bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biosocial perspectives on adolescent wellbeing: time trends and cross-national patterns
Authors: Morgan A 
Published: November 2019

Abstract
Since 1985, the HBSC Study has conducted 9 quadrennial surveys. There has been a growing number of HBSC participating countries over the 3.5 decades - from 5 to almost 50, in Europe and North America. In total there have been 298 national HBSC surveys and data collected from more than 1.5 million 11, 13 and 15 year olds. This paper asks - ‘What have we found out about adolescent mental health’ from this enormous research endeavour?
1000 papers have been published from HBSC and of these, just over 10% (120) have a primary focus on mental health. Notwithstanding the complexity of how mental health is conceptualized in each case, the 120 abstracts were scanned and empirical evidence was organised according to Bronfenbrenner’s bio-ecological model in order to synthesise key findings, in order to evaluate: where there were significant contributions to knowledge/understanding of mental health; where this was limited and where real gaps existed.
A vast array of topics was explored on adolescent mental health with a strong focus on the effects of bullying, the school environment and social and economic inequalities. There was a lack of attention to the importance of friendship and prosocial behaviour. Apart from parents, the role of family members, including grandparents and siblings, in supporting or negatively impacting mental health, was neglected. It was concluded that a deeper investigation is needed into behaviours and social contexts that support positive mental health. The use of the bio-ecological model helped to systematise the evidence to provide an overview of what HBSC has achieved in terms of progressing our understanding of adolescent mental health and where gaps exist.
The implications of this review for HBSC’s future development are considered in addition to reflection on what contribution the research to date can make to policy development to improve adolescent health internationally.
TEAviisari – benchmarking health promotion capacity-building in Finnish municipalities
Authors: Saaristo V , Hakamäki P E S , Ikonen J K , Saukko N S , Wiss K K , Ståhl T P 
Published: November 2019

Abstract

Issue
In Finland, municipalities are responsible for promoting public health on local level. However, there hasn’t been comparable nationwide information on health promotion processes and resources in different municipalities available. In order to enhance evidence-based management, a nationwide online database and user interface called TEAviisari (http://teaviisari.fi/en/) was released in 2010.

Description
TEAviisari is based on a generic health promotion capacity-building framework consisting of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation, and other core functions. Each dimension consists of several indicators. TEAviisari aims to make measures taken by local authorities visible and to provide comparable and objective indicators for the management, planning, and evaluation of health promotion activities in different sectors of administration in all municipalities.

Results
Most of the data are collected biennially with an electronic form by municipal informants, and complemented with register data. Sectors covered are primary health care; comprehensive, upper secondary and vocational education; sport and physical activity; culture; and municipal management. Exceptionally high coverage (76%-97%) supports the quality of the follow-up data. In order to simplify the interpretation, all data are displayed as summary scores ranging from zero to 100, where 100 stands for a desirable quality. It is possible to drill down into more detailed information, all the way down to single indicators.

Lessons
Our work shows that it is possible to collect comparable data on health promotion practices and resources in municipalities. TEAviisari offers access to relevant, interpreted information for decision-makers on all levels, serving as an assessment and planning tool for the local government, making their actions transparent to the residents, and providing information for national policy-making.
Monitoring upstream determinants of dietary health to increase action on nutrition: The INFORMAS initiative
Authors: Vandevijvere S 
Published: November 2019

Abstract

Background
Efforts for tracking malnutrition in all its forms are increasing. The World Health Organization conducts regular surveys among Member States on implementation of policies to prevent non-communicable diseases (NCDs) through online databases and interactive maps. However, there are critical gaps. One of the main factors contributing to unhealthy diets is unhealthy food environments. Food environments are the collective physical, economic, policy and sociocultural surroundings, opportunities and conditions that influence people’s food habits and nutritional status.

Methods
The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) was founded in 2013 and developed a new framework to monitor and benchmark the healthiness of food environments and policies in a standardized way internationally. The framework consists of 7 modules covering different aspects of food environments (e.g. food composition, labelling, marketing, provision) and two tools (focused on policies and business impact) to measure the extent of implementation of priority recommendations to improve food environments by governments and the private sector.

Results
To date about 30 countries implemented one or several modules or tools of the INFORMAS framework. INFORMAS has conducted several multicountry comparisons and has developed a blueprint country profile for measuring progress on creating healthy food environments. The proposed country profile aims to supplement similar efforts by the Global Burden of Disease in monitoring health risk factors and outcomes.

Conclusions
This monitoring fills a gap in the available evidence regarding food environments and policies internationally. Monitoring the healthiness of food environments using key indicators is important to strengthen accountability of governments and food companies, and evaluate the impact of their policies.
Example A: Using online respondent-driven sampling among men who have sex with men in Vietnam
Authors: Thorson A E , Rocha L E C 
Published: November 2019

Abstract
Men who have sex with men (MSM) represent a key population at enhanced risk of sexually transmitted infections including HIV. HIV incidence rates are increasing amongst MSM in Vietnam. The last prevalence rates estimates range between 4% and 12% in major cities (2014). High rates of syphilis, chlamydia and gonorrhoea have also been reported, including drug resistant gonorrhoea. MSM face a strong cultural stigma, especially predominant in rural areas, which make them hard-to-reach in relation to preventive activities. In this context, respondent-driven sampling (RDS) becomes an efficient solution for sampling as well as for testing health promotive interventions. The high Internet penetration rate makes web-based RDS to enable sampling as well as testing risk reduction interventions, an appealing alternative to reduce costs, increase data reliability and to facilitate project management of complex study designs. In this talk, we will present and discuss the implementation of a nation-wide webRDS study of MSM in Vietnam aiming to collect self-reported sexual health and risk behaviour information. Using the same web-RDS system, we combine RDS with a double-blinded randomised controlled trial to implement an online intervention based on the participants own responses to encourage self-reflection. The system allows us to follow up respondents for several months after the initial intervention to check the consequences of the intervention on individual behaviour over time.
Health in Environmental Impact Assessment (EIA): Gaining strength from the ‘Family of health assessments’ approach
Authors: Fehr R , Nowacki J , Martin-Olmedo P , Claßen T h , Fisher T h , Martuzzi M , Mekel O 
Published: November 2019

Abstract

Background
For connecting health-related “scientific knowledge” and “policy-making” with each other, there is a range of approaches, including health reporting, health needs / impact / technology / systems performance assessment as well as evaluative activities. The improved understanding of their communalities and differences provides opportunities for mutual learning and synergetic practice.

Goal and method
The goal is to strengthen the coverage of health within EIAs. We apply the “Family of health assessments” approach, as worked out by the EUPHA “health assessments” working group (EJPH 2017, pp.609-16), for connecting EIA to other approaches used to support decision-making.

Results
Applying this “family” approach leads to various insights, including the following: (i) Existing local health (or environmental) reports provide baseline information, as required in impact assessments. (ii) An existing Health Needs Assessment (HNA) can point to vulnerable populations, Health Systems Performance Assessment (HSPA) to specific weaknesses of local health care, potentially relevant for expected impacts. (iii) Where other impact assessments beyond EIA, e.g. Social Impact Assessment (SIA), are conducted, assessors need to be aware of potential overlap or even contradictions which could irritate decision-makers and the public. (iv) Ex-post evaluations of similar projects can inform prospective EIA. (v) The competencies required for assessing human health in EIA overlap with those required for other types of health assessments, e.g., health reporting or evaluation. Therefore, teaching modules might jointly be developed.

Lessons
The “family” perspective helps to make best use of existing (local) knowledge (which is often embedded in diverse forms of health assessments); and to assure consistent practice across assessments. The inter-relationship of health assessments is a reason to reconsider training courses and to develop more integrated approaches.
Health literacy policies and activities: developments in the past five years
Authors: Rademakers J 
Published: November 2019

Abstract

Background
In the past five years, two inventory studies have been performed in which health literacy policies throughout Europe were described and analyzed: the ‘Study on sound evidence for a better understanding of health literacy in the European Union’(HEALIT4EU, 2015) and the recent HEN-synthesis report on the evidence on existing policies and linked activities and their effectiveness for improving health literacy (2018). In this presentation, data from these two studies will be compared to identify current developments regarding health literacy policy.

Methods
The descriptive data of both studies were, amongst others, compared with respect to the number of countries with policies or activities regarding health literacy, the geographical distribution over Europe, the content of the policies and level of implementation.

Results
More countries have developed policies and activities in the domain of health literacy, or are currently in the process of doing so. However, gaps remain in the geographical distribution of policy, and evidence on the effectiveness of policies and activities is still marginal.

Conclusions
Health literacy is more prominent on the European policy agenda. Rigorous evaluation is needed to demonstrate possible benefits of the policies for individuals, communities and society as a whole.
Ground pillars of a method for quality assurance of public health work
Authors: Magnusson M , Hallmyr M , Wretlind K 
Published: November 2019

Abstract
Socioeconomic position, expressed in terms like educational level, income, wealth or origin, is a strong predictor of most health outcomes. Sustainable efforts for good and equitable health need to draw on theories that consider power relations as well as scientific methods for health promotion, prevention and /or treatment. Systematic planning and documentation is required. The perspective should include not only life style habits but also issues like discrimination and stigmatization. Control and influence from participants are necessary to assure that goal-setting and measures taken are adequate.
Health inequity emerges from structural issues and is mediated by mechanisms on different levels, mechanisms of which some are difficult to describe and analyze. Regrettably, health care systems, including public health interventions, in many cases reinforce this inequity. Health care staff’s personal perspectives and prerequisites (e.g regarding education and income) often differ from the corresponding ones in groups with the less favorable health outcomes. That is one reason why efforts for equitable health need to involve perspectives, prerequisites and health motives of “targeted” individuals and groups as salient parts of interventions, from the planning stage and throughout. A complementary way to prevent intervention procedures from consolidating current positions of power is to allow for professionals to continuously perform critical reflection of their own presuppositions and prejudices in relation to actions and results.
The use of determinants from Social Cognitive Theory (SCT) (self- efficacy, observational learning, facilitating, expectations of outcome, reciprocal determination) enables planning that consider not only individuals and groups but also their social context. Systematic use of strategies from SCT, critical reflection and formative as well as summative evaluations allow for quality assurance and knowledge development.
Implementing HEM in the assessment of oral health promotion to families in underserved areas
Authors: Wretlind K , Magnusson M , Hallmyr M 
Published: November 2019

Abstract

The aim was to, in an oral health promoting setting in low socioeconomic areas, implement a method aiming at improving quality of work by assessing both formative and summative results. The overall aim is to decrease health inequity.

Methods
Five teams of dental hygienists (n = 5) and dental nurses (n = 3), who operated in socioeconomic low-status areas, participated. The teams were performing health promoting activities on arenas as for example family-centrals. These teams were introduced on how to report health promoting activities according to the Health Equilibrium Methodology (HEM), which is based on Social Cognitive Theory. Following questions were put and answered in every report: Which health determinants were targeted? Did any person seem to perceive him-/herself excluded? Did anything unexpected happen? What to think about next time? Quantitative data were also documented: Almost six-hundred individuals were included in a total of 36 reports. Of these 50% were adults/parents and the rest children, most of them between 1-6 years old. The reports were written directly into a database after every activity and then processed by a facilitator and later discussed with the teams in workshops every third month.

Results
Analysis of the reports shows that the implementation of health promoting activities according to HEM included the following: -Identification of important health determinants. - Attention on how to get everyone involved and if anything unexpected happened. - Suggestions for change for the next time. Throughout the workshops the team-members exchanged experiences.

Conclusions
The HEM-method facilitates depicting and discussing the process of health promotion with focus on health equity. Thereby the method has a potential to support development of high-quality health-promoting activities in populations with low socioeconomic status. It may also lead to a better professional self-confidence.
Austria: target country for care workers despite increased anti-migration policies
Authors: Falkenbach M 
Published: November 2019

Abstract

Background
Austria is facing workforce shortages in long-term care making the country an important destination for migrant care workers, particularly from Eastern European countries. Many of them are working in low-status positions as carers in 24-hours care, although they are often qualified professionals. These 24-hour care positions are often in private households with no regulated workplace safety or standard minimum salaries. Despite this steady flow of migrant carers, shortage of nurses and carers in the country persists and is likely to increase.

Methods
A rapid review of available data and research was undertaken.

Results
The migration of nurses to Austria has played a significant role for many years, as the training of certified nurses within the country has only risen marginally. The annual inflow of foreign trained nurses reached a high in 2016 as did the number of 24-hour care workers, most of which are women. The recent cuts by the government towards family allowances for children not living in Austria will hit this population hard. Current anti-migration policies thus take the risk of reducing the numbers of migrant carers, although the government does not have a plan in place on how to fill the gaps and develop more effective health workforce planning and management.

Conclusions
Growing nationalism, a government pushing towards stricter migration laws and a restrictionist policy stance of unions relative to migrants, all create new threats to a health system heavily dependent on migrant carers.
Panel: Care4Care: what is it about the migrant care workforce and how to improve inclusion?
Authors: Jacob G , Azzopardi Muscat N , Greer S L 
Published: November 2019

Abstract
A round table comprising three panelists will discuss the topic from different perspectives. Gabrielle Jacob, WHO: The WHO Global Code of Practice on the International Recruitment of Health Personnel. How far have we come, where are we now and what’s next?Natasha Azzopardi-Muscat, EUPHA President: The role of public health in raising awareness on the contribution of migrant workers to health systemsScott L Greer, European Observatory on Health Systems and Policies: Governance4Care of the migrant care workforce: what matters?
Risk factors associated with repeated voluntary termination of pregnancy in Tuscany, Italy
Authors: Napolitani M , Kundisova L , Serafini A , Lenzi D , Messina G , Nante N 
Published: November 2019

Abstract

Introduction
In Italy, voluntary termination of pregnancy (VTP) was introduced in 1978 with law n°194, it guarantees autonomy of choice and avoids the practice of unsafe abortions, health complications and death. The aim of this work was to analyse variables associated with repeated VTP.

Methods
A cross-sectional study was realized, with data relative to VTP acquired in the period 2016-2018 in Tuscany South-East area (Italy). Data on age, nationality, civil state, education level and n° of living children were extracted from the information system in April 2019. A descriptive analysis was conducted using Stata.

Results
The sample consisted of 3451 females (65% Italian). The average age was 31.1±7.3 years. The majority of females (53%) had medium-high education level (non-Italian females had more frequently low education level: 48% vs. 28%, chi-2; p&lt;0.001). The 57% were unmarried, mostly Italian (64% vs. 43%). The majority (62%) already had child (26% one, 36% two or more). Females with repeated VTP represented 25% and were significantly older (32.1 ±6.4 vs. 30.7±7.6; p&lt;0.001). The non-Italian females (OR = 2.15; 95%CI 1.8-2.6; p&lt;0.001) and females that already have children (OR = 2.4; 95%CI 2.02-2.9; p&lt;0.001) had higher probability of having a VTP in the past. The multivariate analysis showed lower probability of repeated VTP for married women (OR = 0.49; 95%CI 0.42-0.64) and women with higher education level in confrontation to those with an elementary education (OR = 0.3; 95%CI 0.18-0.62). The variables associated with higher probability of VTP were age (OR = 1.02; 95%CI 1.01-1.04), nationality (OR = 2.0; 95%CI 1.7-2.4) and children (OR = 2.4; 95%CI 1.9-3).

Conclusions
Females with repeated VTP were older, have already children and were more frequently of non-Italian nationality. The reduction of VTP should be one of major objectives of public health as in has negative consequences on women’s health. The targeted public health intervention could be a solution of this situation.

Key messages
Females with multiple VTP were older, already had children and were more frequently of non-Italian nationality. Targeted public health interventions could be effective in reducing the number of VTP.
Health service provision for women 50+: the “Frauen 5.0” project in the north-east region in Germany
Authors: Dini L , Pruetz F 
Published: November 2019

Abstract

Background
A higher life expectancy for women in Germany coincides with shortages in health professionals. Besides gynecologists (Gyn), the main providers of ambulatory healthcare services for women 50+ are general practitioners (GPs), which are not providing any gynecological services. The project “Frauen 5.0” aims to identify strategies for improving health care provision for women 50+ in three north-east states of Germany by analyzing health system indicators and exploring the perspective of service providers, users, practitioners and policy makers.

Methods
Mixed-methods combined with participatory research including 1) secondary data analysis (Robert Koch-Institute and Zentralinstitut); 2) postal quantitative survey of all Gyn (n = 1.031) and of a randomized sample of 66% of GPs (n = 3.514); 3) qualitative interviews of women 50 + (n = 25); and 4) round tables with practitioners and policy makers.

Results
In Germany 25% of the population are women 50+, from which 41% do not use Gyn services. Users expressed the need that GPs/Gyn actively address women’s health issues during consultation. The survey (response rate 51% Gyn; 25% GPs) revealed a high willingness to collaborate among GPs and Gyn. Barriers and synergies in organizational, professional and user aspects were identified. Task-sharing between GP and Gyn, delegation to non-medical personnel and the introduction of financial incentives showed to be a key element to improve health care services for women 50+.

Dissusion
In the SDG era of “leaving no one behind” acknowledging and addressing the unmet needs of women 50+ is from a public health perspective an issue of utmost urgency as is closing the gap between research, policy and practice.

Conclusions
New strategies to improve health care services for women 50+ were developed by integrating the evidence from actual data in meaningfull dialogues between research, policy and practice.

Key messages
New models of health care provision are required to adress and improve the health of women 50+. Closer collaboration between research policy and practice can be achieved by participatory methods.