Migration, belonging, and the sustainability of atoll islands through a changing climate.

Climate change might catalyze and exacerbate the trend of outmigration from low-lying atoll islands. There is speculation that migration away from atolls may not stop until such islands are abandoned. Yet migration creates both opportunities and risks for the sustainability of atoll communities. There is a trade-off between reduced demographic pressure on increasingly fragile atoll island environments and the financial and human resources necessary to adapt to climate change that can result from migration. Here we propose and analyze belonging as the centripetal force that makes migration a process that enhances the sustainability of atoll populations. We examine the relationship between migration, belonging, and the sustainability of populations on atoll islands based on data collected in three atoll islands in the Pacific: the island state of Niue; Namdrik Atoll in the Republic of the Marshall Islands; and Budibudi atoll (Laughlan Islands) in Papua New Guinea. In each case, belonging binds the people who live in and migrate from these places into a collective commitment to their continuity, yet it does so to different degrees according to the economic opportunities available to migrants and the infrastructure that enables extended communities to remain connected.

Zoom out: An intervention on the virtual learning environment improves minority students' grades in two field experiments in Israel.

Closing the achievement gap for minority students in higher education requires addressing the lack of belonging these students experience. This paper introduces a psychological intervention that strategically targets key elements within the learning environment to foster the success of minority students. The intervention sought to enhance Palestinian minority student's sense of belonging by increasing the presence of their native language. We tested the effectiveness of the intervention in two field experiments in Israel (n > 20,000), at the height of the COVID-19 pandemic when all classes were held via Zoom. Lecturers in the experimental condition added a transcript of their names in Arabic to their default display (English/Hebrew only). Our findings revealed a substantial and positive impact on Palestinian student's sense of belonging, class participation, and overall grades. In experiment 1, Palestinian student's average grade increased by 10 points. In experiment 2, there was an average increase of 4 points among Palestinian students' semester grade. Our intervention demonstrates that small institutional changes when carefully crafted can have a significant impact on minority populations. These results have significant implications for addressing educational disparities and fostering inclusive learning environment.

Celebrating organizational history triggers social identity threat among Black Americans.

Many mainstream organizations celebrate their historical successes. In their history, however, they often marginalized racial minorities, women, and other underrepresented groups. We suggest that when organizations celebrate their histories, even without mentioning historical marginalization, they can undermine belonging and intentions to join the organization among historically marginalized groups. Four experiments demonstrate that Black participants who were exposed to an organization that celebrated their history versus the present showed reduced belonging and intentions to participate in the organization. These effects were mediated by expectations of biased treatment in the organization. Further, when organizations had a history of Black people in power, celebrating history was no longer threatening, highlighting that the negative effects of celebrating history are most likely when organizations are or are assumed to be majority-White and have treated Black Americans poorly. Taken together, these findings suggest that emphasizing organizational history can be a source of social identity threat among Black Americans.

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study.

BACKGROUND: Loneliness and belonging refer to social connectedness and are associated with young people's health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17-18-years-olds who were followed over 3 years, and the associations that these aspects share with young people's psychosomatic complaints during these ages. METHODS: Swedish cohort data collected among late adolescents (age 17-18 in 2019) who were followed up in young adulthood (age 20-21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. RESULTS: Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. CONCLUSIONS: Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.

Othering and ethics of belonging in migrants' embodied healthcare experiences.

At a time when national identities are being reasserted in Western Europe alongside moral and intellectual visions of a cosmopolitan order more inclusive than nationalism, what does belonging mean for immigrants who are non-Europeans, particularly for women from South Asia, Africa and the Middle East? Based on the lived experiences of 23 women of diverse backgrounds, who are first-generation immigrants, regarding their experiences while accessing the healthcare system in Zurich, Switzerland, I illustrate through migrant experiences how Othering and belonging are experienced within the web of chaotic meanings and social space one navigates. By employing a phenomenological-sociological approach, I present how embodied migrant experiences can capture the experiences of being an 'Other', as well as how moral emotions such as shame and humiliation can influence one's moral self and its significance to everyday moral discourse. While much of the academic discourse around belonging focuses on a place and its related connectedness to one's racial, gender and ethnic identity, here, I analyse cosmopolitanism's possibilities through Othering/belonging experiences within the healthcare context, and beyond. I conclude this paper with the key contributions of the ethics of belonging to the normative discourse on migration health.

Objective and perceived service accessibility and mental health in older adults.

OBJECTIVES: Service accessibility plays a pivotal role in older adults' mental health. However, accessibility measures used in previous studies are either objective or perceived. This study aimed to integrate both objective and perceived measures of service accessibility to explore the relationship between environmental cognition on service accessibility and mental health in older adults and the pathways. METHODS: We used both questionnaire data collected from 2,317 older adults in Hong Kong and geographical data to explore the direct and indirect effect of environmental cognition (i.e. positive, negative, and matching evaluation) relating to service accessibility on mental health and two pathways (i.e. physical activity and sense of belonging) based on a structural equation model. RESULTS: Physical activity mediated the positive relationship between non-negative perceptions toward access to convenience stores, leisure facilities, clinics, community centers, places of worship and mental health. Sense of community can significantly mediate the positive relationships between non-negative perceptions toward all 10 types of services and mental health. CONCLUSION: This study provides an empirical contribution to environmental cognition theory and person-environment fit theory; its findings have implications for urban planning policy.

The findings from this study provide significant evidence that environmental cognition distortion, especially negative perception, can be significantly associated with lower mental health through physical activity and a sense of community. This suggests that policies focused on changing environmental cognitions could be a promising public health strategy. Environmental cognition theory suggests that improving awareness of setting could help improve the precision of cognitive mapping of environmental reality. This can be very important where it is difficult to change the objective environment due to the deep-rooted and long-standing urban structure.

Daily social support and school belonging among rural Chinese adolescents: Variations by parental migration.

"Left-behind" children refer to those who live in rural areas but have parents migrating to urban areas for work. They are at increased risk for developmental problems and family dysfunction. However, we currently know little regarding their support systems at school. Using daily data over five school days from 90 adolescents (Mage = 13.70) in rural China, this study investigated daily associations linking teacher and peer support to school belonging, and how these associations varied by parental migration. Teacher but not peer support was positively associated with same-day school belonging. However, this association was attenuated for adolescents with longer duration and history of parental migration. The findings highlighted the importance of considering school settings and within-group variations for left-behind adolescents.

Adolescents' belonging in post-divorce families: Examining residential and digital contact with mothers and fathers.

Using data of 166 adolescents from divorced families, this study examined longitudinal associations between the quantity and quality of adolescents' residential contact and digital contact with parents, and their sense of family belonging. Cross-lagged panel models showed concurrent associations among adolescents' residential and digital contact with each parent, yet positively for fathers and negatively for mothers. Some cross-lagged paths revealed that higher-quality interactions may contribute to positive changes in contact. Although there were effects of parent-adolescent contact on family belongingness, over time belongingness was mostly predicted by the general quality of contact. The results suggest that post-divorce relationships require frequent and meaningful time together, the effects of which, however, do hardly transfer over time in terms of adolescents' belongingness.

"I realized I was not alone": A mixed-methods investigation of the implementation of Ubuntu groups to reduce burnout and social isolation in an allopathic medical School in the Southeastern United States.

PURPOSE/BACKGROUND: Healthcare providers experience higher rates of workplace burnout, a reality highlighted by the COVID-19 pandemic. In response, small groups, inspired by South African philosophy, Ubuntu, were introduced to decrease burnout and social isolation and build community and belonging. This study examines how participation in these groups can impact these measures. METHODS: In this mixed-methods study, trained facilitators led small groups that utilized story-sharing to foster connections within the group and broader community. Quantitative and qualitative data were analyzed separately and merged to identify convergence. RESULTS: Three main qualitative themes emerged: 1) seeking and building connections and community, 2) curiosity, learning, and growing, and 3) open-hearted and thriving. These themes were linked to quantitative outcomes, showing a statistically significant decrease in social isolation among staff/faculty and students. Furthermore, faculty/staff exhibited reduced burnout compared to students, while students reported increased feelings of belonging. CONCLUSION: Participation in Ubuntu groups positively influenced students' sense of belonging, reduced faculty/staff burnout, and alleviated social isolation for all participants. Future research should explore the potential of this intervention to further promote wellness on medical campuses. Programs emphasizing the well-being of individuals, including faculty, staff, and students, are crucial for supporting the overall health of medical communities and the wider society.

Changes in peer belonging, school climate, and the emotional health of immigrant, refugee, and non-immigrant early adolescents.

INTRODUCTION: Early adolescents who are new to Canada experience dual challenges of navigating developmental changes and multiple cultures. This study examined how changes in early adolescents' emotional health from ages 9 to 12 differed by immigration background, and to what extent peer belonging and supportive school climate protected or promoted their emotional health. METHODS: This study drew upon linked self-report and administrative data. Across 10 school districts in British Columbia, Canada, N = 4479 non-immigrant, immigrant, and refugee adolescents reported on their peer belonging, school climate, and emotional health (life satisfaction, optimism, self-esteem, sadness, worries) in Grades 4 and 7, using the Middle Years Development Instrument. Immigration background including immigration class (economic, family, refugee) and generation status (first, second) were obtained from linked Immigration, Refugees, and Citizenship Canada data. Multi-level modeling assessed the effect of time (grade level), immigration group, and changes in peer belonging and school climate on changes in self-reported emotional health. Analyses were adjusted for gender, English first language, and low family income. RESULTS: Immigrant and refugee adolescents reported worse emotional health in Grade 4 compared to non-immigrants. Non-immigrant and immigrant adolescents reported declines in emotional health from Grades 4 to 7. In contrast, first-generation refugee adolescents reported significant improvements in life satisfaction, and first- and second-generation refugees reported improvements in worries over this period. Perceived improvements in peer belonging and school climate were associated with positive changes in emotional health for all adolescents. CONCLUSIONS: Changes in adolescents' emotional health from Grades 4 to 7 differed between immigrants, refugees, and non-immigrants. Immigrants and refugees who enter adolescence with lower emotional health than their non-immigrant peers may particularly benefit from culturally responsive school and community-based interventions.

Exploring the use of experimental small area estimates to examine the relationship between individual-level and area-level community belonging and self-rated health.

Background: Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precision and reliability. There is growing interest in secondary research applications for small area estimates (SAEs). However, it is crucial to assess the analytic value of these estimates when used as proxies for individual-level characteristics or as distinct measures that offer insights at the area level. This study assessed novel area-level community belonging measures derived using small area estimation and examined associations with individual-level measures of community belonging and self-rated health. Data and methods: SAEs of community belonging within census tracts produced from the 2016-2019 cycles of the Canadian Community Health Survey (CCHS) were merged with respondent data from the 2020 CCHS. Multinomial logistic regression models were run between area-level SAEs, individual-level sense of community belonging, and self-rated health on the study sample of people aged 18 years and older. Results: Area-level community belonging was associated with individual-level community belonging, even after adjusting for individual-level sociodemographic characteristics, despite limited agreement between individual- and area-level measures. Living in a neighbourhood with low community belonging was associated with higher odds of reporting being in fair or poor health, versus being in very good or excellent health (odds ratio: 1.53; 95% confidence interval: 1.22, 1.91), even after adjusting for other factors such as individual-level sense of community belonging, which was also associated with self-rated health. Interpretation: Area-level and individual-level sense of community belonging were independently associated with self-rated health. The novel SAEs of community belonging can be used as distinct measures of neighbourhood-level community belonging and should be understood as complementary to, rather than proxies for, individual-level measures of community belonging.

Risk-Taking, Social Support, and Belongingness Contribute to the Risk for Cannabis Use Frequency in University Students.

Background: Cannabis use and misuse is known to be associated with a variety of negative health, academic, and work-related outcomes; therefore, it is important to study the factors that contribute to or moderate its use. Objectives: The aim of this study was to determine whether risky behavior, belongingness and social support as clustering variables play a role in cannabis use frequency. Method: In a university student sample, participant data on risky behavior, belongingness and social support were used to generate vulnerability profiles through cluster analysis (low vulnerability with low risk, low vulnerability with high belonging, moderate vulnerability, and high vulnerability). Using an analysis of variance, the vulnerability profiles were compared with respect to cannabis use frequency and quantity. Through chi-square tests we assessed whether these profiles are overrepresented in certain demographics. Results: The cluster analysis yielded four groups, which differed in their vulnerability for cannabis use. The most vulnerable cluster group had higher cannabis use frequency relative to the two least vulnerable groups. Low income vs. high income was also associated with high vulnerability group membership. International students were overrepresented in the low vulnerability with high belonging group relative to the low vulnerability with low-risk group. The opposite was observed for domestic students. Conclusions: This research adds to the expanding body of literature on cannabis use and misuse in Canada, which may contribute to public health policy and the prevention and treatment of cannabis addiction by providing new insight on who may be at risk.

Adapting to change: Undergraduate nursing students' sense of belonging transitioning from online to in-person learning environments.

AIM: To examine undergraduate nursing students' sense of belonging as they transitioned from online to in-person learning. DESIGN: A mixed-method design employing a Sense of Belonging Survey and three open-ended questions. METHODS: Participants were first-year undergraduate nursing students who were back to in-person learning after 3 years of online learning during the pandemic. The survey was administered online in April 2023 using Qualtrics survey software. The survey data were analysed using descriptive statistics, and the open-ended questions were analysed by deductive thematic analysis. RESULTS: Seventy-five (48%) of the 155 potential participants responded to the survey. The mean score on the Sense of Belonging Survey was 74%, a positive finding suggesting that many participants feel that they 'belong' in the classroom. Three overarching themes were identified in response to the open-ended questions: factors supporting students' sense of belonging, factors hindering students' sense of belonging and strategies for faculty, administrators and students to increase a sense of belonging. CONCLUSION: Understanding the factors that contribute to or hinder nursing students' sense of belonging during this transition will assist in developing strategies to mitigate challenges, foster a positive learning environment and enhance the overall sense of belonging among nursing students. IMPACT: The first year of a nursing programme is crucial for student retention as students require tailored programmes and strategies to support their success. Examining and analysing the transition from online to in-person classroom settings is crucial to identifying strategies to enhance and support first-year students' sense of belonging and academic success. Exploring nursing students' experiences of belonging during transitions contributes to a more inclusive and equitable educational experience, fostering an environment where all students can thrive and succeed. PATIENT OR PUBLIC CONTRIBUTION: Not applicable.

Assigned group work is associated with increased student motivation and perceptions of belonging in an asynchronous online physiology laboratory course.

With the rise of online instruction, a better understanding of the factors that contribute to belonging and motivation in these contexts is essential to creating optimal learning environments. Although group work is known to be beneficial to student success, few studies have investigated its role in the context of asynchronous online courses. The present study addresses this gap through a survey of 146 undergraduate students in an asynchronous online physiology lab over two semesters, one with required group work and one without group work. Students were surveyed to evaluate the influence of group work on their motivation and sense of belonging, as well as their perceptions of inclusive and exclusive features of the course. Students assigned to groups had a higher sense of belonging (P = 0.006) and beliefs about their competence (P = 0.002) and perceived lower effort and psychological costs associated with the course (P = 0.04 and 0.04, respectively) compared to students not assigned to groups. Students assigned to groups reported that peer interactions made them feel included in the course (70% of coded responses) while those not assigned to groups valued instructor interactions (51% of coded responses) as inclusive. Negative peer interactions were commonly reported as exclusive by students assigned to groups (28% of coded responses) while a lack of peer interactions (23% of coded responses) made students not assigned to groups feel excluded. These data indicate that assigning groups in asynchronous online courses is an effective way to increase student motivation and perceptions of belonging.NEW & NOTEWORTHY This study explores the effect of assigned group work in an asynchronous online physiology laboratory course on student motivation and belonging. Students' perceptions of belonging and competence-related beliefs were higher, and effort and psychological costs were lower, when assigned to groups compared to students not assigned to groups. Students assigned to groups noted peer interactions as the most inclusive aspect of the course, whereas instructor interactions were noted as inclusive by those not assigned group work.

LGBTQ+ faculty, queering health sciences classrooms: student perspectives.

Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) students in undergraduate science, technology, engineering, and math (STEM) majors are more likely to drop out than their cisgender, heterosexual peers despite having equivalent grades and research exposure. It has been demonstrated that a sense of belonging, a very strong predictor of student retention, is low in LGBTQ+-identified STEM undergraduates. It has further been posited that faculty openness and authenticity can enhance a sense of belonging for LGBTQ+ students through the creation of an inclusive classroom culture. The authors of this article, three LGBTQ+-identified faculty in the health sciences department at Boston University, surveyed students enrolled in their courses to elicit student thoughts, feelings, and behaviors regarding the effect of faculty 1) sharing their identity openly in the classroom, and 2) actively working to create open, inclusive dialogue and space in their classrooms. Of 86 student participants across multiple classes, the large majority of students, both LGBTQ+-identified and non-LGBTQ+-identified, described feeling safe, included, and welcomed in the classroom. They described engaging more in peer-to-peer education and felt that instructor authenticity created a safe and inclusive classroom. A minority of LGBTQ+-identified students and non-LGBTQ+-identified students reported feeling unsure of voicing their opinions, for the former related to insecurity about being LGBTQ+ and the latter feeling a liberal bias existed in the classroom. Altogether, these results suggest a positive effect on student sense of belonging when faculty authenticity and intentionality create inclusive classroom environments in the health sciences.NEW & NOTEWORTHY Openness and authenticity of lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+)-identified faculty in the health sciences positively affect students by helping them feel seen, welcomed, and included for both students who identify as LGBTQ+ and those who do not. Moreover, faculty openness fostered student action by encouraging them to have peer-to-peer discussions about inclusive language and engage more openly in classroom discussions. Creating academic job security for LGBTQ+-identified faculty to be open can enhance classroom culture, student engagement, and learning.

Students respond positively to an instructor collecting and sharing aggregated class demographic data from a survey in a high-enrollment physiology course.

The impersonal nature of high-enrollment science courses makes it difficult to build student-instructor relationships, which can negatively impact student learning and engagement, especially for members of marginalized groups. In this study, we explored whether an instructor collecting and sharing aggregated student demographics could positively impact student-instructor relationships. We surveyed students in a high-enrollment physiology course about their perceptions of their instructor 1) distributing a demographic survey, and 2) sharing aggregated survey results in class. We found that 72% of students appreciated the demographic survey, and 91% thought it helped their instructor get to know them. Further, 73% of students expressed that the instructor sharing aggregated demographic data in class positively impacted their overall course experience, and over 90% thought both the collection and sharing of demographic data were appropriate. Most students felt both parts of the intervention increased their sense of belonging in class, increased how connected they felt to their instructor, and made their instructor seem more approachable and inclusive, although the intervention also made some students feel more different from their peers. Women and nonbinary students felt the demographic survey increased instructor approachability more than men, and liberal students felt the survey increased instructor approachability more than nonliberal students. Compared to men, women and nonbinary students were more likely to report that taking the survey increased instructor inclusivity and made them feel less different from their peers. Based on these results, collecting student demographic information and sharing it in aggregate may be a practical, effective way to enhance student-instructor relationships.NEW & NOTEWORTHY This study examined undergraduate student perceptions of a high-enrollment physiology instructor collecting student demographics and sharing aggregated results to promote course inclusion. Most students perceived the collection and sharing positively, with women and nonbinary students, as well as liberal students, perceiving greater benefits from the data collection than their counterparts. Our results indicate that collecting and sharing in aggregate student demographics may be an effective way to enhance student-instructor relationships in high-enrollment science courses.

From corners to community: exploring medical students' sense of belonging through co-creation in clinical learning.

BACKGROUND: Belonging is critical for the development and wellbeing of medical students. Belonging, particularly within a 'relational being' paradigm, presents a significant challenge for students, especially within clinical learning environments. Co-creation is a learning relationship in which students are actively involved in the education process. It is inherently relational and promotes belonging within higher education environments. Little is known about utilising co-creation in the curriculum, within medical education. The aim of this study was to explore medical students' experience of co-creation of learning resources within the clinical learning environment. METHODS: Following ethical approval, medical students were invited to become co-creators of a learning bulletin resource, within the paediatric acute receiving unit, at a paediatric teaching hospital. Interpretative phenomenological analysis (IPA) was used to enable an in-depth exploration of how medical students experienced co-creation within the clinical learning environment. Medical students participated in semi-structured interviews about their experience, which were transcribed verbatim and analysed using IPA. The analysis integrated individual lived experiences into an analytic summary. RESULTS: Nine medical students participated. Three group experiential themes were identified: identity maturation; learning community and workplace integration. The support found within this co-created learning community, along with maturation of their identity, allowed the participants to experience a challenge to their existing worldview. This shift in perspective resulted in them responding and behaving in the workplace in new ways, which enabled them to belong as themselves in the clinical learning environment. These findings were situated within the developmental concept of self-authorship, as well as contributing to a new understanding of how co-creation promoted social integration. CONCLUSIONS: Co-creation enabled students to learn in a meaningful way. The relational power of co-creation, can be harnessed to deliver participatory learning experiences, within our increasingly complex healthcare environment, to support the learning, development and integration of doctors of the future.

School belonging and depressive symptoms: the mediating roles of social inclusion and loneliness.

BACKGROUND: Loneliness and depressive symptoms are prevalent among Finns. OBJECTIVES: This study, which analyzes nationwide data from 149,986 students aged 13-18 years in Finland, focuses on the mediating effects of social inclusion and loneliness in the association between school belonging and depressive symptoms. METHOD AND RESULTS: The analysis of variance showed that boys reported higher levels of school belonging and social inclusion, whereas girls reported higher levels of loneliness and depressive symptoms. Mediation analysis showed that social inclusion and loneliness partially mediated the effect of school belonging on depressive symptoms, but that social inclusion's effect was much greater than loneliness's. By focusing on the moderating role of sex, it was discovered that social inclusion significantly mediated depressive symptoms in girls more than boys. CONCLUSION: The importance of social inclusion in preventing depressive symptoms was highlighted in the discussion.

Exploring young adults' experiences with food allergy during their teenage years: A practice research study.

INTRODUCTION: Symptoms of anxiety, eating disorders and social isolation are prevalent among teenagers with food allergy compared to peers without. Treatment of teenagers with food allergy focus on preventing anaphylactic reactions, with little attention to promoting social and emotional well-being. The aim of the study was to explore young adults' perspectives on everyday life with food allergy during their teenage years to improve future clinical practice. METHODS: Critical psychological practice research. During a 2-day camp the perspectives of 10 young adults (18-23 years) were explored through participant observation and informal interviews. Three follow up interviews were conducted. A co-researcher group discussed preliminary results, clinical challenges and ways forward. RESULTS: Being together with peers with food allergy was crucial, fostering belonging and normalisation. The shift in responsibility of managing the risk feels overwhelming and stressful during teen age. Self-understanding was influenced when managing food allergy in social contexts, inducing feelings of burden and isolation. Acceptance and understanding from social relations became important for all participants, and they all underlined desire for being viewed as individuals rather than being defined by their allergy. CONCLUSION: Support from other peers with food allergy is crucial for the participants. Transition to independently managing risks introduces uncertainty and social constraints, affecting self-understanding and interactions. Clinicians should prioritise peer support and empower teenagers in managing the risk and psychosocial challenges.

Connections matter: Exploring the relationship between belonging and psychosocial well-being in type 1 diabetes in Iran.

AIM: Identify the relationship between a sense of belonging and psychosocial well-being in individuals with type 1 diabetes (T1D) in Iran. BACKGROUND: Understanding this relationship is vital for tailored nursing interventions to enhance individual's sense of belonging and improve diabetes outcomes. METHODS: This cross-sectional study included 205 participants selected via multi-stage cluster and simple random sampling from health centers in Iranian. Electronic surveys designed on Google Forms, using valid and reliable scales and compliant with HIPAA, assessed sense of belonging, distress, and burnout. Data were analyzed using SPSS (version 25). RESULTS: Participants reported high sense of belonging with varying levels of diabetes distress and burnout. Multiple regression analysis of 205 participants showed that sense of belonging index (SOBI) scores significantly predicted diabetes distress (F(2,203) = 39.71, p < 0.001) and burnout (F(2, 203) = 42.319, p < 0.001). Sense of Belonging Instrument-Psychological (SOBI-P) scores were negatively correlated with both distress (r = -0.52, p < 0.001) and burnout (r = -0.53, p < 0.001), indicating higher belonging is linked to lower distress and burnout. Sense of Belonging Instrument-Antecedents (SOBI-A) scores had positive but non-significant correlations (distress: r = 0.07, p = 0.27; burnout: r = 0.10, p = 0.13). SOBI-P accounted for ∼30 % of the variance in distress (R2 = 0.275) and burnout (R2 = 0.288), with significant contributions to both models (t = -8.8, p < 0.001; t = -9.02, p < 0.001). Anticipated belonging showed no significant correlations with distress or burnout. CONCLUSION: The negative correlations between personal belonging, self-reported distress, and burnout suggest that enhancing the psychological sense of belonging may be an effective strategy to mitigate diabetes-related distress and burnout Stigmatization and financial strain in Iran may exacerbate emotional burden, regimen related distress, and burnout. The lack of association between anticipated belonging and psychosocial well-being underscores differences in present and future perceptions of support, emphasizing the need for culturally sensitive nursing interventions.