Although increasingly complex models have been proposed in mediation literature, there is no model nor software that incorporates the multiple possible generalizations of the simple mediation model jointly. We propose a flexible moderated mediation model allowing for (1) a hierarchical structure of clustered data, (2) more and possibly correlated mediators, and (3) an ordinal outcome. The motivating data set is obtained from a European study in nursing research. Patients' willingness to recommend their treating hospital was recorded in an ordinal way. The research question is whether such recommendation directly depends on system-level features in the organization of nursing care, or whether these associations are mediated by 2 measurements of nursing care left undone and possibly moderated by nurse education. We have developed a Bayesian approach and accompanying program that takes all the above generalizations into account.

• MeSH
• Bayes Theorem * MeSH
• Humans MeSH
• Nursing Staff, Hospital statistics & numerical data   MeSH
• Computer Simulation MeSH
• Regression Analysis * MeSH
• Patient Satisfaction MeSH
• Multilevel Analysis * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH

OBJECTIVE: Long-term isolation, including lockdowns and quarantines, may have a distressing effect on anyone experiencing it. Adolescent brain architecture is very sensitive to environmental adversities, and the mental health development of adolescents may be particularly vulnerable during the pandemic era. In order to better understand the triggers for perceived adolescent stress (PSS) during the COVID-19 lockdown, the present study aimed to assess the effects of social well-being and changes in time use during the lockdown, as well as the family COVID experience of adolescents. METHODS: The sample for this study comprised n = 3,440 adolescents (54.2% girls; mean age = 13.5 ± 1.6 years). Bayesian correlations between PSS, health and well-being variables were assessed. PSS was then modeled as an outcome variable in a series of nested Bayesian multilevel regression models. RESULTS: The negative impact of the COVID-19 lockdown was more apparent in girls. PSS was moderately correlated with adolescent health and well-being. The strongest predictor of higher level of PSS was frequent feeling of loneliness. On the contrary, lower level of PSS was most associated with having someone to talk to. CONCLUSION: Long-term social isolation of adolescents could be harmful to their mental health. Psychological coping strategies to prevent the consequences of social isolation and development of mental health problems should be promoted on the individual, family, and even community level.

• Publication type
• Journal Article MeSH

• MeSH
• Bayes Theorem MeSH
• Humans MeSH
• Linear Models MeSH
• Magnetic Resonance Imaging methods   instrumentation   utilization   MeSH
• Brain Mapping methods   instrumentation   MeSH
• Brain physiology   pathology   MeSH
• Statistics as Topic methods   MeSH
• Models, Theoretical MeSH
• Data Display utilization   MeSH
• Check Tag
• Humans MeSH

The student population has been highly vulnerable to the risk of mental health deterioration during the coronavirus disease (COVID-19) pandemic. This study aimed to reveal the prevalence and predictors of mental health among students in Poland, Slovenia, Czechia, Ukraine, Russia, Germany, Turkey, Israel, and Colombia in a socioeconomic context during the COVID-19 pandemic. The study was conducted among 2349 students (69% women) from May-July 2020. Data were collected by means of the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Perceived Stress Scale (PSS-10), Gender Inequality Index (GII), Standard & Poor's Global Ratings, the Oxford COVID-19 Government Response Tracker (OxCGRT), and a sociodemographic survey. Descriptive statistics and Bayesian multilevel skew-normal regression analyses were conducted. The prevalence of high stress, depression, and generalized anxiety symptoms in the total sample was 61.30%, 40.3%, and 30%, respectively. The multilevel Bayesian model showed that female sex was a credible predictor of PSS-10, GAD-7, and PHQ-8 scores. In addition, place of residence (town) and educational level (first-cycle studies) were risk factors for the PHQ-8. This study showed that mental health issues are alarming in the student population. Regular psychological support should be provided to students by universities.

• MeSH
• Bayes Theorem MeSH
• COVID-19 epidemiology   psychology   MeSH
• Depression epidemiology   psychology   MeSH
• Mental Health * MeSH
• Humans MeSH
• Pandemics * MeSH
• Prevalence MeSH
• Stress, Psychological epidemiology   psychology   MeSH
• Regression Analysis MeSH
• Students psychology   MeSH
• Universities * MeSH
• Anxiety Disorders epidemiology   psychology   MeSH
• Multilevel Analysis MeSH
• Geography MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Intention is a proximal predictor of behavior in many theories of behavior change, but intentions to be physically active do not always translate to actual physical activity. Little research has examined intensive longitudinal changes in physical activity and corresponding within-person moderators needed to elucidate the mechanisms, hurdles, and facilitators of individuals' everyday physical activity behaviors. The present study set out to evaluate the possible moderators of the intention-physical activity relationship across within-person and between-person levels, including cross-level interactions. Data comprise the first intensive measurement burst (14 days) of the longitudinal prospective Healthy Aging in Industrial Environment (HAIE) study, with N = 1135 participants (N = 10,030 person-days), aged 18-65. Physical activity was operationalized as step counts measured objectively using Fitbit Charge 3/4 fitness monitor. Intention, barriers to physical activity, and social support for physical activity were measured daily via smartphone surveys. Stable characteristics, i.e., physical activity habit and exercise identity, were measured using an online questionnaire. A multilevel moderation regression model with Bayesian estimator was fitted. At the within-person level, the relation between intention and steps was weaker on days when barriers were more severe than usual for a given person (Estimate = -0.267; CI95 = [-0.340, -0.196]) and social support was below average for a given person (Est = 0.143; CI95 = [0.023, 0.262]). Additionally, the daily intention-behavior relationship was stronger for people with lower average severity of barriers (Est = -0.153; CI95 = [-0.268, -0.052]), higher exercise identity (Est = 0.300; CI95 = [0.047, 0.546]), men (Est = -1.294, CI95 = [-1.854, -0.707]), and older individuals (Est = 0.042, CI95 = [0.017, 0.064]). At the between-person level, only physical activity habit strengthened the intention-behavior link (Est = 0.794; CI95 = [0.090, 1.486]). Our results underscore the need to separate the between-person differences from the within-person fluctuations to better understand the individual dynamics in physical activity behaviors. Personalized interventions aimed at helping individuals translate intentions to actual physical activity could be tailored and become more intensive when there is a higher risk of intention-behavior gap on a given day for a specific individual (i.e., a day with more severe barriers and less social support), by increasing the dosage or deploying more precisely targeted intervention strategies and components. In addition, interventionists should take gender and age into account when tailoring everyday strategies to help individuals act on their intentions.

• MeSH
• Bayes Theorem MeSH
• Exercise * MeSH
• Humans MeSH
• Motor Activity MeSH
• Prospective Studies MeSH
• Intention * MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

PURPOSE: Previous research has shown inconsistent time trends in adolescent mental well-being, but potential underlying mechanisms for such trends are yet to be examined. This study investigates cross-national time trends in adolescent mental well-being (psychosomatic health complaints and life satisfaction) in mainly European countries and the extent to which time trends in schoolwork pressure explain these trends. METHODS: Data from 915,054 adolescents from 36 countries (50.8% girls; meanage = 13.54; standard deviationage = 1.63) across five Health Behaviour in School-aged Children surveys (2002, 2006, 2010, 2014, and 2018) were included in the analyses. Hierarchical multilevel models estimated cross-national trends in adolescent mental well-being and schoolwork pressure. We also tested whether schoolwork pressure could explain these trends in mental well-being. RESULTS: A small linear increase over time in psychosomatic complaints and schoolwork pressure was found. No change in life satisfaction emerged. Furthermore, there was large cross-country variation in the prevalence of, and trends over time in, adolescent mental well-being and schoolwork pressure. Overall, declines in well-being and increases in schoolwork pressure were apparent in the higher income countries. Across countries, the small increase in schoolwork pressure over time partly explained the decline in psychosomatic health complaints. CONCLUSIONS: Our findings do not provide evidence for substantial declines in mental well-being among adolescents. Yet, the small declines in mental well-being and increases in schoolwork pressure appear to be quite consistent across high-income countries. This calls for the attention of public health professionals and policy-makers. Country differences in trends in both adolescent mental well-being outcomes and schoolwork pressure were considerable, which requires caution regarding the cross-national generalization of national trends.

• MeSH
• Bayes Theorem MeSH
• Adolescent Behavior psychology   MeSH
• Child MeSH
• Mental Health statistics & numerical data   MeSH
• Humans MeSH
• Adolescent MeSH
• Personal Satisfaction * MeSH
• Stress, Psychological psychology   MeSH
• Psychophysiologic Disorders epidemiology   psychology   MeSH
• Schools MeSH
• Students psychology   statistics & numerical data   MeSH
• Health Behavior MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH

Alloparental care is central to human life history, which integrates exceptionally short interbirth intervals and large birth size with an extended period of juvenile dependency and increased longevity. Formal models, previous comparative research, and palaeoanthropological evidence suggest that humans evolved higher levels of cooperative childcare in response to increasingly harsh environments. Although this hypothesis remains difficult to test directly, the relative importance of alloparental care varies across human societies, providing an opportunity to assess how local social and ecological factors influence the expression of this behaviour. We therefore, investigated associations between alloparental infant care and socioecology across 141 non-industrialized societies. We predicted increased alloparental care in harsher environments, due to the fitness benefits of cooperation in response to shared ecological challenges. We also predicted that starvation would decrease alloparental care, due to prohibitive energetic costs. Using Bayesian phylogenetic multilevel models, we tested these predictions while accounting for potential confounds as well as for population history. Consistent with our hypotheses, we found increased alloparental infant care in regions characterized by both reduced climate predictability and relatively lower average temperatures and precipitation. We also observed reduced alloparental care under conditions of high starvation. These results provide evidence of plasticity in human alloparenting in response to ecological contexts, comparable to previously observed patterns across avian and mammalian cooperative breeders. This suggests convergent social evolutionary processes may underlie both inter- and intraspecific variation in alloparental care.

• MeSH
• Biological Evolution MeSH
• Phylogeny MeSH
• Humans MeSH
• Social Behavior * MeSH
• Environment * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH