Lopae: geographical dispersal of friendship in Turkana

Lopae are special friendships among the nomadic Turkana pastoralists based on the exchange of stock animals and other gifts. This study of lopae among semi-sedentary southern Turkana has shown that: 1) lopae serve as an investment, insurance, and risk dispersal over a wide geographical area, and 2) settlement itself does not hinder exchanges or diminish the friendships. Indeed, many Turkana in the settlements gained new lopae because of grain from their agricultural plots and their access to purchased food and goods. This study is part of larger research on sedentarization and social changes among the Turkana. The paper outlines the methods and testing of the following hypothesis: "If the Turkana nomadic pastoralists become sedentary, then their stock-associate (lopae) networks will deteriorate." This hypothesis was proved false, and results are given about their number of friends, gifts exchanged, and reasons why friends break off and remain. The geographical dispersal of lopae friends is illustrated with maps

Efficacy of a multimodal lifestyle intervention (The Lift Project) for improving the mental health of individuals with an affective mood disorder living in South Africa

BackgroundAffective disorders are becoming more pervasive worldwide, including in Southern Africa, where treating patients with these conditions is challenging due to social and financial constraints. A variety of non-pharmacological approaches including lifestyle medicine (e.g., exercise, nutrition, sleep) and positive psychology practices (e.g., gratitude, service), are effective for treating mental health (MH) conditions.MethodsTwenty-six individuals from South Africa with a diagnosed MH condition participated in a 10-week multimodal intervention incorporating a diverse range of non-pharmacological strategies for improving MH. MH metrics were assessed pre-and post-intervention, including general MH, vitality/energy (VIT), depression, anxiety, stress, and satisfaction with life. MH and VIT were also measured weekly.ResultsImprovements were observed in all mental metrics from pre-to post-intervention: MH (59%, p < 0.001, Cohen’s D = 1.36), VIT (110%, p < 0.001, Cohen’s D = 1.71), depression (−46%, p < 0.001, Cohen’s D = −1.06), anxiety (−48%, p < 0.001, Cohen’s D = −1.21), stress (−36%, p < 0.001, Cohen’s D = −1.08) and life satisfaction (23%, p < 0.001, Cohen’s D = 0.66). Significant improvements in MH and VIT were observed after only 1 week of the intervention and progressively increased until the seventh week, after which further improvements were not statistically significant.ConclusionThe findings of this cohort study indicate that a multimodal intervention that incorporates lifestyle and positive psychology practices may benefit individuals living with an affective disorder. Non-pharmacological, multimodal interventions might offer a stigma-free way of providing MH promotion and treatment at a population level

The Influence of Human Support on Adherence to, and Outcomes of an Online Interdisciplinary Mental Health Promotion Intervention for a Healthy Adult Cohort

Escalating mental health distress has prompted the call for mental health promotion initiatives to improve the mental resilience of the general population and provide a buffer against common mental health disorders. Digital delivery modes offer accessible and scalable opportunities to implement lifestyle-based interventions to enhance mental well-being. However, digital interventions are hampered by sub-optimal adherence, which negatively impacts outcomes. Little is known about the effectiveness of human support to improve adherence to and outcomes of digital interventions amongst general population cohorts. This dissertation documents the rationale for and findings of a randomised comparative study that assessed the influence of adding different types of human support to an online, interdisciplinary mental health promotion intervention. Participants were randomised into three intervention groups: standard intervention with automated emails only (S); standard intervention plus personalised text messages (S+pSMS); and standard intervention plus videoconferencing support (S+VCS). A questionnaire was administered pre- and post-intervention to assess changes in depression, anxiety, stress, mental health, vitality, life satisfaction, and flourishing. Adherence was measured by the number of video lessons viewed, points scored for experiential activities, and the number of weeks that participants logged activity. Inductive, thematic analysis of free-text responses in the post-intervention questionnaire elicited participant perceptions about facilitators and barriers impacting adherence. The study results led to a series of three publications, which addressed the three research questions presented in the dissertation and a fourth publication that consolidated the findings and reviewed them in the context of the current literature. The first publication addressed Research Question 1—What is the influence of different modes of human support on the outcomes of a web and mobile app, lifestyle-based mental health intervention for a healthy adult cohort? This publication found that human support had little influence on the outcomes of the intervention. Significant improvements were recorded from baseline to post-intervention in every outcome measure, irrespective of the types of human support offered (P≤0.001). Between-group differences were not observed for any of the outcome measures: depression (P=0.93), anxiety (P=0.25), stress (P=0.57), mental health (P=0.77), vitality (P=0.65), life satisfaction (P=0.65), and flourishing (P=0.99). The second publication addressed Research Question 2—What is the influence of different modes of human support on attrition and adherence to a web and mobile app, lifestyle-based mental health intervention for a healthy adult cohort, including the influence of participant preference? Early dropout attrition differed between the groups (P=.009), being disproportionally higher in the videoconferencing support group. However, there was no difference in adherence behaviour between the groups (i.e., number of videos viewed, P=0.42; mean challenge points scored, P=0.71; and the number of weeks challenge points were logged, P=0.66), indicating that human support had little effect. The third publication addressed the final research question—What do healthy adult participants perceive as the facilitators of, and barriers to, adherence to a web and mobile app, lifestyle-based mental health intervention? Qualitative thematic analysis revealed that human support did not feature strongly as a facilitator or barrier to intervention adherence. Perceived adherence facilitators included engaging content, time availability, accessibility, enjoyable challenges, valuing the program, and personal motivation. Time scarcity was overwhelmingly perceived as the most dominant adherence barrier. Other barriers included completing and logging experiential activity, content length, technical difficulties, and interindividual personal factors. The study’s findings provided novel insights into an exposed research gap, as little was known about the influence of human support on adherence to and outcomes of a digital mental health promotion intervention when delivered to a general population group. The fourth publication, a review, synthesised the overall findings of this dissertation in conjunction with other recent literature and provided recommendations for future studies

The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study

Background The global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood. Objective The aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting. Methods This study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the “mental health” and “vitality” subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program. Results On average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures. Conclusions Digital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12619000993190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377889 and Australian New Zealand Clinical Trials Registry ACTRN12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx </jats:sec

A Localized Lifestyle Medicine Initiative Targeting Mental Health

Purpose: To pilot a community-based, localised lifestyle medicine intervention for improving residents\u27 mental health, wellbeing and resilience. Background: Mental health is deteriorating globally, exacerbated by the COVID-19 pandemic and its residual effects. There is an urgent need to provide large-scale interventions that equip the general population with knowledge and skills to improve their mental health, wellbeing and resilience. Disseminating lifestyle medicine interventions through local governing authorities may provide an efficient model for achieving community-wide impact. Methods: Avondale University and Lake Macquarie City Council (LMCC), located in Australia, partnered to offer a free, online, seven-week, lifestyle-based mental health promotion program to all residents of the LMCC during a COVID-19 lockdown. LMCC promoted the program through established networks and 2390 households registered—4041 participants. In a mixed-methods design, 138 participants responded to a post-program survey that included questions and statements (using Likert scales) about: their perceived mental wellbeing before and after the program; the program\u27s effect on self-efficacy for managing mental health; and program satisfaction. Qualitative questions probed participants\u27 likes and dislikes and were analysed thematically. Results: The majority (89%) of respondents reported that participating in the program improved their mental health, and 99% indicated they would recommend the program to a friend. While 37% rated themselves as having either \u27poor\u27 or \u27fair\u27 mental health at the beginning of the intervention, only 6% reported being in that range on completion. Most respondents (94%) believed they gained skills to help them manage their wellbeing, and 91% perceived the learnings would continue to impact their mental health positively. Themes generated from the qualitative data showed that most participants liked the video content and delivery style, community camaraderie, growth in personal empowerment, and accessibility. Some participants did not find accessibility easy, disliked the delivery style, and experienced technical difficulties. Conclusions: The community-based, online, localised lifestyle medicine intervention improved residents\u27 perceived mental health and skills for future mental health management. Overall, participants were satisfied with the intervention and valued the content, community togetherness and emphasis on self-empowerment

The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study (Preprint)

BACKGROUND The global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood. OBJECTIVE The aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting. METHODS This study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the “mental health” and “vitality” subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program. RESULTS On average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures. CONCLUSIONS Digital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12619000993190; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377889 and Australian New Zealand Clinical Trials Registry ACTRN12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx </sec

Addressing the COVID-19 Mental Health Crisis: A Perspective on Using Interdisciplinary Universal Interventions

Mental health is reaching a crisis point due to the ramifications of COVID-19. In an attempt to curb the spread of the virus and circumvent health systems from being overwhelmed, governments have imposed regulations such as lockdown restrictions and home confinement. These restrictions, while effective for infection control, have contributed to poorer lifestyle behaviors. Currently, Positive Psychology and Lifestyle Medicine are two distinct but complimentary disciplines that offer an array of evidence-based approaches for promoting mental health and well-being across a universal population. However, these strategies for improving mental health are typically used in isolation. This perspective calls for a new paradigm shift to create and rollout well-designed interdisciplinary universal multicomponent mental health interventions that integrates the benefits of both disciplines, and uses innovative digital mental health solutions to achieve scalability and accessibility within the limitations and beyond the COVID-19 lockdown and restrictions.</jats:p

Efficacy of a multimodal lifestyle intervention (The Lift Project) for improving the mental health of individuals with an affective mood disorder living in South Africa

BackgroundAffective disorders are becoming more pervasive worldwide, including in Southern Africa, where treating patients with these conditions is challenging due to social and financial constraints. A variety of non-pharmacological approaches including lifestyle medicine (e.g., exercise, nutrition, sleep) and positive psychology practices (e.g., gratitude, service), are effective for treating mental health (MH) conditions.MethodsTwenty-six individuals from South Africa with a diagnosed MH condition participated in a 10-week multimodal intervention incorporating a diverse range of non-pharmacological strategies for improving MH. MH metrics were assessed pre-and post-intervention, including general MH, vitality/energy (VIT), depression, anxiety, stress, and satisfaction with life. MH and VIT were also measured weekly.ResultsImprovements were observed in all mental metrics from pre-to post-intervention: MH (59%, p &amp;lt; 0.001, Cohen’s D = 1.36), VIT (110%, p &amp;lt; 0.001, Cohen’s D = 1.71), depression (−46%, p &amp;lt; 0.001, Cohen’s D = −1.06), anxiety (−48%, p &amp;lt; 0.001, Cohen’s D = −1.21), stress (−36%, p &amp;lt; 0.001, Cohen’s D = −1.08) and life satisfaction (23%, p &amp;lt; 0.001, Cohen’s D = 0.66). Significant improvements in MH and VIT were observed after only 1 week of the intervention and progressively increased until the seventh week, after which further improvements were not statistically significant.ConclusionThe findings of this cohort study indicate that a multimodal intervention that incorporates lifestyle and positive psychology practices may benefit individuals living with an affective disorder. Non-pharmacological, multimodal interventions might offer a stigma-free way of providing MH promotion and treatment at a population level.</jats:sec

Precision Medicine in Lifestyle Medicine: The Way of the Future?

Precision medicine has captured the imagination of the medical community with visions of therapies precisely targeted to the specific individual’s genetic, biological, social, and environmental profile. However, in practice it has become synonymous with genomic medicine. As such its successes have been limited, with poor predictive or clinical value for the majority of people. It adds little to lifestyle medicine, other than in establishing why a healthy lifestyle is effective in combatting chronic disease. The challenge of lifestyle medicine remains getting people to actually adopt, sustain, and naturalize a healthy lifestyle, and this will require an approach that treats the patient as a person with individual needs and providing them with suitable types of support. The future of lifestyle medicine is holistic and person-centered rather than technological. </jats:p