Between wellness and fairness: The mediating role of autonomous human choice and social capital in OECD countries

The EvalUation of goal-diRected activities to prOmote well-beIng and heAlth (EUROIA) scale: Psychometric evaluation with Confirmatory Factor Analysis

OBJECTIVES

While state-based models of health-related quality of life (HRQL) are well-established in providing clinically relevant descriptions of HRQL status, they do not provide information on how to maintain or improve HRQL. The EvalUation of goal-diRected activities to prOmote well-beIng and heAlth (EUROIA), rooted in a novel process-based model of HRQL, measures goal-directed activities that are self-reported to promote HRQL as part of an individual's process of adapting to dynamic changes in health status. Our objectives were to condense and summarize the psychometric properties of the EUROIA by (i) defining and confirming its factor structure, (ii) evaluating its construct validity, and (iii) examining its internal consistency.

METHODS

Principal component analysis was performed on the 18-item EUROIA to explore the underlying factor structure and condense the scale. Confirmatory factor analysis was conducted on the revised 14-item, 4-factor structure EUROIA instrument to evaluate the model fit. Data was obtained from adult participants with a diagnosis of chronic heart failure or advanced chronic kidney disease from 3 hospitals in Toronto, Canada.

RESULTS

The revised 14-item EUROIA demonstrated 4 dimensions-Social Affiliation, fulfillment of Social Roles and Responsibilities, Self-Affirmation, and Eudaimonic Well-being-with a Cronbach's alpha of 0.83, representing good internal consistency. Our confirmatory factor analysis final model achieved good overall model fit: (χ2 / df = 1.80; Tucker-Lewis index = 0.90; comparative fit index = 0.93; standardized root-mean-square residual = 0.06; root-mean-square error of approximation = 0.06). All items exhibited a factor loading greater than λ > 0.4 and p < 0.001.

CONCLUSION

The EUROIA holds clinical potential in its ability to provide informed feedback to patients on how they might maintain or modify their use of goal-directed activities to maintain and optimize perceived well-being.

How older adults recovering from substance use problems experience mattering

AIM

Mattering (to feel valued and add value to self and others) is a fundamental human experience and mechanism in recovery. In this paper, we concern ourselves with the recovery of older adults with substance problems. This population is on the rise in many Western countries. To offer mattering enhancing programs for this group, more knowledge about later life mattering in service-assisted recovery processes is needed. This study aims to explore experiences of mattering in older adults receiving services to recover from substance use problems.

METHODS

A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services. Participants were recovering from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian social contexts: two urban and one medium size municipality. The age of the sample ranged from 65-80 years, with approximately equal numbers for those aged 60-69 (12 participants) and 70-80 (11 participants). Seven participants were women and 16 men.

RESULTS

Three main themes were identified in the analysis: "relational experiences of mattering and not mattering", "service-related experiences of mattering and not mattering" and "recovery and psychological sense of community as interrelated phenomena to experiences of mattering". The findings illustrate various nuanced experiences of mattering and not mattering in later life recovery processes.

CONCLUSIONS

Overall, the participants' mattering experiences rested on fair, healthy and positive community relationships and fair and attentive services, where participants could feel valued and also have a chance to add value to others. Experiences of not mattering were precipitated by lack of support, disrespect, devaluation and loss of relationships, and also by being ignored and not receiving fair treatment and help by professionals. Importantly, reciprocal and enhancing relations between mattering, recovery and relational PSOC seem to exist and to be significant for the older adults' access to substance use services. Several practical implications are suggested to promote the therapeutic and preventive potentials of later life mattering in recovery.

A Cross-Country Examination of Internet Penetration and the Economic Participation of Women: The Influence of Social Capital and Gender Equality

One of the most widespread types of digital technology is the Internet which more than 5 billion people or 63.1% of the world’s population use as of April 2022. Previous studies have established that the relationship between digital technologies, such as the Internet, and labour market participation is worth investigating. While it is widely accepted that digital technologies help in women’s social and economic inclusion, the female labour participation force observed across countries remains slow and varied. There remains a limited investigation into the influence of internet penetration on the changes in the labour market outcomes for women. There is also scope for research on how the Internet affects women’s economic participation from a social and gender perspective. Prior research shows that social capital has been linked to labour allocation. Studies also show that variations in ideas on gender roles are significant for women’s decisions to find employment. We, therefore, investigate how widespread penetration of the Internet has influenced the economic participation of women in this study. We also investigate how social capital and gender equality play a role in the above relationship across countries. Our study uses archival data to conduct a panel analysis of 66 countries from 2014 to 2021. The study’s results show that the penetration of internet and the economic participation of women are positively associated. This study also found that the link between the penetration of internet and the economic participation of women is mediated by social capital. Gender equality was also found to moderate the above relationship, such that social capital had a stronger mediation influence on the association between internet penetration and women’s economic engagement in nations with comparatively lower levels of gender equality.

From public health to public good: Toward universal wellbeing

We aim to consolidate recent trends in public health into a reconceptualization of the field as public good. We build on several strands of theory, research and action to formulate a more impactful future for the field. Our argument comprises three main parts. In the first part, we describe the central components of the proposed public good: conditions of justice, experiences of mattering, and outcomes of subjective and objective wellbeing. In the second section, we identify continua of practices that paint a trajectory from traditional public health to ecological and participatory public health, to universal wellbeing framed as a public good. The continua are defined in terms of assumptions, practices and roles. Among others, these continua pertain to capabilities, scope of the field, ecological focus, timing of intervention, role of citizen, role of professional, role of settings and role of government. Finally, the third section introduces a series of strategies and recommendations to make the narrative of universal wellbeing as public good a reality.