bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of MSM on targeted sexual healthcare about HPV vaccination: a French qualitative study
Authors: Oliveri C , Mora M , Spire B , Girard G , Verger P
Published: October 2024

Background

To improve the effectiveness of public health policies, HPV vaccination campaigns target “high-risk groups”, such as men who have sex with men (MSM). In France, HPV vaccination is recommended for MSM up to the age of 26, rather than 19 for the general population. It’s crucial to assess the impact of such targeting policies on MSM who are eligible for HPV vaccination.

Methods

A qualitative study was conducted between April and July 2022 among MSM participating in the “Vaccigay” electronic survey in France (Brosset et al. 2023). Participants were selected based on age and declared HPV vaccination status. Semi-structured interviews were conducted by telephone using a thematic grid on the barriers and facilitators influencing the uptake of the vaccine against HPV. The interviews lasted on average 40 minutes. The audio-recorded verbatims were transcribed and thematically analysed using NVivo software.

Results

A total of 22 viewpoints were analysed. Two opinions emerged without differences in terms of individuals’ profile. The reasons MSM advocated for targeted sexual healthcare stemmed from the recognition of epidemiological factors, as well as the need for greater listening and understanding from healthcare workers. MSM who didn’t support targeted sexual healthcare did so because they felt stigmatised and because sexual orientation might not always be clear. Among them, some advocated for sexual healthcare based on sexual practices rather than sexual orientation. Others emphasized the necessity of extending prevention tools for sexual risks existing for MSM to the general population.

Conclusions

The findings of this study prompt reflection on universal versus targeted public health policies, as well as sexual and gender discrimination within the healthcare system. We recommend improving healthcare workers’ education on sexual healthcare, and that HPV vaccination guidelines could be extended to all adults up to 26, regardless of their sexual orientation.

Key messages

• Improving knowledge among healthcare workers and MSM about HPV and sexual health is important.

• It is important to extend the age for the HPV vaccination, regardless of sexual orientation.
Systematic review of ethical/methodological issues in transgender youth participative research
Authors: Servais J , Vanhoutte B , Maddy H , Godin I
Published: October 2024

Background

Understanding the experiences of transgender and gender-diverse (TGD) youth is essential for developing appropriate support services. However, studies focusing on TGD youth under 18 outside clinical settings are scarce, limiting effective support development. The requirement for parental consent in participatory research poses ethical and logistical challenges, impacting the safety, well-being, and privacy of adolescent participants. This dynamic complicates the balance between adolescents’ rights to autonomy and privacy and parental duties to protect their children. This review aims to illuminate the ethical and methodological challenges in participatory research with TGD youth.

Methods

A systematic review of bibliometric databases from 2006 to 2022 was conducted, focusing on transgender and gender non-conforming identities, adolescence, qualitative and participatory research methods, and consent issues. This review was registered with PROSPERO in November 2022 (CRD42022368360).

Results

Of 3,794 articles initially identified, 291 met the inclusion criteria, and 48 were extensively reviewed. Research with TGD youth commonly faces ethical tensions including parental inclusion in the consent process, safeguarding participant safety and privacy, ensuring confidentiality, and creating environments that allow TGD youth to express themselves and feel empowered. Methodological challenges include engaging public and stakeholders, recruiting participants, data collection, and maintaining research integrity.

Conclusion & Implications

The literature on participatory research with young transgender and gender-diverse individuals reveals intricate and often conflicting issues related to consent procedures, power dynamics, and the researcher’s role. These findings are applicable in various legal and geographical contexts, providing insights that can guide practices globally.

Key messages

• Research reveals ethical dilemmas in participatory research with transgender young people, highlighting difficulties around consent and the need for tailored support.

• Understanding the complexities of research ethics enables better support for transgender and gender-diverse young people during research.
Drug-facilitated sexual assault: An observational retrospective study in Barcelona (2018-2022)
Authors: Camps A , García-Esteve Ll , Salgado E , Echevarría T , Bertran M J
Published: October 2024

Background

Barcelona handles 400 to 500 sexual assaults yearly. Substance use is expected in one-third of reported assaults, being alcohol and cocaine the most detected substances. Nevertheless, there is a lack of updated information with reliable, recent, and context-specific data.

Methods

Retrospective observational study in people attended at the reference hospital for sexual assault care in Barcelona (H.Clinic) within 24 hours of the drug facilitated sexual assault (DFSA) in the period 2018-2022. Univariate and bivariate analysis have been carried out to describe the characteristics of the victims and identify possible associations with the assault settings, relationship with the aggressor and substances involved.

Results

Among 682 cases of DFSA, women represent 85%. Most incidents (73%) occur in the 18 to 35 age group, primarily in homes (42%), public spaces (23%), and nightlife establishments (15%). Spanish nationality is most common in both sexes (50%), yet Latin American men are prominent in drug-involved cases compared to non-Spanish European men. While alcohol (55%) and cocaine (28%) remain common, emerging drugs like GHB (15%) and MDMA (23%) are rising. The aggressor varies depending on the age and sex of the victim, with the perpetrator often being known (46%) in cases involving minor victims, while it tends to be unknown (46%) in cases involving adult victims. Chemical submission-related cases increased steadily, reaching 17% in 2022. Among these victims, 75% were women, with MDMA and cocaine being prevalent, while methamphetamine and GHB were more common among men. All these findings are statistically significant.

Conclusions

The study highlights a significant number of drug-facilitated sexual assaults mostly among young women, often occurring domestically, alongside emerging substance use trends. Adaptable surveillance systems are crucial to address these dynamic patterns and support vulnerable populations for safer environments.

Key messages

• Drug facilitated sexual assaults are a global health issue that demands attention through a gender perspective. Substances, spaces and consumption patterns evolve over time and across generations.

• Patterns in substance use vary by age, nationality, sex, and consumption type, highlighting vulnerable population groups needing focused protection and assault prevention.
Quitting with pride: Differences in smoking behaviour across sexual identity groups in Ireland
Authors: Kavanagh P , Sheridan A , Kelleher C , Noone C , Ward K , Doyle F
Published: October 2024

Background

As smoking prevalence reduces, smoking inequalities across population groups is emerging as a key challenge. Despite recognition of specific needs among members of the Lesbian, Gay, Bisexual, Transexual Plus (LGBT+) community, differences in smoking across sexual identity groups is uncharted in Ireland and the community is not represented in tobacco policy agenda setting. This study aimed to measure and compare the prevalence of smoking, quitting intention and quitting behaviour across sexual identify groups in Ireland.

Methods

Secondary analysis of the 2023 “Healthy Ireland” cross sectional survey of health status was conducted (n = 7,411). For the first time, this survey included a question on self-reported sexual identify, along with standard questions on smoking prevalence, quitting intention and quitting behaviour. Prevalence of smoking, quitting intention and quitting behaviour were calculated with 95% Confidence Intervals (CI) and compared across groups with Chi Square tests.

Results

In total, 2.3% (95% CI 2.0-2.7%) of respondents reported an LGB+ identity. Compared to those reporting straight identity, LGB+ respondents reported higher smoking prevalence (17.6% versus 21.4% respectively); intention to quit was similar across groups, however, LBG+ respondents also reported a higher prevalence of making at least one quit attempt in the previous 12 months (51.3% versus 78.0% respectively, p < 0.0001).

Conclusions

While this study highlighted tobacco-use as a health challenge for the LGB+ community in Ireland, it also identified an opportunity for tailored stop smoking approaches to support quit success. As a consequence, an innovative Fulbright-sponsored policy dialogue was convened between leaders in tobacco control, LGBT+ community leaders, health services and academia across Ireland and the USA to explore solutions, underlining the important role equity stratifiers and population surveillance play in agenda setting for public health.

Key messages

• Including sexual identity in the national population health survey enabled tobacco-use needs across sexual identity groups in Ireland delineated for the first time.

• Equity-stratified population health surveillance informed a policy dialogue to better represent needs of LGBT+ community in public health agenda setting.
The data layer: the importance of sources critical appraisal
Authors: Gorasso V , Van den Borre L , Scohy A , Schmidt M , Devleesschauwer B , De Pauw R
Published: October 2024

One of the main purposes of public health institute is to tracking the health status of its citizens and understanding its evolution over time. Given the absence of a singular, comprehensive data source, we developed a framework to select databases specific to each disease and outcome of interest. This process includes a thorough evaluation of the operational case definitions, as well as the strengths and weaknesses of each database, with a particular focus on their sensitivity and specificity. These qualities are appraised following a dedicated scoring form into different categories (i.e., high, medium, low). The selection criteria for data sources hinge on several key questions: Is the database exhaustive or merely a sample? Does the case definition rely on direct medical diagnoses or proxies? Does the source capture all cases? Is the data collected at regional or national level? Are there mechanisms for yearly or periodic updates? To establish the most accurate national prevalence estimates for each outcome, we often need to adjust for data misclassification-applying corrections for biases such as self-reported data and interpolating for missing entries. In some instances, a pooled estimate from multiple data sources is developed. A specific case will be presented to illustrate our approach in practice. This critical evaluation is pivotal, as the quality of data underpins the entire health information pyramid. The integrity of our data directly influences our ability to convert data into actionable health wisdom, ultimately affecting public health decision-making and policy formulation.
Large scale system transformation: Ukraine
Authors: Piven N , Aleksandrova O , Aragón de León E , Jakubowski E
Published: October 2024

In the context of the EU-Ukraine Accession agreement, Ukraine started large scale public health systems reform back in 2015. The COVID-19 pandemic tested the response capacity of the national public health system and led to some improvement during the pandemic such as on laboratory capacity. It also generated lessons for strengthening national and subnational health emergency preparedness and response. Multiple interventions, including a Joint External Evaluation led to the adoption of the Public Health System Law in 2022, laying the foundation to bolster health promotion, disease prevention, and health protection. The Ukrainian Public Health Centre was substantially strengthened, partly oriented on models in other European countries. Corresponding centers for diseases control and prevention at the oblast level were reformed and a subnational network of these centers was created. While the war has a significant impact on the public health system, infrastructure, people and more, decision makers and professionals keep working on sustaining and moving forward the achievements on public health reforms, for example with the adoption of the National Health Strategy 2030 and the adoption of the National Health Security Plan. Further legal and strategic preparations are afoot to strengthen public health services governance capacity, financing, institutional innovation and development, and public health workforce development.
Large scale public health system transformation: Germany
Authors: Jakubowski E , Kupfer G , Bruns-Philips E , Teichert U
Published: October 2024

The COVID-19 pandemic was a stress test for public health services in Germany. Decision making was complex (party lengthy and inconsistent) due to the divided responsibilities within the federal system. Some improvements on the public health system were already enacted during the pandemic. A “pandemic radar” was established to bundle up relevant infectious disease indicators with indicators of health services use. The national electronic notification and information system for infectious diseases was extended. Digital improvements were made in the public health offices. Laboratory capacity was strengthened, so was inter-science modelling to forecast pathogen spread. A nation-wide collaborative mechanism, the cloverleaf system, was introduced between regions to avoid the overburdening of hospitals. It is now established for times of excess need for inpatient services. In 2020, a 4 billion euros investment program, the “Pact of Public Health Services”, was adopted to strengthen and modernize the German public health service institutions. The pact is implemented until 2026. The human resources component is the largest. Further priorities include digitalization, improvement of the infrastructure (of designated ports and airports) for the implementation of the International Health Regulations, research and the creation of agile and resilient public health structures. Outputs so far include the establishment of more than 4800 new public health positions, the appointment of new professorships for public health services, the initiation of several research projects, and the roll-out of more than 300 digitalization projects. A new federal institute for prevention is planned. It aims to foster networking between public health services, strengthen health communication, data use, and evidence for public health services. In this process, WHO advised the federal ministry e.g. on behavioral insights; heat health action; prevention on noncommunicable diseases and others. Many public health actors have provided opinions. However, consensus building on how Germany can overcome fragmentation in public health is ongoing.
10.B. Scientific session: The European Health Data Space (EHDS): A sea of change for health data in Europe
Authors:   Organised by: DG SANTE European Commission,   Chair persons: Jerome de Barros (Belgium)
Published: October 2024

A wealth of data is generated every day throughout our health systems which, if leveraged well, can underpin the digital solutions and policies that will transform health and care. However, the complexity and divergence of rules, structures and processes within and across European Member States make it difficult to fully harness that potential at European scale. The European Health Data Space will address this challenge by empowering Europeans to access and control their health data and by offering a harmonised and simplified framework for the reuse of health data, including for research, innovation, and policymaking purposes. During the workshop, we will present an overview of the European Health Data Space framework and its implementation phases and discuss its benefits for targeted stakeholders, including citizens, researchers and policymakers in public health.

Objectives

1. Emphasise the importance of leveraging health data for research, innovation and policymaking; 2. Present the European Health Data Space regulation and what actions are being undertaken to prepare for its implementation; 3. Discuss how access to their health data can enable patients and individuals play an active role in their own health journey; 4. Discuss what will be the main benefits for policymakers and researchers in public health resulting from enhanced access to health data.

Introduction by Chair for presenting the European Health Data Space and the setting the scene for the session. Short presentations by speakers:

1. Implementing the EHDS: lessons from the EHDS2 pilot - Marianne Benderra, Health Data Hub, presenting his experience on developing and piloting the EHDS infrastructure for secondary use of health data, highlighting key project developments;

2. How can the EHDS enable participatory healthcare? - Henrique Martins, ISCTE, xShare project on how the xShare “Yellow Button” will empower individuals with access to and control over their health data and may foster the development of knowledge and tools necessary for prevention and management of their health;

3. What will the EHDS enable for research and policymaking? - Nienke Schutte, Scienciano, bringing the perspective of a leading European public health institute how the benefits the EHDS framework can bring for policymaking, research and innovation.

15 min Q&A session, taking questions from the audience, possibly also through Slido. Possible guiding questions: How can stakeholders contribute more broadly to the development of the EHDS? What support is needed to ensure that data users and data holders are prepared when the EHDS framework becomes operational?

Conclusions

2 min by Chair.

Speakers/Panelists

Marianne Benderra

French Health Data Hub, Paris, France

Henrique Manuel Martins

ISCTE, Lisbon, Portugal

Nienke Schutte

Sciensano, Brussels, Belgium
10.C. Scientific session: Shifting the focus of health and economic policies: Investing in sustainable health and well-being
Authors:   Organised by: Finnish Institute for Health and Welfare (Finland), Society for Social Medicine (Finland),   Chair persons: Ilmo Keskimäki (Finland), Tea Lallukka (Finland)
Published: October 2024

The main theme of the 18th European Public Health Conference, to be held in Helsinki in 2025, is ‘Investing for sustainable health and well-being.’ The theme emphasizes the concept that improving population health and well-being is an investment rather than an expenditure, benefiting society as a whole and contributing to a more sustainable economy. This workshop will introduce the thematic areas of the 2025 European Public Health Conference through three presentations. First, we will highlight the approach of public health policy drawing on the economy of well-being and its application in wider societal policymaking. Second, we will explore how EU policies can contribute towards a Wellbeing Economy and how to ensure health and wellbeing remain on policy-making agendas. Third, we will present an economic case for investing in health and health systems and highlight the co-benefits it brings to other policy areas and sustainable development goals. Finally, we will discuss the future expectations for European public health policy. The workshop will conclude with a general discussion, providing the audience with an opportunity to propose topics for inclusion in the programme of the European Public Health Conference in 2025.

Key messages

• Improving population health and well-being is an investment rather than an expenditure.

• Investing in the population’s health and well-being brings co-benefits to other public policy areas.
How do health systems and health contribute to the sustainable development goals?
Authors: Cylus J , Siciliani L
Published: October 2024

While there is considerable research and policy interest into how factors outside the health system (i.e. social determinants) influence health outcomes, there has historically been less interest in how health and health systems affect other economic and societal objectives. Such evidence can be useful to health policymakers making the case for investing in health systems to demonstrate that health systems do more than just improve health. The European Observatory on Health Systems and Policies has put together a special issue of the journal Health Policy to explore the evidence on how health and health systems advance the Sustainable Development Goals (SDGs), which provides a helpful conceptual framework for considering economic and societal objectives. The articles each consider a particular SDG and review relevant literature with an emphasis on causal studies to explore the ways in which health and health systems have causal effects on key societal objectives such as poverty reduction, gender equality, climate change, and responsible consumption. In this presentation we will provide a summary of the findings from the special issue, highlighting areas with the strongest (and weakest) evidence and discuss how this work can be factored into budget negotiations and decisions about resource allocation.
Empowering People Experiencing Homelessness for cancer prevention using the Health Navigator Model
Authors: Alhambra-Borrás T , Blanes-Selva V , Schiffler T , Gawronska J , Smith L , Tabaki I , Moudatsou M , Gómez-Trenado R , Benito B , Grabovac I
Published: October 2024

Cancer poses a significant public health concern. Reports highlight that cancer-related mortality rates are double among people experiencing homelessness (PEH). CANCERLESS project delivered an innovative solution based on the Health Navigator Model (HNM). The HNM is an evidence-based patient-centred intervention that develops patient empowerment through health education and social support, promoting timely access to cancer prevention services. A pre-post design study conducted across four pilot sites in Europe (Austria, Greece, Spain, UK) involved 652 PEHs. Pilot interventions based on the HNM were implemented, with effectiveness evaluated at baseline and post-intervention. The study assessed the impact of the HNM on various factors including risk behaviors, lifestyles, quality of life, empowerment, health literacy, psychological distress and utilization of health and care services. Preliminary findings from CANCERLESS HNM intervention showed significant improvements (p= .000) in participants’ quality of life (55.82 (27.65) vs. 66.18 (22.27)) and sense of empowerment (25.58 (19.95) vs. 59.94 (43.10)). However, there were no observable impacts in health literacy (p= .509) or psychological distress (p= .140), which remained within acceptable ranges both pre- and post-intervention. Similarly, there were no significant changes observed in lifestyle or risk behaviours among PEHs. Nonetheless, the evaluation of effectiveness suggested that the HNM increase in the uptake of cancer prevention care, such as cancer screening (p= .000). The CANCERLESS HNM intervention significantly improved the quality of life and empowerment of PEHs. Additionally, it successfully promoted their involvement in cancer prevention efforts, addressing disparities in access to preventive healthcare services. Increased engagement in such initiatives can lead to early detection and treatment, ultimately reducing cancer morbidity and mortality rates, thereby positively impacting public health.

Key messages

• By promoting health equity and social justice, interventions like CANCERLESS HNM contribute to building healthier and more resilient public health systems.

• CANCERLESS boosts cancer prevention awareness, tackles healthcare disparities, enhances cancer early detection, benefiting public health.
Environmental burden of disease related to pyrethroid-insecticide exposure and neurodevelopmental toxicity in Europe based on human biomonitoring
Authors: Purece A , Thomsen S T , Plass D , Palmont P , Crépet A , Benchrih R , Devleesschauwer B , Sanchez G , Piselli D , Buekers J
Published: October 2024

As indicated by human biomonitoring (HBM) studies, exposure to pyrethroids is widespread in Europe with significantly higher exposure observed in children compared to adults. Epidemiological, toxicological, and mechanistic studies raise concerns about potential health effects in humans and, particularly, behavioral disorders such as attention deficit hyperactivity disorder (ADHD) in children at low levels of exposure. Based on an exposure-response function from a single European study and on available quality-assured and harmonized HBM data collected in France, Germany, Iceland, Switzerland, and Israel, an initial estimate of the environmental burden of disease for ADHD associated with pyrethroid exposure (measured by the metabolite 3-phenoxybenzoic acid) was made for individuals aged 0-19 years. The estimated yearly number of prevalence-based disability-adjusted life years (DALYs) per million inhabitants due to ADHD were 34 DALYs for Israel, 26 DALYs for France, 14 DALYs for both Switzerland and Iceland, and 4 DALYs for Germany. Additionally, a substantial number of ADHD cases, averaging 18%, were associated with pyrethroid exposure. Yet, these figures should be interpreted with caution given the uncertainty of some input parameter. In addition to burden of disease estimates due to ADHD, the associated burden of autism-spectrum disorder (ASD) due to pyrethroid exposure and the health economic costs attributable to ADHD and ASD will also be investigated further. To ensure adequate follow-up of policy measures and more robust disease burden estimates, more HBM studies are recommended, along with increased efforts to harmonize the design of epidemiological studies to ensure more meaningful meta-analyses of exposure-response functions. This is particularly important for pyrethroids as more evidence on potential adverse health effects is continuously emerging.
10.G. Practice session: Innovation technology to promote healthy lifestyles: teachings from multi-national EU funded projects
Authors:   Organised by: EUPHA-FN, -HP, -DH,   Chair persons: Eric Breton (France), Anna Odone (EUPHA-DH -IDC)
Published: October 2024

The global burden of disease attributable to lifestyle risk factors is constantly escalating on a worldwide scale. Inadequate diet and sedentary behaviors stand out as particularly impactful contributors to chronic non-communicable diseases, resulting in millions of deaths annually and projecting stable, alarming trends for the foreseeable future. These statistics raise significant concerns among public health experts, particularly regarding the pervasive influence of unhealthy lifestyles on younger generations. This demographic cohort’s susceptibility poses a substantial threat to the future trajectory of non-communicable diseases and places immense strain on healthcare systems and global health outcomes. In light of these challenges, the imperative for public health initiatives and interventions aimed at promoting healthy lifestyles becomes glaringly apparent. Addressing the root causes of unhealthy behaviors through targeted interventions is essential to reverse the projected trends and mitigate future health risks. Public health authorities shoulder the responsibility of prioritizing such endeavors, as they play a pivotal role in shaping environments conducive to healthy living for present and future generations alike. Embracing innovative methodologies, leveraging technological advancements, and adopting modern approaches are imperative to engage and mobilize younger populations effectively. Initiatives funded by entities such as the European Union serve as promising examples, highlighting the potential for collaborative efforts to drive meaningful change. Sharing the methodologies and findings of such projects within the public health community can catalyze knowledge dissemination and foster collaboration, ultimately amplifying the impact of intervention strategies worldwide. By prioritizing intervention studies for behavioral change, stakeholders can collectively address the pressing challenge of lifestyle-related diseases and pave the way for healthier, more resilient communities. The aim of this workshop is to provide an overview of multi-national EU funded projects aiming to promote healthy lifestyles in the Mediterranean region.

Key messages

• Innovative and more modern approaches are needed to improve the diet in the Mediterranean region.

• Children and adolescents are the main targets to counteract the rise of non-communicable diseases.
SWITCHtoHEALTHY: Switching Mediterranean Consumers to Mediterranean Sustainable Healthy Dietary Patterns
Authors: Rosi A , Degli Innocenti P , Bergamo F , Rosi A , Calderon Perez L , Boqué B , Scazzina F
Published: October 2024

In the Mediterranean countries profound changes in diet are taking place, largely due to cultural and socio-economic changes in lifestyle, which are leading to the erosion of the Mediterranean food cultures. The diet modernization process is noticeable; it has generated not only a modification of food choices in the direction of unhealthy foods, but also the habit of sedentary behaviours leading to an imbalance between energy intake and consumption. All of this has negative health impacts, as shown by the ever-increasing prevalence of overweight and obesity, as well as the rise of chronic diet-related diseases. The SWITCHtoHEALTHY project aims to generate an overall change of approach to the modern problem of eating behaviours, by strengthening the role of families towards the promotion of the sustainable Mediterranean food model. The main goal is to generate an actual switch to healthier dietary models, that are more consistent with the Mediterranean Diet. The project SWITCHtoHEALTHY aims to generate a dietary behaviour change in the direction of a greater adherence to the Mediterranean food model, by strengthening the role of families in the process of acquiring and maintaining healthy eating habits. The Mediterranean Diet (MD) is a healthy and sustainable food model, with an essentially plant-based dietary pattern (high consumption of fresh fruits and vegetables, cereals, and legumes). This goal will be reached by making available to families a combination of hands-on educational material and digital tools and complementing the dietary and lifestyle recommendations with easy-to-eat healthier snacking products.
A transnational movement to support the sustainable transition towards a healthy and Eco-friendly Agri-Food System through the promotion of MEDIET and its lifestyle in modern society: MEDIET4ALL
Authors: Ammar A
Published: October 2024

The Mediterranean diet is considered the world’s most evidence-based low processed eating pattern for promoting health and longevity while saving water/energy and conserving land. Unfortunately, due to the modern societal trends, adherence to the Mediterranean diet model is decreasing, while the consumption of takeout and ultra-processed foods and drinks (UPFDs) is exponentially growing, with alarming levels in many European-Mediterranean (EUR-MED) regions. The overall objective of “MEDIET4ALL” is to support the transition from UPFs culture to modern and sustainable Mediterranean diet through the creation of transnational movement aiming at implementing best practices and innovative solutions to enhance the convenience, modernity, competitivity, and shelf life of Mediterranean diet. To achieve this overall objective, different multidisciplinary tailored approaches are proposed. Specifically, multicenter databases of ingredients/food and their providers will be created to promote the accessibility. Additionally, a variety of highly nutritional and antioxidant-rich “Quick & Easy” recipes that respond to modern trends while following the Mediterranean diet and considering sustainability aspects will be developed. To preserve the eco-friendly and food safety characteristics and extend the shelf life of the Mediterranean diet products, active bio-packaging will also be designed. A strategic “MEDIET4ALL” platform and m-app integrating the abovementioned MEDIET4ALL products and combined Mediterranean lifestyle interventions tailored to each user profile will be developed. Traditional and technology-based awareness and motivational campaigns with extensive marketing and advertising actions to promote MEDIET4ALL movement are also programmed. Working under the concept of a multidisciplinary approach consortium, multiple impacts, particularly supporting the transition towards a healthy and sustainable MED diet and lifestyle, are expected.
10.I. Scientific session: A National E-Infrastructure for Aging Research to Improve Public Health
Authors:   Organised by: National E-Infrastructure for Aging Research (Sweden),   Chair persons: Ingrid Ekström (Sweden)
Published: October 2024

Global life expectancy gains over the last half-century are remarkable. Yet the resulting demographic shift towards an older population poses substantial public health challenges, particularly in healthcare. To address these challenges, a profound and scientifically-based understanding of older adults’ health and care requirements is needed. Recognizing the need for a better understanding of the aging process and public health challenges, the National E-infrastructure for Aging Research (NEAR) was founded in 2018. NEAR seeks to promote and support aging research by facilitating longitudinal population-based data usage from 15 well-known Swedish cohort studies on aging and health. It is based on a collaboration between eight Swedish universities and includes 15 databases with individual assessments. NEAR comprises a broad range of biomedical, clinical, social, and psychological health data from more than 90,000 adults who are 50+ years old. These individuals have been followed between 12 and 52 years. The objective of this workshop is to give an overview of the NEAR infrastructure, present results from three ongoing NEAR projects, and their implications for public health: 1) Temporal trends in dementia incidence in Sweden; 2) Personality and biomarkers of neurodegeneration and Alzheimer’s disease in Swedish older adults, and 3) Characterizing risk profiles and transitions across living and care settings in Sweden. Infrastructures such as NEAR offer high-quality epidemiological data for achieving broad, interdisciplinary research goals that single databases often cannot provide. Moreover, the value added to these kinds of data includes enhanced sample sizes, variations, representativeness, and generalizability. In turn, this can address an aging society’s public and clinical health demands. Eventually, this could lead to sustainable intervention strategies for improving older persons’ health in the coming decades.

Key messages

• Discover new avenues in public health aging research: Gain insights into cutting-edge aging research opportunities in Sweden, exploring key NEAR projects.

• Recognize the value of national infrastructures using high-quality epidemiological data in fostering collaborative and nationally representative public health research.
Personality and Biomarkers of Neurodegeneration and Alzheimer’s Disease in Swedish Older Adults
Authors: Molinder J , Vetrano D , Zetterberg H , Blennow K , Waern M , Johansson L , Falk Erhag H , Sigström R , Skoog I
Published: October 2024

Background

Personality is associated with dementia risk. Neuroticism and conscientiousness may be involved in resistance and resilience to Alzheimer’s Disease (AD) pathology (ADP). These traits have also been associated with unspecific biomarkers of neurodegeneration; glial fibrillary acidic protein (GFAP) and neurofilament light (NfL). This study explores the role of personality in cognitive ageing.

Methods

We used data from the Swedish population-based studies H70 (individuals age 70 years only), and SNAC-K (individuals ages 60-104). Personality was assessed with the NEO-five-factor inventory. In H70, biomarkers of ADP were measured in cerebrospinal fluid (CSF, N = 305), except NfL which was also available in plasma (N = 1082). In SNAC-K (N = 1754), all biomarkers were measured in serum. We used multivariable regression models to evaluate the association between personality traits and ADP biomarkers, GFAP and NfL among individuals without dementia. We further examined if associations differed by age (SNAC-K only) and sex.

Results

In H70, higher neuroticism and was associated with lower Aβ42/Aβ40 ratio (B=-0.01, p = 0.02). In SNAC-K, higher openness was associated with lower NfL (B=-0.04, p = 0.03). For age 60-66, higher openness was associated with lower NfL (B=-0.09, p = 0.01), higher neuroticism was associated with higher GFAP (B = 0.09, p = 0.01), and NfL (B = 0.10, p = 0.003). For age >80, higher openness was associated with higher ptau-181, (B = 0.14, p = 0.01), and ptau-181/Aβ42 ratio (B = 0.15, p = 0.003).

Conclusions

Higher neuroticism and lower openness are associated with neurodegeneration. Higher openness may also be associated with resilience to AD-pathology.

Key messages

• Neuroticism may contribute to neurodegeneration in people <70.

• Openness may contribute to cognitive resilience to ADP in people >80.
A quantitative study on the impact of a new outdoor advertising restrictions policy in Bristol (UK)
Authors: Buckland G , Toumpakari Z , Jago R , Harding S , Nobles J , Horwood J , Sillero-Rejon C , Hollingworth W , Cummins S , de Vocht F
Published: October 2024

Background

Bristol was the first city outside London to introduce a policy to restrict adverts for high fat, salt and sugar (HFSS) products and other unhealthy commodities (alcohol, gambling, payday loans) on council sites in 2021. This research evaluates the impact of this policy.

Methods

We conducted a controlled repeated cross-sectional study of Bristol (intervention) and neighbouring South Gloucestershire (control) residents before (n = 2,543) and after (n = 2,043) the policy came into effect. Self-reported exposure to adverts of HFSS products, alcohol and gambling and consumption/use of these products was collected. The intervention effect was analysed using a weighted controlled before-after design. In addition, we analysed 2020-23 timeseries of foods and drinks purchased by 1,012 households from Bristol (n = 217) and control areas (n = 795) from Kantar’s Worldpanel Take Home data. A controlled interrupted time series design was used to estimate the impact of the policy on weekly household purchases of energy and nutrients from HFSS products.

Results

Preliminary results did not indicate significant changes in exposure to unhealthy commodity adverts or consumption/use of unhealthy commodities post-intervention. However, the majority of results suggested a potential reduction; with for example a -22.1 (95% CI -47.3, 16.2) percentage point decrease in reported consumption of fast-food compared to controls. We also did not observe significant differences in weekly energy purchased from HFSS products compared to counterfactual; 897.6Kcal, 95%CI -57.7, 1,853.0, nor in purchases of fat (39.0g, 95%CI -20.1, 98.1), sugar (48.0g, 95%CI -19.8, 115.7) or salt (-0.4g, 95%CI -4.1, 3.2) from HFSS products.

Conclusions

Preliminary results indicate the new policy had no clear impact on exposure to unhealthy commodity adverts or purchasing and consumption of HFSS products. This may be attributable to the relatively small amount of total advertisement space owned by Bristol City Council (∼30%).

Key messages

• Policies restricting adverts of HFSS products and other unhealthy commodities are potentially effective tools to improve diet and to reduce diet-related diseases and public health inequalities.

• We did not observe a measurable impact of this policy in Bristol, which may be attributable to the relatively small Council-owned advertisement estate within the total available advertisement space.
What works to reduce regional health inequalities? A case of East vs West Germany post reunification
Authors: Simpson J , Albani V , Bambra C
Published: October 2024

Regional inequalities in mortality are rising across the globe. The case of German reunification offers a unique opportunity to explore how such inequalities can be reduced, or even eliminated: following reunification, a long-standing life expectancy gap between East and West Germany was closed for women and markedly reduced for men in a period of less than 15 years. Drawing from theory on health inequalities, we investigate the contribution of material, behavioural and psychosocial factors likely related to the narrowing of the life expectancy gap between East and West Germany following reunification. We used regional data from official national statistics covering the period 1994-2020 for 15 regions in East and West Germany. Using fixed-effects models with an interaction term for regions in the East, we investigated whether within-region changes in key hypothesised factors (social security expenditure, healthcare improvements, changes in alcohol consumption, and life satisfaction), have had differential impacts on life expectancy at birth and at 65 years. We find that increases in social security benefits in the East following reunification has been the most important factor for lowering inequalities between the two parts of Germany: for every standard deviation increase in social security benefits, life expectancy at birth increased by an additional 0.20 [0.07,0.33] years for males and by 0.15 [-0.01,0.31] years for females in East relative to West Germany. We find the protective effect of social security benefits also for women at 65 years (additional 0.14 years [0.006,0.268]) but not for men. Overall, our findings suggest that increasing social security expenditure could be an effective policy-based tool for reducing health disparities across regions with different levels of economic development. This provides additional support for the relevance of the materialist hypothesis and the political economy of root causes of health inequalities.

Key messages

• Our findings suggest that increasing social security expenditure could be an effective policy-based tool for reducing regional health disparities.

• We find support for the materialist and political economy approaches to explaining health inequalities.
Reinterpreting the NRA’s Eddie Eagle GunSafe® program as a corporate political activity
Authors: van Schalkwyk MCI , Hawkins B , Maani N , Petticrew M
Published: October 2024

Background

In the US firearm injuries are the leading cause of death among children and adolescents. However, and despite there being limited evidence to support the adoption of gun safety education programs, firearm industry-funded groups like the National Rifle Association (NRA) promote the delivery of their education-based Eddie Eagle Gunsafe® program while lobbying against other firearm policies less favourable to the firearm industry. The study aimed to address an important research gap by examining how the NRA frame gun ownership, safety and the role of the Eddie Eagle GunSafe® program as an effective firearm safety intervention and whether the design, promotion and delivery of the program serves the corporate political interests of the firearm industry, and if so, how.

Methods

We conducted a critical analysis of program-related texts and films and the NRA’s practices to promote its legitimacy and effectiveness, guided by the application of published taxonomies of corporate framing and action strategies. Data was collected from the program-specific websites and other NRA outlets to capture the breadth of strategies used to promote their education program.

Results

The NRA’s practices support the corporate political agenda of the firearm industry. The NRA adopts framing and action strategies that present the presence of firearms in homes and communities as inevitable and normal and the education of children through the delivery of their “lifesaving” program as the common-sense and effective way of keeping children safe from firearm injuries. They make misleading claims about the effectiveness of the program while undermining the credibility of those who advocate for the safety of children and adolescents.

Conclusions

The ongoing delivery of the Eddie Eagle GunSafe® program needs to be questioned. Policies based on a recognition that children and adolescents are safest when their homes and communities are free of firearms are needed to prevent firearm injuries.

Key messages

• The NRA makes misleading claims about their program’s effectiveness and distorts understanding of what is needed to prevent firearm injuries and ensure the safety of all children.

• The firearm industry needs more attention from the global public health community. Evidenced policy measures that prioritize the prevention of firearm injuries are needed to save children’s lives.
10.M. Scientific session: JA ImpleMENTAL Abstract Workshop
Authors:   Organised by: JA ImpleMENTAL, EUPHA-PMH,   Chair persons: Vasileia Konte (Greece), Jutta Lindert (EUPHA-PMH)
Published: October 2024

JA ImpleMENTAL is major initiative across Europe and was initiated on the request of Member States, on October 2021 under the European Union 3rd Health Programme. The workshop is organized by JA ImpleMENTAL in partnership with EUPHA Mental Health Section, a member of the JA ImpleMENTAL Stakeholder Forum. It will include four presentations that will contribute to an interesting discussion about the future of community mental health services that are user-centered, recovery-oriented and human rights based as well as about the synergies with national strategies and the EU Initiatives. Vasileia Konte the JA ImpleMENTAL Coordinator will provide an overview of the Mental Health System Reforms based on the Belgian Best Practice model, which is implemented in 11 countries. It will elaborate on key activities and prioritized key areas of mental health system transformation as well as enablers, barriers and key lessons learned from the implementation process. Danijela Štimac Grbić from Croatia will present the Croatian experience in the implementation of a mobile rehabilitation team for providing psychosocial interventions in the community in which peer workers are employed for the first time. Based on the successful work of the mobile team, Croatia has included 30 new mobile teams in its network of public health services that will operate throughout Croatia. Teresa Nicolas Lopez from Murcia Spain will present the project “Inclusive Life Projects” which offers comprehensive community care to adults with severe mental illness within projects of autonomous living and provides a concrete and real response to their needs, with the ultimate objective of avoiding the risk of institutionalization. Anna Paradesioti from Cyprus will focus on how to achieve a smooth transition from inpatient to community mental health services promoting collaboration among those services and professionals, by adopting an intersectoral approach. Jutta Lindert will provide valuable comments by bringing helpful insights and views of the Stakeholder Forum.

Key messages

• Transformation towards community based care increase availability and efficiency of services.

• User’s centered human rights based recovery approach care with engaging stakeholders including people with lived experience.