Abstract Background Smoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and efectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Methods A pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18–65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verifed by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical ftness, cardiovascular risks, substance use, quality of life, and health-related self-efcacy at 12months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals. Discussion The results of the KISMET trial will contribute to the evidence gap of efective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system. Trial registration Netherlands Trial Register, NTR9783. Registered on 18 October 2021.
Abstract Background Smoking among people with severe mental illness (SMI) is highly prevalent and strongly associated with poor physical health. Currently, evidence-based smoking cessation interventions are scarce and need to be integrated into current mental health care treatment guidelines and clinical practice. Therefore, the present study aims to evaluate the implementation and effectiveness of a smoking cessation intervention in comparison with usual care in people with SMI treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Methods A pragmatic, cluster-randomised controlled trial with embedded process evaluation will be conducted. Randomisation will be performed at the level of FACT teams, which will be assigned to the KISMET intervention or a control group (care as usual). The intervention will include pharmacological treatment combined with behavioural counselling and peer support provided by trained mental health care professionals. The intervention was developed using a Delphi study, through which a consensus was reached on the core elements of the intervention. We aim to include a total of 318 people with SMI (aged 18–65 years) who smoke and desire to quit smoking. The primary outcome is smoking status, as verified by carbon monoxide measurements and self-report. The secondary outcomes are depression and anxiety, psychotic symptoms, physical fitness, cardiovascular risks, substance use, quality of life, and health-related self-efficacy at 12 months. Alongside the trial, a qualitative process evaluation will be conducted to evaluate the barriers to and facilitators of its implementation as well as the satisfaction and experiences of both patients and mental health care professionals. Discussion The results of the KISMET trial will contribute to the evidence gap of effective smoking cessation interventions for people treated by FACT teams. Moreover, insights will be obtained regarding the implementation process of the intervention in current mental health care. The outcomes should advance the understanding of the interdependence of physical and mental health and the gradual integration of both within the mental health care system. Trial registration Netherlands Trial Register, NTR9783. Registered on 18 October 2021.
We examined trajectories of multiple health risk behavior (MHRB) patterns throughout adolescence, and changes in mental health from childhood to young adulthood. Further, we assessed how continuity or onset of MHRBs overall were associated with subsequent changes in mental health, and whether this varied by type of MHRBs. We used six waves of the prospective Dutch TRAILS study (2001–2016; n =2229), covering ages 11 until 23. We measured MHRBs (substance use: alcohol misuse, cannabis use, smoking; and obesity-related: overweight, physical inactivity, irregular breakfast intake) at three time points during adolescence. We assessed mental health as Youth/Adult Self-report total problems at ages 11 and 23. Latent class growth analyses and ANOVA were used to examine longitudinal trajectories and associations. We identified six developmental trajectories for the total of MHRBs and mental health. Trajectories varied regarding likelihood of MHRBs throughout adolescence, mental health at baseline, and changes in mental health problems in young adulthood. We found no associations for the continuity of overall MHRBs throughout adolescence, and neither for early, mid- or late onset, with changes in mental health problems in young adult-hood. However, continuity of MHRBs in the obesity-related subgroup was significantly associated with an in-crease in mental health problems. Adolescents with the same MHRB patterns may, when reaching adulthood, have different levels of mental health problems, with mental health at age 11 being an important predictor. Further, involvement with obesity- related MHRBs continuously throughout adolescence is associated with increased mental health problems in young adulthood.
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Digital innovations in the field of immersive Augmented Reality (AR) can be a solution to offer adults who are mentally, physically or financially unable to attend sporting events such as premier league football a stadium and match experience. This allows them to continue to connect with their social networks. In the intended project, AR content will be further developed with the aim of evoking the stadium experience of home matches as much as possible. The extent to which AR enriches the experience is then tested in an experiment, in which the experience of a football match with and without AR enrichment is measured in a stadium setting and in a home setting. The experience is measured with physiological signals. In addition, a subjective experience measure is also being developed and benchmarked (the experience impact score). Societal issueInclusion and health: The joint experience of (top) sports competitions forms a platform for vulnerable adults, with a limited social capital, to build up and maintain the social networks that are so necessary for them. AR to fight against social isolation and loneliness.
Worldwide, a third of all adults is suffering from feelings of loneliness, with a peak at young adulthood (15-25 years old). Loneliness has serious consequences for mental and physical health and should therefore be urgently addressed. However, existing interventions targeting loneliness mainly focus on older adults [1], and rarely consider the physical living environment, while studies prove that the physical environment (e.g. amenities, green, walkability, liveliness) has a significant impact on loneliness. Collaboration between the psychosocial and physical domains is key, to gain insight into the mechanisms and pathways linking characteristics of the physical living environment and loneliness among young adults and which spatial interventions are effective in managing loneliness. The main research questions are thus: how are physical environment and loneliness related, and which interventions should be implemented? The I BELONG proposal aims to build a European consortium that will address these questions. WP1 encompasses collaboration and networking activities that will form the basis for future collaboration, for instance a European research grant application. WP2 will provide insight in the pathways linking spatial attributes and loneliness. This will be achieved by doing a systematic literature review, a photovoice and interview study to collect data on specific locations that affect young people’s experiences with loneliness, and Group Model Building with experts. Building on this, WP3 aims to co-create spatial interventions with partners and young adults, and test ‘proof of concept’ interventions with virtual environments among young adults. WP3 will result in a spatial intervention toolkit. This project has both societal and scientific impact, as it will provide knowledge on pathways between physical environment characteristics and feelings of loneliness among young people, evidence of what spatial interventions work, and design guidelines that can be used in urban design and management that can contribute to managing loneliness and related health risks.
Sport injuries are a major reason for reduced participation and drop-out from sports and PE. Refraining from sport participation has negative bearing effects on mental and physical wellbeing, which tracks into adulthood. It is therefore important for youth to be facilitated into lifelong active participation in physical activity and sport, as the importance of physical activity for the health of youth is undisputed. Participation in physical education (PE) classes and membership of sports clubs and are essential for health enhancing physical activity. Despite the importance of sports injury prevention in youth, no broad scale approaches that work in real-life situations with significant positive effects exist. Main reasons for this are very poor uptake and maintenance of current sports injury prevention exercises. Sportscoaches and physical educators experience these exercises as not context specific, time consuming and not contributing to their training goals. Whereas youth perceives these exercises as not attractive, no fun and without any play or game component. These aspects cause lack of maintenance and thus no significant reduction of injuries. Recent scientific and practical insights promote more emphasis on motivation through autonomy and attractive exercise routines based on principles of motor learning which can be integrated in regular training sessions or physical education classes. Purpose: Therefore, the Move Healthy project develops ICT based support video material of routines for and with physical educators and sport coaches, which supports them to prevent sports injuries in youth. This material should be easy to integrate in regular training sessions or physical education classes.
