UK Young Adults Research Articles

The unequal impacts of the COVID-19 pandemic on young adults' mental health. Predictors of vulnerability and resilience using longitudinal birth cohort data in the UK.

Previous studies have demonstrated deteriorations in young adult mental health during the COVID-19 pandemic, but evidence suggests heterogeneity in the mental health impacts of the pandemic. We sought to identify factors which may predict changes in psychological distress and wellbeing during the COVID-19 pandemic in UK young adults. A total of 2607 young adults from the Millennium Cohort Study were included. Psychological distress and mental wellbeing were measured using the Kessler-6 and Short Warwick-Edinburgh Mental Wellbeing Scale, respectively. Assessment occurred at three timepoints between the ages of 17-19: 2018/19 (pre-COVID Baseline), May 2020 (COVID Wave 1) and September/October 2020 (COVID Wave 2). Latent change score models were used to study change in distress and wellbeing across the study period, as well as the impact of sex, relative family poverty, parental education, preexisting mental health difficulties and perceived social support on these changes. The latent change score models suggested both distress and wellbeing tended to increase across the study period. Being female and in relative poverty predicted greater increases in distress and/or poorer wellbeing. Higher levels of parental education and greater perceived social support were protective against increased distress and associated with improved wellbeing. The impact of the COVID-19 pandemic on UK young adult mental health is complex. We provide further evidence for a distinction between symptoms of poor mental health and wellbeing. Research is urgently needed to assess the long-term impacts of the COVID-19 pandemic on the mental health and wellbeing of young people, particularly in more vulnerable groups.

Young adult mental health during the United Kingdom’s first COVID-19 lockdown: the benefit of living with parents and siblings

ABSTRACT UK young adults saw sharp mental health declines during the COVID-19 pandemic. This paper examines whether living with siblings helped moderate this negative effect. We compare the outcomes of young adults (age 19), i) who were living with parents and siblings, with ii) those who were living with only parents, and iii) with those who were living away from parents. We used data from the Millennium Cohort Study COVID-19 survey, linked with the mainstage survey (N = 2,578), and captured mental health with: the Shortened Warwick-Edinburgh Mental Well-being Scale and the Kessler-6 Psychological Distress scale. As young men and women may be differently affected by sibling co-residence, we vary living arrangements effects by gender. While average young adult mental health deteriorated during the first national lockdown, there were variations by gender and living arrangements. For young men, living with siblings was associated with improved mental health on both measures during the first COVID-19 lockdown. For young women, living with parents was associated with lower psychological distress than living away from home, but siblings provided no additional benefit. Data from later in the pandemic suggests that, as young adults became more accustomed to social restrictions, the importance of family living arrangements declined.

Mhealth interventions to improve public knowledge of HPV-associated oral cancer in the UK

In the UK, the age-standardised incidence rates of cancers of the ‘oropharynx’and ‘lip and oral cavity’ are ‘2.6%’ and ‘4.9%’ respectively.These indicate a significant oral cancer burden. These are attributable tonumerous risk factors; the major risk factors include tobacco use, alcoholconsumption, and exposure to oral HPV infection. Though, significantsuccess in reducing the prevalence of most of the major risk factorshas been recorded, exposure to HPV infection still remains a majordriver of oral cancer prevalence in the UK. HPV-associated oropharyngealcancer prevalence in men and women is 6.29 and 2.04%, respectively,while prevalence for HPV-associated oral cavity cancer in menand women is 11.7 and 6.95%, respectively; and it is projected to overtakecervical cancer by the year 2025. This is mainly due to exposure tooral HPV infection through oral sex practice as over 63% of UK youngadults are found to have a history of oral sex practice. Only a minorityof the UK population is aware of HPV-associated oral cancer whichcalls for more public health efforts to increase knowledge on the role ofHPV in oral cancer. While the use of technology-based, clinic-based,and community-based interventions has been employed to improvepublic knowledge on the role of HPV in oral cancer development, technology-based interventions have not been adequately explored. Mhealthapplication-based interventions have been previously employed toimprove knowledge and behavioural change in diverse chronic diseases.Hence, our recommendation on the adoption of Mhealth application-based intervention strategy in the education of the UK’s populationon HPV-associated oral cancer is highly desirable as it closelyaligns with the country’s National Health Service (NHS) commitmenttowards the digital transformation of the healthcare system.

How Far Can Interventions to Increase Income Improve Adolescent Mental Health? Evidence From the UK Millennium Cohort Study and Next Steps

UK adolescents and young adults are facing increasing rates of mental health problems and extremely difficult economic circumstances. There is strong evidence that interventions to increase income during adolescence can mitigate conditions such as anxiety and depression. However, policymakers lack quantified risk differences in the probability of mental illness between different income groups by which to establish the prospective scale of mitigation. Here, we estimate risk differences using two longitudinal cohort studies: Millennium Cohort Study (cohort members born between 2000 and 2002) and Next Steps (born 1989–1990). We quantify the association between income and risk of depression at age 14, serious mental illness at age 17, and non-psychotic mental illness at age 25. We also conduct sensitivity analysis using numerous other markers of socioeconomic (SES) status. We estimate that those living in the poorest quintile group of households have a greater probability of mental health problems than the richest at ages 14, 17, and 25. We find that other markers of SES status—subjective financial strain, cohort member assessed wealth relative to friends, occupational class, and education—display steeper associations with mental health symptoms relative to associations between mental health symptoms and income. Our findings are likely to be conservative underestimates since they are likely to be attenuated by well-known and large measurement errors in both mental health problems and living standards during adolescence.

Trajectories of physical activity during COVID-19: A longitudinal analysis of UK young adults.

Research has demonstrated a disproportionate reduction in the moderate-vigorous physical activity (MVPA) of young UK adults during the initial months of COVID-19. However, previous research has not examined the trajectory of MVPA for this demographic over subsequent phases of the pandemic. The present study investigated the trajectory of MVPA from April 2020 to January 2021 in young UK adults. Data were drawn from 18-29-year-old participants of the Understanding Society COVID-19 Survey (212 males, 542 females). Weekly MVPA was self-reported at three time points (April and September 2020; January 2021) using the International Physical Activity Questionnaire. After controlling for significant covariates, growth curve modelling revealed no variation in weekly MVPA, which remained higher than the UK Physical Activity Guidelines. Female gender; Asian, Black and Mixed ethnicity; lower income,; living with a partner; and no access to a private garden or other outdoor space were associated with lower MVPA in April 2020. Gender, however, was a significant moderator of the trajectory. Males' MVPA increased between April 2020 to August 2020, followed by a sharp decline; whereas females showed a steady rate of decline from April 2020 to January 2021. Despite the recurrent lockdowns, this study shows that young UK adults, on average, continued to engage in MVPA, above the recommendated amount. Nevertheless, significant variation associated with gender, ethnicity and income highlights the importance of providing accessible spaces for young adults to exercise, especially those with limited access to private gardens.

#2617 CHANGES IN PSYCHOSOCIAL HEALTH IN YOUNG ADULTS WITH KIDNEY FAILURE: A 5-YEAR FOLLOW-UP OF THE SPEAK STUDY

Abstract Background and Aims Young adulthood is a sensitive developmental period, and the psychosocial impact of kidney failure in this group is implicated in the observed high risk for transplant loss and death. In the Surveying People Experiencing young Adult Kidney failure (SPEAK) study we described differences in life-course outcomes, worse mental wellbeing and twice the likelihood of psychological disturbance among UK young adults with kidney failure (transplant or dialysis) compared to the general population. There have been no longitudinal studies investigating the natural history of these outcomes as young adults mature and get older. We undertook SPEAK-2 as a five-year follow-up study to address this. Method In this prospective observational study, respondents to SPEAK were invited to complete a revised online survey. PPI guided components of the original survey to amend. We analysed how psychosocial health had changed among respondents between studies using the paired t-test, Wilcoxon signed-rank test and McNemar's test for continues parametric and non-parametric data, and binary data respectively. We compared responses to age-matched respondents of the Health Survey for England 2012 using regression. Responses were weighted to increase generalisability. Results We had 158 survey responses. The analysis of psychological health change over time is presented in Table 1. A greater proportion of participants had evidence of psychological morbidity (45% versus 24% in the original SPEAK study; p<0.001). They had inferior mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS] β, -1.76; 95% CI, -3.27 to -0.25; P = .02). No differences were identified in domains including quality of life (EQ5D). Key outcomes of the comparison to the age-matched general population are presented in Table 2. Respondents were less likely to be married or have children and were more likely to be living with their parents. They were almost 15 times more likely to report being unable to work due to health. Respondents had poorer quality of life and poorer mental wellbeing compared to the general population. They also five times greater odds of having psychological problems or mental ill health. Conclusion We report the first longitudinal study of the psychosocial health of a cohort of young adults with kidney failure as they age and mature. Over five years, we observed worse psychosocial health in terms of mental wellbeing and psychological morbidity. Respondents also lagged behind their peers in terms of life-course and psychosocial outcomes. Dedicated long-term follow-up is needed to clarify the extent and duration to which kidney failure in young adulthood impacts life participation and psychosocial health in the long term. Regardless, the degree of psychosocial ill health we have described warrants urgent increased support for this group.

Does perpetrator gender influence attitudes towards intimate partner violence (IPV)? Examining the relationship between male-perpetrated and female-perpetrated IPV attitudes among a sample of UK young adults

Purpose Understanding of the role that attitudes and beliefs may play on the judgments people make about intimate partner violence (IPV) is becoming increasingly important, notably in the context of the criminal justice process and in recognising IPV as a public health issue. This study aims to investigate the importance of several established factors predictive of attitudes towards male-perpetrated IPV, which have never previously been explored in relation to female-perpetrated IPV. Design/methodology/approach In total, 295 young adults (18–28) from across the UK completed an online survey (M Age = 23.82) comprised of four established psychometric inventories; the Rosenberg Self-esteem scale, Satisfaction with Life scale, Attitudes Towards Female Dating Violence scale and newly developed Modern Adolescent Dating Violence Attitudes (MADVA) scale, alongside a suite of associated demographic factors. Findings Results derived from a multiple linear regression indicates that three types of attitudes towards male-perpetrated violence against women (physical, sexual, and psychological abuse offline), were significant predictors of attitudes towards female-perpetrated IPV, along with gender and ethnicity. Self-esteem, satisfaction with life, age and education among those surveyed were not associated with attitudes towards female-perpetrated IPV. Practical implications The results have important implications in developing educational programmes for those who have committed IPV offences, as well as teaching young people about the nature of partner abuse. Originality/value The results suggest that those who endorse attitudes supportive of male-perpetrated IPV in offline environments, also endorse violence-supportive beliefs towards female-perpetrated IPV. In effect, violence-supportive attitudes are held irrespective of the sex of the perpetrator. However, this may differ in terms of how individuals view online types of abuse, where these attitudes appear to be processed differentially to offline attitudes.

A quantitative approach to the intersectional study of mental health inequalities during the COVID-19 pandemic in UK young adults

PurposeMental health inequalities across social identities/positions during the COVID-19 pandemic have been mostly reported independently from each other or in a limited way (e.g., at the intersection between age and sex or gender). We aim to provide an inclusive socio-demographic mapping of different mental health measures in the population using quantitative methods that are consistent with an intersectional perspective.MethodsData included 8,588 participants from two British cohorts (born in 1990 and 2000–2002, respectively), collected in February/March 2021 (during the third UK nationwide lockdown). Measures of anxiety and depressive symptomatology, loneliness, and life satisfaction were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models.ResultsWe found evidence of large mental health inequalities across intersectional strata. Large proportions of those inequalities were accounted for by the additive effects of the variables used to define the intersections, with some of the largest gaps associated with sexual orientation (with sexual minority groups showing substantially worse outcomes). Additional inequalities were found by cohort/generation, birth sex, racial/ethnic groups, and socioeconomic position. Intersectional effects were observed mostly in intersections defined by combinations of privileged and marginalised social identities/positions (e.g., lower-than-expected life satisfaction in South Asian men in their thirties from a sexual minority and a disadvantaged childhood social class).ConclusionWe found substantial inequalities largely cutting across intersectional strata defined by multiple co-constituting social identities/positions. The large gaps found by sexual orientation extend the existing evidence that sexual minority groups were disproportionately affected by the pandemic. Study implications and limitations are discussed.

Longitudinal changes in the mental health of UK young male and female adults during the COVID-19 pandemic

An increasing body of research indicates that, whilst young adults are at the lowest risk of becoming severely physically ill as a result of COVID-19, they are at the greatest risk of adverse mental health outcomes. Using data from the Understanding Society COVID-19 survey, the current study examined the mental health of 18-25-year-olds during the pandemic. Current mental health was measured at six time points using the 12-item General Health Questionnaire (GHQ-12), a validated measure for mental distress. The analytic sample included 880 young adults (292 = males; 588 = females). The trajectory of mental health was modeled from April to November 2020, using demographic information and health behaviors (physical activity, alcohol consumption, and smoking cigarettes) as covariates. Growth curve modeling indicated that alcohol consumption, smoking, being female, having a lower income, and having a pre-existing mental health condition were risk factors for worse mental health during the pandemic. For females, their mental health was lowest in April but gradually improved until September, when it began to decline again. Males, in contrast, had a relatively stable trajectory of mental health across the pandemic. These findings can help inform targeted interventions for at risk groups to minimize the adverse impact of the pandemic on young adults’ mental health.

The trajectory of loneliness in UK young adults during the summer to winter months of COVID-19

Current research has shown that young adults are at the greatest risk of loneliness during the pandemic. Drawing upon the Understanding Society COVID-19 survey, this study investigated the trajectory of loneliness in young adults (aged 18-25) from June to November 2020 and its association with emotional support as well as demographic and health factors. The analytic sample included 419 young adults (296 females; 123 males). Growth curve modelling revealed a U-shape longitudinal trend in self-reported loneliness, with a sharp rise during the winter months under the national lockdown. Young adults with long-standing physical or mental health conditions were more likely to report feeling lonely. Those with a lower household income and who were unemployed or not in school reported higher levels of loneliness. Gender was found to moderate the association between self-reported emotional support and loneliness. While greater emotional support was associated with less loneliness in males, no association was shown for females. The current findings add to our understanding of how the pandemic has affected the mental health of young adults and the differential effect of emotional support as a potential coping strategy for males and females.

Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK.

IntroductionPandemic-related social lockdown limited many sexual behaviors, but to date, no study has examined the perceived impact of social lockdown due to COVID-19 on sexual fantasy and solitary sexual behavior.AimsThe present study sought to examine the perceived impact of social lockdown on sexual fantasy and solitary sexual behavior among UK young adults in various living situations.MethodsA convenience sample of 565 adults aged 18–32 and living in the UK completed anonymous, web-based, study-specific questionnaires between May 14 and 18, 2020, 7 weeks after social lockdown was initiated. Mixed-method analyses were conducted.Main Outcome MeasuresThe study presents qualitative and quantitative data. Criterion variables were measured dichotomously as increases (vs no change) in sexual fantasy and increases (vs no change) in pornography consumption. Predictor variables were living arrangement, relationship status, and postlockdown changes in masturbation and pornography consumption.ResultsOf all, 34.3% engaged in more sexual fantasizing during lockdown; women were more likely than men to report this increase. Living context and relationship status were predictors of increased fantasizing. Of all, 30.44% reported an increase in at least one solitary sexual practice. This increase was associated with an increase in sexual fantasizing and also with increased pornography consumption. Nineteen percent of participants reported an increase in pornography use, with men being more likely than women to report this increase. Participants mostly attributed their increases to boredom, increased free time, and replacing partnered sex.ConclusionShifts in sexual fantasizing and solitary sexual practices were predicted by living arrangements, relationship status, and gender. The present findings suggest that the assessment of sexual fantasy and solitary sexual activities may benefit patients presenting with pandemic-related stress. Although mostly exploratory, significant changes in sexual fantasy and solitary sexual practices were observed. A cross-sectional design, convenience sampling, and study-specific measures are limitations. Cascalheira CJ, McCormack M, Portch E, et al. Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK. J Sex Med 2021;9:100342.

The relationship between vitamin D status, intake and exercise performance in UK University-level athletes and healthy inactive controls.

The potential ergogenic effects of vitamin D (vitD) in high performing athletes has received considerable attention in the literature and media. However, little is known about non-supplemented university athletes and students residing at a higher latitude. This study aimed to investigate the effects of vitD (biochemical status and dietary intake) on exercise performance in UK university athletes and sedentary students. A total of 34 athletes and 16 sedentary controls were studied during the spring and summer months. Serum vitD status and sunlight exposure were assessed using LC-MS/MS and dosimetry, respectively. Muscular strength of the upper and lower body was assessed using handgrip and knee extensor dynamometry (KE). Countermovement jump (CMJ) and aerobic fitness were measured using an Optojump and VO2max test, respectively. Statistical analysis was performed using paired/ independent t-tests, ANCOVA and Pearson/ Spearman correlations, depending on normality. VitD status increased significantly over the seasons, with athletes measuring higher status both in spring (51.7±20.5 vs. 37.2±18.9 nmol/L, p = 0.03) and summer (66.7±15.8 vs 55.6±18.8 nmol/L, p = 0.04) when compared to controls, respectively. Notably, 22% of the subjects recruited were vitD deficient during the spring term only (<25nmol/L, n 9). Subjects with ‘insufficient’ vitD status (<50nmol/L) elicited significantly lower CMJ when contrasted to the vitD ‘sufficient’ (>50nmol/l) group (p = 0.055) and a lower VO2 max (p = 0.05) in the spring and summer term (p = 0.05 and p = 0.01, respectively). However, an ANCOVA test showed no significant difference detected for either CMJ or VO2max following adjustments for co-variates. In conclusion, we provide novel information on the vitD status, dietary intake, physical fitness and sunlight exposure of UK young adults across two separate seasons, for which there is limited data at present.

Changes in Sexual Desire and Behaviors among UK Young Adults During Social Lockdown Due to COVID-19

ABSTRACT This study examined self-reported changes in young adults’ sexual desire and behaviors during the most significant social restrictions imposed to deal with COVID-19. Drawing on a survey of 565 British adults aged 18–32 collected at the peak of social lockdown restrictions, we document an overall decrease in sexual behaviors consistent with abiding by social restrictions. We found that the levels of sexual desire reported by women (but not men) decreased compared with reports of pre-lockdown levels. Participants in serious relationships reported more increases in sexual activity than people who were single or dating casually, and there were significant differences according to gender and sexual orientation. The perceived impact of subjective wellbeing of people with high sociosexuality scores was disproportionately associated with social lockdown but there was no effect for general health. Thus, the impact on sexuality and general wellbeing should be considered by policymakers when considering future social restrictions related to COVID-19 or other public health emergencies.

Understanding adolescent health risk behaviour and socioeconomic position: A grounded theory study of UK young adults.

Health risk behaviours such as tobacco smoking, excessive alcohol consumption, drug use, unhealthy diet and unprotected sexual intercourse contribute to the global burden of non‐communicable diseases and are often initiated in adolescence. An individualistic focus on ‘health risk behaviours’ has resulted in behaviour change strategies that are potentially ineffective and increase inequalities. We conducted a grounded theory study of 25 young adults to increase the limited qualitative evidence base surrounding young people, health risk behaviours and socioeconomic inequalities. We found that health risk behaviours were perceived as class markers, manifesting as class stigma, leading some participants from lower socioeconomic backgrounds to employ strategies to avoid such behaviours. Peers and family were core constructs for understanding the relationship between health risk behaviours and socioeconomic life trajectories. However, individualism and choice were consistently expressed as the overriding narrative for understanding health risk behaviour and socioeconomic position during the transition to adulthood. The use of ‘personal responsibility’ discourse by young adults, we argue, highlights the need for a public health focus on achieving structural changes as opposed to individualised approaches to avoid reinforcing neoliberal ideologies that serve to marginalise and maintain social inequalities.

Age-Related Dynamics of Circulating Innate Lymphoid Cells in an African Population

Innate lymphoid cell (ILC) lineages mirror those of CD4+ T helper cell subsets, producing type 1, 2 and 3 cytokines respectively. Studies in adult human populations have shown contributions of non-cytotoxic ILC to immune regulation or pathogenesis in a wide range of diseases and have prompted investigations of potential functional redundancy between ILC and T helper cell compartments in neonates and children. To investigate the potential for ILC to contribute to immune responses across the human lifespan, we examined the numbers and frequencies of peripheral blood ILC subsets in a cohort of Gambians aged between 5 and 73 years of age. ILC2 were the most abundant peripheral blood ILC subset in this Gambian cohort, while ILC1 were the rarest at all ages. Moreover, the frequency of ILC1s (as a proportion of all lymphocytes) was remarkably stable over the life course whereas ILC3 cell frequencies and absolute numbers declined steadily across the life course and ILC2 frequencies and absolute numbers declined from childhood until the age of approx. 30 years of age. Age-related reductions in ILC2 cell numbers appeared to be partially offset by increasing numbers of total and GATA3+ central memory (CD45RA-CCR7+) CD4+ T cells, although there was also a gradual decline in numbers of total and GATA3+ effector memory (CD45RA-CCR7-) CD4+ T cells. Despite reduced overall abundance of ILC2 cells, we observed a coincident increase in the proportion of CD117+ ILC2, indicating potential for age-related adaptation of these cells in childhood and early adulthood. While both CD117+ and CD117- ILC2 cells produced IL-13, these responses occurred predominantly within CD117- cells. Furthermore, comparison of ILC frequencies between aged-matched Gambian and UK young adults (25–29 years) revealed an overall higher proportion of ILC1 and ILC2, but not ILC3 in Gambians. Thus, these data indicate ongoing age-related changes in ILC2 cells throughout life, which retain the capacity to differentiate into potent type 2 cytokine producing cells, consistent with an ongoing role in immune modulation.

Associations with kidney transplant survival and eGFR decline in children and young adults in the United Kingdom: a retrospective cohort study

BackgroundAlthough young adulthood is associated with transplant loss, many studies do not examine eGFR decline. We aimed to establish clinical risk factors to identify where early intervention might prevent subsequent adverse transplant outcomes.MethodsRetrospective cohort study using UK Renal Registry and UK Transplant Registry data, including patients aged < 30 years transplanted 1998–2014. Associations with death-censored graft failure were investigated with multivariable Cox proportional hazards. Multivariable linear regression was used to establish associations with eGFR slope gradients calculated over the last 5 years of observation per individual.ResultsThe cohort (n = 5121, of whom n = 371 received another transplant) was 61% male, 80% White and 36% had structural disease. Live donation occurred in 48%. There were 1371 graft failures and 145 deaths with a functioning graft over a 39,541-year risk period. Median follow-up was 7 years. Fifteen-year graft survival was 60.2% (95% CI 58.1, 62.3).Risk associations observed in both graft loss and eGFR decline analyses included female sex, glomerular diseases, Black ethnicity and young adulthood (15–19-year and 20–24-year age groups, compared to 25–29 years). A higher initial eGFR was associated with less risk of graft loss but faster eGFR decline. For each additional 10 mL/min/1.73m2 initial eGFR, the hazard ratio for graft loss was 0.82 (95% CI 0.79, 0.86), p < 0.0001. However, compared to < 60 mL/min/1.73m2, higher initial eGFR was associated with faster eGFR decline (> 90 mL/min/1.73m2; − 3.55 mL/min/1.73m2/year (95% CI -4.37, − 2.72), p < 0.0001).ConclusionsIn conclusion, young adulthood is a key risk factor for transplant loss and eGFR decline for UK children and young adults. This study has an extended follow-up period and confirms common risk associations for graft loss and eGFR decline, including female sex, Black ethnicity and glomerular diseases. A higher initial eGFR was associated with less risk of graft loss but faster rate of eGFR decline. Identification of children at risk of faster rate of eGFR decline may enable early intervention to prolong graft survival.

EHealth Literacy in UK Teenagers and Young Adults: Exploration of Predictors and Factor Structure of the eHealth Literacy Scale (eHEALS).

BackgroundIncreasingly, teenagers and young adults (TYAs) seek out health information online; however, it is not clear whether they possess electronic health (eHealth) literacy, defined as “the ability to select, appraise, and utilize good quality health information from the internet.” A number of factors are included in the Lily model proposed by Norman and Skinner underpinning the development of eHealth literacy. It is important to understand which elements may influence the development of eHealth literacy in young people, as the current generation will continue to “Google it” when faced with a health problem throughout their lives.ObjectiveThe objectives of this study are to explore potential factors influencing young people’s eHealth literacy and explore the underlying constructs of the eHealth Literacy Scale (eHEALS) in a population of UK university students.MethodsA total of 188 undergraduate psychology students from a large UK University were recruited as an opportunity sample. Of these, 88.8% (167/188) of participants were female with a mean age of 20.13 (SD 2.16) years and the majority were White British (159/188, 84.6%). Employing a cross-sectional design TYAs completed the following measures exploring eHealth literacy (eHEALS): Irrational Health Belief Scale; Newest Vital Sign (NVS), a measure of functional health literacy; Need for Cognition Scale, a preference for effortful cognitive activity; and General Self-Efficacy (GSE) Scale, exploring personal agency and confidence. The eHEALS was also subject to exploratory factor analysis (EFA), for which in addition to the total variance explained, the scree plot, eigenvalues, and factor loadings were assessed to verify the structure.ResultseHEALS and GSE were significantly positively correlated (r=0.28, P<.001) and hierarchical linear modeling revealed GSE as the significant predictor of scores on the eHEALS (F1,186=16.16, P<.001, R2=0.08), accounting for 8.0% of the variance. Other notable relationships were GSE and need for cognition (NFC) were also positively correlated (r=0.33, P<.001), and NFC and irrational health beliefs were significantly negatively correlated (r=–.14, P=.03). Using Spearman correlations, GSE and NVS (rs=0.14, P=.04) and NFC and NVS (rs=0.19, P=.003) were positively correlated. An EFA revealed the scale to be stable and identified a 2-factor structure related to information acquisition and information application.ConclusionsThis is the first study in the UK to explore relationships between these key variables and verify the structure of the eHEALS in a TYA population in the UK. The findings that self-efficacy has a major influence firmly consolidate its status as fundamental to the development of eHealth literacy. Future studies will explore the influence of body image and the development of eHealth literacy in more diverse TYA populations.

P1627KIDNEY TRANSPLANT OUTCOMES FOR CHILDREN AND YOUNG ADULTS IN THE UK

Abstract Background and Aims Multiple international studies report young adulthood is associated with kidney transplant loss. However, there are few published UK graft survival data for children and young adults. To our knowledge, no studies assess initial transplant function or examine declining function, when interventions may improve outcomes. We aimed to report graft survival for UK children and young adults and to explore the importance of donor and recipient variables on graft loss and rate of decline. Method Retrospective cohort study using UK Renal Registry and NHS Blood and Transplant data, including patients aged &amp;lt;30 years who underwent kidney transplantation between 1998-2016. Univariate analyses included Kaplan-Meier survival curves and log-rank tests. Multivariable analyses used Cox proportional hazards to investigate variables associated with death-censored graft failure in a conditional risk-set model for multiple failure data. Age group was time-varying. We used the Efron method for ties, stratification by graft number and clustering at participant level. We calculated estimated glomerular filtration rate (eGFR) using the Schwartz formula if aged &amp;lt;18 years and the 4-variable Modification of Diet in Renal Disease formula otherwise. For participants with ≥4 values outside the first 6 months, individual regressions of eGFR against time were performed. We undertook multivariable linear regression to establish associations with eGFR slope gradients. Results We studied 5121 individuals. Of these, 371 received a further transplant during the study period. There were 1371 graft failures and 145 deaths with a functioning graft over a 39541-year risk period. The cohort was 61% male and 80% white. Most (36%) had structural kidney problems, followed by glomerulonephritides (29%). Live donation occurred in 48%, donation after brainstem death in 46% and after circulatory death in 6%. Mean initial eGFR was 62 mls/min/1.73m2. Median graft survival was 7 years. One-year survival was 94.4% (95% confidence interval (CI) 93.7, 95.0), 5-year survival 84.0% (95% CI 82.9, 85.0), 10-year survival 71.1% (95% CI 69.6, 72.5), 15-year survival 60.2% (95% CI 58.1, 62.3) and 20-year survival 51.2% (47.6, 54.7). Survival at 15 years was least at 54.4% (95% CI 49.9, 58.7) in those transplanted at age 15-19 years and most in those transplanted at age 0-4 years at 71.7% (95% CI 63.4, 78.5). Figure 1 displays hazard ratios for graft loss. Protective associations were male gender (p=0.04), living donation (p=0.02) and higher initial eGFR (p&amp;lt;0.0001). Risk associations included adverse human leucocyte mismatches (p=0.001), black ethnicity (p=0.001), young adulthood and glomerulonephritides. Risk associations for faster eGFR decline included female gender (p&amp;lt;0.0001), age group 15-19 years (p=0.04), higher initial eGFR (p&amp;lt;0.0001), additional graft (p=0.003) and transplants during 2011-2014 (p=0.03). Conclusion This study reports long-term graft survival for UK children and young adults and evaluates associations with declining transplant function. It contributes up to 20 years of follow-up and considers initial graft function in addition to established co-variates. Graft survival was ≈60% at 15 years. The study highlights the changing survival by age group over time. Those aged &amp;lt;5 years at transplant had the least initial survival, but best long-term graft survival relative to other age groups. Initial transplant function is strongly associated with graft performance. Similar associations with gender, ethnicity and age group are seen compared with other studies. Young adulthood is a high-risk period for UK patients and interventions are needed to improve outcomes during transition and young adulthood.

Making every calorie count

AbstractWe live in a world where people are living longer and overweight and obesity are widespread, linked with a calorie intake in excess of the requirements of a sedentary lifestyle. Obesity is known to increase the chance of developing type 2 diabetes and other chronic diseases. But is achieving energy balance the only challenge we face or is the scenario more complex? Evidence from dietary surveys indicates that calories should not be considered in isolation because poor diets are widespread, even in countries such as the UK. The National Diet and Nutrition Survey provides evidence of relatively low intakes of a number of essential vitamins and minerals among UK teenagers and young adults, in particular, and low intakes of fibre in all age groups, associated with low intakes of wholegrain foods, vegetables, fruit and pulses. Despite widespread familiarity with the 5 A DAY message, only 27% of adults eat five portions of fruit and vegetables a day and, on average, teenagers have particularly low intakes. The poor quality of many diets in Britain has been brought into sharp focus by publication of time trend data showing that micronutrient intakes have worsened over the past decade. However, going forward, dietary recommendations need to be considered in the context of delivering a global food supply that is both nutritious and also environmentally sustainable, and takes into account other factors such as equitable access, affordability and acceptability.

Similarity to prototypical heavy drinkers and non-drinkers predicts AUDIT-C and risky drinking in young adults: prospective study

Objective: The aim of the present study was to explore whether constructs within the Prototype Willingness Model (PWM) predicted risky drinking as measured by AUDIT-C, drinking harms and unplanned drunkenness in a sample of UK young adults. Previous studies exploring the PWM often do not use validated measures of alcohol consumption, and the outcomes of risky drinking are underexplored. Design: An online prospective study design with 4 week follow-up was employed and 385 young adults completed the study (M age = 21.76, SD = 3.39, 69.6% female; 85.2% students). Main outcome measures: Intentions to get drunk, AUDIT-C, drinking harms experienced in the last 4 weeks, and unplanned drunkenness in the last 4 weeks. Results: Heavy and non-drinker prototype similarity predicted AUDIT-C, drinking harms and unplanned drunkenness when controlling for past behaviour and reasoned action pathway constructs. Intentions and willingness both mediated the relationship between prototype perceptions and AUDIT-C. Conclusion: This study supports the use of the PWM in the prediction of AUDIT-C, drinking harms and unplanned drinking in a UK sample. Prototype perceptions influenced behaviour via both reasoned and reactive cognitions. Targeting similarity to heavy and non-drinker prototypes should be the focus of future interventions in this population.