bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving from human-centred to society-centred design of health technologies
Authors: Niess J
Published: October 2022

The digitised society promises technological solutions to support mental and physical health and well-being. Amongst others, the consumer market, health insurance providers, and companies offer technologies to, among other things, track one's mood, improve diet and fitness habits, foster healthy sleep patterns or track our brain waves to enhance relaxation. However, while the potential benefits of such technologies are apparent and technologies might increase individual and public health, long-term engagement with health technologies is comparably low. This hints at ineffective solutions and insufficient knowledge of user needs. Understanding the specific context of use and user needs is vital to increasing technology adoption, personal benefits, and profitability of health technologies. Taking the user perspective into account when designing technologies is essential to support health and well-being. To foster long-term engagement with health technologies, we argue for considering the broader social context of digital health tools and reflecting on ways how we can empower society to design better and more inclusive health technologies. Hence, when developing digital public health tools, it is essential to go beyond conceptualising people as users and instead shift the focus to humans as part of society and embed such consideration in the design process.
A community-based participatory approach to engaging Congolese migrants in intervention co-design
Authors: Crawshaw AF , Hickey C , Lutumba LM , Kitoko LM , Nkembi SL , Knights F , Ciftci Y , Vandrevala T , Forster AS , Hargreaves S
Published: October 2022

Issue

The World Health Organization has called for tailored, community-based interventions to address disparities in vaccination uptake affecting migrant and minoritised populations, however few exist. This study directly responds to global calls for community-centred and participatory approaches to engaging migrants in routine and COVID-19 vaccination.

Problem description

Black and African migrants are known to be at risk of under-immunisation and have lower COVID-19 vaccine uptake rates in high-income countries. This UK study will use community-based participatory approaches to engage Congolese migrants in co-developing a tailored intervention to increase vaccine uptake. A community-academic coalition will lead the study. Community members will be trained as peer researchers and financially compensated. The final output will be an intervention strategy tailored to and embedded within the Congolese migrant community.

Preliminary results

The coalition held 20 hours of planning meetings and peer researcher training in 2021 and co-developed a phased study involving 1) community days with poster walls and qualitative in-depth interviews with Congolese migrants, 2) interviews and workshops with local stakeholders, and 3) co-design workshops with Congolese migrants. Following outreach and pre-engagement, approximately 80 migrants attended the community days, with more than 50 interviews and 100% left positive feedback (including: felt valued, welcomed, Congolese language recognised).

Lessons

Community-academic partnerships are resource-intensive but can be an effective means to build and maintain trust required to deliver a community-based research study. Academic partners should support community partners in understanding the research process to help manage expectations and provide financial compensation for their time and effort. This study offers an innovative engagement model and study design that can be adapted to other underserved populations.

Key messages

• Global policy-setting organisations have called urgently for participatory research that engages migrants in the co-production of tailored initiatives to address vaccination inequalities.

• This study uses a novel, theory-driven, participatory approach to engage with and identify barriers to vaccination in Congolese migrants and co-design a tailored strategy to increase uptake.
Social context matters: the role of social support and social norms in healthcare solidarity
Authors: Meijer MA , Brabers AEM , De Jong JD
Published: October 2022

Background

In many European countries, including the Netherlands, the healthcare system is based upon solidarity. It is important that public support for solidarity-based systems is sufficient, to ensure that people remain willing to contribute to them. Although support is generally high, as indicated by high levels of willingness to pay for the healthcare costs of others, there are differences between groups. Previous research has focused on individual and institutional characteristics when explaining these differences. However, people's social context may also play a role. Little research has been conducted into this. To fill this gap, we examined the role of perceived social support and social norms in order to explain differences in the willingness to pay for other people's healthcare costs.

Methods

A questionnaire was sent to a representative sample of 1,500 members of the Dutch Healthcare Consumer Panel in November 2021 (56% response rate, N = 837). The relationship between the social context of people and their willingness to pay was studied via logistic regression analysis.

Results

Higher levels of perceived social support are associated with higher levels of willingness to pay for other people's healthcare costs (p = 0.038). We also found that willingness to pay is higher when someone's social context is more supportive of the solidarity-based healthcare system (p = 0.001). Contrary to our expectations, the effect of social norms does not differ between people who perceive low and high levels of socials support.

Conclusions

The degree to which people feel connected to others and the degree to which someone's social context supports the solidarity-based healthcare system affect the willingness to contribute to the healthcare system. Our results suggest that the social context of people has to be taken into account in both policy and research that addresses healthcare solidarity, next to individual and institutional characteristics.

Key messages

• Social support and social norms play a role in the willingness to pay for healthcare costs of others.

• People's social context must be taken into account in policy and research on healthcare solidarity.
Exploring the link between cancer policies and cancer survival: a comparison of seven countries
Authors: Nolte E , Morris M , Landon S , McKee M , Seguin M , Butler J , Lawler M
Published: October 2022

Background

Disparity in cancer survival across countries has been linked to variation in cancer policy delivery but there is lack of empirical evidence for this association. We traced the evolution of cancer policies in 20 jurisdictions in Australia, Canada, Denmark, Ireland, Norway, New Zealand and the UK since 1995 and present the findings of an exploratory analysis linking cancer policy consistency to cancer survival.

Methods

We systematically searched and analysed national/regional cancer plans and strategies, mapping timelines of cancer policy evolution. For 10 jurisdictions, evidence was synthesised into five categories: oversight function; cancer plan; implementation plan; budget for plan implementation; and evaluation. We assigned scores evaluating whether a category was present or absent, and weighted scores for consistency. Summed scores were correlated with trends in survival from seven cancers between 1995-2014.

Results

All ten jurisdictions had implemented a high-level structure overseeing, steering or delivering cancer control policies (1995 - 2014); all had also published at least one major cancer plan. There was great variation in oversight mechanisms, ranging from institutionalising cancer control (New South Wales, Ontario) to cancer steering groups or taskforces (Denmark, Northern Ireland, Wales). Frequency and consistency of cancer plans also varied, from a succession of plans that build on each other (Denmark, New South Wales, Ontario) to the publication of isolated plans (New Zealand, Northern Ireland). We found a positive, albeit weak, correlation of cancer policy consistency and improvements in survival over time for six of the seven cancers.

Conclusions

Jurisdictions that have implemented consistent cancer control policies over time tended to be more successful in improving survival for a wide range of cancers. Our findings can help guide policymakers seeking approaches and frameworks to improve cancer services and, ultimately, cancer outcomes.

Key messages

• Sustained and consistent strategic cancer planning and investment are crucial for ensuring better patient outcomes, and this requires strong and sustained commitment at all levels.

• The findings can help guide policymakers seeking approaches and frameworks to improve cancer services and, ultimately, cancer outcomes.
Hospital hand hygiene after COVID-19: has the pandemic heightened healthcare workers’ awareness?
Authors: Zeduri M , Sgueglia AC , Vigezzi GP , Ferrara P , Lanave M , Galvi R , Abela S , Novelli V , Muzzi A , Odone A
Published: October 2022

Background

Hand hygiene (HH) is the leading measure for preventing the transmission of healthcare-associated infections (HAI), and a cornerstone to prevent COVID-19 spread. Aim of the research was the assessment of HCWs’ adherence to the application of WHO optimal practices, with the goal to promote a culture of safety and quality infection prevention and control (IPC) activities.

Methods

Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, implemented a HH monitoring plan in which HCWs’ adherence to HH procedures is evaluated using WHO guidelines, technical manual and observation form. Direct field observations took place in March and April 2022 by trained personnel. Process index was HH adherence, stratified by profession, opportunity and unit, which has been visited at least twice.

Results

Overall, 302 HCWs were observed from 18 hospital units (105 physicians, 108 nurses, 84 healthcare assistants and 5 students). Out of 1382 opportunities, global adherence was 52% with 190 handwashing and 598 hand rubbing. The indication with the highest adherence was “after body fluid exposure risk” (76%), whereas the lowest were “after touching the patient's setting” (40%) and “before touching a patient” (43%). Adherence was higher in specialistic surgeries and haematology units, while the worst performances were reported in general medicine ward (29%). Physicians’ and nurses’ adherence was respectively 45% and 61%. Audits occasionally revealed non-conformities in glove use (i.e., unnecessary use, not changed between patients, hand rubbing on gloves).

Conclusions

These preliminary findings could be directly linked to habits acquired during the pandemic, when HW tended to consider COVID-19 patients as a unique block to shield themselves from infections, rather than safeguarding individual patient units. HH awareness could have changed in the wake of COVID-19 pandemic and our study described how HCWs’ adherence to optimal practices needs specific initiatives to promote correct HH.

Key messages

• The COVID-19 pandemic reinforced the importance of handwashing and IPC, showing the key role of the HCWs’ adherence to hand hygiene (HH) procedures.

• HH audits play a leading part in clinical governance and IPC, aiming at enhancing the quality of care and patient safety, particularly to strengthen health system resilience in post-COVID era.
Essential Public Health Functions in Ireland: Perspectives to strengthen capacities and stewardship
Authors: McDarby G , Mustafa S , Zhang Y , Seifieldin R , Saikat S , Hendricks L , McNicholas T
Published: October 2022

Background

COVID-19 has caused unprecedented disruptions to health, social and economic systems in countries worldwide including Ireland. Weaknesses in Public Health capacities have undermined health system resilience compounding the effects of the pandemic. The Essential Public Health Functions (EPHFs) provide a comprehensive, cost-effective approach to operationalising public health and a means to build health systems resilience. As Ireland looks to recovery, the Department of Health engaged the World Health Organization (WHO) to undertake a mapping of the current state of delivery of EPHFs to identify opportunities for improvement and support wider health system strengthening towards resilience.

Methods

A strategic review of the delivery of EPHFs in Ireland was conducted with respect to policy, infrastructure, service provision and coordination and integration. Findings were reported in the context of international lessons identified through experience with COVID-19 and major health system challenges within the Irish context.

Results

There are significant capacities present within the Irish context to support the delivery of the EPHFs though they are limited in strategic cohesion, coordination and implementation. These include a high level of Public Health expertise, an agile and resourceful workforce, a strongly engaged community and significant evidence generation and synthesis capacities. Gaps recognised included ICT infrastructure and capacity, workforce resourcing and support, pandemic planning and public health governance, visibility, legislation, strategy and resourcing. COVID-19 has led to the development and strengthening of mechanisms to leverage a whole-of-government and -society approach to health that should be sustained to tackle ongoing and future stressors.

Conclusions

The use of the EPHFs within the Irish setting provides a comprehensive approach to strengthening capacities for public health and enhanced population health and wellbeing.
4.D. Workshop: The interaction of environmental impact and chronic diseases: from theory to practice
Authors:   Organised by: EUPHA-CHR, EUPHA-ENV,   Chair persons: Sarah Cuschieri (Malta), Marija Jevtic (EUPHA-ENV)
Published: October 2022

Both chronic diseases and environmental change are growing global public health challenges even amidst the ongoing Covid-19 pandemic. Every country is faced with these challenges, although small states and islands have an additional burden imposed on their sustainability, however this is rarely investigated. The intertwined relationship that exists between both epidemics is acknowledged, yet seldom explored or tackled together on a public health research level with bleak effect on policies outcome. People's lifestyles are a contributing factor to the progressive deterrent relationship between chronic diseases and environmental change. Indeed, many public health interventions promoting a healthier life will also produce the double benefit of tackling climate and the environment. For example, promoting more active transportation such as through the increase in bike lanes accessibility and incentives to promote active commuting will both reduce the dependency of carbon-based motor vehicle transportation, with a positive impact on the environment and climate, and on health. In fact, increase in physical activity is a well-known preventive and management action for most chronic diseases. Similarly, lower levels of pollution are also associated to decreases in many chronic diseases. Many other examples exist including the relationship between the food production, food security and carbon emissions. It is therefore imminent that urgent public health action is taken targeting the dominating urbanization and obesogenic environment that concomitantly have a role in the progressive development of chronic diseases and negative environmental impact. The aim of this workshop is to follow a multidisciplinary approach by bringing together different stakeholders to discuss the relationship between chronic diseases and the environment with a focus on small island states. While addressing the need to ensure that both public health and economic sustainability along with decelerating environmental change are on the imminent agenda. The workshop will be composed of four presenters discussing the various impacts on the environment from food production and security, sustainable dietetic models, the impact of city design on healthy living and finally the link between change in climate change and chronic diseases from a small state perspective. This will be followed by an engaging discussion between the presenters and the audience.

Key messages

• An intertwined relationship exists between environmental change (ranging from food security to city planning) and chronic diseases.

• A One Health approach and public health interventions are required to halt the dual epidemic.
The German national public health institute’s journey to becoming a Key Climate Actor: The Robert Koch Institute’s strategy development process
Authors: Taylor A
Published: October 2022

The Robert Koch Institute (RKI) is Germany's national public health institute. It has been working for a number of years on One Health topics such as zoonotic diseases and antimicrobial resistance, as well as wider areas relevant to climate change such as environmental health. Climate change has, however, only been a specific area of focus since 2019. This was signalled through the creation of a coordination role called One Health Climate Change (OHCC). In addition, a number of projects on climate change have been initiated independently of one another during this time across the RKI. Since summer 2021, RKI has been more active in its strategic development and set up a climate change and health working group of over 50 members of staff representing all departments. This offers a hub structure for pulling the relevant work and activities together under one umbrella, thereby promoting exchange, cooperation and cohesion across RKI. The RKI is currently at an early and dynamic phase in its journey as a key Climate Actor. It is developing a strategy on the topic, guided by the “IANPHI Roadmap for Action on Health and Climate Change” in order to further strengthen its contribution in this area. This presentation will share how RKI has developed its strategy and its action plan for implementation, as well as some of the successes and challenges in their development.

The presentation aims to:

• promote shared learning between national public health institutes on climate change and health strategy development;

• provide an opportunity for shaping future planning at RKI through audience input;

• stimulate thinking on how national public health institutes can remain in exchange with key stakeholder groups and open to learning and adaptation of their strategies in order to be effective Key Climate Actors over the long term.
Which disciplines form digital public health, and how do they relate to each other?
Authors: Pan C
Published: October 2022

A standard public health definition, coined by Acheson in 1998 and adapted by the World Health Organization, describes public health as ‘the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society’. Several other definitions emphasise different foci such as living conditions, the efficient use and equitable distribution of resources, or sustainability. Yet, they all share the dual nature as a science and practice of public health, its focus on the health of entire populations, and its interdisciplinary nature. In particular, joint efforts of individual disciplines are needed to combine subject matter knowledge and approaches to protect and promote population health. Traditional core public health disciplines comprise the social sciences, humanities, natural sciences, and environmental sciences. Their key tasks are summarised in the ten essential public health services, which can be further extended to digital public health. This extension leads to increasing use and integration of technological innovation and advancement into public health functions which require intensive collaborations with disciplines from the engineering field. In this presentation, we aim to describe the transition from public health to digital public health, emphasising the disciplines needed to tackle population health challenges in a digitalised world. In a first step, we will illustrate core disciplines and their sub-disciplines that are traditionally known in the public health field. In a second step, we will introduce further core and sub-disciplines prominent in digital public health. Finally, we will briefly present examples of key strengths and challenges of some of the disciplines. After this presentation, workshop participants should have a first understanding of the role and importance of interdisciplinarity in digital public health. Stefanie Do will host the table on epidemiology during the world coffee.
Tool-HLCA: An intervention to promote the health literacy of school-aged children
Authors: Schulenkorf T , Bauer U , Okan O
Published: October 2022

Background

In the age of ‘infodemic,’ children and young people encounter health-related information in digital environments at an early age. They should therefore learn how to deal with these in a health-competent way while still at school. Above all, it is relevant that they learn how to distinguish good health information from false. This can be achieved by promoting health literacy. The intervention “Toolbox” combines areas of media education in schools and health literacy to be implemented in schools and curricula in the long term.

Methods

The intervention was designed to address existing health topics in the classroom while strengthening digital health literacy in grades 7 to 10. The Toolbox was piloted in three school classes in Germany and the feedback provided by teachers and students was implemented in a new version of the intervention.

Results

The basic understanding of health literacy in the Toolbox is finding, understanding, evaluating and using digital health information. These steps are followed through using quality criteria for good health information. Students learn that they need to find out the type of information, analyze the author, investigate the media provider, and also the sources given. If they are unsure, they can conduct an adapted questionnaire regarding identify misinformation and disinformation. In addition, the students and teachers receive working materials for group work.

Conclusions

Recognizing disinformation is a relevant skill already for children and adolescents. The intervention should make it easier for students to recognize good health information. For teachers it should be made easier to address health literacy in school without additional effort.
Health Literate Schools: Organizational Health Literacy in the School Setting
Authors: Kirchhoff S , Okan O
Published: October 2022

Background

Fostering health literacy is considered an important objective within school-based strategies of health promotion. To effectively strengthen health literacy in the school setting the approach of organizational health literacy can be transferred to and implemented in schools. This approach combines behaviour-focused measures (providing individual learning opportunities) and environment-orientated measures (changing school's framework conditions). The HeLit-Schools project aims at developing a school-based concept of organizational health literacy and tools to support schools in becoming health-literate schools.

Methods

Existing concepts of organizational health literacy of other setting are analysed and adapted to the school setting. The concept development includes the expertise of actors from the school field, health literacy research and health sector. They contribute by commenting, reviewing and validating the conceptualization at different stages in the development process. A quantitative assessment of schools’ organizational health literacy is planned to further validate the concept. Furthermore, a screening of existing materials and programs for schools to use to foster health literacy is being conducted.

Results

The developed HeLit-Schools concept describes eight standards of a health-literate school. Every standard focuses on a specific area within the school's organization that can be addressed and changed in order to strengthen everyone's health literacy at school more effectively. To additionally support schools in fostering health literacy in school as well as in the classroom, a structured collection of existing (teaching) materials and programs was assembled.

Conclusions

Enhancing schools’ organizational health literacy and thus promoting school development by optimizing schools’ structures, processes and conditions in a health-literate matter can lead to an effective and sustainable strengthening of health literacy of every individual at school.
Introducing Maternal Oral Health As Global Health And Public Health Agenda
Authors: Lee H
Published: October 2022

Background

Achieving and maintaining good oral health during pregnancy is essential for both the oral and overall health of expecting mothers and their young children. Dental caries can negatively affect daily activities including eating, speaking, and social interaction, and when expecting mothers have active dental caries, the risk for dental caries in these children becomes higher. Another common oral disease, periodontitis, was found to be associated with systemic conditions, including cardiovascular disease, respiratory disease, diabetes, and potentially adverse birth outcomes.

Importance

Some studies also showed the systemic impact of periodontal disease and the related pathogens that can lead to systemic inflammation and adverse birth outcomes. A mother's oral health status, her oral health knowledge, and beliefs also have been shown to significantly affect diet and home oral hygiene practice among her children.

Problem

Despite the importance of mother's oral health and oral health knowledge to prevent dental caries in young children, maternal oral health is much neglected in primary and prenatal health discussion. This is even more significant in developing countries where oral health care infrastructure and workforce are inadequate. With increase in sugar consumption growing worldwide with this lack of oral health care infrastructure, oral diseases prevention and oral health promotion are the key to achieve oral health parity among the maternal and child population.

Solution

In this presentation, the author will discuss literature on maternal oral health and how to position oral health as an essential part of perinatal care along with WHO oral health initiative set for 2030. This is an introduction presentation for this workshop to set a stage and make a case why maternal oral health is a critical topic to discuss in global health and public health perspectives.
Oral Health Literacy In Young Migrant/Refugee Mothers From Developing Countries
Authors: Esimekara J , Lee H
Published: October 2022

Background and problems

In the last decade, migration has increased due to climatic, economic, and social factors. Oral health is an integral part of overall health, but primary health packets for migrants/refugees often neglect oral health education and care in the care delivery system. The present article aims to present a realistic approach to integrating oral health into existing structures for young migrant/refugee mothers on a community level in Switzerland.

Importance

As a young child's oral health is closely related to mother's oral health status and oral health knowledge level, it would be critical that migrant/refugee mothers have access to timely oral health education and care through the primary health care system.

Solution

We propose an integrated oral health care model for migrant/refugee mothers that maximizes the existing primary health care system. Using existing maternal oral health resources, a training module is developed for the primary care care workforce that serve migrant/refugee mothers. This training module includes oral health needs and status assessment and delivering preventive oral health services in primary care settings. The module includes drawings and images to describe the dangers of poor oral hygiene during pregnancy related to the health of mothers and babies and how to keep the mouth healthy with low-cariogenic diet practice and home oral hygiene care. Primary health care workforce in selected migrant health centers, like nurses, medical aides, and community health care workers, is trained by this module and evaluated by a set of self-assessed questionnaires before and after the training for knowledge improvement, attainment, and clinical practice changes. Migrant mothers participate in questionnaires on oral health hygiene practice and access to dental care during pregnancy and for their young children. The questionnaires are validated by the affiliated university-hospital clinical research center.
Risk factors for mental health disorders during the COVID-19 pandemic in Spain: A cohort study
Authors: Miranda-Mendizabal A , Piqueras J , Castellví P , Álvarez S , Díaz S , Gómez L , Recoder S , Sánchez N , García Durán E , Forero CG
Published: October 2022

Background

Data comparing the populations’ mental health from before, during and after the pandemic is needed. We aim to assess the risk factors for the first-onset and persistence of major depressive disorder (MDD) and suicidal thoughts and behaviours (STB) during the first year of the pandemic among the Spanish general population.

Methods

Cohort study through two online surveys from before the pandemic (N = 2,005, October/November 2019) and 12-months later (N = 1,357) on an adult Spanish, nationally representative, population-based sample. Multiple logistic regression models were used to assess the association between socio-demographic, COVID-19 related variables and healthcare received during the pandemic with the onset and persistence of MDD and STB.

Results

Women have more than 3-fold risk for the onset (OR 3.18; CI95% 1.40 -7.22) and persistence (OR 8.62; CI95% 1.74-42.48) of MDD. Studying and working at the same time (OR 10.13; CI95% 2.17-47.35) and having close relatives/friends with COVID-19 infection (OR 14.84; CI95% 1.91-115.18) or death (OR 5.26; CI95% 1.56-17.73) due to COVID-19 are risk factors for MDD onset. Sick-leave (OR 17.19; CI95% 2.65-112.56) and unemployment (OR 7.01; CI95% 1.85-26.43) increased the risk for MDD persistence. Death of friends/colleagues due to COVID-19 (OR 8.40; CI95% 1.47-48.07) increased the risk for STB onset, and being on sick-leave (OR 7.91; CI95% 1.80-34.66) for STB persistence.

Conclusions

During the COVID-19 pandemic, women were consistently more at risk of having worse mental health than men. Direct and indirect consequences caused or aggravated by the pandemic are common risk factors for the increased risk for the onset and persistence of both MDD and STB. Identification of high-risk subgroups and risk factors for MDD and STB among the Spanish general population will allow the developing and implementing of evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health.

Key messages

• The pandemic consequences, whether due to having had COVID-19, having close people affected or who have died from the infection and the social consequences increase the risk for worse mental health.

• Evidence-driven strategies for reducing the long-term impact of the pandemic in populations’ mental health should be a public health priority.
Co-creation of activities to promote health and well-being of older people – a scoping review
Authors: Terkelsen AS , Wester CT , Gulis G , Jespersen J , Andersen PT
Published: October 2022

Background

The global population is ageing and the need to promote health and well-being of this generation is essential. Co-creative practices can be solutions to welfare challenges in the health care sector and local policies. However, literature addressing co-creation of activities to promote health and well-being is sparse. The review aimed to identify health promotive activities co-created between the public and older people, the influence of co-creative activities on health and well-being of older people, and facilitators and barriers for doing co-creation.

Methods

We searched for peer-reviewed and grey literature in eight scientific and five non-scientific databases. Two reviewers independently screened publications for eligibility according to inclusion and exclusion criteria and extracted data. An inductive thematic content analysis was applied for the analysis.

Results

We included nineteen publications. Four themes related to co-creative activities emerged: “Social activities”, “Activities to create age-friendly environments”, “Discussions of healthy ageing”, and “Physical activities”. The co-creative activities influenced the overall well-being, and promoted active and healthy ageing, physical functioning, and quality of life. Identified facilitators for co-creation were the role of the facilitator, a supportive environment, recognition of competencies, while the main barriers were time and resources, and recruitment of participants.

Conclusions

Few studies have investigated co-creation of activities to promote health and well-being of older people. The included studies dealt with activities in any form and not merely social and physical activities co-created. Future co-creation of activities with older people should consider the role of facilitators, the environment in which the co-creation takes place and value time, resources, and competencies of participants.

Key messages

• Studies on co-creation of activities to promote health and well-being of older people is sparse and must be explored further.

• Future research may focus on co-creation of social and physical activities to promote health and well-being of older people and consider known facilitators for co-creation.
Why be a part of the European Public Health Week?
Authors: Guichardon M , Schuffelen A
Published: October 2022

What is the European Public Health Week? What's it's impact and why do you want to be part of it?
How to involve the younger generation in the European Public Health Week?
Authors: Brînzac M
Published: October 2022

This presentation will tell you about the involvement of the next generation: young public health professionals in the European Public Health Week.
Examining existing strategies to prevent multimorbidity – a scoping review
Authors: Nicholson K , Makovski T , van den Akker M , Stranges S
Published: October 2022

Multimorbidity has been acknowledged as the “defining challenge” for health systems around the world, but current research and policy are primarily focused on the management of multimorbidity after it occurs or the prevention of adverse events in those individuals who are already living with multimorbidity. There is still a significant need to develop and establish effective and equitable primary prevention strategies in order to avoid the occurrence of multimorbidity across populations. This scoping review aims to identify existing strategies, programs and policies that are focused on the prevention of multimorbidity across various settings and countries around the world. To identify relevant publications, two databases will be searched: PubMed and Embase. The search strategies will be adjusted for each database and will include variations of the keywords multimorbidity, prevention and strategy. This review will specifically include publications that are original research, focused on multimorbidity and published in English. However, there will be no restrictions on the location of the research or the age of the target sample or population. For the full text screening phase, more specific criteria will apply and information will be extracted from the final set of retained studies. This information will be summarized and will include key factors such as study design, study setting, type of prevention programs, scope of programs (e.g. national, regional, local, etc.) and target population (e.g. age groups, socioeconomic groups, etc.). This scoping review will describe existing prevention programs and highlight areas of gaps and opportunities in the prevention of multimorbidity.
Multimorbidity in Large Canadian Urban Centres
Authors: Wilk P , Stranges S , Bellocco R , Bohn T , Samouda H , Nicholson K , Makovski TT , Maltby A
Published: October 2022

Introduction

Although health outcomes are related to the characteristics of the geographic areas in which people live, there is limited knowledge on how the prevalence of multimorbidity varies within and across major Canadian urban centres. Our goal was to assess the level of between-neighbourhood variation in the prevalence of multimorbidity in Canada's large urban centres, controlling for compositional effects associated with demographic and socioeconomic factors.

Methods

Cross-sectional data from the 2015-2018 cycles of the Canadian Community Health Survey (CCHS) were used. Respondents (20 years and older) residing in one of the 35 census metropolitan areas (CMAs) were included (N = 100,803). Census tracts (CTs), relatively small and stable geographic areas nested within CMAs, were used as a measure of neighbourhood. To assess the between-neighbourhood differences in multimorbidity prevalence, we fitted sequential random intercept logistic regression models.

Results

During the 2015-2018 period, 8.1% of residents of large urban centres in Canada had multimorbidity. The results from the unadjusted model indicate that 13.4% of the total variance in multimorbidity could be attributed to the between-neighbourhood differences. After adjustment for overall characteristics of the CMAs in which these neighbourhoods are located, as well as for individual-level demographic and socioeconomic factors related to compositional effects, 11.0% of the individual variance in multimorbidity could still be attributed to the between-neighbourhood differences.

Discussion and Conclusions

There is significant and substantial geographic variation in multimorbidity prevalence across neighbourhoods in Canada's large urban centres. Residing in some neighbourhoods could be associated with increased odds of having multimorbidity, even after accounting for overall characteristics of the CMAs in which these neighbourhoods are located, as well as individual-level factors.
A Holistic Approach to Urban and Children’s Mental Health
Authors: Van Den Hazel P , Ristovska G , Sandionigi A , Weber M , Benz S
Published: October 2022

Background

EU data show that there is a continuous increase in mental health problems in children. The multiple exposures in the physical and social domain influence the internal exposome and the final health outcomes. The Equal-Life project research focuses on the exposome (physical, social and internal) and mental health of children and adolescents.

Methods

Literature reviews on children's mental health and a total of physical and social exposures from 9 different European cohorts are used to set a framework of data interpretation. In addition, information gathered from 3 surveys/65 interviews with stakeholders from different fields was used to look for a transdisciplinary framework for analysis of the cohort data. The approach develops (in a co-design approach) tools that help stakeholders to collect and organize the information necessary to make decisions. The exposome is as if it were a multilayer system and requires approaches that are able to manage the interconnections between the various variables involved in the field of children's mental health.

Results

The main points extracted are an early life exposure to urban planning related factors (noise/air pollution, traffic), social factors (family relations, stress), biomarkers related to environmental and social exposures. Concerning the life course approach, vulnerable settings were identified such as schools, neighbourhoods, accessibility to green restorative spaces. These ingredients are the basis of interaction between scientists and community stakeholders and from the policy domains to find and interpret the scientific results for the implementation of protective and promotive policies in cities.

Conclusions

Transdisciplinary approach is necessary for management and developing strategies for solving mental health problems in urban spaces when considering all kind of exposures. The development of tools through co-design sessions with different stakeholders gives important contributions for this goal.

Key messages

• Development of interventions and policies for better mental health of children and adolescents should be based on available evidence for meaning of external and social exposome.

• The main outcome of Equal-Life is to develop tools where stakeholders have access and opportunity to use it for solving mental health issues at national or local level.
Air pollution is associated with the risk of neurodegenerative disorders: a prominent role of PM10
Authors: Gialluisi A , Costanzo S , Veronesi G , Zazzaro G , Cembalo A , Ferrario MM , Gianfagna F , Massari S , Iacoviello L
Published: October 2022

Background

Studies revealed an implication of air pollution in neurodegenerative disorders, although this link remains unclear. Here, we investigated this testing multiple pollutants simultaneously.

Methods

In the Moli-sani cohort (N = 24,325; ≥35 years; 51.9% women, baseline 2005-2010), we estimated yearly levels of exposure to nitrogen oxides (NOX, NO, NO2), ozone (O3), particulate matter (PM10) and BTX hydrocarbons (benzene, toluene and xylene) in 2006-2018, applying residence geo-localization of participants and Kriging interpolation algorithm to land measurements of air pollutants. We performed a principal component analysis and tested association of the resulting principal components (PCs) with the incident risk of Parkinson (PD) and Alzheimer disease (AD), through multivariable Cox PH regressions adjusted for age, sex and education level completed.

Results

Over 24,308 subjects with pollution data available (51.9% women, 55.8(12.0) years), we extracted three PCs explaining ≥5% of pollution exposure variance: PC1 (38.2%, tagging PM10 exposure), PC2 (19.5%, O3/CO/SO2), PC3 (8.5%, NOx/BTX hydrocarbons). Over a mean follow-up of 10.9(2.1) years, we observed statistically significant associations of PC1 with an increased risk of PD (HR[CI] = 1.04[1.02-1.05]; 405 incident cases) and AD (1.06[1.04-1.08]; 218 cases). These associations were confirmed when we analyzed PM10 levels averaged over follow-up time, in models further adjusted for professional exposures like working class, compartment and toxic compounds and lifestyles like smoking and drinking habits, physical activity and adherence to Mediterranean diet (PD: 1.27 [1.19-1.37]; AD: 1.22[1.16-1.28] per 1 μg/m3 increase of PM10).

Conclusions

This evidence supports an influence of air pollution - especially PM10 - on increased neurodegenerative risk in the Italian population, independent on concurring risk factors. This suggests reducing PM10 pollution as a potential strategy to reduce neurodegenerative risk.

Key messages

• PM10 levels are associated with increased Parkinson and Alzheimer disease risk.

• This suggests to act on air pollution to reduce neurodegenerative risk in the general population.
Associations between area- and individual-level community belonging and self-rated health
Authors: Mah S , Brown M , Colley R , Rosella R , Sanmartin C , Schellenberg G
Published: October 2022

Background

Previous studies point to the importance of individuals’ sense of community belonging to multiple measures of health and well-being. However, the extent to which collective sense of belonging within neighbourhoods might influence individual health has not been characterized. The objectives of this study are to describe variations in self-rated health by a novel area-level measure of community belonging and determine the impact of including these measures in models of individual-level community belonging and self-rated health.

Methods

We conducted a cross-sectional study of respondents of the 2020 Canadian Community Health Survey (CCHS) living in census tracts. These data were merged with novel small area estimates of community belonging derived by Statistics Canada from the CCHS 2016-2019. Multinomial logistic regression models were used to analyse associations of individual- and area-level community belonging, and self-rated health. We adjusted for sex, age, recent immigrant status, visible minority status, province, marital status, presence of children in the household, smoking status, presence of chronic conditions, income, and employment status. All results were generated using survey weights and bootstraps representing a subpopulation of 21 million people.

Results

A greater proportion of CCHS respondents living in neighbourhoods with the strongest collective sense of community belonging reported being in good, very good, or excellent health. Models indicate that living in a neighbourhood with low collective sense of community belonging is associated with higher odds of reporting being in poor or fair health (OR = 1.44, 95% CI 1.15-1.81) even after adjusting for other factors, including individual-level sense of community belonging, which also remained independently associated with self-rated health.

Conclusions

Both area- and individual-level sense of community belonging are independently associated with self-rated health.

Key messages

• The collective sense of belonging within neighbourhoods may influence health outcomes.

• Measures of area-level and individual-level community belonging may capture different aspects of social connections with respect to health.
Evaluation of an e-learning on involving significant others in occupational health care
Authors: Snippen NC , de Vries HJ , Hagedoorn M , Brouwer S
Published: October 2022

Background

Significant others (SOs) like partners, family members or friends can play an important role in how workers cope with chronic disease, thereby influencing work and health outcomes. Despite the potential benefits of involving SOs in the return-to-work (RTW) process of workers with chronic diseases, guidance and training on how to manage this is scarce. Educating work and health professionals on this topic could lead to better RTW support for workers and prevention of long-term sickness absence.

Objectives

This study aimed to determine the effectiveness of an e-learning for improving occupational health physicians’ (OHPs) knowledge, attitudes, and self-efficacy regarding involving SOs in the RTW process. In addition, we explored OHPs’ responses to and satisfaction with the e-learning. We conducted a randomized controlled trial with 87 OHPs, involving an intervention group and a waitlisted control group. Between-group differences in knowledge, attitude, self-efficacy outcomes, and retention of effects were assessed using ANOVA and paired t-tests. Reactions to the e-learning were analyzed with descriptive statistics and thematic analysis.

Results

We found moderate to large effects on OHPs’ knowledge (p <.001, ηp2 = .202), attitudes (ηp2 = .098), and self-efficacy (p < .001, ηp2 = .237), with retention of all changes at 10-week follow-up. OHPs graded the e-learning with a mean score of 7.9 out of 10 (SD = 1.11) and indicated that the e-learning increased their awareness of the role of SOs in RTW and encouraged them to address this more often.

Conclusions

The developed e-learning is the first evidence-based training to improve the knowledge, attitudes, and self-efficacy of OHPs with regard to involving SOs in the RTW process of workers with chronic diseases. The e-learning and accompanying materials can encourage work and health professionals to more often address the role of significant others in the work re-integration process.

Key messages

• The developed e-learning is effective in increasing occupational health physicians’ knowledge, attitudes and self-efficacy with regard to involving significant others in the return-to-work process.

• The e-learning and accompanying materials can encourage professionals to more often address the role of significant others in the work re-integration process to prevent long-term sickness absence.