bluuebunny/crossref_metadata_2025 huggingface dataset:
4.H. Skills building seminar: Infographics as a tool for knowledge translation
Authors:   Organised by: COST Action CA18218–European Burden of Disease Network, EUPHA-PHMR,   Chair persons: Brecht Devleesschauwer (Belgium), Petronille Bogaert (EUPHA-PHMR)
Published: October 2021

A picture is worth a thousand words – also in population health research. Infographics are increasingly used to disseminate research findings, amongst others driven by the popularity of social media and the increased availability of data. However, the effective use of infographics requires specific technical and communication skills, and an understanding of the broader knowledge translation framework. In this workshop, organized jointly between the European Burden of Disease Network (COST Action CA18218) and the EUPHA Section Public Health Monitoring and Reporting, we will provide insights in how infographics can be used as an effective tool for knowledge translation, including a discussion of challenges and pitfalls. The layout of the workshop is designed to cover a broad view on infographics, going beyond the researcher's perspective. We will start by introducing the basic concepts of knowledge translation and infographics, drawing attention to the need to understand how infographics are interpreted and perceived by the users. Then, we will look at infographics from a scientific point of view, discussing what works and what does not based on a series of best practices. Finally, we will bring in the policy maker's view, creating a better understanding of the needs of the typical end user. Exchange with the audience will be facilitated by using an interactive Mentimeter poll during the session, for the delegates to share their perspectives on selected questions based on the presentations.

Key messages

Infographics are an increasingly popular knowledge translation tool, but come with challenges and pitfalls. Infographics should be embedded within a broader knowledge translation strategy, and should consider the interpretations and perceptions of users.
Delivering health and social services
Authors: Webb E , Karanikolos M
Published: October 2021

Dual delivery of COVID-19 and non-COVID-19 services proved to be the core challenge of the service delivery response. Health systems responded by implementing strategies to manage a surge in demand for both health and social services, while continuing to provide other necessary health care services. These involved adapting or transforming patient care approaches, including the coordination of care across levels (e.g., acute vs. outpatient) and settings (e.g., PHC vs. long-term care), and coordinating response measures with social services provided outside of health system. The initial capacities and available reserves of physical infrastructure, such as hospital and intensive care unit (ICU) beds, the organization and coordination of service delivery and previous experience of responding to epidemics such as SARS or MERS or other health system shocks, influences a country's ability to anticipate and cope with surges in demand for health and social services. This presentation will provide an overview of strategies on ensuring the ability to cope with surge in demand for and managing provision of services for COVID and non-COVID patients, including social services. It will also cover strategies on increasing capacity to cope with surges of need for physical resources, such as infrastructure, equipment and medical supplies. A brief overview of key metrics to assess resilience in delivery of health and social services will also be provided.
The relevance of WHO support to member states in measuring and understanding behaviour insights during Covid-19 syndemic
Authors: Bach Habersaat K , Zaletel M , Rehberger M
Published: October 2021

WHO has developed approaches and activities in measuring pandemic fatigue. Member states were consulted on their needs in beginning October 2020. WHO proposed develop national action plans to measure pandemic fatigue, which should be based on the strategies and principles presented in the WHO document “Pandemic Fatigue - Reinvigorating the public to prevent COVID-19”, and on the basis of recommendations in WHO publications: “Risk communication and community engagement readiness and initial response for novel coronaviruses: interim guidance” and “Risk communication and community engagement strategy for COVID-19 template”. WHO has developed a tool for understanding behavior in COVID-19 (“WHO tool for behavioral insights on COVID-19”) in ten steps, with recommendations to countries on how to approach measuring and monitoring pandemic fatige. In doing so, WHO advises countries to establish a national response coordination mechanism involving a wide range of relevant stakeholders. Stakeholders should be involved in all ten steps of implementing the tool to understand people's behavior in relation to COVID-19. A “Survey tool and guidance: behavioural insights on COVID-19” was launched mid October 2020, supporting member states in organizing their Covid-19 fatigue linked surveying activities. Slovenia is running bi-weekly panel surveying (representative national sample of 1000 participants every 14 days) in 20 waves (dec2020/dec21), extensively exploring ineqalities linked to gender, age, socioeconimic status and others in bi-weekly reports. According to the feedback from member states, international dimension is very valuable for all member states. It is very important for them to have the venue for sharing experiences, challenges and strategies to overcome obstacles. New inequalities emerging from the Covid-19 syndemic will be presented in the next four presentations of the workshop.
4.N. Skills building seminar: Making the elevator pitch perfect: how to convince a policymaker in less than 2 minutes
Authors:   Organised by: EUPHA, EUPHAnxt,   Chair persons: Maaike Droogers (EUPHA), Monica Brinzac (EUPHAnxt)
Published: October 2021

Since a number of years, the European Public Health Association (EUPHA), the European Public Health Conferences and other oganisations, have been working hard to translate the evidence in a such a format that policymakers take notice. For example, the WHO Regional Office for Europe works on ‘telling the public health narrative' and provides factsheets and infographics, in order to effectively communicate public health messages to policymakers. Over the years, EUPHA has organised several skills building workshops on translation of evidence in the past years. At the European Public Health Conference in Glasgow 2014, so-called pitch presentations were introduced where researchers are asked to present their work in 5 minutes with maximum 5 slides (no animations), as a way to learn to present key messages from research in just a few minutes. Since 2018, EUPHA organises this elevator pitch skills-building exercise with great success. Building forward on two successful and well-attended skills-building sessions, the current workshop will be a follow-up workshop in this series and is about perfecting the elevator pitch. Lessons learned at the previous elevator pitch workshops:

Have a clear ask (keep it simple). Appeal to the policymaker's own interests and priorities. Spell out how action will be beneficial for the policymaker. Be aware of upcoming elections. Built a relationship with the assistants of politicians. Considering the ‘policy window'. Make the comparison with the policy plan. Identifying the relevant stakeholders and groups affected by the problem.

The importance of effectively communicating the evidence to policymakers is highlighted by infodemics, e.g. last year called out by the WHO and UN in the context of the COVID-19 pandemic with the spreading of mis- and disinformation about the pandemic. In the context of physical distancing measures, the workshop will also cover virtual tactics. As in the era of teleworking (working from home), advocacy has become a whole different kind of sports. In this skills-building session, we will select a number of abstracts from young professionals/students that have been accepted by the International Scientific Committee as posters and we will invite the presenting authors to this dare: Present your work and key messages in less than 2 minutes. In order to see whether the policymaker is convinced, we are organising a small panel of policymakers and ask them to give their feedback. Are they interested? Do they remember the key message? And if all goes well, do you get an invitation to come back and present more of your work?

Key messages

Being able to present your key messages anywhere, anytime is needed (including virtual tactics). Telling the public health narrative and telling a story are important skills for public health professionals to have.
Informed consent to sex ‘normalising’ treatment of intersex children: the case of Belgium
Authors: Cannoot P
Published: October 2021

Background

This study explores how pervasive constructs regarding sex and gender in society and law limit the human rights of intersex persons. Societal culture promulgates a binary (male/female) gender ideal which includes standards of normality for our bodies.

Problem description

People who do not easily fit these culturally constructed norms, such as intersex persons, encounter numerous difficulties. The binary legal conceptualisation of ‘sex' maintains the medicalisation of variations of sex characteristics and reinforces the focus on sex ‘normalising' treatment of children who are too young to provide informed consent. Through ‘normalising' treatment, children are brought in conformity with the sex binary, upholding society's heteronormative expectations. While not all persons affected necessarily oppose ‘normalising' treatment, many report long-term physical, psychological and sexual trauma, and structural difficulties in accessing high quality healthcare. This presentation is based on legal doctrinal analysis and a literature study, and makes use of Belgium as an illustration. Not only is comprehensive legal research concerning variations of sex characteristics absent in Belgium, but the country has also been responsive to human rights claims regarding sexual identity in recent years, as demonstrated by a recent call in Parliament to legally prohibit non-consensual and deferrable treatment on a person's sex characteristics.

Results and lessons

With regards to the sex ‘normalising' treatment of intersex persons, this study concludes that by accepting the substitution of the child's informed consent for the opinion of the legal representative in the absence of urgent medical necessity, Belgian law has failed to protect the former's right to bodily integrity and best interests. With Parliament now moving towards a legal ban on non-consensual, deferrable ‘normalising' treatment, new challenges to ensure all human rights of intersex persons present themselves.
Impact of organizational innovation in stroke care on post-acute phase health expenses in France
Authors: Kossi D , Bricard DB
Published: October 2021

Background

In France, the creation of neurovascular units and the specialization of follow-up and rehabilitation services in neurology care since since 2010, aimed to reduce post-stroke mortality and comorbidity. This study aims to estimate post-stroke health health expenses and to identify the impact of Neuro Vascular Unit (NVU) and the type of rehabilitation in their evolution.

Methods

The study population is a sample of 8,492 adults who experienced a first stroke in 2012. Demographics and health status data of patient and their health expenditures related to outpatient care, re-hospitalizations and rehabilitation care over 12 months before and 12 months after the onset of stroke were extracted from the French National Health Data System. A ‘pooled' panel model of health expenditures per quarter over the 12 months following discharge from initial hospitalization for stroke was performed. Two complementary models explaining the occurrence of death and of re-hospitalization were carried out. Models were performed on STATA software version 14.

Results

Post-stroke health expenses were estimated at € 17,314 (SD= €25,518) on average for the first year, including € 8,147 (47%) of rehabilitation structure care, € 5,713 (33%) of outpatient care, and € 3,454 (20%) of post-stroke re-hospitalizations. For less severe patients, expenses were reduced considerably in the first year but remained higher than the initial pre-stroke level. Initial care in neurovascular unit was associated with higher expenditure (+ 9%) but allowed the reduction of the onset of deaths (-0.7%) and re-hospitalizations (-4%).

Conclusions

Post-stroke expenditure, the first year after stroke is mainly made up of rehabilitation expenses and depends on the type and intensity of the rehabilitation. Concerning inital care in neurovascular unit, it allows for better quality of life.

Key messages

Post-stroke expenditure, the first year after stroke is mainly made up of rehabilitation expenses and depends on the type and intensity of the rehabilitation. Inital care in neurovascular unit, it allows for better quality of life.
A policy index on healthy and sustainable food systems for governments – INFORMAS 2.0
Authors: Burgaz C , Vandevijvere S
Published: October 2021

Issue/problem

The rising burden of malnutrition in all its forms is driven by a global transition towards unhealthy ultra-processed food consumption patterns. As diets are shaped by food systems, political decision-makers are pressed to guarantee access to healthy diets for all, without harmful environment impacts.

Description of the problem

Scientific evidence on food policies implementation show a need to evaluate and benchmark government policies. Through a compilation of international recommendations, an ongoing scoping review, a Delphi study with policy experts and policy stakeholder interviews, the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) aims to create a policy index to monitor governments' actions on sustainable food systems.

Results

International recommendations from evidence-based global reports (n = 22) on policies for healthy diets from sustainable food systems were compiled. A total of 413 recommendations were extracted and classified to define the components of the new index, structured in three domains (food supply chains, food environments, food consumption), two transversal domains (nutritional vulnerabilities, women's empowerment) and thirteen subdomains. The index addresses the key policy aspects of food systems to be shaped in order to create healthy diets from sustainable food systems.

Lessons

The policy recommendations included in the three domains and two transversal domains may have an impact on nutrition-related outcomes (e.g. stunting, wasting, diet quality, obesity), nutrition inequalities (e.g. socioeconomic) and environmental outcomes (e.g. biodiversity loss, greenhouse gas emissions, water use). Their impact will be assessed in a scoping review. In a next step, a Delphi study and interviews with stakeholders will be conducted to ultimately identify policies with double and triple duty potential to improve sustainable food systems and healthy diets.

Key messages

The index will provide an up-to-date overview of evidence-based policy recommendations on sustainable food systems. The index will represent a useful tool for national and local governments to track malnutrition in all its forms and nutrition inequalities, protecting the environment.
Evidence-informed health care infrastructures: test of SustHealthv2 tool on hospital pilot cases
Authors: Brambilla A , Lindahl G , Capolongo S
Published: October 2021

Background

Healthcare facilities are important node of health systems and several scholars from Public Health and health service field highlighted that high quality and sustainable built environment is fundamental in providing high quality health care services. Nevertheless, most hospital buildings are obsolete, not adequate to contemporary organizational models; additionally, none of the existing quality improvement tools systematically evaluate the built environment. Therefore, the study develops an evidence-informed weighted multicriteria tool and tested it on two pilot case study.

Methods

Starting from previous literature reviews and scenario analysis, different indicators for hospital quality assessment have been grouped in 17 criteria and 3 macro areas, validated through semi-structured interviews and weighted with Multicriteria Simon Roy Figueras (MCDA-SRF) and Deck Card Method (DCM). The weighted tool SustHealthv2 has been tested on two medium sized hospital pilot case studies (H1 and H2) in northern Italy.

Results

The tool is composed by three macro areas: Social, Environmental and Organizational qualities respectively accounting for 22%, 29% and 49%. The application and test of the tool highlighted transversal criticalities such as Sustainable Accessibility (H1=0.04/0.16; H2=0.11/0.16), Sensitization and Education (H1=0.06/0.18; H2=0.10/0.18). The most recent case study (H1) was able to achieve higher scores in energy (0.15/0.0.19), waste management (0.07/0.07), as well as future proofing characteristics (0.20/0.23) compared to the older one. Overall H1 scored higher in all the macro areas reaching a total fulfillment of 72/100, while H2 scored 52/100.

Conclusions

The application of SustHealth v2 on operating health care facilities can support hospital management in defining strategic area of improvements and investments for hospital building renovation providing higher level of services to patients, users and staff.

Key messages

Built environment for healthcare needs systematic evaluation frameworks to improve and contribute to health service quality. SustHealth v2 is an evidence-informed multicriteria framework for hospital built environment sustainability and quality assessment from social, environmental and organizational perspective.
HPV self-sampling among cervical cancer screening nonattenders: a feasibility study in Estonia
Authors: Hallik R , Innos K , Jänes J , Veerus P
Published: October 2021

Background

Organized cervical cancer screening in Estonia was started in 2006, but it has not been effective, partly due to low coverage. In 2021, primary HPV screening was implemented. HPV self-sampling has been shown to be effective in increasing screening uptake. This is the first study in Estonia addressing the feasibility of HPV self-sampling and the acceptance of this method among long-term screening nonattenders.

Methods

A randomized intervention study was conducted in 2020. Women born between 1958-1983 without a Pap-smear in 2013-2019 were included in the study population. Altogether 12 000 women were randomly allocated to three equally sized study groups. Opt-out group received a Qvintip sampling device by regular mail. Two opt-in groups received an e-mail invitation to order a self-sampler from a website, one received Qvintip and the other Evalyn Brush. Data on user experience was collected with a questionnaire. Participantś background characteristics were obtained from the Population Register. The effect of covariates on participation rate was estimated with multivariate Poisson regression with a robust error variance and risk ratios (RR) were calculated.

Results

Overall participation rate was 17%, but significant differences were observed between opt-out (27%) and opt-in groups (11%). Compared to opt-out group, adjusted RRs for Qvintip and Evalyn Brush opt-in groups were 0.39 (95% CI 0.35-0.42) and 0.42 (95% CI 0.38-0.47), respectively. Participation was significantly associated with region, citizenship, and education. Self-sampling was well accepted: 98% agreed that it was easy and convenient; 88% prefer it as a screening method in future.

Conclusions

The study showed the feasibility and high acceptance of HPV self-sampling among long-term screening nonattenders in Estonia. As a next step, self-sampling will be piloted in organized screening program to identify optimal dissemination strategy.

Key messages

HPV self-sampling in Estonia is feasible, well accepted and has the potential for improving screening uptake among hard-to-reach women. Self-sampling strategy will be further tested within cervical cancer screening program.
Tools to advocate for CSE for children and young people with disabilities
Authors: Marquardt Johanna
Published: October 2021

The second part of the workshop will thematize actions which can be take on the political level. Recommendations for comprehensive sexuality education (CSE) for children and young people with disabilities often do not consider that there are different starting points within countries, regarding the implementation of commitments under international instruments (esp. Convention on the Rights of Persons with Disabilities - CRPD). This is why the German Federal Centre for Health Education (BZgA) develops a policy briefing for “Ensuring the right of children and young people with disabilities to sexuality education”, which outcome will build the base for this input. The aim of the workshop is to raise awareness to the human rights issues for children and young people with disabilities in the area of CSE based on international instruments (esp. UN CRPD). Children and young people with disabilities are often facing a higher risk for sexual illness. As there might be different need, there are still the same rights. Therefor the focus should lay on empowerment and a human rights approach and not only on preventing risks. The workshop will provide tools for advocacy on the political level and arguments to get political active for providing CSE for children and young people with disabilities. As the political and legal situation in the countries is very different, the workshop supports and facilitates the creation of a political environment for the implementation of, inter alia, the Convention on the Rights of Persons with Disabilities, from any starting point to make the access of CSE for children and young people with disabilities available.
5.M. Skills building seminar: How to integrate social identities in public health education – an intersectional approach
Authors:   Organised by: Bielefeld University (Germany), ASPHER,   Chair persons: Yudit Namer (Germany), Lisa Wandschneider (Germany)
Published: October 2021

Members of minoritized population groups are exposed to higher burdens of morbidity and mortality and face barriers to accessing health care systems and other critical resources to achieve optimal health. Intersectional perspectives that emphasize the dimensions of social power and discrimination are just beginning to emerge in public health research. These perspectives contextualize longstanding patterns of health inequalities but are rarely translated into public health curriculum. Concepts like “cultural competence” or “diversity, equity and inclusion” do address the importance of awareness and respect for (cultural) diversity in (patient/client) populations. The research and teaching examples available are largely limited to a USA context, tend to consider specific identities, rather than intersectional characteristics, are not systematically integrated in public health curricula and are usually not rooted in a theoretical approach of teaching. It is imperative that Europe bridges the knowledge-to-teaching gap and begins introducing similar programs, while learning from the limitations of USA efforts. Two steps are needed to strengthen public health educational institutions and improve population health: first, to systematically incorporate an intersectional paradigm into public health curricula; and second, to provide faculty members in public health programs with transformative teaching skills. In this skills building seminar, we aim to 1) discuss the need for incorporating intersectionality into public health curricula in Europe; 2) provide an experiential learning opportunity on social identities and health; and 3) create a space for self-reflection. We first present the introductory course on social identities and their importance in public health (Wandschneider et al.) which has been developed in collaboration with the Association of Schools of Public Health in the European Region (ASPHER) (15 minutes). Secondly, we will have an interactive session to apply an exemplary teaching method (25 minutes). To conclude, we will moderate a discussion guided by the questions “What is needed to integrate such efforts more sustainably in public health teaching practices?” and “How do we address potential barriers?” (20 minutes). This workshop addresses persons who engage in teaching in undergraduate or graduate Public Health programs or provide training to public health and health care professionals. It also invites researchers to reflect on how to frame research on health inequalities.

Key messages

To address health inequities, we need to incorporate an intersectional paradigm into public health curricula and provide faculty members in public health programs with transformative teaching skills. A model teaching module that is open access could provide the necessary tools to meet this need.
6.A. Workshop: European Health Emergency Preparedness and Response Authority (HERA)
Authors:   Organised by: DG SANTE, EUPHA, HaDEA,   Chair persons: Massimo Fagnini (European Commission)
Published: October 2021

The inception of HERA originates from the shortcomings revealed by COVID-19 and earlier serious cross border threats to health, such as H1N1, leading to President von der Leyen's 2020 State of the Union address in which she called on Europe to draw lessons from the current crisis and build a European Health Union, including a ‘European BARDA - an agency for biomedical advanced research and development' to support capacity and readiness to respond to cross-border threats and emergencies - whether of natural or deliberate origin. The Commission thus proposed European Health Union proposals on the 11th of November 2020, which also outlined the broad outlines of a European Health Emergency Preparedness and Response Authority - HERA - and the Commission's view on its integral role in strengthening the EU's Health Union. A proposal for HERA is expected to be put forth by the Commission in 2021 based on the lessons learned from COVID-19 and the calls for Europe to ensure better preparedness for the future, with the Authority expected to be operational by early 2022. HERA will play a key role in helping to anticipate serious cross-border threats to health, identify and ensure effective responses in terms of medical countermeasures. Its core mission will be enable the EU and its Member States to rapidly deploy the most advanced medical countermeasures in the event of a health emergency, by covering the whole value chain from conception to distribution and use.

Speakers/Panelists

Paul Zubeil

Ministry of Health, Germany

Antoine Schwoerer

Ministry of Health, France

Nuria Molina

Bill & Melinda Gates Foundation

Magda Chlebus

European Federation of Pharmaceutical Industries and Associations

Anniek de Ruijter

University of Amsterdam, Netherlands

Agnes Marta Molnar

European Commission, DG SANTE

Maarten Vergauwen

European Commission, DG ECHO
Introduction to the Population Health Information Research Infrastructure
Authors: Schutte NM , Bogaert P , Saso M
Published: October 2021

Population Health Information Research Infrastructure (PHIRI) for COVID-19 facilitates research and supports policy making across Europe through the implementation of a research infrastructure to generate the best available evidence for research on health and well-being of populations as impacted by COVID-19.
Skills needed to communicate adequately COVID-19 risk indicators to citizens and policy-makers
Authors: Greco D
Published: October 2021

Risk communication is a sustained communication process established with a diverse audience about the likelihood of the health outcomes of specific conditions or actions. Individuals are influenced by risk information in complex and unpredictable ways and communicating effectively risk during a pandemic event requires a set of different skills: 1) analysis skills, to be able to gather and assess the information; 2) communication skills, to deliver information that is understandable, through the right channels for the specific audience; 3) coordination and leadership skills, to be able to align partners at local, regional, national, international level to meet common goals. In this presentation, challenges of communicating COVID-19 risk indicators such as the risk of infection, risk of being hospitalised, risk of death, risk of long-term consequences, and risk of adverse events from vaccination will be presented. In particular, through case studies we will examine local, national and international risk communication strategies on: 1) risk of death in the vulnerable population; 2) risk of transmission in the home setting; 3) risk of long-term consequences of COVID-19 (“long COVID”). The strengths and weaknesses of the communication strategies in these examples will be pointed out and opportunities to improve them will be covered.
Patient and citizen engagement, and deliberative processes in COVID-19 vaccine assessment
Authors: Petelos E , Oortwijn W , Lingri D , Strammiello V
Published: October 2021

Examining the health technology assessment (HTA) landscape in Europe and globally, the limited involvement of HTA bodies in vaccine assessment becomes evident. To a large extent this is because of the role the National Immunization Technical Advisory Groups in providing recommendations for vaccines and immunisation. The role of patients and citizens, given the fact they are important stakeholders in HTA, is well acknowledged, but their involvement remains limited. Issues on how vaccines are developed, including the lack of patient-reported outcomes (PROs) in vaccine research and development, prevent the clearer benefit/risk information to reduce uncertainty. Given the fast-paced approach in comparison to traditional trials and the high level of uncertainty for different population groups, a comprehensive risk communication strategy, is key both for evidence-informed deliberative processes, as well as to ensure the success of vaccination programmes with the best possible outcomes and to overcome vaccine hesitancy. The impact of vaccination or non vaccination extends to families, communities and also has potential psychological consequences of alternative non-vaccine interventions such as lockdowns. Inclusion of such broader impacts may alter both acceptance and willingness-to-pay thresholds for COVID-19 vaccines. Given the lack of a specific legal framework to allow interaction between patients and other stakeholders at both institutional and individual levels, with respect to GDPR, it is vital to ensure interaction and engagement. In a democratic society, it is also important to assure general engagement that will be inclusive and transparent, without exclusion of vulnerable societal groups, that can only be assured by means of communication of scientific advice and regulatory decisions in a language accessible to all, with readily understood terms.
MIPEX vs Country Assessment Tool – Pros and Cons
Authors: Ingleby D
Published: October 2021

The 2015 MIPEX (Migrant Integration Policy Index) Health strand was developed to benchmark progress on implementing the Council of Europe's 2011 Recommendations on mobility, migration and access to health care. MIPEX collects data on both ‘downstream' and ‘upstream' policies. Though like we identified in the Road Map, it is paying more attention to the former kind. MIPEX data exist for all countries participating in the JAHEE WP7. Its unique advantage is that it contains a large, uniform collection of carefully standardized and operationalised indicators, enabling comparisons to be made between countries and between countries at different points in time. A common thread in the “Road Map” is that without a solid evidence base, we will not succeed in improving health equity for migrants. Background information on a country migrant population is important for estimating the kinds of demands that health and social services will face. Taking steps to promote the collection of such data is one of the most useful contributions JAHEE can make. While MIPEX covers Migrant Integration Policy, the CA includes a more comprehensive overview that can benefit practitioners, bureaucrats and policymakers in implementing strategic measures to mitigate gaps for better migrant health.
Country Experience with using the Country Assessment Tool (Lessons learned)
Authors: Nordström C , Kumar B
Published: October 2021

Findings from the CA show that research and data are largely available, but there are several knowledge gaps and we often lack a comprehensive overview. Gaps include longitudinal studies and knowledge of effects of implemented policy and practice. Lack of knowledge-based practice and policy development is a continuous challenge. Furthermore, we identified a lack of coordination of the migration health field, as well as cross-sectional collaboration.

Lessons learned: The CA and the JAHEE has provided a starting point for conversations with national partners, such as the directorate of health, about how we can strengthen the migration and health field in Norway. The CA has been presented and used in national conferences to highlight gaps and initiate collaboration to mitigate these gaps. The CA tool can become the comprehensive overview that we do not have today. While MIPEX covers integration policy, the CA covers broader topics touching on the work carried out in different sectors and levels in society that affect migrant health.
6.I. Workshop: Social Prescribing: what has been learned in developing evidence, what challenges and solutions?
Authors:   Organised by: EUPHA-HP,   Chair persons: Sonia Dias (Portugal), Megan Elliott (UK)
Published: October 2021

Social prescribing is seen as a mechanism for addressing the social determinants of health, preventing exacerbation of pre-existing diseases, reducing attendance in primary and emergency care and improving general population health and well-being. Social prescribing involves individuals being referred/self-referring to non-medical interventions run by a third-party organisation. Social prescribing has received widespread attention internationally; however, the evidence base to support social prescribing lacks rigour, and gaps remain. The complexity of social prescribing, in that it involves multiple referral routes, partners, pathways and outcomes, poses challenges for its evaluation and research. Researchers across Europe have developed different projects of research to address the challenges associated with evaluating social prescribing. Development of the evidence base for social prescribing is crucial in informing policy and public health systems to deliver effective interventions that contribute to individual, community and systemic outcomes. This workshop aims to share different approaches that have been taken across Europe to address issues in producing evidence base and share learning about the challenges and solutions that researchers have developed, specifically regarding research about implementation and evaluation of social prescribing. The workshop will be structured in a first part of presentations and the second part of open discussion with presenters and the audience. This workshop will present five papers which will address two key questions: 1. What have we learned about developing the evidence in social prescribing?; 2. What challenges have we experienced, and what solutions have we come up with? The short presentations will cover examples of social prescribing initiatives based on implementation and evaluation studies conducted in diverse European countries. Learning shared with the audience through the presentations will stimulate discussions around challenges with implementing and evaluating social prescribing. This workshop will inform the development of an overarching guidance on implementing social prescribing interventions, as well as identify parallel challenges in other areas of public health.

Key messages

Interactive session to discuss strategies for successful social prescribing projects addressing complex health issues that are relevant to stakeholders and for research to inform practice and policy. Collaboration with interdisciplinary stakeholders is crucial in developing the evidence base for social prescribing.
Policy Recommendations for healthy living environments and municipal health promotion in Europe
Authors: Plantz C , Peiró Pérez R , Mattioli B , Weber M
Published: October 2021

Municipalities can be the motor for health equity. But how should health promotion policies at all levels be formulated in order to mobilize local action for health? The Work package (WP) “Healthy Living Environments” in the Joint Action Health Equity Europe (2018 - 2021) focussed its work on this question. Based on a common Policy Framework for Action (PFA) and 14 Country Assessments (CA), actions were implemented representing a wide spectrum of policy responses to promote health equity through a municipal health promotion approach. At the end of the project, policy recommendations subsume the expertise and experience of the partners contributing to the sustainability of results.

The policy recommendations were generated in 3 steps:

Relevant project documents were collected and analysed, including the PFA, the CA, the reports and evaluation of actions and the results of a Delphi study conducted in the frame of the project. A synopsis of these documents was analysed in a workshop with the WP partners, resulting in decisions about the concept and necessary messages the policy recommendations should include. Some of the implemented actions and collected practices from the project were selected to elaborate the individual recommendations along these examples. A working group drafted the policy recommendations. After a second workshop to discuss the draft, the final recommendations were consented by the WP partners.

 

The preliminary results include recommendations for different political levels, as health equity needs multi-level and multi-stakeholder health in all polices approaches along a quality-oriented process. A specific equity lens and a focus on existing frameworks, tools and capacity-building approaches is needed. Also the stronger deficits of municipal health promotion like the lack of scientific evidence or data at local level were identified. Ways of applicability and integration into the agendas of the audience will be discussed.
Local municipalities experiences in managing the covid19 pandemic in Israel – a qualitative study
Authors: Nehushtan H , Donchin M , Bar-Zeev Y
Published: October 2021

Background

Local municipalities have played a central role in the management of the COVID19 pandemic and the mitigation of its grave health, economic and social consequences. In Israel, 57 local municipalities (out of 257) are part of the Healthy Cities Network (HCN). HCN Municipalities have a strong commitment to health promotion and reducing health inequalities. This study explores Israeli local municipalities' management of the pandemic and assesses whether belonging to the HCN impacted this management.

Methods

Fourteen municipalities were chosen - seven HCN municipalities, matched to seven non-HCN municipalities. Matching was based on geographical location, socio-economic status, size and ethnicity. In each municipality semi-structured telephone interviews were conducted with the Mayor or CEO, Head of the Welfare Department, and the person responsible for health (in HCN municipalities this would be the HCN coordinator). Interviews were transcribed and coded using inductive thematic coding.

Results (preliminary)

Themes that emerged from all municipalities included: a) difference in the management during the first lockdown compared to following lockdowns and pandemic ‘routine'; b) difficulties with data management within the municipality; c) need for a central governmental contact; d) desire for more independence and control at the local level; e) distinct regional characteristics impact pandemic management. The Healthy Cities coordinator played a key role in some municipalities, but not in others.

Conclusions

Local municipalities in Israel had an essential role in the pandemic response, adapting their actions as the pandemic and governmental measures unfolded. Challenges and responses were similar across municipalities, regardless of their HCN status. However, in some municipalities, the role of the HCN coordinator was crucial for the pandemic response.

Key messages

Challenges and responses were similar across municipalities, regardless of their HCN status. In some municipalities, the role of the HCN coordinator was crucial for the pandemic response.
Green Space and Mental Health outcomes: a cross-sectional survey as a starting point to bridge Green Areas' features to the post-pandemic needs
Authors: Lindert J , Sisenop F
Published: October 2021

Background

Green space has been associated with health and mental health. Given the high prevalence of mental disorders and costs of worldwide mental ill health and the concurrent rise in mental disorders during the pandemic, there is a need of a better understanding of the impact of different types of green space on mental health. The aim of this study was to assess the impact of characteristics of green space on mental health in a population in a rural area of Germany.

Methods

We conducted a cross-sectional survey based on face-to-face on an online assessment instrument. The instrument consisted of sociodemographic questions (assessing age, gender, income, education), mental health related question (PHQ - 9). Green space was dichotomized into green space with agrarian features and green space without agrarian features and subsequently geocoded using ATkis TN.

Results

In total n = 484 persons participated (female: 240 (49, 6%), male: N = 239 (49, 9%), n= missing). Mean age was 58,17 years (SD: 18,83) with an age range of 19-96 years. Depression symptoms showed n = 122 (54.9%) persons. Green space without agrarian features was associated with lower symptom levels of depression (Beta: 0.045, SE: 0.023, p = 0.015). However, green space with agrarian features was not related to depression.

Discussion

Characteristics of green spaces are associated with better mental health; however, the clear definition of quality green space needs further elaboration. The sample is a rural sample and results need further validation in an urban sample. Outlook: In the post-pandemic era green space itself seems to have no impact on mental health, however quality green space does. These results need further validation in multinational studies.
SARS-CoV2 vaccination roll-out in European prisons
Authors: Tavoschi L
Published: October 2021

Introduction

As SARS-CoV2 mass vaccination campaigns are rolled out, there is debate about which population groups to prioritize. Prison staff and prison residents should be considered a priority. Prison staff are essential workers and absenteeism should be minimized to enable safe and decent regimes. They play a pivotal role in SARS-CoV2 transmission within prison, contributing to disease spread. Prison residents are characterized by high burden of underlying disease, including non-communicable diseases. Furthermore, it is difficult to effectively protect prison populations by means of infection prevention and control and non-pharmaceutical measures, due to the constraints of the prison system.

Methods

Evidence on the inclusion of prison population within national SARS-CoV2 vaccination plans, level of implementation and models of vaccine delivery in prison settings is being collected through a questionnaire developed and disseminated within the European research project “Reaching the hard-to-reach: Increasing access and vaccine uptake among prison population in Europe -RISE-Vac”.

Results and discussion

There are notable differences between countries across Europe regarding inclusion in and priority attributed to prison residents and staff within national vaccination plans. Several challenges have been identified for the implementation of SARS-CoV2 vaccination programs in prison.

Conclusions

Suboptimal healthcare delivery and information systems with poor links to community systems are a major issue to overcome to ensure accurate and timely monitoring of vaccination. Prison residents are highly heterogeneous when it comes to age, ethnicity, level of education and health literacy. Ensuring their meaningful engagement is key to high vaccine uptake. This includes appropriate information and communication strategies prior to and at the point of vaccine delivery, covering inter alia possible side effects and informed consent.
Health Literacy and COVID-19 preventive behaviours in during the Lock-Down Phase in Tuscany (Italy)
Authors: Del Riccio M , Lastrucci V , Bechini A , Boccalini S , Chiesi F , Gori E , Lorini C , Moscadelli A , Zanella B , Bonaccorsi G
Published: October 2021

In the first COVID-19 pandemic period, when no vaccines were available, individual behaviours were essential for controlling the spread of the virus. In this context of rapidly changing guidance, emerging new evidence, fake news and misinformation, there have been new challenges for health literacy (HL). This study explored whether guidance-compliant healthy behaviours were associated with HL in individuals who have performed essential activities (public employees and volunteers of the Civil Protection) during the lock-down period in the Province of Prato, Italy. Items on knowledge, attitudes and practices (KAP) towards COVID-19 preventive measures and COVID-19 risk perception, along with the Italian version of the 6-items European Health Literacy Survey Questionnaire (HLS-EU-Q6), were collected using a self-administered structured questionnaire. In May 2020, 751 responses were collected; respondents were mostly males (59%), younger than 65 years old (83.5%), with sufficient HL (56%), and never smokers (54.2%). Most of the items related to the KAP towards COVID-19 preventive measures were significantly correlated with the HLS-EU-Q6 score in the total sample. In the multiple linear model, HL results to be a predictor of both a better self-reported knowledge of COVID-19 preventive measures (beta 0.32 for sufficient HL, 0.11 for problematic HL, 1.00 for inadequate HL) and a higher score of attitude towards the importance of COVID-19 preventive measures (beta 0.33 for sufficient HL, 0.17 for problematic HL, 1.00 for inadequate HL), while it has no role in predicting a higher risk perception. These findings can be useful to understand the importance of HL in promoting guidance-compliant healthy behaviours and in helping people to understand the rapidly changing public health messages and then act accordingly.

Key messages

Lower levels of Health Literacy predict poor COVID-19 related knowledge and a worse attitudes towards the importance of COVID-19 preventive measures. Health Literacy may be an important factor in promoting guidance-compliant healthy behaviours and in helping people to understand the rapidly changing public health messages and then act accordingly.