Aim: The aim of this rapid review was to investigate whether lifestyle coaching could provide a cost-effective alternative to counselling for the UK National Health Service (NHS) treatment of common mental health conditions such as stress, anxiety and depression. Methods: A rapid review approach was used to determine the evidence of health economics evaluations in the field of mental health services. A literature search of PubMed, CINAHL, Cochrane Library, ASSIA, PsycINFO and MEDLINE produced 2807 articles. We removed 778 duplicates, and 2029 study articles remained. Two reviewers screened titles and abstracts (RG and KP), and 37 papers met the inclusion criteria of this review. Following a full-text screening, a further 27 papers were excluded due to lack of relevance. Study designs which did not include economic evaluations (n=15) or did not include an evaluation treatment of mental health conditions with talking therapies (n=15) did not meet the inclusion criteria. Ten papers were included in the final rapid review. Results: The database search yielded study articles which focused on the cost-effectiveness of counselling and other talking therapies such as Cognitive Behavioural Therapy (CBT). No literature was found to determine the cost-effectiveness, or effectiveness of lifestyle coaching. Due to a lack of economic evaluations, this review could not determine the potential cost-effectiveness of lifestyle coaching as a means of addressing the backlog for mental health support such as counselling in the NHS. Conclusion: This review highlights the research gap in assessing the cost-effectiveness of lifestyle coaching for treating common mental health disorders. The proposed next step is to evaluate the effectiveness and cost-effectiveness of lifestyle coaching versus current treatment as usual (counselling) by using a feasibility randomised control trial.

The COVID-19 pandemic and associated social restrictions had an extensive effect on peoples’ lives. Increased rates of weight gain were widely reported, as were declines in the general populations’ mental health, including increases in perceived stress. This study investigated whether higher perceived levels of stress during the pandemic were associated with greater levels of weight gain, and whether poor prior levels of mental health were a factor in higher levels of both stress and weight gain during the pandemic. Underlying changes in eating behaviours and dietary consumption were also investigated. During January-February 2021, UK adults (n=179) completed a self-report online questionnaire to measure perceived levels of stress and changes (current versus pre-COVID-19 restrictions) in weight, eating behaviours, dietary consumption, and physical activity. Participants also reported on how COVID-19  had impacted their lives and their level of mental health prior to the pandemic. Participants with higher levels of stress were significantly more likely to report weight gain and twice as likely to report increased food cravings and comfort food consumption (OR=2.3 and 1.9-2.5, respectively). Participants reporting an increase in food cravings were 6-11 times  more likely to snack and to have increased consumption of high sugar or processed foods  (OR=6.3, 11.2 and 6.3, respectively). Females reported a far greater number of COVID-19 enforced lifestyle changes and both female gender and having poor mental health prior to the pandemic were significant predictors of higher stress and weight gain during the pandemic. Although COVID-19 and the pandemic restrictions were unprecedented, this study suggests that understanding and addressing the disparity of higher perceived stress in females and individuals’ previous levels of mental health, as well as the key role of food cravings, is key for successfully addressing the continuing societal issue of weight gain and obesity.

BackgroundWelfare legal problems and inadequate access to support services follow both the socioeconomic and the health inequalities gradients. Health Justice Partnership (HJP) is an international practitioner-led movement which brings together legal and healthcare professionals to address the root causes of ill health from negative social determinants. The aim of this paper was to identify the current evidence base for the cost-effectiveness of HJP or comparable welfare advice services.MethodsA rapid review format was used, with a literature search of PubMed, CINAHL, ASSIA, PsycINFO, Medline, Cochrane Library, Global Health and Web of Science identifying 496 articles. After removal of duplicates, 176 papers were screened on titles and abstracts, and 20 papers met the eligibility criteria. Following a full-text screening, a further 14 papers were excluded due to lack of economic evaluations. Excluded papers' reference lists were scanned, with a further 3 further papers identified which met the inclusion criteria. A final pool of nine studies were included in this review.ResultsStudies focused on the financial benefit to service users, with only three studies reporting on cost effectiveness of the interventions. Only one study reported on the economic impact of change of health in service users and one study reported on changes in health service use.ConclusionThis review highlights the current evidence gap in evaluating the cost-effectiveness of adequate access to free legal welfare advice and representation. We propose that an interdisciplinary research agenda between health economics and legal-health services is required to address this research gap.

The COVID-19 pandemic and associated social restrictions had an extensive effect on peoples’ lives. Increased rates of weight gain were widely reported, as were declines in the general populations’ mental health, including increases in perceived stress. This study investigated whether higher perceived levels of stress during the pandemic were associated with greater levels of weight gain, and whether poor prior levels of mental health were a factor in higher levels of both stress and weight gain during the pandemic. Underlying changes in eating behaviours and dietary consumption were also investigated. During January-February 2021, UK adults (n = 179) completed a self-report online questionnaire to measure perceived levels of stress and changes (current versus pre-COVID-19 restrictions) in weight, eating behaviours, dietary consumption, and physical activity. Participants also reported on how COVID-19 had impacted their lives and their level of mental health prior to the pandemic. Participants with higher levels of stress were significantly more likely to report weight gain and twice as likely to report increased food cravings and comfort food consumption (OR = 2.3 and 1.9–2.5, respectively). Participants reporting an increase in food cravings were 6–11 times more likely to snack and to have increased consumption of high sugar or processed foods (OR = 6.3, 11.2 and 6.3, respectively). Females reported a far greater number of COVID-19 enforced lifestyle changes and both being female and having poor mental health prior to the pandemic were significant predictors of higher stress and weight gain during the pandemic. Although COVID-19 and the pandemic restrictions were unprecedented, this study suggests that understanding and addressing the disparity of higher perceived stress in females and individuals’ previous levels of mental health, as well as the key role of food cravings, is key for successfully addressing the continuing societal issue of weight gain and obesity.