bluuebunny/crossref_metadata_2025 huggingface dataset:
Results from the TEHDAS country visits: State-of-play of 12 EU member states in relation to the EHDS2
Authors: Abboud L , Cosgrove S , Kesisoglou I , Bogaert P
Published: October 2022

Successfully launching a sustainable EHDS requires a clear understanding of the current situation in Member States, taking into account the existing diversity. With this in mind, country visits are being carried out in a group of 12 countries: Denmark, Belgium, Hungary, Netherlands, Estonia, Ireland, Portugal, Finland, Czech Republic, Slovenia, Sweden, Germany. The aim of the country visits is to map the state-of-play of health data management in different countries and explore their preparedness to join the EHDS. The topics explored include: the health data sources available, the health data infrastructure (storage, access and interoperability), data quality assurance mechanisms, data governance, as well as resource and training needs and opportunities. Another aim of the country visits is to explore needs and expectations at national level, and how the EHDS can respond to them. This presentation will include an overview of the health data management systems of the 12 countries mapped, providing a snapshot of the situation across Europe. It will then present the findings on their preparedness to join the EHDS. Preparedness takes into account a variety of factors, including political will, as well as legal and technical factors. The presentation will further share the lessons learnt and best practices highlighted from the country visits. Finally, based on these findings, the presentation will close with an overarching view on the preparedness across Europe to deploy the EHDS for the secondary use of health data, EHDS2, as well as planned actions that would facilitate the implementation of the EHDS2 in different member states.
The Vienna self-assessment questionnaire for hospitals: Three explorative case studies in Belgium
Authors: Henrard G , Rademakers J
Published: October 2022

Background

One way to develop adequate health literacy responsive policy and strategies in hospitals is the use of self-assessment tools to raise awareness, help prioritize action and mobilize stakeholders. In this study we have piloted the French version of the Vienna Health Literate Organisation (V-HLO-fr) tool in three hospitals to explore its feasibility.

Methods

We performed explorative case studies in the three main hospitals of Liège (Belgium). Our mode of application of the V-HLO-fr was inspired by the ‘RAND Appropriateness’ method: first, individual members of an internal multidisciplinary panel filled out the questionnaire and then the results were discussed collectively in each hospital during a ‘round table’ meeting. The feasibility of the process was assessed by direct observation of the round tables and with semi-structured phone interviews

Results

The V-HLO-fr tool was fully applied in the three targeted hospitals and the process seems to be acceptable, practicable and integrable. Its mode of application, formalized by taking inspiration from the RAND method, could be further improved, e.g. by paying more attention to recruiting and supporting participants. Strengths (e.g. the facilitation of patient navigation to the hospital) and weaknesses (e.g. the provision of easy to read, understand and act on health information materials) in terms of health literacy responsiveness have been highlighted.

Conclusions

V-HLO-fr could be a suitable tool to create awareness and formulate targeted actions to further strengthen hospitals health literacy responsiveness.

Those explorative case studies give:

– an overall positive signal about the feasibility of the V-HLO-fr

– useful feedback to further formalize and refine its procedure of application.
A multi-component health literacy intervention addressing needs of kidney patients and professionals
Authors: Boonstra M , Reijneveld SA , Westerhuis R , Tullius JM , Vervoort JPM , Navis G , de Winter AF
Published: October 2022

Background

Limited health literacy (LHL) is associated with faster kidney deterioration. To maintain kidney function, health care professionals (HCPs) promote self-management. However, in chronic kidney disease (CKD) care organizations, patients with LHL report multiple communication and self-management barriers. The need for health literacy responsive organizations, and multi-component interventions targeted at patients and HCPs, is recognized. We aimed to determine the objectives and strategies of such an intervention, and to co-create and evaluate it.

Methods

First, we performed a longitudinal qualitative study among CKD patients with LHL (n = 24) and HCPs (n = 37) from general practices and nephrology clinics to assess needs and barriers, and to identify promising intervention objectives. Second, we included patients (n = 19), HCPs (n = 15), educators (n = 3) and students (n = 4) in an Intervention Mapping (IM) process to co-create and evaluate the intervention.

Results

Grip on Your Kidneys (GoYK) addresses the competences of patients with LHL to self-manage CKD on the long-term, and the communication competences of patients and HCPs. Based upon patients’ preferences, GoYK encompasses a visually attractive website and brochures to optimize self-management and a card to contribute to consultations. With HCPs, we developed a training to optimize their competences to support patients with LHL. Evaluation revealed the intervention was useful, comprehensive and fitting needs.

Conclusions

Mapping the needs of CKD patients and HCPs, combined with a process of intervention co-creation, resulted in a multi-component, positively evaluated intervention. Implementation of this type of interventions in organizations is promising to improve care for patients with LHL. However, the effectiveness of these interventions requires further assessment.
Viral hepatitis micro-elimination: models of care and barriers to implementation in 5 EU/EEA prisons
Authors: Seyler T , Montanari L , Ceccarelli L , Torri E , Mazzilli S , Tavoschi L
Published: October 2022

Introduction

Coverage of essential prevention and control services and adequate monitoring schemes for viral hepatitis are often suboptimal in prison settings. Yet, evidence shows that targeted interventions are feasible and effective in reducing viral hepatitis burden and decreasing virus circulation among people living in prison and the community at large. To promote transferability and improvement of prison health quality in EU/EEA the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) will identify and disseminate models of care for viral hepatitis elimination in prisons.

Methods

The models of care were gathered using a data collection tool that has been designed for this purpose based on the literature review and agreed with an expert advisory group. Based on the results of the data collection, a survey for healthcare staff working in 5 selected prison institutions in the EU/EEA has been developed.

Results

The following models of care were collected: HCV micro-elimination in prison; transitional care for HCV treatment or HBV prevention/treatment; HCV or HBV care services tailored to women living in prison; HBV or HAV/HBV vaccination in prison settings. Harm reduction and drug treatment services in the prison are essential at all steps of the prevention and continuum of care. Among barriers identified were: engagement of people living in prison and prison governance structure, availability of infrastructural and human resources, daily prison organisation, inter-sectorial collaboration within prison and between prison and community services, training for prison staff and lack of systematic monitoring.

Conclusions

Evidence of effective and acceptable interventions in prison to prevent and control viral hepatitis is essential to foster inclusion of prison setting within national elimination programmes. Intra-EU benchmarking may help promote awareness, to allocate adequate resources, monitor of impact and ultimately the achievement of the elimination goal.
Contraception free of charge for young women in Tuscany: an interrupted time series analysis
Authors: Ferrari A , Bonciani M , Corazza I , Tortù C , Vainieri M
Published: October 2022

The Regional Health Authority of Tuscany, ITALY, launched in November 2018 a public program providing all contraceptive methods free of charge to all young residing women after medical evaluation at free family counselling centres. We aimed to explore the effect of the regional program on five outcomes - abortions, contraception provision, access to family counselling centres, conception, and outpatient service utilization for six sexually transmitted diseases (STDs). These outcomes were retrospectively computed from January 2016 to December 2020 using regional administrative databases, and then expressed as both annual rates per 1,000 and monthly rates per 100,000 women aged 14 to 25 years and residing in Tuscany. We ran interrupted time series (ITS) models to analyze how the trends in monthly rates changed over time after the intervention (set in November 2018). The decline in annual abortion rates per 1,000 women doubled from 2016-2018 (-9%, from 7.0 to 6.4) to 2018-2020 (-17%, from 6.4 to 5.3). ITS models revealed a significant post-intervention decrease in monthly abortion rates (-0.61, -1.11 to -0.12) and a significant increase in both access rates to counselling centres (87.60, 77.77 to 97.43) and contraception provision rates (16.75, 0.31 to 33.19). Conception rates fell significantly just in under-18 women (-0.84, -1.39 to -0.28). A significant reduction in outpatient service utilization rates for STDs emerged for N. gonorrhoeae, HSV, and HPV. As a prime example of similar initiatives in Italy, the free contraception program of Tuscany promoted access to counselling and contraception services among young under-25 women, empowering the entire care pathway. As a result, abortion rates declined significantly in this group. The wider access to counselling centres to obtain free contraception and overall enhancement of the pathway might have fostered sexual education and reproductive health, leading to a reduction in teenage conception and STD spread.

Key messages

• This study proves the effectiveness of the free contraception campaign of Tuscany in reducing abortions and empowering the entire care pathway, providing further evidence for policy accountability.

• Therefore, this study supports the maintenance of this program and suggests the potential benefits of implementing and promoting similar initiatives in other Regions.
An integrated care pathway for maternal and childcare: evidence from Ethiopia, Tanzania, and Uganda
Authors: Corazza I , Belardi P , Bonciani M , Manenti F , Abebe D , Santini S , Azzimonti G , Nsubuga J , Dall'Oglio G , Vainieri M
Published: October 2022

Performance monitoring and evaluation are key to quality improvement in maternal and child healthcare in Sub-Saharan Africa. This study presents the experience of designing and implementing bottom-up and integrated performance evaluation tools for care pathway to monitor and manage maternity healthcare services. The research project involved four health districts and relative reference hospitals, supported by the NGO Doctors with Africa CUAMM in Ethiopia, Tanzania, and Uganda. The maternal and childcare pathway developed consists of 23 indicators, calculated at hospital and district level, relating to pregnancy, childbirth and first year of life phases. The authors developed staves and performance maps, as graphical representation tools, to display longitudinally integrated health services provision performance along the continuum of care. Substantial variation was observed between the phases of each maternal and childcare pathway and across the care pathways of the different analysed settings. The most impressive results across the four settings are: 1) regarding pregnancy phase, that women tend to attend more than four antenatal classes, still with a quite high drop-out rate, and are largely tested for syphilis, 2) with respect to childbirth, that there are varying percentage levels in terms of C-sections, episiotomies and peri/intra-partum asphyxia cases, and 3) as it regards first year of life, there emerges scope for improvement considering the vaccination coverages attained for pentavalent, measles and polio vaccinations. Thanks to the collaboration with local managers and health professionals, the maternal and childcare pathway allowed to monitor the changes in the quality of maternity services provided within the analysed contexts. The benchmarking approach encouraged local professionals to learn from other settings. The use of such tool allowed the development of targeted quality improvement actions, shared among all involved stakeholders.

Key messages

• In collaboration with local professionals, we designed and implemented an integrated pathway for maternal and childcare, covering the phases of pregnancy, childbirth and first year of life.

• Benchmarking performance results encouraged collaboration among professionals and allowed the identification of actions to improve the provision of maternal and childcare services.
Reducing educational inequalities in mortality: a comparative risk assessment approach
Authors: Eikemo TA
Published: October 2022

Educational inequalities in mortality are increasingly recognized as one of the main challenges for health policy. Studies comparing European countries have shown that such inequalities are substantial almost everywhere, but that there are important variations between countries, suggesting great scope for reduction. However, identifying this scope is difficult because it requires comparative information about the educational distribution of mortality rates, risk factors and relative risks. In this presentation I show how this can be done, by quantifying the impact of a theoretical equalization of the distribution of several known risk factors for mortality, in a comparative risk assessment approach. Harmonized data set on mortality (from register data) and risk factors (from survey data) by educational level for 21 European populations in the early 2000s were applied. The impact of the risk factors on mortality in each educational group was determined using Population Attributable Fractions (PAF). The impact on inequalities in mortality was estimated applying two counterfactual scenarios: a theoretical upward levelling scenario in which it is assumed that inequalities in the risk factor were completely eliminated, and a more realistic best practice scenario, in which it is assumed that inequalities in a risk factor were to be reduced to those seen in the country with the smallest inequalities for that risk factor. The analysis shows how information on risk factors, mortality rates and relative risks can be combined from different data sources and provide a meaningful analysis of the European mortality burden that can be linked to educational inequalities in risk factors. The analysis also shows that upward levelling scenarios and best practice scenarios demonstrate a theoretical potential for reducing inequalities in mortality.
Implementing an eHealth tool to improve referral services for obstetric emergencies in Sierra Leone
Authors: Theuring S , Lewally A , Shepherd J , Williamson Taylor R
Published: October 2022

Background

Maternal health remains a major issue of concern in Sierra Leone. In the main referral maternity institution, Princess Christian Maternity Hospital (PCMH), up to 25% of maternal deaths occur during or shortly after transit from another health facility. There is an urgent need to improve referral systems between peripheral health units (PHUs) and PCMH. Our aim was to pilot and evaluate an eHealth tool facilitating referral of obstetric emergency cases through effective teleconsultation between PHUs and PCMH.

Methods

A web application was designed to capture unclear or complicated delivery cases at PHUs and request respective telemedical counselling from the referral institution PCMH. The eHealth tool was piloted at 10 PHUs in Western area urban and rural in August 2021. Necessary devices were provided and delivery staff was trained to use the app. In December 2021, we conducted focus group discussion with 3-6 delivery staff at five PHUs and at PCMH to evaluate utilization and outcomes of the tool.

Results

All participants perceived the eHealth tool as an improvement of referral procedures. Response time from PCMH after a request for counselling from a PHU was mostly <30 minutes. The main perceived advantage of the tool was the systematic documentation of obstetric complications and procedures. This relieved staff from fear of wrong treatment accusations, and recorded communication with PCMH made processes and responsibilities transparent. Another important benefit was PCMH staff being already prepared to receive a specific emergency case after use of the app, thus reducing the ‘third delay’ within the referral facility. As a major obstacle to smooth referral despite the eHealth tool, a lacking ambulance system was mentioned as a critical gap.

Conclusions

Exceedingly positive user experiences with this simple tool seem to make an expansion to more PHUs worthwhile. Benefits of using the app in more remote districts in Sierra Leone should be further investigated.

Key messages

• Delivery staff in Sierra Leone was capable of using a web app for telemedical counselling in a useful and effective manner.

• The eHealth tool was perceived as very helpful in systematically and transparently documenting emergency delivery cases and treatment procedures.
Application of the patient navigation model with people experiencing homelessness: a scoping review
Authors: Grabovac I , Carmichael C , Smith L , Aldasoro E , Gil-Salmeron A , Alhambra-Borras T , Donate-Martinez A , Seiler-Ramadas R
Published: October 2022

Background

Barriers in accessing healthcare services are a common issue that contributes to the disproportionately poor health outcomes in people who experience homelessness. A possible way to overcome these barriers and meaningfully engage with this under-served population is through the implementation of the so called patient navigation (PN) models. We conducted a systematic scoping review to gain a better understanding on how PN models are utilized with people experiencing homelessness and other comparable populations and to identify their features, barriers and facilitators to their implementation and their outcomes.

Methods

A systematic scoping review was done based on a predetermined protocol. We conducted a search of Web of Science, PubMed/Medline and Scopus databases on the 15th of June 2021. A narrative analysis of the included studies was conducted.

Results

Our search yielded 1203 hits, and after removing 475 duplicates, we were left with 728 publications of interest. Finally, 21 studies have been included in the review, comprising of nine review articles and 12 individual studies, with most studies stemming from the USA. Results show that PN models are consistently associated with improvements in a wide range of health related outcomes, mostly with timely access to healthcare services. Implementation strategies and measurements used in assessing PN models show heterogeneity between studies. However, a number of consistencies were found including; a longitudinal approach, using of non-clinical navigators who share similarities to the participant groups and who engage as facilitators. Additional considerations for gender and age may further improve the outcomes.

Conclusions

In order to improve on the success of the PN models and their application in removing barriers to healthcare access for people experiencing homelessness, more research is needed that focuses on the feasibility, acceptability and scalability of the approach outside the USA.

Key messages

• People experiencing homelessness experience considerable barriers in accessing healthcare service leading to disproportionately larger burden of disease as well as lower life expectancy.

• Patient navigation models have a great potential in removing barriers and facilitating timely access to healthcare services in people experiencing homelessness.
Digitalization-induced changes in health and social care work - perceptions of professionals
Authors: Kaihlanen A , Nadav J , Kainiemi E , Heponiemi T
Published: October 2022

Background

Digitalization has increased rapidly in health and social care and plays an increasingly important role in the daily work of health and social care professionals. The effects of digitalization are often viewed from the societal and economic perspectives, and less from the perspective of the changing health and social care work. This study examined how health and social care professionals perceive the effects of digitalization on their work.

Methods

Eight semi-structured focus-group interviews were conducted in four Finnish health centers at the end of 2020. The participants (n = 30) were nurses, physicians, and social workers. Qualitative content analysis with inductive approach was used to analyze the data.

Results

Four main categories emerged from the perceived effects of digitalization: 1) two-way changes in workload and pace (reduced/increased work, accelerated/slowed pace of work, duplication of work/saved employee resources), 2) changes in the content and nature of work (reallocation of work, emergence of new tasks, new skills needs, diversification of service provision), 3) changes in work community communication and interaction (improved interaction and communication, strengthened multidisciplinary collaboration, complicated remote interaction, reduced encounters) and 4) improved flow of patient information and information security (improved data transfer, patient monitoring and data protection).

Conclusions

Digitalization-induced changes in health and social care work seem to be manifold and often two-sided. It has the potential to ease the work and offer other benefits, but at the same time it may complicate work in other respects, especially if the system does not support work tasks or the usability is poor. When implementing new digital services and pursuing benefits, more attention should be paid to assessing and considering the potential disadvantages to minimize additional strain among already burdened health and social care professionals.

Key messages

• The perceived effects of digitalization on health and social care work are often two-sided and can contribute to the well-being of professionals.

• Monitoring the use of digital services and the experiences of professionals about them, as well as identifying their skills needs and training aspirations is crucial.
Presenting a Social Value Database and Simulator for Public Health
Authors: Cotter-Roberts A , Ashton K , Stielke A , Dyakova M
Published: October 2022

Background

There is increasing recognition that Public Health Institutes need to build on the traditional value for money approach, to find ways to capture, measure and show the full range of their outcomes, impacts and related value. As part of a drive to measure value and impact in public health and demonstrate how investment in health can contribute to an Economy of Well-being, Public Health Wales has developed an interactive database to capture and illustrate the social value of public health services and interventions.

Methods

Scoping reviews of both academic and grey literature were undertaken to populate a database of health economics evaluations of public health interventions, focusing on Social Return on Investment (SROI). In addition, a simulated methodology was developed which allows the evidence to be manipulated and made relevant to individual contexts to help inform investment decisions at a local level.

Results

To date, the database has accumulated an excess of 50 SROI evaluations of various public health interventions, across areas including mental health, behaviour change, physical activity, nutrition, employment and primary care. The evaluations are based on European and International contexts, are published in both grey and academic sources, and are of varying quality.

Conclusions

SROI is a credible method for measuring the value of wider social, economic and environment outcomes achieved from public health interventions. The Social Value Database and Simulator presents a collation of studies and analysis utilising innovative health economics methods.

Key messages

• Public Health Wales’ Social Value Database and Simulator collates economic evaluations of public health interventions, to be used by policy makers to enable improved investment in health and well-being.

• Social Return on Investment is a credible method for measuring the wider impact created by public health interventions.
Sources of perceived social support and emotional difficulties in late adolescence
Authors: Östberg V , Låftman SB , Raninen J
Published: October 2022

Background

Late adolescence is a life phase when mental health problems are common. Social support is, however, associated with less problems. Social support stems from different sources with the family being the main provider in early life while friends gain in importance during adolescence. Using the Multidimensional Scale of Perceived Social Support (MSPSS), this study investigates the relative importance of different sources of support for emotional difficulties in girls and boys.

Methods

Data was derived from the Swedish population-based cohort study Futura01 (girls: n = 2105, boys: n = 1673). Adolescents in the final year in compulsory school (aged 15-16 years) were sampled in 2017 and followed up in 2019 (aged 17-18 years). Perceived social support was measured at 17-18 years by the MSPSS scale. Emotional difficulties were measured at 15-16 and 17-18 years by the Strengths and Difficulties Questionnaire (SDQ) subscale. Linear regression analysis was used to study associations between support sources and emotional difficulties at 17-18 years, adjusting for all support sources, family type, upper secondary school program as well as prior emotional difficulties.

Results

Among girls, emotional difficulties were associated with perceived support from family (b=-0.22; 95% CI -0.29; -0.15) and friends (b=-0.26; 95% CI -0.35; -0.18) but not significant others (b = 0.00; 95% CI -0.10; 0.11). Among boys, emotional difficulties were associated with support from family (b=-0.10; 95% CI -0.18; -0.02), friends (b=-0.17; 95% CI -0.25; -0.09) and significant others (b=-0.13; 95% CI -0.22; -0.04).

Conclusions

The negative association between perceived social support and emotional difficulties, irrespective of prior emotional difficulties, suggests that support has a protective effect. In late adolescence, support from friends and, to a similar degree, the family seems to matter for mental health. Support from significant others did however not show a protective effect in girls.

Key messages

• Adolescents aged 17-18 years with higher levels of perceived social support report less emotional difficulties.

• Efforts to increase family and friend support are relevant for adolescent mental health.
Promotion of healthy living environments in communities: a digital planning tool for local public health actors
Authors: Busskamp A
Published: October 2022

In their function as overarching settings, communities have a controlling role and political competence for the development and implementation of healthy living environments in Europe. However, the establishment of health-promoting structures is often hampered by a lack of resources and know-how, and decisions in practice are mostly based on personal experiences or standard procedures, which are often not in line with scientific findings and evidence-informed decision making. In the area of physical activity and older people, a digital planning tool (“Impulsgeber Bewegungsförderung”) compromising tools for needs assessment, interventions and information on physical activity, process management, legal issues and funding is being built to support the implementation of practices by local public health actors. This presentation will introduce the digital planning tool and its process evaluation. A mixed-method approach was applied to answer the question of whether and how the application can succeed in community settings and which additional needs of local actors exist. Initial steps of the recruited socio-economically disadvantaged model regions were setting up local steering committees and needs assessment using the tool. The model regions confirmed the usefulness of the tool in their day-to-day work, but used it with varying frequency. Among others, the tool helps to raise awareness among key actors, to reflect on their own work, or to identify funding sources. Wider use of the digital tool may lead to more evidence-informed actions in health promotion and prevention. The evaluation of the digital planning tool in a small area of health promotion will provide initial insights into how to support the implementation of activity-promoting living environments on a local level.
7.N. Workshop: Mental health promotion is key to making a change for children and adolescents
Authors:   Organised by: EUPHA-CAPH,   Chair persons: Julia Dratva (EUPHA-CAPH), Jutta Lindert (EUPHA-PMH)
Published: October 2022

The Covid-19 pandemic highlighted the already high burden in children and adolescents and has caused an increasing mental health burden in this age group. While provision of treatment is highly relevant, this alone is unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. It is elemental to promote and strengthen mental health, also knowing this will not be the last crisis to tackle. Alongside of low threshold support and prevention, health promotion can strengthen individuals’ resilience or coping mechanisms. Next to individual and target group interventions, health promotion interventions also follow a setting approach, according to which people are understood as part of the social systems in which they live and spend their time. This workshop is about mental health promotion in youth. We wish to point to the importance of health promotion in the overall aim to improve mental health. The first presentation will provide an overview of mental health promotion concepts and mechanisms, providing evidence-based arguments and examples. The second presentation focusses on the ABC-framework to develop and implement MHP initiatives developed by the WHO. The last two presentations address the setting-approach, school and family and their potential in mental health promotion. In the concluding discussion with workshop participants, we will address questions, experiences, and best practices in mental health. The aim of this workshop is three-fold:

1. Provide the back-drop and a theoretical & practical basis on mental health promotion.

2. Present both individual and setting-specific examples of mental health promotion.

3. Provide room for discussion on experience and best practice in mental health promotion in youth.

Key messages

• Mental health promotion is an important element in reducing mental health burden in children and adolescents.

• Health promotion can effectively be implemented on an individual and structural level.
Challenges in school-to-work transition for marginalized groups - the need to strengthen structures for vulnerable youth (post pandemics) Findings from the German project “Co*Gesund”
Authors: Kuchler M , Heid K , Rademaker A , Quilling E
Published: October 2022

Objective

The transition from school to work is a challenge for young people which is closely correlated with health and well- being. Promoting resilience factors contributes to adolescents’ mental health and social and educational success. The aim of this study is to examine how especially vulnerable youth cope with the transition during the pandemic to identify which structural measures are helpful and which are a hindrance and to develop recommendations for action.

Methods

First, a rapid review on the subject of young people's mental health during the pandemic was conducted. Based on this 30 interviews with professionals from schools and vocational education and two focus groups with young people from participating institutions follow in spring and summer 2022. Finally, recommendations for action will be developed together with both groups.

Results

The results of the literature research illustrate the strong influence of the pandemic on the mental health of adolescents and, in particular, the increase in health inequalities along the social gradient. In relation to school and education, it is clear that young people lacked contact persons during this time. It is expected that the interviews and focus groups give insight, which resources of the young people can be strengthened in a low- threshold way and will provide further concrete indications on what structural development is needed to strengthen the resilience of young people.

Conclusions

For the promotion of mental health it is necessary to rely not only on the resources of young people themselves, but especially on the resources available in their environment. Only in this way transition processes can be managed successfully by the young people and they can be strengthened for the future. To this end, solutions should be developed jointly and support systems should be improved
Italian survey on the use of a multidisciplinary approach for age assessment of UAM
Authors: Diodati A , Curtale F , Mirisola C , Costanzo G
Published: October 2022

Issue

Many methods are used to assess the age of unaccompanied foreign minors (UAM). In Italy, in the frame of a new legislative asset, a multidisciplinary protocol has been adopted in July 2020 with the aim of ensuring that all UAMs are assessed uniformly throughout the country when their age is in doubt. The assessment is based on a multidisciplinary - social, psychological and physical - evaluation performed by a team of specialists. The local health authorities (ASL) carry out the assessment when requested by the Juvenile Court.

Description

One year after the establishment of the protocol, INMP launched a national survey, through an online questionnaire, to investigate the formal adoption of the protocol by the ASL and their adherence in practice. The survey started on 10 January 2022 and closed on 8 March 2022.

Results

Out of 118 ASL that were asked to participate, 102 (85%) answered. 37 declared to have a multidisciplinary team for age assessment. Of them, 18 use the formal protocol, 11 use an approach “in line” with the protocol and 8 have a forensic team, out of the rules of the protocol. Of the 65 that did not set up the team, 22 declared that they were ready to do so. 846 age assessment requests were reported and 687 were carried out. 398 migrants were recognized as minors, 222 migrants were not recognized as minors, and the age of 67 migrants remained uncertain.

Lessons

The pandemic period prevented the effective adoption of the protocol by the ASL, that were strongly engaged in the COVID 19 response. There is still great variability in the way the age assessment of UAMs is conducted and in order to counteract the use of inadequate/outdated practices, it is necessary to actively promote and support the adoption of the protocol. In addition, a continuous comparison/dialogue between the multidisciplinary teams, the Juvenile Court, and the Police Headquarters is also needed, so that the procedure is requested only when necessary and carried out properly.

Key messages

• In case of doubt, the age of all UAM has to be assessed in a uniform manner throughout the country.

• The adoption of the multidisciplinary protocol has to be actively promoted and supported to counter the use of inadequate or outdated assessment practices.
Evaluation of opt-in HIV testing in the construction workplace using the socioecological framework
Authors: Blake H , Somerset S , Jones W , Evans C , Cirelli C , Mbang D
Published: October 2022

Background

Late diagnosis of HIV remains a challenge and the construction workforce has several risk factors for HIV. In the Test@Work programme, we delivered HIV tests embedded within a general health check to construction workers, with high uptake and acceptability. Here, we report the experiences of construction managers and health professionals involved in Test@Work and explore the suitability of construction worksites as a venue for opt-in HIV testing.

Methods

Qualitative interviews (n = 24) were conducted with construction managers who facilitated events (n = 13), and HIV/health check delivery partners (n = 11) at 21 Test@Work events held on construction sites. Interviews explored experiences of events and views towards workplace HIV testing. Event exit questionnaires (n = 107) completed by delivery partners provided qualitative data identifying facilitators and barriers to effective delivery. Thematic analysis identified themes that were mapped against a socioecological framework (individual, interpersonal, organisational, industry, public health).

Results

Delivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing. HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk. Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities.

Conclusions

The construction sector is complex with a largely male workforce. Providing worksite HIV testing and education to an untested population who have poor knowledge about HIV risk helped to normalise testing, increase uptake, and reduce HIV stigma. However, there are practical barriers to testing in the construction environment. This has global implications for delivery of HIV testing in construction workplace settings.

Key messages

• Delivering workplace HIV testing as part of a general health check helps to normalise HIV testing and reduce HIV-related stigma.

• Workplace testing is convenient, accessible and reaches populations at risk for HIV, but there are some barriers to implementation of rapid tests on construction sites.
Review of interoperability standards as data quality supporting elements
Authors: Doupi P , Estupiñán-Romero F , Comendeiro-Maaloe M , Launa R , Mäkinen M , Bernal-Delgado E
Published: October 2022

WP6 has approached the target of supporting trustworthy secondary use of health and health care data through two operational objectives: developing the EHDS data quality assurance framework for real-world health data and developing the EHDS secondary use Semantic Interoperability Framework. For the latter objective, several interoperability standards were identified in accordance with the EHDS2 data life cycle and user's journey approach, hence focusing on data discoverability (at data source and variable levels), communication support across nodes and on development of common data models. Selection was based on active participation of WP6 leaders in various pertinent workshops and interactive activities, both in the framework of TEHDAS (Stakeholder and Project Forum meetings) as well as other relevant initiatives (e.g. the PHIRI project). Input was also sought from Commission representatives and EU-level regulatory authorities. In a first step, standards were catalogued based of features such as typology of interest, utility and application domains. In the next phase we organised virtual semi-structured interviews with key representatives of over 20 standards (incl. HL7, SNOMED, CDISC, DCAT, OMOP etc.). The focus of the interviews targeted experiences in standards’ actual use, challenges in their implementation, issues of maintenance and sustainability, as well as undergoing collaborations and developments. Sessions were recorded and subsequently the transcripts of discussion extracted automatically. The process of analysing interview materials is presently ongoing, using an adapted version of the Common Assessment Method for Standards and Specifications (CAMSS) v.4.0.0. toolkit. Interim results will be discussed within the Joint Action meeting activities in June 2022, to produce a version for wider stakeholder dialogue later in the fall. Results and recommendations generated through this process will also be presented for discussion with the workshop audience.
Intergenerational education and premature mortality: a registry population-based study
Authors: Carmeli C , Anker D , Chiolero A , Cullati S
Published: October 2022

Inequalities in premature mortality due to individual's attained education are well documented. Intergenerational educational trajectories, whereby both parental and individual education may affect mortality, have received less attention. Our aim was to assess the effect of intergenerational educational trajectories on sex- and cause-specific risks of chronic disease-related premature mortality in Switzerland. Data were from 695,972 individuals born between 1971 and 1980, who were followed from adolescence (10-19y) to mid-life (38-47y) in the Swiss National Cohort, a registry population-based study. Educational trajectories were categorized into four levels: High-High, High-Low, Low-High, Low-Low, which corresponded to the sequence of parental-individual attained education (exposure). Cause of death categories were cardiovascular disease (CVD), cancer, substance use and all other chronic diseases (outcome). We implemented a counterfactual-based framework to quantify inequalities and ran negative outcome controls to triangulate findings. Overall, inequalities were negligible for women and substantial for men, particularly in CVD and substance use deaths. Specifically, inequalities in CVD were negligible by age 30, while by age 45 inequalities due to a High-Low or Low-Low trajectory corresponded to 229 (95% confidence interval (CI): 99, 381) additional CVD deaths per 100,000 persons compared to a High-High trajectory. Inequalities in substance use deaths due to a High-Low trajectory corresponded to 106 (95% CI: 47, 208) additional deaths per 100,000 persons compared to a High-High trajectory by age 30, and increased afterwards. We identified sex- and cause-specific groups at high-risk of premature mortality, and life periods when inequalities due to both parental and individual education arise. Prioritization of prevention strategies in those life periods and groups may help reduce educational inequalities in chronic disease-related premature mortality.
Suicide prevention in France put to the test by COVID-19
Authors: Jollant F
Published: October 2022

Introduction

Each year, nearly 9,000 people die from suicide in France, and more than 150,000 attempt suicide. In spite of a decrease for the last 30 years, rates of suicide in France remain higher than the European mean. Since 2018, a national suicide prevention strategy of the Ministry of Health has been in place. In 2020, this new strategy has been exposed to the COVID-19 pandemic.

Methods

First, the different actions of the national suicide prevention strategy will be presented, followed by the results of the available data regarding the impact of COVID-19 on suicidal gestures. These data are 1) hospitalizations for self-harm (ICD-10 codes X60 to X-84) from the national health database; 2) calls to poison control centers and 3) visits to the emergency room for a suicide attempt. The latest figures available will be presented.

Results

The analysis of these data compared to 2019 highlights two main periods. Between March and December 2020, a significant decrease in suicide attempts was observed (8.5%), with a rapid drop during the first week of the first confinement in mid-March 2020, in women and men, and in all age groups except old-aged people. Since January 2021, a significant increase in suicide attempts has been observed among teenage girls, including high-lethality acts. Moreover, among the young and the elderly, the figures are now similar to 2019. Only numbers for middle-aged adults continue to decline.

Conclusions

The impact of the COVID-19 pandemic on suicide attempts appears to be variable over time, according to age and gender. The old-aged people and young people, especially adolescent girls seem to have suffered the most from this situation. It is still too early to know whether the new national suicide strategy has had any positive impact. However, the pandemic has highlighted certain weaknesses in the French system, in particular the lack of recent data on mortality by suicide, and the heavy dependence on a fragile mental health medical system.
Self-stigma in suicide prevention of mental health professionals
Authors: Roškar S , Kralj D , Andriessen K , Krysinska K , Vinko M , Podlesek A
Published: October 2022

Introduction

Stigma is one of the main factors hindering help-seeking, which can have debilitating effects on mental health and even lead to suicidality. Stigma can affect the general public but also mental health professionals. In this study we examined mental-illness and help-seeking self-stigma as well as public stigma of suicidal behavior among suicidologists.

Methods

Invitation to participate in the study was sent to 518 member of the Internat.l Assoc. for Suicide Prevention. 89 participants (55 female, 34 male; 17% response rate) completed the survey. We gathered sociodemographic data, data on personal history of mental illness and suicidal behavior and on different types of stigma. We hypothesized that help-seeking self-stigma is predicted by sociodemographic attributes and personal history of mental illness and that self-stigma related to mental illness and suicide act as mediators.

Results

Personal experience with mental illness predicted mental illness self-stigma. There was no significant predictive value of other variables (age, gender, years working in suicidology) for self-stigma of mental illness and suicide behavior. Both types of self-stigma (mental illness and suicide behavior) were correlated. Mental-illness self-stigma was shown to be a stronger predictor of help-seeking self-stigma than self-stigma of suicide behavior, though the effect did not reach statistical significance. Self-stigma of suicide behavior showed no independent contribution to help-seeking self-stigma.

Conclusions

Mental healthcare professionals represent a particularly vulnerable group for developing mental health issues and suicidality. However, due to fear of being perceived less competent by colleagues and the public, they often disguise their mental struggles and are reluctant to seek help. These pilot findings warrant further research to better understand self-stigma and its impact on help-seeking behavior in order to prevent suicidality in this population.