Search Results (2,710)

Background: Aging is a complex process that involves various biological, psychological and social changes. Moreover, older people (≥65 years) are more susceptible to lower self-efficacy and social support, as well as deteriorating mental health. As the global population ages, there is a growing demand for evidence-based interventions tailored to address specific mental health problems, enhance social support and improve overall well-being. The aim of this study was to investigate the effectiveness of a seven-week mindfulness-based community intervention on mental health, self-efficacy and social support in older people. Methods: This quasi-experimental nonrandomized study included 257 participants who were divided into an intervention group and a comparison group that did not participate in the seven-week mindfulness-based community intervention and was not part of a waiting list. Assessments were conducted before the intervention began and 6 months after its completion. Results: The results revealed a significant reduction in depression in the intervention group (p < 0.001). Furthermore, the intervention led to a significant improvement in general self-efficacy, chronic disease self-management self-efficacy, physical activity and nutritional self-efficacy compared with the comparison group. Perceived social support increased within the intervention group; however, covariate adjusted between-group effects for social support were not statistically significant. Conclusions: Overall, the mindfulness-based community intervention was associated with improvements in current depressive symptoms and multiple self-efficacy domains at 6-month follow-up in older people in a community setting. Effects on perceived social support were less robust, and no statistically significant between-group differences were observed after adjustment for baseline covariates. The results of the present study show that this program leads to immediate health benefits in terms of mental health and self-efficacy in older people while contributing to the development of effective strategies for chronic disease self-management. Full article

Background and Objectives: Payment parity laws require commercial health plans to pay for telehealth on the same basis as in-person care. We systematically reviewed open-access empirical studies to identify and synthesize empirical U.S. studies that explicitly evaluated state telehealth payment parity (distinct from coverage-only parity) and to summarize reported effects on telehealth utilization, modality mix, quality/adherence, equity/access, and expenditures. Methods: Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, and Web of Science for U.S. studies that explicitly modeled state payment parity or stratified results by payment parity vs. coverage-only vs. no parity. We included original quantitative or qualitative studies with a time or geographic comparator and free full-text availability. The primary outcome was telehealth utilization (share or odds of telehealth use); secondary outcomes were modality mix, quality and adherence, equity and access, and spending. Because designs were heterogeneous (interrupted time series [ITS], difference-in-differences [DiD], regression, qualitative), we used structured narrative synthesis. Results: Nine studies met inclusion criteria. In community health centers (CHCs), payment parity was associated with higher telehealth use (42% of visits in parity states vs. 29% without; Δ = +13.0 percentage points; adjusted odds ratio 1.74, 95% CI 1.49–2.03). Among patients with newly diagnosed cancer, adjusted telehealth rates were 23.3% in coverage + payment parity states vs. 19.1% in states without parity, while cross-state practice limits reduced telehealth use (14.9% vs. 17.8%). At the health-system level, parity mandates were linked to a +2.5-percentage-point telemedicine share in 2023, with mental-health (29%) and substance use disorder (SUD) care (21%) showing the highest telemedicine shares. A Medicaid coverage policy bundle increased live-video use by 6.0 points and the proportion “always able to access needed care” by 11.1 points. For hypertension, payment parity improved medication adherence, whereas early emergency department and hospital adoption studies found null associations. Direct spending evidence from open-access sources remained sparse. Conclusions: Across ambulatory settings—especially behavioral health and chronic disease management—state payment parity laws are consistently associated with modest but meaningful increases in telehealth use and some improvements in adherence and perceived access. Effects vary by specialty and are attenuated where cross-state practice limits persist, and the impact of payment parity on overall spending remains understudied. Full article

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. Full article

Amid escalating ecological degradation, social fragmentation, and rising mental health challenges—especially in rural and agricultural communities—there is an urgent need to reimagine systems that support both planetary and human flourishing. This viewpoint examines an emerging paradigm in agriculture that emphasizes the role of farmers’ inner development in fostering practices that enhance ecological health, community well-being, and a resilient food system. A key goal is to draw more academic attention to growing community calls for more holistic, relational, and spiritually grounded approaches to food systems as an important focus for ongoing research. Drawing on diverse case studies from Japan, India, and Europe, we examine how small-scale and natural farming initiatives are integrating inner development, universal human values, and ecological consciousness. These case studies were developed and/or refined through a program led by the Conscious Food Systems Alliance (CoFSA), an initiative of the United Nations Development Programme (UNDP) that seeks to integrate inner transformation with sustainable food systems change. The initiatives are intended as illustrative examples of how agriculture can transcend its conventional, anthropocentric role as a food production system to become a site for cultivating deeper self-awareness, spiritual connection, and regenerative relationships with nature. Participants in these cases reported significant shifts in mindset—from materialistic and extractive worldviews to more relational and value-driven orientations rooted in care, cooperation, and sustainability. Core practices such as mindfulness, experiential learning, and spiritual ecology helped reframe farming as a holistic process that nurtures both land and life. These exploratory case studies suggest that when farmers are supported in aligning with inner values and natural systems, they become empowered as agents of systemic change. By linking personal growth with planetary stewardship, these models offer pathways toward more integrated, life-affirming approaches to agriculture and future academic research. Full article

For individuals with mental illness who experience multidimensional marginalization, the risks of encountering discrimination and receiving inadequate care are compounded. Artificial intelligence (AI) systems have propelled the provision of mental healthcare through the creation of digital mental health applications (DMHAs). DMHAs can be trained to identify specific markers of distress and resilience by incorporating community knowledge in machine learning algorithms. However, DMHAs that use rule-based systems and large language models (LLMs) may generate algorithmic bias. At-risk populations face challenges in accessing culturally and linguistically competent care, often exacerbating existing inequities. Creating equitable solutions in digital mental health requires AI training models that adequately represent the complex realities of marginalized people. This narrative review analyzes the current literature on digital mental health through an intersectional framework. Using an intersectional framework considers the nuanced experiences of individuals whose identities lie at the intersection of multiple stigmatized social groups. By assessing the disproportionate mental health challenges faced by these individuals, we highlight several culturally responsive strategies to improve community outcomes. Culturally responsive strategies include digital mental health technologies that incorporate the lived experience of individuals with intersecting identities while reducing the incidence of bias, harm, and exclusion. Full article

Background/Objectives: Community violence remains a pervasive public health challenge that disproportionately affects Black youth, with lasting impacts on physical and mental health. Traditional models often conceptualize resilience as individual “bounce back” capacity, overlooking how adaptation unfolds amid chronic violence and structural inequity. This study examined how Black youth and trauma clinicians understand, navigate, and redefine resilience within contexts of ongoing community violence exposure. Methods: Using a phenomenological qualitative design, the study drew on semi-structured interviews and focus groups with Black youth and clinicians participating in a community violence trauma recovery program in Chicago, Illinois. Data were analyzed thematically to identify patterns in how resilience was described, practiced, and supported. Results: Black youth redefined resilience through adaptive survival strategies—such as hypervigilance, avoidance, and emotional regulation—that functioned as protective responses to continuous threat. Clinicians recognized resilience as relational and context-dependent but reported limited training to address trauma rooted in chronic, community-level conditions. Both groups highlighted the role of collective and structural supports, including family, peers, and community networks, in sustaining adaptation. Conclusions: Findings highlight the need to expand trauma-informed care beyond individual treatment to address structural conditions that perpetuate community violence. Integrating ecological and culturally grounded models of resilience into clinical training and community programming can improve support for Black youth navigating chronic exposure to violence. Full article

Background/Objectives: Loneliness is a critical public health concern associated with adverse mental and physical health outcomes in later life. However, few large-scale studies have examined loneliness in relation to depression, aspiration risk, frailty, and social participation among Japanese older adults. This study examined associations between loneliness and psychosocial and health-related factors among older adults. Methods: This cross-sectional study involved a secondary analysis of data obtained from online surveys conducted in 2018 and 2021 among 1000 community-dwelling Japanese adults (≥65 years). Loneliness was assessed using the UCLA Loneliness Scale Version 3 and dichotomized at the median to define a high-loneliness group. Depressive symptoms, aspiration risk, frailty, conversation frequency, and volunteering participation were assessed using validated scales. Multivariable logistic regression was used to identify factors associated with loneliness and interaction terms were examined to assess effect modification. Results: High loneliness was observed in 52.2% of participants. Greater loneliness was significantly associated with depressive symptoms (GDS ≥ 5; OR = 4.69, 95% CI: 2.84–7.76), higher dysphagia risk (DRACE score; OR = 1.08, 95% CI: 1.00–1.16), and lower daily conversation frequency (OR = 0.76, 95% CI: 0.67–0.86); however, volunteering (OR = 0.475, 95% CI: 0.23–0.87) was a protective factor. Conclusions: Loneliness among Japanese older adults is closely linked to depressive symptoms and aspiration risk, while frequent conversations and volunteer participation appear to be protective. Community-based interventions promoting social engagement and oral health may mitigate loneliness and its health consequences and improve quality of life for older adults. Given the cross-sectional design, the observed associations should not be interpreted as causal. Full article

Background: Dementia and mild cognitive impairment (MCI) are major public health concerns in rapidly aging societies. However, evidence from non-Western populations with self- or proxy-reported physician-diagnosed cognitive outcomes remains limited. Methods: This study investigated the four-year (2018–2022) incidence of self- or proxy-reported dementia and MCI, and their multidomain risk markers in a nationally representative sample of 3432 Korean adults aged ≥ 65 years from the Korean Longitudinal Study of Aging. Weighted descriptive analyses and multinomial logistic regression accounting for the complex survey design (sampling weights, strata, and clusters) were used to identify demographic, functional, mental health, and social factors associated with the incidence of cognitive impairment. Adjusted predicted probabilities were estimated for age, depressive symptoms, and instrumental activities of daily living (IADL). Results: Over the four-year follow-up period, among 3432 initially cognitively normal community-dwelling older adults, 34 participants developed MCI and 70 developed dementia. Older age, increased IADL impairment, depressive symptoms, and multimorbidity were significantly associated with a higher likelihood of incident cognitive impairment, while living with family was associated with a lower likelihood. Frequent social interaction showed a protective association against dementia. Predicted probabilities demonstrated overall increasing trends across age, depressive symptoms, and IADL, reflecting general risk patterns. Conclusions: These findings emphasize the importance of multidomain assessments for early detection and community-based prevention strategies. By identifying key clinical and social markers, this study provides culturally relevant evidence to support dementia risk management in rapidly aging populations, highlighting the protective roles of family co-residence and frequent social interaction among Korean older adults. Full article

Dementia is a progressive condition that affects cognition, communication, mobility, and independence, posing growing challenges for individuals, caregivers, and healthcare systems. While traditional care models often focus on symptom management in later stages, emerging artificial intelligence (AI) technologies offer new opportunities for proactive and personalized support across the dementia trajectory. This concept paper presents the Assistive Intelligence framework, which aligns AI-powered interventions with each stage of dementia: preclinical, mild, moderate, and severe. These are mapped across four core domains: cognition, mental health, physical health and independence, and caregiver support. We illustrate how AI applications, including generative AI, natural language processing, and sensor-based monitoring, can enable early detection, cognitive stimulation, emotional support, safe daily functioning, and reduced caregiver burden. The paper also addresses critical implementation considerations such as interoperability, usability, and scalability, and examines ethical challenges related to privacy, fairness, and explainability. We propose a research and innovation roadmap to guide the responsible development, validation, and dissemination of AI technologies that are adaptive, inclusive, and centered on individual well-being. By advancing this framework, we aim to promote equitable and person-centered dementia care that evolves with individuals’ changing needs. Full article

While there is extensive literature on the strengths of different supervisory models, we have limited understanding of how the relational capacity of front-line staff may impact how they receive and seek feedback from their supervisor. This study examines how mental health providers’ and front-line staff’s own rejection sensitivity may be associated with the supervisory relationship and the ways in which job feedback is sought and received in community-based mental health settings. Cross-sectional survey data were collected from 156 front-line staff of three mental health agencies. Staff were administered an original survey using validated measures related to supervision, feedback, and relational capacities. We found staff with a higher rejection sensitivity (RS) were less likely to actively seek feedback about their performance; and, when feedback was received, were more likely to rate its quality as poor. Staff with a higher RS were more likely to perceive their supervisor and their relationship negatively. This is the first study to examine whether workers’ relational capacities, as expressed through a higher RS, influence their perceptions of supervision and quality of feedback and their feedback-seeking behaviors. These findings build theory related to the important role that staff relational capacities play in influencing organizational dynamics and support. Full article

The mental distress experienced by ethnic minority students studying at predominantly White institutions is well documented. These institutions and their spaces can be hostile environments for ethnic minority students and staff, leading to low retention, engagement and poor mental health. Often posited through a deficit lens, we challenge models that situate the experiences of what we call the resilient minority (ReM)—racialised ethnic groups—into categories to be fixed. By deploying qualitative research into Black and White university student experiences of racial inclusion, we explore alternative views to building stronger, more resilient communities. By further theorising interracial anxiety (the increased levels of anxiety felt by White people when interacting with ReM or experienced by ReM in predominantly White contexts), we highlight how decolonisation, built on representation and recognition, not only generates important discussions about interracial anxiety but also creates opportunities for change. We evidence how the representation of ReM groups through a Black feminist and decolonial critique in predominantly White contexts can reduce anxiety, promote wellbeing and potentially foster interracial inclusivity in higher education. Full article

Schools focus on the education of students, but it is recognised that student engagement and educational achievement are enhanced where student wellbeing is considered. Student wellbeing can be supported both in school and through connections to the school and broader community. While teachers seek to support student wellbeing, they are often ill-equipped, given workload and educational focus, limiting their capacity to address student wellbeing needs, particularly those linked to social or community issues. School social workers provide a valuable adjunct to the work of educators, enabling a greater focus on wellbeing through the provision of targeted psychosocial support and community engagement that recognises and responds to broader factors impacting education achievement. In schools without social workers, social work student placements can provide opportunities to introduce school communities to the value and benefits social workers offer. This practice paper explores examples of school-based social work student placements offered through the social work field education program at one regional Australian University, including activities, strategies undertaken, and identified benefits of social work student placements. With indicated benefits, it is argued that the inclusion of social workers in schools adds value to the educational team, supporting children’s wellbeing and thereby contributing to improved educational engagement and achievement. Full article

Background: Aging is a multidimensional process influenced by biological, psychological, and social factors. Social support contributes to cognitive reserve by reducing stress, promoting mental engagement, and reinforcing a sense of belonging. Objective: To examine the association between perceived social support and cognitive functioning among older adults, and to investigate whether social support mediates the relationship between living arrangements and cognitive performance. Methods: The sample included 265 older adults aged 65 years and above, recruited using snowball sampling between March and July 2025 in rural communities. Instruments included the Montreal Cognitive Assessment for cognitive function and the Multidimensional Scale of Perceived Social Support for social support. Results: In this study, higher perceived social support from family, friends, and significant others was associated with better cognitive performance. Multiple regression showed that all three dimensions of social support significantly predicted MoCA scores, with the strongest effect from friends’ support. Mediation analysis revealed that perceived social support mediated the relationship between living arrangements and cognitive functioning, while the direct effect of cohabitation alone was not significant. Conclusions: These results highlight the importance of perceived social support in preserving cognitive health in older adults. Full article

Adolescence is a period of significant physical, cognitive, and social change, during which various challenges can affect wellbeing. Understanding adolescents’ own perceptions of wellbeing is crucial for developing effective support strategies. This study explores how Norwegian adolescents conceptualize their wellbeing. Using a qualitative design, semi-structured interviews were conducted with 26 adolescents aged 16–19 years, and the data are analyzed thematically. The findings reveal that wellbeing is viewed as multidimensional, encompassing physical health, social relationships, academic performance, and personal growth. Family support and community engagement emerge as central to promoting adolescents’ wellbeing. The study provides valuable insight into how young people in Norway define and experience wellbeing, emphasizing the need to integrate their perspectives into policies and interventions aimed at supporting adolescent development and mental health. Full article

Objective: To conduct a scoping review of the global trends of adolescent health inequities and their social determinants from 2000 to 2024 and establish an evidence base for developing targeted intervention strategies. Methods: Guided by the rainbow model, we conducted a bibliometric analysis of 171 peer-reviewed articles related to adolescent health inequalities and their social determinants from the Web of Science Core Collection using CiteSpace 6.3.1 to summarize empirical evidence on how social determinants of health (SDOH) influence adolescents’ health behaviors (e.g., drinking) and health outcomes (e.g., overweight). Results: First, results showed a progressive increase in publications addressing social determinants of adolescent health from 2000 to 2024. Journals in public health and preventive medicine accounted for the highest proportion of articles, with the United States contributing the largest national share (21.05% of global output). Second, an analysis of keywords showed that previous studies mostly focused on the effects of socioeconomic status, family affluence on adolescent health (e.g., physical activity, mental health, and overweight). Third, inequalities in adolescent health were prevalent globally. Health behaviors (e.g., diet, oral health, and smoking) have received widespread attention and are influenced by socioeconomic status, family environment, and gender, whereas various indicators of adolescent health outcomes (e.g., obesity, mental health, and suicide) were highly correlated with family socioeconomic status. Conclusions: To reduce adolescent health disparities, it is important to deepen interdisciplinary research, consider the impact of emerging societal (e.g., digital environments) and environmental factors (e.g., climate change), and develop systematic and comprehensive intervention strategies that encompass the individual, family, school, community, and national levels. Full article