Co-creation and regional adaptation of a resilience-based universal whole-school program in five European regions

The co-creation of educational services that promote youth resilience and mental health is still scarce. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is a research and intervention program in the Basque Country (Spain), Trentino (Italy), Low Silesia (Poland), Denmark and Reykjavik (Iceland). UPRIGHT implemented a co-creation research process whose results, outcomes and policy implications are presented here. The co-creation had a mixed-methods participatory research design with nine specific objectives linked to paired strategies of inquiry for adolescents, families, teachers and school staff. The overarching objective was to generate a valid and feasible regional adaptation strategy for UPRIGHT intervention model. Participants answered surveys (n= 794) or attended 16 group sessions (n= 217). The results integrate quantitative and qualitative information to propose a regional adaptation strategy that prioritizes resilience skills, adolescents' concerns, and preferred methods for implementation across countries and in each school community. In conclusion, a whole-school resilience program must innovate, include and connect different actors, services and communities, and must incorporate new technologies and activities outside the classroom. A participatory co-creation process is an indispensable step to co-design locally relevant resilience interventions with the involvement of the whole-school community

UPRIGHT, a resilience-based intervention to promote mental well-being in schools: study rationale and methodology for a European randomized controlled trial

Background: Adolescence is crucial period for laying the foundations for healthy development and mental wellbeing. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention.Methods: UPRIGHT project is a research and innovation project funded by the European Union's Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning. Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods.Discussion: We expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being.Trial registration: ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019

Co-creation and regional adaptation of a resilience-based universal whole-school program in five European regions

Publisher's version (útgefin grein)The co-creation of educational services that promote youth resilience and mental health is still scarce. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is a research and intervention program in the Basque Country (Spain), Trentino (Italy), Low Silesia (Poland), Denmark and Reykjavik (Iceland). UPRIGHT implemented a co-creation research process whose results, outcomes and policy implications are presented here. The co-creation had a mixed-methods participatory research design with nine specific objectives linked to paired strategies of inquiry for adolescents, families, teachers and school staff. The overarching objective was to generate a valid and feasible regional adaptation strategy for UPRIGHT intervention model. Participants answered surveys (n = 794) or attended 16 group sessions (n = 217). The results integrate quantitative and qualitative information to propose a regional adaptation strategy that prioritizes resilience skills, adolescents’ concerns, and preferred methods for implementation across countries and in each school community. In conclusion, a whole-school resilience program must innovate, include and connect different actors, services and communities, and must incorporate new technologies and activities outside the classroom. A participatory co-creation process is an indispensable step to co-design locally relevant resilience interventions with the involvement of the whole-school community.The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: UPRIGHT is a research and innovation project funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant number 754919). UPRIGHT grant agreement (complete project description) has undergone peer-review by the European Commission reviewers (governmental and major funding organism) before getting approval. This paper reflects only the authors’ views, and the European Union is not liable for any use that may be made of the information contained therein. The funding body has had no role in the study design, in the writing of the manuscript or in the decision to submit the paper for publication.Peer Reviewe

Temporal and Reciprocal Relations Between Worry and Rumination Among Subgroups of Metacognitive Beliefs

Metacognitive theory provides strong foundation for hypothesizing relations between worry and rumination among subgroups of metacognitive beliefs. However, empirical exploration of prospective and reciprocal relations between worry and rumination are lacking. This study investigated the stability and relations between worry and rumination to better understand how they influence each other over time, and how different levels of metacognitive beliefs affect relations between (i) initial and future worry, and initial and future rumination, and (ii) the cross-lag relations between worry and rumination. Overall, 482 (Females = 63%) participants (Mean age = 26 years) participated in a two-wave data collection and completed the Metacognition Questionnaire (MCQ-30), the Ruminative Response Scale and the Penn State Worry Questionnaire (PSWQ). A multigroup two-wave autoregressive cross-lagged model was estimated. Multigroup autoregression analyses revealed that independent of participants being in the high or low metacognition group, initial levels of worry predicted future levels of worry, as was the case for rumination. Multigroup cross-lagged analyses revealed that initial levels of worry did not predict future levels of rumination in both high and low levels of metacognitions. However, initial rumination predicted future levels of worry in the high metacognitions group, which was not the case for the low metacognitions group. Thus, high levels of metacognitions do not only strengthen the relation between both present and future worry, present and future rumination, but also present rumination with future worry. This finding may imply that those with rumination related conditions at present are more likely in the future to show both rumination and worry related conditions. Conversely, those with worry related conditions show future worry related conditions. These findings may have implications for a clinical sample regarding the high complexity of rumination conditions that may proceed with multifinality causal pathways especially for individuals with high levels of metacognitions. This complexity may be a possible explanation for the limited success in other traditional treatment of rumination related conditions and the relatively high relapse rates for such conditions in clinical samples

Development and validation of the theory-driven School Resilience Scale for Adults: Preliminary results

Resilience is the ability of an individual or community to adapt to life challenges or adversities while maintaining mental health and well-being. In the multi-systemic resilience paradigm, human development and resilience is embedded in adaptive systems and in their interactions. Although the relationship between school systems and adolescents' mental wellbeing is established, there is no agreement on how to recognize and evaluate the most relevant aspects of the school community, acting at collective level, to boost positive socio-emotional and educational outcomes in children and adolescents. This study presents the development and preliminary validation of a new and theory-driven construct and instrument, the School Resilience Scale for Adults (SRS). School Resilience comprises five interrelated constructs (i.e. Positive relationships, Belonging, Inclusion, Participation, and Mental health awareness) connected theoretically to wellbeing and resilience in children and adolescents. The scale development was theory-driven, and the instrument was tested in four European counties in the frame of the UPRIGHT project (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers). Overall, 340 adults participated, 129 teachers and school staff, and 211 relatives of teenagers. The sample was randomly split for two studies: (1) an Exploratory Factor analysis (ESEM), and (2) Confirmatory Factor (CFA) analysis. In the exploratory analysis, Chi-Square difference test and model fit indices point towards the five-factor solution over a three-factor solution. The confirmatory study indicated that a five-factor model (RMSEA = 0.038, CFI = 0.96, TLI = 0.95, SRMR = 0.045) was slightly better than a second-order model (RMSEA = 0.046, CFI = 0.94, TLI = 0.93, SRMR = 0.05). Convergent and discriminant validities were partially demonstrated. Alpha and omega reliability coefficients verified the measurement model of the scale. The results confirmed that a multidimensional construct of School Resilience, defined as a collective resilience factor, embedded in the school staff, family members, and adolescents’ interrelated systems can be characterized and measured. Further studies must determine its role in the promotion of adolescents' resilience, mental wellbeing, educational outcomes, and in their positive adaptation in challenging contexts

Participación y fortalecimiento comunitario en un contexto post-terremoto en Chincha, Perú

This article presents the lessons learned and a critical analysis of a community intervention on seventeen urban and rural towns after the earthquake of August 15th, 2007 in the province of Chincha, Peru. The critical review proposed emphasizes the analysis of participation and community empowerment. The community intervention strengthened the capabilities of community leaders to enhance social networks for community mental health in a post-disaster context. Through participation and community building, community leaders strengthened social bonds and community action. The lessons from this experience allow us to reflect upon community psychology practice in post-earthquake contexts. Among others: questioning power relations and neutrality, valuing local knowledge, networking, and the incorporation of the subjective dimension and self-care in the intervention.    Este artículo presenta el análisis crítico y las lecciones aprendidas de una intervención comunitaria con 17 centros poblados de Chincha-Perú luego del terremoto del 15 agosto del 2007. Se trata de la revisión crítica de una intervención comunitaria, con énfasis en los conceptos de participación y fortalecimiento comunitario. La intervención fortaleció capacidades de líderes como facilitadores sociales para la acción en salud mental comunitaria en contextos posterremoto. A través de la participación y el fortalecimiento comunitario, los líderes mejoraron el vínculo social y desarrollaron procesos de acción comunitaria. La reflexión sobre esta experiencia permite valorar la praxis de la psicología comunitaria en contextos posterremoto y sus consecuencias, tales como el cuestionamiento de las relaciones de poder y la neutralidad; la valoración del saber local; el trabajo de redes; la incorporación de la dimensión subjetiva y el autocuidado en la intervención.  

Prospective relations between loneliness in different relationships, metacognitive beliefs, worry and common mental health problems.

Background This study investigated prospective relations between loneliness in family, romantic and social relationships and common mental health problems measured as symptoms of anxiety and depression. How these relations are mediated by metacognitive beliefs and worry in a serial mediation model in a full SEM was also tested. Materials and methods Data were collected at two time points, separated by three months among students at the Norwegian University of Science and Technology. In total, 241 (Females = 65%) students completing both waves of data collection were included for analyses. Results Loneliness in family relationships was only concurrently associated with worry whereas loneliness in social and romantic relationships showed concurrent and prospective relations. Overall, the results highlighted that for loneliness in social and romantic relationships, their prospective relations with anxiety and depressive symptoms depended on how an individual responded with metacognitive beliefs or worry or both. However, social loneliness might be an exception since it also had a direct effect on levels of depressive symptoms. Conclusions To prevent or reduce loneliness and common mental health problems, evidence provided show that interventions may incorporate components that target self-focused negative thinking in the form of worry or beliefs about the contents of negative thinking in the form of metacognitive beliefs, underlying loneliness and mental health problems

Resilience or hope? Incremental and convergent validity of the resilience scale for adults (RSA) and the Herth hope scale (HHS) in the prediction of anxiety and depression

Background: Hope and resilience protect against inner vulnerabilities or harsh life circumstances; they explain individual differences in physical or mental health outcomes under high stress. They have been studied in complementary or competing theoretical frameworks; therefore, the study of measures of hope and resilience should be undertaken prior to explore if they are truly value-added for research. This study investigates the convergent and incremental validity of the Resilience Scale for Adults (RSA) and the Herth Hope Scale (HHS), in the prediction of anxiety and depression (HSCL-25). Methods: Participants in this community-based sample are 762 adults from 18 to 74 years old. They answered the RSA, HHS, Spanish Language Stressful Life-Events Checklist (SL-SLE), and the Hopkins Symptom Checklist-25 (HSCL- 25). Incremental validity analyses combined hierarchical regression and structural equation models (SEM). First, hierarchical regression models were compared based on three criteria (R2 Diff.,ΔF, and semi-partial r), then the direct effect of resilience on affective symptoms was compared with the mediated effect of resilience on affective symptoms through hope. Results: The hierarchical models showed that (1) hope and resilience account significantly for the variance of affective symptoms above age, sex, and life-stress; (2) Resilience Total score has greater incremental validity than positive scales of HHS Hope; and (3) RSA Total score, HHS Optimism/Spiritual support, Stressful life-events and sex are unique predictors of affective symptoms. The SEM analyses verified a stronger direct effect of resilience in the prediction of affective symptoms above the significant partial mediated effect of resilience through hope. Additionally, results show that age and better educational opportunities were associated with protection (i.e. resilience and hope) and emotional well-being (i.e. affective symptoms and hopelessness). Women showed higher scores in social competences and resources (RSA), interconnectedness and initiative to take action (HHS). However, they have poorer evaluations of own abilities and efficacy (RSA), and higher scores in all the affective symptoms assessed. Conclusion: The RSA has incremental validity above the HHS, however, both the RSA and the HHS are effective, differentiated and complementary measures of protection that are of high relevance for research on psychosocial and emotional well-being. Keywords: Resilience, Hope, Anxiety, Depression, Incremental validity, SE