Policy brief on improving mental health among young people by increasing their levels of physical activity
1 HBS108 Health Information and Data: Assignment 2 1200 words, 30% of total assessment, due Thursday 10 January, 2019, 4 pm This assignment assesses Topics 4, 5, 6 & 7 Can physical activity improve the mental health of young people? This assignment draws on Topics 4, 5, 6 and 7. It requires you to access, understand, interpret and report on findings from qualitative and quantitative research studies that investigate physical activity and mental health. You are then required, as a health practitioner, to make recommendations about how to improve the mental health of young people in Australian through physical activity. You are required to access and read the following journal articles, and answer a series of questions based on their content: Belair, MA, Kohen, DE, Kingsbury, M & Colman, I 2018. ‘Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents.’ BMJ Open, vol. 8, no. 10, e021119. doi: 10.1136/bmjopen-2017-021119. Carter, T, Morres, I, Repper, J & Callaghan P 2016. ‘Exercise for adolescents with depression: valued aspects and perceived change.’ Journal of Psychiatric & Mental Health Nursing, vol. 2, no. 1, pp. 37-44. doi: 10.1111/jpm.12261. Melnyk, BM, Jacobson, D, Kelly, S, Belyea, M, Shaibi, G, Small, L, O’Haver, J, & Marsiglia, FF 2013. ‘Promoting Healthy Lifestyles in High School Adolescents: A Randomized Controlled Trial.’ American Journal of Preventive Medicine, vol. 45, no. 4, doi: 10.1016/j.amepre.2013.05.013. Topics 4, 5, 6 and 7 (and especially the online tutorial activities and sessions associated with each topic) will provide you with the knowledge and skills you need to successfully complete this assignment. 2 Important note The marks allocated for each question do not necessarily reflect the number of words required to answer the question. For example, some questions worth 2 or 3 marks can be answered in a few words, though others might require one or two sentences. If you are struggling to stay within the word count it is recommended that, if it is possible to answer a question in a few words, you do so in order to save words for those questions that require more text to answer. For brief answers, the following format is acceptable: Q5(i): Random sampling. Introduction The second national survey of the mental health and wellbeing of Australian children and adolescents found that almost one in seven (13.9%) 4-17 year-olds were assessed as having a mental disorder in the previous 12 months, amounting to 560,000 Australian children and adolescents (Lawrence et al. 2015). Mental health and wellbeing is influenced by a wide range of factors, and, increasingly, evidence is pointing to physical activity as an important contributor to mental health, including for children and adults (Mammen and Faulkner 2013). While evidence highlights the potential for physical activity to improve mental health and wellbeing, many Australian children and adolescents have low levels of physical activity. According to the most recent available data, only 30% of children aged 2–17 meet the physical activity guidelines, and physical activity levels decline markedly with age: from 61% of 2–5 year olds to 26% of 5–12 year olds to 8% of 13–17 year olds meeting the physical activity guidelines (Australian Institute of Health and Welfare 2018). These data indicate considerable potential to improve both the physical and mental health of young people in Australia by increasing their levels of physical activity. This assignment requires you to investigate research evidence related to physical activity and mental health for young people. Key questions on this topic that can be answered through research include: 1. Is physical activity associated with better mental health among young people? 2. What are the perceptions and experiences of young people with depression who participate in a physical activity program? 3. Can school skills-building programs that include physical activity improve young people’s mental health? In this assignment you will answer questions based on research studies that address these important questions. 3 TASK A The following questions are based on the study by Belair et al. (2018). Q1(a) What is the study design? How does this study design rate (in comparison to other quantitative study designs) in terms of determining causal relationships between variables (ie between physical activity and mental health)? (NOTE: in selecting the study design you need to distinguish between data collected over a number of years and combined in the analysis, and data collected over a number of years and analysed longitudinally, ie, individual study participants followed up over time). (3 marks) Q1(b) The researchers measured symptoms of depression and anxiety, based on a seven- item scale with items such as ‘I am too fearful or nervous’. For each of these items, participants were asked to rate how well the statement described themselves using the response options: ‘never or not true’, ‘sometimes or somewhat true’ or ‘often or very true’. What type of measurement scale was used to measure items such as ‘I am too fearful or nervous’? (2 marks) Q1(c) Participants were classified as being ‘Physically Active’ or ‘Physically Inactive’. What type of measurement scale is this? (2 marks) Q1(d) In Table 3, the likelihood of having severe symptoms of depression and anxiety was compared for being ‘Not active’ for physical activity relative to being ‘Active’. The odds ratio (OR) was reported as: 1.85 (1.42 to 2.41). Briefly explain what these three figures mean. Your answer should include completing the following sentences: “The OR of 1.85 means that…..” and “The 95% confidence limit (1.42 to 2.41) means that……” (3 marks) Q1(e) In the Conclusions, the researchers state that “….associations between sedentary behaviour and depressive symptoms are less clear”. What data from Table 3 supports this statement? You must include at least two examples of odds ratios and associated confidence intervals and what they mean to achieve full marks. (3 marks) Q1(f) The odds ratios in Table 3 were adjusted for confounding variables including ‘Major stressful life events’. Briefly explain how major stressful life events could possibly confound the relationship between physical activity and mental health. (3 marks)? Q1(g) Can you conclude from this study that increased physical activity will lead to improved mental health for adolescents? Briefly explain the reasons for your answer. (3 marks) 4 TASK B These questions are based on the study by Carter et al. (2016). Q2(a) What was the study aim and the study rationale (ie what did the study aim to achieve, and what knowledge ‘gap’ is it addressing?). Please use your own words to describe the study aim and rationale. (2 marks) Q2(b) What data collection method was used? Why is this data collection method appropriate for addressing the study aim? (3 marks) Q2(c) In the data analysis, the researchers identified the following key themes: 1. The importance of choice 2. A sense of achievement 3. Being distracted 4. Routine 5. Physiological change 6. Emotional, psychological and behavioural change 7. A cycle of change. If you were responsible for the coding analysis, identify the key theme into which you would code each of the following participants’ comments1. To save on words, just write the key theme and the letter that identifies the comment - you do not have to write out the comments. Reading the results section of the journal article will assist in making your coding decisions; and if in doubt about a coding decision, opt for the theme that you consider to be closest to the participant’s comment. (7 marks) A. “They didn’t make me do something hard if I didn’t feel like it.” B. “It took my mind off other things that were stressing me out.” C. “I’m not sure why, but I just seemed to be a bit happier after the sessions.” D. “My life has been a bit all over the place, but this helped me get a bit more structure in my life.” E. “I feel good because I’ve done something I didn’t think I’d be able to do.” F. “It’s a bit strange, but after the sessions I felt like I had more energy.” G. “It seemed to be a bit of a good chain reaction – one thing helped other things.” Q2(d) Qualitative studies are designed to provide new insights and understandings about a health issue. Briefly describe, in your own words, how the findings from this study 1 These participant comments have been made up for the purpose of this assignment. 5 contributed to a new understanding of the role of physical activity in improving mental health for adolescents. (3 marks) TASK C The following questions are based on the study by Melnyk et al. (2013). Q3(a) Identify the study design used by Melnyk (2013). Based on this study design, are the study findings likely to have good internal validity? Briefly explain the reasons for your answer. Based on the study location and the demographic characteristics of the study sample, is this study likely to have good external validity? Briefly explain the reasons for your answer. (4 marks) Q3(b) What was the independent study variable? What were the dependent study variables? (3 marks) Q3(c) Refer to the baseline characteristics data in Table 1. Which factor(s) had statistically significant difference(s) between intervention (COPE program) and control (Healthy Teens) groups, and how did you decide this? (2 marks) Q3(d) Figure 1 includes the number of participants from both groups