bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between school engagement and mental well-being among Finnish parent-child dyads
Authors: Tuomela S K , Nordmyr J , Söderberg P , Forsman A K
Published: October 2024

Background

To understand how individual differences in mental well-being emerge for children and adolescents, it is important to understand the amenable factors in the context in which the development takes place - that is, for children, primarily in the family and in school. There is a notable gap in the research exploring the positive impacts of school factors on parent-child dyads and their mental well-being, and if there are any associations between school engagement and the mental well-being of parents and their children.

Methods

Data from 307 parent-child dyads were included in the study, the data stemming from a Finnish l research project (CONSENSUS) encompassing longitudinal survey data collection among both children in grades 4-6 and their parents. By exploring bivariate correlations and using the Actor-Partner Interdependence Model (APIM), the present study aims to investigate actor and partner effects of school engagement and mental well-being among parents and their child in grade 4-6.

Results

Preliminary results show that there are statistically significant correlations between parents’ and their children’s mental well-being, but that there are no significant correlations between children’s school engagement and parental school engagement. Further, statistically significant actor effects emerge between children’s school engagement and mental well-being, and between parental school engagement and mental well-being.

Conclusions

By clarifying the interaction between school engagement and mental well-being in parent-child dyads, this study not only contributes to the theoretical understanding of these constructs but also offers insights that can inform future development of mental well-being promotion interventions aimed at families and educational settings in Finland and elsewhere.

Key messages

• This study offers an innovative exploration of the links between mental well-being and school engagement among 274 Finnish parent-child dyads.

• Results show various interactions between school engagement and mental well-being among the parent-child dyads, with implications for interventions intended to support well-being in families.
Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study
Authors: Silva C , Abecasis A
Published: October 2024

Background

According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa.

Methods

We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns.

Results

802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition.

Conclusions

An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved.

Key messages

• Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions.

• Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.
Integration of Whole genome sequencing in pediatric healthcare: an Italian HTA
Authors: Nurchis M , Heidar Alizadeh A , Raspolini G M , Damiani G
Published: October 2024

Diagnosing pediatric rare diseases poses challenges due to ambiguous symptoms and genetic complexities. Next-generation sequencing (NGS) technologies, like Whole exome sequencing (WES) and Whole genome sequencing (WGS), offer faster and more accurate diagnoses, enhancing clinical utility. However, WGS implementation faces hurdles including complexity and socio-economic impacts. This Health Technology Assessment (HTA) aims to evaluate the integration of WGS, compared to WES, into the Italian NHS for pediatric genetic disorder diagnosis, considering diverse stakeholders and value generation. The EUnetHTA Core Model 3.0 was the primary framework for evaluations. Various methodologies, such as narrative, scoping, and systematic reviews, meta-analysis, GRADE assessment were employed to assess existing evidence. Bayesian cost-effectiveness analyses were adopted for the economic aspects. Summative thematic analysis was used to evaluate organizational aspects of implementing WGS. In respect to non-clinical domains, organizational differences between WES and WGS implementation were seen in respect to procedural steps (i.e., genome rearrangement analysis, data storage) albeit both reduce the need for additional tests. WGS is cost-effective, with Bayesian analysis revealing incremental cost per additional diagnosis lower than the threshold. Ethically, WGS benefits outweigh risks, but comprehensive genetic counseling should address concerns like unsolicited findings and misattributed parentage. Timely genetic diagnosis through genomic technologies may shorten the diagnostic odyssey ensuring brighter futures for children and advancing health care equity. Nevertheless, the implementation of genomic knowledge in clinical practice brings organizational, economic, and ethical issues urging critical reflection in HTA evaluations and a multi-stakeholders involvement.

Speakers/Panelists

Gianfranco Damiani

Università Cattolica del Sacro Cuore, Rome, Italy

Els Maeckelberghe

University Medical Center Groningen, Groningen, Netherlands

João Vasco Santos

University of Porto, CINTESIS, ARS Norte, Porto, Portugal

Sandra García Armesto

Agència de Qualitat i Avaluació Sanitàries de Catalunya, AQuAS, Barcelona, Spain
Wellbeing, career satisfaction, and educational requirements in healthcare assistants in Ireland
Authors: Jalili P , Conyard K F , Wall P , Gormley E , Codd M B
Published: October 2024

Background

The long-term residential care (LTRC) sector in Ireland relies heavily on Health Care Assistants and Carers (HCAs). This workforce has become increasingly diverse in recent years, often relying on non-national temporary workers with varying levels of education. In 2022, of 22,495 HCAs and 5,289 Healthcare Support Assistants working in 563 nursing homes caring for some 30,000 residents, 22% were non-national. Their plight became evident during COVID-19 which had profound consequences in the LTRC sector.

Objectives

In this study, we investigate the recruitment, training, employment terms and conditions of HCAs in Ireland, as well as their general well-being and career satisfaction.

Methods

A cross-sectional study of members of ‘Care Assistance Ireland’, for which ethics approval was granted for an estimated sample of 1,052, is conducted. Validated instruments used are: the Maastricht Instrument for Sustainable Employability (MAISE); Utrecht Work Engagement Scale (UWES); General Wellbeing Schedule (GWBS) and Minnesota Career Satisfaction Survey (MCSS).

Results

The internal consistency reliability (Cronbach’s alpha) of GWBS and MCSS instruments were high. The response rate in the selected sample is estimated circa 60%, the majority being female and qualified. General well-being status will be investigated once all responses are submitted. Spearman correlation is predicated to show moderate to strong positive correlations (0.2-0.9) for all GWBS and MCSS questionnaires questions. While MAISE and UWES are still under investigation. It is predicted that there is variability in the requirements for, and terms and conditions of, employment among HCAs in Ireland, while job security remains a concern.

Conclusions

These findings reinforce the importance of ensuring standards for recruitment, training, job security and well-being for the LRTC workforce. The lack of educational requirements for HCAs in some settings is a critical consideration.

Key messages

• Findings will impel a more agreeable, consistent entry award in the healthcare system.

• It profiles career needs of HCAs outlining the long-term shortfalls preventable with health policy enactments.
From the first European Climate Risk Assessment to action in policy and practice
Authors: Kazmierczak A
Published: October 2024

The first European Climate Risk Assessment (EUCRA), produced by the European Environment Agency in March 2024, engaging nearly 100 authors across Europe, highlights health among the most at-risk sectors. According to the structured risk assessment that was conducted to support the transparent identification of priorities for policy action, more and urgent action is needed to reduce health risks from heat indoors and outdoors; from wildfires and outbreaks of vector- and water-borne diseases. The responsibility for managing risks lies both with the EU and Member States, and the policy readiness varies depending on the risk. The European Climate and Health Observatory, set up to better understand, anticipate and prevent climate risks to human health in Europe, in the most recent report ‘Responding to climate change impacts on human health in Europe: focus on floods, droughts and water quality’ provides in-depth analyses of some climate-related risks to health and presents examples of responses to them in both policy and practice. Both assessments emphasise that without fast and systemic action to increase societal resilience, the health impacts of the changing climate will worsen, affecting already disadvantaged or vulnerable groups the most. Health and health-determining sectors have the opportunity to address the health impacts of climate change by, among others, increasing the climate resilience of health systems; developing, updating and implementing national health adaptation plans; and supporting the education and training of public health and healthcare professionals on climate change threats. At the same time, addressing health impacts from climate extremes requires responses across sectors, actors and spatial scales.
The European Mobile Laboratory: key insights from a decade of outbreak response
Authors: Nelson E , Duraffour S
Published: October 2024

EMLab has responded to emergencies including the West Africa Ebola virus outbreak (2014-2016), the COVID-19 pandemic, and outbreaks of yellow fever, Marburg virus, and Lassa fever. It has deployed mobile labs and experts to many countries, including Guinea, Liberia, Sierra Leone, Nigeria, Uganda, the Democratic Republic of the Congo, Germany, and Greece. With accumulated experience from each deployment, EMLab’s diagnostic expertise has evolved beyond RT-PCR and serological testing to include basic point-of-care tests, haematology, and genomic surveillance capacities, also focusing on interoperability with other response capacities such as EMTs. Critical to mission success, the organization works closely with the WHO and GOARN, and was certified in 2023 as an official German response capacity within the European Civil Protection Pool. The two-year continuous deployment from 2014-2016 was pivotal in shaping EMLab’s evolution, also leading to significant capacity-building efforts in West Africa. In Guinea, for example, a surveillance network of three diagnostic laboratories has been established and successfully detected cases of viral haemorrhagic fevers, including the re-emergence of Ebola virus and the first reported case of Marburg virus in Guinea in 2021. Ultimately, EMLab’s extensive experience demonstrates that effective public health emergency response requires constant evolution, strategic partnerships, and a commitment to building local capacities, paving the way for a more resilient and prepared global health community.
‘Health in all policies”: effect on health outcomes and collaboration among welfare actors
Authors: Villegas-Gomez T M , Sundewall J
Published: October 2024

Background

The ‘Health in All Policies’ (HiAP) approach, introduced in 2006, recognises the impact of policy decisions and actions on population health. It prioritises health and well-being as a core objective of all public policymaking, ensuring that policies promote health equity and social justice. Implementing HiAP requires collaboration among diverse welfare actors beyond healthcare. Thus, reviewing evidence of the effects of HiAP on collaboration among welfare actors and health outcomes is crucial for informing policy and practice intersectoral collaboration to improve population health outcomes. This study addresses the question: What is the existing evidence of the effects of HiAP on better collaboration among welfare actors and improved health outcomes from 2006 to 2023? We conduct a scoping review on peer-reviewed articles following the Joanna Briggs Institute reviewer’s manual, the five-stage framework outlined by Arksey and O’Malley, and adhering to the PRISMA extension for scoping reviews for reporting.

Preliminary results

472 research articles and 68 other documents published from 2006 to 2023 were identified, mainly from Europe and North America. 90% of the reviewed studies focused on collaboration among welfare actors, while 10% examined the effect of HiAP on improved health outcomes. Themes identified in the studies on collaboration among welfare actors include funding, intersectoral partnerships, shared vision, local and national settings, identity and responsibilities, accountability, dedicated staff, Health Impact Assessment, and indicators.

Conclusions

Despite being widely referred to as an effective approach in health policy, there is limited evidence of the effects of HiAP on health outcomes. However, some evidence supports that HiAP contributes to enhanced collaboration among welfare actors, potentially leading to better health outcomes. More evidence is needed that specifically investigates the effects of the HiAP approach on health outcomes.

Key messages

• Most evidence suggests that HiAP has a positive impact on collaboration among welfare actors; however, evidence of its effects on health outcomes is limited.

• Further research that specifically explores the effects of the HiAP approach on improved health outcomes is crucial for informing policy and promoting intersectoral collaboration.
Adolescents witnessing family violence and its association with socio-economic factors
Authors: Tiikkaja S , Tindberg Y , Durbeej N
Published: October 2024

Background

About 200 000 children in Sweden live in families where violence among adults occurs. About 10% of children have witnessed violence family violence Family violence is often more prevalent in low social status families. The present study describes adolescents that have witnessed threats of violence, abusive words or physical/sexual violence in their families, as well as the association between these types of violence and socio-economic factors.

Methods

Data from a school-based survey, in the County of Sörmland (2023), including 15-18-years-old students in 2023 were used. Witnessing family violence was measured by the following item “Have you experienced that an adult in your family has... 1) threatened to use violence against someone else in your family? 2) used abusive words, oppression, or been dominant or controlling against someone else in your family? 3) used physical violence against someone else in your family, such as hitting, pushing, kicking, or sexual violence”. Parental work status, the child’s living conditions and economic stress were used as socio-economic factors. Data were analysed by descriptive methods and logistic regressions.

Results

This study included 3 407 adolescents among which 19% had witnessed any type of family violence. The most prevalent type was witnessing abusive words, (17%), followed by physical/sexual violence (10%) and threats to use violence (9%). Witnessing any type of family violence was associated with all socio-economic variables in univariate analyses, the strongest association was found for having economic stress (OR = 3.30; 95% CI 2.72-4.01), in comparison to not having economic stress. Further adjustments for gender, grade, ethnicity, parental work status and living with both parents attenuated the association, OR = 2.50 (95% CI 2.03-2.07).

Conclusions

Two of ten adolescents have witnessed any type of family violence. These adolescents often belonged to families with low socioeconomic status making them vulnerable.

Key messages

• In this school-based study, 19 % of adolescents had witnessed any type family violence. Having witnessed abusive words was the most prevalent type of family violence.

• There is as strong association between witnessing family violence hand having economic stress among adolescents. These adolescents need to be noticed in their particularly vulnerable situation.
Social Cost Benefit Analysis – a powerful tool for decision making
Authors: De Wit A , Over E
Published: October 2024

Health Impact Assessment provides policy makers with important information about health effects of programs, policies, plans or projects (PPPP). However, PPPP may have many more effects, both positive and negative, direct and indirect, intended and unintended, immediate and in the far future. Ex-ante insights in all these effects may help policy makers to optimize decision-making, but also to communicate realistically to all stakeholders about the PPPP. Weighing effects that may be very different in scale and reach different stakeholders in different ways is inevitable. One powerful tool to help decision makers in this task is Social Cost Benefit Analysis (SCBA). SCBA requires to specify and quantify all effects of PPPP over a specified time horizon. It is also necessary to specify a base-case scenario, i.e. how the problem under study would develop without further investments in PPPP. All effects of PPPP need to be quantified in monetary terms, these can be financial, e.g. healthcare costs or costs of productivity losses, or non-financial, for instance by placing a value of €50,000 on a QALY gained or a DALY averted or a value of €3,5 million on a lost life. PPPP with positive net monetary value are considered welfare enhancing, while PPPP with a negative monetary value do not add to welfare in society. In the Netherlands, government asks any bigger PPPP to be quantified with SCBA methodology. Guidance on unit values for non-monetary effects is given. This contribution will elaborate on results of the SCBA method for different alcohol policy measures, such as increase in excise taxes, minimum unit pricing, closure of vending spots and a total marketing ban. SCBA is a powerful tool to inform policy makers and assist in their decision making processes. It is also a labour and data intensive process that should only be used for larger PPPP investments and not for local decision making.
Stakeholder involvement in the development of a serious game for and with healthcare professionals
Authors: de Ruijter D , van de Goor I , Assendelft P , Kremers S
Published: October 2024

Increasing pressure on the quality, accessibility and affordability of Dutch health services underlines the need for integrated approaches to healthcare that include lifestyle as preventive measure. Integrated healthcare requires coordinated collaboration between healthcare providers, which is facilitated by the concept of Positive Health as a unifying language. To support primary care providers (PCP) in developing knowledge and skills related to lifestyle as prevention, interdisciplinary collaboration and the concept of Positive Health, we are developing education in the form of a serious game: Game2Connect. Co-creation by active involvement of a consortium of educational institutes, healthcare organisations, a game developer, and PCP as end-users of Game2Connect plays a key role in its development. Data from interviews with PCP (on barriers and facilitators for health-promoting and collaborative behaviours), healthcare recipients (on input for case studies) and consortium meetings were incorporated into an initial version of Game2Connect, which is currently being piloted to assess and improve its utility and usability. Pilot sessions included an observed playthrough, followed by a usability questionnaire and a semi-structured group discussion. So far, 2 pilot sessions were held with consortium members (n = 16), and 3 sessions were held with PCP (n = 22). Learning indicators (e.g. PCP clarifying fellow players’ misconceptions) were observed in all sessions. Usability scores indicate high levels of challenge, content relevance, and positive affect, ranging between 3.3-3.6 on a 4-point scale. Qualitative feedback from group discussions resulted in the development of new case studies to appeal to a broader range of PCP, and the adjustment of a goal-setting exercise as a game component to encourage its use. These results suggest that serious gaming may be a viable and engaging method to educate PCP, especially when developed in active collaboration with stakeholders.
8.F. Scientific session: Promoting Public Health with healthy smart buildings
Authors:   Organised by: EUPHA-URB, -PMH, -ENV,   Chair persons: Jutta Lindert (EUPHA-PMH), Stefano Capolongo (EUPHA-URB)
Published: October 2024

The Workshop titled “Promoting Public Health with healthy smart buildings” - proposed and developed by the three EUPHA Section: Urban Public Health (URB), Public Mental Health (MEN) and Environmental Health (ENV) - is aimed to foster the dialogue between designers (architects and urban planners), Public Health experts (operators, professionals and epidemiologists), policy/decision makers and buildings’ users, to establish a multidisciplinary approach for understanding together how to create and manage healthy living indoor environments (both housing and complex constructions/public buildings). According to the main Conference topic “Sailing the waves of European public health: exploring a sea of innovation”, the workshop mainly addresses both the “Climate emergency/Environment and health/Urban health” and the “Mental health” EPH24 conference topics. The workshop purpose is to explore the effects of the housing conditions, according to “umbrella” exposure of the quality of the buildings, stressing topics like emissions, qualities, functional features, accessibility, supportive, Indoor Environmental Quality, Indoor Air Quality, and health implications on users’ well-being. In fact, time spent at home and in the indoor environment increased due to the COVID-19 experience, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. The workshop program includes inputs which they argue current experiences, emerging practices and scientific outcomes related to the healthy Buildings, coming from four different European countries. From Sustainable Development Goals, in “Healthy air for healthy minds”, to Indoor Environmental Quality implications, in “How to promote health in indoor living and working spaces: quali-quantitative analysis to evaluate the indoor air quality through users’ perception and low-cost sensors”. From experience-based works related to specific functions, in “Leveraging digital platforms to improve Public Health in hospital smart buildings”, to other specific public buildings’ experiences, in “Novi Sad cultural stations as healthy buildings for wellbeing concept”.

Key messages

• explore the relationship between housing conditions, Indoor Environmental Quality, and the implications on users’ well-being, like “umbrella” exposure of the quality of the buildings.

• establish a multidisciplinary approach for understanding together how to create and manage healthy living indoor environments, at private and public scale.
How to promote health in indoor living and working spaces: quali-quantitative analysis to evaluate the indoor air quality through users’ perception and low-cost sensors
Authors: Gola M , Laghezza A , Yu Y , Settimo G , Capolongo S
Published: October 2024

It is well-known that humans spend most of their time in indoor spaces: what it is sometimes underestimated; however, is how much the space in which someone is can affect their abilities, feelings and even their mental and physical health. A team developed a methodology to allow the collection of useful data and giving rise to management strategies for guaranteeing healthy spaces, in terms of Indoor Environmental Quality (IEQ). In particular, the methodology is based on a quali-quantitative analysis of Indoor Air Quality (IAQ) supported by a questionnaire on users’ perception and well-being, based on a scoping review, and low-cost sensors for IAQ monitoring air contaminants (carbon dioxide, temperature, relative humidity, volatile organic compounds, etc.). In particular, for the quantitative analysis, the team adopted a method that considers the location of the sensors in different typology of settings with various solar exposures, ventilation systems, human occupancy, type of activity, etc. with the scope of testing the trends in different seasons. As well as the qualitative data collect several information about the users’ perceived comfort and the symptoms (headache, fatigue, etc.) during their stay. The data analysis highlights how the different users’ perceptions affect the conditions of the environmental units, in particular in crowded rooms (4-6 people). Adequate lifestyles, such as door and window-openings, regular air-changes, etc. can highly affect the performances and the productivity, as well as the quality of the spaces. In that sense the use of low-cost sensors with light signals can be helpful as strategy for informing the user of the state of the air and any actions to be implemented. In conclusion, starting from the methodology, the team gives rise to a decalogue of strategies and good habits that permits -through the support of low-cost sensors - to inform the users on how to guarantee healthy living and working spaces.
England RCT of air filtration to prevent respiratory infections (including covid-19) in care homes
Authors: Hay A D , Brierley R C , Turner N , Thorn J , Rees S , Taylor J , Welsh T , Henderson E , Sprackman J , Kipping R
Published: October 2024

Context

There is evidence that portable high-efficiency-particulate-air (HEPA) filtration units remove microbial particles from the air, but it is unclear whether this is sufficient to reduce infections in care home residents.

Objectives

To investigate the effectiveness of portable HEPA filtration units for winter respiratory infection episode reduction in care home residents. Study design and analysis: Cluster controlled trial with intention-to-treat analysis. Setting: 90 residential care homes for older adults in England. Population: Residents expected to reside in the care home for ≥1 month. Intervention care homes: Five HEPA filtration units in communal rooms and one HEPA filtration unit in 10 to 16 bedrooms. Control care homes: Usual care. Outcome measures: The primary outcome is the number of symptomatic winter respiratory infection episodes recorded by care home staff. Secondary outcomes: other infection measures; falls /near falls; laboratory confirmed infections; hospitalisations; and staff sickness. Process evaluation to assess intervention acceptability and implementation.

Results

Care homes were randomised between January 2022 and February 2024, 43 to intervention and 47 to usual care. Respectively, in intervention and control group care homes: 43% and 45% provided nursing care; 87% and 87% dementia care; and median (IQR) number of communal rooms were 4 (3-5) in both groups. 1126 residents were consented, of whom 31 (3%) moved away; 151 (13%) died; and 5 stopped participating. Primary outcome data is 98% complete with 175,318 'resident days' symptom data collected. Comparing intervention and control group residents: median (IQR) age was 88 (81-92) and 88 (82-92) years; 33% and 43% were receiving nursing care; 58% and 57% had dementia; frailty scores were 6 (4-7) and 6 (5-7); 94% and 94% received influenza; and 97% and 95% COVID vaccines.

Conclusions

Final analytic results of this world-first RCT will be available for the conference.

Key messages

• This world-first RCT using HEPA filters in care homes will report the evidence of effectiveness of respiratory infection episode reduction in care home residents.

• The trial will inform policy makers about the effectiveness, acceptability and implementation of HEPA filters in care homes.
Learning through playing in public health: a card game’s evaluation
Authors: Martinez J , Cottin M , Valter R , Razafindrakoto H , Vauxion S , Josseran L , Delarocque-Astagneau E , Gautier S
Published: October 2024

Background

In medical education and particularly in public health, the shift toward active learning addresses the limitations of traditional lecture-based methods. Game-based learning, such as serious games, showed potential to overcome these limitations. “Accidémie” is a card game designed to improve medical students’ knowledge of home accidents and their competencies in public health through an interactive format. This study aims to evaluate the effectiveness of “Accidémie”.

Methods

We conducted a quantitative pre-post assessment study among sixth-year medical students of the University of Versailles. Data were collected through a 20-item true/false repeated questionnaire before and after. In addition, the post-intervention questionnaire included questions on students’ satisfaction and an open-ended question. Responses to the questionnaires were converted into scores. The main outcome measured was the change in the scores. The scores before and after the intervention are presented with their mean and standard deviation. They were compared using a paired t-test. Student satisfaction is presented in terms of frequency and includes verbatim responses from the students.

Results

Thirty-eight students participated, with pre-test scores averaging 13.13 (SD = 1.98) and post-test scores averaging 14.89 (SD = 1.94). A paired t-test provided statistical evidence of the difference between the pre- and post-test scores (p < 0.001). Students provided positive feedback: 81.6% of the students were very satisfied with the game; 42.1% considered it extremely useful. They also underlined that ‘Accidémie’ is an enjoyable learning tool, praising its innovative approach.

Conclusions

“Accidémie” improved students’ knowledge of home accidents and their engagement. It supports the use of serious games in medical education complementary to traditional methods. Applying the concept of “Accidémie” across various subjects and among diverse groups of health students offers promising prospects.

Key messages

• ‘Accidémie’ significantly improves students’ knowledge of home accidents, a public health topic.

• “Accidémie” allows medical students to learn while playing, boosting satisfaction and engagement.
Interventions’ transferability assessment to strengthen Vaccination Uptake Among Migrants in Greece
Authors: Papaevgeniou N , Karnaki P , Radaiou V , Schloemer T
Published: October 2024

Background

Migrant children in Greece face significantly lower vaccination coverage rates for MMR and HPV compared to their counterparts. To address this disparity, our research focuses on selecting and adapting evidence-based interventions tailored to the specific needs of different migrant communities staying in Greece, guided by the PIET-T framework.

Methods

Using a stakeholder-engaged approach, we involved 26 key stakeholders to select evidence-based interventions relevant to the Greek context. These interventions underwent detailed analysis, considering their effectiveness, cultural appropriateness, and potential for transferability within the PIET-T framework. Key stakeholders provided input on intervention feasibility and country- and context-specific adaptation.

Results

Three interventions were identified as promising for MMR and HPV vaccination uptake: two health promoter interventions and a school-based vaccination one. The health promoter intervention was adapted so to involve health professionals and trusted community members delivering culturally sensitive education and navigation support, addressing barriers such as language and lack of information. The original school-based program implements education sessions and on-site vaccinations, leveraging the trusted environment of schools to reach parents and children. On-site vaccinations were omitted since they were not relevant to the Greek context due to legal barriers.

Conclusions

Our stakeholder-engaged approach, guided by the PIET-T framework, ensures interventions are tailored to the specific needs and contexts of different migrant communities in Greece. By prioritizing cultural sensitivity and community involvement, we aim to enhance MMR and HPV vaccination uptake and improve health outcomes among migrant populations.
The politics of universal health system reform in the context of COVID-19
Authors: Burke S , Parker S , Schulmann K , Bruen C , Mac Conghail L
Published: October 2024

Background

Implementing universalism is more a political than a technical project. With this in mind, Ireland devised a ten-year plan through political consensus to deliver universal healthcare - Sláintecare. The COVID-19 pandemic occurred early in its implementation.

Methods

This is qualitative research drawing on international literature on universal health system reform in the context of COVID-19 as well as the politics of health reform. The overall research programme is co-produced with the Irish health system. A timeline and analysis of the reform journey is drawn from documentary analysis of key policy documents, parliamentary reports and key informant interviews.

Results

Despite a policy commitment since 2005, universal healthcare implementation only became government policy in Ireland 2018. While whole system reform and implementation progress has been slow, the COVID-19 health system response boosted aspects of universalism and reform. All COVID-related services during the pandemic were universal, free at the point of delivery, as are most new services introduced since 2021. Despite the political consensus holding through a change government and the pandemic, and significant additional investment in the public health system, there remain many obstacles to reform. These include different stakeholder understanding of implementing universalism in Ireland especially in the context of COVID-19, how best to implement universal healthcare and the politics of delivering reform.

Conclusions

Contrary to other countries’ experience during COVID, Ireland pursued its policy aim of delivering universalism and expanded services provided universally, free at the point of delivery, with a focus on enhanced community care. The universalism applied to COVID-related prevention and care, new women’s health and chronic disease management services. Despite progress, government has yet to legislate for a universal entitlement to care and obstacles to reform implementation remain.
2.X.1. Sleep Health Disparities across the life-course: from research to public health policy
Authors:   Organised by: EUPHA-CHR, Western University (Canada),   Chair persons: Saverio Stranges (EUPHA-CHR), Dayna Johnson (USA)
Published: October 2024

Poor sleep health is a recognized common problem across the life cycle, globally. Factors that contribute to this problem include the demands of a “Western” lifestyle (urgency, productivity), economic stressors, social and environmental determinants of health, and global crises including international conflicts, political tensions, and climate change. There is a growing consensus that optimizing sleep health should be a public health priority because poor sleep patterns are a modifiable risk factor for myriad health outcomes, such as cardiovascular disease, diabetes, cancer, cognitive decline, mental illness, and early mortality. In Canada, a nationwide sleep consortium funded by the Canadian Institutes of Health Research (CIHR) was recently formed with a mandate to generate new knowledge that will inform clinical practice and support public health initiatives to deliver resources where they are most needed. The proposed workshop organized by the Chronic Disease EPH section will start with a general overview of the impact of sleep health disparities across the life-course, from childhood to older age, as well as discuss evidence-based public health approaches to promote sleep hygiene and mitigate the risk of adverse health outcomes, including chronic disease (Saverio Stranges). It will be followed by three presentations to address the root causes of sleep health disparities and their impact on chronic disease (Dayna Johnson); participatory research with families and care providers on infant sleep intervention development (Elizabeth Keys), and strategies to address common sleep disorders among middle-aged and older adults (Tetyana Kendzerska).

Key messages

• Sleep health disparities are a neglected public health issue.

• Optimizing sleep health is both a clinical and public health priority, as sleep patterns represent a modifiable risk factor for a range of adverse health outcomes.
Thermal inequality and heat-related adaptive capacity: A systematic review
Authors: Slesinski S C , Matthies-Wiesler F , Breitner-Busch S , Gussmann G , Bunge C , Schneider A
Published: October 2024

Background

Extreme heat is an important public health concern. Heat stress exposure and related adaptive capacity are not equally distributed across social groups, generating thermal inequality. We implemented a systematic review to answer the question: In the general population, what is the effect of social disadvantage on exposure to subjective and objective heat stress and adaptive capacity to prevent/reduce exposure to heat stress?

Methods

We searched for peer-reviewed journal articles published between 2005 and 2024. Screening and data extraction were conducted by one reviewer, with a second screening and extracting 10% for comparison. Synthesis included identification and description of specific social groups unequally exposed to heat stress and with lower adaptive capacity as well as a narrative description of the evidence and identification of research gaps.

Results

We identified 114 relevant publications. 53% included evidence on objective heat stress, 19% subjective heat stress, and 58% adaptive capacity. Nearly half came from North America (47%), 24% from Asia, and 17% from Europe. Publishing increased over time, from 0 articles in 2005 to 20 articles in 2023. Most studies considered socioeconomic status (SES) (87%), while fewer focused on race/ethnicity or other social factors. Across global regions, lower-SES populations, immigrants, and racial/ethnic minorities are generally more exposed to heat stress and have lower adaptive capacity, and lower-SES and minority neighborhoods are generally hotter and less green. Most studies of objective heat stress use imprecise measures, such as land surface temperature, which are not representative of experienced temperatures.

Conclusions

This review summarizes the available evidence on inequalities in heat stress exposure and adaptive capacity for the first time and identifies important research gaps related to heat stress measurement and social factors beyond SES.

Key messages

• Heat stress exposure and related adaptive capacity are not equally distributed across social groups, generating thermal inequality.

• Social inequalities must be considered during climate change adaptation planning.
Factors Associated with Unmet Supportive Needs in Adult Cancer Survivors in South Korea
Authors: Jin D-L , Kim Y A , Lee S J , Seo H-J , Yoon S-J
Published: October 2024

Purpose

As the number of cancer survivors increases, addressing their unmet supportive care needs (USCNs) has become crucial. This study aimed to evaluate the influence of financial toxicity on USCNs and identify comprehensive factors associated with USCNs among adults’ cancer survivors.

Methods

A cross-sectional survey using convenience sampling from the 2022 Korean Population Census. Data were collected online between November 17 and December 15, 2022. The study included 1,038 cancer survivors aged 19 years or older who had completed primary treatment. Multivariable logistic regression was analyzed to identify factors associated with USCNs.

Results

Two-thirds (65.7%) of cancer survivors experienced severe financial toxicity, correlating with high unmet supportive care needs. Among those who reported a severe financial burden, a substantial 170 out of 187 respondents, or approximately 90.9%, were identified as having high unmet supportive care needs. Cancer survivors had the highest needs in the order of ‘management of psychological symptoms’ and ‘coping and emotional needs’. Cancer survivors diagnosed between 5 and 10 years ago were found to be less likely to report unmet supportive care needs compared to those diagnosed more recently, with an odds ratio of 0.14. Additionally, breast cancer survivors and individuals who were unemployed at the time of diagnosis had a higher likelihood of experiencing unmet supportive care needs, with adjusted odds ratios of 1.68 (95% confidence interval: 1.088-2.603) and 1.80 (95% CI: 1.125-2.891), respectively.

Conclusions

Cancer survivors with moderate to severe financial distress were more likely to be at risk of experiencing a high level of unmet supportive care needs. Coping and emotional needs are the most important concerns among the unmet needs of cancer survivors regardless of the time since cancer diagnosis.

Key messages

• Cancer survivors in South Korea with moderate to severe financial distress are twice as likely to face a high level of unmet supportive care needs.

• The most significant unmet supportive care needs among South Korean cancer survivors relate to coping and emotional support, highlighting the need for enhanced mental health services.
Unequal cannabis use among European adolescents: the mediating role of perceived access and risk
Authors: Perelman J , Ribeiro M , Alves J , Palladino C
Published: October 2024

Introduction

Cannabis use among adolescents is a public health concern, because of its association with the use of other illicit drugs, mental health disorders, and social problems. Most studies show that adolescents from low socioeconomic status (SE) background are more likely to use cannabis, but the causes of SE inequalities remain to be understood. We test whether access and risk perceptions of cannabis use among disadvantaged adolescents explain the SE gradient.

Objectives

The aim of this study was to measure the mediating effect of access perception and risk perception on the association between SE status and cannabis use among European adolescents in 2019.

Methods

A cross-sectional, observational, analytical study was conducted, among 16-year-old students, based on data from the European School Survey Project on Alcohol and Drugs (ESPAD) in 2019. The outcome was cannabis use (experimental, regular, and problematic) and the exposure was SE status (parental education and subjective social status). Mediating variables were perceived accessibility and perceived risk of cannabis use. We used logistic regressions, where the odds ratio (OR) reduction measures the part of the association explained by the mediators.

Results

Regular and problematic cannabis use was significantly more prevalent among adolescents with a lower SE background (low parental education and low subjective social status, p < 0,001). This relationship remained significant after adjustment for perceived access and risk, and the modification of ORs was of a small magnitude (a non-significant reduction of the association).

Conclusions

Perceived accessibility and risk showed a weak mediating effect of the association between SE background and cannabis use. Consequently, these factors cannot be considered as major explanations for the higher use among worse-off adolescents. Reinforcing information or imposing stronger barriers in access may not help reduces SE inequalities in cannabis consumption.

Key messages

• Perceived accessibility and risk hardly explain the association between socioeconomic background and cannabis use among European adolescents.

• Reinforcing information or imposing stronger barriers in access may not help reduces socioeconomic inequalities in cannabis use.
New evidence on household financial protection against out-of-pocket payments for health in Poland
Authors: Tambor M , Pavlova M
Published: October 2024

Background

Protecting households against financial hardship when using health care is an integral element of universal health coverage. Previous analysis showed that in Poland, catastrophic spending on health is more common than in many European countries. Over the last decade, several measures were undertaken to reduce the burden of out-of-pocket payments for households in Poland.

Methods

The study aimed to assess financial protection in Poland using the indicators of catastrophic and impoverishing health spending. It relies on the methodology developed by the WHO Region Office for Europe. Catastrophic expenditure is defined as out-of-pocket payments that are greater than 40% of household capacity to pay. The study uses data from the Polish household budget surveys in 2013-2021.

Results

The incidence of catastrophic health spending remained relatively constant over the years analyzed, with 9% of households affected. Only in the first year of the COVID-19 pandemic (2020) it reached nearly 10%, although overall household out-of-pocket expenditure declined that year. The share of households impoverished or further impoverished due to out-of-pocket payments decreased from 4% in 2013 to 3% in 2021. Payments on medicines are the main driver of catastrophic spending, particularly among poorer households, although their role has diminished over time. Household’s available resources, gender, age, education, disability status, residence place, number of children, and household’s main source of income are significantly associated with catastrophic health payments.

Conclusions

Despite the implemented policies, household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021. Available evidence should be used to design well-tailored measures to reduce the burden of out-of-pocket payments, targeting the most vulnerable population groups and specific healthcare areas.

Key messages

• Household financial protection against out-of-pocket payments in Poland did not improve significantly between 2013 and 2021.

• Out-of-pocket payments for medicines are the main cause of financial hardship for Polish households.