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Wilcox HC, Pas E, Murray S, Kahn G, DeVinney A, Bhakta S, Rosenbaum L, Hart LM. Effectiveness of teen Mental Health First Aid in Improving Teen-to-Teen Support Among American Adolescents. J Sch Health 2023; 93:990-999. [PMID: 37424234 DOI: 10.1111/josh.13364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/17/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND teen Mental Health First Aid (tMHFA) is an Australian school-based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns. METHODS Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation. RESULTS There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises. CONCLUSION tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents.
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Affiliation(s)
- Holly C Wilcox
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Baltimore, Maryland, 21205
| | - Elise Pas
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Baltimore, Maryland, 21205
| | - Sarah Murray
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Baltimore, Maryland, 21205
| | | | - Aubrey DeVinney
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Baltimore, Maryland, 21205
| | - Sanjana Bhakta
- National Council for Mental Wellbeing, Washington, DC, 20005
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Lu S, Hart LM, Jorm AF, Gregg K, Gross M, Mackinnon AJ, Morgan AJ. Adolescent peer support for mental health problems: evaluation of the validity and reliability of the Mental Health Support Scale for Adolescents. BMC Psychol 2023; 11:193. [PMID: 37391834 DOI: 10.1186/s40359-023-01228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The Mental Health Support Scale for Adolescents (MHSSA) is a criterion-referenced measure of adolescents' supportive intentions towards peers with mental health problems, which was developed for use in evaluations of adolescent mental health interventions, such as the teen Mental Health First Aid (tMHFA) program. The present study aimed to examine the validity and reliability of the MHSSA. METHODS A sample of 3092 school students (Mean ± SD: 15.9 ± 0.4 years old) and 65 tMHFA Instructors (the adult group with known expertise in tMHFA) completed the 12 items of the MHSSA. A sub-sample of 1201 students repeated the scale after a 3-4-week interval. Item concordance rates with the tMHFA Action Plan across helpful and harmful intentions scales were calculated. Scale reliabilities were assessed using agreement coefficients from a single test administration and test-retest reliability measured by intraclass correlation coefficients. The mean differences of MHSSA scores of students and Instructors were compared using independent samples t-tests, while convergent validity was tested via correlations of the scale with validated measures of confidence in providing help, social distance and personal stigma. RESULTS The average score of Instructors was significantly higher than that of students. The scale was positively associated with confidence in providing help, whilst negatively associated with social distance and dimensions of personal stigma. All scales of MHSSA had high agreement coefficients (all > 0.80) and fair to good test-retest reliability over 3-4 weeks. CONCLUSIONS The MHSSA shows evidence of validity and reliability for use among adolescents for evaluating the quality of intentions to help peers with mental health problems.
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Affiliation(s)
- Shurong Lu
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Karen Gregg
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Maxine Gross
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Andrew J Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
- Black Dog Institute, University of New South Wales, Sydney, NSW, 2031, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
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3
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Johnson CL, Gross MA, Jorm AF, Hart LM. Mental Health Literacy for Supporting Children: A Systematic Review of Teacher and Parent/Carer Knowledge and Recognition of Mental Health Problems in Childhood. Clin Child Fam Psychol Rev 2023; 26:569-591. [PMID: 36763174 PMCID: PMC10123050 DOI: 10.1007/s10567-023-00426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/11/2023]
Abstract
The level of mental health literacy (MHL) in adults who work with or care for children is likely to influence the timeliness and adequacy of support that children receive for mental health problems. The aim of this study was to systematically review the literature on mental health literacy for supporting children (MHLSC, recognition/knowledge) among parents and teachers of school aged children (5 to 12 years old). A systematic search was conducted for quantitative studies published between 2000 and June 2021 using three databases (MEDLINE, PsycINFO and ERIC) and relevant citations reviewed in Scopus. To be included, studies needed to measure at least either 'mental health knowledge' or 'recognition'. Synthesis proceeded according to study design, adult population, child MHP, then MHL outcome. Study quality was assessed using AXIS. 3322 documents were screened, 39 studies met inclusion criteria. 49% of studies examined teachers' knowledge or recognition of ADHD; only five studies reported on parent samples. Synthesis found a nascent field that was disparate in definitions, methods and measures. Little research focussed on knowledge and recognition for internalizing problems, or on parents. Methods used for measuring knowledge/recognition (vignette vs screening) were associated with different outcomes and the quality of studies was most often low to moderate. Adults appear to have good recognition of childhood ADHD but their knowledge of internalizing disorders is less clear. Further research is required to develop standard definitions and validated measures so gaps in MHLSC can be better identified across populations who have a role in supporting children with their mental health.
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Affiliation(s)
- Catherine L Johnson
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Carlton, VIC, 3010, Australia.
| | - Maxine A Gross
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Carlton, VIC, 3010, Australia
- Telethon Kids Institute, Adelaide, SA, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Carlton, VIC, 3010, Australia
| | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie Street, Carlton, VIC, 3010, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
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4
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Hart LM, Jorm AF, Johnson CL, Tully LA, Austen E, Gregg K, Morgan AJ. Mental health literacy for supporting children: the need for a new field of research and intervention. World Psychiatry 2023; 22:338-339. [PMID: 37159366 PMCID: PMC10168171 DOI: 10.1002/wps.21099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 05/11/2023] Open
Affiliation(s)
- Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine L Johnson
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Lucy A Tully
- School of Psychology, University of Sydney, Camperdown, NSW, Australia
| | - Emma Austen
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Karen Gregg
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Rosenbaum LL, Bhakta S, Wilcox HC, Pas ET, Girgis K, DeVinney A, Hart LM, Murray SM. Cultural Adaptation of the teen Mental Health First Aid (tMHFA) Program from Australia to the USA. School Ment Health 2023; 15:1-19. [PMID: 37359156 PMCID: PMC10107592 DOI: 10.1007/s12310-023-09576-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 06/28/2023]
Abstract
teen Mental Health First Aid (tMHFA) is an evidence-based program developed in Australia that teaches young people in grades 10-12 how to identify and respond to signs of mental health challenges and crises among peers. Recognizing the growing adolescent mental health crisis in the USA, the National Council for Mental Wellbeing, in partnership with a Johns Hopkins University research team, used a multimethod research approach to adapt the program culturally and contextually from Australia to the USA. The goals of the study were to engage adolescents, MHFA instructors, and content area experts (N = 171) in a process to determine: how to retain the elements of the course that were evidence-based and effective while adapting the program for US students, what topics to add so US students have the essential information and skills teens needed to help a friend experiencing a mental health challenge or crisis, what changes to make to curriculum materials to ensure the style and delivery resonate with US students, and what tools to include so the program is implemented safely and with fidelity in diverse US schools. This paper outlines the adaptation process, including engaging participants, identifying key recommendations for modification, and making changes to the tMHFA program. The findings demonstrate the types of adaptations that may be needed to facilitate implementation and maintenance of program effectiveness when introducing tMHFA to new populations of students in the USA. In addition, the process outlined can be replicated toward this purpose as the program continues to expand both in the USA and in other countries.
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Affiliation(s)
- Lacey L. Rosenbaum
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
- Mental Health and Resilience Group, Cheverly, MD USA
- International Psychology Department, The Chicago School of Professional Psychology, Washington, DC USA
| | - Sanjana Bhakta
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
| | - Holly C. Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Elise T. Pas
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Karen Girgis
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
| | - Aubrey DeVinney
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Laura M. Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, Melbourne, Australia
- School of Psychology and Public Health, Le Trobe University, Melbourne, Australia
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Hart LM, Mitchison D, Fuller-Tyszkiewicz M, Giles S, Fardouly J, Jarman HK, Damiano SR, McLean SA, Prichard I, Yager Z, Krug I. "Can you see me?" Videoconferencing and eating disorder risk during COVID-19: Anxiety, impairment, and mediators. Int J Eat Disord 2023; 56:235-246. [PMID: 36331070 PMCID: PMC10100378 DOI: 10.1002/eat.23844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The use of videoconferencing has increased during the pandemic, creating prolonged exposure to self-image. This research aimed to investigate whether eating disorder (ED) risk was associated with videoconferencing performance for work or study and to explore whether the use of safety behaviors and self-focused attention mediated the relationship between ED risk and perceived control over performance anxiety, impaired engagement, or avoidance of videoconferencing for work or study. METHOD In 2020, an online survey was distributed within Australia to those aged over 18 years via academic and social networks, measuring: use of videoconferencing for work/study, demographics, ED risk, safety behaviors for appearance concerns, self-focused attention, perceived control over performance anxiety, perceived engagement impairment, and avoidance of videoconferencing. A total of 640 participants (77.3% female, Mage = 26.2 years) returned complete data and were included in analyses. RESULTS 245 participants (38.7%) were considered at-risk for EDs (SCOFF > 2). Those at-risk reported significantly more safety behaviors, self-focused attention, impaired engagement, and avoidance, plus lower perceived control over performance anxiety than those not at-risk. Multiple mediation models found the effects of ED risk on control over performance anxiety, impaired engagement, and avoidance were partially mediated by safety behaviors and self-focused attention. DISCUSSION Our cross-sectional findings suggest videoconferencing for work/study-related purposes is associated with performance anxiety, impaired engagement, and avoidance among individuals at-risk for EDs. Poorer videoconferencing outcomes appear more strongly related to social anxiety variables than ED status. Clinicians and educators may need to provide extra support for those using videoconferencing. PUBLIC SIGNIFICANCE Because videoconferencing often involves seeing your own image (via self-view) we wondered whether the appearance concerns experienced by those with eating disorders (EDs) might interfere with the ability to focus on or to contribute to work/study videoconferencing meetings. We found that although those with EDs experience more impairments in their videoconferencing engagement/contribution, these were linked just as strongly to social anxiety as they were to appearance concerns.
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Affiliation(s)
- Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia.,EMBodiED Research, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia.,The Body Confident Collective, Coffs Habour, New South Wales, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | | | - Sarah Giles
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | | | - Hannah K Jarman
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Stephanie R Damiano
- EMBodiED Research, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Siân A McLean
- EMBodiED Research, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Ivanka Prichard
- The Body Confident Collective, Coffs Habour, New South Wales, Australia.,College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Zali Yager
- The Body Confident Collective, Coffs Habour, New South Wales, Australia.,Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
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7
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Subasinghe A, Hart LM, Radeka A, Paxton SJ, Morgan A. Young people's help-giving actions towards a peer with a mental health problem: A systematic review and narrative synthesis. Early Interv Psychiatry 2022; 17:337-353. [PMID: 36222277 DOI: 10.1111/eip.13354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Abstract
AIMS Young people often seek help from their peers for mental health problems. However, little is known about young people's experiences of helping a peer with a mental health problem. The aim of this study was to systematically review the literature on young people's help-giving actions, highlight any gaps in the research and examine the evidence for interventions designed to increase and improve help-giving. The secondary aim was to compare findings between help-giving in face-to-face and online settings. METHODS Embase, SCOPUS, PsycINFO and MEDLINE electronic databases were searched for English studies published from 2003 onwards. Studies focusing on the help-giving actions of young people (aged 12-25 years) towards a peer with a mental health problem were included. Risk of bias was assessed using the Joanna Briggs Institute quality appraisal tools. Data were synthesized using thematic and narrative analysis. RESULTS Twenty-one studies (3440 participants) were included. The most frequently reported help-giving themes were encouraging professional and adult support and providing emotional support. Although limited studies reported on online help-giving, online settings allowed for immediate help to be provided despite time or location. Both positive and negative outcomes for helping were identified. Improvements in the quality of help-giving were found after training; however, help-giving for mental health crises was poor. CONCLUSIONS Further research regarding the young people's help-giving actions to peers online is required. Training programs need to consider how to further improve the quality of help-giving among young people and to increase the trainees' confidence in helping, particularly in a mental health crisis.
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Affiliation(s)
- Aruni Subasinghe
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Victoria, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Angelika Radeka
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Amy Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Hay P, Hart LM, Wade TD. Beyond screening in primary practice settings: Time to stop fiddling while Rome is burning. Int J Eat Disord 2022; 55:1194-1201. [PMID: 35633193 DOI: 10.1002/eat.23735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This forum presents the current state of research in the screening and identification of people with eating disorders in community and primary care, taking a longer-term perspective that highlights the slow rate of progression in development of instruments, and impact on polices and practice. METHOD An historical overview is presented, followed by a critique of contemporary instruments and practice, and barriers to case detection and appropriate referral pathways. RESULTS There are now many instruments but all lack high levels of positive predictive power. However, some do have high sensitivity. Barriers contributing to poor detection and the treatment gap include need for improved education and support for primary care professionals and lack of confidence of individuals with eating disorders to initiate a discussion with health professionals. The best screening instrument would not overcome either of these barriers. DISCUSSION We purport there is an urgent need to improve current screening instruments (not to develop more), particularly those with high sensitivity. These should be being employed alongside programs to both improve primary care professionals' skills in assessment and management of people with eating disorders, and to empower consumers to navigate care pathways. PUBLIC SIGNIFICANCE STATEMENT We argue that further screening instruments for eating disorders are not needed. Rather, it is more urgent to have a greater research focus on how to encourage primary care workers to ask about eating and body image and how to best translate that to more individuals with eating disorders being offered treatment. This work needs to be linked with tools that empower consumers to navigate care pathways.
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Affiliation(s)
- Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.,Camden and Campbelltown Hospitals, SWSLHD, Sydney, New South Wales, Australia
| | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population Health, University of Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne Victoria, Australia
| | - Tracey D Wade
- Blackbird Initiative, Órama Institute, Flinders University, Australia
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Katz-Wise SL, Gordon AR, Sharp KJ, Johnson NP, Hart LM. Developing Parenting Guidelines to Support Transgender and Gender Diverse Children's Well-being. Pediatrics 2022; 150:189276. [PMID: 36045300 DOI: 10.1542/peds.2021-055347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. METHODS We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. RESULTS Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. CONCLUSIONS These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.
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Affiliation(s)
- Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.,Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.,Contributed equally as cofirst authors
| | - Kendall J Sharp
- Department of Psychology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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11
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Hart LM, Morgan AJ, Rossetto A, Kelly CM, Gregg K, Gross M, Johnson C, Jorm AF. teen Mental Health First Aid: 12-month outcomes from a cluster crossover randomized controlled trial evaluation of a universal program to help adolescents better support peers with a mental health problem. BMC Public Health 2022; 22:1159. [PMID: 35681130 PMCID: PMC9185965 DOI: 10.1186/s12889-022-13554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background teen Mental Health First Aid (tMHFA) is a universal mental health literacy, stigma reduction, help-seeking, and suicide prevention program designed for adolescents in Years 10–12 of secondary school (16–18 years). tMHFA is delivered by trained instructors, in a regular classroom setting, to increase the knowledge, attitudes and behaviours that adolescents’ require to better support peers with mental health problems or mental health crises. Methods To explore the efficacy of tMHFA, a cluster crossover randomised controlled trial was conducted with Year 10 students in four schools in Victoria, Australia, using physical first aid training as the control intervention. Of the 1942 eligible students, 1,624 completed baseline and 894 completed follow-up surveys. Online surveys, administered one week before training and again 12-months later, included vignettes depicting peers John (depression and suicide risk) and Jeanie (social anxiety/phobia), measures of mental health first aid (quality of first aid intentions, confidence, first aid behaviours provided, and first aid behaviours received), mental health literacy (beliefs about adult help, help-seeking intentions), and stigma (social distance, weak-not-sick, dangerous/unpredictable, and would not tell anyone). Results The primary outcome—quality of first aid intentions towards the John vignette—showed statistically significant group x time interactions, with tMHFA students reporting more helpful and less unhelpful first aid intentions, than PFA students did over time. Confidence in providing first aid also showed significant interactions. First aid behaviours—both those provided to a peer with a mental health problem and those received from a peer—showed null results. Ratings of both beliefs about adult help and help-seeking intentions were found to be significantly improved among tMHFA students at follow-up. A group x time interaction was found on one stigma scale (would not tell anyone). Conclusions This trial showed that, one year after training, tMHFA improves first aid intentions towards peers with depression and suicide risk, confidence in helping peers with mental health problems, willingness to tell someone and seek help from an adult or health professional if experiencing a mental health problem. Trial registration This research was registered with Australia New Zealand Clinical Trials Registry: ACTRN12614000061639. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13554-6.
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Affiliation(s)
- Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia. .,School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Alyssia Rossetto
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia.,Mental Health First Aid Australia, Melbourne, Australia
| | | | - Karen Gregg
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Maxine Gross
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Catherine Johnson
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
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12
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Norton L, Parkinson J, Harris N, Hart LM. What Factors Predict the Use of Coercive Food Parenting Practices among Mothers of Young Children? An Examination of Food Literacy, Disordered Eating and Parent Demographics. Int J Environ Res Public Health 2021; 18:ijerph181910538. [PMID: 34639838 PMCID: PMC8508140 DOI: 10.3390/ijerph181910538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 12/04/2022]
Abstract
Parents have the most significant influence on the development of young children’s eating patterns. Understanding what parental factors best predict specific negative feeding practices is important for designing preventive interventions. We examined the relationship between parents’ use of coercive food parenting practices (pressure to eat and restriction) and parents’ disordered eating, food literacy, Body Mass Index (BMI) and socio-economic status (SES). Adult mothers, with a mean age of 33 years, at least one child aged between 6 months and 5 years and living in Australia (n = 819) completed an online questionnaire. Regression models were used to examine predictors of pressure to eat and restriction, respectively. Although the amount of variance accounted for by the models was small, maternal eating disorder symptoms were found to be the most important predictor of coercive food parenting practices. This finding has implications for early nutrition education, which has traditionally focused heavily on nutrition literacy. Parental disordered eating may be a more important preventive target and thus including behavioral strategies for positive feeding practices may better assist mothers in promoting positive eating habits with their children, rather than traditional approaches that aim to increase nutrition literacy.
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Affiliation(s)
- Lyza Norton
- Department of Social Marketing, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
- Correspondence:
| | - Joy Parkinson
- Department of Social Marketing, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
| | - Neil Harris
- Department of Public Health, Griffith University, 1 Parklands Drive, Southport, QLD 4215, Australia;
| | - Laura M. Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010, Australia;
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13
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Raspovic AM, Hart LM, Zali Y, Prichard I. Body image profiles and exercise behaviours in early motherhood. A latent profile analysis. J Health Psychol 2021; 27:2056-2067. [PMID: 34030494 DOI: 10.1177/13591053211019114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Early motherhood may impact body image, and its relationship to exercise, potentially affecting mother and infant wellbeing. This study examined whether duration of weekly exercise differed according to body image profile (BIP) based on relative levels of body dissatisfaction and body appreciation. Survey data from 262 women, 0-5 years postpartum, were analysed. Latent profile analysis identified "average", "dissatisfied" and "appreciative" BIPs. Significantly lower exercise was found in the dissatisfied compared to the appreciative BIP (p = 0.005), with marginally lower exercise in the dissatisfied compared to the average BIP (p = 0.029 with adjusted α = 0.02). This research has implications for designing targeted interventions supporting postpartum wellbeing.
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Affiliation(s)
| | - Laura M Hart
- La Trobe University, Australia.,University of Melbourne, Australia
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14
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Norton L, Hart LM, Butel F, Moloney S, O'Connor N, Attenborough V, Roberts S. Promoting Confident Body, Confident Child in community child health: A mixed-methods implementation study. Health Promot J Austr 2021; 33:297-305. [PMID: 33772911 DOI: 10.1002/hpja.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/23/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To evaluate population-level implementation of Confident Body, Confident Child (CBCC); an evidence-based program providing parenting strategies to promote healthy eating, physical activity and body satisfaction in children aged 2-6 years; with community child health nurses (CHNs). METHODS This study utilised an implementation-effectiveness hybrid design, with dual focus on assessing: (a) CBCC implementation into Child Health Centres at a regional health service in Queensland, Australia (process evaluation); and (b) CBCC's effect on CHNs' knowledge and attitudes (outcomes evaluation). Process (CBCC reach, dose, fidelity) and outcome data (CHN knowledge of child body image; and attitudes towards higher body weights) were collected during implementation, and pre- and post-intervention delivery to CHNs, respectively. RESULTS Twenty-six CHNs (all female; mean age 52.7 ± 9.5 years) participated in the study by attending a 1-day CBCC training workshop and completing demographic and outcome surveys. Process evaluation found that CBCC was implemented as planned and reached 56% of CHNs across the health service. Outcome evaluation showed small but non-significant improvements in CHN knowledge (P = .077) and attitudes towards overweight (using Anti-Fat Attitudes scale; significant improvements on willpower sub-scale only (P < .05)). DISCUSSION This is the first study to evaluate population-wide CBCC implementation in a real-world health service setting with CHNs. Findings highlight the potential for using pragmatic, implementation-focused methodologies to translate preventive eating disorder programs into community child health services.
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Affiliation(s)
- Lyza Norton
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Francoise Butel
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Susan Moloney
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Narelle O'Connor
- Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | | | - Shelley Roberts
- Gold Coast Hospital and Health Service, Southport, QLD, Australia.,School of Allied Health Sciences, Griffith University, Griffith University, Southport, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
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15
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Johnson CL, Hart LM, Rossetto A, Morgan AJ, Jorm AF. Lessons learnt from the field: a qualitative evaluation of adolescent experiences of a universal mental health education program. Health Educ Res 2021; 36:126-139. [PMID: 33367691 DOI: 10.1093/her/cyaa050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
teen Mental Health First Aid (teenMHFA) is a school-based mental health program that trains adolescents to support peers who are experiencing mental health problems or crises. The program has been evaluated for adolescents aged 15-18 years as part of a randomized controlled trial, however qualitative feedback from students on their perceptions of the program is yet to be explored. The current study describes the perspectives of students who took part in the trial. Feedback on the perceived strengths and weaknesses of the program was provided by 979 Year 10 students (M = 15.82 years, female = 43.94%, English as a first language = 72.77%) at four government funded public schools in Melbourne, Australia via online surveys. A content and thematic analysis was performed on the data using a six-step process. Students generally found the program relevant and they connected with the visual material, personal stories and interactive activities. Suggestions for improvements included encouraging active student participation in classroom discussion and providing opportunities to practice skills. School-based mental health education can benefit from input from stakeholder perspectives, particularly when designing mental health content for delivery by external trainers.
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Affiliation(s)
- C L Johnson
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053, Australia
| | - L M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053, Australia
- School of Psychology and Public Health, College of Science, Health and Engineering, Level 4, George Singer Building, Melbourne Campus, Kingsbury Drive, Bundoora, Victoria 3086, Australia
| | - A Rossetto
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053, Australia
| | - A J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053, Australia
| | - A F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Melbourne, Victoria 3053, Australia
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16
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Hart LM, Ferreira KB, Ambwani S, Gibson EB, Austin SB. Developing expert consensus on how to address weight stigma in public health research and practice: A Delphi study. Stigma and Health 2021. [DOI: 10.1037/sah0000273] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Raspovic AM, Prichard I, Yager Z, Hart LM. Mothers' experiences of the relationship between body image and exercise, 0-5 years postpartum: A qualitative study. Body Image 2020; 35:41-52. [PMID: 32892146 DOI: 10.1016/j.bodyim.2020.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 01/29/2023]
Abstract
The relationship between body image and exercise in early motherhood is an important yet understudied determinant of mother and infant wellbeing. To address this, we report on a qualitative study of early mothers' lived experiences of the relationship between body image and exercise in the first five years post-birth. Twenty-one mothers (0-5 years postpartum) completed individual, semi-structured online/phone interviews (M interview time =47.25 min), to elicit narratives about peripartum body image and its relationship with exercise. Thematic analysis was conducted according to the Braun and Clarke framework. Three key themes, and several subthemes, were identified: 1.body image in early motherhood is diverse, dynamic and individual, 2.postpartum exercise forms part of early motherhood adjustment, and 3.body image and exercise form an important, intricate relationship in early motherhood. Women's narratives indicated three body image/exercise patterns, each characterised by different behaviours and motivations. Mothers who reported exercising, or avoiding exercising, for reasons related to body dissatisfaction appeared at greatest risk of negative outcomes from body-related distress and maladaptive exercise patterns. Conversely, mothers reporting higher body appreciation described more adaptive exercise behaviours. This research provides important information for the development of interventions to support positive body image and healthful exercise in early motherhood.
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Affiliation(s)
- Anita M Raspovic
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia.
| | - Ivanka Prichard
- Health and Exercise Science, College of Nursing and Health Sciences, Flinders University, Adelaide, 5001, Australia; SHAPE Research Centre, Flinders University, Adelaide, 5001, Australia; Caring Futures Institute, Flinders University, Adelaide, 5001, Australia.
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne, 3011, Australia.
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, 3010, Australia.
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18
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Norton LN, Hart LM, Butel FE, Roberts S. Child health nurse perceptions of using confident body, confident child in community health: a qualitative descriptive study. BMC Nurs 2020; 19:103. [PMID: 33292185 PMCID: PMC7646073 DOI: 10.1186/s12912-020-00499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 10/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background Confident Body, Confident Child (CBCC) is an innovative, evidence-based program providing parenting strategies to promote healthy eating, physical activity and body satisfaction in children aged 2–6 years. This study aimed to explore Child Health Nurse (CHN) experiences with using CBCC in their community health clinics with parents of young children. This work is part of a larger study involving tailoring, implementing and evaluating CBCC in a community child health setting. Methods This qualitative descriptive study was conducted within community child health centres at a public health service in Queensland, Australia. Participants included CHNs who had recently attended a tailored CBCC training workshop providing training/education, group activities/discussions and CBCC resources for CHN use in clinical practice. Semi-structured interviews were conducted to explore CHN perceptions of CBCC training, content and resources; and how CBCC was used in practice. Interviews were recorded and transcribed verbatim and analysed thematically. Results Eleven CHNs participated in interviews, with three themes emerging from the data. In Theme 1, High CHN satisfaction with CBCC messages, resources and utility, nurses expressed CBCC was highly valuable, useful and easy to enact in their practice. In Theme 2, Effects of CBCC on CHN knowledge, behaviour and practice, CHNs said they experienced increased awareness around body image, improved confidence in addressing issues with clients, and positive changes in their own behaviour and practice after attending CBCC training. In Theme 3, CHNs discussed Ideas for future implementation of CBCC, including challenges and considerations for practice, ongoing education/training for CHNs and broadening the target audience for wider CBCC dissemination. Conclusions This study found CHNs were highly accepting of CBCC as it was useful and valuable in practice, increased their awareness and confidence around body image issues, and positively affected their attitudes and behaviours. CHNs’ suggestions for making CBCC delivery more efficient and broadening its reach in the community were valuable and will likely inform local policy and future research. Further research is required on the wider dissemination of CBCC to parents of young children for promoting positive body image and healthy eating, ultimately for the long-term prevention of eating disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-020-00499-7.
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Affiliation(s)
- Lyza N Norton
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Bundoora Campus, Bundoora, VIC, 3086, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Francoise E Butel
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Shelley Roberts
- Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.,School of Allied Health Sciences, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia
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19
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Morgan AJ, Fischer JAA, Hart LM, Kelly CM, Kitchener BA, Reavley NJ, Yap MBH, Jorm AF. Long-term effects of Youth Mental Health First Aid training: randomized controlled trial with 3-year follow-up. BMC Psychiatry 2020; 20:487. [PMID: 33023513 PMCID: PMC7542136 DOI: 10.1186/s12888-020-02860-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/08/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Mental Health First Aid (MHFA) training teaches community members how to provide initial support to someone with a mental health problem. Key gaps in the evidence base supporting the training are the longevity of effects beyond 6 months, effects on mental health first aid behavior, and the impact of support on the recipient of aid. This study aimed to evaluate the effect of the Youth MHFA course 3 years after training. METHODS 384 Australian parents of an adolescent aged 12-15 were randomized to receive either the 14-h Youth MHFA course or the 15-h Australian Red Cross Provide First Aid course. This paper reports outcomes at baseline and 3 years later. Primary outcomes were cases of adolescent mental health problems, and parental support towards their adolescent if they developed a mental health problem, rated by the parent and adolescent. Secondary outcomes included parent knowledge about youth mental health problems, intentions and confidence in supporting a young person, stigmatizing attitudes, and help-seeking for mental health problems. Data were analyzed with mixed-effects models with group by measurement occasion interactions. RESULTS 3-year follow-up data was obtained from 149 parents and 118 adolescents, who were aged 16.5 years on average. Between baseline and 3-year follow-up, there was a non-significant reduction in adolescent cases of mental health problems relative to the control group (odds ratios (OR) 0.16-0.17), a non-significant improvement in parental support reported by adolescents with a mental health problem (OR 2.80-4.31), and a non-significant improvement in the quality of support that parents reported providing to their adolescents with a mental health problem (d = 0.38). Secondary outcomes that showed significant improvements relative to the control group were parental knowledge about youth mental health problems (d = 0.31) and adolescent perceptions of general social support from their parents (d = 0.35). CONCLUSIONS This paper reports on the longest follow-up of Mental Health First Aid training in a controlled trial. Three years after training, participants had maintained their improved knowledge about mental health problems. There were some indications of other positive effects, but the study was underpowered to clearly show benefits to mental health first aid skills and recipients of aid. TRIAL REGISTRATION ACTRN 12612000390886 , registered retrospectively 5/4/2012, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=347502.
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Affiliation(s)
- Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia.
| | - Julie-Anne A Fischer
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | - Betty A Kitchener
- Mental Health First Aid Australia, Parkville, Australia
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
| | - Marie B H Yap
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia
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20
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Rossetto A, Morgan AJ, Hart LM, Kelly CM, Jorm AF. Frequency and quality of first aid offered by older adolescents: a cluster randomised crossover trial of school-based first aid courses. PeerJ 2020; 8:e9782. [PMID: 32874786 PMCID: PMC7439956 DOI: 10.7717/peerj.9782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022] Open
Abstract
Background Research indicates that school-based first aid programmes appear to improve students’ knowledge and skills. However, evidence for their effectiveness is limited by a lack of rigorously designed studies. This research used a cluster randomised crossover trial to assess the effects of two different types of first aid training on the frequency and appropriateness of older adolescents’ first aid behaviours towards their peers 12 months after training. Methods Schools eligible to participate were government funded and able to accommodate first aid training and survey time for two consecutive Year 10 student cohorts. Four Australian public schools were matched in two pairs and randomly assigned to receive either physical first aid (PFA) or teen mental health first aid (tMHFA) training for their Year 10 student cohort (mean age 16 years). In the second year, the new Year 10 cohort received the other intervention. Four cohorts were randomised to receive PFA and four were randomised to receive tMHFA. Online surveys were administered at baseline and 12 months after training, measuring whether students had encountered a peer needing PFA, whether they had provided PFA, what actions they performed and, if applicable, why they had been unable to help the person. Only research staff analysing the data could be blinded to measurement occasion, school identity and condition. Results Four cohorts received PFA and four received tMHFA. The results indicated that there were no differences between groups regarding the frequency of appropriate first aid actions performed 12 months after training. The most common types of PFA provided to a peer were sending for help and wound care. Students most commonly mentioned someone else attending to their peer or lacking skills or experience as reasons for not performing PFA actions. Conclusions More research that examines first aid behaviours using rigorous, longitudinal study designs is needed to establish the effectiveness of school-based first aid training for older adolescents.
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Affiliation(s)
- Alyssia Rossetto
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Amy J Morgan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Laura M Hart
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Mental Health First Aid Australia, Melbourne, VIC, Australia
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Wade TD, Hart LM, Mitchison D, Hay P. Driving better intervention outcomes in eating disorders: A systematic synthesis of research priority setting and the involvement of consumer input. Eur Eat Disord Rev 2020; 29:346-354. [PMID: 32706169 DOI: 10.1002/erv.2759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Setting specific research priorities and involving consumers in this process is one pathway to driving better intervention outcomes in eating disorders (EDs). We reviewed research priority setting in the field and the involvement of consumers in this priority setting. METHOD A systematic review following the PRSIMA statement was conducted and eight studies were identified for inclusion; four included substantial input from consumers, and four were researcher led. Similarities and differences across the types of studies were examined. RESULTS Research priorities informed by consumers were primarily concerned with producing better interventions and outcomes. A large degree of overlap with researcher-led priorities was present. The former studies had a greater focus on early intervention, bridging the research-practice gap, and recovery, while the latter were more likely to address diagnosis, genetic factors, brain circuitry, and pharmacotherapy. Priorities endorsed across more than one consumer-informed study included: the role of self-harm, working with health care professionals to increase early detection, supporting transition between services, and six issues about improved treatments. CONCLUSIONS The ED field needs to engage in more meaningful involvement of co-design across consumers, clinicians and researchers along the entire research journey, not just research priority setting. An integrated research strategy incorporating a co-design perspective has the potential to drive better outcomes.
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Affiliation(s)
- Tracey D Wade
- Blackbird Initiative, Órama Institute, Flinders University, Adelaide, Australia
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Centre for Mental Health, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia
| | - Deborah Mitchison
- School of Medicine and Translational Health Research Institute, Western Sydney University, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Phillipa Hay
- School of Medicine and Translational Health Research Institute, Western Sydney University, Sydney, Australia.,Camden and Campbelltown Hospitals, SWSLHD, Sydney, Australia
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22
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Hart LM, Cropper P, Morgan AJ, Kelly CM, Jorm AF. teen Mental Health First Aid as a school-based intervention for improving peer support of adolescents at risk of suicide: Outcomes from a cluster randomised crossover trial. Aust N Z J Psychiatry 2020; 54:382-392. [PMID: 31707787 DOI: 10.1177/0004867419885450] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this study were to assess evidence for a novel, universal mental health literacy programme in the school setting (teen Mental Health First Aid) as an intervention to improve peer support towards adolescents at risk of suicide and to examine whether participation in a school-based programme dealing with suicide was distressing to participants. METHOD In a cluster randomised crossover trial, Australian high school students aged 15-17 years (N = 1605, 44.74% female, Mage = 15.87) received either teen Mental Health First Aid or a matched control physical first aid course. Data were collected before, immediately after and 12 months after training through online surveys assessing correct recognition of suicidality and intentions to help a fictional peer (John) who was depicted as experiencing depressive symptoms and suicidal thoughts in a vignette. Students were also asked whether any information in the training or surveys was found distressing and completed a validated measure of psychological distress (the Kessler Psychological Distress Scale). RESULTS Students receiving teen Mental Health First Aid training were much more likely to report an increase from pre- to post-training in recognition of suicidality (OR = 1.97, 95% CI = [1.14, 3.39], p = 0.02) and appropriate first aid intentions towards a peer at risk of suicide than students receiving physical first aid (OR = 35.40, 95% CI = [19.86, 63.14], p < 0.001). Twelve months after training, most effects were still significant. Although a greater proportion of teen Mental Health First Aid participants self-reported feeling briefly distressed after the training, there was no evidence of greater distress at 12 months on the Kessler Psychological Distress Scale. CONCLUSION teen Mental Health First Aid is effective in increasing recognition of and intentions to assist a suicidal peer. Although the open discussion of mental health first aid for a suicidal peer was distressing for some students, results suggest this was transient and not associated with harm. Future studies are required to ascertain whether these increases are indeed associated with better provision of support and prevention of youth suicide.
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Affiliation(s)
- Laura M Hart
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Penny Cropper
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Amy J Morgan
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Yager Z, Prichard I, Hart LM. #Ihaveembraced: a pilot cross-sectional naturalistic evaluation of the documentary film Embrace and its potential associations with body image in adult women. BMC Womens Health 2020; 20:18. [PMID: 32013953 PMCID: PMC6998832 DOI: 10.1186/s12905-019-0870-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Abstract
Background The aim of this project was to examine the qualitative responses of adult women who had seen the feature-length documentary film ‘Embrace’. In addition, to establish the potential for the documentary to be used as an intervention to improve adult body image, a naturalistic study was conducted to examine whether any differences on measures of body image were apparent among women who had, versus those who had not, seen the film. Method Participants were 1429 women aged 18–77 who were members of the Facebook group ‘Body Image Movement’ facilitated by Taryn Brumfitt, who also directed the documentary Embrace. Participants completed a cross-sectional online questionnaire regarding whether they had seen the film, their perceptions of the impact of the film on their lives and body image, and a range of standardized scales measuring psychological wellbeing. Results Overall, the majority of participants had seen the film (n = 1053, 73.7%). Qualitative analysis of open-ended data asking about the changes participants made after viewing the film revealed that a large proportion (44.1%) felt they had higher levels of body appreciation and body confidence, many reported engaging less in dieting (19.6%), and some reported lowered disordered eating (2.8%), since seeing Embrace. Women who had seen the film also reported significantly higher levels of body appreciation (Body Appreciation Scale; medium effect size), and significantly lower levels of internalization of body ideals, self-objectification, body shame, and dietary restraint, than women who had not seen the film. Conclusions Adult women reported numerous positive responses to their viewing of the film. Future experimental research should explore the efficacy of Embrace as a brief and engaging intervention for improving body image in adult women.
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Affiliation(s)
- Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Ivanka Prichard
- College of Nursing & Health Sciences, Flinders University, Adelaide, Australia
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Hill KE, Hart LM, Paxton SJ. Confident Body, Confident Child: Outcomes for Children of Parents Receiving a Universal Parenting Program to Promote Healthful Eating Patterns and Positive Body Image in Their Pre-Schoolers-An Exploratory RCT Extension. Int J Environ Res Public Health 2020; 17:E891. [PMID: 32023923 PMCID: PMC7037269 DOI: 10.3390/ijerph17030891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/16/2022]
Abstract
Objective: A four-arm randomized controlled trial (RCT) conducted in Victoria, Australia, previously evaluated parent-report outcomes following Confident Body, Confident Child: a program for parents to promote healthful eating patterns and positive body image in pre-schoolers. This exploratory study evaluated data from children of parents in the trial at 18 months follow-up. Method: Participants were 89 children (58 girls, 31 boys) of parents across all RCT arms (group A: Confident Body, Confident Child (CBCC) resource + workshop, n = 27; group B: CBCC resource only, n = 26; group C: nutrition booklet, n = 18; group D: wait-list control, n = 18). Children's eating patterns, body image and weight bias were assessed via play-based interview. Results: Children of CBCC parents reported higher body esteem. Children of nutrition booklet parents reported stronger weight bias. Children of CBCC workshop parents reported lower External Eating. Discussion: This exploratory study suggests that CBCC may promote healthy eating patterns and child body image 18 months after parents receive the intervention.
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Affiliation(s)
- Katherine E. Hill
- School of Psychology and Public Health, College of Science, Health and Engineering, Level 4, George Singer Building, Melbourne Campus, Kingsbury Drive, Bundoora, Victoria 3086, Australia; (K.E.H.); (S.J.P.)
| | - Laura M. Hart
- School of Psychology and Public Health, College of Science, Health and Engineering, Level 4, George Singer Building, Melbourne Campus, Kingsbury Drive, Bundoora, Victoria 3086, Australia; (K.E.H.); (S.J.P.)
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie St, Victoria 3010, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, College of Science, Health and Engineering, Level 4, George Singer Building, Melbourne Campus, Kingsbury Drive, Bundoora, Victoria 3086, Australia; (K.E.H.); (S.J.P.)
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Hart LM, Wade T. Identifying research priorities in eating disorders: A Delphi study building consensus across clinicians, researchers, consumers, and carers in Australia. Int J Eat Disord 2020; 53:31-40. [PMID: 31571252 DOI: 10.1002/eat.23172] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Eating disorders are underrepresented among successful applications for medical research funding. Developing agreement on the top research priorities may assist in fostering collaborations, innovation, and meaningful consumer and carer involvement. This study aimed to develop consensus among Australian clinicians, researchers, consumers, carers, and interested members of affiliated industries, on the priorities for eating disorders research. METHOD The Delphi expert consensus method was used. Participants were 291 members of the Australia New Zealand Academy for Eating Disorders (ANZAED) or the National Eating Disorders Collaboration (NEDC). Three panels were formed based on participant expertise: "ED Specialists," Consumers/Carers, and Affiliates. A total of 32 potential research areas (29 in Survey 1, 3 in Survey 2) were rated on a 5-point scale of importance, with 80% agreement across all three panels required for endorsement as a priority. Participants also ranked 7 broad research domains in order of priority. RESULTS Research areas describing early intervention and evidence-based treatments were the most highly rated, with more than 90% endorsement from each of the three panels. The research domains of accessible evidence-based treatments, early intervention and detection, and origins of eating disorders, were the most highly ranked. The ED specialists and Consumers/Carers panels had very similar patterns of responding, while the Affiliates panel showed small differences. DISCUSSION Using the Delphi expert consensus method resulted in a collaborative consensus driven eating disorders research agenda for the Australian context and forms a model upon which other countries may also develop their funding priorities.
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Affiliation(s)
- Laura M Hart
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia.,Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tracey Wade
- College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia
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Hart LM, Bond KS, Morgan AJ, Rossetto A, Cottrill FA, Kelly CM, Jorm AF. Teen Mental Health First Aid for years 7-9: a description of the program and an initial evaluation. Int J Ment Health Syst 2019; 13:71. [PMID: 31788023 PMCID: PMC6858708 DOI: 10.1186/s13033-019-0325-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A teen Mental Health First Aid training course for high school students in years 10-12 (tMHFA 10-12) has previously been evaluated in uncontrolled and randomized controlled trials and found to improve Mental Health First Aid intentions, mental health literacy and to reduce stigma. This 3 × 75-min course has more recently been adapted for younger students in years 7-9 (tMHFA 7-9). The present study reports an initial uncontrolled trial of this new training course which aimed to assess feasibility and acceptability of the course and test effects on knowledge, attitudes and behaviour. METHODS An uncontrolled trial was carried out in five schools with measures taken at pre-test, post-test and 3-month follow-up. The outcomes measured were: quality of first aid intentions to help peers, confidence in helping, stigmatising attitudes, recognition of anxiety disorder, number of adults thought to be helpful, help-seeking intentions, quality of support provided to a peer, quality of support received, and psychological distress. Questions were also asked about satisfaction with the course. RESULTS There were 475 students (mean age 13.86 years) who provided data at baseline, with 76% of these providing data at post-test and 75% at follow-up. Sustained changes at follow-up were found for: number of adults thought to be helpful, some components of stigma, recognition of anxiety disorder, and quality of support provided to a peer. However, there was an unexpected decline in willingness to tell others about a mental health problem. Most students found the information presented to be new, easy to understand, and useful. CONCLUSIONS The tMHFA 7-9 training course produced some positive changes that were sustained over 3 months. However, the changes were not as strong as previously found for older high school students, suggesting the need for further refinement of the course.
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Affiliation(s)
- Laura M. Hart
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Kathy S. Bond
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- Mental Health First Aid Australia, Parkville, Australia
| | - Amy J. Morgan
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Alyssia Rossetto
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- Mental Health First Aid England, London, UK
| | | | - Claire M. Kelly
- Mental Health First Aid Australia, Parkville, Australia
- School of Psychology, Deakin University, Geelong, Australia
| | - Anthony F. Jorm
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- Mental Health First Aid Australia, Parkville, Australia
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Damiano SR, Yager Z, Prichard I, Hart LM. Leading by example: Development of a maternal modelling of positive body image scale and relationships to body image attitudes. Body Image 2019; 29:132-139. [PMID: 30953826 DOI: 10.1016/j.bodyim.2019.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
The aims of this study were to develop a measure, the Role Modelling of Body Image (Attitudes and Behaviors) Questionnaire (RMBI-Q), to determine maternal perceptions of their body image role modelling in front of their children, and to evaluate how role modelling differs with demographic characteristics to identify characteristics of mothers who may require assistance in being a positive role model. Participants were a community-based sample of 887 mothers who provided demographic information and completed the RMBI-Q, Body Appreciation Scale (BAS-2), and a measure of dietary restraint (DEBQ) in an online questionnaire. Exploratory factor analysis revealed one 7-item factor for the RMBI-Q. Confirmatory factor analysis revealed that removal of an item was necessary for model fit, and thus, a 6-item version of the RMBI-Q was evaluated. Good internal consistency, test-retest reliability, content validity, and convergent validity were found. Higher scores on the RMBI-Q correlated with greater maternal body appreciation and lower dietary restraint. More positive role modelling was reported by mothers with lower body mass index and younger children. The RMBI-Q is useful for assessing maternal modelling of positive behaviors that may improve children's body image. Findings highlight avenues for body image interventions for mothers.
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Affiliation(s)
- Stephanie R Damiano
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia.
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Ivanka Prichard
- College of Nursing and Health Sciences, Flinders University, Adelaide, 5001, Australia
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
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Morgan AJ, Fischer JAA, Hart LM, Kelly CM, Kitchener BA, Reavley NJ, Yap MBH, Cvetkovski S, Jorm AF. Does Mental Health First Aid training improve the mental health of aid recipients? The training for parents of teenagers randomised controlled trial. BMC Psychiatry 2019; 19:99. [PMID: 30917811 PMCID: PMC6437895 DOI: 10.1186/s12888-019-2085-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/19/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is well-established evidence that Mental Health First Aid (MHFA) training improves knowledge about how to support someone developing a mental health problem, but less evidence that this support improves the mental health of the recipient of aid. This randomised controlled trial aimed to assess the long-term effects of MHFA training of parents on the mental health of their adolescent children. METHODS 384 Australian parents of an adolescent aged 12-15 were randomised to receive either the 14-h Youth MHFA course or the 15-h Australian Red Cross Provide First Aid course. Outcomes were assessed at baseline, 1-year, and 2-year follow-up in both parents and adolescents. Primary outcomes were cases of adolescent mental health problems, and parental support towards their adolescent if they developed a mental health problem, rated by the parent and adolescent. Secondary outcomes included parent knowledge about mental health problems, intentions and confidence in supporting a young person, stigmatizing attitudes, and help-seeking for mental health problems. RESULTS Parent and adolescent reports showed no significant difference between training groups in the proportion of cases of adolescents with a mental health problem over time (ps > .05). There was also no significant difference between training groups in the quality of parental support provided to their adolescent at 1- or 2-year follow-up (ps > .05). In contrast, some secondary outcomes showed benefits from the Youth MHFA training relative to the control, with increased parental knowledge about mental health problems at 1-year (d = 0.43) and 2-year follow-up (d = 0.26), and increased confidence to help a young person (d = 0.26) and intentions to provide effective support (d = 0.22) at 1-year follow-up. CONCLUSIONS The study showed some improvements in mental health literacy in training recipients, but could not detect changes in the mental health of adolescents and the support provided to them by their parents if they had a mental health problem. However, there was a lack of power to detect primary outcome effects and therefore the question of whether MHFA training leads to better outcomes in the recipients of aid remains to be further explored. TRIAL REGISTRATION ACTRN12612000390886 , registered retrospectively 5/4/2012.
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Affiliation(s)
- Amy J. Morgan
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Julie-Anne A. Fischer
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Laura M. Hart
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia ,0000 0001 2342 0938grid.1018.8School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | | | - Betty A. Kitchener
- Mental Health First Aid Australia, Parkville, Australia ,0000 0001 0526 7079grid.1021.2Faculty of Health, School of Psychology, Deakin University, Burwood, Australia
| | - Nicola J. Reavley
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Marie B. H. Yap
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia ,0000 0004 1936 7857grid.1002.3School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Stefan Cvetkovski
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia ,0000 0001 2163 3550grid.1017.7Centre for Urban Research, RMIT University, Melbourne, Australia
| | - Anthony F. Jorm
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia
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Hart LM, Damiano SR, Li-Wai-Suen CSN, Paxton SJ. Confident body, confident child: Evaluation of a universal parenting resource promoting healthy body image and eating patterns in early childhood-6- and 12-month outcomes from a randomized controlled trial. Int J Eat Disord 2019; 52:121-131. [PMID: 30636006 DOI: 10.1002/eat.22992] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To evaluate Confident Body, Confident Child (CBCC), a universal parenting resource designed to promote positive body image and healthy eating patterns in children aged 2-6 years, at 6- and 12-months follow-up. METHOD A four-arm randomized controlled trial with 345 parents was conducted. Group (A) received the CBCC resource pack + workshop, (B) received the CBCC resource pack only, (C) received a nutrition booklet and (D) received no interventions until all questionnaires were completed (i.e., waitlist control). Measures of parenting variables relevant to child body image and eating patterns, and parent-report of child weight, were administered at baseline, 6-weeks post-intervention (results reported previously), and 6- and 12-months follow-up. RESULTS Mixed effects modeling comparing group averages over time revealed that significant group differences on measures of knowledge, parenting intentions and the parental feeding practice of weight restriction were still present at 12-months follow-up, though the remaining measures showed no significant differences between groups over time. The two CBCC groups reported more positive and less negative outcomes than the nutrition booklet active control. DISCUSSION The CBCC program achieved sustained improvements in some parenting variables at 12-months, suggesting its value as an effective parenting intervention. Changes to the intervention design, such as the addition of a follow-up parent workshop, however, would likely increase its efficacy.
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Affiliation(s)
- Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephanie R Damiano
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Connie S N Li-Wai-Suen
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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Hart LM, Morgan AJ, Rossetto A, Kelly CM, Mackinnon A, Jorm AF. Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid. Aust N Z J Psychiatry 2018; 52:638-651. [PMID: 29417834 PMCID: PMC6039867 DOI: 10.1177/0004867417753552] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15-18 years to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma. This research evaluated tMHFA by comparing it to a matched emergency Physical First Aid (PFA) training programme. METHODS A cluster-randomised crossover trial matched four public schools in two pairs and then randomised each to first receive tMHFA or PFA for all Year 10 students. In the subsequent calendar year, the new Year 10 cohort received the opposite intervention, giving eight cohorts. Online surveys were administered at baseline and 1 week post-training, measuring quality of first aid intentions, mental health literacy, problem recognition and stigmatising beliefs, towards fictional adolescents with depression and suicidality (John) and social anxiety (Jeanie). RESULTS A total of 1942 students were randomised (979 received tMHFA, 948 received PFA), 1605 (84%) analysed for the John vignette at baseline and 1116 (69% of baseline) provided post-training data. The primary outcomes, 'helpful first aid intentions' towards John/Jeanie, showed significant group-by-time interactions with medium effect sizes favouring tMHFA ( ds = 0.50-0.58). Compared to PFA, tMHFA students also reported significantly greater improvements in confidence supporting a peer ( ds = 0.22-0.37) and number of adults rated as helpful ( ds = 0.45-0.46) and greater reductions in stigmatising beliefs ( ds = 0.12-0.40) and 'harmful first aid intentions' towards John/Jeanie ( ds = 0.15-0.41). CONCLUSIONS tMHFA is an effective and feasible programme for increasing supportive first aid intentions and mental health literacy in adolescents in the short term. tMHFA could be widely disseminated to positively impact on help seeking for adolescent mental illness.
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Affiliation(s)
- Laura M Hart
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Amy J Morgan
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alyssia Rossetto
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Melbourne, VIC, Australia
| | - Andrew Mackinnon
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Black Dog Institute, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Anthony F Jorm
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Mental Health First Aid Australia, Melbourne, VIC, Australia
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Melioli T, Rispal M, Hart LM, Chabrol H, Rodgers RF. French mental health first aid guidelines for eating disorders: an exploration of user characteristics and usefulness among college students. Early Interv Psychiatry 2018; 12:229-233. [PMID: 27578164 DOI: 10.1111/eip.12369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/13/2016] [Accepted: 06/12/2016] [Indexed: 11/28/2022]
Abstract
AIM The literature has highlighted that strategies to increase appropriate and timely treatment seeking for eating disorders (EDs) are needed. The aim of this study was to use the Internet to disseminate guidelines for providing first aid to individuals suffering from ED among college students. METHODS Users were invited to complete two surveys: an initial one assessing user characteristics and, 28 days later, a questionnaire assessing the perceived usefulness of the guidelines. A sample of 651 college students (M age = 22, standard deviation (SD) = 3.9) responded to the first questionnaire and 50 completed the second questionnaire (M age = 22.2, SD = 2.6). RESULTS The guidelines were downloaded 1174 times and 56% of users reported finding them useful. CONCLUSIONS College students might be particularly interested in learning more about ED and the guidelines could be valuable to address the gap in available resources for ED-related mental health literacy.
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Affiliation(s)
- Tiffany Melioli
- Center of study and research on psychopatology and health psychology (CERPPS), Toulouse, France
| | - Magali Rispal
- Center of study and research on psychopatology and health psychology (CERPPS), Toulouse, France
| | - Laura M Hart
- Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Henri Chabrol
- Center of study and research on psychopatology and health psychology (CERPPS), Toulouse, France
| | - Rachel F Rodgers
- Department of Counseling and Applied Educational Psychology, Northeastern University, Boston, Massachusetts, USA
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Abstract
In this Commentary we outline the case for a national survey of eating disorders in Australia. Given the recent focus of the federal government to provide further funding for mental health research, we call for a national survey to be made a key priority. Such high-quality, nationally representative data are critically important to informing all other domains of eating disorders research in the Australian context, and to informing the research agenda internationally.
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Affiliation(s)
- L M Hart
- 1School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,2Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - D Mitchison
- 3Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia.,4Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - P J Hay
- 4Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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Doley JR, Hart LM, Stukas AA, Petrovic K, Bouguettaya A, Paxton SJ. Interventions to reduce the stigma of eating disorders: A systematic review and meta-analysis. Int J Eat Disord 2017; 50:210-230. [PMID: 28230911 DOI: 10.1002/eat.22691] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 12/27/2022]
Abstract
Stigma is a problem for individuals with eating disorders (EDs), forming a barrier to disclosure and help-seeking. Interventions to reduce ED stigma may help remove these barriers; however, it is not known which strategies (e.g., explaining etiology to reduce blame, contact with a person with an ED, or educating about ED) are effective in reducing stigma and related outcomes. This review described effectiveness of intervention strategies, and identified gaps in the literature. A search of four databases was performed using the terms (eating disorder* OR bulimi* OR anorexi* OR binge-eating disorder) AND (stigma* OR stereotyp* OR beliefs OR negative attitudes) AND (program OR experiment OR intervention OR education), with additional texts sought through LISTSERVs. Two raters screened papers, extracted data, and assessed quality. Stigma reduction strategies and study characteristics were examined in critical narrative synthesis. Exploratory meta-analysis compared the effects of biological and sociocultural explanations of EDs on attitudinal stigma. Eighteen papers were eligible for narrative synthesis, with four also eligible for inclusion in a meta-analysis. Biological explanations reduced stigma relative to other explanations, including sociocultural explanations in meta-analysis (g = .47, p < .001). Combined education and contact interventions improved stigma relative to control groups or over time. Most studies examined Anorexia Nervosa (AN) stigma and had mostly female, undergraduate participants. Despite apparent effectiveness, research should verify that biological explanations do not cause unintentional harm. Future research should evaluate in vivo contact, directly compare education and contact strategies, and aim to generalize findings across community populations.
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Affiliation(s)
- Joanna R Doley
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Laura M Hart
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.,Melbourne School of Global and Population Health, University of Melbourne, Parkville, VIC, Australia
| | - Arthur A Stukas
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Katja Petrovic
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | | | - Susan J Paxton
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
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Hart LM, Damiano SR, Paxton SJ. Confident body, confident child: A randomized controlled trial evaluation of a parenting resource for promoting healthy body image and eating patterns in 2- to 6-year old children. Int J Eat Disord 2016; 49:458-72. [PMID: 26749163 DOI: 10.1002/eat.22494] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Body image and eating patterns develop in early childhood and are influenced by the family environment. This research evaluated Confident Body, Confident Child (CBCC), an intervention for parents of 2- to 6-year-old children, designed to promote body satisfaction, healthy eating, and weight management in early childhood. METHOD A randomized controlled trial compared four groups: (A) received the CBCC resource pack and a workshop, (B) received the CBCC resource pack only, (C) received a nutrition-only resource and (D) received no interventions until all questionnaires were completed (i.e., functioned as waitlist control). Measures of parenting variables relevant to child body image and eating patterns, parent-report of child weight, and evaluation questions about the resource, were implemented pre- and post-intervention. RESULTS At 6-weeks post-intervention, the CBCC resource was associated with significant reductions in parents' intentions to use behaviors that increase the risk of negative body attitudes or unhealthy eating in their children, in parents' use of feeding practices associated with childhood overweight, and in television watching during family meals. Significant increases in parents' intentions to use positive behaviors and knowledge of child body image and healthy eating patterns were also found. Superior results were found for the CBCC resource + workshop condition, suggesting it is the preferred delivery method. DISCUSSION CBCC positively impacts parenting variables associated with childhood risk for body dissatisfaction, unhealthy eating and weight. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:458-472).
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Affiliation(s)
- Laura M Hart
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
| | - Stephanie R Damiano
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
| | - Susan J Paxton
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
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Hart LM, Conway CM, Elliott DG, Hershberger PK. Persistence of external signs in Pacific herring Clupea pallasii Valenciennes with ichthyophoniasis. J Fish Dis 2016; 39:429-440. [PMID: 25865489 DOI: 10.1111/jfd.12377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/28/2015] [Indexed: 06/04/2023]
Abstract
The progression of external signs of Ichthyophonus infection in Pacific herring Clupea pallasii Valenciennes was highly variable and asynchronous after intraperitoneal injection with pure parasite preparations; however, external signs generally persisted through the end of the study (429 days post-exposure). Observed signs included papules, erosions and ulcers. The prevalence of external signs plateaued 35 days post-exposure and persisted in 73-79% of exposed individuals through the end of the first experiment (147 days post-exposure). Among a second group of infected herring, external signs completely resolved in only 10% of the fish after 429 days. The onset of mortality preceded the appearance of external signs. Histological examination of infected skin and skeletal muscle tissues indicated an apparent affinity of the parasite for host red muscle. Host responses consisted primarily of granulomatous inflammation, fibrosis and necrosis in the skeletal muscle and other tissues. The persistence and asynchrony of external signs and host response indicated that they were neither a precursor to host mortality nor did they provide reliable metrics for hindcasting on the date of exposure. However, the long-term persistence of clinical signs in Pacific herring may be useful in ascertaining the population-level impacts of ichthyophoniasis in regularly observed populations.
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Affiliation(s)
- L M Hart
- U.S. Geological Survey, Marrowstone Marine Field Station, Nordland, WA, USA
| | - C M Conway
- U.S. Geological Survey, Western Fisheries Research Center, Seattle, WA, USA
| | - D G Elliott
- U.S. Geological Survey, Western Fisheries Research Center, Seattle, WA, USA
| | - P K Hershberger
- U.S. Geological Survey, Marrowstone Marine Field Station, Nordland, WA, USA
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Hershberger PK, Gregg JL, Hart LM, Moffitt S, Brenner R, Stick K, Coonradt E, Otis EO, Vollenweider JJ, Garver KA, Lovy J, Meyers TR. The parasite Ichthyophonus sp. in Pacific herring from the coastal NE Pacific. J Fish Dis 2016; 39:395-410. [PMID: 25828232 DOI: 10.1111/jfd.12370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/21/2015] [Accepted: 02/14/2015] [Indexed: 05/27/2023]
Abstract
The protistan parasite Ichthyophonus occurred in populations of Pacific herring Clupea pallasii Valenciennes throughout coastal areas of the NE Pacific, ranging from Puget Sound, WA north to the Gulf of Alaska, AK. Infection prevalence in local Pacific herring stocks varied seasonally and annually, and a general pattern of increasing prevalence with host size and/or age persisted throughout the NE Pacific. An exception to this zoographic pattern occurred among a group of juvenile, age 1+ year Pacific herring from Cordova Harbor, AK in June 2010, which demonstrated an unusually high infection prevalence of 35%. Reasons for this anomaly were hypothesized to involve anthropogenic influences that resulted in locally elevated infection pressures. Interannual declines in infection prevalence from some populations (e.g. Lower Cook Inlet, AK; from 20-32% in 2007 to 0-3% during 2009-13) or from the largest size cohorts of other populations (e.g. Sitka Sound, AK; from 62.5% in 2007 to 19.6% in 2013) were likely a reflection of selective mortality among the infected cohorts. All available information for Ichthyophonus in the NE Pacific, including broad geographic range, low host specificity and presence in archived Pacific herring tissue samples dating to the 1980s, indicate a long-standing host-pathogen relationship.
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Affiliation(s)
- P K Hershberger
- U. S. Geological Survey, Western Fisheries Research Center - Marrowstone Marine Field Station, Nordland, WA, USA
| | - J L Gregg
- U. S. Geological Survey, Western Fisheries Research Center - Marrowstone Marine Field Station, Nordland, WA, USA
| | - L M Hart
- U. S. Geological Survey, Western Fisheries Research Center - Marrowstone Marine Field Station, Nordland, WA, USA
| | - S Moffitt
- Alaska Department of Fish and Game (ADF&G) - Commercial Fisheries, Cordova, AK, USA
| | - R Brenner
- Alaska Department of Fish and Game (ADF&G) - Commercial Fisheries, Cordova, AK, USA
| | - K Stick
- Washington Department of Fish and Wildlife, Fish Program, Region 4 LaConner District Office, La Conner, WA, USA
| | - E Coonradt
- ADF&G - Commercial Fisheries, Sitka, AK, USA
| | - E O Otis
- ADF&G - Commercial Fisheries, Homer, AK, USA
| | - J J Vollenweider
- National Oceanic and Atmospheric Administration, Alaska Fisheries Science Center - Auke Bay Laboratories, Juneau, AK, USA
| | - K A Garver
- Fisheries and Oceans Canada - Pacific Biological Station, Nanaimo, BC, Canada
| | - J Lovy
- New Jersey Division of Fish & Wildlife, Office of Fish & Wildlife Health & Forensics, Oxford, NJ, USA
| | - T R Meyers
- ADF&G - Juneau Fish Pathology Laboratory, Juneau, AK, USA
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Hart LM, Mason RJ, Kelly CM, Cvetkovski S, Jorm AF. 'teen Mental Health First Aid': a description of the program and an initial evaluation. Int J Ment Health Syst 2016; 10:3. [PMID: 26788123 PMCID: PMC4717562 DOI: 10.1186/s13033-016-0034-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 01/07/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15-18 years. METHODS An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects. RESULTS Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced. CONCLUSIONS teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed.
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Affiliation(s)
- Laura M. Hart
- />Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- />School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Robert J. Mason
- />Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Claire M. Kelly
- />Mental Health First Aid, Melbourne, Australia
- />School of Psychology, Deakin University, Geelong, Australia
| | - Stefan Cvetkovski
- />Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Anthony F. Jorm
- />Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Hershberger PK, Hart LM, MacKenzie AH, Yanney ML, Conway CM, Elliott DG. Infecting Pacific Herring with Ichthyophonus sp. in the Laboratory. J Aquat Anim Health 2015; 27:217-221. [PMID: 26651222 DOI: 10.1080/08997659.2015.1095809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The protistan parasite Ichthyophonus sp. occurs in coastal populations of Pacific Herring Clupea pallasii throughout the northeast Pacific region, but the route(s) by which these planktivorous fish become infected is unknown. Several methods for establishing Ichthyophonus infections in laboratory challenges were examined. Infections were most effectively established after intraperitoneal (IP) injections with suspended parasite isolates from culture or after repeated feedings with infected fish tissues. Among groups that were offered the infected tissues, infection prevalence was greater after multiple feedings (65%) than after a single feeding (5%). Additionally, among groups that were exposed to parasite suspensions prepared from culture isolates, infection prevalence was greater after exposure by IP injection (74%) than after exposure via gastric intubation (12%); the flushing of parasite suspensions over the gills did not lead to infections in any of the experimental fish. Although the consumption of infected fish tissues is unlikely to be the primary route of Ichthyophonus sp. transmission in wild populations of Pacific Herring, this route may contribute to abnormally high infection prevalence in areas where juveniles have access to infected offal.
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Affiliation(s)
- P K Hershberger
- a U.S. Geological Survey, Western Fisheries Research Center, Marrowstone Marine Field Station, 616 Marrowstone Point Road , Nordland , Washington 98358 , USA
| | - L M Hart
- a U.S. Geological Survey, Western Fisheries Research Center, Marrowstone Marine Field Station, 616 Marrowstone Point Road , Nordland , Washington 98358 , USA
| | - A H MacKenzie
- a U.S. Geological Survey, Western Fisheries Research Center, Marrowstone Marine Field Station, 616 Marrowstone Point Road , Nordland , Washington 98358 , USA
| | - M L Yanney
- a U.S. Geological Survey, Western Fisheries Research Center, Marrowstone Marine Field Station, 616 Marrowstone Point Road , Nordland , Washington 98358 , USA
| | - C M Conway
- b U.S. Geological Survey, Western Fisheries Research Center, 6505 Northeast 65th Street , Seattle , Washington 98115 , USA
| | - D G Elliott
- b U.S. Geological Survey, Western Fisheries Research Center, 6505 Northeast 65th Street , Seattle , Washington 98115 , USA
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Hart LM, Damiano SR, Cornell C, Paxton SJ. What parents know and want to learn about healthy eating and body image in preschool children: a triangulated qualitative study with parents and Early Childhood Professionals. BMC Public Health 2015; 15:596. [PMID: 26135125 PMCID: PMC4487845 DOI: 10.1186/s12889-015-1865-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interventions for parents to encourage healthy eating in children often do not address parental feeding practices and body image development. METHODS The current study investigated what parents (of children aged 1-6 years) understand about child healthy eating and body image, and what they would like in future interventions, by using structured focus groups with parents, and individual interviews with Early Childhood Professionals. Forty three parents (M(age) = 36.95 years, 93% female, 79% university degree) participated across 9 focus groups. Eleven Early Childhood Professionals (M(age) = 51.04, 100% female, 64% university degree, 64% Maternal and Child Health Nurses, 36% Childcare Centre Directors) completed individual telephone interviews. RESULTS Parents described healthy eating as a variety, balance, and range of foods as well as limiting certain foods, such as the intake of sugar, salt, and processed foods. Most often parents defined child body image as a child's physical appearance and did not mention thoughts and feelings related to appearance or body experiences. Body image was most commonly considered a problem in early adolescence and often not an issue of relevance in early childhood. Parents appeared knowledgeable about nutrition and accessed information about healthy eating across a range of resources though rarely accessed information about child body image. They desired more practical information about how to avoid encouraging negative body image when promoting healthy eating. Professionals' responses confirmed these findings. CONCLUSIONS Results suggest future interventions need to stress the important role positive body image plays in encouraging healthy attitudes to food and weight management, and the benefits positive body image can have on the health and mental health of preschool children.
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Hart LM, Cornell C, Damiano SR, Paxton SJ. Parents and prevention: a systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders. Int J Eat Disord 2015; 48:157-69. [PMID: 24796581 DOI: 10.1002/eat.22284] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 03/31/2014] [Accepted: 04/01/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To systematically review the literature on interventions involving parents that aim to prevent body dissatisfaction or eating disorders in children, and provide directions for future research by highlighting current gaps. METHOD The literature was searched for articles using key concepts: parents, prevention and eating disorders or disordered eating or body dissatisfaction. All English language publications between 1992 and 2013 were searched across a range of academic databases. Studies were reviewed if they: (i) delivered an intervention designed to reduce eating disorders or body dissatisfaction or their risk factors, in children or adolescents; (ii) provided some intervention component for parents; and (iii) included some outcome measure of intervention effectiveness on disordered eating or body dissatisfaction. A scoring matrix based on the Critical Appraisal Skills Program (CASP) screening questions was used to assess each study's sample representativeness, relevance and data quality. RESULTS From 647 novel records uncovered by the search, 20 separate studies met inclusion criteria. The CASP scoring matrix revealed eight studies provided no relevant data, four relevant and eight highly relevant data on the effects of involving parents in prevention programs. Two of four high-quality studies reported that parental involvement significantly improved child outcomes on measures of body dissatisfaction or disordered eating. DISCUSSION Although a greater focus on engaging and retaining parents is needed, this review demonstrates that a small number of prevention studies with parents have led to significant reductions in risk of body image and eating problems, and future research is indicated.
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Affiliation(s)
- Laura M Hart
- School of Psychological Science, La Trobe University, Melbourne, Australia
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Hart LM, Damiano SR, Chittleborough P, Paxton SJ, Jorm AF. Parenting to prevent body dissatisfaction and unhealthy eating patterns in preschool children: a Delphi consensus study. Body Image 2014; 11:418-25. [PMID: 25084034 DOI: 10.1016/j.bodyim.2014.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/17/2014] [Accepted: 06/28/2014] [Indexed: 10/24/2022]
Abstract
Interventions to prevent body dissatisfaction and unhealthy eating patterns are needed in early childhood. Identifying effective parenting strategies would be useful for parents and prevention researchers. To develop expert consensus, an online Delphi study was conducted with experts (N=28, Mage=44.34) who rated statements describing potential parenting strategies gleaned from a systematic literature search. If 90-100% rated a statement as either Essential or Important, it was endorsed as a guideline. From a total of 335 statements 153 were endorsed. Despite some areas of disagreement, including whether parents should weigh their child or discourage weighing, experts were able to reach consensus on a wide range of issues, such as how to discuss healthy eating with children. The developed guidelines provide a novel and required resource for parents, and a framework for researchers developing interventions to prevent the onset of body dissatisfaction and unhealthy eating patterns in early childhood.
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Affiliation(s)
- Laura M Hart
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Stephanie R Damiano
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Philip Chittleborough
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Susan J Paxton
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Yoshioka K, Reavley NJ, Hart LM, Jorm AF. Recognition of mental disorders and beliefs about treatment: results from a mental health literacy survey of Japanese high school students. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/17542863.2014.931979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Bailey AP, Parker AG, Colautti LA, Hart LM, Liu P, Hetrick SE. Mapping the evidence for the prevention and treatment of eating disorders in young people. J Eat Disord 2014; 2:5. [PMID: 24999427 PMCID: PMC4081733 DOI: 10.1186/2050-2974-2-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/13/2013] [Indexed: 12/31/2022] Open
Abstract
ABSTRACT Eating disorders often develop during adolescence and young adulthood, and are associated with significant psychological and physical burden. Identifying evidence-based interventions is critical and there is need to take stock of the extant literature, to inform clinical practice regarding well-researched interventions and to direct future research agendas by identifying gaps in the evidence base. AIM To investigate and quantify the nature and distribution of existing high-quality research on the prevention and treatment of eating disorders in young people using evidence mapping methodology. METHOD A systematic search for prevention and treatment intervention studies in adolescents and young adults (12-25 years) was conducted using EMBASE, PSYCINFO and MEDLINE. Studies were screened and mapped according to disorder, intervention modality, stage of eating disorder and study design. Included studies were restricted to controlled trials and systematic reviews published since 1980. RESULTS The eating disorders evidence map included 197 trials and 22 systematic reviews. Prevention research was dominated by trials of psychoeducation (PE). Bulimia nervosa (BN) received the most attention in the treatment literature, with cognitive behavioural therapy (CBT) and antidepressants the most common interventions. For anorexia nervosa (AN), family based therapy (FBT) was the most studied. Lacking were trials exploring treatments for binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS). Relapse prevention strategies were notably absent across the eating disorders. CONCLUSIONS Despite substantial literature devoted to the prevention and treatment of eating disorders in young people, the evidence base is not well established and significant gaps remain. For those identified as being at-risk, there is need for prevention research exploring strategies other than passive PE. Treatment interventions targeting BED and EDNOS are required, as are systematic reviews synthesising BN treatment trials (e.g., CBT, antidepressants). FBTs for AN require investigation against other validated psychological interventions, and the development of relapse prevention strategies is urgently required. By systematically identifying existing interventions for young people with eating disorders and exposing gaps in the current literature, the evidence map can inform researchers, funding bodies and policy makers as to the opportunities for future research.
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Affiliation(s)
- Alan P Bailey
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Alexandra G Parker
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Lauren A Colautti
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Laura M Hart
- Melbourne School of Population Health, The University of Melbourne, Level 3, 207 Bouverie Street, Melbourne, Victoria 3010, Australia
| | - Ping Liu
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
| | - Sarah E Hetrick
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria 3052, Australia ; Centre of Excellence in Youth Mental Health, headspace National Youth Mental Health Foundation Ltd, Level 2, South Tower, 485 La Trobe Street, Melbourne, Victoria 3000, Australia
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Abstract
AIM Mental health first aid guidelines provide the public with consensus-based information about how to assist someone who is developing a mental illness or experiencing a mental health crisis. The aim of the current study was to evaluate the usefulness and impact of the guidelines on web users who download them. METHOD Web users who downloaded the documents were invited to respond to an initial demographic questionnaire, then a follow up about how the documents had been used, their perceived usefulness, whether first-aid situations had been encountered and if these were influenced by the documents. RESULTS Over 9.8 months, 706 web users responded to the initial questionnaire and 154 responded to the second. A majority reported downloading the document because their job involved contact with people with mental illness. Sixty-three web users reported providing first aid, 44 of whom reported that the person they were assisting had sought professional care as a result of their suggestion. Twenty-three web users reported seeking care themselves. A majority of those who provided first aid reported feeling that they had been successful in helping the person, that they had been able to assist in a way that was more knowledgeable, skilful and supportive, and that the guidelines had contributed to these outcomes. CONCLUSIONS Information made freely available on the Internet, about how to provide mental health first aid to someone who is developing a mental health problem or experiencing a mental health crisis, is associated with more positive, empathic and successful helping behaviours.
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Affiliation(s)
- Laura M Hart
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
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Hart LM, Lorenzen N, LaPatra SE, Grady CA, Roon SE, O'Reilly J, Gregg JL, Hershberger PK. Efficacy of a glycoprotein DNA vaccine against viral haemorrhagic septicaemia (VHS) in Pacific herring, Clupea pallasii Valenciennes. J Fish Dis 2012; 35:775-779. [PMID: 22804506 DOI: 10.1111/j.1365-2761.2012.01364.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- L M Hart
- US Geological Survey, Western Fisheries Research Center, Marrowstone Marine Field Station, Nordland, WA 98358, USA.
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Hart LM, Jorm AF, Paxton SJ. Mental health first aid for eating disorders: pilot evaluation of a training program for the public. BMC Psychiatry 2012; 12:98. [PMID: 22856517 PMCID: PMC3549729 DOI: 10.1186/1471-244x-12-98] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 05/14/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Eating disorders cause significant burden that may be reduced by early and appropriate help-seeking. However, despite the availability of effective treatments, very few individuals with eating disorders seek treatment. Training in mental health first aid is known to be effective in increasing mental health literacy and supportive behaviours, in the social networks of individuals with mental health problems. Increases in these domains are thought to improve the likelihood that effective help is sought. However, the efficacy of mental health first aid for eating disorders has not been evaluated. The aim of this research was to examine whether specific training in mental health first aid for eating disorders was effective in changing knowledge, attitudes and behaviours towards people with eating disorders. METHODS A repeated measures, uncontrolled trial was conducted to establish proof of concept and provide guidance on the future design of a randomised controlled trial. Self-report questionnaires, administered at baseline, post-training and 6-month follow-up, assessed the effectiveness of the 4-hour, single session, mental health first aid training. RESULTS 73 participants completed the training and all questionnaires. The training intervention was associated with statistically significant increases in problem recognition and knowledge of appropriate mental health first aid strategies, which were maintained at 6-month follow-up. Sustained significant changes in attitudes and behaviours were less clear. 20 participants reported providing assistance to someone with a suspected eating disorder, seven of whom sought professional help as a result of the first aid interaction. Results provided no evidence of a negative impact on participants or the individuals they provided assistance to. CONCLUSIONS This research provides preliminary evidence for the use of training in mental health first aid as a suitable intervention for increasing community knowledge of and support for people with eating disorders to seek appropriate help. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12611001181998.
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Affiliation(s)
- Laura M Hart
- Melbourne School of Population Health, University of Melbourne, Parkville, VIC, Australia.
| | - Anthony F Jorm
- Melbourne School of Population Health, University of Melbourne, Parkville, VIC, Australia
| | - Susan J Paxton
- School of Psychological Science, La Trobe University, Bundoora, VIC, Australia
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Ross AM, Hart LM, Jorm AF, Kelly CM, Kitchener BA. Development of key messages for adolescents on providing basic mental health first aid to peers: a Delphi consensus study. Early Interv Psychiatry 2012; 6:229-38. [PMID: 22240091 DOI: 10.1111/j.1751-7893.2011.00331.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Most young people fail to receive professional treatment for mental disorders; however, they do indicate a preference for sharing problems with peers. This article describes key messages about knowledge and actions to form the basis of a basic mental health first aid (MHFA) course for adolescents to increase recognition of and help seeking for mental health problems by teaching the best knowledge and helping actions a young person can undertake to support a peer with a mental health problem. METHODS The Delphi method was used to achieve consensus among Australian and Canadian youth mental health experts regarding the importance of statements that describe helping actions a young person can take, and information they should have, to support a friend with a mental health problem. There were two expert panels, one consisting of 36 youth mental health consumer advocates and the other of 97 Youth MHFA instructors. Panellists rated each statement according to how appropriate it would be as a basic mental health first aid message for both a junior adolescent (12-15 years) and a senior adolescent (16-18 years). RESULTS Out of 98 statements, 78 were endorsed as key basic MHFA messages for junior adolescents and 81 were endorsed for senior adolescents. CONCLUSION The study has identified key messages for adolescents on how they can help a peer. These messages will form the basis of the curriculum for an MHFA course for adolescents, which will aim to facilitate early recognition of and help seeking for mental health problems in adolescents.
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Affiliation(s)
- Anna M Ross
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
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Hershberger PK, Gregg JL, Grady CA, Hart LM, Roon SR, Winton JR. Factors controlling the early stages of viral haemorrhagic septicaemia epizootics: low exposure levels, virus amplification and fish-to-fish transmission. J Fish Dis 2011; 34:893-899. [PMID: 21995680 DOI: 10.1111/j.1365-2761.2011.01305.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Viral haemorrhagic septicaemia virus, Genogroup IVa (VHSV), was highly infectious to Pacific herring, Clupea pallasii (Valenciennes), even at exposure doses occurring below the threshold of sensitivity for a standard viral plaque assay; however, further progression of the disease to a population-level epizootic required viral amplification and effective fish-to-fish transmission. Among groups of herring injected with VHSV, the prevalence of infection was dose-dependent, ranging from 100%, 75% and 38% after exposure to 19, 0.7 and 0.07 plaque-forming units (PFU)/fish, respectively. Among Pacific herring exposed to waterborne VHSV (140 PFU mL(-1) ), the prevalence of infection, geometric mean viral tissue titre and cumulative mortality were greater among cohabitated herring than among cohorts that were held in individual aquaria, where fish-to-fish transmission was prevented. Fish-to-fish transmission among cohabitated herring probably occurred via exposure to shed virus which peaked at 680 PFU mL(-1) ; shed virus was not detected in the tank water from any isolated individuals. The results provide insights into mechanisms that initiate epizootic cascades in populations of wild herring and have implications for the design of VHSV surveys in wild fish populations.
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Affiliation(s)
- P K Hershberger
- US Geological Survey, Western Fisheries Research Center (WFRC), Marrowstone Marine Field Station, Nordland, WA, USA.
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Ryan SM, Jorm AF, Kelly CM, Hart LM, Morgan AJ, Lubman DI. Parenting strategies for reducing adolescent alcohol use: a Delphi consensus study. BMC Public Health 2011; 11:13. [PMID: 21210993 PMCID: PMC3022696 DOI: 10.1186/1471-2458-11-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 01/06/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND International concern regarding the increase in preventable harms attributed to adolescent alcohol consumption has led to growing political and medical consensus that adolescents should avoid drinking for as long as possible. For this recommendation to be adopted, parents and guardians of adolescents require information about strategies that they can employ to prevent or reduce their adolescent's alcohol use that are supported by evidence. METHODS The Delphi method was used to obtain expert consensus on parenting strategies effective in preventing and reducing adolescent alcohol consumption. A literature search identified 457 recommendations for parents to reduce their adolescent child's alcohol use. These recommendations were presented to a panel of 38 Australian experts who were asked to rate their importance over three survey rounds. RESULTS There were 289 parenting strategies that were endorsed as important or essential in reducing adolescent alcohol use by ≥90% of the panel. These strategies were categorised into 11 sub-headings: things parents should know about adolescent alcohol use, delaying adolescent's introduction to alcohol, modelling responsible drinking and attitudes towards alcohol, talking to adolescents about alcohol, establishing family rules, monitoring adolescents when unsupervised, preparing adolescents for peer pressure, unsupervised adolescent drinking, what to do when an adolescent has been drinking without parental permission, hosting adolescent parties, and establishing and maintaining a good parent-child relationship. The endorsed strategies were written into a document suitable for parents. CONCLUSIONS A comprehensive set of parenting strategies for preventing or reducing adolescent alcohol consumption were identified. These strategies can be promoted to parents to help them implement national recommendations for use of alcohol by young people.
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Affiliation(s)
- Siobhan M Ryan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Laura M Hart
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Amy J Morgan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
- Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Victoria, Australia
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Kingston AH, Morgan AJ, Jorm AF, Hall K, Hart LM, Kelly CM, Lubman DI. Helping someone with problem drug use: a Delphi consensus study of consumers, carers, and clinicians. BMC Psychiatry 2011; 11:3. [PMID: 21208412 PMCID: PMC3022807 DOI: 10.1186/1471-244x-11-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 01/05/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Problem use of illicit drugs (i.e. drug abuse or dependence) is associated with considerable health and social harms, highlighting the need for early intervention and engagement with health services. Family members, friends and colleagues play an important role in supporting and assisting individuals with problem drug use to seek professional help, however there are conflicting views about how and when such support should be offered. This paper reports on the development of mental health first aid guidelines for problem drug use in adults, to help inform community members on how to assist someone developing problem drug use or experiencing a drug-related crisis. METHODS A systematic review of the scientific and lay literature was conducted to develop a 228-item survey containing potential first-aid strategies to help someone developing a drug problem or experiencing a drug-related crisis. Three panels of experts (29 consumers, 31 carers and 27 clinicians) were recruited from Australia, Canada, New Zealand, the United Kingdom, and the United States. Panel members independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. RESULTS The overall response rate across three rounds was 80% (86% consumers, 81% carers, 74% clinicians). 140 first aid strategies were endorsed as essential or important by 80% or more of panel members. The endorsed strategies provide information and advice on what is problem drug use and its consequences, how to approach a person about their problem drug use, tips for effective communication, what to do if the person is unwilling to change their drug use, what to do if the person does (or does not) want professional help, what are drug-affected states and how to deal with them, how to deal with adverse reactions leading to a medical emergency, and what to do if the person is aggressive. CONCLUSIONS The guidelines provide a consensus-based resource for community members who want to help someone with a drug problem. It is hoped that the guidelines will lead to better support and understanding for those with problem drug use and facilitate engagement with professional help.
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Affiliation(s)
- Anna H Kingston
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Amy J Morgan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Kate Hall
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Laura M Hart
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Victoria, Australia
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