Mental health impact of social capital interventions: a systematic review

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

Co-creating community wellbeing initiatives: what is the evidence and how do they work?

BACKGROUND

Addressing wellbeing at the community level, using a public health approach may build wellbeing and protective factors for all. A collaborative, community-owned approach can bring together experience, networks, local knowledge, and other resources to form a locally-driven, place-based initiative that can address complex issues effectively. Research on community empowerment, coalition functioning, health interventions and the use of local data provide evidence about what can be achieved in communities. There is less understanding about how communities can collaborate to bring about change, especially for mental health and wellbeing.

METHOD

A comprehensive literature search was undertaken to identify community wellbeing initiatives that address mental health. After screening 8,972 titles, 745 abstracts and 188 full-texts, 12 exemplar initiatives were identified (39 related papers).

RESULTS

Eight key principles allowed these initiatives to become established and operate successfully. These principles related to implementation and outcome lessons that allowed these initiatives to contribute to the goal of increasing community mental health and wellbeing. A framework for community wellbeing initiatives addressing principles, development, implementation and sustainability was derived from this analysis, with processes mapped therein.

CONCLUSION

This framework provides evidence for communities seeking to address community wellbeing and avoid the pitfalls experienced by many well-meaning but short-lived initiatives.

Connected communities: Perceived neighborhood social cohesion during adolescence and subsequent health and well-being in young adulthood-An outcome-wide longitudinal approach

Does higher perceived neighborhood social cohesion in adolescence lead to better health and well-being 10-12 years later? We evaluated this question using data from a large, prospective, and nationally representative sample of US adolescents (Add Health; N = 10,963), and an outcome-wide approach. Across 38 outcomes, perceived neighborhood social cohesion was associated with some: mental health outcomes (i.e., depressive symptoms, suicidal ideation, perceived stress), psychological well-being outcomes (i.e., happiness, optimism), social outcomes (i.e., loneliness, romantic relationship quality, satisfaction with parenting), and civic/prosocial outcomes (i.e., volunteering). However, it was not associated with health behaviors nor physical health outcomes. These results were maintained after robust control for a wide range of potential confounders.

SoCap YMH - youth mental health, social capital and help-seeking: a study protocol

Background

The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours.

Aim

This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden.

Methods

A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized.

Conclusion

The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures.

Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews

Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.

Climate change anxiety, hurricane exposure, and climate change actions and attitudes: results from a representative, probability-based survey of US Gulf Coast residents

BACKGROUND

Exposure to climate change-related threats (eg, hurricanes) has been associated with mental health symptoms, including post-traumatic stress symptoms. Yet it is unclear whether climate change anxiety, which is understudied in representative samples, is a specific mental health threat, action motivator, or both, particularly in populations exposed to climate-change related disasters. We sought to examine the associations between exposure to hurricanes, climate change anxiety, and climate change actions and attitudes in a representative sample of US Gulf Coast residents.

METHODS

This study used data from a 5-year, representative, prospectively assessed, probability-based, longitudinal cohort sample of residents in Texas and Florida (USA) exposed to exogenous catastrophic hurricanes rated category 3 or greater. Participants were adults aged 18 years and older and were initially recruited from the Ipsos KnowledgePanel in the 60 h before Hurricane Irma (Sept 8-11, 2017). Relationships between climate change anxiety, hurricane exposure, hurricane-related post-traumatic stress symptoms, general functional impairment, and climate change-related individual-level actions (eg, eating a plant-based diet and driving more fuel efficient cars) and collective-level actions (eg, petition signing and donating money) and climate change action attitudes were evaluated using structural equation modelling.

FINDINGS

The final survey was completed by 1479 individuals (787 [53·2%] women and 692 [46·8%] men). Two climate change anxiety subscales (cognitive-emotional impairment and perceived experience of climate change) were confirmed using confirmatory factor analysis. Mean values were low for both climate change anxiety subscales: cognitive-emotional impairment (mean 1·31 [SD 0·63], range 1-5) and perceived climate change experience (mean 1·67 [SD 0·89], range 1-5); these subscales differentially predicted outcomes. The cognitive-emotional impairment subscale did not significantly correlate with actions or attitudes; its relationship with general functional impairment was attenuated by co-occurring hurricane-related post-traumatic stress symptoms, which were highly correlated with general functional impairment in all three models (all p<0·0001). The perceived climate change experience subscale correlated with climate change attitudes (b=0·57, 95% CI 0·47-0·66; p<0·0001), individual-level actions (b=0·34, 0·21-0·47; p<0·0001), and collective-level actions (b=0·22, 0·10-0·33; p=0·0002), but was not significantly associated with general functional impairment in any of the final models. Hurricane exposure correlated with climate change-related individual-level (b=0·26, 0·10-0·42; p=0·0011) and collective-level (b=0·41, 0·26-0·56; p<0·0001) actions.

INTERPRETATION

Expanded treatment for post-traumatic stress symptoms after disasters could help address climate change-related psychological distress; experiences with climate change and natural hazards could be inflection points to motivate action.

FUNDING

National Science Foundation and the National Center for Atmospheric Research.

The effectiveness of community friendship groups on participant social and mental health: a meta-analysis

Introduction

Social disconnectedness and isolation are risk factors for poor mental health. Community-based friendship group interventions have been designed to increase an individual's social capital and consequently their mental wellbeing. Structured and unstructured friendship groups reflect two distinct approaches to friendship group interventions.

Methods

This meta-analysis investigated whether structured or unstructured community friendship groups are more effective for mental health and social capital outcomes. A systematic search of quantitative studies was conducted across seven databases and study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Eight studies (2 unstructured and 6 structured friendship groups) were included in the review, published between 2005 and 2020.

Results

Structured friendship groups had a small significant effect on reducing participant depression symptoms. There was not enough available data to compare the effectiveness of structured and unstructured groups for mental health outcomes. There was substantial heterogeneity between studies to calculate pooled effect sizes for any social capital outcomes. Data synthesis indicated mixed reviews for social capital outcomes, likely due to the large heterogeneity and limited studies.

Discussion

This meta-analysis provides limited support for positive mental health outcomes following structured community-based friendship group interventions. There is a need for additional research as a large research gap remains, particularly for unstructured friendship groups.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260639, CRD42021260639.

Socioeconomic status and quality of life among older adults with hypertension in rural Shandong, China: a mediating effect of social capital

Background

Improving the quality of life (QoL) of older adults is becoming an important global issue. However, very few studies have been focused on the relationship between socioeconomic status (SES) and QoL in older adults with hypertension. The purpose of this study is to investigate (a) the status of QoL and (b) the mediating effect of social capital in the relationship between SES and QoL, among rural older adults with hypertension in China.

Methods

Using multistage stratified random sampling, a face-to-face questionnaire survey was conducted among rural older adults with hypertension in Shandong province of China from June to July 2021. Three typical measures representing SES were used, namely, annual household income, educational level, and employment status. Individual social capital and QoL were assessed by the Resource Generator-China Scale (RG-China) and a 34-item simplified Patient Report Outcome (PRO)-specific scale for older adults with hypertension, respectively. A total of 950 rural older adults with hypertension were included in the analysis. The mediation model based on bootstrap analyses was employed to explore the relationship between SES and QoL and the mediating role of social capital in the SES-QoL nexus.

Results

The sampled rural older adults with hypertension had an upper-middle level of QoL, and the average score was 132.57 ± 19.40. SES was positively correlated with both QoL and individual social capital; individual social capital was significantly positively correlated with QoL. Controlling for sociodemographic variables, SES was still significantly associated with individual social capital (β = 0.140, P < 0.001), and the higher the individual social capital, the better QoL (β = 0.153, P < 0.001). Individual social capital played a partially mediating role in the association between SES and QoL (indirect effect = 0.021, 95% CI: 0.010-0.038), which accounted for 9.38% of the total effect.

Conclusion

This study provides evidence that the effect of SES on QoL was partially mediated by individual social capital among rural older adults with hypertension in China. The government should pay more attention to the rural older hypertensive population with lower SES and strive to reduce the negative impact of poor SES on their QoL, based on effective strategies including improving their individual social capital.

The influence of social capital in the utilisation of sexual reproductive health services among the youth in Ghana. A community-based cross-sectional study

Social capital, often seen as the resources accessed through social connections, is currently gaining much attention in public health. However, limited studies have focused on the relationship between social capital and reproductive health services. Besides, while the factors associated with the use of reproductive health services among the youth are well documented in the literature, most studies have focused on narrowed perspective failing to take cognisance of the role of social capital. Yet, it is known that these behaviours can be influenced by social factors, which may be beyond the individual's control partly because the youth are embedded in social organisations. Therefore, this study examined the relationship between social capital and the youth's utilisation of reproductive health services.The study population comprised adolescents and young adults aged 15-24 years who were both in and out of school at the time of the survey. The study used a cross-sectional quantitative design involving a community-based household survey method to sample 792 respondents through multi-stage cluster sampling. The chi-square test examined the relationship between sociodemographic, social capital variables and reproductive health services. To account for potential confounding factors, a multivariable logistic regression model included variables from the binary logistic regression analysis with a p-value less than 0.05. In general, access to higher social capital was observed among 493 (62.2%). Almost half, 385 (48.6%) of the respondents have ever used at least one of the reproductive services examined in this study. After controlling all other significant predictors, the following social capital variables remained associated with increased utilisation of SRH services: higher trust in neighbourhood (AOR = 1.8; CI = 1.22-2.66), higher trust in people/institutions (AOR = 2.66; CI = 1.82-3.99), higher social cohesion (AOR = 3.35; CI = 2.21-5.08), stronger network (AOR = 7.55; CI = 4.43-12.87).Access to some social capital dimensions is associated with increased use of reproductive health services. However, any intervention such as mentoring including peer support programs, meant to address social capital needs in sexual and reproductive health should consider the efficacy of each social capital dimension and the intervention's environment.

Mental health impact of cuts to local government spending on cultural, environmental and planning services in England: a longitudinal ecological study

BACKGROUND

Over the past decade, there have been significant and unequal cuts to local authority (LA) budgets, across England. Cultural, environmental and planning (CEP) budgets have been cut by 17% between 2011 and 2019. This funding supports services such as parks, leisure centres, community development and libraries, all of which have potential to influence population mental health. We therefore investigated whether cuts to CEP services have affected mental health outcomes and the extent to which they have contributed to mental health inequalities between areas.

METHODS

Using fixed effects regression applied to longitudinal LA-level panel data in England, we assessed whether trends in CEP spend were associated with trends in mental health outcomes, between 2011 and 2019. The exposure was CEP spend and the primary outcome was the LA-average Small Area Mental Health Index (SAMHI). Additionally, we considered subcategories of CEP spend as secondary exposures, and antidepressant prescription rate and self-reported anxiety levels as secondary outcomes, both aggregated to LA-level. We adjusted all models for confounders and conducted subgroup analysis to examine differential mental health effects of spending cuts based on the level of area deprivation.

RESULTS

The average decrease in CEP spend of 15% over the period was associated with a 0.036 (95% CI: 0.005, 0.067) increase in SAMHI score, indicating worsening mental health. Amongst subcategories of CEP spending, cuts to planning and development services impacted mental health trends the most, with a 15% reduction in spend associated with a 0.018 (95% CI: 0.005, 0.031) increase in the SAMHI score. The association between cuts in CEP and deteriorating mental health was greater in more affluent areas.

CONCLUSION

Cuts to spending on cultural, environmental, planning and development services were associated with worsening population mental health in England. Impacts were driven by cuts to planning and development services in particular. Reinvesting in these services may contribute to improved public mental health.

Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers' perceptions

In this qualitative exploratory study, we investigated the perspectives of mental health providers in Gaza, Palestine, regarding the primary concerns of their clients who are exposed to low-intensity warfare and structural violence. We conducted qualitative interviews with 30 psychologists, social workers, psychiatric nurses, and psychiatrists providing services to communities in Gaza. Participants were asked to discuss their clients' most commonly occurring mental health problems, diagnoses, and psychosocial conditions. Thematic analysis identified one superordinate theme (Impact of the Blockade on Mental Health and Quality of Life) and four second-order themes (Concerns about Social Problems, General Concerns about Quality of Life, Concerns about the Mental Health of the Community, and Concerns Related to Children's Mental Health). Participants indicated that the social and political dimensions of mental health and the economic, educational, and health-related consequences of the ongoing blockade of Gaza were the main determinants of psychological burden among their clients. Findings demonstrated the importance of adopting an approach to mental health that includes understanding psychological indicators in a broader framework informed by human rights and social justice. Implications for research and clinical work are discussed, including the role of investments in social capital that may provide individuals with access to resources such as social support, which may in turn promote overall mental health.

Assessing effectiveness of heart rate variability biofeedback to mitigate mental health symptoms: a pilot study

Introduction: The increasing burden on mental health has become a worldwide concern especially due to its substantial negative social and economic impact. The implementation of prevention actions and psychological interventions is crucial to mitigate these consequences, and evidence supporting its effectiveness would facilitate a more assertive response. Heart rate variability biofeedback (HRV-BF) has been proposed as a potential intervention to improve mental wellbeing through mechanisms in autonomic functioning. The aim of this study is to propose and evaluate the validity of an objective procedure to assess the effectiveness of a HRV-BF protocol in mitigating mental health symptoms in a sample of frontline HCWs (healthcare workers) who worked in the COVID-19 pandemic. Methods: A prospective experimental study applying a HRV-BF protocol was conducted with 21 frontline healthcare workers in 5 weekly sessions. For PRE-POST intervention comparisons, two different approaches were used to evaluate mental health status: applying (a) gold-standard psychometric questionnaires and (b) electrophysiological multiparametric models for chronic and acute stress assessment. Results: After HRV-BF intervention, psychometric questionnaires showed a reduction in mental health symptoms and stress perception. The electrophysiological multiparametric also showed a reduction in chronic stress levels, while the acute stress levels were similar in PRE and POST conditions. A significant reduction in respiratory rate and an increase in some heart rate variability parameters, such as SDNN, LFn, and LF/HF ratio, were also observed after intervention. Conclusion: Our findings suggest that a 5-session HRV-BF protocol is an effective intervention for reducing stress and other mental health symptoms among frontline HCWs who worked during the COVID-19 pandemic. The electrophysiological multiparametric models provide relevant information about the current mental health state, being useful for objectively evaluating the effectiveness of stress-reducing interventions. Further research could replicate the proposed procedure to confirm its feasibility for different samples and specific interventions.

Social capital, perceived stress, and mental health of men who have sex with men in China: A cross-sectional study

Background

Mental health problems are prevalent among men who have sex with men (MSM). Social capital and perceived stress may affect the mental health of MSM. The purpose of this study was to understand the current status of mental health, social capital, and perceived stress among MSM and to explore which variables are influential factors of mental health.

Methods

This study adopted a convenience sampling method and posted recruitment information through online social platforms (Blued, QQ, and WeChat) from January 2022 to June 2022 to recruit participants. The questionnaire included a demographic questionnaire, Social Capital Questionnaire (SCQ), Perceived Stress Scale (PSS), and Self-Reporting Questionnaire 20 (SRQ-20). Descriptive analyses of demographic characteristics, social capital, perceived stress, and mental health were conducted using percentages, median, interquartile range, means, and standard deviations. One-way ANOVA and independent-samples t-test were used to test the relationship between demographic characteristics and mental health, and multiple linear regression was used to analyze which variables were influencing factors of mental health. SPSS 24.0 was used for data analysis, and significant differences were found at p &lt; 0.05.

Results

A total of 546 MSM participated in this study. Total social capital score was 18.59 ± 2.62, cognitive social capital, social participation, and social network scores were 6.53 ± 1.05, 4.15 ± 0.97, and 7.91 ± 1.57. PSS score was 26.91 ± 6.44, and SRQ-20 score was 7.5 (3, 11). Education level, relationship status, employed information, monthly income, sexual orientation, perceived stress, and three dimensions of social capital were included in the multiple linear regression based on the results of One-way ANOVA, t-test, and correlation analysis. Multiple linear regression analysis showed that relationship status (in a relationship), sexual orientation (heterosexual, bisexual, other), perceived stress, social participation, and social network had a significant effect on mental health.

Conclusion

Sex with men have poorer mental health. Relationship status, sexual orientation, perceived stress, social networks, and social participation are important factors influencing mental health. The general public should be called upon to treat them with a more tolerant attitude, improve the social environment, and promote their identification with their sexual orientation, thereby reducing perceived stress and promoting the mental health of this population. In addition, from the perspective of social capital, promoting MSM social participation and expanding social networks may also be an important way to promote MSM mental health.

Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes

PURPOSE

Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood.

METHODS

We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors.

RESULTS

Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation.

CONCLUSION

Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.

Changes in mental health across the COVID-19 pandemic for local and international university students in Australia: a cohort study

PURPOSE

Previous research has indicated that university students experienced substantial mental health issues during the global COVID-19 pandemic, but few studies have considered changes relative to pre-pandemic levels across population groups. Hence, the aim of this study was to compare changes in mental health and associated stressors across the pandemic for international and local university students studying in Australia.

METHODS

In a cohort of 4407 university students, we assessed depression (Patient Health Questionnaire 2), anxiety (Generalized Anxiety Disorder-2), social support (Medical Outcomes Study-Social Support Survey), inability to afford food, fear of partner, and experiences of discrimination, both pre-pandemic (April-May 2019) and during the pandemic (September-October 2020). Change in prevalence between local and international students were estimated with logistic regression, adjusting for baseline factors.

RESULTS

Compared to local students, international students experienced an increase in probable major depression (odds ratio (OR) 1.43, 95% Confidence Interval (CI) 1.23, 1.66), low social support (OR 2.63, 95% CI 2.23, 3.11), inability to afford food (OR 5.21, 95% CI 3.97, 6.83) race-based discrimination (OR 2.21, 95% CI 1.82, 2.68) and fear of partner (OR 3.46, 95% CI 2.26, 5.13). Interaction analyses indicated that these issues were more likely to be experienced by students living outside their country of origin, inclusive of international students based in Australia (depression p value interaction term 0.02).

CONCLUSION

The pandemic had a substantial negative impact on international students, particularly those living outside of their country of origin during the pandemic. The inequalities exacerbated by the pandemic were present prior to the pandemic and are likely to continue post-pandemic without action. Interventions to build the supports for international students need to be urgently explored.

Evidence for the effectiveness of interventions to reduce mental health related stigma in the workplace: a systematic review

OBJECTIVES

Increasing access to mental health support is a key factor for treating mental disorders, however, important barriers complicate help-seeking, among them, mental health related stigma being most prominent. We aimed to systematically review the current evidence for interventions focusing on reducing stigma related to mental health problems in small and medium enterprises (SMEs).

DESIGN

Systematic review with a focus on interventions targeting mental health related stigma in the workplace in accordance with PRISMA guidelines. The methodological quality of included articles was assessed using the Quality Assessment Tool for Quantitative Studies Scale.

DATA SOURCES

PubMed, Ovid Medline, PsycINFO, Scopus, and Cochrane databases and Google Scholar were searched from January 2010 until November 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included experimental or quasi-experimental studies about workplace interventions aiming to reduce stigma, where the outcomes were measured in terms of stigmatisation against depression, anxiety and/or other mental health problems.

DATA EXTRACTION AND SYNTHESIS

Records were screened by two independent reviewers after inspecting titles and abstracts and a full-text read of the articles to assess whether they meet inclusion criteria. The results were synthesised narratively.

RESULTS

We identified 22 intervention studies, 3 with high quality, 13 with moderate quality and 6 with weak quality. Only 2 studies included SMEs, but no study focused on SMEs exclusively . The mode of delivery of the intervention was face to face in 15 studies, online in 4 studies and mixed in 3 studies. We found a significant reduction in stigmatising attitudes in almost all studies (20/22), using 10 different instruments/scales. Effects seemed to be independent of company size. Online interventions were found to be shorter, but seemed to be as effective as face-to-face interventions.

CONCLUSIONS

Although we did not find interventions focusing exclusively on SMEs, it is likely that antistigma interventions also will work in smaller workplaces.

TRIAL REGISTRATION

PROSPERO: ID: CRD42020191307.

Social capital and its role to improve maternal and child health services in Northwest Ethiopia: A qualitative study

BACKGROUND

Social capital is a set of shared values that allows individuals or groups receive emotional, instrumental or financial resources flow. In Ethiopia, despite people commonly involved in social networks, there is a dearth of evidence exploring whether membership in these networks enhances uptake of maternal and child health (MCH) services. This study aimed to explore perspectives of women, religious leaders and community health workers (CHWs) on social capital to improve uptake of MCH services in Northwest Ethiopia.

METHODS

We employed a qualitative study through in-depth interviews with key informants, and focus group discussions. A maximum variation purposive sampling technique was used to select 41 study participants (11 in-depth interviews and 4 FGDs comprising 7-8 participants). Data were transcribed verbatim and thematic analysis was employed using ATLAS.ti software.

RESULTS

Four overarching themes and 13 sub-themes of social capital were identified as factors that improve uptake of MCH services. The identified themes were social networking, social norms, community support, and community cohesion. Most women, CHWs and religious leaders participated in social networks. These social networks enabled CHWs to create awareness on MCH services. Women, religious leaders and CHWs perceived that existing social capital improves the uptake of MCH services.

CONCLUSION

The community has an indigenous culture of providing emotional, instrumental and social support to women through social networks. So, it would be useful to consider the social capital of family, neighborhood and community as a tool to improve utilization of MCH services. Therefore, policymakers should design people-centered health programs to engage existing social networks, and religious leaders for improving MCH services.

Examining the relationship between civic engagement and mental health in young adults: a systematic review of the literature

Researchers have examined civic engagement as a health promotion tool among older adults and adolescents, yet less is known about its mental health implications for young adults. This systematic review identified 53 articles on civic engagement and well-being in young adults. Five key themes emerged: (1) varying associations between type of civic engagement and well-being, (2) duration and frequency of civic behaviors, (3) directionality in the civic-to-well-being pathway, (4) mediation and moderation factors affecting the civic-to-well-being pathway, and (5) civic engagement as a tool for coping with adversity or systemic oppression. Civic engagement demonstrates a heterogeneous relationship to well-being; future research should focus on the explanatory pathways for positive, negative, and null correlations particularly among historically marginalized young adults.

Social capital and oral health promotion: Past, present, and future challenges

Social capital has been widely inserted in health discussions in recent decades. In this sense, social capital has become a popular term and has been highlighted as one of the main determinants of health in the conceptual framework of the social determinants of the World Health Organization. The concept of social capital focuses on the positive consequences of sociability and places these consequences in the broader discussion of capital. In this sense, social capital reflects the benefits that individuals and communities derive from having broad social networks or high levels of social trust. Despite controversies regarding its definition and numerous criticisms, a growing body of evidence suggests that high levels of social capital benefit oral health. This factor has also been recognized as a potential softener of the impact of oral conditions on oral health, through behavioural and psychosocial processes. Thus, efforts to reduce inequities in oral health preferably should be based on their origins and on their complex causal process, such as the social determinants. The future challenges in the area are specially related to the development of interventions and health promotion actions that aim to stimulate social capital, aiming to reduce the impact of social inequalities on oral health throughout the life course.

Scientific Publication Patterns of Systematic Reviews on Psychosocial Interventions Improving Well-being: Bibliometric Analysis

Background

Despite numerous empirical studies and systematic reviews conducted on the effectiveness of interventions improving psychological well-being, there is no holistic overview of published systematic reviews in this field.

Objective

This bibliometric study explored the scientific patterns of the effectiveness of different psychosocial interventions improving well-being among various categories of individuals with mental and physical diseases, to synthesize well-being intervention studies, and to suggest gaps and further studies in this emerging field.

Methods

The bibliometric analysis included identifying the most productive authors, institutions, and countries; most explored fields and subjects of study; most active journals and publishers; and performing citation analysis and analyzing publication trends between 2014 and 2022. We focused on data retrieved from known databases, and the study was conducted with a proven bibliometric approach.

Results

In total, 156 studies were found concerning the research domains and retrieved using LENS software from high-ranking databases (Crossref, Microsoft Academic, PubMed, and Core). These papers were written in English by 100 authors from 24 countries, among which, the leading country was the United Kingdom. Descriptive characteristics of the publications involved an increased number of publications in 2017 (n=35) and 2019 (n=34) and a decreased number in 2021 (n=4). The top 2 leading authors by citation score are James Thomas (3 papers and 260 citations) and Chris Dickens (3 papers and 182 citations). However, the most cited study had 592 citations. BMJ Open (n=6 articles) is the leading journal in the field of medicine; Clinical Psychology Review (n=5), in psychology; and Frontiers in Psychology, in psychological intervention (n=5) and psychology (n=5). The top 2 publishers were Wiley (n=28) and Elsevier (n=25).

Conclusions

This study indicates an overall interest in the declared domains within the last decade. Our findings primarily indicate that psychosocial interventions (PIs) were evaluated as being effective in managing mental and physical problems and enhancing well-being. Cognitive behavioral therapy was assessed as being effective in treating anxiety, psychoeducation in relapse prevention, and gratitude interventions in improving overall health, and the mindfulness approach had a positive impact on decreasing distress and depression. Moreover, all these intervention types resulted in an overall increase in an individuals’ well-being and resilience. Integrating social and cultural factors while considering individual differences increases the efficiency of PIs. Furthermore, PIs were evaluated as being effective in managing symptoms of eating disorders, dementia, and cancer. Our findings could help provide researchers an overview of the publication trends on research domains of focus for further studies, since it shows current findings and potential research needs in these fields, and would also benefit practitioners working on increasing their own and their patients' well-being.

Together through tough times: a qualitative study of community resilience to protect against mental health issues in the UK

Purpose

Living in an area experiencing economic and social disadvantage is a known risk factor to poor mental health and well-being. This paper aims to understand how some communities experiencing disadvantage appear to be more resilient to the enduring challenges they face and display better mental health outcomes.

Design/methodology/approach

A qualitative case study approach was used. Semi-structured interviews (total = 74) were undertaken remotely with residents (n = 39) and voluntary, community and social enterprise groups, community leaders and other local stakeholders (n = 35) in four case study areas. Data analysis was cross-case, thematic analysis. Community analysis workshops (n = 4) and resilience mapping workshops (n = 4) in each site corroborated emerging insights.

Findings

Four overlapping and interacting themes support community resilience: community hubs and local voluntary, community and social enterprise (VCSE) networks; opportunities to participate and make connections within communities; open and supportive environments to talk about mental health and well-being; and community identities and collective narratives. Differences in access to these resources was a cross-cutting theme.

Originality/value

Community resilience can be understood in terms of the amount of resources – articulated in terms of capital – that communities can draw on in response to challenges, and how well these resources are mobilised. A thriving VCSE sector is important for community resilience in communities experiencing disadvantage as a mechanism for both sustainably building and mobilising community resources in the face of daily and enduring challenges.

Acceptability and Feasibility of an Intervention to Enhance Social Group Belonging: Evidence From Three Trials of Groups 4 Health

Groups 4 Health (G4H) is a group psychotherapy program that targets social group disconnection. An emerging evidence base supports its efficacy in reducing loneliness, depression, and social anxiety. However, to date there has been no formal analysis of its acceptability to clients and therapists, nor an investigation of its feasibility for wider implementation. This input from end users is crucial to ensure the program's wider suitability and to contribute to its improvement. This study drew data from three clinical trials, including 266 G4H clients and 68 G4H therapists. From the Phase III trial only, additional data were available from 90 clients in a dose-controlled cognitive-behavioral therapy (CBT) comparison group, and focus groups/interviews with 6 therapists and 13 clients. Client satisfaction was high, with all average ratings &gt;7/10, significantly exceeding the CBT comparison group. Therapist satisfaction with each module was &gt;5/7. Retention was &gt;80%. Homework completion was high, with &lt;10% of clients saying that they had not attempted the homework. Therapists and clients both emphasized the benefits arising from G4H, and the contribution of the group context itself as a vehicle to achieve positive outcomes.

Mainstreaming global mental health: Is there potential to embed psychosocial well-being impact in all global challenges research?

We explore if there is potential to embed psychosocial well-being impact in global challenges research where the primary aims are not mental health related. We are interested in the use of material practices to deliver impact through routine project activities of working with concrete things together. The UK Research and Innovation (UKRI) gateway to research was searched for information on Global Challenges Research Fund (GCRF) grants from 2015 to May 2020. Analysis shows that only 3 per cent of projects self-categorise as engaging with mental health. Thirty-six non-mental health GCRF grants were purposefully sampled for diversity, and each was coded independently by two researchers for relevant information. Findings suggest that 50-70 per cent of non-mental health GCRF projects already engage implicitly, but nonstrategically, with psychosocial well-being impact; opportunities for psychosocial well-being impact, from most to least frequent, are community mobilisation, community building, skills development, positive sense of self, positive emotions and sociocultural identity; the presence of material practice from most to least frequent is as follows: (i) interactions between or enactments upon people, (ii) written materials or images, and (iii) objects; when a material practice was present, it was usually considered usable as a focus to enhance psychosocial well-being. Our study provides evidence that there are low hanging fruit opportunities to impact psychosocial well-being across Sustainable Development Goals (SDGs) through routine project activities.

Adverse childhood experiences, adult anxiety and social capital among women in rural Kenya

Hundreds of millions of people suffer anxiety disorders globally, demonstrating need for scalable and effective interventions. Adverse childhood experiences contribute to this mental health burden. The stress-buffering hypothesis, which posits social factors moderate prior adversity and subsequent mental health outcomes, provides one theoretical avenue to consider observations that group-based microfinance programs improve social capital. We investigate associations between adverse childhood experiences, generalized anxiety among adults and social capital associated with participation in a group-based microfinance program in rural Kenya. Adult participants (n = 400 women) responded to standardized measures of childhood adversity in June 2018, group-affiliated social capital and generalized anxiety in June 2019. Cumulative adverse childhood experiences predicted higher anxiety, which was statistically moderated by the presence of group-affiliated interpersonal trust. This study is the first to find social capital associated with participation in a group-based microfinance program statistically moderates expected associations between adverse childhood experiences and adult generalized anxiety. Future study should be conducted using a cluster-randomized control design to further assess the potential of this intervention method to ameliorate associations between past adversity and current mental health.

Meta-Analysis of Factor Analyses of the General Health Questionnaire – Short Forms GHQ-28 and GHQ-30

Abstract. Two meta-analyses of exploratory factor analyses of the General Health Questionnaire short forms, GHQ-28 ( N = 26,848, k = 40) and GHQ-30 ( N = 43,151  k = 25), were conducted to determine the consistent factors found in each test and any common factors across them. Five databases (PsycINFO, PubMed, BASE, Semantic, and Google Scholar) were searched in 2021. Reproduced correlations derived from the original studies’ factor matrices and aggregated across studies were factor analyzed for the meta-analyses. For the GHQ-28, the standard four subscales of somatic, anxiety, social dysfunction, and depression were clearly identified and strongly supported by a four-factor structure. For the GHQ-30, a four-factor solution identified factors of anxiety, depression, social dysfunction, and social satisfaction, the first three factors shared a number of items with the same scales found in the GHQ-28. These shared factors appear similar across tests and should help bridge research using the GHQ-30 and the GHQ-28. Confirmatory factor analyses supported the four-factor models in both tests. The four standard subscales of GHQ-28 were strongly supported and can be recommended. The three similar factors in the GHQ-30, as well as the social satisfaction factor, appear reasonable to use.

Opening the black box of the relationship between neighborhood socioeconomic status and mental health: Neighborhood social-interactive characteristics as contextual mechanisms

Previous studies have linked low neighborhood socioeconomic status (NSES) to mental health problems. However, few studies have investigated the mechanisms underlying this association and most focused on the association with negative indicators of mental health, such as symptoms of depression or anxiety. This paper investigated whether neighborhood social characteristics (social interaction, trust, safety, organization participation, and attachment) mediate the association between NSES and mental health. We combined Danish register data with survey data from the North Denmark Region Health Survey 2017. Mental health was assessed with the Rand 12-item Short-form Survey (SF-12). The sample consisted of 14,969 individuals nested in 1047 neighborhoods created with an automated redistricting algorithm. We fitted multilevel structural equation mediation models and used a Monte Carlo simulation method to estimate confidence intervals for the indirect effects. NSES was positively associated with mental health. Neighborhood trust significantly mediated this relationship, accounting for 34% of the association after controlling for other mediators. These results indicate that higher levels of mental health in more affluent neighborhoods are partially explained by higher levels of trust. Improving neighborhood trust could mitigate sociogeographic inequalities in mental health.

Association between changes in social capital and mental well-being among older people in China

Background

The mental well-being of older people has become social concern under aging times in China. Social capital has been linked to mental well-being. Our aims were to explore how social capital and the state of mental well-being of older people were changing and what the relationship between them was.

Methods

Data were from six waves of the China Family Panel Studies that were conducted between 2010 and 2020, and a total of 1,055 participants aged 60 and over were included in the analysis. The Generalized Estimated Equation model (GEE) was used to clarify the long-term relationship, and to use GEE we first defined how time points were related, in other words, an appropriate working correlation structure was supposed to choose. Therefore, correlation coefficient between measurements at two time points was calculated to choose the exchange structure. All the analyses were performed in the statistical software Stata 15.0.

Results

The mental well-being of older people has deteriorated over time, especially we found that between 2014 and 2016, the mental well-being of older people plummeted. In addition, cognitive social capital was positively correlated with mental well-being, while structural social capital was inverse.

Conclusions

Policymakers are supposed to take into account the long-term impact of cognitive and structural social capital on the mental well-being of older people and to provide them with projects aimed at increasing cognitive social capital and turning the pressure of structural social capital into a source of happiness in life.

Social Capital of Parents of Children and Adolescents and Its Relation to Psychiatric Disorders; A Population-Based Study

Social capital is a complex concept that is considered an effective factor in the development of societies. Considering the importance of burdens of psychiatric disorders in Iran, we studied the relationship between various dimensions of social capital of parents of children and adolescents and psychiatric disorders among them. In this cross-sectional study, 18,940 parents of children and adolescents aged 6 to 18 years old were randomly selected from all provinces of Iran and were evaluated by the Millon clinical multiaxial inventory-III (MCMI-III) and a modified version of Nahapiet and Ghoshal questionnaire. MCMI-III was designed as a self-report tool for investigating psychiatric clinical disorders and personality traits in the general population. Modified Nahapiet and ghoshal questionnaire has 20 items and measures four components of social capital included trust, values, communication, and collaboration. Validity and reliability of both questionnaires have been approved in Iran. In the regression model, the relationship between social capital components and clinical and sever clinical syndromes, in the form of regression weight and standard weight for trust was - 0.558 and - 0.062 with p value less than 0.0001, and for values was - 0.466 and - 0.057, respectively, with p value less than 0.0001. There was a reverse correlation between social capital components of parents of children and adolescents and psychiatric disorders in Iran. In regression statistical models, the two components of values and trust were negative predictors of psychiatric disorders. Considering the high prevalence of psychiatric disorders in Iran, it seems that the strengthening of cognitive and structural aspects of social capital of parents of children and adolescents is one of the effective factors in reducing the prevalence of these disorders among them.

The effects of neighbourhood social cohesion on preventing depression and anxiety among adolescents and young adults: rapid review

BACKGROUND

Research suggests that increasing neighbourhood social cohesion can prevent mental health problems, including depression and anxiety. However, it is unknown whether this is the case for adolescents and young adults.

AIMS

To investigate whether neighbourhood social cohesion can prevent depression and anxiety, and identify interventions that can increase neighbourhood cohesion in young people.

METHOD

We conducted a rapid review for an overview of the available literature. PubMed, Campbell Collaboration, KSR Ltd and grey literature databases were searched from inception up to 10 July 2020. When synthesising the results, we applied a hierarchy of evidence, prioritising study designs that allowed for the most ability to infer causality. Risk of bias was assessed with the ROBIS tool and Joanna Briggs Institute risk-of-bias assessment. A narrative review and two workshops with young people were conducted to inform what future interventions may look like.

RESULTS

Forty-two peer-reviewed publications, including two systematic reviews, 13 longitudinal studies and 27 cross-sectional studies, were identified. Prospective longitudinal studies found that neighbourhood social cohesion factors (safety, trust, positive social connections, helping others and a lack of crime and violence) were associated with fewer depressive symptoms. Future interventions to increase neighbourhood cohesion should involve creating safe and attractive community centres, accessible and safe outdoor spaces, community activity groups and online communities.

CONCLUSIONS

Neighbourhood social cohesion has the potential to protect mental health. The next step is to conduct intervention studies to evaluate the effects on onset prevention. Clinicians should consider the impact cohesion can have on mental health, and signpost to community initiatives.

Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa

BACKGROUND

Depression is a leading cause of disease burden worldwide but is often undertreated in low- and middle-income countries. Reasons behind the treatment gap vary, but many highlight a lack of interventions which speak to the socio-economic and structural realties that are associated to mental health problems in many settings, including South Africa. The COURRAGE-PLUS intervention responds to this gap, by combining a collective narrative therapy (9 weeks) intervention, with a social intervention promoting group-led practical action against structural determinants of poor mental health (4 weeks), for a total of 13 sessions. The overall aim is to promote mental health, while empowering communities to acknowledge, and respond in locally meaningful ways to social adversity linked to development of mental distress.

AIM

To pilot and evaluate the effectiveness of a complex intervention - COURRAGE-PLUS on symptoms of depression as assessed by the Patient Health Questionnaire (PHQ-9) among a sample of women facing contexts of adversity in Gauteng, South Africa.

METHODS

PHQ-9 scores were assessed at baseline, post collective narrative therapy (midline), and post social intervention (endline). Median scores and corresponding interquartile ranges were computed for all time points. Differences in scores between time points were tested with a non-parametric Friedman test. The impact across symptom severities was compared descriptively to identify potential differences in impact across categories of symptom severity within our sample.

RESULTS

Participants' (n = 47) median depression score at baseline was 11 (IQR = 7) and reduced to 4 at midline (IQR = 7) to 0 at endline (IQR = 2.5). The Friedman test showed a statistically significant difference between depression scores across time points, χ2(2) = 49.29, p < .001. Median depression scores were reduced to 0 or 1 Post-Intervention across all four severity groups.

CONCLUSIONS

COURRAGE-PLUS was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity, in Gauteng, South Africa. Findings supports the need for larger trials to investigate collective narrative storytelling and social interventions as community-based interventions for populations experiencing adversity and mental distress.

Social capital and self-rated health among Chinese rural empty nesters: A multiple mediation model through sleep quality and psychological distress

BACKGROUND

many studies explore the relationship between social capital and self-rated health. However, few studies clarified the mechanisms underlying the relationship between social capital and self-rated health among Chinese rural empty nesters. This study aimed to explore the multiple mediating roles of sleep quality and psychological distress between this relationship.

METHODS

A total of 2,254 rural empty-nest older adults were included in the analysis. A descriptive analysis was conducted to describe the sample characteristics. Logistic regressions were performed to assess the relationships between social capital and self-rated health. The multiple mediating roles of sleep quality and psychological distress was analyzed using Mplus 8.3.

RESULTS

we found that social capital has a significant directly affect self-rated health (β=0.127, 68.65% CI=0.082-0.171), and through three significantly mediation pathways: (1) the path through sleep quality (β=0.013, 95% CI=0.005-0.021), which accounted for 7.03% of the total effect; (2) the path through psychological distress (β=0.037, 95% CI=0.024-0.049), which accounted for 20.00% of the total effect; (3) the path through sleep quality and psychological distress (β=0.008, 95% CI=0.004-0.013), which accounted for 4.32% of the total effect. The total mediating effect was 31.35%.

CONCLUSIONS

sleep quality and psychological distress mediate the relationship between social capital and self-rated health. Attention should be paid to mental health and sleep quality of empty nester through primary health, strengthen the attention to social resources, provide intervention and treatment for the empty nesters with sleep problem and psychological distress.

Socio-economic and technological aspects of mental health of older persons: the role of strong and weak ties in Ghana

Research indicates that social capital can influence the extent to which socio-economic status (SES) and information and communications technology (ICT) affect mental health. This study uses empirical data to examine the veracity of this claim by examining the effect of SES and ICT use on the mental health of older persons in Ghana, as well as the moderating role of bonding (i.e. strong ties) and bridging (i.e. weak ties) social capital in these associations. Data were drawn from 409 older persons from four regions in Ghana as part of a broader cross-sectional survey. Ordinal logistic regression analyses showed that SES and ICT use had positive associations with mental health after adjusting for other socio-demographic factors. Bridging social capital modified the association between SES and mental health positively. Bonding social capital also moderated the relations between ICT use on mental health positively. We argue that the prevalent nature of resources embedded in strong ties and the diversity of support that emerge from weak ties account for the difference in their influence observed in this study. Thus, while advances in socio-economic and technological conditions can enhance older persons’ mental health, equal attention must be paid to the characteristics of their strong and weak ties as they possess the resources to make socio-technological policies even more meaningful.

The Influence of Perception of Social Equality and Social Trust on Subjective Well-Being Among Rural Chinese People: The Moderator Role of Education

The present study explored the moderation effect of education on the relationship between the perception of social equality and social trust and individuals’ subjective well-being (SWB) in rural China. Data were derived from the nationally representative cross-sectional Chinese General Social Survey (CGSS). After handling missingness, 5,911 eligible participants (age 18 years or older) from the 2015 wave were included in the model. We used logistic regression to test the hypotheses. We first tested the effect of the perception of social equality and social trust on SWB. Then we added an interaction term to test the moderation effect of education in this relationship. The results show that education had a significant moderating effect on the association between general social trust and SWB. While had no significant effect on the association between the perception of social equality, special social trust and SWB. The perception of social equality had significant effects in both groups. The relationship between special social trust and SWB in both groups was not significant. For the more educated group, general social trust had a significant and positive effect on SWB.

Association between socio-ecological factors and leisure time physical activity (LTPA) among older adults in Sichuan, China: a structural equation modeling analysis

Background

Few studies examined socio-ecological factors and leisure time physical activities (LTPA) and rarely focused on self-regulation and social capital, which might play a significant role in impacting people’s physical activity behavior. This study aimed to examine the direct and indirect effects of individual level (perceived benefits, perceived barriers, and self-efficacy), interpersonal level (self-regulation), social level (social capital), and environmental level factors (perceived physical environment) on LTPA among older adults.

Methods

A cross-sectional study was conducted in 737 older adults from Sichuan, China. Structural equation modeling (SEM) analysis was used to examine the associations of individual, interpersonal, social, and environmental level factors with LTPA.

Results

The mean age of all participants was 71.22 (range, 60–97), and 56.1% of them were women. The SEM results showed that individual level variables (β = 0.32, ρ < 0.001), self-regulation (β = 0.18, ρ < 0.001) and social capital (β = 0.14, ρ < 0.001) could all directly affect LTPA while there was no significant association of perceived physical environment with LTPA. Self-regulation served as a bridge linking social capital and LTPA. Individual level variables contributed the largest total effect (0.32) on LTPA. Self-regulation and social capital had the same total effect (0.18) on LTPA.

Conclusions

Factors on three levels were all significantly associated with LTPA. Interventions that incorporate individual, interpersonal, social factors may be considered to promote LTPA in older adults. Self-regulation should receive more attention in future interventions.

Posttraumatic Stress Symptoms Among Polyvictimized Women in the Colombian Armed Conflict: The Mediating Role of Social Acknowledgment

For decades, in a situation of armed conflict in Colombia, women have suffered polyvictimization and discrimination with severe consequences that last even during the post-war peace process. This study analyzes the impact on posttraumatic stress and recovery of war-related violence against women, discrimination, and social acknowledgment. A cross-sectional study was conducted in 2019–2020. Participants were 148 women with a mean age of 47.66years (range 18–83), contacted through the NGO Ruta Pacifica de las Mujeres who had experienced significant personal violence. Results show that levels of perceived discrimination and lack of social acknowledgment are mediators in the relationship between polyvictimization and posttraumatic stress symptoms. Recognition by significant others, disapproval by family and the larger social milieu affects different posttraumatic stress disorder (PTSD) dimensions and therefore how these women adapt to the effects of trauma. Findings provide strong evidence that the way society and family treats women after a traumatic event affects how the victim recovers from this event. Recognition as a victim and disapproval can coexist and be a burden for women if not adequately addressed. Results stress the importance of understanding and intervening in PTSD recovery through the analysis of social processes, and not only through and individual focus.

Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review

BACKGROUND

Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs).

METHODS

Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument.

RESULTS

A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services.

CONCLUSIONS

Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42021226923.

Come Together to Decrease Depression: Women's mental health, social capital, and participation in a Kenyan combined microfinance program

BACKGROUND

Tools and systems to improve mental health have been understudied in low-resource environments, such as sub-Saharan Africa. This study explores depression amongst women participating in a community-based intervention combining savings- and lending-groups, entrepreneurial training and other skills training.

AIMS

This study aims to determine whether depression decreases with more program participation, and the extent to which social capital variables may explain these changes.

METHOD

Survey data were gathered in June 2018, within 6 months of group formation, and again in June 2019 from 400 women participants in the program. Data between 2018 and 2019 were compared using Wilcoxon rank-sum and Chi square tests. Inferential statistics included random effects regression models and general structural equation models.

RESULTS

At 1-year follow-up, depression and loneliness amongst Kenyan women (n = 400) participating in the program had decreased. Social capital remained higher within groups than within the broader community, and mediated the association between program participation and decreased depression.

CONCLUSIONS

Findings suggest this novel, community-based intervention has the potential to benefit mental health. Future research, including a randomised control trial, is required to establish (1) the extent of the program's benefits and (2) the program's application to particular subject areas and population segments.

Examination of the Moderating Role of Household Income in the Association Between Cognitive Social Capital and Subjective Well-Being Among Rural Older Adults in Northeast China

The present study explored the moderating effects of household income on the relationship between cognitive social capital and subjective well-being in rural community-dwelling older adults in China. The data were derived from a rural community survey conducted in Liaoyuan City in China's Jilin Province in 2019. The analytic model featured 458 respondents who completed the survey. We used multiple group analyses to test the hypotheses. A latent construct of cognitive social capital was built using social trust and reciprocity indicators. The results showed that household income had a significant moderating effect on the association between cognitive social capital and life satisfaction, but not on the relationship between cognitive social capital and depressive symptoms. Thus, household income and cognitive social capital should be used to assess subjective well-being in older populations. Older adults with low household income deserve particular attention in the design of future social capital policies and programs.

Advancing knowledge on social capital for young people's mental health

Inequalities in young people's mental health have been documented according to social class but less is known about determinants that can buffer or mediate the relationship. Social capital has the potential to contribute to alleviating observed health inequalities. However, clarity about how it can be understood and measured in relation to mental health among younger populations remains inconsistent. This scoping review examined published literature to investigate how social capital has been researched for young people's mental health. An established framework was used to guide the methodology. Studies were included: on age (10-19 years); publication year (since 2000); language (English). Only studies using social capital as a central theme were included. No restriction was placed on mental health outcomes. Nine bibliographic databases were interrogated. Articles (1541) were screened, 793 retained for analysis and 73 articles were included. Most studies were conducted in North America and Europe. Twenty per cent provided insights into how social capital should be described in relation to young people. A majority of the studies provided links between varying social capital indicators and a range of mental health outcomes (70%), however such evidence was associational. Only few studies inferred the causal direction between social capital and health (10%) and there were no dedicated studies on measurement. Findings suggest that literature on social capital and young people's mental health has grown but continues to be variously described and measured. It requires better utilization of existing knowledge and new research to improve its application in practice.

Age and gender differences in the reciprocal relationship between social connectedness and mental health

PURPOSE

To examine (i) reciprocal longitudinal associations between social connectedness and mental health, and (ii) how these associations vary by age and gender.

METHODS

Three waves of nationally representative data were drawn from the HILDA survey (n = 11,523; 46% men). The five-item Mental Health Inventory (MHI-5) assessed symptoms of depression and anxiety. The Australian Community Participation Questionnaire provided measures of informal social connectedness, civic engagement and political participation. Multivariable adjusted cross-lagged panel regression models with random intercepts estimated bidirectional within-person associations between mental health and each of the three types of social connectedness. Multi-group analyses were used to quantify differences between men and women, and between three broad age groups (ages: 15-30; 31-50; 51+).

RESULTS

Reliable cross-lagged associations between prior informal social connections and future mental health were only evident among adults aged 50 years and older (B = 0.101, 95% CI 0.04, 0.16). Overall, there was no significant association between prior civic engagement and improvements in mental health (p = 0.213) though there was weak evidence of an association for men (B = 0.051, 95% CI 0.01, 0.09). Similarly, there was no significant association in the overall sample between political participation and improvements for mental health (p = 0.337), though there was weak evidence that political participation was associated with a decline in mental health for women (B = - 0.045, CI - 0.09, 0.00) and those aged 31-50 (B = - 0.057, CI - 0.10, - 0.01). Conversely, prior mental health was associated with future informal social connectedness, civic engagement, and political participation.

CONCLUSION

Interventions promoting social connectedness to improve community mental health need to account for age- and gender-specific patterns, and recognise that poor mental health is a barrier to social participation.

Religious Affiliation in Relation to Positive Mental Health and Mental Disorders in a Multi-Ethnic Asian Population

Background: This study investigated association of religious affiliation with positive mental health (PMH) and mental disorders. Methods: A cross-sectional survey of 2270 adults was conducted in Singapore. Participants reported their religious affiliation to Buddhism, Christianity, Hinduism, Islam, Sikhism, Taoism, or other religions. A PMH instrument measured total PMH and six subcomponents: general coping (GC), emotional support (ES), spirituality (S), interpersonal skills (IS), personal growth and autonomy (PGA), and global affect (GA). Lifetime history of mental disorders was assessed with the Composite International Diagnostic Interview. Results: Total PMH (mean ± SD) was 4.56 ± 0.66 for participants with any religion versus 4.12 ± 0.63 (p = 0.002) in those without any religion. After adjustment for all potential confounders, the mean difference in total PMH between these groups was 0.348 (95% CI: 0.248–0.448). Having any religion was significantly associated with higher scores for S, GC, ES, IS, but not with PGA, GA or mental disorders. Compared with individuals without any religion, total PMH and S levels were significantly higher across all religions. Additionally, Christianity was significantly associated with higher ES, Taoism with higher GC, Buddhism and Islam with higher GC, ES and IS, Hinduism with higher IS and Sikhism with higher ES and IS. Conclusion: Our results indicate that religious affiliation is significantly associated with higher PMH, but not with mental disorders in an Asian community setting. In addition, different religions showed unique patterns of association with PMH subcomponents.

A Clinician's Guide to Polycultural Psychiatry

Patients and families each present unique microcultures, mixing and blending numerous broadly conceptualized cultural identity groups. Within individuals and families, cultural identities are experienced and enacted as complex matrices of intersecting identities that, to varying degrees, complement, assimilate, accommodate, or clash. In these patterns, individuals' relationships to cultures are not necessarily categorically distinct ("multicultural"). Instead, they are often "polycultural," defined as partial and plural; rather than interpreting different cultural traditions as separate and independent, they are, within the lives of individuals and families, better understood as systems that interact with and influence one another.Cultural identity groups extend beyond those traditionally considered by transcultural psychiatry-that is, beyond ethnic, racial, and language groups. They encompass (in alphabetical order) educational, ethnic, extended family, gender-oriented, generational, geographic, language and dialect, organizational, physical or psychiatric disability, political, professional, racial, religious, sect, social class, and vocational identity groups, among others. Simplistic assumptions and generalities about identity groups risk cultural stereotyping that may negatively bias clinical assessments. Therefore, practitioners striving for cultural sensitivity need to adopt nuanced strategies for approaching broad polycultural identity questions in clinical practice. Accordingly, this article suggests frameworks and strategies for (1) assessing and confronting one's own cultural preconceptions and prejudices, and (2) developing etic (objective quantitative data) and emic (insiders' experiential worldviews) perspectives pertinent to clinical anthropathology. Both etic and emic perspectives are necessary for polyculturally nuanced, respectful, comprehensive inquiries pertinent to patients' and family's health beliefs, psychiatric difficulties, and health practices. Supplementary material from the DSM-5 section on cultural formulation is adapted and discussed, along with the implications of polycultural psychiatry for education and training in psychiatry.

Social capital and psychological distress during Colombian coronavirus disease lockdown

This study aimed to establish the association of low social capital (SC) with psychological distress indicators. A cross-sectional study was carried out using an online questionnaire that evaluated demographic variables, social capital, perceived stress related to coronavirus disease, depression risk, insomnia risk, and suicide risk. SC was taken as an independent variable, and symptoms indicating psychological distress were considered as dependent variables. A group of 700 adults aged between 18 and 76 years (M = 37, SD = 13) participated in the survey. Low SC was associated with depression risk (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.34-2.97), elevated suicide risk (OR = 2.62, 95% CI = 1.40-4.91) high perceived stress related to coronavirus disease (OR = 2.08 95% CI, 1.15-3.76), and insomnia risk (OR = 2.42, 95% CI = 1.69-3.47). In conclusion, low CS was associated with indicators of psychological distress. SC is a community social resource that could help mitigate the quarantine impact of coronavirus disease amidst the Colombian population's psychological health.

Criminal victimization, cognitive social capital and mental health in an urban region in Germany: a path analysis

PURPOSE

There is ample evidence that experiencing a criminal victimization is associated with lasting emotional problems among victims. To date, the mechanisms behind this association are not well understood. Based on the theoretical assumptions derived from a transactional stress-appraisal and coping model this study analyses the role of cognitive social capital (SC) in the association between criminal victimization (CV) and victims' mental health.

METHODS

A cross-sectional, computer-aided telephone survey including a representative sample of 3005 persons from three German cities was conducted. Respondents were asked about CV during their lifetime, cognitive SC, perceived victimization risk, perceived safety and perceived ability to prevent victimization. The PHQ-4 was used as a measure of anxiety and depression. The data were analyzed by means of logistic regression models and a path model controlled for sociodemographic characteristics.

RESULTS

Lifetime CV with any type of crime was associated with a clinically relevant increased risk of mental disorder (PHQ-4 ≥ 9; OR 1.8, p ≤ 0.05). Path analyses revealed that the direct association between CV and PHQ-4 (β = 0.454; p ≤ 0.01) was significantly diminished by cognitive SC (β =  - 0.373; p ≤ 0.05).

CONCLUSION

Our results suggest that cognitive SC is an individual resilience factor against negative experiences related to CV and that it holds the potential to diminish negative mental health consequences of CV. Further research should explore to what extent an enhancement of cognitive SC can help to prevent anxiety and depression among crime victims.

A Brain Capital Grand Strategy: toward economic reimagination

‘I have not found among my possessions anything which I hold more dear than, or value so much as, my knowledge of the actions of great people, acquired by long experience in contemporary affairs, and a continual study of antiquity.’ The Prince, Machiavelli

Social Capital in Old People Living with HIV Is Associated with Quality of Life: A Cross-Sectional Study in China

Objective

Old people living with HIV (PLWH) are experiencing a lower quality of life (QoL) than their younger counterparts and have received insufficient attention in China. Given that social capital has been proven to be effective in improving QoL in other countries, we aimed to examine the association between social capital and QoL among old PLWH in China.

Methods

The data presented in this study was based on the baseline sample of an ongoing observational prospective cohort study, which was carried out from November 2018 to February 2019. Participants were old PLWH aged ≥50 in Sichuan, China, and were recruited by stratified multistage cluster sampling from 30 communities/towns. A total of 529 eligible participants finished the face-to-face investigation to measure their social capital (i.e., individual and family- (IF-) based social capital and community and society- (CS-) based social capital) and QoL. The QoL's dimensions of physical health summary (PCS) and mental health summary (MCS) were taken as dependent variables. Stepwise linear regression models were used to examine the association between social capital and QoL.

Results

After considering all significant covariates, the PCS was nonsignificantly correlated with IF-based social capital (β = −0.08, 95% CI [-0.28-0.11]) and CS-based social capital (β = 0.28, 95% CI [-0.03-0.59]), and MCS was significantly correlated with IF-based social capital (β = 0.77, 95% CI [0.54-0.99], p < 0.001) and CS-based social capital (β = 0.40, 95% CI [0.08-0.72], p < 0.05).

Conclusion

Targeted interventions related to building up social capital should be applied to improve the QoL of old PLWH. Providing extra relief funds and allowances might be helpful to improve PCS; improving community networking and engagement and improving family care might be helpful to improve MCS among this vulnerable population.