OAR@UM Community:

Environmental green cover and mental wellbeing in Malta

Thu, 01 Jan 2026 00:00:00 GMT

Title: Environmental green cover and mental wellbeing in Malta Abstract: This study investigates the relationship between environmental green cover and mental wellbeing among adults living in Malta, offering one of the first national assessments that integrates geospatial greenery measures with validated psychological wellbeing tools. Green spaces are internationally recognised for their capacity to reduce stress, enhance mood, strengthen social ties, and promote physical activity. Yet, in small island states such as Malta— where land is limited, urban density is high, and green infrastructure is unevenly distributed— the extent to which environmental greenery contributes to mental wellbeing has remained unclear. This study addresses this gap by exploring whether objective measures of greenery surrounding participants’ homes and workplaces are associated with mental wellbeing, while considering key behavioural, environmental, and socio-demographic influences. A cross-sectional sample of 691 adults was recruited across educational institutions, workplaces, and primary care settings. Mental wellbeing was measured using the WHO-5 index, while environmental green cover (grassland, tree canopy, cropland, and total greenery) was quantified within 300 m and 900 m buffers using high-resolution land-cover datasets. After geocoding residential and workplace street names, a comprehensive analysis was undertaken, including descriptive statistics, correlation testing, and multivariable regressions adjusting for demographics, physical activity, chronic disease, social cohesion, sedentary behaviour, and residential conditions. Findings showed considerable variability in both mental wellbeing scores and environmental greenery across Malta and Gozo. Bivariate correlations between greenery and mental wellbeing were weak and non-significant at both buffer distances, and regression models confirmed that environmental greenery did not independently predict mental wellbeing once confounders were included. Instead, stronger predictors emerged, particularly social cohesion, physical activity, housing quality, sedentary behaviour, and chronic illness. These results align with international literature suggesting that the benefits of greenery are mediated through behavioural and social pathways, and that simple measures of quantity may overlook the importance of quality, safety, accessibility, and actual use. The study carries several implications for public health and urban planning in Malta. First, increasing the amount of greenery alone is unlikely to yield significant improvements in population mental wellbeing. Instead, efforts should prioritise enhancing the quality, usability, and accessibility of green spaces, ensuring they are well-maintained, safe, shaded, and equipped with facilities that encourage both social interaction and physical activity. Second, interventions should address inequities in access to high-quality green environments, as disadvantaged communities often face greater environmental burdens and may benefit most from targeted greening initiatives. Third, integrating health considerations into environmental and urban development policies can support more holistic approaches to wellbeing, especially by linking green infrastructure planning with strategies for heat mitigation, active travel, and chronic disease prevention. Recommendations for future research include adopting longitudinal designs to better establish causality; incorporating subjective assessments of perceived greenery, quality, and safety; evaluating patterns of actual use of green spaces; and examining the influence of micro-scale greenery such as street trees and pocket parks. Expanding research to include cultural and behavioural factors specific to small island states would further strengthen policy relevance. Overall, this study contributes foundational evidence on environmental greenery and mental wellbeing in Malta. While objective greenery alone does not independently predict wellbeing, the findings highlight the importance of social, behavioural, and environmental conditions that shape how residents interact with and benefit from nearby green spaces. These insights underscore the value of context-sensitive, equity-driven, and health-informed urban greening strategies for supporting population mental wellbeing. Description: M.Sc.(Melit.)

Parental knowledge and awareness on children’s visual health and visual screening in Malta

Thu, 01 Jan 2026 00:00:00 GMT

Title: Parental knowledge and awareness on children’s visual health and visual screening in Malta Abstract: Purpose: Parents are pivotal in whether young children receive timely vision screening and eye care. Despite this, in Malta, little is known about parental awareness, knowledge and beliefs regarding children’s eye health and screening pathways. Methodology: A cross-sectional, quantitative approach via an online survey of parents/guardians of 3 to 6-year-olds in Malta assessed parental awareness, knowledge and beliefs regarding children’s eye health and eye health services. Convenience sampling was used. The quantitative data was analysed using IBM SPSS software Version 29 for Windows. Results: A total of 300 parents or guardians participated. Overall, 58.7% of children had previously an eye or vision test, while 41.3% had not. Notably, 26.3% of 6-year-olds had never been tested within school health services. The mean parental composite knowledge score was 1.27/5 (SD 0.84), indicating low awareness of key topics such as the abnormality of eye turns in early childhood and the benefits of early wearing eyeglasses. Knowledge did not differ significantly by parental education level (p=0.47) or socioeconomic level. Commonly reported barriers included the belief that the child is “too young” for testing and uncertainty about how or where to arrange an appointment. Perceived susceptibility (parental concern) and disability status were positively associated with test uptake. Conclusions: Maltese parents and guardians show limited knowledge and uneven engagement with children’s eye care. Public-health action should prioritise orthoptic-led, school-entry screening at 4–5 years with clear referral pathways as well as a universal parent educative courses which emphasise asymptomatic conditions (e.g., amblyopia) and how to access services. This aligns with international best practice and can reduce preventable visual impairment in Maltese children. Description: M.Sc.(Melit.)

Assessing the prevalence of depression and associated risk factors among healthcare students at the University of Malta

Thu, 01 Jan 2026 00:00:00 GMT

Title: Assessing the prevalence of depression and associated risk factors among healthcare students at the University of Malta Abstract: This dissertation investigates the prevalence of depression and the associated demographic, academic, biological, lifestyle and social risk factors among undergraduate healthcare students aged 18 to 25 years at the University of Malta. Depression represents a major global public health challenge and is particularly prevalent among university students, with healthcare students consistently identified as an especially vulnerable group. Despite extensive international evidence, no previous local study has examined depressive symptoms across the full spectrum of Maltese university healthcare courses. This research fills an important gap and provides the first evidence-based assessment of depression in this vulnerable population. A cross-sectional quantitative design was employed using an anonymous online questionnaire distributed via the University of Malta registrar’s office, via email by KSU and on social media platforms by the relevant student associations. The survey incorporated validated instruments including the Patient Health Questionnaire-9 (PHQ9) to assess depressive symptom severity, alongside items from established, validated international questionnaires to evaluate key risk factors, such as physical and mental health conditions, sleep, exercise, substance use, social support, academic pressures and the impact of Long COVID-19. Statistical weighting was applied to the data to adjust for faculty, nationality and gender distribution. The study found a notably elevated prevalence of depression in the final cohort. Using the internationally accepted PHQ-9 threshold score of 10 or above, 42.7% of the weighted sample met criteria for probable major depressive disorder (MDD). This prevalence aligns with higher-end estimates reported globally in studies analysing mental health issues among healthcare student populations. In terms of potential risk factors, several possible associations were identified. Significant relationships were observed between higher depression severity and being an international student, as well as being enrolled in the Faculty of Health Sciences. Various lifestyle and social factors also showed significant associations with increased depressive symptom severity, including physical inactivity, shorter sleep duration, poor sleep quality, problematic social media use, tobacco smoking, weekday alcohol consumption and cannabis use. Additionally, a significant relationship was noted for those experiencing symptoms of Long COVID-19, as well as those individuals who reported experiencing a recent significant life event. It is critical to acknowledge that these findings are based on a very low response rate of 5.4%, which introduces a high degree of non-response bias and as a result, the final sample was not representative of the wider healthcare student population at UOM. The lack of statistical power also means that non-significant findings, such as those related to BMI or loneliness, must be interpreted with caution. Consequently, this study functions as an exploratory investigation that provides a preliminary baseline. These results underscore the importance of further research using more robust recruitment strategies to accurately determine the mental health needs of this cohort. The study also highlights the need for improved institutional support for research dissemination to further explore wellbeing in Malta’s healthcare student population and ensure a sustainable future healthcare workforce. Description: M.Sc.(Melit.)

Knowledge and attitudes surrounding the ecological sustainability of healthy eating in the adult population of Malta : a cross-sectional study

Thu, 01 Jan 2026 00:00:00 GMT

Title: Knowledge and attitudes surrounding the ecological sustainability of healthy eating in the adult population of Malta : a cross-sectional study Abstract: This dissertation, titled 'Knowledge and Attitudes Surrounding the Ecological Sustainability of Healthy Eating in the Adult Population of Malta: A Cross-Sectional Study', explores the general adult population’s understanding and perceptions of the ecological sustainability of food choices and their relationship to healthy eating. The research addresses a notable gap in local studies by examining public awareness of sustainable diets within Malta’s cultural and socio-economic context. The study stems from growing international concern over the environmental unsustainability of current food systems, which contribute substantially to greenhouse gas emissions (GHGs), biodiversity loss and the depletion of natural resources such as water. Global frameworks including the Sustainable Development Goals (SDGs) and the EAT-Lancet Commission emphasise the urgent need for dietary transitions that benefit both human and planetary health. This study aimed to assess and compare knowledge and attitudes on food sustainability and environmental impacts across demographic factors, and to explore public perceptions of the connection between sustainable and healthy diets. The outcomes are intended to inform national policy and education initiatives promoting sustainable and healthy eating practices. An exploratory descriptive cross-sectional study design was adopted, employing a structured online questionnaire distributed via social media, Whatsapp and via internal Governmental emails. The validated tool, adapted from García-González et al. (2020) and translated into Maltese, collected demographic data along with measures of knowledge, attitudes and perceptions related to food sustainability. Convenience and Snowball sampling yielded 443 valid responses from adults aged 18 years and above residing in Malta, guaranteeing a maximum margin of error of 4.65%, assuming a 95% confidence level. Data were analysed using Statistical Package for the Social Sciences (SPSS) and Microsoft Excel, applying descriptive and inferential statistical tests (Chisquare and Kruskal–Wallis) with a significance threshold of p ≤ 0.05. The sample was predominantly made of women (68.4%), Maltese (95.5%) and highly educated, with more than two-thirds holding tertiary qualifications. Overall, participants demonstrated moderate awareness of sustainability-related terms, with approximately half reporting familiarity with key concepts such as 'ecological footprint' and 'sustainable diet'. Significant differences were found across gender and educational level, with women and highly educated participants showing greater knowledge and more favourable attitudes toward sustainable diets. Attributes such as local production, affordability and low environmental impact were rated as most important features of a sustainable diet, with female respondents assigning consistently significantly higher importance than males (p < 0.05). Age, employment status and monthly income levels also influenced perceptions and attitudes, with older, retired and those falling under ‘other’ employment status and higher-income participants expressing greater willingness to pay for sustainably produced foods. Most respondents (63.9%) perceived 'sustainable diet' and 'healthy diet' as similar but not identical concepts, indicating satisfactory understanding of their interconnection. Promisingly, the overall attitudes reflected positive awareness of the importance of sustainable consumption and a general openness to behavioural change. The findings suggest that while Maltese adults display encouraging levels of awareness and positive attitudes, gaps remain in comprehensive understanding and practical application of sustainable dietary principles. The study recommends targeted educational campaigns and policy measures to strengthen public food sustainability literacy, particularly among younger and less-educated groups. This research provides a valuable evidence base for designing interventions that advance sustainable healthy diets aligned with global sustainability and public health priorities. Description: M.Sc.(Melit.)