Warwick-Edinburgh Mental Well-being Scale Research Articles

“Make it the done thing”: an exploration of attitudes towards rest breaks, productivity and wellbeing while working from home

ObjectiveTaking regular rest breaks while working positively impacts productivity and wellbeing. While home and hybrid working styles have become a popular choice for employees, the impact of, and perceptions towards, taking breaks while working at home is poorly understood. The current research aimed to explore attitudes towards taking rest breaks while working from home and capture levels of breaks taken, wellbeing and productivity in a sample of UK white-collar workers.MethodsA mixed method approach was applied where self-report data from an online survey were gathered from individuals (N = 140) from one organisation. Open-ended questions regarding attitudes and perceptions towards rest break behaviours were obtained. Further quantitative measures included the number of breaks taken while working from home, levels of productivity (measured by the Health and performance Presenteeism subscale) and mental wellbeing (measured by the Short Warwick-Edinburgh Mental wellbeing scale). Both quantitative and qualitative analysis approaches were applied.ResultsQualitative responses indicated two overarching themes (1) Personal and (2) Organisational sat above four further themes including Movement outside, Structure of home working, Home environment and Digital presence. Additionally, quantitative findings indicated that the number of breaks taken outside was associated with positive changes in wellbeing.ConclusionEmployers could aim to support employees working from home in taking outside breaks through flexible working patterns, authentic leadership, and a change in company social norms around break behaviours. Such organisational changes could help to improve workforce productivity and wellbeing.

Adolescent mental well-being, religion and family activities: a cross-sectional study (Northern Ireland Schools and Wellbeing Study)

ObjectivesIn this study, we seek to explore the relationship between adolescent mental well-being, religion and family activities among a school-based adolescent sample from Northern Ireland.SettingThe Northern Ireland Schools and Wellbeing...

Examination of the relationship between basketball referee's mental well-being and emotional regulation levels

This study utilized a relational screening model to examine the relationship between mental well-being and emotional regulation levels among basketball referees. The research sample consisted of 327 active field referees officiating in Turkish basketball leagues during the 2021–2022 season, selected using an accessible sampling method. The sample included 13.50% (n = 44) female referees and 86.50% (n = 283) male referees, with 67.30% (n = 220) holding national accreditation and 32.70% (n = 107) being regional referees. Data collection involved a personal information form, the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and the Referee Emotion Regulation Scale (RERS). Statistical analyses, such as Pearson's correlation coefficient, regression analysis, t-tests, and ANOVA, were conducted using SPSS 21 software, with a significance level set at p < .05. The results of this study indicated that gender and educational status did not significantly influence mental well-being, Suppression, and Cognitive Reappraisal levels among basketball referees. However, the level of refereeing emerged as a significant variable impacting mental well-being, Suppression, and Cognitive Reappraisal levels. Notably, a positive and significant correlation was observed between mental well-being, Suppression, Cognitive Reappraisal levels, age, and experience of basketball referees. Furthermore, a positive correlation was found between referees' mental well-being and emotional regulation levels, highlighting the interplay between these factors. The findings underscore the importance of prioritizing mental well-being and emotional regulation for enhancing the performance of basketball referees. Furthermore, the study emphasizes the need to nurture these aspects to improve referees' psychological resilience and overall performance. Practical research on mental well-being and emotion regulation in refereeing can contribute significantly to the existing literature, providing valuable insights for referee training and support programs.

‘Safety Nets’: a community based social prescribing intervention involving combined physical activity and psychoeducation for young people on mental health service waiting lists: a pilot service evaluation

ABSTRACT Objective Young people can face long waiting lists when accessing UK Child and Adolescent Mental Health Services (CAMHS) with limited support whilst waiting. ‘Safety Nets' was developed as a social prescribing intervention that includes physical activity and psychoeducation for young people with anxiety, depression and low mood on CAMHS waiting lists. This mixed methods service evaluation aims to show the acceptability and impact of ‘Safety Nets’ on the mental health and wellbeing of these young people. Method This study conducted a mixed-methods service evaluation of ‘Safety Nets’. 24 young people on CAMHS waiting lists for support for anxiety, depression and low mood were recruited to an 8-week group intervention, ‘Safety Nets'; delivered in five groups across four sites. Participants completed a Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) at the first and final session and completed a qualitative exit interview. Results Results showed good acceptability and engagement from all stakeholders and young people gave high satisfaction ratings. Paired WEMWBS scores in 24 young people showed an improvement of 11.6 with a 95% confidence interval 7.5–15.6. Discussion This service evaluation showed acceptability and positive impacts of ‘Safety Nets’. A large-scale trial is warranted to test the clinical and cost-effectiveness of social prescribing for children and young people on CAMHS waiting lists.

MENTAL HEALTH AND QUALITY OF LIFE IN PATIENTS WITH CARDIOVASCULAR DISEASES: SOCIAL SUPPORT AS MEDIATOR

Objective: To investigate the relationship between mental health, quality of life social support in patients with cardiovascular diseases, and mediating role of social support between these variables. Methodology: This cross-sectional, correlational study was conducted between February and May 2020. Data was collected with purposive sampling from 180 participants (70.6% males and 29.4% females) with an age range of 17 to 83 years (M = 57.74, SD = 13.02) who had been suffering from cardiovascular diseases. An in­formed consent form, demographic sheet, and Urdu versions of the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), Multidimensional Scale of Perceived Social Support (MSPSS), Depression Anxiety Stress Scale-21 (DASS-21), and WHOQOL-BREF were used. Results: The quality of life is perceived as average by the majority of them (48.9%). A significant negative relation­ship was found between depression (r = -0.43, p&lt;0.01), anxiety (r = -0.28, p&lt;0.01), and stress (r = -0.33, p&lt;0.01) with social support. Wellbeing has also been found to be significantly and negatively correlated with depression (r= -0.57, p&lt;0.01), anxiety (r = -0.37, p&lt;0.01), and stress (r = -0.39, p&lt;0.01). There is also a significant mediating effect of social support on depression, anxiety, stress, and well-being in the quality of life of patients with cardio­vascular diseases. Conclusion: Patients with cardiovascular diseases have poor mental health and perceived low to average quality of life. Social support is a full mediator (B = -.35, p = .01) for anxiety and partial mediator (B = .35, p &lt; 0.01), for depression, stress, and wellbeing with quality of life.

The mental wellbeing of female prisoners in Chile

ObjectiveTo measure and understand mental wellbeing among women prisoners in Chile, as part of a larger study.ResultSixty-eight sentenced prisoners in a women’s prison participated in a survey, giving a response rate of 56.7%. Using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the mean wellbeing score of participants was 53.77 out of maximum score of 70. Whilst 90% of the 68 women felt useful at least some of the time, 25% rarely felt relaxed, close to others or able to make up their own minds about things. Data generated from two focus groups attended by six women offered explanations for survey findings. Thematic analysis identified stress and loss of autonomy due to the prison regime as factors which negatively affect mental wellbeing. Interestingly, whilst offering prisoners an opportunity to feel useful, work was identified as a source of stress. Interpersonal factors linked to a lack of safe friendships within the prison and little contact with family had an adverse impact on mental wellbeing. The routine measurement of mental wellbeing among prisoners using the WEMWBS is recommended in Chile and other Latin American countries to identify the impact of policies, regimes, healthcare systems and programmes on mental health and wellbeing.

Swahili translation and validation of the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) in adolescents and adults taking part in the girls’ education challenge fund project in Tanzania

BackgroundThe Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 11 + and has been translated into 30 + languages. The aims of this study were a) to translate and validate WEMWBS for use in Swahili-speaking populations to facilitate measurement and understanding of wellbeing, evaluation of policy and practice, and enable international comparisons; and b) to examine sociodemographic characteristics associated with higher and lower mental wellbeing in participants in the Girls’ Education Challenge (GEC) project in Tanzania.MethodsA short questionnaire including WEMWBS and similar scales for comparison, socio-demographic information, and self-reported health was translated into Swahili using gold standard methodology. This questionnaire was used to collect data from secondary school students, learner guides, teacher mentors and teachers taking part in the GEC project in Tanzania. Focus groups were used to assess acceptability and comprehensibility of WEMWBS and conceptual understanding of mental wellbeing. These were audio-taped, transcribed and analysed thematically. Internal consistency of WEMWBS, correlation with comparator scales and confirmatory factor analysis were completed as quantitative validation. Finally, multivariable logistic regression was used to explore associations between individual characteristics and ‘high’ and ‘low’ mental wellbeing, defined as the highest and lowest quartile of WEMWBS scores.Results3052 students and 574 adults were recruited into the study. Participants reported that WEMWBS was understandable and relevant to their lives. Both WEMWBS and its short form met quantitative standards of reliability and validity, were correlated with comparator scales and met the criteria to determine a single factor structure. For students in the GEC supported government schools: mental wellbeing was higher in students in the final two ‘forms’ of school compared with the first two. In addition: being male, urban residence, the absence of markers of social marginality and better self-reported health were all significantly associated with better mental wellbeing. For adults, urban residence and better self-reported health were associated with better mental wellbeing.ConclusionsThe Swahili translation of WEMWBS is available for use. Further work to explore how to intervene to increase mental wellbeing in vulnerable GEC participants is needed.

The effect of personal, social, and collective identity on mental well-being in university students

Identity is a process in which self-perception is formed through the groups and culture of which individuals are members, as well as their internal inquiries about who they are. In this respect, personal, social and collective identity types draw attention in the literature. It is known that the achievement of individuals in identity integrity increases well-being. In this context, it was aimed to investigate the effects of personal, social and collective identity on mental well-being in this study. This study was carried out in accordance with the correlational pattern, one of the quantitative research designs. The research group of the study consisted of 341 (254 female, 87 male) university students between the ages of 18-30 (mean = 20.93). Personal Information Form, Identity Questionnaire and Warwick-Edinburgh Mental Well-Being Scale Short Form were used as data collection tools in the study. According to correlation analysis, there was a positive relationship between mental well-being and personal identity, social identity, and collective identity. According to structural equation model analysis, it was found that personal identity and collective identity positively and significantly predict mental well-being, but the effect of social identity on mental well-being was not significant. The results are discussed in the context of identity and well-being literature.

The association between various dimensions of sleep parameters and mental health: A large cross-sectional study of 13554 Chinese students

ObjectivesWe aimed to investigate the association between multiple sleep variables and mental health among Chinese students aged 9–22. MethodWe stratified the included 13,554 students by educational levels. Sleep parameters contained sleep duration on school days and weekends, napping time, chronotype and social jetlag (SJL), which were calculated via questionnaires. Individual psychological well-being and distress were assessed by Warwick-Edinburgh mental Well-being scale and the Kessler Psychological Distress Scale 10 respectively. The multiple linear and binary logistic regression were applied to analyze the association of sleep with mental health. ResultsShort sleep on school days showed significantly positive association with psychological problems. While among senior high school students, we found reverse result that sleeping less might negatively associated with more severe distress (7-8 h: aOR = 0.67, 95% CI: 0.46, 0.97). The association of sleep duration with mental health was attenuated a lot on weekends. The chronotype was significantly related with mental health in primary and junior high school: intermediate chronotype (vs late chronotype) was associated with greater wellbeing (β = 1.03, 95% CI: 0.09, 1.96; β = 1.89, 95% CI: 0.81, 2.97) and less distress (aOR = 0.78, 95% CI: 0.60, 1.00; aOR = 0.73, 95% CI: 0.58, 0.91). The relationship between SJL, napping duration and psychological health problems were also observed in some educational levels. ConclusionSleep deprivation on school days, late chronotype and SJL were positively associated with worse mental health in our study, which differed among various educational stages.

Development and initial psychometric properties of the Warwick-Edinburgh Mental Wellbeing Scale-Intellectual Disability version.

The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; Tennant et al., 2007) is yet to be validated in the intellectual disability (ID) population. The aim of this study was to report the development process and assess the psychometric properties of a newly adapted version of the WEMWBS and the Short WEMWBS for individuals with mild to moderate IDs (WEMWBS-ID/SWEMWBS-ID). The WEMWBS item wordings and response options were revised by clinicians and researchers expert in the field of ID, and a visual aid was added to the scale. The adapted version was reviewed by 10 individuals with IDs. The measure was administered by researchers online using screenshare, to individuals aged 16+years with mild to moderate IDs. Data from three UK samples were collated to evaluate the WEMWBS-ID (n=96). A subsample (n=22) completed the measure again 1 to 2weeks later to assess test-retest reliability, and 95 participants additionally completed an adapted version of the adapted Rosenberg Self-Esteem Scale to examine convergent validity. Additional data from a Canadian sample (n=27) were used to evaluate the SWEMWBS-ID (n=123). The WEMWBS-ID demonstrated good internal consistency (ω=0.77-0.87), excellent test-retest reliability [intraclass correlation coefficient (ICC)=.88] and good convergent validity with the self-esteem scale (r=.48-.60) across samples. A confirmatory factor analysis for a single factor model demonstrated an adequate fit. The SWEMWBS-ID showed poor to good internal consistency (ω=0.36-0.74), moderate test-retest reliability (ICC=.67) and good convergent validity (r=.48-.60) across samples, and a confirmatory factor analysis indicated good model fit for a single factor structure. The WEMWBS-ID and short version demonstrated promising psychometric properties, when administered virtually by a researcher. Further exploration of the scales with larger, representative samples is warranted.

Validation and psychometric properties of the Arabic version of the Warwick–Edinburgh Mental Well‐being Scale (WEMWBS) on a sample of students in Qatar

AbstractThe Warwick–Edinburgh Mental Well‐being Scale (WEMWBS) is a widely used tool to assess mental well‐being and life satisfaction in various populations. However, the psychometric properties of the WEMWBS in Arabic‐speaking populations have not been established. This study aimed to validate and assess the psychometric properties of the Arabic version of the WEMWBS among adolescents. A rigorous translation process was conducted, and the scale was administered to 470 participants aged 13–18 years in Qatar. The data were analyzed using exploratory and confirmatory factor analyses, internal consistency, and validity assessments. The results showed that the Arabic version of the WEMWBS had a unidimensional structure, with high factor loadings and good internal consistency. The findings suggest that the Arabic version of the WEMWBS is a valid and reliable tool for assessing mental well‐being and life satisfaction among Arabic‐speaking adolescents. These results can facilitate the use of the Arabic WEMWBS scale in different mental well‐being studies that include Arabic‐speaking populations.

To be well or not to be well: compositional associations of physical activity, sedentary behaviour and sleep with mental well-being in Flemish adults aged 55+ years

BackgroundWell-being is a key aspect for healthy ageing and there is an established association between physical activity and well-being in ageing adults. Despite the recent interest in physical activity as part of a 24-h continuum also including sedentary behaviour and sleep, there is a lack of studies examining the link between these 24-h behaviours and well-being in older adults. Therefore, the aim of this study was twofold: (1) to describe 24-h behaviours and their associations with mental well-being in community dwelling adults aged 55+ years; and (2) to examine the theoretical changes in mental well-being if time were reallocated from one behaviour to another.MethodsThis was a cross-sectional study (n = 410). Daily time spent in sedentary behaviour, light and moderate-vigorous physical activity, and sleep was assessed using wrist-worn accelerometers during 6 days. Mental well-being was assessed using the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS). The association of 24-h behaviours and well-being was examined using crude and adjusted linear regression models with compositional data analysis procedures (aim 1). Associations between reallocations of five-minute intervals from five to 60 min between these behaviours and well-being were modelled using compositional isotemporal substitutions (aim 2).ResultsMean age (SD) was 71.3 (6.3) years and 71% were female. In 24-h, participants spent 5.66 h asleep, 13.88 h sedentary, 2.58 h in light intensity and 1,89 h in moderate-vigorous intensity physical activity. There were no statistically significant associations between 24-h behaviours and mental well-being in fully adjusted models (aim 1). Reallocations up to 30 min were not significantly associated with changes in well-being (aim 2). There were some statistically significant theoretical changes of up to 2 points on the WEMWBS with substitutions larger than 30 min.Discussion24-h behaviours and time reallocations between behaviours were not associated with better or worse well-being in community dwelling adults aged 55+ years. Considering well-being as a key aspect for healthy ageing, future public health research should continue to examine physical activity (both light and moderate-to-vigorous), sedentary behaviour, as well as sleep as a part of the 24-h continuum and its associations with mental health outcomes in older adults.Trial registration This trial was registered at ClinicalTrials.gov on 3th July, 2018 (Trial registration NCT03576209)

Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study.

Poor mental health in the first year of the COVID-19 pandemic has been well documented in adolescents; however, less is known about the longer-term effect of the pandemic. We aimed to examine adolescent mental health and substance use as well as covariates associated with these outcomes 1 year or more into the pandemic. A nationwide sample of adolescents aged 13-18 years enrolled in school in Iceland were invited to complete surveys administered during October-November or February-March, 2018, October-November, 2020, February-March or October-November, 2021, and February-March 2022. The survey was in Icelandic for all administrations and offered to adolescents aged 13-15 years in English in 2020 and 2022 and in Polish in 2022. Surveys assessed depressive symptoms (Symptom Checklist-90); mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale); and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Covariates comprised age, gender, and migration status as determined by language spoken at home, level of social restrictions based on residency, parental social support, and sleep duration (≥8 h nightly). Weighted mixed-effect models were used to determine the effect of time and the covariates on mental health and substance use. The main outcomes were assessed in all participants with more than 80% of the necessary data, and multiple imputation was used to handle missing data. Bonferroni corrections were used to adjust for multiple testing and analyses were considered significant at a p value of <0·0017. 64 071 responses were submitted and analysed between 2018 and 2022. Elevated depressive symptoms and worsened mental wellbeing across girls and boys aged 13-18 years were observed to have been maintained up to 2 years into the pandemic (p>0·0017). Alcohol intoxication initially decreased during the pandemic but increased again as social restrictions eased (p<0·0001). No changes were observed in cigarette smoking and e-cigarette use during the COVID-19 pandemic. Higher levels of parental social support and an average sleep duration of 8 h or more per night were associated with mental health better outcomes and less substance use (p<0·0001). Social restrictions and migration background were inconsistently associated with the outcomes. Population-level prevention targeting adolescent depressive symptoms should be prioritised in health policy in the wake of COVID-19. Icelandic Research Fund.

A school-based cross-sectional study to understand the public health measures needed to improve the emotional and mental wellbeing of young carers aged 12 to 14 years

The emotional and mental wellbeing of young carers is known to be poorer than their peers. Data from a large cross-sectional school survey of 7,477 12 to 14 year olds (72 per cent response rate) living in Cornwall, South West of England, were analysed to assess whether existing school-based interventions support the wellbeing of young carers. Outcome measures were derived from the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. Young carers experienced greater emotional and mental wellbeing problems than their peers. Being eligible for free school meals did not attenuate these higher needs, indicating that broader support other than financial measures are needed, such as education, health and care plans which were associated with higher mental wellbeing among young carers. Early community and school-based interventions that consider the complex needs of young carers, especially emotional wellbeing, are needed.

PSYCHOLOGICAL SAFETY OF CADETS OF A FIRE-FIGHTING UNIVERSITY IN A SPECIAL SOCIAL SITUATION

Relevance. The article examines the impact of a special social situation on the well-being and psychological safety of fire service cadets during their studies at the university. The purpose of the article is to study the features of psychological safety of cadets of a fire-fighting university in a special social situation associated with the aggravation of geopolitical, technosphere, humanitarian, psychological threats and challenges.&#x0D; Research methods. The Warwick-Edinburgh Mental well-being Scale (WEMWBS), the questionnaire “Assessment of personal satisfaction in the need for security” (O.Y. Zotova), the author’s methodology for studying the anxiety of cadets in connection with a special social situation were used. Methods of qualitative and quantitative data analysis, including factor and correlation analysis, were used. Study participants: cadets of the Ivanovo Fire and Rescue Academy of the Ministry of Emergency Situations of Russia.&#x0D; The results of the study. It is revealed that the factors of anxiety of cadets in special social conditions are situational concern, frustration, stability. It was found that there is a negative relationship between anxiety and the well-being of cadets during a special social situation, a positive relationship was found between satisfaction of the need for security and the well-being of cadets.&#x0D; Conclusion. The practical significance of the research is expressed in the need to update resilience skills based on existing knowledge and experience, motivation and a formed worldview. To do this, it is necessary to optimize the educational environment aimed at maintaining a psychological climate that contributes to maintaining the psychological well-being of cadets through psychocorrective work and psychological counseling.

Derivation of a UK preference-based value set for the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) to allow estimation of Mental Well-being Adjusted Life Years (MWALYs)

BackgroundThe Mental Well-being Adjusted Life Year (MWALY) is an alternative outcome measure to the quality-adjusted life year (QALY) in economic evaluations of interventions aimed at improving mental well-being. However, there is a lack of preference-based mental well-being instruments for capturing population mental well-being preferences. ObjectivesTo derive a UK preference-based value set for the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). Methods225 participants that were interviewed between December 2020 and August 2021 completed 10 composite time trade-off (C-TTO) and 10 discrete choice experiment (DCE) interviewer-administered exercises. Heteroskedastic Tobit and conditional logit models were used to model C-TTO and DCE responses respectively. The DCE utility values were rescaled to a C-TTO comparable scale through anchoring and mapping. An inverse variance weighting hybrid model (IVWHM) was used to derive weighted-average coefficients from the modelled C-TTO and DCE coefficients. Model performance was assessed using statistical diagnostics. ResultsThe valuation responses confirmed the feasibility and face validity of the C-TTO and DCE techniques. Apart from the main effects models, statistically significant associations were estimated between the predicted C-TTO value and participants’ SWEMWBS scores, gender, ethnicities, education levels, and the interaction terms between age and useful feeling. The IVWHM was the most optimal model with the fewest logically inconsistent coefficients and the lowest pooled standard errors. The utility values generated by the rescaled DCE models and the IVWHM were generally higher than those of the C-TTO model. The predictive ability of the two DCE rescaling methods was similar according to the mean absolute deviation and root mean square deviation statistics. ConclusionsThis study has produced the first preference-based value set for a measure of mental well-being. The IVWHM provided a desirable blend of both C-TTO and DCE models. The value set derived by this hybrid approach can be used for cost-utility analyses of mental well-being interventions.

Enhancing Psychological Resilience: Examining the Impact of Managerial Support on Mental Health Outcomes for Saudi Ambulance Personnel.

Ambulance personnel are among the groups with high mental health risks. This study aims to investigate the role of managerial support in determining the mental well-being of ambulance personnel, a group at high risk for mental health issues. A descriptive, cross-sectional survey design was conducted in Riyadh, Saudi Arabia, in February 2022, involving a convenience sample of 354 ambulance personnel. An online survey was distributed via social media platforms. Manager behavior and mental well-being were assessed using the Manager Behavior Questionnaire (MBQ) and the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). The participants represented nearly equal-sized groups from different agencies, with 50.3% residing in the Riyadh Region and 67.5% aged between 25 and 34. The mean score for manager behavior was 2.92 ± 1.124, while the mental well-being scale's mean score was 3.398 ± 0.8219. Variance analyses revealed statistically significant differences in manager behavior concerning gender, age, residence, and years of experience (p < 0.05), as well as in the mental well-being of ambulance personnel. Generalized linear regression analysis demonstrated a statistically significant relationship between manager behavior and mental well-being (p < 0.01). Focusing on improving organizational management behaviors is a promising strategy for enhancing mental health interventions among ambulance personnel. Further research is recommended to monitor the mental health of these professionals and develop evidence-based interventions to support their well-being.

Exploring the Acceptability, Feasibility, and Effectiveness of a Digital Parenting Program to Improve Parental Well-being After the Christchurch Earthquakes: Cluster-Randomized Trial.

Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children's mental health. The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Kākano is an app co-designed with parents to help manage their children's mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true.

The effect of prolonged closed-loop management on athletes' sleep and mood during COVID-19 pandemic: Evidence from the 2022 Shanghai Omicron Wave.

Closed-loop management of athletes at the training base is a compromise approach that balanced epidemic prevention and sports training during the COVID-19 pandemic. This study investigated the impact of prolonged closed-loop management on athletes' sleep and mood during the 2022 Shanghai Omicron wave. The Pittsburgh Sleep Quality Index and the Profile of Mood States were used to assess the sleep and mood states of 110 professional athletes in "closed-loop management" at the training base after 1 and 2 months of closed-loop management, respectively, to characterize changes in sleep and mood with prolonged closed-loop management. After two months of control, the sleep and mood of 69 athletes and students of the same age were measured using the Pittsburgh Sleep Quality Index and Perceptual Stress Scale, as well as the Warwick-Edinburgh Mental Well-being Scale, to compare the differences in sleep and mood between athletes undergoing closed-loop management and the general population who were managed in the community. Paired sample t-tests and independent sample t-tests were used for comparisons across different time intervals and different management approaches. Results showed that with the time of closed-loop management increased, athletes woke up earlier (p = 0.002), slept less (p = 0.024), and became angrier (p = 0.014); athletes had poorer overall sleep quality (p < 0.001) but lower stress level (p = 0.004) than those who were outside the base. In closed-loop management, the athletes were able to maintain a stable sleep and mood state. Sports team administrators must be aware of the need to improve athletes' sleep quality and help athletes to agree with this approach of management.

Health literacy and mental well-being among university students in the United States

Objective: Exploration of the relationship between mental health constructs and physical health constructs can help practitioners better understand the mental health of vulnerable populations, such as college students in the United States. The purpose of this exploratory study was to investigate the connection between mental well-being and health literacy of US college students. Participants: The sample included 410 undergraduate students (63% white; 71% female) attending universities across the United States. Methods: Participants completed the All Aspects of Health Literacy Scale and the Warwick-Edinburgh Mental Well-being Scale. Univariate and bivariate statistics were observed for all study variables, and three linear regression models were run to see whether functional, communicative, and/or critical health literacy scores predicted mental well-being. Conclusions: Findings suggest that health literacy was associated with improved mental well-being among US college students, which has implications for health programming at US universities, such as the coordination of physical and mental healthcare.