A scoping study of interventions to increase the uptake of physical activity (PA) amongst individuals with mild-to-moderate depression (MMD)

Background - Depression is the largest contributor to disease burden globally. The evidence favouring physical activity as a treatment for mild-to-moderate depression is extensive and relatively uncontested. It is unclear, however, how to increase an uptake of physical activity amongst individuals experiencing mild-to-moderate depression. This leaves professionals with no guidance on how to help people experiencing mild-to-moderate depression to take up physical activity. The purpose of this study was to scope the evidence on interventions to increase the uptake of physical activity amongst individuals experiencing mild-to-moderate depression, and to develop a model of the mechanisms by which they are hypothesised to work. Methods - A scoping study was designed to include a review of primary studies, grey literature and six consultation exercises; two with individuals with experience of depression, two pre-project consultations with physical activity, mental health and literature review experts, one with public health experts, and one with community engagement experts. Results - Ten papers met the inclusion criteria and were included in the review. Consultation exercises provided insights into the mechanisms of an uptake of physical activity amongst individuals experiencing mild-to-moderate depression; evidence concerning those mechanisms is (a) fragmented in terms of design and purpose; (b) of varied quality; (c) rarely explicit about the mechanisms through which the interventions are thought to work. Physical, environmental and social factors that may represent mediating variables in the uptake of physical activity amongst people experiencing mild-to-moderate depression are largely absent from studies. Conclusions - An explanatory model was developed. This represents mild-to-moderate depression as interfering with (a) the motivation to take part in physical activity and (b) the volition that it is required to take part in physical activity. Therefore, both motivational and volitional elements are important in any intervention to increase physical activity in people with mild-to-moderate depression. Furthermore, mild-to-moderate depression-specific factors need to be tackled in any physical activity initiative, via psychological treatments such as Cognitive Behavioural Therapy. We argu

From Complex Interventions to Complex Systems: Using Social Network Analysis to Understand School Engagement with Health and Wellbeing

Challenges in changing school system functioning to orient them towards health are commonly underestimated. Understanding the social interactions of school staff from a complex systems perspective may provide valuable insight into how system dynamics may impede or facilitate the promotion of health and wellbeing. Ego social network analysis was employed with wellbeing leads within four diverse case study schools to identify variability in embeddedness of health and wellbeing roles. This variation, as well as the broader context, was then explored through semi-structured qualitative interviews with school staff and a Healthy Schools Coordinator, sampled from the wellbeing leads' ego-networks. Networks varied in terms of perceived importance and frequency of interactions, centrality, brokerage and cliques. Case study schools that showed higher engagement with health and wellbeing had highly organised, distributed leadership structures, dedicated wellbeing roles, senior leadership support and outside agencies embedded within school systems. Allocation of responsibility for wellbeing to a member of the senior leadership team alongside a distributed leadership approach may facilitate the reorientation of school systems towards health and wellbeing. Ego-network analysis to understand variance in complex school system starting points could be replicated on a larger scale and utilised to design complex interventions

Eating, drinking and wellbeing

The aim of the present chapter is to present a conceptual framework for examining associations between eating, drinking, and well-being. The approach is exemplified by considering two topics which have received considerable attention, namely, the effects of consumption of breakfast and ingestion of caffeine. It is argued that other aspects of diet can be considered in a similar way once the volume of research reaches appropriate levels. The first feature of the current approach to well-being is that it is multifactorial. Research on diet and health has confirmed the view that there is more to health than the absence of disease. Being able to function efficiently, both mentally and physically, is an important part of well-being. Similarly, the absence of negative affective states (negative mood, stress, anxiety, and depression) and the presence of positive emotions (positive affect, happiness, and life satisfaction) have long been recognized as key features of well-being. Previous research has investigated the relationship between diet and well-being, with some topics such as the effect of a healthy diet (e.g., consumption of breakfast, fruit and vegetables, and oily fish) or a bad diet (e.g., junk food) being widely studied. Other aspects of eating and drinking require further attention (e.g., eating super-foods such as broccoli; effects of BMI; emotional eating; and consumption of foods which change the gut microbiome – prebiotics and probiotics). There are three major problems with most of the previous research. First, the different dietary topics are often studied in isolation, which clearly misrepresents the real-life situation. Secondly, well-being is influenced by other established predictors (psychosocial factors such as stress, social support, personality and coping styles; health-related behaviors such as exercise; and sleep), and these are rarely controlled for. Thirdly, most of the research involves cross-sectional studies. What is now needed are multivariate, longitudinal studies of eating, drinking, and well-being. Such research will elucidate underlying biological mechanisms and develop practical approaches of preventing and managing negative effects and maximizing positive one