There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention.

Drama, theater and role-playing methods are commonly used in health promotion programs, but evidence of their effectiveness is limited. This paper describes the development, implementation and evaluation of a school-based drama program to enhance social relationships and decrease bullying at school in children in grades 4-5 (mean age of 10.4 years). Students (n = 190) were recruited from two primary schools with similar demographics and socio-economics in the Southern Finland and purposively allocated either to an intervention group or a control group. The drama program included classroom drama sessions, follow-up activities at home and three parents' evenings concerning issues of social well being during the school year September 2007-May 2008. Data on social relationships in the class room and experiences of bullying were obtained before and after the program using self-completed questionnaire from the same students (n = 134). The response rate was 71%. No differences in socio-demographics existed between intervention group and control group at pretest. The positive effect on social relationships resulting from the intervention approached statistical significance (p = 0.065). Moreover, the positive effect was found to be statistically significant in the high-intensity intervention classes (p = 0.011). Bullying victimization decreased 20.7 percentage units from pretest (58.8%) to posttest (38.1%) in the intervention group (p < 0.05). The study indicates that using applied drama and theater methods in the classroom may improve children's social relationships at school.

The purpose of this study was to obtain a more complete understanding of which familial factors contribute to adolescent satisfaction and ill-being, the latter term originally developed by Alexander Grob. Semistructured interviews were conducted with 19 non-clinical adolescents from the 7th and 9th grades. The data were analysed using qualitative content analysis. Six themes concerning satisfaction arose from the analysis. Teenagers described familial contribution to their satisfaction in terms of experiences of a comfortable home, emotionally warm atmosphere, open communication, familial involvement, possibilities for external relations and a sense of personal significance in the family. Three themes related to ill-being emerged: familial hostility, ill-being or death of a family member, as well as excessive dependency. The findings expand our understanding of the diversity of familial contribution to adolescent life and subjective well-being. They challenge nurses to focus on the adolescent's self-perception of familial effects on well-being and on promotion of familial factors in adolescent health issues.

Background Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 – June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality. Results From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi‐agency collaboration, (c) Patient‐centred prevention and (d) Outcomes of programme: cost‐effectiveness and patients’ experiences. Conclusion The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.

Most of the studies reviewed found that exergaming had positive effects. However, more research evidence is still needed. In particular, there is a need for better-validated instruments and follow-up research.

Accessible summary What is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature. Parental mental illness can often be viewed from a risk perspective. Parents with mental illness and their families have unmet support needs. What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible. Many parents adopt an expert by experience identity. Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness. What are the implications for practice? Adult mental health services need to recognize and support parental role of service users. Joint care planning and family oriented care should be promoted. Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development. Abstract IntroductionParental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. AimThis study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. MethodThree focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. ResultsAdult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. DiscussionBeing able to see oneself as a ‘good’ parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents’ anxieties. Implications for practiceMental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice.

Aims To examine the association between peer relations, self‐rated health and smoking behaviour in vocational school setting. Background Smoking in adolescence causes health and socioeconomic inequality in adulthood. There is evidence that smokers are physically less active, have lower academic aspirations and perceive poorer health than non‐smokers. Method The study was conducted in spring 2013 and involved 34,776 vocational students who took part in the School Health Promotion Study in Finland. The associations between adolescent smoking habits and peer relations and smokers' self‐rated health were studied adjusting for the respondents' age, parental education and family type. Results A substantial proportion of the respondents, 37% of the girls and 36% of the boys, reported smoking daily, 15% of the girls and 14% boys smoked occasionally with a further 15% of the girls and 13% of the boys stating that they were ex‐smokers. Of the girls, 33% and 38% of the boys were non‐smokers. Adjusted multinomial regression revealed that having a close friend or friends predicted smoking among girls and boys. Additionally, the adjusted model indicated that being a bully and/or a bully + bully‐victim was associated with smoking behaviour in boys only. Boys and girls who rated their health as moderate or poor were more often daily smokers; in girls, this was also the case in occasional smokers. Conclusion Smoking prevention aimed at vocational schools should take into consideration the norms and expectations related to peer relations which strongly influence adolescents' smoking habits.

Implications for practice are: (1) professionals working with parents with mental illness should be aware of the specific consequences for the children; (2) to empower children they should focus on them, but not excluding parents from the parental roles; (3) the multi-agency collaboration is necessary; (4) schools should provide counselling and teach staff and students about mental health problems to reduce stigma.