Self-reported and accelerometry measures of sleep components in adolescents living in Pacific Island countries and territories: Exploring the role of sociocultural background.

OBJECTIVES: The objective of this study is to assess the concordance and its association with sociocultural background of a four-question survey with accelerometry in a multiethnic adolescent population, regarding sleep components. Based on questions from the Pittsburgh Sleep Quality Index and adapted to a school context, the questionnaire focussed on estimating sleep onset time, wake-up time and sleep duration on both weekdays and weekends. This subjective survey was compared with accelerometry data while also considering the influence of sociocultural factors (sex, place of living, ethnic community and socio-economic status). METHODS: Adolescents aged 10.5-16 years (n = 182) in New Caledonia completed the survey and wore an accelerometer for seven consecutive days. Accelerometry was used to determine sleep onset and wake-up time using validated algorithms. Based on response comparison, Bland-Altman plots provided agreement between subjective answers and objective measures. We categorized participants' answers to the survey into underestimated, aligned and overestimated categories based on time discrepancies with accelerometry data. Multinomial regressions highlighted the sociocultural factors associated with discrepancies. RESULTS: Concordance between the accelerometer and self-reported assessments was low particularly during weekends (18%, 26% and 19% aligned for onset sleep time, wake-up time and sleep duration respectively) compared with weekdays (36%, 53% and 31% aligned, respectively). This means that the overall concordance was less than 30%. When considering the sociocultural factors, only place of living was associated with discrepancies in onset sleep time and wake-up time primarily on weekdays. Rural adolescents were more likely to overestimate both onset sleep time (B = -1.97, p < 0.001) and wake-up time (B = -1.69, p = 0.003). CONCLUSIONS: The study found low concordance between self-assessment and accelerometry outputs for sleep components. This was particularly low for weekend days and for participants living in rural areas. While the adapted four-item questionnaire was useful and easy to complete, caution should be taken when making conclusions about sleep habits based solely on this measurement.

Providing Self-Led Mental Health Support Through an Artificial Intelligence-Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care.

Digital mental health services are becoming increasingly valuable for addressing the global public health burden of mental ill-health. There is significant demand for scalable and effective web-based mental health services. Artificial intelligence (AI) has the potential to improve mental health through the deployment of chatbots. These chatbots can provide round-the-clock support and triage individuals who are reluctant to access traditional health care due to stigma. The aim of this viewpoint paper is to consider the feasibility of AI-powered platforms to support mental well-being. The Leora model is considered a model with the potential to provide mental health support. Leora is a conversational agent that uses AI to engage in conversations with users about their mental health and provide support for minimal-to-mild symptoms of anxiety and depression. The tool is designed to be accessible, personalized, and discreet, offering strategies for promoting well-being and acting as a web-based self-care coach. Across all AI-powered mental health services, there are several challenges in the ethical development and deployment of AI in mental health treatment, including trust and transparency, bias and health inequity, and the potential for negative consequences. To ensure the effective and ethical use of AI in mental health care, researchers must carefully consider these challenges and engage with key stakeholders to provide high-quality mental health support. Validation of the Leora platform through rigorous user testing will be the next step in ensuring the model is effective.

Interdisciplinary eHealth for the care of people living with traumatic brain injury: A systematic review.

OBJECTIVE: To identify literature which discusses the barriers and enablers of eHealth technology and which evaluates its role in facilitating interdisciplinary team work for the care of people with a traumatic brain injury (TBI). DESIGN: Systematic review. DATA SOURCES: Studies were identified by searching CINAHL, Embase, Medline, PsycINFO, Scopus, and Web of Science. STUDY SELECTION: Studies included in the review were required to feature an eHealth intervention which assisted interdisciplinary care for people with TBI. DATA EXTRACTION: Descriptive data for each study described the eHealth intervention, interdisciplinary team, outcomes, and barriers and facilitators in implementing eHealth interventions. RESULTS: The search resulted in 1389 publications, of which 35 were retrieved and scanned in full. Six studies met all the inclusion criteria for the review. Four different eHealth interventions were identified: (i) an electronic goals systems, (ii) telerehabilitation, (iii) videoconferencing, and (iv) a point-of-care team-based information system. Various barriers and facilitators were identified in the use of eHealth. CONCLUSION: eHealth interventions have been reported to support interdisciplinary teams for the care of TBI. However, there is a substantial gap in existing literature regarding the barriers and enablers which characterize a successful interdisciplinary eHealth model for people with TBI.

The Reel Health Care Professionals of Instagram: A Systematic Review.

Social media and health research have covered the benefits for the public and patients as users. Specifically, this has focused on searching for health information, connecting with others experiencing similar health issues, and communicating with their health professionals. Recently, there has been a shift in research to focus on health care professionals as users as they participate in professional development, improve communication with patients, and contribute to health research and service. However, such research has predominantly focused on text-based platforms, namely Facebook and Twitter. The scope of this article is a systematic review of publications on health care professionals' use of the image-based platform Instagram, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. This study, drawing from 51 articles, shows how health care professionals use Instagram, and reveals that these professionals utilize the platform to address health concerns that may not necessarily align with their specific expertise. Images were the common format of posts created by health care professionals, with six content types identified: (a) educational, (b) promotional, (c) patient experience, (d) personal, (e) emotion based, and (f) other. Three measures of post engagement were used by researchers, including (a) likes and comments, (b) use of hashtags, and (c) number of followers. This study also identified the dangers of misleading users, including (a) lack of credentials reported, (b) edited images, (c) quality of content, and (d) patient and client confidentiality issues. In conclusion, insights into the advantages of health care professionals' use of Instagram and ways in which they can maximize its use to reach and engage with their target audience are provided.

Health Professionals' Use of Online Communities for Interprofessional Peer Education.

Online communities in health care are well established as technologies for facilitating interactions between patients with common conditions and communication between patients and health professionals. Less well known is how health professionals use these platforms to connect with their peers, particularly for interprofessional education or support. We present early results from our exploratory international mixed methods (survey and interview) study of health professionals' experience of engaging with online communities for interprofessional peer education. Our results show that health professionals had relatively high levels of confidence engaging with multiple platforms. They used the platforms to formally and informally share evidence-based content, engage in collegial debate and connect with international colleagues. Health professionals are keen to engage with online communities for education and are aware of how these sites' functionality can promote engagement with interdisciplinary peers.

Increasing Access to Mental Health Services: Videogame Players' Perspectives.

Young men's mental health is at the forefront of global public health concerns. Young males, who have a high incidence of mental health disorders, are a population that accesses services at lower rates than females and makes up the majority of videogame players. By considering the unique perspectives of digitally connected individuals on mental health service delivery, interventions may be designed to address their needs with a higher likelihood of success. This study investigated international male videogamers' perspectives on how their access to mental health services could be improved via an open-ended survey question. From a total of 2515 completed surveys, 761 responded to the qualitative question. Of these, the 71 responses that discussed access to and provision of mental healthcare services are reported in this article. Results suggest that digital mental health services were a promising way to reach this group. Anonymity and confidentiality were found to be important factors when considering online mental health services. Male videogame players identified a preference for both online and in-person services that are delivered synchronously, one-on-one with an expert practitioner, and readily available in settings that individuals find comfortable.

Mental Health Help-Seeking Behavior of Male Video Game Players: An Online Survey.

Video gaming is a popular pastime for young males, having been shown to have both positive and negative effects on players' mental health. The aim of the current study was to ascertain the rate that male video gamers may seek mental health support for mental ill-health generally. The secondary aims were to (a) identify the most prolific barriers to seeking help; (b) determine how confident this group is to seek help; and (c) whether the variance in help-seeking efficacy be explained, in part, by age, hours gamed, self-esteem, and social capital. The survey included sections on demographic information, standardized measures of self-esteem (The Rosenberg Self-Esteem Scale), social capital (The Social Capital in Gaming Scale), help-seeking efficacy (Self-Efficacy to Seek Mental Health Care Scale), and non-standardized measures of help-seeking behavior and help-seeking barriers. The survey of 2,515 participants had a mean age of 21.37 years. The analysis identified that most participants had not sought mental health support for themselves. The most prolific barriers for this cohort to seek help were cost, confidentiality, and trust. Confidence to seek help was rated the lowest for overcoming embarrassment, understanding information, and coping with others' reactions. Help-seeking efficacy was found to be significantly predicted by age, hours spent gaming, self-esteem, and social capital. Low rates of seeking help, coupled with identifying the significant barriers of this group to seek help, may inform researchers aiming to develop targeted interventions for male youth interested in gaming and who are exhibiting mental ill-health to gain initial access, or engage more often, with mental health services when needed. Further research is recommended for investigating male gamers' insights in determining how to overcome the identified barriers for this cohort to improve mental health seeking behavior rather than avoidant behavior. From this, stigma reduction and ease of access to digital mental health services could be improved.

The effect of e-health contents on health science students' attitude toward the efficiency of health ICT in care provision.

OBJECTIVE: This study aimed to examine the effects of e-health education content on the attitude of undergraduate health science students towards the efficiency of health ICT in healthcare provision. METHODS: A cross-sectional survey design was used. Participants were Health Sciences students attending The University of Sydney. Students were divided into three groups: junior students enrolled in a subject with non e-health content; senior students enrolled in a subject with non e-health content; and students enrolled in a subject with e-health content. Students' attitude towards the efficiency of ICT in healthcare provision was measured by a modified version of the Information Technology Attitude Scales for Health (ITASH). RESULTS: Students enrolled in the subject with e-health content had a significantly higher average baseline attitude score than the other two groups (T198=-3.47, p=0.001; T93=-2.43, p=0.017). The repeat measures analysis yielded a result with significant interaction between survey time and student group (F2, 267=4.99, p=0.007) suggesting that changes of score was dependent on student group status. CONCLUSION: Subjects rich in e-health content significantly enhanced student attitudes, even with a group of students with a rather positive initial attitude. To facilitate the uptake and utilisation of health ICT by the future health workforce, it is important for tertiary educational institutes to provide students with sufficient exposure to specific health-related ICT training, via specifically designed subjects delivering both generic and specific e-health content.

Desire to Belong Affects Instagram Behavior and Perceived Social Support.

Social networking site (SNS) use has been shown to predict both positive and negative well-being. These discrepant findings may be explained by people's motivations for and frequency of using SNSs. This study aimed to explore how frequency of online interactions can be affected by users' motives, specifically, being motivated by a sense of belonging, and possible perceived social support derived from the popular image-based SNS, Instagram. A total of 313 Instagram users (84.4% female, median age = 22 years) completed an online survey between March and September 2017 asking about their motives for using Instagram, perceived social support, and frequency of Instagram use. Multiple regression mediation analyses examined the relationship between being motivated by a desire to belong, mediator variables (frequency of posting, liking, and viewing posts), and perceived social support. A greater desire to belong significantly positively predicted frequency of Instagram use, total perceived social support, and perceived social support from friends and significant others. However, frequency of Instagram use did not predict perceived social support. As such, frequency of Instagram use did not mediate the relationship between motivation and social support. Future research could explore how other user motives and peer feedback affect Instagram use and other well-being outcomes.

Insights into Facebook Pages: an early adolescent health research study page targeted at parents.

Facebook has been used in health research, but there is a lack of literature regarding how Facebook may be used to recruit younger adolescents. A Facebook Page was created for an adolescent cohort study on the effects of puberty hormones on well-being and behaviour in early adolescence. Used as a communication tool with existing participants, it also aimed to alert potential participants to the study. The purpose of this paper is to provide a detailed description of the development of the study Facebook Page and present the fan response to the types of posts made on the Page using the Facebook-generated Insights data. Two types of posts were made on the study Facebook Page. The first type was study-related update posts and events. The second was relevant adolescent and family research and current news posts. Observations on the use of and response to the Page were made over 1 year across three phases (phase 1, very low Facebook use; phase 2, high Facebook use; phase 3, low Facebook use). Most Page fans were female (88.6%), with the largest group of fans aged between 35 and 44 years. Study-related update posts with photographs were the most popular. This paper provides a model on which other researchers could base Facebook communication and potential recruitment in the absence of established guidelines.

Facebook as a recruitment tool for adolescent health research: a systematic review.

BACKGROUND: Researchers are increasingly using social media to recruit participants to surveys and clinical studies. However, the evidence of the efficacy and validity of adolescent recruitment through Facebook is yet to be established. OBJECTIVE: To conduct a systematic review of the literature on the use of Facebook to recruit adolescents for health research. DATA SOURCES: Nine electronic databases and reference lists were searched for articles published between 2004 and 2013. STUDY ELIGIBILITY CRITERIA: Studies were included in the review if: 1) participants were aged ≥ 10 to ≤ 18 years, 2) studies addressed a physical or mental health issue, 3) Facebook was identified as a recruitment tool, 4) recruitment details using Facebook were outlined in the methods section and considered in the discussion, or information was obtained by contacting the authors, 5) results revealed how many participants were recruited using Facebook, and 6) studies addressed how adolescent consent and/or parental consent was obtained. STUDY APPRAISALS AND SYNTHESIS METHODS: Titles, abstracts, and keywords were scanned and duplicates removed by 2 reviewers. Full text was evaluated for inclusion criteria, and 2 reviewers independently extracted data. RESULTS: The search resulted in 587 publications, of which 25 full-text papers were analyzed. Six studies met all the criteria for inclusion in the review. Three recruitment methods using Facebook was identified: 1) paid Facebook advertising, 2) use of the Facebook search tool, and 3) creation and use of a Facebook Page. CONCLUSIONS: Eligible studies described the use of paid Facebook advertising and Facebook as a search tool as methods to successfully recruit adolescent participants. Online and verbal consent was obtained from participants recruited from Facebook.