bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and preliminary psychometric properties of the Scale of Health Belief Model for Sleep
Authors: Dikici H , Kadioğlu H 
Published: October 2024

Abstract

Background
Sleep-related problems are a serious risk to physical and emotional health, academic success, and safety in adolescents. A measurement tool is needed to comprehensively evaluate adolescents’ sleep and plan the steps necessary for behavioral change. This study aimed to develop a scale based on the Health Belief Model that can reliably and validly evaluate adolescent individuals’ beliefs towards sleep.

Methods
This methodological study was conducted with 494 adolescents between September and October 2022 in Antalya, Turkey. Initially, 81 items about sleep were created according to the Health Belief Model. Validity was assessed as content and construct validity and reliability was assessed as internal consistency. Content validity was evaluated with ten expert views The scale was tested for construct validity with Exploratory Factor Analysis (EFA), after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha.

Results
In the first EFA, sixteen factors with eigenvalues greater than 1 explained 63.80% of the total variance. Items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated. In the last EFA of the 46-item scale, six factors were found with an eigenvalue greater than 1 that explained 57.7 % of the total variance. The scale’s item-total correlations ranged between .26 - .79. Cronbach’s coefficient alpha of subscales was found .92 for perceived susceptibility, .90 for perceived severity, .90 for perceived benefits, .81 for self-efficacy, .79 for motivation and .69 for perceived barriers.

Conclusions
The validity and reliability properties of the scale of Health Belief Model for sleep have been found good levels in Adolescents. Its intercultural adaptation for use with adolescents in other countries is recommended.

Key messages
• The newly developed the scale of Health Belief Model for sleep was found to be valid and reliable.
• It can be used to assess adolescents’ beliefs about sleep.
The French experiential knowledge resource center: strengthening and extending its scope of action
Authors: Krache A , Delescluse T , Villeval M , Georgelin B , Ferron C , Berdougo F , Vuillemin A 
Published: October 2024

Abstract

Issue
The national committee for experiential knowledge in health promotion (EKHP) aims to promote EKHP and improve professional practices. Since 2017, the committee has created methods and toolkits formalizing the capitalization of EKHP. The levers to put the method into practice are in place, now comes the time to find the best means to foster promotion and appropriation of EKHP works.

Description of the problem
The national EKHP resource center has been launched in May 2022, online: www.capitalisationsante.fr. It acts as a database where HP practitioners can read, download and upload EKHP capitalization works (∼12-page documents detailing one HP intervention each) and cross-analyses reports. It is driven by three main objectives: 1/ promoting and disseminating HP practitioners’ experiential knowledge, 2/ building a community of practice to improve capitalization practices and 3/ making a useful and transferable data available to practitioners.

Results
The now two-year-old website has been visited by 32 000+ individuals. More than 120 works, 12 cross-analyses are published. They were submitted by trained HP practitioners and reviewed by an editorial board before publication. The national EKHP resource center offers insight on how HP interventions work from practitioners themselves who share knowledge on their implementation. Compared to best-practices portals, it offers an innovative bottom-up approach to knowledge transfer. The community of practice (CoP) now supports a network of 200+ trained practitioners. This CoP aims to improve knowledge management and ensure the quality of the works produced. Surveys and feedback show that both building up and accessing EKHP meet a high level of interest.

Lessons
The innovative bottom-up approach and the focus on knowledge management can serve as a model for other settings/countries. In 2024, levers of appropriation will be investigated and collaboration with other HP resource centers will be better identified.

Key messages
• The now two-year-old national NEKHPRC enhances EK’s part in the HP field by making otherwise unknown data available to the French-speaking HP community.
• Building of a strong community of practice ensures the high quality of the bottom-up approach to the uploading of the works.
Predictors for psychosocial consequences of screening for liver diseases in Germany: a LASSO approach
Authors: Fichtner U , Maun A , Farin-Glattacker E 
Published: October 2024

Abstract

Background
Medical screening is extensively used across various disciplines for early disease detection and prevention of severe progression aiming to reduce disease-specific burden, improve quality of life and promote health. However, screening is debated due to unclear evidence of its overall benefits from a public health perspective. Screening is associated with improved health behavior and cost-effectiveness. However, studies identified adverse effects of screening like psychosocial burden. Most results originate from cancer screening and it is unclear whether they are transferable to other contexts. Within a research program, a systematic screening procedure to detect patients with liver cirrhosis at early stage in an asymptomatic general population was evaluated. In this study, we aimed to identify patient characteristics that predict and explain variance in psychosocial outcomes of screened patients.

Methods
This study analyzed data from 523 participants who underwent a systematic liver disease screening in Germany from Jan 2018 to Feb 2021. We used bootstrapped LASSO regression with 10-fold validation to evaluate the influence of various predictors on the outcomes measured by the Psychological Consequences of Screening Questionnaire (PCQ). The constructs measured by the PCQ are social, physical and emotional dysfunction associated with screening.

Results
We identified lower severity of comorbidities, higher subjective social status, stronger social support, older age, better critical health communication skills and higher health literacy as relevant predictors of lower psychosocial dysfunction, indicating their protective role in preventing psychosocial burden of screening.

Conclusions
From a public health perspective, medical screening offers should take into account patients’ individual context regarding their subjective social status, health impairments, personal social networks and health literacy skills to reduce post-screening psychosocial burden.

Key messages
• Social support, age, health literacy and higher subjective social status were positively associated with lower psychosocial consequences of liver screening.
• The findings indicate that liver screening should be carried out, taking into account the individual’s situation and resources available.
Evaluation of university food environment and healthy space policy implementation at university
Authors: García-Lorenzo E , Feijoo-Costa G , Rico-Díaz J , Visos-Varela I , Corral-Varela M , Caamaño-Isorna F 
Published: October 2024

Abstract

Issue/problem
Unhealthy diets, along with factors like tobacco, alcohol, and inactivity, contribute significantly to non-communicable diseases (NCDs). Prevention strategies should prioritize reducing exposure to these risk factors. It’s also crucial to consider environmental well-being alongside promoting health.

Description of the problem
During 2023/2024, university cafeterias (UC) were evaluated for healthy eating standards compliance, resulting in a noticeable presence of unhealthy foods together with plastic use, alcohol and tobacco consumption. This led to the development of an accreditation program to boost UC as healthy spaces.

Results
The developed program includes 5 mandatory standards and 42 recommendations. Priority objectives are offering healthy food options like fruit, avoiding alcohol and sugary drink ads, banning tobacco, promoting physical activity, and reducing waste for example by encouraging unpackaged water consumption. Our policy emphasizes evaluation and monitoring, so accreditation is valid only for two years. Our goal is to establish UC as sustainable, healthy spaces. To encourage compliance, we offer institutional financial support and accreditation seals to UC, showcasing their commitment to community health. Implementation begins in the 2024/2025 academic year, with an initial evaluation scheduled at that time.

Lessons
Monitoring UC food offerings is crucial for ensuring healthier options. Cafeterias play a key role in promoting healthy habits. Creating environments with healthier options can mitigate non-communicable disease risk factors presence.

Key messages
• University cafeterias are pivotal in fostering a healthy lifestyle.
• Prioritizing policies to address non-communicable diseases is crucial. Clear programs are essential for sustained effectiveness.
Exploring the policy context of Whole School in eight EU countries: the Schools4Health project
Authors: Kouvari M , Zioga E , Neven L , Escalona Labella I , Sandu P , Dātava S , Meszaros F , Klomp M , Truden-Dobrin P , Sutton G 
Published: October 2024

Abstract

Background
Moving from the recognition of WHO principles of health promoting school (HPS) to concrete practices is challenging. The Schools4Health project is an EU initiative with the aim to introduce, strengthen, and sustain the adoption of a participatory whole-school approach to health and wellbeing. The aim of this work is to present an update about the policy environment around HPS approaches in eight EU countries.

Methods
Between September-November 2023, Schools4Health partners from Spain, Belgium, Hungary, Greece, Latvia, the Netherlands, Romania and Slovenia carried out a preliminary scoping exercise to investigate the policy conditions which can influence the national uptake of HPS approaches. A three-step methodology was developed: a. identification of core stakeholders b. Rapid Situation Analysis survey and c. national roundtable meetings, to assess stakeholders’ awareness of and engagement in health promotion programs in schools.

Results
In total, n = 192 responses from stakeholders from health, education, social and agricultural sectors were selected. Most experts were aware or partly aware of the HPS concept. While there is consensus that health promotion at school is essential, there is a lack of, or weak implementation of legislation and voluntary initiatives due to barriers such as limited time and financial resources, teachers burnout and insufficient interaction between education and health governmental bodies.

Conclusions
Effective advocacy can highlight the potential of HPS in addressing the urgent challenges related to wellbeing in youth, and the associated decline in educational performance across Europe. Policymakers, public authorities and the broader community should also be engaged.

Key messages
• Creating HPSs should not solely fall on schools and teaching staff.
• Policymakers, public authorities and the broader community around schools have responsibility to ensure that policy measures and instruments embed the key considerations for HPS approach.
Determinants and strategies for successful scale-up of health interventions in the Netherlands
Authors: Van Dale D , Smit R A , Nassau F 
Published: October 2024

Abstract

Background
Although many evidence-based health interventions are proven effective, the process of scaling up is often complex and challenging. Yet, some interventions have managed to achieve successful scale-up. This provides a window of opportunity to learn from those experiences to inform future scale up processes.

Objectives
This mixed-methods study aimed to assess determinants and scale-up strategies contributing to successful scale-up of health promotion interventions in the Netherlands.

Methods
Semi-structured interviews were conducted with intervention owners (i.e. the individual or team taking the responsible for several aspects related to implementation and scale-up) (N = 25) of successfully scaled interventions (implemented across various health behaviours and different settings), and other relevant stakeholders (N = 10) involved in scaling up. Additionally, a survey was distributed among interventions (N = 306) registered in a national intervention database to assess scale-up experiences.

Results
Scale-up is often the result of a combination of determinants, such as persistent commitment of intervention owners and stakeholders, new funding opportunities, and accreditation by institutions. Several scale-up strategies were identified related to funding (e.g. reducing costs by setting up collaborations), organizational processes (e.g. infrastructure to support implementation), monitoring and evaluation, and dissemination and advocacy.

Conclusions
Achieving successful scale-up does not happen automatically and continuous effort of the intervention owner is crucial. There is no such thing as one successful scaling strategy which succeeds across all contexts. The intervention owner typically takes the lead in diverse scaling pathways, where sufficient time, funding, the right moment and added value form the critical ingredients for success. Funding: This study was funded by ZonMw.

Key messages
• Crucial elements of achieving scale-up are the continuous effort of the intervention owner, sufficient time, funding, the right moment and added value of the intervention.
• Funding should not me allocated for new initiatives but also for continuous development of interventions, ongoing evaluation and covering overhead costs.
Engaging practitioners in developing a guide for citizen participation in community health promotion
Authors: Griebler U , Kien C , Klingenstein P , Seel M 
Published: October 2024

Abstract

Background
Community health promotion aims to improve the living conditions in municipalities, cities, or regions to support health maintenance or promotion. Participation is a fundamental element in health promotion, as it enables community members to engage in decision-making, program development, and tailored health initiatives. This project focused on crafting a practical guide for citizen participation in community health promotion, involving experts and future users.

Methods
We conducted a literature review to identify existing guidelines and materials pertinent to community health promotion, with a focus on practical guidance for municipal practitioners. To delve deeper into the topic, we conducted interviews with 6 experts in the field of participation and community health promotion as well as with 6 practitioners working in “healthy municipalities” in Lower Austria. The guide was developed collaboratively, with two workshops being held to gather input on the draft concept of the guide and to prioritize topics. Moreover, experts and practitioners were involved to provide feedback on the drafted guidance document.

Results
Discrepancies emerged between theoretical concepts and real-life implementation of community participation. While the literature delineates up to 12 participation levels, practitioners identified three: contributing ideas, advising and co-deciding, and actively participating in planning and implementation. Informing the target group was conceptualized as a preliminary stage and basic requirement for citizen participation. Above all, practitioners sought low-key suggestions and short descriptions of methods that they could use directly in their everyday context.

Conclusions
Involving practitioners and potential users enhanced the accessibility and utility of the guide. Their input ensured that the guide remained practical, relevant and informative without excessive academic or theoretical abstraction.

Key messages
• Involving health promotion practitioners helped shaping the practical guide in a way to be most useful for the intended audience.
• Experts and practitioners have different views regarding the theoretical distinctions of levels of participation in community health promotion.
The impact of a rural school-based oral health intervention among primary schoolchildren in Armenia
Authors: Atanyan A , Muradyan D , Lylozian H , Demirchyan A 
Published: October 2024

Abstract

Objectives
Oral health (OH) interventions are shown to be effective in improving children’s OH status and behavior. This study evaluated the effectiveness of a school-based OH intervention combined with OH educational activities on rural schoolchildren’s OH status and behavior in a rural setting in Armenia.

Methods
The study population were primary schoolchildren of Mrgashat village, Armavir province, Armenia, and their parents. The intervention included sealant application to eligible permanent molars of children and fluoridization of their teeth twice a year over a two-year period. Educational activities included a training session for children and their parents, and distribution of educational materials among them. Baseline (BL) and follow-up (FU) assessments were conducted before and after the intervention (in 2022 and 2024) to evaluate its impact. Both assessments included clinical examination of children’s OH status by calculating their DMFT/dmft index, and telephone survey among parents on OH knowledge and behavior. The changes in DMFT/dmft index and OH knowledge and behavior scores were measured using paired t-test.

Results
Overall, 94 children and their parents participated in both BL and FU assessments. There was no significant change in the parental OH knowledge score: 77.4% (SD 14.0) at the BL and 78.7% (SD 13.2) at the FU. Yet, children’s OH behavior score increased significantly: from 44.9% (SD 18.2) at the BL to 60.0% (SD 15.4) at the FU (p &lt; 0.001). Children’s DMFT/dmft index also improved significantly: from 7.31 at the BL to 5.09 at the FU assessment (p &lt; 0.001).

Conclusions
The study demonstrated the effectiveness of the OH intervention in improving children’s OH status and behavior. Therefore, we recommend expansion of the intervention with inclusion of more rural sites in Armenia, and targeting primary schoolchildren, considering the importance of timely preventive interventions and early development of healthy habits for better OH later in life.

Key messages
• Oral health interventions among primary schoolchildren covering awareness raising and carries prevention activities result in positive changes in children’s oral health habits and teeth health.
• Expansion of this type of interventions with inclusion of new rural sites and conduction of further assessments to explore the long-term effects of such interventions are recommended.
Discussing health behavior change during pregnancy: co-creation of a training and conversation tool
Authors: Turkeli R , Meijer E , Breunis L J , Keij M , Been J V , Crone M R , Numans M E , Smit E S , Langedijk-Wilms A 
Published: October 2024

Abstract

Background
Health risk behaviors during pregnancy are major risk factors for adverse health outcomes for mother and child, and they are more prevalent among vulnerable pregnant women. However, interventions often do not sufficiently meet the needs of disadvantaged groups. Changing behavior is more likely when people feel autonomous and when a behavior aligns with our identity (how we see ourselves). Despite the clear importance of identity in health behavior change, very few identity- based interventions exist for pregnant women, let alone for vulnerable pregnant women. Through co-creation, this study aims to develop an identity- and autonomy- based training program and conversation tool tailored to the needs and preferences of healthcare professionals and vulnerable pregnant women.

Methods
Four co-creation sessions were conducted with five professionals from medical and social domains, and five (expectant) parents in vulnerable situations. The Participatory Learning and Action research methodology was applied to ensure an equal and democratic process in designing the training and conversation tool.

Results
The training for professionals will focus on enhancing knowledge about the importance of identity and autonomy in behavior change, and on improving their self-efficacy through practicing the conversation tool. Example of the conversation tool, which can be integrated into daily practice, is a comic strip illustrating the conflict of being a smoker and a mother.

Conclusions
During intervention development, it is important to consider the needs and preferences of end-users, particularly for whom few appropriate interventions exist. Involving end-users yields valuable insights for feasible (e.g. one-consultation time frame) and accessible (e.g. easy-to-understand language) interventions. This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.

Key messages
• During intervention development, it is important to consider the needs and preferences of end-users.
• This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.
Experiences of weight discrimination were common in Finnish women with obesity
Authors: Sääksjärvi K , Palosaari T , Lundqvist A , Männistö S , Lehtoranta L , Mäki P , Kaartinen N E , Jääskeläinen T 
Published: October 2024

Abstract

Background
The consequences of obesity stigma, particularly weight discrimination, are widely felt in different sectors of society. Our aim was to examine the prevalence of experiences of weight discrimination in the Finnish adult population.

Methods
Data (n = 2,849) consisted of participants aged 20-64 years from the nationally representative Healthy Finland Survey in 2023, pregnant women and people with underweight excluded (body mass index, BMI, ≤18.5 kg/m2). The questionnaire inquired about the experiences of weight discrimination with a question “Have you experienced unfair treatment because of your weight during the last 12 months?”. Information on education (low, middle, high) was inquired too. Height and weight were measured during the health examination, and BMI was calculated (kg/m2). Obesity was defined as BMI ≥ 30 kg/m2. Weighted prevalence was analyzed using logistic regression, considering sampling design and non-response.

Results
Overall, 13% (95% confidence interval, CI, 11-15) of women and 7% (95% CI 5-8) of men had experienced weight discrimination during the last 12 months. The experiences of weight discrimination varied according to BMI, as the prevalence was 27% (95% CI 22-32) among women with obesity vs. 7% (95% CI 6-9) among women without obesity. The corresponding numbers for men were 16% (95% CI 12-20) vs. 4% (95% CI 2-5). The results were similar across all educational classes.

Conclusions
Individuals with obesity had experienced weight discrimination more often than those without obesity. The problem affects women (in particular), as almost one third of women with obesity had experienced weight discrimination. It is important to raise awareness and recognize this phenomenon across all sectors of society to enhance inclusion in a world struggling with overweight and obesity.

Key messages
• People with obesity experience weight discrimination. Experiences of weight discrimination appear to be more common in women than men.
• More information and understanding of weight-related stigma through education, research and values work is needed in different sectors of society.