bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers by professionals in primary care in discussing children of substance abusing parents
Authors: Van Der Meer M , Jansen D E M C , Anthonio G G 
Published: November 2019

Abstract

Background
Children of substance abusing parents are more at risk to develop addiction or psychiatric problems than children of healthy parents. It is therefore important to detect in an early stage, which consequences the problems of the parents might have on the child. Previous research shows that within addiction care children of substance abusing parents are not always in the picture. However for early detection it is at least as important to discuss the influence of parental substance abuse on the children in primary care: early detection of problems in children contributes in starting prevention or treatment programs in a timely manner, so that the chance that a child grows up safely will increase.

Aim
To gain insight in the barriers of professionals working in primary care and public health in bringing up the topic of children in a conversation with substance abusing parents.

Methods
A qualitative design was used. 15 interviews have been conducted with participants consisting of primary care and public health professionals in the Netherlands. By discussing several themes, information on the barriers experienced by the professionals were obtained, written down and analyzed.

Results
The results are being analyzed at this moment, but will be ready to present at the congres in November. The interviews will show which barriers are experienced by the participants. Based on literature the expectation is that the barriers can be divided in three categories: barriers on the content of care, moral dilemma’s and organizational barriers.

Conclusions
The results of this study will provide insight in the barriers of professionals in primary and public health on discussing the circumstances of children of substance abusing parents. Knowing these barriers might serve as input for interventions to remove these barriers and for recommendations to improve so that children of substance abusing parents receive (preventive) care earlier.

Key messages
Gain insight in barries of professionals in primary care and public health on discussing circumstances of children of substance abusing parents. input for interventions so that children of substance abusing parents receive care earlier.
Basic problems in conducting a general preventive review of persons over 18 years of age in Bulgaria
Authors: Kostadinova P S , Kostadinov S D , Stoilova I Y , Georgieva S L , Kamburova M S , Ivanova S K 
Published: November 2019

Abstract

Background
In Bulgaria, following the reforms in healthcare, the Health insurance model and the role of GPs have been adopted as a key figure for primary outpatient medical care. Part of the obligations of the GPs for the implementation of the individual contracts with RHIF are also the preventive examinations of the mandatory health-insured persons over the age of 18 and the formation of risk groups of the population. Since 2006, the overall prophylactic review is mandatory for all health insured persons over the age of 18, regardless of their health status. It includes a core set of activities and studies that identify both people with disabilities and patients at increased risk of developing certain socially significant diseases such as cardiovascular, malignancies and diabetes.

Material and methods
Data were collected by documents review and direct individual self-administered questionnaire among 513 persons from the Pleven region and 229 GPs from three districts in the country.

Results
Despite the mandatory nature of general checkup for all persons over ’18, annually recognizes low range (from 35.8 to 45%). It was found that people over 65 who have chronic diseases more regularly visit the GP for check-up. The main reasons for the low population coverage are: lack of time and motivation of GPs; high relative share of persons with discontinued health insurance rights (over 20%); insufficient awareness and dissatisfaction of the mandatory health insured persons about mandatory prophylactic examinations. Of the respondents, 48% do not know what activities are involved, and 39% consider that the reviews are carried out formally.

Conclusions
Prevention of health-insured persons over 18 years of age is low in scope and is mostly opportunistic. In order to optimize the health and economic impact of the prophylactic review program, it is appropriate to provide for motivation measures for both GPs and those subject to the scope.

Key messages
In Bulgaria, the range of persons over 18 years old with prophylactic examinations is low. Prophylaxis of the persons covered is mostly opportunistic.
Development of an evidence-based reference framework for care coordination interventions in France
Authors: Colombani F , Encrenaz G , Quintard B , Sibé M , Ravaud A , Saillour-Glénisson F 
Published: November 2019

Abstract

Background
Today, the high variability of practices, the lack of common definitions and underlying concepts increases the existing difficulty to standardise, to replicate, to transpose and to assess the coordinated care. This heterogeneity makes very difficult the evaluation of performance of care coordination. The aim of the first phase of Epock study is to develop a theoretical framework for care coordination interventions in the French health system that can be used for description, implementation and evaluation of care coordination intervention in any clinical situation.

Methods
A review of systematic reviews on care coordination interventions was conducted to identify relevant models and constitutive elements of the expected reference framework for care coordination intervention. These elements resulting from the literature review have been grouped by themes, prioritised and selected by a structured consensus method (Nominal Group Technique).

Results
Four dimensions of care coordination were identified: (a) Underlying conceptual models; (b) Care organization, care and facilitation activities; (c) Actors and tools; and (d) Effects classified according to WHO’s quality of care dimensions. Among these dimensions, 4 to 28 elements have been selected to build the reference components of care coordination in France.

Conclusions
This first reference framework for care coordination interventions in France will be used during the Epock project phase 2 as a basis for comparing practices observed in oncology. This framework could be used as of now for: practice by helping to develop job descriptions and training programmes for future care coordination professionals; piloting to measure care coordination (by developing indicators for care coordination); and research, to evaluate the impact of care coordination interventions.

Key messages
Epock is a challenging French national research project for the development of an evidence-based reference framework for cancer care coordination interventions considered as a complex intervention. Epock will provide key elements for cancer care coordination intervention effective implementations and for designing further medico-economic evaluation of cancer care coordination intervention impact.
Alcohol and cancer: risk perception among the French population
Authors: Ancellin R , Cogordan C , Richard J B , Andler R , Deutsch A 
Published: November 2019

Abstract

In 2015, in France, 41 000 deaths were estimated to be attributable to alcohol consumption including 16 000 deaths from cancer. 8% of all new cancer cases were attributable to alcohol. The French National Cancer Institute and Sante Public France have conducted a study on knowledge and opinions of the French population on the risks factors attributed to cancer, including alcohol consumption.
Data came from the 2015 Barometre Cancer survey, a random cross-sectional telephone survey of the French general population (n = 3771 individuals aged 15-85 years). About 88% of the respondents felt well informed about the risks of alcohol. Opinions show an important risk denial and risk relativization: e.g, 85% agreed that the principal risk with alcohol consumption are traffic accidents or violence and 75% agreed that soda and hamburgers are as bad as alcohol for the health. Those perception were higher among men, older respondents, daily drinking consumers and those of low socioeconomic status. Population’s beliefs to deny the cancer risks due to alcohol use are common in France.
These results can be used to redesign public information about the risks of alcohol.

Key messages
Population’s beliefs to deny the cancer risks due to alcohol use are common in France. It’s necessary to adress public information about the risks of alcohol.
Algarve Cervical Cancer Screening Programme
Authors: Correia M , Pacheco A , Morera J , Pereira R , Ferrinho D , Vale L , Cardoso C 
Published: November 2019

Abstract

Issue
Cervical Cancer (CC) is the 7th most frequent and the 2nd most common in women. The standardized mortality rate, in Portugal is 2.3/100000 inhabitants and Algarve is the region with highest rate, 4.9/100000.

Description
Programme started in 2010. Population-based screening programme can reduce incidence, mortality and morbidity with an early diagnosis, preventing aggressive interventions in precancerous phase, improving survival and life quality. Target population, woman age 25-64.are invited to primary test liquid-based cytology (ThinPrep) every 3 years. Health Centres are responsible for select, invite, collect samples and send to Hospital laboratory. For positives, a cervical pathology consultation is required. National Guidelines now indicates DNA testing for human papillomavirus (HPV) as primary screening test, each 5 years, to woman age 25 to 60 and screening program changes will be implemented in 2019 with improved response time and lower cost.

Results
Since 2010 the target population has increased 12% every 2 years and the adhesion rate increased ≈68% and≈108%. Nevertheless the 3rd cycle has showed 10,8% (17.975) adhesion rate. Most women 16.112 (89.6%) had a negative diagnosis, 503 (2,8%) is ASC-US + (HPV test), and 761(4,2%) had a cervical pathology consultation. From those, 117 (15.4%) had a LSIL, 69 (9,1%) HSIL and 2(0,3%) cancer. Cancer detection rate is 0,1 ‰.

Lessons
The small adhesion rate particularly by aged women, the users unfriendly Information System and direct screening health units management are some of the issues that requires improvement. Also population literacy, self-sampling vaginal fluid and clinical meetings are some of the options to improve screening program.

Key messages
Cervical Cancer early diagnosis prevent aggressive interventions in a precancerous phase, improves survival and life quality. Better access and health communication are major points in screening programs.
A framework to help defining relevant preventive actions in multi-professional health care centers
Authors: Pluvinage B , Dugué F , Dépinoy D 
Published: November 2019

Abstract

For more than 10 years in France, multi-professional healthcare centers have been considered as innovative organizations, which offer attractive work conditions for health professionals and help to structure primary care. Their development is strongly supported by public policy (e.g. specific funding methods, a target of 2000 teams by 2022) and is seen as a mean to enhance preventive actions.
From a public health perspective, when professionals define their collective project, preventive actions should be chosen according to their relevance (by considering local population needs), effectiveness (based on evidence) and realism (in terms of implementation). Our goal was to make an inventory of existing tools and recommendations but also to propose a framework that considers the actual practicing conditions of French primary care teams. Three methods were used: a bibliographic study, feedback from a consulting firm with a 10 years’ experience in supporting new teams in defining their multi-professional project, and interviews from experts and health professionals.
Due to professional training and practice, preventive actions are less familiar to professionals when they are not integrated into individual and curative cares. Indeed, most existing recommendations are designed from a macroscopic point of view, dismissing the particularities of multi-professional private practice. Thus, we could identify 9 categories of factors likely to determine the relevance of a preventive action, including a specific context-population-team setting. Although this is an exploratory work, feedback from professionals confirms the potential positive or negative influence of these items on the implementation of an action.
Our framework could be converted into a tool consisting of a list of questions to ask before primary care teams choose a preventive action to implement. Frequent assessments should be carried out and shared in order to develop empirical and reliable knowledge in this field.

Key messages
Despite a strong public policy to develop multi-professional health care centers in France, recommendations about preventive actions insufficiently consider specific conditions of practice. Mixing theoretical and practical perspectives, our framework could help to improve the relevance, effectiveness and realism of preventive actions considering a specific context-population-team setting.
Healthy public policy competences for public health: interactive and practice-oriented curriculum
Authors: Guyon A , Lessard R , Masse-Jolicoeur M , Tessier S 
Published: November 2019

Abstract

Background
Developing and implementing healthy public policy (HPP) is one of the practical competences expected of public health professionals in Europe and beyond (ASPHER 2018, Public Health Agency of Canada 2015, US Public Health Foundation 2014). Yet, organizational practices in building public health capacity to promote HPP are seldom documented. In order to improve its HPP interventions, the Montreal Public Health Unit has been leading and evaluating a HPP multidisciplinary community of practice since 2014. In response to participants’ requests, we recently formalized a HPP curriculum.

Objectives
Over a period of 12 months in 2018-2019, our objectives were to: (1) develop and pre-test a competency-based professional development curriculum in HPP for public health staff and interns (2) provide a repository of relevant references (3) identify dynamic pedagogical strategies applicable to a community of practice.

Results
As community of practice members and facilitators, we developed a HPP curriculum with the support of pedagogical and HPP experts. It was pre-tested and iteratively adjusted with members of the community of practice. We drew content from various disciplines including political sciences, public health, communication studies and public relations. We identified relevant: (1) competences; (2) core concepts; (3) practical skills; (4) key references; (5) practical case studies, (6) interactive pedagogical strategies such as an open-source online learning system.

Conclusions
We developed an innovative healthy public policy (HPP) curriculum in order to support an existing community of practice among public health staff. Dynamic pedagogical strategies and a more formal HPP curriculum can support competence development among public health staff, and this can be achieved while relying mostly on in-house expertise. This constitutes a stimulating capacity-building initiative for the enhancement of public health core competences.

Key messages
Developing healthy public policy is a core practical competence expected of public health professionals. Yet, organizational practices in building healthy public policy capacity are seldom documented. Developing dynamic pedagogical strategies and a more formal healthy public policy curriculum can support competence development among public health staff, while relying mostly on in-house expertise.
Spatial characterization of the targeting’s worst-off au Burkina Faso
Authors: Bonnet E , Nikiéma A , Roy F A , Ridde V 
Published: November 2019

Abstract

Introduction
In 2014, the Government of Burkina Faso received technical and financial support from the World Bank to test the PBF project with various equity measures. Health equity measures included community based selection of worst-off and user fee exemption for them at the point of service. This selection was carried out in 8 health districts. More than 110,000 worst-off have been selected. Several analyses show that their use of care remains low. Our study aims to characterize the selection of the indigent by considering geographical determinants in order to better understand the weakness of access to care.

Methods
We have mapped the selection of the indigent based on the geolocation data collected with a GIS. We carried out spatial analyses to measure access to localities, health center and the main access roads. We have also integrated population data and geo-environmental characteristics. All these data were aggregated in 500 m cells to provide all variables on a single scale. A total of 9 variables were generated to characterize the spatial targeting’s worst-of. We combined two cluster analyses, i.e., k-means, and hierarchical clustering.

Results
We obtain a characterization of the selection into four classes. These classes highlight that the community-based selection of the worst-off is unequal in terms of distances to localities, health centres, and isolation. The results refine our knowledge of geographical accessibility to health centres by illustrating that distances to the health care centre are not the only geographical determinants to be considered.

Conclusions
This study is a contribution to the analysis of the characterization of the targeting of the worst-off. The results suggest that it is important to strengthen support for the most isolated worst-off for an access care. More broadly, this study shows that it is necessary to integrate the geographical dimension into the definition of targeting the worst-off.

Key messages
It is necessary to integrate the geographical dimension into the definition of targeting the worst-off. It is important to strengthen support for the most isolated worst-off for an access care.
What if we combine Quit and win and individual approach to help smokers quit at the community level?
Authors: Kovacevic J , Zombori D 
Published: November 2019

Abstract

Issue
Tobacco eventually kills up to a half of its users. Helping smokers who wish to quit is one of the six cost effective interventions listed by World Bank to decrease smoking harm. Tobacco Control Scale in 2016, shows diversity in approaches and coverage to help smokers quit across Europe. Comprehensive interventions are most effective. Combining contest, financial incentives, individual approach and triggers (start of Lent or other) could be implemented in other settings.

Description of the problem
Contest to motivate smokers for a quit attempt and individual help provided, has been conducted yearly since 2015 in a local community in Pozega-Slavonia County in Croatia. Data on all participants from 2015 through 2018 contests were collected by questionnaires and long term smoking status (6 months) evaluated by phone interviewing. Statistical analysis was conducted in SPSS. The objective was to determine how effective in helping smokers quit is a novel combination of evidence-based approaches “Quit and win” and individual support in local setting and to establish certain smokers characteristics as possible predictors of outcome.

Results
Data for 153 participants were collected. There were more (54%) male participants. Participants mean age was 35.8 years (range 18-67). Short term (30 day) abstinence rate was 73.9% (113/153) and out of those 34.1% (31/91) abstained long term (6 months). Long term follow-up was 80.5% (91/113). Overall, long term quit rate was 23.7% (31/131). There were no statistically significant differences in short and long term quit rates depending on age, sex, education, employment or socio-economic status, pack-year measure or personal success estimates.

Lessons
Comprehensive contest approach was found to be effective in helping smokers quit. Interest for implementation was shown by several counties and cities in Croatia. Effectiveness regardless of personal and social characteristics of contestants shows potential in different settings.

Key messages
Comprehensive interventions that include contest, financial incentives, individual approach and triggers in smoking cessation helped one in four involved smokers to quit. This approach has potential for implementation in diverse local communities as no difference in quit rates in different sex, age or socioeconomic groups were detected.
Digital health literacy among adults living in the community in Singapore
Authors: Soh J S , Wong A W 
Published: November 2019

Abstract

Background
this study aimed to determine the level of digital literacy in adult Singaporeans in the community and its association with demographic characteristics, physical activity, self-rated health and bodily pain, and to identify the health needs of frequent internet users.

Methods
a cross-sectional survey was carried out among individuals living in Punggol, Singapore on 2 June 2018. Survey data were using a 20-minute self-completion questionnaire. The questionnaire included the validated 8-item eHealth Literary Scale (eHEALS), the validated 4-item Exercise Stage of Change Questionnaire, a single item on self-reported health status and Likert scale items to assess level of bodily pain in the last 4 weeks and how much that pain interfered with normal work. The questionnaires and interviews were administered by registered nurses. Quota sampling was used to obtain sufficient numbers from different ethnic groups for analysis of the survey: the initial target was 120 Chinese, 60 Malay and 60 Indian individuals, one per household.

Results
survey data were collected from 279 individuals (49.6% female), including 197 (71.1%) Chinese, 47 (17.0%) Malay, 18 (6.5%) Indian and 15 (5.4%) others. The mean age was 35.6 (SD 11.3). The eHEALS score had a mean of 29.4 (SD 6.2) out of a maximum of 40. Self-reported health status was positively associated with pain in the last 4 weeks (Kendall’s τ = 0.141, p = 0.007), how much that pain interfered with normal work (Kendall’s τ = 0.160, p = 0.003) and the Exercise Stages of Change score (Kendall’s τ=-0.271, p &lt; 0.001). The correlation between the two pain variables was strong (Kendall’s τ = 0.582, p &lt; 0.001). The only one of these measures significantly related to the eHEALS score was the Exercise Stages of Change score (Kendall’s τ = 0.104, p = 0.030). From linear regression models, the only independent variables consistently associated with the eHEALS score were age (B=-0.090, p = 0.006) and having a mobile phone plan (B = 8.171, p &lt; 0.001).

Key messages
Digital health literacy was negatively related to age and positively related to having a mobile phone plan. The study finding suggest the need to identify individual Singaporeans with poor e-health literacy and provide them with remedial education.