Wellbeing-responsive community: a growth target for intentional mental health promotion.

With mental illness remaining a significant burden of disease, there is an ongoing need for community-based health promotion, prevention, and responses (or "mental health promotion activities"). The health promotion, community development, and positive psychology literature identifies significant heterogeneity in the design and delivery of these activities. This variability spans: (1) individual vs. group outcomes, (2) psychological vs. sociological determinants of change, (3) promoting wellbeing vs. reducing mental health symptoms, and (4) the degree activities are contextualized vs. standardized in design and delivery. Mental health promotion activities do not easily accomplish this level of complexity within design and implementation. This has led to the emergence of the complexity-informed health promotion literature and the need for innovative tools, methods, and theories to drive this endeavor. This article directly responds to this call. It introduces "wellbeing-responsive community": a vision and outcome hierarchy (or growth target) for intentionally delivered mental health promotion. The construct enables the design and implementation of interventions that intentionally respond to complexity and contextualization through the drivers of co-creation, intentionality, and local empowerment. It represents a community (support team, programme, agency, network, school, or region) that has the shared language, knowledge, methods, and skills to work together in shared intent. In other words, to integrate best-practice science with their local knowledge systems and existing strengths, and intentionally co-create and deliver contextualized wellbeing solutions at both the individual and community levels that span the "system" (e.g., whole-of-community) to the "moment" (e.g., intentional support and care). Co-creation, as applied through a transdisciplinary lens, is emerging as an evidence-based method to respond to complexity. This article describes the rationale and evidence underpinning the conceptualization of a wellbeing-responsive community through the integration of three key disciplines: (1) positive psychology, (2) ecological or systems approaches, and (3) intentional practice (implementation science). A definitional, contextual, and applied overview of the wellbeing-responsive community is provided, including a hierarchy of outcomes and associated definitions. Its purported application across education, mental health, community service, and organizational settings is discussed, including its potential role in making complexity-informed health promotion practical for all knowledge users.

A systematic review of influences and outcomes of body image in postpartum via a socioecological framework.

BACKGROUND: Women in the postpartum period come under multi-level pressure to return to pre-pregnancy body shape and size. This pressure can lead to reduced body image satisfaction, self-esteem, and mood. In this systematic review we explored the influences and outcomes of body dissatisfaction during the postpartum period. METHODS: Four databases were searched using keywords: postpart* OR postnatal OR peripart* OR 'new mother' OR 'breast feed*' AND 'body image' OR 'body dissatisf*' OR 'body satisf*' OR 'body attitude' OR 'body shape'. RESULTS: The influences and outcomes of body image dis/satisfaction in the postpartum period from 55 international studies were found to align within four of the five factors of the socioecological model. Intrapersonal factors: weight and body shape concerns, mental health and stressors, attitudes and behaviours, and protective coping skills and interventions. Interpersonal factors: social support (partner, family, and friends) and sexual functioning. Institutional factors: experiences with the healthcare system and returning to work. Societal factors: culture and ethnicity, media influences and social norms such as the thin ideal. CONCLUSIONS: A focus on intrapersonal factors alone is insufficient to understand women's experiences of body dis/satisfaction during the postpartum period. This suggests a need for better education and policy practices in pre-natal and postpartum care directed at body image and education to dispel societal norms such as the thin ideal. Doing so shifts the focus to include interpersonal, institutional, and societal influences alongside intrapersonal experiences. Research is needed to explore the utility and efficacy of broader approaches for women during this vulnerable life period.

Differential Effects of Intuitive and Disordered Eating on Physical and Psychological Outcomes for Women with Young Children.

OBJECTIVES: Pressure to lose weight can increase the risk of developing disordered eating behaviours, negative body image and depressive symptomatology. Eating intuitively may counteract these negative outcomes. This research examined the unique relationship between intuitive eating and disordered eating on body mass index (BMI), body image and depressive symptoms for women of young children. METHODS: A survey of women with a child aged between six and 48 months, included the Intuitive Eating Scale, Eating Attitudes Test-26, Body Shape Questionnaire and Edinburgh Postnatal Depression Scale. Multivariate analysis of variance (MANOVA) was conducted as an omnibus test to estimate the effect of intuitive and disordered eating on BMI, negative body image and depressive symptoms. RESULTS: Of the 419 sample (M age = 32.06), 32% were classified with disordered and 32% with intuitive eating. MANOVA and regression analysis found disordered eating positively associated with depressive symptoms, (ß = 0.303) and negative body image (ß = 0.318). Intuitive eating was associated with lower depressive symptoms (ß = - 0.183) and negative body image (ß = - 0.615). Disordered eating (ß = - 0.194) and intuitive eating (ß = - 0.586) both contributed to lower BMI, with the association stronger for intuitive eating. CONCLUSION: The early parenting period involves a high risk for developing disordered eating behaviours. Eating patterns are modifiable factors, illustrating the potential for positive and preventive health outcomes through adopting intuitive eating behaviours. There is an opportunity for healthcare professionals to promote physical and psychological health including for women in the early parenting period.

Striving for the thin ideal post-pregnancy: a cross-sectional study of intuitive eating in postpartum women.

Objective: To conduct a cross-sectional study of women in the postpartum period to identify relationships between intuitive eating, body image satisfaction, eating attitudes and depressive symptomology.Methods: Women with at least one child born in the previous 6-48 months were recruited via Facebook to complete an online survey which included: sociodemographic and health questions, the Intuitive Eating Scale, the Body Shape Questionnaire, the Multi-dimensional Body-Self Relations Questionnaire, the Eating Attitudes Test-26 and the Edinburgh Postnatal Depression Scale. Descriptive statistics were calculated for all variables and hierarchical regressions used to examine associations between intuitive eating styles, body image satisfaction, eating attitudes and depressive symptomology.Results: Of the 419 women (mean age 32 ± 5.3 years), 32% were classified with intuitive eating styles and were more likely to have higher body image satisfaction (F = 476.80, p < .001), less disordered eating attitudes (F = 30.74, p < .001) and lower depressive symptomology (F = 4.14, p = .042).Conclusions: The postpartum period is a time of high risk for developing/maintaining eating styles that may negatively impact psychological health and well-being. Providing education to new mothers about the benefits of intuitive eating could positively influence their health and well-being.

Double Jeopardy: Insurance, Animal Harm, and Domestic Violence.

Although the role of companion animals within the dynamic of domestic violence (DV) is increasingly recognized, the overlap of animal harm and insurance discrimination for victims/survivors of DV has not been considered. Prompted by a case study presented in a National Link Coalition LINK-Letter, this research note examines "Pet Insurance" policies available in Australia and whether nonaccidental injury caused by an intimate partner would be covered. We discuss the implications of exclusion criteria for victims/survivors of DV, shelters providing places for animals within a DV dynamic, and, more broadly, for cross- or mandatory-reporting (of animal harm) initiatives.

Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia.

OBJECTIVE: Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. METHODS: Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. RESULTS: The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. CONCLUSIONS: This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.

How nurses cope with occupational stress outside their workplaces.

Nursing is acknowledged as a stressful occupation, and the negative impact of high stress levels have been widely researched. Less attention has been paid to methods for coping with stress. The researchers conducted a study to explore and identify how nurses cope with work-related stress away from their work environments. Six focus groups were conducted with 38 nurses, including nursing directors, nurse unit managers, and ward nurses from a wide range of clinical areas. From the interview material, 11 coping strategies were identified: drinking alcohol, smoking, using the staff social club, using social networking websites, exercising, family activities, home-based activities, outdoor activities, avoiding people, displacement, and sleep. Although several adaptive strategies appear in this list (e.g., exercising, home-based activities), some nurses were using unhealthy behaviours to cope with work-related stress (e.g., drinking alcohol, smoking, displacement). This study clearly demonstrates the value of using qualitative approaches to understanding how nurses cope with stress. Knowledge produced locally, such as that generated for the hospital in this study, should serve as the foundation for organisational strategies to enhance the health of nurses.

Nursing students and the supervision of medication administration.

Up to one in five medication administrations in Australian hospitals involve an error. As registered nurses (RNs) are at the forefront of medication administration, they have been the focus of attempts to reduce errors. Given that nursing students have reported errors or experiences of near misses, their practices, as well as the supervision they receive from RNs, also deserves investigation. The aim of this study was to investigate student nurses' experiences of supervision while administering medications. Students (N= 45) completed a questionnaire on their supervision experiences while administering medications. The findings revealed that 88% of students agreed that they had been directly supervised during the entirety of administration procedures. Although 7% of students reported not receiving supervision throughout medication administration, higher percentages of students indicated that they received lower levels of supervision when wards were busy (66%), when they felt under pressure to comply with the wishes of RNs (40%), when students had been in clinical settings for extended periods of time (51%), and when the RNs trusted the student nurses (37%). Approximately one third (29%) of student nurses disagreed that RNs followed the six rights when administering medications. These findings suggest that student nurses are not always adequately supervised and are at times administering medications outside the parameters of the law. Healthcare organisations need to adapt their policies and practices to ensure that the legal requirements surrounding student nurse administration of medications are being met, as well as the educational and welfare needs of neophyte nurses.

The influence of ethical values and food choice motivations on intentions to purchase sustainably sourced foods.

This study examined a three-step adaptation of the Theory of Planned Behaviour (TPB) applied to the intention of consumers to purchase sustainably sourced food. The sample consisted of 137 participants, of which 109 were female, who were recruited through a farmers market and an organic produce outlet in an Australian capital city. Participants completed an online questionnaire containing the TPB scales of attitude, subjective norms, perceived behavioural control and intention; measures of positive moral attitude and ethical self identity; and food choice motives. Hierarchical multiple regression was used to examine the predictive utility of the TPB in isolation (step 1) and the TPB expanded to include the constructs of moral attitude and ethical self-identity (step 2). The results indicated the expansion of the TPB to include these constructs added significantly to the predictive model measuring intention to purchase sustainably sourced food. The third step in the adaptation utilised this expanded TPB model and added a measure of retail channel (where consumers reported buying fresh produce) and 9 food choice motives, in order to assess the predictive utility of the inclusion of choice motivations in this context. Of the 8 food choice motives examined, only health and ethical values significantly predicted intention to purchase sustainably sourced food. However, with the addition of food choice motives, ethical self-identity was no longer a significant predictor of intention to purchase sustainably sourced food. Overall the adapted TPB model explained 76% of the variance in intention to purchase sustainably sourced food.

Nurses and stress: recognizing causes and seeking solutions.

AIMS: To identify, from the perspectives of nurses, occupational stressors and ways in which they may be reduced. BACKGROUND: Nurses commonly experience high levels of occupational stress, with negative consequences for their physical and psychological health, health-care organisations and community. There is minimal research on reducing occupational stress. METHOD: Six focus groups were conducted with 38 registered nurses using a qualitative exploratory approach. Participants were asked to identify sources of occupational stress and possible workplace initiatives to reduce stress. FINDINGS: Sources of occupational stress were: high workloads, unavailability of doctors, unsupportive management, human resource issues, interpersonal issues, patients' relatives, shift work, car parking, handover procedures, no common area for nurses, not progressing at work and patient mental health. Suggestions for reduction included: workload modification, non-ward-based initiatives, changing shift hours, forwarding suggestions for change, music, special events, organisational development, ensuring nurses get breaks, massage therapists, acknowledgement from management and leadership within wards. CONCLUSION: The findings highlight the need to understand local perspectives and the importance of involving nurses in identifying initiatives to reduce occupational stress. IMPLICATIONS FOR NURSING MANAGEMENT: Health-care environments can be enhanced through local understanding of the occupational stressors and productively engaging nurses in developing stress reduction initiatives. Nurse managers must facilitate such processes.

Stress shield: a model of police resiliency.

This paper discusses the development of a new model of police officer resiliency. Following Antonovsky's definition of resilience, the model is built on the view that the resilience of a person or group reflects the extent to which they can call upon their psychological and physical resources and competencies in ways that allow them to render challenging events coherent, manageable, and meaningful. The model posits that a police officer's capacity to render challenging experiences meaningful, coherent, and manageable reflects the interaction of person, team, and organizational factors. The paper argues that a model that encompasses these factors can be developed using theories drawn from the literatures of occupational health and empowerment. The development of the model is also informed by the need to ensure that it can accommodate the importance of learning from past experiences to build resilience in ways that increase officers' capacity to adapt to future risk and uncertainty. By building on recent empirical research, this paper outlines a new multi-level model of resilience and adaptive capacity. The Stress Shield model of resilience integrates person, team and organizational factors to provide a proactive framework for developing and sustaining police officer resilience.