Short Warwick Edinburgh Mental Wellbeing Research Articles

Social return on investment of face-to-face versus online lifestyle coaching to improve mental wellbeing

BackgroundThe percentage of people in Wales experiencing severe mental health issues more than doubled during the COVID-19 pandemic. Additionally, hundreds of people in Wales wait more than a year for help with their mental health. The EmotionMind Dynamic (EMD) programme is a six-session programme over 3 months involving self-reflective introspection, self-analysis, problem solving, goal setting, and action taking. Furthermore, this programme challenges negative self-perception and increases self-awareness, self-confidence, and self-esteem. We aimed to estimate the social return on investment of EMD lifestyle coaching, both face-to-face and online formats, by comparing the costs of running the programme with the social value generated from clients as measured by improvement in self-confidence and mental wellbeing. MethodsWe included 15 clients from previous face-to-face EMD coaching and 17 clients from a new online version of EMD. For face-to-face clients, quantitative data were collected retrospectively with a one-time only questionnaire. For new online clients, quantitative data were collected from baseline and follow-up questionnaires. Qualitative data were collected after intervention from interviews with both groups. Outcomes from questionnaires for both groups included changes in mental wellbeing measured with the Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS) and self-efficacy assessed with the General Self-Efficacy Scale (GSES). FindingsFor every £1 invested, lifestyle coaching generated social values ranging from £4·12 to £7·08 for face-to-face clients compared with £2·37 to £3·35 for online participants. Quantitative and qualitative data from questionnaires and interviews indicated that many clients had improved mental wellbeing and self-efficacy. All 15 face-to-face clients and 11 (65%) of 17 online clients reported an increase of 5 points or more on the SWEMWBS questionnaire. Similarly, all 15 face-to-face clients and ten (59%) of 17 online clients reported an increase of 5 points or more on the GSES questionnaire. InterpretationThe results showed that both face-to-face and online formats of the EMD lifestyle coaching generated a positive social return on investment ratios. With continued long waiting lists for people with mental health challenges, face-to-face and online lifestyle coaching might become more essential across statutory, private, and third sectors to meet the growing demand for mental health support. FundingAccelerate: the Welsh Health Innovation and Technology Accelerator.

Mental health of the nursing and midwifery workforce in Wales during the COVID-19 pandemic: a cross-sectional analysis

BackgroundThe mental health of the nursing and midwifery workforce in the UK became a public health concern before the COVID-19 pandemic. Poor mental health is a known factor for those considering leaving the profession, and workforce retention of younger members is crucial for the future of the sector. The aim of this study was to provide up-to-date estimates of mental wellbeing in this workforce in Wales during the COVID-19 pandemic. MethodsWe did a cross-sectional analysis of demographics, work-related information, and health data from respondents to a national online survey of registered and student nurses and midwives and health-care support workers in Wales. The survey was open between June 23 and Aug 9, 2021, and 2910 people responded (approximately 7% of the workforce). Mental wellbeing was calculated using the Short Warwick Edinburgh Mental Wellbeing Score (SWEMWBS). We measured probable clinical depression (SWEMWBS <18) and possible mild depression (SWEMWBS 18–20). We used χ2 analysis and multinomial logistic regression (adjusted for sex and staff grouping) to examine associations between age groups and mental wellbeing. FindingsWe analysed data from 2781 (95·6%) of 2910 respondents (129 respondents did not answer all seven SWEMWBS questions). Overall, 1622 (58·3%) of 2781 respondents had SWEMWBSs indicative of either probable clinical depression (863 [31·0%] of 2781) or possible mild depression (759 [27·3%] of 2781). Probable clinical depression was highest among those aged 18–29 years (180 [33·8%] of 532), 30–39 years (250 [35·6%] of 703), and 40–49 years (233 [33·5%] of 696). Respondents in these age groups were twice as likely to report SWEMWBSs indicative of probable clinical depression than respondents aged 60 years and older (18–29 years adjusted odds ratio [aOR] 2·38 [95% CI 1·43–3·97], p=0·0009; 30–39 years aOR 2·86 [1·77–4·64], p<0·0001; 40–49 years aOR 2·49 [1·54–4·02], p=0·0002). InterpretationThis study highlights the substantial burden of poor mental wellbeing among the nursing and midwifery workforce in Wales, especially in those aged 49 years and younger. These figures, higher than previous estimates, could reflect the mental health effect of responding to the pandemic and could have long-term implications on workforce retention. FundingNone.

Mental wellbeing among Danish employees during the COVID-19 pandemic: results from a longitudinal study on the role of industry and working environment.

The COVID-19 pandemic has had a profound impact on working life. Previous studies have primarily focused on the mental health and wellbeing of healthcare workers and are mostly based on cross-sectional data from non-representative samples. The aim of this study was to investigate mental wellbeing trajectories among employees from different industries, and to longitudinally identify factors that affect mental wellbeing during the COVID-19 pandemic, including job insecurity, fear of COVID-19, working from home or being discharged with wage compensation and management quality. Baseline data were obtained from the Danish Health and Wellbeing Survey in 2019 (September-December), with follow-up in September-November 2020. We included 1995 respondents, who completed the questionnaire in both waves and were employed in 2020 and measured mental wellbeing using the Short Warwick-Edinburgh Mental Well-Being Scale. Mental wellbeing declined among employees in all industries. Employees working from home and employees unsatisfied with management experienced a greater decline in mental wellbeing. We found no differences in mental wellbeing trajectories in relation to fear of infecting others or contracting COVID-19, job insecurity and being discharged with wage compensation. Mental wellbeing declined among employees in all industries with no difference between industries. Employees working from home may have been particularly vulnerable, and the analyses show that managers play a key role in mitigating the negative consequences of the pandemic by ensuring adequate information and involvement of employees.

Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction.

Food addiction, specifically ultra-processed food addiction, has been discussed in thousands of peer-reviewed publications. Although 20% of adults meet criteria for this condition, food addiction is not a recognized clinical diagnosis, leading to a dearth of tested treatment protocols and published outcome data. Growing numbers of clinicians are offering services to individuals on the basis that the food addiction construct has clinical utility. This audit reports on clinical teams across three locations offering a common approach to programs delivered online. Each team focused on a whole food low-carbohydrate approach along with delivering educational materials and psychosocial support relating to food addiction recovery. The programs involved weekly sessions for 10–14 weeks, followed by monthly support. The data comprised pre- and post- program outcomes relating to food addiction symptoms measured by the modified Yale Food Addiction Scale 2.0, ICD-10 symptoms of food related substance use disorder (CRAVED), mental wellbeing as measured by the short version of the Warwick Edinburgh Mental Wellbeing Scale, and body weight. Sample size across programs was 103 participants. Food addiction symptoms were significantly reduced across settings; mYFAS2 score −1.52 (95% CI: −2.22, −0.81), CRAVED score −1.53 (95% CI: −1.93, −1.13) and body weight was reduced −2.34 kg (95% CI: −4.02, −0.66). Mental wellbeing showed significant improvements across all settings; short version Warwick Edinburgh Mental Wellbeing Scale 2.37 (95% CI: 1.55, 3.19). Follow-up data will be published in due course. Further research is needed to evaluate and compare long-term interventions for this complex and increasingly burdensome biopsychosocial condition.

Retention of medical officers in district health services, South Africa: a descriptive survey.

The health workforce is critical to strengthening district health services (DHS). In the public sector of South Africa, medical officers (MOs) are essential to delivering services in primary health care (PHC) and district hospitals. Family physicians, responsible for clinical governance, identified their retention as a key issue. To evaluate factors that influence retention of MOs in public sector DHS. A descriptive survey of MOs working in DHS, Western Cape, South Africa. All 125 MOs working in facilities associated with the Stellenbosch University Family Physician Research Network (SUFPREN) were included in the survey. A questionnaire measured the prevalence of key factors that might be associated with retention (staying >4 years) and included the Satisfaction of Employees in Health Care (SEHC) tool and Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Data were collected in Research Electronic Data Capture (REDCap) and analysed in the Statistical Package for Social Sciences (SPSS). Ninety-five MOs completed the survey. The overall rating of the facility (P = 0.001), age (P = 0.004), seniority (P = 0.015), career plans (P<0.001), and intention to stay in the public sector (P<0.001) were associated with retention. More personal factors such as social support (P = 0.007), educational opportunities for children (P = 0.002), and staying with one's partner (P = 0.036) were also associated with retention. Sex, rural versus urban location, district hospital versus primary care facility, overtime, remuneration, and additional rural allowance were not associated with retention. The overall rating of the facility was important and subsequent qualitative work has explored the underlying issues. These findings can guide strategies in the Western Cape and similar settings to retain MOs in the DHS.

Economics of mental wellbeing: A prospective study estimating associated productivity costs due to sickness absence from the workplace in Denmark

BackgroundFew studies have assessed associations between mental wellbeing (MWB) and productivity loss using nationally-representative longitudinal data. The objective of the study was to determine how different levels of MWB are associated with future productivity loss or costs due to sickness absence. MethodsData stem from a Danish nationally representative panel study of 1,959 employed adults (aged 16–64 years old) conducted in 2019 and 2020, which was linked to Danish register data. The validated Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) was used to assess MWB in 2019. The outcome was days absent from work due to sickness in 2020. Linear regression models were used to predict sickness absence in 2020 while adjusting for sickness absence in 2019, sociodemographics and health status, including psychiatric morbidity. Productivity loss or costs were estimated using the human capital approach (HCA) and friction cost approach (FCA). Costs are expressed in USD PPP. ResultsEach point increase in MWB was significantly associated with fewer sick days in 2020 and, by extension, lower productivity loss (reported in the order HCA/FCA). As compared to low MWB, moderate MWB was associated with $-1,614/$-1,271 per person in 2020, while high MWB was associated with $-2,351/$-1,779 per person in 2020. Extrapolated to the Danish population (2.7 M employed adults aged 16–64) and as compared to low MWB (12.3% of the population), moderate MWB (67.3% of the population) was associated with lower productivity loss amounting to $-2.9bn/$-2.3bn in 2020, while high MWB (20.4% of the population) was associated with lower productivity loss amounting to $-1.3bn/$-0.9bn in 2020. ConclusionsHigher levels of MWB are associated with considerably less productivity loss. Substantial reductions in productivity loss could potentially be achieved by promoting higher levels of MWB in the population workforce.

Wellbeing and coping of UK nurses, midwives and allied health professionals during COVID-19-a cross-sectional study.

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention.

Forgiveness and mental Well-being: a transnational comparison

Purpose The purpose of this study was to investigate forgiveness and mental well-being amongst Forgiveness and mental well-being were investigated amongst British European and Nigerian African samples to compare and determine the similarities and differences in dispositional forgiveness levels between the two populations conducted in terms of their general samples, gender and age and the difference in mental well-being scores between the two samples. Finally, the relationship between forgiveness and mental well-being in both groups was examined. Design/methodology/approach The Bolton Forgiveness Scale and the Short Warwick–Edinburgh Mental Well-Being Scale were administered to the participants (Nigerian n = 1,164, British n = 855). SPSS was used to analyse data; a series of t-test was conducted; and Eta-squared and Z-value were calculated to determine the magnitude of each significant difference among variables and the magnitude of the difference in the correlation coefficient among variables, respectively. Findings Statistically significant results suggested significant differences in the way and manner dispositional forgiveness is conceptualised and practised within one group relative to the other, whereas non-significant results indicated similarities in forgiveness opinions and practises between the two groups. Overall British sample, men and those aged 36–55 reported higher levels of forgiveness than their Nigerian counterparts. However, Nigerians under the age of 35 reported higher levels of forgiveness than their British counterparts, and there was no statistically significant difference between the forgiveness levels of British and Nigerian women. Furthermore, the British total sample, men and women, all had higher well-being scores than their Nigerian counterparts. Research limitations/implications Forgiveness varies according to culture. The findings of this study suggest that the individualistic/collectivistic cultural arguments long held by some authors may not adequately explain the differences and similarities in forgiveness conceptualization and practise across cultures. As a result, research may focus on a variety of factors such as educational background, income, socioeconomic level and religion, among others. Second, consistent with previous studies, this research suggests that forgiveness is positively related to mental health and well-being. Finally, one of the limitations of this study is its exclusive focus on two countries, namely, the UK and Nigeria. Future research could include more countries with both individualistic and collectivistic societies. Originality/value This paper, which is, to the best of the authors’ knowledge, the first to examine forgiveness and mental well-being in a comparative perspective between British European and Nigerian African samples, has made a unique contribution to the forgiveness and mental well-being literature and in particular, has provided a solid foundation and resources for future research of a similar nature in Africa, where little or no research had been conducted previously.

Impact of the COVID-19 Pandemic on the Wellbeing of International Oncology and Hematology Fellows at the Princess Margaret Cancer Center (PMCC)

BackgroundThe COVID-19 pandemic has led to significant disruptions across all levels of medical training. International fellows in subspecialty training programs are essential members of the frontline physician workforce, but may face additional and unique challenges as a result of being away from their home country. In this study, we aimed to understand the impact of the COVID-19 pandemic on the wellbeing of international fellows in the Hematology and/or Oncology fellowship program at the PMCC.MethodsIn collaboration with our staff psychiatrist, we conducted an online survey of hematology and/or oncology fellows at the PMCC from July 6 to August 10, 2020. The survey consisted of 60 questions divided into 4 sections: demographics, wellbeing assessment using the validated Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), fellowship specific questions (personal and professional) and coping strategies using the validated brief COPE scale.ResultsOverall 24/52 (46%) fellows completed the survey: 21/24 were international fellows with 48% from Asia, 3/24 were Canadian fellows but away from home; 54% were male; 48% were aged 31–35 years; 65% were married, 48% had children. Mean SWEMWBS score was 21, indicating lower overall wellbeing than the general population who had a score of 23.6. Compared to their pre-COVID status, many reported a decline in their wellbeing (63%), sense of guilt for not being with their family (45%) or helping their country (41%), stress in personal relationships (26%), fatigue (50%), sleep disorders (38%) and loss of interest in daily activities (38%). Personal events were altered by almost 80%; and 20% planned to extend their fellowship. According to the Brief-COPE scale, during the pandemic, most fellows used more adaptive coping mechanisms (mean score 39.2) as opposed to maladaptive ones (mean score 21.8).ConclusionsThe ongoing COVID-19 pandemic has negatively affected the overall wellbeing of international fellows. Understanding the specific challenges and coping mechanisms used by international fellows may help institutions develop better targeted strategies to promote wellbeing, professional development and ensure high-quality patient care during unprecedented times like the COVID pandemic.

A Social Return on Investment Evaluation of the Pilot Social Prescribing EmotionMind Dynamic Coaching Programme to Improve Mental Wellbeing and Self-Confidence.

The COVID-19 pandemic contributed to longer waiting lists for people seeking to access mental health services. The NHS Five Year Forward View encourages the development of empowerment-based social prescribing interventions to supplement existing mental health programmes. Based in South Wales, EmotionMind Dynamic (EMD) is a lifestyle coaching programme that supports individuals suffering from anxiety or depression. In this evaluation of lifestyle coaching, a mixed-method social return on investment (SROI) methodology was used to value quantitative and qualitative data from face-to-face and online participants. Data collection took place between June 2021 and January 2022. Participants included both self-referred clients and those referred from health services. Mental wellbeing data were collected at baseline and at the end of the programme using the short Warwick–Edinburgh Mental Wellbeing Scale (SWEMWBS) and the General Self-Efficacy Scale (GSES). Baseline and follow-up data were available for 15 face-to-face participants and 17 online clients. Wellbeing valuation quantified and valued outcomes from participants. Results indicated that for every GBP 1 invested, lifestyle coaching generated social values ranging from GBP 4.12–GBP 7.08 for face-to-face clients compared with GBP 2.37–GBP 3.35 for online participants. Overall, lifestyle coaching generated positive social value ratios for both face-to-face and online clients.

Community empowerment and mental wellbeing: longitudinal findings from a survey of people actively involved in the big local place-based initiative in England.

Community empowerment initiatives are receiving increased interest as ways of improving health and reducing health inequalities. Longitudinally examine associations between collective control, social-cohesion and mental wellbeing amongst participants in the Big Local community empowerment initiative across 150 disadvantaged areas of England. As part of the independent Communities in Control study, we analysed nested cohort survey data on mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale-SWEMWBS) and perceptions of collective control and social-cohesion. Data were obtained in 2016, 2018 and 2020 for 217 residents involved in the 150 Big Local areas in England. Adjusted linear mixed effect models were utilized to examine changes in SWEMWBS over the three waves. Subgroup analysis by gender and educational level was conducted. There was a significant 1.46 (0.14, 2.77) unit increase in mental wellbeing score at wave 2 (2018) but not in wave 3 (2020) (0.06 [-1.41, 1.53]). Across all waves, collective control was associated with a significantly higher mental wellbeing score (3.36 [1.51, 5.21]) as was social cohesion (1.09 [0.19, 2.00]). Higher educated participants (1.99 [0.14, 3.84]) and men (2.41 [0.55, 4.28]) experienced significant increases in mental wellbeing in 2018, but lower educated participants and women did not. Collective control and social cohesion are associated with better mental wellbeing amongst residents engaged with the Big Local initiative. These health benefits were greater amongst men and participants from higher educational backgrounds. This suggests that additional care must be taken in future interventions to ensure that benefits are distributed equally.

Psychometric properties of the Short Warwick-Edinburgh Mental Well-Being Scale in a sample of Danish schoolchildren.

The aims of this this study was to examine the psychometric properties, including internal consistency and construct validity, of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) in a sample of Danish schoolchildren aged 10-16 years. A total of 1155 schoolchildren (54% girls) aged 10-16 years (Mage=12 years, SD=1.3) responded to an electronic questionnaire as part of the Danish SELFCARE study. To examine the internal consistency and construct validity of the SWEMWBS, we performed descriptive statistics, reliability and correlation analyses in Stata as well as confirmatory factor analysis (CFA) in Mplus. Correlations between scores on the SWEMWBS and scores on scales from the Strengths and Difficulties Questionnaire (SDQ) were calculated using Spearman's rank correlation coefficients. The analysis was conducted on the general study population and in subgroups divided by sex and class (age groups). CFA confirmed SWEMWBS one-dimensional factor structure, and the model fit the data well (CFI=0.984, TLI=0.97, RMSEA=0.062 and SRMR=0.021). The scale showed satisfactory internal consistency (ɑ=0.78) and composite reliability (ω=0.82). In addition, the scale was shown to have acceptable construct validity. Thus, correlations between scores on the SWEMWBS and SDQ subscales were in line with expectations. Corresponding results were found for subgroups divided by sex and class (age groups). Our study indicates that the Danish translation of the SWEMWBS is valid for measuring well-being among Danish schoolchildren aged 10-16 years. This construct validation study is among the first to validate the SWEMWBS in younger populations.

Psychological wellbeing in the English population during the COVID-19 pandemic: A series of cross-sectional surveys

Psychological distress has been elevated during the COVID-19 pandemic. However, few studies published to date have investigated distress after the first wave of infections (Spring – Summer 2020). We investigated distress and wellbeing between April 2020 and April 2022 in England through a series of cross-sectional online surveys. People aged 16 years or over living in the UK were eligible for the surveys; for this study we selected only those living in England due to differences in restrictions between UK nations. Distress was measured using the PHQ4 (n = 60,921 responses), while wellbeing was measured using the Short Warwick-Edinburgh Mental Wellbeing Scale (n = 61,152 responses). Throughout, approximately 50%–60% of women and 40%–50% of men reported distress, higher than the 25%–30% of women, and 20%–25% of men reported in normative data. Wellbeing was also worse than population norms, with women reporting lower wellbeing than men. Rates of distress in the English population have been consistently high throughout the pandemic. Patterns of distress have broadly mirrored the pattern of restrictions and case numbers, but there are notable exceptions which indicate that other factors may play a part in population mental health.

A cross-sectional study of Malaysian low-income drug addict wives: Relationship between family impact, coping and mental wellbeing

Background: The involvement of the husbands in the issue of drug addiction has impacted the wives’ livelihoods. Due to drug addiction amongst husbands, the wives experience stress and strain. The Stress Strain Coping Support Model (SSCS) was established to better comprehend how coping influences stress and strain. Thus, the purpose of this study was to determine the relationship between the stress which refers to family impact experienced by the wives of drug addicts, in terms of economic difficulties and marital conflict, and mental wellbeing. Furthermore, this study examines the role of coping as a mediating factor between family impact and mental wellbeing. Methods: This study involved 132 wives of low-income drug addicts in Malaysia, who were selected using a purposive sampling method. Economic Strain Scale (ESS) and Braiker-Kelly Marital Conflict Scale (BKMCS) were used to measure family impact. Coping and Adaptation Processing Scale Short Form (CAPS-SF) and Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) were used to measure coping and mental wellbeing of the respective respondents. Results: Path analysis using SmartPLS software version 3.3.7 showed that there is a direct association between family impact and coping, and between coping and mental wellbeing. The results also showed that family impact was associated indirectly with mental wellbeing through coping. Conclusions: The findings benefited drug addict wives and practitioners related to this field in terms of enhancing the use of coping mechanisms in managing family impact and improving mental wellbeing, specifically amongst low-income drug addict wives.

The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia.

BackgroundSuicidal ideation is a major risk for a suicide attempt in younger people, such that reducing severity of ideation is an important target for suicide prevention. Smartphone applications present a new opportunity for managing ideation in young adults; however, confirmatory evidence for efficacy from randomized trials is lacking. The objective of this study was to assess whether a therapeutic smartphone application (“LifeBuoy”) was superior to an attention-matched control application at reducing the severity of suicidal ideation.Methods and findingsIn this 2-arm parallel, double-blind, randomized controlled trial, 455 young adults from Australia experiencing recent suicidal ideation and aged 18 to 25 years were randomly assigned in a 2:2 ratio to use a smartphone application for 6 weeks in May 2020, with the final follow-up in October 2020. The primary outcome was change in suicidal ideation symptom severity scores from baseline (T0) to postintervention (T1) and 3-month postintervention follow-up (T2), measured using the Suicidal Ideation Attributes Scale (SIDAS). Secondary outcomes were symptom changes in depression (Patient Health Questionnaire-9, PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7, GAD-7), distress (Distress Questionnaire-5, DQ5), and well-being (Short Warwick–Edinburgh Mental Well-Being Scale, SWEMWBS). This trial was conducted online, using a targeted social media recruitment strategy. The intervention groups were provided with a self-guided smartphone application based on dialectical behavior therapy (DBT; “LifeBuoy”) to improve emotion regulation and distress tolerance. The control group were provided a smartphone application that looked like LifeBuoy (“LifeBuoy-C”), but delivered general (nontherapeutic) information on a range of health and lifestyle topics. Among 228 participants randomized to LifeBuoy, 110 did not complete the final survey; among 227 participants randomized to the control condition, 91 did not complete the final survey. All randomized participants were included in the intent-to-treat analysis for the primary and secondary outcomes. There was a significant time × condition effect for suicidal ideation scores in favor of LifeBuoy at T1 (p < 0.001, d = 0.45) and T2 (p = 0.007, d = 0.34). There were no superior intervention effects for LifeBuoy on any secondary mental health outcomes from baseline to T1 or T2 [p-values: 0.069 to 0.896]. No serious adverse events (suicide attempts requiring medical care) were reported.The main limitations of the study are the lack of sample size calculations supporting the study to be powered to detect changes in secondary outcomes and a high attrition rate at T2, which may lead efficacy to be overestimated.ConclusionsLifeBuoy was associated with superior improvements in suicidal ideation severity, but not secondary mental health outcomes, compared to the control application, LifeBuoy-C. Digital therapeutics may need to be purposefully designed to target a specific health outcome to have efficacy.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12619001671156

Sleep Quality, Wellbeing and Happiness in Medical Undergraduates in Western India

Background: Medical students appear to be one group that is especially vulnerable to sleep problems. The study's objective was to evaluate the sleep quality, wellbeing, and happiness of Indian medical students at various stages of their education, as well as students from all three major streams (allopathic, ayurveda, and homoeopathic medicine). Methodology: A convenience sample of 873 medical students was used in this cross-sectional and questionnaire-based study, which included homoeopathic (n=205), allopathic (n=389), and ayurvedic (n=279) medical students. The tools used were the Medical Outcomes Study Sleep Scale, the Short Depression – Happiness Scale, and the Short Warwick-Edinburgh Mental Well-Being Scale. Results: Students in the Allopathic stream showed statistically significantly worse sleep quality ratings than students in the Homoeopathic and Ayurvedic streams. Further, when compared to students in the second and fourth years, third-year students had significantly lower sleep quality ratings. The happiness measure had a statistically significant positive relationship with wellbeing (rho = 0.56, p.001), sleep quality (rho = 0.13, p.001), and sleep adequacy (rho = 0.25, p.001). Conclusion: Sleep is essential for maintaining human bio-psychosocial homeostasis. A concerted effort should be made to educate medical students about sleep hygiene and practical techniques to improve their sleep quality.

Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19.

Academic stress may be the single most dominant stress factor that affects the mental well-being of college students. Some groups of students may experience more stress than others, and the coronavirus disease 19 (COVID-19) pandemic could further complicate the stress response. We surveyed 843 college students and evaluated whether academic stress levels affected their mental health, and if so, whether there were specific vulnerable groups by gender, race/ethnicity, year of study, and reaction to the pandemic. Using a combination of scores from the Perception of Academic Stress Scale (PAS) and the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), we found a significant correlation between worse academic stress and poor mental well-being in all the students, who also reported an exacerbation of stress in response to the pandemic. In addition, SWEMWBS scores revealed the lowest mental health and highest academic stress in non-binary individuals, and the opposite trend was observed for both the measures in men. Furthermore, women and non-binary students reported higher academic stress than men, as indicated by PAS scores. The same pattern held as a reaction to COVID-19-related stress. PAS scores and responses to the pandemic varied by the year of study, but no obvious patterns emerged. These results indicate that academic stress in college is significantly correlated to psychological well-being in the students who responded to this survey. In addition, some groups of college students are more affected by stress than others, and additional resources and support should be provided to them.

Wellbeing and Social Network Characteristics in Rural Communities: Findings from a Cohort in Social Housing in Cornwall, United Kingdom

The mental wellbeing of those living in resource poor and rural localities is a public health priority. Despite evidence of a link between social networks and mental wellbeing, little is known about this relationship in the context of rural and resource poor environments. The current study uses novel social network methodology to investigate the extent to which social network size and composition is related to mental wellbeing in a social housing community in rural England. Data come from 88 individuals living in social housing in Cornwall. These participants are part of a larger study of 329 social housing households surveyed in 2017 and 2018. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). A series of multivariable linear regression models were used to test associations between social network characteristics and mental wellbeing. Social network size was significantly associated with the SWEMWBS (b = 0.39, p < 0.01), such that individuals with larger networks reported better mental wellbeing, but after controlling for community social cohesion, this effect dissipated. Neither gender composition or talking with network members about health and wellbeing were significantly associated with the SWEMWBS. Findings suggest that both the quantity of social connections and perceptions of community cohesion are moderately associated with mental wellbeing in rural and resource poor localities. As such, efforts to improve mental wellbeing would benefit from targeting multiple aspects of social relationships, rather than focusing solely on increasing the size of individuals’ social networks.

Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial

ObjectivesTo evaluate the efficacy and acceptability of ‘Whitu: seven ways in seven days’, a well-being application (app) for young people.DesignProspective randomised controlled trial of Whitu against waitlist control, with 45...

Immersive Reality Experience Technology for Reducing Social Isolation and Improving Social Connectedness and Well-being of Children and Young People Who Are Hospitalized: Open Trial.

BackgroundChildren and young people who are hospitalized can feel disconnected from their peers and families, which can, in turn, predispose them to psychological problems, including anxiety and depression. Immersive reality experience technology, recently developed by the New Zealand Patience Project Charitable Trust, may help to overcome these issues. Immersive reality experience technology uses immersive 360° live streaming and a virtual reality headset to enable children and young people who are hospitalized to connect through cameras located in either their school or home environment and via SMS text messaging with a designated buddy.ObjectiveThis trial aims to expand qualitative findings from a previous smaller proof of concept trial to ascertain the views of New Zealand children and young people who are hospitalized, their caregivers, and teachers regarding immersive reality experience technology and quantitatively evaluate the effectiveness of immersive reality experience technology in reducing social isolation and improving social connectedness and well-being using validated outcome measures.MethodsAn open trial of immersive reality experience technology was conducted between December 2019 and December 2020 for which 19 New Zealand children and young people aged 13 to 18 years who had been hospitalized at Starship Hospital—a specialist pediatric hospital in Auckland—for at least 2 weeks were recruited. All young people completed the Short Warwick–Edinburgh Mental Well-Being Scale, an abbreviated version of the Social Connectedness Scale, and the Social Inclusion Scale at baseline. Of the 19 participants, 10 (53%) used immersive reality experience technology as often as they wished over a 6-week period and completed postintervention measures. Semistructured interviews with a subset of the 10 young people, 4 caregivers, and 6 teachers were conducted immediately after the intervention.ResultsParticipants reported improvements in social inclusion (mean change 3.9, SD 2.8; P=.06), social connectedness (mean change 14.2, SD 10.0; P=.002), and well-being (mean change 5.7, SD 4.0; P=.001). Key themes from interviews with participants, caregivers, and teachers were the importance of support for using immersive reality experience technology, connecting versus connectedness, choice and connection, and the value of setting it up and getting it right. Recommendations for improving connectedness via immersive reality experience and related technologies were also provided.ConclusionsImmersive reality experience technology can improve the social inclusion, social connectedness, and well-being of New Zealand children and young people who are hospitalized. With some technological modifications and simplified implementation, immersive reality experience and related technology could become part of standard care and support children and young people who are hospitalized in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems, and more easily return to normal life following the completion of treatment.Trial RegistrationAustralian New Zealand Clinical Trials Network Registry ACTRN12619000252112; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376837&isReview=true