bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teachers perspectives on positive and inclusive sex education in Dutch secondary schools
Authors: de Looze M , Meijburg S , Vermeulen M , van Ditzhuijzen J 
Published: October 2024

Abstract

Sex education in schools can play an important role in improving young people’s sexual health. Dutch youth are often dissatisfied with the sex education they receive at school; they want more attention to discussing pleasure, consent and diversity. While there have been various calls for positive and inclusive sex education over the past decade, still very few schools provide it. This study examined teachers’ perspectives on positive and inclusive sex education and documents the barriers teachers are confronted with in providing this type of sex education. Based on an online questionnaire survey of 508 sex education teachers, we examined the extent to which teachers possess the knowledge, attitudes and skills that facilitate the delivery of positive and inclusive sex education. We also held focus groups with 25 teachers from 10 schools and explored what they consider to be key barriers and best practices in teaching positive and inclusive sex education. Teachers overall have the knowledge, attitudes and skills that are needed to provide positive and inclusive sex education, but there is room for improvement, for example regarding knowledge on intersex individuals and the clitoris. Teachers experienced barriers at three levels: the personal level (e.g. personal discomfort), the classroom level (e.g., safety in the classroom) and the structural level (e.g. sex education not being part of the national curriculum; lack of time). Structural barriers seem to be at the basis of the barriers at the personal and classroom level. It is advised that positive and inclusive sex education gets a permanent place in the national curriculum. By developing concrete core objectives in the area of relationships, sexuality and diversity, for all grades, and by providing more extensive teacher training, teachers and schools will be facilitated to organize sex education in a more sustainable way.

Key messages
• Sex education teachers in the Netherlands desire better training to provide positive and inclusive sex education in the classroom.
• Integrating sex education in the national curriculum would help teachers to address sexuality in a more sustainable way in the classroom.
Perceptions of MSM on targeted sexual healthcare about HPV vaccination: a French qualitative study
Authors: Oliveri C , Mora M , Spire B , Girard G , Verger P 
Published: October 2024

Abstract

Background
To improve the effectiveness of public health policies, HPV vaccination campaigns target “high-risk groups”, such as men who have sex with men (MSM). In France, HPV vaccination is recommended for MSM up to the age of 26, rather than 19 for the general population. It’s crucial to assess the impact of such targeting policies on MSM who are eligible for HPV vaccination.

Methods
A qualitative study was conducted between April and July 2022 among MSM participating in the “Vaccigay” electronic survey in France (Brosset et al. 2023). Participants were selected based on age and declared HPV vaccination status. Semi-structured interviews were conducted by telephone using a thematic grid on the barriers and facilitators influencing the uptake of the vaccine against HPV. The interviews lasted on average 40 minutes. The audio-recorded verbatims were transcribed and thematically analysed using NVivo software.

Results
A total of 22 viewpoints were analysed. Two opinions emerged without differences in terms of individuals’ profile. The reasons MSM advocated for targeted sexual healthcare stemmed from the recognition of epidemiological factors, as well as the need for greater listening and understanding from healthcare workers. MSM who didn’t support targeted sexual healthcare did so because they felt stigmatised and because sexual orientation might not always be clear. Among them, some advocated for sexual healthcare based on sexual practices rather than sexual orientation. Others emphasized the necessity of extending prevention tools for sexual risks existing for MSM to the general population.

Conclusions
The findings of this study prompt reflection on universal versus targeted public health policies, as well as sexual and gender discrimination within the healthcare system. We recommend improving healthcare workers’ education on sexual healthcare, and that HPV vaccination guidelines could be extended to all adults up to 26, regardless of their sexual orientation.

Key messages
• Improving knowledge among healthcare workers and MSM about HPV and sexual health is important.
• It is important to extend the age for the HPV vaccination, regardless of sexual orientation.
Systematic review of ethical/methodological issues in transgender youth participative research
Authors: Servais J , Vanhoutte B , Maddy H , Godin I 
Published: October 2024

Abstract

Background
Understanding the experiences of transgender and gender-diverse (TGD) youth is essential for developing appropriate support services. However, studies focusing on TGD youth under 18 outside clinical settings are scarce, limiting effective support development. The requirement for parental consent in participatory research poses ethical and logistical challenges, impacting the safety, well-being, and privacy of adolescent participants. This dynamic complicates the balance between adolescents’ rights to autonomy and privacy and parental duties to protect their children. This review aims to illuminate the ethical and methodological challenges in participatory research with TGD youth.

Methods
A systematic review of bibliometric databases from 2006 to 2022 was conducted, focusing on transgender and gender non-conforming identities, adolescence, qualitative and participatory research methods, and consent issues. This review was registered with PROSPERO in November 2022 (CRD42022368360).

Results
Of 3,794 articles initially identified, 291 met the inclusion criteria, and 48 were extensively reviewed. Research with TGD youth commonly faces ethical tensions including parental inclusion in the consent process, safeguarding participant safety and privacy, ensuring confidentiality, and creating environments that allow TGD youth to express themselves and feel empowered. Methodological challenges include engaging public and stakeholders, recruiting participants, data collection, and maintaining research integrity.

Conclusion & Implications
The literature on participatory research with young transgender and gender-diverse individuals reveals intricate and often conflicting issues related to consent procedures, power dynamics, and the researcher’s role. These findings are applicable in various legal and geographical contexts, providing insights that can guide practices globally.

Key messages
• Research reveals ethical dilemmas in participatory research with transgender young people, highlighting difficulties around consent and the need for tailored support.
• Understanding the complexities of research ethics enables better support for transgender and gender-diverse young people during research.
Drug-facilitated sexual assault: An observational retrospective study in Barcelona (2018-2022)
Authors: Camps A , García-Esteve Ll , Salgado E , Echevarría T , Bertran M J 
Published: October 2024

Abstract

Background
Barcelona handles 400 to 500 sexual assaults yearly. Substance use is expected in one-third of reported assaults, being alcohol and cocaine the most detected substances. Nevertheless, there is a lack of updated information with reliable, recent, and context-specific data.

Methods
Retrospective observational study in people attended at the reference hospital for sexual assault care in Barcelona (H.Clinic) within 24 hours of the drug facilitated sexual assault (DFSA) in the period 2018-2022. Univariate and bivariate analysis have been carried out to describe the characteristics of the victims and identify possible associations with the assault settings, relationship with the aggressor and substances involved.

Results
Among 682 cases of DFSA, women represent 85%. Most incidents (73%) occur in the 18 to 35 age group, primarily in homes (42%), public spaces (23%), and nightlife establishments (15%). Spanish nationality is most common in both sexes (50%), yet Latin American men are prominent in drug-involved cases compared to non-Spanish European men. While alcohol (55%) and cocaine (28%) remain common, emerging drugs like GHB (15%) and MDMA (23%) are rising. The aggressor varies depending on the age and sex of the victim, with the perpetrator often being known (46%) in cases involving minor victims, while it tends to be unknown (46%) in cases involving adult victims. Chemical submission-related cases increased steadily, reaching 17% in 2022. Among these victims, 75% were women, with MDMA and cocaine being prevalent, while methamphetamine and GHB were more common among men. All these findings are statistically significant.

Conclusions
The study highlights a significant number of drug-facilitated sexual assaults mostly among young women, often occurring domestically, alongside emerging substance use trends. Adaptable surveillance systems are crucial to address these dynamic patterns and support vulnerable populations for safer environments.

Key messages
• Drug facilitated sexual assaults are a global health issue that demands attention through a gender perspective. Substances, spaces and consumption patterns evolve over time and across generations.
• Patterns in substance use vary by age, nationality, sex, and consumption type, highlighting vulnerable population groups needing focused protection and assault prevention.
Quitting with pride: Differences in smoking behaviour across sexual identity groups in Ireland
Authors: Kavanagh P , Sheridan A , Kelleher C , Noone C , Ward K , Doyle F 
Published: October 2024

Abstract

Background
As smoking prevalence reduces, smoking inequalities across population groups is emerging as a key challenge. Despite recognition of specific needs among members of the Lesbian, Gay, Bisexual, Transexual Plus (LGBT+) community, differences in smoking across sexual identity groups is uncharted in Ireland and the community is not represented in tobacco policy agenda setting. This study aimed to measure and compare the prevalence of smoking, quitting intention and quitting behaviour across sexual identify groups in Ireland.

Methods
Secondary analysis of the 2023 “Healthy Ireland” cross sectional survey of health status was conducted (n = 7,411). For the first time, this survey included a question on self-reported sexual identify, along with standard questions on smoking prevalence, quitting intention and quitting behaviour. Prevalence of smoking, quitting intention and quitting behaviour were calculated with 95% Confidence Intervals (CI) and compared across groups with Chi Square tests.

Results
In total, 2.3% (95% CI 2.0-2.7%) of respondents reported an LGB+ identity. Compared to those reporting straight identity, LGB+ respondents reported higher smoking prevalence (17.6% versus 21.4% respectively); intention to quit was similar across groups, however, LBG+ respondents also reported a higher prevalence of making at least one quit attempt in the previous 12 months (51.3% versus 78.0% respectively, p &lt; 0.0001).

Conclusions
While this study highlighted tobacco-use as a health challenge for the LGB+ community in Ireland, it also identified an opportunity for tailored stop smoking approaches to support quit success. As a consequence, an innovative Fulbright-sponsored policy dialogue was convened between leaders in tobacco control, LGBT+ community leaders, health services and academia across Ireland and the USA to explore solutions, underlining the important role equity stratifiers and population surveillance play in agenda setting for public health.

Key messages
• Including sexual identity in the national population health survey enabled tobacco-use needs across sexual identity groups in Ireland delineated for the first time.
• Equity-stratified population health surveillance informed a policy dialogue to better represent needs of LGBT+ community in public health agenda setting.
The data layer: the importance of sources critical appraisal
Authors: Gorasso V , Van den Borre L , Scohy A , Schmidt M , Devleesschauwer B , De Pauw R 
Published: October 2024

Abstract
One of the main purposes of public health institute is to tracking the health status of its citizens and understanding its evolution over time. Given the absence of a singular, comprehensive data source, we developed a framework to select databases specific to each disease and outcome of interest. This process includes a thorough evaluation of the operational case definitions, as well as the strengths and weaknesses of each database, with a particular focus on their sensitivity and specificity. These qualities are appraised following a dedicated scoring form into different categories (i.e., high, medium, low). The selection criteria for data sources hinge on several key questions: Is the database exhaustive or merely a sample? Does the case definition rely on direct medical diagnoses or proxies? Does the source capture all cases? Is the data collected at regional or national level? Are there mechanisms for yearly or periodic updates? To establish the most accurate national prevalence estimates for each outcome, we often need to adjust for data misclassification-applying corrections for biases such as self-reported data and interpolating for missing entries. In some instances, a pooled estimate from multiple data sources is developed. A specific case will be presented to illustrate our approach in practice. This critical evaluation is pivotal, as the quality of data underpins the entire health information pyramid. The integrity of our data directly influences our ability to convert data into actionable health wisdom, ultimately affecting public health decision-making and policy formulation.
Large scale system transformation: Ukraine
Authors: Piven N , Aleksandrova O , Aragón de León E , Jakubowski E 
Published: October 2024

Abstract
In the context of the EU-Ukraine Accession agreement, Ukraine started large scale public health systems reform back in 2015. The COVID-19 pandemic tested the response capacity of the national public health system and led to some improvement during the pandemic such as on laboratory capacity. It also generated lessons for strengthening national and subnational health emergency preparedness and response. Multiple interventions, including a Joint External Evaluation led to the adoption of the Public Health System Law in 2022, laying the foundation to bolster health promotion, disease prevention, and health protection. The Ukrainian Public Health Centre was substantially strengthened, partly oriented on models in other European countries. Corresponding centers for diseases control and prevention at the oblast level were reformed and a subnational network of these centers was created. While the war has a significant impact on the public health system, infrastructure, people and more, decision makers and professionals keep working on sustaining and moving forward the achievements on public health reforms, for example with the adoption of the National Health Strategy 2030 and the adoption of the National Health Security Plan. Further legal and strategic preparations are afoot to strengthen public health services governance capacity, financing, institutional innovation and development, and public health workforce development.
Large scale public health system transformation: Germany
Authors: Jakubowski E , Kupfer G , Bruns-Philips E , Teichert U 
Published: October 2024

Abstract
The COVID-19 pandemic was a stress test for public health services in Germany. Decision making was complex (party lengthy and inconsistent) due to the divided responsibilities within the federal system. Some improvements on the public health system were already enacted during the pandemic. A “pandemic radar” was established to bundle up relevant infectious disease indicators with indicators of health services use. The national electronic notification and information system for infectious diseases was extended. Digital improvements were made in the public health offices. Laboratory capacity was strengthened, so was inter-science modelling to forecast pathogen spread. A nation-wide collaborative mechanism, the cloverleaf system, was introduced between regions to avoid the overburdening of hospitals. It is now established for times of excess need for inpatient services. In 2020, a 4 billion euros investment program, the “Pact of Public Health Services”, was adopted to strengthen and modernize the German public health service institutions. The pact is implemented until 2026. The human resources component is the largest. Further priorities include digitalization, improvement of the infrastructure (of designated ports and airports) for the implementation of the International Health Regulations, research and the creation of agile and resilient public health structures. Outputs so far include the establishment of more than 4800 new public health positions, the appointment of new professorships for public health services, the initiation of several research projects, and the roll-out of more than 300 digitalization projects. A new federal institute for prevention is planned. It aims to foster networking between public health services, strengthen health communication, data use, and evidence for public health services. In this process, WHO advised the federal ministry e.g. on behavioral insights; heat health action; prevention on noncommunicable diseases and others. Many public health actors have provided opinions. However, consensus building on how Germany can overcome fragmentation in public health is ongoing.
10.B. Scientific session: The European Health Data Space (EHDS): A sea of change for health data in Europe
Authors:   Organised by: DG SANTE European Commission,   Chair persons: Jerome de Barros (Belgium)
Published: October 2024

Abstract

A wealth of data is generated every day throughout our health systems which, if leveraged well, can underpin the digital solutions and policies that will transform health and care. However, the complexity and divergence of rules, structures and processes within and across European Member States make it difficult to fully harness that potential at European scale. The European Health Data Space will address this challenge by empowering Europeans to access and control their health data and by offering a harmonised and simplified framework for the reuse of health data, including for research, innovation, and policymaking purposes. During the workshop, we will present an overview of the European Health Data Space framework and its implementation phases and discuss its benefits for targeted stakeholders, including citizens, researchers and policymakers in public health.

Objectives
1. Emphasise the importance of leveraging health data for research, innovation and policymaking; 2. Present the European Health Data Space regulation and what actions are being undertaken to prepare for its implementation; 3. Discuss how access to their health data can enable patients and individuals play an active role in their own health journey; 4. Discuss what will be the main benefits for policymakers and researchers in public health resulting from enhanced access to health data.
Introduction by Chair for presenting the European Health Data Space and the setting the scene for the session. Short presentations by speakers:
1. Implementing the EHDS: lessons from the EHDS2 pilot - Marianne Benderra, Health Data Hub, presenting his experience on developing and piloting the EHDS infrastructure for secondary use of health data, highlighting key project developments;
2. How can the EHDS enable participatory healthcare? - Henrique Martins, ISCTE, xShare project on how the xShare “Yellow Button” will empower individuals with access to and control over their health data and may foster the development of knowledge and tools necessary for prevention and management of their health;
3. What will the EHDS enable for research and policymaking? - Nienke Schutte, Scienciano, bringing the perspective of a leading European public health institute how the benefits the EHDS framework can bring for policymaking, research and innovation.
15 min Q&A session, taking questions from the audience, possibly also through Slido. Possible guiding questions: How can stakeholders contribute more broadly to the development of the EHDS? What support is needed to ensure that data users and data holders are prepared when the EHDS framework becomes operational?

Conclusions
2 min by Chair.

Speakers/Panelists
Marianne Benderra
French Health Data Hub, Paris, France
Henrique Manuel Martins
ISCTE, Lisbon, Portugal
Nienke Schutte
Sciensano, Brussels, Belgium
10.C. Scientific session: Shifting the focus of health and economic policies: Investing in sustainable health and well-being
Authors:   Organised by: Finnish Institute for Health and Welfare (Finland), Society for Social Medicine (Finland),   Chair persons: Ilmo Keskimäki (Finland), Tea Lallukka (Finland)
Published: October 2024

Abstract

The main theme of the 18th European Public Health Conference, to be held in Helsinki in 2025, is ‘Investing for sustainable health and well-being.’ The theme emphasizes the concept that improving population health and well-being is an investment rather than an expenditure, benefiting society as a whole and contributing to a more sustainable economy. This workshop will introduce the thematic areas of the 2025 European Public Health Conference through three presentations. First, we will highlight the approach of public health policy drawing on the economy of well-being and its application in wider societal policymaking. Second, we will explore how EU policies can contribute towards a Wellbeing Economy and how to ensure health and wellbeing remain on policy-making agendas. Third, we will present an economic case for investing in health and health systems and highlight the co-benefits it brings to other policy areas and sustainable development goals. Finally, we will discuss the future expectations for European public health policy. The workshop will conclude with a general discussion, providing the audience with an opportunity to propose topics for inclusion in the programme of the European Public Health Conference in 2025.

Key messages
• Improving population health and well-being is an investment rather than an expenditure.
• Investing in the population’s health and well-being brings co-benefits to other public policy areas.
How do health systems and health contribute to the sustainable development goals?
Authors: Cylus J , Siciliani L 
Published: October 2024

Abstract
While there is considerable research and policy interest into how factors outside the health system (i.e. social determinants) influence health outcomes, there has historically been less interest in how health and health systems affect other economic and societal objectives. Such evidence can be useful to health policymakers making the case for investing in health systems to demonstrate that health systems do more than just improve health. The European Observatory on Health Systems and Policies has put together a special issue of the journal Health Policy to explore the evidence on how health and health systems advance the Sustainable Development Goals (SDGs), which provides a helpful conceptual framework for considering economic and societal objectives. The articles each consider a particular SDG and review relevant literature with an emphasis on causal studies to explore the ways in which health and health systems have causal effects on key societal objectives such as poverty reduction, gender equality, climate change, and responsible consumption. In this presentation we will provide a summary of the findings from the special issue, highlighting areas with the strongest (and weakest) evidence and discuss how this work can be factored into budget negotiations and decisions about resource allocation.