bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving intersectoral working in schools: learning for the future from the COVID-19 pandemic
Authors: Gray N J , Manandhar S , Chabot C , Jourdan D 
Published: October 2024

Abstract

Background
The COVID-19 pandemic highlighted the challenge for school staff to integrate protective health measures into their academic daily responsibilities. The aim of this abstract, within a wider study of safe school re-opening, is to analyse improvements proposed for intersectoral working in schools by health and education professionals, based on their experience of the pandemic.

Methods
In 2021, an online survey was conducted in 6 languages with education and health professionals, followed by optional online semi-structured interviews. These methods explored the: 1-effect of the pandemic on schools/pupils/teachers; 2-reorganisation of schools; 3-experience of implementing infection control measures in schools; 4-intersectoral working; 5-important resources for keeping schools open. Interviews were transcribed verbatim and translated into English where needed. A directed content analysis was undertaken of interview transcripts and free-text survey responses regarding intersectoral working perspectives.

Results
The results are based on a combined analysis of data from 2072 survey responses from health and education professionals from 73 countries and 32 follow-up interviews (18 education professionals and 14 health professionals from 25 countries). Five themes of improvement for the future were identified: create formal coordination between the two sectors to support intersectoral working; that the health sector provide clear information and guidelines; bring health staff into school (especially medical staff); communicate more across all stakeholders (community, parents, students); and a call for capacity-building among education professionals by the health sector.

Conclusions
From the experience of the COVID-19 pandemic, the public health sector should lead the development of collaborative structures, implementation strategies and activities to support intersectoral alliances in the school environment for everyday well-being, ready for future health crises.

Key messages
• During the COVID-19 pandemic, many education and health professionals felt the need for more - and strengthened - collaboration in schools for future health crises.
• Public health professionals could take a leading role in this strengthening strategy, supporting intersectoral alliances and promoting capacity-building in order to improve well-being and resilience.
Parental concerns about the risks associated with harmful industries for their children
Authors: Pitt H , McCarthy S , Hume E , Arnot G , Thomas S 
Published: October 2024

Abstract

Background
Harmful industries including tobacco, vaping, alcohol, and gambling are causing significant harms to communities, including children and young people. These industries try to resist reform by deflecting blame and shifting responsibility, often by suggesting that parents need to educate and protect their children. This study aimed to explore parents’ current concerns and risks relating to these industries and their children, and their attitudes about responses to prevent harm.

Methods
Australian parents (n = 455) who had at least one child aged between 11-17 years were invited through a panel company to complete an online qualitative survey. Participants were asked about their concerns and risks relating to each product, if and what they discuss about these products with their children, and who was responsible for protecting children from these industries. Thematic analysis was used to analyse the data.

Results
Parents were concerned about the short- and long-term consequences of their children engaging in these products. Many parents tried to talk to their children about the risks, however also believed that their child was influenced by their peers, and messages they see on social media. Although parents recognised their own role in protecting their children from harmful industries, they thought that a collective approach was needed, which included greater regulations and more effective education.

Conclusions
Parents are trying their best to protect their children from the harms associated with tobacco, vaping, alcohol, and gambling. However, they feel as though they are unable to counter the range of ways that their children are exposed to and influenced by these industries. Governments need to listen to parents and implement comprehensive regulations restricting marketing practices and increase evidence-based education that focuses on the tactics and harmful practices of these industries.

Key messages
• Harmful industries try to shift blame and put responsibility for protecting children onto parents. However, parents feel they are unable to counter the positive messages that their children see.
• Parents are concerned about the range of risks these products could have for their children and want to see a collective response to address this issue, including government policy intervention.
Developing an Evidence-Based Primary Cancer Prevention Repository: insights from the PIECES project
Authors: Breunese J , Walters B H , Troelstra S , Willemsen M , Gorini G , Caini S , Hensen N , van Nassau F , Vis C 
Published: October 2024

Abstract

Introduction
Up to 40% of cancer cases could be avoided through effective primary prevention. However, cancer prevention tends to be fragmented across Europe, leading to geographical health differences. The dissemination and scale-up of effective primary cancer prevention interventions may address this. Although effective cancer prevention programs exist, finding them and their materials (especially regarding implementation) can be challenging. Repositories of evidence-based interventions provide insight into “what is out there” and can support dissemination within and across national borders. The PIECES project aims to develop and disseminate a repository of evidence-based primary cancer prevention programs adaptable to European contexts, with information to aid adaptation and implementation across countries.

Methods
The development of the PIECES repository has been informed by established repositories such as NCI’s Evidence-Based Cancer Control Programs. The project team developed a scoring sheet with a selection of items that could be included in the repository. All participants rated each item on relevance and applicability and provided comments and suggestions. A final framework, including a set of minimal requirement items, was agreed upon during three online consensus building meetings.

Results
We created a repository of evidence-based primary cancer prevention interventions targeting modifiable risk factors suitable for implementation in European healthcare settings. This 22-item repository provides information about an intervention’s logic model, implementation practices, and appraisal of published evidence of effectiveness.

Conclusions
This repository is innovative as it includes practical information and tools to facilitate implementation. While initially built to serve the PIECES project, the repository is designed to be a valuable tool for European policymakers, researchers, and implementers. Lessons learned from this process will inform future developers.

Key messages
• A comprehensive cancer prevention intervention repository avoids “reinventing the wheel” and allows for more efficient use of existing interventions by building upon the best available evidence.
• The ongoing efforts of the PIECES project represent a significant contribution to reduce cancer prevention disparities and to facilitate the adoption of evidence-based interventions in Europe.
Burnout and perceived stress among health visitors in Hungary
Authors: Gyulai A , Ötvös A , Kiss-Tóth E , Rucska A , Szokol P , Lakatos C S 
Published: October 2024

Abstract

Background
In Hungary, the health visitors are responsible for the health promotion of families and communities. However, as a consequence of the structural reorganization of the health visitors service and the emotionally situations (e.g. the war in a neighboring country, the economic crisis) that have arisen, there has been an increased prevalence of chronic stress, burnout and career abandonment among health visitors. The objective of the cross-sectional study was to ascertain the prevalence of burnout among health visitors and to examine the relationship between burnout and job stress.

Methods
The data was collected via an online questionnaire tool. In addition to questions pertaining to sociodemographic data, the questionnaire employed the Maslach Burnout Inventory (MBI Human Services Survey) and the Perceived Stress Scale (PSS). Hypotheses were tested using analysis of variance (ANOVA), Kruskal-Wallis test, Dunett test. The source population of the study was health visitors. A total of 178 health visitors constituted the target population.

Results
The average age of the study participants was 45.2 years. It can be observed that health visitors who perceive less appreciation from their colleagues, employers and caregivers are more likely to experience higher levels of burnout and stress (p &lt; 0.05). The lowest levels of stress were observed in school health visitors, while the highest levels were seen in health visitors covering villages (p &lt; 0.05). Those who remained in the field due to a passion for working with families and children, a sense of vocation, and a desire to help others exhibited lower levels of burnout (p &lt; 0.05). The high number of clients served by health visitors was found to increase burnout and stress levels (p &lt; 0.05).

Conclusions
The findings of this research will assist in the comprehension of the phenomenon of burnout among health visitors, thereby enabling the development of more efficacious methods for the treatment and prevention.

Key messages
• Preventing burnout among health visitors is a priority, as it affects their work and their relationship with the families they care for in the short and long term.
• Health visitors frequently encounter families in crisis during the course of their work, necessitating regular supervision to maintain their mental health.
Barriers and facilitators of implementing a health literacy-based intervention in Portugal
Authors: Gama A , Kinaan W , Marques P , Peruhype R , Dias S 
Published: October 2024

Abstract

Background
Despite the effectiveness of cervical cancer screening (CCS) in reducing mortality rates, disparities persist in access to screening among women with low health literacy, often termed ‘hard-to-reach women’. Health literacy-based interventions can help promote screening uptake. Based on a health literacy-based intervention for CCS implemented in Lisbon with the support of community workers, this study explores barriers and facilitators of the implementation process as perceived by these actors.

Methods
The intervention consisted of educational sessions on cervical cancer and CCS aimed at 246 women, implemented in community settings in 2023-2024. Within a mixed-methods approach, a pre-and post-intervention survey was applied to assess willingness to screen, and two focus groups were conducted with 10 community workers on their implementation experiences. Descriptive analysis and content analysis were performed where appropriate.

Results
Of the 665 women invited, 37% were enrolled in the sessions; 91% completed the follow-up. Community workers valued the informative content as adequate to raise awareness. Implementation facilitators included women’s trust in collaborating organisations and a complement of peer recruitment. Challenges included the additional workload of community workers, finding creative strategies to engage women, scheduling the sessions that best suited women’s time demands, and limited spaces to accommodate several group sessions. Proposed solutions to overcome barriers included increasing the time availability of community workers to support participants’ recruitment and session delivery, conducting itinerant and open sessions, and integrating the sessions within the organisation’s health-promoting activities.

Conclusions
Health literacy-based interventions are helpful in raising CCS awareness. Tailored interventions sensitive to context demands may contribute to successful actions.

Key messages
• Health literacy interventions can be key to promoting cervical cancer screening among hard-to-reach women.
• Tailored community-based interventions may help address barriers to cervical cancer screening.
Adapting, expanding and embedding community and culture into health ecosystems
Authors: Trigwell J , Gamsu M , Bagnall A M , South J , Mosteanu O , Redwood-Turner B , Bharadwa M , Harris J 
Published: October 2024

Abstract

Background
Community anchor organisations (CAOs) work with communities who experience health inequalities and disadvantage, providing a range of activities and services to meet individuals’ needs in an integrated way. This study explored how CAOs use art, cultural and nature-based activities as part of their work to respond to the needs of people facing inequalities and considered how activities can be scaled in this health setting.

Methods
This study used community-based participatory research within a case study approach to work with four purposively sampled CAOs. Participants were community members, volunteers, staff, trustees, partner organisations and commissioners. Data collection methods included: document analysis, interviews (n = 45), workshops (n = 5) and focus groups (n = 11). This study was also supported by data collected by trained community researchers (n = 18). Framework analysis was conducted for within- and cross-case analysis.

Results
In the context of CAOs, the delivery of art, cultural and nature-based activities were found to be an important mechanism for developing trusted relationships with marginalised groups, who may lack trust in statutory services and health focused activities. Other facilitators to community engagement were the CAOs’ longevity, localness and co-location of services within a trusted and familiar place that connect people to personalised support. Barriers to scaling up included funding models as well as insufficient dialogue and understanding between CAOs and the local public health ecosystem.

Conclusions
CAOs have long term trusted relationships with disadvantaged communities and are influential in connecting individuals with projects and services. Findings suggest that the effectiveness of action to address inequality through art, cultural and nature-based activities could be improved if the role of CAOs was recognised more coherently in place-based public health plans.

Key messages
• Creative activities enable meaningful engagement with disadvantaged groups within place-based settings.
• CAOs must be recognised more coherently in place-based strategies to reduce health inequalities.
Factors Influencing Quality of Life in the Disabled: Focus on Household Members Mental Health
Authors: Choi E H , Cho J H , Yeob K E , Kim S Y , Lee Y S , Park J H 
Published: October 2024

Abstract

Background
Household members of the disabled experience various difficulties such as social isolation and the burden of caregiving. These difficulties can lead to mental health problems, which in turn affect the quality of life(QoL) of the disabled. Research on the QoL of the disabled is ongoing, but there are few studies addressing the mental health of household members. We aimed to investigate the impact of household members’ mental health on the QoL of the disabled.

Methods
We used data from the 2021 Disability and Life Dynamics Panel(nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of household members’ mental health on the QoL of the disabled by using correlation analysis and multiple regression analysis adjusted for gender, age, income level, employment status, education level, activities of daily living, participation in social activities, type and severity of disability, presence of multiple disabilities, and health status.

Results
The level of depression(r=-.316, p&lt;.0001) and self-esteem(r=.248, p&lt;.0001) of household members were found to be significantly correlated with the QoL of the disabled. The level of depression of household members had a significant negative impact on the QoL of the disabled(β=-.153, p&lt;.0001), while self-esteem had a significant positive impact(β=.144, p&lt;.0001). It was found that the level of depression had a greater impact on QoL than self-esteem.

Conclusions
Lower levels of depression and higher levels of self-esteem of household members are associated with higher QoL for the disabled. Improving the mental health of household members is crucial in improving the QoL of the disabled, enabling them to interact more positively with society. Additionally, as 27% of household members experience depressive issues, enhancing their mental health positively impacts on the overall well-being of families with disabilities. Efforts to enhance household members’ mental health are crucial.

Key messages
• Household members’ mental health significantly influences the quality of life of the disabled.
• To improve the quality of life of the disabled, strengthening programs for promoting the mental health of household members and policy improvements are necessary.
Cardiac risk confrontation in primary care as a teachable moment towards improved health outcomes
Authors: Gefeke L M , Brust M , Van Hattum N E , Kiefte-de Jong J C 
Published: October 2024

Abstract

Background
Urgent life events, such as acute coronary events, can evoke a teachable moment (TM) for lifestyle change. This study aims to investigate whether less urgent events, such as being confronted with an increased risk of cardiovascular disease, can evoke a TM, what psychosocial factors are associated with it, and whether experiencing such a TM predicts improved health outcomes.

Methods
The study included 114 patients who were informed about their elevated cardiovascular risk during a primary care visit. Participants completed a survey assessing whether they experienced a TM and several psychosocial factors linked to experiencing it: perceived risk, affective impact, changed self-concept. Participants monitored their weight and blood pressure for six months using an at-home self-monitoring device. Univariate and multivariate regression analyses were conducted to examine the associations between the psychosocial factors and the lifestyle change intentions with changes in blood pressure and weight.

Results
Of the participants, 55.3% experienced increased lifestyle change intentions. Lower risk perception ((B = -0.27; CI = -0.39-(-0.15)) and higher change in self-concept (B = 0.34; CI = 0.23-0.44) were associated with higher intention to change lifestyle. Higher risk perception (B = 0.23; CI = 0.06-0.42) and higher change in self-concept (B = 0.54; CI = 0.37-0.72) predicted a lower weight reduction at six months. A higher change in self-concept predicted a higher blood pressure reduction (B = -3.32; CI = -6.55-(0.09)). Lastly, a higher lifestyle change intention predicted bigger reductions blood pressure (B = -5.04; CI = -9.08-(-0.29)).

Conclusions
Results suggest that less urgent cardiac events, such as a confrontation with an increased cardiac risk, can be experienced as a TM that urges lifestyle change intentions and affects health outcomes. Risk confrontations in primary care therefore offer a unique opportunity to provide lifestyle counseling at the right moment.

Key messages
• A confrontation with an increased cardiac risk in primary care can be experienced as a teachable moment.
• Experiencing a teachable moment after a cardiac risk confrontation in primary care affects health outcomes.
Comparing Italian hospital discharge and mortality data: implications for epidemiological research
Authors: Logan K , Corbetta A , Ieva F , Di Angelantonio E 
Published: October 2024

Abstract

Background
In Italy, regional governments maintain data warehouses of linked administrative health data (AHD) linked to demographic information including mortality. Legal reporting pathways for death certificate detail bypass the Region, resulting in significant amounts of missing data on cause and location of death in regional AHD warehouses and limiting epidemiological research on mortality and incidence. In this study, we determine for the first time in Italy the degree of agreement between last hospital diagnosis and primary cause of death, and how that agreement changes over time. Previous studies have found agreement ranging from 40% to 60%.

Methods
The COV-CVD cohort is comprised of 7.3 million adults aged 30+ from the Lombardy region of northwest Italy, representing all Lombardy residents registered with the health system as of 31 December 2019. Concordance was assessed using the first three characters of the reported cause of death (ICD-10 codes) and primary diagnosis at last hospitalization (converted from ICD-9CM).

Results
In the COV-CVD cohort there were 401,085 deaths between 1 January 2020 and 23 June 2023. Cause and location of death is missing for 50% and 54% of these deaths, respectively. 60% of deceased individuals had a hospitalization in the year before their death. Agreement between primary diagnosis at last hospitalization and cause of death was 27% overall and 40.5% for deaths in hospital. Missing location of death was reduced from 54% to 26%.

Conclusions
When using AHD from Italy, primary diagnosis at last hospitalization prior to death is not an appropriate proxy for cause of death, even when the death occurred in hospital. Different coding systems (ICD-10, ICD-9CM) further complicate comparisons and definitions in observational studies.

Key messages
• In Italy, primary diagnosis at last hospitalization before death is not an appropriate proxy for cause of death.
• Poor linkage of mortality and health data limits epidemiological research.