[Workload and Rehabilitation Needs of Older Workers with and without Migrant Background - Results of the lidA Cohort Study]. / Arbeitsbelastungen und Rehabilitationsbedarf bei älteren Erwerbstätigen mit und ohne Migrationshintergrund ­ Ergebnisse der lidA Kohortenstudie.

BACKGROUND: The need for rehabilitation measures will increase in the future due to increasing retirement age and demographic changes. In addition, the need for rehabilitation measures is determined, among other things, by the strenuousness of work. The aim of the present study was to investigate whether employees with a migrant background (EmM) are exposed to strenuous work more often and have a higher need for rehabilitation than employees without a migrant background (EoM). MATERIAL AND METHODS: The lidA study is a nationwide, prospective cohort study focusing on work, age, health and labour force participation. Study subjects (2443 female, 2281 male) were socially secured employees, born in 1959 or 1965. They were personally interviewed with computer assistance. Data from the first study wave (2011) were used. Multiple logistic regression analyses adjusted for socio-demographic factors (age, gender, education and household equivalent income) were carried out to estimate the influence of migrant background, nationality and high workloads on the need for rehabilitation. RESULTS: First generation EmMs were particularly affected by high workloads compared to EoM. The subjectively experienced workloads of EoM and EmM of the second generation were on a comparable level. In contrast, there were no differences between EmM with German and foreign citizenship. After adjustment for sociodemographic and workload-related factors, a higher need for rehabilitation was shown for the first-generation EmM (not significant) in comparison with the second-generation EoM and EmM, but not for EmM with foreign citizenship in comparison with EmM with German citizenship. DISCUSSION: First-generation EmMs are exposed to strenuous work significantly more often and have a higher need for rehabilitation. However, the migrant background itself is not a determinant for increased rehabilitation needs. The significantly higher need for rehabilitation can rather be explained by the strenuousness of work and socio-demographic characteristics that are more frequent in first-generation EmM. Differentiated considerations of the subgroups of EmM are important to identify special needs and to avoid undersupply (e. g. due to access barriers).

Digital Health Interventions in Depression Care-A Survey on Acceptance from the Perspective of Patients, Their Relatives and Health Professionals.

Digital health interventions may contribute to closing the treatment gap for depression by reaching large populations at relatively low costs. This article presents the results of a broad, multisided German survey in 2020 on the acceptance and use of digital health interventions in depression care from the perspective of patients, their relatives, and health professionals. A total of 97 patients and relatives and 229 health professionals participated. Survey participants reported openness towards the use of digital health interventions in depression care but little knowledge and experience in the field. Digital health interventions appear to be a promising opportunity for reducing depressive symptoms and shortening waiting time for depression treatment, especially in rural areas. Providing information and technical competencies may increase awareness and knowledge about digital health interventions and the benefits of depression care.

Effects of a Mindfulness Intervention Comprising an App, Web-Based Workshops, and a Workbook on Perceived Stress Among Nurses and Nursing Trainees: Protocol for a Randomized Controlled Trial.

BACKGROUND: Previous research has found digitally supported mindfulness interventions to be effective when used for stress management among workers in high-stress occupations. Findings on digitally supported mindfulness interventions among nurses working in acute inpatient care settings are heterogeneous, lack long-term follow-up, and do not assess adherence and acceptability. OBJECTIVE: This study aimed to investigate the effectiveness and efficacy of a digitally supported mindfulness intervention designed to improve health- and work-related outcomes among nurses and nursing trainees working in acute inpatient care settings. METHODS: We will conduct a multicenter randomized controlled trial using a wait-list control group design. Randomization will be stratified by hospital and job status (nurse or nursing trainee). Recruitment will take place on the web and offline during the working hours of nurses and nursing trainees. The intervention group will receive a digitally supported mindfulness intervention, which will comprise an app, 2 web-based workshops, and a workbook, whereas the wait-list control group will be scheduled to receive the same intervention 14 weeks later. The 2 web-based workshops will be led by a certified mindfulness-based stress reduction trainer. Nurses will use the app and the workbook independently. Self-report web-based surveys will be conducted on the web at baseline, at 10 weeks after allocation, at 24 weeks after allocation, and at 38 weeks after allocation. Outcomes of interest will include perceived stress (primary outcome), health- and work-related variables, and variables related to adherence and acceptability of the digitally supported mindfulness intervention. We will perform intention-to-treat and per-protocol analyses. RESULTS: Data collection will be completed by the beginning of August 2022. Data analyses will be completed by December 2022. CONCLUSIONS: Our study design, including long-term follow-up and the investigation of variables related to adherence and acceptability, will ensure rigorous evaluation of effectiveness and efficacy. Relative to costly in-person intervention efforts, this program may present a cost-effective and potentially highly scalable alternative. Findings regarding effectiveness, efficacy, adherence, and acceptability will inform stakeholders' decisions regarding the implementation of similar interventions to promote the well-being of nurses and nursing trainees, which may, in turn, alleviate detrimental stress-related outcomes (eg, burnout) because of work-related demands. TRIAL REGISTRATION: German Clinical Trials Register DRKS00025997; https://tinyurl.com/433cas7u. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37195.

[Is There a Association Between the Conditions in Accommodations and the Mental Health of Refugees in Germany? - A Cross-Sectional Study]. / Gibt es einen Zusammenhang zwischen der Zufriedenheit mit der Unterkunft und der psychischen Gesundheit Geflüchteter in Deutschland? ­ Eine Querschnittstudie.

BACKGROUND: Crowded conditions, noise and little privacy and other characteristics of refugee accommodations can have a negative impact on the mental health of the partially traumatized refugees. The study investigates, whether there are correlations between satisfaction with certain accommodation features in individual and shared accommodation and mental health. METHOD: We used the IAB-BAMF-SOEP survey from Germany 2016 (n=4491 refugees). Linear regression models are calculated to test the association between mental health and the type of accommodation (single accommodation/shared accommodation) and satisfaction with the accommodation (general satisfaction, satisfaction with food quality/noise level/privacy/leisure activities/access to public transport/security, german language courses). We adjust for sociodemographic factors, potentially traumatic experiences prior to arrival in Germany and postmigrant exposures (e. g. asylum status). RESULTS: Within the two accommodation types, there is high heterogeneity with respect to the characteristics examined. Refugees with poor mental health were significantly more likely to live in shared accommodation. When the above covariates were controlled for, the association disappeared. The other eight accommodation characteristics remained significantly associated with poorer mental health. The largest effects on mental health were observed for the satisfaction with safety, privacy, and general satisfaction. Here, the difference between persons who were barely satisfied compared with persons who were very satisfied amounted to 5-6 points on the SF-12 mental sum scale. CONCLUSION: International results on the relationship between accommodation conditions and mental health of refugees were confirmed for Germany. This results in an increased need for mental health services in subjectively worse housing. Questions about satisfaction (especially safety, privacy, and general satisfaction) are more suitable for identifying critical accommodations than the classification into single or shared accommodations, because shared accommodations were assessed very differently. Screening instruments can help identify problematic shelters. However, reverse causality cannot be conclusively ruled out.

[Acceptance of Digital Health Interventions in Light to Moderate Depressive Disorders - A Qualitative Analysis from the Perspective of Affected Persons, Relatives and Health Professionals]. / Akzeptanz von digitalen Gesundheitstechnologien bei leichter bis mittelgradiger Depression ­ Eine qualitative Analyse aus der Perspektive von Betroffenen, Angehörigen und Leistungserbringern.

OBJECTIVE: User acceptance of digital health interventions in light to moderate depressive disorders has been rudimentarily researched and is examined in this study. METHODS: Problem-centered individual interviews were conducted with 3 affected persons, 3 relatives and 13 health care professionals. The data evaluation was based on the structured qualitative content analysis. RESULTS: Along the Unified Theory of Acceptance and Use of Technology attitudes of affected persons, relatives and health care professionals were presented. Expectations of performance and the supportive framework conditions were the most significant influencing predictors for the positive intention to use. CONCLUSION: The results provide a basis for prioritizing needs and attitudes in next step. In terms of ethical, sustainable and economical use further research on user acceptance is required.

Digital Health Interventions in Prevention, Relapse, and Therapy of Mild and Moderate Depression: Scoping Review.

BACKGROUND: Depression is a major cause for disability worldwide, and digital health interventions are expected to be an augmentative and effective treatment. According to the fast-growing field of information and communication technologies and its dissemination, there is a need for mapping the technological landscape and its benefits for users. OBJECTIVE: The purpose of this scoping review was to give an overview of the digital health interventions used for depression. The main goal of this review was to provide a comprehensive review of the system landscape and its technological state and functions, as well as its evidence and benefits for users. METHODS: A scoping review was conducted to provide a comprehensive overview of the field of digital health interventions for the treatment of depression. PubMed, PSYNDEX, and the Cochrane Library were searched by two independent researchers in October 2020 to identify relevant publications of the last 10 years, which were examined using the inclusion and exclusion criteria. To conduct the review, we used Rayyan, a freely available web tool. RESULTS: In total, 65 studies were included in the qualitative synthesis. After categorizing the studies into the areas of prevention, early detection, therapy, and relapse prevention, we found dominant numbers of studies in the area of therapy (n=52). There was only one study for prevention, 5 studies for early detection, and 7 studies for relapse prevention. The most dominant therapy approaches were cognitive behavioral therapy, acceptance and commitment therapy, and problem-solving therapy. Most of the studies revealed significant effects of digital health interventions when cognitive behavioral therapy was applied. Cognitive behavioral therapy as the most dominant form was often provided through web-based systems. Combined interventions consisting of web-based and smartphone-based approaches are increasingly found. CONCLUSIONS: Digital health interventions for treating depression are quite comprehensive. There are different interventions focusing on different fields of care. While most interventions can be beneficial to achieve a better depression treatment, it can be difficult to determine which approaches are suitable. Cognitive behavioral therapy through digital health interventions has shown good effects in the treatment of depression, but treatment for depression still stays very individualistic.

[Utilization of Medical Rehabilitation and Access Barriers for Persons with a Migrant Background - Results of the lidA Cohort Study]. / Inanspruchnahme medizinischer Rehabilitation und Zugangsbarrieren bei Personen mit Migrationshintergrund ­ Ergebnisse der lidA-Kohortenstudie.

INTRODUCTION: Rehabilitation services are considerably less used by persons with a migration background of working age in Germany than by persons without migration background. One reason could be access barriers. They can arise both from the structures of the health/rehabilitation system as well as from influences of the personal environment, e. g. financial burdens incurred through the use of rehabilitation or cultural expectations. In addition to the migration status, other factors such as country of origin, reasons for immigration, length of stay as well as the religious affiliation and social status could influence the utilization of medical rehabilitation. It was examined to what extent differences in utilisation are due to the migration background and to migration-independent personal barriers to access. METHODS: The lidA-study is a nationwide, representative prospective cohort study among employees with insurable employment born in 1959 and 1965 with a focus on work, age, health and employment. Data from the first (2011) and the second wave (2014) were combined for the analyses. In addition to bivariate analyses to describe the sample according to migration status, logistic regression analyses were carried out to estimate the odds ratios for the influence of migration background or nationality and other factors on the use of a medical rehabilitation measure. RESULTS: The chance of receiving medical rehabilitation is increased for migrants of the 1st generation (odds ratio (OR) 1.56, 95% confidence interval (CI): 1.09-2.25). If predominantly or exclusively no German is spoken at home, this could be associated with a comparatively much lower chance of utilisation (OR: 0.56, 95% CI: 0.28-1.15). Because only nationality is often available in routine data to determine the status of migration, another model only considers migrants and 2nd generation nationals and examines the influence of nationality on utilisation. A foreign nationality was not associated with a higher utilisation (OR: 1.07, 95% CI: 0.55-2.08). DISCUSSION: Results of previous studies on the use of medical rehabilitation for people with a migration background are inconsistent. This could be due to different examined population groups, different indications for rehabilitation, a temporal change in utilisation and the various study designs as well as data sources. We found a higher use of medical rehabilitation services by persons with a migrant background (1st generation) compared to non-migrant persons. One reason could be our more precise definition of the migration background compared to analyses of routine data. If predominantly or exclusively another language than German is spoken at home, the utilisation tends to be lower. The finding coincides with a lack of German language skills described as an access barrier in the literature.