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Background: Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status? Methods: This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings. Results: Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status. Conclusions: Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time. Trial registration: PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. Methods: In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9–24-month-old healthy infants (N = 16). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Children's Mercy Hospital Kansas City. This study is registered with clinicaltrials.gov (NCT05868811). Results: Overall, we found some intervention effects on the relative reinforcing value of food (RRVfood) and the home environmental enrichment measures (i.e., increased music use at home and the home language environment). Our intervention demonstrated large effects on the increased use of music at home. We did not find significant group differences in the RRVfood and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated that the intervention was well-liked and that the steps we took to help reduce barriers worked. Conclusions: Music enrichment programs may be a high-impact, low-cost strategy to address socioeconomic disparities. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for Patient Care Impact Reporting Method Patient or Public Contribution To explore the experiences, expectations and needs of mothers from low socioeconomic status at 3 months postpartum.Descriptive qualitative.Mothers aged 21 years old and above, from low socioeconomic status (monthly household income is less than Singapore Dollar [SGD] $4300), and irrespective of their parity were invited to participate in one‐to‐one in‐depth interviews at 3 months postpartum from September 2022 to June 2023. A semistructured guide was used in the interviews, which were conducted until data saturation. A trained researcher conducted the interviews that were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained and voluntary participation was reinforced.Twenty mothers participated in this study and four themes were identified: (1) difficult trade‐offs; (2) help‐seeking behaviours and (3) ‘But if?’ Concerns about Emergencies.This study explored the difficult circumstances that mothers from low socioeconomic status face in their third month postpartum, and how wider societal inequalities exacerbated these circumstances. Current policies and practices need to be relooked, reframed, and reformed to address the unique needs of this community.Nurses should keep mothers' struggles in balancing employment and childcare in consideration and explore other ways of supporting the low socioeconomic status mothers such as online modes in providing patient education and peer support.Mothers from low socioeconomic status are less likely to seek formal help from healthcare professionals, external organizations and the government. These mothers need flexible, affordable and accessible childcare options to return to work. More targeted family‐oriented policies that create empowering and understanding workplaces in Singapore could help ease the stress on mothers returning to employment postpartum. Online peer support groups consisting of mothers of similar socioeconomic backgrounds could help engage and retain this hard‐to‐reach yet vulnerable population.COREQ checklist.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes (EC) and oral nicotine pouches (ONP) may facilitate the substitution of smoking for those unwilling to quit. This pilot study assesses the harm-reduction potential of EC and ONP among smokers with low socioeconomic status (SES). Aims and Methods Adults who smoked daily in the past 6 months, had a household income < 250% federal poverty level and had no intention of quitting smoking in the next 30 days were randomized 2:2:1 to 8 weeks of 5% nicotine EC; 4 mg ONP or assessment-only control (CC). The primary outcome was a within-group change in cigarettes per day (CPD) from Baseline to week 8. Results Forty-five individuals were randomized (EC: N  = 18; ONP: N  = 18; CC: N  = 9). Analyses included 33 participants who completed the week 8 visit. The mean age was 50.1 years (SD: 10.7) and the average CPD at baseline was 13.9 (SD: 10.1). For those randomized to EC, the average CPD decreased from 14.7 (95% CI: 10.3 to 19.1) at the Baseline to 2.9 (95% CI:.1 to 5.8) at week 8 (p -value < .001). For those randomized to ONP, average CPD decreased from 15.0 (95% CI: 5.0 to 24.9) to 8.3 (95% CI: 1.3 to 15.2) by week 8 (p -value = .01). In the EC and ONP groups, respectively, 4 (28.6%) and 1 (8.3%) participant fully switched from smoking to the ANDS product by week 8. Conclusions Individuals with low SES who smoke had lower CPD after switching to EC or ONP. These findings show the potential of ANDS in helping smokers switch to less harmful devices. Implications This study provides novel evidence that e-cigarettes and nicotine pouches can be a harm-reduction tool for individuals with lower SES who smoke and are not willing to quit smoking, contributing to reducing tobacco-related disparities in this population. Clinical Trials Identifier: NCT05327439 [ABSTRACT FROM AUTHOR]

Abstract Background Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status? Methods This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings. Results Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status. Conclusions Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time. Trial registration PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .

Background/Aims This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES). Methods Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis. Results Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60–0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use. Conclusions The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.

Background: Increased understanding of dementia risk-reduction and early detection of Alzheimer's disease and related disorders has spurred interest in the identification of risks for dementia, underlying putative biologies, or dementia itself. Implementation of such approaches require acceptability to the public. Research prior to 2012 indicated limited acceptability for population dementia screening. The changing landscape of dementia prevention research may influence recent perceptions. Additionally, perspectives from underserved populations, such as ethnic minorities and low socio-economic groups, are lacking. Objective: In this systematic review, we sought published studies since 2012 on attitudes and preferences of people with dementia, carers and the general public from ethnic minorities and low socio-economic groups regarding dementia screening. Methods: This review was preregistered on PROSPERO (CRD42023384115) and followed PRISMA guidelines. Key search terms were entered into five databases. Articles were included if they focused on population or risk screening for dementia via primary/community care-based assessments, and which included majority ethnic minority or low socio-economic groups or discretely considered these groups in data analysis. Data were synthesized narratively. Results: Seven studies reported perspectives of ethnic minorities regarding dementia screening; one study included people from low socio-economic groups. Results indicated that participants from ethnic minorities were willing to undergo dementia screening. Predictors of willingness included belief in benefits, desire to boost diversity, and to implement lifestyle changes. Unwillingness was associated with anxiety regarding results. Conclusions: Although there seems to be high acceptability for screening in the studied groups, more research is necessary to explore the practical considerations for screening such as cultural and economic barriers, trust, and post-screening actions. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Impact What Problem Did the Study Address? What Were the Main Findings? Where and on Whom Will the Research Have an Impact? Reporting Method Patient or Public Contribution To explore the factors influencing help‐seeking behaviours amongst mothers with low socioeconomic status at pregnancy, 1 month postpartum and 3 months postpartum.A prospective cohort study was conducted from September 2022 to August 2023. A total of 209 mothers aged 21 years and above, with low socioeconomic status and irrespective of parity, were recruited from a local hospital using convenience sampling. Self‐administered questionnaires were used to collect data at (1) third trimester of pregnancy, (2) 1 month postpartum and (3) 3 months postpartum. Multiple regression analysis was used to identify significant factors influencing help‐seeking behaviour at 3 months postpartum. Sub‐analyses were conducted between primiparous mothers and multiparous mothers. General linear model repeated measures were used to identify longitudinal trends in outcomes of help‐seeking behaviour.Help‐seeking behaviour at pregnancy and 1 month postpartum, sources of social support at 3 months postpartum, birth order of the child, attendance of antenatal classes, paternal involvement in feeding and changing diapers and mode of delivery significantly predicted mothers' help‐seeking behaviour at 3 months postpartum. Amongst primiparous mothers, help‐seeking behaviour at pregnancy at 1 month, social support at 3 months postpartum, employment in part‐time jobs and exclusively breastfeeding their infant were significant factors in influencing their help‐seeking behaviours at 3 months postpartum. For multiparous mothers, help‐seeking behaviour at pregnancy and 1 month postpartum, number of hours of antenatal class attended, Malay ethnicity, educational background, parental satisfaction at 3 months postpartum and infant bonding at both time points were significant factors influencing their help‐seeking behaviours at 3 months postpartum.Primiparous mothers with low socioeconomic status who underwent caesarean section exhibited less help‐seeking behaviours. Attendance of antenatal classes and greater paternal involvement in infant care encouraged mothers with low socioeconomic status to help‐seeking behaviours. A tailored approach is needed to support mothers with low socioeconomic status by providing additional support in improving the accessibility of antenatal classes and involving fathers in infant care. Mothers with low socioeconomic status tend to exhibit lower help‐seeking behaviours due to limited support and access to care services. First‐time mothers who underwent caesarean section, did not attend antenatal classes, and had husbands uninvolved in feeding and diaper changing were significantly less likely to seek help in the third month postpartum. One and 3 months postpartum are crucial time points when mothers with low socioeconomic status could benefit from additional support. Hospitals should explore online informational resources, forums, teleconsultations and virtual antenatal classes as possible alternative options to improve accessibility for mothers with low socioeconomic status. Mothers with low socioeconomic status and healthcare providers of mothers with low socioeconomic status will benefit from the findings of this research. This study was conducted within the Singapore context. Findings could be generalizable to other cultural contexts with similar multi‐ethnic populations. STROBE checklist.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Nutrition health professionals play important roles in developing and implementing healthy eating strategies for socioeconomically disadvantaged populations. However, the values of nutrition health professionals that inform and underly their everyday decisions and practices are not explicit. The purpose of this study was to identify and synthesize the key values of nutrition health professionals. An explorative qualitative research design was used in which a purposive sample of nutrition health professionals (n = 29) were interviewed. The 'Values Wheel of Nutrition Health Professionals (VWNHP)' was created, consisting of 16 values organized into six groups of complementary values – self-transcendence, self-enhancement, openness to change, conservation, connection, and perseverance. The VWNHP may be utilized as a tool to support the critical reflection in health promotion training and practice needed to address nutrition inequities. [ABSTRACT FROM AUTHOR]

Persistent concerns exist regarding the relationship between socioeconomic status (SES) and science achievement, prompting ongoing research into the factors enabling some low-SES students to excel in science despite the odds. This study seeks to identify multiple combinations of individual, family, and school conditions that contribute to successful outcomes within this demographic. Utilising a sample of 1,460 low-SES Chinese students, aged 15, from the 2015 Programme for International Student Assessment (PISA), this study employs fuzzy-set qualitative comparative analysis (fsQCA) as its methodological approach. The results reveal seven viable pathways that can equally enable low-SES students to achieve academic success in science. These pathways involve a combination of multiple factors, such as parental emotional support, school science instruction practices, and science-related attitudes and beliefs. The analysis also indicates that certain causal factors (i.e. parental emotional support, extrinsic motivation, enquiry-based science instruction practices, or teacher adaptation of science instruction), can be absent in the configurations, but can still contribute to academic resilience when complemented by other conditions (e.g. elevated levels of intrinsic motivation, epistemological beliefs about science, teacher-directed science instruction, or teacher support in science classes). [ABSTRACT FROM AUTHOR]

Objective: To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion. Design: We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study. Setting: Economically disadvantaged areas in rural Australia. Participants: Patients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. Main measures: A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28). Results: Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57–0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00–1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02–2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14–2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18–0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion. Conclusions: Cardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes. [ABSTRACT FROM AUTHOR]

Bu araştırmanın amacı, Etkileşimli Kitap Okuma Programı’nın etkililiğini belirlemektir. Araştırmada üç haftalık müdahale programının hem okuma oturumları sırasındaki ebeveyn davranışları hem de gün içerisindeki ebeveyn-çocuk etkileşimi üzerindeki etkisi incelenmiştir. Araştırmada karma desenlerden biri olan eşzamanlı üçgenleme kullanılmıştır. Araştırmaya Ankara ilinin düşük sosyoekonomik bölgesinde ikamet eden sekiz ebeveyn ve bu ebeveynlerin çocukları dâhil edilmiştir. Ebeveynlerin okuma oturumları sırasında sergilemiş olduğu etkileşimsel davranışlar, araştırmacı tarafından hazırlanmış olan kontrol listesi aracılığıyla ön test ve son test olarak değerlendirilmiştir. Ebeveynler ve çocukları arasında gerçekleşen gün içerisindeki etkileşim ise araştırma sonunda ebeveynlerle yapılmış olan yarı-yapılandırılmış görüşmeler aracılığıyla belirlenmeye çalışılmıştır. Nitel verilerin analizinde betimsel analiz, nicel verilerin analizinde Wilcoxon İşaretli Sıralar Testi kullanılmıştır. Bulgular, programın hem ebeveynlerin çocuklarıyla kitap okuma oturumları esnasında sergilemiş oldukları etkileşimli davranışlar hem de gün içerisinde çocuk ve ebeveyn arasında gerçekleşen etkileşimin üzerinde etkili olduğunu göstermiştir. Bulgular, alandaki diğer çalışmalar göz önünde bulundurularak tartışılmış, sınırlılıklara değinilmiş ve gelecekteki araştırmalara yönelik öneriler sunulmuştur.

Background: Anxiety and depression often exacerbate multimorbidity conditions, leading to increased disability rates among affected individuals. Objective: The study aimed to assess the mental health status of individuals with multimorbidity belonging to the marginalized population of Karachi, Pakistan. Specifically, the prevalence of anxiety and depression was investigated. Methods: A multicenter cross-sectional study was conducted between July 2022 and June 2023 in 10 primary healthcare clinics located in 4 peri-urban areas of Karachi. A total of 9331 participants were included in the study. The Patient Health Questionnaire 4 (PHQ-4), Generalized Anxiety Disorder 7 (GAD-7), and Patient Health Questionnaire 9 (PHQ-9) were used to assess symptoms of anxiety and depression. The data collected were analyzed using the statistical analysis system (SAS) version 9.4. Results: Among the study participants, 2894 (31%) were men and 5534 (59.3%) were women. The prevalence of moderate to severe anxiety was 31% among men and 59.3% among women. The age group between 41 and 60 years exhibited the highest rates of moderate to severe anxiety, 19.3% as evaluated by GAD-7 and 34.6% by PHQ-9. The Pathan ethnic group had the highest prevalence of anxiety (11%) and depression (28.3%) in the neighborhoods. Unemployed participants showed moderate to severe anxiety in 21.3% of the cases and moderate to severe depression in 25.5% of the cases. Conclusion: The study revealed a significant cooccurrence of anxiety and depression among individuals with multimorbidity in the marginalized population of Karachi, Pakistan. Furthermore, the presence of anxiety symptoms in multimorbidity patients with depression indicates a more unfavorable health state. It is essential to explore the implementation of screening measures and therapeutic interventions for comorbid anxiety and depression in this population to improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for Patient Care Impact Reporting Method Patient or Public Contribution To explore the experiences, expectations and needs of mothers from low‐socioeconomic status at 1 month postpartum.Descriptive qualitative.Mothers from low‐socioeconomic status and irrespective of their parity were invited to participate in one‐to‐one interviews at 1 month postpartum. Semi‐structured interviews were conducted until data saturation. Interviews were audio recorded, transcribed verbatim and analysed thematically. Written informed consent was obtained.Twenty mothers participated and six themes were identified: (1) No choice but to find meaning; (2) Father as a major pillar of support; (3) ‘Kampung’ Spirit; (4) Trials and Tribulations of Transition to Motherhood; (5) Shame, guilt and internalized stigma and (6) Reclaiming the power.This study reflected the unique struggles of mothers from low‐socioeconomic status with pregnancy, childbirth and early postpartum and the wider health inequities within Singapore's maternal health system. To provide much‐needed support and improved care, the stakeholders within government, healthcare providers and social organizations should consider the niche needs of this community.Nurses need to reflect on their own biases and ensure consistent care delivery regardless of socioeconomic status. When delivering patient education, patient‐centred and sincere advice rooted in personal experience can help to establish rapport.This study is the first to explore the experiences of mothers from low‐socioeconomic status in the Singapore context. Low‐socioeconomic status mothers experienced less autonomy over their health, the care they received and their childcare options. As mothers adjusted to their new roles, they struggled to cope. However, as they were wary of the stigma surrounding poverty and their guilt of not being a ‘good mother’, they preferred to seek informal support from their family, friends and self‐help through learning from social media, as compared to formal, external help.COREQ checklist.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objectives: Hearing impairment affects social networks and mental health. Hearing aids (HA) can improve these deficits. However, their effects might be affected by various factors such as economic status (ES). This study aimed to identify how ES could moderate the effects of HA on social networks, depressive mood, and cognition. Methods: A prospective cohort for new HA users was established and classified into two groups based on their ES: a low ES group (LES group) and a medium to high ES group (MHES group). Audiological examination, Lubben social network scale‐18 (LSNS‐18), Short form of Geriatric Depression Score, Mini‐Mental State Examination in the Korean version of the CERAD Assessment Packet, and surveys for satisfaction with HA were conducted before and at six months after wearing HA. Results: Post‐HA application LSNS‐18 scores were not improved in the LES group whereas they revealed significant improvement in the MHES group (p = 0.003). The LES group showed lower LSNS‐18 score (p = 0.020) and its change (p = 0.042) than the MHES group. Additionally, patients with depressive moods in the MHES group showed better improvements than those in the LES group (p = 0.048). The effects of wearing HA on cognition and satisfaction with HA were not significantly different between the two groups. Conclusions: HA did not improve social relationships and depressive moods in the LES group. Comprehensive and multidirectional support as well as hearing rehabilitation may be important for patients with LES. Level of Evidence: 3 (Nonrandomized controlled cohort/follow‐up study) Laryngoscope, 134:2387–2394, 2024 [ABSTRACT FROM AUTHOR]

Parental educational attainment significantly shapes child socioeconomic status, potentially influencing various aspects of adolescent health. This study aimed to uncover the relationships between parental education and self-reported adolescent health outcomes, including overall health, mental well-being, and body mass index (BMI). Analyzing data from 1,448 participants in the Future of Families and Child Wellbeing Study, we identified notable associations. Our findings revealed that higher maternal and paternal education correlated with reduced odds of adolescent obesity. Furthermore, increased adolescent academic intention was associated with better overall and mental health in adolescents. Notably, it also played a mediating role in lowering adolescent BMI, thereby potentially explaining the association between parent education and adolescent BMI category (overweight vs. obese). These findings emphasize the significant impact of both parent education and adolescent academic intention on adolescent health. Future research should explore interventions leveraging academic intention to positively influence the health trajectory of adolescents. [ABSTRACT FROM AUTHOR]

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Chronic kidney disease (CKD) is a worldwide health problem affecting at least 10% of the world's population. CKD represents especially a large burden in low- to middle-income countries that are ill equipped to deal with its consequences. The burden of CKD is increasing in India as well. Although diabetes and hypertension account for much of this burden of CKD, there are regions where a surprisingly high rate of CKD of undetermined etiology (CKD-U) has been described in certain areas of the country. In our observational cross-sectional study, we attempted to look at burden and etiology of CKD in a predominantly rural referral center. Out of 334 patients with diagnosed CKD, of whom 70% were male, included from Oct 2021 to July 2022, CKD-U was the single largest cause of CKD in 154 (46.1%) followed by diabetic nephropathy in 148 (44.3%). 80% of CKD patients presented initially with advanced CKD (stages 4 and 5). Approximately, 2/3rd of CKD patients reported a family income of less than 10,000 Rs/month (< 130USD). Hypertension was seen in 89% of patients in total (73% in CKD-U vs. 100% in other cause CKD). Our initial study brings to focus another new and as yet unrecognized hotspot for CKD-U in the Indian subcontinent. Given the vast diversity in the population in this region and variable delivery health care resources, we believe that concerted efforts should be made by governmental and other agencies to better understand the nature of this undiagnosed CKD epidemic so that adequate preventative strategies can be envisaged. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. Methods: In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9–24-month-old healthy infants (N = 16). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Children’s Mercy Hospital Kansas City. This study is registered with clinicaltrials.gov (NCT05868811). Results: Overall, we found some intervention effects on the relative reinforcing value of food (RRVfood) and the home environmental enrichment measures (i.e., increased music use at home and the home language environment). Our intervention demonstrated large effects on the increased use of music at home. We did not find significant group differences in the RRVfood and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated that the intervention was well-liked and that the steps we took to help reduce barriers worked. Conclusions: Music enrichment programs may be a high-impact, low-cost strategy to address socioeconomic disparities.

Numerous studies have found a negative and strong association between low socioeconomic status and academic achievement. However, the underlying mechanism in this link remains an open question. The present study tested the mediating effect of future time perspective and the moderating effect of Chinese cultural beliefs about adversity. A total of 586 Chinese adolescents (56.1% girls; Mage = 13.16 years, SD = 1.21) anonymously completed questionnaires regarding socioeconomic status, future time perspective, academic achievement, and Chinese cultural beliefs about adversity. Results showed that low socioeconomic status was negatively linked with academic achievement. Future time perspective served as a mediating variable in this relationship. Furthermore, Chinese cultural beliefs about adversity could buffer the negative effects of low socioeconomic status on future time perspective. These results underscore the potential importance of increasing adolescents' Chinese cultural beliefs about adversity and future time perspective for promoting their higher levels of academic performance. [ABSTRACT FROM AUTHOR]

All children, particularly those with special needs, have been adversely affected by the COVID-19 pandemic. This qualitative study explored the experiences of children with learning disabilities (LD) during the COVID-19 Pandemic. A criterion sample of twenty-three children ages 7 to 10 (M = 8.56, SD = 1.12) from Turkey was interviewed. Thematic analysis was used to analyse the collected data. Three themes were generated: 1) Perceived changes in Children's Daily Lives, 2) Educational Process, and 3) Support During the Pandemic. Overall, findings from the present study provided insights into children's experiences with LD during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The Quality Outcomes Framework (QOF) is a pay incentive scheme in England designed to improve and standardise general practice. QOF attainment has been used as a proxy for primary care quality in previous research. Aim: To investigate whether there is a relationship between socioeconomic deprivation and QOF attainment in primary care in England. Design & setting: Retrospective longitudinal study of primary care providers in England. Method: QOF scores were obtained for individual general practices in England from between 2007-2019 and linked to practice-level Indices of Multiple Deprivation (IMD) scores derived from census data. Beta regression analyses were used to analyse the relationship with either percentage of total QOF attainment or of domain-specific attainment with multivariate analyses, adjusting for additional practice-level demographics. QOF attainment in the most affluent quintile was used as the reference group. Results: General practices in less deprived areas have consistently outperformed those in more deprived areas in terms of QOF achievement. Initially, the gap between least and most deprived practices decreased, however since 2015 there has been relatively little change in comparative performance. The magnitude of inequality was reduced after adjusting for demographic factors. Of the independent variables analysed, the proportion of patients aged >65 years ('over 65s') had the strongest relationship with QOF attainment. Conclusion: There remains an inequality in primary care quality by socioeconomic deprivation in England, even after accounting for demographic differences. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) poses a significant health burden, particularly among individuals of low socioeconomic status (SES) in low- and middle-income countries (LMICs). This study evaluates the clinical effectiveness of cardiac rehabilitation (CR) in addressing CVD outcomes among very low-SES patients in Colombia. Data from participants enrolled in a CR program in Colombia between 2022 and 2023 were analyzed retrospectively. Measures included heart-healthy behaviors, physical/psychological outcomes, and quality of life assessed at 18, 36, and 60 sessions. Significant improvements were observed in exercise capacity, psychological well-being, and quality of life metrics throughout the CR program. However, barriers to CR attendance and the critical need for expanded program availability remain evident, particularly in LMIC settings like Colombia. In conclusion, structured CR programs demonstrate substantial benefits for very low-SES individuals in a LMIC country, highlighting the urgent need for increased program accessibility and equitable healthcare provision to optimize cardiovascular health outcomes.

Abstract Objectives With the emergence of SARS-CoV-2 a global pandemic impacted on health promotion, overlapping and hindering efforts to overcome the worldwide pandemic of lacking physical activity (PA). Nationwide lockdowns, the closure of public facilities and sports venues, made it significantly more difficult to sustain community-run PA projects. In our case study, we explore (a) under which circumstances a community-basedhealth promotion project can be maintained during crisis and (b) what resilience capacities are important for community project coordinators to deal with those aggravating circumstances. Methods Our case study looks at a community-based project called BIG, an exercise promotion project for women in difficult life circumstances. The case study was conducted between July 2021 and January 2022 with six municipalities implementing the project. Following a triangulation approach, we used minutes from short exchanges (n=17) with community project coordinators, information brochures about current exercise classes (n=6) and semi-structured qualitative interviews with project coordinators (n=6). All data were analyzed using the framework approach. Results All sites showed a high level of willingness to adapt to the pandemic situation and to maintain the project as best as possible. Findings highlight that coordinators whose work routine was characterized by intense relationship management with participants and trainers demonstrated higher levels of adaptive and absorptive capacities on an individual level than coordinators of those communities with less social cohesion. At a community level, important resources for strengthening adaptive and absorptive resilience capacities were job security of the coordinators, sufficient financial resources to adapt classes to changing circumstances, and a supportive organizational climate in the coordinators’ working environment to allow them to react flexibly according to current pandemic regulations. Conclusion Despite high resilience capacities especially on an individual level, the low-threshold nature of the project could not be maintained at a pre-pandemic level. For many women, participation in the project was no longer possible at times. Awareness should be raised in communities that PA promotion programs are crucial to strengthening physical and mental health, even in times of crisis. It seems necessary to find permanent funding options for such programs, to integrate them permanently into municipal structures.

Abstract Background When health promotion interventions are implemented, the gains are often short-lived, as interventions are seldom successfully sustained. The current study explores how and under what conditions community-level smoking cessation interventions for people with a lower socioeconomic position can be sustained, drawing upon interventions delivered in Dutch neighbourhoods with a predominantly low socioeconomic position. Methods We conducted 15 semi-structured interviews with key stakeholders from three Dutch community-level smoking cessation interventions implemented at least three years prior. The topic guide was developed based on the Determinants of Innovation framework and transcripts were analysed thematically. Results We identified several factors that promote the sustainment of smoking cessation community-level interventions: 1) structural, long-term funding through the commitment of health insurers and policy makers; 2) continued stakeholder enthusiasm and involvement; 3) training and time for professionals to discuss smoking cessation, thereby also increasing the visibility of the intervention for professionals and residents; 4) integrating the intervention with existing initiatives and adapting it to be compatible with current working practices of executive staff; and 5) planning for sustainment as a team from the outset. Conclusions The current study highlights challenges and successes in intervention sustainment for people with a lower socioeconomic position. Lack of structural funding was one of the most challenging aspects for intervention sustainment in which health insurers and policy makers can play an important role. Planning for sustainment from the outset would enable intervention coordinators to consider the abovementioned factors early on. This need not be done alone but can best be discussed within a team of stakeholders.

BackgroundRegular physical activity has positive effects on both physical and mental health. Nevertheless, socially disadvantaged women are often insufficiently physically active. Through needs-based physical activity offers, community-based participatory research (CBPR) projects have the potential to reach these women and increase the effectiveness of physical activity interventions by supporting women's empowerment, health, and health behaviors. This study aimed to examine socially disadvantaged women's views on the effects of long-term participation in Bewegung als Investition in Gesundheit (BIG, i.e., movement as an investment in health), a long-standing German CBPR project, on their health and health behavior.MethodsSemi-structured qualitative interviews were conducted with 30 participating women at five BIG sites across Germany between April and August 2022. The interviews were recorded, transcribed verbatim, and analyzed using framework analysis.ResultsWomen reported that participation in BIG classes contributed to their physical, mental, and social health. For many women, the positive effects on their mental and social wellbeing were most important. In addition to increased fitness and improved physical endurance, many participating women were able to expand their social networks, thus receiving further social support, and improve their self-esteem, self-confidence, and self-efficacy. Furthermore, participation in BIG physical activity classes positively influenced the health awareness of many women helping them to improve their activity level and diet over time.ConclusionOur results suggest that CBPR projects, such as the BIG project, can increase physical activity among socially disadvantaged groups and contribute to their overall health and wellbeing. CBPR projects could thus be considered a key element of health promotion for this target group. Future interventional research is required to confirm and further explore the effects of CBPR interventions and to examine whether the effects can be replicated in other settings.

Background: The Quality Outcomes Framework (QOF) is a pay incentive scheme in England designed to improve and standardise general practice. QOF attainment has been used as a proxy for primary care quality in previous research. Aim: To investigate whether there is a relationship between socioeconomic deprivation and QOF attainment in primary care in England. Design & setting: Retrospective longitudinal study of primary care providers in England. Method: QOF scores were obtained for individual general practices in England from between 2007–2019 and linked to practice-level Indices of Multiple Deprivation (IMD) scores derived from census data. Beta regression analyses were used to analyse the relationship with either percentage of total QOF attainment or of domain-specific attainment with multivariate analyses, adjusting for additional practice-level demographics. QOF attainment in the most affluent quintile was used as the reference group. Results: General practices in less deprived areas have consistently outperformed those in more deprived areas in terms of QOF achievement. Initially, the gap between least and most deprived practices decreased, however since 2015 there has been relatively little change in comparative performance. The magnitude of inequality was reduced after adjusting for demographic factors. Of the independent variables analysed, the proportion of patients aged >65 years (‘over 65s’) had the strongest relationship with QOF attainment. Conclusion: There remains an inequality in primary care quality by socioeconomic deprivation in England, even after accounting for demographic differences.

Introduction: Unintentional injuries among children are considered a major public health concern since they are one of the leading causes of child death and disability. Inadequate study has been done on whether and how parental influences are linked to childhood injury at home especially among the community with low-socioeconomic status. The study aims to determine the factors affecting unintentional home injury prevention practice among low socioeconomic status (B40) parents of under-five children in Selangor, Malaysia. Methods: This is a cross-sectional and quantitative study. A sample size of 453 parents will be sampled among B40 parents with under-five children in Selangor using a stratified random sampling method. For analysis, only complete questionnaires will be used. Data entry and statistical analysis will be carried out using IBM SPSS version 28.0. Chi-square/Fisher Exact test and simple logistic regression will be used for data analysis. Multiple logistic regression will be used to examine the predictors of poor home injury prevention practice. Discussion: Findings from the study will provide insight on challenges experienced by B40 parents of children under five in implementing preventive injury measures at home. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the predictors of postpartum depression and to examine the effects of maternal racial identity on postpartum depression among women with low incomes in the United States. Study Design and Methods: We conducted a secondary data analysis using baseline data from the Baby's First Years study, including postpartum women living below the federal poverty line who were recruited from four diverse communities in the United States. Postpartum depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were performed to identify associations between pre-identified postpartum depression risk factors and postpartum depression among participants, followed by predictive margins analyses to elaborate on probability of postpartum depression across different racial identity groups in the sample. Results: The sample included 1,051 postpartum women. Almost one-half of participants identified as Black (45.9%), followed by White (20.7%), American Indian (1.8%), and Asian (1.3%). Prevalence of postpartum depression in the sample was 24%. Financial insecurity and alcohol use were positively associated with postpartum depression, whereas level of education and reported physical health were negatively associated with postpartum depression. Mothers who identified as Black had an 8.3% higher probability of postpartum depression than that of White mothers in the sample. Clinical Implications: Nurses working with populations with low income should assess social determinants of health to provide holistic mental health care. Women with low incomes should be referred to resources which account for their financial burden. Racial disparities exist in perinatal care, and birth and postpartum mental health outcomes. It is crucial to address the systemic racism faced by Black mothers experiencing postpartum depression. [ABSTRACT FROM AUTHOR]

This original paper, based on data from the Erasmus+Blurred Lives Project, presents a new multi-dimensional categorisation model to describe negative online experiences, including forms of cyberbullying, based on a study of internet usage among over N = 2,500 adolescents with lower socio-economic status (SES) backgrounds across five European countries. The paper first sets out the rationale for the development of a new coding system, before describing the current study and nature of the survey data collected. There follows a description of the development of the new system and the series of reliability checks undertaken by the research team (N= 11, from 5 countries) and of the refinements made to the categories and codes. The resulting coding system is presented with consideration of the strengths and limitations, and description of two early pilot studies which have successfully adopted the new system. [ABSTRACT FROM AUTHOR]

Two hand-on workshops on social media apps were conducted for the Year-12 students from two schools, one from a regional city and the other from a remote community, in a computer laboratory on the Rockhampton campus at Central Queensland University before the COVID-19 pandemic. The school in the regional city offered a specialist Digital Technologies Curriculum (DTC) to students in Years 11 & 12 whereas the remote school did not offer a similar DTC to students in Years 11 & 12. Statistical analyses of the students' responses to two casual questions during the workshop indicated that firstly the hands-on activities improved all students' general IT knowledge, and secondly the Year-12 students from the regional city were more determined to undertake tertiary IT education than the students from the remote school. Therefore, it is recommended that a mandatory specialist DTC for students in Years 11 & 12 in ALL schools should be included in the national curriculum in the future. Implications of these findings on improving the participation rate of post-secondary education in Australian regional communities are also discussed in this article. In particular, regional universities can play a unique role in producing "IT allrounders" to meet the needs of the regional communities through collaborations with governments, secondary schools, regional industries and businesses.

Abstract Background Low socioeconomic status (SES) is associated with increased rates of overweight and obesity. Proponents of electronic health (eHealth) hypothesise that its inclusion in weight management interventions can improve efficacy by mitigating typical barriers associated with low SES. Objectives To establish the scope of eHealth weight management interventions for people with overweight and obesity from a low SES. Secondary objectives were to determine the efficacy of eHealth interventions in facilitating weight loss, physical activity and fitness improvements. Methods Four databases and grey literature were systematically searched to identify eligible studies published in English from inception to May 2021. Studies examining an eHealth intervention with low SES participants were included. Outcomes included temporal change in weight and BMI, anthropometry, physiological measures and physical activity levels. The number and heterogeneity of studies precluded any meta-analyses; thus, a narrative review was undertaken. Results Four experimental studies with low risk of bias were reviewed. There was variance in how SES was defined. Study aims and eHealth media also varied and included reducing/maintaining weight or increasing physical activity using interactive websites or voice responses, periodic communication and discourse via telephone, social media, text messaging or eNewsletters. Irrespectively, all studies reported short-term weight loss. eHealth interventions also increased short-term physical activity levels where it was assessed, but did not change anthropometry or physiological measures. None reported any effect on physical fitness. Conclusions This review revealed short-term effects of eHealth interventions on weight loss and increased physical activity levels for low SES participants. Evidence was limited to a small number of studies, with small to moderate sample sizes. Inter-study comparison is challenging because of considerable variability. Future work should prioritise how to utilise eHealth in the longer term either as a supportive public health measure or by determining its long-term efficacy in engendering volitional health behaviour changes. Systematic review registration PROSPERO CRD42021243973

Objectives: With the emergence of SARS-CoV-2 a global pandemic impacted on health promotion, overlapping and hindering efforts to overcome the worldwide pandemic of lacking physical activity (PA). Nationwide lockdowns, the closure of public facilities and sports venues, made it significantly more difficult to sustain community-run PA projects. In our case study, we explore (a) under which circumstances a community-basedhealth promotion project can be maintained during crisis and (b) what resilience capacities are important for community project coordinators to deal with those aggravating circumstances. Methods: Our case study looks at a community-based project called BIG, an exercise promotion project for women in difficult life circumstances. The case study was conducted between July 2021 and January 2022 with six municipalities implementing the project. Following a triangulation approach, we used minutes from short exchanges (n=17) with community project coordinators, information brochures about current exercise classes (n=6) and semi-structured qualitative interviews with project coordinators (n=6). All data were analyzed using the framework approach. Results: All sites showed a high level of willingness to adapt to the pandemic situation and to maintain the project as best as possible. Findings highlight that coordinators whose work routine was characterized by intense relationship management with participants and trainers demonstrated higher levels of adaptive and absorptive capacities on an individual level than coordinators of those communities with less social cohesion. At a community level, important resources for strengthening adaptive and absorptive resilience capacities were job security of the coordinators, sufficient financial resources to adapt classes to changing circumstances, and a supportive organizational climate in the coordinators' working environment to allow them to react flexibly according to current pandemic regulations. Conclusion: Despite high resilience capacities especially on an individual level, the low-threshold nature of the project could not be maintained at a pre-pandemic level. For many women, participation in the project was no longer possible at times. Awareness should be raised in communities that PA promotion programs are crucial to strengthening physical and mental health, even in times of crisis. It seems necessary to find permanent funding options for such programs, to integrate them permanently into municipal structures. [ABSTRACT FROM AUTHOR]

Background: When health promotion interventions are implemented, the gains are often short-lived, as interventions are seldom successfully sustained. The current study explores how and under what conditions community-level smoking cessation interventions for people with a lower socioeconomic position can be sustained, drawing upon interventions delivered in Dutch neighbourhoods with a predominantly low socioeconomic position. Methods: We conducted 15 semi-structured interviews with key stakeholders from three Dutch community-level smoking cessation interventions implemented at least three years prior. The topic guide was developed based on the Determinants of Innovation framework and transcripts were analysed thematically. Results: We identified several factors that promote the sustainment of smoking cessation community-level interventions: 1) structural, long-term funding through the commitment of health insurers and policy makers; 2) continued stakeholder enthusiasm and involvement; 3) training and time for professionals to discuss smoking cessation, thereby also increasing the visibility of the intervention for professionals and residents; 4) integrating the intervention with existing initiatives and adapting it to be compatible with current working practices of executive staff; and 5) planning for sustainment as a team from the outset. Conclusions: The current study highlights challenges and successes in intervention sustainment for people with a lower socioeconomic position. Lack of structural funding was one of the most challenging aspects for intervention sustainment in which health insurers and policy makers can play an important role. Planning for sustainment from the outset would enable intervention coordinators to consider the abovementioned factors early on. This need not be done alone but can best be discussed within a team of stakeholders. [ABSTRACT FROM AUTHOR]

Objectives: Measles is one of the most familiar contagious diseases in children associated with numerous systemic complications. The aim of this study is to find the frequency of Myocarditis in children suffering from measles. Materials and Methods: This cross-sectional study was conducted in the department of pediatrics, MTI Lady Reading Hospital Peshawar from 6th December 2019 to 5th June 2020. Ninety-six patients of both genders and ages ranging from 1-12 years having measles for more than one week were enrolled in the study after informed consent. Ethical approval for the study was obtained from the Ethical Review Board. Patient demographic data were collected on a structured proforma and the frequency of children having clinical presentation of myocarditis was recorded. Data were entered and analyzed using SPSS 22. Results: The frequency of Myocarditis was 7.3% in children presented with Measles. The mean age was 6.6± 3.06 years. There were 47.9% males and 52.1% females. Most patients belonged to middle socioeconomic status i.e. 61.5%. Maternal education was 49% in the 6-10 age group. In sampled population, 46.9% belonged to urban areas and 5.1% belonged to rural areas. There were 18.8% vaccinated children and 81.3% were not vaccinated for measles. Myocarditis was significantly associated with the younger age group (p-value 0.028), however, there was no difference in gender (p-value 0.781). Children with low socioeconomic status had significantly higher frequency (p-value 0.05) of myocarditis. Conclusion: Myocarditis is commonly presented in children having measles especially patients in younger age groups and belonging to poor socioeconomic status. [ABSTRACT FROM AUTHOR]

Climate change is having profound effects on natural and built environments, creating unstable living conditions for both flora and fauna. It holds implications for all humankind, however, is disparately impacting people living in Low Socioeconomic Status (SES) communities. This paper seeks to discuss what current literature finds to be the most prevalent themes of climate change related disadvantage experienced by these communities. It will then discuss the relevance of these findings in relation to the social work profession and its role to challenge policies and practices that are oppressive and fail to meet standards of environmental sustainability and human rights. Furthermore, it highlights critical social work theory and strengths-based approaches as key considerations for working alongside low SES communities. This paper was written as part of a final capstone unit of study for a Bachelor of Social Work degree. [ABSTRACT FROM AUTHOR]

There is growing recognition that young adults of low socioeconomic status are among the loneliest in the United Kingdom. However, there has been a dearth of qualitative research exploring how they cope with their loneliness. Using a novel free association technique, this study sought to explore how young adults (n = 48) in London’s most deprived areas cope with feeling lonely. A thematic analysis, informed by an inductive approach, identified six key themes. Seeking connection, avoidance, seeking support and cognitive strategies were most prevalent. Meaning-focused coping and distraction were also identified, albeit less often. Overall, there were diverse ways of coping within and across respondents and important differences were found between the genders. The findings call for the early identification of those at risk of persistent avoidance behaviours and for interventions that provide meaningful leisure activities, with mutual goals in communities, alongside the strengthening of support and authenticity in relationships.

Abstract Background Obesity rates are higher among people of lower socioeconomic status. While numerous health behaviour interventions targeting obesity exist, they are more successful at engaging higher socioeconomic status populations, leaving those in less affluent circumstances with poorer outcomes. This highlights a need for more tailored interventions. The aim of this study was to enhance an existing weight loss course for adults living in low socioeconomic communities. Methods The Behaviour Change Wheel approach was followed to design an add‐on intervention to an existing local authority‐run weight loss group, informed by mixed‐methods research and stakeholder engagement. Results The COM‐B analysis of qualitative data revealed that changes were required to psychological capability, physical and social opportunity and reflective motivation to enable dietary goal‐setting behaviours. The resulting SMART‐C booklet included 6 weeks of dietary goal setting, with weekly behavioural contract and review. Conclusion This paper details the development of the theory‐ and evidence‐informed SMART‐C intervention. This is the first report of the Behaviour Change Wheel being used to design an add‐on tool to enhance existing weight loss services. The process benefitted from a further checking stage with stakeholders.

Objective: To determine whether meaning in life (MIL) was associated with a lower risk of depression in people from low-income families during the COVID-19 pandemic. Methods: Individuals from low-income families were recruited at a community centre during the fourth wave of the COVID-19 pandemic in Hong Kong. Levels of MIL were assessed using the Meaning in Life Questionnaire (MLQ). Severity of depressive symptoms was assessed using the Patient Health Questionnaire-9 (PHQ-9). Scores of ≥24 on the Presence of Meaning subscale (MLQ-P) and Search for Meaning subscale (MLQ-S) were considered high. A score of ≥10 on the PHQ-9 was indicative of clinical depression. Correlations between MLQ and PHQ-9 scores were examined, along with associations between presence of/search for meaning and risk of clinical depression. Results: Among 102 participants, 64 (62.7%) had clinical depression; 14 (13.7%) had both high presence of meaning and high search for meaning. The MLQ score was correlated with the PHQ-9 score (r = -0.56, p < 0.001). The adjusted risk ratio for depression was 0.31 (p = 0.006) in participants with both high presence of meaning and high search for meaning. Conclusion: Among people with lower socioeconomic status, MIL may be important for protecting against depression during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

ObjectivesInsufficient sleep can increase risk for adverse psychological and physical outcomes. Parental monitoring of daily activities is associated with youth health behaviors. We examined parental monitoring of waking and bedtime behaviors and sleep in a community sample of high-risk youth.MethodsOne-hundred sixty-five 10- to 14-year-olds from low-socioeconomic status families participated (11.8 years ±1.16, 52% female; 78% Black/African American). Parents and youth evaluated parental monitoring of waking activities. Parent expectations about bedtime and parent knowledge about adolescent's bedtime and sleep routine were independently rated. Youth sleep was assessed via parent report and actigraphy over 7 days.ResultsMore parental knowledge about bedtime was associated with longer parent-reported sleep duration (β = .18, P  .05). Parental monitoring of waking and bedtime behaviors was not associated with sleep duration variability (P values > .05).ConclusionsParental monitoring of waking activities may indirectly influence adolescent sleep via increased structure and felt security in the parent-adolescent relationship. Youth perception of monitoring may be particularly relevant for youth sleep duration.

Abstract Background Overweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care–physical activity (care–PA) initiatives may improve participants’ lifestyles and thereby lower overweight and obesity rates. A two-year care–PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. Here, we study the impact of X-Fittt 2.0 on health, quality of life (QoL) and societal participation using a mixed-methods design. Methods Questionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t0) and after 12 weeks (t1), one year (t2) and two to three years (t3). We also held 17 group discussions (t1, n = 71) and 68 semi-structured interviews (t2 and t3). Continuous variables were analysed using a linear mixed-model analysis (corrected for gender, age at t0, height, education level and employment status at the different time points), while we used descriptive statistics for the categorical variables. Qualitative data were analysed using a thematic analysis. Results Body weight was significantly lower at all three post-initiative time points compared with the baseline, with a maximum of 3.8 kg difference at t2. Body Mass Index, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks. A positive trend regarding paid work was observed, while social visits decreased. The latter might be explained by the COVID-19 pandemic, as lockdowns limited social life. Furthermore, participants reported increased PA (including sports) and a few stopped smoking or drinking alcohol. Participants mentioned feeling healthier, fitter and more energetic. Additionally, participants’ self-esteem and stress levels improved, stimulating them to become more socially active. However, the participants also mentioned barriers to being physically active, such as a lack of money or time, or physical or mental health problems. Conclusions X-Fittt 2.0 improved the health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. More complete data are needed to confirm the findings.

Background: Mental health concerns of university students are gaining more attention since the emergence of the coronavirus disease. Consequently, scholars in education, health and psychology‐related fields have attributed the dwindling subjective well‐being (SWB) of students to their low levels of digital health literacy (DHL). However, little attention has been paid to an important variable like pocket money (PM) which might serve as a buffer against reduced levels of SWB. In this study, we explored the dynamics of PM and its linkage with DHL and SWB among university students in Ghana. Methods: With a cross‐sectional design, a convenient sample of 1160 students was obtained from the University of Education, Winneba, Ghana. The COVID‐DHL and WHO‐5 Well‐being instruments were used for the data collection for a 2 months period (February–March, 2021). Chi‐square test, multivariate regression, simple linear regression, and PROCESS mediation analyses were performed with the use of SPSS software version 25. Results: The study found that while most of the students were financially supported by their parents (n = 715, 61.6%), a larger proportion of them reported that their PM was either less sufficient or not sufficient (n = 550; 76.9%). Findings revealed a positive relationship between PM and SWB (B = −36.419, p < 0.001; B = −13.146, p = 0.012; B = −10.930, p = 0.043), with this relationship mediated by DHL (B = −1.139, confidence interval [CI] [−2.073, −0.263] vs. −2.300, CI [−4.290, −0.532] vs. −8.366, CI [−14.863, −1.908]). Conclusions: Students with little to insufficient PM were vulnerable to mental health problems, although this could be buffered by the high DHL levels. In practical terms, not only should the PM of university students be increased, but the sources of PM should be complemented since the sufficiency level of PM was associated with the source of finance. More importantly, parents should be empowered through job creation so that sufficient levels of PM can be provided to university students. [ABSTRACT FROM AUTHOR]

Africa faces significant challenges in terms of material and personnel resources for oncology interventions. This is particularly evident in South Africa, where resources are divided into high- and low-resource settings. High-resource settings cater to those with financial means to access private oncology facilities. However, many breast cancer patients receive care in South Africa’s low-resource settings, such as public hospital oncology clinics. Unfortunately, these settings have limited service providers and fail to offer comprehensive interventions, resulting in poor outcomes. However, recent research has highlighted the significance of socially supportive relationships in promoting healing and overall individual well-being, and spirituality has been identified as a source of positive outcomes in cancer patients. This systematic review paper explores the feasibility of implementing support group cancer care and interventions that incorporate social support networks available in community settings, and spiritual practices facilitated by traditional healers, and religious/spiritual leaders. These interventions can be provided within low-resource settings to women diagnosed with breast cancer. Inclusive participation of spouses, children, and extended family in the support group cancer care can facilitate healing for the entire system. Focusing on the strengths and resources within communities and incorporating these complementary services, can enhance the well-being and quality of life for Black African women diagnosed with breast cancer, despite low-resource settings. This approach acknowledges the potential of community-based support networks and encourages collaboration between various stakeholders, including community health educators, nurses, lay counselors, and community volunteers, to address the complex needs of these patients. [ABSTRACT FROM AUTHOR]

There is growing recognition that young adults of low socioeconomic status are among the loneliest in the United Kingdom. However, there has been a dearth of qualitative research exploring how they cope with their loneliness. Using a novel free association technique, this study sought to explore how young adults (n = 48) in London's most deprived areas cope with feeling lonely. A thematic analysis, informed by an inductive approach, identified six key themes. Seeking connection, avoidance, seeking support and cognitive strategies were most prevalent. Meaning-focused coping and distraction were also identified, albeit less often. Overall, there were diverse ways of coping within and across respondents and important differences were found between the genders. The findings call for the early identification of those at risk of persistent avoidance behaviours and for interventions that provide meaningful leisure activities, with mutual goals in communities, alongside the strengthening of support and authenticity in relationships. [ABSTRACT FROM AUTHOR]