Bjørnsen Hanne Nissen, Ringdal Regine, Espnes Geir Arild, Eilertsen Mary-Elizabeth Bradley, Moksnes Unni Karin
Department of Public Health and Nursing, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.
NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway.
BMC Health Serv Res. 2018 Dec 29;18(1):1001. doi: 10.1186/s12913-018-3829-8.
Mental health among adolescents is an important public health challenge. School health services perform central public health functions in Norwegian municipalities, where school nurses are uniquely positioned to educate and promote mental health among adolescents. MEST (MEST is not an acronym; MEST is a short version of the Norwegian word for coping) is a newly developed universal working strategy for school health services that aims to promote positive mental health literacy (MHL) and mental wellbeing in the adolescent population. The aim of this study was to investigate the potential outcome mean differences in positive MHL and mental wellbeing between adolescents who participated and those who did not participate in MEST over a school year.
This study is based on cohort data collected from 357 adolescents (aged 15-21 years) in five Norwegian upper secondary schools at the beginning and end of the 2016/2017 school year. The data were analyzed by describing mean scores and estimating the average treatment effect (ATE) of MEST on positive MHL and mental wellbeing.
Positive MHL increased significantly more among the MEST participants compared to the non-MEST participants (p = .02). No significant change in mental wellbeing was found between MEST and non-MEST participants (p = .98). Estimating the ATE of MEST on positive MHL, the MEST participants showed a significant 2.1% increase (p = .04) in the potential outcome mean of positive MHL compared to the nonparticipants. Estimating the ATE of MEST on mental wellbeing, the girls who attended MEST exhibited a significant 9.7% increase (p = .03) in the potential outcome mean of mental wellbeing compared with the girls who did not attend MEST, while no significant change (p = .99) was detected among boys or the entire sample of both genders combined (p = .12).
This study found a significant ATE of MEST on positive MHL and on mental wellbeing among girls. The results support further investments in studying MEST as a promising work strategy for school health services to promote adolescent mental health. This initial study of MEST may be used as a foundation for investing in future evaluations of MEST.
青少年心理健康是一项重要的公共卫生挑战。在挪威各市镇，学校卫生服务发挥着核心公共卫生职能，学校护士在教育和促进青少年心理健康方面具有独特地位。MEST（MEST不是首字母缩略词；MEST是挪威语中“应对”一词的缩写形式）是学校卫生服务新制定的一项通用工作策略，旨在提高青少年群体的积极心理健康素养（MHL）和心理健康水平。本研究的目的是调查在一学年中，参与MEST和未参与MEST的青少年在积极MHL和心理健康方面潜在结果的平均差异。
本研究基于2016/2017学年开始和结束时从挪威五所高中的357名青少年（年龄在15 - 21岁之间）收集的队列数据。通过描述平均得分并估计MEST对积极MHL和心理健康的平均治疗效果（ATE）来分析数据。
与未参与MEST的青少年相比，参与MEST的青少年在积极MHL方面的增加更为显著（p = 0.02）。在参与MEST和未参与MEST的青少年之间，心理健康方面未发现显著变化（p = 0.98）。估计MEST对积极MHL的ATE，与未参与者相比，参与MEST的青少年在积极MHL的潜在结果均值上显著增加了2.1%（p = 0.04）。估计MEST对心理健康的ATE，参与MEST的女孩在心理健康的潜在结果均值上比未参与MEST的女孩显著增加了9.7%（p = 0.03），而在男孩中或所有男女样本组合中未检测到显著变化（p = 0.99）（p = 0.12）。
本研究发现MEST对积极MHL以及女孩的心理健康有显著的ATE。研究结果支持进一步投入研究MEST，将其作为学校卫生服务促进青少年心理健康的一项有前景的工作策略。这项关于MEST的初步研究可作为未来对MEST进行评估投资的基础。
