Exploring community-based suicide prevention in the context of rural Australia : a qualitative study

Suicide rates in rural communities are higher than in urban areas, and communities play a crucial role in suicide prevention. This study explores community-based suicide prevention using a qualitative research design. Semi-structured interviews and focus groups asked participants to explore community-based suicide prevention in the context of rural Australia. Participants recruited ((n = 37; ages 29–72, Mean = 46, SD = 9.56); female 62.2%; lived experience 48.6%) were self-identified experts, working in rural community-based suicide prevention (community services, program providers, research, and policy development) around Australia. Data were thematically analysed, identifying three themes relating to community-based suicide prevention: (i) Community led initiatives; (ii) Meeting community needs; and (iii) Programs to improve health and suicidality. Implementing community-based suicide prevention needs community-level engagement and partnerships, including with community leaders; gatekeepers; community members; people with lived experience; services; and professionals, to “get stuff done”. Available resources and social capital are utilised, with co-created interventions reflecting diverse lifestyles, beliefs, norms, and cultures. The definition of “community”, community needs, issues, and solutions need to be identified by communities themselves. Primarily non-clinical programs address determinants of health and suicidality and increase community awareness of suicide and its prevention, and the capacity to recognise and support people at risk. This study shows how community-based suicide prevention presents as a social innovation approach, seeing suicide as a social phenomenon, with community-based programs as the potential driver of social change, equipping communities with the “know how” to implement, monitor, and adjust community-based programs to fit community needs

Predictors of professional help-seeking for emotional problems in Afghan and Iraqi refugees in Australia : findings from the Building a New Life in Australia Database

ackground: Refugees are particularly vulnerable to poor mental health outcomes due to exposure to pre migration trauma and post migration stressors. Research has demonstrated evidence to suggest that the professional help-seeking among refugee groups is low or problematic. This study seeks to examine help-seeking for emotional problems in two large samples of Iraqi and Afghan refugees in Australia. Methods: This study uses data from two waves of the Building a New Life in Australia, the longitudinal study of Humanitarian migrants. The data was collected face-To-face between 2013 and 2016, among humanitarian migrants. All participants held a permanent protection visa and had arrived in Australia or been granted their visa between period of May to December 2013. The study sample included 1288 participants born in Iraq and Afghanistan (aged 15 and over). In the Wave 3 interview (2015-2016) participants reported on professional help received to deal with emotional problems. Results: Approximately 36 and 37% of the Iraqi and Afghan groups respectively, reported seeking help for emotional problems. Within the Iraqi group, associations between mental health status, namely general psychological distress and PTSD and help-seeking were found but this was not present in the Afghan group, where age seemed to play a role in help-seeking. Frequency of help received was low with approximately 47% of the Iraqi and 57% of the Afghan groups reporting having received help 5 times or less in the last 12 months. Conclusions: Findings from this study provide clear directions on areas where culturally tailored mental health promotion programs should target in these two refugee communities. Further, the differences in help-seeking behaviour of these communities should be noted by both clinicians and policy makers as efforts to provide culturally responsive mental health services

運動情報の可聴化に関する研究

電気通信大学201

O impacto dos programas de prevenção veiculados na mídia: a gravidez na adolescência

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção.A presente pesquisa aborda questões referentes à gravidez na adolescência a partir da leitura do impacto dos programas de prevenção veiculados na mídia, de acordo com relatos de adolescentes grávidas inscritas no programa de pré-natal da Secretaria Municipal de Saúde, do município de Itaúna (MG). Foi traçado o perfil da adolescente grávida e descrita a sua relação com as diversas mídias no que diz respeito à baixa eficiência dos programas de prevenção veiculados nestas mídias. A partir de estudos já realizados, a atenção recaiu sobre algumas questões: 1) O que é educação para a saúde? 2) Por que a gravidez precoce é um problema de saúde pública? 3) Em que pontos falham os programas de prevenção da gravidez na adolescência, veiculados nas mídias? Os resultados demonstram que o modelo informacional não contribui para a aprendizagem que o processo educativo supõe. A informação sobre como prevenir a gravidez não impede as manifestações psicológicas comuns no período adolescente. Os resultados apontam, também, que os conflitos adolescentes são vivenciados com maior processo de readaptação, quando acompanhado de uma gravidez; que as adolescentes não planejavam as gravidezes, não usavam qualquer método anticoncepcional, apesar de conhecê-los; têm seu comportamento influenciável pelas mídias apesar de não legitimarem os programas de prevenção veiculados nela. Espera-se que os resultados possam contribuir no processo de construção de programas de prevenção, uma vez que retrata a possibilidade do uso da mídia como instrumento da educação. O conhecimento do perfil da adolescente que engravida, assim como a imagem criada pelas campanhas de prevenção da gravidez precoce deve facilitar a criação de sistemas mais eficientes, facilitando a elaboração de programas de saúde coerentes com a demanda real. Research that approaches referring questions to the pregnancy in the adolescence from the reading of the impact of the propagated programs of prevention in the medias, in accordance with stories of enrolled pregnant adolescents in the program of prenatal of the City department of Health, of the city of Itaúna(MG). The profile of the pregnant and described adolescent was traced its relation with the diverse medias in that it says respect to low the efficiency of the propagated programs of prevention in the medias. From carried through studies already, the attention fell again on some questions: 1) What it is education for the health? 2) Why the precocious pregnancy is a problem of public health? 3) Where points fail the programs of prevention of the pregnancy in the adolescence, propagated in the medias? The results demonstrate that the informacional model does not contribute for the learning that the educative process assumes. The information on as to prevent the pregnancy does not hinder the common psychological manifestations in the adolescent period. The results point, also, that the adolescent conflicts are lived deeply with bigger process of readjustment, when folloied of a pregnancy; that the adolescents did not plan the pregnancies, they did not use any contraceptive method, although to know them; they have its influenciável behavior for the medias although not to legitimize the propagated programs of prevention in. It focuses the proposal of the education for the health, the adolescent development and the recocious pregnancy, points with respect to the diverse medias as tool of the education. It presents one to seem on the profile of the pregnant adolescent and the impact of the pregnancy and the campaigns of propagated prevention of the regnancy in the medias

Optimizing prevention programs and maximizing public health impact are not the same thing

Call me pessimistic, but I am concerned that current approaches to reducing the public health burden of body dissatisfaction (BD) and eating disordered behaviour (EDB), in which efforts are focused on prevention of new cases of the most severe disorders, are unlikely to achieve the large-scale impact that we all agree is needed. The article by Austin (Austin, 2015), which I had the opportunity to review prior to writing the current piece, exemplifies such a focus and I shall use it in the current contribution to highlight my concerns, while also outlining my thoughts about the sort of alternative approach that I believe will be needed to achieve such impact

"Excessive exercise" in eating disorders research : problems of definition and perspective

While the association between exercise behavior and eating-disordered behavior (EDB) has been of interest to researchers for decades (see [26]), the status, and definition, of “excessive exercise” as an EDB remain unclear. Here, we reflect, with the benefit of hindsight, on the problems of definition and perspective that beset this field of inquiry

Eating-disordered behavior in Australian and Singaporean women : a comparative study

Objective and Method We used the Eating Disorder Examination Questionnaire (EDE-Q) to compare the specific eating disorder psychopathology of young adult women in Australia (n = 339) and Singapore (n = 164). All participants completed a brief questionnaire that included the EDE-Q, basic socio-demographic information, and self-reported height and weight. Results Overall levels of eating disorder psychopathology, as measured by the EDE-Q global score, were very similar. There were also no differences between groups on the EDE-Q subscales. However, analysis at the item level indicated that Singaporean women were more fearful of losing control over their eating, more fearful of gaining weight or becoming fat, and more anxious at the prospect of regularly weighing themselves, than Australian women. Singaporean women were also more likely to report binge eating and laxative misuse, whereas excessive exercise was more common among Australian women. The findings were unaltered when between-group differences in body weight were statistically controlled. Discussion The findings provide further evidence that levels of eating disorder psychopathology in some Asian countries may be as high as, if not higher than, those of Western nations. Potentially important differences between different cultural groups may be obscured when the assessment of eating disorder psychopathology is confined to summary-type measures

Feelings about the self and body in eating disturbances : the role of internalized shame, self-esteem, externalized self-perceptions, and body shame

Objective: To investigate the roles of feelings of low self-worth (internalized shame and low self-esteem), externalized self-perceptions (self-objectification and body surveillance), body shame, and depressive symptoms in directly and indirectly explaining variance in eating disorder (ED) pathology across two studies. Study 1: In 403 women, internalized shame and self-esteem were found to each be independently associated with ED pathology, over and above one another, depressive symptoms, age and BMI. Further, body shame fully mediated the relationships between ED pathology and internalized shame and self-esteem, controlling for one another, depressive symptoms, age and BMI. Study 2: In a different sample of 548 women, Structural Equation Modeling (SEM) revealed that a path model in which internalized shame predicts ED pathology both directly and indirectly via self-objectification, body surveillance, body shame, and depressive symptoms demonstrated very good fit for the data and explained 68% of the variance in ED pathology. General conclusions: Results support an understanding of EDs as disorders of self, in which negative feelings about the self (internalized shame and low self-esteem) are displaced onto the body (in the form of externalized self-perceptions and body shame) and are associated with increases in depressive symptoms and ED pathology, both directly and indirectly

Eating disorders mental health literacy in Singapore : beliefs of young adult women concerning treatment and outcome of bulimia nervosa

Aim: We examined the eating disorders 'mental health literacy' of young adult women in Singapore. Methods: A self-report questionnaire was completed by 255 women recruited from three university campuses. A vignette of a fictional (female) person exhibiting the characteristic features of bulimia nervosa was presented, followed by a series of questions concerning the treatment and outcome of the problem described. A measure of eating disorder symptoms was included in the questionnaire. Results: Consulting a primary care practitioner, counsellor or psychologist; seeking the advice of a (female) family member or friend; getting advice about diet and nutrition; and taking vitamins and minerals were the interventions most often considered helpful. Participants were less positive about the benefits of psychiatristsand were ambivalent about the use of psychotropic medication. Participants' mothers were most often considered helpful as they are an initial source of help. Among participants with a high level of eating disorder symptoms, recognition of an eating problem was poor. A minority of participants believed that treatment would result in full recovery. Conclusions: Aspects of the eating disorders mental health literacy of young Singaporean women may be conducive to low or inappropriate treatment seeking. Health promotion programmes need to target not only at-risk individuals, but also their family members and social circle

The stigma of anabolic steroid use

Little is known about the stigma of anabolic steroid use despite clear implications for treatment-seekers and for public policy development. We investigated the predictors of steroid stigma and contextualized the results by comparing steroids with marijuana. Undergraduates (N = 304) completed measures of drug stigma, exposure to drug users, and history of drug use. Participants stigmatized steroid use more than marijuana use—a very large effect. Participants reported less exposure to steroid users. Nevertheless, 15% of participants reported having a steroid-using friend. History of drug use, but not exposure to steroid users, predicted lower steroid stigma. Drug use and exposure both predicted lower marijuana use stigma. The amount of stigma expressed toward steroids is commensurate with that of “hard” drugs, such as heroin, likely constituting a formidable barrier to treatment. The public’s difficulty empathizing with male body image insecurities may partially explain why exposure to steroid users did not predict lower stigmatization