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Fung EHC, Dong D. Access to civil justice as a social determinant of health: a legal epidemiological cross-sectional study. Int J Equity Health 2024; 23:123. [PMID: 38877451 PMCID: PMC11179223 DOI: 10.1186/s12939-024-02205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Although it is widely acknowledged that access to civil justice (ATJ) is a key social determinant of health (SDOH), the existing literature lacks empirical evidence supporting ATJ as a SDOH for specific dimensions of health. METHODS A legal epidemiological, cross-sectional, postal survey was conducted on n = 908 randomly sampled participants in Hong Kong in March 2023. Data collected were perceptions of the civil justice system, health, and sociodemographics. Perceived ATJ was assessed using a modified version of the Inaccessibility of Justice scale (IOJ) and Perceived Inequality of Justice scale (PIJ), i.e. the "modified IOJ-PIJ", consisting of 12 of the original 13 items from both scales divided into two subdomains: "procedural fairness", and "outcome neutrality". For health data, quality of life was assessed using the Hong Kong version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF(HK)), psychological distress (including symptoms of anxiety and depression) was assessed using the four-Item Patient Health Questionnaire (PHQ-4), and having comorbidities was assessed using Sangha's Self-Administered Comorbidity Questionnaire (SCQ). Structural equation modelling (SEM) was used to investigate the relationships between perceived ATJ and the measured health outcomes. RESULTS SEM demonstrated that both subdomains for ATJ had significantly negative associations (B < 0; p < 0.05) with all quality-of-life subdomains, except for between outcome neutrality with social relationships; both subdomains for ATJ had significantly positive association (B > 0; p < 0.05) with both anxiety and depression; and, after adjusting for age, only "procedural fairness" had significantly positive association (B > 0; p < 0.05) with having comorbidities. CONCLUSION This study provided empirical evidence that ATJ is a SDOH for specific dimensions of health. The results of this study encourage laws, policies, and initiatives aimed at improving ATJ, as well as collaborative efforts from the legal and health sectors through health-justice partnerships, and from the broader community, to safeguard and promote public health by strengthening ATJ.
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Affiliation(s)
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China.
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Pakpour AH, Eriksson M, Erixon I, Broström A, Bengtsson S, Jakobsson M, Huus K. The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) - A psychometric evaluation of adolescents in Sweden during the COVID-19 pandemic. Heliyon 2024; 10:e27620. [PMID: 38510050 PMCID: PMC10950601 DOI: 10.1016/j.heliyon.2024.e27620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/16/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) is effective in assessing positive aspects of mental health. Despite its advantages, little is known about group differences in the interpretation of SWEMWBS items across age groups, especially during the adolescence period. Hence, this study examined the psychometric properties of the SWEMWBS through Confirmatory Factor Analysis (CFA), Rasch analysis and network analysis of Swedish adolescents during the COVID-19 pandemic. A total of 5548 participants from the south of Sweden (i.e., Jönköping County) took part in this cross-sectional study through an online platform between September 2020 and October 2020. The CFA, Rasch (including differential item functioning, DIF) analysis and network analysis were used to examine the psychometric properties and measurement invariance of the SWEMWBS. The SWEMWBS had a unidimensional structure with robust psychometric properties. The CFA demonstrated measurement invariance across gender, school year and country of birth, which was also confirmed by Rasch DIF. Furthermore, considerable associations between the items of the SWEMWBS, general health and COVID-19 impact items were observed in network analysis. The SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among adolescents.
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Affiliation(s)
- Amir H. Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Marit Eriksson
- Futurum - the Academy for Health and Care, Region Jönköping County, Sweden
- Department of Public Health and Health Care, Region Jönköping County, Sweden
| | - Ida Erixon
- Department of Public Health and Health Care, Region Jönköping County, Sweden
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Vestlandet, Norway
| | - Staffan Bengtsson
- CHILD-research Group, School of Health and Welfare, Jönköping University, Sweden
- Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Malin Jakobsson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- CHILD-research Group, School of Health and Welfare, Jönköping University, Sweden
| | - Karina Huus
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- CHILD-research Group, School of Health and Welfare, Jönköping University, Sweden
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Mareva S, Chapman B, Hardwick R, Hewlett C, Mitchell S, Sanders A, Hayes R. The Mental Wellbeing of Child and Adolescent Mental Health Service (CAMHS) Workers in England: A Cross-Sectional Descriptive Study Reporting Levels of Burnout, Wellbeing and Job Satisfaction. Healthcare (Basel) 2024; 12:430. [PMID: 38391806 PMCID: PMC10888124 DOI: 10.3390/healthcare12040430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
In the UK, there has been a notable increase in referrals to specialist children's mental health services. This, coupled with shortages of qualified staff, has raised concerns about the escalating occupational stress experienced by staff in this sector. In this brief report, we present cross-sectional quantitative data from 97 staff members working in one Child and Adolescent Mental Health Service (CAMHS) in the UK during spring 2023, reporting on their wellbeing, job satisfaction, and burnout. Our findings reveal that over a third of CAMHS staff experienced moderate or high levels of work-related burnout; 39% reported moderate or high levels of personal burnout, but levels of client-related burnout were much lower (13%). Both work- and client-related burnout showed a robust negative relationship with job satisfaction, with higher burnout predicting lower levels of job satisfaction. Only a small proportion of respondents reported high levels of wellbeing, with about a quarter experiencing levels of wellbeing that can be considered indicative of mild or clinical depressive symptoms. Whilst these results are from a small sample in one area of the UK, they present an important snapshot of CAMHS staff wellbeing and are discussed in the context of similar trends reported in the wider NHS sector.
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Affiliation(s)
- Silvana Mareva
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Beth Chapman
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Rebecca Hardwick
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth PL6 8BH, UK
| | - Charlotte Hewlett
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Siobhan Mitchell
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Amy Sanders
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Rachel Hayes
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
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Zhang P, Yang F, Huang N, Yan W, Zhang B, Zhang C, Peng K, Guo J. Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels. JAMA Netw Open 2023; 6:e2324025. [PMID: 37462971 DOI: 10.1001/jamanetworkopen.2023.24025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Importance Although rapid urbanization in China provided improved economic prosperity and educational opportunities, it was associated with increased internalizing and externalizing problems among youths, with negative outcomes for mental well-being. Previous studies suggested that factors in individual, school, and regional levels were associated with mental well-being, and comprehensively examining these factors may provide evidence for policies for improving youth mental health. Objective To investigate factors associated with mental well-being at individual, school, and province levels among Chinese youths. Design, Setting, and Participants This cross-sectional study analyzed nationally representative data collected December 1, 2021, to January 1, 2022, from schools in China. Among 435 schools, 144 institutions had primary school students, 107 institutions had middle school students, 95 institutions had primary and middle school students, and 89 institutions had high school students. A total of 398 520 students were included. Exposures Characteristics at individual, school, and province levels. Main outcomes and measures The main outcome was mental well-being, assessed by the Short Warwick-Edinburgh Mental Well-being Scale. Linear mixed-effects models were used to investigate individual, school, and regional disparities in mental well-being among youths. Results There were 398 520 participants (194 460 females [48.80%]; mean [SD; range] age, 13.78 [2.40; 9-20] years). At the school level, 352 443 students (88.44%) were in public school and 291 354 students (73.11%) were in urban schools. Drinking (coefficient = -1.08; 95% CI, -1.12 to -1.05; P < .001), smoking (coefficient = -0.89; 95% CI, -0.96 to -0.83; P < .001), and increased age (coefficient per 1-year increase in age = -0.02; 95% CI, -0.03 to -0.01; P < .001) were associated with worse mental well-being. Male sex (coefficient = 1.01; 95% CI, 0.98 to 1.04; P < .001), being in a 1-child family (coefficient = 0.17; 95% CI, 0.13 to 0.20; P < .001), being in the Han group (coefficient vs other ethnic groups = 0.20; 95% CI, 0.14 to 0.26; P < .001), a higher frequency and coverage of psychological courses (eg, ≥2/wk for all students vs none: coefficient = 1.02; 95% CI, 0.36 to 1.69; P = .003), and a higher level of self-rated popularity in school (coefficient per 1-unit increase in score = 0.89; 95% CI, 0.88 to 0.89; P < .001) were associated with improved mental well-being. However, age (eg, age and 1 courses/2 wk for all students: coefficient per 1-year increase in age = -0.047; 95% CI, -0.089 to -0.005; P = .03) and sex (eg, female sex and ≥2 courses/wk for some students: coefficient = -0.184; 95% CI, -0.323 to -0.046; P = .009) had interactions with the association between psychological courses and mental well-being. Conclusions and relevance This study found that social disparities in mental well-being existed and that various factors at different levels were associated with mental well-being among Chinese youths. These findings suggest that public mental health programs may be recommended for associated improvements in regional disparities in mental health resources.
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Affiliation(s)
- Peng Zhang
- Department of Psychology, Tsinghua University, Beijing, China
| | - Fan Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Wei Yan
- Department of Psychology, Tsinghua University, Beijing, China
| | - Bo Zhang
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Cancan Zhang
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kaiping Peng
- Department of Psychology, Tsinghua University, Beijing, China
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
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Hong Y, Jiang X, Zhang T, Luo N, Yang Z. Examining the relationship between the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) and EQ-5D-5L and comparing their psychometric properties. Health Qual Life Outcomes 2023; 21:25. [PMID: 36927468 PMCID: PMC10018827 DOI: 10.1186/s12955-023-02108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The purpose of this study is to examine the relationship between the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) and EQ-5D-5L and compare their psychometric properties in 4 chronic conditions in China. METHODS Participants were invited to complete the online survey. Spearman's rank correlation was used to evaluate the correlation between SWEMWBS and EQ-5D-5L; exploratory factor analysis was used to ascertain the number of unique underlying latent factors measured by SWEMWBS and EQ-5D-5L. Next, we assessed the psychometric properties of SWEMWBS and EQ-5D-5L by reporting distributions and examining their known-group validity and convergent validity. RESULTS In total, 500 individuals participated the online survey. Spearman's rank correlation showed that EQ-5D-5L dimensions, except for the anxiety/depression dimension, were weakly correlated with all dimensions of SWEMWBS. The two-factor solution for exploratory factor analysis found that all of SWEMWBS dimensions loaded onto one factor, four EQ-5D-5L dimensions (mobility, self-care, usual activities and pain/discomfort) onto another, and the EQ-5D-5L item of anxiety/depression item loaded moderately onto both factors. Patients of four disease groups had different distributions of responses for both SWEMWBS and EQ-5D-5L. In terms of known-group validity, both the F statistic and AUROC value of EQ-5D-5L utility scores were significantly higher than SWEMWBS scores in all four pair-wised comparisons. The Pearson correlation coefficient between EQ-5D-5L utility scores, SWEMWBS scores and EQ-VAS was 0.44 (P < 0.01) and 0.65 (P < 0.01), respectively. CONCLUSIONS SWEMWBS and EQ-5D-5L measure different constructs and can be seen as complementary measures. Both measures demonstrated good convergent validity and known-group validity with EQ-5D-5L being a more sensitive measure, even for mental conditions.
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Affiliation(s)
- Yanming Hong
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xinru Jiang
- Tianhe Foreign Language School, Guangzhou, People's Republic of China
| | - Tiantian Zhang
- College of Pharmacy, Jinan University, Guangzhou, People's Republic of China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, People's Republic of China.
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Xu RH, Bao XL, Shi LSB, Wang D. Associations between eHealth literacy, mental health-seeking attitude, and mental wellbeing among young electronic media users in China during the COVID-19 pandemic. Front Public Health 2023; 11:1139786. [PMID: 36908426 PMCID: PMC9998951 DOI: 10.3389/fpubh.2023.1139786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/09/2023] [Indexed: 03/14/2023] Open
Abstract
Objective This study aimed to examine the associations among mental health related eHealth literacy (eHL), mental health-seeking attitude, and wellbeing among Chinese young electronic media users during the COVID-19 pandemic. Methods A web-based cross-sectional survey was conducted in Guangzhou, China. The modified eHealth literacy Scale, Mental Help-Seeking Attitudes Scale, and Short Warwick-Edinburgh Mental Wellbeing Scale were used. Structural equation modeling (SEM) examined the associations between them and was adjusted by several controlled variables. Results Totally, 1,008 participants completed the questionnaire and provided valid responses. The eHL showed a statistically significant and direct effect on mental wellbeing in this sample. The higher the level of eHL, the better wellbeing of the participants. The mental health-seeking attitude is also positively correlated with mental wellbeing, indicating that the more positive attitude toward seeking mental health services, the better the wellbeing participants reported. The higher level of eHL is significantly associated with a more positive attitude toward seeking mental health services. Conclusion Training to improve eHL may optimize young electronic media users' mental health outcomes. Development and use of a mental health specific eHL instrument in future studies should be encouraged.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiao-Lu Bao
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Lu-Shao-Bo Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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Lu S, Guo Y, Chui C, Liu Y, Chan OF, Chan SW, Lum TYS. Neighborhood Environment and Mental Well-Being Among Chinese Older Adults: The Mediating Role of Social Capital. Innov Aging 2022; 6:igac070. [PMID: 36600810 PMCID: PMC9799048 DOI: 10.1093/geroni/igac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Indexed: 11/19/2022] Open
Abstract
Background and Objectives Neighborhood environments are increasingly recognized as associated with mental well-being among older adults. However, their underlying mechanisms remain unclear. This study investigated mediating effects of cognitive and structural social capital (SC) in relationships between neighborhood environments and mental well-being among older adults. Research Design and Methods We conducted a cross-sectional analysis of 1,277 community-dwellers aged 60 years and older in Hong Kong in 2021. The Warwick-Edinburgh Mental Well-being Scale assessed mental well-being. Perceived age-friendly environment was assessed. Objective neighborhood environment was measured by the number of neighborhood facilities (e.g., transportation, community centers, leisure facilities) within 200-m and 500-m buffer areas from respondents' residences. Structural equational modeling was used. Results Perceived age-friendly environment regarding community and health support had a protective role on mental well-being. More community centers were directly associated with better affective-emotional well-being, while more passive leisure facilities directly lowered psychological-functioning well-being. Cognitive SC outweighed structural SC in mediating relationships of neighborhood environment on mental well-being. Discussion and Implications Our findings advance the ecological model of aging by providing evidence for cognitive and structural SC as mediators to explain the relationship between neighborhood environment and mental well-being. Policy implications for optimizing mental well-being in aging societies are discussed.
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Affiliation(s)
- Shiyu Lu
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
| | - Yingqi Guo
- Department of Social Work; Department of Geography; Smart Society Lab, Hong Kong Baptist University, Hong Kong, China
| | - Cheryl Chui
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yuqi Liu
- Department of Urban Planning, South China University of Technology, Guangzhou, China
| | - On Fung Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Samuel W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Terry Y S Lum
- Address correspondence to: Terry Y. S. Lum, PhD, Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China. E-mail:
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Measuring mental well-being in Sri Lanka: validation of the Warwick Edinburgh Mental Well-being Scale (WEMWBS) in a Sinhala speaking community. BMC Psychiatry 2022; 22:569. [PMID: 35999535 PMCID: PMC9400250 DOI: 10.1186/s12888-022-04211-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Well-being is an important aspect of people's lives and can be considered as an index of social progress. The Warwick Edinburgh Mental Well-being scale (WEMWBS) was developed to capture subjective mental well-being. It is a widely tested measure of mental well-being at the population level and has 14 items and a short-form with 7 items. This study was carried out to culturally validate and adapt the WEMWBS among a Sinhala speaking population in Sri Lanka. METHODS A forward and backward translation of the scale into Sinhala was done followed by a cognitive interview. The translated and culturally adapted scale and other mental health scales were administered to a sample of 294 persons between the ages of 17-73 using a paper-based version (n = 210) and an online survey (n = 84). Internal consistency reliability and test-retest reliability were tested. Construct validity, and convergent and discriminant validity were assessed using the total sample. RESULTS The translated questionnaire had good face and content validity. Internal consistency reliability was 0.91 and 0.84 for the 14-item and 7-item scales, respectively. Test-retest reliability over two weeks was satisfactory (Spearman r = 0.72 p < 0.001). Confirmatory factor analysis supported a one factor model. Convergent validity was assessed using WHO-5 well-being index (Spearman r = 0.67, p < 0.001), Patient Health Questionnaire (PHQ-9) (Spearman r = (-0.45), p < 0.001) and Kessler psychological distress scale (K10) (Spearman r = (-0.55), p < 0.001). CONCLUSIONS The translated and culturally adapted Sinhala version of the WEMWBS has acceptable psychometric properties to assess mental well-being at the population level among the Sinhala speaking population in Sri Lanka.
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Sun Y, Wang MP, Chan CS, Lo DLO, Wan ANT, Lam TH, Ho SY. Promoting positive parenting and mental wellbeing in Hong Kong Chinese parents: A pilot cluster randomised controlled trial. PLoS One 2022; 17:e0270064. [PMID: 35857769 PMCID: PMC9299310 DOI: 10.1371/journal.pone.0270064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/03/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Effective and brief positive parenting interventions could be adopted widely, but evidence is limited. We aimed to evaluate the effectiveness of a positive parenting programme in Hong Kong Chinese parents. Methods We conducted a pilot cluster randomised controlled trial in 2017 in 144 Hong Kong Chinese parents (84.7% women, mean age 42.5 [SD 5.87] years) of school-age children (mean age 10.9 [2.8] years) in 4 family service centres (clusters). The intervention included two 2-hour interactive talks (4 hours in total). The contents covered skills of giving praise, showing appreciation and playing enjoyable family games. The control group was offered the intervention after all the data were collected. Praise, appreciation and enjoyment related behaviours were measured as primary outcomes at baseline, 1 month and 3 months. The secondary outcomes were subjective happiness, wellbeing, personal health and happiness, family health, family happiness and harmony, and family relationship. After the completion of all assessments, five focus group discussions with the parents and four individual in-depth interviews with community service providers were conducted to explore their experiences. Results Compared with the control group (n = 69), the intervention group (n = 75) showed greater positive changes in appreciation and enjoyment at 3 months with small effect sizes (d = 0.42 and 0.32, respectively), and greater improvements in the secondary outcomes at 3 months with small effect sizes (d: 0.29–0.48). In the focus groups, the parents reported more praise to their children, better temper control, more focus on their children’s strengths and better family relationships. According to the service providers, most of the parents enjoyed the activities. Conclusions The brief intervention in community settings with the engagement of community service providers has shown preliminary effectiveness in promoting positive parenting and mental wellbeing of Hong Kong Chinese parents. Trial registration The authors confirm that all ongoing and related trials for this intervention are registered. The study reported in this manuscript is registered as clinical trial at clinicaltrials.gov: NCT03282071. https://clinicaltrials.gov/ct2/show/NCT03282071.
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Affiliation(s)
- Yuying Sun
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
- * E-mail:
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | | | - Alice N. T. Wan
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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10
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Fung SF, Kong CYW, Liu YM, Huang Q, Xiong Z, Jiang Z, Zhu F, Chen Z, Sun K, Zhao H, Yu P. Validity and Psychometric Evaluation of the Chinese Version of the 5-Item WHO Well-Being Index. Front Public Health 2022; 10:872436. [PMID: 35433612 PMCID: PMC9005828 DOI: 10.3389/fpubh.2022.872436] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/08/2022] [Indexed: 01/05/2023] Open
Abstract
Aims This article evaluates the psychometric properties of the Chinese version of the 5-item WHO Well-Being Index (WHO-5) in mainland China. Methods Two cross-sectional studies with 1,414 participants from a university in China were conducted. The Chinese version of the WHO-5 was assessed to determine its internal consistency, concurrent validity, factorial validity, and construct validity. Results The results indicate that the WHO-5 is unidimensional and has good internal consistency, with Cronbach's a = 0.85 and 0.81 in Study 1 (n = 903) and Study 2 (n = 511), respectively. The findings also demonstrate that the WHO-5 has good concurrent validity with other well-established measures of wellbeing, self-efficacy, self-esteem, and mental wellbeing. The results of confirmatory factor analysis also suggest that the scale has a good model fit. Conclusions This study provides empirical data demonstrating that the Chinese version of the WHO-5 has good psychometric properties. The scale can be a useful measure in epistemological studies and clinical research related to wellbeing in Chinese populations.
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Affiliation(s)
- Sai-Fu Fung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Chris Yiu Wah Kong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Yi-Man Liu
- School of Economics, Finance and Marketing, Royal Melbourne Institute of Technology, Melbourne, VIC, Australia.,University Administrative Office, Guangzhou Huashang College, Guangzhou, China
| | - Qian Huang
- Department of Sports Training, Xi'an Physical Education University, Xi'an, China
| | - Zike Xiong
- University Administrative Office, Guangzhou Huashang College, Guangzhou, China
| | - Zhiquan Jiang
- Society Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China
| | - Fangfang Zhu
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Zhenting Chen
- School of Data Sciences, Guangzhou Huashang College, Guangzhou, China
| | - Kun Sun
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Huiqin Zhao
- School of Economics and Trade, Guangzhou Huashang College, Guangzhou, China
| | - Ping Yu
- Managing Director Office, Global Business College of Australia, Melbourne, VIC, Australia.,General Manager Office, Edvantage Institute Australia, Melbourne, VIC, Australia
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11
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Shah N, Cader M, Andrews B, McCabe R, Stewart-Brown SL. Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): performance in a clinical sample in relation to PHQ-9 and GAD-7. Health Qual Life Outcomes 2021; 19:260. [PMID: 34819104 PMCID: PMC8611866 DOI: 10.1186/s12955-021-01882-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose This study assesses the construct validity and sensitivity to change of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) as an outcome measure in the treatment of common mental disorders (CMD) in primary care settings.
Methods 127 participants attending up to 5 sessions of therapy for CMD in primary care self-rated the SWEMWBS, the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scales. SWEMWBS’s construct validity and sensitivity to change was evaluated against the PHQ-9 and GAD-7 across multiple time points in two ways: correlation coefficients were calculated between the measures at each time point; and sensitivity to change over time was assessed using repeated measures ANOVA. Results Score distributions on SWEMWBS, but not PHQ-9 and GAD-7, met criteria for normality. At baseline, 92.9% (118/127) of participants scored above clinical threshold on either PHQ-9 or GAD-7. Correlations between SWEMWBS and PHQ-9 scores were calculated at each respective time point and ranged from 0.601 to 0.793. Correlations between SWEMWBS and GAD-7 scores were calculated similarly and ranged from 0.630 to 0.743. Significant improvements were seen on all three scales over time. Changes in PHQ-9 and GAD-7 were curvilinear with greatest improvement between sessions 1 and 2. Change in SWEMWBS was linear over the five sessions. Conclusions This exploratory study suggests that SWEMWBS is acceptable as a CMD outcome measure in primary care settings, both in terms of construct validity and sensitivity to change. Given patient preference for positively over negatively framed measures and statistical advantages of measures which are normally distributed, SWEMWBS could be used as an alternative to PHQ-9 and GAD-7 in monitoring and evaluating CMD treatment.
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Affiliation(s)
| | - Mizaya Cader
- National Dengue Control Unit, Ministry of Health, Colombo, Sri Lanka
| | - Bill Andrews
- Department of Psychology, University of Roehampton, London, UK
| | | | - Sarah L Stewart-Brown
- Emeritus Professor of Public Health, Warwick Medical School University of Warwick, Coventry, UK
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Venturo-Conerly KE, Osborn TL, Wasil AR, Le H, Corrigan E, Wasanga C, Weisz JR. Testing the effects of the Shamiri Intervention and its components on anxiety, depression, wellbeing, and academic functioning in Kenyan adolescents: study protocol for a five-arm randomized controlled trial. Trials 2021; 22:829. [PMID: 34809679 PMCID: PMC8607059 DOI: 10.1186/s13063-021-05736-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/20/2021] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Treatments for youth mental disorders are a public health priority, especially in sub-Saharan Africa (SSA), where treatment options remain limited due to high cost, elevated stigma, and lack of trained mental health professionals. Brief, accessible, and non-stigmatizing community-based interventions delivered by lay providers may help address treatment needs in SSA. One such intervention, the Shamiri Intervention, consisting of three elements (growth mindset, gratitude, and value affirmation) has been tested in randomized controlled trials with school-going Kenyan adolescents. This three-element Shamiri Intervention has been shown to significantly reduce depression and anxiety symptoms and improve social support and academic performance relative to a control group. In this trial, we aim to investigate the effects of each element of the Shamiri Intervention. METHODS In this five-arm randomized controlled trial, we will test each of the intervention components (growth mindset, gratitude, and value affirmation) against the full Shamiri Intervention and against a study skills control intervention. Students (Nplanned = 1288) at participating secondary schools who are interested in participating in this universal intervention will be randomized in equal numbers into the five groups. The students will meet in groups of 8-15 students led by local high school graduate lay providers. These lay providers will receive a brief training, plus expert supervision once a week throughout the intervention delivery. Multi-level models will be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes in each intervention group to the control group. Multi-level models will also be used to compare trajectories over time of the primary outcomes (depressive symptoms, anxiety symptoms, academic performance, and wellness) and secondary outcomes of participants in the single-element interventions compared to the full Shamiri Intervention. Finally, effect sizes (calculated as mean gain scores) will be used to compare all groups on all measures. DISCUSSION This trial will shed light on the mechanisms and outcomes targeted by each individual intervention, helping prioritize which mental health interventions are most important to disseminate. TRIAL REGISTRATION PACTR Trial ID: PACTR202104716135752 . Approved on 4/19/2021.
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Affiliation(s)
- Katherine E Venturo-Conerly
- Shamiri Institute, Nairobi, Kenya.
- Department of Psychology, Harvard University, Cambridge, MA, USA.
- Shamiri Institute, Allston, MA, USA.
| | - Tom L Osborn
- Shamiri Institute, Nairobi, Kenya
- Shamiri Institute, Allston, MA, USA
| | - Akash R Wasil
- Shamiri Institute, Allston, MA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Huong Le
- Shamiri Institute, Nairobi, Kenya
- Shamiri Institute, Allston, MA, USA
| | - Emily Corrigan
- Shamiri Institute, Nairobi, Kenya
- Shamiri Institute, Allston, MA, USA
| | - Christine Wasanga
- Shamiri Institute, Nairobi, Kenya
- Department of Psychology, Kenyatta University, Nairobi, Kenya
| | - John R Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Shamiri Institute, Allston, MA, USA
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13
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Guo N, Zhao SZ, Weng X, Wu Y, Luk TT, Wong JYH, Lam TH, Wang MP. Associations of COVID-19 online information sources and information overload with psychological distress symptoms: a population-based study. Transl Behav Med 2021; 11:1330-1338. [PMID: 34160612 DOI: 10.1093/tbm/ibab086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Using information communication technologies as information sources of COVID-19 was associated with psychological problems, but mechanisms remain uncertain. We examined associations of COVID-19 information sources and information overload with psychological distress symptoms and explored the mediating effect of information overload in Hong Kong. A random sample of Chinese adults (N = 1501; 52.6% females; 55.0% aged 30-59) from dual landline and online surveys in April 2020 reported frequency of using traditional media, internet websites, social networking sites, instant messaging, and online discussion forums as COVID-19 information sources. Psychological distress symptoms were measured using the Patient Health Questionnaire 4-item ([PHQ-4]; 0-12). Information overload defined as a perception of being overwhelmed was measured (1-6). Linear regressions were performed to analyze the associations, and the mediating effect of information overload was examined. Greater PHQ-4 score was observed for frequent use of internet websites (adjusted b = 0.58, 95% CI 0.29, 0.87, adjusted β = 0.12) and online discussion forums (adjusted b = 0.39, 95% CI 0.08, 0.70, adjusted β = 0.08) and information overload (adjusted b = 0.54, 95% CI 0.44, 0.63, adjusted β = 0.28). Information overload mediated 44.9% and 36.9% of associations of frequent use of internet websites and online discussion forums with PHQ-4 score, respectively. Frequent use of social networking sites was associated with lower PHQ-4 score (adjusted b = -0.37, 95% CI -0.69, -0.04, adjusted β = -0.07) partially through lower information overload (37.5%). Psychological distress symptoms were associated with frequent use of internet websites and online discussion forums as COVID-19 information sources, which were mediated through information overload.
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Affiliation(s)
- Ningyuan Guo
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Sheng Zhi Zhao
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Xue Weng
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong, China
| | | | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, China
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Fine SL, Malik A, Guimond MF, Nemiro A, Temu G, Likindikoki S, Annan J, Tol WA. Improving mental health in low-resource settings: A feasibility randomized controlled trial of a transdiagnostic psychological intervention among Burundian refugee adolescents and their caregivers. Behav Res Ther 2021; 145:103944. [PMID: 34392115 DOI: 10.1016/j.brat.2021.103944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 05/21/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
There is a paucity of evidence regarding interventions that can improve the mental health of adversity-affected young adolescents living in low-resource settings. We evaluated the feasibility, acceptability, relevance, and safety of the World Health Organization's Early Adolescent Skills for Emotions (EASE) intervention among Burundian refugee adolescents and their caregivers in Tanzania. This study consisted of a feasibility cluster randomized controlled trial (cRCT) and a process evaluation. The feasibility cRCT included 82 young adolescents and their 64 caregivers, with two clusters randomized to EASE and two to an enhanced control condition. EASE was delivered by adult refugees without prior training in mental health. The process evaluation consisted of 36 semi-structured qualitative interviews with key stakeholders, including adolescents, caregivers, and facilitators. EASE participants and facilitators gave positive feedback about its format, accessibility, and content. Trained non-specialist refugee facilitators were able to deliver EASE with high fidelity. The research protocol functioned well in terms of balanced randomization, limited loss to follow-up, and psychometrically promising measures, but discordance was observed between the short screener and psychological distress symptom checklist. This formative study suggests the potential of EASE in targeting psychological distress among displaced young adolescents and lays the groundwork for a future definitive trial.
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Affiliation(s)
- Shoshanna L Fine
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA.
| | - Aiysha Malik
- World Health Organization, Avenue Appia 20, 1211, Geneva, Switzerland
| | | | - Ashley Nemiro
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Getruda Temu
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Samuel Likindikoki
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Jeannie Annan
- International Rescue Committee, 122 East 42nd St., New York, NY, 10168, USA
| | - Wietse A Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, USA; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen, Denmark; HealthRight International, 14 East 14th St., New York, NY, 10012, USA
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Guo N, Luk TT, Ho SY, Lee JJ, Shen C, Oliffe J, Chan SSC, Lam TH, Wang MP. Problematic Smartphone Use and Mental Health in Chinese Adults: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030844. [PMID: 32013111 PMCID: PMC7037190 DOI: 10.3390/ijerph17030844] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/20/2020] [Accepted: 01/24/2020] [Indexed: 12/22/2022]
Abstract
Problematic smartphone use (PSU) has been associated with anxiety and depression, but few explored its mental well-being correlates that could co-occur with or be independent of mental symptoms. We studied the associations of PSU with anxiety, depression, and mental well-being in Hong Kong Chinese adults in a probability-based survey (N = 4054; 55.0% females; mean age ± SD 48.3 ± 18.3 years). PSU was measured using Smartphone Addiction Scale-Short Version. Anxiety and depression symptoms were evaluated using General Anxiety Disorder screener-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2). Mental well-being was measured using Subjective Happiness Scale (SHS) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Multivariable regression analyzed associations adjusting for sociodemographic and lifestyle-related variables. Associations of PSU with mental well-being were stratified by symptom severity of anxiety (GAD-2 cutoff of 3) and depression (PHQ-2 cutoff of 3). We found that PSU was associated with higher odds of anxiety and depression symptom severity and lower scores of SHS and SWEMWBS. Associations of PSU with lower SHS and SWEMWBS scores remained in respondents who screened negative for anxiety or depression symptoms. To conclude, PSU was associated with anxiety, depression, and impaired mental well-being. Associations of PSU with impaired mental well-being could be independent of anxiety or depression symptoms.
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Affiliation(s)
- Ningyuan Guo
- School of Nursing, University of Hong Kong, Hong Kong, China; (N.G.); (T.T.L.); (J.J.L.); (S.S.-C.C.)
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong, China; (N.G.); (T.T.L.); (J.J.L.); (S.S.-C.C.)
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong, China; (S.Y.H.); (T.H.L.)
| | - Jung Jae Lee
- School of Nursing, University of Hong Kong, Hong Kong, China; (N.G.); (T.T.L.); (J.J.L.); (S.S.-C.C.)
| | - Chen Shen
- Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK;
| | - John Oliffe
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada;
| | - Sophia Siu-Chee Chan
- School of Nursing, University of Hong Kong, Hong Kong, China; (N.G.); (T.T.L.); (J.J.L.); (S.S.-C.C.)
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China; (S.Y.H.); (T.H.L.)
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, China; (N.G.); (T.T.L.); (J.J.L.); (S.S.-C.C.)
- Correspondence: ; Tel.: +852-3917-6636; Fax: +852-2872-6079
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