bluuebunny/crossref_metadata_2025 huggingface dataset:
Migrant healthcare workers: exploring resilience and capacity for circular migration
Authors: Kuhlmann E , Ungureanu M , Thilo N , Fehr L M , Cosma N C , Brinzac M G , Dopfer-Jablonka A
Published: October 2023

Background

This study focuses on migrant healthcare workers’ experiences and explores mobility patterns in the middle of a global health crisis, aiming to explore the capacity for circular migration and support effective equitable healthcare workforce policy.

Methods

Romanian physicians working in Germany served as an empirical case study. We applied a qualitative explorative approach; interviews (n = 21) were collected from mid of September to early November 2022 and content analysis was performed.

Results

Migrant physicians showed strong resilience during the COVID-19 crisis and rarely complained. Commitment to high professional standards and career development were major pull factors towards Germany, while perceptions of limited career choices, nepotism and corruption in Romania caused strong push mechanisms. We identified two major mobility patterns that may support circular migration policies: well-integrated physicians with a wish to give something back to their home country, and mobile cosmopolitan physicians who flexibly balance career opportunities and personal/family interests.

Conclusions

Health policy must establish systematic monitoring of the migrant healthcare workforce including actor-centred approaches, support integration in destination countries as well as health system development in sending countries, and invest in evidence-based circular migration policy.

Key messages

• Effective retention policy must consider mobility patterns of healthcare workers and motivational factors, calling for systematic data and research evidence.

• Major push and pull factors reveal strong interconnectedness of healthcare systems and policy in sending and receiving countries, calling for more equitable health workforce policy.
Company commitments and practices on nutrition and environmental sustainability in Ireland
Authors: Steele M , Harrington J
Published: October 2023

Introduction

The Business Impact Assessment (BIA) tools were developed by INFORMAS to document companies’ commitments on population nutrition (BIA-Obesity) and environmental sustainability (BIA-Sustainability). As part of the EU-funded Food Systems that Support Transitions to Healthy and Sustainable Diets (FEAST) project, we used the BIA-Obesity and BIA-Sustainability to map the public commitments of a range of national and international food companies active in Ireland.

Methods

We selected companies (n = 39) across the packaged food, soft drinks, quick service restaurant, grocery retailers, infant formula, and catering industries. Selection was based primarily on the companies’ market shares in Ireland, as well as potential to compare findings across countries. We searched each company's website, annual reports, and other public sources, logging all commitments relevant to the domains of the BIAs. We then asked companies to provide evidence of any additional publicly available commitments not included in our data collection. Then we scored the final set commitments for each company in each domain. The domains were weighted differently in different industries based on current evidence on the impact of each industry.

Results

Within each industry, the results vary widely, with some companies making extensive and detailed public commitments while others made few if any public commitments. Many companies, especially larger multinational companies, make strong commitments on sustainability, while commitments to tackle obesity and non-communicable diseases still lag behind.

Conclusions

There is still scope for food businesses to make more and clearer commitments on environmental sustainability and, especially, on population nutrition and health in Ireland. Now that a benchmark of companies’ commitments has been established, future work will focus on changing commitments over time, as well as, crucially, assessing practices related to these commitments.
Parents’ mental health state and self perceived difficulties of their children
Authors: Lioliou S , Bitsakos N , Vagionaki K , Pitsikaki S , Papadakaki M
Published: October 2023

Past research shows that parents’ mental health is highly associated with children's emotional and behavioural state. The study aimed to explore and verify the hypothesis that high self perceived parental depression and anxiety levels increase observed emotional/behavioural problems in their children. The sample included 53 parent-child pairs, residents of Crete, Greece where the average age of parents (88.7% females) was 42.30 yrs (SD = 5.41) and with mean child (54.7% males) age of 9.16 (SD = 1.36), who presented for learning difficulties assessment at a community Mobile Unit. Among them, 64.2% had university degree while 24.5% had secondary education. The tools used were Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) to assess depression and anxiety symptoms in parents and Child Behaviour CheckList (CBCL /6-18 DSM-oriented scales) to assess observed emotional/behavioural problems of their children (Emotional and Somatic Problems, Anxiety, Attention Deficit, Oppositional Defiant Problems, Conduct Problems). The study found a significant positive correlation (r=.400; p=.011) between BAI (M = 11.89, SD = 8.48) and Anxiety Problems in the CBCL (M = 2.93; SD = 2.11). Additionally, there was a significant positive correlation between BDI (M = 11.44, SD = 10.63) and Emotional Problems (M = 4.22, SD = 3.34), with r = 0.427 (p=.006) as well as with Anxiety Problems (r=.427; p=.006). These results indicate a link between parents’ self perceived anxiety with the anxiety they observe in their children and parents’ self perceived depression levels with the emotional and anxiety problems they identify in their children. It seems that anxious and depressed parents tend to highly identify same characteristics in their children. For the future it is recommended to test a bigger sample and also evaluate children's own beliefs. Nevertheless, the study confirms the connection between parental and child mental health which cannot be ignored when designing family based interventions.

Key messages

• Understanding parents’ mental health issues could improve children’s lives and inform health policy planning.

• Validated tools need to be introduced in community health setting to early detect parent mental health issues.
3.E. Workshop: Air pollution health impacts and costs in EU accessing countries
Authors:   Organised by: European Commission, Joint Research Centre, EUPHA-ENV,   Chair persons: Vlatka Matkovic (Belgium), Marija Jevtic (EUPHA-ENV)
Published: October 2023

Air pollution is detrimental for health, climate, national economies and well-being in the European Union (EU) and in EU candidate countries. In many locations air quality levels are above the EU or national legal standards and/or the guidelines recommended by the World Health Organization. Very often EU neighbours and countries in the process of accessing the EU are disproportionately more affected by the impact of air pollution than others. The newest global evidence is suggesting that human health is affected even at low pollution levels below the current European standards and WHO guideline values. In 2021, the WHO published new air quality guidelines structured in Intermediate targets and final targets which are lower than the previous recommendations published in 2005. Estimating the costs of air pollution requires analysis of extensive data sets by means of econometric and statistical methodologies. In this session is discussed the assessment at country level for Europe and worldwide which is particularly valuable for estimating statistical value of life (VSL) and the value of a life year (VOLY) for counties that have not been the focus of global estimations so far. Moreover, this workshop adds valuable new information on the Western Balkans and Ukraine that could be used in systematic efforts to develop evidence-based air pollution reduction plans and to track progress toward reducing air pollution and consequently the health impacts. The studies included in this session represent valuable efforts to acquire evidence in support of further alignment of national air quality policies with those of the EU.

Key messages

• The newest evidence supports efforts to further aligning the Western Balkans and Ukrainian air quality policies with those of the EU and contribute to national and local implementation.

• The meta-analysis of existing literature leads to the development of econometric models for estimating VSL and VOLY at country level worldwide.
Validation of a translated comprehensive mental health literacy measure for adolescents (KAMHS-NL)
Authors: Tullius J M , Geboers BJM , Reijneveld S A , de Winter A F
Published: October 2023

Mental health literacy (MHL) is considered to be of crucial importance for early recognition and self-management of mental health problems, and for the use and acceptance of mental health services. MHL has been identified as an important factor for the promotion and prevention of mental health problems, especially during adolescence. Recently, the Knowledge and Attitudes to Mental Health Scales (KAMHS) has been developed to assess MHL in adolescents. Studies show that the KAMHS is a comprehensive instrument that could potentially be widely used within the research community. However, it has thus far not been validated in different contexts. Therefore, the aim of the current study was to assess the content, structural, and construct validity of a translated version of the KAMHS in another country, namely the Netherlands. First, we established the content validity of the translated KAMHS (KAHMS-NL) through cognitive interviewing with adolescents (n = 16). Next, we collected data among adolescents aged 13-16 attending secondary schools in the Netherlands (n = 404) on mental health literacy (KAMHS-NL), mental health, resilience, and use of mental health support. We then assessed structural validity by applying confirmatory and exploratory factor analysis. Lastly, construct validity was assessed by analyzing convergent and divergent correlations between subscales of the KAMHS-NL and other instruments. Preliminary results suggest that the KAMHS-NL has good content validity, while the factor structure previously identified by the developers was confirmed with two models for the Dutch version. For construct validity, significant although relatively small-to-moderate convergent correlations with the reference scales (r = 0.14-0.40) and small divergent correlations (r = 0.00-0.06) were found. More detailed results will be made available at the time of the presentation. We conclude that the KAMHS-NL is a reliable and valid measure for adolescent MHL which deserves wider implementation.

Key messages

• The KAMHS-NL is a reliable and valid measure for adolescent mental health literacy.

• Cross-cultural translation and validation of the KAMHS is needed for wider and more streamlined measurement of adolescent mental health literacy.
Holistically assessing digital public health systems: The Digital Public Health Maturity Index
Authors: Maaß L , Zeeb H , Rothgang H
Published: October 2023

Background

In their toolkit on national eHealth strategies, the WHO lists core areas for a holistic approach to digital public health (DiPH) systems: governance, investment, services, infrastructure, interoperability, workforce, legislation, policy, and compliance. However, addressing all of them is challenging, time-consuming, and expensive. Therefore, countries must first assess their DiPH system's maturity to identify gaps or improvement areas and prioritise investments. This ensures that policies align with the system's current state and guide future policy and regulation development. Assessing the system also has international advantages, as global benchmarking and policy learning are possible when multiple countries use the same tool for evaluating their DiPH system's maturity. However, until now, no index asses DiPH systems as comprehensively as the WHO proposes. This is where our research seeks to support public health policymakers by proposing the Digital Public Health Maturity Index (DiPHMI) to holistically assess the maturity of national DiPH systems following the WHO toolkit.

Methods

We developed the DiPHMI through systematic literature research on the characteristics and requirements of DiPH interventions. Indicators were collected through a Delphi process and compared with validated indicators by the EU, the World Bank, and the ITU.

Results

Our composite index consists of four main topics:

1. The required ICT infrastructure

2. The legal framework and political support

3. The attitudes of the population and public health workforce toward DiPH

4. The level of national DiPH intervention rollout

Each area includes thematic subgroups to measure various aspects of national maturity. It will allow experts and policymakers to systematically assess their DiPH system's strengths, weaknesses, and opportunities.

Conclusions

We are confident that using the DiPHMI to evaluate and compare European countries will enable the continent to move forward in unprecedented ways.

Key messages

• The digitalisation of national health systems increases their complexity and needs to be evaluated accordingly. One can only identify its potential and barriers by applying a holistic approach.

• The DiPHMI is currently the only tool that follows the holistic approach suggested by the WHO: Supporting ICT infrastructure and legislative, tool-application level, and social interest in tool use.
Multilingual Covid-19 Communication and Linguistic Minorities in Finland: A Qualitative Study
Authors: Musta L , Mäki-Opas T , Skogberg N
Published: October 2023

Background

Inequality in access to information based on origin have been demonstrated already prior to Covid-19 epidemic and the epidemic widened those differences. Effective multilingual crisis communication can improve equal access to information. However, studies examining experiences of multilingual crisis communication are scarce. This study aims to explore how Arabic, Somali, and Russian speakers in Finland experienced multilingual communication during the Covid-19 epidemic and identify opportunities to improve its effectiveness.

Methods

Qualitative data consisted of 6 semi-structured group interviews with 32 individuals (Arabic n = 9, Russian n = 12, Somali n = 11 speakers). The respondents had lived in Finland since at least from spring 2021 and spoke Finnish or Swedish at most at beginner level. Interviews were conducted between December 2022 and April 2023 together with a translator. Interviews were analyzed thematically.

Results

There were major contradictions in respondents’ opinions. According to some respondents, multilingual information provided by authorities was highly valued in their communities and respondents felt that it strengthened trust towards the authorities. Other felt that messages were irrelevant for the communities, and the messages actually often reduced willingness to follow the guidelines or trust official sources. It was agreed that lack of multilingual information created space for dis- and misinformation. Also, the role of mouth-to-mouth information was seen as crucial during Covid-19 epidemic. Official information often neglected important social and cultural aspects and the information from the authorities only reached a small proportion of linguistic minorities living in Finland.

Conclusions

Multilingual crisis communication should consider social and cultural aspects to strengthen the equal access to trustworthy information of linguistic minorities. By this way, it also builds the trust towards national authorities.

Key messages

• Multilingual crisis communications that considers also social and cultural aspects is an effective way to improve equity of linguistic minorities during crises.

• Multichannel approach and cooperation with communities during crises helps to reach more people and builds trust towards the authorities.
Co-producing a culturally sensitive storytelling intervention with Nepalese migrant workers
Authors: Paudyal P , Wasti S , Neupane P , Sapkota J , Kulasabanathan K , Watts C , Pathak R , Silwal R , Memon A , Cassell J
Published: October 2023

Background

Labour migration is an increasingly important contributing factor to Nepal's economy; remittance from migrants abroad contribute to quarter of Nepal's gross domestic product. However, this income comes at a great cost; nearly 1,000 Nepalese migrant workers (NMWs) die every year in Gulf States and Malaysia. This interdisciplinary study informs the co-production of a culturally adaptive storytelling intervention to support the mental health and wellbeing of NMWs.

Methods

We focused on outgoing and returnee adult NMWs in the GCC countries. The study was conducted in Dhading district, Nepal and involved three different but interconnected phases; 1. a systematic review and a mixed methods study exploring health and wellbeing issues of NMWs (both studies already published, available online); 2. exploration, and analysis of Nepalese literature relevant to contemporary migration (n = 49); and 3. co-development of storytelling intervention working together with a co-production group (n = 12).

Results

Findings from phase one and two showed that NMWs suffer from various health and wellbeing issues (mental health, physical health including workplace hazard, abuse, and exploitation). Themes identified from the Nepalese literature centred around hopelessness, helplessness, and separation. Based on these findings, a culturally sensitive storytelling intervention was co-produced to support the mental health and wellbeing of NMWs in GCC countries. The intervention video includes an animated story centred around the struggles of an archetypal male migrant worker and their use of coping strategies for dealing with adversities.

Conclusions

Our study suggests that co-production of storytelling intervention provides shared spaces for migrant workers to engage, imagine and participate as communities. The process also helps to redistribute power and redress top-down modes of working that may undermine and devalue the stories of marginalised groups.

Key messages

• Co-production of storytelling intervention provides shared spaces to engage, imagine and participate as communities.

• Co-production helps to redistribute power and redress top-down modes of working that may undermine and devalue the stories of marginalised groups.
What can diet of migrants from the French West Indies indicate about the nutrition transition?
Authors: Allès B , Colombet Z , Arnault N , Touvier M , Méjean C
Published: October 2023

Background

French West Indies, like the other Caribbean territories, are currently undergoing a nutrition transition. Little is known about how migration and subsequent changes in food habits could influence adherence to specific dietary patterns. Our study aimed to assess dietary intake among French West Indians who live in and/or were born in the French West Indies, compared with individuals born and living in mainland France.

Methods

1,094 participants from the NutriNet-Santé e-cohort, prospectively included between 2009-2019, were categorized into 4 subgroups: born and living in the French West Indies (West Indies/West Indies WW; n = 172); born in the West Indies and living in France Mainland (West Indies/mainland, WM n = 317); born in France Mainland and living in the French West Indies (mainland/West Indies, MW n = 288) and those born and living in Mainland France (mainland/mainland, MM n = 317). We compared the four subgroups on their nutritional quality of the diet using data provided by 24h records, and sociodemographic, lifestyle and anthropometric characteristics. The association between dietary patterns and migration status was estimated by polytomous logistic regression models.

Results

The WM group had consumptions reflecting an intermediate nutritional quality between the WW and the MM groups, with higher consumption of plant-based foods. The WM and WW groups were more likely to adhere both to a traditional dietary pattern from the West Indies (tubers grown in the West Indies, legumes, fish and offal) and, to a lesser extent, a convenient dietary pattern (high in ultra-processed foods), compared to MM, confirming the ongoing nutrition transition.

Conclusions

Migrants from French West Indies may have changed their traditional dietary habits, suggesting an influence of the environment. Migrants presented both potentially protective and detrimental dietary patterns compared to their peers born in mainland France due to the maintenance of cultural habits.

Key messages

• Migration may influence food habits for migrants between the French West Indies and Mainland France.

• The nutrition transition is on going in the French West Indies, representing a public health issue.
Political trust in the handling of the COVID-19 pandemic – A survey in Denmark and Sweden
Authors: Karlsson E , Nilsen P , Seing I , Vrangbæk K , Wassar Kirk J , Kallemose T
Published: October 2023

Background

The two neighboring countries Denmark and Sweden differed markedly in their initial response to the coronavirus pandemic as Denmark rapidly introduced mandatory restrictions while Sweden's response was characterized by voluntary recommendations and an emphasis on personal responsibility. Both countries saw considerable discussion in media about whether restrictions were sufficient and appropriate.

Aim

To investigate the extent to which there was political trust in the handling of the COVID-19 pandemic in Denmark and Sweden and the characteristics of those in each country who expressed the lowest degree of trust.

Methods

Cross-sectional surveys were completed in Denmark (n = 2619) and Sweden (n = 2633) in 2021. Trust was captured in two questions: trust in how the government and the public health authority in each country had handled the pandemic. Those who expressed “very small trust” or “moderately small trust” were labelled “low-trusters”. The effects of demographic variables were analysed by logistic regression.

Results

Trust in the government's handling of the pandemic was considerably higher in Denmark than in Sweden. Approximately 61% of the Danish respondents expressed moderately or very large trust in the government's handling of the pandemic. The corresponding proportion for the Swedish respondents was smaller, 42%. Further, the proportion of low-trusters was considerably smaller in Denmark than in Sweden, 11% versus 34%. Also, males in both Denmark and Sweden were more than twice as likely as females to express low trust in the handling of the pandemic.

Discussions

Denmark and Sweden are similar in many ways, being universal welfare states, which have been associated with high political trust. Our findings suggest that the more active involvement of the Danish government in the battle against COVID-19 generated a high degree of public trust. The Swedish government's more passive role does not seem to have resulted in the same degree of trust.

Key messages

• Active involvement of authorities and governments seem to increase citizens’ trust.

• The degree of trust in authorities and governments during a crisis differs among groups.
Shifting the paradigm from illness to wellbeing: development of a Municipal Health Strategy
Authors: Sousa I , Martins R , Caldeira R , Ligeiro C , Marques C , Cunha R , Santos O
Published: October 2023

Issue

Portugal is undergoing a health promotion and healthcare competency transferring process to local governments, requiring the development and implementation of Municipal (local) Health Strategies (MHS). Planning an MHS remains a challenge as no guidelines have been established, being imperative to involve citizens and local stakeholders.

Description of the problem

The MHS contemplates, at the municipal level and in the field of health, the priority lines of intervention and respective targets, indicators, activities, resources, and timeframes. This communication will describe the participatory mixed-methods design created for the development of one of the largest municipalities of Portugal: Almada. A technical panel was formed to act as a think tank throughout the development of the MHS, involving different public and private local social actors (Almada city hall, parishes councils, schools, faculties, sports clubs, healthcare units, social service organizations, etc.). The world café method was selected for collaborative thinking, involving also public health and health promotions experts and Almada citizens. A population-based survey complemented public registries as a data source for building up a municipal health profile (a diagnostic tool for supporting the MHS definition). What are the vision and values of Almada's MHS, how to involve the community, and what are Almada's MHS strategic axes, these are some of the questions discussed in the world cafés.

Results

From March to May 2023, six world cafés were conducted, plus one population-based survey focused on municipalities’ health and well-being indicators. The preliminary data point to an MHS “shifting the paradigm from illness prevention to wellbeing promotion”.

Lessons

Collaborative models are pivotal to building up effective intersectoral municipal policies, reflecting real-world health problems, and tackling real-world solutions.

Key messages

• The definition of local health strategies require collaborative, co-construction oriented models, with challenging methodological processes.

• A multi-sectorial stakeholder panel set out positive health and wellbeing indicators and goals (instead of disease prevention goals) as priority for a Municipality Health Strategy.
Association between tobacco control policies and smoking behaviour in Europe
Authors: Starker A , Kuhnert R
Published: October 2023

Background

Smoking is an important public health problem. The European Health Interview Survey (EHIS) provides regular data on prevalence and determinants of smoking for the populations of European countries, while the Tobacco Control Scale (TCS) quantifies the implementation of tobacco control measures. The aim is to examine the associations between tobacco control policies at country level and individual-level smoking prevalence.

Methods

Using multi-level regression modelling, individual data from EHIS 2019/2020 and country-level data from TCS 2019 were analysed. The outcome measure was self-reported current smoking (daily or occasional) at the individual level. Predictor variables were at the individual level: gender, age and education attainment level, and at country level: scores of TCS policy components ‘Price', ‘Public place bans', ‘Advertising bans', ‘Health warnings', ‘Treatment’ and ‘Illicit trade'. Microdata from the 3rd wave of EHIS for 28 European countries were used with a total of n = 66.934 individuals aged >15 years. A weighting factor was applied to consider each country proportionally according to its sample size in EHIS.

Results

There are large cross-national differences in current smoking prevalence ranged from 12.6% (95% confidence interval (CI) 11.9-13.3) in Sweden to 36.2% (95% CI 35.0-37.4) in Bulgaria. In the final multi-level model besides individual variables (female gender, age 60 years and over, medium or high education level), following variables at country level were significantly associated with lower prevalence of current smoking: ‘Price’ (Odds Ratio (OR)=0.96 (p < 0.05) and ‘Treatment’ OR = 0.88; (p < 0.01). For ‘Public place bans', ‘Advertising bans', ‘Health warnings’ and and ‘Illicit trade’ association were in same direction but without significance.

Conclusions

Tobacco control policies help to reduce the prevalence of smoking in population, although the different measures have differing impact.

Key messages

• Our study confirms the link between the implementation of tobacco control policies and smoking prevalence using recent data.

• Policy components have different effects on smoking prevalence at population level.
Mind the gap: analysis of sub-national differences in life expectancy at birth in the European Union
Authors: Pinheiro V , Devleesschauwer B
Published: October 2023

Background

Life Expectancy (LE) at birth, the average number of years a person is expected to live from birth, with constant age-specific mortality, is an essential indicator of a country or region's well-being, highlighting progress and gaps in societal health, including at the sub-national level. In this study, our goal was to analyse sub-national gaps in LE at birth in European Union (EU) member states, between 2000 and 2020.

Methods

A retrospective longitudinal analysis on differences in LE at birth among NUTS2 regions within EU countries was performed, in 2000-2020, taking the largest absolute difference between NUTS2 regions as the country value. Estimates were analysed for the EU mean and 20 member states, due to data availability. All data was retrieved from Eurostat and analysis performed in R version 4.0.0.

Results

The mean gap in LE in the EU increased from 2.46 to 2.73 between 2000 and 2020, reaching its maximum in 2010 (2.82) and its minimum in 2012 (2.43), with great variability across countries. In 2000, the top 3 countries with the largest gap in LE were Greece (4.40), Portugal (4.10) and France (3.60), while in 2020 the top 3 was composed of Belgium, Spain (both 4.60) and Hungary (4.10). The bottom 3 countries with the lowest gaps in LE were Lithuania (0.20), Sweden (1.10) and Hungary (1.40) in 2000, and Lithuania (1.00), Sweden (1.30) and the Netherlands (1.50) in 2020. Lithuania was the country with the lowest value in 2007 (0.00), and Spain the highest (5.50) in 2010.

Conclusions

The mean gap in LE at birth in the EU increased in 2000-2020, with great variability across countries. Further research should address possible associations with policy options at the regional level, such as health expenditure and employment support schemes, in order to reduce inequalities.

Key messages

• Important sub-national gaps in LE at birth persist in the EU, with considerable variability across countries.

• These results may have considerable implications for policy-making and priority-setting.
Multilingual research assistants activate foreign-born persons to respond a survey in Finland
Authors: Klemettilä K-L , Lilja E , Mäkipää L , García-Velázquez R , Litewka-Anttolainen A , Kuusio H
Published: October 2023

Background

The decline in response rate is a major universal concern in population studies. This study demonstrates multilingual research assistants’ (n = 11) perceptions of the factors that influenced research participation in the National survey on health, well-being, and service use among the foreign-born population (MoniSuomi). Participation in the survey was possible via a questionnaire or a short interview by phone.

Methods

The interviewees were selected with purposeful sampling. Six semi-structured interviews with the research assistants were conducted in March 2023. The data were thematically analysed.

Results

Preliminary results can be arranged into three categories. The factors related to the 1) research assistant 2) responder and 3) research institute. The most influencing elements seemed to be the research assistant's ability to speak the participant's mother tongue, the participant's experience of inclusiveness, and their perception of the research institution. The response rate for those who were reached out by the multilingual research assistants was substantially higher (61.6%) compared to those whose phone number was not available (40.1%). The interviewees emphasized the importance of being involved additionally in the planning and reporting phases of a survey.

Conclusions

The findings of the study suggest that multilingual research assistants play an important role in activating foreign-born population to respond in a survey. However, participants’ experiences and the research institution's image are also to be considered.

Key messages

• Utilizing the knowledge of the target population is essential to the success of a survey.

• Multilingual research assistants can represent the voice of foreign-born population during the conduction of a survey.
Long-term trends in family level contribution to mortality – Finland 1990-2000
Authors: Suulamo U , Remes H , Tarkiainen L , Martikainen P
Published: October 2023

Background

Family is among the most relevant sociodemographic factors influencing the health and well-being of individuals. However, the general contribution of the family context to premature adult mortality is seldom measured, and possible changes in this effect over time have not been quantified in previous studies.

Methods

The study is based on individual-level register data on the total Finnish population aged 30 years and over. We estimate two-level Weibull survival models with individuals nested in families for six five-year periods between 1990 and 2020 to assess the degree to which the family context contributes to individual differences in mortality. The median hazard ratio (MHR) is used as a summary measure of this general contextual effect. We assess trends separately by sex and age categories and broad cause of death groups, as well as adjust for different individual- and family-level sociodemographic characteristics.

Results

The preliminary results show that the contribution of the family level to individual mortality risk is substantial. The family effect shows an increasing trend over three decades and is largest among younger individuals aged 30-49.

Conclusions

The overall relevance of the family context to mortality is considerable and has grown over time. From a public health perspective, policy and interventions should place more importance on family-level influences on health.

Key messages

• The family context and whom you live with are increasingly important for health and mortality.

• Family-oriented health care and services that consider family-level influences should be developed further.
Levels of physical activity and sedentary behaviors in different universities of Bogotá
Authors: Morales Eraso N E , Rubiano Espinosa O F , Caviativa Castro Y P
Published: October 2023

The global recommendations for physical activity (PA) advised by the World Health Organization WHO (2012) are 150 minutes of moderate intensity (at least 600 MET-min/week) or 75 minutes of vigorous intensity per week (at least 3000 MET-min/week). The objective were determine the levels of PA and sedentary behaviors (SB) in people at different universities in Bogotá (students, administrative personal). The dimensions IPAQ was applied (PA in the transportation PAT, PA in Leisure Time PALT and auto evaluation of sedentary behaviors ASB). Study was descriptive, correlational, with simple random sampling. The project had ethics considerations aproved by Ethic Comitee of Libre University. The data were analyzed with Rversion 4.2.3. Results were n = 717 distributed in 442 (61.6%) women and 275 (38.4%) men. 100 men (36.4%) with 120.9 ± 185.9 MET-min/week and 161 women (36.4%) with 313.9 ± 198.8 MET-min/week did not fulfill PAT recommendations. 109 men (36.5%) with 193.6 ± 217.0 MET-min/week and 141 women (31.9%) with 186.4 ± 194.5 MET-min/week did not fulfill PALT recommendations. 75 men (27.3%) report sedentary time (ASB) greater than 2 hour/day (2311.2 min/week ± 1487.7) and 104 women (23.5%) report 2255.1 min/week (±1316.4). Instead, people fewer than 2 hours were 200 men (72.7%) with 323.6 min/week (±320.7) and 338 women (76.5%) with 312.4 min/week (±308.8). Statistical tests for association were applied for the variables PAT and PALT which did not have significant statistical differences but between PALT and ASB were found significant statistical differences (p-value < 2.2e–16, CI 1032.740–1608.664), so they were related. Universities must promote and maintain recommended PA levels through strengthening programs and infrastructure oriented to PA in population, especially promoting forms of transportation such as bicycles and different forms of active leisure time differentiated between genders. However, sedentary times are a threat to health, due to its great increase in this population.

Key messages

• The global recommendations for physical activity (PAG) recommended by the WHO (2012) is 150 minutes of moderate intensity or 75 minutes of vigorous intensity per week.
Exploring health service utilization among elderly populations in Hungary: A comparison of rural and urban settings in the context of Unhealthy Ageing
Authors: Kovacs N , Piko P , Kolozsvari L , Kovacs E , Ungvari Z , Adany R
Published: October 2023

Background

The demographic transition presents a significant challenge for health systems due to increasing healthcare needs of ageing population, particularly in Central and Eastern European (CEE) countries. In first step, we aimed to describe the health status and use of health services among elderly living in the most deprived region in Hungary, and to compare the use of health services (including preventive and healthcare services) among older adults living in urban and rural areas.

Methods

A complex health survey was carried out on randomly selected sample of individuals aged 65 years and older (n = 443) in Northeast Hungary in 2022. Demographic, socioeconomic characteristics and use of health services were analysed by type of residence.

Results

Generally, 15.3% of elderlies rated their health as poor/very poor (14.9% in rural and 15.7% in urban areas), and 57.8% (63.5% and 52.6%) reported limitation in daily activities. Elderlies living in rural area in comparison with that living in urban area reported lower frequency of visiting a dentist (21% vs. 32.9%; p = 0.006), and specialists (53.4% vs. 63.8%; p = 0.028), having fecal occult blood testing (8.8% vs. 21.7%; p < 0.001), colorectal cancer screening (12.1% vs. 20.9%; p = 0.014), and mammography (16% vs. 26.6%; p = 0.035), and reported higher frequency of blood pressure measurement (90.9% vs. 84.4%; p = 0.042). After adjustment for demographic, socioeconomic and health related factors, urban residence showed positive association with having fecal occult blood testing (OR = 2.72, 95% CI: 1.42-5.22), and negative association with blood pressure (OR = 0.44, 95% CI: 0.23-0.86) and blood glucose measurements (OR = 0.55, 95% CI: 0.33-0.92).

Conclusions

Our findings suggest the impact of residence on health (especially preventive) service utilization among older adults in Hungary. Further comprehensive studies are needed to describe the health needs of older people to implement policies to promote healthy ageing in CEE countries.
Food and Nutrition Literacy as means to fight against inequalities in diet and nutrition
Authors: Bonaccorsi G , Lorini C
Published: October 2023

The concepts of nutrition (or nutritional) (NL) literacy, food literacy (FL), and the extensively described concept of health literacy (HL) are based on the same idea of increasing the degree to which individuals and groups can access and use specific information needed to make health decisions that benefit the community. More specifically, the terms of FL and NL refer to a set of knowledge, competencies, and abilities that are necessary for people to use information regarding food and nutrition in order to achieve and preserve a healthful diet. Nonetheless, the core elements of the two constructs partially differ, since NL mostly involves nutritional information and individuals’ capacity or interest in relation to accessing and using such information in order to maintain nutritional health status, while FL considers mainly the relationship between people and food (or food system) and the capacity to use food responsibly. From a public health nutrition perspective, NL/FL could help to identify individuals with low diet quality and unhealthy eating habits that make them at higher risk of chronic diseases and other health consequences. In fact, although a very large amount of information about food and nutrition is now available to citizens/consumers, they often struggle to recognize evidence-based information and effectively manage their diet in the current “dietary infodemic”. Thus, there is a need to develop and implement interventions in order to increase the public's NL/FL level, beginning from establishing valid instruments to measure the NL/FL and finding specific targets on which to intervene by education and other preventive measures, so as to develop specific awareness to counteract the pressure from GDOs and the effects generated by commercial determinants.
4.F. Workshop: Supporting present policy making to address future challenges: foresight and public health policies
Authors:   Organised by: EUPHA-FS,   Chair persons: Henk Hilderink (EUPHA-FS), Claudia Habl (Austria)
Published: October 2023

The COVID-19 pandemic and its impact on health showed that we were not prepared for uncertain health events and its uncertain consequences and impact in society. To be prepared for the uncertainty of the future, foresight provides a systematic, participatory, and vision-building process that explores the future to anticipate trends and support present-day actions. Foresight explores possible futures and their impact on society and population health. Foresight can enable better informed present-day decision-making and thereby better short-term and long-term preparedness in European Union (EU) Member States (MS) and the European region for possible future health crises. With foresight, experts and policy makers can explore long-term decisions that need to be made in the present to be prepared for the future. Using foresight to formulate long-term decisions can allow setting priorities, planning budgets and spending to address health threats and challenges, and learning how to cope with challenges while keeping resilient and sustainable health systems. In this workshop, we will focus on how foresight can be integrated into the policy cycle to support policy makers to be prepared for the future. It will provide an outlook on how a foresight exercise can provide insights into future challenges to provide recommendations and explore policy implications. The workshop will start with an interactive Mentimeter session to get a better view on how the audience is familiar with foresight in the policy cycle. Then, a brief presentation is given as introduction to foresight and its role in policy making. This is followed by a presentation of a Foresight study that provides recommendations for policy makers to address present and future challenges related to mental health. The second foresight study provides an example on how digitalization in primary healthcare can address present and future challenges. The last presentation gives an overview on the role that foresight can play in the policy cycle at different stages of the foresight exercise when discussing the use of personalized medicine in cancer prevention. The workshop will be concluded by a discussion with the four presenters on the lessons learned regarding foresight and policy making.

Key messages

• Foresight provides a systematic and participatory process to support policy making towards sustainable and resilient health systems.

• Foresight can enable better informed present-day decision-making towards better short- and long-term preparedness in the European region and its Member States for possible future health challenges.
15 years of Gaining Health strategy in Italy: what's new about behavioral risk factors?
Authors: Pettinicchio V , Marotta D , Trinito M O , Casigliani V , Asta F , Possenti V , Contoli B , Minardi V , Masocco M
Published: October 2023

In Europe chronic non-communicable diseases (NCDs) are responsible for the majority of deaths, premature deaths and disabilities. Actions to fight against smoking, excessive alcohol consumption, sedentary behaviours and obesity are central for the prevention of NCDs. In Italy in 2007 the National Program Gaining Health (GH) was launched and the behavioral risk factor surveillance system (including PASSI and PASSI d’Argento) was promoted. This study has the aim to contribute to assess the impact of the strategies implemented with GH, analyzing over time data on behavioral risk factors in Italy since 2008. Data from PASSI 2008-2021 (468.000 interviews of 18-69 years old people) and PASSI d’Argento 2016-2021 (74.000 interviews of over 65 years old people).

i) time series models on smoking, alcohol, sedentary behaviours and obesity data in adults, stratified by gender, age, residence and social determinants;

ii) Regression models to evaluate the changes in associations over time between behavioral and social determinants.

Smokers’ prevalence dropped from 30% to 24%, not equally in population groups. Excessive consumption of alcohol is stable since 2010 (∼16%); although, it is the result of opposite trends in the different components of the indicator (binge, between meals and usually high) and of improvements in some groups and worsening in others: it increases in the North but not in the Center-South, it is reduced in men but increased among women; it remains stable among young people aged 18-24 (∼27%). Sedentariness is increasing everywhere (31% in 2021), especially in the South (43%) and among the youngest. Obesity also increased in the South and in the North; today about one out of 10 is obese. Social inequalities continue and worse in affecting these phenomena. These data show no improvement in the last 15 years. Prevention Plan is an opportunity to change course. Surveillance is strategic, as long as it is used to guide policies and to monitor their effectiveness over time.

Key messages

• Data on behavioral risk factors show no improvement in Italy since 2008.

• Surveillance is strategic to guide health policies and to monitor their effectiveness over time.