Partnering with patients and community stakeholders to identify, design, undertake, and evaluate research is increasingly common. We describe our experience with creating and developing an ongoing Community Stakeholder Committee to guide lung health research for disease prevention and healthcare improvement. This committee is central to the integrated knowledge translation approach of Legacy for Airway Health, which is dedicated to preventing and improving care for lung diseases. Patient engagement in research (PEIR) aims to improve the relevance, quality, and implementation of research activities. Meaningful patient and community engagement in research remains challenging to implement. The committee was established in October 2019, just prior to the COVID-19 pandemic, and quickly adapted from in-person to virtual engagement activities. This change led to an increased focus on relationship-building and mutual support alongside other research and training activities. We conducted a baseline evaluation survey after one year (October 2020) using a modified version of the Patient Engagement in Research Scale (PEIRS-22). While individual scores suggested varied levels of meaningful engagement within the committee, overall results indicated strong personal relationships and a sense of feeling valued and respected, as well as a desire for increased opportunities to contribute to research within the program. Overall, this experience offers lessons learned about the importance of spending time and effort to build relationships, particularly in a virtual context, and shows that meaningful engagement can be done even when personal contact is limited. These efforts are illustrated in successful grant applications, research involvement, and stronger personal relationships.

BACKGROUND: COVID-19 was declared as a pandemic in March 2020. After confirming the first case, the Ethiopian government has been working a lot to prevent transmission. Most of the reported cases were identified from traveling abroad. Effective prevention and control practices depend on awareness and compliance among the population at all levels. The main objective of this study is to determine the knowledge level and its association with sources of information towards COVID-19 and its prevention techniques in the Gedeo Zone of Southern Ethiopia. METHODS: There are 10 knowledge questions regarding COVID-19 and its prevention techniques. The maximum knowledge score for each question was 1 and the minimum 0, where 0 was scored for incorrect and 1 for correct answers. The overall knowledge score ranges from 0 to 10, where a score of 0-5 as poor knowledge and a score from 6-10 as good knowledge. Bivariate and multivariate binary logistic regression was used to determine the association between dependent and independent variables. The adjusted odds ratio with their 95% CI was used to show the strength of association. p Value < .05 was used to declare a statistically significant association. RESULTS: Among 1170 study participants, 58.1% of the study participants were male. Protestant constitutes 50.6% of the study participants in religion. Regarding knowledge level, 60.5% have good knowledge about COVID-19 and its prevention techniques. Concerning sources of information about COVID-19 and its prevention; internet, family/peer, religious and health workers contributes less <20% whereas telecommunication and television/Radio contributes the largest 56.1% and 85.8% as a source of information respectively. Internet as a source of information AOR: 1.99 (CI: 1.05-3.78, p = .034), information from health worker AOR: 2.324 (CI: 1.228-4.397, p = .010) and information from television or radio AOR: 2.737 (CI: 1.471-5.092, p = .001) has been significantly associated with good knowledge with p value < .05. CONCLUSION: Sources of information had a significant association on the level of knowledge. Residents who had internet, television/radio, and health workers as their information sources had better knowledge regarding COVID-19 and its prevention. Based on this, we recommend increasing internet access, television and radio service, and public health education by trained health workers for effective approaches to fight COVID-19.

"Undisruptive learning with disruptive classes" is the principle for Chinese higher education institutions to handle the challenge they encounter during the COVID-19 pandemic. The purpose of this study is to promote online teaching across three scenarios: online teaching for students within one college, online teaching for students across different colleges, and online training for primary and secondary school teachers. Guided by the "Internet+" concept, we design the MOOC-Based One Plus Three teaching model. Moreover, we apply the model in designing and developing online courses on the Chinese Universities MOOC platform. Empirical results have shown that the model effectively solves the needs of large-scale emergency teaching during the pandemic across online teaching for students within one college, online leaching for students across different colleges, and online training for primary and secondary school teachers. This model supports the rapid implementation of online teaching in more than 180 colleges and over more than 20 courses across the country with 58,107 preservice teachers, in-service teachers, related business employees enrolled. This highly feasibly model embodies the Internet thinking and consists of various teaching, methods, and thus maximize the effectiveness of online teaching. This model especially supports the online teaching of the Instructional Technology program at universities (e.g., Hubei University of Education) which are severely affected by the pandemic. Therefore, the model has a positive promotion and application value.

A 6-year-old African boy with multi-viral infection including parvovirus B19 and severe acute respiratory syndrome coronavirus 2 was admitted for persistent fever associated with respiratory distress and myocarditis complicated by cardiogenic shock needing ventilatory and inotropic support. Coronary aneurysms were also documented in the acute phase. Blood tests were suggestive of macrophage activation syndrome. He was treated with intravenous immunoglobulins, aspirin, diuretics, dexamethasone, hydroxychloroquine, and prophylactic low molecular weight heparin. Normalization of cardiac performance and coronary diameters was noticed within the first days. Cardiac magnetic resonance imaging, performed 20 days after the hospitalization, evidenced mild myocardial interstitial oedema with no focal necrosis, suggesting a mechanism of cardiac stunning related to cytokines storm rather than direct viral injury of cardiomyocytes.

In the unprecedented times of Corona Pandemic (CP), each individual is facing uncertainty and stress. Presence of cancer during these times compounds the troubles. The changing scenario of consultation and treatment during pandemic, logistic issues, dwindling finances and fear are making a negative impact on the mental health of cancer patients. In a qualitative analysis conducted in a tertiary oncology hospital from 1st June to 6th July on the recently diagnosed or under treatment cancer patients. The face to face interview was conducted using a semi structured questionnaire specific to Cancer amid CP, General Anxiety Disorder Item Scale 7 and Physical Health Questionnaire 9 (PHQ-9). There were total 294 patients, mean age around 51 years with a male female ratio of 3:2, 40% were suffering from head and neck malignancy. There was a delay initiating cancer treatment in 22.4% of patients and three fourths of them attributed it to CP. Almost 80% of patients perceived that pandemic has adversely affected their treatment and 50% thought they would have had a better chance of cure. Half of our cohort stated that due to social distancing and usage of masks, there is a communication gap between them and the doctors. They also felt that now, with decreased nonverbal communication; they felt lack of empathy. 14.9% patients were more concerned about corona pandemic as compared to malignancy. This study is about the challenges and perspective of cancer patients during the CP. It indicates a need for more systematic and patient friendly approach by the regulatory authorities, hospital management and staff. Timely intervention of those under stress is recommended more frequently during CP.

Several prominent news outlets have reported increased interest in home births during the COVID-19 pandemic because many pregnant patients are afraid of contracting COVID-19 in the hospital 11,12 In response to these concerns, the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Family Physicians (AAFP), the American College of Nurse-Midwives, and the Society for Maternal-Fetal Medicine released a joint statement asserting that hospitals and community birth centers, with the appropriate accreditation, are the safest places to give birth in the United States 13 Home births are associated with lower rates of obstetric interventions, including cesarean delivery, oxytocin augmentation, and episiotomy, and with lower rates of obstetric complications such as anal sphincter lacerations and maternal infections 14 Psychological trauma from previous birth experiences and/or a history of other traumatic life experiences may cause a pregnant person to fear maltreatment or loss of autonomy if they give birth in a hospital Mistreatment in labor occurs more often in the hospital setting compared with home births (28 1% vs 5 1%) 15 Systemic racism and the stress it creates account for some of this difference 16,17 Birth centers supported by public funding such as Medicaid, which pays for more than 40% of all births, and a higher proportion of births for persons of color18 may achieve improved satisfaction with the birthing experience, lower rates of preterm births and cesarean deliveries, and lower costs for delivery 19 The safety of home or birth center birth can be improved by adequate birth attendant training, access to emergency obstetric care, and careful risk assessment throughout the prenatal and intrapartum periods Substituting the term community birth for out-of-hospital birth removes the assumption that hospital birthing is normative and is preferred 24 Pregnant patients with a fetus in breech presentation near term, a multiple gestation, or a previous cesarean delivery should be counseled that home birth is not recommended because of the increased risk of adverse neonatal outcomes 2,10,25 Many patients in rural areas lack access to trial of labor after cesarean (TOLAC), despite AAFP and ACOG efforts to support maternal choice 26,27 Persons deemed ineligible for maternity care in their local hospital because of a history of cesarean delivery may choose the increased risk of a local home birth rather than transfer care outside of their community 26C28 Supporting the options of TOLAC in rural hospitals and planned vaginal breech delivery for those who meet criteria may decrease the likelihood of pregnant persons with these risk factors choosing home birth

The choice of location is a key facet of decision-making in operations. One such choice is whether to colocate activities, services, or personnel. Prior research, including in healthcare, has reported that colocation yields benefits. However, these benefits may need to be balanced with higher costs of colocation (e.g., due to operational constraints). Thus, it is critical to understand not only whether colocation makes a difference but also under what circumstances it is most beneficial, and the mechanisms through which those benefits are realized. We consider colocation in the context of healthcare services, and ask: Does colocation of mental and physical health resources improve patient outcomes? This colocation is important, as primary care serves as a gateway to address mental health concerns and referrals to specialists. We next study colocation's relationship with two important operational variables: continuity of care (CoC) with a provider, and patient severity. Finally, we examine the mediating role of patients' no-shows and medication adherence in the colocation-outcomes relationship. As America's largest integrated healthcare system, the Veterans Health Administration offers us an excellent setting to study these questions. We analyze over 300,000 patients C over an eleven-year period C who suffer from diabetes, a chronic condition, and show evidence of mental illness. We use an empirical approach to quantify the relationship between colocation and four key outcomes attributable to mental illness: hospitalizations, length of stay (LOS), 30-day readmissions, and suicidal behavior. We find that colocation is associated with improvement in outcomes. For example, a one standard deviation increase in the mean colocation measure is related to a 2.4% decrease in LOS C equivalent to an annual savings of approximately $1.5 million, on average, just for our cohort. In addition, we find that colocation and CoC are substitutes, in that colocation benefits patients whose care is fragmented. Further, we find that colocation offers greater benefits to patients whose mental health conditions are more severe. Finally, our analysis reveals that colocation improves outcomes (partially) through a reduction in the no-show rate and an increase in medication adherence. Our findings are validated by extensive robustness checks and sensitivity analyses. Our study has implications for both the theory and practice of healthcare operations. Theoretically, we advance the location literature, establish its connection with the continuity literature, and highlight key moderators and mediators in the colocation-outcomes relationship. Practically, our work offers insights into how to design an operationally efficient system and, in settings with limited resources, where to target colocation. Our study is particularly timely as it may help address the growing mental health crisis in America and around the world, further exacerbated during the COVID-19 pandemic.

The global pandemic of coronavirus disease 2019 (COVID-19) highlights the shortcomings of the current testing paradigm for viral disease diagnostics. Here, we report a stepwise protocol for an RNA-extraction-free nano-amplified colorimetric test for rapid and naked-eye molecular diagnosis of COVID-19. The test employs a unique dual-prong approach that integrates nucleic acid (NA) amplification and plasmonic sensing for point-of-care detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with a sample-to-assay response time of <1 h. The RNA-extraction-free nano-amplified colorimetric test utilizes plasmonic gold nanoparticles capped with antisense oligonucleotides (ASOs) as a colorimetric reporter to detect the amplified nucleic acid from the COVID-19 causative virus, SARS-CoV-2. The ASOs are specific for the SARS-CoV-2 N-gene, and binding of the ASOs to their target sequence results in the aggregation of the plasmonic gold nanoparticles. This highly specific agglomeration step leads to a change in the plasmonic response of the nanoparticles. Furthermore, when tested using clinical samples, the accuracy, sensitivity and specificity of the test were found to be >98.4%, >96.6% and 100%, respectively, with a detection limit of 10 copies/L. The test can easily be adapted to diagnose other viral infections with a simple modification of the ASOs and primer sequences. It also provides a low-cost, rapid approach requiring minimal instrumentation that can be used as a screening tool for the diagnosis of COVID-19 at point-of-care settings in resource-poor situations. The colorimetric readout of the test can even be monitored using a handheld optical reader to obtain a quantitative response. Therefore, we anticipate that this protocol will be widely useful for the development of biosensors for the molecular diagnostics of COVID-19 and other infectious diseases.

Neuroendocrine hyperplasia of infancy (NEHI) is an interstitial lung disease (ILD) of unknown etiology, which develops in infancy and manifests as persistent tachypnea Objective of the research: to summarize results of observations of patients with NEHI, including during the pandemic of a new coronavirus infectious disease (COVID-19) Materials and methods: clinical and follow-up observation, laboratory and instrumental examination, including lung biopsy, 52 children with NEHI aged from 21 days to 10 years Results: NEHI more often affects boys in the first 6 months of life;can be diagnosed on the basis of pediatric ILD-syndrome detection;specific CT signs, lung biopsy It is characterized by undulating course with increased respiratory failurec aused by acute respiratory viral infections, COVID-19;half of the patients need oxygen therapy

The use of opioid drugs and related overdose deaths, which rose to epidemic proportions over the past decade, have been exacerbated by the COVID pandemic, a time of great uncertainty and isolation. Much is known about opioid pharmacology and related neural circuits that, combined with novel emerging neurobiological insights, can help guide new treatment strategies. To view this SnapShot, open or download the PDF.

Fears regarding various aspects tend to stimulate individuals to escape or to avoid the sources of the threat. We concluded that fears associated with the future aging process, like the fear of aging-related diseases, the fear of loneliness in old age, and the fear of death, would stimulate patterns of avoidance when it comes to ideal life expectancy. We expected fear of aging-related diseases and fear of loneliness in old age to be related to lower ideal life expectancies. We expected fear of death to be related to higher ideal life expectancies. In two adult lifespan samples [N(1) = 1065 and N(2) = 591; ages ranging from 18 to 95 years, M (SD)(1) = 58.1 (17.2) years, M (SD)(2) = 52.6 (18.1) years], we were able to support our hypothesis regarding fear of death. We furthermore found significant interactions among the fears, indicating that individuals fearing diseases or loneliness but being unafraid of death opted for the shortest lives. Our results indicate that fears regarding life in very old age might be associated with the wish to avoid this age period; the fear of death was however associated with the wish for particularly long lives, and thus, with distancing oneself from the dreaded event of death. We conclude that fears seem to be associated with how individuals approach old age and with what they wish for in their own future as aged people.

Recientemente, Carrion et al. (1) publicaban un acertado analisis sobre el uso de la telemedicina (TM) en urologia en el contexto de la pandemia por COVID-19. El escenario de emergencia durante la pandemia debida al SARS-CoV-2 ha propiciado un uso exponencial de la TM que ha permitido mantener el acceso y la continuidad de la atencion a los pacientes y apoyar a los profesionales de primera linea, optimizando los servicios presenciales y minimizando las infecciones por transmision del COVID-19 (2).

BACKGROUND: Novel corona virus, named COVID-19, has spread rapidly to other countries like Italy, Iran and South Korea and affected all people, especially health-care providers. Therefore, due to the rapid spread of the disease in Iran, the aim of the present study was to explore psychological distress experienced by Iranian health-care providers in the first few weeks of the corona virus outbreak. METHODS: The present qualitative study was conducted on 18 Iranian health-care providers exposed to COVID - 19 using a content analysis method. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. RESULTS: By analyzing 236 primary codes, two main categories were extracted from the experiences of health-care providers during corona virus outbreak. The first category included Occupational demands with three sub-categories: nature of illness, Organizational demands and social demands. The second category was Supportive resources included personal support and social support. CONCLUSIONS: The results of this study found that there were some barriers and challenges to medical personnel exposed to COVID-19 that caused psychological distress. Some of these problems related to the nature of illness, others related to social and organizational demands and some of supportive resources buffer the relationship between occupational demands and psychological distress.

Background: In December 2019, a new coronavirus appeared in China, as a cause of acute respiratory disease Healthcare Workers (HCWs) in children's hospitals are one of the groups who are at a high rate of exposure to COVID-19 patients The detection of antibodies is useful and helps diagnose late or recent SARS-CoV-2 infection Most children may present with asymptomatic or mild SARS-CoV-2 infection and can be silent sources of infection in the community and hospitals Objectives: This study was conducted to determine the antibodies (IgM and IgG) against SARS-CoV-2 in Mofid children's hospital staff Methods: This cross-sectional study evaluated 475 staff from Mofid children's hospital from April 20 to May 5, 2020, in Tehran We collected blood samples for the antibody assay with a rapid test kit A questionnaire was used to collect demographic and clinical data Results: Of 475 staff who participated in this study, 25 (5 3%) were diagnosed with COVID-19 by Polymerase Chain Reaction (PCR) and/or CT scan Besides,140 (29 4%) of them were positive for IgM and/or IgG SARS-CoV-2 antibodies Conclusions: The seropositivity of antibodies against SARS-CoV-2 among children's hospital staff was higher than expected Approximately 5% of the participants were diagnosed as definitive positive COVID-19 cases by PCR and/or CT scan, but 29 4% of them were seropositive The difference is a warning, as it shows seropositive people could be silent sources of transmission during asymptomatic infection

PURPOSE: This study aimed to explore the prevalence of and possible risk factors for hand eczema with respect to the dissemination of information about new hand hygiene habits to protect against ongoing COVID-19 cross-transmission. The authors conducted a survey among health care workers (HCWs) and non-HCW populations in Khon Kaen, Thailand. RESULTS: A total of 805 participants participated. The prevalence of hand eczema in the study population was 20.87%. There were several risk factors, including working as a HCW, having a history of previous hand eczema, having underlying atopic dermatitis, wearing gloves in everyday life, and washing hands frequently (more than 10 times/day). Hand hygiene with alcohol-based products was shown to be a risk factor for hand eczema, (OR (95% CI) 1.86 (1.03-3.35), P = .04). CONCLUSION: In terms of hand eczema prevention, we suggest that the use of alcohol-based products should be discontinued if other handwashing methods are available. The following factors increase the risk of hand eczema: being a HCW, having previous hand eczema, and having underlying atopic dermatitis. Proper strategies in terms of hand eczema prevention should be addressed, especially in this group, since we need to continue performing hand hygiene during the ongoing COVID-19 pandemic.

The outbreak of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a global health emergency and became a worldwide pandemic. We summarize the recent findings with respect to the function, structure and immunogenicity of the spike (S) protein, arising mutations, and implications on vaccine development and therapeutics.

AIMS: To estimate the associations between regular exposure to smoking by other people and motivation and attempts to quit among current smokers. To examine whether socio\demographic and other factors moderate these associations. DESIGN: A repeat nationally representative cross\sectional survey. Data were collected monthly between November 2014 and February 2019. SETTING: England. PARTICIPANTS: Current smokers 16 years of age from the Smoking Toolkit Study (n = 15 136). MEASUREMENTS: Participants were asked whether other people regularly smoke in their presence, how motivated they were to quit and whether they had made a quit attempt in the past year. Moderators assessed were occupation\based social grade, housing tenure, urges to smoke, high\risk alcohol consumption, and disability. Adjusted analyses included moderators, socio\demographic (age/sex/ethnicity/sexual orientation/marital status/children in household) and seasonal (quarter/year) confounders. FINDINGS: Current smokers who were regularly exposed to other people smoking in their presence were less likely to be highly motivated to quit (OR = 0.88 [95% CI 0.80C0.97]), but were no less likely to have made a quit attempt in the past year (OR 1.04 [0.97C1.13], Bayes Factor (BF) = 0.05). The inverse relationship between regular smoking exposure and motivation to quit was moderated by urges to smoke, such that exposure was only associated with a reduction in motivation among those without strong urges to smoke (OR 0.83 [0.75C0.93] versus OR 1.04 [0.86C1.26]; P = 0.048). None of the other factors significantly moderated the association with motivation to quit, and none moderated the relationship between regular smoking exposure and quit attempts. All non\significant interactions, except social grade (BF = 1.44) with quit attempts, had Bayes Factors that supported the hypothesis of no moderation (BF range: 0.12C0.21). CONCLUSIONS: Among current smokers in England, regular exposure to other smokers appears to be associated with lower motivation to quit in people without strong urges to smoke, yet there appears to be no association with quit attempts in the previous year. Social grade, housing tenure, high\risk alcohol consumption and disability do not moderate these associations.

BACKGROUND: It is unclear if the prevalence of COVID-19 in rheumatologic patients is similar to that of the general population. There are no reports of seroprevalence of SARS-CoV-2 in these patients. AIMS: To investigate prevalence of COVID-19 cases and seroprevalence among rheumatologic patients and the risk factors for infection. METHODS: A cross-sectional study in a rheumatologic population. An online questionnaire was sent on 31 April 2020. Blood samples from 20% sample of patients were drawn for SARS-CoV-2 antibodies. Patients were divided based on autoimmune (AI) diagnosis. Prevalence of COVID-19 by nasopharyngeal swab and by serology (seroprevalence) was compared to national data. Risk factors for infection of SARS-CoV-2 were assessed. RESULTS: The study group included 1204 patients, 74.5% had an AI diagnosis. The prevalence of COVID-19 was 0.16% in the rheumatologic patient population and 0.22% in the AI group, which was not different from prevalence in Israel on 4 May 2020 (0.18%, P = 0.912 and P = 0.759 respectively). Serologic tests were performed in 242 patients, of which five were found positive pointing to a seroprevalence of 2.07%. Exposure to a known COVID-19 patient was the only significant risk factor for being positive by swab or by serology. AI diagnosis, immunosuppression, corticosteroid, hydroxychloroquine did not influence the risk. CONCLUSIONS: The prevalence of COVID-19 in a population of rheumatologic patients was similar to that of the general population. Mild/asymptomatic cases may be prevalent according to serologic tests. The major risk factor for infection is exposure to a known case of COVID-19, and immunosuppression did not play a role in the risk of infection.

BACKGROUND: Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may not elicit lifelong protective immunity and reinfection could occur Liver function impairment is a common manifestation of coronavirus disease 2019 (COVID-19) However, acute hepatic failure in the setting of COVID-19 is very rare CASE PRESENTATION: We report the case of a 47-year-old woman who presented with acute abdominal pain and vomiting Abdominal examination revealed a soft and lax abdomen with mild tenderness in the right upper quadrant The patient recovered from COVID-19 2 months previously with negative results on reverse transcription-polymerase chain reaction (RT-PCR) Laboratory investigations revealed markedly elevated transaminases with normal results on viral hepatitis serology panel and undetectable blood paracetamol level Prior to admission, the patient underwent RT-PCR for SARS-CoV-2, which revealed a positive result The patient experienced rapid deterioration in the neurological status with a remarkable increase in the liver enzyme levels Despite aggressive resuscitation, the patient suffered irreversible cardiac arrest and died CONCLUSION: Fulminant hepatic failure is a rare manifestation in patients with re-positive RT-PCR tests for SARS-CoV-2 Clinicians should maintain a high index of suspicion for hepatic injury with active monitoring of liver enzymes

BACKGROUND: Approximately one out of every three people in Germany who meets the diagnostic criteria for major depression has contact with mental health services. Therefore, according to treatment guidelines, two thirds of all individuals with depression are insufficiently treated. In the past, the subjective perspective of people who (do not) make use of mental health services has been neglected. Factors related to the use of health services are described in Andersens Behavioral Model of Health Services Use (ABM). The aim of this study is to supplement operationalizations of subjectively perceived and evaluated individual characteristics in the ABM and to evaluate whether the supplemented model can better explain mental health services use in individuals with depression than established operationalizations. METHODS: A representative telephone study with two measurement points will be conducted. In an explanatory mixed-methods design, qualitative interviews will be added to further interpret the quantitative data. A nationwide sample scoring 5 or more on the Patient Health Questionnaire (PHQ-9) will be recruited and interviewed via telephone at T0 and 12 months later (T1). Data on established and subjective characteristics as well as mental health service use will be collected. At T1, conducting a diagnostic interview (Composite International Diagnostic Interview, DIA-X-12/M-CIDI) enables the recording of 12-month diagnoses according to DSM-IV-TR criteria. Ideally, n = 768 datasets will be available and analyzed descriptively by means of regression analysis. Up to n = 32 persons who use or do not use depression-specific health services incongruent with their objective or subjective needs will be interviewed (face-to-face) to better explain their behavior. In addition, theories of non-need-based mental health service use are developed within the framework of the grounded theory-based analysis of the qualitative interviews. DISCUSSION: The study intends to contribute to the theoretical foundation of health services research and to specify the characteristics described in the ABM. Thus, after completion of the study, a further sophisticated and empirically tested model will be available to explain mental health services. The identified modifiable influencing factors are relevant for the development of strategies to increase mental health service use in line with the objective and subjective needs of individuals with depression. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-021-03065-w.