COVID-19 has created significant challenges for higher education institutions and major disruptions in teaching and learning. To explore the psychological wellbeing of domestic and international ...university students during the COVID-19 pandemic, an online cross-sectional survey recruited 787 university students (18+ years) currently studying at an Australian university. In total, 86.8% reported that COVID-19 had significantly impacted their studies. Overall, 34.7% of students reported a sufficient level of wellbeing, while 33.8% showed low wellbeing and 31.5% very low wellbeing. Wellbeing was significantly higher in postgraduate students compared with undergraduate students. Future anxiety was significantly greater among undergraduate than postgraduate students. Multivariable regression models showed female gender, low subjective social status, negative overall learning experience or reporting COVID-19 having a huge impact on study, were associated with lower wellbeing in the first few months (May-July) of the pandemic. Supporting the health, wellbeing, and learning experiences of all students should be of high priority now and post-pandemic. Strategies specifically targeting female students, and those with low self-reported social status are urgently needed to avoid exacerbating existing disparities.
The COVID-19 pandemic has been accompanied by rapidly emerging evidence, changing guidance, and misinformation, which present new challenges for health literacy (HL) and digital health literacy (DHL) ...skills. This study explored whether COVID-19-related information access, attitudes, and behaviors were associated with health literacy and digital health literacy among college students in the United States. Self-reported measures of health literacy, along with items on pandemic-related attitudes, behaviors, information sources, and social networks, were collected online using a managed research panel. In July 2020, 256 responses were collected, which mirrored the racial/ethnic and gender diversity of U.S. colleges. Only 49% reported adequate HL, and 57% found DHL tasks easy overall. DHL did not vary by HL level. In multivariable models, both HL and DHL were independently associated with overall compliance with basic preventive practices. Higher DHL, but not HL, was significantly associated with greater willingness to get a COVID-19 vaccine and the belief that acquiring the disease would negatively impact their life. On average, respondents discussed health with 4-5 people, which did not vary by HL or DHL measures. The usage of online information sources varied by HL and DHL. The study findings can inform future student-focused interventions, including identifying the distinct roles of HL and DHL in pandemic information access, attitudes, and behaviors.
Zusammenfassung
Die Schule ist einer der wichtigsten Orte, an dem die Förderung der Gesundheit von Kindern und Jugendlichen ansetzen kann, u. a. weil die Schülerinnen und Schüler hier einen Großteil ...ihrer Zeit verbringen. Allerdings kann sich Schule nur in Teilen der Gesundheitsförderung widmen und die Schule ist selbst nur ein Teil der alltäglichen Umwelt, von der das Gesundheitsverhalten geprägt wird. Um die Effektivität der Gesundheitsförderung zu steigern, erscheint die Bildung von Netzwerken zwischen schulischen und kommunalen Akteurinnen und Akteuren wie Sportvereinen, Jugendhilfe, Beratungsstellen und Gesundheitsämtern sinnvoll.
Der vorliegende Artikel thematisiert die Frage der Relevanz von Netzwerken im Kontext der schulischen Gesundheitsförderung. Die Herleitung basiert einerseits auf dem gesetzlichen Rahmen des Bildungsauftrags von Schulen und dem sogenannten Präventionsgesetz von 2015 und andererseits auf der Ottawa-Charta der Weltgesundheitsorganisation (WHO) sowie auf dem daraus entwickelten Diskurs um die Begriffe „Gesundheitsförderung“ und „Settingansatz“. Es werden Perspektiven aufgezeigt, wie Netzwerkarbeit wissenschaftlich fundiert gestaltet werden kann und wie passende Netzwerkpartner gewonnen werden können. Mögliche Risiken und Chancen der Netzwerkarbeit werden analysiert und Faktoren des Gelingens und Scheiterns aufgezeigt.
Netzwerkarbeit sollte für Schulen im Sinne der Gesundheitsförderung obligatorisch sein. Sie kann dazu beitragen, Bedarfe innerhalb der Schule zu ermitteln, und gleichzeitig ein Schlüssel im Umgang mit resultierenden Herausforderungen sein. Netzwerkarbeit erfordert vor allem die Motivation der Akteurinnen und Akteure. Eine gemeinsame Vision, feste Strukturen und Kontinuität sowie entsprechende personelle Überlegungen tragen zum Gelingen der Zusammenarbeit bei.
Abstract
Background
The prevalence of mental health problems in childhood and adolescence has increased significantly, not least due to the COVID-19 pandemic in Germany and other countries worldwide. ...Although holistic school interventions to promote mental health and prevent mental health problems are considered promising, there is currently uncertainty about their effectiveness due to evaluation studies with heterogeneous methodological quality. This paper presents the study protocol for the evaluation of the primary school module of MindMatters.
Methods
As part of a universal mental health intervention, the MindMatters primary school module ‘Learning Together with Emotions’ aims to promote social-emotional learning (SEL) in the classroom across five skill areas. In addition to classroom activities, the intervention includes a school development module to help primary schools create structures and processes to maintain and promote mental health. To evaluate the effectiveness of the intervention, a two-arm cluster-randomised controlled trial will be conducted, including schools implementing MindMatters over a 12-month period and a control group with no access to the intervention. Data will be collected before and 18 months after initiation of the intervention. Controlled for baseline conditions, multilevel regression analysis will be used to examine primary intervention outcomes at the pupil level (i.e. reductions in mental and behavioural problems). Further mediation and moderation analyses will examine whether proximal outcomes predict changes in mental health outcomes and whether school-level factors influence the effectiveness of the intervention.
Discussion
This study will contribute to strengthen the evidence base for holistic school (mental) health promotion interventions using a study design with high internal validity. Based on an intervention model, the results will not only provide insights into the relationship between proximal and distal outcomes, but will also allow conclusions to be drawn about how the implementation of the intervention affects its effectiveness. Finally, the findings also address the question of whether improved mental health has a positive effect on primary school pupils’ academic performance.
Trial registration
German Clinical Trials Register DRKS00023762. Registered on 5 January 2021.
Zusammenfassung
Hintergrund
Trotz gesundheitlicher Risiken, die für alle Menschen von SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) ausgehen, weisen Bevölkerungsgruppen mit ...gesundheitlicher Vulnerabilität ein erhöhtes Gefährdungsprofil auf. Zu den Risikogruppen für schwere COVID-19-Verläufe („coronavirus disease 2019“) gehören Personen ab 50 Jahren, Raucher*innen, adipöse Personen sowie Menschen mit bestimmten Vorerkrankungen. Gerade für diese Bevölkerungsgruppe ergibt sich ein erhöhter Schutzbedarf. Inwiefern sich das Schutzverhalten von Personen mit hoher im Vergleich zu Personen mit geringer gesundheitlicher Vulnerabilität unterscheidet, ist bislang wenig untersucht.
Methode
Es wurde eine onlinebezogene Querschnittstudie mit einem „convenience sample“ von
n
= 210 in Deutschland lebenden Personen im Alter ab 18 Jahren realisiert. Es wurden subjektive Selbsteinschätzungen zur Anwendung von Infektionsschutzmaßnahmen sowie der eigenen Informationssuche und -zufriedenheit bezüglich der Pandemie und der COVID-19-bezogenen Gesundheitskompetenz (GK) erfasst. Die Analyse erfolgte uni-, bi- sowie multivariat, wobei für alle Analysen ein Signifikanzlevel von
p
< 0,05 festgelegt wurde.
Ergebnisse
Über alle erhobenen Schutzverhaltensweisen hinweg weisen die Befragten eine insgesamt hohe Compliance (84 %) auf. Während das Tragen einer Maske (96 %) und das Vermeiden von privaten Reisen und Händeschütteln (95 %) die höchste Zustimmung erhielten, berührten 47 % der Befragten ihr Gesicht häufig mit ungewaschenen Händen. Jüngere (35 % bis 29 Jahre) sowie Personen mit eingeschränkter Gesundheitskompetenz (28 %) zeigen sowohl in den bivariaten und multivariaten Analyse signifikant häufiger ein weniger ausgeprägtes Schutzverhalten. Hingegen ließen sich differenziert nach Anzahl gesundheitlicher Risikofaktoren keine Unterschiede im präventiven Schutzverhalten feststellen
Schlussfolgerung
Es konnte ein hohes Niveau der Anwendung von präventiven Schutzmaßnahmen bei Befragten dieser Studie ermittelt werden. Sowohl in den uni- als auch bi- und multivariaten Analysen ist die gesundheitliche Vulnerabilität nicht mit einem stärker ausgeprägten Schutzverhalten assoziiert. Insbesondere für Personen mit eingeschränkter coronaspezifischer Gesundheitskompetenz sind Defizite im Infektionsschutz erkennbar, weshalb die zielgruppenspezifische Aufklärung weiter priorisiert werden muss.
Background During the COVID-19 pandemic, much misinformation and disinformation emerged and spread rapidly via the internet, posing a severe public health challenge. While the need for eHealth ...literacy (eHL) has been emphasized, few studies have compared the difficulties involved in seeking and using COVID-19 information between adult internet users with low or high eHL. Objective This study examines the association between eHL and web-based health information–seeking behaviors among adult Japanese internet users. Moreover, this study qualitatively shed light on the difficulties encountered in seeking and using this information and examined its relationship with eHL. Methods This cross-sectional internet-based survey (October 2021) collected data from 6000 adult internet users who were equally divided into sample groups by gender, age, and income. We used the Japanese version of the eHL Scale (eHEALS). We also used a Digital Health Literacy Instrument (DHLI) adapted to the COVID-19 pandemic to assess eHL after we translated it to Japanese. Web-based health information–seeking behaviors were assessed by using a 10-item list of web sources and evaluating 10 topics participants searched for regarding COVID-19. Sociodemographic and other factors (eg, health-related behavior) were selected as covariates. Furthermore, we qualitatively explored the difficulties in information seeking and using. The descriptive contents of the responses regarding difficulties in seeking and using COVID-19 information were analyzed using an inductive qualitative content analysis approach. Results Participants with high eHEALS and DHLI scores on information searching, adding self-generated information, evaluating reliability, determining relevance, and operational skills were more likely to use all web sources of information about COVID-19 than those with low scores. However, there were negative associations between navigation skills and privacy protection scores when using several information sources, such as YouTube (Google LLC), to search for COVID-19 information. While half of the participants reported no difficulty seeking and using COVID-19 information, participants who reported any difficulties, including information discernment, incomprehensible information, information overload, and disinformation, had lower DHLI score. Participants expressed significant concerns regarding “information quality and credibility,” “abundance and shortage of relevant information,” “public trust and skepticism,” and “credibility of COVID-19–related information.” Additionally, they disclosed more specific concerns, including “privacy and security concerns,” “information retrieval challenges,” “anxieties and panic,” and “movement restriction.” Conclusions Although Japanese internet users with higher eHEALS and total DHLI scores were more actively using various web sources for COVID-19 information, those with high navigation skills and privacy protection used web-based information about COVID-19 cautiously compared with those with lower proficiency. The study also highlighted an increased need for information discernment when using social networking sites in the “Health 2.0” era. The identified categories and themes from the qualitative content analysis, such as “information quality and credibility,” suggest a framework for addressing the myriad challenges anticipated in future infodemics.
Worldwide, one third of the adult population is insufficiently physically active. This fact has led to a strong demand for public health initiatives. Given the mixed evidence on the effectiveness of ...worksite interventions promoting physical activity (PA), a pedometer-based and gamified intervention, Healingo Fit, was developed and evaluated over a period of six weeks.
The effectiveness of Healingo Fit was evaluated as part of a randomized controlled trial (RCT) with two measurement points involving employees of an automobile manufacturer. Direct health promotion outcomes were assessed using self-developed items on PA knowledge, the HAPA brief scales and the exercise self-efficacy scale. IPAQ short version was used to assess different forms of PA behavior. Intervention effects were identified using a two-way analysis of variance (ANOVA) with repeated measurements.
A total of 144 participants took part in the study (intervention group = 80, control group = 64). The results of the ANOVA show significant interaction effects (group x time) for health promotion outcomes (knowledge, intention, and self-efficacy), with medium to high effect sizes. In the health behavior related outcomes, there were significant improvements, with large effect sizes for low levels of PA, but not for moderate and high PA. Walking time increased by 125 min/week in the intervention group, corresponding to a percentage increase of 30% compared to baseline.
Pedometer-based interventions using gamification elements can have positive effects not only on health promotion parameters but can also lead to an increase in PA behavior. The online format of Healingo Fit is suitable for reaching large numbers of people and achieving population effects.
German Clinical Trials Register (DRKS): DRKS00006105 , date of registration: 2017-03-24.
The COVID-19 pandemic caused far-reaching societal changes, including significant educational impacts affecting over 1.6 billion pupils and 100 million education practitioners globally. Senior school ...leaders were at the forefront and were exposed to particularly high demands during a period of "crisis leadership". This occupation were already reporting high work-related stress and large numbers leaving the profession preceding COVID-19. This cross-sectional descriptive study through the international COVID-Health Literacy network aimed to examine the well-being and work-related stress of senior school leaders (n = 323) in Wales (n = 172) and Northern Ireland (n = 151) during COVID-19 (2021-2022). Findings suggest that senior school leaders reported high workloads (54.22±11.30 hours/week), low well-being (65.2% n = 202, mean WHO-5 40.85±21.57), depressive symptoms (WHO-5 34.8% n = 108) and high work-related stress (PSS-10: 29.91±4.92). High exhaustion (BAT: high/very high 89.0% n = 285) and specific psychosomatic complaints (experiencing muscle pain 48.2% n = 151) were also reported, and females had statistically higher outcomes in these areas. School leaders were engaging in self-endangering working behaviours; 74.7% (n = 239) gave up leisure activities in favour of work and 63.4% (n = 202) sacrificed sufficient sleep, which was statistically higher for females. These findings are concerning given that the UK is currently experiencing a "crisis" in educational leadership against a backdrop of pandemic-related pressures. Senior leaders' high attrition rates further exacerbate this, proving costly to educational systems and placing additional financial and other pressures on educational settings and policy response. This has implications for senior leaders and pupil-level outcomes including health, well-being and educational attainment, requiring urgent tailored and targeted support from the education and health sectors. This is particularly pertinent for Wales and Northern Ireland as devolved nations in the UK, who are both implementing or contemplating major education system level reforms, including new statutory national curricula, requiring significant leadership, engagement and ownership from the education profession.
This study investigates university students' digital health literacy and web-based information-seeking behaviours during the early stages of the COVID-19 pandemic in England. It compares ...undergraduate and postgraduate students in non-health related subjects with health care students, many of whom were preparing for, or working in, frontline roles. The survey was conducted as part of a wider study by the COVID-HL research consortium.
A cross-sectional study was conducted among n = 691 university students aged ≥18 years from 25 universities across England using an adapted digital survey developed by COVID-HL. Data were collected regarding sociodemographic characteristics and specific measures drawn from the Future Anxiety Scale and the Digital Health Literacy Instrument (DHLI). These had been adapted for use in an English setting and to the specific context of the COVID-19 pandemic. Other data collected included students' anxiety or worries about the future using the Dark Future Scale as well as behaviours in online information-seeking. Data were analysed using correlations to test for relationships between constructs and also between group comparisons to test for differences between students studying health and non-health related subjects.
Across digital health literacy dimensions, there was no significant difference between students studying health-related subjects and other students. Health care students did report greater difficulties in relation to how to behave online. They also relied less on public body sources for information about the pandemic. A significant difference was found between the two student populations in relation to their anxiety about the future with health care students reporting fewer fears about the future.
Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with evaluating online information which may frustrate public health efforts. This could be addressed by ensuring health students' curriculum in particular encompasses digital health literacy.
We aim to evaluate the associations between digital health literacy (DHL) related to COVID-19 and online information-seeking behavior among university students.
A total of 3.084 students (75.7% ...women), with an average age of 24.2 (SD = 7.5) participated in this cross-sectional study, most of whom (36.5%) were from social sciences and pursued a bachelor's degree (50.7%). Data on COVID-19-related DHL and online information-seeking behavior were collected using an online questionnaire. Logistic regression models were performed.
As the pandemic progressed, participants showed a lower chance of achieving a sufficient DHL (OR = 0.7; 95% CI = 0.6; 0.9). Using search engines more often (e.g., Google) (OR = 0.7; 95% CI = 0.5; 0.9), Wikipedia (OR = 0.7; 95% CI = 0.6; 0.9) and social media (e.g., Facebook) (OR = 0.7; 95% CI = 0.6; 0.9) decreased the likelihood of achieving sufficient DHL related to COVID-19. More frequent use of websites of public bodies (OR = 1.7; 95% CI = 1.1; 2.5) increased the odds of reporting sufficient DHL.
DHL is associated with university students' online information-seeking behavior in the time of COVID-19. From a community and public health perspective, programs aiming at improving DHL should be highlighted.