It is well documented that the health behaviours and health status of Canadian youth are of increasing concern. This includes their inactive and sedentary lifestyle, less than recommended daily consumption of fruits and vegetables, and excessive intake of sugar sweetened beverages thought to contribute to the early development of metabolic syndrome, some cancers and certainly obesity. Strategies for reversing the declining health of Canadian youth have captured the interest of health promotion researchers. Health education in the school system has been identified as a potential vehicle of change since it is considered to be one of the last wide-scale and cost-free opportunities to motivate and educate students to be healthy and active. However, an increasing amount of research is suggesting that traditional curricula may be failing to adequately convey health information in high school youth. As a result of increasing technological literacy and exposure, a growing field of evidence suggests youth now prefer delivery of health information from electronic sources instead of traditional mediums. The majority of studies observing online health interventions show positive results, but research involving youth, and conducted in real world settings, is still in its infancy. Therefore, the purpose of this study was to examine the utility of an online intervention tool as part of a health education curriculum, to motivate and support grade 10 students to make healthy decisions related to physical activity, screen time, fruit and vegetable consumption and intake of sugar sweetened beverages. Research questions included: (1) How do students use the online tool to support their health behaviour changes? (2) What were students’ experiences using the HPSS online tool? Are they satisfied with its function, features, look and content? (3) Was there any relationship between use of the online tool and students’ behaviour change? Students in Planning 10 and PE 10 courses (N = 44) in two high schools participated in the year-long study. Pre and post intervention data collection procedures included self-report survey of health behaviours, and anthropometric measures (BMI and waist and hip measures) to more objectively capture changes in health outcomes. Focus groups were conducted with students (n = 10) and teachers (n = 6) to gather their feedback about the website and its contribution within the curriculum. Finally, web metrics captured students’ use of and exposure to the online tool over the course of the intervention. Despite evidence in the literature that youth strongly engage with electronic mediums, students’ use of the website in this study was infrequent and disappointing: 52% of students did not login once, and the remainder visited the site fleetingly. No significant relationships between students’ web use and behaviour change were found. Qualitative data revealed that students’ appreciated the interactive and reminder functions of the website, but teachers struggled to define its role within the curriculum as a pedagogical tool, so it failed to attract students’ time and attention. The study contributes to the literature through its investigation of an online health education tool, contextualized in the real life setting of the school classroom. / Graduate

Eating disorders are among the most common clinical manifestations in children, and they are frequently connected with maternal psychopathological risk, internalizing/externalizing problems in children, and poor quality of mother–child feeding exchanges. During the COVID-19 lockdown, in person assessment and intervention were impeded due to the indications of maintaining interpersonal distancing and by limits to travel. Therefore, web-based methods were adopted to meet patients’ needs. In this study N = 278 participants completed the SCL-90/R and the CBCL to examine the psychopathological symptoms of mothers and children (age of the children = 24 months); moreover, the dyads were video-recorded during feeding and followed an online video-feedback based intervention. Maternal emotional state, interactive conflict, food refusal in children, and dyadic affective state all improved considerably, as did offspring internalizing/externalizing problems and mothers’ depression, anxiety, and obsession–compulsion symptoms. This study showed that video-feedback web-based intervention might be employed successfully to yield considerable beneficial effects. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Background: Increasingly, it is recommended that to improve access to depression treatment, low-intensity psychological interventions should be developed and investigated. To date, resource-oriented approaches, such as positive psychology, that focus on patients' strengths and positive feelings have not been systematically developed and evaluated, despite evidence of potential effectiveness. This thesis aimed to systematically develop a theoretically sound online intervention using positive psychology and investigate its acceptability. Methods: The intervention's conceptual model was based on evidence synthesised from a systematic review, which identified commonly applied positive psychology components, and a qualitative study with 18 patients and 5 clinicians on the potential acceptability of online positive psychology. The intervention was tested in a feasibility study with 103 participants with depression, to identify the feasibility of study procedures and the acceptability and potential outcomes of the intervention. Intervention acceptability was further explored qualitatively with twenty-three purposively selected participants. Results: Six positive psychology components were included in the intervention to promote positive affect, strengths, and social connections. Half of the sample used the intervention minimally, a third used it moderately, and one fifth used it regularly. The intervention was rated as helpful by a fifth of the overall sample. Participants reported improved symptoms of depression. The qualitative evidence suggested that intervention acceptability could be explained by the extent to which the positive psychology components were perceived as relevant to participants' depression and how empowering they found a low-intensity website. Conclusions: A low-intensity online positive psychology intervention is acceptable and potentially beneficial to some patients with depression. Future research is needed to establish whether online positive psychology is attractive to a distinct population. If so, the developed intervention should be refined and evaluated for effectiveness. However, if there are people who generally prefer online treatments for depression, research should focus on developing the best-evidenced approach.

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Introduction Poor adherence is a common challenge in self-directed mental health interventions. Research findings indicate that telephone prompts may be useful to increase adherence. Method Due to poor adherence in a randomized controlled trial evaluating an Internet-based aftercare program for women with bulimia nervosa we implemented regular short telephone prompts into the study protocol halfway through the trial period. Of the 126 women in the intervention group, the first 63 women were not prompted by telephone (unprompted group) and compared with 63 women who subsequently enrolled into the study and were attempted to prompt bimonthly by a research assistant (telephone prompt group). Completed telephone calls took less than 5 min and did not include any symptom-related counseling. Results Most of the women in the telephone prompt group (67%) were reached only once or twice during the intervention period. However, overall adherence in the telephone prompt group was significantly higher than in the unprompted group (T = − 3.015, df = 124, p = 0.003). Conclusion Our findings from this secondary analysis suggest that telephone prompts can positively affect adherence to an Internet-based aftercare intervention directed at patients with bulimia nervosa.

Introduction Poor adherence is a common challenge in self-directed mental health interventions. Research findings indicate that telephone prompts may be useful to increase adherence. Method Due to poor adherence in a randomized controlled trial evaluating an Internet-based aftercare program for women with bulimia nervosa we implemented regular short telephone prompts into the study protocol halfway through the trial period. Of the 126 women in the intervention group, the first 63 women were not prompted by telephone (unprompted group) and compared with 63 women who subsequently enrolled into the study and were attempted to prompt bimonthly by a research assistant (telephone prompt group). Completed telephone calls took less than 5 min and did not include any symptom-related counseling. Results Most of the women in the telephone prompt group (67%) were reached only once or twice during the intervention period. However, overall adherence in the telephone prompt group was significantly higher than in the unprompted group (T = − 3.015, df = 124, p = 0.003). Conclusion Our findings from this secondary analysis suggest that telephone prompts can positively affect adherence to an Internet-based aftercare intervention directed at patients with bulimia nervosa.

Facing poor long-term outcome and high relapse rates in the treatment of bulimia nervosa, we developed an Internet-based aftercare program for women with severe and chronic bulimia nervosa following inpatient treatment based on previous experiences with self-directed targeted prevention and early intervention programs delivered online. The aim of the present study was to examine adherence to the program in detail, to explore potential variables that predict adherence and to analyze whether adherence affects outcomes. We analyzed data from 126 women in the intervention group of a randomized controlled trial. 107 women (85%) logged on to the program platform at least once. These women opened on average 42.8% (SD=31.9%) of all assigned program pages. Adherence declined during the course of the intervention. Adherence was not associated with the number of outpatient treatment sessions received during the intervention period. Adherence was not related to overall illness severity or duration at baseline. However, excessive exercise at hospital discharge (which may be a sign of insufficient motivation to change eating disorder related behaviors) seems to play some small role in adherence. Adherence did not affect intervention outcomes. Based on our findings, we would like to advocate further research on online aftercare interventions for women with severe and chronic bulimia nervosa.

Prevalence rates of overweight and obesity in Maltese adolescents are amongst the highest in the world. Stress-induced eating and dysfunctional coping skills have been linked to overeating and obesity. This study was undertaken in two phases. Phase 1 examined the relationship between perceived stress, coping and eating behaviours in Maltese adolescents and devised a model to guide the development of an effective Internet-based intervention. Based on the findings, Phase 2 developed ACES – a novel online intervention for the reduction of perceived stress and emotional eating in Maltese adolescents – and assessed its feasibility. In Phase 1, cross-sectional data were gathered from 79 Maltese adolescents using an online questionnaire with 6 self-report measures examining perceived stress, coping responses, eating behaviours, self-efficacy, physical exercise and social support. Findings suggested that emotional eating behaviours can be decreased by reducing perceived stress and dysfunctional coping strategies (self-controlling and escape-avoidance) and increasing self-efficacy and functional coping strategies (seeking social support and planful problem solving). In Phase 2, ACES was developed and a feasibility study, with a one-group pretest-posttest design, carried out to assess the functionality, usability, perceived utility and acceptability of ACES and to test the design of a definitive randomized controlled trial. Forty-six out of 125 participants completed ACES. Findings suggested that ACES is feasible and well-received by participants. Preliminary effectiveness results provide additional support for the Phase 1 findings concerning the variables that need to be taken into account to decrease emotional eating behaviours. This study has made significant contributions to the literature and offered insights into specific functional and dysfunctional coping strategies impacting perceived stress and eating behaviours. It has produced an online intervention, which is a feasible avenue for the reduction of perceived stress and emotional eating, that could be built upon by practitioners and researchers, with potential implications for obesity prevention.

This study examined the efficacy of the My Best Self 101 (MBS101) self-compassion module, an internet-delivered self-compassion training within a non-clinical general population sample. Using a randomized-waitlist control design, this study examined whether module participants experienced significant improvements in self-compassion, well-being, and body image compared to waitlist controls. Participants were 228 adults (mean age 30.3, 23.5% male and 76.5% female). At pretest and posttest, both groups completed self-report measures of self-compassion, subjective well-being, and body image. Repeated measures mixed model analyses revealed that compared to waitlist controls, participants who used the MBS101 self-compassion module reported significant improvements in self-compassion, well-being, and body image with effect sizes ranging from medium to large. These results lend evidence to support the MBS101 self-compassion module as a promising resource to improve well-being and body image. Future research should examine its efficacy in different populations and focus on expanding its content.

Background: Tobacco dependence is among the strongest of addictions and smoking is a significant risk factor for a large number of diseases as well as premature death. New treatment options for tobacco dependence have emerged with the implementation of eHealth approach, especially those provided remotely. In the field of addictology we are mainly talking about applications for smoking cessation, which can be an attractive option for those who want to quit smoking, but their effectiveness needs to be further examined. Aims: The main objective of this study is to describe user experience of tobacco smokers using the online intervention Endre. Partial aims were to find how users rated the visual interface of the intervention, the user-friendliness and what method of cessation they would choose for their future atempts to quit. Material and methods: Data collection was carried out using a quantitative method of probability selection, namely a simple intentional (criteria) selection through an online questionnaire tool sent by e-mail to selected participants of the ongoing RCT study. The research group consisted of 105 respondents, of whom 60 were women and 45 men. To evaluate the collected data, MS excel was used, where frequency analyzes, summary statistics and testing of statistical hypotheses were...