bluuebunny/crossref_metadata_2025 huggingface dataset:
Restoring trust in vaccination through collective engagement with key populations in Eastern Europe
Authors: Mandić-Rajčević S , Cvjetković S , Oot L , Tasevski D , Popović D , Meghani A , Wallace H , Cullen-Balogun T , Cotelnic T , Cogswell L
Published: October 2024

Issue/problem

COVID-19 vaccination rates remained below 50% in Moldova, North Macedonia, and Serbia, especially among vulnerable populations like pregnant women and those with chronic diseases. This was strengthened by a lack of targeted communication and training for healthcare workers, and COVID-19 fatigue. Strategies to increase vaccine demand and confidence are a global priority, especially among vulnerable populations.

Description of the solution

From May 2022 to April 2024, the USAID MOMENTUM Routine Immunization Transformation and Equity project employed behavior integration to design a social and behavior change strategy, centering on vaccination as a part of a healthy lifestyle. It was implemented through continuing medical education (CME) and community engagement (CE) workshops with vulnerable populations, supplemented by cross-country learning exchanges. The outcomes provide a framework for public health initiatives aimed at boosting vaccine uptake through innovative, behavior-based methods.

Results

1,618 healthcare professionals, able to reach 2.5 to 4.8 million patients, received training in immunization, COVID-19 vaccines, and quality health service, and 99% indicated confidence in applying the knowledge. 265 CE workshops, engaging 4,079 patients, increased awareness and addressed concerns related to vaccination. Of 3,223 patients who were followed up, 47% reported setting an appointment with their doctor regarding vaccination, 27% discussed vaccination with their partners, and 7% proceeded to receive the COVID-19 vaccine.

Lessons

Behavior Integration helped address key barriers to vaccination and informed the design of strategies (i.e. situating COVID-19 vaccination as part of a healthy lifestyle). Establishing trust with healthcare providers and patients through collective engagement improved health behaviors. Focusing on health as a wider priority helped re-establish the significance of vaccination as part of a healthy lifestyle.

Key messages

• Behavior science and behavior integration helped identify and address barriers, as well as design tailored interventions to improve vaccination demand and confidence.

• Collective engagement, focused on integration of COVID-19 vaccination as part of a healthy lifestyle, achieved results through addressing vaccine hesitance from both sides of the equation.
Health promotion at local level in Portugal: is childhood obesity a concern in municipal programs?
Authors: Pereira M
Published: October 2024

Health promotion programs targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. There is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. This study aims to provide some input regarding this issue in Portugal. In order to achieve this goal, health enhancing programs promoted by Portuguese municipalities in which children could participate were identified. The search of such programs was limited to the municipalities that were part of the Portuguese Network of Healthy Municipalities in 2021 (N = 57). A subsequent document analysis was conducted to describe how municipalities conceptualized children’s health by retrieving information on which topics the programs were focused on, or acted upon, and identify which socio-ecological model levels of health determinants were addressed (or not) by each program. The 77 identified programs were promoted by 30 municipalities and only 11 programs addressed childhood obesity. Most programs focused on the individual health determinants (N = 27) and provided limited information overall, which hindered a more in-depth analysis. The findings suggest that Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national level, as reflected in the National Health Plans, but not perceived as such locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population’s quality of life, by addressing the social and environmental determinants of health. Hence, municipalities should instill health concerns in all their actions/interventions, taking in consideration the most recent evidence, specifically in the case of childhood obesity.

Key messages

• This study findings suggest that, despite childhood obesity being a major public health concern at national level, as reflected in the National Health Plans, it is not perceived as such locally.

• There is a need to better understand the role of municipalities as key public health promoters considering they are responsible to intervene on the social and environmental determinants of health.
What long-term health outcomes can we anticipate for children who have been in social care?
Authors: Straatmann V
Published: October 2024

The concept of cumulative disadvantage suggests that setbacks in one area of life not only lead to further challenges within that domain but also increase vulnerability to adversities across different domains, as highlighted in life course studies. In the context of children with a history of childhood social care (CSC) experience, research consistently shows poorer long-term health outcomes compared to peers without such experiences. This disparity persists into middle age and can affect subsequent generations, underscoring the enduring impact of early-life adversity. Dr Viviane S. Straatmann, a social epidemiologist based in Sweden and enriched by her experience in studying the health and social life of vulnerable children in diverse international settings, will offer insights from life-course and intergenerational epidemiological studies. She will explore the intricate web of disadvantages preceding children’s entry into social care, shedding light on the complex interplay between early-life adversity, cumulative disadvantage, and long-term health outcomes. Participants will engage in reflective dialogue on pertinent questions, such as how cumulative disadvantage informs interventions for children with CSC backgrounds, the potential mechanisms underlying the contribution of early-life adversities to long-term health disparities, and the ways intergenerational studies can inform strategies for breaking the cycle of disadvantage.
Empowerment and interprofessional collaboration in health promotion centre Murska Sobota
Authors: Atalaia A , Fischill-Neudeck V , Betznec P , Gorjan R , Peinhaupt C , Wiesinger H-P , Habacher W
Published: October 2024

Background

Health promotion centres (HPCs) were introduced in Slovenian primary health care centres to provide interventions against risk factors for noncommunicable diseases (NCDs). HPCs integrate a multidisciplinary and community-based primary care approach to the prevention of NCDs and provide free lifestyle intervention programmes. This study aims to explore the perspectives of health care professionals on promoting health of local community members, as well as their perceptions of interprofessional collaboration in HPCs.

Methods

Two group discussions were conducted with a total of 11 health care professionals at the HPC Murska Sobota. Data collection was accompanied by a dual role interpreter in accordance with the principles of cross-language qualitative research. The data was transcribed, semantically translated and thematically analysed.

Results

Health care professionals emphasize the importance of health-related empowerment of individuals for the success of health promotion activities and therefore for the improvement of individuals’ quality of life. This is based on shared decision-making, self-management and educational measures in a combination of population- and individual-based approaches. The need for efficient interprofessional communication, characterized by a flat hierarchy, is stressed. Structured cooperation with other health care facilities, as well as close collaboration with communities and local media, are described as crucial for reaching all individuals and promoting health equity.

Conclusions

Interprofessional collaboration, health-related empowerment of individuals and collaboration with local communities are fundamental for the success of health promotion activities, achieving health equity and preventing NCDs. Understanding how these activities are implemented from the health care professionals’ perspective can help other health facilities developing and improving local health promotion strategies.

Key messages

• Slovenian health care professionals see interprofessional collaboration as fundamental for the implementation of health-promotion strategies.

• Health-related empowerment of individuals and collaboration with local communities play an important role in achieving health equity in health promotion activities.
Enhancing stroke awareness in schools: efficacy of the HOBIT program in Czechia’s disadvantaged areas
Authors: Volevach E , Maršálková H , Mikulik R
Published: October 2024

Background

For stroke treatment to be effective, it must be given as soon as possible. Delays are often caused by stroke bystanders failing to recognize symptoms and activate emergency medical services (EMS). This is especially a problem in socially excluded localities. This study evaluated the efficacy of a school-based intervention (HOBIT) in improving determinants and behavior intentions of EMS activation for suspected stroke in Czech socially excluded localities.

Methods

The quasi-experiment was conducted from May to June 2023 in the Moravian-Silesian region, Czechia. Schools were allocated to the intervention or control group (1:1). The HOBIT is a school-based intervention used to change health-seeking behavior when stroke is suspected. The primary outcome was the percentage change from the pretest to the follow-up test in the intervention group compared to the control group. The primary outcome was assessed in 4 domains: 1) knowledge, 2) behavioral intentions, 3) self-efficacy, and 4) outcome expectations. The intervention and control groups were compared using an unpaired t-test.

Results

We recruited 138 students aged 10-16 from 4 schools. The absolute differences in improvement between the control and intervention groups were 18% (95% CI 9-26, P < 0.001) for knowledge, 15% (95% CI 2-26, P = 0.01) for behavioral intentions, 6% (95% CI -4-15, P = 0.24) for self-efficacy, and 13% (95% CI 5-21, P < 0.001) for outcome expectations. The subgroup analysis showed that the intervention effect on self-efficacy, outcome expectations, and stroke behavior intentions was significant only in females.

Conclusions

The HOBIT improved stroke determinants and behavior intentions of EMS activation at schools in socially excluded areas. This study presents a health promotion practice that has the potential to improve stroke outcomes on a community level. It underscores the potential of school settings as an appropriate way to reduce health inequalities in socially excluded communities.

Key messages

• The HOBIT intervention improved determinants and behavior intentions of EMS activation for suspected stroke among students in socially excluded localities.

• The study underscores the potential of school settings in reducing health inequalities and improving stroke-related outcomes in socially excluded localities.
Facilitators and barriers to improving beverage consumption among primary school children in Belgium
Authors: Desbouys L , Assakali W , Thiébaut I , Castetbon K
Published: October 2024

Background

School is seen as a relevant setting to intervene in children’s health behaviour, including their beverage consumption. A randomized controlled trial (DRINK) has been implemented to compare nutrition and sustainability-based interventions to reduce sugary beverages and to increase tap water consumptions among primary school children in French-speaking Belgium. The aim of this qualitative study was to describe the context before the intervention implementation and to identify the facilitators and barriers to implementing the project.

Methods

In 2021, the 48 schools included in the trial responded to a semi-structured interview prior to the intervention, and 30 were interviewed one year later. School characteristics (including socioeconomic index, SEI) and contextual components were summarised. The qualitative corpus was analysed using thematic content methods to identify emerging themes, then classified into obstacles and facilitators.

Results

Of the 48 schools, 70.8% were Walloon, 76.6% had a medium or high SEI, and 41.7% included less than 90 pupils. The majority had already implemented nutrition and sustainable development initiatives before the trial. While taps were available in classrooms and reusable bottles were used, the initiatives could be extended, e.g. to increasing the number of water points. The main facilitators were the interest to receive additional support by the schools already involved in other projects, and the flexibility of the intervention. The main barriers were related to lack of access to tap water; insufficient support for the implementation of the intervention; and poor availability of school staff to get involved in such a project.

Conclusions

Alongside the main trial findings, understanding the facilitators and barriers will enable the intervention to be further adapted and extended. Considering the school context and perceptions is essential to ensure effective and durable school health initiatives.

Key messages

• Largely involved in promoting nutrition and sustainability, the schools were keen to receive support to continue.

• Strengthening access to water, communication and support for schools are essential.
Unlocking Health Literacy: investigating Parental Health Literacy and Child Weight Outcomes
Authors: Rosário R , Silva M J , Duarte A , Martins J , Martins S , Augusto C
Published: October 2024

Background

While parental health literacy (HL) is widely recognized as crucial for child health, research on its impact on children’s weight-related outcomes remains limited. This study aims to fill this gap by investigating the associations between parental HL and children’s anthropometric measurements, with a focus on child BMI Z-score and waist-to-height ratio (WHtR).

Methods

As part of a cluster randomized trial in primary schools serving vulnerable populations, 735 children (51.7% boys, mean age 7.7 years) participated. Parental HL was assessed using the HLS-Q12 questionnaire, comprising 12 items. Health literacy levels, standardized from 0 to 100, were categorized into ‘inadequate,’ ‘problematic,’ ‘sufficient,’ and ‘excellent’ HL. General HL and three specific domains-health promotion, disease prevention, and healthcare-were computed. Children’s weight, height, and BMI were measured following standardized procedures. Regression analyses examined HL’s impact on BMI Z-scores and WHtR.

Results

Parents with higher HL in disease prevention and health promotion had children with significantly lower BMI Z-scores, even after adjusting for parental education and children’s sex sex [-0.010 (-0.18; -0.0001) and -0.10 (-0.019; 0.01). Similar associations were found for WHtR [-0.0004 (-0.001; -0.0001)]. Parents with excellent HL in general and health promotion had significantly lower WHtR [-0.027 (-0.046; -0.008)] and BMI Z-score [-0.74 (-1.2; -0.28)].

Conclusions

This study highlights the significant role of parental health literacy in shaping children’s weight-related outcomes. Higher levels of parental HL in disease prevention and health promotion were linked to lower BMI Z-scores and WHtR in children, independent of parental education and children’s sex. Enhancing parental HL, alongside promoting healthy behaviors and environments for children, could lead to more effective approaches for addressing this public health issue.

Key messages

• Parental health literacy is associated with children’s weight outcomes, emphasizing the need for HL-focused interventions.

• Higher parental HL is associated with lower child BMI Z-scores and waist-to-height ratios, highlighting potential HL’s role in combating childhood obesity.
Needs and opportunities for developing health and well-being profiles in Estonian local governments
Authors: Riisenberg L
Published: October 2024

The creation and implementation of health and wellbeing profile, an evidence-based framework for planning health promotion as holistic process, is the responsibility of public health practitioners, who tend work part-time and sometimes lack professional competences. The current study maps the level of awareness, attitudes, needs and possibilities of local government leaders and public health practitioners to develop and implement profiles effectively in Estonian local governments. Semi-structured interviews with leaders in local governments (10) and practitioners (9) were conducted in 2022-2023. Data was analysed using qualitative content analysis. Sample included representatives from all Estonian local governments (79 in total) and were categorized into subgroups based on local governments size, status of the profile, public health specialist employment, and educational background. Preliminary results indicate that leaders find as a supportive factors for enabling and encouraging profile compilation process for example: mandatory requirement; motivated implementors; well organized and effective workplan. Specialists find supportive factors to be cooperation on the national level, good communication practices and joint responsibility. Barriers for health promoters are the lack of time, motivation, financial resources, stakeholders understanding and meaningful action. The first qualitative study on these topics in Estonia highlight that creating a profile is supported by previous positive experience and have per contra an opposite negative effect to start the process. In general, the profile was considered necessary for helping identify problems and support decision-making processes for managing resources, however, assessment whether the profile should be obligatory is needed. In addition, there is a need for further support for the evidence-based decision-making process on the local level in health promotion by offering education and guidance from the national level.

Key messages

• Knowledge about the importance of public health, barriers and decision-making principles of local government leaders and specialists helps to develop interventions based on actual needs.

• Continuously updated health and well-being profile ensures sustainability of health promotion action and is useful knowledge to policymakers, local government leaders and public health practitioners.
Exploring factors of HPV self-sampling acceptance:a qualitative study with hard-to-reach women
Authors: Kinaan W , Gama A , Heleno B , Marques P , Vega Crespo B , Ortiz J , Verberckmoes B , Vermandere H , Degomme O , Dias S
Published: October 2024

Background

Cervical cancer disproportionately affects socially disadvantaged women, who tend to be underscreened and are generally called “hard-to-reach”. HPV DNA testing based on self-sampling test is an alternative strategy to address women’s low screening uptake and reduce inequalities. Psychosocial factors like self-efficacy, ethicality, and testing conditions should be considered when assessing the acceptability of HPV self-sampling. However, research on the acceptability of HPV self-sampling is scarce among hard-to-reach women. Our study aims to explore self-efficacy beliefs, perceptions of how well HPV self-sampling fits participants’ values and their preferred testing conditions and understand how these factors influence the acceptability of HPV self-sampling test among hard-to-reach women.

Methods

This qualitative study used a semi-structured guide based on three constructs of the Theoretical Framework of Acceptability. Focus group discussions (FGD) were conducted with n = 63 hard-to-reach women in Portugal (2 FGD), Ecuador (4 FGD), and Belgium (3 FGD). Data were analysed using deductive content analysis.

Results

While some women viewed HPV self-sampling as acceptable, others questioned its compatibility with their ethical views and moral principles, stressing that the test cannot replace the clinical examination. Participants held conflicting views, with some expressing confidence in their sampling abilities while others feared making errors when taking the sample. Cultural disparities in preferred testing conditions emerged: Ecuadorian women preferred solo testing, while those in Europe preferred assistance.

Conclusions

This study indicated ambivalent attitudes towards self-sampling. Further research on HPV self-sampling acceptability is needed to explore socio-cultural nuances. Our study emphasises the importance of culturally attuned interventions to address these populations’ needs and reduce inequalities.

Key messages

• Hard-to-reach women harbour conflicting views about self-sampling.

• Screening policies may include opportunities for self- and clinician sampling.
Evidence-Based Programs in France: Insights and Strategies for Implementation Support
Authors: Delescluse T , Berdougo F , Van Hoye A , Krache A , Villeval M
Published: October 2024

Issue

In France, both regional and national health institutions increasingly support and fund the implementation of evidence-based programs (EBP), promoted at the national level by the French Public Health agency.

Description of the problem

practitioners who implement EBP face several operational questions: scaling issues, implementation in specific and varying contexts, integration and adjustment to daily regional practices.

Results/effects

In 2023, the French Society for Public Health initiated a collaborative effort to create a platform for discussion among practitioners, researchers, and decision-makers involved in EBP implementation. The first step was to assess EPB implementation experiences, using 3 types of data: an analysis of 6 documented EBP (capitalization works), an online questionnaire answered by 29 stakeholders, and four focus groups with funders, researchers, practitioners, and institutions. Data analysis was based on thematic content analysis and structural data analysis.

Lessons

Different ways to implement EBP were identified through a typology. The results highlight favorable conditions and levers for EPB implementation in France: • Facilitate access and adoption of EBP by concerned stakeholders, including through clear communication and knowledge sharing; • Strengthen and value support for implementation support (i.e., providing necessary resources and continuous monitoring); • A ‘favorable environment’ is also required (i.e. regional context acceptability and information on program themes or topics); • Breadthen perspectives and promote mutual learning through sharing and comparing implementation experiences across regions; • Value transferability and adaptation studies, which are key to enable EBP adaptations to account for context specificities while maintaining effectiveness. The platform’s next steps are to develop deployment tools and structure an advocacy strategy to mobilize stakeholders around the issue.

Key messages

• Achieving wide-scale implementation of EBP requires to tackle key implementation issues such as scaling, context adaptation, etc. and to give support to implementing stakeholders.

• A collaborative assessment helped identify levers and barriers to EBP implementation in France. Involvement in EBP fosters an evidence-based mindset among practitioners.
Understanding influences of cervical screening attendance among women of low socio-economic position
Authors: Mulcahy Symmons S , Drury A , De Brun A
Published: October 2024

Women of lower socio-economic position (SEP) have a higher incidence of cervical cancer and lower uptake of cervical screening. The Integrated Screening Action Model (I-SAM) is a behaviour model aimed to guide intervention development that considers how individuals engage with screening through their environment, capability, opportunity, and motivation. The I-SAM can be used to understand behaviour of cervical screening. We aimed to understand perceptions and awareness of HPV screening among women aged 25-65 of low SEP living in an urban area in Ireland. Semi-structured interviews were conducted with women who self-reported regular or irregular screening attendance, no university-level education, low-income employment or not working, aged 25-65 and living in Dublin. Participants were recruited via community organisations. Data were analysed using I-SAM in a framework analysis to map barriers and enablers of attendance of regular and irregular attenders. Of the seventeen women interviewed, seven attended screening irregularly. Participants thought they had opportunity to attend when they were reminded and supported to attend by peers and healthcare professionals. Participants wanted to promote screening in the community and to normalise conversations on sexual health. Participants felt fear of cancer was a driver and deterrent to attend screening due to cancer running in the family, past health issues and abnormal cell treatments, and wanting to be there for their family. Few were aware of HPV or the switch to HPV screening. Irregular attenders were unsure how to book or find information on screening. Campaigns should involve communities that are less likely to attend to improve visibility of screening. Healthcare professionals could opportunistically promote HPV screening in primary care and community settings. Campaigns should be aimed at improving literacy of HPV screening, address concerns of cancer risk and support navigation through screening.

Key messages

• Understanding of HPV cervical screening is limited and campaigns are needed to improve awareness and literacy.

• Public health campaigns should engage with communities to promote screening via community groups and healthcare professionals.
Quality of life and adherence to healthy lifestyle factors among breast cancer survivors in Cyprus
Authors: Koshiaris C , Cannas A , Demetriou C , Quattrocchi A , Philippou E , Mosquera M C , Papageorgiou E , Kolokotroni O , Marcou Y , Constantinou C
Published: October 2024

Breast cancer is a prevalent disease for women globally, with rising survival rates highlighting the need to address the breast cancer survivors’ (BCS) quality of Life (QoL). Furthermore, adherence to a healthy lifestyle is associated with decreased mortality in BCS. Mapping the Lifestyle Medicine pillars and the World Cancer Research Fund/American Institute for Cancer Research recommendations identifies 7 healthy lifestyle components: weight management, physical activity, healthy eating, restorative sleep, avoidance of risky substances, positive social connections and stress management. This study examines adherence to these healthy lifestyle components and QoL among BCS. A cross-sectional study conducted in 2022-23 recruited primary adult BCS from the Bank of Cyprus Oncology Centre. Participants completed a survey assessing self-reported QoL and adherence to the aforementioned 7 healthy lifestyle components, through validated questionnaires. Out of 349 BCS approached, 272 were included in the final analysis. Mean age and time since main treatment completion were 51 (SD: 7.4) and 3.6 (SD: 2.5) years respectively. Amongst study participants 58% were classified as bad sleepers, 53.3% were overweight or obese, 23% were stressed, 78% reported to have moderate/high physical activity, and 60% adhered to the Mediterranean diet. Regarding substance use, 16% were current smokers, and 18% were hazardous drinkers. Median score for social support was 75 (IQR: 53-97; max score=100) and for QoL was 67 (IQR: 50-97; max score:100). BCS in Cyprus generally exhibit moderate adherence to the Mediterranean diet, engage in fairly active lifestyles and enjoy high levels of social support and QoL. On the other hand, a substantial proportion smoke or drink, are overweight or obese, are stressed and have poor sleep quality. Targeted interventions to increase the adherence of breast cancer survivors to the 7 healthy lifestyle components are required.

Key messages

• Overall variability exists in the adherence to healthy lifestyle components among BCS in Cyprus.

• This population can benefit from intervention targeting sleep, stress and weight management.
Development and validation of the Behavioral Determinants of Deprescribing Questionnaire (BDDQ)
Authors: Alves Jorge S , Van den Broucke S
Published: October 2024

Background

Deprescribing is a strategy to optimize medication use. While health behaviour can successfully be predicted by health behavior theories, the literature on deprescribing relies almost exclusively on questionnaires that measure attitudes only, such as the Beliefs about Medicines Questionnaire and the Patients Attitudes Towards Deprescribing, resulting in poor predictive validity. The aim of this study was to develop a new tool to measure the psychological determinants of deprescribing among people aged over 60, based on concepts derived from health behaviour theories.

Methods

A draft self-report questionnaire was developed consisting of 64 questions measuring 11 dimensions representing determinants of deprescribing. As well as previous deprescribing experience, current deprescribing behaviour and willingness to deprescribe. Face validity was assessed by asking 10 health professionals and 13 of older people to complete the questionnaire and comment in a small group discussion, resulting in the removal of 18 items. Construct validity was assessed on a sample of 103 participants aged over 60, using exploratory factor analysis (EFA). Internal consistency was assessed via Cronbach’s alpha.

Results

The EFA could confirm 11 dimensions explaining 70,5% of the total variance, but revealed poor loadings for several items and inadequate alphas (<.50) for two factors. Removal of items and these two dimensions resulted in 26 items measuring 9 dimensions, all showing acceptable internal consistencies (between .52 and .77): perceived risk; relatives’ involvement; deprescribing concerns; attitudes; medication beliefs; healthcare support; perceived difficulties; motivation to comply; communication accessibility.

Conclusions

This study produced a conceptually based and psychometrically validated questionnaire to assess behavioural determinants of deprescribing. It provides for a more comprehensive investigation of deprescribing intentions and behaviour of older adults.

Key messages

• A conceptually sound, psychometrically validated questionnaire (BDDQ) was developed.

• BDDQ can be used for a more comprehensive study of de-prescribing in older people.
Is harmonizing to social drinking norms associated with alcohol use in Danish high school students?
Authors: Vallentin-Holbech L , Feldstein Ewing S , Rømer Thomsen K
Published: October 2024

Background

Alcohol use is positively linked with perceived drinking norms within the peer group and the social plasticity hypothesis proposes that youth are very good at harmonizing to social norms (social attunement). Youth with high social attunement may adjust their drinking habits to the perceived drinking norms of the peer group to a higher extent potentially leading to a larger impact on personal alcohol use. This study examined if frequency of personal alcohol use was associated with perceived peer approval of drinking and the role of social attunement in Danish high school students aged 15-19 years.

Methods

An online survey was administered to 2977 first-year students from 16 public high schools in Denmark. Students reported past month alcohol use (drinking days, using TLFB) and perceived approval of alcohol use among peers of their grade. Social attunement was calculated as a sum score of the 11-item Dutch Social Attunement Questionnaire (SAQ) (range: 11-77; α = 0.81). Number of drinking days was analysed as dependent variable, with age, gender, perceived peer approval and SAQ-score as independent variables.

Results

Older students were more likely to perceive peers to approve drinking (β = 0.25; p = 0.004) and getting drunk (β = 0.22; p = 0.003). More females (83.2%) than males (81.8%; p = 0.003) perceived peers to approve youth getting drunk. Multilevel regressions showed increased drinking days for students perceiving peers to approve of drinking (β = 1.68; p < 0.001) and getting drunk (β = 1.80; p < 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p < 0.001) indicating that perceived peer approval had less effect on drinking days for students with high SAQ-score.

Conclusions

Social attunement explained additional variance in the association between personal alcohol use and perceived drinking norms. Our findings stress the importance of addressing the influence of behavioural adaptation in e.g. school-based health promotion programs.

Key messages

• Students perceiving peers to approve of youth alcohol use drink more frequent, but the link is weakened when the need to harmonize to perceived drinking norms are high.

• Social attunement needs to be considered when examining the link between individual alcohol consumption and perceived drinking norms and should be addressed in e.g. school health programs.
Culturally-relevant physical activity for public health promotion: global evidence synthesis
Authors: Sentell T , Look M , Pirkle C , Ylli A , Heil D , Schmid S , Câmara S
Published: October 2024

Background

The WHO has noted the importance of cultural insights for health. Culturally-relevant physical activity has a growing evidence base in many regions and specific populations, but the scope and scale for global health promotion is underexplored.

Methods

A multinational expert team used a critical literature review method to: (1) define culturally-relevant physical activity; (2) delineate relevant characteristics supporting inclusion in population-level health promotion and surveillance; and (3) provide agenda setting in research, policy, and practice from a global public health promotion perspective. The critical review method, which evaluates rather than summarizes literature, was chosen as the research evidence is complex, broad, and has not been synthesized previously from this perspective.

Results

Culturally-relevant physical activity was defined as practices that include physical activity based on a population’s cultural customs. These can be Indigenous (e.g., hula, an Indigenous dance of Native Hawaiians) or regional (e.g., Shota (Shotë), an Albanian folk dance). Practices have shared characteristics that support multi-dimensional value for health, engagement, and healing. These include a collectivist, intergenerational component, passed from elders and shared forward with children as part of a community. Many have foundations in nature, a strength for health and wellbeing in green and blue spaces. Many include traditional art, clothing, accessories, and music with deep significance, including care for the tools and location of practice (e.g, drums, boats, land). Many practices would not be captured in harmonized public health surveillance systems despite their value. From this synthesis, research hypotheses were created and next steps proposed.

Conclusions

This evidence synthesis supports engagement, planning, uptake, policy, surveillance, and study of culturally-relevant physical activity for public health promotion locally and globally.

Key messages

• An important strength of culturally-relevant physical activity is that it is context and population specific. However, this may hide the scope and scale of the existing evidence supporting this work.

• This evidence synthesis confirms how culturally-relevant physical activity is valuable globally across shared assets in research and practice, supporting next steps for public health promotion.
A global research agenda for understanding the role of alcohol consumption in older women’s lives
Authors: McCarthy S , Pittt H , Benjamin K , Stafford J , Keric D , Arnot G , Thomas S
Published: October 2024

Background

The alcohol industry has targeted women for profit and resisted global efforts to address the impact of alcohol on women’s health. Scholars have called for research that moves beyond individual determinants of alcohol consumption in women, to investigate the range of social, environmental, and commercial factors that may contribute to women’s alcohol attitudes, risk/benefit perceptions, and consumption behaviours. While qualitative research has explored younger and midlife women’s perspectives on alcohol consumption, there is a notable lack of research focusing on older women.

Methods

This study investigated the factors that influence how older Australian women drinkers conceptualised the role of alcohol in their lives, using data collected from an online qualitative survey with n = 144 women aged 60-88 years. Qualitative responses were analysed using a ‘Big Q’ reflexive approach to thematic analysis.

Results

Participants perceived alcohol consumption as a socially accepted and normalised activity within Australian culture. For some women, alcohol served as a coping mechanism for life changes, such as retirement, and for managing stressful situations. Alcohol also formed part of daily routines and rituals, such as having wine with dinner. Participants had personal expectancies regarding ‘responsible drinking’, often aligning with alcohol industry messaging and resulting in a reduced perception of alcohol-related risks.

Conclusions

This research provides global lessons for future public health research examining the factors that may shape older women’s alcohol consumption beliefs and behaviours. The authors consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry. Further public health research and policy attention should focus on the impact of alcohol industry messaging on older women’s knowledge, attitudes, and behaviours about alcohol risks and harms.

Key messages

• This research highlights the role of alcohol in older women’s lives, urging further public health research and policy attention to prevent alcohol-related harms in older women.

• Older women’s perceptions of responsible alcohol consumption mirror the ambiguous messaging employed by the alcohol industry, highlighting the necessity for targeted interventions.
The Workplace Health Promotion project in an Italian manufacturing
Authors: Marconi D , Moscatelli C , Centi L , Erba F , Lazzeri G , Nante N
Published: October 2024

Introduction

The Workplace Health Promotion (WHP) program aims to improve employee’s health and well-being in the workplace by intervening in lifestyles. The objective of our study was to assess the impact of the WHP promoted by the Local Health Authority Tuscany South-East at a manufacturing.

Methods

The program was set at the STOSA Company in Radicofani (Siena, Italy) between 31 May 2017 to 31 December 2021, with a one-year interruption due to the COVID-19 pandemic. Based on an assessment of the workers’ health status, we identified nutrition and fighting smoking as areas of intervention. The WHP project was integrated into the company policy and targeted all staff. Evaluation of interventions was conducted using an anonymous paper questionnaire (Regional Decree no. 1565, Annex 3) administered in three moments: at the beginning of the project (T0), one year later (T1), and at the end (T2). We conducted a descriptive and inferential analysis (chi-square test) with R.

Results

We collected 131 (T0), 136 (T1), and 123 (T2) responses. The cohort is composed entirely of males (T0 M:F 122:8, T1 130:6, T2 109:14). The median age is 40 years (SD 8.24 (T2)). There is a statistically significant difference in the perception of health status by education (p<.001), type of work (p<.001), smoking habit (p<.001), and the change in smoking habit (p<.001). The whole sample positively evaluated the interventions on nutrition and fighting to smoke. Moreover, the entire sample reported improvements in their diet since the beginning of the project.

Conclusions

The COVID-19 pandemic caused difficulties in carrying out the project and possible changes in workers’ lifestyles. However, positive outcomes were observed in the targeted areas. The company has evaluated positively the WHP’s project and decided to maintain the good practices acquired.

Key messages

• The workplace represents a privileged setting to promote healthy lifestyles and prevent non-communicable diseases.

• Collaborations between health authorities and other sectors are strategic to reach the general population.
Vaccines are coming closer to you: the experience of the Corporate Healthcare Company (ASL) Rome 4
Authors: Sinopoli M T , Fusillo C , Scognamiglio D , Belfiori G , Marini M , Razzetti L , Ursino S , Matranga C
Published: October 2024

Issue

The post-Covid period is characterised by vaccine fatigue and declining coverage, especially among children. Access to vaccination for adults and the elderly, outside of the influenza vaccination campaign, has historically been very low due to limited awareness of opportunities and difficulties in accessing vaccination centres.

Description of the problem

ASL Roma 4 is characterised by a dispersed population across a large territory of 28 municipalities, many of which are small and predominantly populated by elderly people. In order to reach this population, ‘proximity clinics’ were opened in 6 small municipalities in 2023, where the vaccination service offers a wide range of vaccines every 1-2 months. Since June 2023, two mobile vaccination units have also been used to extend the reach of vaccination activities.

Results

In 2023, vaccination activities at nearby clinics reached 343 people (166 males and 177 females), with a total of 473 vaccines administered. More than 70% of those vaccinated were over 65 years of age, including 47% over 80 years of age. Between September and December 2023, vaccination vans were deployed in high-traffic areas such as markets, supermarkets, squares, or in locations with hard-to-reach populations such as migrant reception centres, volunteer centres, and senior centres. As a result, 1183 people (585 men and 557 women) with an average age of 49 years were reached and 1699 vaccines were administered. 62% were over 65, 37% over 80, 41 were homeless and 87 were migrants. 56% of the vaccines administered were influenza and covid, but all types were provided.

Lessons

Although this method of vaccine delivery is still being implemented, its value lies mainly in vaccinating people who would not have voluntarily sought vaccination services, demonstrating the need to bring prevention as close to the user as possible.

Key messages

• The post-Covid period is characterised by vaccine fatigue and declining coverage.

• It is necessary to bring vaccination prevention as close to the user as possible.
How can we measure labour exploitation and develop interventions to protect migrant workers’ health? Insights from intervention-focused research on cattle ranching in Brazil and child domestic work in Liberia and Nigeria
Authors: Zimmerman C , Keaveny E
Published: October 2024

Much of our food and services rely on the work of migrants, which is often carried out under exploitative terms. Exploitative work results in work-related injuries and illnesses and mental ill-health. Yet, the global health community has been negligent in detecting migrant workers in the general population, and in measuring the effects of their work terms on their health. For instance, the International Labour Organization’s global labour force and forced labour surveys capture few health data. Conversely, health surveys, such as the Demographics and Health Survey (DHS), include few questions on exploitative and hazardous work conditions or aspects of migration status. Studies are even more remiss when it comes to developing evidence for work-related health interventions. This presentation will draw on two recent mixed-methods studies - on cattle ranching in the Amazon region of Brazil (Pará State) (n = 1,241), and on child domestic work in Liberia (n = 1,088) and Nigeria (n = 1,088). Findings suggest some necessary improvements to the measurement of migrant labour exploitation and its health effects, and approaches to gathering intervention-focused evidence. Each study highlights the value of re-thinking data collection beyond disciplinary silos and narrow dichotomous measures (e.g., forced/unforced labour), towards generating a more specific understanding of the different dimensions of labour exploitation (e.g., pay conditions, hours, occupational health and safety training and PPE), various types of associated harm, and how they compare across sectors and contexts. Further, each study demonstrates the benefits of intervention-focused research methods that are designed to feed directly into participatory intervention development processes. On this basis, we will suggest shifts in measurement and research designs to foster operationalizable evidence on migrant workers’ working conditions, health, and worker-informed interventions.
Key Factors Influencing Quality of Life in the Disabled Based on Multifaceted Life Satisfaction
Authors: Choi E H , Cho J H , Yeob K E , Kim S Y , Lee Y S , Park J H
Published: October 2024

Background

Healthy life of the disabled is considered a global social issue, and enhancing the quality of life (QoL) of the disabled is an important task. The disabled have lower multifaceted life satisfaction due to various daily restrictions, which negatively affects their QoL. Research on the QoL of the disabled is ongoing, but there are few comprehensive studies addressing multifaceted life satisfaction. To enhance the QoL of the disabled, it is essential to understand their multifaceted life satisfaction and investigate key factors influencing their QoL.

Methods

We used data from the 2021 Disability and Life Dynamics Panel (nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of multifaceted life satisfaction of the disabled on their QoL by using multiple regression analysis adjusted for gender, age, education level, daily living activities, type and severity of disability, and presence of multiple disabilities.

Results

The satisfaction with social relationships(β=.535, p<.0001), income(β=.146, p<.0001), housing environment(β=.132, p<.0001), occupation(β=.130, p<.0001), and health(β=.111, p<.0001) was found to have a significant positive impact on the QoL of the disabled. Particularly, satisfaction with social relationships exerted the greatest impact on their QoL.

Conclusions

Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. These findings can support the government in prioritizing health policy development for the disabled and contribute to improving the QoL for the disabled through a comprehensive and integrated approach. The government should develop health policies to enhance social connections and support networks for the disabled, while also considering aspects for improving income, housing environment, occupation, and health.

Key messages

• Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled.

• The government should prioritize developing health policies aimed at enhancing social relations for the disabled, while also considering income, housing environment, occupation, and health.