Indicated Prevention for Children Screened in Routine Health Care: Effectiveness of a Social Skills Program on Social Anxiety and Depressive Symptoms.

Social anxiety is common in childhood and potentially transitions into clinical disorders including depression. The present study aimed to examine the effectiveness of an indicated prevention program for children screened in routine care. Data came from the PROMPt project, a prospective implementation study (10/2018-09/2022) that explored a novel care chain, starting with screening with the Strengths and Difficulties Questionnaire (SDQ) as part of regular health check-ups, followed by indicated assignment and participation in a prevention program. Questionnaires assessing anxiety and depression symptoms were administered shortly after screening or before program participation (T0), six months after screening or after program participation (T1) and at a follow-up, six months after T1 (T2). Children who participated in a group cognitive-behavioral social skills program (TT; n = 145) were compared using mixed model analyses with non-participating children who were either screened as normal (NOR; n = 894) or refused program participation despite indication (NoTT; n = 67). TT scores improved from T0 to T1 compared to NOR and NoTT (anxiety ß = -0.71 and ß = -0.71, social anxiety ß = -0.46 and ß = -0.52, depression ß = -0.52 and ß = -0.73). Improvement was maintained at T2. Moderation analyses showed a trend toward greater benefit for participants with higher baseline scores. Indicated prevention can improve anxiety and depression symptoms in children identified by screening in routine care. Systematic screening and targeted prevention may positively affect mental health of children on a population level.

The digitalization of outdoor recreation: Global perspectives on the opportunities and challenges for protected area management.

The increasing popularity of digital media among protected area visitors poses challenges to protected area management. It alters the way visitors move and behave in the area, potentially increasing disturbance of nature, and it might also affect their expectation prior to the visit and their reflection on it. Simultaneously, digital media allow protected area managers to develop and implement new methods of digital visitor management (DVM). This may help to avoid conflicts and ensure compliance with rules and regulations and may have much further reaching positive consequences. Based on an online survey across 131 parks in 46 countries covering all continents, this study examined for the first time how protected areas view DVM. The results showed that the majority of park managers see digitalization as an opportunity, with 91% agreeing that it enables them to reach larger numbers of visitors and to provide real-time information. The advantage of integrating digital media into visitor monitoring was recognized. However, some park managers perceived digitalization as problematic, with 42% agreeing that it increases visitor load in sensitive areas and 40% agreeing that it leads to more off-trail activity. A clear majority of the respondents (61-91%) saw the proposed methods of DVM as effective or very effective. Accordingly, 70% of them envisioned using DVM in the future. Our findings suggest that the effects of digitalization in outdoor recreation are largely similar across the globe, with no significant influence of economic status or region. They offer insights into the potential of DVM for protected area management, but also its main obstacles. Adoption will be facilitated by increasing staff and funding for DVM. Additionally, knowledge exchange between protected areas can ease the successful implementation of new digital tools.