bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare providers’ insights on enhancing health literacy and access for Arab Bedouin in Israel
Authors: Shibli H , Limor Aharonson-Daniel L , Feder-Bubis P
Published: October 2023

Background

The Arab Bedouin minority is considered as one of the most vulnerable populations in Israel due to socio-cultural factors that affect their healthcare utilization patterns. This study investigates continuity of care and health literacy within the Bedouin community, aiming to identify gaps and barriers to healthcare services (HS) utilization for Bedouins, as perceived by healthcare providers serving this community.

Methods

A qualitative study was conducted June 2019 and January 2022, involving in-depth semi-structured interviews with 32 healthcare providers from community health centers/clinics in Bedouin villages and towns in Southern Israel, as well as Soroka Medical Center. Thematic analysis was used to analyze the collected data, and trustworthiness was ensured through audit, reflexivity, and peer debriefing.

Results

Healthcare providers identified factors that hinder HS utilization and the absence of various healthcare options for Bedouin patients. Interviews revealed discontinuity in treatment due to insufficient health literacy and unaffordability of medications. Additionally, many Bedouins choose to forgo or delay their visits to the community health services and visit the Emergency Department directly, because of physical, cultural, and gender barriers. Elderly Bedouins are a particularly vulnerable subgroup, susceptible to complications from chronic diseases such as diabetes and hypertension.

Conclusions

This study highlights the necessity of targeted interventions to improve healthcare access for Bedouin minority population, particularly tailoring HS to elderly subgroups. Potential interventions comprise health education programs designed to enhance health literacy, address medication affordability, and confront cultural and gender barriers obstructing access to primary care services. These findings hold implications for public health policies and initiatives addressing healthcare disparities among minority groups worldwide.

Key messages

• Health literacy is a key barrier for the Bedouin minority in Israel, with global implications for addressing healthcare disparities in minority groups.

• Targeted interventions, like health education programs, are needed to improve healthcare access for Bedouin minority, especially the elderly subgroup.
A solution-focused coaching approach to promote adolescent mental well-being in a school setting
Authors: Gustafsson J , Öster S
Published: October 2023

Solution-focused brief coaching departs from the idea that a focus on the clients’ strengths and hopes for the future, rather than on past or present problems, will lead them to do more of what works well and move them toward a desired future. Compared to a problem-oriented approach, the solution-focused is systemic and interactive; the client is viewed as a resourceful individual in a context and as an expert on his or her own life. From this foundation, the Solution-focused Intervention for mental health (SIM) was developed for students in upper secondary school. SIM builds upon four fundamental assumptions. First, an understanding of the cause of a personal problem does not necessarily bring the student closer to a solution of it, or to a desired future. Second, what we focus our attention on and the language we use to describe and discuss our health will grow on us. Third, all students “want to and can do something” that can lead them towards their desired future. Fourth, all students are resourceful and can act in a self-desired direction. During the coaching process in SIM, what the students “hope will start to happen and resources and abilities that can make this possible” are explored and reinforced with a solution-focused dialogue. With support from a group coach and their classmates, students are encouraged to explore what could help towards a desired future and what efforts need to be taken to move in this direction. This is followed up in future sessions by focusing on what works well and efforts made towards what is wanted. The solutions-focused coaching approach, and its associated techniques, aim to engage the students in a process that enhances the awareness and motivation to explore their own strengths and resources so as to engender self-efficacy and self-confidence and strengthen their desire to further develop their abilities and skills. The objective of the process is to establish a mental health promotion that is positively self-reinforcing.
5.A. Workshop: Reducing and monitoring sugar, fat, and salt in packaged food: Germany and the European context
Authors:   Organised by: Max Rubner-Institute (Germany),   Chair persons: Corinna Gréa (Germany), Anna Dittmann (Germany)
Published: October 2023

Today, packaged food constitutes more than 50 % of the food supply in most European households. Many of those products are high in energy, sugar, fat, and salt, and consuming them is positively associated with overweight and obesity. Measures such as taxation and reformulation of packaged food high in sugar, fat, or salt are considered effective means to improve food environments and facilitate healthier food choices for individuals. However, the measures as well as their implementation and evaluation vary across Europe. The aim of this workshop is to give an overview of the different actions taken to stimulate the reformulation of food and beverages. Furthermore, we will present the German monitoring of packaged food, including selected findings, as one example to guide such reformulation initiatives. In the first part of our workshop we summarize existing measures in Europe to facilitate health-promoting food choices, focusing on reformulation measures and related monitoring approaches: Presentation 1 will give a systematic overview of measures to reduce sugar, fat, and salt content of food and beverages in selected European countries (Abstract 1). With presentation 2, we will give methodological insights into the German monitoring of the energy and nutrient content in packaged food (Abstract 2). Presentation 3 will focus on the latest results of the German product monitoring, with an emphasis on sugar reduction in soft drinks, yoghurts, and breakfast cereals. Furthermore, we will compare our results to those of other European countries and highlight methodical differences (Abstract 3). In the second half of the workshop, we aim to discuss our findings with the participants. Participants are encouraged to contribute further examples and experiences from their countries, which then will be discussed and documented. Opening questions and polls will be used to stimulate active involvement. Our workshop aims to contribute to better reporting of existing measures and reformulation monitoring methods in Europe, as information is often limited and only available in respective national languages. Moreover, we hope to create a community of practice to continue exchange on the effectiveness of the respective measures and good practice models across Europe.

Key messages

• The workshop gives an overview of different measures to reduce sugar, fat, and salt content in packaged food in Europe, incl. related monitoring.

• The workshop provides a platform to exchange experiences in packaged food monitoring and stimulate scientific exchange and transparency within this area.
Measures to reduce sugar, fat, and salt content of food and beverages in selected European countries
Authors: Dittmann A , Luft T , Mendoza Pardo C , Storcksdieck genannt Bonsmann S
Published: October 2023

Introduction

Improving food environments to promote healthy diets is a core element of many nutrition and health policies. Government-driven attempts at achieving such improvements comprise mandatory and voluntary measures to reduce the content of sugar, fat, and salt in food and beverages. Here we provide an overview of the different measures taken in selected European countries.

Methods

A systematic internet search for ongoing or planned national reduction measures in each of the three categories of taxation, legal limits/bans, and self-commitments was conducted for 19 European countries. Core characteristics of each measure, including evaluations thereof, were extracted and summarized.

Results

The measures varied in, e.g., the nutrients, product groups, and sectors addressed (manufacturing, retail, out-of-home), the timeframe, and the target values. Taxation (15 countries) mainly concerned sweetened beverages, with tax levels mostly depending on the sugar content. Independent evaluations concluded that the tax introduction had led to the sugar content being reduced as well as consumer demand shifted towards lower-sugar options. Six countries had legal limits for the salt content in bread (limits between 1.3 g and 2 g/100 g bread), and nine countries set legal limits for sugar, fat, and salt in food or meals or vending bans for products high in these nutrients in food service for the public sector. The limited evaluations of compliance with the upper limits were ambivalent. Voluntary commitments (12 countries) mainly concerned the reduction of salt and sugar. Independent studies and monitoring results on the achievement of the agreements showed mixed results.

Conclusions

National measures to reduce sugar, fat, and salt in food and drinks varied in content and depth, and thus in their likely ability to contribute to a healthier food environment. More comprehensive monitoring and evaluation is needed to better assess the effectiveness of the different approaches.
Reexploring problematic social media use and the relationship with adolescent mental health
Authors: Reiten Finserås T , Johnsen Hjetland G , Sivertsen B , Colman I , Træland Hella R , Olesen Andersen A I , Skogen J C
Published: October 2023

Background

Previous approaches used to assess problematic social media use risk inflating prevalence numbers and classify unproblematic social media use as addictive or problematic. The main aim of this study was to take an exploratory view as to how different types of activities, experiences, and motivations on social media are associated with problematic mental health outcomes in adolescents.

Methods

This study is based on a cross-sectional survey of 2023 adolescents (mean age 17.4 years (SD 0.9), 44.4 % males) from 2020. Exploratory graph analysis, Mokken scaling analysis and confirmatory factor analysis were performed on 28 pre-selected items assessing adolescents’ activities, experiences, and motivations on social media, to identify underlying potentially problematic factors associated with social media use. Sets of gender-adjusted multiple linear regression analyses were performed to assess the degree to which social media factors predicted depression, anxiety, well-being, and time spent on social media.

Results

Three factors were identified and named: 1) ‘subjective overuse’, 2) ‘social obligations’, and 3) ‘source of concern’. All three factors showed significant positive associations with mental health problems. The factor ‘source of concern’, which identifies feelings of being overwhelmed and concerned over social media use, had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media.

Conclusions

Three identified factors measuring problematic social media use showed positive associations with mental health problems. This lends support to the notion that problematic social media use is a multidimensional phenomenon.

Key messages

• Being overwhelmed and concerned over social media use had the strongest association to mental health problems and simultaneously the weakest association to time spent on social media.

• The results from this study lends support to the notion that problematic social media use is a multidimensional phenomenon.
Build health in childhood: is it possible to promote health through a social media campaign?
Authors: Cattaneo C , Pani P , Palermo V , Maurel E , Nardone P , Scardetta P , Dittami A , Menzano M T , Carletti C V ,   Project Research Group BIG
Published: October 2023

Introduction

Given the rise of overweight rate among Italian school-aged children (detected by the surveillance system “OKkio alla SALUTE”-WHO-COSI Italy, a communication campaign, addressed to parents, was carried out on social media to promote knowledge and encourage healthy choices to improve children's well-being. Social media allows both to inform users and to actively involve them through an exchange of ideas and opinions. The National Institute of Health, the IRCCS Burlo Garofolo and the Ministry of Health promoted this initiative.

Methods

The campaign consisted in the dissemination, through the institutional page “Guadagnare Salute” on FB and IG, of messages, videos and infographics about a healthy lifestyles. An evaluation plan was set up. Data considered 16/11/2022-04/12/2023 on FB.

Results

The campaign started on November 23rd 2022 and will end in May 2023. 33% of the published posts were sponsored. Users. In the considered timeframe, FB users increased by 78%; 86% were women aged between 35 and 54. The most significant user increase occurred during: a. the first three weeks of the social media campaign and b. after the Christmas break. Exposure. 483.926 users viewed the published contents and 15.056 visited the FB page. Involvement. What affected most the post coverage was: a. sponsorships; b. type and topic of content. The topic that most interested the users was physical activity (active mobility and physical activity in school). Some particular posts about fruit and vegetable consumption, healthy eating and sedentary lifestyle also had a high engagement rate. The topic of sugar-sweetened beverages received the most controversial comments.

Conclusions

Currently, there still is little evidence on the role that social media has on actually changing attitudes and health behaviors among people. The initiative aims to provide further evidence of institutional channels using social media for health promotion purposes.

Key messages

• Social media could be a key communication channel, especially in order to reduce inequalities.

• Evidence about the effectiveness of social media as a health promotion setting is still limited.
Waves of inequality: Income differences in intensive care due to Covid-19 in Sweden
Authors: Cederstrom A , Gauffin K , Östergren O
Published: October 2023

Background

Individuals in lower social strata were overall more likely to develop severe Covid-19 during the pandemic. However, specific conditions in terms of preparedness, knowledge and the properties of the virus itself changed during the course of the pandemic. Socioeconomic inequalities in Covid-19 may therefore shift over time. This study examines the relationship between income and intensive care (ICU) episodes due to Covid-19 in Sweden during three distinct waves.

Methods

This study uses Swedish register data on the total adult population and estimate the relative risk (RR) of ICU episodes due to Covid-19 by income quartile for each month between March 2020 and May 2022, and for each wave, using Poisson regression analyses.

Results

The first wave had modest income-related inequalities, while the second wave had a clear income gradient, with the lowest income quartile having an increased risk compared to the high-income group (RR: 1·55 [1·36 - 1·77]). In the third wave, the overall need for ICU decreased, but relative risks increased, particularly the top and bottom income quartiles (RR: 3·72 [3·50 - 3·96]). Inequalities in the third wave were partly explained by differential vaccination coverage by income quartile, although substantial inequalities remained after adjustment for vaccination status (RR: 2·39 [2·20 - 2·59]).

Conclusions

The study highlights the importance of considering the changing mechanisms that connect income and health during a novel pandemic. Health inequalities per income group increased for each subsequent wave. As the aetiology of Covid-19 became better understood those with more resources could better protect themselves from infection. Understanding the social dynamic of infectious diseases can help prepare for possible future pandemics.

Key messages

• Health inequalities in severe covid-19 infections increased as the pandemic progressed.

• Understanding the social dynamic of infectious diseases can help prepare for possible future pandemics.
Using socioeconomic disparities in ACS mortality to identify opportunities for better cardiac care
Authors: Satokangas M , Arffman M , Lindell E , Manderbacka K , Reissell E , Lumme S , Antikainen H , Leyland A , Keskimäki I
Published: October 2023

Background

Though cardiac care in acute coronary syndrome (ACS) should be equitable, socioeconomic disparities in associated mortality persist. In this study we ask if problems in provision of cardiac care could be pinpointed by examining these disparities in mortality between different time-points of ACS care. Thus, we assessed how socioeconomic disparities in one-year coronary heart disease (CHD) mortality emerged in Finland both outside hospital and in three consecutive time-points after ACS hospitalisation.

Methods

We obtained individual data of incident ACS hospitalisation for those aged ≥40 in 2013-2017 from national hospitalisation registers. Respective data for CHD mortality, education, income, living alone and travel time to hospital were obtained from Statistics Finland and from Digiroad database. Comorbidity was measured with Charlson index. Two-level Poisson multilevel models provided incidence rate ratios (IRRs) separately in total CHD mortality (including prehospital deaths) and by the time of death after ACS hospitalisation (within 1-7 days, 8-28 d and 29-365 d). Variation between hospital districts was adjusted for with random effects.

Results

Of 31,902 CHD deaths 74.9% occurred prehospital, 9.0% within 1-7 d, 6.2% within 8-28 d and 9.9% within 29-365 d of ACS hospitalisation. IRRs for living alone were 1.25-fold (CI95% 1.22-1.29) for total CHD mortality but varied between 0.95-1.05-fold after ACS hospitalisation. A clear income gradient emerged favouring higher quintiles. In the highest quintile IRRs were constantly 0.53-0.56-fold (CI95% 0.43-0.73) to those of the lowest quintile. In other quintiles income disparities were fewer, especially within 1-7 d.

Conclusions

Though socioeconomic disparities in CHD mortality persisted throughout cardiac care, more focus should be given especially to subacute care and rehabilitation of vulnerable groups. Improving early identification of ACS in those living alone offers opportunities to decrease excess CHD mortality.

Key messages

• A detailed analysis of socioeconomic disparities in one-year mortality after acute coronary syndrome event can provide opportunities for improving provision of cardiac care.

• More focus should be given especially to subacute cardiac care and rehabilitation of vulnerable populations, as well as to early identification of acute coronary syndrome events in those living alone.
Socioeconomic differences in SARS-CoV-2-antigen contacts after one year of the vaccination campaign
Authors: Beese F , Bartig S , Wachtler B , Mercuri E , Schmid L , Schmid-Kuepke N , Poethko-Müller C , Gößwald A , Hoebel J ,   RKI-SOEP-2 study group
Published: October 2023

Background

Evidence on the SARS-CoV-2 serological status of the German population by socioeconomic position (SEP) is still limited for the vaccine era of the pandemic, but could contribute to the understanding of the unequal risks of severe COVID-19. This study aims to evaluate the socioeconomic patterns of antigen contacts through infection, vaccination or both (‘hybrid immunity’) after one year of vaccination campaign in Germany.

Methods

We used nationwide serological and self-reported data from the population-based German seroepidemiological Corona Monitoring Nationwide study (RKI-SOEP-2, November 2021-February 2022) to estimate prevalence ratios (PR) of SARS-CoV-2 infection, COVID-19 vaccination (at least one dose of vaccine), basic immunization (at least two SARS-CoV-2 antigen contacts), and three antigen contacts by education and income. Estimates were derived from Poisson regression models adjusted for age, sex, migration status, urban-rural residence, federal state and date of participation.

Results

Across 10,448 adult participants, low-education groups had a 1.35-fold greater risk of SARS-CoV-2 infection compared to high-education groups (95% CI 1.01-1.82, p = 0.045). COVID-19 vaccination and basic immunization decreased with lower education and income. Low-education and low-income groups were less likely to have had at least three SARS-CoV-2 antigen contacts (PR low vs. high education: 0.74, 95% CI 0.65-0.84, p < 0.001; PR low vs. high income: 0.66, 95% CI 0.57-0.77, p < 0.001)

Conclusions

The results show socioeconomic inequalities in SARS-CoV-2 infections, COVID-19 vaccinations and antigen contacts, suggesting a lower level of protection against severe COVID-19 for individuals with low and medium SEP. The majority of the German population exhibits further prevention potential, which could be addressed via more targeted interventions. Future research, pandemic response and vaccination campaigns should address the specific needs and barriers of these groups.

Key messages

• Multiple antigen contacts, especially through vaccination, are less prevalent in groups with low or medium socioeconomic position.

• Potential to prevent severe COVID-19 exists in the majority of the German population after one year of vaccination campaign.
Findings of the German COVID-19 Health Literacy school principal study
Authors: Meyer M , Dadaczynski K , Messer M , Okan O
Published: October 2023

Background

The education sector faced tremendous challenges during the Covid-19 pandemic, requiring adjustments to meet the needs of an unprecedented public health emergency, while also maintaining school health promotion measures. School principals are key actors to lead, drive, and implement school health promotion activities in their setting. Higher school principal health literacy is known to be a predictor for the implementation of school health promotion. The international COVID-HL school principal study was implemented to assess corona-specific health literacy of principals and investigate assocaitions with school health promotion.

Methods

Findings from Germany, that were generated by employing an online survey in school principals during the third infection wave from March to April 2021 in four federal states, will be discussed. Sociodemographics, health literacy, and implementation of school health promotion were measured using self-report tools. Descriptive statistics and variance analyses were conducted.

Results

The survey was completed by N = 2186 school principals. While 60.5% showed an adequate health literacy level, 31.4% showed problematic, and 8.1% even inadequate levels. For the subscale finding, 75.4% showed an adequate level, whereas only 50.5% demonstrated adequate levels regarding information appraisal. Welch's ANOVA indicated significant differences between the health literacy levels and the implementation rate of school health promotion and prevention measures regarding students (p < 0.001; η2=0.054), school staff (p < 0.001; η2=0.015) and school (p < 0.001; η2=0.017).

Conclusions

School principals demonstrated adequate corona-specific health literacy. The most difficulties were indicated when appraising health information in the context of the pandemic. Principals with higher health literacy are more likely to implement school health promotion measures than those with lower levels, making health literacy an important public health and education target.
Organizational health literacy of schools in Germany: a cross-sectional study in schools
Authors: Krudewig C , Kirchhoff S , Okan O
Published: October 2023

Background

Organizational health literacy facilitates health literacy by creating health-literate settings. The school setting is an important venue for the promotion of health literacy of children and adolescents. Within the Health-Literate Schools project (HeLit-Schools), a concept for organizational health literacy of schools was developed, with eight standards informing a questionnaire. This study aims at assessing the implementation status of organizational health literacy of schools in Germany.

Methods

School principals from primary and secondary schools in Germany were invited to take part in an online survey that was launched in winter 2022/23. The implementation status of organizational health literacy was measured using a 48-item self-report questionnaire (OHLS-Q), based on the HeLit-schools concept. Sociodemographics of principals and schools, as well as other health-related variables were assessed. Descriptive statistics were conducted using SPSS.

Results

The preliminary sample from two federal states comprises N = 482 principals (71% female, Ø 52.3 years old). Of the schools, 44% were primary, 41% secondary, and 15% special education schools. Overall, two-thirds of the items reflecting organizational health literacy were rated as partly or fully implemented while across the individual standards a great variance was found. Schools already participating in school promotion programs or networks (28%) reported a higher implementation status of organizational health literacy.

Conclusions

This was the first ever assessment of organizational health literacy of schools based on a novel concept and questionnaire. The findings provide insights into resources and barriers for the implementation of school health literacy. German schools show a relatively high overall implementation status of organizational health literacy. Nevertheless, potential for improvement could be identified. The survey is currently ongoing and more states will provide useful data to be analysed.
'smart life’ implementation as a best practice in tackling child obesity
Authors: Kuusipalo H
Published: October 2023

Smart family targets families expecting a baby, or having children aged 0-12 years aims to help public health nurses and other professionals to bring up lifestyle issues with families without arousing guilt and to identify their strengths in their health habits. Since launch in 2008, 5000 health professionals, mostly public health nurses, have been educated to use the method method does not require resources for public health nurses since it is integrated in their everyday work. Municipalities need to cover expenses for education families highly appreciated that the nurse made visible and acknowledged the family's existing strengths in healthy lifestyle.
Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data
Authors: Hoffmann S , Schulze S , Löffler A , Becker J , Gremmels H D , Holmberg C , Rapp M A , Entringer S , Spallek J
Published: October 2023

Background

Health workers play a vital role in response to outbreaks under pandemic circumstances, but are also highly vulnerable to stress-related mental health issues (e.g., due to pandemic workload). There are knowledge gaps regarding temporal development of the emergence of depressive symptoms among health workers during the COVID-19 pandemic and their determinants. This study examined the trajectory of depressive symptoms and their association with a) stress perception, b) own COVID-19 infection and c) COVID-19 exposure at work.

Methods

This cohort study with 91 health workers (90% female, x¯=45 years) from a German general hospital included (1) medical, nursing and therapeutic staff and (2) administrative staff. Data were collected longitudinally every month from July to December 2020. Linear multilevel models were used to evaluate associations between trajectories of depression scores (German ‘General Depression Scale’) with perceived stress (‘Perceived Stress Scale’). Laboratory-confirmed COVID-19 infection was tested as a moderator of depressive symptom development. Trajectoires of depressive symptom modalities (e.g., somatic, emotional) were analysed stratified by COVID-19 exposure at work.

Results

Depression scores increased across the study period (b=.03, .02-.05). Perceived stress was associated with depression scores (b=.12, .10-.14). The presence of health workers’ own COVID-19 infection was associated with a higher increase (b=.06, .01-.10). Somatic symptoms of depression increased over time only among health workers directly exposed to COVID-19 patients at work (b=.25, .13-.38).

Conclusions

The increase in depressive symptomatology among health workers exposed to COVID-19 in the workplace points to the need for further research. Since the infection with COVID-19 is associated with an increase of depressive symptoms across time, awareness should be raised about measures to protect against virus transmission, especially during a pandemic.

Key messages

• Perceived stress and own infection during the COVID-19 pandemic are additively linked to depressive symptoms among health workers.

• Exposure to COVID-19 in the workplace is associated with increased somatic depressive symptoms.
6.E. Workshop: Evaluating progress in adaptation in the European public health sector
Authors:   Organised by: ENBEL, EUPHA-ENV,   Chair persons: Sari Kovats (UK), Marija Jevtic (EUPHA-ENV)
Published: October 2023

Most national climate adaptation plans and strategies mention risks to human health. However, this is not often translated to specific policies, measures or targets to reduce these risks. The ENBEL project, funded by the European Commission under the H2020 program LC-CLA-22-2020, aims to support European policy making on climate change and health. In this workshop we present the results of recent research on the implementation of adaptation measures in Europe and review the evidence needs of EU, national and international decision makers. The workshop aims to support evidence translation for adaptation that prioritises health protection and equity. The workshop will include presentations on stakeholder mapping and interviews with key decion makers, as well as a comparison of current policies in health adaptation. We review the recent European policies on COIVID recovery and evaluate whether these will benefit adaptatoin. Economic evaluations are important for decision making and we review economic assessments for local climate action and for climate services for health.

Key messages

• Public health professionals can support adaptation actions through intersectoral working.

• Post-COVID recovery is missed opportunity to improve adaptation in Europe.
Digital Public Health in Ireland
Authors: Staines A
Published: October 2023

Before COVID-19 Ireland had a very limited digital health infrastructure. There are no unique health identifiers, and it is common for patients to be on the books of multiple providers, be that general practitioners, or hospital waiting lists, so capacity analysis beyond actual hospital admissions, is very limited. There are separate systems used to manage child development and vaccine delivery. Infectious disease reporting is done, feeding into a 25-year-old central system. General practice (GP) is the only sector that uses electronic records widely, which support a messaging system, to return hospital test results to the GP. Prescriptions were commonly handwritten on paper or typed, specifically on three-layer fan-fold paper, using obsolete printers for fully state-funded prescriptions. The patient transferred these to the pharmacist. COVID-19 shook this system to the foundation. It became necessary to set up contact tracing systems and vaccination systems for the entire population. These were built very quickly as free-standing systems. In addition, hospital activity data, which had been typically available a month after the date of discharge, was needed daily to manage bed capacity. Pharmacists had to receive prescriptions online, and e-prescribing was brought in. All of this worked and often worked well. More embarrassingly, as COVID-19 case numbers rose, the recording system did not scale, and reported case numbers were substantially too low for a time. Now that the acute pandemic response is over, very little has changed. Hospital prescriptions are still paper-based, although GP prescriptions use the new system. Contact tracing is shut down, and the vaccination system is scaled back. There is still no health identifier in use. Few of the lessons of the pandemic response have been learned, and the opportunity to make more significant changes in public health systems has been missed. A ‘good’ crisis was wasted.
Perioperative patient safety recommendations: best practices derived from a systematic review and a multidisciplinary expert consensus
Authors: Martinez-Nicolas I
Published: October 2023

Surgery care has one of the highest pooled prevalence of preventable patient harm. Many clinical practice guidelines have been developed around the world to overcome this safety and public health concern. Moreover, clinical practice guideline (CPG) recommendations may efficiently provide a sound source of evidence-based practices for quality indicator development. However, the question is which healthcare processes should be measured. The “Improving quality and patient SAFEty in surgical care through STandardisation and harmonisation of perioperative care in Europe” (SAFEST) project aimed to reach a Europe-wide consensus on perioperative patient safety recommendations for adults that will be further transformed in quality measures and guide implementation activities. To achieve such a goal, a systematic review of CPGs was performed, identifying more than 250 CPGs and more than 2600 recommendations; eventually selected and synthesized into 99 recommendations. Then, we recruited an expert panel including organisations from the European Region, and focusing on a balanced representation of geographical location, clinical and non-clinical expertise, and gender. A two-round online Delphi was conducted, and a Consensus Conference was held in Brussels. During the entire process, some recommendations were reworded, separated, merged, added or removed. Additionally, feasibility and equity concerns emerged and were further explored in-person during the conference. Finally, a list of 101 perioperative patient safety recommendations was agreed. These evidence-based practices incorporate clinical and managerial experts’ considerations as well as patient representatives’ reflections. In conclusion, this presentation will explore the relationship between recommendations and quality of care indicators. We will discuss the usefulness of SAFEST evidence-based recommendations, and their pros and cons as process and structure quality measures.
Policy progress through the right to know and standardisation of alcohol labelling
Authors: Gokani N
Published: October 2023

The fourth presentation will continue the discussions on trade law by showing how policies can progress through increased recognition on the right to know and efforts to grant this right through standardising alcohol labelling internationally.
Gender-specific differences in at-risk alcohol consumption among older German adults
Authors: Geigl C , Spagert L , Janssen C
Published: October 2023

Background

At-risk alcohol consumption can lead to serious health effects among older adults for several reasons. Older adults generally tolerate alcohol less well due to a slower metabolism, and interactions with medications are more common (as the likelihood of being dependent on medication increases with age). In addition, older people have an increased risk of falling. This analysis examines alcohol consumption among older German adults as well as gender differences in alcohol consumption and at-risk consumption.

Methods

Cross-sectional data of adults aged 65 and older were collected through a community-based full-population postal survey in Puchheim, Germany (n = 1687, 33% response rate, 52% female). The validated AUDIT-C screening instrument was used to assess at-risk alcohol consumption. Gender-specific analyses of average alcohol consumption (t-test) and at-risk alcohol consumption (chi-square test) were performed. Binary logistic regressions were conducted separately by gender to estimate the likelihood of at-risk alcohol consumption depending on socioeconomic status.

Results

Older men had a higher average in alcohol consumption than older women, t(1491) = 11.18, p < .001, d = .6. However, in at-risk alcohol consumption, older women (26%) were more often affected than older men (21.4%), χ2(1) = 4.13, p = .042, φ =.05. Higher socioeconomic status increased the likelihood of at-risk alcohol consumption among older women, OR = 1.08 (95%−CI[1.011, 1.153], p = .022), but not among older men.

Conclusions

At-risk alcohol consumption among older German adults affected one in four women and one in five men. Surprisingly, more older women reported at-risk alcohol consumption than older men, and it was associated with a higher socioeconomic status only in older women. This information is important for developing targeted interventions, especially for older women.

Key messages

• One in four older women and one in five older men are affected by at-risk alcohol consumption.

• There is a higher likelihood of at-risk alcohol consumption among older women who report a higher socioeconomic status.
Costing the mental health harms of sexual and physical violence in adulthood: a prevalence-based analysis
Authors: McManus S , Barbosa E C , Walby S
Published: October 2023

Background

When economists estimate how much violence ‘costs’, they rarely address the longer-term mental health harms resulting from sexual violence or the combined impact of sexual and physical violence, nor have most gender-disaggregated costs.

Methods

We applied prevalence-based modelling techniques to estimate the annual cost of experience of violence in adulthood, in terms of reduced quality of life and health service costs. Data were drawn from multiple sources, including the general population probability sample Adult Psychiatric Morbidity Survey. Prevalence and duration estimates used weighted data. Adjusted marginal effects for limiting mental health conditions and substance dependence were estimated for experience of sexual violence, physical violence, and sexual and physical violence combined. Disability weights were applied to estimate associated reduced quality of life and relative risks applied to health service delivery costs.

Findings

The estimated cost in 2019 of long-term reduced quality of life adults in England experienced because of violence during their adult years was £3,767 mil (€4,290 mil), with associated healthcare costs of £4,130 mil (€4703 mil). Both the costs of long-term lost quality of life and healthcare were higher in women than men. The costs associated with combined sexual and physical violence were particularly high, with an estimated 96% of these costs resulting from experiences of violence in women. Combined sexual and physical violence in women was associated with the highest cost per victim.

Conclusions

Sexual and physical violence both have substantial and independent associations with long-term mental distress, substance dependence and treatment and service use. Violence reduction interventions have the potential to reduce health service costs and increase population level quality of life. Future costings of sexual violence should fully incorporate the long-term impacts on mental health and gender-disaggregate estimate.
Violence and abuse exposure and health complications in older age
Authors: Fadeeva A , Hashemi L , Cooper C , Stewart R , McManus S , Obolenskaya P
Published: October 2023

Background

Due to the ageing population, the extent and impacts of violence in later life could become increasingly prominent. However, there is a lack of evidence on violence and its effects in older age, which impedes prevention measures. The present research draws on data collected from two nationally representative population health surveys - the Adult Psychiatric Morbidity Survey (APMS) 2014 and the English Longitudinal Study of Ageing (ELSA) to examine associations between violence and health outcomes in older adults in England.

Methods

APMS is a cross-sectional design and collected data on violence and abuse as well as mental health in adults aged 16+. Multivariable regression analyses were run to measure associations between violence and common mental disorder (CMD) in adults aged 60+ in comparison with the younger population group (16-59). ELSA is a panel data study, which has collected information on health, social, and economic lives of individuals aged 50 and over every two years since 2002. In wave 3, ELSA included questions on childhood abuse and life experiences of physical and sexual violence. Logistic multilevel regressions were used to examine associations between violence and subsequent limiting illness and depression.

Results

Violence conferred an independent risk for CMD (AOR 2.2, 95% CI:1.0-4.8) based on the APMS data. According to ELSA results, physical violence (AOR 2.50, 95%CI 1.69-3.68) and childhood abuse (AOR 2.47, 95%CI 1.51-4.04) were associated with the development of limiting illness, with sex differences between men and women observed.

Conclusions

Violence remains a problem that affects older people and presents risks to their health. Moreover, earlier life victimization could cause long-lasting health impacts that persist in later life. To mitigate the challenges associated with the ageing population, policies and interventions should focus on the prevention of violence and its long-lasting effects on health.
Data collection and analysis on the burden of injuries: Lessons learned from the IDB network
Authors: Bauer R , Giustini M , Nijman S , Bejko D
Published: October 2023

The EU-IDB (European Injury Database) contains cross-national data on the external causes and circumstances of injuries treated in the emergency departments of hospitals. Its primary purpose is to facilitate the development and evaluation of injury prevention policies and programmes, which aim to control external risks. The information is complementary to death and hospital discharge statistics and specific surveillance systems on road and workplace accidents. Unique is the wealth of information about external circumstances of injuries as needed for evidence-based prevention actions. The IDB data are collected by dedicated national agencies and provided to the Italian National Institute of Health (ISS) which hosts the databank. As part of the EU BRIDGE-Health initiative 2017 (WP9-Injury Surveillance Platform), the EU-IDB Network was commissioned to generate comparable burden of injury estimates across Europe: “Disability Adjusted Life Year (DALY) estimates for injury utilising the European Injury Data Base (IDB)”. DALY estimates were generated for IDB countries and years where both fatal and non-fatal injury data were available. Non-fatal injury data were acquired from Emergency Department data recorded in the IDB Minimum Data Set (MDS), fatal data were obtained from the European Detailed Mortality Database (EDMD). The general approach to calculating DALYs followed that of the Global Burden of Disease (GBD) study but utilised new and different disability weights created by the the Injury-VIBES cohort and detailed injury incidence data from nineteen countries. DALY estimates were between 2-10 times larger than estimates generated by previous studies such as the GBD study, due to much higher incidence figures and larger disability weights.

In the workshop, the most recent results of the EU-IDB and the respective DALY estimates will be presented and discussed.
Power and politics of health system data: how data shape responses and equity during pandemics
Authors: Kihlström L , Satokangas M , Skogberg N , Viita-aho M , Gissler M , Nykänen E , Keskimäki I , Tynkkynen L K
Published: October 2023

Background

Pandemics disproportionately affect vulnerable groups. There are documented socioeconomic, gendered, and racialized differences in the burden of disease during COVID-19 and previous pandemics due to factors such as lack of access to social safety nets, poor quality of housing, and precarious working conditions. Therefore, equity should be a key principle for health system preparedness. However, the monitoring and detection of inequities largely depend on the availability of disaggregated data. Often, such data are not available nor are they utilized to promote equity-based approaches during major public health crises.

Methods

The article builds on social epidemiology and is conducted as a theoretical review. It uses health monitoring data collected in the Finnish health system and the Finnish response to COVID-19 as case studies to investigate how data shape equity and responses during rapidly unfolding crises. Finland provides an interesting context for the case studies due to its extensive and high-quality health registers and health monitoring data.

Results

In the article, we present a summary of the Finnish health system monitoring data infrastructure and a review of factors affecting data collection and utilization processes in Finland. We then describe how register data was utilized as a part of the Finnish response to COVID-19. Finally, we present an example of how the utilization of disaggregated vaccination coverage data helped create an equity-based community health promotion response during COVID-19 in Finland.

Conclusions

The article points out several understudied populations in the Finnish health system monitoring infrastructure, including those with lower incomes, undocumented immigrants, racialized minorities, and LGBT populations. While waiting for national health monitoring systems to “catch up”, smaller-scale community-based responses can be used to tackle inequities during health system crises.

Key messages

• Critical research approaches to health system data and data gaps are crucial since these data are the product of decisions, prioritization and value judgments made by health system actors themselves.

• Revision work of pandemic preparedness plans across Europe needs to acknowledge how health system monitoring shape both responses and equity during crises.
Writing for impact: How to create policy briefs that influence policy-making
Authors: Nagyova I , Michie S
Published: October 2023

Issue/problem

Effective communication between academics and policy makers can be challenging due to differences in language, priorities, and deadlines. Policy makers are often pressed for time and require concise and actionable information to inform their decisions.

Description of the problem

Policy briefs are a useful tool for bridging the gap between research and policy making. However, not all policy briefs are created equal, and some may not effectively communicate research findings and recommendations to policy makers. To be effective, policy briefs should incorporate behavioural insights. This can help them to be understandable and succinct, evidence-based, and feasible and actionable. Moreover, the type and content of a policy brief should be informed by the needs of the stakeholders and the specific stage of the policy cycle.

Results

Policy briefs that adhere to these characteristics have a higher likelihood of informing policy decisions and creating impact for researchers. They can raise awareness of current research on a policy issue and communicate evidence-based recommendations in a concise and accessible format.

Lessons learned

Policy making is a cyclical process and it is possible to influence policy at all stages in its formation, implementation or evaluation. Writing effective policy briefs requires careful consideration of the target audience and their needs. In addition, researchers should create a specific research plan, including methods and procedures, for how to measure the impact of their briefs.