bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing the Bloom Trial: Community health nurses’ perceptions of potential barriers
Authors: Brautsch L , Kierkegaard L , Carlsson RR , Bonnesen CT 
Published: October 2022

Abstract

Background
The overall aim of the Bloom Trial is to develop and test a program promoting healthy weight development during infancy within the community health nurse setting in Denmark. Many interventions are poorly implemented, and to ensure adequate implementation support, previous studies have suggested to assess barriers and organizational readiness before intervention start. The aim of the present study is to assess barriers for implementing and sustaining the Bloom Trial among program adopters and implementers.

Methods
Telephone interviews with managing health nurses (adopters) and health nurses (implementors) from twenty Danish municipalities were carried out (n = 22) in 2017. Moreover, two workshops with health nurses, and continuously meetings with implementation science experts were conducted in 2021-2022.

Results
Barriers were identified on different levels. Organizational barriers within the work of health nurses included lack of time, economic resources, project fatigue, and political priority. Furthermore, health nurses lacked relevant tools to guide parents about promoting healthy weight development. Interpersonal barriers between health nurses and parents were identified as the difficulties of having conversations about healthy weight development, especially if the parents or health nurses were overweight themselves. Cultural differences including language barriers and different perceptions of for example healthy food choices were also found.

Conclusions
The findings are central for ensuring that the Bloom Trial is relevant and applicable to the setting of health nurses in Danish municipalities. This is crucial for ensuring successful adoption, implementation, and prolonged sustainability.

Key messages
• The study pinpoints key barriers (e.g. lack of time, project fatigue and cultural factors) of implementing an intervention promoting healthy weight in the community health nurse setting in Denmark.
• Involving community health nurses’ perceptions aim at increasing the chances of producing a relevant and successful implementation strategy.
Trends of risk behaviors in adolescents: a 10-year study in a representative sample of Tuscany, Italy
Authors: Lastrucci V , Lazzeretti M , Innocenti F , Berti A , Silvestri C , Schirripa A , Paoli S , Lorini C , Voller F , Bonaccorsi G 
Published: October 2022

Abstract

Background
The aim of the study was to evaluate the trends of prevalence of several health risk behaviors (HRBs) and health conditions over a 10-years period in a representative sample of adolescents of Tuscany Region, Italy.

Methods
The study had a repeated cross-sectional design, data from the last four survey waves of EDIT surveillance (2008-2018) were used. EDIT surveillance investigates HRBs in a representative sample of students attending the upper secondary schools of Tuscany. Prevalence of 17 HRBs and health conditions were considered and analyzed by age, sex, and socioeconomic status (SES).

Results
A total of 21.943 students were surveyed from 2008 to 2018. Declining trends in the participation in smoking, cocaine use, driving under the influence of alcohol and drugs, and problem gambling were observed, while alcohol abuse and at-risk sexual behaviors remained unchanged or increased during the study period. During the most recent survey males resulted more frequently involved in most of the HRBs, while females more frequently reported physical inactivity, regular smoking and not using a condom. Female participation in smoking and alcohol abuse behaviors, fruit and vegetables consumption, and bullying worsened over the study period. Smoking, poor dietary habits, physical inactivity, high distress level, and obesity were more frequently observed in low SES students than in high SES students.

Conclusions
In conclusion findings showed various different tendencies in adolescent participation in HRBs over the course of the last decade; concerning trends in at-risk sexual behaviors and alcohol consumption and females’ risk-taking behavior on the rise require careful monitoring and intervention.

Key messages
• Distinct tendencies according to sex, socio-economic condition and specific health risk behavior were observed in adolescent participation in health risk behaviors over the course of the last decade.
• Health promotion and prevention interventions tailored on specific health risk behaviors and population groups are needed.
Consequences of Housing Conditions on Maternal Health of Forced Migrant Women
Authors: Engelhardt M , Gaudion M , Kamhiye J , Al-Munjid R , Borde T 
Published: October 2022

Abstract

Background
Housing is a major social determinant and contextual factor of health. Forced migrants are restricted in their freedom of choosing and shaping their housing conditions. This qualitative study highlights the impact of housing restrictions on reproductive and maternal health from the lived experience of forced migrant women who recently gave birth to a child.

Methods
Qualitative problem-centered interviews were conducted with 33 refugee mothers (Mage = 31 years) 1-9 month postpartum. Interviewees came from 19 countries of origins, spoke 22 languages, and had lived in Germany for an average of three years. The mothers’ perspectives were complemented by 75 qualitative interviews with maternal health care professionals, (HCPs: midwives, gynecologists, social workers). Interview transcripts were analyzed via framework method regarding (1) type of housing: shared accommodation vs. private apartment, (2) region: rural vs. urban, (3) exhausting and supporting conditions as well as (4) consequences on maternal health.

Results
Interviewees living in shared accommodations reported exhausting conditions hindering self-determined upbringing of their newborn, e.g., confined living spaces, racism of staff, shared kitchen and bathrooms, lack of privacy, mobility, access to medical care, hygiene. Reported consequences on maternal health ranged from physical stress to social stress and mental stress (e.g., sleeping problems, depression, fear, worrying about health of the newborn). Interviewees living in private apartments showed higher autonomy and contentment. HCPs reported missing time and staff to provide adequate support.

Conclusions
Both refugee women and HCPs reported housing as main stressor during pregnancy and childbed, resulting in higher physical, social, and mental stress. Strategic social support for finding suitable private apartments for new families is needed as well as comprehensive visiting midwifery care in accommodations.

Key messages
• Living conditions in shared accommodations are unacceptable from a public health and human rights perspective, especially for women during pregnancy and childbed.
• Negative effects on maternal health and self-determination of families were shown.
Insufficient support and help for adolescents with disabilities during the COVID-19 pandemic
Authors: Holm ME , Sainio P , Sjöblom S , Nurmi-Koikkalainen P 
Published: October 2022

Abstract

Background
The COVID-19 pandemic may have increased the need for help and support for adolescents with disabilities. At the same time, moving to distance learning can reduce access to support services. Despite this, little is known about this issue. Thus, we investigated differences in the unmet need for help and support between adolescents with and without disabilities during the COVID-19 pandemic.

Methods
We analyzed large population-based data from the Finnish School Health Promotion study obtained during 2019 and 2021 (2019: n = 87,215; 2021: n = 91,560). The target group comprised adolescents from lower secondary schools in Finland (age: M = 15.3, SD = .64). Logistic regression models were applied to investigate differences in the unmet need for help and support between adolescents with and without disabilities.

Results
During the pandemic, adolescents with disabilities reported insufficient help and support related to their learning and well-being from teachers, school curators and psychologists, and school nurses and doctors more often than other adolescents (p &lt; .001). Adolescents with disabilities reported more often than others that distance learning involved insufficient learning support (p &lt; .001). Between 2019 and 2021, an increasing proportion of adolescents with disabilities felt that they had received insufficient help and support related to their well-being from nurses, doctors, psychologists, school curators, and teachers. To summarize, the COVID-19 pandemic reduced access to support and assistance for adolescents, particularly those with disabilities.

Conclusions
Policies in schools should be developed and resources secured so that support and help for adolescents with disabilities can be secured in exceptional circumstances. Insufficient support and assistance for adolescents with disabilities can impair their learning outcomes and health.

Key messages
• During the COVID-19 pandemic, adolescents with disabilities reported insufficient help and support related to their learning and well-being more often than other adolescents.
• In times of crisis, support and help for adolescents with disabilities must be guaranteed.
Impact of COVID-19 on University Students’ Quality of life and mental health in Greece
Authors: Vantarakis A , Fotini Tsami F , Kanellopoulou A , Alexopoulou-Prounia L , Tsapara A , Alexopoulos P , Katsadoros K 
Published: October 2022

Abstract

COVID-19 has a serious impact on people’s physical health and mental health. The COVID-19 pandemic has highlighted an increasing deterioration of university students’ quality of life and mental health due to several factors. The COVID-19 pandemic forced university students to take online classes, which may have bad impacts on students’ learning. In addition, the students lost many job opportunities during the pandemic. Faced with employment and study pressure and worried about the epidemic, university students were prone to increased overall negative emotion, anxiety and depression. Our study aims to conduct a timely assessment of the impact of the COVID-19 pandemic on the quality of life and mental health of University students. We conducted a cross sectional study using an online interview survey in students at public universities in Greece to better understand the effects of the pandemic on their quality of life and mental health. Three questionnaires were used (WHOQOL-BREF, IES-R and HADS). The data were analyzed with IBM SPSS 26. 1.266 university students from public Greek Universities participated in the study, 73.1% of which were female, 26,3% were male. We observed that 55,8% had a score lower in psychological domain and 52,3% in social domain of WHOQOL-BREF. Also 46.6% of the respondents had a score of 37+ on the IES-R questionnaire, 45% of the respondents had abnormal results regarding anxiety and 33.6% had abnormal results regarding depression. Due to the long-lasting pandemic and onerous measures such as lockdown and stay-at-home orders, the COVID-19 pandemic brings negative impacts on University education and quality of life of students. The findings of our study highlight the urgent need to develop interventions and preventive strategies to address the quality of life and mental health of University students.

Key messages
• There is a need for preventative measures for university students to ensure that their mental health and quality of life do not suffer.
• Female students reached higher levels of anxiety in the COVID-19 pandemic period.
Low resilience as risk factor of mental disorders during COVID-19 pandemic: A cohort study
Authors: Castellvi P , Llistosella M , Miranda-Mendizabal A , Recoder S , Calbo E , Casajuana-Closas M , Leiva D , Manolov R , Matilla-Santander N , Garcia-Forero C 
Published: October 2022

Abstract

Background
To analyze whether people with low resilience are at higher risk of mental health problems during the COVID-19 pandemic in Spanish adults.

Methods
A longitudinal cohort study was carried out. Resilience was measured pre/post-pandemic with the CD-RISC. Mental health problems assessed were: Major Depressive Episode (MDE), Generalized Anxiety Disorder (GAD), Suicidal Thoughts and Behaviors (STB), and Posttraumatic Stress Disorder (PTSD) symptoms.

Results
We found statistically significant differences between groups and resilience scores in MDE [F (3;48.40)=19.55], GAD [F(3;19.63)=6.45] and STB [F(3;111.74)=31.94]. Multivariable analyses showed individuals with very low resilience were at a 5-fold risk of Incidence of MDE and a 4-fold risk of STB. Persistent group presented a 21-fold risk of MDE and 54-fold risk of STB, respectively. No evidence of higher risk was found for GAD. Individuals with low resilience and exposed to COVID-19 did not have a significantly higher risk. Individuals with low resilience were at higher risk of PTSD in general population [β(95%CI)= -3.25(-3.969 to -2.54)], but not for individuals with COVID-19.

Conclusions
In the general population, having low or very low resilience increases the risk of suffering MDE, STB, and PTSD, but not GAD during the COVID-19 pandemic, but not in the population with COVID-19.

Key messages
• Resilience was a buffer of mental health problems in general population, but not in those exposed to COVID-19.
• Those with low resilience were at 21-fold risk of mental health problems before and during the first year of pandemic.
Building capacity for mental health resilience – local impact of the UK Better Mental Health Fund
Authors: Lie M , Visram S 
Published: October 2022

Abstract

Background
COVID-19 as a public mental health emergency has exacerbated existing mental health inequalities. The UK government invited local authorities with areas of high deprivation to apply for a year of funding, in order to address the mental health impacts of COVID-19 and incentivize investment in prevention and promotion interventions for better mental health. South Tyneside Council in North East England made a successful bid to the Better Mental Health Fund (BMHF), and distributed grants to 7 organisations delivering 13 programs. A qualitative evaluation of these programs aimed to answer the following questions:
1. How were the funded programs implemented?
2. What difference did they make to local beneficiaries?
3. How might these programs and their impacts be sustained into the future?
4. Has the BMHF led to any wider impacts on organisations and local communities?

Methods
In-depth interviews with individuals, pairs and groups were conducted online or in person with service providers and beneficiaries. Non-verbatim transcripts were made from recordings, checked with verbatim transcripts from Teams and Zoom, and analyzed thematically to generate a coding frame. Throughout the analysis, comparisons were made between organizations and programs.

Results
Fifteen interviews involving 22 participants lasting up to an hour each were conducted. The main themes identified as impactful were 1) community approaches based on supportive and good relationships between the local authority public health lead and participating organizations (mainly voluntary agencies), enabling 2) capacity-building for mental health resilience and 3) community empowerment. This was despite the short turnaround of the grant application process, limited time to deliver on targets, and anxieties about future sustainability.

Conclusions
Short-term funding can build capacity in mental health resilience in deprived areas if administered by public health leaders who relate well with provider organizations.

Key messages
• Public health leaders who relate well with provider organizations are key drivers of community health promotion strategies that include mental health capacity building.
• Qualitative methods used in evaluations can inform public health commissioning by capturing the benefits and challenges of short-term funding for interventions promoting community mental health.
Health-related behaviors during adolescence and subsequent anxiety and depression: the HUNT study
Authors: Kleppang AL , Vettore MV , Hartz I , Haugland SH , Stea TH 
Published: October 2022

Abstract

Background
Evidence on the predictors of common mental disorders using nationwide health registries are scarce in Norway. Identifying modifiable behaviours affecting mental health across the lifespan is paramount to develop tailored strategies to tackle mental illnesses. The aim of this study was to identify patterns of health-related behaviours in adolescence and their influence on anxiety and/or depression in adulthood.

Methods
This was a prospective study based on data from the Trøndelag Health Study (HUNT) and health register data (N = 2061). Patterns of health-related behaviours were assessed according to physical activity, consumption of wholegrain bread, fish, fruit, vegetables, and sugar sweetened beverages and insomnia. Participant’s use of healthcare system for anxiety and/or depression was recorded at least once in the health registries. The patterns of health-related behaviors were identified through latent class analysis. Multivariable logistic regression was used to test the association between patterns of health-related behaviors and depression or/and anxiety.

Results
Four classes of health-related behaviors were identified: class 1 (15.2%), class 2 (36.0%), class 3 (24.2%), class 4 (24.6%). Adolescents with unhealthy behaviors (classes 1, 2 and 3) had 82%, 34% and 84% higher odds of depression and/or anxiety during adolescence and early adulthood than those from the healthy-related behaviors group (class 4).

Conclusions
Our findings suggest that health-related behaviors are clustered among Norwegian adolescents. There was a meaningful association of the three patterns of unhealthy behaviors during adolescence with anxiety and depression in adulthood. Population strategies and policies aiming to tackle unhealthy behaviors among adolescents can positively impact on adult’s mental health.

Key messages
• Improving healthy behaviors during adolescence may reduce the burden of mental illness in adulthood.
• Population strategies and policies aiming to tackle unhealthy behaviors among adolescents can positively impact on adult’s mental health.
Anxiety and depression disorders in Portugal during the COVID-19 pandemic
Authors: Santos A , Rachadell J 
Published: October 2022

Abstract

Background
Mental disorders are a major contributor to the global burden of disease. During the first year of the pandemic by COVID-19, increases of 25% in the prevalence of anxiety and depression were reported globally. In Portugal, studies conducted during lockdown showed an increase in the prevalence of these disorders. However, previous studies have shown that negative life events, such as exposure to disasters or grief, later lead to resilience or recovery. It is therefore necessary to study the evolution of these disorders in order to adapt mental health measures.

Methods
The number of patients registered with “P76 - Depressive Disorder” and “P74 - Anxiety Disorder/anxiety state”, according to ICPC-2 criteria, and the total number of patients registered in the Portuguese Health Centers for the months of January 2019 to 2022 were obtained from the Portuguese NHS Information and Monitoring System (SIM@SNS). We calculated the percentage of patients with each of the disorders, individually and combined. Data by health regions were also obtained in order to compare the evolution within each region (North, Center, Lisbon and Tagus Valley, Alentejo and Algarve).

Results
Between January 2019 and 2022, the proportion of patients with anxiety disorder increased linearly from 8% to 9%. Similarly, the proportion of patients with depressive disorder increased from 11% to 12%. When considered together, anxiety and depression disorders affected 21% of users in mainland Portugal at the beginning of 2022. The Alentejo and Center regions have the highest prevalence of anxiety and depression (24.9% and 24%, respectively) and the Algarve region has the lowest (16.74%). The increases were consistent across health regions, with the largest increase in the North region (2.6%) and the smallest in the Central region (1.7%).

Conclusions
Anxiety and depression disorders increased in mainland Portugal during the years of the COVID-19 pandemic.

Key messages
• Mental health has been an important factor in public health since before the pandemic.
• Monitoring depression and anxiety levels in the general public can guide priorities after the pandemic.
Mental health surveillance of German adults in the COVID-19 pandemic: trends in depressive symptoms
Authors: Walther L , Junker S , Kersjes C , Damerow S , Mueters S , Thom J , Mauz E 
Published: October 2022

Abstract

Background
While literature on mental health in the COVID-19 pandemic has grown rapidly, studies reporting on developments beyond the first wave using continuous, population-based data are still scarce. We examined monthly estimates of depressive symptom levels in Germany’s adult population covering almost two years of the pandemic and the year prior.

Methods
We analyzed representative data from two population-based telephone surveys of German adults: “German Health Update (GEDA)” and “COVID-19 vaccination rate monitoring in Germany (COVIMO).” Core symptoms of depression measured using the Patient Health Questionnaire-2 (PHQ-2) were observed in approximately 1,000 randomly sampled participants monthly from April 2019 to December 2021. We estimated three-month moving means and proportions as well as smoothing curves to produce time series graphs. Statistical comparisons between specific time periods were used to verify results of visual inspection. Analyses were stratified by gender, age and level of education to assess potential time trend differences between subgroups.

Results
Both the mean population depressive symptom score and the proportion of the population with a positive PHQ-2 depression screen first decreased to below 2019 levels between the first wave and summer of the pandemic and then increased from autumn 2020, reaching levels significantly above 2019 in 2021 and remaining elevated. 2021 saw a 2.2% increase in positive screens compared to 2019. Women, the youngest and eldest adults, and those with a high level of education experienced a particular increase in depressive symptoms between 2019 and 2021. However, we found no corresponding changes in symptom level differences between population subgroups.

Conclusions
Our finding of elevated depressive symptoms among Germany’s adults following an increase in the second wave of the pandemic demonstrate the importance of continued surveillance to assess the further development of mental health in the ongoing crisis.

Key messages
• Monthly data from April 2019 to December 2021 suggests that depressive symptoms decreased at the start of the pandemic and then increased from autumn 2020, reaching levels above 2019 in 2021.
• Continued mental health surveillance is needed to assess the further development of mental health indicators in the ongoing crisis and its aftermath.