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Several countries mandate informed or shared decision-making for low-dose computed tomography (LDCT) lung cancer screening, but there is limited knowledge about the type of information and presentation techniques used to support decision-making in practice. This review aimed to characterise the content, format, mode, and presentation methods of decision support tools (DSTs) for LDCT lung cancer screening. DSTs reported within peer-reviewed articles (January 2000 to April 2021) were identified systematically from Pubmed, PsycInfo, EMBASE, and CINAHL Plus. Inclusion criteria revolved around the development or evaluation of a resource or tool intended to support individual or shared decision-making for LDCT lung cancer screening. The data-charting and extraction framework was based on the International Patient Decision Aids Standards instrument and Template for Intervention Description and Reporting. Extracted data were organised within two categories: 1) study characteristics and context, format, and mode of DST use; and 2) DST content and presentation methods. This review identified 22 DSTs in paper, video, or electronic formats across 26 articles. Most DSTs (n=13) focused on knowledge exchange, while seven used interactive techniques to support values clarification (e.g., Likert scales) and nine DSTs guided deliberation (e.g., suggested discussion topics). The DSTs addressed similar topics, but the detail, quantification of probability, and presentation methods varied considerably. None described all the potential screening harms and results. The heterogeneity in DST design may affect the quality of decision-making, particularly for participants with lower literacy and numeracy. Evidence-based consensus guidelines for DST content and presentation methods should be developed collaboratively with screening-eligible adults.

BackgroundWaves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health & Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown, however, suicidal ideation increased. AimsTo report the prevalence of mental health and wellbeing of adults in the UK from March/April 2020 to February 2021.MethodQuota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at 7 time-points. Primary analyses cover wave 4 (May/June 2020), wave 5 (July/August 2020), wave 6 (October 2020), and wave 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and wellbeing. Results 2691 (87.5% of wave 1) participated in at least one survey between waves 4 to 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020 and remained elevated in February 2021. Wellbeing decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those socially disadvantaged, or with a mental health condition reported worse mental health.ConclusionsThe mental health and wellbeing of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, a period coinciding with the second wave of COVID-19. Suicidal thoughts did not decrease significantly suggesting a need for continued vigilance as we recover from the pandemic.

Background Waves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health and Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown; however, suicidal ideation increased. Aims To report the prevalence of mental health and well-being of adults in the UK from March/April 2020 to February 2021. Method Quota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at seven time points. Primary analyses cover waves 4 (May/June 2020), 5 (July/August 2020), 6 (October 2020) and 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and well-being. Results A total of 2691 (87.5% of wave 1) individuals participated in at least one survey between waves 4 and 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020, and remained elevated in February 2021. Well-being decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those who were socially disadvantaged and those with a pre-existing mental health condition reported worse mental health. Conclusions The mental health and well-being of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, which coincided with the second wave of COVID-19. Suicidal thoughts did not decrease significantly, suggesting a need for continued vigilance as we recover from the pandemic.

Background: \ud The lasting effects of the coronavirus disease 2019 pandemic are likely to be significant.\ud \ud Aims: \ud This study tracked worry and rumination levels during the pandemic and investigated whether periods with higher COVID-related worry and rumination were associated with more negative mental health and loneliness.\ud \ud Methods: \ud A quota survey design and a sampling frame that permitted recruitment of a national sample were employed. Findings for waves 1 (March 2020) to 6 (November 2020) are reported (N = 1943).\ud \ud Results: \ud Covid-related worry and rumination levels were highest at the beginning of the first lockdown, then declined but increased when the UK returned to lockdown. Worry levels were higher than rumination levels throughout. High levels of COVID-related worry and rumination were associated with a five- and ten-fold increase in clinically meaningful rates of depression and anxiety (respectively) together with lower well-being and higher loneliness. The effects of COVID-related worry on depression and anxiety levels were most marked and clinically meaningful in individuals living with a pre-existing mental health condition.\ud \ud Conclusions: \ud Psychological interventions should include components that specifically target COVID-related worry and rumination. Individuals with pre-existing mental health conditions should be prioritised as we emerge from the current pandemic and in any future public health crises.

Background: The lasting effects of the coronavirus disease 2019 pandemic are likely to be significant.Aims: This study tracked worry and rumination levels during the pandemic and investigated whether periods with higher COVID-related worry and rumination were associated with more negative mental health and loneliness. Methods: Quota survey design and a sampling frame that permitted recruitment of a national sample were employed. Findings for waves 1 (March 2020) to 6 (November 2020) are reported (N=1943). Results: Covid-related worry and rumination levels were highest at the beginning of the first lockdown, then declined but increased when UK returned to lockdown. Worry levels were higher than rumination levels throughout. High levels of COVID-related worry and rumination were associated with a five- and ten-fold increase in clinically meaningful rates of depression and anxiety (respectively) together with lower wellbeing and higher loneliness. The effects of COVID-related worry on depression and anxiety levels were most marked and clinically meaningful in individuals living with a pre-existing mental health condition. Conclusions: Psychological interventions should include components that specifically target COVID-related worry and rumination. Individuals with pre-existing mental health conditions should be prioritised as we emerge from the current pandemic and in any futurepublic health crises.

ObjectivesThis study provides an in-depth understanding of the impact of physical distancing restrictions and other quarantining measures during the first 6 months of the COVID-19 pandemic on physical and mental health and well-being.DesignLongitudinal qualitative research using semistructured interviews at two time points (21 May to 10 June 2020 when the first restrictions were eased, and 2 to 26 August 2020 when many restrictions had been eased, but physical distancing measures remained) and framework analysis.SettingInterviews by telephone or video call in Scotland.ParticipantsThirty participants: 16 women, 93% reporting white ethnicity, 18+ years, 47% from deprived areas, 47% reported mental and/or physical health conditions.ResultsFour main themes described the impact of physical distancing restrictions on (1) health behaviours; (2) healthcare access; (3) physical health; and (4) mental health. Changes in impact over the two time points were compared. For example, health behaviours in May/June, such as reduced physical activity and increased calorie intake, appeared to improve by August. From May/June to August, an increasing number of participants expressed dissatisfaction with healthcare they received. Participants with existing physical health conditions reported continued negative impact of restrictions on their physical health. All participants reported some negative mental health impact, mostly anxiety. An increasing number reported mental health improvements in August, with those with mental health conditions or under 30 years reporting improvement most frequently.ConclusionsIn line with previous research, our participants felt able to return to prepandemic health habits. Our findings corroborate evidence of reduced preventive healthcare use and help-seeking behaviours. People with existing health conditions appear to be most vulnerable to negative mental and physical health impacts of physical distancing. These negative impacts and periods of unhealthy behaviours have potential long-term consequences, especially among already underserved groups. We recommend public health and policy strategies to mitigate long-term impacts of physical distancing.

Background: The effects of COVID-19 on the population’s mental health and wellbeing are likely to be profound and long-lasting.Aims: To investigate the trajectory of mental health and wellbeing during the first six weeks of lockdown in adults in the UK.Method: A quota survey design and a sampling frame that permitted recruitment of a national sample was employed. Findings for waves 1 (31st March to 9th April 2020), 2 (10th April to 27th April 2020) and 3 (28th April to 11th May 2020) are reported here. A range of mental health factors was assessed: pre-existing mental health problems, suicide attempts and self-harm, suicidal ideation, depression, anxiety, defeat, entrapment, mental well-being, and loneliness. Results: A total of 3077 adults in the UK completed the survey at wave 1. Suicidal ideation increased over time. Symptoms of anxiety, levels of defeat and entrapment decreased across waves whereas levels of depressive symptoms did not change significantly. Positive wellbeing also increased. Levels of loneliness did not change significantly over waves. Sub-group analyses showed that females, young people (18-29 years), those from more socially disadvantaged backgrounds, and those with pre-existing mental health problems have worse mental health outcomes during the pandemic across most factors. Conclusions: The mental health and wellbeing of the UK adult population appears to have been affected in the initial phase of the COVID-19 pandemic. The increasing rates of suicidal thoughts across waves, especially among young adults, are concerning