bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving implementation of health interventions among ECEC organisations: a social network analysis
Authors: Leurs-Stijnen M , Kremers S , Gubbels J 
Published: October 2024

Abstract
The environment wherein a child grows up determines many health and life outcomes of the child. The early childhood education and care (ECEC) is an important setting for children which offers possibilities for health promotion activities. A learning network with professionals from ECEC organisations in South-Limburg, the Netherlands is established, aimed at sharing health promotion ‘best practices’. This study examined the network structure of the learning network and of ECEC locations regarding health topics such as nutrition, physical activity and sun protection. A mixed-methods design was adopted. An online-questionnaire was used to examine the relationships of the members of the learning network (N = 6) and ECEC locations (N = 59) between these organisations and with organisations related to the health topics. Data was analysed and visualised using a social network analysis (SNA) in UCINET. Thereafter, semi-structured interviews were held with the members of the learning network (N = 6), to discuss the network structure and possible improvements of the network. The SNA showed a weak network structure for the learning network and ECEC locations. Connections were mostly related to organisations in the field of nutrition and physical activity. This implied that health interventions related to sun protection and green environments were not implemented to the same extent as nutrition and physical activity. The interviews provided insight into the underlying reasons for (the lack of) certain connections. Overall, the members were satisfied with the quality and quantity of their current collaborations. The SNA and interviews indicated that the collaboration between ECEC organisations and organisations related to other health topics like green environment or sun protection could be improved. Therefore, it is recommended that ECEC organisations should engage in collaborations with organisations in these domains.
Involving stakeholders in planning the scale-up of a health promotion intervention: a practical example
Authors: Harms L , Gubbels J , Gerards S 
Published: October 2024

Abstract
Scaling up health promotion interventions is complex. Despite the potential effects and impact on society, factors related to the intervention itself, potential adopters or implementers, and contextual factors can hinder or promote widespread scale-up. Frameworks such as the PRACTIS (PRACTical planning for Implementation and Scale-up) guide and approaches such as Design Thinking offer practical guidance for researchers to increase the likelihood for successful scale up. SuperFIT is an integrated intervention approach aiming to promote healthy energy balance-related behaviours in children aged 2-4 years. To date, SuperFIT has been implemented in over one hundred childcare locations, reaching at least 1800 children per day. A local PA-providing organisation is responsible for the implementation of SuperFIT. The aim of this project was twofold: to identify the needs of future adopters and implementers of SuperFIT (i.e. What information and materials do you need?) and to develop the relevant tools and implementation strategies. We used a co-creation approach, combining stakeholder interviews (n = 6) based on the PRACTIS guide to identify gaps and needs, with creative sessions (participants n = 8) and multiple thinking-out-loud sessions (participants n = 6) to generate solutions that would be relevant to implementers. Stakeholders included researchers with experience in SuperFIT and implementation science, implementers and managers of the current and new PA-providing organisations. Gaps were identified and summarised under three main themes: 1) a lack of clarity what SuperFIT entails, 2) SuperFIT adaptations to new implementation contexts, 3) the skills and implementation capacity required to ‘train the trainer’. Creative sessions assisted the generation of prototype tools. We have learnt the value of patience and perseverance, as some obstacles need time to be overcome.
WHO/Europe tools for strengthening health information systems
Authors: Adib K , Davtyan K , Verschuuren M , Novillo Ortiz D 
Published: October 2024

Abstract
WHO/Europe offers different tools and capacity building activities to support Member States (MS) in strengthening their health information systems (HIS). These range from assessment methodologies and guidance documents to situation reports and workshops and trainings. The HIS assessment method of WHO/Europe provides an overview of the performance of the entire HIS in an MS. As such, this is often applied as a starting point for HIS strengthening activities in a country, and ideally repeated every few years to measure progress. Next to an assessment of the overall HIS, WHO/Europe also has methods for assessing specific HIS aspects, such as cybersecurity preparedness and GIS capacity. There are also several tools and capacity building activities that specifically focus on strengthening HIS digitalisation (d-HIS). For example, there is a modular d-HIS training, the programme of which can be adapted to meet specific MS needs. This also applies to the population health monitoring training that is available for interested MS. In addition, WHO/Europe has published a range of guidance documents, ranging from a comprehensive d-HIS strengthening manual to guidance on how to write an impactful health report, and guidance on how to apply data protection principles in public health. Finally, WHO/Europe supports HIS strengthening by making Regional and country-level situation reports, and by writing and contributing to scientific papers. In this presentation, first a general overview of available types of HIS strengthening tools and activities will be provided, after which the available tools and capacity building related to data protection and cybersecurity will be presented in more detail, because of the high interest WHO/Europe encounters for these topics in the Region currently.
Climate change adaptation measures in the context of health promotion using participatory foresight
Authors: Spagl S , Horváth I , Durstmüller F , Brugger K , Schmidt A E 
Published: October 2024

Abstract

Issue/problem
Climate change is regarded as a big threat to human health (WHO 2023), requiring action to prepare our health systems. Using participatory foresight approach has the potential to increase capacities of communities and to sustain future health. The process is easily transferable to other regions or countries across Europe. The work is part of the Austrian “Climate-Resilience-Check Health for regions and municipalities”.

Description of the problem
We present an innovative qualitative method to contribute to a climate change and health vulnerability and adaptation assessment following WHO’s guidelines. Questions answered by the project were: • What measures can be taken to shape the regions’ potential for a health-promoting lifestyle and to increase climate resilience? • Does participatory foresight represent a well-suited method to develop climate adaptation measures which address local needs? Taking place between 10/23 to 12/23, the participatory foresight process consisted of (1) a foresight-workshop facilitating development of adaptation measures through the creation of personas and (2) intervention boards, which gave the broader population the opportunity to vote for measures developed in the workshop. The aim of the approach was to identify measures that receive approval within the population.

Results
The participatory foresight process highlighted the local populations’ wish of revitalizing village centers to strengthen social cohesion. Particular emphasis was placed on the establishment of a community center and the expansion of daycare services.

Lessons
The process will be conducted in further regions as part of the Climate-Resilience-Check Health for Austrian regions and provides lessons of good practice for roll-out across European countries aiming to bridge efforts for climate adaptation and health promotion at regional levels.
Driving policy changes: RISE-Vac lessons learnt and recommendations
Authors: Tavoschi L , Thanasi E , Di Nino M G , Tramonti Fantozzi M P , Moazen B 
Published: October 2024

Abstract
The RISE-Vac project consortium applied evidence-based public health methods to collate, assess, and analyze all the evidence generated through project activities, including literature review and prospective data collection on quantitative and qualitative aspects of vaccine services implementation in prison settings. A multi-sectorial and inter-disciplinary group of experts was set-up including health professionals, statisticians, social scientists and people with lived experience from civil society organisations, health services, prison administrations, academia and international agencies. A set of recommendations, advice, and policy options on how to increase vaccine uptake, targeted to people in prison and using a citizen-centred approach, were developed and tailored to specific needs profiles of different prison population subgroups. Vaccinations to be considered in prison settings were grouped according to target population and/or public health objective into: Seasonal vaccinations and vaccination during outbreak; Childhood life-course vaccinations (booster doses); Vaccinations for cancer prevention; Vaccination for older population groups and people with chronic conditions. In consideration of the diversity of the countries participating in the project, their epidemiological context and available resources and infrastructures, a multi-tiered approach for the development and implementation of models for vaccination services implementation in prison settings was devised, encompassing core vaccinations, such as HBV, Flu, COVID-19 and tetanus, as well as expanded vaccination offer to respond to enhanced health needs and to promote equity of health outcomes, including e.g. HPV vaccination.
Measuring the economic impact of environmental stressors on health
Authors: Barbosa A , Orujova L , Feldens T , Soprani J , Martins F , Pinheiro V , Freitas A , Santos J V 
Published: October 2024

Abstract
Environmental stressors are an important source of burden of disease worldwide. The accurate economic evaluation of health hazards caused by environmental stressors guide the design of more effective and comprehensive public policies. However, guidelines on cost assessment, monetisation and discounting methodologies are scarce. Therefore, several different methodologies are applied in multiple contexts, making comparability difficult. Within BEST-COST, methods for monetising health hazards caused by environmental stressors are identified and described based on a systematic review approach. An electronic search was performed in Medline, Scopus, Web of Science and Econlit, alongside with grey literature and citation and reference tracking identifying all relevant studies. Different methods are identified, such as value of a statistical life (VSL) and value of a life year (VOLY), as well as specificities from data collection to modelling for the economic evaluation. These methods may be categorised based on their approach (market-based or non-market based), perspective of analysis (payer, patient or societal) and health measures. In this presentation, the various key methodologies to assess the economic impact of environmental stressors on health will be introduced and demonstrated. Through these insights, workshop participants will be supported in performing health impact assessments and cost-benefit analyses, which play a pivotal role in informing public policies that impact environment and subsequently health.
Sex differences in cardiovascular disease in relation to socioeconomic position in the NAKO study
Authors: Moreno Velasquez I , Peters SAE , Dragano N , Greiser K , Dörr M , Fischer B , Berger K , Hannemann A , Peters A , Pischon T 
Published: October 2024

Abstract

Background
Low socioeconomic position (SEP) is associated with cardiovascular disease (CVD) risk; yet, the underlying pathways are not fully clear and may affect sexes differently. We investigated sex differences in the relationship of SEP with prevalent CVD, cardiovascular risk factors (CRF) and estimated cardiovascular risk in a contemporaneous German population.

Methods
Data derived from the baseline examination of 204,780 participants in population-based German National Cohort (NAKO). Logistic, multinomial, and linear regression models were used to estimate sex-specific odds ratios (OR) and beta-coefficients with 95% confidence intervals (CI) of CVD, CRF and very high-risk score (SCORE2 ≥7.5% (age 40-49 years) or ≥ 10% (age 50-69 years)) associated with educational attainment and relative income. Women-to-men ratios of ORs (RORs) with 95%-CI were estimated.

Results
In women compared to men, low vs. high SEP was more strongly associated with obesity, overweight, self-reported myocardial infarction and hypertension, elevated blood pressure values, antihypertensive medication, and alcohol consumption, but less strongly related to smoking. In women with the lowest vs. highest educational level, the OR for a very high 10-year CVD risk was 3.61 (95%-CI 2.88; 4.53), compared to 1.72 (95%-CI 1.51; 1.96) in men. The women-to-men-ROR was 2.33 (95%-CI 1.78; 3.05), attenuated after age-adjustments. For the comparison of low vs. high relative income, the odds of having a very high 10-year CVD risk was 2.55 (95%-CI 2.04; 3.18) in women, and 2.25 (95%-CI 2.08; 2.42) in men (women-to-men ROR, 1.31 (95%-CI 1.05; 1.63).

Conclusions
In both sexes, there was an inverse graded relationship between SEP and the likelihood of prevalent CVD and CRF, with stronger associations in women than in men. Although women had a lower estimated 10-year CVD risk compared to men, the likelihood of having a very high CVD risk conferred by low SEP vs. a high one was higher in women than in men.
Changes in physical activity and sedentary behavior during COVID-19 pandemic restrictions in Germany
Authors: Herbolsheimer F , Brummer J , Stein M , Krist L , Steindorf K 
Published: October 2024

Abstract

Background
During the COVID-19 pandemic’s first wave, mobility restrictions and protective measures have impacted both public and private life. In Germany, the population was advised to stay home except for work, outdoor sport activities, and essential shopping. This study aims to evaluate how these measures affected physical activity and sedentary behavior, focusing on identifying the groups most affected.

Methods
In April and May 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). The questionnaire was specifically designed to assess changes in physical activity and sedentary behavior compared to pre-restriction levels, along with data on anxiety and depressive symptoms.

Results
Around 26 % of the 152,421 respondents reported increased sedentary time, and about 38 % reported reduced participation in sport activities compared to pre-restriction levels. Over one-third of those who previously met the WHO’s physical activity recommendation could not maintain it during the restrictions. There was also a notable decline in active transportation (M = - 0.12; 95% CI: -.126; -.117), whereas participants spent more time on recreational physical activities (M = 0.12; 95% CI: .117; .126). Based on multivariable linear and log-binomial regression models, we found that younger people were more affected by the restrictions than older adults. Factors such as transitioning to remote work, self-rated health, and depressive symptoms strongly correlated with changes in all physical activity domains, including sedentary behavior and adherence to physical activity guidelines.

Conclusions
The shift towards inactivity or low-intensity activities during the nationwide restrictions poses potential long-term health risks, highlighting the urgent need for public health policies to address the negative impact of COVID-19 restrictions on physical activity and sedentary behavior.
The Network of Expertise on Long COVID as a means to synthesise intelligence and improve our response to long COVID at EU level
Authors: Van Der Heide I 
Published: October 2024

Abstract
To promote international collaboration and strengthen EU and national-level responses to Long COVID, the Commission set up the Network of Expertise on Long COVID (NELC) in 2023. It brings together national institutions involved in Long COVID work, nominated by the Public Health Expert Group (PHEG) representatives of each Member State. The network provides a platform for exchanges of national experiences on diagnosis, treatment, and management of long COVID. The Commission and the NELC agreed on eight specific actions to be implemented to manage Long COVID. The development of a Long COVID definition is complex due to the diverse range of symptoms experienced by patients, and so working towards a unified EU case definition is the first action proposal. This will allow the development and implementation of a surveillance system on national and EU level to foster the knowledge on the actual scale and the symptomatology of Long COVID across the EU leading to a better comparability of health data at Union level. The proposal to develop and implement a training programme for healthcare professionals at EU level will allow for the exchange of expertise/training on Long COVID across Member States. The provision of clinical guidelines based on evidence to Member States will help manage Long COVID, and international collaboration will allow for the sharing of valuable information and data with third countries that have experience with Long COVID. The Commission will use the EU Health Policy Platform to create an open stakeholder group. This group will allow stakeholders and patient groups to express their point of view, and to share experiences. Assessing the far-reaching social and economic consequences of Long COVID across the EU will allow for more targeted social and economic policy responses from Member States. It is important that priority is given to research responding to the most urgent needs of health care systems, which is why the Commission aims to identify research needs.
Assessment of the impact of Long COVID on labour market participation and potential economic effects in the EU
Authors: De Leon Edo A 
Published: October 2024

Abstract
This paper estimates the economic cost of long COVID through its direct impacts on the labour market. The direct implications of long COVID for affected individuals concern their capacity to work, and their productivity at work. Some individuals might continue to work, but at a lower productivity level, some might reduce their hours worked, including as a result of temporary absences, and some might stop working at all. To the best of our knowledge, so far, no study has explicitly addressed the impact of long COVID on the EU labour market. The present paper provides a tentative assessment using available estimates from surveys, clinical follow-up studies and model simulations of the prevalence of long COVID. This tentative approach yields an estimated negative impact on labour supply of 0.2-0.3% in 2021 and 0.3-0.5% in 2022. In person-equivalents, this means long COVID would have reduced labour supply by 364,000-663,000 in 2021 and by 621,000-1,112,000 in 2022, combining the effect of lower productivity, higher sick leaves, lower hours, and increased unemployment or inactivity. The lower bound of this range is close to a recent estimate put forward for the US (Abraham & Rendell, 2023). Available labour market data suggest a mixed picture when it comes to the impact of long COVID. Overall, the possible role of long COVID in the rising trend in sick leave, disability and activity-limiting health factors, warrants careful monitoring going forward, due to its potential impact on labour supply and labour productivity, and on public finances through increased social benefits, pensions, health care and long-term care expenditure.
Community Healthcare-Associated Infections: Enhancing Control with Software and Tailored Protocols
Authors: Morais Vilaça I , Monteiro H , Pereira C , Silva R , Cabral I , Silva F , Sousa R , Pratas Valente C , Tavares F 
Published: October 2024

Abstract

Issue/Problem
Healthcare-associated infections are major global public health challenges. In Portugal, the prevalence of resistant Enterobacteriaceae is particularly alarming. Studies typically focus on hospitals and long-term care facilities, neglecting community settings where patients, particularly the elderly with multiple comorbidities, often transition between hospital and home.

Description of the problem
Effective control measures are vital across all healthcare environments. In home care, sporadic implementation of Contact Precautions, due to the lack of specific guidelines and challenges in accessing colonization information, has been a major gap. This project aimed to close this gap by integrating a software, previously used only in hospitals, to enhance infection control in domiciliary care. The intervention adapted contact transmission-based precautions for home settings and used data from the previous year’s infections and colonization to tailor recommendations for each patient, preventing transmission between homes and enhancing caregiver education.

Results
Preliminary data from a two-month monitoring period involved 40 patients under the care of three domiciliary teams. Eleven had records of infections involving 19 microorganisms, including 7 Enterobacteriaceae, five of which were carbapenemase producers. This led to five customized recommendations for improved precautions. The intervention also heightened nurses’ awareness of patients’ microbiological histories, evidenced by increased inquiries to the infection control team.

Lessons
Adapting measures to the unique dynamics of home care, distinct from hospital settings, is critical. Involvement of care teams in decision-making ensures practical adherence and enhances measure effectiveness. Regular monitoring is crucial for compliance, making this approach a model for other settings.

Key messages
• Adapting hospital protocols to community settings and offering close support to caregiving teams increases compliance.
• Implementing software that facilitates communication about infection and colonization enhances infection control effectiveness in community settings.