bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the drivers of m-Mental Health uptake among emerging adults
Authors: Hasa M 
Published: October 2020

Abstract

Background
In the age of the ever-increasing prevalence of depressive symptoms and suicidal rates among young people, aiding this population to foster healthy mental well-being poses a key public health challenge. Since emerging adults generally tend to avoid offline help-seeking in case of mental health troubles, this population might especially benefit from m-Mental Health. The present study aimed to identify the determinants of the use of m-Mental Health apps among emerging adults and investigate the role of privacy and safety concerns of potential users in the highly confidential area of mental health.

Methods
A mixed design comprising an online survey and manipulation tested the new model among 229 adults aged 18-29 from 27 different countries.

Results
The SEM analysis indicated good model fit. Significant strong associations were found between Health Technology Efficacy, Health Technology Self-Efficacy, attitude toward mobile mental health and intention to use m-Mental Health. Health Technology Social Acceptance had a significant positive relationship with Health Technology Efficacy. Confidence in Health Technology negatively moderated the way Health Technology Efficacy shaped the attitude toward m-Mental Health.

Conclusions
When emerging adults are to decide whether or not to use an app to enhance their mental well-being, several factors come into play: Perceived efficacy of the app, positively linked with one's self-efficacy and social influence, predicts behavioural intention through the attitude toward m-Mental Health, while health technology self-efficacy is also directly related to the intention to use such an app. Moreover, the variable Confidence in Health Technology manifested its indispensable role within the model. Finally, the study disconfirmed the assumption that young people would be less confident in the app if they were confronted with signs of its profit-driven origin.

Key messages
The perspectives-bridging, variables-contextualizing approach is a promising avenue for investigating the drivers of e-Health uptake in various health domains, technologies, and populations. Young adults who believed in m-Mental Health apps in terms of safety and privacy were less influenced by the perceived efficacy of such apps with regard to their attitude and intention to use.
Digital health in a social health insurance system: new emergent market powers in Germany
Authors: Posselt J , Kuhlmann E 
Published: October 2020

Abstract

Background
This presentation analyses the dynamics of digital health from a governance perspective. It aims to explore the driving forces for the implementation of digital health in Germany. Germany is chosen as a case study of a social health insurance system, which is based on joint self-governance of sickness funds and providers, and strong corporatist power of the medical profession.

Methods
A qualitative explorative approach is applied, drawing on document analysis and other secondary sources. The research is based on a governance approach adapted from Glassman and Buse's model of public health policy reform.

Results
The WHO Global Strategy for Digital Health 2020-2024 serves as a key international policy framework. However, the analysis reveals firstly that implementation is shaped by national healthcare systems and may create different results; secondly, the global strategy provides only a weak guidance on the national level. In Germany, strong corporatism and weak state intervention is supporting market forces and private actors. Poorly developed digital health governance has opened a window of opportunity for market powers as driving forces for digital health, thus creating new risks of social inequalities. There is an urgent need for public health to step up advocacy for health literacy to improve the accessibility to digital health for all citizens.

Conclusions
National healthcare systems strongly shape the implementation of international digital health frameworks, which makes digital health an issue of governance. Stronger public health orientation and a people-centred approach are needed to counteract new emergent social inequalities created by market power.

Key messages
Market power and private actors are important drivers of digital health in the German healthcare system. Social health insurance systems may be vulnerable to market powers and new digital health inequalities.
An app-based quick assessment tool for childcare PA environments and practices
Authors: Müller C , Kaiser V , Hassel H 
Published: October 2020

Abstract

Background
Childcare centers are settings with a huge impact on children's health and health behavior and should therefore be encouraged to implement policies and practices to promote physical activity (PA). The project “QueB 2 - developing quality with and through physical activity” aims at exploring how stakeholders can be involved to identify childcare centers with need for action. For this purpose, an app-based quick assessment tool is developed.

Methods
We conducted two group discussions with stakeholders working with childcare centers (consultants, supervisors) about requirements in terms of applicability and criteria that are important and easily verifiable. Based on the results of the discussions and building on scientific evidence and existing frameworks, a quick assessment checklist was created and developed as a web app. The tool is tested by stakeholders and evaluated in further group discussions.

Results
Stakeholders require a simple assessment tool that can be used in counseling with small expenditure and is combined with information material. The developed app-based assessment tool consists of 20 items in 7 categories (indoor space, outdoor space, play equipment, activities, childcare center culture, professional development, network). It incorporates a simple scoring system with a total score ranging from 0 to 126. Based on the score, the tool shows a feedback window stating whether there is little, some or much need for action and providing additional information.

Conclusions
Stakeholders can be involved to sensitize childcare centers to the issue of physical activity environments and practices with the help of an app-based quick assessment tool. This is an important step before possible interventions can be implemented in childcare centers.

Key messages
An app-based assessment tool for childcare physical activity environments and practices is developed. It will enable stakeholders to identify childcare centers with need for action and offer support.
AcademicMind - The mindfulness app for academics
Authors: Guedes R , Valois R , Costa A , Delineau V 
Published: October 2020

Abstract
Support better mental health is a long-term investment. Stressful life events and chronic adversity have a substantial impact on brain functions and may result in mental health problems. Stress during academic life was already established as a problem, and university students have a high-stress rate. Create and improve strategies to lower those levels can increase student wellbeing. Smartphones connect individuals across the world, and its software applications may have the ability to facilitate behavior change. Mindfulness-based interventions bring positive results for physical and mental health and are recommended to reduce stress. We offered a Mindfulness-based program for stress reduction for eight weeks on a progressive web application (app) for higher education students. The main objective of the project is to increase wellbeing by reducing stress levels in university students, providing them with tools and knowledge through a digital intervention program. Individuals completed the Warwick - Edinburgh Mental Well-being Scale before the 1st, in the 5th week, and the 8th week of intervention. The pilot study counted with 15 participants from 4 countries, from undergrad to postdoc. Preliminary results showed that participants are mostly female (69%) from a master (52%) in health sciences (45%) and located in Brazil (50%). The access was usually via mobile (67%), and the first month had six times more visits and 1.3 times more meditations listened than the second. Participants improved their test score considering before (M = 43.20, 5.26) and after (M = 49.80, SE = 6.90), t(4)= -3.404, p = 0.027, demonstrating an increase of wellbeing after the program. Our lessons were: To maintain adhesion rate to the program constant. Provide access to professional help if needed. Turn the progressive web app into a native IOS and Android app. Integrate the smartphone application into university health programs with the possibility of referrals to mental health professionals.

Key messages
An intervention program as a progressive web app designed for academic students to improve wellbeing can offer good cost-benefit, ample reach, and early detection of cases that need specialized help. Provide a readily available and understandable program that permits the improvement of stress levels and wellbeing may be a possibility to decrease academic abandon and improve academic achievements.
Process modelling of organized screening programs – breast cancer
Authors: Terras Marques I , Santos C , Santos V 
Published: October 2020

Abstract
Breast cancer is the most frequent cancer among women and one of the principal causes of cancer related death in women worldwide, being a public health problem. Oncology screenings allow its early detection and reduce its mortality. Business process management (BPM) is a management field that leads an organization into continuously improvement with increase of efficiency. The processes of the healthcare system are complex what makes the application of BPM techniques harder, however their usage has been increasing in this sector.
The main objective of this study is the identification and modelling of BPM processes for the Portuguese breast cancer screening.
The current processes and the entities (actors, systems and documents) involved in the Breast Cancer Organized Screening performed by the Portuguese League Against Cancer were identified through interviews to the employees. With the information retrieved and using Bizagi the related As-Is diagrams were developed.
In this work 5 processes within the Breast Cancer Organized Screening were identified: Process “Patients' invitation”; Process “Screening”; Process “Reading of the exam”; Process “Check-up Consultation” and Process “Sending Results”. Through the analysis of the As-Is diagrams and of the available information, a critical analysis was made. As for example, in the process “Patients' invitation” an invitation letter is sent 15 days earlier to the patient but no telephone contact is done before the screening. An improvement could be sending a message in the day before the screening, remembering the appointment, avoiding forgetfulness absences.
With this work the mainly processes of the breast cancer organized screening were modelled as “As-Is” diagrams and, in a macroscopic way, some of the problems were identified and improvement suggestions were made in order to achieve the main objective of the process, the early detection of breast cancer, while optimizing the process.

Key messages
This work represents an important contribution to the Breast Cancer Organized Screening since, through the use of BPM, a set of actions is proposed with an impact on its effectiveness and efficiency. This work represents an example of what the BPM techniques can do to help in the optimization of all the processes of the healthcare sector, from screening to diagnosis and treatment.
Digital and innovation skills in health care professionals in Europe
Authors: Fornes-Romero G , Doñate-Martinez A , Garces-Ferrer J , Fredskild T U , Hansen H , Traver-Salcedo V , Martinez-Piqueras M , Gil-Granados A , Gimenez-Campos S 
Published: October 2020

Abstract

Background
Rising life expectancy and ageing population are current phenomena that European society is facing and these are challenges for the European healthcare systems. To face them, several e-health solutions are already designed to optimize resources of the healthcare provider system. However, most of them are not being implemented or deployed. Some of the reasons are the lack of digital skills and innovation readiness in staff, and existing barriers to changing organizational practices.

Objectives
The DISH project (601008-EPP-1-2018-1-DK-EPPKA2-SSA) will develop 3 concepts to improve the digitalization of healthcare staff to help them in the use of e-health solutions already developed: 1)Learning Innovation Units, where healthcare staff, SMEs and educational institutions work together for improving the e-health solutions development and implementation; 2)On the job training, where healthcare staff will be trained in e-health and digital competences; 3)Assessment, where competences accomplished by healthcare staff will be recognized. All these concepts will be tested in 6 EU countries.

Results
The development of the 3 concepts is based on a needs analysis on present and future competences required to support the implementation of e-health solutions in Denmark, Norway, UK, Germany, Spain and Poland. Also, each country will test the 3 concepts and train 100 healthcare staff in the use of an e-solution/innovation already developed but not being fully implemented. An evaluation of the achieved skills/competences by the staff will be also conducted.

Conclusions
Healthcare workers and SMEs show willingness and motivation in contributing to the digitalization but there is a clear lack of digital skills (although this is different from country to country) to make easier the adoption in daily practice of such solutions. The project looks for promoting close collaboration between the interested parties to work together in overcoming the stated deficiency.

Key messages
The DISH concepts will facilitate a training framework for healthcare professionals in the use of digital solutions. The DISH project will promote the use of several innovations already available in the market.
Using personalised avatars in a weight loss management programme: participants’ perspectives
Authors: Horne M , Hill A , Ugail H , Murrells T , Hardy M 
Published: October 2020

Abstract

Background
Obesity interventions rely predominantly on managing dietary intake and/or increasing physical activity but sustained adherence to behavioural regimens is often poor. Avatar technology is well established within the computer gaming industry and evidence suggests that virtual representations of self may impact real-world behaviour, acting as a catalyst for sustained weight loss behaviour modification. We explore patient's experiences of using an avatar as an adjunct to a weight management programme.

Methods
Exploratory, qualitative research design with a sub sample of participants to explore uncertainties and develop intervention optimisation and conduct of a future trial. Semi-structured interviews, with a purposive sub sample of obese and overweight patients a undergoing weight management programme (n = 12) from two settings in West Yorkshire, England (November-March 2020). Ethical approval was granted. Data were analysed using framework approach of verbatim transcripts.

Results
Three main themes emerged through data analysis (i) avatar appearance (ii) added benefits and (iii) areas of development. Visual perception of the personalised avatar could positively or negatively influence current and future realities. Patients generally found that using a personalised avatar provided added motivation to continue with the weight management programme and increased their confidence in their ability to work towards a healthy lifestyle to reduce weight loss. Several areas of development were identified for both the weight loss programme and the personalised avatar in relation to accessing psychological support and ways of developing and strengthening their own personal resilience.

Conclusions
The findings suggest that using personalised avatars could be a useful technique to increase engagement, motivation and adherence to weight loss management programmes among individuals who are obese or overweight.

Key messages
There appears to be some added motivational benefits to using personalised avatars. Virtual representations of self may impact real-world behaviour, acting as a catalyst for sustained weight loss behaviour.
An evaluation matrix for self-instructional courses of Continuing and Online Education in Health
Authors: Gasque K C S , Guizardi F L , Coomans de Brachene SMDBTC , Fernandes K , Dutra E B , Lemos A S P , Passos M F D 
Published: October 2020

Abstract

Background
In 2003, the National Policy for Continuing Education in Health (PNEPS) was created as a strategy to train and update workers of the Unified Health System. To be effectively instituted, the Open University of the Brazilian Unified Public Health System was conceived to offer free online courses. But, it was observed that the online educational modules developed were not structural and pedagogically homogeneous.

Objective
Propose a matrix of criteria and guidelines to support the improvement of the design of instructional modules, investigating three main areas: ergonomics, education and health.

Methodology
Anasynthesis was the approach to build the evaluation matrix.

Results
The matrix consists of 29 criteria (Accessibility, Progression Activities, Updating Practices, Self-Analysis and Self-Management, Assessment, Cognitive Load, Student-Centered, Collaboration, Compatibility and Interoperability, Consistency, Knowledge Building, Student Control, Documentation and Help, Aesthetics, Feedback, Flexibility, Error Management, Interactivity, Maintenance, Clear Instructional Goals and Objectives, Motivation, Personalization, Problem Practicing, Critical Reflection, Relevance, Renewable, Safety, Use of Different Paths, Valorization of Knowledge) with 132 guidelines that allows to check if the online self-instructional module meets minimum quality criteria. Five courses produced by the UNA-SUS system were tested and compared with the perception of users of these courses, obtained by the polls for opening and closing the courses. There was an approximation between the evaluations using the matrix and the responses of the surveys of the courses, answered by the users. Results from these surveys were transferred to a user matrix. The Interactivity and Collaboration criteria were considered non-mandatory for self-instructional courses without tutors.

Conclusions
The matrix is an adequate evaluation tool for self-instructional courses developed for Continuing Education.

Key messages
The evaluation matrix is adequate to evaluate online self-instructional courses developed for Health professionals qualification. Self-instructed courses could be a good tool for Continuing Education in health, according to students’ perceptions.
Are persons with a limited health literacy less satisfied with the German health care system?
Authors: Achstetter K , Köppen J , Blümel M , Busse R 
Published: October 2020

Abstract

Background
Health literacy (HL) is the ability to find, understand, appraise and apply health information with the aim of using this information to make decisions affecting the own health. Previous studies showed limited HL in around 50% of the German population. The assessment of the German health care system from the perspective of persons with limited HL is subject of this study.

Methods
In 2018, a survey was conducted among 20,000 persons with private health insurance in Germany. Survey items were based on the intermediate and final goals of the WHO Health Systems Framework. Questions comprised, for example, satisfaction with the health care system, responsiveness (e.g. perceived discrimination), access (e.g. off-hour care), and safety (e.g. medical errors). HL was assessed with the HLS-EU-Q16 questionnaire. Descriptive statistics and Chi-square test were used to analyze the data and group differences.

Results
Overall, 3,601 participants (18.0%) completed the survey (58.6 years ± 14.6; 64.6% male). Limited HL was seen with 44.6% (8.5% inadequate & 36.1% problematic), whereas 55.4% did not report limited HL (43.4% sufficient & 12.0% excellent). Very satisfied with the German health care system were 6.5% of the persons with limited HL (vs. 14.3%). Perceived discrimination within the last 12 months was reported by 11.0% of the persons with limited HL (vs. 5.1%). To get medical care on weekends, holidays or evenings outside hospitals was rated as “very hard” by 34.6% of the persons with limited HL (vs. 23.6%). The feeling that they experienced medical errors was reported by 18.7% with limited HL (vs. 11.5%) and 5.9% were unsure (vs. 2.2%). All results were statistically significant (p &lt; 0.001).

Conclusions
Persons with limited HL were less satisfied with the overall German health care system in comparison to persons with not limited HL and reported more often perceived discrimination. Strengthening HL could help to improve satisfaction with the health care system.

Key messages
Limited HL among persons with private health insurance in Germany was found in 44.6% of the survey’s participants. Persons with limited HL indicated to be less satisfied with the German health care system and perceived more often discrimination in their health care.
howtostayfocused.org Addressing attention-related health problems in higher education with an eTool
Authors: Van Der Heijde CM , Arts D L , Vonk P 
Published: October 2020

Abstract

Background
20 to 30% of university students consistently report attention-related health problems (studenthealthcheck), such as depression, a less healthy lifestyle (e.g. alcohol/ drugs, sleep, etc.) or adhd. Students are healthcare avoiders and as such ideal candidates for eHealth. To sort out their attention problems, increase their knowledge and guide them to solutions, howtostayfocused.org/ has to be scientifically evaluated.

Methods
A qualitative study was conducted in 2019 at the Student Health Service of the UvA. A prototype eTool and interview guide were developed in accordance with CeHRes, contextual background and value specifications for attention-related issues. Semi-structured cognitive interviews were administered to students before, during and after completion of the Etool (i.e. think aloud method) (N = 9; 5 female; mean age 23.5) concerning its' system, content and service quality. (audio recorded, transcribed verbatim and thematically analyzed).

Results
They were triggered to conduct the test and appreciated the personal advice that advanced the acceptance and confirmation of their complaints. the system: User-friendliness, lay out and abundance of information were appreciated. Improvements included technical errors, too much text provision, low visualizations, unclear navigation.the content: Although appreciative of the content, improvements included experience stories, study tips, information clarity.the service quality: Self-sufficiency has added value. (perceived usefulness) Soon after the launch of the eTool, it was used about 1000 times.

Conclusions
An eTool to address, clarify and analyze attention-related health problems among university students is considered of added value to meet their self-sufficient ways. They appreciated the personal advice from the test for the acceptance and confirmation of their attentional complaints. These results are of value for the development of other health-related web-based innovations for students.

Key messages
eHealth is a suitable way to address (attention-related) health problems that are common in university students, who are typically healthcare avoiding. The eTool contributes to prevention in the sense that university students may identify their attention-related health problems at an earlier stage and prevent aggravation of their complaints.