bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual and food environment factors associated with the diet of disadvantaged adults in Flanders
Authors: Inac Y , de Clerq E , Van de Weghe N , Dury S , D'Hooghe S , Vandevijvere S , van Dyck D , Deforche B , De Ridder K
Published: October 2022

Background

Health inequalities partially remain due to differences in diet between socioeconomic groups. Examining the association between socio-ecological factors and the diet of socioeconomically disadvantaged (SED) individuals can enhance the development of interventions to decrease health inequalities.

Methods

In total, 278 SED adults residing in two Flemish municipalities completed a survey addressing sociodemographics, diet, health and their perceptions of the food environment. The objective food environment was examined by assessing food retailer information in street network-based buffers of 500m and 1000m around participants’ addresses. Linear regression was used to test assumptions.

Results

Individual factors such as poor subjective health (OR0.58;CI 0.34-0.97), food insecurity (OR0.60;CI 0.38-0.94) and living alone (OR0.86;CI 0.75-0.98) were negatively associated with healthy dietary habits such as daily fruit and vegetable (FV) consumption. Positive perceptions on the availability of FV were positively associated (OR1.09;CI 1.02-1.17) with daily FV consumption. Objective food environmental factors showed a stronger association with unhealthy dietary habits. A greater amount of retailers within 1000m walking distance was negatively associated with fast-food (OR0.96;CI 0.94-0.99) and sugar-sweetened beverages (SSB) consumption (OR0.93; CI 0.88-0.98). More supermarkets within 500m distance was negatively associated (OR0.77;CI 0.58-0.97) with SSB consumption, while more convenience stores within a 1000m distance was positively associated (OR1.48;CI 1.17-1.88) with SSB consumption.

Conclusions

Our findings suggest that factors associated with the diet of SED adults differ according to food and drink items. Interventions focused on this population should take these differences into account.

Key messages
The community pharmacy model for colorectal cancer screening: policy insights from Italy
Authors: Deandrea S , Della Valle PG , Battisti F , Mantellini P , Mantovani W , Narne E , Odone A , Senore C , Brusa P , Calsolaro R
Published: October 2022

Background

Despite its effectiveness, compliance to colorectal cancer (CRC) screening remains low. Different strategies to improve the adherence were identified, such as the involvement of new stakeholders as the community pharmacists. In Italy a recent national project fuelled the development of this strategy, scaling-up the collaboration between screening programmes and pharmacies formerly at the local level up to the national level.

Methods

The regional representatives of the CRC screening programmes provided to the National Screening Monitoring Centre the agreements arranged between the Regions/Autonomous provinces and their respective pharmacy owners representatives. The agreement decrees were analysed describing the fecal occult blood test pathway (e.g. kit supply and delivery) and supplementary activities provided by the pharmacies together with the CRC screening kit delivery, such as health promotion ones.

Results

Information was received from 18 Regions and Autonomous provinces (86% of the total). Regarding the economic compensation, the amount of money paid for each kit varies a lot, with a range from 0 to 18 EUR. The number of process phases covered by the agreements ranged from a maximum of 16 (out of 18) to a minimum of 0. The processes that were included most often were the supply of the kit, the delivery of the kit, and education/awareness of CRC screening (68.8%), followed by sample transfer to the laboratory, test tube tracing and counselling (62.5%). Among the processes less covered there were the warehouse management and awareness of other healthcare initiatives (12.5%), and only in one case a supplementary agreement on delivery of preparation for intestinal cleansing was included.

Conclusions

The arrangements between pharmacies and CRC screening programmes in Italy are very diverse and unique model is missing. Collaboration between programs and pharmacies is promising and quality standards of the service should be set at international level.

Key messages
Social capital and STIs testing among young men in Stockholm, Sweden: A cross-sectional study
Authors: Canabarro APF , Eriksson M , Nielsen A , Salazar M
Published: October 2022

Background

Testing for sexually transmitted infections (STIs) is highly accessible in Sweden, but young men's testing rate is considerably lower than young women's. Social capital (SC) might shape people's STIs testing patterns. However, such association has not been studied among young men before. This study assessed the prevalence of different forms of SC and if they increase STIs testing among young men in Stockholm, Sweden.

Methods

This population-based cross-sectional study was conducted in 2018 and included 523 men aged 20-29 years living in Stockholm. Bonding SC (having helped someone; having received help; having someone to share inner feelings with), institutionalized trust SC (in school; healthcare; media) and STIs testing behavior (never tested, tested only in the last 12 months, only more than 12 months ago, or both before and after the last 12 months) were assessed. Weighted adjusted multinomial logistic regression tested the associations between SC and STIs testing.

Results

High levels of bonding SC (range: 86.5 - 95.5%), as well as trust in healthcare (76.7%) and school (64.8%) were reported. Having helped someone (aRRR 6.1, 95% CI 1.7 - 21.6), having received help (aRRR 8.1, 95% CI 2.6 - 24.7) and having someone to share feelings (aRRR 4.0, 95% CI 1.7 - 9.2) were associated with being tested for STIs more than 12 months ago. Trust in media was the only institutional trust significantly associated with STIs testing (tested in the last 12 months: aRRR 2.5, 95% CI 1.1 - 5.4; both before and after: aRRR 3.8, 95% CI 1.6 - 8.9).

Conclusions

Peer-to-peer interventions using bonding SC should be used to promote STIs testing. More studies are needed to understand how trust in media increases testing for STIs. Although trust in healthcare and school were not statistically associated with testing, the high overall trust in these institutions reported in our study could be harnessed to implement sexual education programs promoting STIs testing among young men.

Key messages
The impact of depression on satisfaction with prenatal care in Kazakhstan during COVID-19 pandemic
Authors: Kossybakova G , Alibekova R , Crape B , Kuntuganova A
Published: October 2022

Background

Depression and anxiety are common during perinatal periods, representing a considerable public health concern during global pandemic. Only few studies have examined the influence of emotional disturbances on satisfaction with maternity care. This study aimed to assess the prevalence of satisfaction with prenatal care and to examine its association with depression and anxiety among pregnant women in Kazakhstan.

Methods

Participants were recruited to this online cross-sectional survey in the outpatient clinic in Novoshamalgan, Almaty region (n = 174) in December-January, 2022. A single-item measure of satisfaction was used by asking a question “How satisfied are you with health services?”, scored on a 5-point Likert scale. A simplified 2-item Edinburgh Postpartum Depression Scale and 2-item Generalized Anxiety Disorder scale were used to measure depressive and anxiety symptoms.

Results

Majority of women were very satisfied or satisfied (n = 128; 74%), while less than a third of the sample (n = 46; 26%) were dissatisfied with the received care. The prevalence of depression in the total sample was higher, compared to the prevalence of anxiety (34% versus 18%). Multivariable logistic regression showed that dissatisfaction with prenatal care was associated with older age, not attending check-ups regularly, and being employee of private company or student. Depression increased the odds of being dissatisfied by 2.6 times (95% CI 1.19∼5.79); while obstetric issues and anxiety were not associated with satisfaction. Perception of women about inadequate solution of the problem of antenatal depression was a significant predictor of dissatisfaction (AOR 6.87; 95% CI 1.81∼26.12).

Conclusions

Depressed women in our study were less satisfied with prenatal care. Further investigation of the perception of women about specific aspects of perinatal health services is suggested. Providing a quality, patient-centered care is needed to support pregnant women during the current pandemic.

Key messages
A questionnaire to measure the impact of ICT-based coordination mechanisms on clinical coordination
Authors: Campaz D , Vargas I , Plaja P , Sanclemente M , Paino M , Madrid MT , Vázquez ML
Published: October 2022

Background

In national health systems based on primary care, cross-level clinical coordination (CC) is a priority, as it may improve quality of care. Evidence on the impact of information and communication technology (ICT)-based coordination mechanisms on CC is inconclusive. The implementation of those mechanisms increased during the pandemic. The aim is to adapt the validated COORDENA-CAT questionnaire, for measuring CC, to analyse the implementation of ICT-based coordination mechanisms and its impact on CC in three regions of Spain.

Methods

The COORDENA-CAT questionnaire underwent a two-stage adaptation process:1) contents revision based on literature review, expert discussions, and pretest to adapt the contents and language and produce a version for each region; and 2) piloting the adapted version by self-administration of the questionnaire to primary and secondary care doctors in the health systems of two of the participating regions.

Results

The adapted version (COORDENA-TICs) kept most of the original contents. Main changes were on coordination mechanisms section. Pretest showed an adequate level of comprehensiveness, comprehension, sequence of themes and questions, and length. A low non-response rate was observed, with little variability or unexpected responses. The question on any difficulties encountered in answering the questionnaire revealed no relevant difficulties. The Shared Electronic Medical Record of each region was the most frequently used ICT-based coordination mechanism. Limited access to information and technical issues related to its use were the most common difficulties encountered. Suggestions for improving its use were receiving specific training on its use.

Conclusions

COORDENA-TICs questionnaire is a useful tool to assess utilization of ICT-based coordination mechanisms and its impact on CC from the perspective of primary and secondary care doctors. It will allow comparisons across areas, regions and to evaluate changes over time

Key messages
Coronavirus-related Health Literacy in elderly and adult population during COVID pandemic in Italy
Authors: Palmieri L , Rosano A , Lorini C , Cadeddu C , Bonaccorsi G , Unim B , De Castro P , Galeone D , Onder G , Donfrancesco C
Published: October 2022

Background

The COVID-19 pandemic caused an overabundance of valid and invalid information rapidly spread via traditional media, by internet and digital communication. Health Literacy (HL), as the ability to access, understand, appraise, apply health information, is fundamental for finding, interpreting, correctly using COVID-19 information.

Methods

In 2021, in the framework of the participation to the WHO M-POHL (Measuring Population and Organizational Health Literacy) network, a survey was conducted in a representative sample of the Italian general population aged 18+ years (N = 3,500). The validated HL questionnaire included coronavirus-related HL (HL-COVID, 16-items), general HL, sociodemographic characteristics, risk factors, lifestyles sections. For the HL-items, a 4-point Likert scale was applied: very easy, easy, difficult, very difficult. HL-COVID levels were defined as Good: very easy+easy>81.3% (more than 12 of 16 answers); Sufficient: 50.0%<very easy+easy < =81.3% (9-12 of 16 answers); Limited: very easy+easy < =50.0% (fewer than 9 of 16 answers). Elderly were responders aged 65+ years, the remaining ones were defined as adults. Ordinal Logistic Regression analysis was performed to assess the association of HL-COVID with sociodemographic characteristics (sex, age-group, educational level, financial deprivation).

Results

Good HL-COVID prevalence was lower in elderly than in adults (44.8% vs. 51.0%, p-value=0.001); the opposite for both sufficient (22.8% vs. 19.9%) and limited (32.5% vs. 29.1%) levels, but not statistically significant. The odds of a low HL-COVID (sufficient/limited) increased by 31% in the elderly and by 50%, 92%, and almost triple in persons with a low, considerable, and severe financial deprivation level, respectively.

Conclusions

The COVID-19 pandemic highlighted the need to improve HL and to prepare the general population for future emergency and non-emergency situations, confirming that HL can be considered a social vaccine.

Key messages
Evaluation of culturally sensitive educational video for informed screening decisions among migrants
Authors: Hamdiui N , Stein ML , van Steenbergen JE , Crutzen R , Bouman M , Khan A , Çetin MN , Timen A , van den Muijsenbergh METC
Published: October 2022

Background

In the Netherlands, especially Turkish- and Moroccan-Dutch women show low cervical cancer screening participation and limited informed decision-making in this regard. To meet the needs of these women, a culturally sensitive educational video was developed. The objective was to evaluate the effect of the video on informed decision-making regarding cervical cancer screening participation among Turkish and Moroccan women aged 30-60 years in the Netherlands.

Methods

Initial respondents were recruited via several social media platforms and invited to complete an online questionnaire. Following respondent-driven sampling, respondents were asked to recruit a number of peers from their social network to complete the same questionnaire. Respondents were randomly assigned to the control condition (current information brochure) or intervention condition (brochure and video). We evaluated the added effect of the video on knowledge, attitude, intention, and informed decision-making using intention-to-treat analyses.

Results

The final sample included 686 Turkish- and 878 Moroccan-Dutch women. Of this sample, 793 were randomised to the control group (350 Turkish and 443 Moroccan) and 771 to the intervention group (336 Turkish and 435 Moroccan). Among Turkish-Dutch women, 33.1% of the control respondents and 40.5% of the intervention respondents consulted the brochure (not statistically significant). Among Moroccan-Dutch women, these percentages were 28.2% and 37.9%, respectively (P = 0.003). Of all intervention respondents, 96.1% (Turkish) and 84.4% (Moroccan) consulted the video. The video resulted in more positive screening attitudes among Moroccan-Dutch women, in comparison to the brochure (74.3% versus 68.4%, P = 0.07).

Conclusions

Our short, easily implementable video resulted in more positive screening attitudes in Turkish- and Moroccan-Dutch women and can thus contribute to informed cervical cancer screening decisions.

Key messages
Mental well-being of healthcare workers in two hospital districts with differing COVID-19 incidence
Authors: Rantanen N , Lieslehto J , Oksanen L-MAH , Oksanen SA , Anttila V-J , Lehtonen L , Geneid A , Sanmark E
Published: October 2022

Objectives

Healthcare systems and healthcare workers have been under considerable strain during the COVID-19 pandemic in many countries. Our study aimed to assess the mental well-being of Finnish healthcare workers from two hospital districts with differing COVID-19 incidence rates (HUS, Hospital district of Helsinki and Uusimaa/Helsinki University Hospital; and Kymsote, Social and Health services in Kymenlaakso region) during the first wave of the COVID-19 pandemic in spring 2020.

Material and methods

The data of this prospective survey study was collected during summer 2020, and a total of 996 healthcare workers (HUS N = 862, Kymsote N = 134) participated. Mental health symptoms were self-reported, and symptom criteria followed ICD-10 classification, excluding duration criteria. We divided participants into symptom categories “often/sometimes” (those who met the diagnostic criteria), and “rarely/never” (those not meeting the diagnostic criteria), and compared these groups to sociodemographic factors and factors related to work, workload, and well-being.

Results

Despite differences in COVID-19 incidence, the degree of mental health symptoms did not differ between HUS and Kymsote districts (p = 1). A significant relationship was found between self-reported diagnostic mental health symptoms and experiences of insufficient instructions for protection against COVID-19 (in HUS cohort, p < 0.001), insufficient recovery from work (p < 0.001), and subjective increased workload (p < 0.001).

Conclusions

These findings show the importance of sufficient, well-designed instructions for protection from SARS-CoV-2 for healthcare workers, indicating their need to feel safe and protected at work. The workload of healthcare workers should be carefully monitored to keep it moderate and ensure their adequate recovery from work. Sufficient control of the epidemic to keep the burden of the healthcare system as low as possible is essential for healthcare workers’ well-being.

Key messages
Interprofessional collaboration in Austrian primary care: an analysis of requirements and challenges
Authors: Atalaia A , Schnegg CJ , Grabner B , Roth M
Published: October 2022

Background

Primary health care (PHC) is built on interprofessional collaboration (IPC) between health and social professions. According to international frameworks, interprofessional communication, client-centred care, collaborative leadership, role clarification, team functioning and interprofessional conflict resolution are essential for IPC. As of April 2022, 36 PHC units were registered in Austria. This study aims to explore the perspectives of health care professionals on IPC in PHC in Austria.

Methods

Between October 2021 and March 2022, 15 guided group interviews were conducted with a total of 57 representatives of the professional groups biomedical analytics, dietetics, medical training therapy, medicine, midwifery, nursing, occupational therapy, office assistance, orthoptics, pharmacy, physiotherapy, psychotherapy, radiology technology, social work and speech therapy. The data was analysed using qualitative content analysis according to Mayring.

Results

Interdisciplinary counselling and prevention services, monitoring, acute interventions and treatment of chronic diseases are seen as fields of action for increased IPC in PHC. Interprofessional relationships are established during joint home visits and weekly multiprofessional meetings, when communication is collegial. Challenges mentioned for the IPC in PHC were i.e. role ambiguity, lack of time for networking or unclear legal regulations. Taking over responsibility as well as the ability to delegate and to deal with conflict, a sense of justice and willingness to accept criticism are core competences required for IPC in PHC.

Conclusions

The interviewees aim to get more involved in PHC, but not all feel optimally prepared for the necessary collaboration in this setting. In their view, specific training content, focusing on the unique structure of PHC, the roles of all the involved professional groups and conflict management, is necessary to successfully shape IPC in the interest of the clients.

Key messages
Dealing with staff diversity in German hospitals: A comparative analysis of doctors and nurses
Authors: Peppler L , Molzberger K , Beck P , Matusiewicz D , Schenk L
Published: October 2022

Background

Germany is increasingly recruiting foreign healthcare staff due to the shortage of skilled workers. This diversity of professional and cultural backgrounds poses a challenge to everyday life in inpatient care. Previous studies have focused on the renegotiation of professional identities and competencies in nursing or medicine. In contrast, this study sheds light on group-specific mechanisms through a comparative analysis: How do doctors and nurses deal with diversity in the workplace? Where do profession-specific differences emerge and what does this mean for future interventions?

Methods

Eight group discussions (June 2019 to October 2020) were conducted with groups of doctors and nurses with and without a migration background in four hospitals in two federal states in Germany; including 22 nurses and 10 doctors (n = 32). The data were analysed using the documentary method to examine professional meaning-making processes. The results were validated intersubjectively.

Results

The respective handling of diversity in the workplace is influenced by different professional group identities. The situation is precarious for nurses with a migration background - especially for those with an academic degree, as nursing is still an apprenticeship profession in Germany. In the medical profession, on the other hand, diversity does not lead to significant controversies, even if cultural differences are discussed.

Conclusions

Dealing with diversity is negotiated within professional groups. As nursing or medical ‘communities of practice’ (E. Wenger), these have a mediating role through which they can mitigate institutional and individual barriers to the integration of migrants in the workplace.

Key messages
Diversity Competence in Healthcare: A minimal definition
Authors: Ziegler S , Sørensen J , Michaëlis C , Krasnik A , Bozorgmehr K
Published: October 2022

Background

Health professionals face a variety of professional challenges in today's plural societies. Sciences propose a specific skill set can help to meet those challenges. Various terms and sometimes extensive concepts are provided for diversity competence. The related learning processes are time-consuming and demanding to implement in hectic clinical realities, so that a basic, easy to deplore training package of essential skills would be desirable in order to enable health professionals to take equally good care of all patients including migrants and minorities.

Methods

A two-round Delphi study was conducted to prioritise teaching objectives; 31 clinical and academic migrant health experts from 13 European countries participated. A round of open questions was followed by a standardised rating round of 65 items. Data was descriptively analysed (m, M, SD) and consensus defined as 80% of experts assigning high importance to a competence.

Results

The process identified essential competences as well as high priority cognitive, affective and pragmatic competences, leading to a minimal definition of diversity competence for health professionals which includes respectfulness, empathy, diversity awareness and reflection, knowledge on social determinants as well as ethics and human rights; Further skills are: being able to listen, observe and communicate understandably, including professional usage of interpreters, shared decision-making and individual, need-based care.

Conclusions

The panel reached consensus on many of the competences. In general, attitudes and practical skills were considered essential. Basic trainings that meet the needs of professionals and help them cope with everyday challenges can be designed on the grounds of these findings.

We provide a working definition of ‘diversity competence of health professionals’ for scientific exchange and investigation and propose the conscious use of a ‘diversity’ instead of ‘intercultural” terminology.

Key messages
Training needs assessment of European healthcare workers on vaccinology and vaccine acceptance
Authors: Paladini A , Lanza TE , Gianfredi V , Blandi L , Ricciardi W , Damiani G , Signorelli C , Odone A , Cadeddu C
Published: October 2022

Background

Healthcare workers (HCWs) are at the frontline of interaction with those that are taking decisions around vaccination. They need adequate training. The general aim of this systematic review is to assess HCWs’ training needs on vaccinology and vaccine acceptance. This work was performed for the European Centre for Disease Control (ECDC) under the specific contract No 1ECD.12108 ID.12922 implementing the framework contract number ECDC/2021/005.

Methods

The search was performed using MEDLINE, Scopus and Google Scholar databases in February 2022. The following inclusion criteria were used: date (from 01/01/2011 to 24/02/2022); language (English, Italian, Portuguese, Spanish, French and Romanian); geographic location of the study (Europe). Appraisal tool for Cross-Sectional Studies (AXIS checklist) was used to assess the methodological quality of the included papers.

Results

The scientific literature search retrieved 640 results on PubMed, 556 on Scopus and 15 on Google Scholar. In total, 1211 records were identified. After the duplicate removal and the title/abstract assessment, 132 publications were assessed for eligibility. Finally, after the full-text assessment, only 25 articles were included. As regards for the quality assessment, all studies were judged of moderate-good quality. The majority of studies stressed the need to deepen general knowledge of vaccine preventable diseases, vaccine efficacy, vaccination schedule and adverse effects of vaccines.

Conclusions

Considering their role in the community, especially as source of information and trust for vaccine acceptance, educational initiatives in vaccinology and vaccine hesitancy should be prioritized for HCWs, aimed at increasing their knowledge, awareness, and attitudes. An important heterogeneity of educational backgrounds, activities performed and training needs of the HCWs involved in vaccination at European level was one of the main critical issue to be addressed for future actions.

Key messages
Racism-critical self-reflection of professors of public health in Germany
Authors: Tezcan-Güntekin H , Simke J , Nassal T , Karls R , Löhning L , Döring T
Published: October 2022

Background

In public discourse, universities are rarely understood as places of institutionalized discrimination, but rather as places of enlightenment and intercultural cosmopolitanism (Nghi Ha 2016). Existing studies focus on students’ perspectives on institutionalized discrimination. In this context, the critical self-reflection on racism is particularly relevant for people who are in positions of power, as their attitudes and actions have a direct impact on many other people, such as in the case of professors on students, academic and non-academic staff. The study reconstructs to what extent conscious or unconscious attitudes in terms of critical whiteness manifest themselves in the attitudes and, in the actions of professors in health sciences and co-constitute the realities of staff and students.

Methods

Based on the critical whiteness concept according to Dietze (2009) a reconstructive, qualitative-empirical analysis (Bohnsack 2000) of eight episodic interviews (Flick 2011) with public health professors in Germany was conducted. Attitudes of professors are examined with regard to the critical reflection of their own power position in dealing with employees and students.

Results

Interviewees have heterogeneous reflective skills and few structurally anchored opportunities for racism-critical self-reflection in their professional environment. The spaces are demanded by students or staff or initiated by themselves, expecting resistance from colleagues. Unconscious racism is sometimes present even with a high degree of reflexivity.

Conclusions

Criticism of racism must be systematically addressed in schools of public health in order to create spaces for reflection where staff can reflect on and identify their racisms and develop collective action for racism-sensitive teaching and workplace.

Key messages
Health literacy and gender differences in colorectal cancer screening
Authors: Zanobini P , Lorini C , Giusti M , Minardi V , Possenti V , Masocco M , Mereu G , Cecconi R , Bonaccorsi G
Published: October 2022

Introduction

Colorectal cancer (CRC) is one of the major causes of death worldwide. Previous research reported differences in screening adherence both by gender and socioeconomic determinants. However, little is known about the extent to which Health Literacy (HL) may affect gender differences in CRC screening rates. Here, we aimed to assess HL levels in both genders and their relations with CRC screening adherence.

Methods

The study was performed within the Tuscan population sample selected in the Italian Behavioral Risk Factor Surveillance System (PASSI - Progress by local health units toward a healthier Italy) in 2017-2019. Socioeconomic status was measured by education level, occupation, financial status, and nationality, while HL by the Italian version of the 6-items European Health Literacy Survey Questionnaire (HLS-EU-Q6). Multivariate analysis was performed to investigate associations between CRC screening rates, social determinants, and HL.

Results

Among 4,268 people aged 50-69 years included in PASSI, 64% undergo to CRC screening in the 2 years preceding the interview. No statistically significant differences in screening adherence were found by gender. In the multivariate analysis, the odds of adherence to CRC screening increased in both genders for being aged 60-69 years (Males: OR 1.43, 95% CI 1.12-1.82; Females: OR 1.72, 95% CI 1.37-2.14) and high education level (Males: OR 1.34, 95% CI 1.08-1.66; Females: OR 1.30, 95% CI 1.05-1.60). Males with a poor financial status and females with a low HL level were less likely to undergo CRC screening (OR 0.71, 95% CI 0.57-0.88 and OR 0.68 95% CI 0.49-0.95 respectively).

Conclusions

Our findings suggest that adherence to CRC screening is associated with HL in females only, while it depends on financial status in males. Therefore, gender specific interventions, tailored on different factors, are needed to increase the CRC screening rates.

Key messages
Implementation, home mediators and children’s sugary drink consumption - results from DAGIS study
Authors: Lehto R , Vepsäläinen H , Lehtimäki A-V , Lehto E , Leppänen MH , Skaffari E , Abdollahi A , Roos E , Erkkola M , Ray C
Published: October 2022

Background and objectives

The effectiveness of a health behavior intervention can depend on the extent to which the intervention is implemented; higher degree of implementation (DOI) might associate with larger intervention effects. This study examined whether the parental DOI of an health behavior intervention had an effect on children's consumption of sugar-sweetened beverages (SSB) and was the effect mediated by home factors.

Methods

the DAGIS preschool intervention was conducted in 2017-2018 in Finland among 3-6-year-olds with valid data from 476 children. At baseline and follow-up parents reported 1) children's SSB consumption in a semi-quantified food frequency questionnaire, 2) availability of SSB at home, parental role modelling of drinking SSB, and norm (parental view on the suitable amount of SSB for children), and 3) DOI: a dichotomized sum variable on several aspects of parental program implementation. In the analyses, high and low DOI were compared to control group. Mediation analysis of the effect of DOI on the change in children's SSB consumption via change in availability, role modelling and norm was conducted with R statistical software.

Results

High DOI was associated with reduced consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No mediated effects were found. All studied mediators impacted the change in SSB consumption, but the DOI had no effect on the change in mediators.

Conclusions

Intervention effect on the consumption of SSB was only found in the high DOI group, which supports the importance of assessing intervention implementation. Since the found effect was not mediated by the studied mediators, other possible mediators should be examined, as understanding intervention mediators is crucial in developing successful interventions.

Key messages
Health sciences students’ Covid-19 digital health literacy – information reliability evaluation
Authors: Leventi N , Vodenicharova A
Published: October 2022

Background

In the Shanghai Declaration on promoting health in the 2030 Agenda of the UNs for Sustainable Development highlighted the importance of health literacy (HL) to empower individual citizens and enable their engagement in collective health promotion action. The aim of this study was to demonstrate the COVID-19 digital HL and the information-seeking behavior among students in Medical University - Sofia.

Methods

For the purpose of the study a web-based questionnaire was distributed among medical students from the Faculty of Medicine, and health sciences students from the Faculty of Public Health and the Medical College-Sofia, all from Medical University - Sofia in Bulgaria. The study was conducted between February and April 2022. In total 239 respondents participated, all anonymously and voluntarily. In data analysis established statistical methods were used.

Results

Data collected show that when students searched the Internet for information on the coronavirus or related topics, nearly two thirds (66%) of the respondents could either easy or very easy decide whether the information is reliable or not, and (81%) could easy or very easy decide whether the information is written with commercial interests. In addition among the respondents 82% find easy or very easy to check different websites to see whether they provide the same information.

Conclusions

From the presented analysis the following conclusion can be made: when navigate the social media platforms and forums, it is significant for health sciences students to obtain the appropriate searching skills, in order to be confident to identify the validity of the information and make informed decisions, as well as decide whether commercial interests are in focus of the provided information. Furthermore it is important to emphasize that searching competencies help to cross check the provided information.

Key messages
The vulnerability of migrants living in large urban areas to COVID-19: Exacerbators and mitigators
Authors: Hitch L , Cravero K , Masoud D , Moujabber M , Hobbs LA
Published: October 2022

Background

Even though large urban areas have been researched in the context of COVID-19, evidence on how COVID-19 impacted migrants -a particularly vulnerable group- in these settings is still limited.

Objective: To explore exacerbating and mitigating factors of large urban areas on migrants’ vulnerabilities during the COVID-19 pandemic.

Methods

We conducted a systematic review of peer-reviewed literature published between 2020-2022 and focused on migrants (foreign-born individuals who have not been naturalized in the host country, regardless of immigration status) in urban areas with a population >500.000. After screening 880 studies, 29 studies were included and categorized within the following thematic framework: 1) Underlying structural inequities, 2) governance and economic structure, 3) urban design, and 4) engagement of civil society organizations (CSO).

Results

Exacerbating factors include pre-existing inequities (e.g., unemployment, financial precarity, and barriers to healthcare access), exclusionary government responses (e.g., relief funds or unemployment benefits), and residential segregation. Mitigating factors include the engagement of CSOs and the implementation of innovative governance strategies such as e-governance and use of teleservices. Recommendations: We recommend increased attention to pre-existing social inequities faced by migrants, inclusive governance strategies, and partnerships between government and CSOs to improve the design and delivery of services to migrants in large urban areas. More research is needed on how urban design can be utilized to mitigate the COVID-19 impacts on migrant communities.

Conclusions

The factors identified in this systematic review should be considered as part of migrant-inclusive emergency preparedness to address the disproportionate impact of similar public health crises on migrant communities.

Key messages
Assessment of mental health and psychosocial support in Ukrainian refugee minors resettled in Norway
Authors: Dangmann C , Leonhard M , Kleppang AL , Lien L
Published: October 2022

Background

The recent invasion of Ukraine has forced millions of civilians, especially women and children, to leave their country. Although the European Union offers guidance on individual health assessment of refugees fleeing the war in Ukraine, assessment practice varies across host countries and even on national basis. Thus, the aim of this project was to identify and prioritize procedures for mental health assessment of Ukrainian refugee minors in Norway.

Methods

This project applied a modified three-round-Delphi method. In a first step, the leading public health nurse and community physician in 40 municipalities across Norway were contacted via e-mail and asked to state who is in charge of health assessment, what is current assessing practice and what are the problems and needs. Answers were analysed and condensed and will be presented for rating in a second and third round.

Results

Preliminary results from the first round suggest that most municipalities are currently in a planning phase with uncertainties surrounding who and how future assessments will be done. Public health nurses or general practitioners are often in charge of health assessments, but it is unclear if this includes age-adjusted mental health assessments.

Conclusions

Preliminary results show that current practice in assessing mental health and psychosocial support for Ukranian refugee minors in Norway is very diverse. There is a need to evaluate and prioritize current procedures to assure an equal and age-adjusted procedures for all refugee minors, regardless of where they have resettled.

Key messages
The use of social media platforms by migrant populations during the COVID-19 pandemic
Authors: Hargreaves S , Goldsmith LP , Rowland-Pomp M , Hanson K , Deal A , Crawshaw AF , Ahmad A , Razai M , Vandrevala T
Published: October 2022

Background

The rapid expansion of internet and social media use has meant that both useful and potentially harmful health information can spread rapidly. Groups experiencing barriers to health systems may be more reliant on social media as a source of health information. We did a systematic review to determine the extent and nature of social media use in migrant and ethnic minority communities for COVID-19 information, and implications for preventative health measures including vaccination intent and uptake.

Methods

We reviewed published and grey literature following PRISMA guidelines (PROSPERO registered CRD42021259190). Global research was included that reported on the use of social media by migrants and/or ethnic minority groups in relation to COVID-19.

Results

1849 unique records were screened, and 21 data sources included in our analysis involving studies from the UK, US, China, Jordan, Qatar, and Turkey. We found evidence of consistent use of a range of social media platforms for COVID-19 information in some migrant and ethnic minority populations (including WeChat, Facebook, WhatsApp, Instagram, Twitter, YouTube), which may stem from difficulty in accessing COVID-19 information in their native languages or from trusted sources. There were positive and negative associations with social media use reported, with some evidence suggesting circulating misinformation and social media use may be associated with lower participation in preventative health measures, including vaccine intent and uptake, findings of which are likely relevant to multiple population groups.

Conclusions

Urgent actions and further research are now needed to better understand the use of social media platforms for accessing health information by groups who may be marginalised from health systems, effective approaches to tackling circulating misinformation, and to seize on opportunities to make better use of social media platforms to support public health communication.

Key messages
Care obligations, employment and mental health
Authors: Rose U , Burr H
Published: October 2022

Background

The presentation is dedicated to employees who care for others in addition to their work. The starting point is the representative cohort study on mental health at work (S-MGA), which covered both care at home and care outside the home in the second wave of the survey. In this regard, cross sectional associations with exhaustion and work-life balance as indicators of mental health were examined taking into account full-time and part-time employment.

Methods

The sampling frame consisted of all German employees being subject to social security contributions and born between 1951 and 1980. The baseline sample consisted of 4511 survey participants of whom 1279 males and 1358 females were asked for informal care at the follow-up interview. Employment conditions as well as work-life balance were obtained by personal interview; exhaustion was obtained in a paper and pencil questionnaire. Statistical analysis was conducted descriptively and in linear and logistic regressions stratified by gender and controlled for age.

Results

Informal care at home was reported by n = 74 individuals (2.8%) and care outside of their home by n = 236 (8.9%). The association between both types of care with exhaustion was below the level for significance. There was an increase of work-life-imbalance for females caring at home but not for those who were caring outside. For males there were no effects of both types of care. Including the part-time/full-time distinction indicator within the regression models showed that women who cared at home had lower exhaustion scores and lower work-life imbalance when they were employed part-time.

Conclusions

The results show that caring at home for females leads to work-life imbalance and that part-time employment mitigates the negative effects on work-life imbalance and exhaustion. However, there are strong limitations by the sample size and the number of observations at the second wave of assessment.

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Major economic burden of musculoskeletal and connective tissue diseases in Slovenia
Authors: Jelenc M , Sedlak S , Simonović S
Published: October 2022

Background

Musculoskeletal and connective tissue diseases represent a growing public health problem, a great burden on health systems and place a heavy burden on society as a whole. Patients with musculoskeletal and connective tissue diseases often retire early, and any early retirement that could be prevented represents a loss of human capital, which means great social and economic damage to society. The present study was conducted in order to calculate for the first time in Slovenia the costs of the six most common diseases of the musculoskeletal and connective tissue diseases for the period from 2016-2018.

Methods

The calculated burden of musculoskeletal and connective tissue diseases was based on the calculation of various direct and indirect costs cross-sectionally at the level of one year. The methodology of National Transfer Accounts (NTA) was used for the calculation of indirect costs. Six major diagnoses based on the International Classification of Diseases and Related Health Problems for statistical purposes were selected for calculation. Data were obtained from different national routine databases.

Results

Calculations of the economic burden of musculoskeletal and connective tissue diseases in Slovenia showed that the economic costs of six selected diagnoses in the period 2016-2018 averaged about 5% of total health expenditure or 0.4% of gross domestic product in this period. The highest direct costs were hospitalizations, followed by costs for medicines, first curative visits at the primary level and visits to the outpatient clinic at the secondary level.

Conclusions

The results of the first calculation of the burden of musculoskeletal and connective tissue diseases in Slovenia showed a high economic burden of these diseases in the period from 2016 to 2018. The economic burden is underestimated and would be significantly higher considering all diagnoses from this group of diseases.

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Normalisation of mental health problems: Adolescents’ views on mental health problems and stigma
Authors: Hermann V , Durbeej N , Karlsson A-C , Sarkadi A
Published: October 2022

Background

It is essential to listen to adolescents’ views on mental health issues since these problems are common among young people. Exposure to stigmatization is an additional burden, causing increased suffering. This qualitative descriptive study aimed to explore adolescents’ views on the prevalence of mental health problems and public stigma related to mental health problems.

Methods

Semi-structured individual interviews and focus group interviews were conducted with a total of 32 adolescents, aged 15-18 years. The interviews were held on Gotland, Sweden's largest island, between October and December 2020. Systematic text condensation was used to analyse the data.

Results

Three themes were identified: Having mental health problems is the new normal; What others think of us affects us a lot; If others lack experience and knowledge, they don't respond in a good way. The adolescents perceived mental health problems as a common phenomenon. Increased mental health problems in young people were linked to pressure related to school performance, social media and improved openness about mental health problems. Stereotypic gender norms, rumours and prejudice were perceived as important causal risk factors of mental health problems. Lack of knowledge was suggested as a source of prejudice against people suffering from mental health problems.

Conclusions

The adolescents recognised mental health problems as an increasing public health issue, but also as a normal phenomenon due to current living conditions for young people.. They perceived stereotypic gender norms, taboo and prejudice against mental health problems as factors contributing to and increasing mental health problems and wished for a society without such factors. The results suggest that the tri-folded description of stigma involving stereotypes, prejudice and discrimination can be applicable to adolescents.

Key messages