bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying Cardiovascular Disease Burden and Quality of Care Index across Four Visegrád Countries
Authors: Merzah M , Fiatal S , Sándor J
Published: October 2024

Background

Cardiovascular diseases (CVDs) have surged to become the leading cause of premature death in Europe. Yet, analyses examining the Quality of Care Index (QCI) and CVD burden within the 4-Visegrád (4V) nations remain notably sparse. This study aims to address this gap by comprehensively assessing both the QCI and CVDs burden across these countries.

Methods

The burden of CVDs was assessed using data extracted from the GBD-study 2019. We employed min-max normalization to standardize each health indicator, including Mortality-to-Incidence Rate, Prevalence-to-Incidence Rate, Disability-Adjusted Life Years-to-Prevalence rate, and Years of Life Lost-to-Years Lived with Disability. Subsequently, we utilized a weighted sum approach to aggregate the normalized values of the health indicators. The QCI was then derived as the sum of the products of normalized values and their corresponding weights.

Results

In 2019, age-standardized rates (per 100,000) significantly decreased compared to those in 1990. Ischemic heart disease remained the primary cause of death in all 4V countries, followed by stroke. Czechia exhibited the most substantial reduction in 2019 compared to the rates in 1990, with incidence and mortality rates decreasing by -252.55 and -308.95, respectively. Poland demonstrated the highest reduction, compared to the Central European average rates, in both incidence (-113.73; 95% CI: -125.08_-103.79) and death rates (-74.79; 95% CI: -73.53_-75.31) in 1990, and in 2019 (-175.22; 95% CI: -169.52_-178.29 and -41.55; 95% CI: -40.12_-40.64, respectively). Poland scored highest in QCI among the 4V countries, with Czechia scoring the lowest.

Conclusions

The findings underscore the imperative for continued efforts to boost cardiovascular healthcare and outcomes in the region. While the reduced ratio signals improvement, there remain avenues for refining disease management, prevention strategies, and access to care to further enhance patient outcomes.

Key messages

• Our study on 4V nations’ QCI and CVD burden underscores urgent need for sustained efforts in cardiovascular healthcare, with notable rate reductions since 1990.

• Challenges persist in managing heart disease and stroke in the 4-Visegrád (4V) countries.
Health mediation for promoting cancer screening and vaccination in deprived neighbourhoods in France
Authors: Legendre E , Kelly D , Franke F , Ménager C , Ramalli L , Dutrey Kaiser A , Attalah Y , Gaudart J , Chaud P , Rebaudet S
Published: October 2024

Social inequalities in health affect access to healthcare and prevention. In Marseille, these inequalities are pronounced, with 26% of the population below the poverty line. In September 2022, a health mediation and outreach program was launched in deprived neighbourhoods to promote cancer screening and vaccination by going towards populations and providing information and orientation adapted to individuals’ health literacy and autonomy. We aimed to evaluate the effectiveness of this intervention. A repeated cross-sectional study compared knowledge, attitudes and practices about cancer screening and vaccination before and after health mediation interventions and between control and intervention neighbourhoods. Trained investigators administered a questionnaire door-to-door to individuals aged 18-74 years in randomly selected households. A first T0 survey was conducted in September 2022, and a second T1 survey is underway in May 2024, in 13 intervention and 26 control neighbourhoods. We compared the before-and-after participation rates and associated risk factors for cancer screening and vaccination between both areas using mixed regression models. Of the 2,647 respondents at T0, 61% were women, 43% non-native French speakers, 40% unemployed, and 53% had public health insurance. Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels. At T0, the cancer screening participation rate was 31% for colorectal cancer, 51% for breast cancer, and 68% for cervical cancer. Factors associated with non-participation were not believing in the effectiveness of cancer screening, not being aware of its existence or not speaking French. At T0, only 54% knew about human papillomavirus vaccine and only 35% of eligible women were vaccinated. A comparison of these T0 results with results of the ongoing T1 survey will be presented, in order to assess the effectiveness of this health mediation intervention.

Key messages

• Health mediation promotes cancer screening and vaccination by going towards populations in deprived neighbourhoods and providing information adapted to individuals’ health literacy and autonomy.

• Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels.
The role of interoception in lifestyle factors: a systematic review
Authors: Mulder J , Boelens M , Van der Velde L A , Brust M , Kiefte-de Jong J C
Published: October 2024

Interoception, the perception of the internal state of the body, has been shown to play an important role in various conditions. A clear overview of the relationship between interoception and lifestyle factors has to the best of our knowledge not yet been presented. This systematic review aims to provide insight into the current state of evidence about the role of interoception in lifestyle factors. A protocol for this systematic review was registered in PROSPERO (CRD42023465957). A systematic search conducted in PubMed, Embase, and Web of Science databases included terms such as interoception (accuracy, attention, awareness, sensitivity, or sensibility), as well as lifestyle factors (alcohol consumption, cognitive leisure and relaxation activities, eating behavior, exercise, sleep, or smoking). Studies written in English, using qualitative data, including adults, using at least one measure of interoception, and using at least on measure of a lifestyle factor were included. The review included 68 studies, in which 47 measures of interoceptive accuracy and 34 measures of interoceptive attention were identified. Six studies quantified interoceptive awareness (e.g., the interaction between interoceptive accuracy and attention). 12 studies focused on alcohol consumption, 22 studies on cognitive leisure and relaxation activities, 19 studies on eating behavior, 9 studies on exercise, 4 studies on sleep, and 5 studies on smoking. Generally, cognitive leisure and relaxation activities, eating behavior, and fasting showed positive relations with interoception. Conflicting evidence on the relation between exercise and some interoceptive domains, and moderate evidence on the positive relation with other interoceptive domains was found. Greater sleep difficulties were related to enhanced interoception scores and alcohol consumption was negatively related with interoception, while results on the relation between interoception and smoking behavior showed varying results.

Key messages

• Some lifestyle factors positively influence interoception and vice versa, while for other factors the results are varying or conflicting.

• The role of interoceptive skills in lifestyle factors is important for lifestyle and health management.
Improving physical healthcare for people experiencing mental illness: The COMITMENT project
Authors: Schiffler T , Kainzbauer L , Tupy C , Lehner L , Eitenberger M , Grabovac I
Published: October 2024

Background

People experiencing mental illness (PMI) face significant challenges in accessing and using somatic healthcare services, reducing their overall life expectancy by up to 20 years. The COMITMENT project aimed to identify barriers and facilitators in accessing and using somatic healthcare services for PMI and co-design strategies that could address existing challenges.

Methods

This study employed a qualitative participatory approach, involving a “trialogic” steering group composed of a person with lived experience of mental illness, a family member and caregiver of PMI, as well as a health professional. Two co-design workshops were conducted with members of each trialogic group, based on “World Café” methodology, facilitating open discussion between and among the three perspectives. Data was gathered through participant observations and systematically collecting participants’ workshop contributions, and analyzed thematically.

Results

Overall, 52 people participated in the two workshops. Findings identified six overarching themes regarding challenges in somatic healthcare access/use for PMI: (1) accessibility and facility design, (2) support and bureaucracy, (3) awareness among healthcare professionals, (4) societal awareness, (5) structural diversity of services, and (6) lack of networking abilities. Notable insights include inclusivity design requirements for healthcare facilities and the importance of integrating lived experiences of PMI into the training of healthcare professionals to reduce stigma.

Conclusions

This study underscores the critical need for systemic changes to improve somatic care for PMI. It suggests that greater awareness among healthcare professionals, coupled with more inclusive service design and enhanced networking abilities, could substantially improve the quality of healthcare for PMI. The COMITMENT project provides robust and co-designed results for social, systemic, and political reforms aimed at reducing healthcare inequity.

Key messages

• This study shows how direct involvement of relevant stakeholders improves the design of interventions that truly meet the needs of people with mental illness regarding somatic healthcare services.

• To improve healthcare access and treatment for people experiencing mental illness, systemic social, design, educational, and political changes and adaptations are required.
Evaluation of a public health workplace staff psychosocial risk assessment and wellbeing initiative
Authors: Ryan L , Cooney F
Published: October 2024

Adverse psychosocial work environments can have a detrimental effect on staff wellbeing causing chronic stress leading to burnout. Despite legislation mandating regular risk assessments, only one third of workplaces assess psychosocial risks. A 2020 European report identified one of the main barriers being a reluctance to talk openly about psychosocial issues. This paper describes an evaluation of a staff psychosocial risk assessment and wellbeing initiative in a Public Health Department in Ireland. The initiative commenced in October 2022 during a period of major health service organisational change. Informed by positive organisational psychology conceptual frameworks, guided by the European Psychosocial risk assessment framework (PRIMA-EF) and utilising the HSE Work Positive (CI) survey tool it was possible to constructively identify and categorise psychosocial risks across the Public Health team. In the evaluation, a mixed methods approach was used based on Donabedian’s structures, processes and outcomes overarching framework and Nielsen’s Model of Process Evaluation Framework. The first three iterative quality improvement cycles of the intervention were reviewed. The evaluation demonstrated that all of Nielson’s three indicators for a successful organisational level staff wellbeing intervention had been met: there was evidence of improvement in both working conditions and staff wellbeing; iterative quality improvement cycles including appreciative inquiry staff collaborative engagement ensured staff views and key learning was captured; new organisational structures within the Department enabled the sustainability of this process. The evaluation indicates that the staff psychosocial risk assessment process is beneficial for staff wellbeing and that the methods used are appropriate. The resources used in this process continue to be readily available within the health service organisation. The evaluation supports continuation of this process in its present form.

Key messages

• This evaluation supports staff psychosocial risk assessment and mitigation processes and provides a framework for healthcare managers to implement such processes and comply with legislation.

• This evaluation indicates that effective and sustainable collaborative staff engagement can be achieved using a positive focus which builds on team strengths and harnesses collective wisdom.
Leveraging epidemiological data for the development of interventions to promote healthy nutrition and physical activity among adolescents from disadvantaged backgrounds
Authors: Schmengler Heiko
Published: October 2024

ePro-Schools is a public health initiative designed to promote healthy nutrition and physical activity among adolescents from socially disadvantaged backgrounds using a targeted e-health intervention to be deployed in the school context. A central theme of ePro-Schools is its robust cross-sectoral collaboration, involving stakeholders from academia, healthcare, education, and local communities. This cooperative approach not only enhances the intervention’s relevance and efficacy but also ensures its cultural, social, and economic adaptability to the needs of the target population. The project embodies a truly interdisciplinary effort, integrating insights from epidemiology, behavioural science, public health, and digital technology to innovate and improve health promotion strategies. This presentation will explore how data from epidemiological studies, such as the Health Behaviour in School-aged Children (HBSC) study, are used to support the development of the ePro-Schools intervention. Utilizing high-quality epidemiological data, the project identifies key determinants of physical activity, dietary habits, and sedentary behaviour amongst adolescents growing up in low-SES contexts, allowing to craft tailored strategies to promote healthier lifestyles within this vulnerable population.
Social influence on post-drinking risky sexual behaviours: evidence in France and South Korea
Authors: Jeong J , Simmat-Durand L
Published: October 2024

Background

Post-drinking risky sexual behaviours are at the conjunction of the dual risks of sexually transmitted infections and further problematic substance use, necessitating contextual analysis for determinants that promote these behaviours. This study examines the influence of social groups on post-drinking risky sexual behaviours in different cultural samples.

Methods

A cross-sectional survey was conducted among young adults aged 18-30 in France and in South Korea in 2023-2024 (n = 998). A construct of post-drinking risky sexual behaviours includes 3 types: having sex without condoms, having sex with occasional partners, and having transactional sex. Perceived drinking norms were measured as a proportion. Multivariate logistic regression was conducted after controlling for sociodemographic factors.

Results

Young adults who reported that their social group had a higher proportion of drinkers were more likely to engage in a wider range of post-drinking risky sexual behaviours (aOR=1.02 [95%CI 1.01-1.03] in France; 1.01 [1.01-1.03] in Korea). Young adults in social groups who had experienced two types of risky sexual behaviours were more likely to engage in risky sexual behaviours after drinking (5.13 [2.21-14.1] in France; 10.65 [5.86-19.8] in Korea), compared to young adults in social groups with no experience. Young adults in social groups who had experienced all three types of risky sexual behaviours had a 10 times higher likelihood of engaging in post-drinking risky sexual behaviours in the French sample (10.12 [3.69-31.4]) and a 16 times higher likelihood in the Korean sample (16.0 [7.31-35.8]).

Conclusions

Alcohol-related risky sexual behaviours among young adults were found to be significantly associated with their social group’s drinking and risky sexual behaviours, across different cultural settings. More attention should be paid to direct/indirect influence of social groups on health risk behaviours.

Key messages

• The influence of social groups on alcohol-related risky sexual behaviours is significant regardless of cultural setting.

• Peer and social norms-based health promotion is recommended to prevent IST and HIV/AIDS.
Closing the Gap: Implementing Gender-Sensitive Care to Address Healthcare Disparities
Authors: Sgraja S , Mollenhauer J , Seeland U , Kloepfer M , Kurscheid C , Amelung V
Published: October 2024

Background

Women still face a higher mortality rate after a heart attack compared to men, and the reasons remain unknown. The project HeartGap aims to investigate the disparity between evidence-based guidelines and the integration of Gender-Sensitive Care (GSC+) in clinical settings. By exploring healthcare providers’ attitudes and knowledge on GSC+, the project seeks to develop holistic recommendations for its effective implementation.

Methods

The project HeartGap employs a mixed-methods approach, including a scoping review, qualitative focus group interviews, and quantitative surveys. The focus of this abstract will be on the qualitative survey. From June 13, 2023, to April 26, 2024, a total of 18 focus group interviews were conducted in 9 hospitals of varying sizes and levels of care in Germany. These interviews involved separate groups of 3-8 nurses or physicians to explore attitudes, knowledge including the european guidelines for cardiology and current implementation of GSC+ into clinical practice. Facilitating factors and barriers were also discussed and in which fields measures should be applied. The results were evaluated using a qualitative content analysis.

Results

The interviews revealed discrepancies in healthcare providers’ awareness of GSC+ and identified both facilitating and hindering factors in its implementation. Facilitating factors included increased awareness, more evidence by considering gsc+ in research, university and professional education, support from hospital leadership and politics. Barriers included a lack of time and knowledge, other priorities and vague content on GSC+ in medical and nursing guidelines.

Conclusions

Gender-sensitive care is crucial for personalized healthcare, yet its implementation remains inconsistent in clinical practice. Targeted strategies are necessary to enhance awareness, knowledge, and guidelines and policy support for GSC+. The Identified recommendations for action are transferable throughout Europe.

Key messages

• Gender-sensitive care is pivotal for addressing healthcare disparities but faces implementation challenges.

• Comprehensive strategies, including awareness, teaching and policy support, are indispensable for integrating gender-sensitive care into clinical practice.
The wisdom layer: how to support evidence-informed policymaking
Authors: Van den Borre L , Gorasso V , Scohy A , Schmidt M , Devleesschauwer B , De Pauw R
Published: October 2024

One of the returning challenges faced by public health scientists is bridging the ‘evidence-policy gap’-the disparity between identifying public health issues and implementing policies to address them. Despite the extensive literature documenting the challenges of promoting evidence-informed policymaking, opportunities for researchers to exchange experiences and learn from each other’s failures are limited. This presentation seeks to: (a) analyze key concepts in evidence-informed policymaking, based on the health information pyramid; (b) identify obstacles and facilitators in the translation of knowledge into actionable policy; and (c) present both successful and unsuccessful examples from our initiatives to influence health policy in Belgium. Specifically, we will discuss the concrete impact of the Belgian Health Status Report and the role this report plays in the development of actionable health objectives for Belgium. We will also cover the role of healthybelgium.be in governing and monitoring the health status of the Belgian population by discussing why this website has been recognized by WHO Europe as a model of good practice in evidence-informed policymaking.
Large scale public health system transformation: Ireland
Authors: Smyth B , O’Reilly E , Jakubowski E , Aragón de León E
Published: October 2024

Ireland has coped comparatively well with the COVID-19 pandemic when considering excess mortality. The reasons are likely complex and multifaceted, but it may be, in part, attributable to a comparatively young population and progress on indicators related to premature mortality and preventable mortality on chronic diseases and lifestyle risk factors. “Healthy Ireland” is a national framework in place since 2013 and utilizes a settings based approach to promote health and wellbeing in communities. It aims to improve collaboration between government, institutions, local communities, and individuals. Sláintecare is an all’party long-term health reform initiative developed in 2017 aimed at delivering the right care, at the right time, in the right place by the right team. In addition, in 2018 Ireland embarked on an ambitious public health reform programme with the implementation of the recommendations of the Crowe Horwath review of Public Health. While challenges exist, including access to services and waiting times, the governments has put in place initiatives to address these and is committed to, amongst other things, promo ting the continued integration of services across a variety of domains including primary to quaternary prevention. As Ireland began to emerge from the COVID-19 pandemic it established “The Public Health Reform Expert Advisory Group” to identify learnings from the public health components of the response, with a view towards strengthening public health and health protection generally and, specifically, future public health pandemic preparedness. The group, made up of national and international public health experts, submitted its final report in September 2023 which outlined a series of recommendations focused on potential improvements to public health policy, structures and governance. The WHO analysis of the Essential Public Health Functions provided complementary results. More work is now ahead to consider and implement these recommendations and foster institutional reforms including at the Health Services Executive, the Department of Health, and at the Health Protection Surveillance Centre.
Wellbeing Economy: Integrating Sustainability and Social Welfare
Authors: Kyyrönen O
Published: October 2024

Wellbeing economy refers to the interconnectedness of the economy, social security, healthcare, planetary boundaries, and overall welfare, highlighting the long-run sustainability of the socioeconomic system in accordance with the UN Sustainable Development Goals. As the OECD concisely states, the wellbeing economy is meant to put people and their wellbeing at the centre of policy. In Finland, where the Ministry of Social Affairs and Health is currently rendering the concept into an official steering model for policymaking, the wellbeing economy has historically developed in relation to the Nordic welfare model, which has helped regulate demand with high efficiency. This presentation will introduce the core principles of the Finnish wellbeing economy, discuss its relationship to the Nordic welfare model, and explain how the wellbeing economy has successfully given rise to rapid and inclusive growth.
Temporal Trends in Dementia Incidence in Sweden: Insights from NEAR Data
Authors: Thiesmeier R , Grande G , Hofer S , Orsini N , Rizzuto D
Published: October 2024

Background

This study investigates the temporal trends of dementia incidence in Sweden over a span of 35 years, drawing on data from the National E-Infrastructure for Aging Research (NEAR).

Methods

Our comprehensive analysis encompassed over 10,000 participants aged 50 and above. We estimated dementia incidence rates across the study period, considering birth cohort, age, and sex while controlling for potential confounders. Additionally. We explored potential modifiers influencing the estimated trend of dementia incidence.

Results

The analysis reveals a notable decline in dementia incidence rates, particularly among individuals born in more recently. Octogenarians born in the 1920-1930 cohort had a 74% lower dementia incidence rate compared to their counterparts born before 1900. Similarly, nonagenarians born in the 1910-1920 cohort experienced a 45% lower incidence rate. We further investigate determinants influencing this declining trend, shedding light on various factors shaping the observed patterns.

Conclusions

The incidence rate of dementia in Sweden has shown a consistent decline over the past 35 years, with a notable birth cohort effect indicating lower rates among individuals born more recently. This finding suggests evolving factors in lifestyle, healthcare, or environmental conditions contributing to improved cognitive health outcomes.

Key Messages

• These findings underscore the importance of proactive public health measures aimed at sustaining and enhancing cognitive health outcomes among aging populations.

• Understanding the temporal dynamics and underlying factors driving these trends can inform strategies for promoting healthy aging and improving the quality of life for older adults.
Characterizing Risk Profiles and Transitions across Living and Care Settings in Sweden
Authors: Gentili S , Calderón-Larrañaga A , Rizzuto D , Agerholm J , Lennartsson C , Hedberg Rundgren Å , Fratiglioni L , Vetrano D
Published: October 2024

Background

Older adults are at increased risk of frequent healthcare transitions between health care (hospitals) and social care providers (formal care and institutions). Therefore, our objective was to quantify and characterize the potential risk profiles of multiple transitions between living and care settings for older adults.

Methods

Data were obtained from the National E-Infrastructure for Aging Research (NEAR), including the Swedish National Study on Aging and Care (SNAC) and the National Patient Register, to evaluate living and care transitions of over 7,000 individuals aged 60+, across homes, formal care, nursing homes, hospitals, and post-acute facilities. A multi-state model was used to represent moving likelihood.

Results

Over 15 years, the average length of stay was two years at home, one year in home care, one year in institutionalization, eight days in the hospital, and 17 days in post-acute facilities. Older age and being a woman increased the chance of receiving home care after hospital discharge (Hazard Ratio [HR] range 1.35-4.38, 1.06-1.08), whereas multimorbidity and slow walking speed were associated with an 11%-50% increased hazard of hospitalization and home care. Generally, cognitive impairment increased the hazard of institutionalization (HR range 1.99-2.15), and disability was associated with a higher hazard of nursing home placement (HR range 2.57-3.07).

Conclusions

These findings underscore that care transition patterns are associated with different sociodemographic, clinical, and functional characteristics. This highlights the complex and dynamic interplay between these characteristics and social and health care use.

Key messages

• The study emphasizes that hospitalization is a major driver of transitions between living and care settings for older adults.

• Age, gender, multimorbidity, walking speed, cognitive impairment, and disability all play a role in shaping older adults’ transition patterns between different care settings.
Inclusive Life Projects for people with Serious Mental Disorder and/or addictions
Authors: López Nicolás T , Ruiz Periago B
Published: October 2024

Project “Inclusive Life Projects” offers comprehensive and community care to people with SMD/A within projects of autonomous living, which provide a concrete and real response to their needs, with the ultimate objective of avoiding the risk of institutionalization. Currently, 26 actions have been designed and are being implemented within JA ImpleMENTAL pilot in five municipalities in the Region of Murcia: Caravaca, Cartagena, Lorca. Molina de Segura and Yecla with a participation of 50 people with SMD/A. The following elements are selected from the Belgian good practice: • Creation of local intersectoral networks promoting person-centered care process; • Personalization of care through the Individualized Care Plan, responding to the needs, and desires of people with SMI/A, activating the appropriate support; • Professional case manager. It generates the well-being of people on an empathy and trust basis and articulates coordination so that the agreed Plan can be developed as planned.

A strategic and support coordination tool for action and facilitation of institutional support, the Social and Health Coordination Protocol for people with SMI/A, has been developed. The protocol facilitates the creation of coordination structures, among them the Socio-Health Coordination Base Teams stand out, teams made up of professionals from the different agents involved, multi-professional and intersectoral, (Mental Health, Primary Health Care, Social Services, Social Initiative) taking into account the needs of the person. It also serves to share information, detect training needs, influence resources, etc. PETRA, a computer platform, has been developed for sharing information between the systems involved, especially the health system and the social services system, both primary care, hospital care and specialized care. It allows the exchange of information, in real time, between professionals, the planning of actions, and the design of indicators and control and evaluation processes.
10.N. Scientific session: Gender and parenthood: short and long-term income, career, and health inequities
Authors:   Organised by: Institute of Public Health of the University of Porto (Portugal),   Chair persons: Teresa Leão (Portugal), Julian Perelman (Portugal)
Published: October 2024

Despite the last decades’ changes in the distribution of household and child-rearing tasks, its main responsibility tends to fall on women. As such, parenting may remain an important determinant of gender inequalities in income, careers, and health and well-being. In 2022, on average, European women’s gross income was 12.7% below men’s. This income gap is, in part, explained by inequalities in full-time employment: in the EU, 31.5% of women with children worked part-time, which contrasts with 20.2% of women without children, with 4.9% of men with children, and 7.2% of men without children. These income and career impacts may occur due to the persistence of some traditional conceptions of the division of paid and nonpaid labor. These conceptions, and the subsequent inequalities in career progression and income, may be reflected in women’s living conditions, work-family conflict, chronic strain, well-being, and health. Yet, it can also be posited that men, experiencing the pressure to remain the main provider in the family and the most recent expectations to comply with childrearing roles, may also see their well-being and health affected. However, countries with higher gender equity have shown better results in life expectancy and healthy life expectancy for women and men. It can be argued that women and men, especially those who have children, benefit from countries with more progressive parental policies, such as longer and more equally divided parental leaves, accessible childcare, or flexible working schemes. It could, thus, be expected that these countries present higher gender equity in paid and nonpaid work division, career progression, and income, with a higher couple balance, and healthier family environments, with health gains for women and men who are parents and their children. This workshop aims to present and open to discussion recent research outcomes on the role of parenthood on income, career, and health inequalities across European countries. It will show results from quantitative and qualitative studies that focus on analyzing these impacts in the short- and long-term. By discussing these results, researchers and public health professionals may grasp parental, labor market, or social policies or health programs to foster gender equality in access to better living conditions and health, especially during and after parenthood.

Key messages

• Parenthood may widen gender inequities regarding income and career progression, contributing to the gender gap in health and well-being.

• By understanding the magnitude of gender inequities and their distribution across countries, public health researchers and professionals may identify policies that effectively address the gender gap.
Developing a tool to support vaccine literacy with a participatory approach: Glossary of essential terms on vaccinations
Authors: Bellini A , Russo M L , Bartolucci C , Marchetti G , Aloise I , Papaevgeniou N , Karnaki P , Declich S , Marceca M
Published: October 2024

Issue

Access to vaccination services on their own is often difficult for migrants, especially newcomers (NAM), due to few vaccine literate services. Professionals who meet migrants need easily accessible vaccine information, to strengthen their ability to promote vaccination and facilitate vaccination access for NAM, especially non-medical professionals such as cultural mediators, reception staff, language teachers, social workers and community leaders.

Description

For offering accurate, accessible and actionable information by using plain language, a Glossary of Essential terms on Vaccination was developed and then tailored in each consortium countries, with a participatory approach. The Glossary is structured in two sections: vaccination related terminology and terms specific to country healthcare organization.

Results

8 workshops were organized in Greece, Italy, Spain, Germany, Cyprus, Malta, Poland, Romania to consult health and non-health professionals who work with migrants to make the tool as actionable as possible (83 participants). Cultural mediators were most represented, followed by NGO operators and physicians. The workshops were held based on shared guidelines, the focus was on assessing the clarity, completeness and usability of the glossary. 90% reported that the glossary is clear and useful, 80% considered the tool relevant, while 75% thought it is easy to use. The Glossary has been formatted with facing text in different languages for each consortium country, thus providing a comprehensive resource (53 final versions).

Lessons

By implementing the glossary, we aim to enable, empower, guide and facilitate access to immunization for NAMs. Sharing an essential vaccine-related information tool with “professionals for health” boosts their advocacy for NAM’s vaccination and healthcare system’s responsiveness to vaccine literacy. The participatory approach increases effectiveness and permeability of the tool itself.
Vaccine literacy and cultural competence training of Professional FOR health to improve the vaccination offer
Authors: Russo M , Marchetti G , Gatta A , Bartolucci C , Aloise I , Papaevgeniou N , Declich S , Marceca M
Published: October 2024

Background

It is essential that healthcare institutions have a high level of organizational vaccine literacy so that they can support Newly Arrived Migrants (NAM) to navigate, understand and make informed decisions on vaccinations in an effort to make uptake equitable. Developing training material for Professional-FOR-health (PfH) working with NAM, i.e. health and non-health workers, can improve the vaccination offer for NAM.

Objectives

A holistic training framework for PfH was designed to increase capacity building skills and cultural sensitivity of the healthcare system in promoting active immunization of NAMs. The blended training should cover four topics: “Vaccine Literacy”, “Cultural awareness/migrant sensitivity”, “Health promotion tools with community-based approach” and “Entitlement to vaccination for NAMs/NAMs profile”. As learners cannot be seen as mere recipients of notions, their needs, motivations, and experiences should be put right at the center of the training process. Therefore, a training guide and materials were shared to Consortium Countries to be adapted and implemented in their context. Training sessions were conducted in the summer of 2023.

Results

A total of 180 participants showed an average increase of 8.2% in correct answers from pre- to post-raining. Notably, 112 participants experienced more than a 10% increase in correct answers. Significant increases were observed across all topics, particularly in Vaccine Literacy (A1) and NAM Profile (A4), with increases of 52% and 74%. The training was evaluated positively with an overall index of 4.2 out of 5. All items analyzed from the satisfaction questionnaire yielded positive evaluations, with an average rating of 4 out of 5.

Conclusions

The evaluation underscores the effectiveness of training in meeting educational needs of participants. This type of training can be the groundwork for the changes needed to make the NAMs vaccination process more guaranteed and inclusive.
Enhancing Data Quality through Electronic Health Records in Prison Settings: Towards a Learning Health System
Authors: Bes J , Bos I , Elffers B , Heins M , Verheij R
Published: October 2024

Utilizing electronic health records (EHRs) in prison settings offers a unique opportunity to establish a learning health system (LHS) aimed at enhancing healthcare quality for incarcerated individuals. Despite the challenges inherent in prison healthcare, leveraging EHRs can facilitate data-driven decision-making and foster continuous improvement initiatives. This study describes the results of an intervention aimed at improving EHR data quality in prisons and explores the potential to enhance the development of a robust LHS. We assessed EHR data quality in 2015 (38 prisons) and 2022 (35 prisons) in the Netherlands over six months. Data were extracted, de-identified, and analyzed across demographic, medication use, (history of) diagnosis, and healthcare usage categories. We measured indicator scores and evaluated variation between prisons in data quality. This project was commissioned by the Custodial Institutions Agency. In 2015, age and gender were recorded for 93% of prisoners, increasing to 100% in 2022. Diagnostic coding use rose from an average of 82% in 2015 to 98% in 2022, with reduced variation between prisons. Consultation frequency per inmate ranged from 3 to 13, reflecting challenges in constructing a uniform denominator due to institutional differences. Mental health problems accounted for 17.7% of recorded disease episodes in 2022. In addition, consultations were most often related to oral health (4.4%), drug abuse (3.2%), sleep (1.8%), fear of diseases (1.6%), and respiratory infections (1.5%). Our findings indicate improvements in EHR data quality in Dutch prisons between 2015 to 2022. Integrating EHR data reuse into prison healthcare systems is pivotal for realizing the vision of an LHS in correctional facilities. This study underscores the potential of advancing EHR recording habits and the reuse of EHR data to enhance healthcare quality in prison settings.
Growth and challenges in biomedical scientific publishing: the phenomenon of mega-journals
Authors: Pezzullo A M , Boccia S
Published: October 2024

The landscape of academic scientific publishing has seen relentless growth, with the number of articles published and indexed on Web of Science exceeding three million in 2023 alone. This increase in both the number of publications and authors has significantly impacted scientific research, enhancing our collective knowledge. In response to the surge in authorship and the shift towards open-access publishing-where authors bear the cost of publication-information has become more accessible to researchers, educators, and policymakers, fueling a lucrative global industry with annual revenues estimated at 30 billion euros. However, the system faces challenges, such as slow peer review times, potential biases towards significant findings, and issues with reviewer recruitment and compensation. Mega-journals like PLOS One and Scientific Reports have emerged in the early 2000s and 2010s, respectively, focusing on methodological rigor over novelty, publishing high volumes of articles. In 2022, mega-journals published a quarter of all biomedical literature, reflecting a shift towards specific publication scopes and capturing larger market shares. These journals charge authors publication fees in return for open access, benefiting from minimal operational costs as they do not produce in-house materials or print editions. Recent concerns include vulnerabilities to poor scientific conduct and potential biases in publication practices. Some sectorial mega-journals offer faster, often perceived as less rigorous, peer review processes. Notably, the International Journal of Environmental Research and Public Health was removed by Clarivate from the Web of Science Core Collection database, with potential wide ranging impact, especially for authors who have published in these journals (e.g., loss of the impact factor, less visibility) explored in the following presentation.
The assessment of society’s acceptance of artificial intelligence use in healthcare
Authors: Smola P , Wojcieszko M , Duplaga M
Published: October 2024

Background

We observe the surge of interest and application of artificial intelligence (AI) in various areas. AI use in healthcare and medicine is followed by society with interest; however, acceptance varies depending on the area of its application. This study aimed to understand the differences in acceptance depending on the type of solution and explain the factors influencing the attitude toward the use of AI in healthcare.

Methods

The data from the online survey was collected from a representative sample of 1109 adult Internet users in Poland. The respondents were asked about their acceptance of AI use for several purposes in healthcare. Based on the responses to these items, an ad-hoc score of AI acceptance in healthcare (AIAHC) was developed. The determinants of AIAHC were assessed with uni- (ULRM) and multivariable linear regression (MLRM) models.

Results

The highest acceptance of AI use was found for monitoring medication intake at home: mean (standard deviation, SD)-3.81 (1.39), the lowest for AI making decisions about the mode of therapy -2.78 (1.35). ULRMs showed that significant predictors of AIAHC were age, gender, chronic disease, vocational status, income, the use of the Internet (IU), and e-health literacy (eHL). In MLRM, only gender, vocational status, income, and eHL maintained a significant relationship with AIAHC. Males showed significantly higher AIAHC than females (B, 95%CI: 2.56, 1.42 - 3.71), and students had higher AIAHC than employees (B, 95%CI: 3.01, 0.14 - 5.89). Persons who refused to reveal their income demonstrated lower acceptance of AI use than those who revealed their income (B, 95%CI: -4.64, -6.54 - -2.74). Finally, greater eHL favored higher AIAHC (B, 95%CI: 0.46, 0.34 - 0.57).

Conclusions

Evidently, there is a hierarchy of potential areas of application in terms of society’s acceptance. Improving eHL should exert a positive effect on the acceptance of innovative technologies, including AI, in healthcare.

Key messages

• Citizens show moderate enthusiasm toward the broader use of AI in healthcare.

• E-health literacy exerts a positive effect on the introduction of AI-based solutions in healthcare.
Enhancing Health Literacy Among Disadvantaged Youth: A Participatory Approach in School Settings
Authors: Poulsen V R
Published: October 2024

Background

School-based health literacy interventions have the potential to significantly impact the health of disadvantaged youth. However, the effectiveness of such interventions varies. The aim of the ‘health literacy among youth’-intervention was to improve the health literacy of disadvantaged youth in two school settings in Denmark.

Methods

The intervention began with identifying the health literacy needs of 128 students. Groups of teachers from each school participated in workshops facilitated by the research team to develop activities to address the specific needs of the students. Over the course of one school year (August 2023 to May 2024), these activities were implemented. Questionnaires were administered to students before, during, and after the intervention, and semi-structured interviews were conducted among teachers and students.

Results

Teachers at each school created activities aligned with the organizational structure and the needs of the students, focusing on occupational diseases and injuries, and physical activity and mental well-being, respectively. However, contextual factors such as time constraints, students’ characteristics, and teachers’ professional backgrounds and varying levels of motivation, influenced the implementation.

Conclusions

The intervention design offered flexibility in tailoring health literacy activities and their implementation to suit the unique contexts of the two schools. While the participatory approach facilitated targeted and organizationally aligned health interventions, its feasibility varied across contexts. Our findings highlight the importance of involving participants in developing health interventions to ensure relevance and alignment with specific needs of the target group.

Key messages

• Despite contextual similarities, the outcome of participatory intervention approaches may vary across contexts.

• Co-creation contribute to health literacy interventions that are tailored the needs of the target group.
Carving out space for co-creation in implementation of evidence-based mental health interventions
Authors: Thomsen C , Castaner M M , Sabriye A T , Buhl A , Tol W
Published: October 2024

Background

Mental health is identified as a pressing public health priority for European countries challenged by societal changes. The ADVANCE project aims to strengthen our understanding of mental health promotion and prevention in seven countries in Europe. In Denmark, the research project sets out to understand how WHO’s stress management intervention Self Help Plus can be embedded within social and integration programmes for adults who have experienced migration.

Methods

We are using a common methodology across the 7 country projects oriented by co-creation with end users and relevant stakeholders to initially develop implementation scenarios and stigma reduction strategies. We will present findings from this process and reflect on the tension and potential of the co-creation methodology in the implementation of evidence-based mental health interventions.

Results

In the first project phase of problem analysis and co-creation, the project’s society advisory group discussed 10 tailored intervention scenarios. Then, a Delphi survey and two rounds of scenario-based workshops with additional involvement of 16 end users/actors resulted in a final implementation scenario and stigma reduction strategies. We identified and reflected on questions around ownership of the project, boundaries of the proposed intervention, alignment of expectations, and intervention sustainability within the parameters of the ADVANCE project.

Conclusions

Even when interventions are pre-selected in response to funding calls, co-creation can facilitate the development of acceptable and sustainable implementation strategies. However, meaningful co-creation requires time, flexibility, and negotiation, which is not always guaranteed.

Key messages

• Co-creation creates productive tension and potential for the implementation of ADVANCE.

• Space for co-creation was negotiated with collaborators to ensure meaningful engagement.