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BACKGROUND The demand for orthopaedic specialist consultation for patients with osteoarthritis (OA) in public hospitals is large and continues to grow. Lengthy wait times are increasingly affecting patients from low socioeconomic and culturally and linguistically diverse (CALD) backgrounds who are more likely to rely on public health care. OBJECTIVE The aim of this study was to co-design a digital health intervention for patients with OA who are waiting for an orthopaedic specialist consultation at a public health service, which is located in local government areas (LGAs) of identified social and economic disadvantage. METHODS The stakeholders involved in the co-design process included the research team, end-users (patients), clinicians, academic experts, senior hospital staff and a research, design and development agency. The iterative co-design process comprised of several key phases, which included the collation and refinement of evidence-based information by the research team with assistance from academic experts. Structured interviews with 16 clinicians (sex: 10 female and six male) and 11 end-users (mean ± SD, age: 64.3 ± 7.2, sex: seven female and four male) of 1-hour duration were completed to understand the needs of the intervention. Weekly workshops were held with key stakeholders throughout the development. A different cohort of 15 end-users examined the feasibility of the study during a 2-week testing period (age: 61.5 ± 9.7, sex: 12 female and three male). The system usability scale (SUS) was utilized as the primary measure of the feasibility of the intervention. RESULTS Seven content modules were developed which were refined over several iterative rounds. Key themes highlighted in the clinician and end-user interviews were the diverse characteristics of patients, the hierarchical structure with which patients view health practitioners, the importance of delivering information in multiple formats (written, audio and visual) and access to patient-centered information as early as possible in the healthcare journey. All content was translated to Vietnamese, the most widely spoken language following English in the LGAs included in this study. Patients with hip and knee OA from diverse CALD backgrounds tested its feasibility. A mean score of 82.7 ± 16 was recorded for the SUS placing it in the excellent category for usability. CONCLUSIONS Through the co-design process, we developed an evidence-based, holistic and patient-centered digital health intervention. The intervention has been specifically designed to be used by patients from diverse backgrounds, including those with low health, digital and written literacy levels. The effectiveness of the intervention for improving the physical and mental health of patients will be determined by a high-quality randomized controlled trial.

The status quo of many not-for-profit organisations is well-intentioned service provision often coupled with an absence of critical understanding sustained by the restricting nature of neoliberal bureaucracy and funding. In this context, programs aimed at assisting young people from marginalised communities can become mired in individualistic thinking that constrains the space of possibilities for young people through depoliticisation and decontextualization of their realities and thus the kinds of subjectivities available to them. The challenge for the evaluation we discuss in this paper was not only to evaluate the outcomes of the program, but to promote community narratives about the realities for young racialized people in Australia that counter majoritarian stories. We conclude that social change begins within the multidirectional relationships and contact zones of the stakeholders, participants and researchers of youth programs. This means, extending the focus beyond generic youth development and moving toward engaging young people in critical social analysis and empowering them as future social change agents in their communities.

BACKGROUND The unprecedented changes and isolation measures to contain COVID-19 have had multiple psychological and social impacts, with implications for professional and personal functioning. Evidence-informed interventions that can be rapidly implemented under pandemic conditions to support mental health during such times are urgently needed. OBJECTIVE The aim of this study was to determine the acceptability and preliminary outcomes of a daily online mental health promotion program for tertiary education staff during the COVID-19 pandemic. METHODS The “Victoria University (VU) Elevenses” program was delivered as an uncontrolled intervention at Victoria University (VU) in the western metropolitan region of Melbourne, Australia. In April 2020, an email invitation was sent to all academic and professional staff inviting them to: (1) participate in the program and (2) opt-in to the research component. The “VU Elevenses” program provided 10-15–minute microinterventions comprising lifestyle and well-being strategies to promote mental health via an online meeting platform at 11 AM each weekday. A mixed methods approach was used to evaluate the program, combining structured questionnaires with semistructured interviews to investigate the experiences of staff who participated in the program. RESULTS Between 16 and 90 participants provided weekly program feedback. A total of 106 university staff opted into the longitudinal research component and 10 staff participated in the interviews. Participants reported high levels of satisfaction with sessions and perceived benefits for mental health. Approximately one quarter of participants reported moderate to severe symptoms of depression, anxiety, and stress at baseline, with significant reductions in these symptoms in the first 7 weeks of the program, corresponding with easing in mandatory isolation (“lockdown”) restrictions. Symptoms of depression, anxiety, and stress all increased when lockdown measures were reintroduced, but not to the same levels as found during the initial lockdown period. Overall changes in depression and anxiety from baseline to the end of the program were explained by changes in COVID-19–related distress, whereas changes in self-compassion explained changes in stress. CONCLUSIONS We show that it is feasible and acceptable to develop and deliver a program of brief interventions in a timely manner, using a simple and accessible online platform. Although participation in the program was initially associated with reduced symptoms of depression, anxiety, and stress, participants’ mental health worsened with the reintroduction of a “lockdown” period. However, as symptoms of depression, anxiety, and stress did not return to levels observed at the start of the VU Elevenses program, participation in the uncontrolled intervention may have offered a protective benefit against the impact of the second significant lockdown period.

This qualitative study examines how young people of Moroccan descent in Italy construct their social identities and make sense of acculturation experiences. Twenty nine Moroccan young people, fourteen males and fifteen females (16–23 years old) took part in five focus groups. Thematic analyses of data indicated that participants have to navigate different identity categories in the host country, including Muslim, Moroccan, and migrant, which are often used to construct them as not belonging. They use different strategies to negotiate experiences of prejudice and exclusion including; “Italy is not my home… it is other people’s home”: Accommodating an outsider status, turning critically towards one’s community, claiming an insider status: Feeling Italian, Creating activist identities: Becoming bridge builders. In the absence of legal status, participants conceived citizenship as respecting Italian laws and norms, accommodating their status and position, but making claims based on being and feeling as belonging – cultural citizenship. By using a liberation orientation, our analysis shows the political nature of acculturative integration in a context that denies citizenship as a legal status. These political aspects include deconstructing exclusionary dominant group narratives and forming identities of resistance that are important to their claims for recognition and belonging. We discuss the findings with reference to ways in which researchers and activists can support the activities of young people of immigrant background.