bluuebunny/crossref_metadata_2025 huggingface dataset:
Food insecurity among food banks users during the COVID-19 pandemic in Germany – what have we learnt and what should we do?
Authors: Simmet A , Stroebele-Benschop N
Published: October 2024

Background

Before the start of the COVID-19 pandemic in 2019, up to 1.65 million people visited a total of 956 food banks called “Tafel” in Germany. The start of the pandemic and the associated first lockdown led to shortages in commercial food outlets and to considerable restrictions on the range of food banks. The aim of the study “Food INsecurity Among TAfel users” (FINATA) was to investigate the prevalence of food insecurity (FI) and its association with social support and food shopping behaviours among Tafel users during the pandemic.

Methods

A written and/or oral survey was conducted in 2020 and 2021 among a total of 985 Tafel users. In addition to descriptive analyses, regression analyses, stratified for 2020 and 2021, were conducted to investigate associations between FI and the other variables.

Results

Participants of 2020 (n = 565) and 2021 (n = 420) differed in several socio-demographic characteristics. Whereas the prevalence of moderate FI over the 30 days prior to the survey differed between participants of 2020 (21,6 %) and 2021 (6,6 %), the prevalence of severe FI was almost identical (3,9 % vs. 4,0 %). Variables being significantly (p < 0,05) associated with moderate/severe FI included being single vs. being married (2020: OR 4,89, 2021: OR 2,69), receiving at least half of food in the household from the Tafel (2020: OR 0,34), low vs. moderate/high social support (2020: OR 2,93), buying food in commercial food outlets at least once/week vs. less often (2021: OR 0,38) and time of travel to the most used commercial food outlet (2021: OR 1,04).

Conclusions

The social safety net during the pandemic failed to enable “all people to have (...) economic access to sufficient (...) food” in Germany. Future studies should investigate the relationship between social support, shopping behaviours and FI at the long-term. Food banks are recommended to introduce measures to improve the social situation of their clients such as cooperating with social cafés and restaurants.
Addressing Regional Health Disparities: Estonia’s Approach to Burden of Disease Studies
Authors: Lepnurm M , Idavain J
Published: October 2024

Background

Estonia, a small country defined by NUTS2 regions, faces challenges in assessing health disparities across its different counties when using global health data such as the Global Burden of Disease (GBD). Recognizing this limitation, Estonia initiated independent burden of disease studies in Estonia since 2013, with the findings being biennially published through the health statistics database of the National Institute for Health Development. The objective of this research is to assess the strengths and limitations inherent in various methods when calculating the years of life lost due to premature mortality (YLLs).

Methods

The approach to assess the burden of disease in Estonia differs somewhat from the Global Burden of Disease (GBD) methodology. One key distinction lies in our utilization of a national life expectancy table and our presentation of results at the LAU1 regional level. These burden of disease studies utilize region-specific life tables supplied by Statistics Estonia, categorized by county and gender, to compute Years of Life Lost (YLLs), offering an opportunity to pinpoint and tackle regional health issues.

Results

Since the calculation of YLL (Years of Life Lost) in these past studies has relied upon Estonia’s regionalized life tables, categorized by county and gender, the results exhibit substantial disparities when juxtaposed with the Global Burden of Disease study conducted by the Institute for Health Metrics and Evaluation (IHME).

Conclusions

This research aims to delve deeper into these variations, examining the challenges related to methodology, the availability, and the quality of data, and most importantly, knowledge translation. Our own burden of disease studies empowers us to formulate informed policy recommendations precisely tailored to the distinctive needs of each county, thereby facilitating targeted interventions, and driving improvements in overall public health outcomes.
All-cause Years of life lost due to death at municipality level in Norway. Association to educational attainment and median income
Authors: Baravelli C , Breivik H , Forthun I , Skrindo Knudsen A K , Nguyen T T
Published: October 2024

Background

Norway, with 5.5 million people spread across 356 municipalities, has pursued an active policy to reduce social and geographical health inequalities. Despite, studies find significant health disparities linked to socioeconomic factors at the individual-level, although evidence at larger geographical-levels has been mixed. We used a key burden of disease (BoD) metric, Years of Life Lost (YLL), to examine spatial health inequities among Norwegian municipalities and their association with socioeconomic factors.

Methods

We analysed data from all residents in Norwegian municipalities with over 1000 inhabitants as of January 1, 2019. Data was sourced from the National Population Register and Statistics Norway. All-cause YLL were calculated based on age-specific aspirational life expectancy obtained from GBD 2019. Deprivation was measured using educational attainment and median income, categorized into quartiles. Geographical maps illustrating municipality-level all-cause age-standardised YLL rates for males and females were generated. Negative binomial regression models assessed associations between socioeconomic factors and YLL rates, adjusting for age, sex, and an index of centralisation.

Results

High-deprivation municipalities exhibited a 9% higher YLL rate in terms of education (Incidence Rate Ratio [IRR] = 1.09, 95% Confidence Interval [CI] = 1.01-1.17) and a 10% higher YLL rate in terms of income (IRR = 1.10, 95% CI = 1.02-1.08) compared to the least deprived, translating to absolute differences of 1391 and 1466 YLL per 100,000 population, respectively. Additionally, we discuss the potential expansion of this study to incorporate cause-specific outcomes and other BoD metrics based on previous county-level analyses.

Conclusions

Our study demonstrates the feasibility of using BoD methods to assess geographical deprivation and premature mortality at the municipality level, providing valuable insights for public health policy targeted at small administrative areas.
Planetary health as a paradigm shift towards health and well-being
Authors: Jevtic M
Published: October 2024

Planetary health is a concept that focuses not only on human health but wider - on the health of our planet. Health is not only a privilege of human beings. Planetary health emphasizes the interconnected nature of human health and environmental health. This also makes a shift in the direction from human anthropocentricity to a more fair approach - health of the whole planet. Human well-being is dependent on the health of the planet, including clean air, water, and food sources. Paradigm shift towards planetary health promotes a holistic view of health that encompasses social, economic, and environmental factors. It considers the complex interactions between humans, animals, plants, and ecosystems. Planetary health insists on a preventative approach by addressing root causes such as pollution, climate change, and biodiversity loss. We should be aware of human responsibility linked to terrible symptoms of our Planet like heat waves, fires, droughts, floods... Planetary health approaches underline the importance of sustainable practices that protect the environment, promoting human health, but also actions to achieve that. By adopting sustainable lifestyles, industries, and policies, we can ensure the well-being of current and future generations. Planetary health calls for global collaboration, interconnecting nature, environment and human health challenges. By prioritizing planetary health, we show that we can be less selfish and that we respect nature and the environment. Planetary health insists on a paradigm shift towards a more integrated and sustainable approach using social and nature sciences in a holistic approach. But, we should also use Planetary health concept as a call for peace, which is a condition for all other achievements.
Community gardening: metaphorical reconstruction of transformative health governance
Authors: Bekker M
Published: October 2024

Transdisciplinary working has been defined by the inclusion of non-academic stakeholders in the process of knowledge production. While theoretical, phenomenological and experimental dimensions have been described in the literature, Rigolot proposes transdisciplinarity as a ‘way of being’ that stretches beyond professional life. The promise of transdisciplinarity however does not always meet the expectations in practice. How to get started, maintain and overcome barriers requires guidance. In an action-oriented evaluation research study we explored this dimension in the Dutch All about Health collaborative platform, which since 2014 facilitates a continuous development of bottom up health initiatives, networks, alliances and other forms of collaboration and learning. From our case studies we developed the Transformative Health Governance model. The model shows the ongoing and reciprocal connections between the actions, the context and intermediate results that were verified in a survey among 103 platform participants. Five types of returns are also building blocks that increase the chance of real (yet hardly measurable) increasing health benefits. They reinforce each other in a continuous process of ideation, integrative approach, innovation, implementation, and impact. The context provides for acceleration or deceleration of that process. With the help of a cartoonist we translated our model into an ongoing cycle of community gardening and maintenance. This metaphor makes the intangible of underlying social processes more tangible, providing a bit more grip on the building blocks, timing and time aspects, as well as deeper understanding the role and necessity of conflict and explicit conflict engagement rather than management. Moreover the cartoon elicits recognition, acknowledgement and spirit to continue their rowing against the systems-invoked tide for better health. It serves as a concrete aid to transdisciplinary working towards planetary health.
Health literacy & somatic education: a salutogenic self-resource critical health intervention
Authors: Bertani J
Published: October 2024

Issue

Non-communicable diseases (NCDs), such as musculoskeletal conditions, cause severe functional limitations. Therapeutic practices in this field have employed a theoretical-practical framework with a pathogenic and mechanistic bias. However, the causes of these NCD’s are also related to biopsychosocial factors. Therefore, a critical theoretical-practical approach, such as Somatic Education, becomes relevant as it introduces a subjective experience to an educational praxis, modifying the meaning processes in human movement experience in a complimentary approach to the pathogenic perspective.

Description of the problem

There is a perceptual poverty in movement experience, which dissociates doing from feeling. Somatic practices aim to foster movement awareness (perception) and autonomy (self-regulation), placing the individual as a valuable resource, strengthening the capacity for understanding, reflection and habitus change. This presentation will focus on the following research questions: Can Somatic Education, as a critical intervention of the body, contribute to increased levels of health literacy? Can somatic practices contribute to sustainable health development? Is it possible to create a new meaningful process in human movement experience through this practice incrementing its salutogenic emphasis?

Results/Effects

Somatic practices foster integrative approaches of health, promoting subjective bodily experience (interface between doing, thinking and feeling). Integrative progress can urge the embodiment of health literacy, encouraging more active and awareness of individuals related to their well-being, contributing to sustainable health development. Moreover, subjective bodily experience transforms the process of meaning in movement experience.

Lessons

Somatic practices enhance NCDs prevention and education, increasing health literacy rates through innovative conceptual foundations.
Where should health system investments be made to protect the mental health of healthcare workers?
Authors: Williams G
Published: October 2024

Background

This study explores trends and work-related determinants of mental health and wellbeing among health and care workers in Europe since the COVID-19 pandemic. The aim is to determine where investments can best be made to protect and support mental health and wellbeing among health and care workers to improve retention and recruitment.

Methods

Data are analysed from the National Health Service staff survey in England and the Health Service Executive ‘Your Opinion Counts’ survey in Ireland to explore trends in mental health and wellbeing and burnout. Evidence is then taken from a series of European Observatory policy briefs, based on expert-led literature reviews, to explore determinants of poor mental health and wellbeing and to identify potential areas for investment.

Results

Rates of burnout and poor mental health and wellbeing have increased in England and Ireland since the start of the pandemic among all professional groups. Workplace-based factors are important determinants of poor mental health and wellbeing, and can be grouped into: macro-level structural factors such as staff shortages, poor working conditions and low pay; meso-level organisational factors including poor leadership, and insufficient education, training and support; micro-level individual factors such as insufficient self-care or not seeking support. However, determinants at the micro-level, especially seeking support from others, are largely shaped by structural or organisational factors.

Conclusions

Increased financing to address structural and organisational determinants of mental health and wellbeing contributes to improved patient care, better staff experience, lower rates of absenteeism, and enhanced recruitment and retention. It is therefore one of the best health system investments that can be made.
9.Y.1. Breaking down silos: Maximizing the impact of different EU funding schemes in health
Authors:   Organised by: EUPHAnxt, EUPHA-PHMR, Sciensano (Belgium),   Chair persons: Nienke Schutte (Belgium)
Published: October 2024

The European Commission (EC) has established various funding schemes to support large health initiatives, such as EU4Health, Horizon Europe, and Digital Europe. These initiatives aim to support research and innovation in order to tackle different health challenges faced by EU member states, improve the health and well-being in European citizens and invest in resilient health systems Funding can come in different forms such as grants, subsidies, loans, prizes, and procurements and is managed by different Directorates General of the European Commission. The EC offers a wealth of financial resources, enabling health scientists to conduct cutting-edge research. However, to make the full potential of the EC funding programmes it is essential to achieve interactions and synergies. Thematic interactions consider the underlying policies of specific actions, striving to connect projects focused on related topics rather than letting them work in isolation, and transferring results from one to another. Implementation interactions involve the sequential or cumulative funding of one or multiple projects. Moreover, the abundance of financial sources poses the possibility for duplication of efforts and redundancy among the various programmes. In addition, complexities in rules and guidelines pose challenges for researchers to fund their long term research projects through cumulative funding. To avoid redundancy and tackle health issues efficiently, it is essential to ensure collaboration and coordination across funding schemes to effectively address both overarching and specific health topics. The aim of this roundtable is to share with the audience the different funding mechanisms provided by the European Commission, explore barriers and challenges to fostering collaborative innovation through the funding programs, and demonstrate best practices for optimizing synergies across different programs. This round table gathers panelists from a variety of backgrounds covering the European Commission, national health institutes, NGOs and SMEs.

Key messages

• The European Commission provides diverse and rich funding schemes supporting health research and innovation to tackle European health challenges.

• Complexities in rules and guidelines pose challenges and combined efforts of both the European Commission and research communities can foster collaborative innovation across the funding schemes.

Speakers/Panelists

Jinane Ghattas

Sciensano, Brussels, Belgium

Agnès Mathieu-Mendes

HaDEA, EC, Brussels, Belgium

Anabela Isidro

Agência de Investigação Clínica e Inovação Biomédica, Lisbon, Portugal
9.Y.2. Leveraging GenAI and Deep Learning for the Analysis of Public Health Data: A Global Perspective
Authors:   Organised by: Conduent,   Chair persons: Dianna Lydiard (USA), Tarun Khatri (Canada)
Published: October 2024

The evolution from Artificial Intelligence (AI) to Generative Artificial Intelligence (Gen AI) represents a significant advancement in technological capabilities and applications. Advancements in computing power, algorithmic complexity, and data availability have enabled Gen AI to exhibit broader cognitive abilities such as reasoning, problem-solving, and learning across diverse domains. Private sector investment and innovation is advancing capability in this space at a rapid pace, trending toward a complete paradigm shift towards machines capable of autonomously adapting and learning in dynamic environments, promising profound impacts across industries from education and finance to healthcare and beyond. Yet harnessing the power of GenAI remains out of reach for most public health entities. Questions like “How to start” and “What to do”, let alone concerns regarding cost, security, and ethics, often thwart an agency from endeavoring to even begin their journey to the program improvement they visualize through the lens and promise of AI. Conduent’s longstanding presence and pioneering work in AI across various sectors, has led to a simple, underlying philosophy: we leverage Gen AI technologies to assist and enable humans to improve business processes. Instead of developing Gen AI technologies ourselves, we focus our efforts on making advanced technologies accessible to our clients and enabling them to achieve their outcomes.

This session focuses on accessibility and enablement for public health agencies looking to jump start their journey to AI and evolve their public health programs with the use of Gen AI, covering topics such as: • The evolution of GenAI in the private sector; • Visualizing objectives in public health outcomes and improved business processes; • What to do about data; • Using human intelligence to drive machine learning; • Managing security, ethics, and equity; • Roadmap your Journey to Gen AI.

For Conduent, Gen AI is not intended to replace humans but to harness its potential to support and empower humans in creating innovative, additive opportunities that enhance business process outcomes. In the public health space, its impact is immense and far reaching. Let’s shift from “How do I start” to tackling the questions that improve programs and their outcomes. So how will you optimize your program with Gen AI? Let’s get started.

Key messages

• Private sector Gen AI capability is expanding at a rapid pace yet many public health agencies are struggling just to start. Conduent offers an informed perspective to jump start your Gen AI journey.

• Accessibility and enablement for public health agencies looking to jump start their journey to AI and evolve their public health programs with the use of GenAI.

Speakers/Panelists

Mark Marostica

Conduent Public Health Solutions, Florham Park, USA

Dianna Lydiard

Conduent, Florham Park, USA

Tarun Khatri

Conduent, Burlington, Canada
Impact of the WELLBASED urban programs on health, well-being, and energy poverty
Authors: van Grieken A , Stevens M , Costa-Ruiz B , Martínez J J , Barbagelata M , Pilotto A , Redon J
Published: October 2024

Background

The WELLBASED project developed and implemented urban programs across six pilot sites to tackle energy poverty. This study aimed to evaluate these programs’ effectiveness on a broad range of health, well-being, and energy poverty indicators.

Methods

a controlled study was performed in six European pilot sites. Participants in the intervention condition receive the 12-month WELLBASED urban program. Participants were recruited via different methods and provided informed consent to participate in the 18-month study. Self-report questionnaires were completed at baseline, 6-, 12 and 18 months in both research conditions. In the intervention group, monthly health monitoring of e.g. heart rate and blood pressure, and continuous monitoring of indoor CO2, temperature and humidity were performed. Descriptive statistics and regression analyses are performed to assess the impact of the urban programs on health, well-being and energy poverty-indicators

Results

In the baseline sample (n = 1350; n = 661 intervention group, n = 689 control group) the mean age was 49 years (SD 16), 15.6% was >65 years, 65% were women, and 42% was married. At baseline people reported not feeling comfortable warm in winter (58%) or cool in summer (70%), 43% reported damp or leak. Preliminary findings at 6-month follow-up indicate changes in HR-QoL, subjective well-being and depression/anxiety differ strongly per pilot site location (p < 0.01). In summer 2024 all data will be available for analysis.

Conclusions

the comprehensive urban programs developed in the WELLBASED project may support public health to tackle energy and improve health and well-being of vulnerable citizens.
10.Y.2. Unlocking innovation: trustworthy co-creation for tackling complex public health challenges
Authors:   Organised by: Health CASCADE,   Chair persons: Vinayak Anand-Kumar (Germany), Sebastien Chastin (UK)
Published: October 2024

Background

Public health interventions often have limited effects, with few achieving large-scale implementation. Moreover, these interventions frequently fail to replicate their effects in real-world settings, possibly due to an overemphasis on generating universal knowledge through theory building and testing in controlled conditions. An alternative approach involves developing interventions within specific contexts, fostering collaborative knowledge generation, and establishing equitable partnerships. Co-creation offers a transformative strategy for addressing complex public health issues by generating real-world solutions. However, utilizing co-creation in public health presents challenges, including a lack of guidance on implementation and evaluation in public health settings. This underscores the need to integrate real-world co-creation with rigorous research to establish a reliable methodology grounded in both scientific evidence and participatory principles.

Workshop

This Pecha Kucha-style workshop will explore the essence of an evidence-based co-creation methodology developed through rigorous research by the European-funded H2020 Marie Sklodowska-Curie Innovative Training Network, Health CASCADE, and its partners. Emphasizing the significance of fostering innovative solutions to public health challenges, the workshop will provide key considerations for designing co-creation projects. It will also examine the role of enabling technologies in optimizing hybrid intelligence for effective co-creation, highlighting their contribution to collaboration enhancement. Perspectives from co-creators will be presented to offer unique insights into their experience of the co-creation process. Additionally, the workshop will elucidate the adaptation of co-creation processes within the Danish context, exploring collaborative efforts across sectors and shedding light on cross-sectoral cooperation intricacies. A moderated panel discussion will conclude the workshop, facilitating deeper engagement with the presented topics. Delegates will gain insight into applying co-creation in health promotion and behaviour change research, navigating prevalent challenges through Health CASCADE’s systematic approach, and discovering strategies for fostering effective and inclusive co-creation. They will also acquire strategies and resources to overcome potential obstacles, fostering more effective and inclusive approaches to complex public health challenges.

Key messages

• Co-creation presents a powerful approach to addressing complex public health challenges by fostering collaboration, creativity, and inclusivity across diverse stakeholders and communities.

• Effective and trustworthy implementation of co-creation requires an understanding of its principles and methods, enabling technologies, and strong partnerships across sectors and institutions.
15 years of the Colorrectal Cancer Screening Programme. Decreasing inequalities
Authors: Idigoras Rubio I , Portillo I , Sainz de Rozas I , Ijalba M , Aguilar D
Published: October 2024

Background

The Colorectal Cancer (CRC) Screening Programme approved in 2008 by the Regional Parliament and carried out in 2009 a pilot study inviting to residents 50-69 years old (586,700), through a biennial Faecal Immunochemical Test (FIT), colonoscopy in FIT positive. The Programme Coordinating Centre sends FIT by post and involves Primary Care and Endoscopy departments in process and results control. In 2013, 100% coverage was reached, and in 2023 more than 80% were invited more than 6 times. However, inequalities in participation were detected: by age, gender, deprivation and vulnerability. Since 2014, different strategies have been carried out in order to decrease with the commitment of authorities, researchers and associations.

Objectives

To describe strategies and results to decrease inequalities in participation

Results

From the pilot participation rate increased (p < 0.001) 58.1% to 72.0% in 2023. Inequalities by gender (69.4 men vs 74.4% women) and deprivation index were detected (55.7/1000 lower vs high 41.0/1000). The non-adherence to colonoscopy was 5% along the period. Training, and communication campaigns developed. 2016-2017 special recruitment for imprisoned and mental health patients increasing participation rate (9.3 to 97.1%). In 2021 and ongoing: thanks to Resilience Funds (European Union), strategies were implemented: SMS specific by sex, research health literacy, studying CRC behavior by sex in FIT sensitivity 85.4% (CI95% 84.2-86.7) in men and 80.9% (CI95% (79. -82.6) in women p < 0.001

Conclusions

The governance and involvement of professionals, researchers and patient associations crucial to decrease inequalities. The Basque Programme achieved one of the highest participation rate. Investment in reducing barriers will probably impact on the reduction of incidence and mortality.

Key messages

• A population based CRC Screening Programme reduces incidence and mortality on participants.

• Intervention to increase participation reduces inequities and is crucial on Public Health policies.
Tobacco Industry CSR activities in Poland between 2020-2023
Authors: Dera P , Banach M , Majchrzak J , Balwicki Ł
Published: October 2024

Background

The tobacco industry has undergone a significant transformation in its approach towards Corporate Social Responsibility (CSR) activities. Once primarily associated with controversy and criticism due to the health risks associated with tobacco consumption, many tobacco companies have begun to embrace CSR initiatives as a means to mitigate these concerns and demonstrate their commitment to broader societal well-being.

Methods

Methods were based on the Global Tobacco Industry Interference Index. Between 1 January 2020 and 31 March 2023 scoping review of legal basis, Polish media websites, Polish government and local government websites, also social media of tobacco industry companies has been done by four reviewers searching separately.

Results

Between 2020 and 2023 several tobacco companies supported public schools (organized workshops, offered internships, and demonstrated the production processes). In 2022, the National Revenue Administration signed an agreement with Philip Morris Polska, among other companies, under the Cooperation Program. The objective of the Program is to initiate collaborative measures that promote compliance with tax regulations. At the end of 2021, the National Revenue Administration took patronage over the Business Center Club social campaign entitled ‘Coming together to fight the illicit trade in tobacco products’. Moreover, in March 2023 the General Police Headquarters started cooperation with BAT and JTI in the field of combating illegal production and trade in tobacco products, as well as disclosing and eliminating tobacco products from illegal sources from economic circulation.

Conclusions

In Poland, which currently has no specific regulation constraining tobacco industry lobbying, implementation of the provisions of WHO FCTC Article 5.3 is needed to limit interactions between the government and the tobacco industry. Government and public schools should not accept any support from the tobacco industry.

Key messages

• The government should have regulatory measures to manage its interactions with the tobacco industry, emphasizing the importance of refraining from accepting industry assistance.

• Implementation of WHO FCTC Article 5.3 of is needed to limit interactions between the government and the tobacco industry.
Scientific policy advice during the SARS-CoV-2 pandemic – a comparison of 25 democratic countries
Authors: Dicks T , Centeno Beltran C , Toffeleit L , Busetto L , Semmler I , Ciesek S , Drosten C , Schäfer M
Published: October 2024

Background

The SARS-CoV-2 pandemic required rapid and effective policy responses from governments worldwide, especially in the realm of public health. Due to the global impact of the pandemic, it is important to compare country-specific approaches. A systematic analysis of the role and institutionalization of different bodies of scientific policy advice during the pandemic was conducted to gain insights into scientific policy advice structures and to inform future solutions.

Methods

We contacted the governments of 35 democratic countries about the role and institutionalization of bodies of scientific advisory advice during the pandemic. Data collection took place between September 2023 and March 2024. We analyzed primary data provided by the governments by qualitative systematic document analysis.

Results

We received feedback from 25 countries within the research period (including 19 European countries). The results were divided into three main categories: (1) temporality, (2) structure, function, & composition, and (3) transparency. Further sub-categories emerged that helped to compare and classify the countries’ approaches, such as initiation, financing, selection, expertise, and diversity of members, systematics of documentation. For example, some used existing structures from ministries, research institutions or the private sector while others were entirely newly established. National bodies of scientific policy advice mostly developed ad hoc, were temporary, and showed several differences between countries.

Conclusions

Different types of bodies of scientific policy advice were identified in terms of e.g. initiation, function, expertise, and institutionalization. The results demonstrate a significant variation regarding the role and impact of scientific policy advice during the SARS-CoV-2 pandemic. Our study can help to identify essential aspects of scientific policy advice and to formulate recommendations for future health crises.

Key messages

• The innovative methodological approach and the data which was collected from 25 countries give new insights into an important field of research.

• National bodies of scientific policy advice mostly developed ad hoc, were temporary, and showed several structural differences between countries.
Factors for sustainable cross-sector collaboration for health equity: a Dutch qualitative study
Authors: Coolen C M , Vendrig-de Punder YMR , Hugen C , Jambroes M , Kamphuis CBM , Ruijer E
Published: October 2024

Background

Cross-sectoral collaboration between healthcare and the social domain is necessary to address the complexity of health inequity. However, this collaboration is often unsustainable in the long-term, for example due to temporary budgets and professionals changing jobs. We explored the factors that facilitate or restrain sustainable cross-sectoral collaboration by applying an interdisciplinary theoretical lens combining insights from relevant frameworks from governance, interprofessional learning and health policy. Following, we applied the framework in an ‘Integrated Community Approach’ in two Dutch cities (Utrecht and Amersfoort).

Methods

A qualitative research was conducted, involving 32 semi-structured interviews with professionals involved in an ‘Integrated Community Approach’ in the two Dutch cities in 2022 and 2023. Participants worked at various levels of the municipality, or as a local professional in the medical or social domain in the community. Thematic analysis and a deductive approach were employed- based on the theoretical framework.

Results

We identified nine components as important for sustainable cross-sectoral collaboration. Whether these components acted as facilitator or barrier varied between participants, depending on their position and organizational context. The nine components could be summarized into three main mechanisms: 1) the foundation for collaboration, which is dependent on having a shared vision and the competencies to engage residents; 2) a pre-condition, which is having support at management level and having the right resources; 3) support, which is provided by data and flexibility.

Conclusions

Long-term cross-sectoral collaboration is important, complex and depends on various interconnected factors. To improve cross-sectoral collaboration in the long term, it is necessary to disentangle each theme and conduct in-depth analysis of each one individually to facilitate deeper understanding of the context and problem.

Key messages

• Collaboration between medical and social sectors is challenging, yet significance is clear. While the start is evident, sustaining the ‘how’ is unclear.

• The opportunities and obstacles of cross-domain collaboration vary among stakeholders, influenced by both their organization and position within it.
Decision-making under pressure: ethical considerations in COVID-19 policy making in Switzerland
Authors: Brall C
Published: October 2024

Background

Policy making and science were deeply intertwined during the COVID-19 pandemic, particularly in justifying health policy measures with ethical considerations being at the core of decision-making trade-offs. However, not much is known about the actual ethical challenges encountered by policy makers and scientists involved in policy advice. This study aims to explore the ethical challenges in COVID-19-related political decision-making as perceived by Swiss policy makers and scientists involved in policy making, the role of ethics advice, and what can be learned for future public health crises.

Methods

Thirteen qualitative expert interviews were conducted with policy makers and scientists involved in COVID-19 policy decisions in Switzerland at regional and national levels. We used inductive thematic content analysis to analyse the interviews.

Results

Key ethical challenges included making trade-offs between common vs. individual good and economic welfare vs. health of the population, proportionality of policy measures, and public capacity to handle uncertainty. Opinions varied on the sufficiency of ethical considerations on the policy level. Constraints included a lack of time in the fast-paced dynamic of the pandemic, ethics as a complex subject area, its overlap with law, too much focus on few topics such as vaccination-related questions, and individual character traits, such as the dominance of medical professionals over ethicists. While ethics support was deemed adequately present in the decision-making process, there were calls for more ethics training, involvement of the public in the discourse, and for accompanying communication to build trust among the population for the future.

Conclusions

The study offers empirical insights into the ethical considerations of COVID-19 policy making in practice in Switzerland, providing a basis to enhance ethics support for future crises also in other countries.

Key messages

• This study uncovers the key ethical considerations in Swiss COVID-19 policy making, emphasizing constraints to sufficient ethical discussions.

• Enhanced ethics training and greater public engagement is needed in future health crises to build trust and improve decision-making in future health crises.
Does staffing impact health and work conditions of staff in long-term care homes?: a scoping review
Authors: Miller M , Hopwood P , Haghighi P , Littler E , Davis A , Al Momani Y , MacEachen E
Published: October 2024

Background

Long-Term Care (LTC) homes are highly regulated and task oriented, with demanding work and insufficient resources. Chronic underfunding of the sector, coupled with increased complexity of care, has deteriorated working conditions, resulting in precarious employment, intensified and stressful work, and decreased job satisfaction. These work conditions have contributed to severe staffing shortages of healthcare workers globally. To meet increased labour demands, OECD countries on average will need to increase the proportion of overall employment dedicated to LTC by 32% over the next decade. While reviews of literature have examined the association between staffing and care outcomes for residents in LTC, they have not examined how staffing structures affect the healthcare staff themselves. This scoping review asks: How does staffing impact the health of staff and working conditions in LTC?

Methods

A scoping review of empirical peer reviewed and grey literature was conducted to examine the association between LTC staffing practices and how they impact working conditions and the health and well-being of staff. PubMed, CINHAL, and Scopus databases were searched for relevant articles published within the past 10 years.

Results

Searches yielded 3994 unique articles, which were independently screened by pairs of reviewers. Preliminary results highlight that staffing levels are not optimized for healthy, sustainable work conditions. The level of staff, their skill mix, and ratios all impact the ability to provide care. In circumstances where there is inadequate staffing, care workers are more likely to experience stress, burnout, job dissatisfaction, and increased injury and illness.

Conclusions

Staffing practices shape working conditions which impact healthcare workers own health outcomes. To facilitate a strong LTC workforce, working conditions and occupational health need to be a priority in improvement initiatives.

Key messages

• With extreme staffing shortages challenging the healthcare sector, this review highlights the need for heightened attention to the impact of staffing practices on the healthcare workforce.

• Improving working conditions and attuning to the needs of the workforce, ultimately improves quality of care.
Ready or not? The state of emergency preparedness among Italian Public Health medical residents
Authors: Zotti N , Guicciardi S , Di Serafino F , Mimmo R , Sanna A , Granvillano G , Iagnemma A , Rizzo C , Tafuri S ,   WG
Published: October 2024

Background

Italy frequently experiences major events like earthquakes, floods, and migrant shipwrecks, reflecting global concerns that also include climate change, pandemics, and wars. This study aims to assess the role of public health experts and the current state of Italian post-degree Public Health schools in addressing these challenges.

Methods

In June 2023, a cross-sectional online survey was administered to all Italian Public Health residents enrolled in the Italian Society of Hygiene, Preventive Medicine, and Public Health (SItI). The survey investigated the availability and frequency of training and updates related to emergencies, measured the interest and perceived importance of these topics among residents, examined the impact of the COVID-19 pandemic on their awareness, and identified their primary sources of information in the subject.

Results

Out of 289 respondents, a significant majority (86.2%) acknowledging the importance of being trained in emergency management and 74.4% expressed interest in topic (p < 0.001). A 90.1% of residents indicated a lack of dedicated courses and 93.1% reported an absence of specialized master’s programs (p < 0.001). There was a strong correlation between recognizing the importance of the topic and the desire to attend specialized conferences (p < 0.001). The COVID-19 pandemic had a noticeable impact: 24.6% recognized the importance of the topic pre-pandemic, while 50.9% raised awareness during (p < 0.001).

Conclusions

The findings highlight a critical gap in the training of public health professionals in Italy, particularly in the domain of emergency preparedness and management. There is a pressing need to establish enhanced, uniform training programs across different public health training networks in Italy. Implementing such programs would ensure a more robust and effective response to future emergencies, thereby safeguarding public health and improving outcomes during crises.

Key messages

• Significant gap in specialized training and awareness among health professionals.

• Urgent need for emergency preparedness training in public health.
Strengthening the quality of primary healthcare services and interdisciplinary collaboration
Authors: Lyhne C
Published: October 2024

Background

Political organisations stress the need for preventive strategies to reduce the amount of avoidable hospital admissions, i.e. admissions that could have been avoided given timely and adequate care in the primary healthcare setting. Interdisciplinary collaboration has been suggested as a means to prevent hospitalizations, but effective implementation remains a challenge. Thus, there is a need for evidence-based strategies to prevent avoidable admissions and support interdisciplinary collaboration. The aim was to develop an evidence-based framework for preventive and coordinated interventions strengthening the quality of primary healthcare services and supporting interdisciplinary collaboration.

Methods

The project consists of three sub-studies: 1) a mixed methods systematic review following the JBI methodology; 2) a focus group study with primary healthcare providers in the Central Denmark Region, including general practitioners, physiotherapists, occupational therapists, home care providers, registered nurses and nurse specialists; and 3) a study using participatory design, where a framework for coordinated interventions were developed based on the results from study 1 and 2, supported by all stakeholders.

Results

Findings suggest that some hospitalizations can be prevented by intervening on mental factors, e.g., through trustful relations, and social factors, e.g., living situation. Also, a strong collaboration between healthcare providers from different disciplines and healthcare services is needed to improve the care pathway and prevent hospitalization. The collaboration may be strengthened if the health providers share a common language regarding the citizens’ health status.

Conclusions

Stakeholders at all levels should be informed about the relevance of considering mental, social and physical factors to improve the quality and responsiveness of primary healthcare services and to develop initiatives to support interdisciplinary collaboration.

Key messages

• By focusing on the whole person, it could be possible to provide more person-centred care through interdisciplinary collaboration and ultimately to prevent some admissions.

• Well-established primary healthcare services are important to provide person-centred care through interdisciplinary collaboration.
Future proof competencies for nurses working in primary care; a mixed methods study
Authors: Wit R F , de Groot K , de Bruijn EHML , Batenburg R S , Francke A L
Published: October 2024

Background

Healthcare services, also those provided by nurses, are challenged by the increasing care demands of an ageing population and people with chronic conditions. To improve care efficiency and quality, now and in the future, nurses must have competencies regarding self-management support of patients, electronic communication, preventive care, and engaging relatives in care. This study aimed to assess primary care registered nurses’ (RNs) time allocation to these competencies and their perceived needs for further development of these competencies.

Methods

A mixed methods design was used, involving a nationwide survey (n = 303) and focus groups (12 participants), both with RNs working in community care services or general practitioners (GPs) practices. Survey data were analysed descriptively, and focus group transcripts underwent qualitative thematic analysis.

Results

The majority of RNs invest significant time in client self-management support (90%), preventive care (82%), and involving relatives in care (74%). RNs also recognized an increasing demand for these competencies in the future and the need to motivate patients and relatives to self-manage their health. Furthermore, RNs reported that competencies regarding electronic communication skills will become extra important in the future, yet currently only 37% dedicate substantial time to this. RNs face challenges in effectively utilizing electronic communication with patients and thus need opportunities to improve digital skills. Additionally, RNs desire enhanced collaboration with other healthcare professionals, such as GPs and medical specialists.

Conclusions

RNs’ limited time allocation and perceived inadequacy in electronic patient communication, underscore the importance of targeted training in this area, and prioritizing this by healthcare organizations. In addition, fostering collaboration between nursing staff and other healthcare professionals could support future proof nursing in primary care.

Key messages

• Nurses demonstrate resilience in addressing healthcare challenges, emphasizing client care, prevention and family engagement.

• Training nurses in competencies for electronic communication with patients is essential to meet the anticipated increase in demand for this aspect in their practice.