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This paper reflects on the roundtable session at the 36th annual conference of the European Health Psychology Society titled‘Mind the digital divide: How to reduce social inequalities in digital health promotion?’, chaired by Dr Laura M König and Dr Max J Western. The session was intended to present contemporary evidence on the existence of a digital divide in health behaviour promotion via two brief presentations of recent evidence syntheses by Dr Eline Smit and Dr Max Western, followed by two short talks on potential underlying mechanisms of the digital divide by Professors Efrat Neter and Falko Sniehotta. Finally, we aimed to explore through a panel discussion and an audience workshop how we, the health psychology community, could focus our research on better understanding and addressing this phenomenon. In the following, we will discuss how the roundtable was implemented and which aspects were perceived to be most useful from the perspectives of the organising chairs, presenters and participants, to provide input for roundtable organisers at future conferences.

Additional file 1. Final list of criteria and definitions by the local stakeholders.

Additional file 2. Final list of criteria and definitions by scientists.

This is a protocol for a scoping review. This scoping review focuses on creating an overview of systems frameworks for childhood obesity prevention.

BACKGROUND: Previous findings suggest that university students are at an elevated risk to experience financial hardship and to suffer from depressive symptoms. This vulnerability may have substantially increased during the coronavirus disease 19 (COVID-19) pandemic which might have affected students' socio-economic situation but possibly also their mental well-being. We examined whether the financial situation changed during the COVID-19 pandemic among German university students, and whether changes were associated with mental well-being. METHODS: We conducted a cross-sectional online survey in May and July 2020 at five German universities. Participants were asked, if they had sufficient financial resources to cover monthly expenses before and during the pandemic. The answer options were dichotomized into worsened and no change/better financial situation compared to before the COVID-19 pandemic. Depressive symptoms were assessed using the CES-D 8 scale. For examining associations between sociodemographic, study-related, and financial factors and “worsened financial situation,” we ran a generalized linear mixed model. To assess associations between depressive symptoms and worsened financial situation, we performed a linear mixed model. RESULTS: We included 7,199 participants in the analyses (69% female, 30% male, 1% diverse, mean age: 24 years, standard deviation: 4.7). Overall, 25% of the participants reported to have a worsened financial situation at the time of the survey than in the time before COVID-19. Factors associated with a worsened financial situation were migration background, parents not being academics, not being able to borrow money, and payment of tuition fee by student and loan [odds ratios (OR) ranging from 1.20 to 2.35]. Factors associated with lower odds were: being single, living with others, studying a health-related field, being enrolled in a doctoral/Ph.D. or state exam program, and publicly funded tuition/tuition paid with a scholarship (OR ranging from 0.42 to 0.80). A worsened financial situation was associated with 1.02 points more on the CES-D 8 scale (95% CI: 0.80–1.24). CONCLUSION: Our results suggest that the pandemic put a number of students under financial strain with detrimental consequences for their mental well-being. Renewed attention must be paid to this vulnerable group to prevent the potentially damaging effects on their mental health.

Background Scoping reviews provide an opportunity to broadly explore a specific field and to synthesize a heterogeneous body of knowledge (Tricco et al., 2018). Scoping reviews include a systematic search for literature, however, the risk of bias in studies is not assessed. This is because the major focus of scoping reviews is on the methods to measure the outcomes rather than the outcomes themselves. In this abstract, we present an example of such a scoping review in a rapidly developing field that is highly relevant during a global pandemic. Digital interventions offer a method to address the high demand for mental health promotion, especially when facing physical contact restrictions (Vigo et al., 2020). Although the market for digital interventions is rapidly growing, their effectiveness at improving mental health is limited in clinical trials (Weisel et al., 2019). Engagement with digital interventions is critical for their effectiveness especially in real-life settings outside of a research context (Szinay et al., 2020). Although several factors to promote and maintain user engagement have been identified (Szinay et al., 2020), it remains unclear what strategies facilitate the engagement with digital interventions targeting mental health promotion. Objective The objective of this scoping review is to identify strategies that facilitate user engagement with digital interventions targeting mental health promotion. Research question The research question of the current scoping review is: What are the strategies to facilitate user engagement with digital interventions for mental health promotion? Method/Approach This review was registered in OSF (https://osf.io/9xyg7) and it adheres to the PRISMA-ScR guidelines for scoping reviews (Tricco et al., 2018). Study selection and data coding were done by two authors independently and any inconsistencies were resolved by consensus. Eligibility criteria. The inclusion criteria were: 1) adult (18 years+) users of digital interventions for mental health promotion from the general population, 2) any digital intervention for mental health promotion, 3) user engagement strategies described in intervention design. The exclusion criteria were: 1) clinical populations, 2) digital interventions for the treatment of mental health disorders; 3) no or inadequate information on the engagement strategies used in the intervention, 4) no primary data (reviews). Search strategy and study selection. The search was conducted in seven electronic databases: MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Social Science Citation Index (SSCI), the Science Citation Index (SCI), the Emerging Sources Citation Index (ESCI) and PsycINFO. Databases were searched from inception to April 2020, with no language or publication type restrictions, using three main search terms: digital intervention AND (mental health promotion OR engagement) in titles/abstracts. A total of 2766 studies were identified, and k = 16 studies met inclusion criteria. Data items. We coded the following data items: study characteristics (citation, design, country of data collection), digital intervention (type, engagement strategy) and evaluation of engagement strategy (method and result specifying if the strategy was effective at facilitating engagement) and features of engagement (usability measures and subjective measures). Data synthesis. We synthesized the data narratively. Results Study characteristics. All k = 16 studies were published in 2013 to 2020, originated from Europe (k = 6), North America (k = 6) and Australia (k = 4). Studies designs included randomised controlled trials (RCTs; k = 6), secondary data analyses (k = 5), cohort studies (k = 3) and qualitative studies (k = 2). Digital interventions and engagement strategies Digital interventions for mental health promotion were either web-based (75%) or mobile-app-based (25%). The engagement strategies included: support for the content of the intervention, personalized feedback for content, guidance or e-coaching for content, social forum, flexibility, gamification, avatar customisation and reminders. Effective engagement strategies The engagement strategies were deemed effective based on user qualitative feedback or questionnaires/tools (k = 4), usability data (k = 5) or both (k = 7). Most of the studies identified the availability of personalized support throughout the intervention in the form of e-coaching guidance, peer support through a social platform, personalized feedback, or joint video conference sessions as an engaging feature. Features of engagement Engagement features were explored heterogeneously in all k = 16 studies: k = 9 studies explored usage frequency, duration, and amount; k = 6 studies explored subjective measures like affect, attention, and interest together with usage measures; k = 3 study explored the depth of engagement. Conclusions and implications Various engagement strategies have been reported in digital interventions for mental health promotion including individual and social support, personalised feedback, and reminders. User engagement was predominantly reported in terms of frequency, duration and amount; but also subjectively (affect, attention, interest). Solely two out of the 16 studies evaluated different types of engagement strategies. Personalized support during the intervention, access to social support and personalized feedback may work best to promote engagement. Findings need to be interpreted with caution as the included studies were heterogeneous, had small sample sizes and typically explored engagement strategies as a by-product only. All studies were from high-income settings, questioning the generalisability to other contexts. Despite the importance of user engagement for the effectiveness of digital interventions (Szinay et al., 2020), this area has not yet received much attention. Further research is needed on the effectiveness (and cost-effectiveness) of different types of strategies to facilitate user engagement with digital interventions for mental health.

BACKGROUND: Digital interventions offer a solution to address the high demand for mental health promotion, especially when facing physical contact restrictions or lacking accessibility. Engagement with digital interventions is critical for their effectiveness; however, retaining users’ engagement throughout the intervention is challenging. It remains unclear what strategies facilitate engagement with digital interventions that target mental health promotion. OBJECTIVE: Our aim is to conduct a scoping review to investigate user engagement strategies and methods to evaluate engagement with digital interventions that target mental health promotion in adults. METHODS: This scoping review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. The search was conducted in 7 electronic databases from inception to April 2020. The inclusion criteria for studies were as follows: adult (aged ≥18 years) users of digital interventions for mental health promotion from the general population; any digital intervention for mental health promotion; and user engagement strategies described in the intervention design. We extracted the following data items: study characteristics, digital intervention (type and engagement strategy), evaluation of engagement strategy (method and result specifying whether the strategy was effective at facilitating engagement), and features of engagement (extent of use and subjective experience of users). RESULTS: A total of 2766 studies were identified, of which 16 (0.58%) met the inclusion criteria. The 16 studies included randomized controlled trials (6/16, 37%), studies analyzing process data (5/16, 31%), observational studies (3/16, 19%), and qualitative studies (2/16, 13%). The digital interventions for mental health promotion were either web based (12/16, 75%) or mobile app based (4/16, 25%). The engagement strategies included personalized feedback about intervention content or users’ mental health status; guidance regarding content and progress through e-coaching; social forums, and interactivity with peers; content gamification; reminders; and flexibility and ease of use. These engagement strategies were deemed effective based on qualitative user feedback or responses on questionnaires or tools (4/16, 25%), usability data (5/16, 31%), or both (7/16, 44%). Most studies identified personalized support in the form of e-coaching, peer support through a social platform, personalized feedback, or joint videoconference sessions as an engaging feature. CONCULSIONS: Personalized support during the intervention, access to social support, and personalized feedback seem to promote engagement with digital interventions for mental health promotion. These findings need to be interpreted with caution because the included studies were heterogeneous, had small sample sizes, and typically did not address engagement as the primary outcome. Despite the importance of user engagement for the effectiveness of digital interventions, this field has not yet received much attention. Further research is needed on the effectiveness of different strategies required to facilitate user engagement in digital interventions for mental health promotion.

INTRODUCTION: Physical inactivity is known as a leading cause of mortality and tracks from childhood to adulthood. Many types of school-based single-component and multicomponent interventions to promote physical activity (PA) have been undertaken and evaluated, with mixed findings overall. Enlarging the intervention areas beyond the school setting is a promising approach. WHO’s Health Promoting School (WHO HPS) framework is a holistic, setting-based approach where health is promoted through the whole school environment with links to other settings such as the home environment and wider community. In this paper, we outline our scoping review protocol to systematically review the published literature from the last 10 years to identify existing school-based interventions to promote PA and cardiorespiratory fitness among children aged 6–10 years old and to map intervention components according to the features of this framework. METHODS AND ANALYSIS: Arksey and O’Malley’s scoping review methodology framework will guide the conduct of this review. We will search Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sports Medicine & Education Index, Education Resources Information Centre and CENTRAL and hand search the reference lists of key studies to identify studies appropriate for inclusion. Any empirical study that evaluated the effectiveness of a school-based intervention promoting PA and/or cardiorespiratory fitness in children aged 6–10 years old will be included. Two reviewers will independently screen all abstracts and full texts for inclusion. One reviewer will extract general information, study characteristics and intervention contents to classify them according to the features of the WHO HPS framework. Results will be synthesised narratively. ETHICS AND DISSEMINATION: Findings will be disseminated in conference presentations and peer-reviewed publications. A condensed version of the results will be made available for the public. Stakeholder meetings will be arranged to discuss and disseminate the findings.

Mentoring programmes are commonplace, yet little is known about the circumstances in which they operate. This study aimed to gain insight into the context surrounding youth mentoring programmes by asking programme managers and experts in the United Kingdom about their experiences. Telephone interviews with twenty-three programme managers and five experts were undertaken. Interviews were recorded, transcribed verbatim and analysed iteratively using thematic analysis. Contextual influences at the individual-, interpersonal-, organisational-, community-, policy-, and societal-level were identified to impact on programme's development, delivery and maintenance and were summarised in a model. This study further found that youth mentoring programmes operate within a complex context. This context provides challenges and opportunities that impact on programme's sustainability; resulting in many externally-funded programmes to ‘hang by a thread’. It is important for service providers, commissioners and academics to recognise the complexity surrounding mentoring programmes to ensure that programmes are delivered as intended and evaluated appropriately.

Background: Youth mentoring is used with vulnerable young people to help improve their health, well-being and educational attainment. While there is growing interest in mentoring programmes among policy makers and practitioners the evidence base is weak with no randomised control trial (RCT) yet undertaken in the UK. The aim of this study was to assess the feasibility and acceptability of conducting a definitive RCT of the effectiveness and cost effectiveness of the Breakthrough Mentoring programme targeted at secondary school students who are at risk of exclusion from school.Methods: Thirty-one young people were approached and twenty-one were recruited to the feasibility study. Participants were aged 12–16 years (mean age = 14.10 years) and randomised to either receive weekly 2-hour mentoring sessions for one academic year (n = 11, intervention) or care as usual (n = 10, control). Participants were asked to complete self-reported questionnaires on a range of measures including the Strength and Difficulties Questionnaire, which were analysed descriptively. Qualitative interviews were conducted with participants and with parents, schools staff, mentors and commissioners as part of the process evaluation. Interviews were facilitated using a topic guide, were audiotaped, transcribed verbatim and analysed thematically.Results: Follow-up at 6 and 12 months was 100% and 86% for 18 months. Participants were happy to complete the self-report questionnaires, showed a good understanding of randomisation and were accepting of this study design. Control group participants reported wanting a mentor and some were mildly upset at not achieving this. Intervention group participants indicated that having an adult mentor, unconnected with the school that they could talk to about their problems helped them to give voice to and deal with difficult feelings. Some mentees reported negative experiences of the way that the mentoring relationship ended. The process evaluation showed that the study design and intervention were acceptable to parents, mentors, schools and commissioners. A need for further evidence on the effectiveness of mentoring was highlighted by commissioners, and parents and schools staff expressed a wish to be informed of progress made by mentees during mentoring sessions.Conclusion: It is feasible and acceptable to recruit, randomise and retain students at risk of exclusion from school to an RCT for 6, 12 and 18 month follow-up. Further research is required to characterise youth mentoring in schools in the UK and to investigate how to best measure its effectiveness before a definitive trial can be considered.

Objective: To undertake a systematic review and metaanalysis to establish the effectiveness of handwashing in reducing absence and/or the spread of respiratory tract (RT) and/or gastrointestinal (GI) infection among schoolaged children and/or staff in educational settings. Design: Randomised-controlled trials (RCTs). Setting: Schools and other settings with a formal educational component in any country. Patients: Children aged 3-11 years, and/or staff working with them. Intervention: Interventions with a hand hygiene component. Main outcome measures: Incidence of RT or GI infections or symptoms related to such infections; absenteeism; laboratory results of RT and/or GI infections. Results: Eighteen cluster RCTs were identified; 13 school-based, 5 in child day care facilities or preschools. Studies were heterogeneous and had significant quality issues including small numbers of clusters and participants and inadequate randomisation. Individual study results suggest interventions may reduce children's absence, RT infection incidence and symptoms, and laboratory confirmed influenza-like illness. Evidence of impact on GI infection or symptoms was equivocal. Conclusions: Studies are generally not well executed or reported. Despite updating existing systematic reviews and identifying new studies, evidence of the effect of hand hygiene interventions on infection incidence in educational settings is mostly equivocal but they may decrease RT infection among children. These results update and add to knowledge about this crucial public health issue in key settings with a vulnerable population. More robust, well reported cluster RCTs which learn from existing studies, are required.