bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of unmet needs and barriers to end-of-life care provision in Kazakhstan
Authors: Toleubekova L , Crape B , Dauyey K , Argandykov D , Bekenova A , Madikenova M , Kaukenova B , Noskov A
Published: November 2019

Introduction

Palliative care, a holistic multidisciplinary approach for those persons with terminal diseases, providing relief for physical, emotional, psychosocial and spiritual suffering of both the patients and their families and to support the dignity of all involved in the process of dying. The purpose of this qualitative research project is to identify the barriers for end-of-life care provision in Kazakhstan and to provide recommendations on how to integrate and assure high quality palliative care for patients within the cultural context of Kazakhstan.

Methods

Our proposed research project employed qualitative research methods, including semi-structured in-depth interviews using grounded theory. We conducted purposive recruiting with content analysis and semi-structured interviews until saturation was achieved. The interviews have been conducted at the University Medical Center (UMC) teaching hospitals, including National Research Center for Maternal and Child Health and the National Children’s Rehabilitation Center. The total number of participants were 65 individuals, of whom 26 were medical doctors, 20 nurses, 7 speech therapists, 6 psychologists, 4 educators and 2 social workers. All participants had experience working with terminally ill patients, family members, and caregivers. The data was then translated into English. Analysis of the interview data have been performed by using the computer assisted software analysis package - NVivo. Institutional review board (IRB) approval of the Nazarbayev University has been received, assuring informed consent and confidentiality safeguards in the research.

Results

The study findings indicate the evidence of growing demand in training of healthcare professionals, inadequate provision of pain relief and lack of public awareness about palliation as primary obstacles for palliative care development in Kazakhstan.

Key messages

The findings of the study are very important to help stakeholders to focus on the development of training opportunities for palliative care specialists. The results of the study help to develop milestones and concrete strategy for integration of palliative care services into the national healthcare system of Kazakhstan.
Keeping up with the codes; accounting for quality in cancer patient pathways (CPPs) in Norway
Authors: Håland E , Melby L
Published: November 2019

Background

Standardised cancer patient pathways (CPPs) were introduced in Norway in 2015. CPPs are national standardised patient pathways which are discipline- and target-based (28 cancer diagnoses), aiming to minimize waiting times and make cancer care more predictable and secure for patients. One important part of the CPPs are different codes aimed at measuring time in the different phases of the pathway. These codes are reported to the Norwegian directorate for health and are made public on a national web site. On the basis of these reports hospitals across the country can be compared regarding compliance to timescales. From a political and bureaucratic level, the codes are seen as signs of quality, and hence very important.

Methods

In this paper, we present preliminary results from a project which is evaluating the introduction of CPPs. Based on interviews with administrative staff responsible for coding and with other health personnel (physicians, nurses, clerical workers and managers) in different hospitals, we present experiences with and perceptions of coding practices.

Results

We find that even though the coding manual is presented as a universal tool implying standardised coding practices, there is a multitude of coding practices (which makes comparison between hospitals challenging). The coding represents a massive bureaucratic workload for the dedicated staff, raising concerns if their time is spent on the most important issues.

Conclusions

The codes are seen as timescales set according to logistics and not according to what is medically safe - and some of the health personnel argue that these timescales have nothing to do with quality. However, they still recognize that keeping the timescales might be important for the patient experience.

Key messages

Standardised coding are often not standardised, but contains a multitude of practices. These practices need to be explored in order to understand if and how codes can be seen as signs of quality.
Reasons for cervical cancer screening participation among Turkish- and Moroccan-Dutch: focus groups
Authors: Marchena E , Hamdiui N , Stein M L , van Steenbergen J E , van den Muijsenbergh M , Timen A
Published: November 2019

Background

Cervical cancer (CC) is ranked fourth most frequently diagnosed cancer in women worldwide. Compared to the 79% CC screening participation rate of native Dutch women, the rate of 64% among Turkish- and 53% among Moroccan-Dutch women is considerably lower. Our aim was to explore reasons for CC screening (non)participation of Turkish- and Moroccan-Dutch women, and their attitude towards self-sampling.

Methods

Six focus groups were conducted in March and April 2019 with Turkish (n = 25) and Moroccan (n = 20) women in the Netherlands, aged 30-60 years. Questions were based on an extended Health Belief Model. Discussions were transcribed verbatim and thematically analysed.

Results

We found that women lack knowledge and awareness about CC. Barriers for screening were lack of a good command of the Dutch language, having a male as general practitioner, fatalism, shame and taboo related to the intimate procedure, and the association of CC with lack of femininity and infertility. Other barriers were fears of the test result, cancer, suffering, death, and leaving their children behind after death. Facilitators were perceived severity of disease, social support, and short procedure time. Additional religious facilitators included the responsibility to take care of one’s own health using medical facilities that God provided. Differences were found between Turkish and Moroccan women, such as lack of a good command of the Dutch language. Conflicting attitudes were found regarding self-sampling. Although perceived easy and accessible, women were hesitant whether they could sample correctly. Overall, women preferred a physician-taken smear to a self-sample.

Conclusions

Several barriers and facilitators for CC screening participation were identified that can be used to design tailored information materials. Women’s doubts about incorrect self-sampling should be taken into account to encourage self-sampling among nonparticipating Turkish and Moroccan women.

Key messages

Important barriers and facilitators were identified that can be used to well-inform Turkish and Moroccan women. To promote self-sampling, women’s attitudes on their self-efficacy should be explored.
Obstetrical complications treated in the maternities of the region of Sousse (Tunisia)
Authors: Limam M , Sahli J , Hachani F , Ghardallou M El , Mellouli M , Bachraoui M , Zedini C , Khairi H , Mtiraoui A , Ajmi T
Published: November 2019

Background

About 800 women die each day worldwide due to complications related to pregnancy, childbirth or in the postpartum period. The objective of this study was to describe the activity of the public maternities in the Governorate of Sousse (Tunisia) and to identify obstetrical complications treated in these facilities.

Methods

A cross sectional study of all public health facilities, which performed deliveries in Sousse was conducted in 2017 (Five maternities: one University maternity and four peripheral ones). Data were collected by reviewing clinical records and registers of these maternities for the year 2016.

Results

In total, in the health visited structures, there were 13427 deliveries in 2016, the majority of them (78.8%) took place at the university maternity of Farhat Hached hospital. Of these deliveries, 3397 were performed by caesareans (25.3%). In 2016, there were three maternal deaths and 69 very early neonatal deaths. There were 2036 direct obstetric complications treated in the five maternities visited. The most frequently encountered direct complications were: ’obstructed/prolonged labor’ (41.21%), ’severe pre-eclampsia/eclampsia’ (19.5%) and ’ante and postpartum haemorrhage’ (15.18%). The most encountered indirect obstetrical complications were: gestational diabetes and anaemia.

Conclusions

The reduction of maternal and neonatal mortality requires the existence of a functioning basic health care system that provides all pregnant women and their newborns with timely access to skilled care, particularly when a complication occurs. The provision of this qualified care requires also the presence of qualified personnel working in a suitable professional environment.

Key messages

The majority of obstetrical complications occur in university maternity and this is due to excessive references from peripheral maternities. Peripheral maternities need to be strengthened with material and human resources.
Availability and drug lag of new medicines in South Korea
Authors: Son K
Published: November 2019

Introduction

This study aims to capture the availability of new medicines, to measure drug lags for new medicines, and to demonstrate various factors affecting timely availability of new medicines in Korean market.

Methods

We construct two models for the analysis; logistic and Cox model. First, we provide the logistic regression to analyze the availability of new medicines in Korean market. Second, we are interested in the timely availability of new medicines in Korea. Therefore, we calculated the drug lag between the United States and South Korea, and applied an event history model for a statistical estimation.

Results

There have been 160 NDAs approved by the FDA in the United States between 2007 and 2015. Among 160 new drugs approved in the United States during the study period, 112 NDAs (70%) were also approved by the MFDS in Korea, while 48 new drugs (30%) are not currently available in the Korean market. In addition, we are interested in the order of timing for market approval for 112 NDAs that approved in both countries. Not surprisingly, 95 NDAs (85%) were approved in the United States, and then approved in Korea, while 17 NDAs (15%) were approved in Korea, and then approved in the United States.

Conclusions

Compared to the United States, a striking drug lag was observed in Korea. For the new drugs approved between 2007 and 2015, the median approval lag ranged from 1.72 years in 2013 to 5.84 years in 2007. Presence of the manufacturers in Korea and medicines belonging to the antineoplastic agents were not only positively associated with the availability in Korea, but also accelerated the time to approval in Korea compared to the reference.

Key messages

Compared to the United States, a striking drug lag was observed in Korea. Presence of the manufacturers in Korea were not only positively associated with the availability in Korea, but also accelerated the time to approval in Korea.
Capturing the social value and return on investment of public health services and interventions
Authors: Ashton K , Stielke A , Dyakova M
Published: November 2019

The need for investment in health and well-being to achieve sustainable development and inclusive economic growth is stronger than ever in the face of multiple adversities. Making the case for investing in public health is essential. The social, economic and environmental value of public health programmes has to be embedded in every organisational balance sheet in order to progress national and international commitments; and to enable sustainable policy and action for the benefit of people, communities and societies.

The WHO Collaborating Centre on Investment for Health and Well-being at Public Health Wales has developed a programme of work to assess the (social)return on investment of services and interventions. This involves looking at specific health and well-being outcomes, and estimating the wider social, economic and environmental value of the organisation and its various health protection and health improvement programmes. Specific health economics methods used will be Social/Return on Investment and Social/Cost-Benefit Analysis.

The programme will generate an ’extended balance sheet’, including estimates of health and well-being outcomes and monetarising the social and environmental value. This will result in establishing the holistic economic value of Public Health Wales. Specific outputs are: a comprehensive costing model to capture input; outcome and impact maps; capturing the value of public health programmes in terms of health and well-being, as well as social, economic and environmental outcomes. Finally, a generalised framework for other similar organisations will be developed.

This innovative programme aims to measure the social, economic and environmental value of Public Health Wales as a national public health institute. The developed framework can be used by other organisations across Europe to inform and guide their efforts to capture the wider social value, involve key stakeholders from the outset and achieve sustainable financing in the long run.

Key messages

Making the case for investing in public health by illustrating its social, economic and environmental value is vital. Social Return on Investment is an innovative and useful method to estimate the wider value of public health interventions.
Economic burden of main Noncommunicable diseases in the Russian Federation in 2016
Authors: Kontsevaya A , Balanova Y , Khudyakov M , Myrzamatova A , Mukaneeva D , Sapunova I
Published: November 2019

Aim

To estimate the economic burden of noncommunicable diseases (NCDs) in the Russian Federation (RF) in 2016, including the direct costs and the economic losses caused by reduced productivity.

Material and

Methods

We included 4 diseases: cardiovascular, type 2 diabetes, cancer and chronic pulmonary disease (COPD). We used the official statistics data collected by Ministry of health on the number of patients, health care resources utilization (hospitalizations, emergency visits, outpatients’ visits). The costs of health care were obtained from health insurance fund. Directs nonmedical costs included disabilitypayments, calculated based on the number of disabled persons from each group and by the amount of the disability allowance. Indirect costs (economic losses) included decreased productivity due to premature mortality and disability. The potential years of life lost (PYLL) were calculated using the number of life years lost due todeath and disability due to NCDs before 70 years. Human capital approach was used, and calculation were based on the GDP per person.

Results

Number of PYLL due to premature death from NCDs was estimated to be 8,0 million years. Economic burden because of NCDs in 2016 in the RF reached 3,3 trillion (45.9 billion €), which is equivalent of 3.9% of GDP for this year. Direct costs were responsible only for 13% of losses, indirect costs for 87% of the total burden. CVD were responsible for 81,4% of burden, cancer – for 7,1%, diabetes - 6,5% and COPD for 5,0%.

Conclusions

The economic burden because of NCDs in the RF in 2016 was 3.3 trillion (3.9% of GDP). Such the significant economic burden and absence of positive dynamics is a strong argument for increasing investments in the prevention and treatment of NCDs.

Key messages

Number of PYLL due to premature death from NCDs was estimated to be 8,0 million years. Economic burden because of NCDs in 2016 in the RF reached 3,3 trillion (45.9 billion €), which is equivalent of 3.9% of GDP for this year.
Public expenditure on health promotion and prevention interventions in Austria in 2016
Authors: Antony K , Fröschl B , Ivansits S , Gaiswinkler S , Laschkolnig A
Published: November 2019

Issue/problem

Government and social insurance-funded health promotion and prevention interventions in Austria are surveyed on an irregular basis. Comprehensive data on government expenditures, categorized according to financial providers and/or intervention types had not been published since 2012.

Description of the problem

In accordance with Austrias current federal target contract, the survey is intended to support the targeted use of funds in the fields of health promotion and prevention by providing timely and detailed information on public spending in these areas.

Results

In 2016, the public sector spent 2,441.3 million euros on health promotion and prevention, which corresponds to 280.6 euros per capita (of the Austrian population). Additionally, administrative bodies reported staff-related costs, which could not be monetarily assessed for all administrative levels.

70 per cent of the expenditure on health promotion and prevention incurred by public institutions in Austria went towards tertiary prevention. The shares for primary and secondary prevention are 13.5 and 13.2 per cent respectively, the remaining funds were spent on health promotion and capacity building (3.4 per cent).

Lessons

The collection and coordination effort is considerable for data reporters and study authors, still more frequent collection facilitates data reporting and quality.

An overview of the data is still not available at the administrative level of the countries (Länder), this could contribute to informed decisions.

Key messages

Expenditures on health promotion and primary prevention show high growth rates for the period 2012-2016 (+21.3%) reflecting the continuing social importance that this topic has gained in recent years. An allocation of funds to the areas prioritized in the Austrian health promotion strategy 2013-2016 is evident for at least three topic areas.
From pillars of postgraduate education towards motivated and competent public health workforce
Authors: Chikhladze N , Pitskhelauri N
Published: November 2019

Background

Motivation and effective supervision are key factors in postgraduate Public Health Education. On the one hand motivation represents a power that derives and then steers students’ activities in order to achieve their objectives; on the other hand, supervision practices can significantly influence the behavior of students, from encouraging students to endeavor future goals to letting them lose the motivation to continue the study. The aim of this research is to study motivation of PhD students and to explore the supervision practices at the Department of Public Health.

Methods

A Special questionnaire has been developed and quantitative method has been used for this study. The questionnaires were distributed to all PhD students at TSU Faculty of Medicine.

Results

A total of 79 completed questionnaires have been used for analyses (response rate 52,6%). The study found that around 90% of the PhD students are generally satisfied with existing supervisory experiences. 87% of respondents mentioned that they have regular meetings with their supervisors and the importance of these meetings are evaluated as important or very important. The study also found that PhD students are more influenced by intrinsic motives and students place priority emphasis on the interest in scientific research and continuing learning experience. At the same time the greatest incentive for deciding to become a PhD student is the possibility of acquiring experience within international partnerships, among them short- or long-term mobility in the Framework of DIKU funded project ,,Georgian-Norwegian Collaborative in Public Health’’ and NIH funded project, ICREATE - Increasing Capacity in Research in Eastern Europe’’.

Conclusions

The study has provided the insights into supervision practices and PhD students’ motivation. Survey has raised some emerging issues, which are inclined to be improved in order to strengthen the postgraduate Public Health Education.

Key messages

The research emphasizes the importance of evaluating the motivation and supervision practices in postgraduate public health education for strengthen the public health graduates and workforce. The research highlights the impacts of international collaborative partnerships in transitional countries.
Implementation and development of guidelines in the emergency services in Kosovo – PARIHS framework
Authors: Hodza-Beganovic R , Carlsson H , Lidberg H , Blaku V , Berggren P
Published: November 2019

Background

The aim of this project is to create understanding on the determinant factors enhancing adherence to treatment guidelines for the emergency medical services in Kosovo (EMSK). Focus is on barriers, and enablers while introducing the guidelines. It is aiming to create clearance and understanding of how and why the implementation outcomes are achieved. The factors influencing implementation will be mapped in three main domains. The domains are part of the determinant framework Promoting Action on Research Implementation in Health Services (PARIHS). Each of the domains is further divided into sub-constructs.

Methods

The process of implementing treatment guidelines into the emergency medical services in Kosovo was observed and documented by 4 researchers, using a participatory research design. The PARIHS framework that consists of three core components: evidence, context, and facilitation was applied to make clarity on what works better and why, in order to achieve the outcomes of the implemented guidelines.

Results

The preliminary results have shown that the three constructs have an important role in the process of implementation. The domain evidence determined the way the evidence based practice is conceived in this particular setting. The domain context concerns the organization and teamwork shaped challenges and possibilities for adherence to the guidelines. The role of an external facilitator was of specific importance.

Conclusions

The PARIHS framework serves in both practical and theoretical planning of an intervention. In the present project it provides clarity on planning of the process, while also offer understanding of the elements that contribute to the sustainability of the intervention. Finally the lessons from the approach can be replicated in similar context.

Key messages

Implementation projects can be more successful suing a framework to direct the effort. Such interventions should be premised with clarity on the evidence, the local context, and facilitation factors.
Preferences and expectations of graduates in nursing towards lifelong learning (Bulgaria, 2016-2019)
Authors: Grancharova G , Djulgerova S , Aleksandrova-Yankulovska S , Dimitrova E
Published: November 2019

Background

Nurses have a vital role to play in provision of high quality and safety health care in a global perspective. This is extremely valid for Bulgaria with the lowest nurses to doctors’ ratio 1.1. The future nursing generations should be motivated for lifelong learning (LLL), irrespectively of scarce human and financial resources in health care. The aim of the study was to explore preferences, expectations and motivation of graduates in nursing towards LLL.

Methods

A cross-sectional descriptive study was conducted among 174 bachelors in nursing (152 women and 22 men) before their graduation in 2016-2019 at the Faculty of Health Care in MU-Pleven. Anonymous self-administered questionnaire was used to collect information about graduates’ work preferences, expectations and motivation for LLL (response rate 95%). Data processing was performed by SPSS v.24 using descriptive statistics and correlations. The accepted level of significance was p < 0.05.

Results

Most of the graduates prefer high-technology clinics with only 13.2% for outpatient care and community centres; 50% plan to get higher educational degree; 81.5% will need a clinical mentor to start practicing. LLL is appraised by 82% as ultimate for nursing. It should be directed to developing skills and knowledge for effective team work (29.9%), capacity for self-directed practice and adaption to innovations (24.1%), skills to cope with critical situations (14.1%). The first motivating factors for LLL are professional development (44.3%) and better payment (37.4%). The most common demotivating factors: financial reasons (37.9), health problems (21.3), absence from home (13.8%), employer permission (13.8%). All the results have p=.000 for one sample x2 test.

Conclusions

The graduates understand the crucial role and have realistic expectations of LLL for their professional development. Prevailing motives and demotivating factors correlate to the whole Bulgarian health system problems.

Key messages

The graduates in nursing at the Faculty of Health care in Pleven Medical University highly appreciate the role of LLL for their professional development and prestige. The schools in nursing should continue working to further motivation for LLL as indispensable requirements for contemporary effective and efficient nursing care delivery.
What do health workers think about a population exposed to health inequalities? The Bastogi case
Authors: Salvatori L M , Tofani M , Angelozzi A , Caminada S , Paglione L , Iorio S , Ricotta G , Brandimarte A M , Biliotti D , Marceca M
Published: November 2019

Introduction

Previous qualitative researches highlighted that people living in Bastogi - a peripheric area of Rome marked by social deprivation - have difficulties in accessing and relating health services. We explored the healthcare workers’ perception of the relationship with such population.

Methods

A 42 items questionnaire was addressed to the reference Local Health Unit employees, evaluating: context knowledge; perception of the relationship between users and health services and between users and operators; training needs. The association between answers and social characteristics of the respondents has been evaluated through Chi Square Test for categorical variables and T Student Test for continuous variables.

Results

Questionnaire respondents were 73 (50% of the total employees). 77% reported knowing Bastogi. Adverse social determinants mostly identified (>65%) were economic problems, housing conditions and unemployment, while less people pointed out the poor social support network (38%).

50% assumed that Bastogi inhabitants face health inequalities. 26% claimed to have difficulties in the

relationship with users; 81% considered useful a training activity about the relationship with socioeconomic deprived users. 25% believed the responsibility for the main social problems in Bastogi lies in the inhabitants themselves. Such answer was statistically more frequent among: administrative professionals, professionals with longer length of service, those who deny the existence of health inequalities and those who don’t feel the need of training. Further results will be presented during the congress.

Conclusions

Preliminary results of the survey confirm that the relationship between users from a socially deprived area and the competent services is problematic, and underline the need for training of healthcare professionals on the subject. This need is also perceived by the majority of the respondent personnel.

Key messages

We explored the healthcare workers’ perception of the relationship they have with a population exposed to health inequalities. Interventions and trainings will be implemented to contain this problem.
User typology for workplace health offers
Authors: Noehammer E , Stummer H
Published: November 2019

Background

Workplace Health Promotion/Management (WHP/M) is not mandatory in Europe. However, it is often considered to be a standard for attractive workplaces, but this does not necessarily result in high use. This opens the question if WHP/M is perceived only as quality criterion, or if the offer per se needs to be adapted. In this study, we therefore analyze the user typology for the WHP/M offers in four organizations

Methods

A self-administered quantitative Likert-scaled questionnaire was filled in by the employees (N = 237) regarding use of offers, determinants of use, perceived attendance barriers and effects, interests, and demographic questions. We determined user profiles using cluster analysis and here focus on perceived barriers of use, reporting first results.

Results

We found three clusters that mainly differ regarding intensity and type of perceived barriers. Cluster 1 experiences barriers to be very high, Cluster 2 reports very low barriers, Cluster 3 feels almost no information related, but intensive offer related barriers. Regarding demographics, there are more men in Cluster 2, women perceived barriers more intensively. Employees belonging to Cluster 1 are younger than those in Cluster 2; Cluster 3 is close to Cluster 1 regarding age. Additionally, Cluster 1 is made up of employees who are better educated, have joined the current employer more recently, have a better position and work less hours than those in the other clusters.

Conclusions

Employees visibly diverge regarding perceived attendance barriers. Current WHP/M offers seem to be better adapted to those with lower position, longer working hours and more experience with the employer - or the employer with them. The potentials of WHP for integrating all employees have not yet been realized. This is critical should the possibility to us WHP/M offers i.e. play a role for newly hired part-timers or high potentials.

Key messages

Companies offering WHP/M need to prioritize reducing offer related barriers and respond to divergent user profiles. Workplace health programs do not yet reach their potentials due to attendance barriers.
Nurses’ experiences with the Implementation of a Manchester Triage System in an Emergency Department
Authors: Raich M , Lorenzoni N , Angerer S , Nöhammer E , Stummer H
Published: November 2019

Background

Emergency Departments (ED) are very often confronted with a high number of non-acute patients. This circumstance has negative effects on the quality of care because of limited human resources and infrastructure in dealing with overcrowding. In Spring 2017 an Austrian hospital has implemented the Manchester Triage System to improve the management of patient flows. From the date of implementation the nurses were responsible for the preliminary assessment of the patients. The aim of this study was to investigate the nurses’ experiences and attitudes concerning the implemented Manchester Triage System as well as its impact on their work and quality of patient care.

Methods

A qualitative approach was chosen. In order to get a deep insight interviews with ten nurses were conducted by using an interview guide with open questions. The answers of the interviewed people were recorded, transcribed and analyzed by the qualitative method GABEK (GAnzheitliche BEwältigung von Komplexität).

Results

The triage process has changed the working hours, processes, collaboration, task responsibilities and stress levels. The triage process itself is defined by the nurses as diversified activity with a high degree of responsibility. Experienced, well-trained nurses guarantee an appropriate preliminary assessment of the patient. Teamwork and backing by nurses and physicians are of importance in the case of unclear patient assessments. Finally, more time is available for acute patients in order to provide them an appropriate care.

Conclusions

The Manchester Triage System has changed the nurses’ working conditions and influences positively the management of patient flow and quality of care.

Key messages

The activities of the nurses have changed into diversified tasks with a high degree of responsibility. The implementation of the Manchester Triage System has a positive impact on the patient flow and quality of care.
ASPHER V4 Working Group supports the road map for professionalising the public health workforce
Authors: Petrakova A , Otok R , Prikazsky V , Dlouhy M , Prazanova Z , Stepanek L , Ghazal Asswad A , Fundano N , Khan H , Holm S
Published: November 2019

Background

The ASPHER V4 Working Group (WG) was established in 2016 and officially launched during the 9th European Public Health Conference in Vienna. One of the key objectives of the WG is to strengthen public health capacity development in V4 countries. The WG supports the implementation of the recently reviewed European Action Plan for Strengthening Public Health Capacities (EAP). The EAP’s review highlighted the need to focus further action on four enabling Essential Public Health Functions (EPHOs) including human resources for public health. This is why the WG is heavily involved in the recent development of a new Road map for professionalising the public health workforce, one of the products of the recently established Coalition of Partners (CoP) that was convened by the WHO Regional Office for Europe in close cooperation with ASPHER and Maastricht University.

Objectives

Supporting the WHO CoP with a focus on development and further implementation of a new Road map for professionalising public health workforce in V4 countries. Using a new rapid assessment tool to evaluate the state of the public health profession in the Czech Republic. Sharing the report on the current state of public health professions in the Czech Republic with the WG and using it as a comparison of the current state in all V4 countries.

Results

Key strengths and weaknesses of the first rapid assessment of the current state of the public health profession in the Czech Republic are presented. Key actions are proposed for the WG: a) Preparation of a grant proposal to the International V4 Fund and b) Continuing active involvement in CoP activities.

Conclusions

The rapid assessment tool for evaluating the state of the public health profession was successfully implemented in the Czech Republic with the close cooperation of academia, researchers, policy makers and practitioners. The summary confirms that further work on the professionalization of the public health workforce is needed.

Key messages

ASPHER V4 WG is strongly involved in the development of a new road map for professionalising the public health workforce, coordinated by the WHO CoP, ASPHER and Maastricht University. Summary of the first rapid assessment of the current state of the public health profession in the Czech Republic confirms the importance of further action in this area of work.
The Comprehensive Community Engagement Framework for Health and Well-being
Authors: Adnan H S , Venticich P M , Prevo L , Schneider F , Kremers S
Published: November 2019

Background

Community engagement (CE) and empowerment are required to support the sustainability and effectiveness of actions to reach Agenda 2030. There is a need to guide CE for health and well-being to take action on important societal challenges such as the growing burden of non-communicable diseases (NCDs) and health inequities. The framework proposed in this study has been designed to assist professionals, practitioners and communities to effectively engage.

Methods

A narrative review of existing grey literature, policy papers and models related to CE was performed. This guided the development of a systematic search strategy, performed by two researchers, which reviewed CE approaches and key influencing factors. The search strategy captured different terms used for CE.

Results

A total of 27 studies of different types, from around the world, were identified for inclusion into the review. The study compiled a set of widely-used theories and approaches to CE. Key factors such as governance, trust, accessibility and sociocultural contextualisation were also identified as important for the success of CE initiatives. Subsequently, the Comprehensive Community Engagement Framework (CCEF) was developed. It combines theoretical and empirical principles, proven participatory actions and key factors to produce evidence-based health and well-being outcomes across different sectors and levels of society.

Conclusions

This study has formed the basis of a forthcoming WHO report on CE. The CCEF enables the operationalisation of CE to guide for possible practical approaches to planning, initiating, sustaining and evaluating CE processes alongside the community. It can be used by the health sector as well as the non-health sectors to address health, well-being and broader societal challenges.

Key messages

The CCEF can be used to engage health and non-health stakeholders to tailor CE processes, increase impact of interventions and policies, building capacity and empowering communities. The proposed framework provides the first comprehensive guidance to conduct community engagement.
Self-regulation, norms and alcohol consequences: study on university freshman from four EU countries
Authors: Bacikova-Sleskova M
Published: November 2019

High alcohol consumption is undoubtedly one of the most serious health and public issues across Europe. In addition to other licit and illicit drugs, it causes more than 4% of all deaths in the EU for those aged between 25 and 39. Among protective factors the self-regulation (SR) has been frequently associated with lower levels of risky drinking. On the other hand, overestimated descriptive normative beliefs (NB) may serve as a powerful source of social influence on personal alcohol use. Both SR and NB may be especially important during the period when young adults leave their families and may feel less external control and more freedom to use alcohol what may lead to serious health consequences. Therefore this study explores the associations among SR and NB in relations to alcohol use and negative alcohol consequences.

Data among 2671 first-year college students were collected in 2011. Students from the Czech Republic (n = 357), Hungary (n = 783), Lithuania (n = 928) and Slovakia (603) who filled in the AUDIT test, Self-Regulation Questionnaire and questions regarding NB. Regression models (separately for each country) were computed to test whether different level of SR influences the relationship between NB and alcohol use and between alcohol use and negative consequences.

Overestimated NB were positively associated with risky drinking in all countries and similarly alcohol use increased the level of negative consequences. Moreover, in predicting risk drinking and alcohol consequences, a moderation effect of SR was confirmed as associations among NB and alcohol use and among alcohol use and negative consequences were stronger among those students with lower SR.

The protective effect of SR on risky alcohol and consequences together with social norms approach may potentially improve the intervention accuracy and make it a promising target for intervention among young adults.

Key messages

Students from all explored countries highly overestimated the actual alcohol use what was significantly associated with theirs higher alcohol consumption. Those students who overestimated the actual alcohol consumption but had higher levels of self-regulation were less likely to drink or report negative alcohol consequences than their peers.
Building a social marketing Strategy to reduce alcohol-related harm in France
Authors: Hochet M , Quatremère G , Andler R , Cogordan C , Nguyen Thanh V
Published: November 2019

Background

Alcohol use ranks among the top three risk factors in France, leading to about 40 000 deaths annually. French health authorities wished to renew the public health message about alcohol consumption and build a social marketing Strategy to lower the social and health consequences of alcohol consumption in France.

Objectives

Two main steps were followed: 1) gathering a group of experts to provide up-to-date low-risk drinking guidelines, 2) building, testing and implementing a social marketing Strategy based on this expertise.

Results

In 2017, the group of experts established low-risk drinking Guidelines based on both scientific evidence and socially acceptable risks for the French population. They suggested to increase awareness on alcohol-related harm as well as on the new Guidelines. In 2018, a social marketing Strategy was set up by Santé publique France, the French national public health Agency. Qualitative and quantitative pretests allowed to develop understandable and potentially effective communication materials consisting of the following message: “To protect your health, no more than 2 alcoholic drinks a day, and not every day”. A web-based brief intervention to assess a person’s alcohol consumption was developed, based on a previous tool whose effectiveness had been demonstrated. In 2019, the Campaign was launched: health professionals were informed at first, followed by a national mass media Campaign that was broadcasted for 3 weeks, targeting the general population (TV, radio, press, the Internet).

Conclusions

It is the first time in France that such a global Strategy is set up to promote an alcohol harm reduction message. A robust evaluation is in progress but this structured approach seems feasible and reproducible abroad.

Key messages

In France, an alcohol harm reduction Strategy has been built up and implemented, based on scientifically-established Guidelines. The social marketing campaign is rigorously evaluated to assess its impact and portability.
Implementation process of social prescribing to improve primary care patients’ health and well-being
Authors: Dias S , Figueiredo C , Coelho A , Hoffmeister L , Gama A
Published: November 2019

Social prescribing (SP) is an innovative approach to tackle social determinants of health. It enables general practitioners (GPs) to address non-medical causes of ill-health by linking primary care patients with non-medical community sources of support. Despite convincing results from punctual evaluations, comprehensive evaluation of SP is needed to provide guidance on what works and evidence on its impact.

A SP pilot-project started in 2018 in a primary care service in Lisbon. Its implementation process and outcomes are being evaluated through a longitudinal mixed-method evaluation study assessing patients’ wellbeing, quality of life, anxiety and depression in key stages of the intervention and stakeholders’ perspectives on facilitators/barriers to the intervention implementation.

GPs refer patients to a social worker of the service, who defines with the patient the individual intervention plan using community resources. Initially, GPs and social workers were trained on SP, a network of community partners was built, SP information was distributed to patients, a referral online platform was created and a baseline study is being conducted. In the 1st semester, 130 patients were referred: 39.2% were ≥65 years old, 70.8% were female, 45.4% had foreign nationality. Over two thirds were referred for multiple reasons mostly social isolation, immigration/social integration, mental health, sedentary lifestyle, access to social benefits and employment/skills training.

The project has enabling to support patients with multiple complex psychosocial needs. Regular meetings between GPs and partners have improving collaboration and patients’ supervision. The participatory approach and training emerged as facilitators of the intervention. Yet, the increased burden on social workers due to growing referral profile and some stakeholders’ scepticism toward SP need to be addressed. The triangulation of sources, methods and data provide evidence on the intervention impact and scalability.

Key messages

The social prescribing intervention has been effective in tackling multiple social determinants of health. Intervention evaluation is being key to identify facilitators and opportunities for scale up.
Facebook Intervention To Improve Physical Activity Level Among Youth
Authors: Todorovic J , Terzic-Supic Z , Piperac P , Stamenkovic Z , Santric-Milicevic M , Djikanovic B
Published: November 2019

Background

Physical activity level decreases during the transition from late adolescence to young adulthood. Social media are nowadays widely used and part of many people’s daily routines and the interventions on these websites have the possibilities to be integrated into those routines without becoming a burden. The aim of this study was to assess physical activity level among medical students and to assess the possibilities of using social media intervention with an aim to improve physical activity among them.

Methods

Prospective study was conducted during October of 2016 at the Faculty of Medicine, University of Belgrade, Serbia. The study included 375 first and fifth-year students. At the baseline, students filled in the questionnaire regarding social and lifestyle characteristics as well as their physical activity. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). After completing the questionnaire, students were asked to join a Facebook discussion group. The intervention consisted of motivation for physical activity through motivational pictures, texts, and discussions. The second assessment was done after one month. Based on the reported physical activity level students were divided into two groups: sufficient (>600MET-minutes/week) and insufficient physical activity (≤600 MET-minutes/week).

Results

Total of 85.4% of students were sufficiently active at the baseline, while 90.4% were sufficiently active after one month. Multivariate logistic regression analysis showed that students who were part of the Facebook group (OR: 3.51, 95% CI: 1.46-8.43) and students who had sufficient physical activity at the baseline (OR: 5.44, 95% CI: 2.44-12.13) had a higher likelihood to be sufficiently active after one month.

Conclusions

Social media can be used for interventions targeting lifestyle change among young adults and activities on these websites can be adjusted to meet the needs of the target population.

Key messages

Intervention on social media could lead to lifestyle change. Interventions on social media could be adjusted to fit the target population.
A Bridge to Wellness: Gains from a health fair among fishermen in the Port of New Bedford, USA
Authors: Brisbois M , Silva H , Santos A , Canasta H , Feno A , Cabral L , Soares R
Published: November 2019

Background

Globally, it has been noted that fishermen have a higher mortality from cardiovascular disease, cancer, and injury from work-related accidents when compared to the general population. A potential increase in unemployment in fishermen in New Bedford could result in a lower income level which relates to an increase in risk behaviors, less health screenings, and negative health behaviors. While there is a lack of health-related data among fishermen across the globe, there is little information regarding the health among fishermen, who are predominantly immigrants, in the US.

Objectives

The objectives include designing a health promotion fair to prepare nursing students with the skills to educate fishermen associated with nutrition, diabetes mellitus, cancer and hypertension as identified by key informants in the community.

Results

Students expressed gains in achieving nursing competencies related to collaboration, communication, and teaching/learning by designing a fair with stations related to the four health topics with posters and activities. Educational materials were available in both Portuguese and English to support this aggregate who expressed learning new knowledge. Networking among local fishing agencies, nursing students and the fishermen supported this project from start to finish.

Conclusions

Despite limited access to this vulnerable group, learning nursing competencies and increased fishermen’s knowledge were realized. Connecting students with vulnerable populations is an effective way to promote learning for both groups.

Key messages

Multiple gains are noted when nursing students are paired with vulnerable community aggregates. Learning to work in the community with local agencies and groups is an effective teaching/learning pedagogy.