Considering the importance of evidence on interventions to tackle mental health problems in healthcare workers (HCWs) during pandemics, we conducted a systematic review, aiming to identify and summarize the implemented interventions to deal with mental health issues of HCWs during infectious disease outbreaks and report their effectiveness. Web of Science, PubMed, Cochrane, Scopus, CINAHL and PsycInfo electronic databases were searched until October 2 nd , 2020. Primary-data articles, describing any implemented intervention and their effectiveness were considered pertinent. Studies were screened according to the inclusion/exclusion criteria and subsequently data extraction was performed. Twenty-four articles, referring to SARS, Ebola, Influenza AH1N1 and COVID-19 were included. Interventions addressing mental health issues in HCWs during pandemics/epidemics were grouped into four categories: 1) informational support (training, guidelines, prevention programs), 2) instrumental support (personal protective equipment, protection protocols); 3) organizational support (manpower allocation, working hours, re-organization of facilities/structures, provision of rest areas); 4) emotional and psychological support (psychoeducation and training, mental health support team, peer-support and counselling, therapy, digital platforms and tele-support). These results might be helpful for researchers, stakeholders, and policymakers to develop evidence-based sustainable interventions and guidelines, aiming to prevent or reduce the immediate and long-term effect of pandemics on mental health status of HCWs.

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Background Extended evidence has established that healthcare workers face several mental health problems during a disease outbreak, which could have a long-term impact. To address these issues, elaboration and implementation of psychological/psychiatric interventions or strategies is of utmost importance. In this context, this systematic review aimed at identifying strategies to manage mental health issues in healthcare workers during infectious disease outbreaks. Methods PubMed, Cochrane, Scopus and Web of Science were searched to retrieve pertinent articles published in English until May 2020. Articles reporting measures, interventions, strategies, or recommendations to manage mental health problems in healthcare workers during an infectious disease outbreak, of any study design were included. The quality assessment was performed according to the study design of the included articles. Results Our search strategy produced a total of 2358 articles. After the screening process 33 articles met the inclusion criteria, addressing COVID-19 (40%), followed by SARS (21%) and Ebola Virus (15%). The findings emphasized that organisations should follow an evidence-based approach and establish comprehensive programs to assist hospital staff during disease outbreaks. The preliminary results show that the creation of a psychological response team, training, e-learning, courses, psychosocial counselling, screening instruments and telemedicine activities could improve the capacity of response and coping, and reduce mental health issues in healthcare workers. Conclusions To minimize the psychological impact of future infectious disease outbreaks, evidence-based intervention strategies should be implemented to retain mental health among healthcare workers. Our results may provide the necessary insights that could be applied during the COVID-19 pandemic. Key messages During infectious disease outbreaks healthcare workers are faced with mental health issues, that need to be addressed through tailored interventions offering coping strategies and increase resilience. Mental health related interventions or strategies include the implementation of professional training, psychosocial counselling, courses, and the creation of a psychological response team.

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Background Pre-conceptional health refers to women's conditions before pregnancy. Women's knowledge, behavior and lifestyle in this period greatly influence the health of the future mother and child. This study aimed at creating and validating a questionnaire to describe the knowledge, behaviors, health status and access to healthcare services of young women of childbearing age in Italy. Methods A systematic literature review on Scopus, PubMed and Web of Science was conducted to collect the relevant information for the questionnaire's construction. Based on the review's results, a first draft of the questionnaire was developed and, then, submitted to a panel of experts for validation through the Delphi Procedure. Twenty-one multidisciplinary experts reviewed the items for content, applicability, and rated each item in terms of validity and relevance by indicating a value from 1 to 5 on a Likert scale. Cronbach's Alpha and Internal Validity Index were calculated to verify the internal reliability and validity of content. Results After the screening process, thirty-one articles were included in the systematic review. The main results concerned knowledge on pre-conceptional health, physical, mental and social health, nutritional status, lifestyle and access to healthcare services. The first draft of the questionnaire, submitted to the experts' panel for consensus, consisted of 89 items and 13 sections. Consensus was reached after two rounds of Delphi Procedure. The final version of the questionnaire consisted of 88 items and 10 sections, reporting a Cronbach's Alpha of 0.99 and an Internal Validity Index of 0.93. Conclusions The questionnaire developed in this study is a valid tool to identify the pre-conceptional health needs of young women. The results may be used by policy makers and various guidelines concerning pre-conceptional health and for the implementation of personalized interventions, aimed to improve the health of this population. Key messages Women’s knowledge, behaviours and lifestyle in the pre-conceptional period greatly influence the health of the future mother and child. This study reports the process of creation of a questionnaire which is proved to be a valid tool to identify the pre-conceptional health needs of young women of childbearing age in Italy.