bluuebunny/crossref_metadata_2025 huggingface dataset:
Sport federation investment in health promotion: program implementation and viability
Authors: Van Hoye A , Regan C , Lane A , Cullen B , Vuillemin A , Woods C
Published: October 2022

Background

Researchers have called for a better recognition of the potential of sports clubs for health promotion (HP), but less is known on the support provided by sports federation. The present study analyses the the implementation of the Gaelic Athletics Association (GAA) Healthy Club Project, to investigate its organization’s viability.

Methods

A single case study was realized, based on observation, document analysis and interviews, to document the viable system model.

Results

Results have identified a three-level structure, where 6 employees at national level support the work of 28 volunteer’s county health and well-being officers and 439 clubs implicated. Strengths of the organization are the identification of a single national referent for clubs or county, the learning process and openness to novelty, as well as the enhanced workforce through county implication as role model. Challenges are the financial and human resources provision, the ability to implicate county and club board and the training in HP of volunteers. Interlevel relationship are supported by the creation of a community of practice and the centralization of the project at national level, but hindered by a clear definition of county tasks. The strengths of the controlling system include a steering committee implicating partners completing each other and the proper use of evaluation to build evidence on the project, where challenges remains in wider collaboration within the GAA.

Conclusions

The present work has underlined key scaling up factors of the HCP implementation to support its viability, which could be learnt from other sports federation implementing HP interventions.

Key messages

• Sports federation have a key role to play to support sports clubs to promote health, by developing specific programs.

• Health Promotion development in sports clubs has similar scaling up implementation factor than other public health interventions.
Impact of a multidisciplinary intervention on Mediterranean diet adherence and cardiovascular health
Authors: Marziali E , De Marco S , Nachira L , Arcaro P , D'Ambrosio F , Villani L , Galasso V , Laurenti P , Bruno S
Published: October 2022

Background

Cardiovascular diseases represent a significant public health issue, and the promotion of healthy lifestyles plays a major role in their prevention. Good adherence to the Mediterranean diet has a protective effect on cardiovascular health and may reduce the risk of developing cardiovascular disease. Our prospective study aimed to evaluate the impact of educational lifestyle interventions on cardiovascular risk parameters and the improvement in adherence to the Mediterranean diet of the involved population.

Methods

Participants have been recruited by General Practitioners in Torresina neighborhood in Rome. From December 2018 to June 2020, 41 patients were involved in nutritional, psychological, and physical activity meetings by a multidisciplinary team of healthcare professionals. In particular, a nutritionist provided information to patients on balanced nutrition, considering the Mediterranean diet as a dietary model. Information on lifestyle, dietary habits and physical activity, anthropometric data and laboratory measurements were collected at baseline and after 12 months. The variations of the evaluated parameters were analyzed by paired t-test e Wilcoxon signed-rank test.

Results

The analysis showed statistically significant decreases in weight (p = 0.03) and BMI (p = 0.02), as well as in systolic (p < 0.001) and diastolic (p = 0.001) blood pressure and in total (p = 0.02) and LDL (p = 0.01) cholesterol level. Results also showed an improvement in the adherence to the Mediterranean diet (p = 0.001): the frequency of consumption of fruits and vegetables, legumes, cereals and fish has increased significantly, while the consumption of meat, milk and dairy products and alcohol decreased.

Conclusions

This study highlights that a multidisciplinary educational program can be effective in improving healthy habits and in reducing cardiovascular risk factors, supporting its implementation in primary prevention at the community level.

Key messages

• Promoting healthy lifestyle through primary prevention and health promotion actions is critical to reduce the onset of cardiovascular diseases.

• A population-based multidisciplinary educational intervention may be effective in improving adherence to a healthy, balanced diet and decreasing cardiovascular risk factors.
Awareness of Female Genital Schistosomiasis: A cross-sectional survey in rural Madagascar
Authors: Rausche P , Rakotozandrindrainy R , Rasamoelina T , Rakotomalala RS , Kutz JM , Lorenz E , May J , Rakotoarivelo RA , Puradiredja DI , Fusco D
Published: October 2022

Background

Infections with S. haematobium are endemic in tropical regions and emerging in some European countries. Prolonged chronic infection with S. haematobium can cause Female Genital Schistosomiasis (FGS), which can lead to serious gynecological conditions, including infertility. However, awareness of FGS is limited, as are adequate guidelines and public health strategies to manage the disease. The aim of this study is to determine the levels and quality of FGS awareness among women and healthcare workers (HCW) in the Boeny region of Madagascar, where the disease is endemic.

Methods

Data collection involved a cross-sectional survey of adult women (n = 694) and HCWs (n = 93) on topics, such as respondents’ sociodemographic background characteristics, FGS awareness, and risk perceptions. Results were analyzed using descriptive statistics including proportions and 95% confidence intervals.

Results

Of the 694 women included in the study, 11.2% (CI [9.0-13.8%]) had heard of FGS. Among these, 34.6% (CI [24.1-46.2%]) were unaware of the gynecological symptoms signature for FGS, and 41% (CI [30.0-52.7%]) were unaware of the urological symptoms of the disease. Out of the 93 HCW surveyed, 53.2% (CI [42.6-63.6%]) had heard of FGS. Among these, 42.0% (CI [28.1-56.8%]) were unaware of the gynecological symptoms, and 52.0% (CI [37.4-66.3%]) were unaware of the urological symptoms.

Conclusions

Preliminary results show overall low levels of FGS awareness among the study population. While more women reported to have never heard of FGS than HCW, the proportion of HCWs who did not know the gynecological and urological symptoms of FGS was higher. Given the occurrence of FGS in Europe and the chronic character of the disease it would be crucial to conduct similar investigations in Europe. Such findings can contribute to the design of targeted local and global FGS awareness campaigns to improve the health of women affected by this disease worldwide.

Key messages

• Awareness of FGS among the study population in Madagascar, an endemic country, is low.

• Lack of awareness can delay the identification of the disease and increase individual and community burden.
The role of health literacy in vaccination behaviours: a systematic review
Authors: Siena LM , Isonne C , Sciurti A , De Blasiis MR , Migliara G , Marzuillo C , De Vito C , Villari P , Baccolini V
Published: October 2022

Background

Health literacy (HL) is recognized as a driver of health-promoting behaviors, including preventive actions. However the influence of HL on vaccines uptake remains unclear. This study aimed at summarize the evidence on the role of HL in vaccination behaviors.

Methods

PubMed, Scopus, and Web of Science were searched. Observational studies of any design conducted worldwide, published through June 2021 and investigated the association between HL and vaccination intention or status using HL validated tools were included. Any vaccine was considered. An adapted Newcastle-Ottawa Scale was used to assess quality.

Results

Twenty-one articles were included, 6 investigated intention to vaccinate and 15 explored vaccination status. Studies of the first group had a cross-sectional design, considered anti-COVID-19 vaccination and were judged of high or fair quality. Population investigated was heterogeneous as well as the tool used to assess HL. Five analysis provided adjusted estimates. HL seemed not influence the vaccination intention in 3 studies whereas adequate HL was associated with positive attitude to get vaccinated in the remained 3 ones. The majority of articles assessed vaccine status, had a cross sectional design (N = 11) and were of high quality (N = 8). The HL tool more frequently used was TOFHLA (N = 5), sample investigated was heterogeneous included parents of children who received vaccinations (N = 5). Four articles considered multiple vaccinations, thus providing a total of 19 analysis. Vaccine against influenza was the most investigated (N = 11) and 15 studies provided adjusted estimates. No association was found between HL and the receipt of vaccination in 11 analysis, whereas HL levels significantly influenced vaccination uptake in 8 studies.

Conclusions

Health literacy did not seem to strongly influence people decision on vaccinations. Difference in population and vaccines considered, but also in tool used to measure HL might explain the heterogeneity of the results.

Key messages

• The impact of HL on vaccination behaviours remains controversial.

• Efforts to extend the studies on targeted populations applying a comprehensive HL measurement tool should be devised.
Longitudinal relationships between youth assets, seat belt use while driving, and the environment
Authors: Tolma E , Vesely S , Oman R , Boeckman L , Aspy C
Published: October 2022

Background

Positive youth development theory can provide an alternative approach to promote Seat Belt Use while Driving in a Car (SBUDC) among youth. The study aims to explore the relationship between youth assets, and the neighborhood environment in predicting SBUDC.

Methods

The Youth Asset Study (YAS) is a 4-year (5 waves) longitudinal study of a random sample of 1,111 youth (12-17 years old) and their parents, taking place in a Midwestern city, USA from 2003-2008. Seventeen youth assets were developed. The environment was measured objectively via the broken windows survey and subjectively via parents’ interviews. Assets and environmental factors at Waves 1-4 were predicted SBUDC at Waves 4-5 while controlling for demographics. Data were analyzed via marginal logistic regression and generalized estimated equations analyses.

Results

The sample consisted of 1001 youth: 53% female; mean age=14.36 (SD = 1.59); 50% with income <$35,000; and 69% two-parent families. The proportion of youth not wearing a seat belt while driving increased from wave 4 to 5 only among African American youth. Individually, most assets had a positive relationship with SBUDC (ORs ranged from 1.3 to 2.7), with general aspirations for the future, educational aspirations for the future and positive peer role models having the largest ORs [2.7, 95% CI (1.7, 4.3); 2.2, 95% CI (1.5, 2.0); 1.9, 95% CI (1.5,2.4)] respectively. Youth with a higher (≥ 12) number of assets were almost twice as likely to use a seat belt while driving than those with a lower (<12) number [OR = 1.8, 95% CI (1.4, 2.3)]. Only one environmental factor had a significant effect on SBUDC [(OR = 1.32, 95% CI (1.01, 1.72)]. Assets retained their impact on SBUDC, controlling for the environmental and demographic factors.

Conclusions

Youth assets can be a promising approach to promote SBUDC among teens with emphasis on promoting general aspirations for the future, educational aspirations, and positive peer role modeling.

Key messages

• Building youth assets can be another mechanism to promote seat belt use while driving among youth.

• The neighborhood environment might not be as important as other factors are in the promotion of seat belt use while driving.
Promoting migrant HL, good practice in adult education and lessons learned for other interventions
Authors: Harsch S
Published: October 2022

Problem

Migration is a global phenomenon, and migrants face myriad challenges, e.g., building context-specific health literacy (HL). To sustainably promote HL, translations, interpreters, or programs in other languages are insufficient. Courses that promote HL holistically are needed, e.g., second language courses. In the SCURA research project, part of the HLCA Consortium, we ethnographically studied language courses and developed interventions. The insights gained are relevant not only for courses promoting HL of migrants or in Germany but also for other target groups and countries.

Description

Based on extensive ethnographic research, we participatory created interventions to promote HL. As language courses promote HL to varying degrees but are severely limited by the rigid conditions and support, we identified strategies to improve HL therein and ensure uptake and sustainability: add-in, pimp-up, dive deeper. The multimodal intervention consists of an extensive collection of teaching ideas, materials to prepare and reflect on sessions, and a 6-part teacher training (in-house, online, and self-study course, based on adult learning principles). The 90-minutes sessions address Health in Language Courses, Health and Me, Using materials, Critically Analyzing Materials and Developing Empowering Activities, Promoting Family HL, and Mental HL. A hands-on tool was developed to help teachers intentionally promote the seven components of HL.

Results

The preliminary results of the ongoing evaluation showed that the flexibly adaptable and applicable offerings, the online workshop, and self-study courses, were well received. The teachers liked the choice of topics and the combination of short inputs and many recommendations for practice.

Lessons

The project’s success relies on knowing the context and setting, considering the needs of all stakeholders, and developing offerings that are a relief but not an additional burden, and that can be easily integrated into the program.

Key messages

• A thorough ethnographic understanding of the course is key to developing interventions that will be perceived to be appropriate and relevant.

• HL promotion should integrate teachers’ HL, informal occasions on health information exchange, diverse and multilingual ways to engage with health information and a systematic, deliberate development.
Health literacy and its association with health outcomes among students in upper secondary education
Authors: Paasio H , Roos E , Kokko S , Simonsen N
Published: October 2022

Background

Health literacy (HL) - as a broad range of health-related competencies and skills- has been recognized as a determinant of health outcomes, and suggested to be a modifiable health resource and a factor contributing to empowerment and equity. Thus, there is a need to identify the state of HL in various population groups. The aim of this study was to investigate HL levels and associations between HL, physical activity and subjective health among students in general upper secondary and vocational Swedish-language schools in Finland.

Methods

The study used cross-sectional data from the Finnish LIITU-study among students in Swedish-speaking general upper secondary and vocational schools (N = 887; age 16-20 years) conducted in the spring and autumn 2020, during the covid-19-pandemic. Students answered a web-based questionnaire during school hours. HL was measured with the 10-item Health Literacy for School-Aged Children (HLSAC) instrument. Data was analyzed with descriptive statistics and logistic regression analyses.

Results

According to preliminary findings, one third of students had high HL. HL was higher among female than male students, general upper secondary school students than vocational school students, and in spring than in autumn 2020. A higher proportion of students with high HL, as compared to students with low/medium HL, reached the national recommendations for physical activity, perceived their health to be excellent and, moreover, did not have recurrent psychological symptoms.

Conclusions

The findings confirm previous research findings on the importance of HL in promoting health outcomes. The pandemic year 2020 provided a unique perspective to the subject. It would be important to survey and discuss the role of schools in providing equal opportunities for the promotion of HL as this may contribute to decreasing health disparities in the population.

Key messages

• One third of students in upper secondary education (age 16-20 years) had high HL; there were differences between genders, students on different educational paths, and in spring and autumn 2020.

• High HL was associated with better self-rated health, less psychological symptoms and reaching national recommendations for physical activity among students in upper secondary education.
Do religious people in Western Balkans have faith in COVID-19 vaccines?
Authors: Cvjetkovic S , Jeremic Stojkovic V , Jankovic J , Mandic-Rajcevic S
Published: October 2022

Background

Recently, it was established that more religious people tend to have less favorable views of vaccination. The aim of this study was to assess the relationship between the religiousness and attitudes towards COVID-19 vaccination and disease, in five Western Balkans countries.

Methods

Using online questionnaire and convenience sampling procedure, data were obtained from 1605 respondents aged 18-75 years. Perceived COVID-19 vaccine safety and efficacy, and observed danger and susceptibility to disease were assessed by short five-point Likert scales. Religiousness was estimated using single item scale. Multivariate regression analysis was employed.

Results

In Serbia, respondents who assessed themselves as more religious considered vaccine against COVID-19 as less safe (β=-.10, p<.01) and effective (β=-.12, p<.01), were more prone to the attitude that dangers of COVID-19 are not that serious (β=-.09, p<.01), and believed to a greater extent that they are less susceptible to the virus (β=-.07, p<.01). Similarly, in Bosnia and Herzegovina more religious individuals were less convinced that vaccine is effective (β=-.07, p<.05), less inclined to believe that danger of the virus is serious (β=-.07, p<.05), and assessed their susceptibility as lower (β=-.06, p<.05). More religious people in Montenegro (β=-.06, p<.05) regarded the vaccine as less safe, while in North Macedonia (β=.06, p<.05) and Albania (β=.08, p<.01) stronger religiosity was associated with more favorable attitudes towards vaccine safety.

Conclusions

The relationship between religiosity and attitudes towards COVID-19 vaccination and disease is culturally conditioned. While in some Western Balkans societies religious beliefs render individual with a sense of lack of control triggering worry and anxiety, in some others they work as psychological shield against existential threats.

Key messages

• Religiosity should be considered as a relevant factor in vaccination campaigns implementation.

• In the societies where negative attitudes towards vaccination prevail among the believers, religious leaders should be peculiarly educated and encouraged to participate in vaccination campaigns.
Health Literacy, Covid-19 and risk perception: a cross-sectional survey in Prato in the 2nd wave
Authors: Velpini B , Stancanelli E , Stacchini L , Bruschi M , Lastrucci V , Puggelli F , Berti R , Lorini C , Bonaccorsi G
Published: October 2022

During the Covid-19 pandemic, individual and collective public health measures were undertaken to control the spread of the virus. Their effectiveness relies on people’s abilities to understand and adopt the correct behaviors. This study aims to evaluate the role of Health Literacy (HL) in influencing the adherence to Covid-19 preventive measures and risk perception of a sample of workers employed in various activities involving close contact with the population in the province of Prato (Tuscany, Italy) in the second pandemic wave (November-December 2020). A cross-sectional survey was conducted on a sample of public workers (e.g., teachers, educators, assistants/aides, other health personnel). Data on knowledge, attitudes and practices towards (KAP) Covid-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Spearman correlation analysis was used to assess the correlation between HL and KAP and Covid-19 risk perception. Multivariate linear regression analyses were performed to evaluate the role of HL in predicting KAP and Covid-19 risk perception, adjusted for sex, age, comorbidity, educational level, country of birth. A total of 402 people participated in this study; 47.8% had a problematic HL level. The HL level was correlated with KAP and practices towards Covid-19 prevention measures; no significant associations were found with Covid-19 risk perception. In multivariate models, HL significantly and positively predicted a higher level of knowledge of Covid-19 preventive measures (B = 0.413 for problematic HL; B = 0.542 for sufficient HL). Confirming a previous study conducted in Prato in the first pandemic wave, HL did not predict adherence to Covid-19 infection control measures, probably due to fear of the disease and attention towards prevention behaviors being still higher in the second pandemic wave.

Key messages

• HL skills are linked to understanding of public health measures.

• HL skills should be improved to favor the adherence to correct behaviors.
Living Lab: Design a digital health intervention for healthy diet of ethnic minority adolescents
Authors: Lee J , Lee H , Lee H , Konlan K , Seo J
Published: October 2022

Eating habits cultivated during adolescence continue through adulthood, and can widen the health gap in adulthood for vulnerable ethnic minority adolescents (EMA). Living Lab is a methodological approach through which stakeholders co-create innovations as citizen scientists in real-life settings. This study aimed to design a digital health intervention (DHI) for enhancing the heathy diet of EMA using the Living Lab approach. The DHI’s content and strategies were derived through literature reviews and focus group interviews. The Living Lab was structured by using 5 principles: real-life setting, user engagement, multi-stakeholder participation, multi-method, and co-creation. It has four activity phases of discovering problems, exploring solutions, solving problems, and disseminating solutions putting more emphasis on the use of digital device and multiple stakeholders such as peers and teachers in co-ideation. DHI participants were grouped into equal proportions of EMA and Korean-ethnic peers. The DHI operates for 2 hours once a week for 4 weeks, with orientation and wrap-up sessions before and after the DHI. Each activity of the co-working process is designed by applying behavior change techniques such as prompts/cues, framing/reframing, and credible sources in a digital educational environment: creating content using Google Jamboard and Padlet, and working on the metaverse platform ZEP. The responses and feedback from the participants are received through an online reflection diary weekly. Usability and acceptability of digital technology are assessed by an online survey on completion of the DHI. The efficacy of DHI is assessed through the change in dietary behavior and food literacy. This study was designed to enable EMA recognize the harmful effects of an unhealthy diet and co-create solutions through dynamic activities in a digital environment. Further, it may serve to change the cultural sensitivity of native peers that influence the health choices of EMA.

Key messages

• Digital-based intervention would be an effective way for vulnerable ethnic minority adolescents to engage in healthy diet.

• The Living Lab approach was used as an essential strategy to develop a digital health intervention to improve the healthy diet of ethnic minority adolescents.
A unified qualitative-quantitative method to evaluate the impact of being a near-peer health educator
Authors: Arva D , Cseh A , Mészáros Á , Major D , Jeney A , Dunai D , Zörgő S
Published: October 2022

Grasping the complexity of public health interventions is of increasing interest. Program evaluation may involve previously known and unknown variables; the former are best explored with quantitative, the latter with qualitative methods. As part of the impact evaluation of the Balassagyarmat Health Education Program (BEP), a near-peer education intervention targeting adolescents from a disadvantaged region of Hungary, we aimed to understand the complex effects of being an educator on medical students’ knowledge about the biopsychosocial model of health. Thus, we developed a unified method that enables us to conduct an exploratory study on the effects of our intervention, then quantify and model that qualitative data. We started the method design with literature review and consultations with methodological and public health experts. We then refined the research questions based on a focus-group discussion held with 6 peer educators. After a set of pilot-interviews, we chose simulation interviewing as our knowledge elicitation procedure, then finalized the protocol with the help of additional piloting. In this unified method, simulation interviews are administered to peer educators and aligned controls, and cognitive task analysis is performed with the help of visual stimuli. Codes are developed inductively and, along with segmentation procedures, applied deductively to the entire dataset via the Reproducible Open Coding Kit. Resulting quantified narratives are further processed with Epistemic Network Analysis. The relative frequency of code co-occurrence in each segment is modelled with networks enabling the qualitative and statistical comparison of data between subsamples. Building on the benefits of qualitative and quantitative approaches, this method offers a complex evaluation of the impact of health education interventions. By strengthening the methods of program evaluation we aim to facilitate the development of more effective interventions.

Key messages

• Qualitative and quantitative methods can be unified in program evaluation to promote a deeper understanding of the complexity in public health interventions.

• Cognitive task analysis as a knowledge elicitation procedure can be used for the impact evaluation of health education programs.
Improving the quality of medical records
Authors: Guarducci G , Sanguineti I , Cuccaro C , Randisi R , Messina G , Nante N
Published: October 2022

Background

Medical record is an essential tool both in patients’ diagnostic and therapeutic pathways and communication between different care providers. It also has an economic-administrative, medical-legal and epidemiological function. From an economic-administrative point of view, a medical record allows an evaluation and review of services to better manage the corporate health budget. In addition, it allows traceability and complete transparency of the health activities carried out. The study evaluates the formal quality of medical records compiled in an Italian private clinic before and after a training intervention.

Methods

In June 2019, a retrospective study was carried out to assess a private clinic’s quality of medical records. One month later, healthcare providers were trained on the appropriate compilation of medical records, whose pre-printed format was structurally improved. In March 2020, we verified the quality of medical records produced after that training intervention. Statistical analysis (Wilcoxon test) was carried out through Stata.

Results

A total of 149 medical records were reviewed. Statistically significant improvements (p < 0,05), between before and after training intervention, were for overall readability (33.3% vs 74.7%), completeness of admission and discharge dates (33.3% vs 74.40%), for completeness of anamnesis (13.6% vs 63.9%), for completeness of therapeutic card (53% vs 85.5%), in the reduction of non-compliance corrections (22.7% vs 4.8%), signature presence of physical examination (34.9% vs 71.1%) and for signature presence in the hospital discharge card (86.4% vs 96.4%).

Conclusions

The results show that simple measures, such as staff training and restructuring of the format, are effective in improving the quality of medical records.

Key messages

• Healthcare providers should perceive the proper completion of medical records as a common goal.

• Well-completed medical records contribute to better health care.
Trends in emigration of Polish health professionals. Where are we heading?
Authors: Domagała A , Kautsch M , Kulbat A , Parzonka K
Published: October 2022

Background

Migration of health professionals is one of the key challenges for many healthcare systems. In Poland this phenomenon is still under-researched. The aim of our study was to explore the estimated trends and directions of emigration among Polish health professionals.

Methods

The research was based on the data analysis of specifying the number of people who applied for the certification of their professional qualifications (the right to practice a profession) at five national registers maintained by chambers of health professionals: 1) doctors and dentists, 2) nurses and midwives, 3) physiotherapists; 4) pharmacists and 5) laboratory diagnosticians. The gathered data reported information which allows for an approximate determination of how many professionals are considering a decision to migrate from Poland. Additionally exploration of data from the European Commission Regulated Profession Database in the EU Single Market was performed.

Results

About 7-9% of Polish doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries. The number of such certificates applied for by physiotherapists is also worrying. Emigration among pharmacists and laboratory diagnosticians is rather marginal. The biggest number of certificates, was issued to health professionals in the years 2004-2007, right after Poland joined the EU. In the period 2008-2015 the trend was not constant and it was related to the healthcare reform and changes in health professionals’ remuneration. Since 2016 the number of health workers applying for the certificates is by to a certain extent falling. The main destination of Polish emigrants were and are: United Kingdom, Germany, Sweden, Spain, Ireland, and EFTA countries (Norway, Switzerland).

Conclusions

Implementation of a mechanism for monitoring emigration is necessary, but systemic improvement of working conditions in Polish healthcare system is also needed.

Key messages

• The emigration, especially of young generations of medical staff, causes significant problems for the Polish healthcare system.

• More in-depth research on migration of health professionals is necessary.
Factors associated with Finnish home care workers job satisfaction
Authors: Ruotsalainen S , Väisänen V , Corneliusson L , Noro A , Sinervo T
Published: October 2022

Background

In Finland, home care is seen as a primary form of care for older people. However, rising numbers of clients with increasingly complex conditions have led to deteriorated working conditions and poor job satisfaction among home care staff. In this study, we examined if greater amount of direct care time, higher team autonomy, number of unique clients, and client’s need for care are associated with job satisfaction.

Methods

Data for the study was collected in October 2021. The amount of direct care and number of unique clients were obtained from a staff time measurement in home care units. The level of team autonomy was obtained from a survey sent to managers of participating organizations. Demographic information and a score for job satisfaction were retrieved from a survey for workers in the participating organizations. Client’s need for care was based on Resident Assessment Instrument (RAI). Data was analyzed using multiple linear regression.

Results

The number of respondents was 387, of which the majority were practical nurses 307 (79%). Higher team autonomy was associated with better job satisfaction, whereas higher number of unique clients and higher amount of direct care time were associated with poorer job satisfaction. The models were adjusted with clients’ care needs, but these effects will be further examined.

Conclusions

The results demonstrated that the workers are more satisfied if there is enough time to perform the work, they have adequate number of clients, and teams have autonomy over their work. This seems to be the case despite the level of clients’ need for care, however this needs further analysis. By increasing job satisfaction, better retention of care workers and attraction of care work might be achieved.

Key messages

• Higher team autonomy is associated with care worker’s job satisfaction.

• Enhancing care continuity is important, therefore, when planning home care workers’ workday, it is important to consider that the workers could work with clients they know.
Time trends in Surgical Site Infection rates in a Tunisian university hospital
Authors: Ghali H , Bhiri S , Ben Cheikh A , Bannour R , Khefacha S , Ben Rejeb M , Said Latiri H
Published: October 2022

Background

Surgical site infections (SSIs) are the most common hospital-acquired infections (HAIs) in low- and middle-income countries. Many reports have shown that surveillance and management of factors associated with SSI decreased rates and improved overall outcomes.This study aimed to appraise the prevalence trend and risk factirs of SSIs during 10-year period (2012 - 2021) in a Tunisian university hospital.

Methods

The SSI surveillance module is based on the National Healthcare Safety Network (NHSN), Centers for Disease Control and Prevention (CDC). For the current study, data collected over ten years through point prevalence surveys were analyzed. Univariate and multivariate logistic analysis were used to identify SSI risk factors.

Results

Overall, 2957 patients were observed; the mean age was 48.4 ± 23.5 years and 57.2% were male. We identified 289 infected patients (9.8%) and 319 HAIs (10.8%). SSIs were found in 21.6% of cases.The prevalence of SSI decreased from 27.9% in 2012 to 21.6% in 2021. However, this decrease was not statistically significant. The majority of the positive cultures were Staphylococcus aureus (14.3%) followed by Escherichia Coli (11.1%) and Klebsiella pneumoniae (9.5%). Antimicrobial resistance was found in 17.5% of cases. Univariable analysis found that lenght of stay (p < 10-3), obesity (p = 0.047), the use of antibiotic treatment in 6 months (p = 0.002), and the use of central line (p < 10-3) were associated with SSI. Independent risk factors significantly associated with SSIs were length of stay (aOR=8.6), the use of central line (aOR=3), and the use of antibiotic treatment in 6 months (aOR=2.2).

Conclusions

With continuous surveillance, the prevalence of SSIs decreased. In Sahloul university hospital, there has been a strengthening of the application of hygiene standard precautions during the two last years, and more particularly the respect of hand hygiene, combined with continued inpatient antimicrobial stewardship programs.

Key messages

• Active surveillance and management of factors associated with surgical site infection (SSI) decreased the incidence and improved overall outcomes.

• With continuous surveillance, the prevalence of SSIs decreased over the 10-year study period.
Linear pathway analysis of European botulism poisoning response guidelines
Authors: Learoyd T
Published: October 2022

Background

Botulism is a rare illness caused by Clostridium botulinum toxin with a naïve case fatality ratio of 40-50%. There is no coordinated collective worldwide reporting on cases and comparatively few recommendations on case management. This study examined 14 European botulism treatment guidelines.

Methods

A ten-language search was conducted to examine European botulism guidelines. The guidelines were classified by differential diagnosis advice; expert advice access; mention of causalities; contract tracing; biological sampling method; and treatment access rapidity. The guidelines were linearly represented on a probability pathway. Quantified probabilities were entered into the algorithm. Probabilities for algorithmic delay or deviance were estimated or mathematically modeled against Hamiltonian, Ford- Fulkerson and Kruskal pathways. Case recognition was deemed proportional to the availability of information at point of care and produced a hazard function related to a Bayes’ probability model.

Results

Two guidelines did not display all diagnostic information in one place, and six European nations had incomplete descriptions of the chain of causality linking botulism cases: factorially reducing the Borel algorithmic likelihood of diagnosis through contact tracing and decreasing the affectable survival chance. Another limitation was specialist advice and treatment availability in a 48-hour window. Survival probability models to the quoted naïve minimum constraint of a 60% survival factor were depicted, with pharmacokinetic tendential to an exponential decay model. This highlighted the importance of well-constructed case management and logistical stockpiling methods.

Conclusions

In botulism poisoning the 48-hour window is cited as crucial to patient survival chances, to this extent, the availability of clear diagnostic criteria including causation considerations, expert advice access and logistically considered therapeutic stockpiles could improve survival probability.

Key messages

• An international standard for botulism guidance may further improve botulism case identification and survival rates.

• National botulism guidelines with direct contact method to an expert and with strategic positioning of therapeutic stockpiles may reduce time to treatment and improve survival chances.
Trust and its relations to vaccine beliefs: a latent class analysis on 140,000 individuals worldwide
Authors: Sanmarchi F , Gibertoni D , Golinelli D , Gori D , Scheier LM
Published: October 2022

Background

Research shows that vaccine-related beliefs (i.e., about efficacy, safety, purpose) may reflect a host of within-person and contextual factors yielding homogeneous subgroups of individuals. This study aims to characterize distinct subgroups of people and identify ideal targets for tailored public health interventions to increase vaccine adherence.

Methods

Latent class analysis was used to derive subgroups based on unique response profiles using the 2019 Gallup survey of 140 countries (>140,000 individuals). We modeled a composite of vaccine beliefs as a distal outcome examining differences for the obtained classes, with and without covariates in the model.

Results

A 5-class model fit best with classes distinguished primarily on whether individuals possessed or sought personal knowledge about science, medicine, and health, whether they trusted science, scientists and have confidence in the healthcare system. The lowest levels of vaccine beliefs were reported by a class not endorsing any of these indicators and the highest levels by a class endorsing all the indicators (p < 0.001). Age class showed a U-shaped relation with vaccine beliefs, while higher educational level (p = 0.025), higher subjective income (p = 0.006) and employment (p < 0.001) were related to higher vaccine beliefs. Country-level income was moderately related to class membership and vaccine beliefs were higher in lower-income countries (p < 0.001).

Conclusions

Our findings suggest that more work is needed to improve trust in science and medical providers. Tailored interventions grounded in a community-based and empowering approach with the collaboration of multiple stakeholders seems to be needed to improve vaccination rates. This can only be achieved when individuals trust science, scientists and healthcare providers and accrue the necessary wisdom to make good healthcare decisions that affect not only themselves but their fellow citizens.

Key messages

• Efforts to alter vaccine beliefs should touch on where people access information on science and health, the processes that build trust, and their belief whether science improves well-being.

• Public health interventions should focus on reassuring individuals that science and health workers are benevolent. An essential first step in the health worker-patient relations is building trust.
Flu shot in the era of COVID-19 vaccination: findings from a research hospital of Rome
Authors: Pascucci D , Nurchis MC , Sapienza M , Lontano A , Marziali E , Castrini F , Ricciardi W , Damiani G , Laurenti P
Published: October 2022

Influenza represents a major burden for public health. Healthcare workers (HCWs) are a priority target group for flu vaccination. During the COVID-19 pandemic, when SARS-CoV-2 vaccines were not yet available, susceptibility to influenza vaccination especially by HCWs increased. The aim of this study is to analyze the flu vaccination coverage among HCWs and to study which factors affected their adherence given the concomitant COVID-19 vaccination. The retrospective study was conducted in an Italian research hospital from October 2021 to January 2022. A total of 7,048 individuals was included. Age class, gender and job category variables were analyzed. Statistically significant differences among groups were tested through χ2 test. Univariate and multivariate analyses (p < 0,005) were performed to assess differences towards vaccination attitude. The flu vaccination coverage rate was 24.6%. Among the selected job categories, 29.8% of physicians, 19.9% of nurses and 19.7% of other HCWs were vaccinated with a statistically significant decrease (p < 0.001) across all categories respect with the last campaign. The findings of the logistic regression depicted that the 40-59 years old age class, compared with the youngest age class (OR 1.30, 95% CI 1.12-1.43) as well as being physician (OR 2.79, 95% CI 1.87-3.41) with the respect to being nurses, had a higher adherence to vaccination. Interestingly, being male, is associated with a statistically significant reduction (OR 0.71, 95% CI 0.59-0.87) in vaccination uptake. Study findings showed a several decline in the flu vaccination coverage comparing with previous campaigns, probably due to the concomitant administration of the booster dose against SARS-CoV-2. This alarm should not be underestimated and requires timely and innovative organizational approaches (i.e., combined vaccine). Further studies are needed to analyze the reasons for this poor adhesion and the strategies to be adopted to increase the awareness of the HCWs.

Key messages

• Reaching high coverage rates and restore a positive trend for the future campaign for flu vaccination it is essential strategy to protect HCWs themselves, their patients and the hospital community.

• Decision-makers should implement consistent communication strategies to lessen vaccine hesitancy among HCWs.
Knowledge about HPV vaccination among Croatian university students
Authors: Miskulin I , Simic I , Pavic Z , Miskulin M , Bilic-Kirin V , Kovacevic J
Published: October 2022

Background

Studies have shown the low uptake of the human papillomavirus (HPV) vaccine among university students. Knowledge about the HPV virus and the vaccine can be a factor that may sway an individual’s decision to receive the vaccine. This study aimed to investigate HPV vaccine uptake and knowledge about HPV vaccination among Croatian university students.

Methods

This cross-sectional questionnaire study was conducted from February to May 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, and data regarding knowledge about the HPV virus and the vaccination was self-administered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia.

Results

The study sample included 840 subjects with, median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females. The prevalence of vaccination uptake in the studied population was 20.8%. The study revealed that there were 25.6% of students with a low level of knowledge and 74.4% of students with satisfactory levels of knowledge about the HPV virus and the vaccination. The excellent knowledge about the HPV virus and the vaccination was more frequently shown by students who studied in biomedicine and health area of science (p < 0.001) and students with an excellent average grade of study (p < 0.001). HPV vaccination uptake was higher among females (p < 0.001), students who studied within biomedicine and health area of science (p < 0.001), students with an excellent average grade of study (p < 0.001), and students who showed excellent knowledge about the HPV virus and the vaccination (p < 0.001).

Conclusions

The majority of Croatian university students had a satisfactory level of knowledge about the HPV virus and the vaccination but the vaccination uptake is still very modest. Additional efforts are needed to organize more appropriate education and promotion of vaccine uptake in the studied population.

Key messages

• The HPV vaccination uptake among Croatian university students is very modest although the majority of students have a satisfactory level of knowledge about the HPV virus and the vaccination.

• Continuous examination of HPV knowledge gaps and identification of factors influencing vaccine uptake is key to increasing vaccination rates in the Croatian university student population.
COVID-19 knowledge among Ukrainian refugees in Poland
Authors: Pasek O , Ganczak M , Sikora A , Sobieraj E , Duda-Duma Ł , Pyzio K , Goławski J
Published: October 2022

Background

The constantly growing refugee population may constitute public health threat in Poland in the context of COVID-19 pandemic. This study objective was to investigate COVID-19 knowledge among Ukrainian refugees in Poland.

Methods

This cross-sectional study was carried out between March-April 2022 among Ukrainian refugees registering in Zielona Góra, Poland. An anonymous, self-administered questionnaire was used which included 10 questions related to COVID-19 knowledge. Each correct answer was given 1 point.

Results

Response rate was 96.0%, 190 Ukrainians responded (mean age 37.8±15.7 years; 42.1% males); 52.1% were living in the cities >50,000 inhabitants; 61.6% reported high SES; 39% higher education; 44.2% were married. The mean knowledge score was 3.47 (SD ± 2.2), 15.8% collected >50% points. The knowledge level was higher among those with higher SES (p < 0.0001) and higher education (p = 0.003); 31.7% stated that SARS-CoV-2 is an animal-human transmitted disease (more with high SES, p = 0.004), 55.0% considered COVID-19 as highly contagious disease (more living in bigger cities, p = 0.04), 26.3% reported that SARS-CoV-2 infection ensures lifetime immunity (more unmarried, p = 0.02); 24.7% correctly stated that compared with 18- to 30-year-olds COVID-19 mortality rate is about 10 times higher in those who are >65 years (more with higher education and high SES; p < 0.05, p = 0.01 respectively), 44.4% - that COVID-19 treatments are now available (more with high SES and higher education; p = 0.03 both). Regarding prevention, 37.0% reported that FFP3 is the most protective type of mask, 43.3% that vaccines effectively protect against COVID-19 (more with high SES; p = 0.006, p < 0.001 respectively).

Conclusions

COVID-19 knowledge among Ukrainian refugees in Poland was far unsatisfactory, in particular among those with lower education and lower SES. Educational campaigns are urgently needed to effectively raise the knowledge level in this vulnerable group to better control the pandemic.

Key messages

• This study results may be used by public health experts to expand educational campaigns targeting Ukrainian refugees in Poland.

• COVID-19 education oriented to Ukrainian refugees in Poland should specifically address deficits of knowledge identified in this study.