bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge and use of ICT-based coordination mechanisms in three regions of Spain
Authors: Campaz D , Vargas I , Pomar J , Sanclemente C , Bulilete O , Ortuño R , Ogueta M , Cots F , Plaja P , Vázquez M L
Published: October 2023

Background

Although there is a consensus on the potential benefits of information and communications technology (ICT) based mechanisms to improve cross-level clinical coordination, their introduction varies greatly among regions and services. The aim is to analyse the knowledge and use of digital coordination mechanisms and the factors related to the use in the health services of three autonomous communities (ACs) of the Spanish national health system.

Methods

Cross-sectional study based on an on-line survey by means of self-administration of the COORDENA-TICs questionnaire to primary and secondary care doctors of the health services in Catalonia (CAT) (n = 2277), Balearic Islands (BI) (n = 441), Basque Country (BC) (n = 572). Outcome variables: Knowledge and use of digital coordination mechanisms and difficulties of use. Explanatory variables: sociodemographic, labour-related, contextual, organizational, and interactional factors. Descriptive and multivariate analysis were performed to compare the ACs.

Results

There were some differences between the ACs: the access to and use of ICT-based coordination mechanisms in BI was limited, with the electronic health record (EHR) being the most available but infrequently used, whereas in BC and CAT there was wide access to and use of the EHR and virtual consultations between levels. In all three ACs common difficulties in EHR use emerged such as, technical problems, disorganized and/or insufficient information. Different contextual, organizational, and interactional factors were associated to their use in all three ACs.

Conclusions

There were differences in the type and level of implementation of ICT-based coordination mechanisms between the ACs that can be related to organizational and contextual factors, that should be further analysed. Addressing the relevant factors in each context should contribute to design effective strategies based on ICT-based coordination mechanisms to improve cross-level clinical coordination.

Key messages

• Implementation and use of ICT-based coordination mechanisms differed across the three ACs and could be related to differences in contextual and organizational factors in each context.

• It is necessary to explore factors and difficulties related to the use of these mechanisms to develop more effective strategies to improve their use and hence impact on clinical coordination.
Gender and citizenship disparities in the COVID-19 vaccination campaign in Italy
Authors: Marconi D , Arniani S , Magi S , Cotoloni C , Moscatelli C , Nisticò F , Golinelli D , Nante N
Published: October 2023

Background

The literature identifies several cultural, religious, and gender-related factors associated with vaccine hesitancy. To guide a fair and more effective vaccination campaign, we investigated the association between these factors and adherence to COVID-19 vaccination in the 815,000 population assisted by the Local Health Authority (LHA) of Tuscany South-East, Italy.

Methods

Anonymized data on the vaccination status of patients (≥5 years) assisted by the LHA from December 2020 to January 2022 were extracted from the Health Information System of Collective Prevention. We evaluated vaccination coverage (≥2 doses, also considering any previous or subsequent infections) by age, gender and nationality. We performed logistic regression with STATA/MP13, setting the significance level at p < 0.05.

Results

Adherence to vaccination was significantly lower among foreign patients (68.1% vs 86.6% p < 0.01); after adjusting for age and nationality, a significantly lower propensity to vaccination was observed among women (adjOR 0.90 CI95% 0.89-0.91), also of Italian nationality (aOR 0.94 0.93-0.95). The gender difference was more marked among non-Italian citizens (aOR 0.82 0.79-0.84) and is accentuated in specific ethnic groups: Macedonian (aOR 0.61 0.52-0.71), Kosovar (aOR 0.53 0.45-0.61), Pakistani (aOR 0.63 0.52-0.75), Nigerian (aOR 0.49 0.38-0.64).

Conclusions

Lower vaccination coverage in women, particularly of foreign nationality, can be due to lower participation in social and working life, as it was decisive by law to access jobs with regular contracts. Public health has the task of removing these barriers and protecting the health of all citizens equally. According to our findings, we implemented equity-oriented measures, such as vaccination sessions without an appointment and with the presence of a cultural mediator, specific awareness campaigns aimed at personal assistants, dissemination of information material translated into several languages.

Key messages

• Women, especially of foreign nationality, have lower vaccination coverage.

• Gender is a determinant of health: Public health has the task of removing these barriers and protecting the health of all citizens equally.
Gender and regional differences of avoidable mortality in Italy: a 14-year time-trend analysis
Authors: Sanna A , Golinelli D , Guarducci G , Viti F , Lenzi J , Sanmarchi F , Nante N
Published: October 2023

Background

Similar to other European countries, Italy's healthcare system is undergoing significant changes. Variations in ‘avoidable’ mortality (AM) may reflect such changes on management and quality of care. The aim of this study was to investigate the regional and gender-related trends of AM, and to provide evidence for addressing policy and reducing health disparities in Italy.

Methods

We conducted a 14-year time-trend analysis (2006-2019). Mortality and population data were obtained from the Italian Institute of Statistics. Bi-yearly age-standardized AM was calculated by gender and region, using the joint OECD/Eurostat list that includes both preventable and treatable causes of death.

Results

Overall, AM showed a significant reduction from 2006/7 to 2018/9 (221.0 vs. 166.4 per 100,000 pop, p < 0.05). A heterogeneous decrease in AM was registered between regions, ranging from −39% of Trento to − 17% of Molise. The analysis showed significant gender differences in AM, with females showing lower rates in both 2006/7 (144.5 vs. 306.3, p < 0.05) and 2018/9 (117.1 vs. 219.9, p < 0.05). Gender differences were also registered across regions, both overall and in terms of yearly % reduction.

Conclusions

While gender disparities in AM have reduced between 2006 and 2019 in Italy, the study shows that inequalities between regions have increased, thus underlying a worsening in the capacity of the Italian healthcare system to equally provide quality care to its population. We advocate the urgent need to reduce health disparities through a balanced regional development strategy.

Key messages

• Avoidable mortality is a key indicator for assessing quality and equity of healthcare. We have recorded significant gender and regional differences in this indicator between 2006 and 2019 in Italy.

• Targeted interventions are needed to reduce gender and geographic disparities and to achieve the global goals of universalism and accessibility of health services, also in Italy.
The challenge of community care: evidence from the Family and Community Nurse model in Tuscany
Authors: Taddeucci L , Barchielli C , Vainieri M
Published: October 2023

Background

The strengthening of primary care is one of the solutions proposed to increase the resilience of healthcare systems in Italy. Tuscany was the first region in Italy to use this model based on the results of a Regional Agency for Regional Health Services study. The aims is to describe the FCN model implementation across the three Local Health Authorities (LHAs) through the four C's framework of primary care. The regional resolution on FCN relabeled these milestones based on the FCN's role: transversality, proximity, continuity, customization.

Methods

A mixed method study was conducted with in-depth interviews of regional managers and surveys administered to middle nurse managers of the three LHAs.

Results

The interviews revealed a different state of progress of the FNC organisational model implementation, with one LHA pioneering, another LHA dealing with the implementation stage, and the third with a more recent, non-gradual implementation. The first two LHAs interpret the transversality as a strategic and the proximity as a vicinity feature. The other LHA sees the FNC as a tool for patient empowerment and proximity as service availability. The quantitative analysis shows a continuous take in charge in the pioneer LHA 54.8% (IC95% 46.8%-62.9%) with a lower temporary taking charge, 25.9% (IC95% 19.8%-31.9%), compared to the others, respectively 34.3% (IC95% 21.7%-47.0%) and 36.39% (IC95% 26.9%-45.8%). Places where the FCN provides care: the pioneering LHA as most of the home care and a 12% (IC95% 1.4%-22.5%) of intermediate care facilities use, the implementing LHA is totally home-based: 99% (IC95% 97.6%-100.3%) and with a continuous take in charge 48.6% (IC95% 34.5%-62.8), the recently implemented LHA a 6.8% (IC95% 2.2%-11.3%) of others.

Conclusions

Even in the same regional context, ruled by the same features’ model defining resolution, there have been different implementations and interpretations related to the different LHAs’ organizational histories.

Key messages

• In spite of the model’s implementations, the assistance provided doesn’t focus on single diseases but on people in the broader context of their family and community.

• The FCN model is designed to strengthen the timely care of patients at home by coordinating activities and care interventions through a multidisciplinary team.
Comorbidities in women with polycystic ovary syndrome: a sibling study
Authors: Boldis V , Grünberger I , Cederström A , Björk J , Nilsson A , Helgertz J
Published: October 2023

Background

Polycystic ovary syndrome (PCOS) has previously been associated with several comorbidities that may have shared genetic, epigenetic, developmental or environmental origins. We analyzed the association between PCOS and several relevant comorbidities while adjusting for early-life biological and socioeconomic conditions, also investigating the extent to which the association is affected by familial risk factors.

Methods

This total-population register-based cohort study included 857,757 singleton females (333,999 with at least one full sister) born between 1962 and 1980. PCOS and comorbidity diagnoses were measured at age 17-45 years through national hospital register data from 1997 to 2011, and complemented with information on the study subjectś early-life and social characteristics. In the main analysis, sibling fixed effects (FE) models were used to control for all factors that are shared and time-invariant among sisters, thereby testing whether PCOS and examined comorbidities are determined by unobserved familial; environmental, social or genetic factors.

Results

9,321 women were diagnosed with PCOS, of whom 15% had obesity, 9% had depression, 8% had anxiety and 4% suffered from sleeping, sexual and eating disorders (SSE). Having PCOS was associated with the odds of obesity increasing nearly 6-fold (adjusted OR (aOR): 5.8 [95%CI:5.5-6.2]). This association was attenuated considerably when accounting for characteristics shared between full sisters (Sister FE: aOR: 4.5 [95% CI: 3.6-5.6]). Among the psychiatric comorbidities, depression (Sister FE: aOR: 1.4 [95% CI: 1.2-1.8]) and anxiety (Sister FE: aOR: 1.5 [95% CI: 1.2-1.8), there was a small decrease in the aORs when also controlling for factors shared between sisters.

Conclusions

Having been diagnosed with PCOS is associated with an increased risk of obesity and psychiatric comorbidities and a substantial part of this risk can be attributed to factors shared between sisters.

Key messages

• PCOS is associated with an increased risk of obesity, depression and anxiety.

• Among women with PCOS, 16% of the increased risk for obesity, 20% for depression and 29% for anxiety can be attributed to shared family factors between sisters.
Cross-cultural comparisons of limited cancer health literacy rates
Authors: Dumenci L , Wing-Lok C , Pun J
Published: October 2023

Purpose

This study aims to compare the limited cancer health literacy (LCHL) rates among White (U.S.), Black (U.S.) and Chinese (H.K.) cancer patients using the Cancer Health Literacy Test - 6 (CHLT-6) and its recent adaptation in Chinese.

Rationale

Arbitrary nature of determining LCHL using the cut-score method is a major obstacle to scientifically investigate racial/ethnic differences in LCHL rates. To overcome, we used the multi-group latent class analysis (LCA) to test invariant measurement properties of the CHLT-6, a necessary condition to claim that the differences in LCHL rates reflect true group differences.

Results

Data included 1,899 cancer patients: White (N = 806) and Black (N = 491) and Chinese (N = 602). Measurement invariance test between the unconstrained and conditional probability constrained multi-group LCA favored the latter using the Bayesian Information Criterion (BIC: 10,388 vs.10,334) indicating that the LCHL label has the same meaning between three groups. The CHLT-6 determines cancer patients with LCHL with high accuracy (>90%) in all three groups. The model-based estimates of LCHL rates varied across groups: White (4%), Black (50%), and Chinese (25%).

Conclusions

This study provides a strong construct validity evidence for the CHLT-6 by showing that it has invariant measurement properties between racial/ethnic groups and that it assigns cancer patients into LCHL group with high accuracy. Causal mechanisms underlying a wide range of LCHL rates need further explorations.

Key messages

• A substantial difference in limited cancer health literacy rates among White (U.S), Black (U.S.), and Chinese (Hong Kong) cancer patients.

• The CHLT-6 accurately captures the limited cancer health literacy in diverse racial/ethnic groups.
Mental health promotion in the elderly in Slovenian local communities
Authors: Stanojević Jerković O , Brlek A , Tkalec S
Published: October 2023

Issue/problem

Key issues in the elderly's mental health are: growing trends in mental disorders (dementia, depression), social exclusion with consequent lack of information, awareness and poorer access to prevention and assistance programs, discrimination, and high risk of poverty after retirement (especially in women). The public health challenge is to cope with these issues, as the share of the elderly population rapidly increases, also across European countries.

Description of the problem

According to the Resolution of the National Mental Health Program 2018-2028, and Action Plan 2021-2023, an interdisciplinary working group for mental health promotion among the elderly was established. Basic goals were prepared through regular meetings: adequately providing necessary information for the target population and enabling better networking of key actors in the field of mental health, including cooperation with existing networks. Specific activities ( >>Open hours for elderly << and >>Longevity society fairs <<) were implemented in the local communities.

Results

Twenty-one events, broadly promoted in the local communities, were realized. Different stakeholders were supported with developed materials (brochures, leaflets). A national conference on decreasing loneliness and social exclusion in the elderly was organized.

Lessons

Supportive environment for the empowerment of key actors and their continuous cooperation, could improve information flow, competencies, and inclusion of the target population in the local community and consequently decrease stigma. Despite pandemic measures, activities were realized, as recognized to be necessary. Regular financial support of less developed communities is a precondition for preventing inequities between communities.

Key messages

• A sensitized, empowered, connected, proactive and supported local community is a key for improving elderly's quality of life.

• A connected and empowered local community is a precondition to prevent further stigmatization of the elderly.
2.P. Workshop: Mental health in old age
Authors:   Organised by: EUPHA-PMH, EUPHA-CHR,   Chair persons: Jutta Lindert (EUPHA-PMH), Julian Mamo (EUPHA-CHR)
Published: October 2023

Mental health conditions affect people throughout the world, at all ages. Additionally, mental health conditions are associated with social health and with physical health. Applying a body - mind concept of health framework to mental health conditions can add to existing knowledge on mental health conditions in old age. We organized this workshop based on the understanding that mental health and mental health conditions differ according to individual and community factors. The data presented propose that mental health plays a critical role in old age, and as such, deserves greater attention to further understand how who might be at risk for mental health conditions in old age. More specifically, we focus attention on physical health, socio-economic and environmental factors that affecting mental health in old age. First, based on the Survey of Health, Ageing and Retirement in Europe (SHARE), the author examines a reciprocal relationship between functional disability and depression over time and further proposes the potential role of social participation in alleviating depression in old age. Second, mental health of older persons with migrant children will be analyzed across different European regions. Third, based on data from the SHARE study, retirement as a major life event with long term consequences on depression risk is identified. Fourth, the study examines how financial adversity in old age is associated with mental health among older adults who are living in a rural area in Germany. Finally, the associations between loneliness and mental health among Spanish older adults during the COVID-19 pandemic are presented. Based on the presentations, research gaps and promising areas of research, practice, and policy focused on promoting mental health in old age and across the lifespan will be discussed with participants.

Key messages

• Migration of children, functional disability and financial adversity are related to old age depression.

• Loneliness in old age is associated with mental health conditions.
Perceived and functional health literacy and antibiotic use in children among Cypriot parents
Authors: Menikou J , Middleton N , Papastavrou E , Nicolaou C
Published: October 2023

Background

Several factors have been associated with antibiotic misuse leading to antibiotic resistance, an increasing public health problem. Health literacy (HL) may influence parents’ knowledge, attitudes, and practices (KAP) towards antibiotic use in their children.

Methods

A cross-sectional study was conducted with a convenience sample of parents of children, aged 6 months to 15 years, presenting in pediatric primary care centers across 3 Cypriot cities. Participants completed a KAP tool on antibiotic use. They also rated their HL competences using HLS-EU-Q47 and completed the NVS (Newest Vital Sign), a performance-based HL tool. Associations between parental KAP towards antibiotic use with both perceived health literacy (PHL) and functional health literacy (FHL) were explored.

Results

Among 203 parents (84.2% female, 84.3% tertiary education), preferred information source was associated with HL in different ways with higher FHL among those reporting using the internet for information regarding antibiotics in children (p = 0.04), whereas higher PHL was recorded among those reporting the doctor as information source (p = 0.01). An increase in the FHL score was associated with an increase in the knowledge (p = 0.01), attitudes (p = 0.01), and practices (p < 0.005) towards antibiotics. In contrast, no significant associations were observed between PHL and either knowledge or practices towards antibiotic use. However, antibiotic misuse, based on the number of recognized antibiotics from a list, was associated with lower PHL (p = <0.005). Parents with sub-optimal attitudes towards antibiotics had lower PHL scores on average (32.74, SD = 6.58 versus 36.30, SD = 7.77).

Conclusions

Better performance in a FHL measure among parents was with an increase in KAP towards antibiotic use in their children. Although this association did not appear consistent with PHL, a high number of parents with limited HL, either PHL or FHL, faced challenges in KAP towards antibiotic use in children.

Key messages

• Unnecessary use of antibiotics in children, problematic attitudes, and limited knowledge towards antibiotics among parents are associated with lower HL, either perceived or functional.

• Assessing the association of parental KAP towards antibiotics and HL is important in gaining a comprehensive understanding of their HL and in developing targeted Public Health interventions.
Relationship between functional disability, depression, and social and civic engagement among older European adults: A three wave longitudinal study using SHARE
Authors: Lee S
Published: October 2023

Background

Studies show that depression has a long-term effect on physical health and functional capabilities. Vice versa, onset of functional disability has a detrimental role in the decline in emotional and mental well-being of older adults. The current study was sought to explore the direction of the association between functional disability and depression, and further examined if social-civic engagement, as a means of coping, moderated the association.

Methods

Study employed a secondary analysis using data derived from waves 5 (2013), 6 (2015) and 7 (2017) of the Survey of Health, Aging and Retirement in Europe (SHARE). In total, 36 323 older adults aged 65+ at baseline (mean age 74.41 ± 7.09 years; 54.8% women; 83.2% retired) were followed up over a 4-year period. Analysis included GALI (The Global Activity Limitation Indicator), ADLs (Activities of Daily Living), IADLs (Instrumental Activities of Daily Living), EURO-D depression scale, and different types of social/civic activities (voluntary/charity work; educational or training course; sport, social or other kind of club; and political or community-related organization). Covariates included socio-demographic variables.

Results

Controlling for the effects of covariates, the association between functional disability and depression is reciprocal over time, but depression had a greater impact on functional disability than the reverse at both follow-up points. Different types of social-civic participation appeared to moderate the association between depression and functional disability, but in varied ways.

Conclusions

Finding suggests that depression is associated with higher odds of functional disability, and impede recovery from the disability. Early behavioural and psychological interventions and social prescribing including social/civic activities can help develop positive resources, coping strategies, and resilience, and thereby, alleviating the vicious cycle linking functional disability and depression.
The fear of loss of autonomy as lever for vaccination of the elderly: a qualitative study
Authors: Addario A , Pardo M , Dorier S , Barth N , Gavazzi G , Botelho-Nevers E
Published: October 2023

The COVID-19 pandemic has highlighted the challenges of vaccination and the infectious risks among the elderly. According to available data, vaccination rates for recommended vaccines in this population are insufficient in France. The aim is to identify the levers and obstacles to vaccination among seniors, and then to shed light on the possible arguments that could lead to a commitment to new vaccination behaviours. A qualitative survey based on 14 semi-structured interviews was conducted with people aged 65 and over, living at home in the Auvergne Rhône-Alpes region (France) from March to May 2022. The interviews were recorded, transcribed in their entirety and then subjected to a thematic content analysis by two independent persons. The participants declared themselves to be in good health and to be concerned about maintaining their health by keeping their physical and cognitive capacities and their autonomy. To this end, they mentioned carrying out preventive behaviours, such as regular physical activity and a balanced diet. However, vaccination, which is associated with infectious disease prevention, was not mentioned as a factor in the prevention of good ageing during the interviews. Participants’ experiences of the polio epidemic and the COVID-19 pandemic highlighted older people's fears of infections. While infections are not a source of fear, their after-effects, more specifically, physical and cognitive alterations leading to a loss of autonomy, are a source of apprehension. These elements could be a good lever to bring hesitant elderly people to think about their own vaccination. In the light of these elements, given the protection against cardiovascular events provided by vaccinations for the elderly (influenza, shingles, pneumococcus), this argument could be the starting point for a prevention campaign aimed at the elderly. This avenue will be tested more precisely and with a larger number of subjects in a quantitative study based on a questionnaire.

Key messages

• the protection against cardiovascular events provided by vaccinations for the elderly (influenza, shingles, pneumococcus) seems to be argument could be change vaccination behavior.

• Older people are not afraid of infections but of the consequences they can have, such as loss of autonomy.
Prevalence, risk, and protective factors of health among Irish university students
Authors: Noonan A , Norton C , Tierney A , Kennedy S , Woods C B
Published: October 2023

Background

Young adulthood (18-25 y) is associated with increased engagement with risky health behaviours, with those in transitionary phases most vulnerable. The transition to higher education (HE) make such settings important in health promotion. However, global evidence suggests that the health-related behaviours of HE students are both sub-optimal, and worsening. Our objectives, therefore, are to determine prevalence and risk of various health behaviours, and to identify protective factors in Irish HE students.

Methods

Using an anonymous, repeated measures (annually 2019-2022) cross-sectional student survey of health behaviours (physical activity, mental health and wellbeing, healthy eating, healthy environment, addictive behaviours, and sexual health), data on 4924 participants (2019:N=1302, 2020:N=1128, 2021:N=967, 2022:N=1527), 58.5% identifying as female (2877), aged [mean(SD)] 21.8 (6.3) years are eligible. Most respondents (60.4%, N = 2539) are undergraduates in first year.

Results

Preliminary prevalence data show vaping has risen from 10.8% in 2019 to 17.9% in 2022. Those reporting poor mental health (MHI-5) has also increased from 17.4% in 2019 to 21.5% in 2022. Similarly, happiness declined from 2019 to 2022 (2019, 6.5, (1.92) | 2022, 6.09 (2.00). Further work will aim to calculate prevalence of health indicators (weighted means and 95% CIs) each year; dichotomise variables where necessary and perform logistic regression to determine if health behaviours (i.e., substance use, physical activity etc.) are associated with illness indicators (i.e., GAD, general mental health, BMI, happiness etc.), controlling for gender, economic status, course of study, marital status, sexual orientation, age and underlying health conditions.

Conclusions

While the results so far are concerning, they align with existent literature. Outcomes may be of interest to HE health services and policy makers in determining how to optimise the student health.

Key messages

• The health of students in HE settings is at risk.

• Emphasis should be placed on factors that enhance the health of students.
Health literacy of informal caregivers: findings from a Portuguese study
Authors: Pedro A R , Avelar F G , Raposo B , Brandão D , Amaral O , Escoval A
Published: October 2023

Background

Health literacy (HL) concerns the knowledge and competences of people to meet the complex demands of process of caring. Providing health care to someone can be an extremely demanding task that requires a combination of skills and knowledge. HL can be considered a key factor in promoting the health of both the informal caregiver and the cared person. The aim of this study was to assess the characteristics associated with health literacy among informal caregivers.

Methods

A cross-sectional study was conducted through an online survey directed to informal caregivers. It was applied the Portuguese version of European Health Literacy Survey (HLS-EU-PT-Q16) and it was calculated a 0-50 Score. Bivariate analyses were performed using one-way ANOVA, independent T-tests, and Pearsońs correlation, at a 5% significance level in SPSS®.

Results

In total, 760 informal caregivers were surveyed, mean age 57 years (±9.9), 92.5% female, 62.6% married or living with a partner, 41,5% higher education, 44.4% works full or part-time, 58.7% receives up to two national minimum wages. Regarding the process of care, 78.9% takes care of one person, 85.2% have been caring for more than 1 year, 54.3% feel that are not supported at all, and 20.3% do not feel competent to care. The mean HL score (n = 673) was 31.9 (+7.8), and 58.6% has a problematic or inadequate HL level. Education (p < 0.001), marital status (p = 0.030), employment (p < 0.001), family income (p < 0.001), perception of general and mental health status (p < 0.001), level of support (p < 0.001), level of perceived competence (p < 0.001), access to health care (p < 0.001) and access to information (p < 0.001) were associated with the informal caregivers’ HL Score.

Conclusions

Socioeconomic determinants are associated with HL Score, better socioeconomic status is associated with a higher level of health literacy among informal caregivers. Future studies focused on these determinants are needed to better understand and act on them.

Key messages

• Health literacy levels are associated to socioeconomic determinants, better socioeconomic status is associated with a higher level of health literacy among informal caregivers.

• Higher levels of health literacy are associated with higher levels of perceived competence to provide care.
The challenge of infodemic: a scoping review of strategies to tackle health-related fake news
Authors: Gentili A , Villani L , Valz Gris A , Osti T , Solimene V , De Maio L , Corona V F , Zaino A , Bonacquisti M , Cascini F
Published: October 2023

Introduction

The term “infodemic” was coined by David J. Rothkopf during the SARS epidemic to describe the phenomenon of the uncontrolled spread of speculation amplified by the media and the technologies of the 21st century. During the COVID-19 pandemic, a tremendous increase of misinformation was observed. The purpose of this scoping review is to collect and describe all the strategies, tools, and recommendations available from the literature aimed at counteracting infodemic and provide useful information for decision makers to build effective responses.

Methods

We performed a systematic search of scientific literature from 1 January 2018 to 31 January 2023 on PubMed, Web of Science, Scopus electronic databases. Eligible articles were English article analysing tools (strategies, policies, recommendations, guidance, guidelines, toolkits, etc) aiming at supervising, monitoring, preventing and countering infodemic.

Results

The overall research in the scientific databases yielded a total of 5,516 record. Following the inclusion and exclusion criteria, we selected 26 articles from scientific and grey literature.

From the included articles, 21 public health actions were extracted. These recommendations were grouped into five main categories (“Strategies”) that act on the infodemic phenomenon:

- Increasing the health literacy of the population

- Surveillance of the spread of misinformation strategies

- Checking and debunking misinformation strategies

- Legal and Institutional strategies

- Communicate and dissemination programs

Conclusions

The review showed a large number of stakeholders envolved (social media companies, healthcare professionals, institutions, population). To properly address the problem of infodemia, it will be essential the creation of a solid health network, capable to tackle the spread of fake news in every moment of the process, from the surveillance systems to the checking and debunking information.

Key messages

• Healthcare professionals have the responsibility of disseminating information in an understandable manner; government and authorities should implement laws to tackle the dissemination of fake news.

• Social media companies (and their most famous users, the ‘influencers'), should take stronger actions to contain the dissemination of fake news.
Health literacy for the prevention of noncommunicable diseases–health sciences students’ perception
Authors: Leventi N
Published: October 2023

Background

World Health Organization highlights the importance of health literacy development for noncommunicable diseases (NCDs) prevention and control. NCDs were recognized by the 2030 Agenda for Sustainable Development as a major challenge. The aim of our research is to explore health sciences students’ perception on the role of health literacy, digital health literacy and NCDs risk factors, related to their prevention.

Methods

A cross-sectional survey was conducted among 210 first year students from the Faculty of Medicine and the Medical College in Medical University-Sofia, Bulgaria. An anonymous questionnaire distributed among students and all respondents participated voluntarily. Data was collected during January 2023. A descriptive statistical method was used to analyze the data collected.

Results

Among respondents the majority 83,7% stated that promoting health literacy is an approach to promote the prevention of NCDs while 88,2% of them considered very important or important the role of digital health literacy among medical and non-medical professionals for NCDs prevention. Data collected show that a significant percentage (81,5%) among participants reported the necessity of interdisciplinary initiatives as an action to promote health literacy. In addition, more training on NCDs risk factors was pointed as essential by 82,0% of the students.

Conclusions

It appears very important for the future health professionals to develop health literacy on and be familiar with the risk factors associated with NCDs. That could lead them to gain confidence, and be more effective in health issues related decision making. Special attention should be given the digital tools and instruments, as they can significantly contribute for the health literacy improvement. An interdisciplinary approach can provide the environment to optimize access to health information, and support health and well-being of individuals and communities.

Key messages

• Both health professionals to build capacity on health literacy improvement, and the population to directly engage, need interdisciplinary actions, focused on NCDs control and prevention.

• The successful digital transformation of health services, requires digital competencies and skills. They are the major components for digital health literacy, that supports health and wellbeing.
A regional gap analysis to inform the implementation of the Irish Healthy Campus Framework
Authors: Calnan S , Bickerdike A , Byrne M , O'Neill C , Millar S , Muttucomaroe L , Oliveira V
Published: October 2023

Higher Education Institutions (HEIs) constitute prudent ecological contexts for ‘whole-setting’ health promotion (HP) encompassing institutional policies, built environments, sociocultural norms, transdisciplinary research, and capacity-building curricula. As potent life course conduits for both monitoring and addressing public-health priorities, evidence-based HP within HEIs synergistically aligns with cross-sectoral agendas, including the UN SDGs, Okanagan Charter for Health Promoting Universities, and the EU Global Health Strategy. In Ireland, the health-enhancing potential of the higher education sector has been recognised, and validated, via the design and implementation of the Irish Healthy Campus Framework (IHCF). Concurrently, however, there remains a dearth of empirical evidence to underpin the efficacy of ecological HP interventions in contemporary HEIs. As the first inter-institutional collaboration of its kind to inform the implementation of the IHCF within two HEIs in Ireland (N > 37,000 students, N > 4,700 staff), this mixed-methods (QUAN-QUAL) research aims to examine the health and lifestyle profiles of inherently diverse campus populations, in addition to exploring the qualitative perspectives of cross-campus HP stakeholders. Pertinent measures will include two comprehensive web-based health instruments, comprised of iteratively devised items, in addition to a series of validated scales. Qualitative analyses will be rooted in an empirical model, which will be utilised to map and evaluate the ecological reach of HP services and interventions, serving as a regional gap analysis. This novel research will identify thematic priorities amongst a heterogeneous target population comprised of students and staff across two distinct universities, spanning seven regional campuses in the southwest of Ireland. Given the magnitude of HEIs as settings for health, these data will be of interest to a multitude of public health practitioners, academics, and policy makers.

Key messages

• This research is the first inter-institutional collaboration of its kind to inform the implementation of the Healthy Campus Framework within two HEIs in Ireland (N > 37,000 students, N > 4,700 staff).

• Emerging international frameworks recognise universities as potent, and highly-scalable, life course conduits through which to monitor and address public health priorities.
Barriers and enablers to delivery of Making Every Contact Count: A cross-sectional study
Authors: Hayes C B , Meade O , O'Brien M , Noone C , Lawless A , McSharry J , Murphy A , Murphy P J , O'Reilly O , Byrne M
Published: October 2023

Background

The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by healthcare professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation.

Methods

Online cross-sectional survey design. Healthcare professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict the frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER).

Results

Seventy-nine percent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R2 = .34), the significant enablers of intervention delivery were ‘professional role’ (OR = 1.86 [1.10, 3.15]) and ‘intentions/goals’ (OR = 4.75 [1.97, 11.45]); significant barriers included ‘optimistic beliefs about consequences’ (OR = .41 [.18, .94]) and ‘negative emotions’ (OR = .50 [.32, .77]). In the multiple linear regression (R2 = .29), the significant enablers of frequency of MECC delivery were ‘intentions/goals’ (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were ‘negative emotions’ (b = −4.74, p = .04) and ‘barriers to prioritisation’ (b = −5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: ‘intentions and goals', ‘barriers to prioritisation', ‘environmental resources', ‘beliefs about capabilities', ‘negative emotions’ and ‘skills'.

Conclusions

High levels of brief intervention delivery were identified, however, there were also many missed opportunities and significant barriers to delivery.

Key messages

• Implementation interventions to enhance MECC delivery should target intentions, goals, beliefs about capabilities, negative emotions, environmental resources, skills, and barriers to prioritization.

• Future interventions should address these barriers by: (a) supporting setting intentions and goals; (b) improving training and (c) ensuring the environment is conducive to MECC delivery.
Using the QATCHEPP quality assessment tool to critically reflect on health promotion practice
Authors: OHara L , Taylor J
Published: October 2023

Issue

Critical health promotion is required to reduce health inequities and is distinguished from selective health promotion by its focus on the unequal distribution of structural and systemic privilege and power. This approach is central to progressing global priorities of health equity and sustainable development. However, much practice remains selectively oriented to a biomedical-behavioural approach. The Quality Assessment Tool for Critical Health Promotion Practice (QATCHEPP) was designed to support practitioners to engage in critical reflection on health promotion initiatives to assess the extent to which they align with a critical approach.

Project description

This project was a case study conducted in 2023. The objective was to use QATCHEPP to critically reflect on a place-based health promotion project. The case study question was to what extent does the health promotion project align with a critical approach? QATCHEPP includes three reflection questions for 10 critical health promotion values and principles, scored as strongly critical (2), somewhat critical (1), minimally or not at all critical (0), or insufficient evidence to be rated (0). Total scores for each value and principle and an overall summary score were calculated.

Results

The QATCHEPP summary score was 55% indicating that the project was somewhat aligned with a critical approach, with highest scores for assuming that people are doing their best for their wellbeing, and maximum beneficence, and lowest scores for consideration of non-maleficence and a salutogenic approach.

Lessons

QATCHEPP is an innovative and useful tool for critically reflecting on the extent to which health promotion initiatives align with a critical approach. We recommend that findings from such critical reflection be used by practitioners to identify where initiatives may benefit from re/orientation towards a more critical health promotion approach in any setting or country.

Key messages

• Practitioners should engage in critical reflection to determine the extent to which health promotion initiatives align with a critical health promotion approach.

• QATCHEPP is an innovative and useful quality assessment tool to support critical reflection. Findings can be used to re/orient health promotion practice towards a more critical approach.
Is scientific knowledge or trust responsible for preventive behaviours during COVID-19 pandemic?
Authors: Yaddanapudi L , Hahn J
Published: October 2023

Background

When the public exhibit high levels of trust in science, adoption of new technologies becomes easier. Yet, one can note a crisis of trust in science, as declared by the UK Government in 2000, which found that lowering trust causes less public support for science. Especially in precarious situations like the COVID-19 pandemic, quick acceptance and adoption of regulations, measures and technologies are important.

Objectives

To identify whether scientific knowledge or trust in science, health institutions & governments lead to preventive behaviours during COVID-19 pandemic, & greater acceptance of technologies designed to battle it.

Methods

An online public opinion survey is conducted in Germany (n1=1000) and India (n2=1000) using stratified random sampling. The questionnaire consists of 4 sections: COVID-19 knowledge, preventive behaviours during various phases of the pandemic, trust in self & institutions, and acceptance of technologies. Knowledge items are scored, and preventive behaviours are evaluated in categories. The trust section consists of imaginary scenarios in each of the components of trust - integrity, responsiveness, reliability, openness and fairness. These trust scenarios identify the level of trust in individuals, close friends & family, scientists & researchers, and the government. Correlations between knowledge scores, preventive behaviours, trust, and acceptance of technologies are explored and reported.

Results

It is expected that knowledge can be correlated to preventive behaviours. But, for acceptance of technologies, it is expected that trust might play a greater role rather than knowledge.

Conclusions

This study is unique in its design where public trust is not just a single variable but is measurable due to severable scenarios for each of the components of trust. Additionally, this study provides a direction for policy and institutional responses to future pandemics- answering whether to focus on knowledge or build more trust.

Key messages

• Online, representative public opinion surveys in Germany & India compare and contrast whether knowledge or trust is responsible for preventive behaviours and acceptance of technologies during COVID-19.

• Adoption of new technologies becomes easier when public exhibit higher levels of trust. However, knowledge can be important for preventive behaviours.
Health promoting schools in Iceland - SHE4AHA Erasmus+ project
Authors: Gudmundsdottir I , Karlsdottir S
Published: October 2023

Background

The Green paper on ageing recognizes learning and experience in early childhood influences our lives. Healthy childhood in general shapes our future prospect, health situation and well-being. SHE4AHA Erasmus+ project approaches the Green paper and this work is lead by Schools for Health in Europe Network Foundation (SHE) in cooperation with researchers and coordinators for Health promoting schools in five countries. The green paper advocates for interventions and activities, which will help to laying the right foundation for early in life, preventing, limiting, and postponing some of the challenges linked to ageing. This could help European member states to fulfil the objective of adding healthier years to the life expectancy.

Description

The objective of SHE4AHA is to show Health Promoting School (HPS) framework used as a validated and evidence-based contribution to implement the Green paper on ageing that calls for solutions to support healthy and active ageing from an early age. The SHE4AHA project involves 15 pilot schools in five European countries, Iceland, Portugal, Denmark, France, and Slovenia. These schools receive training, coaching and support to work with the whole school approach for HPS. The SHE4AHA project started in March 2022 and will finish in February 2025. Each pilot school is working with aim on project selected of them to try out for the schoolyear 2022-2023.

Lessons and results

All pilot schools work with a pixie version of the SHE Manual made for the project. The school systems in the countries are very different and there is need for a little different approach for the countries. The three pilot schools in Iceland are also working with the Icelandic frame of being a HPS. The supporting material is e.g., checklists and interactive website. Results have shown e.g., need to increase and recognise appropriate resources like time and flexibility for coordinators at schools.

Key messages

• Health promoting framework built on the Ottawa Charter the process, enabling individuals and communities to increase control over the determinants of health to live an active and a productive life.

• In the development process of health promoting schools, school principals, school management, teachers, other school staff, pupils and community partners need to be involved.