The role of spirituality, religiosity, and self-care on infection preventionist well-being: Results from a national survey in the United States

BACKGROUND

The degree to which religiosity, spirituality, and self-care practices can improve well-being among infection preventionists is not well understood.

METHODS

We surveyed infection preventionists from a random sample of United States hospitals in 2021. Multivariable logistic regression models were used to examine the associations between measures of spirituality, religiosity, and self-care and well-being.

RESULTS

Our response rate was 47% (415/881). A total of 49% of respondents reported burnout, 17% reported increased feelings of uncaring, and 69% would choose to become an infection preventionist again. Most respondents found importance in spiritual well-being (88%), religious beliefs (82%), and self-care practices (87%). Spiritual well-being was associated with increased odds of choosing to become an infection preventionist again (odds ratio = 2.32, 95% confidence interval = 1.19-4.53, P = .01).

DISCUSSION

Our national survey provides evidence that spiritual importance is associated with career satisfaction among infection preventionists. Our findings contribute to a general body of evidence suggesting spiritual importance may translate to higher flourishing and well-being via serving a higher purpose.

CONCLUSIONS

Promoting spiritual well-being may positively influence career satisfaction and overall well-being among infection preventionists.

Evolution of Sleep Duration and Screen Time Between 2018 and 2022 Among Canadian Adolescents: Evidence of Drifts Accompanying the COVID-19 Pandemic

PURPOSE

We quantified the joint evolution of sleep duration and screen time between 2018 and 2022 in a large sample of adolescents from Quebec, Canada, to ascertain changes that occurred during the COVID-19 pandemic.

METHODS

A natural experiment design was used to compare variations from year to year and in association with the pandemic outbreak. Using structural equation modeling on data collected between 2018 and 2022 among adolescents attending 63 high schools, we analyzed the joint evolution of sleep duration and screen time while adjusting for previous year values, concurrent flourishing score, sex, age, and family level of material deprivation.

RESULTS

A total of 28,307 adolescents, aged on average 14.9 years, were included in the analyses. Between 2019 and 2022, sleep duration increased by 9.6 (5.7, 13.5) minutes and screen time by 129.2 (120.5, 138.0) minutes on average. In 2022, the adolescents spent almost equal amounts of time sleeping and using screens. Lower flourishing scores were associated with shorter sleep duration and lengthier screen time. Girls' screen time became similar to boys' over time.

DISCUSSION

Adolescents now spend almost equal amounts of time sleeping and using screens, a situation that calls for urgent public health actions. These findings highlight the importance of tracking changes in adolescents' behaviours over time, to design and implement interventions adapted to the changing health needs of different groups.

Smartphone survey data reveal the timecourse of changes in mood outcomes following vitamin C or kiwifruit intervention in adults with low vitamin C

Vitamin C-rich foods can improve mood; however, the timecourse of these benefits is unknown. This study utilised intensive longitudinal smartphone surveys from a three-armed placebo-controlled trial to determine mood-related changes following supplementation with vitamin C (250 mg tablet/d), kiwifruit (2 SunGold™ kiwifruit/d) or a placebo (1 tablet/d). Secondary data were analysed from the KiwiC for Vitality trial (Trial ID: ACTRN12617001031358). Adults (n 155, 63 % female, aged 18-35 years) with low plasma vitamin C (<40 μmol/l) completed a 14-d lead-in, 28-d intervention and 14-d washout. Participants self-reported vitality (SF-36), mood (POMS total mood disturbance), flourishing (flourishing scale), sleep quality, sleep quantity and physical activity every second day using smartphone surveys. Plasma vitamin C, measured fortnightly, reached saturation after 2 weeks of vitamin C or kiwifruit supplementation. Kiwifruit supplementation improved vitality and mood within 4 days, peaking around 14-16 days, and improved flourishing from day 14. Vitamin C marginally improved mood until day 12. Incremental AUC analyses revealed significant overall effects of kiwifruit consumption on vitality and mood compared with placebo, which were stronger than effects for vitamin C tablets, but attenuated when adjusting for covariates. Sensitivity analyses of participants with low baseline vitamin C status revealed improved mood (vitamin C and kiwifruit) and flourishing (kiwifruit only). This is the first study to use intensive smartphone surveys to model the day-to-day timecourse of mood-related states following vitamin C intervention and highlights the value of using smartphone surveys to reveal the temporal changes in mood-related outcomes following nutrient supplementation.

Thriving from work questionnaire: Spanish translation and validation

BACKGROUND

Thriving from Work is a construct that has been highlighted as an important integrative positive worker well-being indicator that can be used in both research and practice. Recent public discourse emphasizes the important contributions that work should have on workers' lives in positive and meaningful ways and the importance of valid and reliable instruments to measure worker well-being. The Thriving from Work Questionnaire measures how workers' experiences of their work and conditions of work contributes in positive ways to their thriving both at and outside of work.

METHODS

The purpose of this study was to translate the Thriving from Work Questionnaire from English to Spanish, and then validate the translated questionnaire in a sample of 8,795 finance workers in Peru and Mexico. We used item response theory models replicating methods that were used for the original validation studies. We conducted a differential item functioning analysis to evaluate any differences in the performance of models between Peru and Mexico. We evaluated criterion validity with organizational leadership, flourishing, vitality, community well-being, and worker's home location socio-economic position.

RESULTS

The current study demonstrates that the Spanish (Peru/Mexico) questionnaire was found to be a reliable and valid measure of workers' thriving from work. One item was dropped from the long-form version of the original U.S. questionnaire. Both the long and short form versions of the questionnaire had similar psychometric properties. Empirical reliability was high. Criterion validity was established as hypothesized relationships between constructs was supported. There were no differences in the performance of the model between countries suggesting utility across Latin American countries.

CONCLUSIONS

The current study demonstrated that the Spanish (Peru and Mexico) version of the questionnaire is both a reliable and valid measure of worker well-being in Latin America. Specific recommendations are made for the adaptation of the questionnaire and directions of future research.

The Impact of Early Violence Exposure on Adolescent Flourishing : Is There Light at the End of the Tunnel?

Child maltreatment (CM) and intimate partner violence (IPV) are prevalent in the United States and associated with negative mental and physical health outcomes. Thus far, research and clinical care have focused on reducing symptoms of illness, but little is known about whether or how CM and IPV exposure can lead to flourishing in adolescence. To examine the impact of CM and IPV exposure on adolescent mental and physical flourishing as well as moderators and mediators affecting this pathway. A secondary data analysis of 2,232 children in the Future of Families Child Wellbeing Study (FFCWS) was conducted to examine waves 1-6 including variables on CM/IPV, general flourishing, mental flourishing, BMI, and healthy eating. Race, socioeconomic status (SES), and gender were included as moderators; depression and anxiety were included as mediating variables. Adolescent boys experienced significantly more general flourishing (β = 4.00, p < .001). There were significant direct effects of CM (p = .025) and anxiety (p = .019) on well-being, and anxiety mediated the pathway from CM to mental flourishing (CI [0.001, 0.017]). Depression (CI [0.001, 0.026]) and anxiety (CI [-0.023, - 0.005]) mediated the pathway from CM to BMI. Our findings indicated that exposure to CM and IPV impacted the likelihood of adolescent flourishing. Future research should evaluate whether and how these flourishing outcomes could be modified.

Develop Your CORE2 for Career Flourishing: A Career Development Workshop for Hospitalists

Introduction

Appreciative inquiry harnesses an individual's strengths to realize positive change, and a flourishing-focused mindset emphasizes engagement, social connectivity, and seeking meaningful work. Though the impact of these models on physician well-being and career planning has been evaluated in graduate medical education, their integration into career development initiatives for faculty has been limited. We designed a workshop to nurture hospitalist career development, based on our CORE2 conceptual framework (character strengths, overall vision, role assessment, explicit goals, and evaluation).

Methods

We presented the workshop at the 2022 and 2023 Society of Hospital Medicine (SHM) annual conferences. This 1.5-hour workshop comprised four modules and three small-group activities designed to help participants identify their signature character strengths, draft a professional vision statement, prioritize professional roles, and develop SMART goals aligned with these roles.

Results

At the 2023 SHM annual conference, 36 participants attended the workshop, and 32 (89%) completed pre- and postworkshop surveys. After workshop completion, participants' self-assessed familiarity with their signature character strengths, knowledge of evidence-based principles to develop SMART goals, and confidence in their ability to write a vision statement and SMART goals all increased significantly (p < .05).

Discussion

This workshop provides a valuable framework for self-directed longitudinal career development and reflection. We build on prior curricula on educator identity formation by guiding participants from identity definition to professional vision development to professional role evaluation to aligned goal creation and iterative evaluation. Our workshop's principles are readily generalizable to clinician-educators across medical disciplines.

Psychosocial correlates of flourishing in the late lifespan

BACKGROUND

Flourishing is a primary dimension of psychological well-being that contributes massively to the development of an active, purposeful, and respectful life, full of meaning, values, and personal interests that nurture social ties.

AIMS

This study primarily intended to examine the contribution of satisfaction with family relations, resilience, metacognitive efficiency, and crystallized intelligence in predicting a flourishing measure in cognitively healthy older adults. Moreover, the impact of gender was investigated on flourishing, satisfaction with family ties, resilience, and metacognitive efficiency.

METHODS

One hundred and eighty 65-94-year-old community dwellers were recruited in Sardinia (Italy). Participants self-rated their flourishing, satisfaction with their family connections, psychological hardness (i.e., a dimension of resilience), and cognitive function, whereas global cognitive efficiency and vocabulary were assessed through two internationally validated objective tests.

RESULTS

A hierarchical regression analysis revealed that 30% of the variance in the flourishing condition was explained by satisfaction with family ties, resilience, and metacognitive efficiency. In addition, males exhibited higher flourishing and satisfaction with family ties than females, and the former group also reported being more autonomous and acting proactively to influence its destiny.

CONCLUSION

Emotional support and rewarding relations with family members, the ability to face stressful events, and a good perception of one's cognitive efficiency play a crucial role in promoting flourishing in late adulthood.

Boundary violations and university teachers' well-being during mandatory telework: Recovery's role and gender differences

BACKGROUND

This study aimed to explore the role of psychological detachment from work in the relationship of boundary violations and flourishing, as well as gender differences among university teachers during mandatory telework. We developed and tested a moderate mediation model where psychological detachment was the explanatory mechanism of the relationship between boundary violations with flourishing and using gender as the moderating variable.

METHODS

A cross-sectional study was conducted with a sample of 921 Brazilian university teachers (mean age 44 years, 681 women and 240 men) during mandatory telework. Multigroup analysis and moderate mediation were performed using Mplus 7.2.

RESULTS

Psychological detachment mediated the relationship between boundary violations (in both directions) and flourishing and work-to-family violations were more harmful to women' recovery instead family-to-work violations were more harmful to men' recovery, among university teachers during mandatory telework.

CONCLUSION

By focusing on boundary violations in the context of mandatory telework, the study sheds light on the impact of blurred boundaries between work and personal life. This contributes both literature on work-life balance and literature recovery. Moreover, it helps to understand a crisis setting of remote work. Further, the study's findings regarding gender differences highlight how men and women may experience and cope with boundary violations differently during mandatory telework, supporting future specific interventions across genders.

On religious ambiguity: Childhood family religiosity and adult flourishing in a twin sample

Ambiguity is an important notion in sociology, denoting situations where social actors and groups carry on without shared meaning. The current article applies this concept to the context of religiosity during people's upbringing, recognizing that multiple factors make family-level religion a complex experience. Indeed, though recent research portrays household religiosity in childhood as a sociocultural exposure with long-term implications for well-being, existing studies have yet to incorporate multiple inputs to consider the cohesiveness of that exposure. Using twin data from a national sample, we investigate whether consistency in recalled household religiosity is associated with mid-life flourishing. Multi-level linear regression models reveal that similarity in twin reports matter, above and beyond the actual level of religiosity individuals report and net of dis/similarity across other childhood recollections. We conclude that coherence in religious upbringing-whether religion was understood to be important or not-is a key ingredient for thriving later in life and then reflect more broadly on manifestations of sociocultural ambiguity in families and in larger social units.

Association of positive childhood experiences with flourishing among children with ADHD: A population-based study in the United States

BACKGROUND

Child flourishing includes healthy social and emotional development and an open, engaged approach to learning. However, there remains a significant knowledge gap concerning a minority of children with ADHD who may demonstrate flourishing in one or more areas of functioning. This study investigated the association between positive childhood experiences (PCEs) and flourishing among children with ADHD.

METHOD

Data were derived from the 2021 National Survey of Children's Health in the United States. The analysis included a final sample of 3727 children with ADHD. Logistic regression, restricted cubic splines, and random forest were used to examine the associations between seven PCEs and flourishing.

RESULTS

The adjusted odds of flourishing were 72% lower (odds ratio [OR] = 0.28,95% confidence interval [CI] = 0.21, 0.38) among children with PCE scores of 0-2 compared to those with scores of 3-5. In addition, the adjusted odds of flourishing were 2.45 times (95%CI = 2.00, 2.99) greater for children with PCE scores of 6-7 compared to those with scores of 3-5. These associations were consistent regardless of the level of adverse childhood experiences. Having a "connected caregiver" was the PCE most closely related to flourishing (unweighted OR = 3.24, 95%CI = 2.72, 3.89).

CONCLUSIONS

Our findings revealed a positive association between higher levels of PCEs and greater flourishing among children with ADHD, regardless of the level of childhood adversity they experienced. These results highlight the importance of positive experiences in the lives of children with ADHD, with a specific focus on nurturing supportive relationships within families.

Flourishing, Mental Health Professionals and the Role of Normative Dialogue

This paper explores the dilemma faced by mental healthcare professionals in balancing treatment of mental disorders with promoting patient well-being and flourishing. With growing calls for a more explicit focus on patient flourishing in mental healthcare, we address two inter-related challenges: the lack of consensus on defining positive mental health and flourishing, and how professionals should respond to patients with controversial views on what is good for them. We discuss the relationship dynamics between healthcare providers and patients, proposing that 'liberal' approaches can provide a pragmatic framework to address disagreements about well-being in the context of flourishing-oriented mental healthcare. We acknowledge the criticisms of these approaches, including the potential for unintended paternalism and distrust. To mitigate these risks, we conclude by suggesting a mechanism to minimize the likelihood of unintended paternalism and foster patient trust.

Life experienced as worth living and beyond: a qualitative study of the pathways to recovery and flourishing amongst individuals treated for borderline personality disorder

BACKGROUND

Dialectical Behaviour Therapy (DBT) is recognized as a leading evidence-based treatment, effective in reducing symptoms of borderline personality disorder (BPD), as well as co-occurring clinical syndromes. However, symptom remission may not be the same as a life experienced as worth living. The purpose of the study was to understand, from the perspective of individuals with lived experience, the concepts of recovery, life experienced as worth living and flourishing after treatment for BPD, and to describe the pathways to wellness after symptom remission.

METHODS

Semi-structured interviews were conducted with nine adult women previously diagnosed with BPD, co-occurring clinical syndromes and severe self-harm behaviour who self-identified as recovered for a minimum of two years, recruited from a network for individuals with lived experience. The average duration of recovery was 5.7 years with a range from 2 to 10 + years. Data were analysed using thematic analysis.

RESULTS

Four main themes and 14 subthemes were generated from our analyses. Main themes indicated that loved ones helped recovery and to create a life worth living, that participants identified as recovered and as healthy and beyond, and that becoming well is a long process associated in part with reclaiming a healthy identity. Participants defined recovery as separate but related to a life worth living, which in turn was separate but related to being healthy and having lives they described as being beyond health and well-being. The wellness process was described as lengthy and non-linear, including setbacks that with time no longer derailed daily life. A proposed theoretical model depicting the wellness process over time from symptom remission to the experience of a life beyond health and wellness is presented.

CONCLUSIONS

This qualitative study contributes knowledge of what a life experienced as worth living means, as well as how wellness progressed into flourishing for some participants within a sample of individuals with lived experience. Our findings may inform treatment development that targets more than symptom reduction, which in turn may shorten trajectories from symptom remission to health, wellness, and flourishing.

Flourishing and the Prioritization of Workplace Elements in General Surgery Residents

INTRODUCTION

To explore and begin to operationalize workplace elements that influence general surgery (GS) resident wellbeing. Tailoring workplace wellbeing interventions is critical to their success. Occupational science has revealed that a person-centered approach to identifying positive and negative workplace influences can inform tailoring while accounting for individual differences. To our knowledge, this approach has not been applied to the surgical training environment.

METHODS

A national sample of GS residents from 16 Accreditation Council for Graduate Medical Education training programs ranked the importance of workplace elements via an anonymous survey. Latent profile analysis was performed to identify shared patterns of workplace element prioritization and their relation to levels of flourishing, a measure of global wellbeing.

RESULTS

GS trainee respondents (n = 300, 34% response rate - average for studies with this sample population) expressed a hierarchy of workplace element importance which differed by gender and race. "Skills to manage stress" and "a team you feel a part of" were prioritized higher by non-males than males. Residents of color and residents underrepresented in medicine, respectively, prioritized "recognition of work/effort" and "skills to manage stress" more than White and overrepresented in medicine residents. Flourishing prevalence varied by 40% with small differences in the specific profile of workplace element prioritization.

CONCLUSIONS

Differences in prioritization of workplace elements reveal subtle but important differences that may guide the design of wellbeing interventions for different populations within surgery.

Mindful self-care and resilience in first-year undergraduate students

OBJECTIVE

Post-secondary students experience elevated levels of academic stress. The objective of the current study is to examine the relationship between a three factor model of resilience (ie, mastery, emotionality reactivity, and relatedness), mindful self-care and flourishing in first-year undergraduate students.

PARTICIPANTS

A sample (n = 177) of first-year undergraduates were recruited from a large urban university in Alberta during the 2019-2020 academic year.

METHOD

A multiple regression analysis was utilized to examine whether the three-factor model of resilience and mindful self-care predicted flourishing in undergraduate students.

RESULTS

Self-reported resilience significantly predicted flourishing. Specifically, a sense of mastery and a sense of relatedness was positively associated with flourishing. Additionally, mindful self-care significantly predicted flourishing. Specifically, supportive relationships and supportive structure.

CONCLUSIONS

University demands are significant and academic stress reduction interventions should be offered to support students entering post-secondary education.

Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing

AIM

The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions.

METHODS

This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (n = 38,679) and data collected in 2020 were used for Study 2 (n = 50,307).

RESULTS

Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity.

CONCLUSION

Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.

Psychological resilience and competence: key promoters of successful aging and flourishing in late life

Many individuals, both in the public and within the field of psychology, often perceive aging as a burden that negatively impacts intellectual and mental health. Our present study aims to challenge this notion by identifying the crucial components of positive mental health in later life. These components not only promote positive mental health but also actively contribute to it, even under difficult circumstances. To accomplish this, we first offer a concise review of well-being and mental health models that highlight the psychological aspects of flourishing in late life. We then introduce a psychological competence-based model for positive mental health, which aligns with the concept of positive aging. Subsequently, we present a measurement tool suitable for practical applications. Finally, we provide a comprehensive overview of positive aging, drawing on methodological guidelines and existing research findings concerning sustainable positive mental health in later life. We examine the evidence indicating that psychological resilience (the capacity to adapt and recover from adversity or stress) and competence (skills and abilities to effectively cope with challenges across various life domains) significantly contribute to slowing down biological aging processes. Furthermore, we discuss insights into the relationship between psychological factors and aging derived from research on Blue Zones (regions characterized by a higher proportion of individuals experiencing longer, healthier lives).

Change of human flourishing during the COVID-19 pandemic in Japan: Results from population-based U-CORONA study

Longitudinal change in flourishing during the pandemic of COVID-19 would provide new insight to reveal determinants of well-being. We aimed to describe changes in flourishing during the COVID-19 pandemic in Japan and to examine the association of sex, age, education, and income with changes in flourishing. Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study conducted in October 2020 and November 2021 was used (n = 419 in 2020 and n = 478 in 2021, and n = 327 for both waves). Flourishing was assessed using a 12-item multidimensional flourishing scale including six domains. Change of flourishing was categorized into decreased, unchanged, and increased. Multinomial logistic regression was applied to longitudinal data to estimate the relative risk ratio of increase and decrease in flourishing scores. Cross-sectional analysis showed that the mean score of flourishing was approximately seven in both waves, with no sex differences, but older adults had higher scores than young-aged adults. We found that men were twice as likely to lose their flourishing scores as women and lower levels of education were associated with 2-3 times declining flourishing scores than higher levels of education. Age and income were not significantly associated with the change of flourishing. During the COVID-19 pandemic, flourishing declined, and men and lower-educated people were more vulnerable. In prolonged difficult situations, support for men and less educated people may contribute to the prevention of declining well-being in Japan.

Positive Psychological Well-Being in Hematopoietic Stem Cell Transplantation Survivors

Positive thoughts and emotions contribute to overall psychological health in diverse medical populations, including patients undergoing HSCT. However, few studies have described positive psychological well-being (eg, optimism, gratitude, flourishing) in patients undergoing HSCT using well-established, validated patient-reported outcome measures. We conducted cross-sectional secondary analyses of baseline data in 156 patients at 100 days post-HSCT enrolled in a randomized controlled trial of a psychological intervention (ClinicalTrials.gov identifier NCT05147311) and a prospective study assessing medication adherence at a tertiary care academic cancer center from September 2021 to December 2022. We used descriptive statistics to outline participant reports of positive psychological well-being (PPWB) using validated measures for optimism, gratitude, positive affect, life satisfaction, and flourishing. The participants had a mean age of 57.4 ± 13.1 years, and 51% were male (n = 79). Many, but not all, participants reported high levels of PPWB (ie, optimism, gratitude, positive affect, life satisfaction, and flourishing), defined as agreement with items on a given PPWB measure. For example, for optimism, 29% of participants did not agree that "overall, I expect more good things to happen to me than bad." Aside from life satisfaction, mean PPWB scores were higher in the HSCT population than in other illness populations. Although many patients with hematologic malignancies undergoing HSCT report high levels of PPWB, a substantial minority of patients reported low PPWB (i.e., no agreement with items on a given PPWB measure). Because PPWB is associated with important clinical outcomes in medical populations, further research should determine whether an intervention to promote PPWB can improve quality of life in HSCT recipients.

Occupational burnout, flourishing and job satisfaction among HIV/AIDS healthcare workers in Western China: a network analysis

BACKGROUND

Healthcare workers suffered with high prevalence of occupational burnout, which might be related with their job satisfaction and well-being. This study aimed to provide evidence of complex interrelations among occupational burnout, flourishing, and job satisfaction, and identify key variables from the perspective of network structure among healthcare workers.

METHODS

A cross-sectional study was conducted between July and October 2021, and 907 (the response rate was 98.4%) HIV/AIDS healthcare workers completed their sociodemographic characteristics, occupational burnout, flourishing and job satisfaction. Network analysis was conducted to investigate the interrelations of occupational burnout, flourishing, and job satisfaction communities, and identify central variables and bridges connecting different communities with different bridge strength thresholds in the network structure. The Network Comparison Test (NCT) was conducted to examine the gender differences in networks.

RESULTS

In the network, feeling exhausted at work (strength: 1.42) and feeling frustrated at work (1.27) in occupational burnout community, and interested in daily activities (1.32) in flourishing community were central variables. Bridges in the network were job reward satisfaction (bridge strength: 0.31), satisfaction with job itself (0.25), and job environment satisfaction (0.19) in job satisfaction community, as well as interested in daily activities (0.29) and feeling respectable (0.18) in flourishing community, with bridges selected with top 20% bridge strengths. Feeling frustrated at work (0.14) in occupational burnout community and leading a purposeful and meaningful life (0.11) in flourishing community became bridges when using thresholds of top 25% and 30% bridge strengths, respectively. We also observed higher network densities in females (network density: 0.37) than that in males (0.34), and gender differences in the distribution of partial correlation coefficients (M = 0.27, P = 0.017).

CONCLUSIONS

In the network structure of occupational burnout-flourishing-job satisfaction, feeling frustrated at work in occupational burnout community and interested in daily activities in flourishing community were both central variables and bridges, which may be targeted variables to intervene to alleviate the overall level of symptoms in the network and therefore prevent poor health outcomes in healthcare workers.

Psychometric properties of the Spanish version of the Flourishing Scale in the Honduran population

Studying Flourishing is important to understand wellbeing. The current study aimed to determine the psychometric properties of the Spanish version of the Flourishing Scale (FS) in the Honduran population. The primary sample consisted of 422 residents of the Central District of Honduras; this included 275 (65.17%) women and 147 men (34.83%). Their average age was 28.18 years (SD = 10.58). Findings from the Exploratory Factor Analysis and Confirmatory Factor Analysis support a unidimensional factor structure. The FS achieved a high internal consistency with McDonald's ω = 0.89, 95% CI [0.86, 0.91]. The average inter-item correlation was 0.48, 95% CI [0.43, 0.53]. Using Student's t-test for paired samples, results indicate that none of the FS items varied significantly between baseline and post-test. Additionally, Spearman's rho was used to correlate test-retest scores; this yielded a statistically significant correlation coefficient of 0.66. The Flourishing Scale had adequate convergent validity with the Subjective Happiness Scale (r = 0.70) and the PANAS-Positive Affect Subscale (r = 0.70) (p < 0.001). In contrast, it correlates inversely with the PANAS-Negative Affect Subscale (r = -0.34) and the PHQ-9 (r = -0.51). Strict measurement invariance for sex was supported. The results indicate that the Flourishing Scale has robust psychometric properties for the Honduran population. Practical implications for public policy are discussed.

Adolescent Anxiety, Depression and Flourishing before and During COVID-19 and the Predictive Role of Baseline Psychological Capital (PsyCap) on Student Mental Health and Subjective Wellbeing During the Pandemic

Studies indicate the COVID-19 pandemic has resulted in rises in adolescent mental health symptoms globally, although the impact of the pandemic on subjective wellbeing is under-researched in this population. Psychological capital (PsyCap), a cluster of four positive psychological constructs comprising hope, efficacy, resilience and optimism (HERO), has demonstrated preventative and promotive qualities on mental health symptoms and subjective wellbeing outcomes with adult populations (employees, university students). However, PsyCap's influence on these outcomes in young people is unclear. The present exploratory study investigated changes in self-reported anxiety and depressive symptoms (measured via the RCADS-SV) and subjective wellbeing (measured by the Flourishing Scale) from pre-pandemic levels to 3 months into the pandemic and explored gender differences at each time point in a sample of Australian Year 10 students (N = 56, Mage = 14.93 years, SD = 0.50, 51.8% male). The longitudinal predictive role of baseline PsyCap on follow-up assessments of anxiety symptoms, depressive symptoms and flourishing were also examined. There were no significant changes in levels of anxiety and depressive symptoms between the timepoints, but flourishing significantly declined from T1 to T2. Baseline PsyCap was not a significant predictor of T2 anxiety and depressive symptoms but was a significant predictor of T2 flourishing. Further, different baseline HERO constructs predicted T2 mental health symptoms and flourishing. Future larger studies building on the current preliminary findings investigating the roles of student PsyCap, mental health and subjective wellbeing are warranted to better understand these constructs in the COVID-19 era and beyond.

Positive childhood experiences on flourishing mediated by meaning in life in Chinese undergraduate nursing students: A cross-sectional study

AIM

To examine the associations of positive childhood experiences (PCEs) with positive mental well-being (i.e. meaning in life and flourishing) in Chinese undergraduate nursing students. The mediation effect of meaning in life on the association between PCEs and flourishing was investigated.

BACKGROUND

Mental health problems, such as high stress, have been prevalent in nursing students. Less is known about positive well-being that could be independent of mental health problems.

DESIGN

This was a cross-sectional study in Chinese nursing students of age ≥ 18 years enrolled in either three-year associate degree or four-year bachelor's degree program at 25 different universities across mainland China.

METHODS

PCEs were measured using the 10-item Benevolent Childhood Experiences scale on perceived relational and internal safety and security, positive and predictable quality of life, and interpersonal support by age 18. Measures of positive mental well-being included the Secure Flourish Index on flourishing and the Meaning in Life Questionnaire on presence of meaning and searching for meaning. Associations were analyzed using multivariable linear regression adjusting for perceived stress.

RESULTS

Of 2105 participants, 87.7% were female, the mean [SD] age was 19.8 [1.6] years. More PCEs were associated with higher flourishing (adjusted b=6.82, 95% CI 6.23, 7.41, β = 0.44), presence of meaning (adjusted b=0.91, 95% CI 0.75, 1.06, β = 0.24), and searching for meaning (adjusted b=0.67, 95% CI 0.49, 0.84, β = 0.17). Presence of meaning (indirect effect: adjusted b=1.57, 95% CI 1.27, 1.89) and searching for meaning (indirect effect: adjusted b=0.84, 95% CI 0.60, 1.08) partially mediated 23% and 12% of the association between PCEs and flourishing, respectively.

CONCLUSIONS

PCEs showed dose-response associations with meaning in life and flourishing in Chinese undergraduate nursing students, and the associations remained independent of perceived stress. The association between PCEs and flourishing was mediated through meaning in life. Higher meaning of life and flourishing associated with more PCEs highlighted the importance of increasing awareness and early screening of PCEs in nursing schools. The mediation effects of meaning in life warranted targeted interventions for helping students with fewer PCEs to flourish.

Ethical aspects of the work conditions of public safety personnel: a need for attention and solidarity

The work of public safety personnel (PSP; e.g. firefighters, police officers, and paramedics, among others) is essential to society but is practically and ethically complex, especially with the increased challenges posed by the COVID-19 pandemic. The strain on mental health in this population of workers and volunteers has been the focus of recent research. New programs and strategies are being developed and implemented in order to address the causes and implications of mental health problems at the individual and organizational levels in Canada and elsewhere. Yet, the properly ethical aspects of the work and work conditions of PSP have largely fallen outside the scope of public health research. There are few empirical studies on moral distress and moral injury of Canadian PSP, and the rich and complex moral life of these workers is often obfuscated by a pervasive, stoic, militaristic moral model that generally aligns with narrow biomedical treatment approaches. We argue that the lack of attention to the public, social, and ethical aspects of the moral distress and moral injuries experienced by PSP in Canada warrants greater public and academic awareness, more research on experiences of moral distress and moral injury in PSP, and evidence-informed training and support programs for individuals and organizations.

Suffering and the dilemmas of pediatric care: a response to Tyler Tate

In a recent article, Tyler Tate argues that the suffering of children - especially children with severe cognitive impairments - should be regarded as the antithesis of flourishing, where flourishing is relative to one's individual characteristics and essentially involves receiving care from others. Although initially persuasive, Tate's theory is ambiguous in several ways, leading to significant conceptual problems. By identifying flourishing with receiving care, Tate raises questions about the importance of care that he does not address, giving rise to a bootstrapping problem. By making flourishing relative to an individual's circumstances, Tate is forced to confront questions about exactly how relative it can be, suggesting the possibility that, on his view, to flourish is simply to be however one is. In an attempt to surmount these problems, I offer a revision and restatement of Tate's view that defines the relationship between individualized flourishing and the more conventional, species-relative concept, and describe more clearly the role that care should play with respect to flourishing - one that is instrumental and not merely constitutive. Even this restated view, however, fails to answer difficult questions about how one should respond to the medical needs of some children, highlighting the fact that a conceptual analysis of suffering may do little, in the end, to untangle ethical dilemmas in the care of severely ill children.

Does variability across three universities in the implementation of a college course on human flourishing affect student outcomes?

OBJECTIVE

This study explores whether variability in the implementation of an undergraduate course on human flourishing is differentially associated with student outcomes.

PARTICIPANTS

101 students in the "Art and Science of Human Flourishing" course across three large, public, R1 universities in Fall 2018 participated in the study.

METHODS

Formative course data included researcher observations of weekly class pedagogy, students' weekly meditation practice logs and end-of-course assessments, and pre/post surveys measuring changes in participating students' outcomes related to flourishing (e.g., attentional skills, social-emotional skills, perspectives on flourishing, mental and physical health).

RESULTS

Although course pedagogy and student engagement varied across the three universities, students' outcomes were nonetheless similar.

CONCLUSIONS

Variability in course implementation did not appear to differentially affect students' outcomes. We tentatively conclude that other institutions interested in offering the flourishing course may make limited adaptations to fit their pedagogical preferences without concern for altering its impact on students.

Flourishing with chronic illness(es) and everyday stress: Experiences from Soweto, South Africa

The pursuit of flourishing, or living a good life, is a common human endeavor with different meanings across individuals and contexts. What is needed is a further exploration of the relationship between flourishing and health, particularly chronic illness, which affects individuals across the life course and is affected by experiences of stress derived from social and structural vulnerability. Drawing on data from the Soweto Syndemics study, including a locally derived stress scale and in-depth interviews, we explore the connections between flourishing and health for those living with multiple chronic illnesses in Soweto, South Africa within a syndemic of communicable and non-communicable disease. Rather than drawing on Western-centric notions of flourishing (which place emphasis on an individual's capabilities or capacities to thrive), we draw on previous ethnographic work on flourishing in Soweto, South Africa, which described how ukuphumelela, or "becoming victorious," as a social or communal affair. This conceptualization reflects local values and priorities for people's lives and the ways in which their lives are deeply intertwined with each other. We contribute to a more robust understanding of flourishing in context, of how chronic illness is experienced, and of how the role of a patient is transcended in spaces where individuals are part of a social or faith community. As people living with chronic illness(es) actively pursue the good life, health care systems must consider these pursuits as valid parts of the human experience that also challenge narrow definitions of health.

The impact of social capital and social environmental factors on mental health and flourishing: the experiences of asylum-seekers in France

BACKGROUND

There is growing interest on how social capital and related social environmental factors impact overall population health and well-being. The nature of asylum-seekers' social environment alters once they migrate to a new context and these changes influence their mental health and well-being. However, there is limited scholarship on how these social environmental factors impact the mental health, well-being, and capacity to flourish of asylum-seekers.

METHODS

The aim of the study, therefore, was to examine how specific social environmental factors-social networks, social support, and social cohesion at various levels (micro, meso, and macro)-influence the mental health, well-being, and capacity to flourish of asylum-seekers in France. In collaboration with a community-based organization, we used a qualitative research design to conduct 120 semi-structured interviews with asylum-seekers in France.

RESULTS

The emerging salient themes depicted how the asylum-seekers' usual informal social networks comprised of family and friends had been disrupted since they migrated to France, which impacted their mental health and well-being. Conversely, staying connected with their informal transnational social networks via social media and developing ties with new local informal and formal social networks allowed them to receive different forms of social support, and buffered some of the negative mental health consequences. However, the lack of social cohesion due to a lack of belonging, marginalization, and current harmful migration-related policies impeded asylum-seekers' capacity to flourish.

CONCLUSION

While social support derived from social networks buffered some negative impacts on mental health and well-being, the overall lack of social cohesion ultimately impeded asylum-seekers' capacity to flourish within their host communities, which was further exacerbated by harmful migration policies of exclusion within France. Introducing more inclusive policies related to the governance of migration and an intersectoral approach that views health in all policies is key to promoting social cohesion and flourishing among asylum-seekers in France.

The road to postpandemic recovery in the USA: a repeated cross-sectional survey of multidimensional well-being over two years

OBJECTIVES

Examine differences in multidimensional well-being from before (January 2020) to three timepoints during the COVID-19 pandemic (June 2020, January 2021, January 2022).

STUDY DESIGN

Repeated cross-sectional design.

METHODS

Nationally representative cross-sectional cohorts of US adults completed the Secure Flourish Index before (January 2020 cohort: N = 1010) and during the COVID-19 pandemic (June 2020 cohort: N = 3020; January 2021 cohort: N = 3366; January 2022 cohort: N = 2598). We estimated differences in indicators, domains, and composite well-being between the January 2020 cohort and each of the subsequent cohorts. We also explored whether changes in well-being between January 2020 and January 2022 varied based on age, gender, and race/ethnicity.

RESULTS

Initial declines in well-being observed by June 2020 were largely followed by a return to prepandemic levels in January 2022, with some exceptions. Notably, general declines in mental health have persisted through to January 2022. On the other hand, there was evidence of general improvements in character & virtue that exceeded prepandemic levels in January 2022. Young adults and racial/ethnic minorities reported lower financial & material stability in January 2022 compared to before the COVID-19 pandemic.

CONCLUSIONS

Although there are promising signs that the well-being of US adults has mostly recovered to prepandemic levels, a coordinated response is urgently needed to support population mental health and the financial security of vulnerable groups. As society continues the journey toward postpandemic recovery, continued tracking of multidimensional well-being will be important for making informed decisions about public health priorities.

Terminology and the Well-being Literature

In this commentary, we offer some remarks concerning distinctions that might be drawn between psychological well-being, emotional well-being, well-being more generally, and flourishing. We put forward a flexible map of flourishing to help understand the relative place of these and other terms, and their respective nestings. We discuss some of the challenges concerning terminology related to the use of ordinary language, as well as practices of branding ordinary language expressions that potentially threaten understanding, and we offer some suggestions as to how to navigate some of these terminological challenges in the well-being literature.

Flourishing or physical activity?: Identifying temporal precedence in supporting the transition to university

Objective: Flourishing is a mental health indicator that helps students function optimally, which may be important for first-year university students. Physical activity (PA) also contributes to optimal functioning, yet the flourishing and PA relationship has received little attention. The bidirectional relationships between flourishing and meeting moderate-to-vigorous PA (MVPA) guidelines were assessed during the first year of university. Methods: First-year university students completed surveys (September [T1], March [T2]). Reciprocal effects were examined in a cross-lagged path model. Results: Over 40% of the sample was not meeting MVPA guidelines at T1 or T2. Controlling for sex, higher T1 flourishing was associated with higher odds of meeting T2 MVPA guidelines. T1 MVPA did not predict T2 flourishing. Conclusions: The findings provide preliminary evidence that flourishing may support meeting MVPA guidelines for first-year students. Given low rates of meeting guidelines, flourishing and PA could be targeted to foster MVPA, supporting a healthy university transition.

Psychometric Properties of PERMA Profiler Scale in Argentinian Adolescents

Aim

To adapt and validate the PERMA Profiler Scale (Butler & Kern, 2016) for Argentinian adolescents.

Method

The items were reviewed by 6 expert judges and 21 adolescents. The sample consisted of 421 adolescents (M = 14.9; SD = 1.75). The content validity and the discrimination capacity of the items were assessed. Afterwards, the structure of the scale was analyzed, as well as the internal consistency and the concurrent validity.

Results

All the items obtained an Aiken's V between .8 and 1 and were discriminatory. The factor analysis confirmed the five-dimension structure (CFI = .94, T LI = .92; RMSEA = .08, SRMR = .04). An Alpha of .92 was obtained for the full scale and satisfactory levels were obtained for the subscales. The correlations for concurrent validity were significant and in line with what was theoretically expected.

Conclusion

This adaptation enables the assessment of flourishing in a practical way.

Exploring factors associated with complete mental health of pregnant women during the COVID-19 pandemic

OBJECTIVE

To explore a wide range of factors associated with complete mental health (i.e., positive mental health - the presence of flourishing, and the absence of mental illness - depressive and anxious symptoms) among Portuguese pregnant women, during the COVID-19 pandemic.

DESIGN

Quantitative cross-sectional study.

SETTING

Data were collected through an online survey placed on social media websites targeting pregnant Portuguese adult women between October 2020 and April 2021.

PARTICIPANTS

The sample comprised 207 pregnant women.

RESULTS

A multivariate logistic regression model showed that higher levels of self-compassion and higher engagement in mindful self-care practices increased the likelihood of reporting complete mental health during pregnancy.

CONCLUSIONS

Promoting self-compassion and mindful self-care may be particularly important in pregnant women, as these psychological factors appear to contribute to complete mental health during COVID-19 pandemic.

IMPLICATIONS FOR PRACTICE

The COVID-19 pandemic represented a demanding period for pregnant women. Our findings highlight that targeting the promotion of self-compassion and mindful self-care practices during stressful periods could significantly contribute to their overall mental health.

Rebound in sexually transmitted infections after the COVID-19 pandemic

Sexually transmitted infections (STIs) have become the second in the global rating of infectious diseases after respiratory infections. Globally, over 1 million, new STI is diagnosed every day. Although four conditions are the most representative and of obligatory declaration (gonorrhea, syphilis, chlamydia, and human immunodeficiency virus [HIV]), there are many other prevalent STI, including trichomona, herpes simplex, papillomavirus, and viral hepatitis. Herein, we perform a narrative and retrospective review, analyzing information from public databases from distinct Spanish government institutions. STI significantly declined in Spain during 2020 as a result of lockdown and social isolation measures dictated in response to the COVID-19 pandemic. After releasing restrictions, a major STI rebound occurred in 2021. Increases were 49% for gonorrhea, 45% for HIV, 39% for chlamydia, and 32% for syphilis. Based on nationwide statistics, we build a narrative review of the recent STI surge after COVID-19. In summary, we propose a holistic approach to confront the current re-emergence of STI. On one hand, new innovative medical advances must be implemented, including new rapid tests, novel vaccines, pre-exposure prophylaxis beyond HIV, and long-acting antivirals. On the other hand, information to citizens needs to be reformulated with interventions aimed to build a healthier society, alike it has been undertaken with tobacco, alcohol, diet, and lifestyle. STI determines important sexual, reproductive, and maternal-child health consequences. To promote human well-being or flourishing, the education of adolescents and young adults should be aligned with human ecology. Therefore, it is urgent to address new approaches in sexual health that represent a clear benefit for individual persons and society. In this way, favoring a cultural evolution aimed to delay the age of first sexual intercourse and the avoidance of multiple sex partners should be prioritized.

Promoting Resilience and Flourishing Among Older Adult Residents in Community Living: A Feasibility Study

BACKGROUND AND OBJECTIVES

The Stress Management and Relaxation Training-Relaxation Response Resiliency Program (SMART-3RP) is a mind-body group intervention that integrates relaxation training with cognitive behavioral and positive psychology techniques. This study assessed SMART-3RP feasibility, acceptability, and preliminary efficacy for enhancing resilience and flourishing among older adults in continuing care retirement communities (CCRCs).

RESEARCH DESIGN AND METHODS

We conducted a prospective single-arm study of SMART-3RP groups delivered by clinicians at 4 CCRCs (n = 80). Eligible residents lived in community apartments. Participants completed pre- and postintervention surveys. We evaluated attendance (hypothesis: ≥60% attend ≥6 of 9 sessions), enrollment, and retention. Mixed methods were used to explore acceptability. Paired samples t-tests were conducted to explore changes in resilience, flourishing, and key intervention targets.

RESULTS

From March to June 2021, we screened 89 residents with 87 (98%) consenting to participate and 80 (90%) enrolling in the study. Among 80 participants (85% female; 98% non-Hispanic White; M age = 80 years [SD = 6]), 88% attended ≥6 sessions, and 89% completed the postintervention survey. Participants found meaning in participation and practiced skills in the context of challenges such as caregiving burden or bereavement. Survey results, showing increases in resilience, flourishing, and several intervention targets, aligned with participants' perceived intervention value.

DISCUSSION AND IMPLICATIONS

SMART-3RP was feasible and acceptable for CCRC residents; participants perceived value in practicing mind-body strategies in a group-based setting. Preliminary evidence suggested a pattern of improvements in resilience, flourishing, and intervention targets. Findings provide insights for mind-body interventions and recommendations for adaptations to late-in-life concerns and community settings.

CLINICAL TRIALS REGISTRATION NUMBER

NCT04720014.

The Moral Pitfalls of Cultivated meat: Complementing Utilitarian Perspective with eco-republican Justice Approach

The context of accelerated climate change, environmental pollution, ecosystems depletion, loss of biodiversity and growing undernutrition has led human societies to a crossroads where food systems require transformation. New agricultural practices are being advocated in order to achieve food security and face environmental challenges. Cultivated meat has recently been considered one of the most desired alternatives by animal rights advocates because it promises to ensure nutrition for all people while dramatically reducing ecological impacts and animal suffering. It is therefore presented as one of the fairest means of food production for the coming decades, according to utilitarian arguments. However, food security, environmental concerns and animal welfarism guided by a short-term utilitarianism could have techno-optimism bias and could result in some forms of oppression such as anthropocentrism. I argue that there are still deep-rooted moral issues in food systems that are not addressed primarily by lab-grown meat, mainly derived from a loss of sovereignty. Food practices developed in high-tech labs with artificial interventionism constrain the ability of living entities (that are used as food) to flourish on their own terms. This paper aims to explore how sovereignty entitlements for humans and nonhumans are often overlooked by advocates of cultivated meat and the moral challenges it may pose. Accordingly, a more than utilitarian approach framed by ecological and republican justice is proposed here to shed light on some pitfalls of food chains based on cellular agriculture.

The fear of COVID-19 and flourishing: the mediating role of search for meaning and presence of meaning

Past researches have found that sense of control and meaning in life can act as a protective factor against fear of COVID-19 pandemic. The current study examined whether the search for meaning and the presence of meaning could mediate the link between fear of COVID-19 and flourishing. A total of 312 Iranians who were identified by snowball sampling were recruited as the subjects of the cross-sectional study. The participants gave their consent to complete the Meaning in Life Scale, Flourishing Scale, and Fear of COVID-19 Scale. The findings demonstrated that fear of COVID-19 had a significant direct effect on flourishing. The presence meaning was positively and significantly connected with flourishing and the search for meaning. Both the search for - and the presence - of meaning were negatively and significantly linked with fear of COVID-19. Mediation analysis demonstrated that a presence of meaning is a protective factor for flourishing, but the search for meaning can be detrimental to flourishing. As a result, it may be worthwhile to conduct longitudinal research to track how the effects of the presence of meaning and the search for meaning vary over time. The study calls on mental health providers to take into account how the presence of meaning might lessen the negative impacts of fear in crisis situations and promote flourishing.

Flourishing mental health among adults with child welfare contact during childhood: Findings from a nationally representative Canadian survey

This study investigated the prevalence of and factors associated with complete mental health (CMH) among a nationally representative sample of Canadians who had contact with child welfare services before age 16. CMH was defined as (1) the absence of suicidality, mental illness, and substance abuse or dependence in the preceding year; (2) happiness or life satisfaction almost every day in the preceding month, and; (3) social and psychological well-being almost every day in the preceding month. Data came from the 2012 Canadian Community Health Survey - Mental Health. A subsample of 732 adults with child welfare contact during childhood was analyzed using bivariate chi-square analyses and multivariate logistic regression models. Overall, 63.5% of adults with child welfare contact during childhood were in CMH. Those with a post-secondary degree, who were married, who had a confidant, and who used religion or spirituality to cope with daily challenges were more likely to be in CMH. The odds of CMH were higher among those without chronic pain, functional limitations, and a history of depression, anxiety, or substance abuse or dependence. The results of this study indicate significant resiliency among adults following contact with child welfare services during childhood. Implications for appropriate interventions are discussed.

The association of physical activity, sleep, and screen time with mental health in Canadian adolescents during the COVID-19 pandemic: A longitudinal isotemporal substitution analysis

BACKGROUND

The impact of COVID-19 on adolescent mental health is a global concern. Increased screen time and reduced physical activity due to the lockdown measures have been linked to detrimental mental health outcomes; however, the literature remains limited by cross-sectional and retrospective designs, and consideration of behaviours in isolation. Prospective evidence is necessary to examine whether moderate-to-vigorous physical activity (MVPA), sleep and screen time influenced changes in mental health.

METHOD

Analyses used data from a prospective cohort study of secondary school students in Canada with baseline data from the 2018-2019 school year and linked follow-up data from online surveys completed during the initial COVID-19 outbreak (May-July 2020). Multilevel linear regression models were used to evaluate the within- and between-person isotemporal substitution effects of sleep, MVPA and screen time behaviours on depression, anxiety, subjective well-being, and trait emotional dysregulation.

RESULTS

Linked longitudinal data from 2645 students attending 44 schools were available. Between-person effects indicated that individuals who engaged in more MVPA and sleep while minimizing screen time had lower depression scores, less severe emotional dysregulation, and better subjective well-being. While controlling for between-person effects, within-person year-on-year change suggests those who increased screen time while decreasing either MVPA or sleep experienced mental health decline on all outcomes.

CONCLUSION

MVPA and sleep were associated with youth mental health during the early COVID-19 lockdown. Increasing MVPA and sleep (or at least mitigating the increase of screen time) compared to the prior year was associated with better mental health during the early pandemic. A limitation to consider is that the screen time measure represents a combination of screen behaviours, and effects of replacing screen time may have varied if distinctions were made.

Youth Lens: Youth Perspectives on the COVID-19 Pandemic and its Impact on Well-being in an Urban Community

The COVID-19 pandemic has greatly altered the lives of children and youth throughout the world, with significant implications for their long-term health and well-being. Children were largely excluded from the development and implementation of the various pandemic mitigation strategies and policies, yet their lives were significantly affected. This study sought to shed light on children's perspectives and experiences during the COVID-19 pandemic, the various ways it impacted their health and well-being, along with the resources which allowed them to continue to flourish in the face of extreme hardship. We present a subset of findings regarding the COVID-19 pandemic from the Youth Lens study, with 65 youth (aged 10-18) from urban communities in Cleveland, OH, USA. We utilized a participatory methodology with youth, including the data collection techniques of photo voice, community mapping, group discussion, individual interviews, and journaling. This study highlights important and timely findings related to children's well-being during the COVID-19 pandemic from the youth's perspectives and underscores potential ways to address their challenges and concerns.

Demographic Predictors of Complete Well-Being

This paper examines demographic differences in flourishing, defined as "complete well-being" and consisting of six domains: emotional health, physical health, purpose, character strengths, social connectedness, and financial security. Results are based on a random, cross-sectional sample of 2363 survey respondents drawn from employees of a large, national, self-insured employer based in the United States. We found that well-being across domains tends to increase with age, although there are some variations. Results are similar across most domains for men and women, although women score higher on character strengths, while men had higher scores on financial security. Racial and ethnic differences were striking. Black employees score higher than the reference group (White employees) on the emotional, purpose, and character strengths domains, but considerably lower on financial security. Hispanics also score lower on financial security (though not as low as Blacks), but higher than Whites on purpose, character strengths, and social connectedness. Asians reported higher well-being than Whites across all domains except purpose.

Can the Academic and Experiential Study of Flourishing Improve Flourishing in College Students? A Multi-University Study

Objectives

Significant concerns have been raised about the "mental health crisis" on college campuses, with attention turning to what colleges can do beyond counseling services to address students' mental health and well-being. We examined whether primarily first-year (89.1%) undergraduate students (n=651) who enrolled in the Art and Science of Human Flourishing (ASHF), a novel academic and experiential for-credit elective course on human flourishing, would demonstrate improved mental health and strengthen skills, perspectives, and behaviors associated with flourishing relative to students who did not enroll in this course.

Methods

In a two-wave, multi-site, propensity-score matched controlled trial (ASHF n=217, Control n=434; N=651), we used hierarchal linear models and false discovery rate corrected doubly robust estimates to evaluate the impact of the ASHF on attention and social-emotional skill development, flourishing perspectives, mental health, health, and risk behavior outcomes.

Results

ASHF participants reported significantly improved mental health (i.e., reduced depression) and flourishing, improvements on multiple attention and social-emotional skills (e.g., attention function, self-compassion), and increases in prosocial attitudes (empathic concern, shared humanity; Cohen's ds= 0.18-0.46) compared to controls. There was no evidence for ASHF course impacts on health or risk behaviors, raising the possibility that these outcomes take more time to change.

Conclusions

This research provides initial evidence that the ASHF course may be a promising curricular approach to reduce and potentially prevent poor mental health while promoting flourishing in college students. Continued research is needed to confirm these conclusions.

Eudaimonic well-being in individuals with mild to moderate intellectual disability

BACKGROUND

Subjective well-being research in individuals with intellectual disability (ID) has a large hedonic focus and eudaimonic well-being is understudied in this population. Knowledge on eudaimonic well-being of individuals with ID is however necessary to improve their experienced well-being and support them in leading meaningful and flourishing lives.

AIMS

The current study adopted a qualitative design to examine whether and how people with ID experience elements of eudaimonic well-being.

METHODS AND PROCEDURES

Eleven adults with mild to moderate ID participated in individual semi-structured interviews about their subjective well-being. Interviews with their relatives and their direct support providers were conducted to contextualize the data.

OUTCOMES AND RESULTS

By means of an interpretative phenomenological analysis, social relationships, accomplishment, purpose and balance, individuality, autonomy, and growth could be identified as relevant elements of eudaimonic well-being. Eudaimonic well-being of individuals with ID seemed to be mediated by acceptance of others.

CONCLUSIONS AND IMPLICATIONS

The results provide insight in eudaimonic indicators of well-being, expanding the current view on well-being in individuals with ID. Efforts to use these elements in the care and support for individuals with ID are discussed.

Examining child flourishing, family resilience, and adversity in the 2016 National Survey of Children's Health

PURPOSE

Explore factors associated with flourishing and family resilience among children aged 6 months to 5 years old in the 2016 National Survey of Children's Health (NSCH).

DESIGN AND METHODS

Cross-sectional analysis of the 2016 NSCH was conducted using Kleinman and Norton's Regression Risk Analysis method to derive adjusted risk measures for logistic regression models to assess factors contributing to (1) child flourishing and (2) child flourishing stratified between resilient and non-resilient families.

RESULTS

In multivariable models, resilient families less often reported a child with two or more lifetime ACE exposures (ARD -0.11, 95% CI -0.15, -0.08), more likely to live in a supportive neighborhood (ARD 0.08, 95% CI 0.05,0.11), and more likely to report emotional support in raising children (ARD 0.07, 95% CI 0.12, 0.40). Accounting for ACE exposures, within resilient families, child flourishing was more likely when the child lived in a supportive neighborhood (ARD 0.09, 95% CI 0.03, 0.15), received care in a patient centered medical home (ARD 0.09, 95% CI 0.02,0.15), and when parents reported having emotional support in raising children (ARD 0.10, 95% CI 0.05, 0.17) Within non-resilient families, child flourishing was more likely when parents had emotional support in raising children (ARD 0.15, 95% CI 0.04,0.27).

CONCLUSION

Promoting emotional support for parents may bolster family resilience and help young children to flourish despite adversity.

PRACTICE IMPLICATIONS

Further research and innovative models of care are needed to optimize the role of pediatric primary care in promoting safe, stable, nurturing relationships and environments for children and families.

Quiet Ego Intervention Enhances Flourishing by Increasing Quiet Ego Characteristics and Trait Emotional Intelligence: A Randomized Experiment

The quiet ego-a personality construct characterized by empathy, inclusivity, non-defensiveness, and growth-mindedness in self-other relations-correlates positively with varied health markers. There is also emerging evidence that quiet-ego-based interventions may have a positive impact on health-related outcomes. However, no research has examined whether such interventions promote psychological flourishing and through what mechanisms. We addressed this gap with a randomized longitudinal experiment, hypothesizing that a quiet ego contemplation would improve participants' flourishing and that the link between the intervention and flourishing would be mediated by higher trait emotional intelligence (EI). Using Amazon MTurk, we randomly assigned 75 participants to a 3-session intervention or control condition. As hypothesized, participants in the intervention condition reported higher trait EI scores that, in turn, elevated their flourishing. Results extend the causal benefits of brief quiet ego interventions to psychological flourishing. Given the study's context during the COVID-19 pandemic, the findings may have implications for mitigating the negative impact of the pandemic.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-022-00560-z.

Toward Measurement for a Whole Child Health Policy: Validity and National and State Prevalence of the Integrated Child Risk Index

OBJECTIVE

To develop, validate and estimate national and across state prevalence on a multidimensional index that assesses the complex medical, social, and relational health risks experienced by United States children.

METHODS

Data from the National Survey of Children's Health were used to construct the Integrated Child Risk Index (ICRI) which includes medical health risk (MHR), social health risk (SHR) and relational health risk (RHR) domains. Confirmatory factor analysis and logistic regression analyses were employed to assess construct and predictive validity. Validity outcomes were child flourishing, school engagement/readiness, emergency room utilization and forgone care.

RESULTS

Confirmatory factor analysis confirmed the ICRI 3-domain structure and greater correlation between MHR and RHR than MHR and SHR. Logistic regressions confirmed strong predictive validity of the ICRI for all study outcomes and ICRI scoring approaches. Nearly two-thirds of children (64.3%) with MHR also experienced SHR and/or RHR. Nearly one-third of United States children experienced risks on 2 or more ICRI domains and 15% of publicly insured children had risks on all domains (16.2%; 9.0%-25.7% across states). Significant variations were observed across states and by age, race/ethnicity, health insurance and household income.

CONCLUSIONS

The ICRI is a valid national and state level index associated with children's flourishing and educational preparedness and emergency and forgone care. National child health policies and Medicaid risk stratification and payment models should consider children's RHR in addition to SHR and MHR. Results call for integrated systems of care with the capacity to address medical, social and relational health risks and promote well-being. Substate and clinical applications require research.

Differences in the age-varying association of school belonging with socioemotional flourishing among minority and non-minority college and university students

Objective: This study aimed to assess the age-varying prevalence of and association between school belonging and flourishing among sexual or gender minority (SGM) and racial or ethnic minority (REM) students compared with non-minority students in the U.S. college setting. Participants: Data were drawn from a 2017-2018 national survey of U.S. college and university students ages 18-26. Method: Data were examined using varying-coefficients models to estimate the relation of school belonging and flourishing across ages 18-26. Results: SGM students (n = 6,718) and REM students (n = 10,539) reported significantly lower belonging and flourishing than cisgender heterosexual students (n = 19,492) and white students (n = 16,444), respectively, at several age points. The association of belonging with flourishing was significantly greater for SGM students than for cisgender heterosexual students across all ages. Conclusions: Findings of this study underline the important role of school belonging in socioemotional flourishing for SGM young adults.

Individual, family, and social correlates of flourishing outcomes among youth: Findings from the 2016-2017 National Survey of Children's Health

BACKGROUND

Flourishing is considered an optimal state of well-being and is associated with positive psychological outcomes. Although, individual, family, and social factors may either facilitate or impede flourishing, their unique influence on flourishing outcomes is not well-understood among youth.

OBJECTIVE

Using data from the 2016-2017 National Survey of Children's Health (NSCH), this study investigated cross-sectional associations among adverse family experiences (AFE), community safety, family resilience, parental aggravation, and flourishing among youth.

PARTICIPANTS AND SETTING

Data from the 2016-2017 NSCH (N = 51,156) were analyzed. Participants included males (n = 26,124) and females (n = 25,032) whose ages ranged from 6 to 17 years old (M = 12.14, SD = 3.45).

METHODS

After controlling for relevant demographics, adjusted odds ratios (AORs) using a single-block logistic regression determined the relative likelihood of flourishing.

RESULTS

Youth who experienced zero to one AFE (AOR = 2.10; 95% CI [1.95, 2.26]) and two to three AFEs (1.32 [1.20, 1.45]) were more likely to flourish than youth with four or more AFEs. Youth whose parents endorsed low parental aggravation (6.80 [6.41, 7.22]) and moderate parental aggravation (3.70 [3.51, 3.89]) were more likely to be flourishing than youth whose parents endorsed high parental aggravation.

CONCLUSIONS

Findings suggest that high parental aggravation is related to poorer flourishing outcomes, after considering community safety, family adversity, family resilience, and demographic characteristics. Providers should consider interventions to support the emotional regulation of parental systems as a means of maximizing developmental outcomes among youth.

The Impact of Compassion from Others and Self-compassion on Psychological Distress, Flourishing, and Meaning in Life Among University Students

Objectives

Research shows that compassion from others and from the self may enable university students to face, overcome, and bounce back from adversity and generate a greater sense of thriving and meaning in life. However, the underlying processes are largely unknown. The present study aimed to examine the associations of compassion with psychological distress, flourishing, and meaning in life among university students and explore the mechanisms underlying these associations.

Methods

A total of 536 Hong Kong university students completed questionnaires measuring their experiences of compassion from others, self-compassion, resilience, psychological distress, flourishing, and meaning in life.

Results

Serial mediation analyses showed that compassion from others was associated positively with self-compassion, which was, in turn, linked to greater resilience and consequently lower levels of psychological distress and higher levels of flourishing and meaning in life.

Conclusions

Our findings reveal the associations of compassion from others and self-compassion with the well-being and life meaning of university students. The findings highlight the importance of being open and receptive to love and kindness from others. The findings also point to the importance of developing a caring attitude toward oneself.

Perceived procedural justice and psychological flourishing among mental health professionals in Macao: a moderated mediation model

This study aimed to examine whether and how organizational factors (i.e., procedural justice) are associated with psychological flourishing, an optimal mental state. Path analysis was conducted among 195 Chinese mental health professionals (females = 69%; Mean age = 30 years) in Macao, and results showed that emotional exhaustion partially mediated the positive association between procedural justice and psychological flourishing, whereas emotion regulation significantly diminished the effects of procedural injustice on emotional exhaustion. Our findings highlight the emotional mechanisms underlying the influence of organizational procedures on employees' wellbeing, and wellness programs for enhancing employees' emotional regulation skills are recommended.

Do You Really Want to Be Forever Young? Emotional Health and Psychosocial Well-being by Relative Birth Quarter in Canadian Adolescents

PURPOSE

Those born earlier within cohorts of similarly aged children tend to outperform peers in athletic and academic pursuits. Subsequent evidence suggests relatively younger children may also experience worse emotional and psychosocial health; however, evidence from middle adolescents is limited. This study assessed whether depression, anxiety, and psychosocial well-being differed by the relative birth quarter (RBQ) within a cohort of grades 9-12 in secondary schools across Canada.

METHODS

Data from the 2018-19 student self-report surveys of the cannabis use, obesity, mental health, physical activity, alcohol use, smoking, and sedentary behavior study were analyzed. Students having made normative progress were categorized into RBQs by the provincial enrollment cutoff date (n = 49,921). Hierarchical modeling approaches assessed whether self-reported depression, anxiety, psychosocial well-being, and positive controls differed by RBQ after controlling for covariates.

RESULTS

Despite relative age effects for positive control outcomes, no significant difference was detected for anxiety and depression scores or likelihood of meeting thresholds for having clinically relevant symptoms. However, a significant difference emerged between RBQs for psychosocial well-being scores; post hoc tests found that psychosocial well-being scores were lower in the fourth RBQ than those in all prior quarters.

DISCUSSION

Results agree with limited findings that relative age differences in emotional health are not significant in older cohorts. Nonetheless, relatively older individuals reported very small (d = .04-.05) advantages in psychosocial well-being than their youngest peers, which aligns with previous data. Longitudinal approaches to assess relative age effects on mental health during and throughout the transition into middle adolescence are warranted.