Well-being Outcome Measures Research Articles

Computerized Cognitive Training in the Older Workforce: Effects on Cognition, Life Satisfaction, and Productivity

Background: The accelerated aging of the world’s population will lead to an increase in the number of older people in the workforce. Computerized Cognitive Training (CCT) is effective in improving cognitive outcomes, but its benefits for older workers remain controversial. We investigate the real-world efficacy of CCT in the workplace, focusing on employees aged 50+ years from a public sector agency. Methods: Case managers (n = 82) were randomized to either an intervention group (24 40 min CCT sessions two times per week) or a waiting list passive control group. Cognitive ability, well-being, job satisfaction, and productivity outcome measures were collected and assessed before and after CCT or the comparable control wait time. Results: Participants undergoing CCT improved on a task of executive functioning (p = 0.04). There was a trend toward a change in work productivity after CCT (p = 0.09), with the control group showing a significant decrease (p = 0.02), while the intervention group remained stable. Conclusions: CCT during office hours has a positive effect on cognition and well-being without affecting productivity among white-collar office workers. CCT could be considered as an intervention to support the older workforce in managing the cognitive and behavioral challenges of changing workplace demands.

Evaluation of a PTSD group intervention in a secondary care mental health service

Introduction: Secondary care mental health services in the United Kingdom are under increasing pressure to meet the demand for support for Post-Traumatic Stress Disorder (PTSD), however, there is a lack of clear guidance for treating complex cases of PTSD. Therefore, an evaluation was conducted to investigate the effectiveness of a pilot stabilisation group programme for clients with PTSD in a secondary care mental health service. Method: Attendees of the group (n = 64) were asked to complete routinely collected outcome measures of wellbeing (WEMWBS) and PTSD symptoms (PCL-5). A repeated-measures t-test analysed the pre and post group scores for statistical significance, whilst Reliable Change Indices analysed the data forreliable improvement and clinically significant change. Results: There was a significant difference between the pre and post group scores on the measures of wellbeing and PTSD symptoms. A large proportion of clients demonstrated reliable and clinically significant improvements in wellbeing. A small proportion of service users demonstrated clinically significant improvements in PTSD symptoms. Conclusion: The intervention shows promise as an initial stage of trauma treatment due to the improvements in wellbeing. However, a large proportion of clients are likely to require further intervention to reduce symptoms of PTSD.

Applying an equity lens to social prescribing.

Social prescribing is often described as an intervention that can help reduce health inequalities yet there is little evidence exploring this. This study aimed to assess the feasibility of accessing and analysing social prescribing (SP) service user data to demonstrate the impact of SP on health inequalities. The sample size consisted of records for 276 individuals in Site 1 and 1644 in Site 2. Descriptive analyses were performed to assess the characteristics of people accessing SP, the consistency of data collected and the missingness across both sites. Both sites collected basic demographic data (age gender, ethnicity and deprivation). However, data collection was inconsistent; issues included poor recording of ethnicity in Site 2, and for both sites, referral source data and health and well-being outcome measures were missing. There was limited data on the wider determinants of health. These data gaps mean that impacts on health inequalities could not be fully explored. It is essential that SP data collection includes information on user demographics and the wider determinants of health in line with PROGRESS Plus factors. Considering equity around who is accessing SP, how they access it and the outcomes is essential to evidencing how SP affects health inequalities and ensuring equitable service delivery.

Socio-economic inequities in mental health problems and wellbeing among women working in the apparel and floriculture sectors: testing the mediating role of psychological capital, social support and tangible assets

BackgroundIt is still unknown whether the mechanisms proposed by the Reserve Capacity Model (RCM) explaining socio-economic health and wellbeing inequities in high income countries can be applied to low-income countries. This study investigates whether different reserve capacities (intra-, inter-personal, and tangible) can explain the association between relative socio-economic position (SEP) and wellbeing outcome measures among Ethiopian women working in Foreign Direct Investment (FDI).MethodUsing a cross-sectional design, we collected quantitative survey data among 2,515 women working in the apparel and floriculture sectors in Ethiopia, measuring GHQ-12 mental health problems, multi-dimensional wellbeing, relative SEP, psychological capital (PsyCap), social support (emotional and financial social support network), and tangible assets (e.g., owning mobile phone, having access to toilet facilities). We used cluster-adjusted structural equation modelling to test whether PsyCap, social support, and/or tangible assets mediate the association between relative SEP (IV) and GHQ-12 mental health problems and multi-dimensional wellbeing (DVs).ResultsPsyCap and the size of the financial support network significantly mediate the socio-economic gradient in both wellbeing outcomes. The size of the emotional social support network shows no association with multi-dimensional wellbeing and shows an unexpected negative association with GHQ-12 mental health problems scores, including a significant mediation effect. Tangible assets show no association with the wellbeing outcome measures and do not mediate socio-economic mental health problems and wellbeing inequities.ConclusionsThe RCM can be applied in low-income countries, although in unexpected ways. Similar to findings from high-income countries, PsyCap and size of the financial social support network show significant mediation effects in explaining mental health problems and wellbeing inequities in Ethiopia. These reserves could therefore serve as a buffer for socio-economic inequities in mental health and wellbeing and can therefore assist in decreasing these inequities for women working in FDI sectors in Ethiopia.

Post-Pandemic Changes to Employment and Employment Satisfaction in Early Career and Career Advancing Athletic Trainers.

The labor market suffered a mass exodus of employees, including healthcare workers, due to the COVID-19 pandemic. Previous research highlights the vulnerability of young professional athletic trainers (YPATs) to attrition. Investigating pandemic-related employment changes and their impact is essential for developing strategies to improve the retention of YPATs. to determine impact of COVID-19 on YPATs' employment and effect of COVID-19 and employment setting migration on outcome measures of personal and financial well-being, job and career satisfaction, and optimism about staying in the profession. Cross-sectional, descriptive study. Web-based survey. 1,111 participants responded to survey for an 11.5% response rate (n=1,111/12,810). Partial responses were included; thus, number of respondents varied by question. A web-based survey comprised of 34 closed-ended questions was disseminated to NATA members in November 2022. Descriptive statistics including counts and frequencies for each surveyed item in addition to chi-square tests were used to analyze responses. 30.2% (n=335/1,111) of YPATs changed employers and 25.7% (n=286/1,111) reported a change in employment setting. Notably, YPATs migrated from high school, collegiate, and professional athletics to clinic, industrial, or sales settings. Overall, the pandemic decreased job satisfaction, career satisfaction, and optimism about professional longevity. Changes in employment had a positive impact on personal well-being in addition to job and career satisfaction, but not optimism regarding staying in profession. Salary and work-life balance were reported as important predictors of short and long-term retention for YPATs. The pandemic brought changes to employers and employment settings for many YPATs. To reduce turnover and attrition, administrators must begin to prioritize employee well-being and satisfaction. In addition to increasing salary and reducing workload, employers should recognize the importance of administrative support in promoting well-being together with satisfaction and professional optimism in early professional and career-advancing athletic trainers.

Influence of CrossFit and Deep End Fitness training on mental health and coping in athletes.

Physical exercise is known to improve mental health. Athletes can experience unique physical and emotional stressors, which can deteriorate mental health and cognitive function. Training apathy can lead to cognitive dissonance and further degrade performance by promoting maladaptive, avoidance coping strategies. Introduction of psychosocial and training variables, such as those used in CrossFit (CF) and other community-based fitness programs with strong peer support have been shown to help reduce training apathy and negative affect. Here, we explored whether addition of psychophysiological variation, experienced as "hunger for air" during underwater breath-hold exercises, could provide unique mental health benefits for athletes. We studied the influence of CF and Deep End Fitness (DEF), a community-based underwater fitness program, on several outcome measures of mental health and emotional well-being in volunteer athletes. We observed a significant reduction in stress scores of both the control CF training group and the experimental DEF group. We found that DEF produced a significant improvement in positive affect while CF training did not. Further supportive of our hypothesis that the psychological and biological stressors experienced in underwater, breath-hold training cause positive adaptive changes and benefits, DEF training uniquely increased problem-based coping. While our observations demonstrate both CF and DEF training can improve mental health in athletes, DEF produced additional, unique benefits to positive coping and attitudes of athletes. Future studies should further evaluate the broader benefits of community-based, underwater training programs on psychological and physiological health in athletes and the public.

A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care

PurposeOne of the challenges for mental health research is the lack of an agreed set of outcome measures that are used routinely and consistently between disciplines and across studies in order to build a more robust evidence base for how to better understand young people’s mental health and effectively address diverse needs.MethodsThis study involved a scoping review of reviews on consensus of the use of mental health and wellbeing measures with children and young people. We were particularly interested to identify if there are differences in measures that are recommended for children and young people with care experience including those with developmental disabilities.FindingsWe identified 41 reviews, of which two had a focus on child welfare settings, three on childhood trauma and 14 focused on children and young people with developmental disabilities. Overall, our review highlights a lack of consensus and a diversity of measures within the field. We identified 60 recommended measures, of which only nine were recommended by more than one review.ConclusionsOur review highlights the need for greater agreement in the use of mental health outcome measures. While our review highlights that there is value in identifying measures that can be used with any child or young person, researchers need to take into account additional considerations when working with children and young people with care experience and those with developmental disabilities, to ensure measures are accessible and sensitive to their life experiences.

Efficacy of transdiagnostic cognitive-behavioral therapy for assertiveness: A randomized controlled trial

Assertiveness training has been an essential component in cognitive-behavioral therapy (CBT), for example, in the treatment of social anxiety and in dialectical behavioral therapy. However, the assertiveness construct has garnered little attention in recent clinical research. The objective of this study was to investigate the efficacy of an eight-week transdiagnostic stand-alone internet-based CBT intervention specifically aimed at increasing levels of assertive behavior. Following inclusion, we randomized N = 210 participants into three groups: therapist-guided self-help, unguided self-help, and a wait-list control condition. After a one-year follow-up, we employed a linear mixed model to estimate the effects at both post-test and follow-up for the primary outcome measures of assertiveness, Adaptive and Aggressive Assertiveness Scales, the Rathus Assertiveness Schedule, and secondary outcome measures of anxiety, depression, and general well-being. We also assessed reliable clinical change. Compared to the wait list at the post-treatment, estimated between-group effect sizes on self-rated adaptive assertiveness were statistically equivalent for the two treatment groups both at the post and at the one-year follow-up time points, ranging from ES = 0.95 to 1.73, with reliable clinical recovery proportions from 19 % to 36 %. The increase in aggressive assertiveness ranged from ES = 0.62 to 0.90 compared to the wait-list condition at post. For social anxiety symptoms, the effects compared to the wait list at post-treatment ranged from ES = 0.67 to 0.93, with a reliable clinical recovery rate from 16 % to 26 %. For self-assessed well-being, the effects compared to the wait list at post ranged from ES = 0.70 to 1.05. No effects were observed for generalized anxiety, although within-group evidence was found for a medium effect on depression one year after treatment. Overall, the two treatment conditions produced similar effects. In general, participation increased healthy assertive expressions regardless of treatment condition, all the while reducing self-assessed social anxiety and, over time, possibly also depression. Participation also improved general well-being. The findings demonstrate that the assertiveness construct can be a suitable target for intervention, with reductions of both psychiatric symptoms and non-syndromal problems in daily life. The study was preregistered at ClinicalTrials.gov (NCT04240249).

Evaluating programs for young people with a family member with mental health challenges: protocol for a mixed methods, longitudinal, collaborative evaluation

BackgroundYoung people with a sibling or parent who experiences mental health challenges have their own support needs. Most programs designed for this population lack a strong evidence base, and the involvement of young people in the development and evaluation of programs designed to support them is unclear or lacking.MethodsThis paper describes a protocol for a mixed methods, longitudinal, collaborative evaluation of a suite of programs delivered by The Satellite Foundation, a not-for-profit organisation for young people (5–25 years) who have a family member with mental health challenges. Young people’s lived experience and knowledge will guide the research approach. Institutional ethics approval has been obtained. Over a three year period, approximately 150 young people will be surveyed online on various wellbeing outcome measures, prior to, six and twelve months following program participation with data analysed using multi-level modelling. Groups of young people will be interviewed after participating in different Satellite programs each year. An additional group of young people will be interviewed individually over time. Transcripts will be analysed using thematic analysis. Young people’s creative artworks on their experiences will be included as part of the evaluation data.DiscussionThis novel, collaborative evaluation will provide vital evidence on young people’s experiences and outcomes during their time with Satellite. Findings will be used to inform future program development and policy. The approach used here may guide other researchers engaging in collaborative evaluations with community organisations.

Exploring the Association Between the Healthcare Design Elements and Physician Well-Being: A Scoping Review.

To evaluate the association between elements of the built environment and physician well-being using a scoping review. Physicians currently report low work satisfaction, high burnout and depression. The built environment has been shown to affect well-being in the general population, but its relationship to physician well-being is not well understood. Gaining a better understanding of this relationship will allow for better evidence-based design for physician well-being. A scoping review of the literature was conducted of Scopus and PubMed databases using key words for (1) environmental variables such as "environmental design"; (2) physician terms, such as "doctor"; and (3) outcome measures of well-being, such as "burnout." Studies were included if they had at least one measure of the built environment and one measure of physician well-being. Of 1,723 abstracts screened, 146 full-text articles were reviewed, leaving 16 articles to be included for data extraction. Included studies were from all around the world, except for, notably, the United States. Robust interpretation of the data was challenging because of the lack of standardization in the assessment of environmental factors and physician well-being. Excessive noise was the variable most linked to well-being. Suitable surroundings, including lighting, furniture, and art, were also linked with satisfaction, but it was unclear whether there was an association with well-being. Understanding how environmental factors affect physician well-being is paramount but considerably understudied. Standardization of research approach should be developed in order to produce more robust research to create evidence-based designs for physician well-being.

Sistematización de una intervención cognitivo – comunicativa basada en reminiscencia para adultos mayores

ABSTRACT Purpose To determine the effect of the reminiscence-based cognitive-communicative intervention program (CCSP-R) on global cognitive processing and self-perception of subjective well-being. Methods A purposive sample of 100 self-care elderly adults, with 65 composing the study group and 35 in the control group. The study group was subjected to the proposed program. The Wilcoxon test compared the outcome measures of global cognitive efficacy (MMSE) and subjective well-being (SWLS) before and after the program, whereas the Mann-Whitney U test compared the pre- and post-test differences between the two groups. Results A statistically significant difference was found between the pre- and post-test of the SWLS in the study group, but not in the control group. This result was replicated in the global cognitive efficacy variable. A difference between the groups occurred in both measures, with greater benefit for the group that received the intervention. Conclusion The CCSP-R is a viable alternative for cognitive-communicative stimulation of functional order. The evidence of differences in performance supports its usefulness and validity for intervention in primary care or other similar contexts.

Systematization of a cognitive-communicative intervention based on reminiscence for older adults.

To determine the effect of the reminiscence-based cognitive-communicative intervention program (CCSP-R) on global cognitive processing and self-perception of subjective well-being. A purposive sample of 100 self-care elderly adults, with 65 composing the study group and 35 in the control group. The study group was subjected to the proposed program. The Wilcoxon test compared the outcome measures of global cognitive efficacy (MMSE) and subjective well-being (SWLS) before and after the program, whereas the Mann-Whitney U test compared the pre- and post-test differences between the two groups. A statistically significant difference was found between the pre- and post-test of the SWLS in the study group, but not in the control group. This result was replicated in the global cognitive efficacy variable. A difference between the groups occurred in both measures, with greater benefit for the group that received the intervention. The CCSP-R is a viable alternative for cognitive-communicative stimulation of functional order. The evidence of differences in performance supports its usefulness and validity for intervention in primary care or other similar contexts.

Impact of intrawork rest breaks on doctors’ performance and well-being: systematic review

ObjectivesTo summarise evidence on intrawork breaks and their associated effect on doctors’ well-being and/or performance at work.DesignSystematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelinesData...

Neighborhood matters: Neighborhood violence, collective efficacy, and social emotional development in early childhood

Exposure to community violence has been associated with a range of negative behavioral outcomes among school-age children and adolescents; yet there is limited evidence in the preschool setting. In the current study we examined the association between objective and parent-perceived neighborhood safety, and perceived collective efficacy, on behavioral concerns of children aged 3–5 enrolled at an early childhood school in New Orleans, Louisiana, from 2014 to 19 (n = 165). Teachers collected data on outcome measures of child social emotional well-being in the classroom setting. A parent survey included data on residential address, how safe they felt in their neighborhood, and perceived collective efficacy. Addresses were geocoded and linked by Census tract number to data on violent crime rates (per 1,000 tract residents). Associations between neighborhood violent crime, perceived safety, perceived collective efficacy, and child social emotional development were assessed with generalized estimating equations. After mutually adjusting for perceived neighborhood safety and violent crime rate, children of parents with the lowest perceived neighborhood collective efficacy had similar findings: children of parents that perceive the neighborhood as unsafe had a lower attachment (β = −6.55, 95 % CI 1.44, 11.66) and protective score (β = −4.51, 95 % CI 0.89–8.13) and a 10-unit increase in violent crime was associated with a decrease in attachment score (β = −2.77, 95 % CI −4.22, −1.32). Overall, child attachment and protective scores were significantly associated with perceived unsafe neighborhoods and violent crime, and the relationship was moderated by perceived neighborhood efficacy. These findings suggest a negative impact of perceived neighborhood safety and protective impact of collective efficacy on early childhood social emotional development.

Recovery in Mind: A Recovery College's journey through the Covid-19 pandemic.

The Covid-19 restrictions of 2020-2021 are known to have undermined theUK population's mental health. Working alongside staff, peer trainersand students at Recovery in Mind (RiM), a Recovery College (RC) in West Berkshire, England, this mixed-methods study is amongst the first to investigate how an RC has responded to the pandemic. Working in co-production with RiM staff and peer-trainers, this study employed a mixed-methods design, gathering Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) well-being outcome measures by questionnaireand student experience, learningand co-production by interviews. This research found that RiM continued to produce demonstrable improvements in student mental health. Students welcomed the way that RiM adapted to offering online and socially distanced provisions. Students valued the skills that RiM taught and the way that RiM courses reinforced prior learning; above this, however, they valued the mutual support and sense of community that participation provided. This study underlines the value of RCs maintaining 'hidden curriculums' of peer support and community involvement. This research emphasizes co-production as not only a tool for empowerment or service improvement but as a valuable skill for personal mental health recovery. Even when operating under the most unforeseen or challenging of conditions, RCs should always endeavour to prioritize and maintain co-production. In accordance with the RC ethos, this was an entirely co-produced study, with academic researchers and RiM staff and peer trainers working democratically in partnership with one another to design and manage the study and to write up and disseminate findings. To ensure the independence and rigour of findings, data analysis was undertaken by external academic researchers.

Latent variable mixture models to address heterogeneity in patient-reported outcome data.

The populations included in studies that investigate patient-reported outcome (PRO) measures of health or well-being, including health-related quality of life, are often heterogeneous with respect to their sociodemographic and health status characteristics. If the sources of heterogeneity are not observed or are not known a priori, latent variable mixture models (LVMMs) can be used to identify homogeneous sub-groups within the study population based on observed patterns of responses in PRO data. Our purpose is to review the characteristics of LVMMs and their applications for PRO data, and provide a demonstration of their use. We focus on mixture item response theory (IRT) models, which combine latent class analysis with the conventional IRT model to define the measurement model for one or more latent variables. In PRO studies, IRT models can be used to assess differential item functioning and response shift. An illustrative example is presented using clinical registry data for 1391 total hip replacement patients who provided responses for the physical component items of the 12-item Short Form Health Survey (SF-12). After assessing model fit and class discrimination statistics, a three-class model was selected. Model parameter estimates across classes were dissimilar for many of the items. Sex and self-reported presence of arthritis and back pain were associated with class membership. LVMMs represent a potentially useful tool to explore patterns of responses in PRO data. Opportunities for other applications of LVMMs to PRO data are discussed.

An analysis of the construct validity and responsiveness of the ICECAP-SCM capability wellbeing measure in a palliative care hospice setting

BackgroundFor outcome measures to be useful in health and care decision-making, they need to have certain psychometric properties. The ICECAP-Supportive Care Measure (ICECAP-SCM), a seven attribute measure (1. Choice, 2. Love and affection, 3. Physical suffering, 4. Emotional suffering, 5. Dignity, 6. Being supported, 7. Preparation) developed for use in economic evaluation of end-of-life interventions, has face validity and is feasible to use. This study aimed to assess the construct validity and responsiveness of the ICECAP-SCM in hospice inpatient and outpatient settings.MethodsA secondary analysis of data collated from two studies, one focusing on palliative care day services and the other on constipation management, undertaken in the same national hospice organisation across three UK hospices, was conducted. Other quality of life and wellbeing outcome measures used were the EQ-5D-5L, McGill Quality of Life Questionnaire – Expanded (MQOL-E), Patient Health Questionnaire-2 (PHQ-2) and Palliative Outcomes Scale Symptom list (POS-S). The construct validity of the ICECAP-SCM was assessed, following hypotheses generation, by calculating correlations between: (i) its domains and the domains of other outcome measures, (ii) its summary score and the other measures’ domains, (iii) its summary score and the summary scores of the other measures. The responsiveness of the ICECAP-SCM was assessed using anchor-based methods to understand change over time. Statistical analysis consisted of Spearman and Pearson correlations for construct validity and paired t-tests for the responsiveness analysis.ResultsSixty-eight participants were included in the baseline analysis. Five strong correlations were found with ICECAP-SCM attributes and items on the other measures: four with the Emotional suffering attribute (Anxiety/depression on EQ-5D-5L, Psychological and Burden on MQOL-E and Feeling down, depressed or hopeless on PHQ-2), and one with Physical suffering (Weakness or lack of energy on POS-S). ICECAP-SCM attributes and scores were most strongly associated with the MQOL-E measure (0.73 correlation coefficient between summary scores). The responsiveness analysis (n = 36) showed the ICECAP-SCM score was responsive to change when anchored to changes on the MQOL-E over time (p < 0.05).ConclusionsThis study provides initial evidence of construct validity and responsiveness of the ICECAP-SCM in hospice settings and suggests its potential for use in end-of-life care research.

Personalised Nutritional Recommendations Based on Individual Post-Prandial Glycaemic Responses Improve Glycaemic Metrics and PROMs in Patients with Type 2 Diabetes: A Real-World Assessment.

The recommended first-line therapy in type 2 diabetes (T2D) is lifestyle modification. In many patients, such interventions fail, and disease progresses inexorably to medication requirement. A potential reason for the failure of standard nutritional interventions is the use of generic dietary advice, with no personalisation to account for differences in the effect of food on blood glucose between different individuals. Another is the lack of instant feedback on the impact of dietary modification on glycaemic control, which supports sustained behaviour change. The use of continuous glucose monitoring (CGM) may help address both these shortcomings. We conducted an observational study to explore how personalised nutritional information impacts glycaemic control and patient-reported outcome measures (PROMs) of well-being. Free-living people with T2D eating their normal diet were provided with personalised nutritional recommendations by state-registered nutritionists based on the CGM-enabled analysis of individual post-prandial glycaemic responses (PPGRs). Participants demonstrated considerable inter-individual differences in PPGRs, reductions in post-prandial incremental area under the curve (iAUC) and daytime AUC, and improvements in energy levels, ability to concentrate, and other PROMs. These results suggest a role for personalised nutritional recommendations based on individual-level understanding of PPGRs in the non-pharmaceutical management of T2D.

Experiences of home as an aspect of well-being in people over 80 years: A mixed method study.

To (1) describe experiences of home from a well-being perspective, (2) describe participant characteristics and well-being measures in relation to housing type (3) and how the aforementioned aspects may affect well-being in very old persons. Cross-sectional, convergent parallel-results mixed method design with semi-structured interviews analysed by qualitative content analysis, in relation to descriptive statistics and specific well-being outcome measures related to home. A total of 50 persons 80years or older living in ordinary housing were interviewed (July 2017 to November 2018) about home in relation to well-being, along with collection of participant characteristics and well-being measures related to home. Participants described how home had become increasingly important as it provided autonomy and acted as a social and occupational hub. However, autonomy was not unconditional, and home could also be perceived as a place of inactive solitude. Results were interpreted as relating to being in the margins of home and had a major impact on well-being. Housing type seemed of importance with higher measures of well-being for participants in single-living housing compared with those living in apartment. Home is increasingly central to well-being in old age; however, very old persons also have to relate to being physically and mentally in the margins of being able to remain in the home. These aspects of home potentially have a major impact on well-being. As very old persons living in ordinary housing will constitute a larger segment of society in coming years, aspects of home can potentially have a considerable impact on well-being for this age-group. This study describes aspects of home that contribute to, or has adverse impact on well-being. These aspects need thorough consideration in policy-making and planning of health care that can affect experiences of home.

The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study.

BackgroundThe global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood.ObjectiveThe aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting.MethodsThis study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the “mental health” and “vitality” subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program.ResultsOn average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures.ConclusionsDigital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12619000993190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377889 and Australian New Zealand Clinical Trials Registry ACTRN12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx