Multisectoral Collaboration Research Articles

Integrating mental health and psychosocial support (MHPSS) into infectious disease outbreak response: Results of an expert consensus study

ObjectivesOutbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response. MethodsA participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response. ResultsSystematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing. ConclusionsDespite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

Evolution of Flood Prediction and Forecasting Models for Flood Early Warning Systems: A Scoping Review

Floods are recognised as one of the most destructive and costliest natural disasters in the world, which impact the lives and livelihoods of millions of people. To tackle the risks associated with flood disasters, there is a need to think beyond structural interventions for flood protection and move to more non-structural ones, such as flood early warning systems (FEWSs). Firstly, this study aimed to uncover how flood forecasting models in the FEWSs have evolved over the past three decades, 1993 to 2023, and to identify challenges and unearth opportunities to assist in model selection for flood prediction. Secondly, the study aimed to assist in model selection and, in return, point to the data and other modelling components required to develop an operational flood early warning system with a focus on data-scarce regions. The scoping literature review (SLR) was carried out through a standardised procedure known as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The SLR was conducted using the electronic databases Scopus and Web of Science (WoS) from 1993 until 2023. The results of the SLR found that between 1993 and 2010, time series models (TSMs) were the most dominant models in flood prediction and machine learning (ML) models, mostly artificial neural networks (ANNs), have been the most dominant models from 2011 to present. Additionally, the study found that coupling hydrological, hydraulic, and artificial neural networks (ANN) is the most used ensemble for flooding forecasting in FEWSs due to superior accuracy and ability to bring out uncertainties in the system. The study recognised that there is a challenge of ungauged and poorly gauged rainfall stations in developing countries. This leads to data-scarce situations where ML algorithms like ANNs are required to predict floods. On the other hand, there are opportunities to use Satellite Precipitation Products (SPP) to replace missing or poorly gauged rainfall stations. Finally, the study recommended that interdisciplinary, institutional, and multisectoral collaborations be embraced to bridge this gap so that knowledge is shared for a faster-paced advancement of flood early warning systems.

Relationship between Access to Clean Water and Child Growth and Development in Kenya

Purpose: The aim of the study was to analyze the relationship between access to clean water and child growth and development in Kenya. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Access to clean water significantly impacts child growth and development in Kenya by reducing waterborne diseases like diarrhea, improving hygiene practices, and ensuring adequate hydration. Children with reliable access to clean water experience better nutritional outcomes and enhanced immune function, crucial for their physical growth and cognitive development. Unique Contribution to Theory, Practice and Policy: Ecological systems theory (Bronfenbrenner), health belief model (Rosenstock) & social determinants of health (SDH) theory may be used to anchor future studies on relationship between access to clean water and child growth and development in Kenya. Expand the implementation of effective water purification technologies and community water supply projects in resource-constrained environments. Advocate for integrated policies that prioritize water security alongside nutrition-sensitive interventions. Policies should support multi-sectoral collaboration between health, water, and sanitation sectors to address the complex interplay between water access and child nutrition.

Contributing Factors to the Progress of Inclusive Education Implementation in Indonesia

Indonesia made its commitment clear to obtain education for all its citizen without discrimination. However, the research-to-practice gap remains in terms of the implementation of inclusive education in the country. Therefore, this scoping review aimed to describe the current progress of the country’s inclusive education implementation efforts through the previous literature. A total of 20 articles were included in this review. The findings showed that an increasing number of studies report on Indonesia’s progress in the implementation of inclusive education in terms of inclusive, innovative, and integrated learning programs, improvement of teachers’ competence, collaboration efforts, society’s respect towards persons with special needs and disabilities, and several challenges serve as a room for improvement. Factors contributing to the gradual progress of the country’s inclusive education implementation are teacher competence and awareness about inclusive education, good government support, multi-sectoral collaboration and coordination, profound legal support, and student-focused strategies.

Benefits, Challenges, and Opportunities in Addressing Medicaid Beneficiaries' Non-Medical Risks to Health: A Qualitative Analysis.

North Carolina's Healthy Opportunities Pilots (HOP) is a Medicaid 1115 Waiver program that seeks to address nonmedical risks to health for Medicaid beneficiaries through multisector collaboration. Among other stakeholders, HOP involves collaboration between human services organizations that deliver interventions, network leads, which establish and oversee the human services organizations within a region of the state. To understand how employees at human services organizations and network leads prepared to deliver HOP services. Qualitative analysis of semistructured interviews. Interviews were conducted between April and June 2022. Interviews were recorded, transcribed verbatim, coded thematically, and analyzed using a conceptual model derived from the consolidated framework for implementation research. Organizations within North Carolina counties participating in HOP. Employees of human services and network lead organizations across all 3 HOP regions of North Carolina. The researchers interviewed 37 participants. Overall, organizations experienced benefits from HOP participation, including capacity-building resources, flexibility in allocating resources, and creating community-wide enthusiasm for addressing nonmedical risks to health. There were also key challenges. These included the time needed to build capacity, adjustments to the work processes and regulations inherent to multisector collaboration, geographic variation in availability of services to offer, and the difficulty of addressing different needs. Finally, participants recognized substantial opportunities that HOP presented, including membership in a more extensive network, exposure to a learning community, and a more sustainable funding source. The perspectives of individuals preparing to deliver HOP services offer important lessons for those developing and implementing large-scale programs that can address nonmedical threats to health.

STRATEGI KEBIJAKAN PERTUMBUHAN HIJAU (GREEN GROWTH) INDONESIA: DALAM ADAPTASI PERUBAHAN IKLIM

The purpose of this research is to understand and discuss Indonesia's green growth strategies in facing global challenges related to climate change The main focus of this study lies in policy adaptation and practices that support climate change mitigation and adaptation, taking into account both local and global contexts. Through secondary data analysis, this article identifies the main challenges faced by Indonesia, such as increasing greenhouse gas emissions and deforestation Additionally, the article evaluates government and private sector initiatives in promoting renewable energy, natural resource conservation, and enhancing community adaptation capacity. Research findings indicate that the success of Indonesia's green growth strategy heavily relies on multisectoral collaboration, increased public awareness, and strong political commitment The conclusion of this article emphasizes the need for a holistic and inclusive approach in designing policies and implementing them to achieve sustainable economic growth and climate resilience.

Variability in public health programming and priorities to address health inequities across public health units in Ontario, Canada.

In 2018, Ontario Public Health Standards were updated to include the foundational Health Equity Standard to guide planning, implementation, and evaluation of public health programs and services. Public health units (PHUs), the regional public health bodies, are now required to address health equity through four requirements: (a) Assessing and Reporting; (b) Modifying and Orienting Public Health Interventions; (c) Engaging in Multi-sectoral Collaboration; and (d) Health Equity Analysis, Policy Development, and Advancing Healthy Public Policies. This qualitative descriptive study explored how the 27 participating PHUs (out of 34) serving urban (N = 10), mixed urban-rural (N = 15), and rural (N = 9) populations addressed the Health Equity Standard. Using document analysis, we inductively and deductively coded the content of 68 PHU Annual Service Plan and Budget Submissions from a 3-year period (2018-2020) received from the 27 PHUs. Emergent categories were organized into the four requirements and one additional emergent theme: Organizational Implementation of Health Equity. The approaches of embedding health equity into PHUs' activities varied across groups. Urban PHUs presented more diverse strategies, including working with a larger number of organizations, and participating in academic research projects. We found more process standardization and greater discussion of capacity building in urban and mixed urban-rural PHUs. Rural PHUs strategically addressed the needs of their diverse populations through relationship building with Indigenous communities. Findings suggest broad implementation of health equity approaches in public health independent of PHUs' geographic size and population dispersion, though strategies and key challenges differ across units.

DETECTION OF SARS-COV-2 IN A SQUIRREL MONKEY (SAIMIRI SCIUREUS): A ONE HEALTH INVESTIGATION AND RESPONSE.

Through collaborative efforts, One Health partners have responded to outbreaks of COVID-19 among animals, including those in human care at zoos. Zoos have been faced with numerous challenges, including the susceptibility of many mammalian species, and therefore the need to heighten biosecurity measures rapidly. Robust One Health collaborations already exist in Arizona to address endemic and emerging zoonoses, but these have rarely included zoos. The pandemic shed light on this, and Arizona subsequently expanded its SARS-CoV-2 surveillance efforts to include zoo animals. Testing and epidemiologic support was provided to expedite the detection of and response to zoonotic SARS-CoV-2 infection in zoo animals, as well as to understand possible transmission events. Resulting from this program, SARS-CoV-2 was detected from a rectal swab collected from an 8-yr-old squirrel monkey (Saimiri sciureus) from a zoo in Southern Arizona. The animal had rapidly become ill with nonrespiratory symptoms and died in July 2022. Genomic sequencing from the swab revealed mutations consistent with the Omicron (BA.2) lineage. An epidemiologic investigation identified an animal caretaker in close proximity to the affected squirrel monkey who tested positive for COVID-19 the same day the squirrel monkey died. Critical One Health partners provided support to the zoo through engagement of local, state, and federal agencies. Necropsy and pathologic evaluation showed significant necrotizing colitis; the overall clinical and histopathological findings did not implicate SARS-CoV-2 infection alone as a causal or contributing factor in the squirrel monkey's illness and death. This report documents the first identification of SARS-CoV-2 in a squirrel monkey and highlights a successful and timely One Health investigation conducted through multisectoral collaboration.

Ohio Presents Opportunities For Understanding Hospital Alignment With Public Health Agencies On Community Health Assessments.

Multisector collaboration is critical for improving population health. Improving alignment between nonprofit hospitals and local health departments is one promising approach to achieving health improvement, and a number of states are exploring policies to facilitate such collaboration. Using public documents, we evaluated the alignment between Ohio nonprofit hospitals and local health departments in the community health needs they identify and those they prioritize. The top three needs identified by hospitals and health departments were mental health, substance use, and obesity. Alignment across organizations was high among the top needs, but it varied more among less commonly identified needs. Alignment related to social determinants of health was low, with health departments being more responsive to social determinants than hospitals. Given the different strengths and capacities of hospitals and health departments, this divergence may be in the best interests of the communities they serve. Community benefit policies should consider how to promote collaboration between hospitals and health departments while also encouraging organizations to use their own expertise to meet community needs.

Utilization and associated determinants of multi-sectoral approach in zoonotic disease surveillance among animal and human healthcare workers in Nakuru County, Kenya

Background Zoonoses are naturally transmissible between humans and animals. Globally, they account for more than 60% of human infections, 75% of emerging infections, 2.7 million human deaths, and 10% of the total DALYs lost yearly in Africa. In the last three decades, Kenya has had sporadic outbreaks of zoonoses. To increase the speed of reporting and efficiencies in detection and control, a multi-sectoral collaboration in zoonotic disease surveillance (MZDS) between human and animal health workers is essential. In an effort, Zoonotic disease unit (ZDU) in Kenya has been established at national and county levels. Methods A cross sectional study was carried out to determine the level of utilization of multisectoral collaboration and its associated determinants in zoonotic disease surveillance among animal and human healthcare workers in Nakuru County. Quantitative data was gathered from 102 participants and quantitative data from 5 key informants. To test for significant differences, Chi-square and independent t-test were used. Results MZDS utilization level was 16% and the factors associated with higher utilization include; knowing what MZDS entails, education level, sector affiliation, trainings, supportive infrastructure and data storage. Lack of financing and poor coordination are hindrances to MZDS. Conclusion There is need to finance MZDS activities, strengthen coordination mechanisms, carry out more sensitization and trainings among animal and human healthcare.

Shaping global health promotion: a comprehensive analysis of the 10 Global Conferences on Health Promotion Conferences (1986‒2021)

ObjectiveThis study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing diverse health challenges that evolved over different periods. MethodsThe textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions. ResultsThe fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale. The primary purpose and goal are to promote health from regional to global. Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization, governments, and international bodies, to a more inclusive approach involving non-governmental organizations and the general public. This development implies that health promotion has evolved into a collective global endeavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health. Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health promotion, underscoring the need for intensified focus on areas including disease prevention, health education, and the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive approach in public health initiatives. ConclusionsSustained collaboration and innovative strategies are pivotal to advancing health promotion globally. Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration among partners such as healthcare, education, social security, and the industry is vital for health promotion and achieving global health goals.

Empowering Namibia's Fight against Malaria: Drawing Inspiration from China's Remarkable Malaria Elimination Journey

Malaria is a debilitating parasitic disease that has been prevalent in various parts of the world, including China and Namibia. China’s successful elimination of Malaria offers valuable lessons for Namibia in its ongoing efforts to control the parasitic disease. This paper explores the historical context of Malariamalaria in Namibia and its fight towards elimination of malaria, as well as China, the strategies employed by the Chinese government in the elimination of malaria, and the key lessons that Namibia can learn from China’s success. The discussion highlights the importance of political commitment, multisector collaboration, tailoring control strategies to local contexts, adopting a comprehensive approach, and emphasizing health education and community mobilization. By adopting these lessons and fostering a robust national strategy, engaging diverse stakeholders, and ensuring active community involvement, Namibia can work towards achieving eliminating Malaria, improving the public health system, and promoting sustainable health development.

A national audit of facilities, human and material resources for the comprehensive management of diabetes in Ghana-A 2023 update.

The human and material resources as well as the systems for managing diabetes in Africa are inadequate. This study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana. We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant. Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin, respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones. Majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Fifteen facilities (12.3%) had Diabetes Support Groups in their locality and catchment areas. An urgent multisectoral collaboration, including prioritisation of resources at the facility level, to promote and achieve acceptable comprehensive diabetes care is required.

The impact of humanitarian aid on financial toxicity among cancer patients in Northwest Syria

IntroductionThe ongoing crisis in Syria has divided the country, leading to significant deterioration of the healthcare infrastructure and leaving millions of people struggling with poor socioeconomic conditions. Consequently, the affordability of healthcare services for the population has been compromised. Cancer patients in Northwest Syria have faced difficulties in accessing healthcare services, which increased their financial distress despite the existence of humanitarian health and aid programs. This study aimed to provide insights into how humanitarian assistance can alleviate the financial burdens associated with cancer treatment in conflict-affected regions.Materials and methodsThis research employed a quantitative, quasi-experimental design with a pre-test-post-test approach, focusing on evaluating the financial toxicity among cancer patients in Northwest Syria before and after receiving humanitarian aid. The study used purposeful sampling to select participants and included comprehensive demographic data collection. The primary tool for measuring financial toxicity was the Comprehensive Score for Financial Toxicity (FACIT-COST) tool, administered in Arabic. Data analysis was conducted using SPSS v25, employing various statistical tests to explore relationships and impacts.ResultsA total of 99 cancer patients were recruited in the first round of data collection, out of whom 28 patients affirmed consistent receipt of humanitarian aid throughout the follow-up period. The results of the study revealed that humanitarian aid has no significant relationship with reducing the financial toxicity experienced by cancer patients in Northwest Syria. Despite the aid efforts, many patients continued to face significant financial distress.ConclusionThe research findings indicate that current humanitarian assistance models might not sufficiently address the complex financial challenges faced by cancer patients in conflict zones. The research emphasizes the need for a more comprehensive and integrated approach in humanitarian aid programs. The study highlights the importance of addressing the economic burdens associated with cancer care in conflict settings and calls for a re-evaluation of aid delivery models to better serve the needs of chronic disease patients. The findings suggest a need for multi-sectoral collaboration and a systemic approach to improve the overall effectiveness of humanitarian assistance in such contexts.

Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India

BackgroundMultisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding “How” to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs.MethodsUsing purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants’ experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration.ResultsContext and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership’s influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish “central management units” for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency.ConclusionThis study offers multiple solutions to enhance local implementers’ engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.

Exploring regulatory flexibility to create novel incentives to optimize drug discovery.

Efforts by governments, firms, and patients to deliver pioneering drugs for critical health needs face a challenge of diminishing efficiency in developing those medicines. While multi-sectoral collaborations involving firms, researchers, patients, and policymakers are widely recognized as crucial for countering this decline, existing incentives to engage in drug development predominantly target drug manufacturers and thereby do little to stimulate collaborative innovation. In this mini review, we consider the unexplored potential within pharmaceutical regulations to create novel incentives to encourage a diverse set of actors from the public and private spheres to engage in the kind of collaborative knowledge exchange requisite for fostering enhanced innovation in early drug development.

Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health.

Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.

Rethinking technology innovation for mental health: framework for multi-sectoral collaboration

Rethinking technology innovation for mental health: framework for multi-sectoral collaboration

Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective.

Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms. We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14-15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0-1 year, 4-5 years and 12-13 years). Outcomes at 14-15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used. There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support. Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.

Animal behaviour and welfare research: A One Health perspective

Animal behaviour and welfare research are part of a wider endeavour to optimize the health and wellbeing of humans, animals and ecosystems. As such, it is part of the One Health research agenda. This article applies ethical principles described by the One Health High Level Expert Panel to animal behaviour and welfare research. These principles entail that animal behaviour and welfare research should be valued equitably alongside other research in transdisciplinary and multisectoral collaboration. It should include and promote a multiplicity of marginalized voices, including those of animals, and it should apply and describe a harmonious balance between human—animal-environment interactions. Lastly, it should describe how humans need to change behaviour, adopt sustainable solutions and recognize the importance of animal welfare and the integrity of the whole ecosystem.