Associations between interpersonal contexts, positive emotions, and related experiences in school students: A systematic review of experience sampling studies

Studies investigating students' social interactions and related experiences have mostly relied on retrospective methodologies-techniques known to be subject to recall bias that threaten ecological validity. This article is the second part of a systematic review of experience sampling studies on students' social interactions. This article focuses on exploring associations between interpersonal contexts, positive emotions, and related experiences assessed by intensive repeated measurement techniques in naturalistic environments. A systematic literature search was conducted for experience sampling studies between 1996 and 2020. Details of the literature search process and results were reported in the companion (Part I) of the study (Mölsä et al., 2022; Frontiers in Psychology 2022; 13: 844698). Using a narrative synthesis, the associations of interpersonal contexts and positive emotionality in school students were analyzed. Findings suggest that school students experience higher levels of positive emotions during peer, teacher, and family interactions than when they are not being with someone. The overall findings indicate that positive emotionality in children and adolescents is dependent on the characteristics of the interpersonal contexts, although the multilevel associations vary. This review contributes to experience sampling research on students' social interactions. The systematic review concludes with discussion of the main findings, theoretical implications, and an analysis of limitations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Timely support for promoting mental wellbeing among families with young children -an interview study exploring the experiences of multi-professional practitioners in Finland

BACKGROUND

Childhood is a critical period for promoting mental wellbeing and previous research suggests that various family-focused mental health promotion and early prevention initiatives are effective. The aim of the study was to explore Finnish health and social care practitioners' views and experiences of mental health promotion practice targeting families with young children.

METHODS

Individual semi-structured interviews with 14 practitioners representing various municipal services, faith-based and third sector organizations were conducted in 2021 and analysed using thematic analysis.

RESULTS

Various challenges and opportunities for supporting mental health related to both structural features of the health and social care landscape and the varying needs of families were identified. The lack of resources as well as the social stigma associated with mental health problems and with public welfare services, hindered proactive work approaches and timely support. However, low-threshold initiatives and adapted information to families as well as further training about mental health for practitioners together with multi-professional collaboration and teamwork were suggested as potential enablers for mental health promotion.

CONCLUSIONS

The study highlights the importance of reaching families in a timely manner in order to promote mental wellbeing and prevent mental health problems. The findings, bringing to the fore the practitioners' own experiences and views, suggest how current practice could be developed in order to safeguard mental health and wellbeing for all families with young children. The practitioners' views and experiences are key components when building future sustainable and proactive health and social care services.

Promoting sexual health in schools: a systematic review of the European evidence

Introduction

Sexual ill-health is an urgent public health issue with subsequent social and economic costs. There is, therefore, a need for more effective sexual health promotion interventions in an early stage of life. Previous research has focused on preventive sexual health interventions applying a risk perspective, and the limited and scattered evidence concerning school-based sexual health promotion interventions employing a health-resource perspective has not been compiled and synthesized. Hence, this study aimed to systematically review the current evidence on the effects of sexual health promotion interventions conducted in schools in Europe.

Method

A systematic review based on the JBI and PRISMA standards was performed, encompassing searches in seven databases to identify sexual health promotion interventions conducted in European schools between 2012 and 2022. Data coding was performed according to a predetermined protocol and included information on study characteristics, intervention content, methods, and outcomes relevant to the current review. A narrative synthesis of the included studies was performed, highlighting the collective results.

Result

Seventeen records were included in the review, reporting on 16 individual studies conducted in 7 European countries. Of the 16 included studies, 13 had a quantitative research design, and three had a qualitative design. All three studies with a qualitative research design described positive effects experienced by the participants. Six of thirteen quantitative studies showed statistically significant positive effects on at least one of the outcomes of interest. The outcomes of interest were grouped into five areas, and most studies focused on the area of attitudes toward sexual health.

Conclusion

The findings indicate promising evidence of effect for interventions with a health promotion approach, highlighting the importance of strengthening sexual health resources related to respect, communication skills, attitudes, and other positive psycho-social aspects of sexual health. Most sexual health promotion intervention studies have focused on sexual health resource outcomes connected to attitudes and skills, whereas a comprehensive focus on the multi-dimensional sexual health literacy concept is less common and can be recommended to be included in future intervention research.

Work-life balance and work engagement across the European workforce: a comparative analysis of welfare states

BACKGROUND

Few large-scale, comparative studies have examined both the positive mental well-being outcomes of work-life balance and the broader socio-economic context by which it is shaped. Therefore, the aim of this study was to investigate the association between work-life balance and work engagement across a wide range of European welfare states, as well as to examine whether work-life balance varies across European countries and whether this variance can be explained by welfare regime, controlling for individual-level factors.

METHODS

This study utilized data from the 2015 European Working Conditions Survey. In total, 35 401 workers from 30 European countries could be classified into the adopted welfare regime typology. Work engagement was measured using an ultra-short version of the Utrecht Work Engagement Scale, and work-life balance with a question on the fit between working hours and family or social commitments. Due to the hierarchical structure of the data, multilevel regression models were applied.

RESULTS

A statistically significant positive association between work-life balance and work engagement across the European workforce was found. Between-country variance in work-life balance was demonstrated and this can in part be explained by welfare regime.

CONCLUSIONS

While it has long been recognized that occupational stress and work-related mental health problems are shaped by the socio-economic context and thus regarded as public health concerns in Europe, our results suggest that this applies to well-being at work and related support factors as well.

Meeting the Needs of Older Adults with Mental Ill-Health in Non-Psychiatric Care Settings: Self-Rated Confidence in Helping and its Co-Variates within a Multiprofessional Study Sample

In this paper we sought to explore health and social care professionals' self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants' (n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals' attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.

Exploring the Association between Welfare State and Mental Wellbeing in Europe: Does Age Matter?

Previous research reports show mixed results regarding the age gradient in population mental wellbeing, which may be linked to the role that welfare states play. In this study, we investigate whether an age gradient exists in relation to the association between welfare state and mental wellbeing within the adult population in Europe. We combine individual level data from Round 6 of the European Social Survey and country level data on welfare state and use multilevel regression analyses to explore population mental wellbeing. Subjective and psychological wellbeing dimensions were analyzed, and different approaches to measuring welfare state were explored, including a regime typology and composite welfare state measures constructed on the basis of a set of eight individual indicators. We found the age gradient for mental wellbeing to differ between welfare states, with the positive impact of the welfare state increasing with age. A universal and generous welfare state seems to be particularly important for older adults, who are also more likely to be in higher need of transfers and services provided by the welfare state.

Investigating employee perceptions: Association between recognized individual talents and social wellbeing

Background

Organizations worldwide increasingly adopt inclusive talent management, and this approach appears to rhyme particularly well with the Nordic welfare model. Questions about its value remain understudied, however. The inclusive approach is rooted in positive psychology and focuses on recognizing each employee's individual talents and assessing whether they fit the long-term needs of the organization, since a fit is assumed to be associated with employees' wellbeing. In the present study, we test this assumption focusing specifically on a key talent management practice, talent identification, and the social dimension of employee wellbeing.

Method

Data were collected through an employee survey conducted within the Finnish units of four international manufacturing organizations and analyzed using logistic regression (n = 618).

Results

We found that the recognition of individual talents for long-term deployment by the organization is positively associated with social wellbeing in terms of supervisor support and social climate in the work unit, as perceived by the employees.

Conclusion

Our results tentatively suggest that inclusive talent management creates value through the identification of employees' individual talents as this practice can be associated with their enhanced wellbeing.

Health Promotion Practice Among Older Persons: A Nordic Multi-Professional Focus Group Study Exploring what It Is and How It Could be Achieved

The growing ageing population in the Nordic region calls for increased focus on health promotion work. To enhance multi-professional understanding and further develop strategies for promoting healthy ageing, it is vital to consider the perspectives of those working with health promotion. The aim of this study was to explore a wide spectrum of practitioners’ experiences of community-level health promotion targeting older adults in Finland and Sweden. Nine focus group interviews (34 informants) were conducted in 2019–2020. “Seeing the person” emerged as the ideal for health promotion targeting older adults, but this ideal was not always realized in current practice. Barriers related to organizational structures and the practitioner role were identified. However, work methods connected to user involvement and technology-based tools were considered key facilitators, enabling tailored health promotion initiatives.

Exploring the Nuanced Links Between Internet Use and Subjective Well-Being Among Older Adults: A Nordic Population-Based Study

Aim

The aim was to explore the various associations between subjective well-being and internet use among older adults in two regions in Finland and Sweden.

Methods

The data was collected through a population-based survey (N = 9,386) as part of the GERDA project conducted in 2016. The connection between subjective well-being (measured by perceived meaningfulness, happiness and life satisfaction) and internet use (distinguishing between internet users, non-users and users with support, and diverse internet activities) was studied by conducting binary regression analyses, calculating odds ratios with 95% confidence intervals. The analyses also controlled for key subjective well-being covariates.

Results

Statistically significant associations were found between perceived life meaningfulness and internet use. When looking into the specific internet-based activities under study, activities related to leisure and entertainment showed statistically significant associations to perceived meaningfulness as well as perceived happiness, also after controlling for potential covariates. However, internet use and the different internet activities failed to show statistical significant associations to life satisfaction in the adjusted regression model.

Conclusion

The things we do on the internet (the activities) as well as how we conceptualize and measure subjective well-being in this type of research studies seem to matter when it comes to the relationship between subjective well-being and internet use in later life. Internet use and internet activities displayed various connections to the subjective well-being proxies used in this study. Therefore, the complexity and multidimensionality of both subjective well-being and internet use and related links need to be carefully explored in order to deepen our understanding of experienced well-being among older adults in a digitized world.

Bottom-Up Interventions Effective in Promoting Work Engagement: A Systematic Review and Meta-Analysis

Background: Promoting work engagement is of interest to organizations across sectors due to the associated positive outcomes. This interest warrants research on the evidence of work engagement interventions. Intervention research increasingly advocates a bottom-up approach, highlighting the role of employees themselves. These workplace interventions often encourage employees to identify, develop, and make use of workplace resources. The aim of this systematic review and meta-analysis is to investigate the effectiveness and potential underlying mechanisms of these bottom-up, resource-developing interventions. Method: Systematic searches were conducted in the online databases Web of Science, Academic Search Complete, Business Source Ultimate, PsycInfo, PsycArticles, SCOPUS, and Google Scholar. Publication year range was 2000-2020. Eligibility criteria were defined using PICOS. To be eligible for the systematic review, the intervention study identified had to aim at promoting working individuals' work engagement by developing workplace resources from bottom-up. Work engagement had to be measured using the Utrecht Work Engagement Scale. The systematic review included one-, two-, or multiple-armed - randomized or non-randomized - intervention studies with various study designs. Further, a meta-analysis was conducted on a sub-set of the studies included in the systematic review. To be eligible for the meta-analysis, the studies had to be two- or multiple-armed and provide the information necessary to compute effect sizes. Results: Thirty-one studies were included in the systematic review. The majority reported that overall work engagement increased as an effect of the intervention. The evidence regarding the sub-components of work engagement was scattered. Potential underlying mechanisms explored were intervention foci, approach, and format. Dimensions of satisfaction and performance were identified as secondary outcomes. Participant experiences were generally described as positive in most of the studies applying mixed methods. The meta-analysis showed a small but promising intervention effect on work engagement (24 studies, SMD: -0.22, 95% CI: -0.34 to -0.11, with I 2=53%, indicating moderate inconsistency in the evidence). Conclusion: The synthesized evidence suggests that bottom-up, resource-developing interventions are effective in the promotion of work engagement. The meta-analysis suggests that focusing on strengths use or mobilizing ego resources and adopting a universal approach increase intervention effectiveness.

Roles and responsibilities in substance use prevention in the school setting: views among Finnish school personnel representatives

OBJECTIVE

This study explores the views of Finnish school personnel representatives regarding substance use prevention responsibilities.

DESIGN

Twenty-two focus groups were conducted within the scope of a regional intervention study in 2019. Qualitative content analysis was performed.

SETTING

Focus group interviews were conducted in the school setting.

SUBJECTS

Focus group participants included representatives for educational personnel and student welfare personnel working in basic education, general upper secondary education or vocational education settings.

MAIN OUTCOME MEASURES

Views and experiences concerning roles and responsibilities in primary prevention of substance use.

RESULTS

Findings highlight the need for intersectoral efforts and intra-school collaboration in primary prevention efforts, but also in mental health promotion - on which the informants placed great emphasis. The health promotion leadership in schools, structural guidelines and the school curriculum could both challenge and support school personnel in their roles. An increased need to focus on the early years of life and related responsibilities of the homes was emphasized, along with the need to place more emphasis on health education in the first years of basic education, and responsibilities related to early risk identification.

CONCLUSION

The findings highlight a need to develop structures and role clarity among school personnel, which can advance further development of intra-school and inter-sectoral collaboration in primary substance use prevention and mental health promotion. In the Finnish context, the successful implementation of relevant legislation, which some school representatives view as unclear or contravening, could be further supported.Key pointsViews regarding responsibilities in primary substance use prevention in the school setting have been less researched in the Nordic countries:The importance of inter-sectoral and intra-school collaboration is emphasized among school personnel representatives, including the role of the homesPrimary prevention and mental health promotion responsibilities are viewed as less clear than secondary and tertiary prevention responsibilitiesStructural guidelines concerning e.g. confidentiality aspects and curriculum features can both support and challenge school representatives in their roles.

Instruments to evaluate mental well-being in old age: a systematic review

OBJECTIVE

The aim of this study is to identify and appraise existing instruments to evaluate mental well-being in old age.

METHOD

Systematic literature searches in PubMed, PsycINFO, ProQuest Research Library, AgeLine and CINAHL databases were performed. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline was used to assess the measurement properties, reported according to the Preferred Reporting Items for Systematic Reviews and meta-Analysis (PRISMA) statement. For each measurement property, results were classified as positive, negative or indeterminate. The quality level of evidence was rated as high, moderate, low or very low following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

A total of 28 instruments were found. Most instruments evaluated different dimensions of mental well-being, including various subscales. The quality was adequate overall. Six instruments showed high quality (Perceived Well-Being Scale-PWB, Salamon-Conte Life Satisfaction in the Elderly Scale-SCLSES, Herth Hope Scale-HHS, Life Satisfaction Index Third Age-LSITA, Meaning in Life Scale-MLS, and SODdisfazione dell'Anziano-SODA), and other six a moderate level (Scale of Happiness of the Memorial University of Newfoundland-MUNSH, Six Scales of Psychological Well-Being-PWBS, Valuation Of Life-VOL, Life Satisfaction Scale for Chinese Elders-LSS-C, Meaningful Activity Participation Assessment-MAPA and Will To Life-WTL).

CONCLUSION

This review provides the first comprehensive synthesis of instruments assessing mental well-being in older populations. The PWB, SCLSES, HHS, LSITA, MLS and SODA were the most appropriated instruments. An instrument that specifically measures mental well-being in the oldest old age group (aged 80 plus) and that considers its multidimensional nature is needed.

Nordic population-based study on internet use and perceived meaningfulness in later life: How they are linked and why it matters

AIM

The aim was to explore the association between internet use, the use of specific internet-based activities and perceiving life as meaningful, among older adults in two regions in Finland and Sweden.

METHODS

The data was collected through a population-based survey (N = 9386) as part of the GERDA project conducted in 2016. In order to analyse the associations between perceiving life as meaningful and internet use and related activities, odds ratios with a 95% confidence interval were calculated using binary logistic regression analysis, where socio-demographic factors and health status were controlled for.

RESULTS

Statistically significant associations were found between perceiving life as meaningful and internet use in later life. When looking further at the specific internet-based activities under study, activities related to leisure and entertainment showed a statistically significant connection to perceived meaningfulness in later life, after controlling for socio-demographic factors and health status.

CONCLUSIONS

The results indicated that there was a statistically significant positive association between internet use and perceiving life as meaningful in later life. Online activities related to leisure and entertainment seem to be especially associated with perceived meaningfulness. Although causal direction could not be determined, the results suggest that internet use may support the experience of wellbeing in everyday life among older persons, through the unlimited access to interest-driven activities that it provides.

Mental well-being among the oldest old: revisiting the model of healthy ageing in a Finnish context

Purpose: This study aimed to examine how participants aged 80 years old or over describe their mental well-being—exploring the suitability of the model of healthy ageing when outlining the mental well-being concept.

Methods: Six structured focus group interviews with 28 participants were conducted in Western Finland in 2017. Qualitative content analysis was performed, where both manifest and latent content was considered in a process involving meaning condensation and coding, followed by categorization.

Results: The healthy ageing model constituted a useful framework for the conceptualization of mental well-being, illustrating the links between these two constructs. The analysis resulted in a four-dimensional model of mental well-being in oldest old age, the key components being: Activities—enjoyment and fulfilment; Capability—functioning and independence; Orientation—awareness, shifted perspectives and values; and Connectedness—sense of belonging.

Conclusions: Although functional status plays an important role for well-being in general, it is not the principal component of self-reported mental well-being within the heterogeneous group of the oldest old. Further, many persons in this age group do not view themselves as passive or dependent, on the contrary, they underline the importance of empowering attitudes, a positive mindset and actively creating circumstances which support their mental well-being.

The EMMY Project: Promoting mental wellbeing among the oldest old – The Finnish Case

Background

The European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY, 2017-19) project covers interdisciplinary and mixed method studies on mental wellbeing among the oldest old in Finland, Italy, Norway and Spain. The overarching aim is to strengthen the understanding of how welfare models and related policies could be adapted to support mental wellbeing in the oldest old. Project results will be incorporated in a new tool for assessing the mental wellbeing impact of welfare policies.

Methods

23 focus group interviews were conducted, including 117 participants aged 80 years or older. Six of these were conducted in Finland (N = 28) and the data was analysed using qualitative content analysis. In a policy analysis, relevant national legislation, plans and programmes were identified from the four countries. Five key stakeholders in each country validated the identified policies in interviews. The policy items were systematically coded (N = 42 in Finland), focusing on their correspondence with older adults’ own views on their mental wellbeing and its protective factors.

Results

The findings highlight that although functional status undeniably plays an important role for experienced wellbeing in general, it is not the principal component of the experienced mental wellbeing among the oldest-old. The Finnish policy case pinpoints both promising policy examples, but also development needs such as the inclusion of issues related to e.g. digitalization and social challenges including loneliness.

Conclusions

These findings have significant multi-level implications, showcasing the importance of coordinated actions at societal and individual levels alike. Actions to enhance social participation, especially for individuals with reduced social networks are needed, as well as a more holistic approach in general considering the multi-dimensional nature of experienced mental wellbeing in later life.

Key messages

Results support the exchange of good policies between EU Member States to incorporate a change of focus from mental disorders to mental wellbeing among older people and its protective factors. Country-specific case studies highlight the relevance of context,pinpointing the various pathways to increased mental wellbeing that could be translated into policy.

The Nordic @geing Online project: Co-creating a social application together with older adults

Background

Online resources present various possibilities for health promotion, also in the growing older adult population. Tailored online services aiming to support social participation among users could potentially promote older adults’ psychosocial health. In the @geing Online project an online application is developed, focusing on access to meaningful social activities among older adults in rural areas in Finland and Sweden. The innovation project (2017-2020) is funded by the Interreg Botnia-Atlantica programme (European Regional Development Fund).

Methods

A collaborative, user-centred design approach is applied when developing the online application, allowing older potential users and personnel groups from the social and health care sector to evaluate application features in a step-wise process. The inclusion of personnel groups allows for the exploration of the feasibility of introducing the tool in home care services and similar relevant contexts from an organizational perspective. Further, the inclusion of regional IT-companies presents opportunities for them to develop their competence regarding eHealth tools and older adults as a target group.

Results

An advanced prototype of the application and its core features is presented. Promising approaches and outcomes regarding the co-creation methods applied to ensure the involvement of stakeholders in the development process are elaborated upon. Challenging issues related to the project theme, such as stereotypical and negative views of older adults’ competences and motivation related to application use are also discussed.

Conclusions

The project highlights possibilities - but also challenges - when co-creating a social application together with older adults, some of whom have no experience in internet use. The gathered project outcomes will provide lessons on the potential of new technologies for delivering health promotion initiatives among older adults.

Key messages

Tailored online services aiming to support social participation among users provide possibilities for promoting psychosocial health in the growing population of older adults. Application development utilizing a user-centered design approach can be implemented even if the end-users are not familiar with the internet or application use.

Problematic alcohol use and problem gambling: Associations to structural and functional aspects of social ties in a Finnish population sample

Aims

This study aims to explore associations between structural and functional aspects of social networks and relationships (here labelled social ties) among individuals exhibiting problematic alcohol use and problem gambling, respectively.

Material & Methods

Data was collected in the 2011 Western Finland Mental Health Survey, a postal questionnaire survey applying a stratified random sampling approach. The survey response rate was 46.2% (n = 4624, age range 15–80 years). Problem behaviours were assessed using the CAGE and Lie/Bet tools. Logistic regression analyses were performed, with problematic alcohol use and problem gambling as dependent variables. Demographic variables, structural social tie factors (marital status, frequency of social contacts, engagement in association activities) and functional social tie factors (experienced loneliness, social support, neighbourhood trust, general trust) constituted explanatory variables.

Results

In this representative population sample, only one structural social tie variable, marital status, proved to be significantly associated with one of the outcomes (problematic alcohol use). Identical functional social tie variables were associated with both problematic alcohol use and problem gambling: individuals exhibiting the problem behaviours experienced higher levels of experienced loneliness and low levels of neighbourhood trust. Identified interaction effects with demographic factors highlight the complexity of links.

Conclusions

Functional aspects of individual-level social ties appear to be more relevant when studying problematic alcohol use or problem gambling, similarly to other forms of mental health problems. The role of social ties as preventive or risk factors for problem behaviour development, as a part of problem behaviour maintenance or as a cessation and a recovery resource should be further explored, considering also interactions with demographic variables.

The association between social capital and loneliness in different age groups: a population-based study in Western Finland

Background

Previous studies of loneliness have largely focused on establishing risk factors in specific age groups such as in later life or in young people. Researchers have paid less attention to the link between social capital and loneliness across different age groups. The aim of this study was to examine the association between social capital and experienced loneliness in different age groups in a Finnish setting.

Methods

The data originates from a population-based cross-sectional survey conducted among 4618 people aged 15–80 in Western Finland in 2011. The response rate was 46.2 %. The association between social capital, measured by frequency of social contacts, participation in organisational activities, trust and sense of belonging to the neighbourhood and loneliness was tested by logistic regression analyses stratified by four age groups.

Results

Frequent loneliness (defined as experienced often or sometimes) was higher among younger people (39.5 %) compared to older people (27.3 %). Low levels of trust were linked to loneliness in all four age groups. The association between other aspects of social capital and loneliness varied across age groups.

Conclusions

Frequent loneliness is common among the general adult population and could be seen as a public health issue. Our findings imply that low social capital, especially in terms of low trust, may be a risk factor for loneliness. However, further research is needed to assess the influence of poor health and reverse causality as explanations for the findings.

Mental health research priorities for Europe

Mental and brain disorders represent the greatest health burden to Europe-not only for directly affected individuals, but also for their caregivers and the wider society. They incur substantial economic costs through direct (and indirect) health-care and welfare spending, and via productivity losses, all of which substantially affect European development. Funding for research to mitigate these effects lags far behind the cost of mental and brain disorders to society. Here, we describe a comprehensive, coordinated mental health research agenda for Europe and worldwide. This agenda was based on systematic reviews of published work and consensus decision making by multidisciplinary scientific experts and affected stakeholders (more than 1000 in total): individuals with mental health problems and their families, health-care workers, policy makers, and funders. We generated six priorities that will, over the next 5-10 years, help to close the biggest gaps in mental health research in Europe, and in turn overcome the substantial challenges caused by mental disorders.

Contribution of the Nordic School of Public Health to the public mental health research field: a selection of research initiatives, 2007-2014

The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of significant importance in this work.

Psychosocial Links Between Internet Use and Mental Health in Later Life: A Systematic Review of Quantitative and Qualitative Evidence

Research on the role of information and communication technology (ICT) use for active aging is limited. The aim of this systematic review is to investigate the link between Internet use and mental health among older adults. The review was conducted based on searches in 9 electronic databases (2002-2014). A meta-synthesis approach was applied, examining quantitative (18) and qualitative (14) studies. The findings from the synthesis of quantitative statistical data indicate an overall positive association between Internet use and mental health and its psychosocial covariates in later life. The psychosocial links between Internet use and mental health identified from the qualitative data were (a) enhanced interpersonal interaction at individual level, (b) increased access to resources within the community, and (c) empowered social inclusion at society level. The results highlight the multi-level psychosocial links between Internet use and mental health, which may be applied in initiatives targeting healthy aging in various settings.

Public mental health research in Europe: a systematic mapping for the ROAMER project

BACKGROUND

As part of the ROAMER (ROAdmap for MEntal health Research in Europe) project, aiming to create an integrated European roadmap for mental health research, we set out to map the hitherto unmapped territory of public mental health research in Europe.

METHODS

Five electronic databases (CINAHL, Health Management, Medline, PsycINFO, Social Services Abstracts) were used for identifying public mental health research articles published between January 2007 and April 2012. The number of publications for each European country in five research domains (i.e. mental health epidemiology, mental health promotion, mental disorder prevention, mental health policy and mental health services) was analysed by population size and gross domestic product (GDP), and mean impact factors were compared.

RESULTS

In all, 8143 unique publications were identified. Epidemiology research dominates public mental health research, while promotion, prevention and policy research are scarce. Mental health promotion is the fastest growing research area. Research targeting older adults is under-represented. Publications per capita were highest in northwestern Europe, and similar trends were found also when adjusting the number of publications by GDP per capita. The most widely cited research origins from Italy, Switzerland, the UK, the Nordic countries, the Netherlands, Greece and France.

CONCLUSION

In Europe, public mental health research is currently a matter of the affluent northern and western European countries, and major efforts will be needed to promote public mental health research in south and east Europe. In spite of a smaller public mental health research output, some Mediterranean countries produce highly cited public mental health research.

ROAMER: roadmap for mental health research in Europe

Despite the high impact of mental disorders in society, European mental health research is at a critical situation with a relatively low level of funding, and few advances been achieved during the last decade. The development of coordinated research policies and integrated research networks in mental health is lagging behind other disciplines in Europe, resulting in lower degree of cooperation and scientific impact. To reduce more efficiently the burden of mental disorders in Europe, a concerted new research agenda is necessary. The ROAMER (Roadmap for Mental Health Research in Europe) project, funded under the European Commission's Seventh Framework Programme, aims to develop a comprehensive and integrated mental health research agenda within the perspective of the European Union (EU) Horizon 2020 programme, with a translational goal, covering basic, clinical and public health research. ROAMER covers six major domains: infrastructures and capacity building, biomedicine, psychological research and treatments, social and economic issues, public health and well-being. Within each of them, state-of-the-art and strength, weakness and gap analyses were conducted before building consensus on future research priorities. The process is inclusive and participatory, incorporating a wide diversity of European expert researchers as well as the views of service users, carers, professionals and policy and funding institutions.

Social capital as a resource for mental well-being in older people: a systematic review

Social capital has previously been reviewed in relation to mental health. However, none have focused specifically on positive aspects of mental health such as mental well-being. This review aimed to explore the relationship between social capital and mental well-being in older people. Ten relevant databases were systematically searched using an extensive search strategy for studies, analyzing the link between social capital and mental well-being. Criteria for inclusion in the systematic review were: the study sample included older people (≥50 years); the study reported a mental well-being outcome; social capital was an exposure variable; and empirical research using quantitative methods and published in English, between January 1990 and September 2011. Eleven studies met the inclusion criteria. Each study was assessed against seven possible exposure measures (structural, cognitive; bonding, bridging, linking; individual, collective). The results showed that all included studies found positive associations between parts of social capital and aspects of mental well-being. Typically, the relationship between social capital and mental well-being differed within as well as between studies. Our results highlight that there is no 'gold standard' of how to measure social capital or mental well-being. Social capital is generated in the interaction between individual and collective life. A possibility for future research is therefore to follow Bronfenbrenner's classical division into macro, meso, and micro levels. We consider family and friends at the micro level to be the key factors in generating social capital and well-being in older people.

Social Capital and Loneliness Among the Very Old Living at Home and in Institutional Settings

Objective: The aim of this study was to investigate the association between aspects of social capital and loneliness among the very old living at home and in institutional settings. Method: Half of those aged 85 years, and all 90- and 95-year-olds and older in urban and rural municipalities in northern Sweden and western Finland were invited to participate in a cross-sectional population-based study in 2005-2007. A sample of 483 participants who completed the study was included in the analyses. Results: Loneliness was experienced by 55% percent of those living in institutional settings often or sometimes and 45% of those living in their own homes. Loneliness was closely related to living alone, to depression, and to region (northern Sweden). Discussion: Social capital and loneliness are context dependent (i.e., geographical or living environment). Among the very old, the link between social capital resources and loneliness is also highly influenced by health status.

A comparison of older workers’ and retired older people’s social capital and sense of mastery

Aim: To assess if older people with higher levels of social capital experience higher levels of sense of mastery than those with lower levels of social capital and to assess whether this association is stronger for retired older people than for older workers. Methods: The data originates from a general population mental health survey conducted among 2610 older people (50 years of age or older) in Finland in 2011. The response rate was 57.1%. The association between sense of mastery, measured by Pearlin’s Sense of Mastery Scale, and social capital, measured by social networks, organisational activities, trust, and sense of belonging, were tested by logistic regression analyses. Results: The results showed that older workers experienced greater sense of mastery than retired older people. Trust and neighbourhood belonging were positively associated with sense of mastery. Conclusions: Inequalities in mental wellbeing between older people included in or excluded from the workforce are a public health challenge. Our findings imply that social capital needs to be prioritised as a means for enhancing mental health. More attention should be paid to promote mental wellbeing in retired older people.

Structural and cognitive social capital and depression among older adults in two Nordic regions

OBJECTIVE

To study the association between structural and cognitive aspects of social capital and depression among older adults in two Nordic regions.

METHOD

Data were retrieved from a postal survey targeting older adults aged 65, 70, 75 and 80 years (N=6 838, response rate=64%) residing in the Västerbotten region (Sweden), and the Österbotten region (Finland) in 2010. The associations between structural (measured by frequency of social contact with friends and neighbours) and cognitive (measured by experienced trust in friends and neighbours) aspects of social capital and depression (measured by Geriatric Depression Scale, GDS-4) were tested by logistic regression analyses.

RESULTS

Both low structural and cognitive social capital as defined in the study showed statistically significant associations with depression in older adults. Only experienced trust in neighbours failed to show significant association with depression. In addition, being single and being 80 years of age indicated a higher risk of depression as defined by GDS-4.

CONCLUSION

The findings underline the connection between adequate levels of both structural and cognitive individual social capital and mental health in later life. They also suggest that the connection differs depending on various network types; the cognitive aspect of relationships between friends was connected to depression, while the connection was not found for neighbours. Further, the oldest age group in the sample (80 years of age) is pointed out as a population especially vulnerable for depression that should not be overlooked in mental health promotion and depression prevention.

Cognitive components of social capital and mental health status among older adults: A population-based cross-sectional study

Aims: To determine the associations between the cognitive aspects of social capital and mental health status in older adults. Methods: Data on older people (65 years of age or older, n = 1,102) were retrieved from a general population mental health survey conducted in Finland in 2008. The response rate was 61%. The associations between self-reported depression (measured by the Composite International Diagnostic Interview Short Form, CIDI-SF) or psychological distress (measured by the General Health Questionnaire, GHQ-12) and perceived social support, sense of belonging, and trust were tested by logistic regression analyses. Results: For the cognitive social capital indicators, difficult access to help from neighbours showed a significant association with depression. Furthermore, not having people to count on, experiencing a lack of concern from other people, and feeling mistrust towards other people were all significantly associated with psychological distress. Conclusions: Links between mental health and cognitive social capital indicate that social support and trust may be important factors to consider when developing interventions to promote mental health and prevent mental disorders among older adults.

Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis

OBJECTIVE

To assess the effectiveness of psychosocial interventions for the prevention of depression in older people.

METHOD

Systematic review and meta-analysis of prospective controlled trials.

RESULTS

Thirty studies were included. Overall, psychosocial interventions had a small but statistically significant effect on depressive symptoms (17 trials, standardized mean difference = -0.17, 95% CI = -0.31 to -0.03). In comparison with no-intervention controls, social activities were effective in reducing depressive symptoms, but results should be interpreted with caution due to the small number of trials. No statistically significant effect on depressive symptoms was found for physical exercise, skill training, reminiscence, or for multicomponent interventions.

DISCUSSION

Psychosocial interventions have a small but statistically significant effect in reducing depressive symptoms among older adults. The current evidence base for psychosocial interventions for primary prevention of depression in older people is weak, and further trials warranted especially for the most promising type of interventions evaluated, that is, social activities.