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Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the association between disclosure and sustainable employability and well-being at work is scarce. The aim of this study was to investigate the association between the disclosure decision (yes/no), experiences with the decision (positive/negative) and sustainable employment and well-being at work among military personnel with mental illness (N = 323). Methods A cross-sectional questionnaire study was conducted. Descriptive and regression (linear and ordinal) analyses were performed. Comparisons were made between those with positive and negative disclosure experiences. Results Disclosure decision (yes/no) was not significantly associated with any of the measures of sustainable employability and well-being at work. However, positive disclosure experiences were significantly associated with higher scores on almost all measures of sustainable employability and well-being at work. Those with negative disclosure experiences reported significantly more shame (Mpos = 2.42, Mneg = 2.78, p <.05) and discrimination (Mpos = 1.70, Mneg = 2.84, p <.001). Those with a positive disclosure experience, reported significantly more supervisor support (Mpos = 3.20, Mneg = 1.94, p <.001). Conclusion We did not find evidence that the disclosure decision itself is related to measures of sustainable employment and well-being at work. In contrast, how participants had experienced their (non-)disclosure decision was significantly related to almost all measures. This emphasizes the importance of the work environments reactions to disclosure and mental illness in the workplace. Future research and interventions should focus on increasing the likelihood of positive disclosure experiences through creating a more inclusive work environment, with more supervisor support and less stigma. [ABSTRACT FROM AUTHOR]

An increasing body of evidence shows that informal mutual aid groups benefit those in addiction recovery. However, attention for mutual aid groups in practice and policy varies internationally and is only recently emerging in continental Europe. Existing evidence is mostly limited to studies of Alcoholics Anonymous groups in the United States. The aim of this cross-sectional study is to examine the relationship between membership of a variety of mutual aid groups and recovery capital, participation in social networks, and commitment to sobriety for individuals in drug addiction recovery (N = 367), living in the UK, the Netherlands, and Belgium. A convenience sample of participants completed an extensive assessment about their recovery experiences. Sixty-nine percent of participants reported lifetime (ever) membership of different mutual aid groups. Analyses reveal that membership of mutual aid groups is strongly associated with more participation and (self-reported) changes in social networks, greater levels of recovery capital, and a stronger commitment to sobriety. The findings suggest that participation in mutual aid groups may support addiction recovery through multiple mechanisms of change in favor of recovery. These findings highlight how mutual aid support may complement formal addiction treatment. [ABSTRACT FROM AUTHOR]

Many studies on addiction recovery focus on recovery initiation and short-term outcomes for alcohol addictions. In this study, we examine associations between three recovery stages and recovery markers for persons in drug addiction recovery. Data were collected for a multi-country study (REC-PATH) among 722 individuals living in the UK, the Netherlands, and Belgium, who consider themselves in addiction recovery for a period of three months or more. We focus on typical life domains that characterize recovery: housing, crime, work or education, and substance use. The relation with time in recovery was examined for three recovery stages: early (<1 year), sustained (1–5 years), and stable (>5 years). Using the Life in Recovery survey, cross-sectional analyses reveal that participants in later recovery stages have lower odds of having housing problems, being involved in crime, and using illicit hard drugs and higher odds of having work or education, when compared to participants in the early recovery stage. This study provides further empirical support for defining drug addiction recovery as a gradual, long-term process that is associated with various life domains beyond abstinence. The findings suggest that drug policy, treatment and research need to be oriented towards long-term objectives and recovery goals that cover multiple life domains in order to support stable recovery. [ABSTRACT FROM AUTHOR]

The number of older homeless people with a limited life expectancy is increasing. European studies on their health‐related characteristics are lacking. This study compared self‐reported health, healthcare service use and health‐related needs of older and younger homeless people in the Netherlands. It is part of a cohort study that followed 513 homeless people in the four major Dutch cities for a period of 2.5 years, starting from the moment they registered at the social relief system in 2011. Using cross‐sectional data from 378 participants who completed 2.5‐year follow‐up, we analysed differences in self‐reported health, healthcare service use, and health‐related needs between homeless adults aged ≥50 years (N = 97) and <50 years (N = 281) by means of logistic regression. Results show that statistically significantly more older than younger homeless people reported cardiovascular diseases (23.7% versus 10.3%), visual problems (26.8% versus 14.6%), limited social support from family (33.0% versus 19.6%) and friends or acquaintances (27.8% versus 14.6%), and medical hospital care use in the past year (50.5% versus 34.5%). Older homeless people statistically significantly less often reported cannabis (12.4% versus 45.2%) and excessive alcohol (16.5% versus 27.0%) use in the past month and dental (20.6% versus 46.6%) and mental (16.5% versus 25.6%) healthcare use in the past year. In both age groups, few people reported unmet health‐related needs. In conclusion, compared to younger homeless adults, older homeless adults report fewer substance use problems, but a similar number of dental and mental problems, and more physical and social problems. The multiple health problems experienced by both age groups are not always expressed as needs or addressed by healthcare services. Older homeless people seem to use more medical hospital care and less non‐acute, preventive healthcare than younger homeless people. This vulnerable group might benefit from shelter‐based or community outreach programmes that proactively provide multidisciplinary healthcare services. [ABSTRACT FROM AUTHOR]

Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL ( β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress ( β = −0.45, P < 0.001), income ( β = 0.14, P = 0.002) and being institutionalised ( β = 0.12, P = 0.004). In conclusion, the majority of homeless adults entering the social relief system have personal goals regarding socioeconomic resources and their goal-related self-efficacy is positively related to QoL. It is therefore important to take the personal goals of homeless people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions. [ABSTRACT FROM AUTHOR]

Objective: Problematic video-gaming or social media use may seriously affect adolescents' health status. However, it is not very well known which health-related problems are most strongly related to these issues. To inform the development of prevention and intervention strategies, this study aims to gain a better understanding of the healthrelated problems and demographical factors associated with problematic video-gaming or social media use in early adolescence. Method: A cross-sectional analysis was performed on data collected by two Municipal Health Services in the Netherlands in 2013-2014. In this survey among youth, 21,053 students from secondary schools (mean age 14.4 years) completed a web-based questionnaire. Multivariate analyses were carried out to assess the strength of the associations between mental health problems, life-events, lifestyle and substance use as independent variables, and problematic video-gaming and problematic social media use as dependent variables. Results: Of the participating students, 5.7% reported problematic video-gaming and 9.1% problematic social media use. Problematic video-gaming was most strongly associated with conduct problems, suicidal thoughts (all medium effect sizes, OR ≥2, p<0.01), sedentary behavior (large effect size, OR ≥3, p<0.01), and male gender (large effect size). Problematic social media use was highly associated with conduct problems, hyperactivity and sedentary behavior (all medium effect sizes). Additionally, female gender and non-Western ethnicity were relevant demographics (large and medium effect size). Conclusions: Most mental health problems were consistently associated with both problematic video-gaming and problematic social media use, though associations were only practically relevant for conduct problems (both groups), suicidal thoughts (problematic video-gaming) and hyperactivity (problematic social media use). This study also highlights sedentary behavior as health risk as it was associated with both problematic video-gaming and problematic social media use. Interventions for young problematic video-gamers or social media users should take into account mental health and physical activity. [ABSTRACT FROM AUTHOR]

Background. The aims of this study are 1) to investigate the association between maternal educational level and healthy eating behaviour of 11-year-old children (fruit, vegetables and breakfast consumption), and 2) to examine whether factors in the home food environment (parental intake of fruit, vegetables and breakfast; rules about fruit and vegetables and home availability of fruit and vegetables) mediate these associations. Methods. Data were obtained from the Dutch INPACT study. In total, 1318 parent–child dyads were included in this study. Multilevel regression models were used to investigate whether factors of the home food environment mediated the association between maternal educational level and children’s healthy eating behaviour. Results. Children of mothers with a high educational level consumed more pieces of fruit per day (B = 0.13, 95% CI: 0.04-0.22), more grams of vegetables per day (B = 23.81, 95% CI = 14.93- 32.69) and were more likely to have breakfast on a daily basis (OR = 2.97, 95% CI: 1.38- 6.39) than children of mothers with a low educational level. Home availability, food consumption rules and parental consumption mediated the association between maternal education level and children’s fruit and vegetable consumption. Parental breakfast consumption mediated the association between maternal education level and children’s breakfast consumption. Conclusions. Factors in the home food environment play an important role in the explanation of socioeconomic disparities in children’s healthy eating behaviour and may be promising targets for interventions. [ABSTRACT FROM AUTHOR]

ObjectiveTo examine cross-sectional and longitudinal (one-year follow-up) associations of parental feeding styles with child snacking behaviour and weight in the context of general parenting, taking into account the multidimensionality of the controlling feeding style.DesignLinear regression analyses were performed. Parents completed a questionnaire to measure five feeding style dimensions (Instrumental Feeding, Emotional Feeding, Encouragement, Overt Control and Covert Control) and children's fruit, energy-dense snack and sugar-sweetened beverage (SSB) intakes. Children's height and weight were measured to calculate their BMI Z-scores. Moderation by parenting style was tested by adding interaction terms to the regression analyses.SettingObservational study in the Netherlands.SubjectsParent–child dyads (n 1275) participating in the INPACT (IVO Nutrition and Physical Activity Child cohorT) study; children were (on average) 9 years of age.ResultsInstrumental Feeding and Emotional Feeding were negatively related to child fruit intake one year later and positively to (changes in) child energy-dense snack intake. Encouragement was negatively related to child energy-dense snacking and SSB intake one year later. Overt Control was cross-sectionally and prospectively related to (changes in) child energy-dense snacking and SSB intake in a negative direction. Covert Control showed similar associations with child energy-dense snacking and SSB intake as Overt Control. Although Covert Control was also positively related to child fruit intake and (changes in) child BMI Z-score, bootstrapping analyses revealed only a differential effect of Overt Control and Covert Control on child BMI Z-score one year later, with Covert Control displaying a stronger, positive association. Moderation analyses showed that some significant associations between parental feeding styles and outcome measures were dependent on the degree of psychological control and behavioural control.ConclusionsInstrumental Feeding and Emotional Feeding may have a detrimental impact on children's snacking behaviour, while Encouragement, Overt Control and Covert Control may lead to less energy-dense snacking and less SSB intake. Overt Control and Covert Control have differential effects on child BMI Z-score one year later, which supports the idea that they should be treated as separate constructs. Prospective studies with a longer follow-up may elucidate the causal pathways between the various feeding styles and children's snacking behaviour and weight, as well as the moderating influences of psychological and behavioural control. [ABSTRACT FROM PUBLISHER]

Background: Various diet- and activity-related parenting practices are positive determinants of child dietary and activity behaviour, including home availability, parental modelling and parental policies. There is evidence that parenting practices cluster within the dietary domain and within the activity domain. This study explores whether diet- and activity-related parenting practices cluster across the dietary and activity domain. Also examined is whether the clusters are related to child and parental background characteristics. Finally, to indicate the relevance of the clusters in influencing child dietary and activity behaviour, we examined whether clusters of parenting practices are related to these behaviours. Methods: Data were used from 1480 parent-child dyads participating in the Dutch IVO Nutrition and Physical Activity Child cohorT (INPACT). Parents of children aged 8-11 years completed questionnaires at home assessing their diet- and activity-related parenting practices, child and parental background characteristics, and child dietary and activity behaviours. Principal component analysis (PCA) was used to identify clusters of parenting practices. Backward regression analysis was used to examine the relationship between child and parental background characteristics with cluster scores, and partial correlations to examine associations between cluster scores and child dietary and activity behaviours. Results: PCA revealed five clusters of parenting practices: 1) high visibility and accessibility of screens and unhealthy food, 2) diet- and activity-related rules, 3) low availability of unhealthy food, 4) diet- and activity-related positive modelling, and 5) positive modelling on sports and fruit. Low parental education was associated with unhealthy cluster 1, while high(er) education was associated with healthy clusters 2, 3 and 5. Separate clusters were related to both child dietary and activity behaviour in the hypothesized directions: healthy clusters were positively related to obesity-reducing behaviours and negatively to obesity-inducing behaviours. Conclusion: Parenting practices cluster across the dietary and activity domain. Parental education can be seen as an indicator of a broader parental context in which clusters of parenting practices operate. Separate clusters are related to both child dietary and activity behaviour. Interventions that focus on clusters of parenting practices to assist parents (especially low-educated parents) in changing their child's dietary and activity behaviour seems justified. [ABSTRACT FROM AUTHOR]

Objective. In this examination of the association between parenting style and child weight, the neglected concept of 'psychological control' has been added to the generally accepted parenting dimensions 'support' and 'behavioural control'. Also explored is whether the potential association between parenting and child weight is moderated by socio-demographic variables (child's age/ethnicity, and parent's education level). Methods. A cross-sectional study was performed among 1,665 parent-child dyads. The children's mean age was 8 years. Their height and weight were measured to calculate their body mass index (BMI). Parents completed a questionnaire to measure the three parenting dimensions. Based on these dimensions, five parenting styles were defined: the authoritative, permissive, authoritarian, neglecting and rejecting parenting style. Child BMI z-scores were regressed on parenting style, adjusting for parental BMI, child ethnicity, and parent's education level. Results. Rejecting parenting, characterized by high psychological control, low support and low behavioural control, is the only parenting style significantly related to child BMI z-scores (β == 0.074, p < 0.001). The positive association was not moderated by socio-demographic variables. Conclusions. By adding the dimension of psychological control to the concept of parenting, this study has further elucidated the mechanisms whereby parenting may affect child weight. Demonstrating that 'rejecting parenting' is associated with a higher child weight, emphasizes the need for longitudinal studies in which parenting style is measured three-dimensionally. Potential mediating effects of parental feeding style and children's eating style, as well as age moderation, should be included in these studies. [ABSTRACT FROM AUTHOR]

Objective: The first aim of this study was to gain more insight into the bi-directionality between alcohol-specific parental factors (i.e., parents' alcohol use, alcohol availability at home, parental rule setting, and frequency and quality of communication about alcohol) and adolescents' alcohol intake and alcohol-related problems. The second aim was to examine the relative impact of alcohol-specific parental factors on adolescents' alcohol intake and related problems by studying them in a comprehensive model. Method: A two-wave longitudinal study, with a 2-year interval, was conducted among a sample of 537 adolescents (56% girls) ages 12-15 years in The Netherlands. Under supervision of well-instructed teachers, students filled Out questionnaires in a classroom setting. Results: The findings show that perceived alcohol availability at home was the only parenting factor predicting an increase in alcohol intake and alcohol-related problems among adolescents 2 years later. Cross-sectional findings, furthermore, suggest that the effect of alcohol availability on adolescents' alcohol-related problems disappears when adolescents perceive strict alcohol rules. In addition, results indicate that parents respond to their youngsters' experienced alcoholrelated problems by engaging in more rigorous alcohol-specific parenting (e.g., by increasing alcohol-specific rules and decreasing alcohol availability at home). Conclusions: The findings emphasize that parent interventions aiming at the prevention of adolescents' alcohol use should include the advice to restrict the perceived presence of alcohol beverages at home. Moreover, to prevent alcohol problems, parents should be advised to enforce strict rules about drinking, particularly when a total absence of alcohol at home is not feasible. [ABSTRACT FROM AUTHOR]

Often, military personnel do not seek treatment for mental illness or wait until they reach a crisis point. Effective, selective, and indicated prevention is best achieved by seeking treatment early. We aimed to examine military personnel's attitudes, beliefs, and needs around seeking treatment for mental illness. We compared those who sought treatment to those who did not and those with and without the intention to seek treatment. Finally, we examined factors associated with intentions of not seeking treatment. We conducted a cross-sectional questionnaire study of military personnel with (N = 324) and without (N = 554) mental illness. Descriptive and regression analyses (logistic and ordinal) were performed. The majority of the personnel believed treatment was effective (91.6%); however, most preferred to solve their own problems (66.0%). For personnel with mental illness, compared to those who sought treatment, those who did not had a higher preference for self-management and found advice from others less important. For those without mental illness, those with no intention to seek treatment indicated a higher preference for self-management, stigma-related concerns, denial of symptoms, lower belief in treatment effectiveness and found it less important to be an example, compared to those with treatment-seeking intentions. A clear indication of where to seek help was the most reported need (95.7%). Regression analyses indicated that not seeking treatment was most strongly related to preference for self-management (OR(95%CI) = 4.36(2.02–9.39); no intention to seek treatment was most strongly related to a lower belief that treatment is effective (OR(95%CI) =.41(0.28–0.59) and with not having had positive earlier experiences with treatment seeking (OR(95%CI) =.34(0.22–0.52). To facilitate (early) treatment seeking, interventions should align with a high preference for self-management, mental illness stigma should be targeted, and a clear indication of where to seek treatment is needed. [ABSTRACT FROM AUTHOR]

Objective: Cross-sectoral alcohol policy is recommended to reduce youth alcohol consumption, but little evidence is available on its effectiveness. Therefore, we examined whether regions and municipalities in the Dutch province of Noord-Brabant with stronger cross-sectoral alcohol policy showed larger reductions in alcohol consumption among adolescents aged 12-15.Method: Strong regional cross-sectoral alcohol policy was defined as participation in a regional alcohol prevention program. Strong municipal cross-sectoral alcohol policy was operationalized by measures on (a) sector variety: involvement of different policy sectors, and (b) strategy variety: formulation of different policy strategies. Relevant data from policy documents were searched for on the Internet. Data on trends in alcohol consumption were extracted from the 2007 and 2011 cross-sectional Youth Health Monitor that includes a random subset of adolescents aged 12-15 (n = 15,380 in 2007 and n = 15,437 in 2011). We used multilevel regression models.Results: Two of the three regions in which municipalities participated in a regional alcohol prevention program showed a larger reduction in weekly drinking than the region in which municipalities did not participate (-12.2% and -13.4% vs. -8.3%). Municipalities with strong compared to weak sector variety showed a larger increase in adolescents' age at consuming their first alcoholic drink (0.63 vs. 0.42 years). Municipalities with strong strategy variety showed a decrease (-3.8%) in heavy weekly drinking, whereas those with weak variety showed an increase (5.1%). Cross-sectoral alcohol policy did not affect trends in other alcohol outcomes.Conclusions: Our results suggest that strong cross-sectoral alcohol policy may contribute to reducing some aspects of youth alcohol consumption. Monitoring policy implementation is needed to assess the full impact. [ABSTRACT FROM AUTHOR]