Alternative interventions for young men's mental health

The main aim of this thesis was to explore the effectiveness and acceptability of alternative interventions for facilitating help-seeking and improving the mental health of young adult males. Based on recommendations for innovative ways to develop interventions that facilitate mental health help-seeking specific to men (Addis & Mahalik, 2003), the interventions employed in this thesis integrate exercise and psychotherapeutic strategies, and make use of sport as a vehicle for mental health promotion. Findings from the Randomised Controlled Trial (RCT) comprising study 1 provided support for a team-sport/psychosocial intervention (Back of the Net; BTN programme) for improving depressive symptoms among men. Employing qualitative methodology, study 2 explored men’s perceptions and experiences of receipt, implementation and acceptability of the BTN programme. Findings from this process evaluation reported positively on the use of sport as a vehicle for accessing and engaging men in a mental health intervention. The RCT employed in study 3 found that the combined strategies of exercise and a sports-based psychotherapeutic intervention delivered via the internet were not beneficial for mental health beyond the effects of exercise alone. Thus, the studies comprising this thesis further provide both quantitative and qualitative evidence in support of the effectiveness of exercise for improving mental health. With respect to the therapeutic processes that may mediate the antidepressant effect of exercise, study 4 reports on exercise self-efficacy, physical self-concept and global self-esteem as potential mechanisms of change. Temporal findings from study 4 suggest that these psychosocial mechanisms may be important factors associated with the effect of exercise on depression. Overall, the findings from this thesis advance our understanding of the effectiveness and acceptability of exercise and CBT-based interventions delivered within the context of sport for young men’s mental health

Lipid Peroxides and α-Tocopherol in Rat Streptozotocin-Induced Diabetes Mellitus

Measurement of lipid peroxides and alpha-tocopherol was undertaken in rats with streptozotocin-induced diabetes. In sera and livers in diabetic rats, the lipid peroxides increased but alpha-tocopherol decreased. To study the effect of vitamin E deficiency in the diabetic state, diabetes was induced in rats maintained on a vitamin E deficient diet. Serum lipid peroxides increased greatly but alpha-tocopherol decreased. Lipid peroxides and alpha-tocopherol increased in the liver of vitamin E deficient states. In the liver, vitamin E deficient diabetic rats had lower lipid peroxides levels but higher alpha-tocopherol levels than vitamin E deficient non-diabetic rats. On the basis of the present experiments, it was considered that the decrease of alpha-tocopherol might be due to consumption as an antioxidant as lipid peroxides increased in sera and livers. The decrease of lipid peroxides in the liver was thought to play an important part of the increase in serum lipid peroxides.</p

Exploring the effectiveness of an integrated exercise/CBT intervention for young men's mental health

Objective. This pilot study investigated the effectiveness of a team-based sport/psychosocial intervention (Back of the Net, BTN) with an individual exercise (IE) and a control condition for the mental health of young men. Design. Ten-week randomized control trial and eight-week post-intervention follow-up. Methods. A total of 104 sedentary males aged between 18 and 40 years were recruited and randomly assigned to the BTN, IE, or a control condition. The BTN programme integrated team sport (i.e., football) and cognitive-behavioural techniques. IE sessions included aerobic and resistance training. The control group refrained from exercise. Participants completed the Beck Depression Inventory – 2nd Edition (BDI-II), the Social Provisions Scale (SPS) and a short qualitative questionnaire at pre-intervention, week 5, post-intervention and at 8-week follow-up. Results. Participants in both the BTN and the IE condition demonstrated a significant decrease in BDI-II scores compared to the control condition at post-intervention and at 8-week follow-up. The IE condition demonstrated significantly greater perceived social support than the BTN condition at week 5 and the control group at 8-week follow-up. Qualitative data support the main empirical findings. Conclusion. Exercise-based interventions were effective in reducing symptoms of depression in a non-clinical community sample of young men. The BTN programme demonstrated potential for improving the mental health of young men however larger scale community-based research is warranted to further examine the effectiveness of this type of intervention

A qualitative exploration of men's experiences of an integrated exercise/CBT mental health promotion programme

This study investigated qualitatively the experiences of men who took part in a 10 week integrated exercise/psychosocial mental health promotion programme, "Back of the Net" (BTN). 15 participants who completed the BTN programme were recruited to participate in either a focus group discussion (N = 9) or individual interview (N = 6). A thematic analytic approach was employed to identify key themes in the data. Results indicated that participants felt that football was a positive means of engaging men in a mental health promotion program. Perceived benefits experienced included perceptions of mastery, social support, positive affect and changes in daily behaviour. The findings support the value of developing gender specific mental health interventions to both access and engage young men. © 2012 by the Men's Studies Press

A 19-SNP coronary heart disease gene score profile in subjects with type 2 diabetes: the coronary heart disease risk in type 2 diabetes (CoRDia study) study baseline characteristics

Background The coronary risk in diabetes (CoRDia) trial (n = 211) compares the effectiveness of usual diabetes care with a self-management intervention (SMI), with and without personalised risk information (including genetics), on clinical and behavioural outcomes. Here we present an assessment of randomisation, the cardiac risk genotyping assay, and the genetic characteristics of the recruits. Methods Ten-year coronary heart disease (CHD) risk was calculated using the UKPDS score. Genetic CHD risk was determined by genotyping 19 single nucleotide polymorphisms (SNPs) using Randox’s Cardiac Risk Prediction Array and calculating a gene score (GS). Accuracy of the array was assessed by genotyping a subset of pre-genotyped samples (n = 185). Results Overall, 10-year CHD risk ranged from 2–72 % but did not differ between the randomisation groups (p = 0.13). The array results were 99.8 % concordant with the pre-determined genotypes. The GS did not differ between the Caucasian participants in the CoRDia SMI plus risk group (n = 66) (p = 0.80) and a sample of UK healthy men (n = 1360). The GS was also associated with LDL-cholesterol (p = 0.05) and family history (p = 0.03) in a sample of UK healthy men (n = 1360). Conclusions CHD risk is high in this group of T2D subjects. The risk array is an accurate genotyping assay, and is suitable for estimating an individual’s genetic CHD risk. Trial registration This study has been registered at ClinicalTrials.gov; registration identifier NCT0189178

Effectiveness of a self-management intervention with personalised genetic and lifestyle-related risk information on coronary heart disease and diabetes-related risk in type 2 diabetes (CoRDia): study protocol for a randomised controlled trial

Background Many patients with type 2 diabetes fail to achieve good glycaemic control. Poor control is associated with complications including coronary heart disease (CHD). Effective self-management and engagement in health behaviours can reduce risks of complications. However, patients often struggle to adopt and maintain these behaviours. Self-management interventions have been found to be effective in improving glycaemic control. Recent developments in the field of genetics mean that patients can be given personalised information about genetic- and lifestyle-associated risk of developing CHD. Such information may increase patients’ motivation to engage in self-management. The Coronary Risk in Diabetes (CoRDia) trial will compare the effectiveness of a self-management intervention, with and without provision of personalised genetic- and lifestyle-associated risk information, with usual care, on clinical and behavioural outcomes, the cognitive predictors of behaviour, and psychological wellbeing. Methods/Design Participants will be adults aged 25–74 years registered with general practices in the East of England, diagnosed with type 2 diabetes, with no history of heart disease, and with a glycated haemoglobin level of ≥6.45 % (47 mmol/mol). Consenting participants will be randomised to one of three arms: usual care control, group self-management only, group self-management plus personalised genetic- and lifestyle-associated risk information. The self-management groups will receive four weekly 2-hour group sessions, focusing on knowledge and information sharing, problem solving, goal setting and action planning to promote medication adherence, healthy eating, and physical activity. Primary outcomes are glycaemic control and CHD risk. Clinical data will be collected from GP records, including HbA1c, weight, body mass index, blood pressure, and HDL and total cholesterol. Self-reported health behaviours, including medication adherence, healthy eating and physical activity, and cognitive outcomes will be assessed by questionnaire. Measures will be taken at baseline, 3 months (questionnaire only), 6 months and 12 months post-baseline. Discussion This study will determine whether the addition of personalised genetic- and lifestyle-associated CHD risk information to a group self-management intervention improves diabetes control and CHD risk compared with group self-management and usual care. Effectiveness of the combined intervention on health behaviours cognitions theorised to predict them, and psychological outcomes will also be investigated. Trial registration This study has been registered at ClinicalTrials.gov; registration identifier NCT01891786, registered 28 June 2013

Additional file 1: of Effectiveness of a self-management intervention with personalised genetic and lifestyle-related risk information on coronary heart disease and diabetes-related risk in type 2 diabetes (CoRDia): study protocol for a randomised controlled trial

SPIRIT checklist CoRDia protocol. Completed SPIRIT checklist relevant to the study protocol. (DOCX 59 kb