bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of changes in working conditions, health behavior and BMI on work ability and health
Authors: van de Ven D , Robroek SJW , Oude Hengel KM , van Zon SKR , Brouwer S , Ots P , Burdorf A , Schuring M
Published: October 2021

Background

Research on how to improve work ability and health of workers is essential for prolongation of working lives. Therefore, this study assessed the impact of 1) within-individual improvements, and 2) within-individual deteriorations in working conditions, health behavior and BMI on changes in work ability and self-rated health among workers.

Methods

The Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) was used to identify participants whose working conditions, health behavior, and BMI improved (N = 14,045) or deteriorated (N = 14,066) at least once during 7 year follow-up (2010-2017). The impact of within-individual improvements and deteriorations in health behavior (moderate- and vigorous physical activity, smoking status), BMI, psychosocial (psychological- and emotional job demands, autonomy, social support) and physical working conditions in a given year on changes in work ability (0-10 scale) and self-rated health (1-5 scale) in the same year were analyzed with fixed-effects regression models.

Results

Workers with deteriorated physical or psychosocial working conditions decreased in work ability (β's:-0.21 (95%CI: -0.25;-0.18) to -0.28 (95%CI: -0.33;-0.24)) and health (β's:-0.07 (95%CI: -0.09;-0.06) to -0.10 (95%CI: -0.12;-0.08)), whereas improvements were to a lesser extent associated with increased work ability (β's: 0.06 (95%CI: 0.02;0.09) to 0.11 (95%CI: 0.06;0.16)) and health (β's: 0.02 (95%CI: 0.00;0.03) to 0.04 (95%CI: 0.02;0.06)). Decreased physical activity and increased BMI were associated with reduced work ability and health. Workers whose BMI decreased or vigorous physical activity increased improved in health, but those with increased moderate or vigorous physical activity reduced in work ability. Quitting smoking was associated with reduced work ability and health.

Conclusions

Preventing deteriorations in working conditions and health behavior could be of importance for sustainable employability.

Key messages

Modification of working conditions and health promotion might contribute to sustained employability. Preventing deteriorations in working conditions might be of particular importance for prolongation of working lives.
SARS-C0V-2 vaccination in the context of employment: the legal framework in Hungary
Authors: Földes ME , Kaposvári Cs
Published: October 2021

Background

Deployment of SARS-CoV-2 vaccines has sparked the debate on action that employers can lawfully take to promote vaccination uptake among employees. Absenteeism reduction, liability concerns, occupational health and safety, protecting the health and safety of clients and service recipients might prompt such action. This raises questions about employees' freedom of choice and right to (refuse) consent. The research examined the related policy and regulatory framework in Hungary.

Methods

Legal and policy analysis was conducted on Hungary's immunization policy as well as its legal and regulatory framework for SARS-CoV-2 vaccines deployment. The focus was on health law and labour law to explore whether and how SARS-CoV-2 vaccination could be turned into a workplace safety requirement.

Results

In Hungary, SARS-CoV-2 vaccination is currently voluntary. However, the Hungarian Healthcare Act and Labour Code allow for making it mandatory by ministerial decree prescribing a vaccination obligation as an employment condition for certain jobs. The National Public Health Center determines on a yearly basis the list of jobs concerned. Individuals may only be exempted if their (current or foreseeable) underlying health conditions so require. Further to the Labour Code, if employers use negative incentives (e.g., sanctions) and positive incentives (e.g., bonuses) to enforce vaccination, they must satisfy the conditions of necessity, proportionality and non-discrimination.

Conclusions

Although SARS-CoV-2 vaccination is currently voluntary in Hungary, the legal framework for mandatory vaccination at work is put in place. When it comes to enforcing the vaccination obligation, sanctions imposed by employers and related application of the necessity and proportionality standards have not yet been tested in Hungarian courts.

Key messages

Regulation shall ensure protection of employees’ rights as part of SARS-CoV-2 vaccination policies. Measures promoting vaccination must respect the legal requirements of proportionality, necessity and non-discrimination.
Trends in associations between sickness absence, disability pension and paid work after age 65
Authors: Farrants K , Head J , Alexanderson K
Published: October 2021

Aim

The increasing workforce participation at higher ages may impact social insurance systems, however, this has hardly been studied at all. We investigated associations between sociodemographic factors, prior sickness absence, and prior disability pension, with being in paid work after age 65 and to what extent they then had any sickness absence, and if such associations changed over time.

Methods

We conducted three prospective cohort studies. We used longitudinal data from three nationwide registers linked at individual level covering all residents in Sweden who turned 65 years in 2000, 2005, or 2010 (N = 50,000, 68,000, and 99,000, respectively). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between sickness absence and disability pension when aged 60-64 and a) being in paid work when aged 66-71, and b) having sickness absence when aged 66-71 among those in paid work, adjusted for sociodemographic variables in each of the three cohorts.

Results

Although the percentage of individuals in paid work when aged 66-71 increased substantially between the cohorts (2000 cohort 28.7%, 2005 cohort 39.5%, 2010 cohort 48.2%), associations of sociodemographic factors with being in paid work or having sickness absence when aged 66-71 remained steady. Both sickness absence and disability pension when aged 60-64 were negatively associated with working past 65 (sickness absence 2000 cohort OR 0.86, 95% CI 0.82-0.90; 2010 cohort OR 0.89, CI 0.87-0.92 - disability pension 2000 cohort OR 0.41, 0.39-0.44; 2010 cohort OR 0.36, CI 0.35-0.38). Sickness absence when aged 60-64 was positively associated with sickness absence after 65 (2000 cohort OR 2.16, CI 1.86-2.51; 2010 cohort OR 2.15, CI 1.98-2.33) while disability pension was negatively associated with sickness absence after 65 (2000 cohort OR 0.69, CI 0.52-0.92; 2010 cohort OR 0.83, CI 0.68-1.01).

Key messages

Rates of people in paid work >65 increased much from 2000 to 2010; their sickness absence increased marginally, while associations of sociodemographic factors with paid work did not change over time. Prior sickness absence was associated with paid work and sickness absence after age 65, while disability pension before age 65 was associated with less sickness absence after 65.
Trends in adolescent mental health problems: Differences by SES and gender
Authors: Buli B , Larm P , Nilsson K , Giannotta F
Published: October 2021

Background

Studies in Sweden and elsewhere have shown that mental health problems have increased among adolescents in recent decades. Unlike the previous studies, we extend the investigation to the trends of various mental health problems, namely: psychosomatic symptoms, suicide attempts, depressive symptoms, and suicide ideations in the last two decades, from 2004 to 2020. We also investigate the moderating role of gender and SES on these trends.

Methods

Data were collected through repeated bi-annual cross-sectional surveys between 2004 and 2020 among 32061 adolescents (49% girls) in middle and upper secondary schools in a county of Sweden. We fitted two linear and two logistic regressions with gender and socioeconomic status (SES) as predictors, and by interacting them with year of survey, we examined if they are associated with trends in mental health problems.

Results

Psychosomatic and depressive symptoms remained stable overtime (β = -0.04, p = 0.12; and β = 0.007, p = 0.69, respectively). Trend in depressive symptoms has declined overtime only for girls (β = -0.07, p < 0.005) while gender did not have effect on the trend in psychosomatic symptoms. Both psychosomatic (β = -0.09, p < 0.001) and depressive (β = -0.08, p < 0.001) symptoms have declined overtime only among those with high SES. Trends in both suicidal ideations and attempts were stable. Suicidal ideations declined overtime only for the girls (OR = 0.86, CI = 0.82 - 0.91, p < 0.001). However, gender did not have significant effect on trends in suicidal attempts. Both suicidal ideations (OR = 0.97, CI = 0.95 - 0.99, p = 0.02) and suicidal attempts (OR = 0.98, CI = 0.96 - 0.99, p = 0.007) declined overtime among those with higher SES.

Conclusions

Mental health problems seem to decrease from 2004 to 2020, however only for girls and adolescents with high SES. This indicates an increase in health inequalities especially for youth with low SES.

Key messages

Mental health problems declined in the last two decades, especially among girls. Adolescents with low SES did not show the same mental health improvement, which indicated that health inequalities in adolescent mental health seem to have increased in the last two decades.
‘That decision really was mine...'. Self-reported healthcare controversies among intersex persons
Authors: Lampalzer U , Schweizer K
Published: October 2021

Background

After 20 years of debate on intersex care, there has been a slight movement away from the paradigm of ‘optimal gender' including early genital modification to conform to predicted gender identity towards a paradigm of ‘full consent' including the provision of full information about the risks, benefits and alternatives to interventions and the postponement of irreversible interventions on minors too young to give informed consent. However, controversy continues. Against this background, the aim of this study was to analyse core aspects of current debates in intersex care. Focus was placed on controversies about surgery on external genitalia; gonadectomies; the expressed wishes of patients under the age of consent; and how to deal with intersex within the family.

Methods

Eight guideline-based interviews were conducted with two people with intersex/diverse sex development conditions who had been subjected to surgery, two parents of children with an intersex/dsd condition, two medical doctors, and two psychologists. Data were analysed thematically.

Results and Conclusions

Findings indicate that while ‘full consent' influenced actions and debate, the persons involved held differing opinions about how this policy can or should be achieved. In addition, the data illustrated how concepts such as normalcy, identity and sexuality are relevant when dealing with intersex issues.
Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in day care centres – Lessons learned from a prospective analysis of outbreaks in Germany
Authors: Varnaccia G , Schienkiewitz A , Loer A-K , Hornbacher A , Wurm J , Kuttig T , Wess B , Schrick L , Jordan S , Loss J
Published: October 2021

Background

The role of children for the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still unclear. The aim of our case-ascertained study is to examine transmission dynamics of SARS-CoV-2 among children and staff based on outbreaks in day care centres in Germany.

Methods

Based on day care centres with at least one reported case of SARS-CoV-2 we include 1-6-year-old children and staff of the affected group in the day care centre as well as their respective households. We test each study participant on acute and past SARS-CoV-2 infection with innovative child friendly tests and collect data on sociodemographics and symptoms. At four further measurement points within 12 days, the participants carry out the tests on SARS-CoV-2 by themselves. From October 2020 to May 2021, 25 day care centres with SARS-CoV-2 outbreaks participated and we included n = 244 children 1-6 years and n = 72 staff members in the study.

Results

First analyses from 25 outbreaks showed that the observed infection events in the examined day care centres were very different. Often, no or only few transmissions were found among the participants in the day care group, but in one day care centre, 13 people were infected: Between 0% and 81% of close contact persons in the day care centres were tested positive for SARS-CoV-2 in the study period. Children showed a similar percentage of secondary SARS-CoV-2 infections compared to adults (both 11%).

Conclusions

The study has been successful in detecting previously undetected infections of SARS-CoV-2 in day care centres. Results of these outbreaks examinations are presented regularly in public reports to inform public health decision-makers. By studying individual day care centre-related infection dynamics the data supplement the information from national reporting data.
An analysis of how lobbying by the alcohol industry has eroded the French marketing regulation law
Authors: Millot A , Gallopel-Morvan K , Maani N , Knai C , Petticrew M , Guillou-Landréat M
Published: October 2021

Background

In response to the positive association between alcohol marketing and young people's alcohol consumption, several countries have adopted marketing regulation laws. This is the case in France with the 1991 Evin Law, which prohibits advertising in media targeting young people and regulates content in authorized media. However, this law has faced intense opposition from its inception. The aim of this research is to identify the arguments and lobbying strategies deployed by the alcohol industry to undermine it.

Methods

We conducted semi-structured interviews with 18 French key informants involved in implementing and/or updating the Evin Law, including initiators of the law, former ministers, non-governmental organizations, national public health institutes and academic associations and institutions. A thematic analysis was conducted to highlight strategies and arguments employed by the alcohol industry to undermine the Evin Law using Savell et al. framework (2016).

Results

Several of the identified strategies and arguments to combat marketing regulations were similar to those identified in other countries, while some strategies and arguments were specific to the French context. These include highlighting winegrowing and its integration into decision-making bodies, and forming alliances with parliamentarians. These specific features may in part be explained by the economic significance of alcohol and wine at the heart of French culture.

Conclusions

For the first time, the long-term lobbying strategies and arguments used by the alcohol industry to weaken the Evin Law are analyzed from the perspectives of those closely involved in its implementation. This study may be useful for other countries that have - or are in the process of - implementing alcohol marketing regulation laws.

Key messages

The pioneering French alcohol marketing regulation law has faced intense opposition from the alcohol industry, in particular viticulture. Analyzing the strategies and arguments used by the alcohol industry to erode this pioneering law is important to better counter them.
Communicative health literacy of Hungarian adults – who are the most vulnerable?
Authors: Bíró É
Published: October 2021

Background

Good communication in health care can improve health outcomes and satisfaction of the patients and doctors. Therefore enhanced communicative health literacy is inevitable. This was the first time to assess communicative health literacy among the Hungarian adult population with a new measure developed within the framework of the European Health Literacy Survey 2019. The aim of the present survey was to provide a snapshot of communicative health literacy and determine the most vulnerable groups.

Methods

Data was collected by a polling company in a representative sample of the adult population (N = 1206) with computer-assisted telephone interviewing below the umbrella of the Health Literacy Survey 2019. The questionnaire included items among others on demographic and socioeconomic data, subjective well-being, and communicative health literacy. Statistical weights were applied to ensure that estimates reflect the general adult Hungarian population by gender, age group, educational level, settlement type.

Results

The mean age of the respondents was 48.0 years (standard deviation: 17.5 years), 47% of them were male. The mean score of the communicative health literacy scale was 86.8 (95% CI 85.5-88.1), and 13.3% of respondents had difficulties during communication in health care services. Explaining health concerns was the easiest task, while getting enough time in the consultation had the highest difficulty percentages. Communicative health literacy was lower among those who can be characterized by lower socioeconomic and worse health status, and belong to the older age group.

Conclusions

The findings suggest that the ill people and the members of the lower socioeconomic status are the most vulnerable regarding communicative health literacy, so special interventions are needed in order to enhance their health literacy. Maybe the first step can be the improvement of the communication skills of the health care professionals and implementing environmental changes.

Key messages

Getting enough time in the consultation was the most difficult for the respondents. Patients and people from lower socioeconomic status are the most vulnerable regarding communicative health literacy, so they need special attention.
A systematic literature review of studies estimating the risk factor attributable burden in Europe
Authors: Gorasso V , Nazaré Nogaro J , Charalampous P , Haagsma J , Monteiro Pires S , Von der Lippe E , Devleesschauwer B , Plass D
Published: October 2021

Along with the computation of disability-adjusted life years (DALY), the Global Burden of Disease (GBD) study uses the comparative risk assessment method to estimate the burden attributable to risk factors (RF). The methodology used for GBD studies has undergone continuous improvements through the years and across many independent studies. The European burden of disease network launched a series of systematic literature reviews (SLR) to explore key assumptions used in the European burden of disease (BoD) assessments. The SLR will give an overview of existing studies, including those estimating the BoD attributable to RF and focus on the different computational approaches. The SLR will also help to identify ways to harmonize computational procedures to enhance the comparability of RF attributable burden. The SLR involved four parallel reviews: non-communicable diseases, communicable diseases, injuries and RF. For the latter, we used a search strategy with terms describing the population (GBD area “European region”) and terms specifically used in comparative risk assessments (comparative risk assessment [CRA], attributable mortality/burden/risk). Studies published between January 1990 and April 2020 were included, without language restrictions. The search strategy was run in PubMed, Web of Science, Cochrane, and Embase. OpenGrey, OAIster, CABDirect, WHO, and targeted public health agency websites were screened for indexed grey literature. In addition, burden-eu members were asked to supplement the list of publications with any material available in their national public health institutes. The title, abstract, and full-text screening resulted in the final inclusion of 114 publications. The list of publications includes peer-reviewed articles and reports showing a variability in CRA analysis (e.g. use of exposure-response function, relative risks) and other methodological choices. Further data extraction and analysis is in process and will be presented during the workshop.
Barriers to CSE for children and young People with disabilities and how to overcome them
Authors: Michielsen Kristien
Published: October 2021

While sexuality education can support children and young people with disabilities in their sexual development and contribute to their wellbeing, challenges to its provision exist. In this part of the workshop, we will focus on CSE for children and young people with disabilities. More specifically, we will present the current scientific evidence on barriers to CSE for this specific group, based on a recently published paper in the Journal of Sex Education. We will present results of a scoping review based on scientific literature from 2006 up to 2020. Together, the identified studies present seven barriers to sexuality education for children and young people with disabilities, including the social misperception of people with disabilities as asexual and in need of protection which, combined with limited support for educators, resulted in noncomprehensive and normative sexuality education. Educators seemed inclined to redirect responsibility for sexuality education to others, and diversity among children and young people with disabilities, as well as cultural and religious diversity, makes it difficult to define a general approach. Finally, competing priorities related to the general health and wellbeing of children and young people with disabilities may appear to render sexuality education less important. Further, we will enter in discussion with the audience to discuss recommendations to overcome these barriers in different settings and countries. Finally, attention is given to best practices of doing research with children and young people with disabilities. We will present some best practices that can be applied in research on different topics and in different settings.
Symptoms of Anxiety and Depression among Italian UNiversity academics: the 2020 UN-SAD study
Authors: Del Pin M , Scarpis E , Ruscio E , Tullio A , Brunelli L , Brusaferro S
Published: October 2021

Background

The potential impact of demanding working conditions and career opportunities on the mental health of academic professionals has recently arisen some concerns, possibly resulting in psychological distress. This study aims to assess the prevalence of depression and anxiety within Udine University, comparing academic and administrative staff.

Methods

A cross-sectional survey involving regular (RP) and short-term academic professionals (STP), and administrative staff (AS) was carried out between June and December 2020 throughout the administration of an online anonymous survey. Prevalence of depressive and anxiety symptoms was assessed using PHQ-9 and GAD-7 tools. Demographic information about age, gender, marital status and seniority was collected. Relationship between mental health outcomes and professional role was analysed using nonparametric tests and ordinal logistic regression.

Results

All 5 university departments participated for a total of 366 people, being 109 of them STP, 146 RP and 111 AS. 55,7% of them were female, with a mean age of 47,9 years. Compared to administrative and regular staff, short-term professionals have a higher prevalence (95%CI) of both depressive (39,4% (30,8 - 48,8) vs 14,4% (9,6 - 21,0) vs 27,0% (19,6 - 35,9); p < 0,001) and anxiety symptoms (STP: 33,0% (24,9 - 42,3); RP: 15,1% (10,2 - 21,8); AS: 22,5% (15,8 - 31,1); p < 0.005). Multivariate models suggest an increased risk of depression OR 1.61 (0.98-2.64) and anxiety OR 2.08 (1.27-3.41) for female.

Conclusions

The higher prevalence of depressive and anxiety symptoms among STP could represent the effect on younger academics' mental health of the career uncertainty and challenging arena. The difference between AS and STP in psychological distress could be explained by the different job security status. More support should be given by universities to young academics for their both effective and healthy contribution to the progress of research.

Key messages

The high level of external pressure, referred as “publish or perish”, can play an important role in determining academics’ mental health. Investment to provide coping tools for young academics could be strategical for researchers’ empowerment.
Understanding climate health adaptation in practice: adaptation to the oak processionary moth in The Netherlands
Authors: Buist Y , Bekker M , Vaandrager L , Koelen M
Published: October 2021

Background

Understanding of climate health adaptation and its organisation and implementation is limited. This presentation focuses on the adaptation to the oak processionary moth (OPM). The OPM spreads out northwards through Europe, and human contact leads to reactions in skin mucous membranes, conjunctivitis, pharyngitis and respiratory distress. Literature has focused largely on the ecology and epidemiology of the OPM. However, there is limited understanding of the organisation and implementation of climate health adaptation knowledge and coordinating an effective response.

Methods

In an explorative case study we examined the current OPM adaptation strategies in practice. Semi-structured interviews with 26 actors in The Netherlands were held to unravel the problem and the complexities involved in OPM adaptation.

Results

The results indicate that the context of OPM adaptation is multidimensional, given the involvement of many interdependent actors. At regional and local level early networks emerge aiming to improve the effectiveness of OPM adaptation. At the national level the Knowledge Platform OPM was set up, in which actors collaborate to collect and share knowledge and experience. Nevertheless, OPM strategies are based on ad hoc approaches with ambiguous tasks and expertise. In addition, actors have different perceptions and values concerning health, sustainability, risks and responsibilities influencing decision-making processes, collaboration and a coordinated approach.

Conclusions

The generation of knowledge and its translation into practical strategies calls for interdisciplinary cooperation in knowledge development. Climate health adaptation involves more than technical and organisational solutions alone. It also entails the development of a shared problem perception and solution space in which citizens are also engaged. Therefore, implementation of vertical and horizontal coordination climate health adaptation strategies are required.
6.F. Workshop: Risk communication in the context of a pandemic event
Authors:   Organised by: EUPHA-EPI, EUPHA-HTA, EUPHA-IDC, EUPHA-PHMR,   Chair persons: Stefania Boccia (EUPHA-EPI), Michael Edelstein (EUPHA-IDC)
Published: October 2021

The World Health Organisation defines risk communication as “the exchange of real-time information, advice and opinions between experts and people facing threats to their health, economic or social well-being with the ultimate purpose of enabling people at risk to take informed decisions to protect themselves and their loved ones”. As public health practitioners and researchers, we are aware that being able to communicate effectively risk is part of the basic set of skills to be successful in our work environment. Nevertheless, the COVID-19 pandemic exposed the difficulty of communicating risk to policymakers and the public: the urgent need arose while the science on the virus was uncertain and yet the spread of both accurate and inaccurate information was rapid and far-reaching (so-called “infodemic”). By sharing the experiences of leaders in the public health community, this workshop focused on COVID-19 associated risk aims to provide young and experienced public health practitioners with the skills needed (and pointers on the pitfalls to avoid) to successfully develop a risk communication strategy in uncertain times.

Key messages

Individuals are influenced by risk information in complex and unpredictable ways and communicating effectively risk during a pandemic event requires a set of different skills. Risk communication only works well when the communication is based on trust between those with the expertise, those with responsibility, those affected.
Pandemic response credit-claiming and blame-avoidance in Austria
Authors: Falkenbach M
Published: October 2021

Credit claiming led in Austria during the first wave to centralization and during the summer to decentralization. During the second wave, blame-avoidance led again to centralization. First Wave: between end of February, when the first cases arrived in Austria and End of May, Austrian policy makers acted swiftly and boldly. A hard lockdown was introduced on March 18th, the government presented a €38 billion aid package to “save workplaces”. Chancellor Kurz stated,“no matter the cost, we will do whatever it takes to secure jobs” and vice Chancellor Werner Kogler (Green) assured citizens that “no one would be left behind”. The government's quick actions and assurances garnered it much praise from citizens and other governments alike. Summer: Due to the decreasing infection rate, Austria was able to begin relaxing measures as early as mid-April 2020. With the beginning of the summer, the confidence index ratings in politicians returned to normal, meaning that those politicians that saw drastic increases (Kurz and Anschober) lost percentage points by the summer likely due to the fact that less press conferences were necessary. In late July, Minister Anschober announced the introduction of a traffic-light system to establish regional differentiation in terms of potential containment measures based on a set of indicators. The indicators would include epidemiological measures and take into account the resources available in each region. Second wave: The clear strategy that the government followed in the Spring seemed to have disappeared along with the population's approval. What started out as a corona success story steadily deteriorated into a story surrounding the destruction of Chancellor Kurz' well-polished poster boy image, increasing corona cases, the resignation of the Health Minister and corruption scandals within the governmental party.
Social isolation & loneliness among asylum-seeking parents with young children (0-5 years old)
Authors: Merry L , Trintignac M , Groulx G , Cleveland J , Hanley J , Rose D
Published: October 2021

I will present findings from a qualitative study in Montreal, that aimed to gain a better understanding of the experiences of social isolation and loneliness, key contributors to mental health problems, among asylum seeking families with young children. Using semi-structured interviews, we interviewed 14 families from 11 countries who had children ≤ 5 years old. Social isolation was largely linked to parents' asylum status which contributed to a number of their struggles (poverty, difficulty finding housing, challenges accessing healthcare, family separation, asylum process), and meant they were ineligible for certain benefits and services, particularly subsidized daycare, and as a result left families little time, financial or mental capacity, or support to engage in social interactions. A lack of access to daycare also limited integration of mothers into the workforce and their ability to participate in language courses. Mothers expressed feeling loneliness, which was tied to feelings of sadness and despair due to their precarious situation and uncertain future and having no one to share these worries with, while fathers felt frustrated and spoke about a sense of responsibility to keep moving forward and overcome the family's challenges. Due to parents' isolation, some children were spending lots of time at home, and consequently were being exposed to their parents' stress, which concerned parents as they felt it was affecting their children's well-being. In contrast, children provided a means for breaking families' isolation, either through their participation in recreational activities or because parents were motived to have their children integrated into their new society. Religion/religious organizations were also identified as sources of hope and assistance and contributed to families' well-being. Interventions at the policy, community and individual levels are needed to facilitate families' integration and promote social connectedness and belongingness.
Feasibility and Acceptability of a Patient Navigation Intervention to Prevent Suicide in LGBTQ Youth and Young Adults
Authors: van der Star A , Randall A , Calzo JP , Weersing VR , Rojas SA , Williams K , Alexander J , Blashill AJ , Wells KJ
Published: October 2021

Background

Across Western countries, young LGBTQ+ individuals are at a four to seven-fold increased risk of attempting suicide, compared to the general public. Despite these substantial health disparities, no known empirically supported suicide prevention programs exist for this highly vulnerable population. Patient navigation (PN), as an intervention to assist people in overcoming barriers to care, paired with the Safety Planning Intervention (SPI), may be a promising intervention to target mechanisms (e.g., thwarted belongingness and suicide-related coping skills) that theoretically underlie suicide. The purpose of this presentation is to describe the developed intervention and present initial data on its feasibility and acceptability.

Methods

In collaboration with a Participatory Planning Group (PPG), an iterative process was used to develop a PN+SPI intervention to prevent suicide among at-risk LGBTQ+ youth and young adults. A mixed-methods case series was used to examine feasibility and acceptability of implementing the PN+SPI intervention over a three-month period of time.

Results

Theoretical models regarding suicidality and LGBTQ+ mental health along with PPG feedback have informed the development of the PN+SPI intervention, with 7 modules included in feasibility evaluation: 1) Introduction + SPI; 2) Minority Stress Psychoeducation; 3) Barriers to Mental Health Services; 4) Barriers to Community Resources; 5) Decision Making; 6) Crisis Intervention; and 7) Wrap Up.

Conclusions

This project has the potential for reducing mortality and morbidity due to suicide attempts among LGBTQ+ youth/emerging adults, who are one of the most vulnerable groups for attempting suicide globally. Given the brevity of the PN+SPI intervention and its emphasis on safety planning and accessing community resources, the PN+SPI intervention has high potential for wide dissemination and public health impact, should it demonstrate feasibility, acceptability, and preliminary efficacy.
Effects of ‘It Gets Better’ suicide prevention videos on LGBTQ youth: randomised controlled trial
Authors: Kirchner S , Till B , Ploderl M , Niederkrotenthaler T
Published: October 2021

Background

The ‘It Gets Better' suicide prevention project (IGBP) features video narratives of LBTQ+ persons telling their stories of overcoming difficulties related to coming-out. Research on the effects of the videos is scarce.

Methods

We conducted a double-blind randomised controlled trial between January and November 2020. LGBTQ youth aged 14-22 years (n = 483) were randomized to an IGBP (n = 242) or unrelated video (n = 241). Suicidality (primary outcome), depressive symptoms, help-seeking intentions, hopelessness, mood and sexual identity were assessed at baseline (T1), immediately after exposure (T2) and at 4-week follow-up (T3). Identification was assessed at T2. Data were analysed with linear mixed models, and a mediation analysis was used to explore effects of identification on suicidality.

Results

No significant effect was identified for the entire intervention group with regard to suicidal ideation but nonbinary/transgender individuals experienced a short-term improvement in suicidality (T2: mean change from baseline [MC]=-0.20 (95% CI -0.39 to -0.02); P = 0.01, mean difference [MD] compared with control group MD=-0.54 (95% CI -1.01 to -0.08); P = 0.02; d=-0.10). The effect was most pronounced among nonbinary/transgender individuals with depressive symptoms. The effect on suicidal ideation was mediated through identification. Intentions to seek help from personal contacts showed a short-term improvement in the overall intervention group (T2: MC = 0.25 (95% CI 0.15 to 0.35); P < 0.001, MD = 0.28 (95% CI 0.01 to 0.54); P < 0.05; d = 0.09).

Conclusions

Personal narratives of coping with adversity have beneficial effects on LGBTQ youth, particularly nonbinary/transgender youth including those with depressive symptoms. Identification with the featured characters is relevant for suicide preventive effects.
Social determinants of health during the COVID-19 pandemic: a systematic review
Authors: Lord H , Fernandez R , MacPhail C
Published: October 2021

Introduction

The emergence of COVID-19 has created global transmission. While effective at reducing the spread, public health measures implemented may impact individuals differently leaving them susceptible to the detrimental effects on their health and wellbeing. Therefore this review aims to synthesise the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID-19 pandemic.

Methods

A three-step search strategy was used to find both published and unpublished papers. The databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. Following the search, all identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed independently by two reviewers, with meta-synthesis conducted in accordance with JBI methodology.

Results

Fifteen papers were included. Three synthesized conclusions were established a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID-19 including mortality; b) Gender inequalities and family violence have been exacerbated by COVID-19, leading to diminished wellbeing among women; and c) COVID-19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to healthcare, housing instability, homelessness and difficulties in social distancing.

Conclusions

Vulnerable population groups have been disproportionately impacted by COVID-19, including health outcomes such as hospitalisations and mortality. The COVID-19 pandemic has highlighted the need for action on health inequalities and the social determinants of health. Reflection on social and health policies implemented are necessary to ensure that the COVID-19 pandemic does not exacerbate health inequalities into the future.

Key messages

Vulnerable populations including racial minority groups and low income earners have been disproportionately impacted by COVID-19. Action on social determinants of health is required to ensure COVID-19 does not exacerbate health inequalities into the future.
Digital Health Literacy – results of a representative survey among adults in Germany
Authors: Zeeb H , Pohlabeln H , Preising A , Schulz B , Naczinsky A , Dortmann O , Kolpatzik K
Published: October 2021

Whereas the concept of health literacy has already found its place in Public Health, this is less the case for digital health literacy (DiHL). To investigate the distribution of digital health literacy in the German adult population, we used a definition encompassing individual, social and technical competencies and resources to search, find, understand, apply and evaluate digital health information. We conducted a representative survey including 8.500 persons aged 18-75 years, based on an online access panel. All participants filled a questionnaire which covered the seven domains of the Digital Health Literacy Instrument (DHLI). Demographic information for participants was available through existing panel data. Optimal cut points to categorize digital health literacy were developed via regression modelling. Data were analysed using descriptive statistics and logistic regression modelling, comparing the two lower categories of DIHL against high/very high DiHL. Results are presented via odds ratios and 95% confidence intervals. Overall, 52.4% of respondents were categorized as having low or moderate DiHL (W: 51.2%; M: 53.7%). There were few differences according to age group and migration status. Those with higher educational attainment also scored higher in terms of DiHL. Operative competencies were generally rated high, whereas the evaluation of reliability of content scored lowest. In the regression analysis, the adjusted odds ratio (OR) for limited DiHL was 2.01 (95%CI 1.51;2.67) among those with poor or very poor self-reported health. Digital health literacy addresses a complex set of competencies and resources. More than half of the adult German population report a limited digital health literacy according to this nationwide survey. Impaired health is associated with low digital health literacy, and many have difficulties assessing the reliability of digital content. This is troublesome as more and more health-related information becomes digitalized.

Key messages

More than half of the German adult population reports limited digital health literacy. Poor health status was found to be associated with low digital health literacy.
Dutch DALYS: The Dutch National Burden of Disease study
Authors: Hilderink HBM , Plasmans MHD , Poos MJJC , Eysink PED
Published: October 2021

The Netherlands National Institute for Public health and the Environment published for more than 25 years their National Burden of Disease estimates (Dutch DALYs). This is done as part of their Public health Status and Foresight study which is commissioned by the Ministry of Health. In these 25 years, the translation of knowledge resulting from the Burden of Disease study has been progressed over the years. The knowledge translation has both pull and push elements. Various stakeholders are consulted for example to select health conditions and relevant risk factors, to better interpret input data and to compare results with other burden of disease results. As push elements, website, concise reporting and visualization techniques such as infographics are being used. Burden of disease results are being used in several Dutch policy documents. Policy goals to reduce avoidable disease burden is based on the results of the Dutch DALY studies. In addition, the allocation of disease burden to underlying risk factors receives substantial attention from policy maker to prioritize policies on prevention. It is also used by other organizations to advocate specific issues, such as cardiovascular diseases. However, policy makers still have difficulties interpreting a complex metric as the Disability-Adjusted Life Year (DALY). In the Netherlands, the uptake by policy makers of burden of disease results has increased strongly over the years and forms by now an essential aspect of public health reporting. However, improving understanding of the DALY concept, for example by using complementary metrics such as the healthy life expectancy, could stimulate its use further. Also, the allocation to risk factors is used frequently. Policy makers indicated that a better link of risk factors to policy interventions, is a valuable next step.
COVID-19 infections and prevention and control measures in European prisons
Authors: Alves da Costa F
Published: October 2021

Introduction

WHO-HIPP rapidly implemented measures to assess the situation and address the spread of COVID-19 inside European prisons. Specific tools included preparedness guidance to support Member States (MS) in, preventing and controlling COVID-19, factsheets directed at people living in prison (PiP) and at their visitors, checklists directed at prison administrators to self-assess their compliance with recommendations and a surveillance dataset.

Methods

The WHO-HIPP Surveillance Dataset comprises variables enabling the extraction of epidemiological indicators. This data has been collected weekly since May 2020.

Results and discussion

Data from 21 MS or regions has been obtained, 14 of which submitted national data regularly, enabling the observation of time trends. Ten MS experienced outbreaks at some moment, during which the ration of infection rate in PiP/general population varied widely (Median=1.58 {1.01-4.09}), highlighting the effect of congregate living on amplified transmission. Prevention and control measures in prisons were implemented in several MS. Eleven MS decreased occupancy rate to varying degrees (0.1-7.3%), while three increased population. Baseline occupancy rate of countries experiencing outbreaks was considerably higher than of those remaining controlled during all period. Among recent measures, seven MS have an established testing strategy, varying in methods, including rapid, polymerase-chain reaction (PCR) and sewage testing. While some MS have not been yet able to include PiP in the national COVID-19 vaccination roll-outs, seven are progressing, albeit coverage is highly heterogenous (0.1-34.5%).

Conclusions

Even though our data represents a self-selected sample, it suggests the level of infections in prison is, in some cases and periods, double of that observed in the general population. Strategies adopted to prevent and control the spread of infections vary widely in Europe.
Breast self-examination among older women in Ireland: The Irish Longitudinal Study on Ageing -TILDA
Authors: Bhardwaj N , Fitzpatrick P
Published: October 2021

Background

Regular breast self-examination (BSE) is a simple, cost-effective way of early breast cancer detection, particularly for women outside eligible screening age and for interval cancers. Although mammographic screening is the current most effective breast screening tool, the importance of regular BSE and breast awareness may be overlooked. The study aimed to identify socio-demographic, lifestyle and health-related factors associated with BSE practice among women in Ireland.

Methods

This study was conducted using Wave 4 data from The Irish Longitudinal Study on Ageing (TILDA), which collects health-related information from people aged 50 plus in biennial data collection waves. Those women aged 50-64 (eligible breast screening age in 2016) were selected. Following univariate analysis, logistic regression analysis was performed on selected variables to determine the factors independently associated with BSE practice.

Results

The prevalence of BSE was 70.7%. There was no significant association found between socio-demographic, lifestyle or health related factors and BSE. On logistic regression analysis, family history of cancer was not found to be associated with increased practice of BSE (Adjusted Odds Ratio (OR) 1.02, 95% Confidence Interval (CI) 0.79-1.31, p = 0.86). Having attended for mammogram showed a non-significant reduction in the likelihood of doing BSE (Adjusted OR 0.77, 95% CI 0.58-1.02, p = 0.07).

Conclusions

There are few studies on BSE from developed countries and this is the first from Ireland. BSE prevalence was 61%, 22.6% and 46.8% from Canada, United Kingdom and United States respectively, and was considerably lower from Asian and African countries. Women in this study were more educated than the general population counterparts, this might have overestimated BSE prevalence and obscured true associations. While we did not identify significant associations there is a suggestion that attending for mammography reduces women's interest in BSE.

Key messages

Being ‘Breast Aware’ and BSE are important alongside mammography for early detection of breast cancer. In countries where screening mammography is unavailable, BSE is an important detection tool.