Chronic musculoskeletal pain (CMSKP) in adolescence is associated with physical, psychological, social, and academic impairment and increased risk for chronic pain in adulthood. Although physical activity interventions are an evidence-based approach for managing pediatric chronic pain, many adolescents with CMSKP avoid physical activity due to fear of increased pain, low confidence in physical functioning, and other pain-avoidance behaviors. Resilience-focused interventions targeting self-efficacy, motivation, and mental flexibility may improve engagement in valued activities despite pain. This study describes the design and protocol of the Pain REsilience Promotion for Youth (PREP-Y) intervention, a resilience-focused physical activity intervention for adolescents with CMSKP.

This single-site, pilot phase 2, single-group, non-randomized clinical trial will enroll 40 adolescents aged 12-17 years with CMSKP from Nationwide Children's Hospital in Columbus, Ohio, USA. Participants complete questionnaires, objective physical functioning assessments, and physical activity monitoring using activPAL devices as baseline measures. Participants then complete 4 virtual resilience-focused intervention sessions targeting pain resilience, self-efficacy, motivation, and adaptive coping related to physical activity. Garmin watches are used to track activity during the intervention period. Follow-up assessments occur post-intervention and at 3 months post-intervention. Primary outcomes include feasibility and acceptability, assessed through recruitment, retention, attendance, intervention fidelity, and completion of study measures. Exploratory outcomes include physical activity, sedentary behavior, pain-related functioning, pain catastrophizing, kinesiophobia, self-efficacy, and resilience-related constructs.

The study was approved by the Nationwide Children's Hospital Institutional Review Board. Findings will inform a future randomized clinical trial. This manuscript reflects protocol version 5.0 dated 23 March 2026.

ClinicalTrials.gov NCT06923891.

Depression remains a critical mental health challenge among young people in low-resource settings, where financial, structural, and social barriers frequently limit care access. Digital approaches, including Tele-Support Psychotherapy (TSP), have emerged as promising, scalable alternatives to Standard in-person Mental Health Services (SMHS), yet evidence comparing their implementation remains limited. This study explored facilitators and barriers influencing the feasibility, acceptability and engagement of youths with TSP versus SMHS for depression treatment in Kampala District, Uganda. A qualitative phenomenological study was conducted among youth aged 15-30 years enrolled in a randomized controlled trial evaluating both interventions. Data were collected through semi-structured key informant interviews and focus group discussions with participants and lay counselors and analyzed using deductive thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). In the parent trial, 95 of 154 participants (61.69%) in the TSP arm and 15 of 146 (10.27%) in the SMHS arm engaged with their assigned intervention; these figures provide contextual background for these qualitative findings. Key facilitators for both interventions included strong social support networks and higher income levels. Technological challenges, such as unreliable mobile phone connectivity, hindered TSP, while high costs and limited awareness were barriers to SMHS. Government policies both supported trust in digital interventions and, in some cases, constrained access while lay-counselor attributes, including on-phone session flexible scheduling and rapport-building skills facilitated TSP. TSP presents a viable alternative to SMHS, particularly for youth facing financial and logistical barriers to accessing facility-based mental health services. However, optimizing its delivery requires addressing technological constraints, ensuring consistent government support, and integrating mental health literacy initiatives. Findings underscore the need for flexible and contextually tailored models that leverage technology and address individual and systemic barriers to enhance mental health service access in resource-constrained settings.

Postpartum depression (PPD) is a common mental health condition affecting mothers, infants, and families, with higher prevalence in middle-income countries. Despite its burden, PPD remains under-screened in Lebanese public hospitals, particularly in disadvantaged areas like Tripoli.

To assess nurses' knowledge, attitudes, and practices regarding PPD and explore facilitators, and barriers influencing the potential implementation of systematic PPD screening.

A mixed-methods study was conducted in a Lebanese public university hospital, combining a quantitative survey with qualitative focus group discussions involving nurses and managers. Descriptive analyses were applied to survey data, and thematic analysis was used for qualitative findings.

Most nurses were aware of PPD (92.9%) and "baby blues" (92.9%), but only 21.4% were aware of standardized screening tools. Correct identification of key symptoms was reported by 71.4%, while only 35.7% correctly identified all risk factors and 28.6% recognized appropriate combined management (psychotherapy and antidepressants). Regarding attitudes, all participants (100%) agreed that PPD screening should be part of routine postnatal care, and 92.9% recognized its seriousness and the role of nurses in early detection. However, only 78.6% felt confident identifying PPD signs. In terms of practice, only 28.6% consistently assessed mothers' emotional well-being before discharge. Qualitative findings suggested a generally positive attitude toward the potential implementation of screening, while also highlighting perceived barriers, including insufficient training, unclear role delineation, inadequate referral pathways, time constraints, and weak internal communication regarding mental health services.

The findings suggest that challenges to the potential implementation of PPD screening may be related to capacity and organizational support than to resistance among participants. Strengthening training, integrating standardized screening into routine postnatal care, clarifying roles and referral pathways may facilitate the implementation of PPD screening. Given the exploratory nature of this single-center study, further research is needed to assess the transferability of these findings to other maternity care settings in Lebanon.

Divorce is an important social issue that has destructive consequences for both the individual and the family. It is a multi-dimensional and complex phenomenon that occurs under the influence of various factors, so this research was conducted to explain the reasons for divorce among young couples in the West of Iran with a qualitative approach. This research was carried out with a qualitative approach and conventional content analysis. Purposeful and snowball sampling were used to identify the participants. Semi-structured interviews were used to collect data and continued until theoretical saturation was reached. In this research, 16 key informants and 32 main participants were present. For data analysis, Graneheim and Lundman method was used. Also, to increase the quality of the research, Guba and Lincoln's four criteria were observed. 212 primary codes, 24 subcategories, and 3 categories came from the analysis of the interviews. Categories and sub-categories include 1- individual factors (sexual problems, mental-psychological disorders, spouse's behavioral characteristics, individualism, physical appearance problems, Formation of a positive understanding of divorce consequences, having defective relationships before marriage, drug use), 2- socio-cultural factors (de-tabooing of divorce, women-oriented social changes, media and social networks, lack of a suitable support system, inappropriate spouse choosing, economic challenges, modeling of divorce), 3- family factors (job's impact on family life, improper communication with spouse's family, accumulation of negative feelings in marital life, issues related to children, cheating on spouse, inefficient relationships, heterogeneity of lifestyle, violence, inability to manage challenges). The results indicate that divorce is a complex, multi-dimensional phenomenon influenced by individual, social, cultural, and family factors. Prevention requires multi-level interventions, including educating couples on sexual issues and communication skills, promoting responsible marital roles, preventing superficial marriages, reducing stigma around seeking psychological help, managing personality and lifestyle differences, guiding families on conflict resolution, and providing access to counseling and mental health services before and after marriage.

People in contact with the criminal justice system outside institutional settings have high levels of mental health and substance use problems, contributing to adverse outcomes. Help-seeking behaviour is an important component of optimising access to effective treatment and support that is under-explored in this population. Empirical investigation into the influences on help-seeking for stigmatised health conditions is needed to inform efforts to facilitate help-seeking.

This study established the individual, relational, and contextual influences on help-seeking for mental health and substance use problems among people in contact with the criminal justice system living in the community, and examined the applicability of existing models and frameworks for understanding help-seeking behaviour in this population.

We applied framework analysis to qualitative data from a mixed-methods social network analysis study. Our framework drew on help-seeking behaviour and healthcare access models to determine initial categories for help-seeking influences (desire, ability, and context).

Help-seeking was confirmed to result from an interaction between 'desire to seek help', 'ability to seek help', and 'help-seeking context'. We show that help-seeking is not an individual behaviour, but strongly affected by relational influences that operate between individuals, across social networks, and via cultural norms. High levels of criminal justice involvement, and mental health and substance use problems in the social networks of people in contact with the criminal justice system shape these influences.

Optimising help-seeking for mental health and substance use problems among people in contact with the criminal justice system living in the community requires critical engagement with, and application of, existing models to ensure sufficient appreciation of relational and contextual influences. Research is needed to develop and test multi-level policy/practice interventions that go beyond individual factors.

People who use opioids (PWUO) experience a disproportionately high burden of suicidal risk. Syringe services programs (SSPs) are a critical point of contact for this population, providing low-threshold, harm-reduction services. However, gaps persist in understanding suicidal risk among individuals attending SSPs and the extent to which such risk is associated with mental health service utilization in this setting. This study aimed to assess the prevalence and specific risk factors for suicidal ideation (SI) in PWUO, as well as their use of and barriers to accessing mental health services.

We conducted a cross-sectional survey between April and June 2024 among PWUO (N = 199) who were utilizing services in the SSP in New Haven, Connecticut. We used the ninth item from the Patient Health Questionnaire (PHQ-9) scale, which assesses passive thoughts of death and self-harm in the past two weeks, as a proxy measure for the SI. Additionally, participants reported their use of and barriers to accessing mental health services in the past six months. Bivariate and multivariable logistic regression were conducted to examine factors associated with SI.

Approximately 84% of participants met the criteria for opioid dependence, and more than two-thirds (71.9%) were currently receiving medication for opioid use disorder. Over one-third of the sample reported SI in the past two weeks (34.7%). Additionally, over one-third of participants (36.2%) reported unmet mental health needs, and 84.4% reported experiencing at least one barrier to accessing mental health services. Individuals with depressive symptoms (aOR: 5.4; 95% CI: 2.5-11.7) were more likely to report SI, while those who were aware of naloxone (aOR: 0.2; 95% CI: 0.1-0.6) were less likely to report SI in the past two weeks.

Our study showed a high prevalence of SI among SSP clients who use opioids and a low use of mental health services due to access barriers. These findings support incorporating a brief suicide risk screening and referral options within SSPs and other settings serving PWUO and addressing key access issues like cost and transportation that can prevent timely linkage to mental health services.

This study explored how adolescent mothers in Pakistan experience the transition to motherhood and the mental health challenges that arise during this period.

A focused ethnographic study was conducted with 25 adolescent mothers in Matiari, Sindh. Data were collected through semi‑structured interviews, participant observations, and artifact elicitation. Meleis' Transition Theory informed the study focus and development of the interview guide. Reflexive thematic analysis guided interpretation, informed by an intersectional lens.

Five themes described mothers' experiences: early educational disruption and redirected aspirations; continuous caregiving with uneven support; barriers to maternal healthcare access; emotional distress and psychological strain; and identity transformation. These intersecting challenges contributed to significant mental health strain and highlighted persistent gaps in access to supportive, adolescent-responsive maternal care.

Adolescent mothers navigate motherhood with substantial emotional and practical burdens yet demonstrate meaningful resilience. Findings highlight the need for adolescent‑responsive mental health support, accessible care, routine and confidential distress screening, referral pathways, and supportive educational and community‑based interventions tailored to underserved rural settings.

Artificial Intelligence (AI) has emerged as a transformative force revolutionizing various sectors, including healthcare, particularly the mental health field. However, the acceptance and integration of AI technologies in different healthcare systems can be influenced by various factors, including cultural, social, and individual aspects. Nevertheless, there is a need for a valid and reliable tool for assessing AI's perception among healthcare consumers.

To develop and validate a tool for the perception of AI among healthcare consumers and apply the tool to assess AI's perception among mental health consumers in the Jordanian healthcare system.

A cross-sectional descriptive correlational design was utilized in the study. Data was collected from a convenience sample of 431 mental health consumers visiting mental health clinics of the International Medical Corps and university hospitals in Jordan. Structured interviews were conducted using an AI Perception (AIP) questionnaire developed by the authors. The questionnaire's content validity was assessed by an expert panel. Using Principal Component Analysis (PCA), the construct validity of the tool was evaluated, and its internal consistency was examined using Cronbach's alpha. Descriptive statistics were used to assess the levels of AI perception among participants.

The final AIP tool consisted of 20 items across 4 domains and has demonstrated strong internal consistency across its four domains: AI acceptance and readiness (α = 0.92), AI perceived importance (α = 0.92), AI perceived risk (α = 0.9), and AI perceived challenges (α = 0.85). The construct validity of the four-domain structure of the tool was supported by PCA. Additionally, the mean scores for each domain indicated the average level of agreement with AI perception items among participants. Specifically, the mean score for AI acceptance and readiness was [Formula: see text]). AI perceived importance was (2.18 [Formula: see text]0.83), AI perceived risk was (2.58[Formula: see text]0.92), and AI perceived challenge was (2.78 [Formula: see text] 0.87).

The findings of this study resulted in developing a valid and reliable 20-item tool to assess AI's perception among mental health consumers. The tool can be used to assess the predictors of AI's readiness among mental health consumers. Therefore, aiding policymakers and other stakeholders in understanding the AI adoption barriers from the perspective of end-users. In addition, this study developed the AIP tool that can be validated and used among other populations in future research.

Opioid use disorder (OUD) is a global public health crisis that has steadily worsened despite significant efforts. Maladaptive opioid use can have significant negative impacts, yet a minority receive evidence-based treatments. Leveraging common personal technologies like smartphones and computers may help extend access to such services. The current study aims to describe the landscape of personal technology use in opioid use recovery by combining an academic scoping review with a review of commercially available smartphone apps and devices. The scoping review provides an overview of research examining feasibility and efficacy, whereas the commercial review investigates whether available technology is supported by peer-reviewed research or regulatory approval. Four databases were searched for the scoping review (i.e., PubMed, PsychINFO, EMBASE, and MEDLINE) alongside Apple and Google Play stores for the commercial review. Two independent reviewers evaluated the studies. The academic search yielded 937 articles, of which 34 were included, and the commercial review found 21 apps and devices. The included studies show good acceptance and feasibility; however, research reporting on efficacy outcomes is mixed and nascent. Of the commercially available interventions, only eight underwent peer-reviewed evaluation, and only three had received healthcare body approval at the time of the search. Thus, more research is needed to ascertain the efficacy of such interventions, especially in underrepresented groups such as women, minority groups, and insecurely housed people. Additionally, given the limited data identified and the legal and medical risks associated with OUD, further consideration of safety and privacy is warranted. Further, since commercialization has vastly outpaced peer-reviewed research, we suggest amendments to regulatory procedures that consider the risks associated with the intended population, rather than just the intended use. Lastly, we offer suggestions to guide clinical decision-making regarding the use of digital tools in their practice.

Virtual Reality (VR) is increasingly being used in mental healthcare settings. VR relaxation appears feasible, effective, and acceptable for reducing stress in patients with psychiatric problems. Understanding healthcare professionals' perspectives is essential for sustainable integration, as they play a key role in its adoption and use. This study explores the facilitators and barriers perceived by healthcare professionals in using VR relaxation (VRelax) while treating patients with psychiatric problems to support its implementation in mental healthcare, as part of a preliminary qualitative investigation informing the design of a subsequent randomized controlled trial (RCT) on its implementation and cost-effectiveness. From November to December 2021, three focus groups and three individual interviews were conducted with healthcare professionals who had used VRelax for four weeks in clinical practice. Participants were recruited via the researchers' professional network. Semi-structured interviews were analyzed thematically. The Consolidated Framework for Implementation Research (CFIR) guided data structuring and interpretation. Fifteen nurse specialists, psychologists, and psychiatrists were included. Six themes and seventeen subthemes emerged. Key barriers included the need for evidence-based information and technical and logistical challenges. Professionals' attitudes were shaped by their interest in technology and perceived technical skills, affecting their confidence in using VR. Healthcare professionals base VRelax use on patient characteristics rather than DSM-5 diagnoses. No themes emerged in the outer setting or implementation domains of the CFIR, suggesting underexplored systemic factors. Future implementation efforts should involve policymakers and implementation experts for a broader, multi-stakeholder approach to address these gaps. Structured guidance and clear workflows are recommended to support scalable and context-sensitive integration of VR relaxation in mental healthcare.