bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opticourses: promoting healthier food purchases at no additional cost in low-income households
Authors: Tharrey M , Perignon M , Dubois C , Gaigi H , Darmon N 
Published: November 2019

Abstract

Introduction
Healthy diets are generally more expensive than unhealthy diets, explaining why socially disadvantaged individuals perceive food prices as a barrier to improve their diets. It is thus crucial to develop strategies enabling the achievement of good nutritional quality with a low budget, taking into account actual beliefs and expectations of the target population. A co-construction approach is thus recommended, involving participants at each step of the intervention to maximize its impact.

Methods
The “Opticourses” program was launched in 2010 with a feasibility study, followed by an intervention research in 2012-2014, in order to develop and evaluate a prevention program aiming at improving the nutritional quality of food purchases at no additional cost in a socioeconomically disadvantaged population. In order to implement activities tailored to the target population, participants were involved in the development of the protocol and the tools of the intervention and evaluation processes.

Results
Opticourses’s workshops (8 to 12 participants) include different activities displayed in four 2h sessions around real food purchases of participants, and games and exchanges aimed at promoting food and food choices of good nutritional quality for their price. The intervention research showed improvements in food purchasing behaviors of Opticourses participants. A transferability phase was conducted in 2015-2017. Since 2017, Opticourses is spreading in several regions of France, through training of professionals, in particular the courses organized by the Health Education Regional Committee (CRES) in the South of France.

Discussion
Bringing an original, concrete, co-constructed and scientifically based response to an everyday life problem is the main strength of the program. One important risk of failure for such prevention program is the underestimation of the requirements of the intervention research, in terms of time and human and budgetary resources.

Key messages
From a research point of view, getting access to new food purchasing data will allow a continuous refinement and innovation in the improvement of the diet for people with budgetary constraints. By focusing on food purchasing, a familiar activity that most adults feel able to handle, the Opticourses program is engaging and pragmatic, in accordance with health promotion principles.
Appropriate approaches for improving health promotion literacy in adolescents – a systematic review
Authors: Florescu S , Mihaescu Pintia C , Sasu C , Ciutan M , Scintee S G , Sfetcu R , Vladescu C 
Published: November 2019

Abstract

Background
Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight, stress, violence, unsafe sexual behaviours, self-medication. Health literacy is defined as the knowledge, motivation and competence to access, understand, appraise and apply right information to make decisions in terms of healthcare, disease prevention and health promotion. Despite the advancement of theoretical models, many national and international health promotion programs, the percentage of unhealthy behaviours still persist in young age. Objective: Current review proposes to assess the implementation and effectiveness of various interventions in order to identify possible success or failure factors.

Methods
Comprehensive Systematic review was performed. After three steps data searching (in PubMed, SCOPUS, Cochrane, PsycINFO, Google Scholar) and critical appraisal, 63 studies out of 739 were fully retrieved.

Results
Implementation aspects as intervention types (single or combined targeted risk factors), type of audience (students, parents, school staff, communities), settings (home, school or outdoor), type of organization (face to face, groups, online), professional or peer-led, communication type (written materials as brochures, posters or videoconferencing) or effectiveness measures were extracted and synthesized. Important features of context such as funding, European or government programs were used for clustering the studies.

Conclusions
Health literacy interventions in adolescents need the involvement of education staff and parents participation. Health literacy for adolescents has to take into account cultural context, language, psychological features of each age; either digital or non-digital interventions cannot elude face to face communication between adolescents and their parents, academics or peers.

Key messages
Health literacy school-based interventions are effective but the content for adolescents audience should rely on guidelines provided by interdisciplinary teams of experts. Health Literacy interventions in adolescents should be age-appropriate and do-not-harm precautions must always be taken in order to avoid prejudices, body-image or self-esteem concerns.
Using retrospective process analysis to identify lessons learned from a community health initiative
Authors: Schluefter C , Albrecht M , Fischer J E , Georg S , Hoffmann K 
Published: November 2019

Abstract

As the WHO-Health-in-all-Policies-concept suggests many of the health-related aspects of the social, physical and economic environments can be modified within the community setting. In reality, developing and implementing population-based health initiatives is often challenging for both communities and researchers. To guide future efforts of community health initiatives, we systematically analyzed challenges we encountered and the lessons learned.
We systematically reviewed daily logbooks, meeting minutes and press releases about the initiative to identify successes, unexpected challenges and barriers in its implementation. Comments from two reflective workshops held in the partner community identified additional areas of knowledge. Retrospective content analysis of these sources uncovered emerging process-related themes.
Success was evident in a high degree of citizen participation in initiative-related forums. Challenges included a greater need to a) develop a common vision before starting initiative activities, b) establish an effective collaboration between community residents and our team, c) create more transparent lines of communication, foster trust and better manage community expectations. Establishing a project office in the community for regular updates, trust building and partnering with a professional communication agency were key steps that helped turn some challenges into successes. Barriers identified were missing resources both within the community and our team, a limited time period and limited possibilities of reach into all systems within the community (e.g. kindergartens).
The use of the method of retrospective process analysis helped to uncover detailed insights into the operational implementation process of a community health initiative. These insights serve as a transfer of practical knowledge, which intends to enable researchers and practioneers within communities to plan and conduct their community health initiatives to large success.

Key messages
Analyzing the process of health initiatives retrospectively uncovers detailed insights into implementation processes and helps to understand successes, challenges and barriers of the initiative. Insights into the implementation process of health initiatives function as guidance to other researchers and practioneers to support future efforts in the field of community health.
Perceived needs of elderly for living a self-reliant life: implications for municipal health policy
Authors: Dierx J 
Published: November 2019

Abstract

Background
The population in the Netherlands and in the municipality of Oss is getting older in good health and wellbeing, living more independently and self-reliant with changing needs of support (Hilderink, 2018). However, offered support by health care and wellbeing professionals has not changed. Since it is unknown whether offered support matches the changed needs, the municipality of Oss wanted to know what elderly perceive supporting them in self-reliant life so they could be empowered by more effective supported and more efficient use of staff and finances. Results might have implications for more municipalities with an aging population.

Methods
41 Elderly (age 65-92 y) in Oss were invited to enjoy a meal prepared by their grandchildren at their school and attend a Structured Interview Matrix-session (O’Sullivan et al., 2013) at the same time to map their perceived needs for an self-reliant life. Collected voice recorded data were transcribed and analyzed using thematic analysis (Braun & Clarke, 2006).

Results
Results show that elderly prefer living independently, self-reliant and being self-supporting as long as possible first in physical mobility (walking, biking, driving a car), second in socially with respectively their children, friends and neighbors and third in financially independency. When inevitably getting dependent, they prefer help from children, friends and neighbors for practical daily living activities (e.g. cleaning, gardening, groceries). However, concerning medical care they prefer health and wellbeing professionals with general practitioner and municipality as gateway.

Conclusions
Elderly want to be self-reliant as long as possible, living in their own house and neighborhood. When getting dependent, they prefer friends and neighbors for assistance in daily living and support from health and wellbeing professionals only for medical assistance with a key role for the municipality and general practitioner.

Key messages
Elderly prefer living a self-reliant life as long as possible in their own house and neighborhood. Municipal health services are perceived to play a key role in supplying adequate support from Health and wellbeing professionals.
Participatory action research for global antibiotic stewardship network in CPLP: mixed-method study
Authors: Maia M R , Lapão L V 
Published: November 2019

Abstract

Background
Antibiotic stewardship services (ABS) contribute to antibiotic resistance (AR) global monitoring. Aiming at co-implement an ABS network within the Portuguese-speaking setting (CPLP), by enabling the evidence translation and second opinion between the countries, we surveyed Cape Verdean (CV) health professionals (HP) perceptions about AR prevention and control, assessing ABS opportunities.

Methods
A Design Science with Participatory Action Research establishes a contextualized ABS process. This mixed-method study addressed the first 2 stages, the problem and objectives. Quantitative study considered the HP’s answers (56 HP; 2 hospitals) to a questionnaire, about their perception on AR and ABS. Qualitative study set-up 10 open-ended structured interviews, clinical shift observation in 2 pilot-services (1 hospital), and meetings with key-elements for ABS, including leadership.

Results
Key-stakeholders for ABS multidisciplinary teamwork were identified. Preliminary results are: 1. HP reveal some knowledge but lack of awareness on AR and ABS (eg. 34% don’t recognize the AR local threat); 2. The absence of guidelines and lack of access to key-information affect prescribing confidence (eg. only 46% HP consider microbiology results in deciding antibiotherapy); 3. Priorities for a pilot service are the lack of qualified HP, the need to optimize material resources management and stock procurement, and the need for better access to patient’s clinical and prescription information; 4. Digital resources and telemedicine system can be facilitators. Top-down communication and support are essential for the ABS process sustainability.

Conclusions
A Global ABS network can be important in promoting prevention and effective control of AR, reducing differences between the CPLP countries. In CV, an educational program to support the co-design of ABS service and a decision-support information system are identified priorities. Digital health, like telemedicine, can be ABS facilitators.

Key messages
The implementation of a Global Antibiotic Stewardship network, aiming at reducing Portuguese-speaking Countries differences, could be leveraged by a Participatory Action Research process. An educational program, a decision-support information system and the telemedicine are key for the Global Antibiotic Stewardship network implementation success.
Knowledge of Romanian young women regarding HPV and cervical cancer
Authors: Brinzac M , Coci A , Ionaşcu V 
Published: November 2019

Abstract

Romania has the highest prevalence of cervical cancer in Europe. Cervical cancer is ranked the fourth deadliest cancer and the first among women aged between 15-44 years. In Romania, this type of cancer has 4443 new cases annually and is responsible for 1909 deaths. Lack of sexual education was linked to the increased prevalence rates of cervical cancer. Romania has a two-fold incidence rate than Finland, Luxembourg and France, countries which have sexual education courses.
HPV is the most prevalent risk factor for cervical cancer and this disease is the third most common cancer among women and the second most common among women aged between 15-44 years.
The design of the present study is quantitative as the data was gathered through an online questionnaire. The target group was selected through some pre-established parameters based on the previous searches on Facebook and Google like age, sex, HPV, vaccine, immunization, cervix, cervical cancer. The sample was represented by all the women that reach the parameters aged between 18- 24 years. The results show the knowledge on HPV, HPV vaccination and cervical cancer to be good as for all the questions more than half of the sample had an adequate understanding. In contrast, the overall tendency of the sample was for most of them to be aware of the existence of the mentioned diseases, of the testing process and vaccine existence, but then to lose their expertise when having to give details on the concepts reminded. This trend was noticed in all section as the first questions assessed their awareness of the HPV, cervical cancer, Pap- smear and vaccination, while the following needed a more comprehensive knowledge (i.e. 94.5% of the sample heard of Pap-smear while only 58.7% what it is).
The results have highlighted the gap in the knowledge of Romanian women and the need of campaigns and policies targeting this area. This study can form a basis for the development of such programs as it emphasizes the under-developed areas.

Key messages
Presenting a snapshot of the knowledge of young adult women on HPV and cervical cancer. Putting the groundwork for future studies and policies.
Strategies to achieve HPV-related disease control in Italy: results from an integrative approach
Authors: Acampora A , Grossi A , Colamesta V , Barbara A , Causio A , Calabrò G E , Boccia S , Cicchetti A , de Waure C 
Published: November 2019

Abstract

Background
Vaccination against Human Papilloma Virus (HPV) might allow controlling HPV-related diseases but coverage in Italy is far from the optimal goal. This project aimed at identifying strategies to promote HPV vaccination in Italy.

Methods
an integrative approach including a systematic review and a two-step panel consultation was used to identify strategies for improving coverage among adolescents who are already target of the national campaign and promote vaccination in further targets. The systematic review followed PRISMA recommendations and the panel consultation relied on the administration of questionnaires in the first step and on a televoting system during a consensus conference in the second one. Ten experts were involved belonging to Gynecology, Public Health, General Practice, Pediatrics and Consumers. Recommendations relied on a set of criteria drawn from the Evidence to Decision framework.

Results
The systematic review led the identification of three main strategies to improve coverage respectively based on reminds, education and multicomponent approaches. Following the evaluation of selected criteria, namely relevance of benefits, evidence strength, feasibility, equity, acceptability and costs, a strong recommendation was formulated on the use of reminds tailored to vaccine recipients or their parents whereas a moderate one was developed on the use of reminds directed to health professionals. A moderate recommendation was released on the implementation of multicomponent interventions. The panel consultation also supported the elaboration of a strong recommendation on the promotion of vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women. Catch-up initiatives, in particular among women and men 18 years old, were also identified as strongly recommendable.

Conclusions
This project led to identify several valuable strategies to strengthen HPV vaccination at national level.

Key messages
Using reminds tailored to vaccine recipients or their parents is strongly recommended while using reminds directed to health professionals and multicomponent interventions are moderately recommended. It is strongly recommended to promote HPV vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women.
Challenges in handling congenital anomalies clusters: a recent mediatic example in France
Authors: Regnault N , Beltzer N , Boudet-Berquier J , Gomes E , Bauchet E , Gallay A ,   limb reduction cluster investigation group
Published: November 2019

Abstract

Issue
In 2018 in France, reports of aggregated cases of isolated transverse limb reduction defects, a rare congenital anomaly (1.7 for 10,000 total births) generated a large mediatic interest with environmental factors overtly pointed out. Our aim is to describe the investigations carried out and to share the challenges we met.

Description of the response
Over a period of 5 years (2010-2015), 3 aggregates were signaled by health professionals in 3 different areas in France. Investigations included case ascertainment, epidemiological analyses, and search for a common exposure. Standardized Incidence Ratios were computed using the 6 French registries’s data as reference. In one area, the local registry performed a concurrent analysis using satscan. Parents filled a questionnaire addressing environmental and occupational exposures. Environmental databases were consulted as well as animal health surveillance data.

Results
Fourteen cases met the case definition. The excess of cases was ascertained in two aggregates located in a two small towns in the western part of France and comprising respectively 3 children born in 2007-2008 (SIR: 87.8 CI95%:[17-256]) and 4 children born in 2011-2013 (79.8 [2.5-204.2]). The third signal included 7 cases born between 2009 and 2014 residing in 7 towns located above the Alps and did not yield a significant excess when related to expected cases in the administrative subdivision (0.94 [0.38-1.95]). The concurrent analysis found a significant excess, generating a lengthy debate. None of the investigations identified a common cause or notable exposure. Delayed feedback and negative conclusions led to incomprehension among families.

Lessons
Informing stakeholders timely is crucial but communicating effectively about methods used and negative results can be challenging.

Key messages
Congenital anomalies clusters are sensitive topics. Cluster investigations involve a scientific and a societal component that must both be taken into account in organizing the public health response.
Depression, anxiety stress and associated factors among university students in France
Authors: Herrmann K , Déchelotte P , Ladner J , Tavolacci M P 
Published: November 2019

Abstract

Background
Graduate education is associated with many life changes and stressful events for students, potentially causing depression, anxiety and stress. Prevalence of these disorders and potential associated factors are not clearly identified.

Methods
A cross-sectional study was conducted among university students in France. The students filled out a self-questionnaire recording depression anxiety and stress with the DASS21. High” and “very High” intensity symptoms were grouped into “presence” of depression, anxiety and stress and “moderate” “light” “normal” were grouped into “absence” of depression, anxiety and stress. Curriculum, perceived academic pressure, financial difficulties, smoking, binge drinking and eating disorders were also recording.

Results
A total of 1,202 students were included of which 17.8% were healthcare students. The sex ratio (M:F) was of 0.42 with a mean age of 20.0 years. Prevalence of depression, anxiety and stress were respectively 16.4%, 26.4% and 16.0%. After multivariate analysis, female gender was associated with presence of stress (AOR=1,41 IC 95% [1,03-1,93]). High level of perceived academic pressure (AOR=2,13 [1,61-2,82], 2,05 [1,57-2,68], 2,35 [1,72-3,22]) financial difficulties (AOR=1,33 [1,03-1,73], 1,54 [1,19-1,99], 1,37 [1,04-1,82]) and eating disorders (AOR=2,46 [1,83-3,31], 2,36 [1,75-3,19], 2,21 [1,63-23]) were associated with presence of depression, anxiety and stress. Binge drinking (AOR=1,48 [1,05-2,09]) and smoking (AOR=1,46 [1,01-2,13]) were associated with anxiety.

Conclusions
These results show prevalence of depressive, anxiety and stress symptoms among students. Poor mental health is related to academic and financial difficulties, and is associated especially with eating disorders. There is a pressing need to prioritize mental health of college students through the national public health policies. Additional studies are needed to better understand the relationships between these different factors.

Key messages
There is a significant prevalence of depression, anxiety and stress symptoms among Rouen students. Depression, anxiety and stress symptoms among students are associated with high level of perceived academic pressure, financial difficulties and presence of eating disorders.