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Abstract Background Mental health literacy (MHL) is crucial for early recognition of and coping with mental health problems, and for the use and acceptance of mental health services, leading to better health outcomes, especially in adolescence. The prevalence of mental health problems among adolescents is seen as a major public health concern and MHL is an important factor in facilitating positive mental health outcomes. However, the availability of valid measurement instruments for assessing the multifaceted nature of MHL is limited, hindering the ability to make meaningful comparisons across studies. The Knowledge and Attitudes to Mental Health Scales (KAMHS) is a promising comprehensive instrument for measuring adolescents’ mental health literacy but its psychometric properties have not been explored in any other contexts than the Welsh. The aim of this study was to translate the KAMHS into Dutch, adapt it in this context, and evaluate its psychometric properties. Methods We performed a cross-sectional study with Dutch adolescents between the ages 11–16. We translated the KAHMS and assessed its content validity using cognitive interviewing with n = 16 adolescents. Next, n = 406 adolescents were asked to fill in the translated KAMHS-NL and reference scales, on mental health (SDQ and WHO-5), resilience (BRS), and mental health help-seeking behaviors. We assessed construct validity based on a priori hypotheses regarding convergent and divergent correlations between subscales of KAMHS-NL and the reference scales. Finally, we assessed structural validity via confirmatory factor analysis and exploratory structural equation modeling. Results The KAMHS-NL showed good content validity and satisfactory construct validity. In total, 28 of the 48 hypotheses regarding convergent and divergent correlations between the KAMHS and reference scales were confirmed. Contrary to our expectations, weak, but significant associations were found between MHL and resilience. The KAMHS showed an acceptable to good internal consistency (McDonald’s omega ranging from 0.62 to 0.84). Finally, we could generally confirm the postulated structure of the KAMHS-NL in the Dutch sample with a 5-factor solution (RMSEA = 0.033; CFI = 0.96). Conclusions The Dutch version of the KAMHS is a valid measure for detecting differences in MHL levels in adolescents. The KAMHS is a promising instrument for assessing MHL in adolescents in a multifaceted manner in other countries which may facilitate rigorous global MHL research. The instrument therefore deserves further validation research in other settings and comparisons across various cultural contexts.

Abstract Background The COVID-19 pandemic endangered the quality of health care and the safety of patients and health care workers (HCWs). This provided challenges for HCWs’ resilience and for hospital management and probably increased risks for patient safety incidents (PSI). HCWs may also have experienced psychological consequences as second victims of PSI, but evidence on this is lacking. Therefore, we mapped HCWs’ experiences with PSI during the second wave of COVID-19, the associations of these experiences with the hospital management of patient safety culture and HCWs’ interests in receiving further training. Methods We obtained data from 193 HCWs working at the COVID-related departments of one large hospital in eastern Slovakia via a questionnaire developed in direct collaboration with them. We measured PSI experiences as various HCWs’ experiences with near miss and adverse events and the hospital management of patient safety culture using indicators such as risk of recurrence, open disclosure and second victim experiences. For analysis, we used logistic regression models adjusted for age and gender of the HCWs. Results One-third of the hospital HCWs had experienced PSI; these were more likely to expect adverse events to recur (odds ratio, OR = 2.7–3.5). Regarding the hospital management of patient safety culture, the HCWs’ experiencing openly disclosed PSI was associated with one negative outcome, i.e. conflicts among colleagues (OR = 2.8), and one positive outcome, i.e. patients’ acceptance of their explanation and apologies (OR = 2.3). We found no associations for any other essential domains after disclosure. PSI experiences were strongly associated with psychological indicators of second victimhood, such as sadness, irritability, anxiety and depression (OR = 2.2–4.3), while providing support was not. The majority of the HCWs would like to participate in the suggested trainings (83.4%). Conclusion HCWs with PSI experiences reported poor hospital management of the patient safety culture, which might reflect they missed the opportunities to strengthen their resilience, especially during the COVID-19 pandemic.

Abstract Purpose We assessed the association between trajectories of stressful life events (SLEs) throughout adolescence and changes in mental health from childhood to young adulthood. Further, we assessed whether family functioning moderated this association. Methods Data of the first six waves of the TRAILS study (2001-2016; n = 2229) were used, a cohort followed from approximately age 11 to 23. We measured SLEs (death of a family member or other beloved one, delinquency, moving, victim of violence, parental divorce, and sexual harassment) at ages 14, 16 and 19. Family functioning was measured at all six time points using the Family Assessment Device (FAD), and mental health was measured through the Youth/Adult Self-Report at ages 11 and 23. Latent class growth analyses (LCGA) were used to examine longitudinal trajectories and associations. Results We identified three SLE trajectories (low, middle, high) throughout adolescence, and found no significant associations between these trajectories and changes in mental health from childhood to young adulthood. Family functioning and SLE trajectories were significantly associated, however, the association of SLE trajectories and changes in mental health was not modified by family functioning. Mental health problems at age 11 increased the likelihood of high SLE trajectories during adolescence, and of experiencing negative family functioning. Conclusion Experiencing SLEs throughout adolescence does not have a direct impact on changes in mental health from childhood to young adulthood, but early adolescence mental health problems increase the likelihood of experiencing SLEs.

Abstract Background Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years’ cognitive decline with health literacy in older adults. Methods Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed. Health literacy was measured by the Brief Health Literacy Screening. Memory, mental flexibility, information processing speed, and global cognitive functioning were assessed at the same time as health literacy and also 10 years earlier. Logistic regression analyses were performed, adjusted for age, gender, and educational level. Results Higher scores on tests in all cognitive domains were associated with a lower likelihood of having low health literacy after adjustment for confounders (all ORs 1.37, p-values

Abstract Background Family-centered care seems promising in preventive pediatrics, but evidence is lacking as to whether this type of care is also valid as a means to identify risks to infants’ social-emotional development. We aimed to examine the validity of such a family-centered approach. Methods We conducted a prospective cohort study. During routine well-child visits (2–15 months), Preventive Child Healthcare (PCH) professionals used a family-centered approach, assessing domains as parents’ competence, role of the partner, social support, barriers within the care-giving context, and child’s wellbeing for 2976 children as protective, indistinct or a risk. If, based on the overall assessment (the families were labeled as “cases”, N = 87), an intervention was considered necessary, parents filled in validated questionnaires covering the aforementioned domains. These questionnaires served as gold standards. For each case, two controls, matched by child-age and gender, also filled in questionnaires (N = 172). We compared PCH professionals’ assessments with the parent-reported gold standards. Moreover, we evaluated which domain mostly contributed to the overall assessment. Results Spearman’s rank correlation coefficients between PCH professionals’ assessments and gold standards were overall reasonable (Spearman’s rho 0.17–0.39) except for the domain barriers within the care-giving context. Scores on gold standards were significantly higher when PCH assessments were rated as “at risk” (overall and per domain).We found reasonable to excellent agreement regarding the absence of risk factors (negative agreement rate: 0.40–0.98), but lower agreement regarding the presence of risk factors (positive agreement rate: 0.00–0.67). An “at risk” assessment for the domain Barriers or life events within the care-giving context contributed most to being overall at risk, i.e. a case, odds ratio 100.1, 95%-confidence interval: 22.6 - infinity. Conclusion Findings partially support the convergent validity of a family-centered approach in well-child care to assess infants’ social-emotional wellbeing and their developmental context. Agreement was reasonable to excellent regarding protective factors, but lower regarding risk factors. Trial registration Netherlands Trialregister, NTR2681. Date of registration: 05–01-2011, URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2681 .