Barriers and facilitators of older adults for professional mental health help-seeking: a systematic review.

BACKGROUND: Older adults are at an increased risk for mental health issues, yet they are less likely to seek professional help. This systematic review aims to identify and summarize literature on the barriers and facilitators that older adults face when seeking professional mental health help. METHODS: A comprehensive literature search was conducted using multiple databases including PubMed-Medline, EMBASE, ProQuest central, CINAHL and Scopus to identify relevant studies published between 2010 and 2021 that focused on barriers and/or facilitators to seeking help for depression, anxiety, and psychological distress among older adults aged 65 years or older. Studies' risk of bias was assessed using the Newcastle-Ottawa Scale and results of studies were synthesized guided by the methodological framework of Rodgers and colleagues. RESULTS: A total of eight cross-sectional studies, from Australia, United States, Mexico, Netherlands, and Malaysia met the inclusion criteria for this review. Included studies reported that the majority of their participants had anxiety or depression, yet they exhibited a preference for informal mental health help over professional help. Stigma, negative beliefs about mental health professional services, and cost were the most reported barriers. Main reported facilitators were prior positive experience with mental health services and high socioeconomic status. CONCLUSION: Older adults are in need of interventions normalizing mental health help seeking and ensuring these services are accessible in terms of costs. This should be the focus of policy makers, healthcare providers, and public health practitioners working with older adults. PROTOCOL REGISTRATION: PROSPERO 2021 CRD42021238853.

Adolescents' Internet addiction: Does it all begin with their environment?

BACKGROUND: This is one of the few studies that examines adolescent Internet addiction (IA) among Middle Eastern population. The purpose of this study is to determine whether adolescents' family and school environments play a role in their Internet Addiction. METHODS: We conduced a survey that included 479 adolescents in Qatar. The survey collected demographic data, the Internet Addiction Diagnostic Questionnaire (IADQ), the Brief Family Relationship Scale (BFRS) and questions from the WHO Health Behavior in School-aged Children (HBSC) survey that assess school environment, academic performance, teacher support, and peer support of the adolescents. Factorial analysis, multiple regression, and logistic regression were used for statistical analysis. RESULTS: Family environment and school environment were negative and significant predictors of adolescent Internet addiction. The prevalence rate was 29.64%. CONCLUSION: Results imply that interventions and digital parenting programs should not only target adolescents, but also include entities in the developmental environment of adolescents, i.e. their family and school.

Diabetes Self-Management and Health-Related Quality of Life among Primary Care Patients with Diabetes in Qatar: A Cross-Sectional Study.

Diabetes self-management (DSM) practices are an important determinant of health-related outcomes, including health-related quality of life (HRQOL). The purpose of this study is to explore DSM practices and their relationship with the HRQOL of patients with type 2 diabetes in primary health care centers (PHCCs) in Qatar. In this cross-sectional study, data were collected from PHCC patients with diabetes via interview-administered questionnaires by utilizing two instruments: the DSM questionnaire (DSMQ) and the HRQOL Short Form (SF-12). Frequencies were calculated for categorical variables and medians were calculated for continuous variables that were not normally distributed. A statistical comparison between groups was conducted using chi-square for categorical data. Binary logistic regression was utilized to examine the relationship between the significant independent factors and the dependent variables. A total of 105 patients completed the questionnaire, 51.4% of whom were male. Approximately half of the participants (48.6%) reported poor overall DSM practices, and 50.5% reported poor physical health quality of life (PC) and mental health quality of life (MC). Female participants showed significantly higher odds of reporting poor DSM than male participants (OR, 4.77; 95% CI, 1.92-11.86; p = 0.001). Participants with a secondary education (OR, 0.18; 95% CI, 0.04-0.81; p = 0.025) and university education (OR, 0.18; 95% CI, 0.04-0.84; p = 0.029) showed significantly lower odds of reporting poor DSM than participants with no/primary education. Older participants showed higher odds of reporting poor PC than younger participants (OR 11.04, 95% CI, 1.47-82.76 and OR 8.32; 95% CI, 1.10-62.86, respectively). Females also had higher odds for poor PC than males (OR 7.08; 95% CI, 2.21-22.67), while participants with a secondary (OR, 0.13; 95% CI, 0.03-0.62; p = 0.010) and university education (OR, 0.11; 95% CI, 0.02-0.57; p = 0.008) showed significantly lower odds of reporting poor MC. In conclusion, patients with diabetes reported poor overall DSM practices and poor HRQOL. Our findings suggest intensifying efforts to deliver culturally appropriate DSM education to patients and to empower patients to take charge of their health.

Following Interprofessional Education: Health Education Students' Experience in a Primary Interprofessional Care Setting.

BACKGROUND: There is an accelerating need for interprofessional education (IPE) in the Public Health field, as healthcare providers become diverse and multi-disciplinary. Public Health students with health education concentration at Qatar University are required to join training sessions in IPE before the start of their field experience, where students are placed in a variety of community-based and clinical settings including, but not limited to, primary healthcare. PURPOSE: The goal of this qualitative research study is to understand health education students' experience in interprofessional care during their field experience in a primary healthcare setting and to highlight the successes and challenges. PATIENTS AND METHODS: Participants were third-year health education students (N = 22) enrolled in the Public Health program at Qatar University who obtained their experiential learning in three different primary health care centers. Students' weekly reports reflecting on primary interprofessional care were included in the analysis for the purpose of this study. Following constant comparative techniques, thematic analysis was conducted on health education students' reports. RESULTS: Interprofessional care was witnessed and practiced by students in teamwork and collaboration for the benefit of the patient, communication among health care professionals and referral process and patient flow. Health education students understood their role in interprofessional care in the fields of behavior change, and patient education and empowerment. However, professionals and patients were not recognizing health educators' role and were not familiar with their contributions to interprofessional care in primary healthcare. Students suggested delivering interprofessional education for health care providers to enhance collaborative teamwork and promote knowledge about the evolving health education field among healthcare providers in Qatar. In addition, they recommended orienting their training supervisors about the goal of IPE-based practice in a primary healthcare setting. CONCLUSION: Interprofessional care was observed and practiced by health education students through collaborative teamwork, communication among health care professionals and management of patient flow. However, they faced challenges during their practice-based IPE. The findings can be tailored towards planning for interprofessional education workshops to boost collaboration progress among health care providers including health educators and supporting professionals interested to implement practice-based IPE in their placement curriculums.

An investigation of the relationship between cyberbullying, cybervictimization and depression symptoms: A cross sectional study among university students in Qatar.

BACKGROUND: Cyberbullying is a modern form of bullying that could be practiced electronically or on the internet. It is related to different mental health issues such as depression, which can affect both the cyberbully and the victim. Although a few studies have been conducted regarding the prevalence of cyberbullying and cyber-victimization among the younger generation in Qatar, no studies have been conducted among young adults despite studies showing that they are also prone to cyberbullying. METHODS: This is a cross-sectional study to investigate the prevalence and the relationship between cyberbullying, cyber-victimization, and depression symptoms among Qatar University students. A self-administered close-ended electronic questionnaire was used to assess student's cyberbullying/cyber-victimization behaviors and depression symptoms. The Revised Cyberbullying Inventory scale (RCBI-II) and Patient Health questionnaire-9 (PHQ-9) were utilized to measure involvement in cyberbullying and depression symptoms, respectively. A total of 836 students participated in the study. Pearson Chi-Square test and binary logistic regression were conducted to analyze the data. RESULTS: Results indicated the majority of students have been involved in cyberbullying as follows: 6.8% cyberbullies, 29.2% cybervictims, 35.8% cyberbully-victims, and 28.2% not involved in either. Approximately 50% of the students scored a ten or higher on the PHQ9 test indicating symptoms of depression. Moreover, significant associations were found between cyberbullying experiences and gender (p = 0.03), depression and gender (p = 0.046), and between cyberbullying experiences and depression (p<0.001). CONCLUSION: Our findings indicate that among Qatar University students, cyberbullying and cyber-victimization are prevalent behaviors that could be associated with the high reported rates of depression symptoms.

Diabetes Self-Management Education and Support: Referral and Attendance at a Patient-Centered Medical Home.

BACKGROUND: Although evidence shows that diabetes self-management education and support (DSMES) is an effective tool to help individuals with type 2 diabetes (T2DM) improve their health outcomes, there remains a large number of individuals not attending DSMES. Understanding how frequently patients receive referrals to DSMES and the number of DSMES hours they receive is important to determine, as well as patients' health outcomes of utilizing DSMES. This will help us understand patterns of utilization and the outcomes that occur when such a valuable resource is utilized. METHODS: Secondary data analysis was conducted of patient electronic medical records at a primary healthcare federally qualified clinic and 2 area hospitals. We identified 105 adult patients with a new T2DM diagnosis with at least 2 A1c lab results 3 to 12 months apart during the study period. RESULTS: Only 53.5% were referred to DSMES. Out of those who were referred, 66% received no DSMES, 17% received 1-hour assessment, 4% received partial DSMES, and 13% received 8 or more hours. Linear regression of percent change in A1c and number of DSMES hours received, revealed that receiving 1 (P = .001) or 8 or more hours of DSMES (P = .022) had a significant negative relationship with the percent difference in A1c compared to the group who received no DSMES. Patients who had an hour of assessment had a similar percent reduction in A1c to those who had partial DSMES. CONCLUSION: Referral rates and enrollment in DSMES remain low. Those who enrolled often dropped out after the one-hour assessment session. Results suggest making the one-hour assessment session more educationally comprehensive or longer to retain patients. Improving the DSMES referral process and further investing physicians' decisions on whether to refer or not refer patients to DSMES are key for future studies.