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Despite growing emphasis on the benefits of physical activity for promoting mental health, inclusion of muscle-strengthening (MS) (e.g., body-weight exercises, resistance machines) activities is limited. Notably, few studies collectively assess MS behavioural frequency, duration, and intensity. To address the gap, the current study examined associations between frequency (days), intensity (rating of perceived exertion in relation to repetitions in reserve [RPE/RIR]), and duration (minutes per typical session) of MS activities on anxiety, depression, and mental well-being.A cross-sectional study of 601 participants (Mean age = 30.92 years [SD = 12.70]; 57.7 % female) across Ireland was conducted. Participants completed a self-report questionnaire containing MS instruments previously used, or adapted from valid and reliable measures (i.e., International Physical Activity Questionnaire IPAQ, RPE/RIR), alongside, the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8) and the Mental Health Continuum- Short Form (MHC-SF). A multivariate regression model was tested in MPLUS, using dummy coding for MS frequency in relation to no activity (i.e., 0-days) non-adherence (i.e., 1-day), adherence (i.e., 2-days) and enhanced adherence (i.e., ≥3 days) to the MS public health guidelines, with the mental health variables representing the dependent variables. Intensity and duration were specified in the model as continuous variables; gender and age were included as statistical controls.Three or more days engaged in MS activities was associated with fewer anxiety (β = -0.12, p .05) and depression (β = -0.14, p .01) symptoms. Increased intensity had a negative association with anxiety (β = -0.10, p .05) and depression (β = -0.15, p .001). Unexpectedly, adherence to the MS guidelines (2-days) did not predict any of the mental health outcomes, whereas 1-day of MS activity was associated with fewer depression symptoms (β = -0.11). No effects were observed for mental well-being, and MS duration exerted a null effect across all mental health outcomes.Higher frequency and intensity of MS activities may protect against anxiety and depression symptoms. Doing some MS activities (at least 1-day) is likely more beneficial than none for depression. Evidence-based, MS interventions may help curb mental illness rates, and future longitudinal, intervention-based research could consider inclusion of MS frequency, intensity and duration variables to enhance efforts to identify at-risk groups and trends within physical activity and mental illness surveillance.

Participation in sport can paradoxically be a source of psychological needs satisfaction and psychological needs frustration. Self-determination theory was applied to explain temporal relationships of athletes’ psychological needs satisfactions and psychological needs frustrations with burnout through a two-wave longitudinal study. Participants included 184 athletes (Mage = 24.04 years, SD = 5.56, 67.9% male) representing a range of competitive levels. A latent difference score model specifying longitudinal relationships between burnout and needs satisfactions and needs frustrations was tested. Significant within-variable changes were observed for all needs-satisfaction and needs-frustration variables. Longitudinal associations were found in Models 3 (autonomy frustration) and 6 (relatedness satisfaction). Higher burnout at baseline predicted an increase in autonomy frustration (β = 0.13, p p

BackgroundObesity is a global epidemic affecting all age groups, populations and income levels across continents, though is known to disproportionately affect socioeconomically disadvantaged populations. The causes of obesity are complex, informed by diet and weight practices, but shaped by social, commercial and environmental factors and government policy. Consequently, a Whole System Approach (WSA) – which considers the many causes of obesity and shifts the focus away from individuals as points of intervention and puts an emphasis on understanding and improving the system in which people live – is required. This scoping review of reviews aims to: determine how WSAs to diet and healthy weight have been implemented and evaluated nationally and internationally; to determine what models or theories have been used to implement WSAs; describe how WSAs have been evaluated; determine if WSAs are effective; and to identify the contribution of the public and/or service users in the development of WSAs. MethodSystematic searches were carried out using CINAHL, Scopus, PsycINFO (ProQuest), the Cochrane Library, and MEDLINE. Included review papers were those that focused on the application of a whole system approach to diet and/or healthy weight, and/or reported the theory/model used to implement or simulate this approach. Databases were searched from 1995 to March 2022 using a combination of text and Medical Subject Headings (MeSH terms). In addition, reference sections of identified articles were examined for additional relevant articles. Covidence software was used to screen titles and abstracts from the electronic databases and resolve conflicts.Results A total of 20,308 articles were initially retrieved; after duplicate removal 7,690 unique title and abstracts were reviewed, and 110 articles were selected for full text review. On completion of full text review, 8 review articles were included for data extraction. These included: one umbrella review, four systematic reviews, a rapid review, and two literature reviews (one of which was on strategic reports written for government and public health policy). Evaluations of WSA were mainly process evaluations although health outcomes were assessed in some studies. Several conceptual frameworks or mathematical modelling approaches have been applied to WSAs for diet, healthy weight and obesity to inform their planning or delivering, and to understand/map the associated systems. Common mathematical approaches include agent based or system dynamic modelling. Underlying both conceptual and mathematical models is an understanding how the elements of the complex systems impact each other to affect diet, healthy weight and obesity. WSA implementations have reported some success in positively impacting health outcomes including reducing Body Mass Index, reducing sugary food intake and increasing physical activity. Public and user involvement in WSA was not widely reported.ConclusionThe application of WSA to diet and healthy weight shows promise, yet the research is lagging behind their implementation. Further robust evidence for using WSA to address diet and healthy weight are required, including incorporating process and outcome evaluations (perhaps using established approaches such as Systems Dynamic Modelling). Furthermore, the analysis of epidemiological data alongside longitudinal process and outcome evaluation regarding the implementation of a WSA is required.

Aim: A recent mental health in sport consensus statement advocates Keyes’ two continua model with an associated Mental Health Continuum (MHC) instrument to assess mental health in athletes. However, there remains statistically inconsistent usage of the MHC in athletes, so further exploration of the MHC’s psychometric factors is required. Methods: Athletes (N = 1,097) aged 32.63 (SD = 11.16) comprising 603 females (55.7%) and 478 males (44.3%), completed the 14-item MHC-Short Form, alongside validated measures of anxiety and depression. Five confirmatory factor analytic and bifactor models were developed based on extant research and theory. Results: Overall, a bifactor structure with a “general” positive mental health factor, and three specific factors (“hedonic well-being,” “social well-being,” and “psychological well-being”) fitted the data well and was deemed the superior model. Conclusion: A bifactor model of the MHC-Short Form is recommended comprising a composite score alongside specific factors of hedonic, social, and psychological well-being.

BackgroundA minority of children in the United Kingdom meet the recommended physical activity guidelines. One initiative which has been introduced to try and increase the physical activity levels of school children is The Daily Mile™ (TDM). The aim of this review was to determine the effect of TDM on children’s physical activity levels, physical health, mental health, wellbeing, academic performance and cognitive function.MethodsSix databases were systematically searched from TDM’s inception (2012) to 30thJune 2022. Studies were included if they involved school-aged children (aged 4-12 years), taking part in TDM and measured at least one pre-defined outcome.ResultsThirteen studies were included from the 123 studies retrieved. Longer-term participation in TDM was found to increase moderate-to-vigorous physical activity and physical fitness. None of the studies reported a significant change in Body Mass Index or academic performance. An acute bout of TDM was not found to improve cognitive function, however one good-quality study reported that longer-term participation in TDM increased visual spatial working memory. There was evidence from one fair-quality design study that TDM can improve mental health in the short term. There were no significant effects on wellbeing, however scores on self-perceptions improved mainly for children with low baseline self-perceptions.ConclusionThere is evidence to show that TDM can increase physical activity and physical fitness. However, higher-quality research, with adequate participant randomisation and longer-term, post-intervention follow-up is needed to ensure that any changes accurately reflect the components of TDM and are sustained beyond an intervention time frame. Policy recommendations of TDM increasing PA levels in the short term are supported by the evidence in this review. However, long-term improvement on mental health, wellbeing, academic performance and cognitive function requires further good-to excellent quality research. Promisingly, several protocol articles that include randomised controlled trials with long term follow-up have been published. These higher-quality design studies may provide a stronger evidence-base on the effects of TDM on children’s health and should underpin future recommendations in public health policy.Systematic Review registrationPROSPERO CRD42022340303

Adolescent mental illness is of increasing concern, with prevalence increasing especially in females in the United Kingdom. While service-related barriers can deter help-seeking, the role of family...

The current study addresses the need to empirically develop effective mental health interventions for youth from ethnic/racial minority and low-income neighborhoods. Using Stage Model evaluation methods supported by the National Institutes of Health in the US to address underutilization of mental healthcare among racial/ethnic minority youth, this feasibility study demonstrates empirical adaptation of an innovative sport-specific psychological intervention for use in youth from ethnic/racial minority and low-income neighborhoods. An international group of professionals familiar with sport performance and mental health intervention serving the target population experientially examined the adapted intervention protocols in workshops and provided feedback. Survey results indicated the professionals found the intervention components were easy to administer and likely to be safe, enjoyable, engaging and efficacious for youth mental health and sport performance. The protocols were revised based on feedback from these professionals and the intervention was examined in a case trial involving an Asian American youth who evidenced Social Anxiety Disorder. Case study results indicated the intervention could be implemented with integrity, and severity of psychiatric symptoms and factors interfering with sport performance decreased after intervention implementation. The participant’s relationships with family, coaches and teammates were also improved.

Purpose This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being. Design/methodology/approach In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being. Findings In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores. Practical implications Findings highlight the need for mental health promotion and support in equestrian sport. Social implications Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being. Originality/value This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.

Recreational athletes comprise the most prevalent population using illegal Anabolic Androgenic Steroids (AAS). Despite regulatory efforts, substances are widely accessible, and most users report the experience of harmful side effects. It remains unclear why few users seek professional medical help. The aim of this study was to determine AAS users’ experience of side effects and help-seeking beliefs using an Interpretative Phenomenological Analysis of six interviews. Participants were from the United Kingdom (n = 5) and United States (n = 1), had all experienced side effects, with some reporting prolonged use of AAS (>10 years) and self-manufacturing the drugs from raw ingredients. Results showed that AAS users discredit medical professionals’ competencies, and practice cognitive dissonance by avoiding challenging situations. A microculture for information-sharing has developed among AAS users who initially self-treat to counteract side effects, leaving them vulnerable to further harm. To conclude, there is an urgent need for educational interventions that outline the risky practice of unregulated AAS use and self-treatments, and the need to seek professional help. Such interventions could be developed through a co-production basis, and be implemented by current/former AAS users alongside the medical community.

Background: Substance misuse is a significant global health concern. In the UK, the prevalence of substance misuse has increased over the past decade and the number of alcohol and drug related deaths are increasing. Individuals with substance dependency issues are entitled to access treatment services. However, the COVID-19 pandemic created significant challenges for public services, including drug and alcohol treatment, and resulted in significant service reconfiguration and a shift from in-person to remote delivery. This study aims to evaluate the delivery of drug and alcohol services in a large metropolitan area in Northern England during the COVID-19 pandemic. It aims to understand the impact of service reconfiguration for services, staff and service users, and to use this understanding to inform the future optimised design of services. Design and methods: The study has five workstreams within a mixed methods framework: (1) Systematic review of literature; (2) Qualitative process evaluation with service providers (digital timelines, focus groups and interviews); (3) Qualitative process evaluation with service users (interviews, focus groups, text based conversations and case studies); (4) Quantitative outcomes and health economic analysis; and (5) Data synthesis and dissemination. Expected Impact of the study for Public Health: The breadth of the study, its novel nature, and the importance of substance misuse as a public health issue, mean that this study will provide valuable findings for those who commission, deliver and use drug and alcohol treatment services nationally and internationally. There will also be important learning for the effective remote delivery of services in sectors beyond drug and alcohol treatment.

Background People with severe mental illness (SMI) often have poorer physical health than the general population. A coproduced physical activity intervention to improve physical activity for people with SMI in Northern Ireland was evaluated by co‐researchers (researchers with lived experience of SMI) and academic researchers using a new approach to participatory data analysis called participatory theme elicitation (PTE). Objective Co‐researchers and academic researchers analysed the data from the pilot study using PTE. This paper aimed to compare these analyses to validate the findings of the study and explore the validity of the PTE method in the context of the evaluation of a physical activity intervention for individuals with SMI. Results There was alignment and congruence of some themes across groups. Important differences in the analyses across groups included the use of language, with the co‐researchers employing less academic and clinical language, and structure of themes generated, with the academic researchers including subthemes under some umbrella themes. Conclusions The comparison of analyses supports the validity of the PTE approach, which is a meaningful way of involving people with lived experience in research. PTE addresses the power imbalances that are often present in the analysis process and was found to be acceptable by co‐researchers and academic researchers alike.

Purpose The high prevalence of mental illness within the prison population necessitates innovative mental health awareness provision. This purpose of this feasibility study with 75 males (47 intervention; 28 control) was to evaluate State of Mind Sport (SOMS), originally developed as a community based mental health and well-being initiative, in a notoriously challenging prison setting. Design/methodology/approach A mixed 2 (group) × 2 (time) factorial design was adopted. Questionnaires tested for effects on knowledge of mental health, intentions to seek help, well-being and resilience. For each outcome measure, main and interaction effects (F) were determined by separate mixed factors analysis of variance. Two focus groups (N = 15) further explored feasibility and were subjected to general inductive analysis. Findings A significant group and time interaction effect were shown for mental health knowledge, F(1, 72) = 4.92, p = 0.03, ηp2 = 0.06, showing a greater post-programme improvement in mental health knowledge score for the intervention group. Focus group analysis revealed an increase in hope, coping efficacy and intentions to engage more openly with other prisoners regarding personal well-being as a result of the SOMS programme. However, fear of stigmatisation by other inmates and a general lack of trust in others remained as barriers to help-seeking. Originality/value The implications of this study, the first to evaluate a sport-based mental health intervention in prison, are that a short intervention with low costs can increase prisoner knowledge of mental health, intentions to engage in available well-being opportunities and increase a sense of hope, at least in the short term.

Mindfulness may improve well-being through increasing one’s ability to self-regulate stressors, which are common and multifaceted among the student-athlete population. However, the mechanis...

WHAT IS KNOWN ON THE SUBJECT?: Individuals with a severe mental illness (SMI) are less physically active and have a lower life expectancy than the general population due to increased risks of cardiometabolic diseases (obesity, diabetes and respiratory diseases) and other health risks. Physical activity has been used as an adjunct therapy for individuals with SMI yielding improvements in cognitive functioning, quality of life and a reduction in psychiatric symptoms. Individuals with SMI residing within a secure forensic setting have reduced physical activity opportunities, possibly due to a number of factors including low motivation and restricted access to exercise facilities combined with a lack of knowledge and/or confidence in staff members to assist in physical activity programmes. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review demonstrates that little is known around the effects of physical activity for people with SMI who reside in secure forensic settings, with little to no long-term effects reported. Physical activity interventions have shown some positive results through decreasing weight and waist circumference as well as a reduction in negative symptom scores in an exercise group compared with the "no treatment" control group post-intervention. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Service users' reluctance to engage in physical activity may be overcome by improving staff commitment, creating a motivational atmosphere and promoting service user decision making.INTRODUCTION: Participating in physical activity has many benefits, yet those with severe mental illness (SMI) living in forensic settings are less likely to be active, and more likely to experience ill-health. The aim of this study was to systematically review the effectiveness of physical activity programmes on mental and physical health and specifically on reducing symptoms of SMI in forensic settings.A systematic search of six databases was conducted, in addition to a grey literature search. Studies were included if they had participants with SMI; were based in a forensic setting; involved a physical activity programme and reported physical and mental health outcomes.A total of 112 participants were included in four studies. One study showed a significant improvement in negative symptom scores in the exercise group compared with a treatment as usual group. Two studies reported improvements in psychiatric symptoms with no significant difference between groups; however, statistically significant changes in weight and waist circumference were evident (p .001). No adverse effects were reported.Only a small number of studies were included and of limited design and quality, with no follow-up assessments; therefore, more research is needed to determine the true effects of physical activity for improving SMI symptoms in a forensic setting. This review highlights the need for further studies exploring the barriers and facilitators of physical activity in secure forensic settings. Studies are required that include a more thorough research design. Furthermore, interventions if designed with patients and caring staff in mind may lead to lowered psychiatric symptoms and increased physical health benefits for all in forensic settings.

This chapter examines contemporaneous theories, methodologies, and applied interventions specific to mental health in sport. First, contributions in the field are summarized, including mental health awareness programs designed to destigmatize mental health disorders in athletes, screening instruments experimentally developed to identify athletes who are likely to benefit from mental health services, assessment methods that have been psychometrically validated to assist intervention planning, interventions that have been indicated to assist engagement of athletes into mental health interventions, and prevention and intervention programs that have been shown to prevent or decrease the severity of mental health symptomology. Five seminal readings that are specific to advancing mental health in athletes are offered. These readings complement five questions that are presented to stimulate clinical and experimental growth in the mental health of athletes, including the scientific development of cost-effective methods of addressing mental health in sport organizations and disseminating evidence-supported mental health interventions in athletes.

We aimed to determine whether a mental health awareness and self-management program could improve intentions to self-manage mental health for both athletes and nonathletes. Two hundred students (M ...

Purpose The purpose of this paper is to test the effects of augmenting an evidence-based physical activity intervention within an existing commercial weight loss program to assess effects on increasing physical activity and reducing psychological distress. Design/methodology/approach The CONSORT guidelines were adopted for the study. In total, 49 women with overweight or obesity (M age=39.5, SD:12.4; M Body Mass Index=31.02, SD: 2.10) enrolled in a six week commercial weight loss program were randomized to an intervention or a control group. Participants in the control group received care as usual; participants in the intervention group additionally received an evidence-based intervention to increase physical activity that included behavior change techniques including implementation intentions, goal-setting and self-monitoring. Findings Weekly steps increased in the intervention group (M=31,516.25; SD=9,310.17 to M=62,851.36; SD=13,840.4) significantly more (p η p 2 =0.32) than in the control group (M=30,207.67; SD=7,833.29) to M=46,969.33 (SD=9,470.96), along with experiencing significantly lower anxiety (p η p 2 =0.15), social dysfunction (p η p 2 =0.16) and depression symptoms (p η p 2 =0.08) at follow-up. Research limitations/implications This intervention warrants extension to those seeking to improve mental health through physical activity. Originality/value This study took a novel approach of augmenting a commercial weight loss program with a theory-based physical activity module, showing positive effects for physical activity behavior and psychological health.

Horse racing requires jockeys to weigh-in prior to competition, with failure automatically excluding the jockey from competition. As such, many jockeys frequently employ long-and-short-term ‘wasting’ weight loss techniques which can be harmful to health. This study aimed to: (a) explore jockeys’ social norms and experiences regarding wasting, and (b) the effects of wasting on their mental health. Six professional jockeys with a minimum of two years professional riding experience were recruited from a range of stud racing yards in Ireland. Following individual participant interviews, an Interpretative Phenomenological Analysis approach revealed four themes: (1) ‘Day in day out’, (2) ‘Horse racing is my life’, (3) ‘You just do what you have to do’, and (4) ‘This is our world’. Themes were interpreted through Social Identity Theory, which highlighted how wasting is an acceptable ‘in group’ norm among jockeys, irrespective of relationship problems and mental health consequences. Recommendations are offered fo...

The objective of this study was to assess the factorial and predictive validity of an Integrated Behaviour Change (IBC) model ( Hagger & Chatzarantis, 2014 ) for predicting Higher Education (HE) student-athlete and non-athletes’ intentions to self-manage mental health. Students (n = 200) aged 21.10 (SD= 3.73; male = 53%; athlete =69%) completed a questionnaire, and a two-step model building approach was conducted (i.e. confirmatory factor [CFA] and path analysis). Demographic (i.e. female or male; athlete or non-athlete) and IBC (i.e. autonomous and controlled motivation, subjective norms, perceived behavioural control and attitudes) variables were specified as predictors of students’ intentions to self-manage mental health. The factorial validity of the IBC was supported through models achieving satisfactory fit indices. Further, the path model explained a significant proportion of the variance for self-management intentions (R2 = 0.30). Autonomous (β = 0.29) and controlled (β = 0.13) motivation, alongside perceived behavioural control (β = 0.12) and gender (i.e. female; β = 0.12) predicted better self-management intentions. Autonomous motivation also positively predicted attitudes (β = 0.42), subjective norms (β = 0.32) and perceived behavioural control (β = 0.15). The promotion of autonomous motives and enhanced perceived behavioural control may offer the opportunity to facilitate effective self-management of mental health among students. Those involved in designing interventions may consider integrating the IBC for mental health promotion, tailoring interventions to gender and athlete norms.

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children’s Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

BackgroundInterventions designed to increase mental health awareness in sport have grown substantially in the last 5 years, meaning that those involved in policy, research and intervention implementation are not fully informed by the latest systematic evaluation of research, risking a disservice to healthcare consumers. Hence, our aim was to update a 2017 systematic review that determined the effect of sport-specific mental health awareness programmes to improve mental health knowledge and help-seeking among sports coaches, athletes and officials. We extended the review to incorporate parents as a source of help-seeking and report the validity of outcome measures and quality of research design that occurred since the original review.MethodsSport-specific mental health awareness programmes adopting an experimental or quasi-experimental design were included for synthesis. Five electronic databases were searched: Psychinfo, Medline (OVID interface), Scopus, Cochrane and Cinahl. Each database was searched from its year of inception to June 2020. As all of the outcomes measured were derived from psychometric scales, we observed statistically significant quantitative effects on the basis ofp< .05, and a small, medium or large effect size asd= .2, .5 or .8, respectively. Risk of bias was assessed using the Cochrane and QATSQ tools.ResultsTwenty-eight articles were included from the 2048 retrieved, eighteen additional articles since the original review. Eighteen studies targeted athletes, five with coaches, one sport officials (i.e. referees), one ‘at-risk children’ and three with parents. One of the studies was a combination of athletes, coaches and parents. In terms of study outcomes, health referral efficacy was improved in seven studies; twelve studies reported an increase in knowledge about mental health disorders. Proportionally, higher quality research designs were evident, as three of ten studies within the previous review did not demonstrate a high risk of bias, whereas thirteen of the eighteen additional studies did not display a high risk of bias. However, only one study included a behaviour change model in both the programme design and evaluation.ConclusionsOur updated systematic review provides evidence of the benefits of mental health awareness interventions in sport; these benefits are mainly for athletes and show improvements in the methodological design of recent studies compared to the first review. There was also evidence of the extension of programme delivery to parents. In conclusion, researchers, practitioners and policy makers should consider methodological guidance and the application of theory when developing and evaluating complex interventions.Systematic review registrationPROSPEROCRD42016040178

Introduction Alcohol and substance misuse are a public health priority. The World Health Organisation (WHO) estimates that harmful alcohol use accounts for 5.1% of the global burden of disease and that 35.6 million people worldwide are affected by substance misuse. The Coronavirus Disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has disrupted delivery of face-to-face alcohol and substance misuse interventions and has forced the development of alternative remote interventions or adaptation to existing ones. Although existing research on remote interventions suggests they might be as effective as face-to-face delivery, there has been a lack of systematic exploration of their content, the experience of service users, and their effectiveness for behavioural outcomes. This review will provide a narrative synthesis of the behaviour change techniques (BCT) contained in interventions for alcohol and/or substance misuse and their association with effectiveness. Methods and analysis Systematic searches will be conducted in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library. Included studies will be those reporting remote interventions focusing on alcohol and/or substance misuse among adults living in the community and which have a primary behaviour change outcome (i.e., alcohol levels consumed). Data extraction will be conducted by one author and moderated by a second, and risk of bias and behaviour change technique (BCT) coding will be conducted by two authors independently. A narrative synthesis will be undertaken focussing upon the association of BCTs with intervention effectiveness using promise ratios. Patient and Public Involvement (PPI) The Public Involvement in Research Group (PIRG), part of the NIHR-funded PHIRST, will be involved in refining the review questions, eligibility criteria, data synthesis and dissemination. Dissemination Dissemination will be through an academic peer reviewed publication, alongside other outputs to be shared with non-academic policy, professional, and public audiences, including local authorities, service users and community organisations.

This chapter provides an overview of the health issues in relation to mental well-being and men in prison, alongside the role of sport in promoting mental health and well-being in custodial settings. These topics formed the backdrop for the implementation and evaluation of the State of Mind Sport community programme, aimed at raising awareness of mental health and tackling stigma. The chapter continues with a detailed reflexive account of key ethical and methodological considerations of conducting the research within the prison environment in line with the principles of implementation science. The chapter concludes with practical guidance on planning and conducting health research in prisons based on the reflexive learnings detailed.

Background Adolescent mental health problems and suicidality appear to be increasing in Western countries but contact with health services remains stubbornly low. While social disadvantage is often implicated in aetiology and help-seeking, evidence on the relative contribution of school and family life factors is limited. We sought (a) to examine the prevalence and factors associated with mental health problems in adolescent boys and girls; and (b) to examine factors associated with trust and contact with GPs for mental health problems. Method Cross-sectional study of adolescent pupils in Northern Ireland Results High rates of mental health problems and suicidality were recorded, especially among females. While social circumstances do not influence mental health outcomes, factors of interest were atheist/agnostic beliefs and having a bedroom to oneself. While overall trust in GPs was high, more than 36% of the sample reported low trust. GP Trust was associated with positive home life factors. Importantly, adolescents with mental health problems including suicidality were much less likely to seek help. Limitations Cross-sectional data Conclusions This study confirms the high rates of mental health problems and suicidality among adolescents in Northern Ireland, particularly among young women. Those most in need of professional help appear least prepared to seek it. The influence of home life and environment on both poor mental health and trust and help-seeking from family doctors, is considerable and there is a need to find interventions that nurture appropriate levels of trust and help-seeking guidance for adolescents.

The current study examines the wellbeing, resilience and physical activity (PA) levels among Irish pre-service teachers. Participants were a sample of 128 higher education students (29% male; 71% female; mean age range 18–27 years old) who completed a self-report questionnaire, using a combination of established instruments for wellbeing, resilience, and PA. Descriptive data revealed that 39.1% presented with low levels of resilience, and 74% were not meeting the PA guidelines for health. One sample t-tests further revealed the sample population of higher education students had lower wellbeing (t (127) = −3.05, p = .003) and resilience (t (127) = −6.48, p = .003) levels, when compared to the population normative data. Results from the existing study suggest that a structured mental health and PA education awareness intervention for Irish pre-service teachers may be warranted, specifically to increase the lower than expected levels of resilience. The existing sample of pre-service teachers are at a critical time of transition, as they move forward into a profession where self-awareness of wellbeing is required at the beginning of their careers to sustain health both inside and outside of the classroom.

Background Self-determination theory (SDT) has been used to predict children’s physical activity and well-being. However, few school-based SDT intervention studies have been conducted, and no research exists with children of low socio-economic status (SES). Therefore, SDT-derived needs-supportive teaching techniques informed the design and analyses of the Healthy Choices Programme (HCP). The aim was to determine if the HCP could enhance moderate-to-vigorous physical activity (MVPA) and well-being among children of low SES through increasing autonomy-support, needs satisfaction and intrinsic motivation. Method A mixed factorial two (group) × two (time) wait-list controlled trial was conducted and reported using the TREND guidelines. A total of 155 children (56% females; intervention n = 84, control n = 71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (model 1) and well-being (model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation). Results In comparison to the control group, the intervention was related to increases in MVPA (β = .45) and autonomy-support (β = .17). In model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β = .14), intrinsic motivation (β = .51) and all three SDT mediators in sequence (total r2 = .34). In model 2, well-being was indirectly enhanced through autonomy-support (β = .38) and autonomy-support and needs satisfaction in sequence (total r2 = .21). Conclusions The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention’s design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion. Trial Registration This study is registered on Research Registry (number researchregistry2852). Electronic supplementary material The online version of this article (10.1186/s40798-018-0129-0) contains supplementary material, which is available to authorized users.

The present study had three aims, to determine: (a) whether providing a curriculum-based mental health awareness program to athletes increased knowledge of mental health and intentions to offer support; (b) whether the program increased resilience and well-being compared to a control group; and (c) the feasibility of the program. A total of 100 participants (Mage = 20.78; SD = 2.91; male = 59) either attended the program or were part of a control group. Participants completed questionnaires pre-, post-, and 3-months post-intervention, although there was a low participant return rate for the 3-month follow-up (n = 15). Participants were invited to take part in a focus group to explore program relevance. Knowledge of mental health and intentions to offer support increased for the intervention group, compared to the control. The program with some modification could be integrated into university sport courses to promote mental health awareness.