bluuebunny/crossref_metadata_2025_split huggingface dataset:
A policy index on healthy and sustainable food systems for governments – INFORMAS 2.0
Authors: Burgaz C , Vandevijvere S 
Published: October 2021

Abstract

Issue/problem
The rising burden of malnutrition in all its forms is driven by a global transition towards unhealthy ultra-processed food consumption patterns. As diets are shaped by food systems, political decision-makers are pressed to guarantee access to healthy diets for all, without harmful environment impacts.

Description of the problem
Scientific evidence on food policies implementation show a need to evaluate and benchmark government policies. Through a compilation of international recommendations, an ongoing scoping review, a Delphi study with policy experts and policy stakeholder interviews, the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) aims to create a policy index to monitor governments' actions on sustainable food systems.

Results
International recommendations from evidence-based global reports (n = 22) on policies for healthy diets from sustainable food systems were compiled. A total of 413 recommendations were extracted and classified to define the components of the new index, structured in three domains (food supply chains, food environments, food consumption), two transversal domains (nutritional vulnerabilities, women's empowerment) and thirteen subdomains. The index addresses the key policy aspects of food systems to be shaped in order to create healthy diets from sustainable food systems.

Lessons
The policy recommendations included in the three domains and two transversal domains may have an impact on nutrition-related outcomes (e.g. stunting, wasting, diet quality, obesity), nutrition inequalities (e.g. socioeconomic) and environmental outcomes (e.g. biodiversity loss, greenhouse gas emissions, water use). Their impact will be assessed in a scoping review. In a next step, a Delphi study and interviews with stakeholders will be conducted to ultimately identify policies with double and triple duty potential to improve sustainable food systems and healthy diets.

Key messages
The index will provide an up-to-date overview of evidence-based policy recommendations on sustainable food systems. The index will represent a useful tool for national and local governments to track malnutrition in all its forms and nutrition inequalities, protecting the environment.
Evidence-informed health care infrastructures: test of SustHealthv2 tool on hospital pilot cases
Authors: Brambilla A , Lindahl G , Capolongo S 
Published: October 2021

Abstract

Background
Healthcare facilities are important node of health systems and several scholars from Public Health and health service field highlighted that high quality and sustainable built environment is fundamental in providing high quality health care services. Nevertheless, most hospital buildings are obsolete, not adequate to contemporary organizational models; additionally, none of the existing quality improvement tools systematically evaluate the built environment. Therefore, the study develops an evidence-informed weighted multicriteria tool and tested it on two pilot case study.

Methods
Starting from previous literature reviews and scenario analysis, different indicators for hospital quality assessment have been grouped in 17 criteria and 3 macro areas, validated through semi-structured interviews and weighted with Multicriteria Simon Roy Figueras (MCDA-SRF) and Deck Card Method (DCM). The weighted tool SustHealthv2 has been tested on two medium sized hospital pilot case studies (H1 and H2) in northern Italy.

Results
The tool is composed by three macro areas: Social, Environmental and Organizational qualities respectively accounting for 22%, 29% and 49%. The application and test of the tool highlighted transversal criticalities such as Sustainable Accessibility (H1=0.04/0.16; H2=0.11/0.16), Sensitization and Education (H1=0.06/0.18; H2=0.10/0.18). The most recent case study (H1) was able to achieve higher scores in energy (0.15/0.0.19), waste management (0.07/0.07), as well as future proofing characteristics (0.20/0.23) compared to the older one. Overall H1 scored higher in all the macro areas reaching a total fulfillment of 72/100, while H2 scored 52/100.

Conclusions
The application of SustHealth v2 on operating health care facilities can support hospital management in defining strategic area of improvements and investments for hospital building renovation providing higher level of services to patients, users and staff.

Key messages
Built environment for healthcare needs systematic evaluation frameworks to improve and contribute to health service quality. SustHealth v2 is an evidence-informed multicriteria framework for hospital built environment sustainability and quality assessment from social, environmental and organizational perspective.
HPV self-sampling among cervical cancer screening nonattenders: a feasibility study in Estonia
Authors: Hallik R , Innos K , Jänes J , Veerus P 
Published: October 2021

Abstract

Background
Organized cervical cancer screening in Estonia was started in 2006, but it has not been effective, partly due to low coverage. In 2021, primary HPV screening was implemented. HPV self-sampling has been shown to be effective in increasing screening uptake. This is the first study in Estonia addressing the feasibility of HPV self-sampling and the acceptance of this method among long-term screening nonattenders.

Methods
A randomized intervention study was conducted in 2020. Women born between 1958-1983 without a Pap-smear in 2013-2019 were included in the study population. Altogether 12 000 women were randomly allocated to three equally sized study groups. Opt-out group received a Qvintip sampling device by regular mail. Two opt-in groups received an e-mail invitation to order a self-sampler from a website, one received Qvintip and the other Evalyn Brush. Data on user experience was collected with a questionnaire. Participantś background characteristics were obtained from the Population Register. The effect of covariates on participation rate was estimated with multivariate Poisson regression with a robust error variance and risk ratios (RR) were calculated.

Results
Overall participation rate was 17%, but significant differences were observed between opt-out (27%) and opt-in groups (11%). Compared to opt-out group, adjusted RRs for Qvintip and Evalyn Brush opt-in groups were 0.39 (95% CI 0.35-0.42) and 0.42 (95% CI 0.38-0.47), respectively. Participation was significantly associated with region, citizenship, and education. Self-sampling was well accepted: 98% agreed that it was easy and convenient; 88% prefer it as a screening method in future.

Conclusions
The study showed the feasibility and high acceptance of HPV self-sampling among long-term screening nonattenders in Estonia. As a next step, self-sampling will be piloted in organized screening program to identify optimal dissemination strategy.

Key messages
HPV self-sampling in Estonia is feasible, well accepted and has the potential for improving screening uptake among hard-to-reach women. Self-sampling strategy will be further tested within cervical cancer screening program.
Tools to advocate for CSE for children and young people with disabilities
Authors: Marquardt Johanna 
Published: October 2021

Abstract
The second part of the workshop will thematize actions which can be take on the political level. Recommendations for comprehensive sexuality education (CSE) for children and young people with disabilities often do not consider that there are different starting points within countries, regarding the implementation of commitments under international instruments (esp. Convention on the Rights of Persons with Disabilities - CRPD). This is why the German Federal Centre for Health Education (BZgA) develops a policy briefing for “Ensuring the right of children and young people with disabilities to sexuality education”, which outcome will build the base for this input. The aim of the workshop is to raise awareness to the human rights issues for children and young people with disabilities in the area of CSE based on international instruments (esp. UN CRPD). Children and young people with disabilities are often facing a higher risk for sexual illness. As there might be different need, there are still the same rights. Therefor the focus should lay on empowerment and a human rights approach and not only on preventing risks. The workshop will provide tools for advocacy on the political level and arguments to get political active for providing CSE for children and young people with disabilities. As the political and legal situation in the countries is very different, the workshop supports and facilitates the creation of a political environment for the implementation of, inter alia, the Convention on the Rights of Persons with Disabilities, from any starting point to make the access of CSE for children and young people with disabilities available.
5.M. Skills building seminar: How to integrate social identities in public health education – an intersectional approach
Authors:   Organised by: Bielefeld University (Germany), ASPHER,   Chair persons: Yudit Namer (Germany), Lisa Wandschneider (Germany)
Published: October 2021

Abstract

Members of minoritized population groups are exposed to higher burdens of morbidity and mortality and face barriers to accessing health care systems and other critical resources to achieve optimal health. Intersectional perspectives that emphasize the dimensions of social power and discrimination are just beginning to emerge in public health research. These perspectives contextualize longstanding patterns of health inequalities but are rarely translated into public health curriculum. Concepts like “cultural competence” or “diversity, equity and inclusion” do address the importance of awareness and respect for (cultural) diversity in (patient/client) populations. The research and teaching examples available are largely limited to a USA context, tend to consider specific identities, rather than intersectional characteristics, are not systematically integrated in public health curricula and are usually not rooted in a theoretical approach of teaching. It is imperative that Europe bridges the knowledge-to-teaching gap and begins introducing similar programs, while learning from the limitations of USA efforts. Two steps are needed to strengthen public health educational institutions and improve population health: first, to systematically incorporate an intersectional paradigm into public health curricula; and second, to provide faculty members in public health programs with transformative teaching skills. In this skills building seminar, we aim to 1) discuss the need for incorporating intersectionality into public health curricula in Europe; 2) provide an experiential learning opportunity on social identities and health; and 3) create a space for self-reflection. We first present the introductory course on social identities and their importance in public health (Wandschneider et al.) which has been developed in collaboration with the Association of Schools of Public Health in the European Region (ASPHER) (15 minutes). Secondly, we will have an interactive session to apply an exemplary teaching method (25 minutes). To conclude, we will moderate a discussion guided by the questions “What is needed to integrate such efforts more sustainably in public health teaching practices?” and “How do we address potential barriers?” (20 minutes). This workshop addresses persons who engage in teaching in undergraduate or graduate Public Health programs or provide training to public health and health care professionals. It also invites researchers to reflect on how to frame research on health inequalities.

Key messages
To address health inequities, we need to incorporate an intersectional paradigm into public health curricula and provide faculty members in public health programs with transformative teaching skills. A model teaching module that is open access could provide the necessary tools to meet this need.
6.A. Workshop: European Health Emergency Preparedness and Response Authority (HERA)
Authors:   Organised by: DG SANTE, EUPHA, HaDEA,   Chair persons: Massimo Fagnini (European Commission)
Published: October 2021

Abstract

The inception of HERA originates from the shortcomings revealed by COVID-19 and earlier serious cross border threats to health, such as H1N1, leading to President von der Leyen's 2020 State of the Union address in which she called on Europe to draw lessons from the current crisis and build a European Health Union, including a ‘European BARDA - an agency for biomedical advanced research and development' to support capacity and readiness to respond to cross-border threats and emergencies - whether of natural or deliberate origin. The Commission thus proposed European Health Union proposals on the 11th of November 2020, which also outlined the broad outlines of a European Health Emergency Preparedness and Response Authority - HERA - and the Commission's view on its integral role in strengthening the EU's Health Union. A proposal for HERA is expected to be put forth by the Commission in 2021 based on the lessons learned from COVID-19 and the calls for Europe to ensure better preparedness for the future, with the Authority expected to be operational by early 2022. HERA will play a key role in helping to anticipate serious cross-border threats to health, identify and ensure effective responses in terms of medical countermeasures. Its core mission will be enable the EU and its Member States to rapidly deploy the most advanced medical countermeasures in the event of a health emergency, by covering the whole value chain from conception to distribution and use.

Speakers/Panelists
Paul Zubeil
Ministry of Health, Germany
Antoine Schwoerer
Ministry of Health, France
Nuria Molina
Bill & Melinda Gates Foundation
Magda Chlebus
European Federation of Pharmaceutical Industries and Associations
Anniek de Ruijter
University of Amsterdam, Netherlands
Agnes Marta Molnar
European Commission, DG SANTE
Maarten Vergauwen
European Commission, DG ECHO
Skills needed to communicate adequately COVID-19 risk indicators to citizens and policy-makers
Authors: Greco D 
Published: October 2021

Abstract
Risk communication is a sustained communication process established with a diverse audience about the likelihood of the health outcomes of specific conditions or actions. Individuals are influenced by risk information in complex and unpredictable ways and communicating effectively risk during a pandemic event requires a set of different skills: 1) analysis skills, to be able to gather and assess the information; 2) communication skills, to deliver information that is understandable, through the right channels for the specific audience; 3) coordination and leadership skills, to be able to align partners at local, regional, national, international level to meet common goals. In this presentation, challenges of communicating COVID-19 risk indicators such as the risk of infection, risk of being hospitalised, risk of death, risk of long-term consequences, and risk of adverse events from vaccination will be presented. In particular, through case studies we will examine local, national and international risk communication strategies on: 1) risk of death in the vulnerable population; 2) risk of transmission in the home setting; 3) risk of long-term consequences of COVID-19 (“long COVID”). The strengths and weaknesses of the communication strategies in these examples will be pointed out and opportunities to improve them will be covered.
Patient and citizen engagement, and deliberative processes in COVID-19 vaccine assessment
Authors: Petelos E , Oortwijn W , Lingri D , Strammiello V 
Published: October 2021

Abstract
Examining the health technology assessment (HTA) landscape in Europe and globally, the limited involvement of HTA bodies in vaccine assessment becomes evident. To a large extent this is because of the role the National Immunization Technical Advisory Groups in providing recommendations for vaccines and immunisation. The role of patients and citizens, given the fact they are important stakeholders in HTA, is well acknowledged, but their involvement remains limited. Issues on how vaccines are developed, including the lack of patient-reported outcomes (PROs) in vaccine research and development, prevent the clearer benefit/risk information to reduce uncertainty. Given the fast-paced approach in comparison to traditional trials and the high level of uncertainty for different population groups, a comprehensive risk communication strategy, is key both for evidence-informed deliberative processes, as well as to ensure the success of vaccination programmes with the best possible outcomes and to overcome vaccine hesitancy. The impact of vaccination or non vaccination extends to families, communities and also has potential psychological consequences of alternative non-vaccine interventions such as lockdowns. Inclusion of such broader impacts may alter both acceptance and willingness-to-pay thresholds for COVID-19 vaccines. Given the lack of a specific legal framework to allow interaction between patients and other stakeholders at both institutional and individual levels, with respect to GDPR, it is vital to ensure interaction and engagement. In a democratic society, it is also important to assure general engagement that will be inclusive and transparent, without exclusion of vulnerable societal groups, that can only be assured by means of communication of scientific advice and regulatory decisions in a language accessible to all, with readily understood terms.
MIPEX vs Country Assessment Tool – Pros and Cons
Authors: Ingleby D 
Published: October 2021

Abstract
The 2015 MIPEX (Migrant Integration Policy Index) Health strand was developed to benchmark progress on implementing the Council of Europe's 2011 Recommendations on mobility, migration and access to health care. MIPEX collects data on both ‘downstream' and ‘upstream' policies. Though like we identified in the Road Map, it is paying more attention to the former kind. MIPEX data exist for all countries participating in the JAHEE WP7. Its unique advantage is that it contains a large, uniform collection of carefully standardized and operationalised indicators, enabling comparisons to be made between countries and between countries at different points in time. A common thread in the “Road Map” is that without a solid evidence base, we will not succeed in improving health equity for migrants. Background information on a country migrant population is important for estimating the kinds of demands that health and social services will face. Taking steps to promote the collection of such data is one of the most useful contributions JAHEE can make. While MIPEX covers Migrant Integration Policy, the CA includes a more comprehensive overview that can benefit practitioners, bureaucrats and policymakers in implementing strategic measures to mitigate gaps for better migrant health.
Country Experience with using the Country Assessment Tool (Lessons learned)
Authors: Nordström C , Kumar B 
Published: October 2021

Abstract
Findings from the CA show that research and data are largely available, but there are several knowledge gaps and we often lack a comprehensive overview. Gaps include longitudinal studies and knowledge of effects of implemented policy and practice. Lack of knowledge-based practice and policy development is a continuous challenge. Furthermore, we identified a lack of coordination of the migration health field, as well as cross-sectional collaboration.
Lessons learned: The CA and the JAHEE has provided a starting point for conversations with national partners, such as the directorate of health, about how we can strengthen the migration and health field in Norway. The CA has been presented and used in national conferences to highlight gaps and initiate collaboration to mitigate these gaps. The CA tool can become the comprehensive overview that we do not have today. While MIPEX covers integration policy, the CA covers broader topics touching on the work carried out in different sectors and levels in society that affect migrant health.
6.I. Workshop: Social Prescribing: what has been learned in developing evidence, what challenges and solutions?
Authors:   Organised by: EUPHA-HP,   Chair persons: Sonia Dias (Portugal), Megan Elliott (UK)
Published: October 2021

Abstract

Social prescribing is seen as a mechanism for addressing the social determinants of health, preventing exacerbation of pre-existing diseases, reducing attendance in primary and emergency care and improving general population health and well-being. Social prescribing involves individuals being referred/self-referring to non-medical interventions run by a third-party organisation. Social prescribing has received widespread attention internationally; however, the evidence base to support social prescribing lacks rigour, and gaps remain. The complexity of social prescribing, in that it involves multiple referral routes, partners, pathways and outcomes, poses challenges for its evaluation and research. Researchers across Europe have developed different projects of research to address the challenges associated with evaluating social prescribing. Development of the evidence base for social prescribing is crucial in informing policy and public health systems to deliver effective interventions that contribute to individual, community and systemic outcomes. This workshop aims to share different approaches that have been taken across Europe to address issues in producing evidence base and share learning about the challenges and solutions that researchers have developed, specifically regarding research about implementation and evaluation of social prescribing. The workshop will be structured in a first part of presentations and the second part of open discussion with presenters and the audience. This workshop will present five papers which will address two key questions: 1. What have we learned about developing the evidence in social prescribing?; 2. What challenges have we experienced, and what solutions have we come up with? The short presentations will cover examples of social prescribing initiatives based on implementation and evaluation studies conducted in diverse European countries. Learning shared with the audience through the presentations will stimulate discussions around challenges with implementing and evaluating social prescribing. This workshop will inform the development of an overarching guidance on implementing social prescribing interventions, as well as identify parallel challenges in other areas of public health.

Key messages
Interactive session to discuss strategies for successful social prescribing projects addressing complex health issues that are relevant to stakeholders and for research to inform practice and policy. Collaboration with interdisciplinary stakeholders is crucial in developing the evidence base for social prescribing.