Quantitative evaluation of urban green exposure and its impact on human health: A case study on the 3-30-300 green space rule

BACKGROUND AND AIMS

Urban green spaces offer various health benefits, yet the impact of comprehensive green exposure criteria on multidimensional health remains unclear. The 3-30-300 green space rule represents the green exposure indicators with specific thresholds. This study aims to quantitatively evaluate urban green exposure in cities and can support investigation of its relationship with human health.

METHODS

We conducted a cross-sectional study based on 902 investigated individuals in 261 residential locations aged 11-95 years from Xiamen City, China. 3-30-300 green exposure was calculated using field surveys, GIS, and Baidu Maps Application Programming Interface (API). Physical health data was based on Occupational Stress Indicator (OSI)-2. Mental health was from the 12-item General Health Questionnaire (GHQ-12). Social health was from a self-constructed evaluation questionnaire. Statistical analyses were conducted using Geographically Weighted Regression and Geographically Weighted Logistic Regression for global and local effects on green exposure and multidimensional health.

RESULT

Among the investigated individuals, only 3.55 % (32/902) fully meet the 3-30-300 rule in Xiamen. Global results show that individuals achieved at least 30 % vegetation coverage (Yes) is associated with better physical (β: 0.76, p < 0.01) and social (β: 0.5, p < 0.01) health. GWLR global results indicate that individuals can "see at least 3 trees from home" meeting one (OR = 0.46, 95%CI: 0.25-0.86, p < 0.05) or two (OR = 0.41, 95%CI: 0.22,0.78, p < 0.01; OR = 0.24, 95%CI: 0.07-0.77, p < 0.05) 3-30-300 rule components are significantly associated with reduced medical visits and hospitalizations refer to not met these criterias. In the GWR local analysis, achieved 30 % vegetation cover is significantly related to improved social health at all locations. Meeting any two indicators also contribute to improved social health (n = 511, β: 0.46-0.51, P < 0.05).

CONCLUSION

Green exposure indicators based on the 3-30-300 rule guiding healthy urban green space development. We observed multidimensional health benefits when 1/3 or 2/3 of the indicators were met.

"Relationships, Very Quickly, Turn to Nothing": Loneliness, Social Isolation, and Adaptation to Changing Social Lives Among Persons Living With Dementia and Care Partners

BACKGROUND AND OBJECTIVES

Persons with dementia and their care partners have known risks for loneliness and social isolation throughout the disease trajectory, yet little is described about social lives in a population heterogeneous for disease stage, syndrome type, and setting.

RESEARCH DESIGN AND METHODS

We conducted a secondary analysis of qualitative interviews from multiple studies to triangulate responses from a cohort of persons with dementia (n = 24), and active (n = 33) or bereaved (n = 15) care partners diverse in setting, dementia type and stage, and life experience. Interviews explored challenges related to social lives and were analyzed thematically.

RESULTS

Persons with dementia were on average 80 years old (range: 67-94), 38% female, and 78% diagnosed with Alzheimer's dementia; care partners were on average 67 years old (range: 40-87) and 69% female. We identified 3 primary themes. First, dyads lost external social networks due to complex factors, including discomfort of surrounding social networks, caregiving responsibilities, and progressive cognitive deficits. Second, care partners described disruptions of meaningful dyadic relationships due to progressive cognitive and functional deficits, leading to loneliness and anticipatory grief. Third, adaptive strategies centered on care partners facilitating shared social activities and programs addressing caregiver burden. An overarching theme of disease-course accumulation of barriers to social interactions and constant adaptations was present in all themes.

DISCUSSION AND IMPLICATIONS

Isolation and loneliness are a shared experience and source of distress for persons with dementia and care partners. Results can inform interventions tailored to individual needs and disease stages of dyads that enhance social connectedness.

Autonomy and its relevance for the construction of personhood in dementia- a thematic synthesis

BACKGROUND

This article examines the concept of autonomy in the context of person-centred dementia research and care, which is frequently being used but not clearly defined. Also, there is no clear conceptual relation between autonomy and personhood in this context.

METHODS

Therefore, literature on person-centred dementia research and care was examined to answer the following question: How is the concept of autonomy discussed in person-centred dementia research and care literature?

RESULTS

This analysis revealed heterogeneous perspectives on autonomy within the context of dementia. These were assigned to two different perspectives on personhood: one that links personhood to the existing cognitive abilities and the other one, that understands personhood relationally as the result of a socially constructed process. These results are discussed with regard to a nursing and care practice that could be considered as being deficit-oriented, but also with regard to the concept of social health in dementia.

CONCLUSIONS

Derived from this analysis, there is a clear need for general conceptual sensitivity in this field. Also, an in-depth examination of the social constructionist approach to personhood in the context of dementia is warranted.

Statistical groupings of mental and social health measurements correlate with musculoskeletal capability - A cross sectional study

OBJECTIVE

A better understanding of the degree to which social health factors contribute uniquely to statistical clusters associated with variation in levels of capability might inform targeted whole person care strategies for more comprehensive management of musculoskeletal health. Therefore, we asked: (1) What are the statistical groupings of social and mental health measurements in patients seeking specialty care for musculoskeletal conditions? (2) Do identified psychosocial groupings correspond with different mean magnitudes of incapability accounting for demographic and clinical factors?

METHODS

We included 158 patients seeking musculoskeletal specialty care and collected measures of magnitude of incapability, unhelpful thoughts and distress regarding symptoms, symptoms of depression, symptoms of anxiety, and social health. A k-means clustering algorithm was fit to the data and a linear regression model compared mean PROMIS-PF CAT scores for grouping.

RESULTS

A quantitative social health measure contributed to 4 statistical clusters as follows: 1) relatively low levels of all mental health measures and high social health; 2) greater unhelpful thoughts and distress regarding symptoms, average symptoms of general anxiety and depression, and average social health; 3) higher levels of all mental health measures and severely compromised social health; and 4) severely compromised mental health and lower social health. Magnitude of incapability was significantly greater for groups with worse mental and social health.

CONCLUSION

The finding of a relatively independent association of social and mental health factors with greater incapability supports the importance of introducing comprehensive health strategies in musculoskeletal specialty care. Strategies may include mindset training and case management of social unmet needs.

LEVEL OF EVIDENCE

Level III; Cross-sectional study.

What is the Impact of Human Trafficking on the Biopsychosocial Health of Victims: A Systematic Review

The health consequences of human trafficking have been poorly researched compared to other aspects of this crime. A systematic review was carried out to study health from a broader perspective, beyond psychophysical symptoms, to understand the global impact of human trafficking on sexual, social, physical, and psychological health. The search identified many studies focused on the violence of sex trafficking in female samples. This work leads us to conclude that social health is an important dimension of the well-being of trafficking victims. More studies are needed on aspects of social health, especially regarding research gaps related to spirituality and nutrition, thus continuing preventing and combating human trafficking. Many gender biases were also discovered: unlike studies of trafficking in women, the few studies on men did not look at parenting, sexual health, marital status, or sex trafficking.

Social Health Is Associated With Tract-Specific Brain White Matter Microstructure in Community-Dwelling Older Adults

Background

Poor social health has been linked to a risk of neuropsychiatric disorders. Neuroimaging studies have shown associations between social health and global white matter microstructural integrity. We aimed to identify which white matter tracts are involved in these associations.

Methods

Social health markers (loneliness, perceived social support, and partnership status) and white matter microstructural integrity of 15 white matter tracts (identified with probabilistic tractography after diffusion magnetic resonance imaging) were collected for 3352 participants (mean age 58.4 years, 54.9% female) from 2002 to 2008 in the Rotterdam Study. Cross-sectional associations were studied using multivariable linear regression.

Results

Loneliness was associated with higher mean diffusivity (MD) in the superior thalamic radiation and the parahippocampal part of the cingulum (standardized mean difference for both tracts: 0.21, 95% CI, 0.09 to 0.34). Better perceived social support was associated with lower MD in the forceps minor (standardized mean difference per point increase in social support: -0.06, 95% CI, -0.09 to -0.03), inferior fronto-occipital fasciculus, and uncinate fasciculus. In male participants, better perceived social support was associated with lower MD in the forceps minor, and not having a partner was associated with lower fractional anisotropy in the forceps minor. Loneliness was associated with higher MD in the superior thalamic radiation in female participants only.

Conclusions

Social health was associated with tract-specific white matter microstructure. Loneliness was associated with lower integrity of limbic and sensorimotor tracts, whereas better perceived social support was associated with higher integrity of association and commissural tracts, indicating that social health domains involve distinct neural pathways of the brain.

FindMyApps compared with usual tablet use to promote social health of community-dwelling people with mild dementia and their informal caregivers: a randomised controlled trial

Background

FindMyApps is a tablet-based eHealth intervention designed to help people learn to use a tablet and find easy-to-use apps. This study evaluated the effectiveness of FindMyApps for supporting social health of people living with dementia, and sense of competence of their informal caregivers.

Methods

A single-centre, two-arm, non-blinded randomised controlled trial was conducted (Netherlands Trial Register NL8157). From 1st January 2020 to 31st July 2022, community-dwelling people in the Netherlands with a pre-established diagnosis of mild cognitive impairment (MCI) or dementia (Brief Cognitive Rating Scale 17-32), an informal caregiver and internet connection were allocated by block randomisation to receive FindMyApps or digital care-as-usual. Primary outcomes (measured at baseline and after three months) for people with dementia/MCI were self-management (Adult Social Care Outcomes Toolkit total score) and social participation (Maastricht Social Participation Profile frequency and diversity scores), and for caregivers, sense of competence (Short Sense of Competence Questionnaire total score). Between-group differences were tested by MANCOVA or ANCOVA (alpha = 0.05).

Findings

150 dyads were randomised (FindMyApps n = 76, care-as-usual n = 74). Follow-up data were available for 128 dyads (FindMyApps n = 64, care-as-usual n = 64), who were included in the analysis in the trial arm to which they were assigned. No harms of the intervention were identified. There were no statistically significant differences in outcomes for people with dementia/MCI at group level. Diagnosis and experiencing apathy appeared to be relevant effect modifiers of secondary outcomes (neuropsychiatric symptoms, positive affect, sense of belonging, and pleasurable activities). Caregivers who received FindMyApps had higher sense of competence at three months (F [1,123] = 7.01, p = 0.0092, η2 = 0.054).

Interpretation

Overall we found no evidence that the FindMyApps intervention better supported social participation or self-management of people with MCI/dementia than digital care-as-usual. FindMyApps does seem to better support informal caregivers' sense of competence. For people with a diagnosis of mild dementia and older people, better tailored interventions, implementation and outcome measures may be needed.

Funding

Marie Skłodowska Curie Actions Innovative Training Network H2020 MSCA ITN, grant agreement number 813196.

Adolescents' Perspectives on Facilitators and Barriers to Social Health in the Family: A Qualitative Study

BACKGROUND

Family plays the most fundamental role in the adolescent's health. A deep understanding of family characteristics, beliefs, and function about the adolescent social health provides a framework, relying on which one can perceive how this dimension of health is developed and promoted in this setting. In this study, we aimed to understand the family context that facilitates or limits adolescent social health.

METHODS

Fifty-four adolescents and fifteen parents participated using a purposive sampling method. The findings were collected through semi-structured interviews and group discussions. The data was analyzed through conventional content analysis by the MAXQDA10 software.

RESULTS

Healthy and unhealthy family reactions are the two main categories that facilitate and limit the adolescents' social health. Sub-categories of healthy reactions included effective guidance, cultural safeguard, and accountable interactions. The unhealthy family reactions included sub-categories of poor intergenerational perception and passive parenting.

CONCLUSION

Our findings revealed that the family context of the adolescent's social health ranged from healthy to unhealthy responses. These results can contribute to improving and designing interventions for promoting the adolescent's social health. It is essential for policymakers and health experts to pay attention to the family empowerment approaches.

The impact of sports participation on mental health and social outcomes in adults: a systematic review and the 'Mental Health through Sport' conceptual model

BACKGROUND

Sport is a subset of physical activity that can be particularly beneficial for short-and-long-term physical and mental health, and social outcomes in adults. This study presents the results of an updated systematic review of the mental health and social outcomes of community and elite-level sport participation for adults. The findings have informed the development of the 'Mental Health through Sport' conceptual model for adults.

METHODS

Nine electronic databases were searched, with studies published between 2012 and March 2020 screened for inclusion. Eligible qualitative and quantitative studies reported on the relationship between sport participation and mental health and/or social outcomes in adult populations. Risk of bias (ROB) was determined using the Quality Assessment Tool (quantitative studies) or Critical Appraisal Skills Programme (qualitative studies).

RESULTS

The search strategy located 8528 articles, of which, 29 involving adults 18-84 years were included for analysis. Data was extracted for demographics, methodology, and study outcomes, and results presented according to study design. The evidence indicates that participation in sport (community and elite) is related to better mental health, including improved psychological well-being (for example, higher self-esteem and life satisfaction) and lower psychological ill-being (for example, reduced levels of depression, anxiety, and stress), and improved social outcomes (for example, improved self-control, pro-social behavior, interpersonal communication, and fostering a sense of belonging). Overall, adults participating in team sport had more favorable health outcomes than those participating in individual sport, and those participating in sports more often generally report the greatest benefits; however, some evidence suggests that adults in elite sport may experience higher levels of psychological distress. Low ROB was observed for qualitative studies, but quantitative studies demonstrated inconsistencies in methodological quality.

CONCLUSIONS

The findings of this review confirm that participation in sport of any form (team or individual) is beneficial for improving mental health and social outcomes amongst adults. Team sports, however, may provide more potent and additional benefits for mental and social outcomes across adulthood. This review also provides preliminary evidence for the Mental Health through Sport model, though further experimental and longitudinal evidence is needed to establish the mechanisms responsible for sports effect on mental health and moderators of intervention effects. Additional qualitative work is also required to gain a better understanding of the relationship between specific elements of the sporting environment and mental health and social outcomes in adult participants.

A cohort study reveals different dynamics of SARS-CoV-2-specific antibody formation after Comirnaty and Vaxzevria vaccination

The Coronavirus (COVID-19) Disease Pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has affected millions of people worldwide, prompting a collective effort from the global scientific community to develop a vaccine against it. This study purports to investigate the influence of factors such as sex, age, type of vaccination (Comirnaty, BNT162b2, Pfizer Inc. or Vaxzevria, ChAdOx1-S, Oxford/AstraZeneca), and time since vaccine administration on the process of antibody production. Both of them are based on the introduction of SARS-CoV-2 spike protein (S protein) to the body using different mechanisms (mRNA and recombinant adenovirus, respectively). S protein is responsible for host cell attachment and penetration via its receptor-binding domain (RBD domain). The level of anti-RBD IgG antibodies was tested with an ELISA-based immunodiagnostic assay in serum samples from a total of 1395 patients at 3 time points: before vaccination, after the first dose, and after the second dose. Our novel statistical model, the Generalized Additive Model, revealed variability in antibody production dynamics for both vaccines. Interestingly, no discernible variation in antibody levels between men and women was found. A nonlinear relationship between age and antibody production was observed, characterized by decreased antibody levels for people up to 30 and over 60 years of age, with a lack of correlation in the middle age range. Collectively, our findings further the understanding of the mechanism driving vaccine-induced immunity. Additionally, we propose the Generalized Additive Model as a standardized way of presenting data in similar research.

Have Middle-Aged and Older Americans Become Lonelier? 20-Year Trends From the Health and Retirement Study

OBJECTIVES

Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves); (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone; and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years).

METHODS

Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841-23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup samples (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model.

RESULTS

Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928-1945, with university education, working, married/partnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger.

DISCUSSION

Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention.

Socio-Economic Characteristics and Risk Factors Affecting Domestic Violence in Montenegro: A Case-Control Study

Background

Domestic violence is defined as the combined pattern of physical, psychological, economic and/or sexual violence against a family member. Intimate partner violence is the most common form. We aimed to present the basic characteristics of the Montenegrin families and family members affected by domestic violence, with the intent to inform the global mosaic of differences related to cultural specificities.

Methods

A cross-sectional study was performed using 323 cases judicially processed and officially judged according to Criminal Act from 2015-2017 in Montenegro. Socioeconomic characteristic were investigated followed by analysis of many variables.

Results

Demographic characteristics, socio-economic status, and other characteristics of the perpetrators and the victims, as well as characteristics of violent act with posible risk factors, are presented. The results of case-control analyisis of intimate-partner relationships are given, too.

Conclusion

A typical example of domestic violence in Montenegro shows an intimate couple with a violent male and a victimized female partner, living in a rented residence in the suburbs, with both partners in the fourth decade of their lives. The most frequent income level was poor, with half of the batterers and nearly three quarters of the victims unsatisfied with their marriage. The increased presence of such factors (both modifiable and unmodifiable) in the partiarchical families suffering from domestic violence should spark interest in public health and government authorities regarding domestic violence screening adapted for patriarchical societies.

A qualitative investigation of health benefits through a modified Taekwondo activity among nursing home residents

BACKGROUND

A few studies suggest that Taekwondo is an effective intervention in increasing physical functions among older adults. This study is intended to focus on a multitude of health benefits of participation in a modified Taekwondo activity for nursing home residents in the U.S.

METHODS

This qualitative study used semi-structured, in-depth interviews with seven participants consisting of 2 males and 5 females older adults from a community nursing home. The interview protocol included content mapping and content mining interview questions. The study followed the five steps of constant comparative analysis.

RESULTS

Four main themes were identified as health benefits resulting from a modified Taekwondo participation: (a) promoting mental health, (b) increasing physical functions, (c) stimulating cognitive abilities, and (d) facilitating positive social interaction.

DISCUSSION

This study indicates modified Taekwondo can be instrumental in promoting their physical functioning, cognitive functioning, social interactions, and mental health. Practical implications and further discussion are addressed in this paper.

Magnitude of Incapability and Pain Intensity are Associated More with Unhelpful Thoughts Than Stressful Life Events

Prior studies show that stressful life events are associated with greater magnitude of incapability and symptom intensity. We sought to understand the association of such events (i.e., both adverse childhood experiences and recent difficult life events [DLEs]) alongside feelings of worry or despair and unhelpful, on the magnitude of incapability and symptom intensity in musculoskeletal patients. One hundred and thirty-six patients presenting for musculoskeletal specialty care completed measures of incapability, pain intensity, adverse childhood experiences, DLEs in the last year, unhelpful thoughts, symptoms of anxiety and depression, and sociodemographic factors. Factors associated with the magnitude of incapability and pain intensity were sought in multivariable analysis. Accounting for potential confounders, greater incapability was associated with greater unhelpful thoughts (RC  =  -0.81; 95% CI  =  -1.2 to -0.42; P  ≤  .001), but not with stressful life events (either during childhood or more recently). Greater pain intensity was associated with greater unhelpful thoughts(RC  =  0.25; 95% CI  =  0.16 to 0.35; P  ≤  .001) and being divorced or widowed (RC  =  1.8; 96% CI  =  0.43 to 3.2; P  =  .011), but again, not with stressful life events. The strong association of unhelpful thoughts with magnitude of incapability and pain intensity can motivate musculoskeletal specialists to anticipate patients expressing negative pain thoughts and behaviors. Future studies might account for social and environmental context behind stressful life events and the influence of resiliency and pain-coping strategies on these interactions.

Level of Evidence

Level III, prognostic study.

Quality of life in the elderly: A community study

Background

Standard information about the physical, mental, and social status of older people is needed to promote their health. The aim of this study was to determine the physical, mental and social health status of older people in Mazandaran, taking into account the specific climatic conditions and public culture, and to adapt it to the indicators of the "Aging and Health Program" of the World Health Organization (WHO) to localize and better use this index.

Methods

In this cross-sectional study, 390 elderly aged ≥65 years in Mazandaran were selected by the quota method. Their physical, mental, and social health status and demographic information were collected using a questionnaire (a 36-item short-form health survey (SF-36)) and face-to-face interviews. Physical and mental health status was classified into five levels based on the score obtained. The data were analyzed using SPSS 26.

Results

The average age of the elderly was 71.48 years. In terms of physical performance, 40.7% of the elderly were below and 30.8% above the average of international standards. In terms of mental health, 18.9 and 41.5% of the elderly were below and above the average, respectively, and 17 and 51.8% of the elderly had low and high social performance, respectively. The Pearson correlation test showed a significant relationship between physical health (0.176), mental health (0.16), and social health (0.178) and quality of life at the 0.01 level.

Conclusion

The physical, mental and social health status of the elderly in Mazandaran is far from the indicators of health in old age established by WHO, and their condition is unfavorable (at least in terms of physical and mental health).

Urban park use and self-reported physical, mental, and social health during the COVID-19 pandemic: An on-site survey in Beijing, China

The COVID-19 pandemic created unprecedented challenges for people's health. Studies have demonstrated the positive impact of urban green spaces, particularly urban parks, on physical and mental health. However, few studies have evaluated social health, which is a component of human health, and more understanding of the relationship between urban parks and human health during the COVID-19 pandemic is required. This study examined the effects of urban parks on people's health using a canonical correlation model. Physical, mental, and social health were the dependent health variables, and five factors related to urban parks were the independent variables. This study investigated 22 urban parks inside the Forth Ring Road in Beijing, China using a questionnaire survey. The results demonstrated a positive association between urban parks and human health during the pandemic. Distance to the parks, park area, and park size were positively correlated with physical, mental, and social health. Furthermore, frequency and duration of visits to urban parks were positively associated with mental health and contact with neighbors. The health effects of urban park use varied with park types and locations' urbanization background. These findings can provide insights for health-oriented urban park planning and construction.

Sense of purpose in life and concurrent loneliness and risk of incident loneliness: An individual-participant meta-analysis of 135,227 individuals from 36 cohorts

BACKGROUND

Sense of purpose, the feeling that one's life is goal-oriented and driven, tends to be protective for psychological health. Less is known about its relation with social health, particularly loneliness. We test whether the cross-sectional association between purpose and loneliness is replicable and whether purpose protects against the development of incident loneliness over time.

METHODS

Participants from 36 cohorts (total N = 135,227; age range 18-109) reported on their sense of purpose, loneliness, and psychological distress. Follow-up measures of loneliness were available in 28 cohorts that ranged from six weeks to 15 years. Prospective, random-effect meta-analysis was used to summarize the cross-sectional and longitudinal associations from each cohort.

RESULTS

Sense of purpose was associated significantly with less loneliness in all 36 cohorts, controlling for sociodemographic factors (meta-analytic mean effect estimate = -0.31, 95% CI = -0.34, -0.29, p < .001). This association was stronger among participants experiencing concurrent severe psychological distress. Sense of purpose was protective against the development of new incident loneliness (meta-analytic mean hazard ratio estimate = 0.85, 95% CI = 0.82, 0.87, p < .001). Age did not moderate any of the associations.

LIMITATIONS

Limitations include the lack of lower-income countries. The mechanisms that explain this association also need to be identified in future research.

CONCLUSIONS

Sense of purpose is associated with less loneliness and with protection against developing loneliness over time, associations that replicated across cohorts from North America, South America, Europe, and the Middle East. Sense of purpose may be a useful target of intervention to prevent or reduce loneliness, especially among individuals suffering from psychological distress.

Priorities for Advancing Mental and Social Health Among People Presenting for Care of Musculoskeletal Symptoms : International Consortium for Mental and Social Health in Musculoskeletal Care

An international group of clinicians and researchers formed a consortium to advance mental and social health among people seeking musculoskeletal specialty care: The International Consortium for Mental and Social Health in Musculoskeletal Care (I-MESH). As a first step to organize the work of the consortium, we sought to identify important, appropriate, and feasible interventions to address mental and social health. Members of I-MESH responded to a list of 10 queries intended to elicit mental and social health priorities. Open text answers were analyzed by 2 researchers to elicit individual themes. A modified RAND/UCLA Delphi Appropriateness process was conducted of 32 candidate social and mental health priorities using a 15-person panel of I-MESH members, using 2 rounds of independent voting with intervening discussion via surveys and video teleconferences. Panelists rated each potential priority for importance, feasibility, and appropriateness on a 9-point Likert scale. Top level priorities scored both mean and median greater than 7 in all 3 categories. Second level priorities scored a median 7 or greater on the final scoring in all 3 categories. Candidate priorities were organized into 9 themes: viable business model, coordination of specialty and non-specialty care, actionable measurement, public health/cultural interventions, research, adequate and timely access, incorporating assessment in care, strategies to develop the patient-clinician relationship, communication strategies that can directly enhance health, and support for mental and social health. Twelve top level (met mean and median criteria) and 17 s level priorities (met median criterion) were identified. Implementing evidence-based strategies to efficiently diagnose, prioritize, and begin addressing mental and social health opportunities has the potential for notable impact on both musculoskeletal and overall health. It is our hope that the results of this Delphi panel will generate enthusiasm and collaboration for implementing the mounting evidence that social and mental health are integral to musculoskeletal health.

Examining the role that weight perception and social influences have on mental health among youth in the COMPASS study

PURPOSE

We investigated whether social health mitigates the association between weight perception and anxiety and depression 1 year later in a large sample of Canadian youth in a prospective, gender-specific analysis.

METHODS

We used 2 years of linked survey data from 20,485 grade 9-11 students who participated in wave 6 (2017/18) and 7 (2018/19) of the COMPASS study. Mental health outcomes included the Generalized Anxiety Disorder-7 item (GAD-7) scale and the 10-item Centre for Epidemiological Studies Depression Scale Revised (CESD-10-R). Social health encompassed students' perceived relationships with friends, family, teachers, and within schools. Multilevel, prospective, linear models regressed mental health (at wave 7) on social health (at wave 6) and weight perception (at wave 6) while controlling for weight status, ethnicity, and grade (at wave 6). Interaction terms were used to test social health factors as moderators in the association between weight perception and mental health.

RESULTS

Overweight perceptions were associated with higher anxiety and depression scores among youth; this was more pronounced among females. Social health was associated with lower anxiety and depression scores. Among females only, an overweight perception had the highest predicted scores for significant depressive symptoms. Among males only, underweight perceptions were associated with higher anxiety scores. No social health factors had moderating effects in females, and only two interactions were significant among males: feeling safe at school had protective associations with anxiety scores among those with underweight perceptions while those with overweight perceptions had higher depression scores when they reported rewarding social relationships.

CONCLUSION

Overweight perceptions in all youth, and underweight perceptions in males, predicted anxiety and depression symptoms 1 year later. The role of social health should not be discounted as a means of preventing anxiety and depression in youth, although this study suggests it is not sufficient to protect against adverse associations with overweight perceptions for all youth, and underweight perceptions for males.

Meal kits in the family setting: Impacts on family dynamics, nutrition, social and mental health

Families face many barriers in providing nutritious home-cooked family meals. Meal kit subscription services are increasingly popular among families and may address obstacles to cooking at home and facilitate shared family meals. This study aimed to understand why families use meal kits and what they perceived to be the main impacts on family dynamics, nutrition, social and mental health. Sixteen primary meal providers with at least one child 18 years and under living at home, were recruited via social media (e.g., Facebook, Twitter) to participate in a semi-structured interview using Zoom videoconferencing. Interviews were conducted with participants who currently purchased and used commercially available meal kits in Australia (e.g., HelloFresh, Marley Spoon). Thematic analysis of interview transcripts revealed that women, as the primary carers responsible for family meals, primarily reported the role that meal kits played in reducing their mental load through reduced food-related decision making, enhanced family participation in meal preparation, and opportunities for food literacy. Additionally, meal kits were reported to reduce food eaten away-from-home with the majority of participants perceiving meal kits to provide nutritionally dense meals and appropriate portion sizes aligned with National dietary guidelines. This study provides important insights into the potential physical, mental and social health benefits of meal kits in supporting families to cook and eat meals together at home. While meal kits have the capacity to positively influence population health and wellbeing, it is necessary that meal kit subscription services address the nutritional quality of their meals and provide evidence-based nutrition messaging to facilitate improvements in food literacy and nutritional intake.

Impact of economic factors, social health and stressful life events on physical health-related quality of life trajectories in older Australians

Purpose

Physical health-related quality of life (HRQoL) is associated with adverse health outcomes, including hospitalizations and all-cause mortality. However, little is known about how physical HRQoL changes over time in older people and the predictors of this trajectory. This study (a) identified trajectories of physical HRQoL among older people and (b) explored whether economic factors, social health or stressful life events impact physical HRQoL trajectories.

Method

A cohort of 12,506 relatively ‘healthy’ community-dwelling Australians aged ≥ 70 years (54.4% females), enrolled in the ASPREE Longitudinal Study of Older Persons (ALSOP) study and was followed for six years. Economic factors, social health and life events in the last 12 months were assessed through a questionnaire at baseline. Physical HRQoL was measured by using the 12-item short form at baseline and annual follow-ups. Growth mixture and structural equation modelling were used to identify physical HRQoL trajectories and their predictors.

Results

Four physical HRQoL trajectories were identified—stable low (7.1%), declining (9.0%), stable intermediate (17.9%) and stable high (66.0%). Living in more disadvantaged areas, having a lower household income, no paid work, no voluntary work, loneliness and stressful life events (i.e. spousal illness, friend/family illness, financial problem) were associated with a 10%–152% higher likelihood of being in the stable low or declining physical HRQoL trajectory than the stable high group.

Conclusion

Specific stressful life events had a greater impact on adverse physical HRQoL trajectories in older people than other factors. Volunteering may prevent physical HRQoL decline and requires further investigation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-021-03021-x.

Psychosocial consequences of oocyte donation in donors: A systematic review

Assisted Reproductive Technology by means of oocyte donation is a very successful method leading to psychosocial consequences in donors. The aim of the present study was to conduct a systematic review of the existing literature on the psychosocial consequences of oocyte donation in the donors. The present study was conducted as a systematic review based on the PRISMA checklist. Searches were performed in PubMed, Web of Science, Scopus, and SID databases for the documents written between 2000 and 2020 regardless of the research methodology and the employed tools. English and Persian articles focusing on psychological and social issues of oocyte donation were reviewed. From 2,759 studies which were found, finally 14 related ones were selected. Psychosocial challenges of donors were obtained in three dimensions including short-term and long-term psychological reactions to treatment complications, emotional reactions to their function as an oocyte donor, and emotional reactions to the resulting offspring resulting and related social challenges. According to the existing studies, oocyte donation is a challenging process with short-term and long-term psychosocial consequences for donors. In order to prevent the feasible psychosocial hazards caused by the donation process, it is necessary to provide oocyte donors with psychosocial support, proper counseling, and awareness of the facts and possible issues ahead.

Leisure and health benefits associated with acculturation among Western international students living in South Korea

Purpose: Prior research provides limited information on the roles that leisure can play among Western international students studying in Eastern countries. Exploring this directional difference can provide its implications for Western international student support. Therefore, the purpose of this study is to explore leisure behaviours and leisure benefits associated with acculturation among Western international students residing in South Korea.Method: Using a purposeful criterion sampling strategy, a total of 18 participants (7 males and 11 females) were recruited. This study employed semi-structured in-depth interviews and a content mapping and content mining question strategy was incorporated.Results: The following core themes were associated with the health benefits of leisure activities experienced by international students living in South Korea: (a) promoting mental health, (b) experiencing dynamics of inter-and intra-group friendships, and (c) facilitating acculturation.Conclusions: The findings showed that participants developed friendships with the host individuals and other international students, became well acculturated into a new culture and experienced benefits to their mental health, indicating that leisure participation can be instrumental in improving social and psychological wellbeing.

The Paradox of Dementia and Driving Cessation: "It's a Hot Topic," "Always on the Back Burner"

BACKGROUND AND OBJECTIVES

Despite the well-recognized difficulty that persons with dementia and family carers experience in the decision making and transition to nondriving, there are few interventions and resources to support them. As part of our ongoing research to develop a driving cessation toolkit that addresses this gap, we sought to examine the context-specific factors relevant to its effective implementation in settings that support older adults with dementia.

RESEARCH DESIGN AND METHODS

A qualitative descriptive approach was used to explore the perspectives of Alzheimer Society (AS) staff in their work of supporting people with dementia and family carers within the context of driving cessation. Individual in-depth interviews were conducted with 15 AS staff members in 4 Canadian provinces. Data were examined using interpretative thematic analysis.

RESULTS

The study results revealed an overarching paradox that despite the importance of driving cessation in people with dementia, it continues to be largely avoided at the individual and system levels. This is explored via the themes of (a) paradox of importance and avoidance identified in AS settings; (b) lack of awareness and understanding about dementia and driving among people with dementia and family carers; (c) distress and avoidance rooted in ongoing system issues; and (d) moving driving cessation to the "front burner."

DISCUSSION AND IMPLICATIONS

Viewed through the emerging social health paradigm, which focuses on the social and emotional consequences of dementia, our results highlight the urgent need to mobilize our communities, medical education systems, and transportation authorities to finally resolve the dementia and driving cessation paradox.

Technology-driven solutions to prompt conversation, aid communication and support interaction for people with dementia and their caregivers: a systematic literature review

Background

The impact of dementia for communication skills can result in difficulties in social interactions between people with dementia and their conversation partner, as initiating and maintaining conversations becomes increasingly challenging. The role of technology in enhancing social health and participation for people with dementia is increasing, but the use of technological devices to support social interactions and aid communication quality is still in its infancy. The objective of this literature review is to provide a comprehensive description of technology-driven interventions for people with dementia and their conversation partners to prompt communication and facilitate positive social interactions.

Methods

A systematic search was conducted using PubMed, CINAHL and PsycINFO, with titles and abstracts independently screened by two researchers. Quality appraisal of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results

Of the 18 papers included, the technology most commonly used to facilitate communication and interactions was tablet-computers (n = 7), social robots (n = 5) and computers systems (n = 4). By analyzing the impact of the device(s) for social interaction and communication, four major themes emerged: i) breaking the ice; ii) increased interaction; iii) better understanding of the person with dementia; and iv) reduced pressure for the conversation partner.

Conclusion

While the majority of the included studies are small-scale, they indicate promising findings for the potential of technology to promote interaction in a way that relieves strain on the caregiver, enhances relationships and engages people with dementia in social activities. Rigorous investigation using standard, comparable measurements is needed to demonstrate the effects of technological solutions, as well as to explore and address barriers and potential adverse outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02105-0.

Evaluation of FindMyApps: protocol for a randomized controlled trial of the effectiveness and cost-effectiveness of a tablet-based intervention to improve self-management and social participation of community-dwelling people with mild dementia, compared to usual tablet use

BACKGROUND

For the rising number of people living with dementia, cost-effective community-based interventions to support psychosocial care are needed. The FindMyApps intervention has been developed with and for people with dementia and their caregivers, to help them use tablets to facilitate self-management and engagement in meaningful social activities. A feasibility study and exploratory pilot trial evaluating FindMyApps have been carried out. This definitive trial further evaluates the effectiveness of the intervention and, for the first time, the cost-effectiveness.

METHODS

A randomized controlled non-blinded single-center two-arm superiority trial will be conducted. Community-dwelling people with Mild Cognitive Impairment (MCI), or dementia with a Mini Mental-State Examination (MMSE) of > 17 and < 26, or Global Deterioration Scale 3 or 4, with an informal caregiver and access to a wireless internet connection will be included. In total, 150 patient-caregiver dyads will be randomly allocated to receive either usual care (control arm - tablet computer; n = 75 dyads) or usual care and the FindMyApps intervention (experimental arm - tablet computer and FindMyApps; n = 75 dyads). The primary outcomes are: for people with dementia, self-management and social participation; for caregivers, sense of competence. In addition to a main effect analysis, a cost-effectiveness analysis will be performed. In line with MRC guidance for evaluation of complex interventions a process evaluation will also be undertaken.

DISCUSSION

Results of the trial are expected to be available in 2023 and will be submitted for publication in international peer-reviewed scientific journals, in addition to conference presentations and reporting via the EU Marie Sklodowska-Curie DISTINCT ITN network. By providing evidence for or against the effectiveness and cost-effectiveness of the FindMyApps intervention, the results of the trial will influence national implementation of FindMyApps. We hope that the results of the trial will further stimulate research and development at the intersection of technology and psycho-social care in dementia. We hope to further demonstrate that the randomized controlled trial is a valuable and feasible means of evaluating new digital technologies, to stimulate further high-quality research in this growing field.

TRIAL REGISTRATION NUMBER

Netherlands Trial Register: NL8157 ; registered 15th November 2019.

Social Health Is Associated With Structural Brain Changes in Older Adults: The Rotterdam Study

BACKGROUND

Social health markers have been linked to the development of dementia. We hypothesize that social health affects brain structure and consequently influences cognitive function. We aim to elucidate the cross-sectional and longitudinal associations between social health markers and structural brain changes in older adults in the general population.

METHODS

Social health markers (loneliness, perceived social support, marital status) were assessed in the Rotterdam Study from 2002 to 2008. Magnetic resonance imaging of the brain was performed repeatedly between 2005 and 2015 for 3737 participants to obtain brain volumetrics, cerebral small vessel disease markers, and white matter microstructural integrity as measures of brain structure. Cross-sectional associations between social health and brain structure were studied using multivariable linear and logistic regression models. Longitudinal associations between baseline social health and changes in brain structure were examined using linear mixed models and generalized estimating equations.

RESULTS

Loneliness was associated with smaller white matter volume at baseline (mean difference = -4.63 mL, 95% confidence interval = -8.46 to -0.81). Better perceived social support was associated with larger total brain volume and gray matter volume at baseline and a less steep decrease in total brain volume over time. Better social support was associated with higher global fractional anisotropy and lower mean diffusivity at baseline. Participants who had never been married had a smaller total brain volume (mean difference = -8.27 mL, 95% confidence interval = -13.16 to -3.39) at baseline than married peers.

CONCLUSIONS

Social health is associated with brain structure. Better perceived social support at baseline was associated with better brain structure over time.

Cannabis use and stigma among Canadian high school students: Results from the 2015 and 2017 Cancer Risk Assessment in Youth Survey

BACKGROUND

Adolescent cannabis use is perceived as a risky behavior, has been linked with many negative health outcomes, and is increasingly being connected with stigma.

METHODS

The purpose of this study is to investigate how cannabis use is associated with potentially stigmatizing markers of identity among adolescents two waves of a repeat cross-sectional survey (2015 N = 12,110; 2017 N = 15,191) of high schools students in seven Canadian provinces. Students were asked about ever use of cannabis, as well as "stigma markers", including their current living arrangement, mother's education, and ethnicity. Multivariable logistic regression models were used to examine associations between cannabis use and stigma markers.

RESULTS

After adjusting models for grade, gender, and province of residence, students who did not live with their mothers had higher odds of cannabis use relative to students living with their mothers [OR = 1.94, 95% CI 1.62-2.31]. Low maternal education was also significantly associated with cannabis use, as was ethnicity (students who identified as Indigenous had 3.38 (95% CI 2.29-4.99) times higher odds of using cannabis compared to students who identified as "white" in 2017). Findings related to attending school in a rural (vs. urban) area (2015 OR = 1.33 95% CI 0.99-1.78; 2017 OR = 1.44 95% CI 0.9 to -2.15) and low SES (2015 OR = 0.99, 95% 0.98-1.00; 2017 OR = 1.00, 95% CI 0.98-1.01) were more marginal.

CONCLUSIONS

Future research should explore cannabis initiation experiences among vulnerable groups to better understand potential stigma triggers.

The evolution of social health research topics: A data-driven analysis

The realm of social health has not yet been properly established in terms of fixed definitions, concepts, and research areas. This study attempts to define social health using macro and micro perspectives and explores trends in social health research by mapping their topics and fields. We used Latent Dirichlet allocation (LDA) topic modeling, which allows the extraction of key terms and topics derived from a large volume of literature. We traced the evolution of research topics from past (the literature that "present" articles cited), present (existing journal articles on social health), to future (the literature which cited the articles) studies based on connections between citations. The datasets were collected by the query terms "social health" in the Scopus database, including title, abstract, and keywords of journal articles. We collected a total of 443 articles from recent social health literature, 6588 articles from past literature that the recent articles on social health cited, and 2680 articles from future literature in which recent social health articles were cited. We defined social health as positive interaction that increases individual engagement in social life at the micro level, and the high degree of social integration that deals with collective problems in society at the macro level. The results of LDA showed that social health research has developed into seven fields: Health Care Delivery; Vulnerable Groups; Measurement; Health Inequality; Social Network and Empowerment; Clinical/Physical Health; and Mental/Behavioral Health. Based on citation relationships, topics grounded in an individual/micro perspective have grown increasingly specialized and productive, while topics grounded in a social/macro perspective have stagnated or was underexplored. Our findings imply that social health studies should follow a more interdisciplinary approach to integrate current health models of individual-centered treatments with social science concerns on building collective capacity for social well-being.

Using the concept of activity space to understand the social health of older adults living with memory problems and dementia at home

Globally as the population ages, the prevalence of dementia will increase. Simultaneously, there is a trend toward people ageing at home. Therefore, more people will be ageing at home with dementia, as opposed to institutional environments. In this context, there has been a recent shift in research exploring ways that people can live well with the consequences of the disease. As a part of this emerging research, the social and spatial aspects of the lives of people living with memory problems are becoming increasingly of interest. The aim of this article is to use the concept of activity space to examine the social health of older adults with memory problems and dementia who live at home. Activity space data were collected from seven older adults experiencing memory problems and living at home in the Netherlands. Using a mixed-methods approach, insight into their activity spaces were gained through walking interviews, 14 days of global positioning system (GPS) movement data, travel diary entries and in-depth interviews. The GPS data, travel diary data and interview transcripts were analyzed using a grounded visualization approach. Our findings show that participants interact independently in routine activity spaces but depend on others to participate in occasional activity spaces. Interactions within both these spaces contribute to the social health of older adults with memory problems and dementia who live at home. Additionally, participants used coping strategies and decision-making to maintain autonomy in daily life. The findings can inform dementia-friendly initiatives and social health care planning.

Is the modified household food security survey (HFSS) questionnaire a practical tool for screening food insecurity? Evidence from northwest of Iran

BACKGROUND

Adequate supplies of food and food security (FS) are the fundamental aspects of human societies, and considered one of the pivotal factors of individual and social health. The aim of the present study was to assess the applicability of the short questionnaire for screening food insecurity (FI) and to evaluate the prevalence of FI in northwest of Iran.

METHODS

In this study, 550 subjects aged ≥16 years were studied. Three-day dietary records and a short questionnaire were applied to estimate the prevalence of FI in terms of hunger and hidden hunger. The sensitivity, specificity and accuracy of the short questionnaire were assessed. Moreover, the association between the results of the short questionnaire and the criteria that were theoretically related to FI were examined. Data were presented as mean (SD), median (min-max) for the numeric normal and non-normal variables, respectively, and frequency (percent) for categorical variables. The between-group comparisons of variables were done using independent samples t test. P values less than 0.05 were considered statistically significant.

RESULTS

The prevalence of hunger and hidden hunger was 30.8 and 46.0%, respectively. Overall, 23.2% of the subjects were classified as "food secure". The sensitivity, specificity and accuracy of the short questionnaire in determining hunger were 92.8% (95% CI: 87.3-95.9), 84.2% (95% CI: 79.3-89.3), and 87% (95% CI: 84-90.2), respectively. These values for hidden hunger were 21.6% (95% CI: 15.7-29.9), 92.3% (95% CI: 88.7-99.4), and 53.4% (95% CI: 47.9-59.8), respectively. Our study showed a statistically significant association between FI and socio-economic status. FI significantly enhanced the risk of underweight, while it markedly reduced the risk of overweight and obesity. The average frequency of monthly consumption of meat, dairy products, fruits, vegetables, and rice was significantly lower in food insecure group, while the median frequency of bread consumption was markedly higher in food insecure group. The participants of insecure group were less likely to consume fruits, vegetables, dairy products, rice and meat.

CONCLUSIONS

FI was frequent in North-west of Iran. The findings indicated that the short questionnaire was a simple, low-cost and practical tool for screening FI in terms of hunger.

TRIAL REGISTRATION

IR.TBZMED.REC.1397.400.

Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang

Background

Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang.

Methods

This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score).

Results

A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: β = 1.90(95%CI: 1.09, 2.71) for PCS, β = 1.78(1.08, 2.48) for MCS, β = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: β = 3.29(2.24, 4.34) for PCS, β = 3.10(2.12, 4.01) for MCS, β = 3.20(2.48, 3.91) for SF-12 total score).

Conclusion

In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.

The nexus between social impacts and adaptation strategies of workers to occupational heat stress: a conceptual framework

Adverse effects of occupational heat stress in the context of the changing climate on working populations are subtle but considerably harmful. However, social dimensions and impacts of climate change-related occupational heat concerns on workers' safety and health, productivity and well-being are often overlooked or relegated as minor issues in social impact analyses of occupational heat exposure due to climate change. This paper offers a conceptual framework based on an appraisal and synthesis of the literature on social impacts of climate change-related occupational heat exposure on workers' safety and health, productivity and social welfare and the quest to localise and achieve sustainable development goals. A sustained global, national, institutional and individual collaborative involvement and financial support for research, improved adaptation and social protection strategies, predominantly in the developing world, where a large number of people work outdoors, can reduce heat exposure and boost the resilience and adaptive capacity of workers to facilitate efforts to achieve sustainable development goals.

Composite social health index: Development and assessment in provinces of Iran

Background: Overall human health has been considered as physical, mental, and social health. The aim of the present study was to develop and measure Social Health Index in Iran by regions. Policymakers can implement evidence-based interventions by gaining knowledge about social health status.

Methods: To develop Social Health Index, social health indicators were collected by literature review and indicators whose information existed in provincial level. The final list of indicators was derived based on expert opinions. Then, data were normalized by comparative standardization. Using additive model, the total score of social health was calculated and provinces were ranked.

Results: Based on the composite index, including 39 indicators, a healthy society is properly characterized by lack of drug use, child labor, divorce, unemployed academics, child abuse, and smoking. The highest and lowest social health belonged to Yazd and Sistan and Baluchistan provinces, respectively.

Conclusion: This study showed the provinces’ social health as an important tool for evidence-based policymaking. To monitor social health status, similar studies should be conducted every 3 to 5 years.

Joining forces to improve psychosocial care for people with cognitive deficits across diagnoses: social health as a common framework

Cognitive deficits such as memory problems have a major impact on independence in daily life and participation in society in several populations, such as people with dementia, brain injury (i.e. stroke) or a severe mental illness such as schizophrenia. Similarities in the impact on participation and well-being have resulted in the development of comparable psychosocial interventions across populations, aiming to support people to adapt to cognitive deficits or by adapting the environment. These interventions are developed separately, without using the expertise in other fields. We argue that each of the fields and the field of psychosocial care in general would benefit from closer collaboration on development and evaluation of innovative psychosocial interventions. Collaboration has been complicated by the use of different care models and theoretical frameworks, each with their own terminology. The concept of social health - the ability to participate in work or other meaningful activities and to feel healthy despite a condition - translates to the leading care models within the fields of dementia, brain injury and severe mental illness. The concept of social health provides a common language and framework. In this paper, we elaborate on strategies for collaboration using examples of interventions to improve social health.

Reconsidering frameworks of Alzheimer's dementia when assessing psychosocial outcomes

The purpose of this introductory article to the special issue on psychosocial outcome measures in Alzheimer's & Dementia: Translational Research & Clinical Interventions is to outline new frameworks to more effectively capture and measure the full range of how people living with Alzheimer's dementia and their family caregivers experience the disease process. Specifically, we consider the strengths and weaknesses of alternative perspectives, including person-centered, strength-based, and resilience-focused approaches that may complement and extend the dominant deficit paradigm to reflect the entirety of the dementia experience. Our aim is to encourage innovative methods to measure psychosocial aspects of Alzheimer's dementia and caregiving that have not yet received sufficient attention, including resources (e.g., services and supports) and positive caregiver and care recipient outcomes (e.g., positive mood and adaptation).

Reliability and validity of PROMIS® pediatric family relationships short form in children 8-17 years of age with chronic disease

PURPOSE

Families play a key role in managing pediatric chronic illness. The PROMIS® pediatric family relationships measure was developed primarily within the general pediatric population. We evaluated the Family Relationships short form in the context of pediatric chronic diseases.

METHODS

Children aged 8-17 years with asthma (n = 73), type 1 diabetes (n = 122), or sickle cell disease (n = 80) completed the Family Relationships 8a short form and the PROMIS Pediatric Profile-25's six domains representing physical, mental, and social health. Parents (N = 275) of these children completed the parent versions of the same measures. We evaluated reliability of the Family Relationships measure using Cronbach's alpha and IRT-based marginal reliability, and the standard error of measurement (SEM). Convergent/discriminant validity were assessed from correlations between the Family Relationships domain and the PROMIS-25 domains.

RESULTS

SEM increased for scores above the normative mean of 50. Cronbach's alpha and IRT-estimated marginal reliabilities exceeded 0.80 for children and parents across diseases, except in asthma, where marginal reliability was 0.75 for parents. Scores displayed small to large correlations in the expected directions with social and mental health domains. The largest correlations occurred with parents' proxy reports of children's depressive symptoms in sickle cell disease and asthma, r = - 0.60 (95% CI - 0.74, - 0.48) and r = - 0.58 (95% CI - 0.68, - 0.48) respectively.

CONCLUSIONS

The Family Relationships 8-item short form demonstrated adequate reliability and convergent/discriminant validity for use in pediatric chronic conditions, though scores above the mean displayed greater uncertainty. Evidence of the measure's reliability and validity in multiple contexts furthers the case for its use.

Evaluating the social fitness Programme for older people with cognitive problems and their caregivers: lessons learned from a failed trial

Background

This process evaluation article describes the lessons learned from a failed trial which aimed to assess effectiveness of the tailor-made, multidisciplinary Social Fitness Programme to improve social participation of community-dwelling older people with cognitive problems (clients) and their caregivers (couples).

Methods

A process evaluation was performed to get insight in 1) the implementation of the intervention, 2) the context of intervention delivery from professionals’ point of view, and 3) the potential impact of intervention delivery from participants’ perspectives. Data was gathered using mixed-methods: questionnaires, focus group discussions, interviews, medical records.

Results

1) Implementation. High study decline (65,3%) was mainly caused by a lack of internal motivation to increase social participation expressed by clients. 17 couples participated, however, intervention delivery was insufficient. 2) Context. Barriers during intervention delivery were most often related to client (changing needs), caregiver (increased burden) and health professional factors (delivery of integrated care lacked routine). 3) Impact Qualitative analyses revealed participants to be satisfied with intervention delivery, we were unable to capture these results through our primary outcome measure.

Conclusions

This process evaluation revealed the Social Fitness study did not fit in three ways. First, framing the intervention on social participation promotion was as threatening to clients. The feeling of being unable to adequately contribute to social interactions seemed to be causing embarrassment. Second, the intervention seemed to be too complex to implement in the way it was designed. Third, there is a tension between the offering of a personalised tailor-made intervention and evaluation through a fixed study design.

Trial registration

The trial which is evaluated in this article (the Social Fitness study) is registered with the Dutch Trial Register (NTR), clinical trial number NTR4347.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0927-8) contains supplementary material, which is available to authorized users.

The development of the social health scale for the elderly

Background

With the elderly population comprising an increasing large proportion of society, a valid and reliable measure of social health in the elderly is indispensable for a comprehensive health assessment. The objective of this study is to develop a Social Health Scale for the Elderly (SHSE).

Methods

A draft scale was generated based on a literature review and expert surveys. Pilot testing was conducted from December 14, 2015, to January 8, 2016. Some items were removed after assessment with five statistical analysis methods. Field testing began on November 6, 2016, and ended on January 20, 2017. After field testing, the reliability and validity of the scale were assessed and the norms in Hangzhou were calculated.

Results

In the two tests, 430 and 2404 subjects were included in the statistical analyses. The long form of the SHSE (SHSE-L) contained 25 items, 14 of which were also in the short form (SHSE-S). The internal consistency of the SHSE-L was acceptable. The test-rest reliability and inter-rater reliability were moderate, but the concurrent validity, construct validity, and convergent and discriminant validity were desirable in both versions. The standard and percentile rank norms in Hangzhou, China were developed based on the field testing data.

Conclusions

The population-based social health of the Chinese elderly can be validly and reliably assessed with the SHSE.

Electronic supplementary material

The online version of this article (10.1186/s12955-018-0899-6) contains supplementary material, which is available to authorized users.

Examining Social Health and Its Related Factors among Iranian Medical students

Introduction: Given the importance of providing social health for students, this study was conducted to investigate the social health and its related factors among Iranian students of medical sciences.

Methods: This descriptive and cross-sectional study was carried out in 2016. The population of the study included students of Mazandaran University of Medical Sciences (Sari, Iran). Using random sampling, we selected 352 students. Eligible students for the study were those who (i) consented to participate, (ii) agreed to participate fully, and (iii) had no physical illnesses. Exclusion from the study was due to any event that prevented them from participating in the study (e.g., the death of a family member). Then, standardized questionnaire of "Keyes's Social Well-being" and demographic questionnaire were used in this study to collect data. The data were tabulated and analyzed by means of SPSS 13.0 for Windows (SPSS Inc., Chicago, IL, USA), which was used to calculate descriptive and inferential (Two-way ANOVA) indices.

Results: In this study, 202 women and 150 men participated with the mean age of 23.14 (2.41). The mean score of social health of students was average 92.99 (7.54). About 75.4% of participants had average levels of social health. Maximum and minimum levels of social health were related to contribution 20.64 (3.65) and social coherence 15.86 (2.12) respectively. There were no differences in the overall social health score of the students in terms of gender; however, regarding marital status, place of residence, father's education, and mother's education, there was a significant difference among students.

Conclusion: Given the importance of social health, it is necessary to have proper planning such as providing for the requirements of stable marriages for students, good place of residence to improve the quality of life and enhance their satisfaction with it.

Children's family experiences: development of the PROMIS® pediatric family relationships measures

PURPOSE

To describe the development of pediatric family relationships measures, with versions for child self-report (8-17 years) and parent-report for children 5-17 years old. Measures were created for integration into the Patient Reported Outcomes Measurement Information System (PROMIS®).

METHODS

Semi-structured interviews with 10 experts, 24 children, and 8 parents were conducted to elicit and clarify essential elements of family relationships. A systematic literature review was conducted to identify item concepts representative of each element. The concepts were transformed into items that were iteratively revised based on cognitive interviews (n = 43 children) and item translatability review. Psychometric studies involving 2846 children and 2262 parents were conducted to further refine and validate the instruments.

RESULTS

Qualitative procedures supported the development of content valid Family Relationships item banks. Final child- and parent-report item banks each contain 47 items. Unidimensional item banks were calibrated using IRT-modeling to estimate item parameters representative of the US population and to enable computerized adaptive test administration. Four- and eight-item short forms were constructed for standard fixed format administration. All instruments have strong internal consistency, retest-reliability, and provide precise estimates of various levels of family relationship quality. Preliminary evidence of the instruments' validity was provided by known-group comparisons and convergence with legacy measures.

CONCLUSION

The PROMIS pediatric Family Relationships measures can be applied in research focused on determinants, outcomes, and the protective effects of children's subjective family relationship experiences.

Social and functional health of home care clients with different levels of cognitive impairments

OBJECTIVES

The ability to manage one's life with some degree of independence, to fulfill basic obligations, and to participate in social activities are social functions that delineate the core of 'social health'. We examine to what extent clients of community care in Europe (n = 2884) complete such activities despite their cognitive problems. We focus on mildly and moderately impaired people, aged 65+ years.

METHODS

Data were collected using the interRAI HC-Assessment in IBenC-project. We tested the association between participants' capacity and performance in three LADLs (instrumental activities of daily living) and their cognitive performance and specific memory problems.

RESULTS

About 30% of home care clients in Europe suffer from mild-to-moderate cognitive impairment. Their relatively independent coping with requirements of routine activities is strongly determined by overall cognitive performance. Specific memory functions seem unimportant, except for procedural memory. It is striking that all clients, and particularly those with mild-to-moderate cognitive impairment, interact mostly with close relatives and friends. Mild-to-moderate cognitive limitations do not hinder clients from coping semi-independently with routine requirements.

DISCUSSION

When considering the influence of cognitive function on clients' capacity and performance in everyday activities and social relations, a comprehensive construct of cognitive function has to be applied.

Social health and dementia: a European consensus on the operationalization of the concept and directions for research and practice

BACKGROUND

Because the pattern of illnesses changes in an aging population and many people manage to live well with chronic diseases, a group of health care professionals recently proposed reformulating the static WHO definition of health towards a dynamic one based on the ability to physically, mentally and socially adapt and self-manage. This paper is the result of a collaborative action of the INTERDEM Social Health Taskforce to operationalize this new health concept for people with dementia, more specifically the social domain, and to formulate directions for research and practice to promote social health in dementia.

METHOD

Based on the expertise of the Social Health Taskforce members (N = 54) three groups were formed that worked on operationalizing the three social health dimensions described by Huber et al.: (1) capacity to fulfil potential and obligations; (2) ability to manage life with some degree of independence; (3) participation in social activities. For each dimension also influencing factors, effective interventions and knowledge gaps were inventoried. After a consensus meeting, the operationalizations of the dimensions were reviewed by the European Working Group of People with Dementia (EWGPWD).

RESULTS

The social health dimensions could be well operationalized for people with dementia and are assessed as very relevant according to the Social Health Taskforce and EWGPWD. Personal (e.g. sense of coherence, competencies), disease-related (e.g. severity of cognitive impairments, comorbidity), social (support from network, stigma) and environmental factors (e.g. enabling design, accessibility) that can influence the person with dementia's social health and many interventions promoting social health were identified.

CONCLUSION

A consensus-based operationalization of social health in dementia is proposed, and factors that can influence, and interventions that improve, social health in dementia identified. Recommendations are made for research and practice.

Disparities in Social Health by Sexual Orientation and the Etiologic Role of Self-Reported Discrimination

Some past work indicates that sexual minorities may experience impairments in social health, or the perceived and actual availability and quality of one's social relationships, relative to heterosexuals; however, research has been limited in many ways. Furthermore, it is important to investigate etiological factors that may be associated with these disparities, such as self-reported discrimination. The current work tested whether sexual minority adults in the United States reported less positive social health (i.e., loneliness, friendship strain, familial strain, and social capital) relative to heterosexuals and whether self-reported discrimination accounted for these disparities. Participants for the current study (N = 579) were recruited via Amazon's Mechanical Turk, including 365 self-identified heterosexuals (105 women) and 214 sexual minorities (103 women). Consistent with hypotheses, sexual minorities reported impaired social health relative to heterosexuals, with divergent patterns emerging by sexual orientation subgroup (which were generally consistent across sexes). Additionally, self-reported discrimination accounted for disparities across three of four indicators of social health. These findings suggest that sexual minorities may face obstacles related to prejudice and discrimination that impair the functioning of their relationships and overall social health. Moreover, because social health is closely related to psychological and physical health, remediating disparities in social relationships may be necessary to address other health disparities based upon sexual orientation. Expanding upon these results, implications for efforts to build resilience among sexual minorities are discussed.

The Impact of Future World Events on Iranians' Social Health: A Qualitative Futurology

BACKGROUND

Social health is a dimension of health affected and interacts with other dimensions. Considering the rate of world changes, foresighting the influence of future events and possible trends on social health could bring about advantageous information for social policy makers.

METHODS

This is a qualitative study of futurology with cross impact analysis approach. After studying possible trends and events in future, they were categorized in four domains including population, resources, climate changes, and globalization and 12 groups of events; and they were used to design a questionnaire. It was given to experts and their opinions were collected through depth interviews between May 2013 and Sep 2013.

RESULTS

Analysis of experts' opinions reveals that future trends in four main potential domains may have some positive and more negative impacts on Iranians' social health.

CONCLUSION

The global "resource challenge" is the most important incoming event, considering to the four domains of global events and its final and potential effects will be the increase of inequalities leading to social threat. Since inequalities are considered the most important risk factor of health in the societies, the solution for dispel the impact of world trends on Iranians' social health is managing the crisis of inequalities which is started with fore sighting and adopting preventive strategies in all four domains.

The PROMIS satisfaction with social participation measures demonstrated responsiveness in diverse clinical populations

OBJECTIVES

To conduct a longitudinal evaluation of Patient-Reported Outcomes Measurement Information System (PROMIS) social function measures (satisfaction with participation in social roles and satisfaction with participation in discretionary social activities) in English-speaking people with chronic health conditions.

STUDY DESIGN AND SETTING

Adults receiving treatment for chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), chronic back pain, or depression completed PROMIS computer-based measures of social health at two time points approximately 3 months apart and global ratings of change. Linear mixed effects models and standardized response means were estimated for the two social function measures.

RESULTS

A total of 599 people participated: 79 with stable COPD, 46 COPD exacerbation, 60 with CHF, 196 with depression, and 218 with back pain. Four groups experienced improvement over time, one (COPD stable) changed very little. Those who reported better global ratings of change in overall health experienced larger changes in social function than those who reported the same or worse global health.

CONCLUSION

This study provided support for responsiveness to change for two PROMIS social function measures. These results provide further evidence of the PROMIS goal to enable comparable measurement of universally relevant symptoms and experiences that apply to people with a variety of diseases.

The status of social well-being in Iranian nurses: a cross- sectional study

INTRODUCTION

Social well-being is one of the important aspects of individual's health. However, the social aspect of health, or social well-being, has not been attended to as equally as the other aspects. Social well-being is people's perceptions and experiences in social circumstances as well as the degree of successful responses to social challenges. The aim of the study was to investigate the social well-being of a sample of Iranian nurses.

METHODS

This study was a cross- sectional conducted in 2013. The study population consisted of all 1200 staff nurses working in all hospitals located in Ardabil, Iran. We invited a random sample of 281 practicing nurses to respond to the 33-item Keyes's Social Well-Being Questionnaire and the possible range of the total score is 33-165. Higher score reflect better SWB. The quantitative analysis of this study used the Statistical Package for Social Science SPSS version 13.0.

RESULTS

The results showed that Participants' mean score of social well-being was 105.45 (15.87). Social well-being was significantly related to participants' age, gender, work experience, satisfaction with working in hospital and with income, familiarity with nursing prior to entering it, official position, and type of employment. However, there was no significant relationship between nurses' social well-being and their marital status, their parents and spouses' educational status, as well as the type of hospital.

CONCLUSION

Nurses' social well-being deserves special attention. Effective well-being promotion strategies should be executed for promoting their social well-being particularly in areas of social integration and social acceptance. Moreover, nurses, particularly female nurses, need strong financial, emotional, informational, and social support for ensuring their social well-being.

Expressive writing promotes self-reported physical, social and psychological health among Chinese undergraduates

The present study examines the efficacy of expressive writing among Chinese undergraduates. The sample comprised of 74 undergraduates enrolled in a 9-week intervention (35 in experimental class vs. 39 in control class). The writing exercises were well-embedded in an elective course for the two classes. The 46-item simplified Chinese Self-Rated Health Measurement Scale, which assesses psychological, physical and social health, was adopted to measure the outcome of this study. Baseline (second week) and post-test (ninth week) scores were obtained during the classes. After the intervention on the eighth week, the self-reported psychological, social and physical health of the experimental class improved. Psychological health obtained the maximum degree of improvement, followed by social and physical health. Furthermore, female participants gained more psychological improvement than males. These results demonstrated that the expressive writing approach could improve the physical, social and psychological health of Chinese undergraduates, and the method can be applied in university psychological consulting settings in Mainland China.

Development of a scale for measuring social health of Iranians living in three big cities

BACKGROUND

Social health is considered as a significant dimension of health and, hence, its assessment is vital in health planning. Within this context, this study aimed to develop a valid and reliable scale for measuring individual's social health in Iran. To do so, an exploratory sequential mixed method was used.

METHODS

To establish the item pool and primary scale, 30 interviews with experts and other stakeholders, and a primary review of relevant literature and similar questionnaires were conducted. Then, a survey with 800 respondents from three cities in Iran was undertaken to assess the validity and reliability of the scale.

RESULTS

In the qualitative stage of this study, after careful consideration, forty questions were remained for the next step. Considering the correlation of the score of each question with the total score of the questionnaire, seven questions were omitted. For this questionnaire with 33 remaining questions, Cronbach's alpha for internal consistency was estimated to be 0.86. The reliability coefficient for 100 samples (taken after 7 to 10 days from the first round of sampling) was 0.91. Considering the factor analysis, three factors were recognized. These factors were named as "family", "community" and "friends and relatives". Cronbach's Alpha for internal consistency of community, friends and relatives, and family factors were estimated to be 0.91, 0.77 and 0.78 respectively. The corresponding value of the reliability indicator, intraclass correlation coefficient (ICC), for community, friends and relatives, and family were calculated 0.69, 0.80 and 0.67 respectively.

CONCLUSION

We developed a measurable scale for social health at an individual level in the Iranian community with an acceptable level of validity and reliability. The new developed scale is able to provide an opportunity to measure Iranians' social health at an individual level. Such an indicator of individual health can be used in evaluating the performance of social health policies and providing a platform for evidence-based policy-making in the social health context.

Determining dimensions of iranians' individual social health: a qualitative approach

BACKGROUND

Social health is important to be assessed as a dimension of health. The aim of study was to determine domains and sub-domains of individual social health of Iranians.

METHODS

This study was carried out with a qualitative approach, using thematic content analysis. Twenty five experts participated in interviews, using individual semi-structured interviews between November 2010 and June 2011.This data supported with strong search.

RESULTS

Two main areas extracted from these interviews including social support and social function. The social support domain contained seventeen sub-areas, including social support at the time of disease; disability; daily life issues, etc. And the social function as second domain contained twelve sub-areas, including: financial aids to others; emotionally aids to others; participating in social groups, etc.

CONCLUSION

We developed a conceptual framework for social health in the individual level in Iranian population. It makes preparations for providing a valid and reliable measurement scale for social health in next studies and evidence-based policy-making.