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Aim: To investigate early career progression and national insurance use in young adults with paediatric coeliac disease.

Methods: We performed a register study of a population born in Sweden between 1976 and 1992. Coeliac disease was diagnosed before 15 years of age. The comparison population was matched 4:1 by sex, region of residence at birth and birth year/month. We analysed education, employment, income, job position and national insurance use (sickness benefits, parental leave benefits and social welfare provision) at 25 and 30 years of age.

Results: We identified 1812 individuals with coeliac disease (6888 comparison population) at 25 years of age and 263 individuals (984 comparison population) at 30 years of age. No statistically significant differences were seen in education, employment, income, job position, use of parental leave benefits or social welfare provision. More individuals with coeliac disease used sickness benefits at age 25 years (OR 1.34 [95% CI 1.12–1.59]).

Conclusion: In this register study, we showed that coeliac disease diagnosed in childhood does not cause disadvantages on career progression on a population level. However, findings suggest that coeliac disease increases the risk for sickness benefit use.

Health behaviour is crucial for influencing health, making it a key component in health promotion. However, changing behaviours is complex, as many factors interact to determine health behaviours. Information, awareness, and knowledge are important but not enough. It is essential to move beyond focusing solely on individual psychological and cognitive factors to an understanding of the complex processes involved in health behaviour change. Social-ecological models account for these complex processes but risk being overly broad and all-encompassing.

This qualitative grounded theory study explores how individual, interpersonal, and environmental factors interplay to influence health behaviour, and examines how social-ecological models in health promotion can be tailored to address different ecological needs. Participants were recruited from a community-based cardiovascular disease-prevention program in Northern Sweden. Data was collected through in-depth interviews about health and health behaviours throughout the life course among middle-aged men and women.

The results illustrate how factors obstructing or enabling health behaviours vary in patterned ways for individuals with different health identities. Social-ecological interventions could be more effective if adapted to the specific needs of people with different health identities. In addition to screening for various risk factors, screening for health identities could be helpful in designing social-ecological health-promoting interventions.

Purpose: Rural communities face specific challenges when attempting to implement evidence-based interventions, due to their size, distance from knowledge centers, and broad responsibility for the local population. The aim of this study was to investigate the utilization of an RPC (Research Practice Collaboration) initiative as a strategy for translation and implementation of EBPs in rural municipalities seeking to develop their services for individuals with serious mental illness.

Materials and Methods: Following a broad invitation consisting of a presentation of the newly produced National Psychiatry Guidelines, to four northern regions in Sweden, four municipalities participated in an RPC process that focused on the implementation of specific EBPs.

Results: In addition to confirming many of the challenges in rural areas, the participants reported that the RPC process helped them to understand the relevance of these methods to their own conditions and ambitions. They were able to recognize and build on their already existing strengths and achieve incremental steps toward EBPs.

Discussion: The collaborative nature of the structure and knowledge dissemination, requiring extremely tailored implementation strategies while considering the essential components in relation to local conditions, led to increased readiness to implement these practices as locally relevant.

Conclusion: Research practice collaborations may contribute to the implementation of EBPs in rural areas by increasing the accessibility and relevance of these methods in these challenging conditions. Identifying structures for sustainably supporting these types of collaborations is a challenge for national actors.

Introduction: The increased focus on the ethical aspects of artificial intelligence (AI) follows the increased use in society of data-driven analyses of personal information collected in the use of digital applications for various purposes that the individual is often not aware of. The purpose of this study is to investigate how values and norms are transformed into design choices in a participatory design process of an AI-based digital coaching application for promoting health and to prevent cardiovascular diseases, where a variety of expertise and perspectives are represented.

Method: A participatory design process was conducted engaging domain professionals and potential users in co-design workshops, interviews and observations of prototype use. The design process and outcome was analyzed from a responsible design of AI systems perspective.

Results: The results include deepened understanding of the values and norms underlying health coaching applications and how an AI-based intervention could provide person-tailored support in managing conflicting norms. Further, the study contributes to increased awareness of the value of participatory design in achieving value-based design of AI systems aimed at promoting health through behavior change, and the inclusion of social norms as a design material in the process.

Conclusion: It was concluded that the relationship between the anticipated future users and the organization(s) or enterprises developing and implementing the health-promoting application is directing which values are manifested in the application.

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system.

Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionalsand managers in the youth mental health system in Sweden. Interviews explored participants’ experience andunderstanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergentstudy design using reflexive thematic analysis.

Results: The analysis produced three themes. The first shows that collaboration is considered as essential andimportant, and that it serves diverse purposes and holds multiple meanings in relation to professionals’ roles andresponsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, andtarget levels, and the third captures the challenges and criticisms in collaborating across the youth mental healthlandscape, but also in growing possibilities for future development.

Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.

Purpose: The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness".

Methods: Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke.

Results: The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'.

Conclusion: This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health

Social-emotional problems occurring early in life can place children at future risk of adverse health, social and economic outcomes. Determinants of social-emotional problems are multi-layered and originate from different contexts surrounding children, though few studies consider them simultaneously. We adopted a holistic approach by using Bronfenbrenner's process-person-context-time model as a structuring device. We aimed to assess what characteristics of families and children from pregnancy, over birth, and up to 3 years of age are associated with social-emotional problems in boys and girls. This study used regional data from the Salut Programme, a universal health promotion programme implemented in Antenatal and Child Health Care, and data from national Swedish registers. The study population included 6033 3-year-olds and their parents during the period 2010–2018. Distinct logistic regression models for boys and girls were used to assess associations between the family social context, parents' lifestyle, parent's mental health, children's birth characteristics, and indicators of proximal processes (the independent variables); and children's social-emotional problems as measured by the parent-completed Ages and Stages Questionnaire: Social-Emotional between 33 and 41 months of age (the outcome). Overall, a less favourable family social context, detrimental lifestyle of the parents during pregnancy, and parents' mental illness from pregnancy onwards were associated with higher odds of social-emotional problems in 3-year-olds. Higher screentime and infrequent shared book-reading were associated with higher odds of social-emotional problems. The multifaceted determinants of children's social-emotional problems imply that many diverse targets for intervention exist. Additionally, this study suggests that Bronfenbrenner's process-person-context-time theoretical framework could be relevant for public health research and policy.

Purpose – Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies.

Design/methodology/approach – Six focus group discussions were carried out in three prisons with atotal of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semistructured questions guided the discussions, and thematic analysis was applied to analyse the data.

Findings – Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partlyinfluenced by the socio-economic support from outside the prisons and previous involvement or not indrug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms.

Originality/value – This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings inthis study underline the importance of prison authorities tackling overcrowding to promote well-being andreduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

Introduction: Numerous studies globally confirmed that young prisoners are more susceptible to mental health problemscompared to adult prisoners and the general population. The lack of life skills has been reported as one of the main reasons forthis vulnerability. This study aimed to assess the effectiveness of a life skills education program on mental health and life skillsamong young prisoners in Cambodia.

Method: This is an intervention study, applying a ‘difference-in-difference’ analysis. The life skills education program wasimplemented to promote essential skills for mental health and social competence among young prisoners. Mental health and lifeskills competence were evaluated using the Youth Self-Report and Life Skills Development – Adolescent Form scales, respectively.Four prisons were selected from a total of 24 prisons in Cambodia, a post-conflict country in Southeast Asia. A total of 412 youngprisoners aged 15–24 years participated in the study and were randomly assigned to intervention and control groups.

Results: Both the intervention and control groups reported decreased mental health problems (DiD=3.78, p=0.34) and improvedlife skills competencies (DiD=0.39, p=0.80) after the intervention; however, the differences were not statistically significant.

Conclusion: The life skills intervention program had no significant effect on young prisoners’ mental health and life skillscompetencies. Further studies should be conducted to evaluate the impact of the life skills education program in the prison setting,particularly in low- and middle-income countries (LMICs) such as Cambodia.

Introduction: Capability-adjusted life years Sweden (CALY-SWE) are a new Swedish questionnaire-based measure for quality of life based on the capability approach. CALY-SWE are targeted towards use in cost-effectiveness evaluations of social welfare consequences. Here, we first motivate the measure both from a theoretical and from a Swedish policy-making perspective. Then, we outline the core principles of the measure, namely the relation to the capability approach, embedded equity considerations inspired by the fair-innings approach, and the bases for which capabilities should be considered. The aims were to 1) the most vital capabilities for individuals in Sweden, 2) to define a sufficient level of each identified capability to lead a flourishing life, and to 3) develop a complete questionnaire for the measurement of the identified capabilities.

Material and methods: For the selection of capabilities, we used a Delphi process with Swedish civil society representants. To inform the questionnaire development, we conducted a web survey in three versions, with each Swedish 500 participants, to assess the distribution of capabilities that resulted from the Delphi process in the Swedish population. Each version was formulated with different strictness so that less strict wordings of a capability level would apply to a larger share of participants. All versions also included questions on inequality aversion regarding financial, educational, and health capabilities.

Results: The Delphi process resulted in the following six capabilities: Financial situation & housing, health, social relations, occupations, security, and political & civil rights. We formulated the final phrasing for the questionnaire based on normative reasons and the distribution of capabilities in the population while taking into account inequality aversion.

Conclusion: We developed a capability-based model for cost effectiveness economic evaluations of broader social consequences, specific to the Swedish context.