Nutrition-focused group intervention with a strength-based counseling approach for people with clinical depression : a study protocol for the Food for Mind randomized controlled trial

BACKGROUND: Depression is a highly prevalent mental disorder with major public health effects globally. It impairs the quality of life and reduces the ability to work and function, leading to increasing costs of sick leaves and disability pensions. Current treatment strategies focus on biological and psychological pathways while understating the role of lifestyle factors. Epidemiological studies have shown convincing evidence of an inverse relationship between diet quality and depression. However, only limited data are available on the therapeutic effects of diet quality improvement on depression. Using a randomized controlled trial design, our primary aim is to investigate the effectiveness and cost-effectiveness of a behavioral nutrition group intervention compared to a social support intervention in the treatment of depression. METHODS: Participants (N=144, aged 20-65 years) with a diagnosis of moderate or severe depression recruited in collaboration with outpatient care units will be randomized into two arms: Food for Mind (FM) nutrition intervention (n=72) or Bring Good Mood (BGM) social support control group (n=72). Both arms will be provided with 6 group sessions over an 8-week period. FM involves improving diet quality by applying strength-based behavioral nutrition counseling and activities facilitated by a registered dietitian. The control arm comprises a befriending protocol. During the interventions, all participants will continue their treatment for depression as usual. Longitudinal data are collected at baseline, at 8 weeks, and at 6- and 12-month follow-ups. Depressive symptoms, diet quality, eating behavior, ability to work and function, and quality of life are assessed by self-reported questionnaires. A treatment expectancy questionnaire will be administered at baseline and an acceptability questionnaire at 8 weeks. The Center for Epidemiologic Studies Depression Scale is used as the primary endpoint at 1 year. The results will be analyzed with linear mixed-effects models. Economic evaluation includes both cost-effectiveness and cost-utility analysis. Two incremental cost-effectiveness ratios will be calculated to evaluate the incremental cost per QALY and the incremental cost per improvement in CES-D. DISCUSSION: If the intervention proves to be cost-effective and acceptable, it be can be implemented in healthcare to support the treatment of depression. TRIAL REGISTRATION: ClinicalTrials.gov NCT03904771 . Retrospectively registered on 5 April 2019.publishedVersionPeer reviewe

Review: Economic evidence of preventive interventions for anxiety disorders in children and adolescents - a systematic review

BackgroundAnxiety disorders are common in children and youth. Also, in prevention, be it universal, selective or indicated, economic evaluation supports decision-making in the allocation of scarce resources. This review identified and summarised the existing evidence of economic evaluations for the prevention of anxiety disorders in children and adolescents.MethodsA systematic search was conducted on the EBSCO, Scopus, Web of Science, ProQuest, Cochrane and PubMed databases. We included studies that focused on children and adolescents under 18 years of age, aimed to prevent anxiety disorders and presented an incremental analysis of costs and effectiveness. A registered checklist was used that assessed the quality of the included articles.ResultsThe search yielded 1697 articles. Five articles were included in this review. Three were RCT-based, and two were model-based studies. Out of five included interventions, one was a universal school-based intervention, two selective interventions and two indicated interventions. Universal school-based prevention of anxiety was not cost-effective compared with usual teaching. Selective parent training and indicative child- and parent-focused CBT prevention were likely cost-effective compared with usual care or doing nothing.ConclusionParent education and cognitive behaviour therapy interventions can be cautiously interpreted as being a cost-effective way of preventing anxiety in children and adolescents. However, the evidence is weakly related to cost-effectiveness as there are only a few studies, with relatively small sample sizes and short follow-ups.</p

Valmennuspaja Mahiksen vaikutusten ja kustannusten tarkastelua. ”Aina saa tulla ja voi puhua mistä vaan – luottamuksella”

Koulutuksen ulkopuolelle jääminen ja työttömyys ovat keskeisiä riskitekijöitä nuorten syrjäytymiseen johtavalla polulla. Koulutus- ja työelämävalmiuksien lisäksi moni nuori tarvitsee tukea arjen asioissa ja yleisimmin elämänhallinnassa. Tietoa erilaisten palveluiden ja toimenpiteiden vaikutuksista ja niistä aiheutuvien kustannusten jakautumisesta ei kuitenkaan ole juuri saatavilla. Tässä tutkimuksessa arvioidaan matalan kynnyksen valmennuspajan toimintamallilla aikaansaatuja vaikutuksia. Tutkimustulokset antavat tietoa siitä, millaisia vaikutuksia pajajaksolla on asiakkaiden arjen sujuvuuteen ja hyvinvointiin sekä, mihin nämä nuoret sijoittuvat jakson loputtua. Lisäksi selvitetään pajatoiminnan ylläpidon kustannuksia sekä sitä, mitä kustannuksilla saadaan aikaan. Valmennuspaja on esimerkki kokonaisvaltaiseen ja yksilölliseen tukeen perustuvasta palvelusta, jonka avulla voidaan edistää nuorten osallisuutta ja toimijuutta

Liikuntaa lisää pienillä tempuilla - työpaikan hyvinvointiprojektin vaikutukset ja kustannukset

Onnistunut työyhteisön hyvinvointiprojekti vaatii alkuinnostamisen ja motivoinnin sekä selkeän alun ja lopun. Projektin lanseeraus ja työntekijän saama ensivaikutelma ovat tärkeitä. Tämä julkaisu kokoaa Tuottavuutta hyvinvointia kohentamalla -hankkeen tulokset. Itä-Savon sairaanhoitopiirin (Sosteri) toteuttaman hankkeen aikana työntekijöillä oli mahdollisuus osallistua kuuden kuukauden mittaisiin hyvinvointiprojekteihin, jotka tukivat työntekijän kykyä huolehtia omasta hyvinvoinnistaan entistä paremmin. Arviointiraportissa on myös laskettu hankkeen toimintamallin kustannukset. Työntekijöiden hyvinvointia mitattiin hyvinvointi-intervention alussa ja lopussa kehonkoostumus- ja työkykymittauksilla. Erityisesti liikunnan edistämistä oli tukemassa älykello ja työyhteisökohtainen sovellus. Mittausten lisäksi arviointiaineistona ovat myös kaikille osallistuneille suunnattujen kyselytutkimuksien tulokset sekä joidenkin osallistuneiden haastattelut. Hyvinvointi-interventio lisäsi liikuntaa 1,5 tuntia viikossa. Paino putosi naisilla reilun kilon ja miehillä yli kaksi kiloa. Liikunnan lisäämiseen vaikuttivat eniten itse hankkeeseen osallistuminen, alkutilanteen kehonkoostumusmittaukset sekä hyvinvointisovelluksen yhteisöllinen merkitys. Painonpudottaminen oli haasteellisempaa kuin liikunnan lisääminen. Ravintotottumusten muuttaminen olisi vaatinut osallistujien mukaan enemmän tukea kuin vain tietoa terveellisestä ravinnosta. Viittaaminen Kuvaja-Köllner, V., & Kautonen, J. (2021). Liikuntaa lisää pienillä tempuilla - työpaikan hyvinvointiprojektin vaikutukset ja kustannukset. (Diak Puheenvuoro 40). Diakonia-ammattikorkeakoulu. http://urn.fi/URN:ISBN:978-952-493-385-

Nutrition-focused group intervention with a strength-based counseling approach for people with clinical depression: a study protocol for the Food for Mind randomized controlled trial

Background Depression is a highly prevalent mental disorder with major public health effects globally. It impairs the quality of life and reduces the ability to work and function, leading to increasing costs of sick leaves and disability pensions. Current treatment strategies focus on biological and psychological pathways while understating the role of lifestyle factors. Epidemiological studies have shown convincing evidence of an inverse relationship between diet quality and depression. However, only limited data are available on the therapeutic effects of diet quality improvement on depression. Using a randomized controlled trial design, our primary aim is to investigate the effectiveness and cost-effectiveness of a behavioral nutrition group intervention compared to a social support intervention in the treatment of depression. Methods Participants (N=144, aged 20&ndash;65 years) with a diagnosis of moderate or severe depression recruited in collaboration with outpatient care units will be randomized into two arms: Food for Mind (FM) nutrition intervention (n=72) or Bring Good Mood (BGM) social support control group (n=72). Both arms will be provided with 6 group sessions over an 8-week period. FM involves improving diet quality by applying strength-based behavioral nutrition counseling and activities facilitated by a registered dietitian. The control arm comprises a befriending protocol. During the interventions, all participants will continue their treatment for depression as usual. Longitudinal data are collected at baseline, at 8 weeks, and at 6- and 12-month follow-ups. Depressive symptoms, diet quality, eating behavior, ability to work and function, and quality of life are assessed by self-reported questionnaires. A treatment expectancy questionnaire will be administered at baseline and an acceptability questionnaire at 8 weeks. The Center for Epidemiologic Studies Depression Scale is used as the primary endpoint at 1 year. The results will be analyzed with linear mixed-effects models. Economic evaluation includes both cost-effectiveness and cost-utility analysis. Two incremental cost-effectiveness ratios will be calculated to evaluate the incremental cost per QALY and the incremental cost per improvement in CES-D. Discussion If the intervention proves to be cost-effective and acceptable, it be can be implemented in healthcare to support the treatment of depression. Trial registration ClinicalTrials.gov NCT03904771. Retrospectively registered on 5 April 201