bluuebunny/crossref_metadata_2025 huggingface dataset:
Health literacy and access to health services: insights from a national survey in Italy
Authors: Marcozzi B , Unim B , Rosano A , Lorini C , Bonaccorsi G , Donfrancesco C , Zanobini P , Lo Noce C , Galeone D , Palmieri L
Published: October 2024

Background

Health Literacy (HL) entails accessing, understanding, evaluating, and applying healthcare (HC) information. Aim of this study is to assess HL association with HC services use in the Italian adult population.

Methods

A national survey was conducted in Italy in 2021, in the framework of the WHO network Measuring Population and Organizational Health Literacy (M-POHL). A validated questionnaire was administered to a representative sample of the Italian resident population aged 18+ years (N = 3,500). A 4-point Likert scale was used for answers: very easy, easy, difficult, very difficult. The HL index, as the percentage of very easy/easy responses, was categorized as Inadequate (0-50%), Problematic (51-66%), Sufficient (67-80%), Excellent (81-100%). Inadequate/Problematic were combined in ‘Limiting’ and Sufficient/Excellent in ‘Not limiting’ categories. A multivariate logistic regression analysis, adjusted by sex, age, geographical area, education, and financial deprivation, was used to explore the associations between HL and the frequency, of utilization of general practitioners-GPs (never, once/twice, three/more times), medical or surgical specialist services-MSS (never, once, twice/more), inpatient hospital services-IHS (never, once/more), day-patient hospital services-DPS (never, once/more), taking sick days at work-SD (never, once/twice, three/more) in the last 12 months, and emergency services-ES (never, once/more) in the last 24 months.

Results

In Limiting HL (64.6%), the prevalence of never using ES is significantly lower compared to Not limiting HL (81.83% vs 83.80%); likewise for never using MSS (45.84% vs 51.24%) and never using DPS (90.87% vs 93.80%). Significant association with Limiting HL was found for using MSS once (Odds Ratio-OR=1.55), twice/more (OR = 1.76) and taking SD once/twice (OR = 1.58).

Conclusions

Results demonstrate that people using HC services more frequently, in particular MSS and taking SD, require dedicated support to improve HL.

Key messages

• This study aims to evaluate the association of the individual Health literacy level with the use of several healthcare services in the Italian adult population.

• ‘Limiting’ Health Literacy is associated with using medical or surgical specialist services twice or more times and taking sick days at work once or twice.
3.M. Skills building seminar: Culture, Arts and Mental Health
Authors:   Organised by: EUPHA-PMH, -ENV,   Chair persons: Marija Jevtic (EUPHA-ENV), Jutta Lindert (EUPHA-PMH)
Published: October 2024

Improving mental health is a challenge, not only for the health sector, so research into innovative ways to improve mental health in the community is necessary. The WHO Regional Office for Europe together with its expert group on the cultural contexts of health and well-being promote a culturally grounded approach to enrich policies related to health and well-being. The cultural contexts of health and well-being argues that incorporating cultural issues into policy-making is critical to the development of adaptive, equitable and sustainable health care systems, and to making general improvements in many areas of population health and well-being. Population health and well-being are influenced by actions external to health care systems, also. By health-in-all-policies approach it is given an understanding of how policies in non-health domains can foster or constrain a culture and art for health. Social prescribing and art-for -health activities are important tool for improvenment mental health. This skils building seminar will discuss some good practice and examples, and also cooperation with experts from cultural sector in the mental health field.

Key messages

• The innovative concept of cooperation between Culture and Health institutions brought positive experiences and impressions to all participants who used ‘culture on prescription’.

• The integration of arts into healthcare and community settings offers a holistic approach to promoting health and fostering well-being.
Psychometric evaluation of a COVID-19 health literacy scale applying Rasch analysis
Authors: Meyer M , Dadaczynski K , Messer M , Okan O
Published: October 2024

Background

Assessing health literacy in times of the COVID-19 pandemic is vital, since health literacy has been highlighted as a personal resource for managing health information. The HLS-Covid-Q22 questionnaire was developed to measure self-reported COVID-19 health literacy in adults. It has been used and validated, mainly using confirmatory factor analysis, in some studies with different target groups. However, several comprehensive validation studies are needed to ensure the feasibility of a novel measurement tool. In the current study, Rasch analysis has been chosen, as this analysis transforms the categorical responses of the items of the HLS-Covid-Q22 into linear measures.

Methods

The psychometric properties of the HLS-Covid-Q22 were evaluated in a sample of 2187 German adults applying Rasch analysis. The data is from the German COVID-HL school survey that was generated by employing an online survey in school principals during the third infection wave from March to April 2021 in four federal states. Applying the Partial Credit Model for polytomous data, the responses to the HLS-Covid-Q22 items were transformed into linear measures, unidimensionality was tested and several indices to assess the quality of the measurement tool were computed.

Results

Unidimensionality of the questionnaire could be confirmed. The rating scale steps worked as intended. Participants used every rating category. Item fit could be verified. High reliability indices were found with a person separation index of 3.41, person reliability of .92, item separation of 20.08 as well as item reliability of 1.0.

Conclusions

The HLS-Covid-Q22 appeared to be a reliable and valid questionnaire which has not been validated by applying Rasch analysis before. Even though Rasch analysis is already a well-established validation method in other disciplines, it should be used to evaluate other health literacy questionnaires more often to gain comprehensive insights into the intended functioning of measurement tools.

Key messages

• The HLS-Covid-Q22 questionnaire appears to be a valid and reliable measurement tool.

• Rasch analysis is an appropriate method to evaluate the psychometric properties of likert-type rating-scale questionnaires.
The effect of health literacy course on the level of health literacy in medical students
Authors: Topcu V , Ozdemir Oztel H , Ozkan S
Published: October 2024

Health literacy (HL) concerns not only individuals but also health systems and health professionals. Most of the literature on HL has focused on patient factors, with little emphasis on the communication skills and practices of health professionals. Training is needed at all levels to understand the concept of HL and its impact on health inequalities. This study is an intervention study. Data were collected from 29 students taking the third year elective course at the Faculty of Medicine through an online survey. The survey consists of 40 questions aimed at assessing the demographic characteristics of the participants, the TSOY-32 Scale and some factors affecting HL. During the training period, role-play scenarios were played to teach the importance of HL, sample videos were watched to evaluate physician-patient communication, and case studies were conducted. The mean pre-test TSOY-32 scale score of the participants was 32.8±5.8. The mean post-test TSOY-32 scale score was 36.4±7.1. There was a significant difference between pretest and posttest groups in terms of TSOY-32 scale score (p = 0.033). Health professionals often overestimate patients’ HL levels and do not have sufficient competence to effectively manage limited HL. These gaps need to be addressed through the curricula of medical schools and specialties.

Key messages

• Training on health literacy improves medical students’ communication skills, bridging gaps in patient care.

• Addressing health literacy in medical training enhances patient-doctor communication, vital for quality care.
Health literacy and health-related outcomes among preschool educators: a cross-sectional survey
Authors: Rauschmayr S , Krudewig C , Okan O
Published: October 2024

Background

Given the increasing use of childcare services and the shortage of skilled workers, preschool educators are under particular pressure. Health literacy has previously been shown to be an asset for stress and well-being in school principals. Within the organizational health literacy in preschools project, the Health-Literate Preschools Survey aims to assess educators’ health literacy levels and investigate differences in health-related outcomes based on these levels.

Methods

Preschool educators from a Bavarian county participated in a cross-sectional online survey in February 2024. Sociodemographic information, health literacy, and health-related outcomes (well-being, exhaustion, psychosomatic complaints) were assessed using established self-report tools. Descriptive statistics and variance analyses were carried out using SPSS.

Results

The sample consists of N = 114 preschool educators from a Bavarian region (94.6% female, Ø 41.5 years). Of the educators, 23.7% showed adequate, 50.0% problematic, and 26.3% inadequate health literacy levels. Kruskal-Wallis H analyses indicated statistically significant differences in well-being (H(2, n = 113) = 14.200, p < 0.001), exhaustion (H(2, n = 114) = 6.098, p = 0.047), and psychosomatic complaints (H(2, n = 114) = 8.910, p = 0.012) across health literacy levels.

Conclusions

The survey provides first-time insights into preschool educators’ health literacy and health-related outcomes in Germany. Only one-quarter of preschool educators demonstrated adequate health literacy levels. Further, the findings confirm the link between health literacy and well-being and stress already shown for other samples. Health promotion initiatives for preschool staff should focus on strengthening educators’ health literacy, especially given their role model function for children.

Key messages

• This survey is the first assessment of health literacy among preschool educators, which is an important target group given their role model for young children.

• Preschool educators demonstrated overall low levels of health literacy, which is associated with well-being, exhaustion, and psychosomatic complaints.
Food and nutrition literacy in Austria - results of a representative study
Authors: Schuetze D , Griebler R , Link T , Schindler K
Published: October 2024

Background

A healthy diet is a key factor in people’s long-term health. The nutritional health literacy and food literacy of the population play a crucial role in this. In 2021, comprehensive data on these competences were collected for the first time in Austria.

Methods

Almost 3,000 people were surveyed online. Nutrition health literacy was assessed with the newly developed Nutrition Health Literacy Scale (NHLS) and food literacy with the Self-Perceived Food Literacy Scale Short-Form (SPFL-SF). Scores and subscores were calculated. Associations between socio-demographic and socio-economic factors and the competences surveyed were assessed using t-tests, variance analysis, correlations, and multivariate regression models.

Results

In terms of nutritional health literacy, respondents score an average of 60 out of 100 points, with judging (51 points) and applying (60 points) nutritional information being the most difficult. In the area of food literacy, respondents score an average of 62 out of 100 points. The most challenging areas are ‘healthier choices’ (44 points), ‘healthy snacking’ (52 points) and ‘healthy eating in exceptional circumstances’ (54 points). In both areas, men and people with less formal education score lower. In the case of nutritional health literacy, people aged 65 and over have greater difficulties. Conversely, this group performs better in the area of food literacy. Differences by income can only be seen for nutritional health literacy, to the detriment of low-income groups.

Conclusions

Possible options for action include the provision of quality-assured and target-group-specific information, the implementation of appropriate tools to facilitate the assessment of foods, and measures to strengthen assessment skills, digital health literacy, food and nutrition skills.

Key messages

• The survey showed that there is potential for improvement in both nutritional health literacy and food literacy.

• The biggest challenge is to evaluate and use nutritional information and to stick to a healthy diet without making exceptions.
Assessing cancer prevention literacy among European population: a cross-sectional study
Authors: Romeo-Cervera P , Pinto-Carbó M , Blanco-Cabañes A , Torres-Mariner M A , Fons-Martínez J , Vanaclocha-Espí M , Castán-Cameo S , de Pablo-Pardo T , Molina-Barceló A ,   BUMPER Consortium
Published: October 2024

Background

Cancer prevention literacy (CPL) is essential for empowering individuals to make health-informed decisions and adopt preventive measures to reduce their cancer risk. This study aims to measure CPL among the European population.

Methods

A cross-sectional population-based study was conducted from February to March 2024 among European residents over 18 years old (N = 2312) in the context of BUMPER Project (https://bumper.cancer.eu/). An online self-administered questionnaire was developed including: sociodemographic characteristics (age, gender, country of residence, educational level), and CPL (general and by European Code Against Cancer -ECAC- topics). A descriptive analysis was performed and the chi-square and Kruskal-Wallis test were calculated to examine the relationship between CPL and sociodemographic variables.

Results

44.2% showed a high level of CPL, followed by 39.5% with medium, and 16.3% with low level. 61.1% of participants are not aware of ECAC. ECAC topics with higher levels of knowledge are: UV exposure (88.3%), pollution (81.6%), tobacco (78.7%), second-hand smoking (60.9%). ECAC topics with lower levels are: hormone replacement therapy (47.9%), breastfeeding (41.6%), and vaccination (32.9%). Statistically significant differences (p < 0.05) are observed in CPL level by gender, country of residence, and educational level. Those with a higher % of low CPL levels are men (22.8%), people from West and South Europe (20.8% and 18.1%), and primary education level (34.7%).

Conclusions

CPL level is medium-high among the European population, with social and gender inequalities. Further studies are needed to delve into these inequalities.

Key messages

• The cancer prevention literacy level is medium-high among the European population, with social and gender inequalities.

• There is a need of tailored interventions to address social inequalities in cancer prevention literacy among European population.
Implementation of organizational health literacy depending on school characteristics in Germany
Authors: Krudewig C , Kirchhoff S , Okan O
Published: October 2024

Background

Children and adolescents are important target groups for health promotion measures to sustain a healthy upbringing. Organizational health literacy in schools is a promising environmental intervention to strengthen health literacy in school children. This study examines the relationship between school characteristics and the implementation of organizational health literacy.

Methods

School principals in Germany were invited to complete a 20-minute online survey between November 2022 and July 2023. An 8-item self-report tool was used to measure organizational health literacy in schools (OHLS-Q-SF) that comprehends eight different areas within schools to become health literate. A hierarchical cluster analysis was carried out to identify groups according to the composition of the socioeconomic status of the student body. Descriptive statistics, Mann-Whitney-U tests, and Kruskal-Wallis tests were performed.

Results

598 school principals (73.6% female, Ø 52.3 years old) who worked at primary schools (49.1%), secondary schools (37%), and special education schools (13.9%) completed the survey. Cluster analysis revealed two groups. The first one (36.8%) contains schools with mainly students with lower socioeconomic status, and the second group (63.2%) contains schools with more students from middle or higher socioeconomic status. The socioeconomic status of students within the schools showed no significant results for any area of organizational health literacy, whereas all eight areas are more likely implemented if the schools already participate in a school health promotion program or network (p < 0.001).

Conclusions

Participating in a school health promotion program was associated with higher levels of implementation in all areas of organizational health literacy in schools. This finding highlights the importance of those programs. Integrating organizational health literacy into those interventions can be a beneficial approach to sustaining health literate schools.

Key messages

• Participating in a school health promotion program or network might facilitate schools to become health literate organizations.

• In Germany, the socioeconomic status of the students within the schools is not associated with the implementation of organizational health literacy.
Health literacy and individuals’ perception regarding Heart Failure management: patient perspective
Authors: Pedro A R , Raposo B , Brandão D , Martinho H , Almeida M , Pardal M , Bernardo F , Cunha A S
Published: October 2024

Background

Heart failure (HF) is a multidimensional disease that has a significant impact on the quality of life of people with this condition and the person’s level of health literacy is a key element in disease management. Therefore, this analysis aims to assess the correlation between the level of health literacy of people with HF and their level of concern about managing the disease, their perception about quality of life, and access to healthcare.

Methods

Cross-sectional study conducted through a survey among adults with HF, residents, and healthcare consumers in Portugal. The survey comprised 6 questions on health literacy (HLS-EU-Q6); 9 dimensions of concerns in HF management (4-level scale ranging from “not concerned” to “very concerned”); quality of life and access to healthcare perceptions (5-level scale ranging from “very bad” to “very good”). Concerns global score was calculated based on 9 dimensions of concerns about HF management. The statistical analysis included Spearman’s and Pearson’s correlations.

Results

A total of 428 responses were analysed. Respondents had a mean age of 70 years, 52.1% were men and 67.9% have secondary education. 47.0% of respondents perceived their access to healthcare as “good”, 63.3 % perceived their quality of life as “reasonable” and 61% have low levels of health literacy. Individuals with a higher health literacy level tended to have lower levels of concerns regarding HF management (r=-0.133; p = 0.006); individuals with a higher level of health literacy tended to have a better perception of their access to healthcare (ρ = 0.145; p = 0.003) and quality of life (ρ = 0.220; p < 0.001).

Conclusions

The findings reinforce that overcoming health literacy obstacles must continue to be a focus of healthcare systems and institutions to enhance healthcare access, quality of life, and chronic disease management. These efforts may result in better health outcomes, promote health equity and general well-being in this population.

Key messages

• Individuals with Heart Failure with higher levels of health literacy report less concerns about the management of their condition.

• Individuals with Heart Failure and lower levels of health literacy have a worst perception of their access to healthcare and quality of life. Health literacy promotion must continue to be a priority.
Training of women in the methodology of Gamification for the promotion of healthy habits in children
Authors: Castro Ramírez C , Ruiz González L , Sierra Delgadillo V , Acosta Fajardo L , Córdoba Pulido S , Gutiérrez Gómez D , Romero Correa J , Guzmán Gutiérrez C , Aburto-Corona J
Published: October 2024

Background

It has been evidenced that gamification has scope in the change of people behavior and in the acquisition of knowledge, therefore this methodology contributes to the promotion of health and adapts to the needs of children from the language of play, which increases their motivation in health literacy processes, so it is necessary to encourage the acquisition of new methodologies for community mothers and women caregivers, who are configured as promoters of healthy habits with their children.

Objectives

To train 150 women in the methodology of Gamification for the promotion of healthy habits in children; for which 20 sessions were developed addressing the following modules: a) Empowerment of women b) Gamification methodology c) Healthy habits and lifestyles d) Healthy eating e) Physical activity.

Results

The training of women evidenced a) the empowerment and recognition as health promoters for their life and that of their community b) the identification of the methodology of gamification and its application in processes of promotion of healthy habits c) a high adherence in the participation and learning through gamification methodology, training 150 women through sessions mediated by Information and Communication Technologies (ICTs), Learning and Knowledge Technologies (TACs) and Technologies of Empowerment and Participation (TEP) enabling the participation of women from urban and rural territories, which accounts for an inclusive process and democratization of health knowledge, impacting both women and their families, communities and children under their care, an average of 5 members per woman, benefiting 750 people in health promotion actions.

Conclusions

150 women were certified, who from the application of the gamification methodology promote healthy habits in children, in their families and their communities, starting from the recognition of the experience of these in themselves to be health promoters in their territories.

Key messages

• Training women in gamification methodologies to promote healthy habits in children strengthens the health system by empowering them in their role as health literacy teachers in their territories.

• ICT, TAC and TEP enable access to health education from an inclusive process that democratizes knowledge so that communities are active agents in health promotion activities.
Can ChatGPT affect health literacy?
Authors: Marasovic Šušnjara I , Ćulav Šolto M
Published: October 2024

Background

ChatGPT is a large language model based on artificial intelligence, which nowadays finds application in various fields, including medicine.

Objectives

To investigate the usefulness of ChatGPT related to health literacy and to highlight its potential limitations.

Methods

We searched PubMed/MEDLINE for published research and articles that reviewed ChatGPT in the context of health literacy, written in English over the past five years with free full text access. All original articles were screened.

Results

A total of 53 publications were found. Twenty-five publications met the inclusion criteria and were included in the review. Most of the works presented a positive opinion towards the use of ChatGPT. The authors of six articles believe that ChatGPT generates more readable papers, while four of them believe the opposite. In four articles authors found out possibility to simplify text. The negative sides relate to the possibly insufficient education of users, the accuracy of the information, potential bias, dependence on the outdated data, and the ethical problem of the real authors not being cited, and therefore not recognized for their work.

Conclusions

According to the conducted research, ChatGPT represents an opportunity to improve health literacy by generating accessible and comprehensible information about health. It has also been shown to improve the readability and accessibility of public education materials on selected health topics. Furthermore, while AI models like ChatGPT can serve as a reliable source of health information, they should be used as an addition to professional medical consultation, and not as a standalone advice service.

Key messages

• ChatGPT represents an opportunity to improve health literacy.

• AI models like ChatGPT can serve as a reliable source of health information, but they should be used as an addition to professional medical consultation, and not as a standalone advice service.
Mental health literacy in Austria - results of the first representative population survey
Authors: Griebler R , Schuetze D , Vana I
Published: October 2024

Background

Mental health has been a pressing public health issue long before COVID-19 and is even more so now. In this context, strengthening mental health literacy (MHL) is seen as a key lever for improving the mental health of the population. qAs there are no nationwide data available, the aim of our study was to collect data on MHL in Austria.

Methods

Data on population MHL were collected in 2023 as part of the second wave of the ‘Health Promotion Panel’, a representative survey of the Austrian resident population aged 16 and over. Data were collected online and by mail from approximately 1,000 individuals. As part of the M-POHL Health Literacy Survey 2024-2026, we developed and tested a new survey instrument to measure MHL. The MHL instrument comprises 26 MHL tasks distributed across four domains (mental well-being, mental stress, mental health problems, mental illness). The respondents were asked to rate the tasks according to their perceived ease and difficulty. Associations with sociodemographic factors and mental well-being were examined using bivariate and multivariate methods.

Results

In all four domains of MHL, respondents rated tasks related to finding and understanding information and services as easier. Tasks related to judging and applying information and services were rated as more difficult. The results indicate that MHL differs according to age and educational level. Across all tasks and domains of MHL, people aged 60+ and those with lower education exhibited greater difficulties with the MHL tasks. While people aged 60+ had the greatest difficulty in judging information and services, people with lower education had greater difficulty in almost all domains.

Conclusions

This study was the first representative study on MHL and showed major deficits in MHL among the Austrian population, also in prevention and health promotion. Targeted interventions are urgently needed to strengthen MHL in Austria, targeting the most vulnerable population groups.

Key messages

• A large proportion of the Austrian population has difficulty dealing with information and services to promote, maintain and restore mental health.

• The difficulties also affect the areas of prevention and health promotion that are crucial for coping with mental stress and enhancing well-being in everyday life.
Impact of digital health literacy on public health: an umbrella review
Authors: Corvo E , Di Carlo M , De Caro W
Published: October 2024

Background

Digital health literacy (DHL) is increasingly important for public health initiatives in the digital era. However, its impact on public health outcomes remains unclear. This umbrella review synthesizes evidence on relationships between DHL and public health.

Methods

Electronic databases were searched from 2010 to January 2024 for reviews evaluating associations between DHL and public health outcomes. Two independent reviewers screened records and extracted data. Results were narratively synthesized and screened respect quality using Amstrar 2 check list.

Results

12 reviews met the inclusion criteria. Higher population DHL was consistently linked to positive health behaviors like preventive screening uptake, medical adherence, chronic disease management, and vaccination. However, lower DHL correlated with health disparities and exacerbated risk of mis/disinformation. DHL interventions improved eHealth skills and health status.

Conclusions

Digital Health Ltieracy shapes engagement with digital public health tools and programs. Integrating DHL assessments into planning can help identify at-risk groups and optimize interventions. Developing population DHL through education represents an avenue to advance health equity and resilience against digital health threats. However, more evidence and more digital maturity of tools appear to be necessary.

Key messages

• Digital Health Literacy as milestone of next health generation.

• Health outcomes are clearly linked to digital and digital health literacy.
Enhancing literacy among the elderly on sexually transmitted infections: an educational intervention
Authors: Lima D , Cunha C , Magalhães A , Barreira V , Teixeira R , Mendes M , Vasconcelos R
Published: October 2024

Issue

Sexually transmitted infections (STIs) pose significant public health concerns across different settings and countries, especially in elderly populations, in which recent increases have been noted. This project aimed to target STIs literacy among the elderly, addressing a crucial gap in public health education.

Description of the problem

This project focused on improving STIs literacy among elderly residents in a municipality in Northern Portugal. Using innovative methods such as tailored materials and interactive sessions, the intervention aimed to evaluate their effectiveness through pre-, post-, and one-month follow-up STD-KQ questionnaire assessments (composite score of total correct calculated as average, ranged from 0 to 27). Statistical analysis used SPSS IBM for Mac OS® v29. Descriptive statistics: mean ± standard deviation for continuous, proportions (%) for categorical variables. Analysis included only individuals with complete data. ANOVA with Bonferroni post hoc tested intervention impact on STD-KQ scores.

Results

Fifty-one individuals participated in this study, with an average age of 70,89 ± 5,10 years old, and 64,7% female. The average STD-KQ score increased by 151.54% immediately after, 11.39 ± 5.66 (p < 0,01), and by 122.54% after one month, 10.08 ± 5.35 (p < 0,01), compared to pre-intervention, 4.53 ± 3.96 (p < 0.01). The score at one month follow-up remained similar to post-intervention (p = 0.39), presenting a significant improvement in STIs knowledge.

Lessons

This pioneering project, to the best of our knowledge the first of its kind, demonstrates the effectiveness of tailored educational interventions in improving STIs literacy among the elderly, with sustained effects after one month. This innovative approach can be adapted and scaled up for broader use in different settings and countries.

Key messages

• Tailored educational interventions can be a powerful public health strategy to effectively enhance long-term STI literacy among elderly populations.

• Assessing knowledge about STIs can be a crucial initial step for physicians to provide or refer for comprehensive education on safe sexual practices in this age group.
The need for health-promoting school attendance efforts in a Norwegian context
Authors: Horverak M O , Langeland G M , Hellang Ø , Helmersen M
Published: October 2024

Issue/problem

There has been an increase in mental health issues among young people in Norway in recent years, as in other European countries. This seems to result in more school anxiety and school absence across different school contexts. To meet this challenge, health promotion theory has been applied to develop practices facilitating mastering and empowerment in school.

Description of the problem

The objective of the project has been to develop health promoting principles and practices that support students to thrive and learn in school. Six primary schools, two lower secondary schools, one upper secondary school and five adult learning centres have participated in workshops and discussions for a period of a year. The questions that this project aims to answer are: 1) How can teachers facilitate health promotion in school? 2) How can health promoting practices support school attendance?

Results

The following principles for health promotion in schools were developed: 1) acknowledging by seeing the whole person, 2) trusting each individual, 3) respecting by creating tolerance for differences, 4) facilitating mastery and achievement, 5) facilitating participation by letting students develop ownership to solutions, 6) creating safety through clear and predictable frameworks, 7) facilitating motivation through engagement, 8) building relations by meeting students where they are, 9) promoting significant values.

Lessons

Based on the operationalisation of health promotion in this project, it is recommended that school employees promote and facilitate acknowledgement, trust, respect, mastery, participation, safety, motivation, relations, and values. The health promoting principles developed may easily be transferred to other educational contexts with similar challenges.

Key messages

• It is important to create an acknowledging and respectful learning environment to facilitate health promotion in schools.

• To support school attendance, the environment needs to be supportive of student participation and empowerment.
JOBS Program Germany for health promotion among the unemployed
Authors: Hollederer A
Published: October 2024

Aim

The unemployed suffer from poorer health than the employed, especially in terms of mental health. At the same time, health promotion reaches unemployed less than employed. The “JOBS Program” is an intervention for the unemployed to promote health. It has shown positive effects in the USA and Finland. The aim of this confirmatory study (Hollederer & Jahn, 2023; Jahn & Hollederer, 2024) was to investigate whether the JOBS Program produces similar effects in Germany.

Methods

A multicenter randomized controlled trial was applied to compare an intervention group (IVG) with a waiting control group (WCG) before (T0; n = 94), shortly after (T1; n = 65) the intervention and about 6 months after the intervention (T2; n = 43). Fourteen JOBS Program trainings have been conducted. Additionally, JOBS Program trainers were interviewed via voluntary computer-assisted web interviews (resulting in 28 interviews).

Results

JOBS Program Germany was beneficial. Following changes in the primary outcomes were identified from T0 to T1: Compared to the WCG, a multivariate regression estimated that the IVG had (1) a 0.34 scale point higher level of self-rated general health (p = 0.025; scale range: 1-5 points), (2) a 14.52 scale point higher level of mental well-being (p = 0.004), and (3) a 2.74 scale point higher level of life satisfaction (p = 0.049). About 6 months after the training had been conducted (T2), participants in the JOBS training showed better general health status (0.41-point; p = 0.016) compared to the WCG. Furthermore, 78.5% of the JOBS Program trainers were rather or very satisfied with the theoretical contents and 85.7% with the practical implementation. A central obstacle to the implementation was the COVID-19 pandemic.

Conclusions

This study provides evidence for the effectiveness of the JOBS Program with respect to the above outcomes, and for older and long-term unemployed, suggesting the benefit of regular implementation for different groups of unemployed in Germany.

Key messages

• The results of the confirmatory study show positive effects of the JOBS Program on the general health status and unemployment-related mental burden among unemployed people in Germany.

• The introduction of the JOBS Program as a nationwide intervention in Germany could be an intervention approach for the unemployed to achieve better health.
Promotion included in prevention (PIP)
Authors: Magnavita N , Meraglia I , Viti G
Published: October 2024

Issue/problem

Every year in Europe more than 20 million visits are carried out on workers. The opportunity to integrate health promotion into prevention is now under the attention of large companies, according to the American model known as Total Worker Health©.

Description of the problem

The main critical points of this strategy are the correct balance between promotion and prevention efforts and the extension of the projects to small companies. Furthermore, coordination is necessary between all the figures who promote health, particularly in the national health service.

Results

Occupational risk prevention activities, mandatory in all European countries, have been integrated with health promotion campaigns, addressing health topics chosen in a participatory way.

The costs of designing the campaign, information material for employees and data processing are borne by the university, which covers the costs with research funds. No costs are borne by workers or companies. During their medical check-up in the workplace, workers are invited to fill in a questionnaire regarding the project topic, its outcome, and some related factors. Workers receive advice on how to improve their lifestyles and are referred to the National Health Service for any necessary tests or treatments. In the last 15 years, as many annual campaigns have been conducted. Projects have dealt with: Eating behavior disorders; Post-COVID syndrome; Syncope and presyncope; Headache; Musculoskeletal disorders; Work engagement; Sleep health promotion; Aging; Violence at work; Work organization; Indoor air quality; Mediterranean Diet; Hand skin disorders; Teleworking; Work Ability. More than 30,000 workers from 38 companies participated.

Lessons

The participatory character of the projects, their simplicity and cost-effectiveness, the integration between occupational medicine and basic medicine demonstrate that PIP projects are economical, sustainable, and effective.

Key messages

• Health promotion can be integrated into the prevention of occupational risks, without additional costs.

• The creation of a network of occupational physicians who are involved in PIP projects respects corporate and professional independence and improves the work culture, health, and safety of workers.
The relationship between sleep quality and emotional eating during the pandemic in Croatian adults
Authors: Miskulin I , Candrlic S , Dumic J , Fotez I , Puz Britvic P , Dumic L , Candrlic M , Kovacevic J , Kotromanovic Simic I , Miskulin M
Published: October 2024

Background

Social isolation during pandemics has adverse effects on sleep quality which in connection with COVID-19 distress facilitates the development of emotional eating patterns in various populations. This study aimed to evaluate the interconnection between sleep quality and emotional eating in the Croatian adult population during the COVID-19 pandemic.

Methods

This cross-sectional questionnaire study was conducted from February to June 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data on eating habits, and the Pittsburgh Sleep Quality Index (PSQI), was self-administered to a convenient sample of Croatian adults from central and northwestern Croatia.

Results

The study sample included 939 subjects with, a median age of 42 years (interquartile range 35-48), 35.4% males, and 64.6% females. At the PSQI 22.6% of subjects presented sleep disturbances. Sleep disturbances were more frequent among females (p < 0.001), and inhabitants of the Croatian capital Zagreb (p = 0.001). Subjects with sleep disturbances detected by PSQI during pandemics consumed a larger amount of food than usual (p < 0.001), consumed snacks more frequently (p < 0.001), and cooked more in their households (p = 0.006).

Conclusions

Poor sleep quality caused by the COVID-19 pandemic led to emotional eating patterns in the Croatian adult population. Health promotion programs directed toward healthy lifestyle choices need to be implemented to successfully tackle observed poor health indicators in the studied population.

Key messages

• Following the COVID-19 pandemic the obvious deterioration of sleep quality and eating habits is seen in the Croatian general population.

• Comprehensive health promotion programs directed toward healthy lifestyle choices adoption are needed.
Development and preliminary psychometric properties of the Scale of Health Belief Model for Sleep
Authors: Dikici H , Kadioğlu H
Published: October 2024

Background

Sleep-related problems are a serious risk to physical and emotional health, academic success, and safety in adolescents. A measurement tool is needed to comprehensively evaluate adolescents’ sleep and plan the steps necessary for behavioral change. This study aimed to develop a scale based on the Health Belief Model that can reliably and validly evaluate adolescent individuals’ beliefs towards sleep.

Methods

This methodological study was conducted with 494 adolescents between September and October 2022 in Antalya, Turkey. Initially, 81 items about sleep were created according to the Health Belief Model. Validity was assessed as content and construct validity and reliability was assessed as internal consistency. Content validity was evaluated with ten expert views The scale was tested for construct validity with Exploratory Factor Analysis (EFA), after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha.

Results

In the first EFA, sixteen factors with eigenvalues greater than 1 explained 63.80% of the total variance. Items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated. In the last EFA of the 46-item scale, six factors were found with an eigenvalue greater than 1 that explained 57.7 % of the total variance. The scale’s item-total correlations ranged between .26 - .79. Cronbach’s coefficient alpha of subscales was found .92 for perceived susceptibility, .90 for perceived severity, .90 for perceived benefits, .81 for self-efficacy, .79 for motivation and .69 for perceived barriers.

Conclusions

The validity and reliability properties of the scale of Health Belief Model for sleep have been found good levels in Adolescents. Its intercultural adaptation for use with adolescents in other countries is recommended.

Key messages

• The newly developed the scale of Health Belief Model for sleep was found to be valid and reliable.

• It can be used to assess adolescents’ beliefs about sleep.
The French experiential knowledge resource center: strengthening and extending its scope of action
Authors: Krache A , Delescluse T , Villeval M , Georgelin B , Ferron C , Berdougo F , Vuillemin A
Published: October 2024

Issue

The national committee for experiential knowledge in health promotion (EKHP) aims to promote EKHP and improve professional practices. Since 2017, the committee has created methods and toolkits formalizing the capitalization of EKHP. The levers to put the method into practice are in place, now comes the time to find the best means to foster promotion and appropriation of EKHP works.

Description of the problem

The national EKHP resource center has been launched in May 2022, online: www.capitalisationsante.fr. It acts as a database where HP practitioners can read, download and upload EKHP capitalization works (∼12-page documents detailing one HP intervention each) and cross-analyses reports. It is driven by three main objectives: 1/ promoting and disseminating HP practitioners’ experiential knowledge, 2/ building a community of practice to improve capitalization practices and 3/ making a useful and transferable data available to practitioners.

Results

The now two-year-old website has been visited by 32 000+ individuals. More than 120 works, 12 cross-analyses are published. They were submitted by trained HP practitioners and reviewed by an editorial board before publication. The national EKHP resource center offers insight on how HP interventions work from practitioners themselves who share knowledge on their implementation. Compared to best-practices portals, it offers an innovative bottom-up approach to knowledge transfer. The community of practice (CoP) now supports a network of 200+ trained practitioners. This CoP aims to improve knowledge management and ensure the quality of the works produced. Surveys and feedback show that both building up and accessing EKHP meet a high level of interest.

Lessons

The innovative bottom-up approach and the focus on knowledge management can serve as a model for other settings/countries. In 2024, levers of appropriation will be investigated and collaboration with other HP resource centers will be better identified.

Key messages

• The now two-year-old national NEKHPRC enhances EK’s part in the HP field by making otherwise unknown data available to the French-speaking HP community.

• Building of a strong community of practice ensures the high quality of the bottom-up approach to the uploading of the works.
Predictors for psychosocial consequences of screening for liver diseases in Germany: a LASSO approach
Authors: Fichtner U , Maun A , Farin-Glattacker E
Published: October 2024

Background

Medical screening is extensively used across various disciplines for early disease detection and prevention of severe progression aiming to reduce disease-specific burden, improve quality of life and promote health. However, screening is debated due to unclear evidence of its overall benefits from a public health perspective. Screening is associated with improved health behavior and cost-effectiveness. However, studies identified adverse effects of screening like psychosocial burden. Most results originate from cancer screening and it is unclear whether they are transferable to other contexts. Within a research program, a systematic screening procedure to detect patients with liver cirrhosis at early stage in an asymptomatic general population was evaluated. In this study, we aimed to identify patient characteristics that predict and explain variance in psychosocial outcomes of screened patients.

Methods

This study analyzed data from 523 participants who underwent a systematic liver disease screening in Germany from Jan 2018 to Feb 2021. We used bootstrapped LASSO regression with 10-fold validation to evaluate the influence of various predictors on the outcomes measured by the Psychological Consequences of Screening Questionnaire (PCQ). The constructs measured by the PCQ are social, physical and emotional dysfunction associated with screening.

Results

We identified lower severity of comorbidities, higher subjective social status, stronger social support, older age, better critical health communication skills and higher health literacy as relevant predictors of lower psychosocial dysfunction, indicating their protective role in preventing psychosocial burden of screening.

Conclusions

From a public health perspective, medical screening offers should take into account patients’ individual context regarding their subjective social status, health impairments, personal social networks and health literacy skills to reduce post-screening psychosocial burden.

Key messages

• Social support, age, health literacy and higher subjective social status were positively associated with lower psychosocial consequences of liver screening.

• The findings indicate that liver screening should be carried out, taking into account the individual’s situation and resources available.