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Gao Y, Yu Q, Schuch FB, Herold F, Hossain MM, Ludyga S, Gerber M, Mullen SP, Yeung AS, Kramer AF, Taylor A, Schinke R, Cheval B, Delli Paoli AG, Ng JL, Van Damme T, Block M, Cunha PM, Olds T, Haegele JA, Zou L. Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems. J Affect Disord 2024; 349:176-186. [PMID: 38190861 DOI: 10.1016/j.jad.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/28/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth. METHODS In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates. RESULTS The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05). CONCLUSION Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.
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Affiliation(s)
- Yanping Gao
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Qian Yu
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Faculty of Education, University of Macau, 999078, Macau, China
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile
| | - Fabian Herold
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX, USA
| | - Sebastian Ludyga
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise & Health, University of Basel, Basel, Switzerland
| | - Sean P Mullen
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, USA
| | - Albert S Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth BH5 2DF, United Kingdom of Great Britain and Northern Ireland
| | - Robert Schinke
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, ON P3E 2C6, Canada
| | - Boris Cheval
- Department of Sport Sciences an d Physical Education, Ecol e Normal e Supérieure Rennes, Bruz, France; Laboratory VIPS2, University of Rennes, Rennes, France
| | | | - Jonathan Leo Ng
- Department of Health, Physical Education, and Sport, School of Education, College of Design and Social Context, RMIT University, Melbourne, VIC, Australia
| | - Tine Van Damme
- Research Group for Adapted Physical Activity and Psychomotor Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, O&N IV Herestraat49, Mailbox 1510, 3000 Leuven, Belgium; UPC KU Leuven, Kortenberg, Leuven, Belgium; Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
| | - Martin Block
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22904-4407, USA
| | - Paolo M Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide SA5001, Australia
| | - Justin A Haegele
- Department of Human Movement Sciences, Old Dominion University, USA
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China.
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Kacmarek CN, Johnson NE, Osborn TL, Wasanga C, Weisz JR, Yates BT. Costs and cost-effectiveness of Shamiri, a brief, layperson-delivered intervention for Kenyan adolescents: a randomized controlled trial. BMC Health Serv Res 2023; 23:827. [PMID: 37542304 PMCID: PMC10403919 DOI: 10.1186/s12913-023-09856-z] [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: 03/05/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Low- and middle-income countries (LMICs) have the highest socio-economic burden of mental health disorders, yet the fewest resources for treatment. Recently, many intervention strategies, including the use of brief, scalable interventions, have emerged as ways of reducing the mental health treatment gap in LMICs. But how do decision makers prioritize and optimize the allocation of limited resources? One approach is through the evaluation of delivery costs alongside intervention effectiveness of various types of interventions. Here, we evaluate the cost-effectiveness of Shamiri, a group- and school-based intervention for adolescent depression and anxiety that is delivered by lay providers and that teaches growth mindset, gratitude, and value affirmation. METHODS We estimated the cost-effectiveness of Shamiri using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines for economic evaluations. Changes in depression and anxiety were estimated using the Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder questionnaire (GAD-7) at treatment termination and 7-month follow-up using two definitions of treatment benefit. Cost-effectiveness metrics included effectiveness-cost ratios and cost per number needed to treat. RESULTS Base case cost assumptions estimated that delivering Shamiri cost $15.17 (in 2021 U.S. dollars) per student. A sensitivity analysis, which varied cost and clinical change definitions, estimated it cost between $48.28 and $172.72 to help 1 student in Shamiri, relative to the control, achieve reliable and clinically significant change in depression and anxiety by 7-month follow-up. CONCLUSIONS Shamiri appears to be a low-cost intervention that can produce clinically meaningful reductions in depression and anxiety. Lay providers can deliver effective treatment for a fraction of the training time that is required to become a licensed mental health provider (10 days vs. multiple years), which is a strength from an economic perspective. Additionally, Shamiri produced reliable and clinically significant reductions in depression and anxiety after only four weekly sessions instead of the traditional 12-16 weekly sessions necessary for gold-standard cognitive behavioral therapy. The school setting, group format, and economic context of a LMIC influenced the cost per student; however, broader conclusions about the cost-effectiveness of Shamiri have yet to be determined due to limited economic evaluations of mental health programs in LMICs. TRIAL REGISTRATION This study was registered prior to participant enrollment in the Pan-African Clinical Trials Registry (PACTR201906525818462), registered 20 Jun 2019, https://pactr.samrc.ac.za/Search.aspx .
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Affiliation(s)
- Corinne N. Kacmarek
- Department of Psychology, American University, 4400 Massachusetts Ave NW, Washington, DC 20016 USA
| | - Natalie E. Johnson
- Department of Clinical Research, Division of Clinical Epidemiology, University Hospital Basel, Totengässlein 3, 4051 Basel, Switzerland
| | - Tom L. Osborn
- Shamiri Institute, 13th Floor, Pioneer Point (CMS Africa), Chania Avenue, Nairobi, Kenya
| | - Christine Wasanga
- Department of Psychology, Kenyatta University, Box 43844, Nairobi, 00100 Kenya
| | - John R. Weisz
- Department of Psychology, Harvard University, 1030 William James Hall, 33 Kirkland Street, Cambridge, MA 02138 USA
| | - Brian T. Yates
- Department of Psychology, American University, 4400 Massachusetts Ave NW, Asbury Building Room 321, Washington, DC, 20016-8062 USA
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