Development of a Proposal for a Program to Promote Positive Mental Health Literacy among Adolescents: A Focus Group Study.

Over the last years, there have been several studies that have shown insufficient levels of adolescents' mental health literacy (MHL). Knowledge about intervention programs that promote positive mental health literacy (PMeHL) among adolescents is still very scarce. In this sense, we defined as objectives to identify and describe the necessary components to design a program proposal that promotes adolescents' PMeHL. We conducted an exploratory, descriptive, qualitative study using two focus groups in July and September 2022 with an intentional non-probability sample of eleven participants (nine professional experts and two adolescents). Data were analyzed using content analysis, using NVivo® 12 software (version 12, QRS International: Daresbury Cheshire, UK). We obtained a total of four categories and eighteen subcategories: structure (context; format; contents; length and frequency; pedagogical methods; pedagogical techniques; resources; denomination), participants (target group; program facilitators), assessment (timing; evaluation instruments), other components (planning, articulation and adaptation; involvement; training; special situations; partnerships; referral). The perspectives of the professional experts and of the adolescents that we obtained from this study contributed to the design of a proposal for a program to promote adolescents' PMeHL.

The Impact of COVID-19 Confinement on Substance Use and Mental Health in Portuguese Higher Education Students.

The mental health of higher education students is a constant concern, and the pandemic situation caused by COVID-19 has intensified this concern. The social measures imposed to control and minimize the disease have led, among other things, to the reconfiguration of higher education students' academic life habits, which has naturally altered their emotional balance, mental health, and substance abuse. This cross-sectional, descriptive, and correlational study assesses the influence of higher education students' personal characteristics on their (self-reported) use of addictive substances (alcohol, tobacco, drugs, and pharmaceutical drugs) before and during their first compulsory confinement in Portugal, as well as its relationship with mental health. An online questionnaire was applied between 15 April and 20 May 2020, to students from various study cycles of higher education institutions in one region of Portugal (northern area of Alentejo), which included the Mental Health Inventory in its reduced version (MHI-5) and questions (constructed by the authors) on personal characterization and on the use of addictive substances before and during confinement. The convenience sample included 329 mostly female health care students between the ages of 18 and 24. In our results, we found a statistically significant decrease in tobacco, alcohol, and drug use; however, there was an increase in tobacco use among older students and an increase in anxiolytic use among students with higher academic achievement and among students who exhibited more active social behavior in the period prior to confinement. Students who took anxiolytics during confinement had higher MHI-5 scores and students who used the most addictive substances during confinement had lower MHI-5 scores than the other students.

Psychological Vulnerability Indices and the Adolescent's Good Mental Health Factors: A Correlational Study in a Sample of Portuguese Adolescents.

Background: Psychological vulnerability (PV) indicates the individual's inability to adapt to stressful situations. Adolescents experience negative impacts on their future mental health if they do not acquire the skills and knowledge necessary to have good mental health during their developmental stage. Aim: To compare the PV index among the three stages of adolescence and to explore the factors involved in good mental health, including the relationship between adolescents' PV indices and sociodemographic variables, and the relationship between adolescents' PV index and their knowledge of the factors that characterize good mental health. Method: An exploratory, cross-sectional, correlational study was carried out in three public schools in a region of Portugal, using online self-completed questionnaires: the Psychological Vulnerability Scale (PVS) and the Mental Health-Promoting Knowledge (MHPK-10). Results: Our convenience sample consisted of 260 adolescents, with a mean age of 14.07 years who were students between 5th and 12th grades, mostly female. Moderate PV indexes were obtained that were higher in late adolescence, i.e., in older adolescents, who were females in a more advanced school year, with worse self-perceptions of their physical and mental health and body image, and who frequently used a health service due to mental health problems. The association between the PV index and the level of knowledge about the factors involved in good mental health did not reach a statistical significance (p = 0.06). Conclusions: These results suggest a need for a design of personalized interventions that promote adolescents' mental health literacy, that prevent PV, and that should be initiated in early adolescence.

Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic.

The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.

Grieving Experiences of Parents with Children in End-of-Life Care-A Qualitative Review Protocol.

Parents that accompany their children in end-of-life care until death go through a devastating, complex and vulnerable situation, which is experienced in a unique way and with individual needs, given the specificity of the palliative care setting in which it occurs. This qualitative review aims to identify and synthesize the best evidence available on the grieving experiences of parents with children in end-of-life care in a palliative care setting. This qualitative review protocol is according to the review method proposed by the Joanna Briggs Institute. The results will enable us to identify how parents of children in end-of-life care in a palliative care setting experience their grieving process. This review will broaden the horizon of understanding of the specificities of the grieving experience of parents who have accompanied their children in end-of-life care until their death in a palliative care setting and promote research in this context. The results of the review will also allow the construction of an "end-of-life grieving script", with the aim of identifying one's individuality in the grieving process. This protocol is registered at Open Science Framework.

Mental Health Literacy and Positive Mental Health in Adolescents: A Correlational Study.

This study aimed to assess adolescents' Mental Health Literacy (MHL) level, Positive Mental Health (PMH) level, the association between sociodemographic variables and the MHL and PMH levels, and the relationship between adolescent's MHL and PMH levels. A quantitative, cross-sectional, correlational study was conducted with a convenience sample of 260 adolescents studying in the 5th to 12th years of school. The Mental Health Knowledge Questionnaire, the Mental Health-Promoting Knowledge, and the Positive Mental Health Questionnaire were used for data collection. Most of the adolescents were female (55.8%) with a mean age of 14.07 years. The participants showed good levels of MHL (MHKQ). The participants showed good levels of MHL (MHKQ 𝘹¯ = 60.03; MHPK-10 𝘹¯ = 4.49) and high levels of PMH (𝘹¯ = 128.25). The adolescents with higher levels of MHL were the oldest, in a higher year of school, female, those whose mothers are employed, those who have healthy eating habits, and those who have a better body image self-perception. Adolescents in a lower year of school, with adequate sleep habits, who spend fewer hours a day in front of a screen or online, and who have a better self-perception of mental and physical health and body image were the ones with higher PMH levels. These findings suggest the need to implement experimental or quasi-experimental studies to ascertain the effectiveness of interventions that promote adolescents' positive mental health literacy.

Social Media Use and Its Association with Mental Health and Internet Addiction among Portuguese Higher Education Students during COVID-19 Confinement.

The use of social media was one of the most common way to keep in touch with friends and family during confinement. For higher education students, the fact that their universities were closed was a major change in their lives. The aim of this study is to relate the prevalence and type of social media with Internet addiction and mental health of university students in a district of Portugal during COVID-19 confinement. Mental health was studied by applying the reduced version of the Mental Health Inventory (MHI-5) and to measure the Internet use and dependence, the Internet Addiction Test (IAT) was used. The study (cross-sectional, descriptive, and correlational) used an online questionnaire, conducted on Google® Forms and the link was sent to 4450 students, in the months of April to June 2020, during the confinement. A total of 329 valid questionnaires were obtained. We can conclude that regarding mental health, students in the 18-24 age group, single or divorced and who are not in a relationship, and with worse academic results, show worse levels of mental health. It is noteworthy that the students with the same characteristics also have the highest levels of addiction to internet.

Promotion of Mental Health Literacy in Adolescents: A Scoping Review.

In recent years, there has been an important commitment to the development of programs to promote mental health literacy (MHL) among adolescents, due to the prevalence of mental health problems and the low level of MHL that affects this group. The aim of this study was to map the structure and context of programmes/interventions for promoting MHL among adolescents in school settings. A scoping review was conducted following the guidelines of The Joanna Briggs Institute. We searched for studies on programmes/interventions promoting at least one of the components of MHL of adolescents, written in Portuguese, English or Spanish, published from 2013 to 2020, in MEDLINE, CINAHL Plus with Full Text, SciELO, SCOPUS, OpenGrey, RCAAP and in the article reference lists. This review included 29 articles. The majority of programmes/interventions addressed one or more of the four components of MHL, with the knowledge of mental disorders and stigma reduction components being the most covered; were taught by adolescent's regular teachers; used face to face interventions; had a height variable duration; used non-validated instruments; were implemented in a classroom environment; and showed statistically significant improvements in adolescent's MHL levels. More research is needed to implement/construct programmes/interventions promoting adolescents' MHL concerning knowledge on how to obtain and maintain good mental health.

Entomological impact and social participation in dengue control: a cluster randomized trial in Fortaleza, Brazil.

BACKGROUND: This study intended to implement a novel intervention strategy, in Brazil, using an ecohealth approach and analyse its effectiveness and costs in reducing Aedes aegypti vector density as well as its acceptance, feasibility and sustainability. The intervention was conducted from 2012 to 2013 in the municipality of Fortaleza, northeast Brazil. METHODOLOGY: A cluster randomized controlled trial was designed by comparing ten intervention clusters with ten control clusters where routine vector control activities were conducted. The intervention included: community workshops; community involvement in clean-up campaigns; covering the elevated containers and in-house rubbish disposal without larviciding; mobilization of schoolchildren and senior inhabitants; and distribution of information, education and communication (IEC) materials in the community. RESULTS: Differences in terms of social participation, commitment and leadership were present in the clusters. The results showed the effectiveness of the intervention package in comparison with the routine control programme. Differences regarding the costs of the intervention were reasonable and could be adopted by public health services. CONCLUSIONS: Embedding social participation and environmental management for improved dengue vector control was feasible and significantly reduced vector densities. Such a participatory ecohealth approach offers a promising alternative to routine vector control measures.

Relatório de estágio de intervenção comunitária / Community intervention internship report

Numa época em que o progresso científico e o desenvolvimento tecnológico têm proporcionado importantes avanços a todos os níveis, paralelamente têm emergido novas ameaças à saúde de todos nós. O cenário atual em que vivemos não é fácil, os recursos são cada vez mais escassos e as disparidades sócio-económicas começam a acentuar-se. É um cenário onde os adolescentes são um grupo de intervenção prioritário, pois neste grupo etário tem-se verificado um aumento da adoção de comportamentos prejudiciais à saúde. Desta forma, a educação para a saúde assume um papel muito importante como o processo através do qual os indivíduos/grupos/comunidades procuram melhorar o controlo dos seus determinantes pessoais e ambientais da saúde. Tendo em conta estas premissas, o nosso estágio decorreu no período de 14/02/2011 a 30/06/2011, na ESSP, na ESMS e na ESSL. Foi dividido em duas intervenções: uma na área da promoção de estilos de vida saudáveis nos adolescentes do concelho de Portalegre integrada na promoção da imagem da ESSP e outra intervenção na área da sexualidade na adolescência. A primeira intervenção teve como população alvo os adolescentes do 9.º ano e do 12.º ano da área de Ciências e Tecnologias das escolas do concelho de Portalegre, a segunda intervenção destinou-se aos adolescentes do 8.º, 9.º, 10.º ano e CEF da ESMS e às turmas o 10.ºE e 10.ºF da ESSL. Na realização de ambas as intervenções foi utilizada a metodologia do planeamento em saúde e as sessões de educação para a saúde suportaram-se na Teoria da Aprendizagem Social de Bandura. Foram abrangidos um total de 317 adolescentes na intervenção da promoção dos estilos de vida saudáveis e 276 adolescentes na intervenção na área da sexualidade na adolescência. Em ambas as intervenções todas as reuniões e sessões programadas foram realizadas, sendo que mais de 99% dos adolescentes se mostraram Satisfeitos ou mais com as sessões realizadas no âmbito da primeira intervenção e mais de 98% também se apresentaram Satisfeitos ou mais relativamente às sessões efetuadas na segunda intervenção. Este estágio de intervenção comunitária permitiu-nos adquirir a maioria das competências gerais do Enfermeiro Especialista, bem como as competências específicas do Enfermeiro Especialista em Enfermagem Comunitária e de Saúde Pública definidas pela Ordem dos Enfermeiros.

In a time that the scientific progress and the technological development provides important advances at many levels, alongside have emerged new threats to the health of us all. The atual scenario in which we live is not easy, the resources are increasingly scarce, and social and economic disparities become more pronounced. It is a scenario where adolescents are a group of priority intervention, because in this age group there has been na increased adoption of unhealthy behaviours. This way, healthy education assumes a very important role, as the process by which individuals/groups/communities seek to improve control of their personal and environmental determinants of health. Given these assumptions, our stage took place in the period since 14/02/2011 to 30/06/2011, at ESSP, at ESMS and at ESSL. It has been divided in two interventions: one in the area of promoting healthy lifestyles among adolescents in the municipality of Portalegre integrated in promoting the image of the ESSP and other intervention in the area of sexuality in adolescence. The first intervention had as target population adolescents of 9th and 12th grades of Sciences and Technologies from the schools of Portalegre, the second intervention intended to adolescents of 8th, 9th and 10th grades and CEF, from ESMS and to classes of 10thE and 10thF from ESSL. In both interventions was used the methodology of health planning and the educations sessions for health were supported on the Social Learning Theory of Bandura. A total of 317 adolescents were covered in the intervention of the promotion of healthy lifestyles and 276 adolescents in the intervention in the area of sexuality in adolescence. In both interventions all scheduled meetings and sessions were accomplished, in which more than 99% of adolescents were Satisfied or more with the meetings within the first intervention and more than 98% also showed Satisfied or more with the sessions of the second intervention. This stage of community intervention allowed us to acquire most of the general competences of the Specialist Nurse, as well as the specific competences of the Specialist Nurse in Community Nursing and Public Health defined by Order of Nurses.