bluuebunny/crossref_metadata_2025 huggingface dataset:
Participatory development of inclusive health communication on COVID-19 with homeless people
Authors: Specht A , Sarma N , Hellmund T , Linzbach T , Hörig M , Wintel M , Mockenhaupt FP , Seybold J , Lindner AK
Published: October 2022

Background

The COVID-19 pandemic demonstrates the important role of providing people with easy to access up-to-date health information in digital formats. People experiencing homelessness have limited access to health information and were hardly ever directly addressed through communication channels in Germany. Lack of digitalization within shelters and social services, as well as technical and socio-economic barriers in purchasing and maintaining a smartphone are further barriers to information.

Methods

The Charité-COVID-19-project for and with homeless people has created digital health information videos and posters, with an interdisciplinary team and in a participatory approach. Two videos on general information and testing of COVID-19 were launched in 5 languages in February 2021. Vaccination posters in two language versions including 9 languages are available since April 2021.

Results

We will present the collaboration of research, practice and community, the production process, the distribution and the acceptance of the formats. The web link refers to the videos, posters and further information:

https://tropeninstitut.charite.de/forschung/charite_covid_19_projekt_fuer_und_mit_obdachlosen_menschen/

Conclusions

Exclusion from (digital) information is an increasingly important part of the structural marginalization of homeless people. This, as well as the inadequate consideration of this population in health communication and the pandemic response have to be addressed. Tackling the digital gap allows improved access to health information for homeless people and promotes health-seeking behaviour. Empowerment of the community through participation and a network between community, service providers, politics and research are also crucial for improvement of homeless people's health in the future.

Key messages
Using Intervention Mapping to develop an intervention to promote healthy child weight development
Authors: Bonnesen CT , Carlsson RR , Brautsch LAS , Kierkegaard L
Published: October 2022

Background

Clear documentation of the understanding of the problem, development process, and content of interventions is essential to understand why interventions succeed or fail. Transparent reporting will enable future researchers to build on previous evidence and replicate or adapt interventions for new contexts. This paper describes the theory- and evidence-based systematic development of the Bloom Trial - a home-based intervention to promote healthy weight development among infants and children in Denmark.

Methods

Development of the intervention is guided by the six-step planning tool the Intervention Mapping protocol. Step 1: Needs assessment including identification of risk factors in infancy and existing interventions, interviews with parents, and an organizational capacity assessment. Step 2: Development of program theory and matrices. Step 3: Selection of theoretical methods and practical applications for modifying personal and environmental determinants. Step 4: Development of intervention tools. Step 5: Planning of program adoption, implementation, and sustainability. Step 6: Generation of an evaluation plan.

Results

The Bloom intervention is universal but with a strong focus on families with low socio-economic position and non-Danish ethnic background. It is aimed at first-time parents and addresses early risk factors for child overweight such as parental skills and healthy habits related to food and meals, movement, screen time and sleep, and introduce a new theme: sense of security in the family. It will be integrated in existing services delivered by community health nurses supplemented with extra elements such as telephone consultations, family groups and a video library.

Conclusions

The transparency of the developmental process and theoretical, empirical, and contextual foundation of the Bloom Trial may enable future studies to build on our findings and accumulate knowledge to promote healthy weight development among infants and children.

Key messages
A training ground Lay out improves rehabilitation after trauma surgery: A Fast Track Policy
Authors: Balato G , Palladino R , Montella E , Diana L , Coviello A , Festa E , Iervolino A , Rubba F , Mariconda M , Triassi M
Published: October 2022

Fracture patients are frail and have high mortality. We investigated whether introducing a fast-track strategy during post-surgery care and including early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness. A training ground was built inside the inpatient area dedicated to trauma settings. Usual postoperative care consists of immobilization during the first day, but patients may start rehabilitation earlier, 24 hours after the surgical procedure, with a fast-track strategy. In general, gait speed, step length, and self-assessment in terms of mobility improve significantly in the first six postoperative weeks in fracture patients. As delayed postoperative mobility during hospitalization was observed, the established training ground may help with this concern. The expert physiotherapist may contribute to ameliorating the indicators showing great potential in postoperative rehabilitation regardless of fracture pattern. The primary outcome was postoperative physical functioning. Secondary outcomes included the patient’s assessment of therapeutic effect (overall improvement), perceived pain intensity, health services utilization, treatment side effects, and adverse events. Data were analyzed by univariate analysis and binary logistic regression showing a reduction of LOS of almost three days. Further, the optimized hip fracture program reduced the rate of in-hospital postoperative complications and mortality. Adding to the schedule, some PROMPTS (Patient-reported outcome measures) could further integrate the patient empowerment perspective into the quality set of values. For this reason, ‘fast track’ may define a crucial policy able to guarantee rapid rehabilitation, becoming a key factor to achieving a good clinical effect. Fast-track rehabilitation facilitates a shortened hospital stay and cost-saving and can be used to optimize the patient’s condition before admission to a rehabilitation facility

Key messages

• Early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness.

• Human factors and patients empowerments may help.
Evaluation of primary health care system in Yangon Region, Myanmar: a mixed-method approach
Authors: Moon J , Kang SJ , Noh JW
Published: October 2022

Background

Many low- and middle-income countries and international organizations have invested resources to strengthen primary health care services. Despite efforts from the Ministry of Health on primary health care, barriers to accessing health care services and health inequality in Myanmar still exist. This study aimed to identify the challenges and unmet needs in the current primary health care services by assessing the experiences and perceptions of healthcare workers and local leaders in three townships (Htantabin, Hmawbi, and Taikkyi) in Yangon, Myanmar.

Methods

The study was conducted among healthcare professionals and community leaders in three townships. By adopting a mixed-method approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (15 group discussions) were conducted online for qualitative data.

Results

As a result of the survey regarding six domains; hygiene, primary medical care, maternal and child health, infectious diseases, non-communicable diseases, and leadership, enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5), while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28 out of 5) and the impact of the intervention (4.7). The focus group discussions revealed that while specific infrastructures and equipment necessary for the category were addressed, the need for financial support has been the recurrent theme throughout the discussions.

Conclusions

Utilizing the World Health Organization’s six-building block framework, our findings suggest that a long-term targeted financial investment in the primary health care system is critical in Myanmar by increasing health care expenditure per capita. At the same time, related barriers and facilitators should be considered to optimize the effectiveness of prioritized interventions.

Key messages

• Health care providers and local leaders perceived the management and leadership capacity as the lowest current achievement.

• A long-term targeted financial investment in the primary health care system is critical in Myanmar.
Attitudes of children and adolescents towards healthy lifestyle issues
Authors: Antia N , Tabidze D , Gabunia L , Zarnadze I , Khetsuraini Sh , Gamkrelidze N , Sulashvili N
Published: October 2022

Background

Health education for promoting healthy lifestyle from early ages is considered to be important. However, this issue has not been thoroughly examined in Georgia. The research, undertaken on adolescents, aimed to analyse adolescents’ lifestyle, awareness and attitudes towards healthy lifestyle.

Methods

The study applied a mixed methods design and included both, qualitative and quantitative research methods. 145 students aged 17 to 23 years participated in the research. In order to evaluate the adolescent’s perceptions and attitudes, qualitative individual interviews with university students were conducted. For the quantitative method, a self-administered questionnaire assessing the level of adolescents’ awareness and attitudes towards healthy lifestyle was developed.

Results

This section presents preliminary findings of the study. We found that more than 67% of adolescents were aware on the importance of healthy lifestyle. However, most of the participants did not transfer their knowledge into practice. The participants found it challenging to maintain healthy eating habits due to increased costs of healthy, organic food. The study also confirmed the need for integrated work of public, governmental, and non-governmental organizations to initiate and implement health promotion programs for children and adolescents.

Conclusions

Overall, the study found that even though adolescents are aware about the importance of the healthy lifestyle, it is challenging for them to maintain it. In order to change adolescents’ attitudes towards unhealthy behaviour, it is necessary to carry out targeted interventions.

Key messages

• Health education is a necessary component for healthy lifestyle.

• Healthy lifestyle requires careful study of the issue and making evidence-based conclusions.
Health system efficiency in Germany: results of a pilot study to assess health system performance
Authors: Hengel P , Achstetter K , Blümel M , Schwarzbach V , Busse R
Published: October 2022

Background

Improved efficiency is one overall goal in WHO’s Health Systems Framework. Efficiency is an important dimension of health system performance assessment (HSPA). HSPA is used as a tool to monitor and evaluate the performance of health systems and to support evidence-based policymaking. In the pilot study for a first German HSPA, efficiency was assessed as one dimension.

Methods

Indicators were selected based on a systematic search of established instruments in national and international HSPA initiatives. Criteria for the inclusion of indicators were data availability and international comparability. Where possible, indicators were evaluated in terms of their development over time (2000-2020), in comparison to eight European countries (e.g., Austria, Denmark, France), and regarding equity aspects (e.g., age, gender, region).

Results

Eight indicators to assess the efficiency of the German health system were identified and analysed accordingly. They cover the pharmaceutical sector, outpatient and inpatient care, and system-wide efficiency. Trend analyses were possible for all indicators, and most were also suitable for international comparisons. Overall, results of the chosen indicators indicate a moderate health system efficiency. The volume of generics as share of all pharmaceuticals, e.g., was 83% in Germany in 2019 (country average: 54%) and has been steadily increasing since 2000. In contrast, expenses for pharmaceuticals overall rose from 1.4% of GDP in 2004 to 1.7% in 2019, whereas it declined from 1.3% to 1.1% on average in the other countries.

Conclusions

Within this first pilot study, a systematic and comparative German HSPA measuring the efficiency of the German health system using eight predefined indicators was proven to be feasible. The results give insights into efficiency measurements across different sectors, e.g., pharmaceuticals, identify developments of efficiency over time, and can support evidence-based policymaking.

Key messages

• In the pilot study for a first German HSPA, efficiency was evaluated using eight indicators covering pharmaceuticals, outpatient and inpatient care, and system-wide efficiency.

• Based on the available data, which allowed trend analyses for all indicators and comparisons to eight European countries for most indicators, Germany’s health system efficiency can still be improved.
The European pharmacy market: the density and its influencing factors
Authors: Schwaabe S
Published: October 2022

Community pharmacies deliver high-quality health care and are responsible for medication safety. During the pandemic, accessibility to the nearest pharmacy became more essential to get vaccinated against Covid-19 and to get medical aid. The government’s goal is to ensure nationwide, reachable, and affordable medical health care services by pharmacies. Therefore, the density of community pharmacies matters. Overall, the density of community pharmacies is fluctuating, with slightly decreasing tendencies in some countries. The research question is: upon which conditions depends the variance in the density of community pharmacies in Europe? So far, the literature has shown that changes in the system affect prices and density. However, a European overview of the development of the density of community pharmacies and its triggers is still missing. This research is essential to counteract against decreasing density consulting in a lack of professional health care through pharmacies. I focus on liberal versus regulated market structures, mail-order prescription drug regulation, and third-party ownership consequences. In a panel analysis, the relative influence of the measures is examined across 27 European countries over the last 21 years. The results show that regulated pharmacy markets have over 10.75 pharmacies/100.000 inhabitants more than liberal markets. Further, mail-order prescription drugs decrease the density by -17.98 pharmacies/100.000 inhabitants. Countries allowing third-party ownership have 7.67 pharmacies/100.000 inhabitants more. The results are statistically significant at a 0.001 level. The output of my analysis recommends regulated pharmacy markets, with a ban on mail-order prescription drugs allowing third-party ownership to support nationwide medical health care through community pharmacies.

Key messages

• Regulated pharmacy markets, with a ban on mail-order of prescription drugs and third-party-ownership have a positive effect on pharmacies density.

• The results of my analysis provide the government with measures to improve professional nationwide health care coverage for the population through pharmacies.
Need for a competency-based approach for the Public Health Workforce training: the ISS proposal
Authors: Mazaccara A , Privitera G , Di Pucchio A , Barbina D , Bertinato L , Mistretta A , Simonelli M , Caminada S , Arzilli G , Brusaferro S
Published: October 2022

Issue

The COVID-19 pandemic acted as a catalyst for a reconsidering health care professional workforce (HCPW) competency needed to face future public health challenges, in line with the recent WHO “Global Competency and Outcomes Framework for UHC” document. In this context, in the Italian G20 Presidency framework, the Italian National Institute of Health (ISS), launched a program named “Laboratorium” - recognised in the G20 Declarations of Ministers of Health and Leaders - aimed to the development of training tools suitable for distance learning in whatever context they are placed.

Description of the problem

Common competencies and needs of the HCPW have to be fulfilled through cross-sectional and multilevel training, to overcome the current emergency and be able to face future challenges. The aim is to provide a modular educational approach that is finalized to actively involve the participant: health professionals step in their training pathway according to their knowledge gaps, identify their specific learning objectives and, through a problem-based learning approach, acquire the proper skills for their function and tasks.

Results

We propose a two-tiered approach to training: the development of competence based courses oriented to active learning. A pilot course on Epidemic Intelligence design according to this model is ready to be released. At the same time, a repository of everything available on the web systematically selected from authorised sources by a scientific committee was created to support the training objective. It is characterised by a detailed multilevel tagging that allows an effective modularisation to reach only the content useful for its user.

Lessons

Accessibility to health-related training materials is a required necessity at every level of HCPW. Profiles within healthcare are increasingly heterogeneous and there is a need to focus on disseminating tools that can provide knowledge to address different healthcare scenarios and common purposes.

Key messages

• Future public health challenges underline a need for a competencies-based learning approach in Healthcare Workforce training.

• Italian National Institute of Health propose two methods within the ‘Laboratorium’ project to enable this type of learning: specifically designed courses and a structured document repository.
Ukrainian refugee crisis: the experience of the Roman Local Health Authority “ASL Roma 1”
Authors: Melnyk A , Barone LC , Messina S , Grossi A , Kohut M , Cascini F , Damiani G , Parente P , Goletti M
Published: October 2022

Problem

On February 24th, 2022, Ukraine was invaded by Russian forces, forcing many Ukrainians to flee from their homes as refugees. More than 55,000 Ukrainians have since arrived on Italian territory. In response to the humanitarian crisis, the Roman Local Health Authority “ASL Roma 1” provided socio-sanitary assistance through first reception centers to more than 7700 refugees, prioritizing people with high social vulnerability. Ukraine’s vaccine hesitancy and different epidemiological landscape represented a major hurdle to be overcome.

Practice

ASL Roma 1’s practice served to ensure infectious diseases prevention and control, as well as continuity of care for non-communicable diseases and mental health issues. It consisted of repurposing resources, such as COVID-19 Hubs and their personnel, stipulating Public-Private Partnerships and collaborations with the local Ukrainian community, massive training, creating a centralized multidisciplinary team (with Ukrainian members) and a dedicated database/IT system.

Results

ASL Roma 1 empowered local Ukrainian communities by providing equipment, medical and administrative staff and socio-sanitary assistance. Ukrainian volunteers helped bridge the cultural gap for essential service provision, such as COVID-19 screening, enrolment in the NHS, health and social orientation, vaccinations and a tailored care pathway. Thus, more than 7700 refugees were assisted, with 1830 COVID-19 vaccinations administered and 170 in critical conditions promptly receiving specialized care.

Lessons

The multidisciplinary and cross-cultural interaction between doctors, nurses, cultural mediators, social workers, and other key actors was essential in ensuring a holistic care pathway. Services catered to Ukrainian refugees need complete integration between primary and centralized care. Flexibility and resilience are fundamental to foster an ecosystem of innovation and optimization of healthcare provision on all levels, from local to supranational.

Key messages

• The multidisciplinary and cross-cultural interaction between all medical and non-medical key actors is essential in ensuring a holistic care pathway and complete social integration of asylum seekers.

• Health system flexibility, resilience and an ecosystem of innovation and optimization of healthcare provision on all levels are fundamental components of preparedness for future refugee crises.
Establishment of the Namibian National Public Health Institute: laboratory systems strengthening
Authors: Thieleke-Matos C , Endjala N , Nepolo E , Winter C , Nowaseb V , Mataranyika M , Ochurus P , Jansen A , Weiss S , Ellerbrok H
Published: October 2022

In 2020, the Namibian Ministry of Health and Social Services (MoHSS) and the Robert Koch Institute (RKI) started a twinning project with the long-term goal of establishing a Namibia Institute of Public Health (NIPH). A fundamental pillar of an NIPH is a fully operational Public Health laboratory system. Due to the COVID-19 pandemic, the need for strengthening the existing Namibian Laboratory system became eminent. Following the Intra-Action Review (IAR) of the COVID-19 response in Namibia in 2020, three regional diagnostic laboratories, at points of entry, were assessed. The major issues identified were long delays between sampling of both suspected cases and COVID-19 patients and receiving test results due to extended sample transport times to the central laboratory in Windhoek and the overload of the central capacities due to overwhelming numbers of samples during peak times. This led to the establishment of three SARS-CoV-2 PCR diagnostic laboratories through procurement and installation of equipment, provision of consumables/reagents, and on-site training of laboratory technicians with continued virtual technical support. Consequently, an important reduction of the diagnosis turnaround time was achieved. Of great value was the technical support given by the staff at the central laboratory during the trainings allowing for immediate validation of the newly established laboratories and to strengthen the communication between regional laboratories and the central laboratory. The Namibian molecular diagnostic capacities have increased in important regions in Namibia and will provide data to support the health policies of the future NIPH. New diagnostic protocols will be developed to foster the sustainability of the established laboratories and could support the implementation of genomic surveillance capacities. Finally, stronger relationships were built through these joint activities, which will support and the next steps of the establishment of the NIPH.

Key messages

• Supporting and Strengthening the Namibian Public Health Laboratory system.

• Long-term goal of establishing a Namibia Institute of Public Health (NIPH).
Dealing with the unknown: perceptions and fears of SARS-CoV-2 infection among hospital workers
Authors: Utzet M , Villar R , Díaz P , Rodríguez Arjona MP , Ramada JM , Serra C , Benavides FG
Published: October 2022

Introduction

This study aims to explore perceptions, fears and worries regarding SARS-CoV-2 risk of infection and transmission to relatives and/or co-workers and non-pharmacological preventive interventions among hospital workers.

Materials and Methods

The research used an explorative qualitative approach. Six focus groups and ten individual interviews across multidisciplinary workers (physicians, nurses, aides, cleaners, maintenance, and security staff) were conducted online and audio-recorded, transcribed verbatim and analysed using thematic analysis and mixed coding.

Results

Forty professionals participated in the study. Four common themes emerged in all groups: challenges related to the lack of pandemic preparedness, concerns about personal protective equipment, unclear guidelines for case and contact tracing, and communication-related difficulties.

Conclusions

This study emphasizes the key recommendations to improve non-pharmacological preventive interventions to reduce workers’ fears and worries about the risk of infection and spreading the infection to others, including families. Above all, these should include ensuring the availability, and correct use of adequate personal protective equipment, improve guidelines on case and contact tracing, and setting effective communication channels for all workers of the organization. These recommendations must be reinforced in maintenance and security personnel, as well as night shift nurses and aides, in order to reduce also health inequalities.

Key messages

• Lack of pandemic preparedness increased HCW’ fear of infection, which could be reduced by ensuring the availability and good use of proper PPE, and by clear guidelines on case/contact detection.

• The improvement on non-pharmacological preventive interventions must be underpinned by effective communication channels and/or communication staff, and should reach all workers in the institution.
Willingness to participate in a COVID-19 follow-up study and symptoms 1.5 years after infection
Authors: Schramm S , Wilk L , Kowall B , Jöckel KH , Stang A , Schmidt B
Published: October 2022

Introduction

Data on willingness to participate in population-based long-COVID studies are sparse. We invited all citizens of Essen aged 18-74 years with a positive SARS-CoV-2 PCR test between Mar-Aug 2020 and assessed COVID-related symptoms in responders ∼1.5 years after infection.

Methods

The invited population included 1282 infected citizens (48% women). At the time of testing 64% reported symptoms. We asked responders about past and current symptoms, hospitalization, smoking, sport, pre-existing conditions (heart attack, stroke, diabetes), subjective health status as compared to before infection, assessed BMI, and performed descriptive statistics.

Results

We investigated 255 participants (50% women, 19-73 years, response rate 20%) ∼20 month (median) after the PCR test. 95% reported symptoms at the time of testing: 67% fatigue, 58% taste disorders, 56% limb pain, 55% odor disorders, 54% headache, 50% cough, 43% fever; 10% needed hospitalization, 3% intensive care, 1.6% artificial ventilation. Compared to the non-hospitalized the formerly inpatients were more often male (62% vs 49%), older (56±13 vs 49±14 years), less often never smokers (42% vs 53%), had a higher BMI (31±7 vs 28±5 kg/m2), and more pre-existing conditions (23% vs 10%). Compared to before infection, 53% rated their current health worse, with a higher rate among inpatients (81%). After ∼1.5 years, 55% still reported symptoms: 25% fatigue, 20% concentration disorder, 18% breathing problems, 13% odor and 11% taste disorders. Persistent symptoms were more common in inpatients than in non-hospitalized (69% vs 53%).

Conclusions

Symptomatic individuals are more likely to participate in a COVID19 follow-up study than asymptomatic ones. This may overestimate the number of individuals with long-term symptoms in population-based long-COVID study populations. However, persistent symptoms seem to be more likely in formerly inpatients compared to non-hospitalized individuals with former SARS-CoV-2 infection.

Key messages

• Symptomatic individuals are more likely to participate in a COVID19 follow-up study than asymptomatic ones.

• Persistent symptoms seem to be more likely in formerly inpatients compared to non-hospitalized individuals with former SARS-CoV-2 infection.
Impact of COVID-19 on the essential healthcare services at primary healthcare level
Authors: Hayrumyan V , Abrahamyan A , Harutyunyan A , Sahakyan S
Published: October 2022

Background

The COVID-19 pandemic triggered numerous challenges for the healthcare systems worldwide, particularly affecting the continuity of essential health services in low- and middle-income countries. We explored the effects of the COVID-19 pandemic on the utilization and delivery of essential health services in Armenia.

Methods

We applied a conventional qualitative study design using semi-structured in-depth interviews (n = 17) in public and private primary healthcare (PHC) facilities in Armenia (2021). Participants included physicians providing primary health services (e.g. endocrinologists, gynecologists/obstetricians, and pediatricians), regular PHC facility patients (e.g. adults with chronic diseases, parents of children), and policymakers. Iterative thematic analysis was done based on inductively emerged 3 main themes: patient-provider communications, maternal and child health services, and management of chronic diseases.

Results

Overall, visits to the PHC facilities were decreased due to fear to contract COVID-19 coupled with lack of information, misinformation and panic. There was a lack of digital platforms for ensuring continuous patient-provider communication and phone calls were the main way of communication. PHC providers intentionally limited the number of maternal and child visits to only essential antenatal visits, newborn screenings and routine child immunizations. Still, the latter has suffered resulting in delayed and decreased vaccinations. The pandemic remarkably decreased the number of follow-up visits and monitoring of patients with chronic conditions resulting in more critical and severe conditions.

Conclusions

The COVID-19 pandemic affected the provision and utilization of essential health services at PHC facilities by changing people’s health-seeking behavior. Unified national-level guidance for PHC facilities is needed to direct the provision of essential services, effective health communication and usage of digital platforms.

Key messages

• Though provider encounters should be limited during outbreaks, continuous provision of essential services is critical in the prevention of morbidity, complications and worsened disease severity.

• Efforts are needed to develop effective health and risk communication strategies and enhance appropriate usage of digital platforms to promote adequate health-seeking behavior among the public.
What factors contribute to maintaining mental well-being during the COVID-19 pandemic?
Authors: Kausmann C , Cohrdes C ,   RKI-SOEP-2-study group
Published: October 2022

Background

The COVID-19 pandemic posed numerous challenges for many people and first results indicate high variability of responses in mental well-being. Thus, this research aimed to identify longitudinal factors contributing to the maintenance of mental well-being despite the adverse life circumstances and derive recommendations suitable for the promotion of mental well-being in the context of future pandemic or similar stressful situations.

Methods

We analysed representative longitudinal panel data of the Socio-Economic Panel (SOEP) from 15,122 adults (age range 18-99 years) who participated in the collaborative SOEP-CoV and RKI-SOEP surveys comprising self-reports of mental well-being (e.g., life satisfaction) and potentially relevant factors (e.g., control beliefs). By taking data from before (2015-2019) and during the COVID-19 pandemic (2020-2021) into account, we investigated different patterns of mental well-being trajectories and factors associated with the maintenance of mental well-being over time.

Results

Preliminary results suggest that the majority of adults in Germany managed to maintain or even enhance their mental well-being in the considered time frame. Moreover, results suggest that certain factors seem to be of universal importance (e.g., altruism, locus of control) while others are particularly relevant for distinct mental well-being dimensions (e.g., life goals). Most decisively, the probability of experiencing mental well-being deterioration during the COVID-19 pandemic was enhanced in individuals with an internal locus of control.

Conclusions

The findings revealed longitudinal factors that contribute to maintaining mental well-being during the COVID-19 pandemic. Promoting altruism, family-related life goals and external locus of control beliefs can help fostering resilient responses in the face of challenging life events such as the COVID-19 pandemic.

Key messages

• Several factors (e.g., locus of control) offer the potential to maintain or even improve mental well-being in times characterized by the COVID-19 pandemic.

• To enhance preparedness for stressful life events such as the COVID-19 pandemic, the identified key factors should be included in basic universal public health promotion.
Healthy aging in place during the pandemic in Northern Italy
Authors: Paone N , Mairhofer S
Published: October 2022

Many elderly people would like to stay in their own homes as long as possible. Therefore, a focus on enabling factors for a healthy aging in place in needed. Italy was the first European country to be hit hard by the pandemic. These had an impact on people’s everyday lives, on social participation and freedom of movement for all sections of the population. But especially elderly people were considered a risk group and were urged to leave their homes as little as possible. The project aimed to analyse the situation of elderly people in South Tyrol (Northern Italy), focusing on the characteristics of enabling factors for a healthy ageing in place. The main research question was: What kind of enabling factors ensure a healthy aging in place during the pandemic? Using a mixed-methods-approach, we conducted 10 semi-structured interviews (experts: social workers, health professionals, responsible persons from senior associations, ...) analysed by qualitative content analysis and a quantitative questionnaire (536 respondents, aged 60 to 101 still living in their own home) from 2020 to 2021. The questionnaire was distributed in digital and analogue form to reach a wider study group and to facilitate access to the research group despite the infection control measures or technical challenges. The results show that there were numerous changes in the everyday life of elderly people during the pandemic, which were described as particularly important for a healthy ageing in place. Based on the answers to the pandemic-related restrictions, 6 categories could be identified: Loneliness versus desire for social contact, mobility, emotions, needs, opportunities, restrictions. To be able to guarantee healthy ageing in place, we need to examine and promote these enabling factors in the long term.

Key messages

• A focus on enabling factors for a healthy aging in place in needed.

• There were numerous changes in the everyday life of elderly people during the pandemic, which were described as particularly important for a healthy ageing in place.
Public Health Workforce training Laboratorium: Pilot e-Learning course on CBE and PBL models
Authors: Barbina D , Riccardo F , Di Pucchio A , Del Manso M , Mammoli M , Croci R , Vittozzi A , Mazzaccara A , Ferrelli R , Brusaferro S
Published: October 2022

Background

The National Institute of health (ISS), within the G20 Health Working Group, launched at March 2021 an innovative training Laboratorium, to strengthen the capacity and competencies of the Public Health Workforce (PHW) on prevention, preparedness and response to health crises. It was recognised in the G20 Declarations of Ministers of Health and Leaders and it was aimed to the development of training tools suitable for distance learning. ISS proposed the design of e-Learning courses based on an integration of WHO’s Competency-Based Education (CBE) and Problem Based Learning (PBL) models.

Objectives

Describe the design of a pilot e-Learning course based on CBE- PBL models, focused on Epidemic Intelligence (EI).

Results

The pilot e-Learning course “Use of Epidemic Intelligence systems with a particular focus on event-based surveillance for pandemic preparedness” will be delivered by ISS e-Learning platform https://www.eduiss.it. By the end of the course participants will be able to evaluate the potential use/applicability of EI systems, focusing on event-based surveillance for preparedness and early warning at country/institutional level. CBE is the basis for articulating the outcomes and identifying the required competencies and PBL for creating learning activities associated to learning outcomes. Interactive tools (exercise, web pages, quiz and other activities) are associated to learning objectives. The course is offered to public health professionals free of charge, in English language. About 16 hours are required to complete all the activities and receive attendance certification.

Conclusions

Continuously updated training of PHW is a hallmark to better face health challenges. In our proposal, the learning methodology integrates CBE vision with PBL approach, adapting both to e-Learning context.

Aknowledement

Pietro Carbone, Debora Guerrera, Federica Regini, Licia Bacciocchi, Stefania Bocci, Silvia Stacchini, Giovanna Failla - ISS, Rome Italy

Key messages

• Design an innovative e-learning course through synergic integration of two educational models crucial in public health, CBE and PBL.

• Adapt e valorize CBE and PBL models in the context of e-Learning.
Migrant and ethnic minorities at higher risk of COVID-19 severe outcomes? A systematic review
Authors: Mazzalai E , Giannini D , Tosti ME , Jaljaa A , Caminada S , Turatto F , De Marchi C , Gatta A , Marchetti G , Marceca M
Published: October 2022

Background

The Covid-19 pandemic has had a recognised impact in widening health inequalities, both between and within countries, with a major impact on socially disadvantaged population groups such as Migrants and Ethnic Minorities (MEMs). While there is growing evidence on the matter worldwide, data specific to the WHO European Region is scarce. The issue, however, is pressing, since it is estimated that almost 10% of the population living in the WHO European Region is made up of migrants. The aim of the study is to investigate the impact of Covid-19 on MEMs compared to the general population in terms of serious outcomes.

Methods

We conducted a systematic review collecting studies on the impact of Covid-19 on MEMs compared to the general population in the WHO European Region regarding hospitalisation, intensive care unit (ICU) admission and mortality, published between 01/01/2020 and 19/03/2021. Fourteen researchers were involved in selection, study quality assessment, data extraction and analysis.

Results

Of the 82 studies included, 15 of the 16 regarding hospitalisation for Covid-19 reported an increased risk for MEMs compared to the white and/or native population and 22 out of the 28 studies focusing on the ICU admission rates found an increased risk for MEMs. Among the 65 studies on mortality, 43 report a higher risk for MEMs. 82% of the studies were conducted in the UK.

Conclusions

These findings highlight the disproportionate impact of Covid-19 on MEMs population, with an increased risk of all the adverse outcomes taken into consideration. Social determinants of health are among the main factors involved in the genesis of health inequalities: a disadvantaged socio-economic status, a framework of structural racism and asymmetric access to healthcare are linked to increased susceptibility to the consequences of Covid-19. These findings underline the need for policy-makers to consider the socio-economic barriers when designing health promotion plans.

Key messages

• The combination of disadvantage socioeconomic conditions with COVID-19 transmission characteristics put migrants and ethnic minorities at a higher risk of facing sever health outcomes.

• The amount of evidence on the inequal impact of COVID-19 on migrants and ethnic minorities produced by European countries is poor. This gap must be filled to develop effective health promotion plans.
Covid-19-related health literacy: a cross-sectional study in Israel
Authors: Abdel-Rahman N , Laron M , Baron-Epel O , Artom T , Levin-Zamir D
Published: October 2022

Background

The “infodemic” related to Covid-19 emphasized the importance of the public’s ability to access, understand, appraise and use information to make decisions about health. This study aimed to:

1. Assess the components of Covid-19 related health literacy (Co-HL)

2. Examine the associations of socio-demographic variables and health status with Co-HL

Methods

This study was conducted as part of the European Health Literacy Population Survey 2019-2021 (HLS19). A cross-sectional survey of a representative sample of adults in Israel was conducted in December 2020 using phone interviews and an online survey (n = 1,315). Five items measuring Co-HL were added. Multivariable regression models were used to assess the associations between socio-demographic variables and health status with Co-HL.

Results

Of participants, 63% reported concern about Covid-19. The mean general HL was lower among those who reported concern about Covid-19 compared to those who worried less (p = 0.002). The most difficult component of Co-HL was “judging the reliability of information regarding Covid-19” (36% expressed difficulty). Older participants, those with low self-reported social status, and low self-assessed health, were significantly (p < 0.05) more likely to express difficulty in judging the reliability of Covid-19 information. Interestingly, education level was not significantly associated with Co-HL.

Conclusions

Our results suggest that, to best promote the use of information on Covid-19 prevention, older people, those with low social status and those with poor general health should be prioritized for improving critical health literacy.

Key messages

• Co-HL is unequally distributed in the population, warranting tailored health promotion efforts.

• It is vital to improve the ability of the population to identify reliable information about covid-19.
Factors associated with post-COVID-19 confinement vape use in young adults
Authors: Villegas Dominguez JE , Reyes Hernandez C , Rodríguez Barranco AR , Pérez Santamaria M , Juárez de la Huerta H , Martínez Torralva A , Gonzalez David EA , Muñoz Bautista BL , Marquez Celedonio FG
Published: October 2022

Introduction

The use of Vape has increased during the pandemic due to the changes generated by it. Currently we have finished the conditions of confinement, so it is important to identify

Objective: To determine the factors associated with post-COVID-19 confinement vape consumption in young adults

Methods

A cross-sectional, prospective study was carried out between January and April 2022, including men and women residents of Veracruz aged between 18 and 35 years, excluding participants with addiction treatment or with a diagnosis of a lung disease. A survey was applied through Google Forms to identify the factors associated with Vape consumption after confinement by COVID-19, including depression, anxiety and stress evaluated with the DASS-21 instrument (Cronbach’s alpha between 0.79 and 0.87). For data analysis, SPSS v22 software was used, X2 test with Odds Ratio (OR) and 95% confidence interval (CI95%) and MannWhitney U test, assigning statistical significance with p < 0.05.

Results

514 participants were included, with a prevalence of vape use of 28.5%. Physical activity, cigarette consumption by a family member, levels of anxiety, depression and stress showed a value of p > 0.05 for Vape consumption, while other factors (OR/95%CI) such as being female (0.6/0.4-0.9), identifying vape advertising on Facebook (0.35/0.19-0.65), having a family member who vapes (2.4/1.5-3.6), consuming cigarettes (4.2/2.7-6.4) and identifying vape advertising on Instagram (1.5/ 1.0-2.3) had values of p < 0.05

Conclusions

Post-pandemic vape use is not affected by anxiety, stress or depression, identifying other factors that favor its use such as the environment in which it develops, such as being someone with a history of tobacco use, in addition to the family smoker and advertising on Instagram, which is a social network that often works as an aspirational image for users, a situation contrary to what is shown on Facebook.

Key messages

• Vape consumption continues to be a post-pandemic public health problem, so it is necessary to reinforce educational measures on the subject and the post-Covid complications of its use.

• It is necessary to regulate vape advertising on social networks, as has been done with tobacco in different countries, since it can become a risk factor by showing aspirational images for users.
Prior activation of social work team process by pre-admission one-click automatic referral system
Authors: Chon S , Kim BE , Lee IJ , Choi GY
Published: October 2022

Background

Coronary artery disease (CAD) is the leading global cause of mortality. Coronary angiography (CAG) is often performed for CAD patients, and the mean length of stay (LoS) is 4 d. Requests to the social work team (SWT) are often delayed until just before discharge, causing unnecessarily prolonged LoS and reduced chances of obtaining financial support. If the SWT’s support system is activated beforehand for scheduled CAGs, the LoS would be shorter and patients would be relieved of emotional and financial burdens.

Methods

Collaborating with the cardiology and medical informatics departments, a one-click automatic referral system (OARS) was set up (January-May 2021). When cardiologists scheduled a CAG in the outpatient department, an OARS cue popped automatically for the medical aid recipients. The cardiologists could also activate the pre-admission OARS for other patients when necessary. Subsequently, the SWT responded on that day to discuss initiating the financial support process with the candidates. The rate of cardiologists’ pre-admission referral to SWT, decision-making time on financial support provision, and proportion of patients receiving financial support were compared before and after initiating OARS.

Results

After initiating pre-admission OARS, the rate of cardiologists’ pre-admission referral to SWT increased from 17.8% (18/101: mean age, 64.6±12.0 y; 32 females; January-December 2020) to 59.1% (55/93: mean age, 64.0±11.8 y; 29 females; June-December 2021) (p < 0.001). Although the decision-making time to provide financial support did not change significantly (8.4±11.1 vs. 4.7±11.6 d; p = 0.96), the proportion of patients receiving financial support increased (45.5% [46/101] vs. 60.2% [56/93]; p = 0.045).

Conclusions

By enhancing the cardiologists’ pre-admission referral to SWT and success rate of receiving financial support, the proactive strategy of pre-admission OARS benefits CAD patients scheduled for CAG.

Key messages

• By building a proactive referral strategy of pre-admission OARS, more CAD patients scheduled for CAG could obtain timely financial support and be relieved both emotionally and financially by the SWT.

• This pre-admission OARS might be incorporated for more disease entities for patients in need.