bluuebunny/crossref_metadata_2025_split huggingface dataset:
Boosting influenza vaccination rates through policy gamification: the ‘Let’s Control Flu’ project
Authors: Lopes H , Hermenegildo C , Franco D 
Published: October 2024

Abstract

Background
Influenza remains a public health challenge globally, leading to substantial morbidity and mortality, particularly among vulnerable groups. Despite the benefits of vaccination, achieving the desired vaccination coverage rates (VCR) proves challenging across Europe. The ‘Let’s Control Flu’ (LCF) tool emerges as a new contribution, merging gamification with epidemiological data and public health policies to help increase influenza VCR.

Methods
The LCF tool, developed from an extensive literature review and validated by a National Advisory Board, initially showcased its capabilities in Sweden. Offering an interactive simulation, it allows stakeholders to explore the outcomes of implementing 13 targeted public health policies (PHP) on influenza VCR and health outcomes such as infection rates, hospitalizations, and mortality. This approach simplifies epidemiological complexities, paving the way for informed decision-making.

Results
Following its success in Sweden, the LCF tool was extended to Germany and Czechia, underlining the value of gamified tools in public health decision-making. The application across these new countries not only resulted in paths to improve VCR but also provided insights into the tool’s scalability and adaptability different landscapes.

Conclusions
The LCF project underscores the efficacy of integrating gamification into health policy decision-making, offering a replicable model for enhancing influenza vaccination uptake across Europe. With the tool now successfully applied in multiple countries, its potential for broader European and global application is evident. This initiative aligns with WHO’s objectives, spotlighting gamification as a relevant component in improving vaccination strategies and readiness for influenza and other preventable diseases, thereby reinforcing the importance of innovative approaches in public health policy development.

Key messages
• The LCF tool integrates gamification with public health strategies to help effectively raise influenza vaccination coverage.
• By merging gamification and epidemiological insights, the LCF tool also serves as a scalable model for Europe, supporting WHO’s goals to improve vaccine strategies and preparedness.
What’s pension got to do with it? Mortality inequality at older ages
Authors: Fritzell J , Forslund M , Östergren O 
Published: October 2024

Abstract

Background
The potential role of social protection systems and welfare states for population health and mortality has attracted increased interest in recent decades but mostly focused on overall characteristics or clusters of countries. Moreover, often neglecting older people even though the great majority of all deaths in high-income countries occur at later ages. We focus on the key social protection scheme for old adults: the generosity of the level of pensions. We compare pensions based on previous work history to basic minimum pensions. Our study is novel both by linking pension system to remaining life expectancy at age 65(LE65+), but also by studying the association to variation in LE65+, since that gives a measure of inequality. We do so across countries and over time.

Methods and Materials
Our sources of data are from the Human Mortality Database and the Social Policy Indicator Database. Data for OECD countries are matched over a long period of time and analysed by pooled time-series regression analyses with fixed effects.

Results
Although the results indicate that the generosity of pensions based on both pervious work history and basic minimum income our results primarily show the importance of basic minimum income. Here the effect sizes are larger and especially for women than for men (0.149*** vs. 0,.0715***). Concerning the variation in LE (65+) we find that more generous basic pensions are associated with reduced variation for women -4.64e-05**.

Conclusions
We provide new insights in how pension policies potentially influence mortality among older persons especially by extending our analyses also to inequality in mortality. Our results points to the importance of basic pensions. The gendered division of labour is a plausible explanation for the findings and to have an adequate pension for all should be of primary concern for public health.

Key messages
• Adequate basic pension for all of importance for remaining life expectancy among older people.
• Adequate basic pension for all of importance for reducing mortality inequality among women.
Setting targets for antibiotic use in general practice in Europe: a scoping review
Authors: Garzon-Orjuela N , Roche K , Vornhagen V , Moran A , Walkin S , Cullen W , Blake C , Vellinga A 
Published: October 2024

Abstract

Background
National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice. This scoping review aims to identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs.

Methods
A systematic search strategy was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. Two research questions were addressed: ‘What are existing targets for antibiotic use in general practice in the 31 European countries?’ and ‘How are these targets linked to the NAPs on AMR?’. The results are presented narratively.

Results
77 reports were included, of which 33 focused on national targets and general practice or linking national targets to local areas. Reports describe local strategies or initiatives to achieve targets, such as feedback to prescribers, systems with benchmarks (at local, regional, and national levels) and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses (DDD) or in items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners (GPs).

Conclusions
Most European countries have a NAP with national targets. The type of targets and their implementation at the national and local level vary between countries. Translating national targets into daily clinical practice is challenging and often lacks the involvement and input of prescribers (GPs).

Key messages
• Translating targets into daily clinical practice is challenging and often lacks the involvement and input of prescribers (GPs).
• Local strategies, feedback to prescribers, benchmark systems (local, regional, national), and financial incentives drive successful target achievement.
Study on access to social protection policies by homeless people during the COVID-19 pandemic
Authors: Andrade de Souza A , Jorge Martins A L , Drummond Marques da Silva G , de Moraes Teixeira Vilela Dantas A C , Alves Marinho R , da Matta Machado Fernandes L , Miranda Magalhães Júnior H , Debortoli W , Paes-Sousa R 
Published: October 2024

Abstract

The study analyzed the access of homeless people (HP) to health and social protection policies, including emergency measures, during the COVID-19 pandemic in Belo Horizonte (BH), capital of the state of Minas Gerais, Brazil. Its main objective was to provide data on the profile of HP in the municipality, in addition to evaluating existing public policies focused on HP, based on the time frame of the health emergency. Study with mixed methods design with triangulation of quantitative and qualitative data. It used official databases in parallel with document analysis, interviews and focus groups. As a result, the cartography showed that in the first months of the pandemic the municipality had difficulty reorganizing the health system, which underwent constant protocol updates, consolidating, however, over the months. Important emergency interventions in the municipality of BH involved activities that facilitated HP’s access to the provision of services, including intersectorality between health services, social assistance and the third sector. The temporary offer of various intersectoral services, simultaneously with the offer of daytime shelters by organized civil society, was considered a key factor for the expansion and intensification of care networks for HP during the emergency phase. Itinerant services were among those with the greatest positive evidence of service to HP, with emphasis on the ‘Consultório na Rua’. The study concluded that understanding the profile of homeless people in BH and the intersectoral variables that impact HP contributes to better directing investments in interventions for these individuals and increasing the effectiveness of health and social protection systems, in line with with the work carried out by the third sector.

Key messages
• Understanding the inter-sector variables that impact Homeless People contributes to better targeting of investments in interventions in protection social.
• Knowing the profile of the homeless population makes it possible to organize more effective health care and social assistance.
Agenda 2030 for sustainable development in Portuguese Speaking Countries, indicators inequalities
Authors: Carvalho Malta D , Santos Magalhães Cardoso L , Gomes da Silva A , Augusto Veloso G , Malta dos Santos F , Ferrinho P , Ferreira A , Passos Cupertino de Barros F , Luiz Pinho Ribeiro A , Naghavi M 
Published: October 2024

Abstract

Background
Achieving the SDG Sustainable Development goals represents a major global challenge. The Community of Portuguese Speaking Countries (CPLP) is made up of countries: Angola, Cape Verde, Guinea-Bissau, Equatorial Guinea, Mozambique, São Tomé and Príncipe, Brazil, Portugal, and East Timor. Studies on SDG indicators are little studied among these countries. The study analyzes SDG health indicators in the Community of Portuguese Speaking Countries (CPLP) and their projections for 2030, and investigates the correlation between the countries’ level of development and the performance of these indicators.

Methods
Ecological epidemiological study. Estimates from the Global Burden of Disease (GBD) study between 1990 and 2021 were analyzed, referring to fifteen indicators: universal health coverage, sanitation, smoking, maternal and child health, vaccination coverage and communicable diseases. The GBD study generated projections by calculating the annual change since 1990 for each country and year and then calculating the weighted annualized rate of change. The correlation between the Sociodemographic Index (SDI) and the SDG indicators was investigated using the Spearman test, at a significance level of 5%.

Results
The best performances of the analyzed indicators were seen for Portugal, followed by Brazil, Cape Verde and São Tomé and Príncipe. In other countries, high rates of infectious diseases, maternal and childhood mortality, malnutrition, low vaccination coverage and sanitation were observed. There was a negative correlation between the SDI and the indicators of childhood mortality rate (R=-0.82; p &lt; 0.05), malnutrition (R=-0.7; p &lt; 0.05), incidence of tuberculosis (R =-0.73; p &lt; 0.05) and positive between SDI and sewage coverage (R=-0.83; p &lt; 0.05).

Conclusions
The CPLP presents internal differences regarding the health indicators analyzed, making it essential to advance cooperation between countries to achieve the SDG targets in 2030.

Key messages
• There are great inequalities between SDG indicators in Portuguese-speaking countries.
• It is important to advance technical cooperation between countries to formulate solutions and leave no one behind.
Exploring UK adult and policy stakeholder perspectives on obesity prevention policy and inequalities
Authors: Brown O , Langley T , Murray R , Bogdanovica I , Bains M 
Published: October 2024

Abstract

In England, 14 obesity strategies have been published, including 689 proposed policies, while rates of obesity persist, and inequalities worsen. This study explores adults’ attitudes in relation to food-related obesity policy and how socioeconomic inequalities in obesity are considered throughout the policy process through the perspective of policy stakeholders (PSH). 31 semi-structured interviews with UK-based adults (GPP) (18+) and 14 interviews with PSH categorised as government officials, academics, and advocacy group representatives were conducted and analysed using Braun and Clarke’s thematic analysis. Both PSH and GPP attributed obesity causation primarily to the food environment rather than to individual behaviour. The PSH identified the food industry’s role in shaping the environment. Level of deprivation was believed to exacerbate the barriers to healthy weight in both samples. All participants agreed that, in the UK, there was an unequal opportunity to attain a healthy diet. A disconnect was found between the GPP perspectives towards the barriers to healthy weight and their attitudes towards policy action. The GPP described mistrust in the government’s motives and willingness, fuelling the perspective that policy lacked impact and was disconnected from their lived experiences, particularly among participants of lower socioeconomic status and higher weight classifications. The PSH raised concerns regarding barriers to policy implementation, including inconsistent government commitment, competing priorities, and resistance to state intervention. PSH suggested that it was unfeasible to prioritise inequalities while population rates remain high, and the failure of implement proposed policies continue. This study shows the necessity of incorporating a health equity lens, breaking down policy silos, and amplifying community voices in the policy process to challenge assumptions regarding lived experiences and ensure healthier equitable policy outcomes.

Key messages
• The study shows the importance of integrating a health equity lens, breaking policy silos, and amplifying community voices to challenge assumptions and achieve more equitable policy outcomes.
• Obesity policy requires greater consideration to inequalities to strengthen policy impact as demonstrated by all participants recalling the unequal opportunity to sustain a healthy weight in the UK.
Proficiency in Personalized Medicine and Health Data Sharing in the EU
Authors: Causio F A , Beccia F , Kreeftenberg Ll , Calabrò G E , Pastorino R , van El C , Boccia S 
Published: October 2024

Abstract

Personalized medicine, leveraging genetic, environmental, and lifestyle data, has already transformed healthcare by tailoring prevention, diagnosis, and treatment to individual patients. The successful development and implementation of personalized approaches rely on the public’s proficiency and awareness of personalized medicine, enabling access to innovative techniques and fostering a willingness to share health-related data. We distributed a survey to 6,581 respondents from 8 EU countries: France, Germany, the Netherlands, Italy, Spain, Poland, Hungary, and Romania. 52.5% of respondents were female (n = 3,458), with a mean age of 48.5 years (range 18-89 years, median = 49 years, SD = 15.96), and 37.91% of the participants reported achieving tertiary education. Our survey investigates the general public’s knowledge of personalized medicine, support for genetic testing, and willingness to share health data among EU citizens while assessing their perception and acceptance of these medical paradigms. Knowledge levels vary among different EU countries. Only 12.11% of respondents had a high knowledge of the topics presented in this survey. Support for implementing genetic testing in healthcare was high, with 81.52% supporting the implementation of genetic testing in their healthcare systems, and nuanced differences in acceptance were observed based on testing purposes. 52.35% reported willingness to share health data. Both support for implementing genetic testing and the willingness to share health data correlated positively with knowledge and education levels. Geographical differences within the EU highlighted variations in attitudes toward personalized medicine and data sharing, with respondents from Southern Europe displaying higher odds than their peers in Central and Eastern Europe. The results emphasize the need for targeted communication and education strategies to enhance public understanding and trust in personalized medicine and health data sharing.

Key messages
• High support for genetic testing across the EU highlights the need for enhanced public education on personalized medicine to boost understanding and data sharing willingness.
• Geographical differences in attitudes toward personalized medicine in the EU suggest targeted strategies to build trust and knowledge, particularly in Central Europe.
Mapping the Policy Alternatives for Rare Cancer
Authors: Kostadinov K , Hristova-Atanasova E , Musurlieva N , Iskrov G , Stefanov R 
Published: October 2024

Abstract

Issue
This policy research addresses the issue of rare cancers in the European Union (EU). Rare cancers have an annual incidence rate of less than 6/100 000 and face challenges in diagnosis, clinical care, and research investment. Survival rates for rare cancers are lower compared to common cancer types, with significant variations among EU Member States.

Description of the problem
Policy frameworks for rare cancers are often fragmented and greatly vary across the EU. This study aims to develop a tool for assessing policy alternatives by reviewing existing national rare cancer policies, conducting interviews with experts, and analysing core stakeholders at the EU level.

Results
The main policy alternatives covered five domains: definition, registration, organisation of care, access to innovative therapies, and funding. Interviews revealed four policy options for each domain. Six core stakeholders were determined: patient organisations, healthcare professionals, researchers, industry, health legislators, and health authorities. A pilot policy assessment tool was developed on this basis.

Lessons
The pilot study coherently explored policy alternatives for rare cancers in the EU. Using these findings, policymakers and researchers can assess the impact of different policy options at a national level and contribute to the development of a unified EU policy framework for rare cancers. The pilot survey was also useful to collect input from the core stakeholders.

Key messages
• This study identifies key policy domains and feasible alternatives. A pilot preference assessment study based on these options can aid in EU policy development.
• Navigating rare cancer policy complexities demands collaboration and innovation. Engaging stakeholders and exploring alternatives can forge a more effective EU framework for addressing rare cancers.
An overview and comparison of approaches used for health policy analysis: What to use and when?
Authors: Berghuis-Mutubuki E , Hilderink H 
Published: October 2024

Abstract

Background
Public health challenges are complex and analyzing them requires advanced approaches such as, societal cost-benefit analysis (SCBA), health impact assessment (HIA), and strategic foresight. Analyzing health policy is a multifaceted process, and depends on, among others, the scope, approach, and policy goals. Given this complex and multifaceted nature, it is not always clear which approach to use, and how the approaches can complement each other. Therefore, health policy analysis could benefit from practical and explicit guidance regarding clear identification of cases and types of analysis. Hence in this paper we aim to develop a framework that can provide this guidance.

Methods
In this paper we describe the differences and similarities of three distinct health policy assessment approaches, SCBA (an economic evaluation approach that takes into account the impact on society as a whole), HIA (is a combination of tools that focus on evaluating the potential health effects of a given policy) and strategic foresight (a systematic and participatory approach used to anticipate and plan for future trends and uncertainties that may impact policy), their application, and how they can complement each other within the field of public health. A framework that can be used when deciding which health policy approach to use for a given case will be developed, based on existing literature, frameworks, and a case study.

Discussion
This paper contributes to knowledge on health policy analysis and towards efficiency and clarity in analyses conducted in this field.

Key messages
• There is little guidance regarding how to conduct health policy analysis.
• Clear guidance on which approaches to use and how they complement each other will contribute towards efficiency and clarity in health policy analysis.
The meta-governance of quality registries for public health
Authors: Kuhrn M M , Laschkolnig A , Degelsegger-Márquez A 
Published: October 2024

Abstract

Issue/problem
Healthcare-related planning and policy requires evidence, which in turn requires data. Generating sensitive, high-quality data is expensive. Given the constraints of routine or study-related data for quality monitoring, quality registries are commonly used. But when is it adequate, from a public health meta-governance point of view, to establish dedicated quality registries?

Description of the problem
Many countries have established public patient registries over time. The lack of a meta-governance framework complicates decision-making for establishing and funding dedicated quality registries. Simultaneously, legal advancements like the European Health Data Space may enhance the use of routine data in healthcare policy, potentially transforming both registry and meta-governance practices.

Results
We identified key meta-governance challenges, such as setting criteria for the creation, modification, or closure of registries, deciding on public funding and choosing between routine and specially collected data. We argue against using absolute thresholds like disease prevalence, advocating for a scorecard approach that evaluates epidemiologic reasoning, policy relevance, healthcare impact and factors like data availability and registry synergies.

Lessons
The EHDS will enable enhanced secondary data use, necessitating decisions on when to use routine versus specifically collected data. Decision-makers must consider sustainability, ethics, practicability and data linkability, while recognizing risks such as data quality limitations and potential bias from original data collection purposes.

Key messages
• The necessity for quality registries varies by case, serving specific policy questions. Optimizing funds and avoiding arbitrary decisions require a strategy based on a meta-governance framework.
• With the introduction of EHDS, the focus may shift more toward data curation and quality control, making it critical to align registry efforts with the broader health information system.