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Morton DP, Renfrew M, Matthews S. The American College of Lifestyle Medicine's Offering of a Mental Health and Wellbeing Program (The Lift Project) to its Members - Caring for the Carers. Am J Lifestyle Med 2024; 18:671-680. [PMID: 39309330 PMCID: PMC11412376 DOI: 10.1177/15598276231178762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024] Open
Abstract
In the wake of COVID-19, the American College of Lifestyle Medicine offered its members an online 10-week multicomponent mental health and wellbeing program (The Lift Project), and extended the invitation to members from sister organizations associated with the Lifestyle Medicine Global Alliance. A total of 1785 members registered for the program, representing 39 countries. The website hosting the program recorded 9815 total visits over the 10 weeks. In a post-program questionnaire completed by 145 participants, 91% agreed or strongly agreed that the program supported their mental wellbeing, and participants reported their wellbeing as higher after the program as compared to its commencement (X2 = 80.8, P < .01). Ninety-four percent of respondents indicated they would recommend the program to a friend. Thematic analysis of open-ended responses included in the post-program evaluation indicated that the participants liked: the structure of the program and content covered; the style of the video presentations; and the practical application of the program. Some participants indicated they would have liked more time to engage with the program and would have enjoyed the provision of group meetings. In conclusion, healthcare organizations can support their members' mental health and wellbeing by offering large-scale, evidence-based interventions.
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Affiliation(s)
- Darren P Morton
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, NSW, Australia
| | - Melanie Renfrew
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, NSW, Australia
| | - Simon Matthews
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, NSW, Australia
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McGoron L, Towner EK, Martel MM, Trentacosta CJ, Purkayestha S, Friedrich FS, Traylor P, Ondersma SJ. Developing the Technology-based Parenting Young Children Check-Up Intervention for Disruptive Behavior Problems Identified in Pediatric Primary Care. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2024; 12:128-142. [PMID: 39021503 PMCID: PMC11251713 DOI: 10.1037/cpp0000498] [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] [Indexed: 07/20/2024]
Abstract
Objective Behavioral parent training programs show clear efficacy and effectiveness in response to young children's disruptive behavior problems, but limitations in engagement and accessibility prevent many families from benefiting from these programs. The Parenting Young Children Check-up (PYCC) is a technology-based program designed to overcome these barriers and increase the reach of behavioral parent training. Developed for use in pediatric health care, the PYCC includes three components: 1) an initial check-up designed to motivate program involvement; 2) text messages to connect parents with program content and reinforce content; and 3) a parent training website involving video-based content to teach parenting skills. This report details initial steps to refine PYCC intervention components. Methods Seventeen mothers and 17 primary care physicians participated in this mixed methods data collection across three iterations by providing feedback on early drafts of the three components of the PYCC and completing a feedback questionnaire. Results Feedback from one iteration informed modifications that were then evaluated in subsequent iterations. Saturation of qualitative input, positive qualitative feedback, and positive quantitative ratings on the feedback questionnaire was achieved in iteration three. Conclusions Outcomes of this investigation informed the full version of the PYCC that will subsequently be tested in a proof-of-concept trial. Implications for Impact Statement Several barriers limit the reach of parenting skills programs that reduce child problem behavior. We gathered feedback from parents and physicians to refine a parenting program that uses technology and delivery in pediatrics to overcome barriers. Future testing of the program will further inform implementation in pediatric settings.
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Affiliation(s)
- Lucy McGoron
- Merrill Palmer Skillman Institute for Child & Family
Development, Wayne State University
| | - Elizabeth K. Towner
- Merrill Palmer Skillman Institute for Child & Family
Development, Wayne State University
- Department of Family Medicine and Public Health Sciences,
Wayne State University
| | | | - Christopher J. Trentacosta
- Merrill Palmer Skillman Institute for Child & Family
Development, Wayne State University
- Department of Psychology, Wayne State University
| | - Sharmi Purkayestha
- Merrill Palmer Skillman Institute for Child & Family
Development, Wayne State University
| | | | - Parris Traylor
- Merrill Palmer Skillman Institute for Child & Family
Development, Wayne State University
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Burlaka J, Johnson RM, Marsack-Topolewski CN, Hughesdon K, Owczarzak J, Serdiuk O, Bogdanov R, Burlaka V. Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:586. [PMID: 38791800 PMCID: PMC11121383 DOI: 10.3390/ijerph21050586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
Depression is a pervasive issue among college students worldwide, yet there is a significant gap in the literature regarding its prevalence and coping strategies in the Ukrainian context. The present study aims to fill this gap by investigating how substance use and health-promoting behaviors relate to depressive symptoms among Ukrainian college students. Health-promoting behaviors are an important strategy to prevent depression, whereas substance use can contribute to depression or make it harder to manage. Given the substantial psychosocial problems and stressors related to the ongoing war in Ukraine and the limited availability of mental health services for college students, it is important to understand how we can encourage college students to keep themselves mentally healthy. A cross-sectional study was conducted among college students on 10 campuses in 2018. Almost 16% of participants met a cut-off for depression. Female students and those who were older reported significantly higher depressive symptoms. Participants were more likely to report depressive symptoms if they were more often involved with alcohol and cannabis use, were older, and engaged in fewer health-promoting behaviors. Tobacco use was not significantly associated with depressive symptoms. Our findings suggest a moderate prevalence of depressive symptoms in our study population. We recommend implementing balanced public health interventions that address risk factors (such as substance use) while also promoting protective behaviors and can be tailored to the specific cultural and environmental context of the region.
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Affiliation(s)
- Julia Burlaka
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1996, USA;
| | - Renee M. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1996, USA;
| | | | - Kathryn Hughesdon
- School of Nursing, Eastern Michigan University, Ypsilanti, MI 48197, USA;
| | - Jill Owczarzak
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1996, USA;
| | - Oleksii Serdiuk
- Research Lab for Psychological Support of Law Enforcement, Kharkiv National University of Internal Affairs, 61080 Kharkiv, Ukraine; (O.S.); (R.B.)
| | - Roman Bogdanov
- Research Lab for Psychological Support of Law Enforcement, Kharkiv National University of Internal Affairs, 61080 Kharkiv, Ukraine; (O.S.); (R.B.)
| | - Viktor Burlaka
- School of Social Work, Wayne State University, Detroit, MI 48202, USA
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Aschentrup L, Steimer PA, Dadaczynski K, Mc Call T, Fischer F, Wrona KJ. Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review. BMC Public Health 2024; 24:69. [PMID: 38167010 PMCID: PMC10763397 DOI: 10.1186/s12889-023-17517-3] [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: 08/14/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Though still a young field of research, gamified digital interventions have demonstrated potential in exerting a favourable impact on health and overall well-being. With the increasing use of the internet and digital devices, the integration of game elements presents novel opportunities for preventing mental disorders and enhancing mental health. Hence, this review aims to assess the effectiveness of gamified interventions focusing on preventing mental disorders or promoting mental health among adults. METHODS Based on a scoping review across four databases (MEDLINE, Embase, PsycInfo and Web of Science), 7,953 studies were initially identified. After removing duplicates and screening titles, abstracts and full texts, 16 studies were identified as suitable for inclusion in a narrative synthesis of findings. We included interventional studies encompassing an intervention and a control group aiming to investigate the effectiveness of the use of gamified digital mental health interventions and the use of gamified digital elements. RESULTS Overall, positive effects of gamified interventions on mental health-related outcomes were identified. In particular, beneficial consequences for psychological well-being and depressive symptoms were observed in all studies. However, further outcomes, such as resilience, anxiety, stress or satisfaction with life, showed heterogenous findings. Most game elements used were reward, sensation and progress, whilst the quantity of elements was not consistent and, therefore, no substantiated conclusion regarding the (optimal) quantity or composition of game elements can be drawn. Further, the outcomes, measurements and analyses differed greatly between the 16 included studies making comparisons difficult. CONCLUSION In summary, this review demonstrates the potential of integrating digital game elements on mental health and well-being with still a great gap of research. A taxonomy is needed to adequately address relevant game elements in the field of mental health promotion and prevention of mental disorders. Therefore, future studies should explicitly focus on the mechanisms of effect and apply rigorous study designs.
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Affiliation(s)
- Leona Aschentrup
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Pia Anna Steimer
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Global Public Health, Karolinska Institute, Solna, Sweden
| | - Kevin Dadaczynski
- Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Sciences, Leuphana University Lueneburg, Lueneburg, Germany
| | - Timothy Mc Call
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany.
| | - Kamil J Wrona
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
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da Conceição V, Mesquita E, Gusmão R. Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial. Psychiatry Res 2024; 331:115673. [PMID: 38113809 DOI: 10.1016/j.psychres.2023.115673] [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: 09/25/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. METHODS A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma. RESULTS Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. CONCLUSION Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.
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Affiliation(s)
- Virgínia da Conceição
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Edgar Mesquita
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ricardo Gusmão
- EPIUnit - Institute of Public Health, University of Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Portugal
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Yosep I, Suryani S, Mediani HS, Mardhiyah A, Maulana I. Digital Therapy: Alleviating Anxiety and Depression in Adolescent Students During COVID-19 Online Learning - A Scoping Review. J Multidiscip Healthc 2023; 16:1705-1719. [PMID: 37366385 PMCID: PMC10290852 DOI: 10.2147/jmdh.s416424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
The learning method has changed from offline to online since Coronavirus Disease 2019 pandemic cause mental health problems in students such as stress, anxiety, and even depression. Interventions to reduce mental health problems in adolescents need to be carried out digitally to reduce the transmission of Coronavirus Disease 2019. The purpose of this study is to explore methods of digital therapy to reduce symptoms of anxiety and depression among students during the Coronavirus Disease 2019. A scoping review study design was used in this study. Database the study from CINAHL, PubMed, and Scopus databases. This study used PRISMA Extension for Scoping Reviews (PRISMA-ScR) and for quality appraisal used JBI Quality Appraisal. The inclusion criteria for articles in this study are full text, randomized control trial or quasi-experiment research design, English language, students sample, and the publication period during COVID-19 pandemic (2019-2022). There were found 13 articles discussing digital therapy and it was found that the digital therapy model to reduce anxiety and depression includes directions through digital modules, directions via video, and asynchronous discussions via online meeting. The sample range in this study is 37-1986 students. Most of the articles come from developed countries. Delivery services of digital therapy consist of three phases, namely psycho-education, problem-solving, and implementation of problem-solving strategies. The authors found that there are four digital therapy methods, namely Improving psychological abilities, Bias-modification intervention, Self-help intervention, and Mindfulness intervention. The implementation of digital therapy must still pay attention to various aspects that affect students, so that therapists need to pay attention to physical, psychological, spiritual, and cultural aspects. Here we highlight, digital therapy interventions are proven for improving mental health by reducing depression and anxiety levels among students during the COVID-19 pandemic by paying attention to all aspects that affect students.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Suryani Suryani
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Indra Maulana
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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Edge D, Watkins ER, Limond J, Mugadza J. The efficacy of self-guided internet and mobile-based interventions for preventing anxiety and depression - A systematic review and meta-analysis. Behav Res Ther 2023; 164:104292. [PMID: 37003138 DOI: 10.1016/j.brat.2023.104292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Anxiety and depression are highly prevalent mental disorders which are associated with a considerable personal and economic burden. As treatment alone has a minimal impact on prevalence, there is now a growing focus on interventions which may help prevent anxiety and depression. Internet and mobile based interventions have been identified as a useful avenue for the delivery of preventative programmes due to their scalability and accessibility. The efficacy of interventions that do not require additional support from a trained professional (self-guided) in this capacity is yet to be explored. METHOD A systematic search was conducted on the Cochrane Library, PubMed, PsycARTICLES, PsycINFO, OVID, MEDline, PsycEXTRA and SCOPUS databases. Studies were selected according to defined inclusion and exclusion criteria. The primary outcome was evaluating the effect of self-guided internet and mobile based interventions on incidence of anxiety and depression. The secondary outcome was effect on symptom severity. RESULTS After identifying and removing duplicates, 3211 studies were screened, 32 of which were eligible for inclusion in the final analysis. Nine studies also reported incidence data (depression = 7, anxiety = 2). The overall Risk Ratios for incidence of anxiety and depression were 0.86 (95% CI [0.28, 2.66], p = .79) and 0.67 (95% CI [0.48, 0.93], p = .02) respectively. Analysis for 27 studies reporting severity of depressive symptoms revealed a significant posttreatment standardised mean difference of -0.27 (95% CI [ -0.37, -0.17], p < .001) for self-guided intervention groups relative to controls. A similar result was observed for 29 studies reporting severity of anxiety symptoms with a standardised mean difference of -0.21 (95% CI [-0.31, -0.10], p < .001). CONCLUSIONS Self-guided internet and mobile based interventions appear to be effective at preventing incidence of depression, though further examination of the data suggests that generalisability of this finding may be limited. While self-guided interventions also appear effective in reducing symptoms of anxiety and depression, their ability to prevent incidence of anxiety is less clear. A heavy reliance on symptom measures in the data analysed suggests future research could benefit from prioritising the use of standardised diagnostic measuring tools to assess incidence. Future systematic reviews should aim to include more data from grey literature and reduce the impact of study heterogeneity.
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Affiliation(s)
- Daniel Edge
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom.
| | - Edward R Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
| | - Jenny Limond
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
| | - Jane Mugadza
- Mood Disorders Centre, School of Psychology, University of Exeter, United Kingdom
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Oakes-Cornellissen A, Morton D, Rankin P, Renfrew M. Efficacy of a multimodal lifestyle intervention (The Lift Project) for improving the mental health of individuals with an affective mood disorder living in South Africa. Front Psychol 2023; 14:1127068. [PMID: 36760459 PMCID: PMC9905116 DOI: 10.3389/fpsyg.2023.1127068] [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: 12/19/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Background Affective disorders are becoming more pervasive worldwide, including in Southern Africa, where treating patients with these conditions is challenging due to social and financial constraints. A variety of non-pharmacological approaches including lifestyle medicine (e.g., exercise, nutrition, sleep) and positive psychology practices (e.g., gratitude, service), are effective for treating mental health (MH) conditions. Methods Twenty-six individuals from South Africa with a diagnosed MH condition participated in a 10-week multimodal intervention incorporating a diverse range of non-pharmacological strategies for improving MH. MH metrics were assessed pre-and post-intervention, including general MH, vitality/energy (VIT), depression, anxiety, stress, and satisfaction with life. MH and VIT were also measured weekly. Results Improvements were observed in all mental metrics from pre-to post-intervention: MH (59%, p < 0.001, Cohen's D = 1.36), VIT (110%, p < 0.001, Cohen's D = 1.71), depression (-46%, p < 0.001, Cohen's D = -1.06), anxiety (-48%, p < 0.001, Cohen's D = -1.21), stress (-36%, p < 0.001, Cohen's D = -1.08) and life satisfaction (23%, p < 0.001, Cohen's D = 0.66). Significant improvements in MH and VIT were observed after only 1 week of the intervention and progressively increased until the seventh week, after which further improvements were not statistically significant. Conclusion The findings of this cohort study indicate that a multimodal intervention that incorporates lifestyle and positive psychology practices may benefit individuals living with an affective disorder. Non-pharmacological, multimodal interventions might offer a stigma-free way of providing MH promotion and treatment at a population level.
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Baldassarini CR, Gonçalves JS, Masella TAC, de Oliveira JL, de Souza J. Evaluation of software for mental health promotion of undergraduate nursing students in the early years of college. Rev Esc Enferm USP 2022; 56:e20220006. [PMID: 36122361 PMCID: PMC10081642 DOI: 10.1590/1980-220x-reeusp-2022-0006en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/24/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate mental health promotion software for students in the early years of undergraduate nursing course. METHOD Descriptive study developed with 41 undergraduates from a private higher education institution in an inland city of the state of São Paulo, approved by the Research Ethics Committee. Data collection was carried out remotely from April to October 2021, using a sociodemographic characterization questionnaire and student assessment of the software. The results were analyzed by descriptive statistics. RESULTS Most respondents rated the tool and the clarity of its content as excellent. The modules considered most relevant were those related to solving problems with future implications. The students considered the advice very applicable to everyday life and a good correspondence between problem situations and real life. CONCLUSION This type of intervention is configured as one more option in the list of strategies to promote nursing students' mental health, although it does not replace face-to-face care.
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Affiliation(s)
- Caíque Rossi Baldassarini
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
| | | | | | - Jaqueline Lemos de Oliveira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
| | - Jacqueline de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Enfermagem Psiquiátrica, Ribeirão Preto, SP, Brazil
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Wong VWH, Ho FYY, Shi NK, Sarris J, Ng CH, Tam OKY. Lifestyle medicine for anxiety symptoms: A meta-analysis of randomized controlled trials. J Affect Disord 2022; 310:354-368. [PMID: 35523299 DOI: 10.1016/j.jad.2022.04.151] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lifestyle medicine (LM) is gaining increasing attention as a treatment option for anxiety, but the current state of evidence has not yet been systematically examined. METHODS Six electronic databases were systematically searched from inception to February 2022. Randomized controlled trials (RCTs) comparing the effects of multicomponent LM interventions on anxiety symptoms with either care-as-usual, waitlist, no intervention, or attention control group on anxiety symptoms were identified. RESULTS A total of 53 RCTs with 18,894 participants were included for qualitative synthesis, in which 45 RCTs with data available were included for meta-analysis. Multicomponent LM intervention was significantly more effective than the control groups in reducing anxiety symptoms at immediate posttreatment (d = 0.19, p < .001) and at short-term follow-up (d = 0.29, p < .001). However, no significant difference at medium-term was found (p = .14), whereas more studies are needed to study the long-term effects. The subgroup analyses suggested that baseline anxiety symptoms was a significant moderator, suggesting that those with moderate level of baseline anxiety symptoms appeared to have greater improvements (d = 0.66, p < .05). LIMITATIONS Minimal anxiety symptoms at baseline contributed to the floor effect and influenced the degree of improvement. The included RCTs had a high risk of bias in general with potential publication bias detected. CONCLUSION The findings of this meta-analysis provided support for the positive effects of multicomponent LM interventions for anxiety symptoms. Future research is needed to determine the long-term effects of multicimponent LM and the optimal baseline anxiety severity.
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Affiliation(s)
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong.
| | - Nga-Kwan Shi
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Jerome Sarris
- Western Sydney University, NICM Heath Research Institute, Westmead, NSW, Australia; Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, VIC, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, The University of Melbourne, Richmond, VIC, Australia
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Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022; 9:954644. [PMID: 35957845 PMCID: PMC9361711 DOI: 10.3389/fmed.2022.954644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months. The interventions were offered as an adjuvant treatment delivered in Primary Healthcare Centers (PHCs) for people with depression symptoms. Methods We conducted an open-label, multicentre, pragmatic, randomized clinical trial. Participants were recruited from several PHCs. Those participants visiting general practitioner for any reason, who also met the inclusion criteria (scoring 10 to 30 points on the Beck II Self-Applied Depression Inventory) were invited to take part in the study. TAU+LMP consisted of six weekly 90-min group sessions focused on improving lifestyle. TAU+LMP + ICTs replicated the TAU+LMP format, plus the addition of a wearable smartwatch to measure daily minutes walked and sleep patterns. A total of 188 participants consented to participate in the study and were randomized. We used linear mixed models, with a random intercept and an unstructured covariance to evaluate the impact of the interventions compared to TAU. Results Both interventions showed a statistically significant reduction on depressive symptoms compared to TAU (TAU+LMP vs. TAU slope difference, b = −3.38, 95% CI= [−5.286, −1.474] p = 0.001 and TAU+LMP+ICTs vs. TAU slope difference, b = −4.05, 95% CI = [−5.919, −2.197], p < 0.001). These reductions imply a moderate effect size. In the TAU+LMP+ICTs there was a significant increase regarding minutes walking per week (b = 99.77) and adherence to Mediterranean diet (b = 0.702). In the TAU+LMP there was a significant decrease regarding bad sleep quality (b = −1.24). Conclusion TAU+LMPs administered in PHCs to people experiencing depression symptoms were effective on reducing these symptoms compared to TAU. They also have a positive impact on changing several lifestyle factors. These findings indicate that these interventions can be promising strategies for PHCs.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Guillermo Pérez Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | | | - María J. Serrano-Ripoll
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Research in Preventive Activities and Promotion and in Cancer Illes Balears (GRAPP-CAIB), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Barcelona, Spain
- *Correspondence: María J. Serrano-Ripoll
| | - Bárbara Oliván-Blázquez
- Primary Healthcare Center Arrabal, Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Baldassarini CR, Gonçalves JS, Masella TAC, de Oliveira JL, de Souza J. Avaliação de um software de promoção da saúde mental para graduandos de enfermagem dos anos iniciais. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0006pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Avaliar um software de promoção da saúde mental destinado a estudantes dos anos iniciais da graduação em enfermagem. Método: Estudo descritivo desenvolvido com 41 graduandos de uma instituição privada de ensino superior do interior do estado de São Paulo, aprovado pelo Comitê de Ética em Pesquisa. A coleta de dados foi realizada de forma remota de abril a outubro de 2021, usando um questionário de caracterização sociodemográfica e avaliação dos estudantes acerca do programa. Os resultados foram analisados por estatística descritiva. Resultados: A maioria dos participantes classificou a ferramenta e a clareza de seu conteúdo como excelentes. Os módulos considerados mais relevantes foram aqueles relacionados à resolução de problemas com implicações futuras. Os estudantes consideraram os aconselhamentos muito aplicáveis ao cotidiano e uma boa correspondência das situações-problema com a vida real. Conclusão Essa modalidade de intervenção configura-se como mais uma opção no rol de estratégias de promoção da saúde mental de graduandos de enfermagem, ainda que não substitua o cuidado face-a-face.
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Tsai CL, Tu CH, Chen JC, Lane HY, Ma WF. Efficiency of an Online Health-Promotion Program in Individuals with At-Risk Mental State during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211875. [PMID: 34831631 PMCID: PMC8622344 DOI: 10.3390/ijerph182211875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
Mental health issues caused by the COVID-19 pandemic greatly impact people’s daily lives. Individuals with an at-risk mental state are more vulnerable to mental health issues, and these may lead to onset of full psychotic illnesses. This study aimed to develop and evaluate an online health-promotion program for physical and mental health of the individuals with at-risk mental state during the COVID-19 pandemic. A single group study with pre- and post-tests was conducted in 39 young adults with at-risk mental state. The participants were provided with the online health-promotion program after completing the pretest. Via social media, the online counseling program released one topic of material (about 15–20 min) every two weeks and provided interactive counseling for specific personal health needs on the platform. Study questionnaires, physiological examination, and blood serum examination were completed at both pre- and post-tests. The participants showed significant improvements in mental risk, anxiety, and physical activity after participating in the program. Furthermore, those who did not complete the program had significantly more severe negative symptoms. These results imply that the online health-promotion program is effective and accessible under certain barriers such as the COVID-19 pandemic, but not for individuals with higher risk of more negative mental health symptoms.
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Affiliation(s)
- Ching-Lun Tsai
- Department of Public Health (in Epidemiology and Preventive Medicine), China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung 406040, Taiwan;
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404333, Taiwan;
| | - Jui-Cheng Chen
- Neuroscience Laboratory, Department of Neurology, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan;
- School of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404333, Taiwan
- Department of Neurology, China Medical University, No. 199, Sec. 1, Xinglong Rd., Hsinchu County 302056, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, No. 91 Hsueh-Shih Road, Taichung 404333, Taiwan
- Department of Psychiatry, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 404332, Taiwan
- Department of Psychology, College of Medical and Health Sciences, Asia University, No. 500, Lioufeng Rd., Wufeng, Taichung 41354, Taiwan
- Correspondence: (H.-Y.L.); (W.-F.M.); Tel.: +886-4-2205-2121 (ext. 1855) (H.-Y.L.); +886-4-2205-3366 (ext. 7107) (W.-F.M.); Fax: +886-4-2236-1230 (H.-Y.L.); +886-4-2205-3748 (W.-F.M.)
| | - Wei-Fen Ma
- PhD Program for Health Science and Industry and School of Nursing, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung 406040, Taiwan
- Department of Nursing, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 404332, Taiwan
- Correspondence: (H.-Y.L.); (W.-F.M.); Tel.: +886-4-2205-2121 (ext. 1855) (H.-Y.L.); +886-4-2205-3366 (ext. 7107) (W.-F.M.); Fax: +886-4-2236-1230 (H.-Y.L.); +886-4-2205-3748 (W.-F.M.)
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Przybylko G, Morton D, Morton J, Renfrew M. The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study. JMIR Ment Health 2021; 8:e29866. [PMID: 34762058 PMCID: PMC8663468 DOI: 10.2196/29866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/21/2021] [Accepted: 10/03/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood. OBJECTIVE The aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting. METHODS This study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the "mental health" and "vitality" subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program. RESULTS On average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures. CONCLUSIONS Digital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619000993190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377889 and Australian New Zealand Clinical Trials Registry ACTRN12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx.
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Affiliation(s)
- Geraldine Przybylko
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
| | - Darren Morton
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
| | - Jason Morton
- Faculty of Education, Business and Science, Avondale University, Cooranbong, Australia
| | - Melanie Renfrew
- Lifestyle Medicine and Health Research Centre, Avondale University, Cooranbong, Australia
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Renfrew ME, Morton DP, Morton JK, Przybylko G. The Influence of Human Support on the Effectiveness of Digital Mental Health Promotion Interventions for the General Population. Front Psychol 2021; 12:716106. [PMID: 34489818 PMCID: PMC8416605 DOI: 10.3389/fpsyg.2021.716106] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/28/2021] [Indexed: 11/25/2022] Open
Abstract
Mental wellbeing amongst the general population is languishing—exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. Digital mental health promotion interventions, that improve mental health literacy and encourage adoption of evidence-informed practical strategies are essential. However, attrition and non-adherence are problematic in digital interventions. Human support is often applied as an antidote; yet, there is a paucity of randomized trials that compare different human support conditions amongst general population cohorts. Limited trials generally indicate that human support has little influence on adherence or outcomes in DMHPIs. However, providing participants autonomy to self-select automated support options may enhance motivation and adherence.
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Affiliation(s)
- Melanie Elise Renfrew
- Lifestyle Medicine and Health Research Center, Avondale University College, Cooranbong, NSW, Australia
| | - Darren Peter Morton
- Lifestyle Medicine and Health Research Center, Avondale University College, Cooranbong, NSW, Australia
| | - Jason Kyle Morton
- Lifestyle Medicine and Health Research Center, Avondale University College, Cooranbong, NSW, Australia
| | - Geraldine Przybylko
- Lifestyle Medicine and Health Research Center, Avondale University College, Cooranbong, NSW, Australia
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