gamified sleep intervention for veterans: an overview

A good night’s sleep is well known to be imperative for maintaining one’s overall wellness. Yet, about half of Canadian adults struggle with falling asleep or maintaining sleep. The impacts of insufficient sleep are wide-ranging, from physiological correlates such as diabetes to mental correlates such as depression. Effective treatments for sleep-related issues exist: for example, online interventions for insomnia have been found to be effective. As a medicine and a health psychology student at, respectively, Sherbrooke University and McGill University, we worked on the MissionVAV health promotion program during the COVID-19 pandemic, providing free gamified interventions for Canadian Veterans and their families. Over the course of several online interventions related to physical health, we observed that a large proportion of our participants were dissatisfied with their sleep. Consequently, we have developed an 8-week online sleep intervention to address this primordial element of primary prevention. The intervention aims to better our participants’ sleep through providing weekly readings on the following topics: age-related changes in sleep, proper sleep hygiene, varied relaxation techniques as well as the relationship between sleep and chronic pain, menopause, shift work, rumination, exercise and light. To promote healthy sleep hygiene habits, daily self-assessment questions are provided and are incentivized through points and storytelling. Furthermore, health coaches trained in sleep medicine follow participants throughout their journey to provide support and reinforcement. Ultimately, the intervention aims to shed light on the importance of sleep within preventative medicine, tackling it systematically in an engaging, gamified fashion.

Trusting in the online ‘community’: An interview study exploring internet use in young people with chronic pain

Background Chronic pain in young people is prevalent in the UK. Young people are digital natives, yet there has not been any online intervention developed in a UK context to help them manage chronic pain. Key to understanding the context in which young people engage with online interventions is better understanding their internet use for chronic pain management. The overarching aim of this study was to explore young peoples’ experiences of searching for information about chronic pain using the internet. This included experiences of using search engines (e.g. Google), health information websites (e.g. the National Health Service [NHS] website) and social media (e.g. Facebook and Instagram). Methods Semi-structured interviews were conducted with young people aged 16–24-years ( n = 24), online, via Microsoft (MS) Teams. The study was advertised online and via patient partner charities. Interview data was analysed using reflexive thematic analysis. Results Participants presented with a variety of chronic pain conditions, including joint hypermobility syndrome ( n = 6), chronic headache and/or migraine ( n = 4) and fibromyalgia ( n = 3). Four themes were generated: ‘Trustworthy information, or experiences?’, ‘Diagnostic labels in a digital world’, ‘The online chronic pain community’ and ‘A mind and body approach to self-management’. Young people trust advice from others in their online community and having a diagnostic label help them find relevant pain management strategies and support networks online. Conclusions This study is the first qualitative exploration of internet use in UK-based young people with chronic pain. Findings highlight the importance of considering internet use when developing new online interventions for young people with pain and that internet use, particularly social media use, is an important psychosocial consideration in pain management. Young people should be encouraged to verify practical pain management techniques found online with their doctor and be empowered in the safe use of appropriate psychology-based self-management resources.

Online Interventions to Improve Mental Health of Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis

Objective: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement.Methods: On June 25–30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis.Results: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04–0.66) and psychological well-being g = 0.32 (95% CI 0.09–0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI −0.13 to 0.47), anxiety g = 0.05 (95% CI −0.15 to 0.25), and pain g = 0.13 (95% CI −0.13 to 0.39).Conclusion: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn. The study protocol was registered in PROSPERO (CRD42021266276).

Investigating differential effects of socio-emotional and mindfulness-based online interventions on mental health, resilience and social capacities during the COVID-19 pandemic: The study protocol

Background The SARS-CoV-2 pandemic has led to a mental health crisis on a global scale. Epidemiological studies have reported a drastic increase in mental health problems, such as depression and anxiety, increased loneliness and feelings of disconnectedness from others, while resilience levels have been negatively affected, indicating an urgent need for intervention. The current study is embedded within the larger CovSocial project which sought to evaluate longitudinal changes in vulnerability, resilience and social cohesion during the pandemic. The current second phase will investigate the efficacy of brief online mental training interventions in reducing mental health problems, and enhancing psychological resilience and social capacities. It further provides a unique opportunity for the prediction of intervention effects by individual biopsychosocial characteristics and preceding longitudinal change patterns during the pandemic in 2020/21. Methods We will examine the differential effects of a socio-emotional (including ‘Affect Dyad’) and a mindfulness-based (including ‘Breathing Meditation’) intervention, delivered through a web- and cellphone application. Participants will undergo 10 weeks of intervention, and will be compared to a retest control group. The effectiveness of the interventions will be evaluated in a community sample (N = 300), which is recruited from the original longitudinal CovSocial sample. The pre- to post-intervention changes, potential underlying mechanisms, and prediction thereof, will be assessed on a wide range of outcomes: levels of stress, loneliness, depression and anxiety, resilience, prosocial behavior, empathy, compassion, and the impact on neuroendocrine, immunological and epigenetic markers. The multi-method nature of the study will incorporate self-report questionnaires, behavioral tasks, ecological momentary assessment (EMA) approaches, and biological, hormonal and epigenetic markers assessed in saliva. Discussion Results will reveal the differential effectiveness of two brief online interventions in improving mental health outcomes, as well as enhancing social capacities and resilience. The present study will serve as a first step for future application of scalable, low-cost interventions at a broader level to reduce stress and loneliness, improve mental health and build resilience and social capacities in the face of global stressors. Trial registration This trial has been registered on May 17, 2020 with the ClinicalTrials.gov NCT04889508 registration number (clinicaltrials.gov/ct2/show/NCT04889508).

Translation of Two Healthy Eating and Active Living Support Programs for Parents of 2–6-Year-Old Children: Outcomes of the ‘Time for Healthy Habits’ Parallel Partially Randomised Preference Trial

This translation study assessed the effectiveness of two remotely delivered healthy eating and active living interventions for parents of 2- to 6-year-old children in improving child fruit and vegetable intake, non-core food intake, body mass index (BMI), physical activity, screen time, and sleep. Parents (n = 458) were recruited to a partially randomised preference trial comprising three intervention groups. Healthy Habits Plus comprised six telephone calls, Time2bHealthy comprised six online modules, and the active control comprised ten information sheets and a summary booklet. Data were collected from parents via a telephone questionnaire at baseline and nine months post-baseline. Data were analysed for randomised participants alone (n = 240), preference participants alone (n = 218), and all participants combined (n = 458). There was no significant improvement in fruit and vegetable intake (primary outcome) when comparing the telephone and online interventions to the control. In both the randomised only and all participants combined analyses, there was a significant improvement in non-core food intake for the telephone intervention compared to the control (p < 0.001). Differences between interventions for other outcomes were small. In conclusion, the telephone and online interventions did not improve child fruit and vegetable intake relative to written materials, but the telephone intervention did improve non-core food intake.

Understanding user communication around loneliness on online forums

Increasingly, individuals experiencing loneliness are seeking support on online forums—some of which focus specifically on discussions around loneliness (loneliness forums); loneliness may influence how these individuals communicate in other online forums not focused on loneliness (non-loneliness forums). In order to provide effective and appropriate online interventions around loneliness, it is important to understand how users who publish posts in a loneliness forum communicate in the loneliness forum and non-loneliness forums they belong to. In this paper, using language features, the following analyses are conducted: (1) Posts published on an online loneliness forum on Reddit, /r/Lonely are compared to posts (published by the same users and around the same time period) on two Reddit online forums i.e. an advice seeking forum, /r/AskReddit and a forum focused on discussions around depression (depression forum), /r/depression. (2) Interventions related to loneliness may vary depending on if an individual is lonely and depressed or lonely but not depressed; language use differences in posts published in /r/Lonely by the following set of users are identified: (a) users who post in both /r/Lonely and a depression forum and (b) users who post in /r/Lonely but not in the depression forum. The findings from this work gain new insights, for example: (i) /r/Lonely users tend to seek advice/ask questions related to relationships in the advice seeking forum, /r/AskReddit and (ii) users who are members of the loneliness forum but not the depression forum tend to publish posts (on the loneliness forum) on topic themes related to work/job, however, those who are members of the loneliness and depression forums tend to use more words associated with anger, negation, death, and post on topic themes related to affection relative to relationships in their loneliness forum posts. Some of the findings from this work also align with prior work e.g. users who express loneliness in online forums tend to make more reference to self. These findings aid in gaining insights into how users communicate on these forums and their support needs, thereby informing loneliness interventions.