bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of university food environment and healthy space policy implementation at university
Authors: García-Lorenzo E , Feijoo-Costa G , Rico-Díaz J , Visos-Varela I , Corral-Varela M , Caamaño-Isorna F
Published: October 2024

Issue/problem

Unhealthy diets, along with factors like tobacco, alcohol, and inactivity, contribute significantly to non-communicable diseases (NCDs). Prevention strategies should prioritize reducing exposure to these risk factors. It’s also crucial to consider environmental well-being alongside promoting health.

Description of the problem

During 2023/2024, university cafeterias (UC) were evaluated for healthy eating standards compliance, resulting in a noticeable presence of unhealthy foods together with plastic use, alcohol and tobacco consumption. This led to the development of an accreditation program to boost UC as healthy spaces.

Results

The developed program includes 5 mandatory standards and 42 recommendations. Priority objectives are offering healthy food options like fruit, avoiding alcohol and sugary drink ads, banning tobacco, promoting physical activity, and reducing waste for example by encouraging unpackaged water consumption. Our policy emphasizes evaluation and monitoring, so accreditation is valid only for two years. Our goal is to establish UC as sustainable, healthy spaces. To encourage compliance, we offer institutional financial support and accreditation seals to UC, showcasing their commitment to community health. Implementation begins in the 2024/2025 academic year, with an initial evaluation scheduled at that time.

Lessons

Monitoring UC food offerings is crucial for ensuring healthier options. Cafeterias play a key role in promoting healthy habits. Creating environments with healthier options can mitigate non-communicable disease risk factors presence.

Key messages

• University cafeterias are pivotal in fostering a healthy lifestyle.

• Prioritizing policies to address non-communicable diseases is crucial. Clear programs are essential for sustained effectiveness.
Exploring the policy context of Whole School in eight EU countries: the Schools4Health project
Authors: Kouvari M , Zioga E , Neven L , Escalona Labella I , Sandu P , Dātava S , Meszaros F , Klomp M , Truden-Dobrin P , Sutton G
Published: October 2024

Background

Moving from the recognition of WHO principles of health promoting school (HPS) to concrete practices is challenging. The Schools4Health project is an EU initiative with the aim to introduce, strengthen, and sustain the adoption of a participatory whole-school approach to health and wellbeing. The aim of this work is to present an update about the policy environment around HPS approaches in eight EU countries.

Methods

Between September-November 2023, Schools4Health partners from Spain, Belgium, Hungary, Greece, Latvia, the Netherlands, Romania and Slovenia carried out a preliminary scoping exercise to investigate the policy conditions which can influence the national uptake of HPS approaches. A three-step methodology was developed: a. identification of core stakeholders b. Rapid Situation Analysis survey and c. national roundtable meetings, to assess stakeholders’ awareness of and engagement in health promotion programs in schools.

Results

In total, n = 192 responses from stakeholders from health, education, social and agricultural sectors were selected. Most experts were aware or partly aware of the HPS concept. While there is consensus that health promotion at school is essential, there is a lack of, or weak implementation of legislation and voluntary initiatives due to barriers such as limited time and financial resources, teachers burnout and insufficient interaction between education and health governmental bodies.

Conclusions

Effective advocacy can highlight the potential of HPS in addressing the urgent challenges related to wellbeing in youth, and the associated decline in educational performance across Europe. Policymakers, public authorities and the broader community should also be engaged.

Key messages

• Creating HPSs should not solely fall on schools and teaching staff.

• Policymakers, public authorities and the broader community around schools have responsibility to ensure that policy measures and instruments embed the key considerations for HPS approach.
Determinants and strategies for successful scale-up of health interventions in the Netherlands
Authors: Van Dale D , Smit R A , Nassau F
Published: October 2024

Background

Although many evidence-based health interventions are proven effective, the process of scaling up is often complex and challenging. Yet, some interventions have managed to achieve successful scale-up. This provides a window of opportunity to learn from those experiences to inform future scale up processes.

Objectives

This mixed-methods study aimed to assess determinants and scale-up strategies contributing to successful scale-up of health promotion interventions in the Netherlands.

Methods

Semi-structured interviews were conducted with intervention owners (i.e. the individual or team taking the responsible for several aspects related to implementation and scale-up) (N = 25) of successfully scaled interventions (implemented across various health behaviours and different settings), and other relevant stakeholders (N = 10) involved in scaling up. Additionally, a survey was distributed among interventions (N = 306) registered in a national intervention database to assess scale-up experiences.

Results

Scale-up is often the result of a combination of determinants, such as persistent commitment of intervention owners and stakeholders, new funding opportunities, and accreditation by institutions. Several scale-up strategies were identified related to funding (e.g. reducing costs by setting up collaborations), organizational processes (e.g. infrastructure to support implementation), monitoring and evaluation, and dissemination and advocacy.

Conclusions

Achieving successful scale-up does not happen automatically and continuous effort of the intervention owner is crucial. There is no such thing as one successful scaling strategy which succeeds across all contexts. The intervention owner typically takes the lead in diverse scaling pathways, where sufficient time, funding, the right moment and added value form the critical ingredients for success. Funding: This study was funded by ZonMw.

Key messages

• Crucial elements of achieving scale-up are the continuous effort of the intervention owner, sufficient time, funding, the right moment and added value of the intervention.

• Funding should not me allocated for new initiatives but also for continuous development of interventions, ongoing evaluation and covering overhead costs.
Engaging practitioners in developing a guide for citizen participation in community health promotion
Authors: Griebler U , Kien C , Klingenstein P , Seel M
Published: October 2024

Background

Community health promotion aims to improve the living conditions in municipalities, cities, or regions to support health maintenance or promotion. Participation is a fundamental element in health promotion, as it enables community members to engage in decision-making, program development, and tailored health initiatives. This project focused on crafting a practical guide for citizen participation in community health promotion, involving experts and future users.

Methods

We conducted a literature review to identify existing guidelines and materials pertinent to community health promotion, with a focus on practical guidance for municipal practitioners. To delve deeper into the topic, we conducted interviews with 6 experts in the field of participation and community health promotion as well as with 6 practitioners working in “healthy municipalities” in Lower Austria. The guide was developed collaboratively, with two workshops being held to gather input on the draft concept of the guide and to prioritize topics. Moreover, experts and practitioners were involved to provide feedback on the drafted guidance document.

Results

Discrepancies emerged between theoretical concepts and real-life implementation of community participation. While the literature delineates up to 12 participation levels, practitioners identified three: contributing ideas, advising and co-deciding, and actively participating in planning and implementation. Informing the target group was conceptualized as a preliminary stage and basic requirement for citizen participation. Above all, practitioners sought low-key suggestions and short descriptions of methods that they could use directly in their everyday context.

Conclusions

Involving practitioners and potential users enhanced the accessibility and utility of the guide. Their input ensured that the guide remained practical, relevant and informative without excessive academic or theoretical abstraction.

Key messages

• Involving health promotion practitioners helped shaping the practical guide in a way to be most useful for the intended audience.

• Experts and practitioners have different views regarding the theoretical distinctions of levels of participation in community health promotion.
The impact of a rural school-based oral health intervention among primary schoolchildren in Armenia
Authors: Atanyan A , Muradyan D , Lylozian H , Demirchyan A
Published: October 2024

Objectives

Oral health (OH) interventions are shown to be effective in improving children’s OH status and behavior. This study evaluated the effectiveness of a school-based OH intervention combined with OH educational activities on rural schoolchildren’s OH status and behavior in a rural setting in Armenia.

Methods

The study population were primary schoolchildren of Mrgashat village, Armavir province, Armenia, and their parents. The intervention included sealant application to eligible permanent molars of children and fluoridization of their teeth twice a year over a two-year period. Educational activities included a training session for children and their parents, and distribution of educational materials among them. Baseline (BL) and follow-up (FU) assessments were conducted before and after the intervention (in 2022 and 2024) to evaluate its impact. Both assessments included clinical examination of children’s OH status by calculating their DMFT/dmft index, and telephone survey among parents on OH knowledge and behavior. The changes in DMFT/dmft index and OH knowledge and behavior scores were measured using paired t-test.

Results

Overall, 94 children and their parents participated in both BL and FU assessments. There was no significant change in the parental OH knowledge score: 77.4% (SD 14.0) at the BL and 78.7% (SD 13.2) at the FU. Yet, children’s OH behavior score increased significantly: from 44.9% (SD 18.2) at the BL to 60.0% (SD 15.4) at the FU (p < 0.001). Children’s DMFT/dmft index also improved significantly: from 7.31 at the BL to 5.09 at the FU assessment (p < 0.001).

Conclusions

The study demonstrated the effectiveness of the OH intervention in improving children’s OH status and behavior. Therefore, we recommend expansion of the intervention with inclusion of more rural sites in Armenia, and targeting primary schoolchildren, considering the importance of timely preventive interventions and early development of healthy habits for better OH later in life.

Key messages

• Oral health interventions among primary schoolchildren covering awareness raising and carries prevention activities result in positive changes in children’s oral health habits and teeth health.

• Expansion of this type of interventions with inclusion of new rural sites and conduction of further assessments to explore the long-term effects of such interventions are recommended.
Discussing health behavior change during pregnancy: co-creation of a training and conversation tool
Authors: Turkeli R , Meijer E , Breunis L J , Keij M , Been J V , Crone M R , Numans M E , Smit E S , Langedijk-Wilms A
Published: October 2024

Background

Health risk behaviors during pregnancy are major risk factors for adverse health outcomes for mother and child, and they are more prevalent among vulnerable pregnant women. However, interventions often do not sufficiently meet the needs of disadvantaged groups. Changing behavior is more likely when people feel autonomous and when a behavior aligns with our identity (how we see ourselves). Despite the clear importance of identity in health behavior change, very few identity- based interventions exist for pregnant women, let alone for vulnerable pregnant women. Through co-creation, this study aims to develop an identity- and autonomy- based training program and conversation tool tailored to the needs and preferences of healthcare professionals and vulnerable pregnant women.

Methods

Four co-creation sessions were conducted with five professionals from medical and social domains, and five (expectant) parents in vulnerable situations. The Participatory Learning and Action research methodology was applied to ensure an equal and democratic process in designing the training and conversation tool.

Results

The training for professionals will focus on enhancing knowledge about the importance of identity and autonomy in behavior change, and on improving their self-efficacy through practicing the conversation tool. Example of the conversation tool, which can be integrated into daily practice, is a comic strip illustrating the conflict of being a smoker and a mother.

Conclusions

During intervention development, it is important to consider the needs and preferences of end-users, particularly for whom few appropriate interventions exist. Involving end-users yields valuable insights for feasible (e.g. one-consultation time frame) and accessible (e.g. easy-to-understand language) interventions. This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.

Key messages

• During intervention development, it is important to consider the needs and preferences of end-users.

• This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.
Experiences of weight discrimination were common in Finnish women with obesity
Authors: Sääksjärvi K , Palosaari T , Lundqvist A , Männistö S , Lehtoranta L , Mäki P , Kaartinen N E , Jääskeläinen T
Published: October 2024

Background

The consequences of obesity stigma, particularly weight discrimination, are widely felt in different sectors of society. Our aim was to examine the prevalence of experiences of weight discrimination in the Finnish adult population.

Methods

Data (n = 2,849) consisted of participants aged 20-64 years from the nationally representative Healthy Finland Survey in 2023, pregnant women and people with underweight excluded (body mass index, BMI, ≤18.5 kg/m2). The questionnaire inquired about the experiences of weight discrimination with a question “Have you experienced unfair treatment because of your weight during the last 12 months?”. Information on education (low, middle, high) was inquired too. Height and weight were measured during the health examination, and BMI was calculated (kg/m2). Obesity was defined as BMI ≥ 30 kg/m2. Weighted prevalence was analyzed using logistic regression, considering sampling design and non-response.

Results

Overall, 13% (95% confidence interval, CI, 11-15) of women and 7% (95% CI 5-8) of men had experienced weight discrimination during the last 12 months. The experiences of weight discrimination varied according to BMI, as the prevalence was 27% (95% CI 22-32) among women with obesity vs. 7% (95% CI 6-9) among women without obesity. The corresponding numbers for men were 16% (95% CI 12-20) vs. 4% (95% CI 2-5). The results were similar across all educational classes.

Conclusions

Individuals with obesity had experienced weight discrimination more often than those without obesity. The problem affects women (in particular), as almost one third of women with obesity had experienced weight discrimination. It is important to raise awareness and recognize this phenomenon across all sectors of society to enhance inclusion in a world struggling with overweight and obesity.

Key messages

• People with obesity experience weight discrimination. Experiences of weight discrimination appear to be more common in women than men.

• More information and understanding of weight-related stigma through education, research and values work is needed in different sectors of society.
Impact of ‘10,000 Steps Duesseldorf’ after one year: Results of a controlled intervention study
Authors: Pischke C , Schmitz E , Matos Fialho P , Vomhof M , Icks A , Lang A , Kuss O , Cardon G , Weyers S
Published: October 2024

Background

Despite marked decreases in physical activity (PA) in Germany due to the pandemic, population-based intervention strategies to tackle this public health problem remain sparse. The 12-month PA intervention ‘10,000 Steps Duesseldorf’ was composed of multiple components: at individual level, website to self-monitor steps; organizational level, step count competitions; environmental level, city-wide media campaign to increase awareness regarding benefits of PA and street signage indicating walking routes. This study aimed to replicate a research trial from Belgium addressing two questions: (1) Do individuals located in the city that the intervention is implemented in (Duesseldorf) engage in more PA compared to individuals located in the control city (Wuppertal) after one year? (2) Is the proportion of those reaching 10,000 steps/day higher in the intervention than in the control city after the intervention?

Methods

To investigate intervention effects, PA was assessed via pedometers in two representative samples of adults aged 25-75 years in the cities of Duesseldorf (intervention) and Wuppertal (control) at baseline (April 2021 - March 2022) and one-year follow-up (May-November 2023). Baseline differences in socio-demographic and health-related variables between intervention and control were adjusted for in a propensity score model with matching weights.

Results

627 adults participated in the study at baseline and 553 at follow-up (60% female, 60% intervention). The results of the propensity score analyses revealed that intervention participants walked 462 steps more (95% confidence interval: -146 to 1070) than controls at follow-up. However, the proportion of residents reaching 10,000 steps/day was comparable between intervention and control city after the intervention (26%, both cities).

Conclusions

Our results suggest an intervention effect on daily steps taken in Duesseldorf experiencing intervention activities compared to the control city after one year.

Key messages

• The complex PA intervention from Belgium was successfully adapted and implemented in Germany resulting in a higher level of daily steps taken in the intervention city (compared to control).

• A limitation of the study is that the recruitment process was hampered by the ongoing pandemic, resulting in selection bias, i.e. already active individuals were more likely to enrol in the study.
Effectiveness of a check-up for rehabilitation and prevention needs in primary care
Authors: Burchardi J M , Rossek S , Brünger M
Published: October 2024

Background

General practitioners play a central role in initiating rehabilitation and prevention services. However, systematic screening for rehabilitation and prevention needs has not been carried out in general practices so far. The legislation encourages the implementation and evaluation of so-called ‘check-up 45+’, which target individuals aged 45 and older. The study aims to evaluate the effectiveness of a check-up 45+ in primary care.

Methods

A pragmatic, randomized controlled trial was conducted in 26 general practices in the German states of Berlin and Brandenburg among patients aged 45 to 59 years (DRKS00028303). The control group (n = 695) received usual care plus a questionnaire on sociodemographic and health-related characteristics. The intervention group (n = 706) completed additionally the 2-page ‘screening 45+’, which captures rehabilitation and prevention needs in five dimensions. After algorithm-based ad hoc evaluation by practice staff, the general practice could modify the recommendation based on available information (e.g., diagnoses, social situation). Information and application documents were provided in case of identified needs. Applications (primary outcome) and approvals (secondary outcome) of rehabilitation and prevention services were recorded using routine data.

Results

In the intervention group, 64.2% were women, compared to 63.0% in the control group (mean age 52.1 (SD 4.3) and 52.5 (SD 4.4) years). In the intervention group, 85 applications (12.0%) for medical rehabilitation or prevention services were submitted within two months after the study participation, compared to 20 applications (2.9%) in the control group (p < 0.001). The number of approvals for these services was 59 vs. 17 (p < 0.001).

Conclusions

The application rate for rehabilitation and prevention services was significantly higher in the intervention group compared to the control group, with a relative risk difference by a factor of 4 and an absolute risk difference of 9.1%pt.

Key messages

• The implementation of a check-up 45+ in primary care leads to a higher rate of applications for rehabilitation and prevention services compared to usual care.

• The check-up 45+ may assist general practitioners in systematically identifying rehabilitation and prevention needs of their patients and in applying for these services.
Support mechanisms and obstacles for developing public health practitioners’ core competences
Authors: Parder M
Published: October 2024

Community health needs assessment is one of the central activities for local governments in Estonia, specifically under the health promotion strategic planning, and this includes developing health and well-being profiles for evidence-based public health promotion. For effective implementation of the profile, sufficiently trained public health practitioners are needed. Therefore, analysis of the needs of the additional study programmes according to the core competences of professional standard for health promotion was carried out among public health practitioners and the leaders of local governments. The study was based on the 19 semi-structured interviews carried out in 2022-2023 with leaders (10) and public health practitioners (9) in Estonian local governments. Based on the local government’s size, status of the health and well-being profile and the employment and educational background of the public health practitioner three sub-groups were developed. The collected data was analysed using qualitative content analysis with focus on support mechanisms and obstacles of core competences of public health practitioners. The respondents indicated the need for training on communication (leadership and advocacy) and analytical skills (evaluation and research). Core competence training is however limited by resources (time, energy, motivation, funding), employer expectations (overload at work) and working full-time. Training is supported by personal motivation (e.g., wish to stay competent, understanding the need for training), employer support (including flexible work arrangements), and curriculum support (funding is covered). The results indicate there is a need for flexible education as the need for developing and maintaining core competences emerges in practical work. The results can be used for developing the public health curriculum, to assess and provide training for public health practitioners to better meet the needs of the labor market in the future.

Key messages

• Local government employees performing health promotion tasks feel the need to upgrade various core competences: e.g., communication, management, data analysis and assessment.

• In health promotion, there is a growing need for flexible education, which creates challenges for higher educational institutions to meet the needs of the labor market.
Exploring health-related quality of life in Portuguese Informal Caregivers
Authors: Pedro A R , Brandão D , Raposo B , Cunha A S , Escoval A
Published: October 2024

Background

Caregiving can be associated with several adverse health impacts, such as in terms of mental health, health services use, or health-related quality of life (HRQoL). This study assessed HRQoL levels in Portuguese Informal Caregivers, and their relationship with caregiver psychosocial characteristics (e.g., perceived general and mental health; perceived level of support) and caregiving circumstances (e.g., caregiving duration, caregiving hours).

Methods

A cross-sectional study was conducted through an online survey directed to informal caregivers. HRQoL was measured using the Portuguese translation of the EQ-5D-5L. This instrument yields two values for HRQoL: a health profile (EQvalue) covering five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and a visual analogue scale (EQvas). Bivariate analyses were performed and results with p-values below 0.05 were considered statistically significant.

Results

A total of 760 informal caregivers were surveyed (mean age 57 years (±9.9), 92.5% female, 41.5% at least university level, 44.4% works full or part-time). The mean total score for EQvalue (n = 733) was 0.8 (SD = 0.2). The mean total score for EQvas (n = 760) was 63.1 (SD = 21.5). The perceived general (p < 0.001) and mental (p < 0.001) health status, and the perceived access to healthcare (p < 0.001) were associated with EQvalue score. Also, EQvalue score was found to be directly correlated with the perceived level of support (r = 0.142; p < 0.001) and competence (r = 0,237; p < 0.001), and inversely correlated with the number of caregiving hours per day (r= -0,150; p = < 0,001) and the caregiving duration (r= -0,109; p = 0.008).

Conclusions

A significant relationship between caregiver HRQoL and several caregiver psychosocial variables was identified. Investing in and promoting the use of respite care services, as well as ensuring better access to healthcare for caregivers, appears important for improving caregivers’ HRQoL.

Key messages

• Improving caregivers’ access to healthcare and education or training programs (promoting a greater sense of competence) can be important in helping them maintain their quality of life.

• Increasing the availability and promoting the use of respite care services by caregivers can be important in helping them maintain their quality of life.
Influencers as a new source of health information: Insights from an Austrian youth survey
Authors: Engel E , Gell S , Heiss R , Karsay K
Published: October 2024

Background

Social media influencers (SMIs) have become the dominant source of health information for youth. While some SMIs may share valuable content, critics raise concerns that they lack expertise, have commercial motives, or hold personal biases. Yet, little is known about the epidemiology of the health influencer phenomenon. This study offers first insights into the reach of SMIs among Austrian youth, informing public health strategies to promote positive health behaviors in young populations.

Methods

A cross-sectional study was conducted with a representative sample of 1003 Austrian adolescents and young adults aged 15-25. Key research questions focus on the epidemiology of health influencers, engagement with SMIs, prevalent health topics, advertising, and perceived impact of SMIs on health.

Preliminary results

Participants estimate that over 51% of social media posts they see are from SMIs, and 75.37% follow at least one SMI. Additionally, 37.19% follow SMIs who specifically share health content, and 30.91% have purchased health products recommended by them (e.g., foods, supplements, beauty products). Moreover, 40.27% trust their followed SMIs for health information, similar to trust in traditional media (43.47%). Finally, over a third find SMI content beneficial for health (32.34%), while 29.20% find it harmful, and 33.83% neither.

Conclusions

The study provides first insights into the epidemiology of health influencers, revealing their extensive reach and positive reception among young people. Despite concerns about conflicts of interest or expertise, SMIs are perceived as trusted sources for health information and product purchases. This research enhances our understanding of influencers’ impact and informs public health strategies aimed at promoting positive health behaviors among youth. The insights from Austrian youth can inform future studies across Europe, deepening our understanding of the health influencer phenomenon and its implications for public health.

Key messages

• This cross-sectional study shows the high reach of social media influencers among youth and their important role as emerging sources of health information.

• The study breaks new ground by investigating adolescents’ engagement with health influencers, offering insights for public health to promote positive health outcomes among young populations.
Physical activity promotion as intersectoral planning in Milan Health Protection Agency
Authors: Calloni L , Elisa F , Bertolini E , Cassatella C , Pullano M , Melis C , Galessi L , Ieva B , Iannaccone N , Boni R
Published: October 2024

Issue/problem

Physical activity is a protective factor for preventing Noncommunicable diseases (NCDs) and, for this reason, it plays an important role in all the different guidelines for prevention and health promotion. The Italian Regional Prevention Plans and in particular the Lombardy one promote physical activity with a systemic approach, through both upstream and downstream actions to encourage the role of communities.

Description of the problem

Based on the regional plan, the Health Protection Agency (HPA) of the Metropolitan City of Milan developed locally validated actions and best practices for the promotion of physical activity, through the cross-sectoral involvement of different stakeholders (health system, companies, universities, local authorities, sports associations, etc.).

Results

Physical activity is embedded in all lines of health promotion activities in local planning documents. Sustainable and active mobility activities have been implemented in companies and schools with a comprehensive approach. Validated regional programs (Pedibus, Walking Groups, ecc.) have been implemented in the local community, along with the construction of permanent local laboratories for physical activity, structured through the development of specific territorial networks and providing for integration with the socio-sanitary setting.

Lessons

Promoting physical activity becomes an opportunity to both consolidate territorial networks and to develop evidence-based health promotion actions able to meet the different health needs of the population and to produce a structural change in living contexts.

Key messages

• Physical activity is both a protective factor for health promotion and a tool for implementing intersectoral and equity-oriented system actions from a life-course perspective.

• Promoting physical activity becomes an opportunity to consolidate territorial networks.
How does a Smoke-Free campus initiative generates changes in smoking? A theory-based evaluation
Authors: Gnonlonfin E , Gallopel-Morvan K , Breton E
Published: October 2024

Background

Smoke-free campuses (SFC) prohibit smoking and vaping on all university grounds and for all users. Despite their effectiveness in reducing smoking prevalence, passive smoking, and denormalizing tobacco use, the complex interplay between the programme activities and their impact on users and campus environments remain unclear. This study aims to improve our understanding of the transformation processes associated with SFC expected outcomes.

Methods

We conducted a retrospective qualitative study on the first SFC implemented in France by the EHESP School of Public Health. Guided by Mayne’s theory of change framework that includes ten dimensions of an impact pathway (e.g. activities, reach/reaction, capacity, behaviour changes, etc.), the research examined the chain of effects and hypotheses driving this SFC. Our dataset included internal documents (e.g. minutes of meetings, administrative documents) and semi-structured interviews with stakeholders (n = 16) involved in the development and implementation of the analysed SFC. Data is currently being analysed.

Results

Initial results suggest that the EHESP’s SFC activities included communication initiatives, student ambassadors, cessation support for smokers, installation of smoking shelters on campus periphery, etc. These activities were geared on capacity change (e.g. securing support and compliance among campus users, reduce smoking opportunities, promoting the use of cessation aids) and were intended to drive behaviour change (reducing smoking and facilitating cessation among students and staff). The goal of this SFC was not only to impact behaviors but also to educate future health service managers at EHESP to implement SFC policies and set an example for other institutions in France.

Conclusions

This study identifies some of the transformations that activities of the EHESP’s SFC can generate in students and staff in order to fulfil its outcomes. It also highlighted its expected impact on other institutions.

Key messages

• Understanding how a smoke-free campus generates its changes is essential in facilitating transferability of experiences to other universities.

• Smoke-free campus policies can also generate a broader impact on other institutions.
Exploring co-creator’s experiences: a multiple case study addressing workplace sedentary behaviour
Authors: McCaffrey L , Vogelsang M , de Boer J , McCann B , Giné-Garriga M , Dall P
Published: October 2024

Co-creation is an innovative approach for addressing complex public health issues. Co-creator’s experience of participating in co-creation can impact engagement yet research investigating co-creation experience is limited. A better understanding of co-creation experiences can inform optimal design and implementation of the co-creation process. This study’s objective was to conduct a cross-case analysis of co-creator’s experiences from 3 co-creation processes aimed at addressing workplace sedentary behaviour within 3 different small-to-medium sized companies in Scotland. Thirty-one co-creators were involved in the case study companies from Oct 2022 to Jun 2023. Data sources included observations, interviews, and researchers’ reflections. A multiple case study design enabled the exploration of co-creator’s experience across cases. A within-case thematic analysis was conducted to develop a deep understanding of cases before comparing findings between cases using Miles and Huberman’s guide to cross-case analysis. Preliminary findings indicate co-creation experiences are associated with events occurring before, during and after the co-creation process and are influenced by company context (i.e., company structure, resources and demands) and co-creation context (i.e., design and facilitation of the process). Co-creators had various motivations for their involvement. During the co-creation process there was a range of common experiences such as a sense of belonging, enjoyment and frustration. After co-creation, there was an overall sense of satisfaction accompanied by positive outcomes, including an intention to adopt healthier behaviours. Insights into co-creator’s experiences support the use of co-creation for addressing workplace sedentary behaviour. The findings have implications for researchers planning co-creation processes at small-to-medium sized companies. Tailoring co-creation to co-creator’s needs and wider company context can enhance its innovative potential.

Key messages

• This study’s significance lies in its qualitative cross-case analysis of co-creation experiences which enhances research rigour and enables contextualised generalisation.

• The innovative potential of co-creation can be enhanced by tailoring it to meet the needs and preferences of the co-creators and considering the wider company context.
Analysis of parents’ needs regarding sexual and reproductive health issues of their children
Authors: Gazzetta S , Iop I , Cherpessi S , Cudiz I , Bastiani E , Pascut S , Brunelli L , De Carlo L , Parpinel M
Published: October 2024

Background

Promoting sexual and reproductive health is a key intervention for young people’s health and well-being. Studies have shown that young people have a need to be supported by a strong network and that parents are considered an important source of information. The aim of our work was to understand the needs and critical issues parents face when raising the topic of sexual and reproductive health with their children in order to strengthen their skills and provide the best tools to support young people.

Methods

A qualitative focus group research methodology was used; a sexual psychologist facilitated the meetings. Parents of children attending secondary schools in Udine (Italy) in the 2022/2023 school year were invited to participate in the project. The meetings were recorded and transcribed verbatim by two independent researchers. Following an inductive method, recurring themes were extrapolated to represent the main categories and more specific subcategories.

Results

46 parents participated in the focus group; 76% of them had no experience with sexual and affective education. Parents felt that sex education was useful in providing accurate information, preventing risks and promoting respect and relationships with others; however, there were concerns that the values taught were not consistent with those of the family. The topic was found to be difficult to discuss with children, both in terms of technical/scientific aspects and addressing issues such as gender identity and sexual orientation. Parents would like to understand what the right communication key is to discuss with their children in an atmosphere of trust.

Conclusions

Parents recognized the importance of the topic and saw the need to deepen some aspects, especially in terms of relationship and communication. The results of this work will be a useful starting point for the creation of ad hoc pathways aimed at parents to strengthen the relationship with their children.

Key messages

• Parents want to overcome difficulties by finding the right key to communicate with their children.

• Supporting young people and their network to promote sexual and reproductive health is essential.
Improving intersectoral working in schools: learning for the future from the COVID-19 pandemic
Authors: Gray N J , Manandhar S , Chabot C , Jourdan D
Published: October 2024

Background

The COVID-19 pandemic highlighted the challenge for school staff to integrate protective health measures into their academic daily responsibilities. The aim of this abstract, within a wider study of safe school re-opening, is to analyse improvements proposed for intersectoral working in schools by health and education professionals, based on their experience of the pandemic.

Methods

In 2021, an online survey was conducted in 6 languages with education and health professionals, followed by optional online semi-structured interviews. These methods explored the: 1-effect of the pandemic on schools/pupils/teachers; 2-reorganisation of schools; 3-experience of implementing infection control measures in schools; 4-intersectoral working; 5-important resources for keeping schools open. Interviews were transcribed verbatim and translated into English where needed. A directed content analysis was undertaken of interview transcripts and free-text survey responses regarding intersectoral working perspectives.

Results

The results are based on a combined analysis of data from 2072 survey responses from health and education professionals from 73 countries and 32 follow-up interviews (18 education professionals and 14 health professionals from 25 countries). Five themes of improvement for the future were identified: create formal coordination between the two sectors to support intersectoral working; that the health sector provide clear information and guidelines; bring health staff into school (especially medical staff); communicate more across all stakeholders (community, parents, students); and a call for capacity-building among education professionals by the health sector.

Conclusions

From the experience of the COVID-19 pandemic, the public health sector should lead the development of collaborative structures, implementation strategies and activities to support intersectoral alliances in the school environment for everyday well-being, ready for future health crises.

Key messages

• During the COVID-19 pandemic, many education and health professionals felt the need for more - and strengthened - collaboration in schools for future health crises.

• Public health professionals could take a leading role in this strengthening strategy, supporting intersectoral alliances and promoting capacity-building in order to improve well-being and resilience.
Parental concerns about the risks associated with harmful industries for their children
Authors: Pitt H , McCarthy S , Hume E , Arnot G , Thomas S
Published: October 2024

Background

Harmful industries including tobacco, vaping, alcohol, and gambling are causing significant harms to communities, including children and young people. These industries try to resist reform by deflecting blame and shifting responsibility, often by suggesting that parents need to educate and protect their children. This study aimed to explore parents’ current concerns and risks relating to these industries and their children, and their attitudes about responses to prevent harm.

Methods

Australian parents (n = 455) who had at least one child aged between 11-17 years were invited through a panel company to complete an online qualitative survey. Participants were asked about their concerns and risks relating to each product, if and what they discuss about these products with their children, and who was responsible for protecting children from these industries. Thematic analysis was used to analyse the data.

Results

Parents were concerned about the short- and long-term consequences of their children engaging in these products. Many parents tried to talk to their children about the risks, however also believed that their child was influenced by their peers, and messages they see on social media. Although parents recognised their own role in protecting their children from harmful industries, they thought that a collective approach was needed, which included greater regulations and more effective education.

Conclusions

Parents are trying their best to protect their children from the harms associated with tobacco, vaping, alcohol, and gambling. However, they feel as though they are unable to counter the range of ways that their children are exposed to and influenced by these industries. Governments need to listen to parents and implement comprehensive regulations restricting marketing practices and increase evidence-based education that focuses on the tactics and harmful practices of these industries.

Key messages

• Harmful industries try to shift blame and put responsibility for protecting children onto parents. However, parents feel they are unable to counter the positive messages that their children see.

• Parents are concerned about the range of risks these products could have for their children and want to see a collective response to address this issue, including government policy intervention.
Developing an Evidence-Based Primary Cancer Prevention Repository: insights from the PIECES project
Authors: Breunese J , Walters B H , Troelstra S , Willemsen M , Gorini G , Caini S , Hensen N , van Nassau F , Vis C
Published: October 2024

Introduction

Up to 40% of cancer cases could be avoided through effective primary prevention. However, cancer prevention tends to be fragmented across Europe, leading to geographical health differences. The dissemination and scale-up of effective primary cancer prevention interventions may address this. Although effective cancer prevention programs exist, finding them and their materials (especially regarding implementation) can be challenging. Repositories of evidence-based interventions provide insight into “what is out there” and can support dissemination within and across national borders. The PIECES project aims to develop and disseminate a repository of evidence-based primary cancer prevention programs adaptable to European contexts, with information to aid adaptation and implementation across countries.

Methods

The development of the PIECES repository has been informed by established repositories such as NCI’s Evidence-Based Cancer Control Programs. The project team developed a scoring sheet with a selection of items that could be included in the repository. All participants rated each item on relevance and applicability and provided comments and suggestions. A final framework, including a set of minimal requirement items, was agreed upon during three online consensus building meetings.

Results

We created a repository of evidence-based primary cancer prevention interventions targeting modifiable risk factors suitable for implementation in European healthcare settings. This 22-item repository provides information about an intervention’s logic model, implementation practices, and appraisal of published evidence of effectiveness.

Conclusions

This repository is innovative as it includes practical information and tools to facilitate implementation. While initially built to serve the PIECES project, the repository is designed to be a valuable tool for European policymakers, researchers, and implementers. Lessons learned from this process will inform future developers.

Key messages

• A comprehensive cancer prevention intervention repository avoids “reinventing the wheel” and allows for more efficient use of existing interventions by building upon the best available evidence.

• The ongoing efforts of the PIECES project represent a significant contribution to reduce cancer prevention disparities and to facilitate the adoption of evidence-based interventions in Europe.