bluuebunny/crossref_metadata_2025 huggingface dataset:
FC Prostate - Football for men with prostate cancer in local football clubs
Authors: Soerensen C D
Published: November 2019

Prostate cancer is the most frequent cancer found in men. Physical activity has shown to counteract some unwanted psychological and physiological side-effects, however sustainable exercise concepts have been hard to achieve.

Since 2011 Danish researchers from The University Hospitals’ Center for Health Research have tested, evaluated, and developed football training for men with prostate cancer. In the period 2011-2017 FC Prostate was conducted in three phases (I-III). Pilot study (I), a small scale randomized controlled trial (II), and the FC Prostate Community (III) conducted in a real-world setting in six Danish football clubs.

Researchers found that participants who played football once a week or more improved their mental health and reduced fat mass. For some men with prostate cancer, football proved to be a sustained, and viable alternative to other types of physical rehabilitation.

Based on these research results the ambition in phase IV is to offer FC Prostate nationally. This task was undertaken by The Danish Health Committee (DCHE) and The Danish Football Association (DBU). During the period 2018-2019 DCHE and DBU have collaborated to initiate and implement local partnerships around each of the currently 20 active FC Prostate-teams in Denmark (spring 2019). DCHE have developed a simple model of collaboration. The model contains a clear division of relevant tasks and outlines a meaningful collaboration between municipal rehabilitation centers, hospitals, and local football club to run locally based FC Prostate-teams; covering such tasks as recruitment, training, and retention of men with prostate cancer in an active life style.

The main focus of the presentation will be the national implementation of FC Prostate, including experiences and identified barriers during the project, and expected outcomes based on the project development so far.

Key messages

Local club-based football is a viable alternative to other types of physical rehabilitation. Rehabilitation centers and hospitals are currently collaborating with local club to host and run FC Prostate-teams in Denmark.
Interrupted time series analyses on the effect on integrated care among the older population
Authors: Agerholm J
Published: November 2019

Background

Current health and social care systems in most European countries, are highly fragmented into specialist services, and poorly designed to provide health and social care for patients with multiple health problems and social needs. As some groups of patients might have greater difficulties navigating in a fragmented and divided system than others, current system also risks increasing inequalities in access and use of health and social care services. The aim of this study is to investigate if a comprehensive integrated care system perform better than ‘standard care’ in regards to emergency department visits, hospitalization for ambulatory care sensitive conditions (ACSC), costs and re-admissions as well as increase equity in health care among older people.

Methods

This study is an intervention study based on a comparative interrupted time series design comparing data from Norrtälje, where an integrated care system was implemented in 2006, with other areas of Stockholm county with a standard care system. The time series consists of register data from 2000-2015, obtained from the Stockholm County Council’s administrative database of healthcare utilization and population data on socio-demographic characteristics from national registers.

Preliminary results

The preliminary results based on data from 2000-2011 suggest that the introduction of an integrated care system in Norrtälje did not affect the rate of hospitalization for ACSC, costs or rates of emergency department visits. When stratifying on income group we saw that the lowest income group did improve in some of the outcomes.

Conclusions

The integrated care system in Norrtälje seems to have no significant effect on the outcome measures included. Whether socioeconomic inequity was affected is still to be investigated further.

Key messages

In this study we used interrupted time series to investigate organisational changes in the health care sector. Introducing integrated care in Norrtälje seems to have little effect on register based outcome measures.
In-home monitoring evaluation by home-dwelling older adults, caregivers and healthcare providers
Authors: Pais B , Buluschek P , Nef T , Schütz N , Saner H , Gatica D , Santschi V
Published: November 2019

Background

In Europe, population ageing is increasing the healthcare needs and costs. Both frailty and chronic diseases affecting older people reduce their ability to live independently. However, most older people prefer to age in their own homes. New development of in-home monitoring can play a role in staying independent, active and healthy. Our objective was to evaluate a new in-home monitoring system among home-dwelling older adults (OA), their family caregivers (FC), and their healthcare providers (HCP) for the support of home care.

Methods

The system continuously monitored OA’s daily activities (e.g., mobility, sleep habits, fridge visits, door events) at home by ambient sensor system (DomoCare®) and health-related events by wearable sensors (Fitbit®, ECG). In case of deviations in daily activities (e.g., changes in mobility), alerts were transmitted to HCP via email. Using specific questionnaires, the opinion of 13 OA, 13 FC, and 20 HCP were collected at the end of 12-month of follow-up focusing on their user experience and the impact of in-home monitoring on home care services.

Results

These preliminary results underlined that the majority of OA, FC, and HCP consider that in-home sensors can help staying at home, improving home care, reducing family stress, and preventing domestic accidents. The opinion tended to be more favourable toward ambient sensors (80%) than toward Fitbit® (67%) and ECG (64%). On average, OA (80%) and FC (73%) tended to be more enthusiast than HCP (63%). Some barriers reported by HCP were a fear of weakening of the relationship with OA and an excessive surveillance.

Conclusions

Overall, the opinion of OA, FC and HCP were positive related to in-home sensors, with HCP being more mixed about their use in clinical practice.

Key messages

In-home monitoring technologies seem to be generally well accepted. In-home monitoring technologies could be help facilitating home care of older people.
Impact of a community respiratory service on emergency hospital admissions
Authors: Levin K , Anderson D , Milligan M , Crighton E
Published: November 2019

Background

A community respiratory service was implemented in the North West of Glasgow in January 2013, comprising a team of physiotherapists, occupational therapists and support workers, to provide education, self-management advice, and, where appropriate, treatment at home, for COPD patients, to reduce the risk of hospital admission. This study measures the impact of the service on emergency admission to hospital.

Methods

COPD EAs were defined as emergency admissions to hospital with a primary diagnosis of COPD. Rate of COPD EAs per 1000 population aged 65 years+ in Glasgow City was compared before and after onset of the service, using segmented linear regression with 21-month pre- and 17-month post-intervention periods. COPD EAs for residents of South and North East Glasgow (S+NE) - areas with no such service in place - were used as a comparison group. The model adjusted for the rate of all-cause emergency admissions. Autoregressive terms were included in the model, as well as a fourier term to adjust for seasonality. Models were similarly run for outcome emergency admissions with COPD in any of the other five fields of diagnosis.

Results

Adjusting for all cause EAs and changes in S+NE, thus factoring out the impact of other initiatives that may have affected emergency admission to hospital, the impact of the service was found to be a level change of -0.33 (-0.51, -0.16) and a trend change of -0.03 (-0.05, -0.02) COPD EAs per 1000 per month. This is equivalent to a predicted reduction due to the service of -0.88 COPD EAs per 1000 popn per month, in March 2015, and a relative reduction of 35.8%. Rate of COPD EAs per month reduced over time after the introduction of the service (from the point of full staffing). Rate of EAs with COPD in a field of diagnosis other than primary saw no significant change in level or trend associated with the service.

Conclusions

The community respiratory service was associated with a significant reduction in the rate of COPD EAs.

Key messages

The Community Respiratory service was associated with reductions in emergency hospital admissions with COPD as a primary diagnosis. There was no significant change in emergency admissions with COPD as a secondary diagnosis, suggesting hospital attendance for patients with COPD overall reduced following the intervention.
Energy drink consumption pattern among university students in North East England
Authors: Visram S , Ananthakkarasu V
Published: November 2019

Background

Energy drinks (EDs) are popular beverages with young people, particularly in the UK. There is an emerging evidence base on the negative health impacts in children and adolescents, largely relating to the high caffeine and sugar contents of these drinks. However, no studies have been conducted to date focusing on university students in the UK. The purpose of this study was to investigate factors underpinning ED consumption, as well as health effects reported by students.

Methods

An online survey was conducted with a non-representative sample of 900 students from the five universities in the North East of England. This included questions on ED consumption, perceived stress (10-item PSS), general health status, personal wellbeing (ONS4), lifestyle and use of other substances such as alcohol. Responses were analysed using SPSS.

Results

84% of respondents (n = 756) had consumed EDs at least once, mainly while partying or during revision. Of these ED consumers, 542 (71.7%) reported experiencing symptoms following intake, with the most common being elevation of heart rate and palpitations. No associations were found between ED consumption and perceived stress or wellbeing, but an inverse U-shaped association was observed with self-reported health (i.e. lowest consumption among those who rated their health as either “very good” or “bad”). Consumers were more likely to be male, White, from the UK, less affluent backgrounds, and report having no religion. Co-consumption with alcohol was common in the cohort (46.2%). Those who used substances such as cigarettes, e-cigarettes and cannabis were also more likely to be ED consumers.

Conclusions

ED consumption is highly prevalent in the student population, linked to socioeconomic and cultural factors rather than perceived stress or wellbeing. Prevention campaigns targeting students should aim to raise awareness of the consequences of chronic and acute ED consumption, particularly in conjunction with other substances.

Key messages

ED consumption is highly prevalent in the student population, often in conjunction with alcohol. Consumption is linked to socioeconomic and cultural factors rather than perceived stress or personal wellbeing.
Community infrastructure to boost social relations: a systematic review
Authors: Bagnall A , South J , Southby K , Di Martino S , Pilkington G , Mitchell B , Pennington A , Corcoran R
Published: November 2019

Background

‘Boosting social relations’ in communities has been identified as a priority UK policy-related topic. An earlier scoping review identified evidence gaps in social relations & community infrastructure. We undertook a mixed method systematic review on this topic, which has potential for immediate practical impact.

Methods

A comprehensive search included 11 databases (1997-2017), grey literature and citation checking. Studies of interventions to improve or make alternative use of community or neighbourhood places, reporting outcomes of social relations, community wellbeing & related concepts were included. Established validity checklists. Qualitative data was synthesised thematically and a narrative synthesis was produced. GRADE and CERQual approaches were used to rate the overall strength of evidence for each outcome.

Results

51 included studies, mostly of poor to moderate quality, and mostly qualitative, provided moderate evidence that: Community hubs may promote social cohesion, increase social capital and build trust, widen social networks, increase interaction, and increase knowledge or skills;Changes to neighbourhood design may positively affect sense of belonging and pride in a community;Green and blue space interventions that provide the opportunity to participate in activities or meetings may improve social interactions, increase social networks, bonding and bridging social capital, physical activity and healthy eating, and improve people’s skills and knowledge.

There were also common themes relating to facilitators and barriers to successful interventions.

Conclusions

There is moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Future research should prioritise high quality evaluations using repeated measures and validated tools, and robust and credible qualitative evidence.

Key messages

There is moderate evidence that a range of intervention approaches to community infrastructure can boost social relations and community wellbeing. Community hubs may promote social cohesion, increase social capital and build trust, widen social networks, increase interaction, and increase knowledge or skills.
School environment and obesity in primary schools. An analysis of the WHO European COSI in Austria
Authors: Aufschnaiter A , Schindler K , Fuchs-Neuhold B , Maruszczak K , Pail E , Sulz I , Weghuber D
Published: November 2019

Background

Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016.

Methods

A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods.

Results

In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %.

28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p < 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018).

Conclusions

The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI.

Key messages

73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.
Use of voice messaging via mobile phone to communicate female adolescents in Bangladeshi urban slum
Authors: Shah M , Rahman K , khondker H
Published: November 2019

Problem

Utilization of available maternal health services is comparatively low among adolescent population in Dhaka urban slum areas and lack of adequate knowledge is one major contributor to low service utilization among slum dwelling adolescent mothers.

Description of problem

Dhaka urban slum dwelling female adolescents are difficult to reach adequately with health messages through traditional home visit by community health workers for counseling, because many of these adolescents in Dhaka urban slums have a job outside home. We designed and implemented an innovative health communication intervention “Health Boost” - an approach to provide reproductive, maternal and newborn health information for married female adolescents using the voice message system on mobile phone.

Methods

We delivered ‘Health Boost’ (HB) voice messages to enrolled married adolescent girls, twice a week, with re-listening option. Pregnant and non-pregnant participants received separate sets of messages. Enrollment was started after baseline survey (September 2016) and continued during October 2016 - April 2017. Pregnant participants received messages at least for 6 months before delivery. For evaluation, we followed pre-post observation study design and had the endline survey in November 2017.

Results

Comparing HB non-receivers at baseline (n = 321) and HB receivers at endline (n = 45), statistically significant improvement was revealed for knowledge on danger signs - (a) during pregnancy (55.5% vs. 93.3%; p < 0.001), (b) during child delivery (54.2% vs. 82.2%; p < 0.001), (c) for newborn (56.7% vs. 75.6%; p < 0.02). We also found significantly higher utilization of service among HB receivers: Utilization of antenatal care increased from 70.4% to 87.5% (p < 0.02); and use of postnatal care increased from 31.6% to 73.7% (p < 0.03).

Lessons

‘Health Boost’ messages were instrumental and effective to increase knowledge and service utilization among married adolescent girls in Dhaka urban slum areas.

Key messages

Voice message is an innovative way to reach hard-to-reach population by using mobile phone technology. Voice messages were instrumental and effective to increase knowledge and service utilization among urban female adolescent population, for reproductive, maternal and newborn health.
Work stress, migration background and risk of long-term sickness absence in Denmark
Authors: Rugulies R , Sørensen J K , Madsen I E H , Nordentoft M , Sørensen K , Framke E
Published: November 2019

Background

Work stress may increase risk of long-term sickness absence, but little is known if this association differs by migration background. In this study, we examined the prospective association between effort-reward imbalance at work and risk of long-term sickness absence in individuals with and without migration background in the Danish workforce.

Methods

We included 59,468 respondents from a nationwide survey on work and health, 3,226 with a migration background (immigrants or first generation descendants of immigrants) and 56,242 without a migration background. Effort-reward imbalance was assessed by self-report. Migration background and long-term sickness absence (spells ≥6 weeks) were assessed by national register data. Using Cox regression, we estimated the association between effort-reward imbalance and onset of long-term sickness absence during 12 months follow-up separately for participants with and without a migration background, adjusted for age, sex, education and previous long-term sickness absence.

Results

The effort-reward imbalance score at baseline was similar for respondents with and without a migration background. The hazard ratio for long-term sickness absence during follow-up per 1 standard deviation increment in effort-reward imbalance at baseline was 1.26 (95% CI: 1.16-1.37) and 1.16 (95% CI: 1.13-1.20) for respondents with and without a migration background, respectively.

Conclusions

Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. Although the estimate was higher in workers with a migration background, confidence intervals overlapped indicating that associations were similar in both groups. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence should not be prioritized by migration background but should be offered to the whole workforce.

Key messages

Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence activities should be offered to the whole workforce.
Socioeconomic differences in paid sickness allowances in Finland
Authors: Blomgren J , Jäppinen S , Pekkala J , Rahkonen O
Published: November 2019

Background

Receipt of sickness allowance (SA), which in the Finnish benefit system functions as compensation for loss of income due to over 10-days-long sickness absence, is more prevalent in lower socioeconomic groups. As SA is an earnings-related benefit and higher occupational classes have on average higher previous income, their share of SA expenditure must be higher than their share of SA days would suggest. However, the allocation of SA costs to different socioeconomic groups is not known. The aim of this study was to compare occupational classes in terms of their shares of total paid SA days and SA benefit costs.

Methods

We used register data covering the total working-age (16-64) employed population of Finland at the end of 2016 (N = 2.2 million), with linked data on paid sickness allowances during 2017. Yearly accumulated sickness allowance days and allowance costs, paid by the Social Insurance Institution of Finland, were calculated for upper and lower non-manual employees, manual workers and self-employed persons.

Results

Of the total yearly SA days of the employed population, 13% were paid to upper non-manual employees, 40% to lower non-manual employees, 37% to manual workers and 10% to the self-employed (the respective shares of these occupational classes of the employed population were 23%, 36%, 30% and 11 %). The average gross allowance was 77€ per day among upper non-manuals and between 54€ and 60€ in the other groups. Accordingly, upper non-manuals accounted for a larger share of the SA costs compared to their share of SA days: the proportions of costs were 16%, 39%, 36% and 9% in each occupational class, respectively.

Conclusions

The results show that as the average amount of daily sickness allowance is distributed in an opposite manner compared to the prevalence and length of sickness allowance spells, socioeconomic differences in sickness allowance costs are smaller than differences in the prevalence of sickness allowance.

Key messages

Upper non-manual employees have a lower prevalence of sickness absence and shorter spells than other occupational groups. Because of higher earnings-related sickness allowance among upper non-manual employees, their share of sickness allowance costs is higher than their share of sickness allowance days.
Organizational climate and work commitment as predictor of 10-year registered sickness absence
Authors: Knapstad M , Lissner L , Bjorkelund C , Holmgren K
Published: November 2019

Background

Early identification of persons at risk for sickness absence offers an opportunity to put in place preventive measures in the future. The Work Stress Questionnaire (WSQ) is specifically designed to identify people at risk for sickness absence due to work-related stress. In this study we examine prospective associations between work-related stress as measured by the WSQ and registered sickness absence up till 10 years later among employed and self-employed women in the general population in Gothenburg.

Methods

This is a survey-linkage study based on the 2004-05 wave of the Swedish “Population Study of Women in Gothenburg (PSWG)” and 10-year follow-up in the MiDAS sickness absence register. Participants registered as employed or self-employed were included (n = 396). Outcomes were number of sickness absence episodes during follow-up and sickness absence during each two-year time band of follow-up.

Results

High perceived stress due to poor organizational climate, compared to low stress, gave an adjusted Incidence Risk Rate (IRR) of 1.99 [95% CI 1.19-3.34] for sickness absence episodes. Combining high perceived stress due to poor organizational climate with high perceived stress due to work commitment gave an IRR of 2.32 [95% CI 1.26-4.26]. Examining separate time periods, similar associations were found during years 5-6 and 7-8. Perceived low influence at work also gave increased odds for sickness absence, at both in the shorter term (1st-2nd year) and longer term (7th-8th year).

Conclusions

The findings align with previous studies that WSQ may successfully identify women with elevated risk for future sickness absence, and adds that this is even true in a general population context and using a very long follow-up period. Nevertheless, the findings should preferably be confirmed using a larger sample to improve precision of the observed associations.

Key messages

The present study contribute with knowledge about screening instruments that may identify women in the general working population with elevated risk for sickness absence. The findings suggest that high perceived stress due to organizational climate, alone and in combination with high work commitment, as well as low influence at work, increase risk of sickness absence.
Workshop: Paving the path to the health systems of the future
Authors:   Organised by: Chafea, EUPHA, DG Sante Chairperson: Anne-Marie Yazbeck, Chafea
Published: November 2019

Reforming health systems is a priority that is being addressed at local, regional, national and European level. Health system reforms are complex; they require political commitment, know-how, skills and sustained financial investments. The EU can provide support in various stages of such reforms: from initiation to design and to implementation. The session will describe the main EU tools for this, such as the European Semester, programmes that can offer technical assistance, as well as programmes that provide opportunities for financial support.

EU tools to support health system reforms

Loukianos Gatzoulis

DG SANTE

Technical support / twinning

Sonia Mueller

VIGOUR

Financing support

Dita Protopopová

Mental Healthcare reform project, Ministry of Health, Czech Republic
Long working hours and mortality in Central and Eastern Europe: the HAPIEE study
Authors: Pikhart H , Liu Q , Pajak A , Malyutina S , Kubinova R , Bobak M
Published: November 2019

Background

Long working hours are common in countries of Central and Eastern Europe (CEE). A wide range of epidemiological studies have showed that long working hours had an adverse effect on health but the evidence mostly comes from Western Europe, East Asia and North America. This study aimed to assess the relationship between long working hours and the risk of mortality in employed people in three Eastern European countries.

Methods

Participants, aged 45-69 years at baseline, were from the Health, Alcohol and Psychosocial Indicators in Eastern Europe (HAPIEE) cohort study conducted in Russia, Poland and the Czech Republic. Baseline survey included a structured questionnaire and examination in the clinic during 2002-2005. Working hours were assessed by a self-reported questionnaire at baseline. Participants have been followed-up for all-cause mortality and cause-specific mortality for an average of 11 years. Impact of long working hours on mortality was analysed by Cox proportional hazards regression. In all-cause mortality analysis, a total of 10878 men and women were included, and 10399 participants were included in cause-specific mortality analysis.

Results

During the follow-up, there were 1187 deaths from all causes, 288 from CVD, and 251 from cancer. Those who worked 61 hours or more in a week showed higher risk of mortality compared to those working 36-45 hours per week: HR 1.32 (95%CI 1.01 to 1.74) for all-cause mortality and 1.73 (95% CI 1.03-2.93) for CVD mortality. There was no significant increase in risk of cancer mortality associated with working long hours. There was no significant association between working 46-60 hours a week and risk of mortality, including all-cause mortality and cause-specific mortality.

Conclusions

The risk of all-cause and CVD mortality in three CEE was significantly higher among employees working extensive hours. These findings suggest that more attention should be paid to shortening working hours for those who work extensively.

Key messages

Long working hours increase risk of all cause and CVD mortality. Cancer mortality is not related to long working hours.
Workshop: Transferring innovation in health systems: The role of national mirror groups
Authors:   Organised by: TO REACH Consortium, EUPHA Chair persons: Natasha Azzopardi Muscat - EUPHA, Karine Chevreul - France
Published: November 2019

To-Reach has the aim to build and push forward a strategic agenda at European level for health services and policy research into practice in order to help decision makers in identifying and understanding the value of a given innovation in the field, the potential for joint development of innovation and facilitating implementation to fit the regional/local contexts.

Given the diversity of health systems in Europe and the element of subsidiarity within the European Treaty, in order, to achieve this aim the commitment of all categories of stakeholders (funding bodies, researchers, policy makers, systems managers...) at national level is as essential prerequisite for success.

France has created a mirror group to consult these stakeholders to ensure that national priorities will be reflected at European level and respectively that national priorities and funding direction are influenced by the European strategic agenda. The objectives of this workshop will be to learn from the French experience and to discuss how similar experiences in other countries could be shared and promoted. Their role going forward in the project and their contribution to the expected outcomes will be the focus of this workshop. Stakeholders from a number of European countries will be invited to present and discuss their perspective on this issue.

Key messages

Joint development of health services research at European level is necessary to overcome key system challenges. National stakeholders are key to the development of a European health services research progarmme.
Skills building seminar: How to improve vaccination coverage in the European Union?
Authors:   Organised by: EC, Observatory Chair persons: Josep Figueras - European Observatory, Isabel de La Mata - European Commission - DG Sante
Published: November 2019

In recent years, the European Union (EU) has been facing several serious outbreaks of vaccine-preventable diseases, including measles. Vaccination coverage rates for the first dose of the vaccine against measles vary from 85% in Italy to 99% in Luxembourg and Hungary, with the average for the EU (93.6%) falling below what is required to ensure herd immunity. Similar variations can be seen for other vaccinations, including influenza immunization programmes targeting older adults who are at greater risk of severe complications. Of particular concern is that in a number of EU countries anti-vaccine groups, aided by social and mainstream media, and sometimes populist politicians, are gaining traction and have started to influence public and health worker attitudes towards the safety and effectiveness of vaccinations.

The EU has started to respond to these developments in a number of ways. In his 2017 State of the Union address, Jean-Claude Juncker, the President of the European Commission, has called for action to increase vaccination coverage and to ensure that everyone in the EU has access to vaccines. This was followed by a number of new policy and research activities initiated by the European Commission.

The workshop provides an overview of some of these activities. It starts with an introductory presentation on recent initiatives of the European Commission to support national vaccination efforts. This is followed by a presentation on the work of the Expert Panel on effective ways of investing in Health and their report on vaccination programmes and health systems in EU countries. A third presentation presents EU-funded research on vaccine hesitancy in EU member states, based on the largest ever study on attitudes to vaccines and vaccination in the EU. A final presentation explores a study undertaken for the European Commission by the European Observatory on Health Systems and Policies on the organization and delivery of vaccination programmes in EU member states, based on detailed country fiches.

The workshop will provide opportunity for the audience to comment on and discuss presentations and to consider current policy options in Europe to address vaccine hesitancy and improve vaccination coverage through health system interventions. It will be of interest to public health researchers, practitioners and policy-makers from across Europe.

Key messages

The workshop provides a forum for discussing European initiatives to overcome vaccine hesitancy and improve vaccination coverage. It explores policy options at the European and national level.
Vaccination programmes and health systems in the European Union. Report of the Expert Panel on effective ways of investing in Health
Authors: McKee M , Siziliani L , Wild C , Kringos D , Barry M M , Barros P , De Maeseneer J , Murauskiene L , Ricciardi W
Published: November 2019

Background

Vaccination is one of the most cost-effective public health interventions available and the main tool for primary prevention of communicable diseases. However, the EU is facing increasing outbreaks of vaccine preventable diseases, while some fatal cases of measles and diphtheria have been reported.

Methods

The presented report is based on the work of the Expert Panel on effective ways of investing in Health, which was informed by a literature review on the main factors (enablers and obstacles) influencing vaccination uptake.

Results

Obstacles to vaccination coverage include individuals’ and parents’ concerns or fears about vaccine safety and side effects, lack of trust, social norms, exposure to rumours and myths undermining confidence in vaccines, failure by some healthcare providers to counter these myths and provide evidence-informed advice, access barriers (e.g. poor availability, co-payments), and failure to understand the underlying mechanisms that decrease vaccination confidence. Enablers include sources of reliable information about vaccination, exposure to positive media messages, building trust in institutions and providers, building confidence in vaccination, easy access and availability to healthcare services, ease of administration, active involvement and engagement by healthcare providers, and targeting of high-risk groups.

Conclusions

There is a range of policy options that countries can implement to increase vaccination coverage. Communication strategies about the benefits of vaccination are important but need to be combined with opportunities for dialogue with vaccine hesitant groups and participatory approaches. These strategies need to be targeted not only at the uninformed (i.e. the lack of information) but also at the misinformed (when the information is incorrect) or disinformed (when information is spread with the intention to deceive).
Vaccination coverage in the European Union
Authors: Pastore Celentano L
Published: November 2019

Background

Vaccination coverage rates in the European Union (EU) vary considerably across countries and there has been a decline for some diseases in some countries in recent years.

Methods

The ECDC supports member states in their vaccination programmes through a range of activities, including identification of threats, surveillance, international collaboration, scientific working groups, assessments of national vaccination programmes, and communication activities.

Results

For the first dose of the vaccine against measles, coverage ranges from 85% in Italy to 99% in Luxembourg and Hungary, with the average for the EU (93.6%) falling below what is required to ensure herd immunity. Uptake of the second dose against measles reached the target of 95% in only four countries in 2017, compared to 14 in 2007.

Conclusions

Despite the fact that there are safe and efficient vaccines, there seems to be a crisis of confidence in them. Each EU citizen should receive correct evidence-based information on vaccines and have the same immunisation opportunities.
Skills building seminar: Measuring children mental health
Authors:   Organised by: EUPHA (PMH) Chair persons: Viviane Kovess-Masfety - France, Kerry Keyes - USA
Published: November 2019

This workshop will be a skills building seminar aimed to present different instruments that have been used in measuring children or adolescents mental health, plus some results to illustrate their pertinence.

It aims to render child psychiatric epidemiology accessible by presenting easy to use instruments for children and adolescents that allow to conduct surveys in schools or in other contexts. It will also present and discuss some results in order to stimulate the epidemiological approaches for child mental health problems as well as evaluating access to care,specialized and no specialized, and the relationships between school achievements and mental health problems.

This will be based on two major studies: The School Children Mental Health Europe, an EU funded project designed to set up a kit of instruments enabling cross EU comparisons. For this project a literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers and the Dominic Interactive, a sort of video game designed to evaluate DSM more commune diagnoses since the children were primary school children 6 to 11 years old.Previously done in France, the project has collected around 1000 children per country in Germany, Italy, Netherlands, Lithuania, Bulgaria, Romania and Turkey. In addition it measured parental attitudes, domestic accidents, some physical diseases, parental mental health, access to care for mental health problems and some socio demographics. Teachers are asked to evaluate school achievements in addition to their own child mental health evaluation.The project allows evaluating relative concordance on the above instruments results with clinical judgments on separate clinical samples from each of the countries using the DAWBA (a clinical instrument).The lecture proposes to present the instruments and their usage and some of the comparative results among them the relationships between academic performances and mental health problems.The US National Comorbidity Survey Adolescent Supplement (N = 6256), in that survey the Composite International Diagnostic Interview (CIDI) assessed fifteen lifetime mental disorders and The Sheehan disability scale assessed disorder severity. ID was defined as: 1) IQ ≤ 76, measured using the Kaufman Brief Intelligence Test; and 2) an adaptive behavior score ≤76, measured using a validated scale.

The lecture will present the instruments and some of the results concerning psychiatric comorbidity and intellectual disability.

Key messages

Children mental health problems are affecting around 12% of the children and should be evaluated and monitored. Easy to use instruments exist; as children could be surveyed in schools it becomes relatively easy and not too costly to conduct surveys that will integrate risk factors and access to care.
Comparing children mental health across countries: challenges and results
Authors: Kovess-Masfety V
Published: November 2019

Background

The School Children Mental Health Europe was a EU funded project designed to set up a kit of instruments enabling cross EU comparisons.

Methods

A literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers after a validation process in each country and the Dominic Interactive (DI), a sort of video game designed to evaluate DSM more commune diagnoses on children 6 to 11 years old.

Results

Data were collected on 7682 children randomly selected in a two stages selection: schools by country and children within the schools for whom 1) either parent- or teacher SDQ were completed: Overall, 12.8 % of children have any probable disorder with significant inter-country differences, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. Adjusting for socio-demographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. 2) Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems.

Conclusions

This lecture aims to present and discuss child mental health measure instruments from different informants perspectives, comparisons across countries and the challenges for interpreting the differences.
French validation of a measurement scale of life skills for children
Authors: Simar C , Masson J , Pironom J , N’Sambu C , Tessier D
Published: November 2019

Background

According to WHO (2003), ‘Life skills’ are defined as psychosocial abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life. They are loosely grouped into three broad categories: cognitive for analyzing and using information, personal for developing personal agency and managing oneself, and inter-personal skills for communicating and interacting effectively with others. Skills-based health education is an approach to creating or maintaining healthy lifestyles and conditions through the development of knowledge, attitudes, and especially skills, using a variety of learning experiences, with an emphasis on participatory methods. Our aim was to develop an integrated measure of the life skills grouped into three broad categories of skills for children who are at least 9 years old. The present communication is focused on the validation in a French validation of a tool measuring social competencies in children - Weiss et al. (2014) - which represents one of the three categories of psychosocial competencies (emotional and cognitive competencies).

Methods

Data were collected three times during year 2017-2018: 614 questionnaire (T1), 564 (T2), 331 (T3) - 311 children filled the questionnaire three times. Three types of analyses were conducted in order to assess the validity and reliability of social competence (SPSS version 23 et AMOS version 21): Validity of construct, concurrent validity and reliability.

Results

The results show a high reliability and a good validity of construct and concurrent, thus indicating satisfactory psychomotor qualities.

Conclusions

This compendium will also assess the validity and reliability of this scale with the data collected at the other two measurement times and study the predictive validity of the scale. The same process will be applied to the cognitive skills measurement scale for validation. Acknowledgment: CPS team and schools and pupils involved.
Development of a European Public Health Emergency Preparedness Training Toolkit
Authors: Guicciardi S , Fantini M P , Savoia E , Stoto M A , Nelson C , Piltch-Loeb R , Pommier J , Ciotti M , Riley P
Published: November 2019

Background

In 2017, under the supervision of the European Centre for Disease Prevention and Control (ECDC), a list of competencies and knowledge and skill statements for EU professionals working in Public Health Emergency Preparedness (PHEP) systems were identified and integrated into a Competency Model. Building on these efforts, a PHEP competency-based training toolkit was developed, pilot tested and finalized with the goal of providing a standardized training resource for experts involved in response to cross-border threats to health.

Objectives

Led by the ECDC, an international research team drafted a preliminary version of a curriculum consisting of five modules, with a list of targeted competencies, learning objectives, reading and training methods including case studies and simulation exercises. In May 2018, the curriculum was pilot tested in a 3.5-day training course at the University of Bologna, Italy. The participants included 20 representatives from 8 EU Member States. An evaluation strategy, combining both quantitative and qualitative methods, was designed to assess the impact of the training on participants’ applied knowledge and competence.

Results

Overall, the participants’ feedback on the pilot course was positive, with scores from 4.0 to 4.8 out of 5 for all the items considered. Several suggestions were made both by the trainers and the trainees to enhance the effectiveness of the learning activities, and the curriculum was integrated into a training toolkit with more exercises, teaching materials and a guide for facilitators.

Conclusions

This European Public Health Emergency Preparedness Training Toolkit is the first EU competency-based toolkit intended to help Member States improve their response to public health emergencies through standardized training. Designed for individuals working in strategic positions at the national level, its general approach, modular structure and content are relevant and can be tailored to a wider range of professionals.

Key messages

To improve PHEP in the EU, competency-based curricula and standardized training programs and resources for health professionals are needed. By enhancing the overall public health professionals’ experience and competency, the European PHEP Training Toolkit represents a step towards strengthening preparedness and response systems in the EU.