Making life better: Monitoring the wider social determinants of health and well being - key indicators 2015

This report monitors progress against the key indicators of Northern Ireland’s public health strategy ‘Making Life Better’ launched by the Department of Health, Social Services & Public Safety (DHSSPS) in 2014. In addition to presenting the revised baseline positions for each of the key indicators of the framework, the report also monitors progress against each indicator by comparing the latest position with the baseline.

Patients' experiences of support for learning to live with diabetes to promote health and well-being : A lifeworld phenomenological study

Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.

Intergenerational Transfers over the Life Course: Addressing Temporal and Gendered Complexities via a Human Well-being Approach

Research on intergenerational transmissions of poverty and inequality has tended to focus on material transfers. This paper refocuses attention on the intersection of material and psychosocial transfers, which reveals temporal and gendered complexities. It examines three key ideas emerging from the life course literature (relationality, intersectionality and intergenerationality) to shed light on how these complexities might be addressed. It is argued that a human wellbeing lens is potentially useful as a unifying framework to integrate these ideas as it interrogates what living well means over the life course and how it is constructed relationally.

The Development and Evaluation of a School-Based Programme to Promote and the Enhance Well-Being of Primary School Children

The current study was carried out to evaluate the impact of a well-being curriculum based on existing knowledge of themes within PP, which contribute to well-being. The Positive Well-Being Curriculum consists of twelve ninety minute sessions delivered weekly during a school term. The twelve well-being sessions fit into four domains: positive experience, positive emotions, positive relationships, achievement and meaning (Seligman, 2007). The objectives of the study were to test the practical implications of running a well-being curriculum, to develop a range of activities within each domain and to evaluate the impact on student well-being with regard to life satisfaction, positive affectivity and subjective happiness. A pilot was carried out as preparation for the main mixed method intervention study, which was conducted in two London primary schools. Pre and post data was collected using standardised measures, focus groups and one to one interviews. Findings from the pilot demonstrated a significant increase in well-being as demonstrated by increases in: life satisfaction, positive affect and subjective happiness. Additional information was gathered which informed the content and implementation of the curriculum in the main study. The experience of taking part in the study as evidenced through qualitative and quantitative results, indicate that the Positive Well-being Curriculum was perceived by participating teachers and children to contribute positively to the well-being of the children. These findings would be of interest to educational psychologists as there is an increasing interest by schools to include creative and validated resources to support and enhance the well-being of all children. A number of useful insights were developed about the usefulness of the curriculum for children in a variety of educational settings.

Jatropha cultivation in Malawi and Mozambique: impact on ecosystem services, local human well-being, and poverty alleviation

Jatropha-based biofuels have undergone a rapid boom-and-bust cycle in southern Africa. Despite strong initial support by governments, donors, and the private sector, there is a lack of empirical studies that compare the environmental and socioeconomic impacts of Jatropha’s two dominant modes of production: large plantations and smallholder-based projects. We apply a rapid ecosystem services assessment approach to understand the impact of two Jatropha projects that are still operational despite widespread project collapse across southern Africa: a smallholder-based project (BERL, Malawi) and a large plantation (Niqel, Mozambique). Our study focuses on changes in provisioning ecosystem services such as biofuel feedstock, food, and woodland products that can have important effects on human well-being locally. Qualitative information is provided for other regulating and cultural ecosystem services. Although at this stage no impact is tremendously positive or negative, both projects show some signs of viability and local poverty alleviation potential. However, their long-term sustainability is not guaranteed given low yields, uncertain markets, and some prevailing management practices.

Changes in biodiversity and trade-offs among ecosystem services, stakeholders, and components of well-being: the contribution of the International Long-Term Ecological Research network (ILTER) to Programme on Ecosystem Change and Society (PECS)

The International Long-Term Ecological Research (ILTER) network comprises > 600 scientific groups conducting site-based research within 40 countries. Its mission includes improving the understanding of global ecosystems and informs solutions to current and future environmental problems at the global scales. The ILTER network covers a wide range of social-ecological conditions and is aligned with the Programme on Ecosystem Change and Society (PECS) goals and approach. Our aim is to examine and develop the conceptual basis for proposed collaboration between ILTER and PECS. We describe how a coordinated effort of several contrasting LTER site-based research groups contributes to the understanding of how policies and technologies drive either toward or away from the sustainable delivery of ecosystem services. This effort is based on three tenets: transdisciplinary research; cross-scale interactions and subsequent dynamics; and an ecological stewardship orientation. The overarching goal is to design management practices taking into account trade-offs between using and conserving ecosystems toward more sustainable solutions. To that end, we propose a conceptual approach linking ecosystem integrity, ecosystem services, and stakeholder well-being, and as a way to analyze trade-offs among ecosystem services inherent in diverse management options. We also outline our methodological approach that includes: (i) monitoring and synthesis activities following spatial and temporal trends and changes on each site and by documenting cross-scale interactions; (ii) developing analytical tools for integration; (iii) promoting trans-site comparison; and (iv) developing conceptual tools to design adequate policies and management interventions to deal with trade-offs. Finally, we highlight the heterogeneity in the social-ecological setting encountered in a subset of 15 ILTER sites. These study cases are diverse enough to provide a broad cross-section of contrasting ecosystems with different policy and management drivers of ecosystem conversion; distinct trends of biodiversity change; different stakeholders’ preferences for ecosystem services; and diverse components of well-being issues.

The Relationship between Materialistic Aspirations and Distinct Aspects of Psychological Well-being in a UK sample

The purpose of this research is to gain a deeper understanding of how materialistic aspirations are related to distinct aspects of psychological well-being. Research has consistently found a negative relationship between materialistic goals and well-being, but a review of the literature identified that the measures of well- being used in the majority of studies were measures of what Keyes (2002) describes as “subjective well-being” or “hedonic happiness”. Criticisms of these types of measures are that they fixate too much on the momentary experience of pleasure and don’t take into account what is meaningful and or what contributes to long lasting fulfilment. Very little research was found investigating the impact of materialism on “eudaimonic” well-being, which is found through doing what is worthwhile and realising ones potential and has been found to have a longer lasting impact on overall well-being (Huta & Ryan, 2010). To address this gap in the literature, a convenience sample of 113 adult subjects in the UK were recruited through Facebook and asked to respond to the Aspiration Index and the Psychological wellbeing scale. The relative importance placed on extrinsic (materialistic) and intrinsic aspirations was compared to the six dimensions of psychological well-being. In line with previous research, higher importance placed on materialistic aspirations for wealth, status and image were found to be negatively correlated with all aspects of psychological well-being. However, the strongest and only statistically significant negative correlation was between extrinsic aspirations and positive relations with others (r = -.256, p< 0.01). Positive relationships with other people form a central component of many theories of well- being and so this negative relationship may help to explain why materialistic aspirations are so consistently found to be negatively correlated to a variety of measures of well-being. Further research is needed to explore this relationship as no causation could be inferred.

Lifestyles of higher education students: the influence of self- esteem and psychological well-being

Background The transition to higher education can affect lifestyle-related factors. Objectives: To identify lifestyles of higher education students and analyse the influence of self-esteem and psychological well-being. Methods Correlational cross-sectional study. A total of 4,314 students partici- pated in the study. Online questionnaires were used: Estilo de Vida Fantástico (Fantastic Lifestyle Assessment) [1]; Questionário de Bem- estar Psicológico (Psychological General Well-Being Questionnaire) [2], and Escala de auto-estima de Rosenberg (Rosenberg Self-Esteem Scale [3]. Results Most students (85.3 %) have a healthy lifestyle. Lifestyle is strongly correlated with self-esteem and psychological well-being (p < 0.001). While analysing the association between self-esteem and psycho- logical well-being and the various lifestyle domains according to gen- der, a positive and significant correlation (p < 0.001) was found among female students, except for the Smoking domain (p = 0.393); in relation to psychological well-being, positive correlations were found in all domains. Among male students, positive and significant correlations (p < 0.001) were found in most lifestyle domains and self-esteem, except for the Smoking (p = 0.992), Alcohol and other drugs (p = 0.181) and Other behaviours (p = 0.442) domains; in rela- tion to psychological well-being, positive and significant correlations (p < 0.001) were found in most lifestyle domains, except for the Smoking (p = 0.458) and Other behaviours (p = 0.128) domains. Conclusions Based on the results, higher education institutions should support intervention projects to maintain high levels of psychological well- being and self-esteem, promoting healthy lifestyles.

Dietary restraint and subjective well-being in university students in Chile

Objective: To characterize university students typologies according to chronic food restriction, satisfaction with life and food consumption. Materials and method: A questionnaire was applied on a non-probability sample of 369 male and female students from five Chilean universities. The questionnaire included: Revised Restraint Scale (RRS), Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFL) and the Health-related Quality of Life Index. The survey included food and drink consumption habits, weight and approximate height and sociodemographic variables. Results: Two factors in the RRS were detected by exploratory factor analysis: Preoccupation with Diet (PD) and Weight fluctuations (WF). A confirmatory factor analysis validated the bifactor structure of the RRS with an acceptable adjustment kindness. The cluster analysis allowed a distinction of four typologies with a significant variation in PD, WF, SWLS and SWFL scoring, number of days with mental health problems, frequency of alcoholic drinks consumption, restraint on the consumption of certain foods, drinks and spices, consumption frequency of fruit out of the main meals and types. Typologies did not differ on their body mass index. Conclusions: Both, students preoccupied with diet and those who are not, experience higher levels of satisfaction with life and with food. Lower levels of global life satisfaction and satisfaction with food are related with the fluctuations in weight.

Sexuality in the media and emotional well-being among lesbian, gay, & bisexual adolescents

LGB teens’ feelings, desires, and physical attractions run contrary to the heteronormative standards of American society. As such, LGB youth often experience feelings of sadness and dejection that can lead to depression and suicidal tendencies (Russell & Joyner, 2001). Evaluating the factors that could possibly influence the emotional well-being of LGB youth would be an important undertaking given the hindrances LGB adolescents face during sexual socialization. The purpose of this dissertation was to study the portrayal of sexuality in media popular with LGB adolescents and to assess the relationship between media exposure and emotional well-being among LGB teens. In particular, this dissertation distinguished between mainstream media and gay- and lesbian-oriented (GLO) media. GLO media were defined as any media outlet specifically designed, produced, and marketed for gay and lesbian audiences. Two studies were conducted to serve as the initial investigation in a program of research that will be designed to better understand the role of media in the lives of LGB individuals. The first study of this dissertation was a content analysis of the television programs, films, songs, and magazines most popular with LGB teens as determined by self-reports of media consumption in a survey of media use. A total of 96 media vehicles composed the content analysis sample, including 48 television programs, 22 films, 25 musical artists, and 6 magazines. Using a coding scheme that was adapted from previous media sex research, Study 1 measured the frequency of sexual instances as well as the type, nature, and source characteristics for each sexual instance. Results of the content analysis suggest that heterosexuality reigns supreme in mainstream media. When LGB sexuality is depicted in mainstream media, it is often sanitized. LGB sexual talk is rarely sexual; rather it is primarily about the social or cultural components of being lesbian, gay, or bisexual. LGB sexual behavior is also rare in mainstream media, which tend to depict LGB individuals as non-sexually as possible. LGB sexuality in mainstream media exists, but is more about proclaiming LGB identity than actually living it. GLO media depicted LGB sexuality more frequently than mainstream media did. GLO media often depict LGB sexuality in a more realistic manner. LGB sexual talk is about LGB identity, as well as the relational and sexual aspects of being a sexual minority. LGB sexual behavior is commonplace in GLO media, depicting LGB individuals as sexual beings. LGB sexuality in GLO media is prevalent and relatively authentic. The second study was a survey that assessed the relationship between media exposure (both mainstream media and GLO media) and LGB teens’ emotional well-being, considering self-discrepancy as an important mediating variable in that relationship. Study 2 also considered age, sex, and sexual identity commitment as possible moderating variables in the relationship between media exposure and emotional well-being. In Study 2, emotional well-being was defined as lower levels of dejection-related emotions. LGB adolescents (N = 573) completed a questionnaire that was used to investigate the relationships between media exposure and emotional well-being. Results of the survey indicated that mainstream media exposure was not significantly associated with dejection-related emotions. In contrast, GLO media exposure was negatively related to feelings of dejection even when controlling for age, sex, race, perceived social support, school climate, religiosity, geographical location, sexuality of peers, and motivation for viewing LGB inclusive media content. Neither age nor sex moderated the relationships between media exposure variables and dejection, but sexual identity commitment did act as a moderator in the relationship between GLO media exposure and dejection. The negative relationship between GLO media exposure and dejection was stronger for participants lower in sexual identity commitment than for participants higher in sexual identity commitment. In addition, the magnitude of discrepancies between the actual self and the ideal self mediated the relationship between GLO media exposure and dejection for LGB adolescents low in sexual identity commitment. However, self-discrepancy did not mediate the relationship between GLO media exposure and dejection for LGB teens highly committed to their sexual identities. Results of both the content analysis and the survey are discussed in terms of implications for theory and method. Practical implications of this dissertation’s findings are also discussed, as well as directions for future research.

The Warwick-Edinburgh Mental Well-Being Scale

Background There is increasing international interest in the concept of mental well-being and its contribution to all aspects of human life. Demand for instruments to monitor mental well-being at a population level and evaluate mental health promotion initiatives is growing. This article describes the development and validation of a new scale, comprised only of positively worded items relating to different aspects of positive mental health: the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). Methods WEMWBS was developed by an expert panel drawing on current academic literature, qualitative research with focus groups, and psychometric testing of an existing scale. It was validated on a student and representative population sample. Content validity was assessed by reviewing the frequency of complete responses and the distribution of responses to each item. Confirmatory factor analysis was used to test the hypothesis that the scale measured a single construct. Internal consistency was assessed using Cronbach’s alpha. Criterion validity was explored in terms of correlations between WEMWBS and other scales and by testing whether the scale discriminated between population groups in line with pre-specified hypotheses. Test-retest reliability was assessed at one week using intra-class correlation coefficients. Susceptibility to bias was measured using the Balanced Inventory of Desired Responding. Results WEMWBS showed good content validity. Confirmatory factor analysis supported the single factor hypothesis. A Cronbach’s alpha score of 0.89 (student sample) and 0.91 (population sample) suggests some item redundancy in the scale. WEMWBS showed high correlations with other mental health and well-being scales and lower correlations with scales measuring overall health. Its distribution was near normal and the scale did not show ceiling effects in a population sample. It discriminated between population groups in a way that is largely consistent with the results of other population surveys. Test–retest reliability at one week was high (0.83). Social desirability bias was lower or similar to that of other comparable scales. Conclusions WEMWBS is a measure of mental well-being focusing entirely on positive aspects of mental health. As a short and psychometrically robust scale, with no ceiling effects in a population sample, it offers promise as a tool for monitoring mental well-being at a population level. Whilst WEMWBS should appeal to those evaluating mental health promotion initiatives, it is important that the scale’s sensitivity to change is established before it is recommended in this context.