of different methods for anticoagulation, with most extrapolated from techniques used in percutaneous coronary interventions. In this review, we analyze the current literature for anticoagulation used during peripheral vascular intervention of the lower extremity, renal, carotid, and aortic arteries, with special consideration to the choice of anticoagulant used to maximize safe and effective procedural outcomes.

Heavy Rydberg behaviour in high vibrational levels of some ion-pair states of the halogens and inter-halogens.

We report the identification of heavy Rydberg resonances in the ion-pair spectra of I2, Cl2, ICl, and IBr. Extensive vibrational progressions are analysed in terms of the energy dependence of the quantum defect δ(Eb) rather than as Dunham expansions. This is shown to define the heavy Rydberg region, providing a more revealing fit to the data with fewer coefficients and leads just as easily to numbering data sets separated by gaps in the observed vibrational progressions. Interaction of heavy Rydberg states with electronic Rydberg states at avoided crossings on the inner wall of the ion-pair potential is shown to produce distinctive changes in the energy dependence of δ(Eb), with weak and strong interactions readily distinguished. Heavy Rydberg behaviour is found to extend well below near-dissociation states, down to vibrational levels ∼18,000-20,000 cm(-1) below dissociation. The rapid semi-classical calculation of δ(Eb) for heavy Rydberg states is emphasised and shows their absolute magnitude to be essentially the volume of phase space excluded from the vibrational motion by avoiding core-core penetration of the ions.

The MOVE study: a study protocol for a randomised controlled trial assessing interventions to maximise attendance at physical activity facilities.

BACKGROUND: Physical activity is associated with a host of health benefits, yet many individuals do not perform sufficient physical activity to realise these benefits. One approach to rectifying this situation is through modifying the built environment to make it more conducive to physical activity, such as by building walking tracks or recreational physical activity facilities. Often, however, modifications to the built environment are not connected to efforts aimed at encouraging their use. The purpose of the Monitoring and Observing the Value of Exercise (MOVE) study is to evaluate the effectiveness of two interventions designed to encourage the ongoing use of a new, multi-purpose, community-based physical activity facility. METHODS/DESIGN: A two-year, randomised controlled trial with yearly survey points (baseline, 12 months follow-up, 24 months follow-up) will be conducted among 1,300 physically inactive adult participants aged 18-70 years. Participants will be randomly assigned to one of three groups: control, intervention 1 (attendance incentives), or intervention 2 (attendance incentives and tailored support following a model based on customer relationship management). Primary outcome measures will include facility usage, physical activity participation, mental and physical wellbeing, community connectedness, social capital, friendship, and social support. Secondary outcome measures will include stages of change for facility usage and social cognitive decision-making variables. DISCUSSION: This study will assess whether customer relationship management systems, a tool commonly used in commercial marketing settings, can encourage the ongoing use of a physical activity facility. Findings may also indicate the population segments among which the use of such systems are most effective, as well as their cost-effectiveness. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12615000012572 (registered 9 January 2015).

Self-control, self-regulation, and doping in sport: a test of the strength-energy model.

We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes' behavioral responses to taking illegal performance-enhancing substances, or "doping." Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a "lollipop" decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the "lollipop" protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.

Messages that increase women's intentions to abstain from alcohol during pregnancy: results from quantitative testing of advertising concepts.

BACKGROUND: Public awareness-raising campaigns targeting alcohol use during pregnancy are an important part of preventing prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder. Despite this, there is little evidence on what specific elements contribute to campaign message effectiveness. This research evaluated three different advertising concepts addressing alcohol and pregnancy: a threat appeal, a positive appeal promoting a self-efficacy message, and a concept that combined the two appeals. The primary aim was to determine the effectiveness of these concepts in increasing women's intentions to abstain from alcohol during pregnancy. METHODS: Women of childbearing age and pregnant women residing in Perth, Western Australia participated in a computer-based questionnaire where they viewed either a control or one of the three experimental concepts. Following exposure, participants' intentions to abstain from and reduce alcohol intake during pregnancy were measured. Other measures assessed included perceived main message, message diagnostics, and potential to promote defensive responses or unintended consequences. RESULTS: The concepts containing a threat appeal were significantly more effective at increasing women's intentions to abstain from alcohol during pregnancy than the self-efficacy message and the control. The concept that combined threat and self-efficacy is recommended for development as part of a mass-media campaign as it has good persuasive potential, provides a balance of positive and negative emotional responses, and is unlikely to result in defensive or unintended consequences. CONCLUSIONS: This study provides important insights into the components that enhance the persuasiveness and effectiveness of messages aimed at preventing prenatal alcohol exposure. The recommended concept has good potential for use in a future campaign aimed at promoting women's intentions to abstain from alcohol during pregnancy.

Predictors of positive outcomes of a school food provision policy in Australia.

This study identified predictors of parents' and school principals' perceptions of the impact of a Western Australian school food policy. An initial qualitative phase involving focus groups with parents and interviews with school principals, teachers, canteen managers and Parents & Citizens Committee members provided general feedback on the policy and identified various factors that appeared to be related to its successful implementation. In the following quantitative phase of the study, 1200 parents responded to a telephone questionnaire and 310 principals responded to an internet-based questionnaire. The primary outcome variables were, respectively, the extent to which parents reported that their children's diets were healthier as a result of the policy, and the extent to which principals reported that their schools complied with the policy. Logistic regression models were generated for the parent and principal samples. Those parents reporting that their children's diets were healthier were more likely to agree that the policy reflected their beliefs and their children's dietary needs and preferences, that their child talked about the traffic light food classification system and that this system influenced their food choices in the supermarket. Those principals reporting full compliance with the policy were more likely to agree that implementing the policy was not overly difficult. Specific factors facilitating school compliance were canteen manager training and conducive kitchen setup. Provision of appropriate information and training prior to implementation may assist schools in implementing new food policies, thereby enhancing their impact beyond the school environment.

A critical re-assignment of the Rydberg states of iodomethane based on new polarization data.

2- and 3-photon excitation of components of the lower Rydberg states of iodomethane (CH3I) using linearly and circularly polarized light, followed by ionization with one more photon, is used to determine their molecular term symbol, Ω, values as well as quantum defects. These Ω values, together with a detailed theoretical analysis, require a re-assignment of the 7s and 8s states to various components of the 5d and 6d states, but there is evidence of (n+2)s∕nd hybridization in the pairs of Ω = 1 states. Predissociation sets in for all Rydberg states beyond 6d based on the ground ((2)Π(3∕2)) state of the core, but sharp autoionizing resonances based on the (2)Π(1∕2) core state are assigned to the 9s, 7d, and 5f states. The dominant effect of the singlet∕triplet character of the Rydberg states on their accessibility from the ground state, seen in bromomethane and chloromethane, is again apparent and a concordant interpretation of the Rydberg spectra of CH3I can now be presented. Evidence for coupling of some Ω = 1 and Ω = 0(+) Rydberg states with a repulsive valence state and an ion-pair state, respectively, is also put forward.

Promoting abstinence from alcohol during pregnancy: implications from formative research.

This research developed messages to promote abstinence from alcohol during pregnancy and identified elements that enhance message persuasiveness. An exploratory phase was conducted in 2009 that comprised four focus groups with 23 women in Western Australia and elicited beliefs and attitudes on alcohol use during pregnancy and motivations for behavior change. Four television concepts were subsequently developed and appraised in five focus groups with 31 participants using standard advertising pretesting questions. The implications for campaigns addressing prenatal alcohol exposure and further research are noted and limitations discussed. Funding was received from Healthway and the National Health and Medical Research Council.

Impact on community organisations that partnered with the Act-Belong-Commit mental health promotion campaign.

ISSUE ADDRESSED: A primary aim of the pilot phase of the Act-Belong-Commit mental health promotion campaign was to form partnerships with community organisations. As a component of the broader campaign strategy, collaborating organisations promoted their activities under the Act-Belong-Commit banner in exchange for resources, promotional opportunities and capacity building in event management and funding. METHODS: The impact of the Act-Belong-Commit campaign on the capacity and activities of collaborating organisations during the pilot phase was evaluated using self-completed mail surveys in 2006 and 2008. RESULTS: Collaboration with the campaign had a positive impact on community organisations' capacity, including staff expertise, media publicity and funding applications. Collaborating organisations had strong positive perceptions of Act-Belong-Commit officers and all expressed a willingness to collaborate in future events and activities. CONCLUSIONS: The partnership model used during the pilot phase of the Act-Belong-Commit campaign was successful in creating mutually beneficial exchanges with collaborating organisations. So what? Community partnerships are necessary for the effective delivery of mental health promotion campaigns at a local level. Successful partnerships involve the provision of real and valuable benefits to collaborating organisations in return for their cooperation in promoting health messages.

Impact on Students of the Act-Belong-Commit Mentally Healthy Schools Framework.

Schools can have a significant role in affecting the mental health and wellbeing of both students and staff, with considerable implications for society as a whole. Hence, there is a need for school-based interventions to both assist those experiencing mental health problems and to implement activities and policies that facilitate the enhancement and maintenance of good mental health. Unlike most school mental health interventions that are focussed on, and specific to, the school setting, the Act-Belong-Commit Mentally Healthy Schools Framework is based on the principles of the Act-Belong-Commit community-wide general population mental health promotion campaign, which has been adapted to the school setting via the World Health Organisation's Health Promoting Schools Framework. The Mentally Healthy Schools Framework is a whole-school approach to enhancing both student and staff mental health. This paper reports the findings of a preliminary impact survey administered to students after the adoption of the Framework in a number of primary and secondary schools in Western Australia. Students from two schools that had only recently adopted the Framework completed a "Baseline" questionnaire, and students from three schools that had been implementing the Framework for at least 17 months completed a "Follow-up" questionnaire. The results suggest that the Mentally Healthy Schools Framework, adapted from a community-wide campaign, can have a positive impact on students in terms of increasing openness about mental health, increasing awareness of behaviours conducive to good mental health, and increasing engagement in behaviours to improve their mental health. Such positive impacts have clear implications not only for prevention of mental disorders, but for academic achievement, employment, and overall contribution to society.

Engagement with arts and culture activities in the Danish general population: Longitudinal associations with new onset or persistent depression and mental wellbeing.

OBJECTIVES: International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population. DESIGN: Observational prospective study. METHODS: Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values. RESULT: In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of .43 (95%CI .23-.80), while 8 times or more was associated with an OR of .53 (.29-.97). In terms of persistent depression, quarterly engagement was associated with an OR of .30 (.10-.90), while 8 times per year or more was associated with an OR of .26 (.07-.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds for high mental wellbeing but did not reach statistical significance. CONCLUSIONS: The results support the involvement of the cultural and creative sectors in health strategies. Mental health promotion initiatives as well as arts and culture sectors may encourage the general public to engage in arts and culture activities with frequencies of at least once per quarter.

Stakeholder support for school food policy expansions.

The aim of this study was to assess the extent to which parents and school-based stakeholders (principals, teachers, canteen managers and Parents & Citizen Committee presidents) are supportive of potential expansions to a new school food policy. Eight additional policy components elicited in preliminary focus groups with parents and 19 additional policy components elicited from interviews with school stakeholders (including the eight also elicited from parents) were presented to 1200 parents and 607 school stakeholders, respectively. Each of the 8 potential policy components presented to parents was supported by more than two-thirds of parents, and 13 of the 19 policy components presented to school stakeholders received support from around two-thirds or more of the school stakeholder respondents. For all eight common policy components, parents exhibited significantly higher levels of support than school stakeholders. This information is of value to policy makers in their deliberations relating to the appropriate nature and timing of school food policy modifications.