bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of ‘10,000 Steps Duesseldorf’ after one year: Results of a controlled intervention study
Authors: Pischke C , Schmitz E , Matos Fialho P , Vomhof M , Icks A , Lang A , Kuss O , Cardon G , Weyers S 
Published: October 2024

Abstract

Background
Despite marked decreases in physical activity (PA) in Germany due to the pandemic, population-based intervention strategies to tackle this public health problem remain sparse. The 12-month PA intervention ‘10,000 Steps Duesseldorf’ was composed of multiple components: at individual level, website to self-monitor steps; organizational level, step count competitions; environmental level, city-wide media campaign to increase awareness regarding benefits of PA and street signage indicating walking routes. This study aimed to replicate a research trial from Belgium addressing two questions: (1) Do individuals located in the city that the intervention is implemented in (Duesseldorf) engage in more PA compared to individuals located in the control city (Wuppertal) after one year? (2) Is the proportion of those reaching 10,000 steps/day higher in the intervention than in the control city after the intervention?

Methods
To investigate intervention effects, PA was assessed via pedometers in two representative samples of adults aged 25-75 years in the cities of Duesseldorf (intervention) and Wuppertal (control) at baseline (April 2021 - March 2022) and one-year follow-up (May-November 2023). Baseline differences in socio-demographic and health-related variables between intervention and control were adjusted for in a propensity score model with matching weights.

Results
627 adults participated in the study at baseline and 553 at follow-up (60% female, 60% intervention). The results of the propensity score analyses revealed that intervention participants walked 462 steps more (95% confidence interval: -146 to 1070) than controls at follow-up. However, the proportion of residents reaching 10,000 steps/day was comparable between intervention and control city after the intervention (26%, both cities).

Conclusions
Our results suggest an intervention effect on daily steps taken in Duesseldorf experiencing intervention activities compared to the control city after one year.

Key messages
• The complex PA intervention from Belgium was successfully adapted and implemented in Germany resulting in a higher level of daily steps taken in the intervention city (compared to control).
• A limitation of the study is that the recruitment process was hampered by the ongoing pandemic, resulting in selection bias, i.e. already active individuals were more likely to enrol in the study.
Effectiveness of a check-up for rehabilitation and prevention needs in primary care
Authors: Burchardi J M , Rossek S , Brünger M 
Published: October 2024

Abstract

Background
General practitioners play a central role in initiating rehabilitation and prevention services. However, systematic screening for rehabilitation and prevention needs has not been carried out in general practices so far. The legislation encourages the implementation and evaluation of so-called ‘check-up 45+’, which target individuals aged 45 and older. The study aims to evaluate the effectiveness of a check-up 45+ in primary care.

Methods
A pragmatic, randomized controlled trial was conducted in 26 general practices in the German states of Berlin and Brandenburg among patients aged 45 to 59 years (DRKS00028303). The control group (n = 695) received usual care plus a questionnaire on sociodemographic and health-related characteristics. The intervention group (n = 706) completed additionally the 2-page ‘screening 45+’, which captures rehabilitation and prevention needs in five dimensions. After algorithm-based ad hoc evaluation by practice staff, the general practice could modify the recommendation based on available information (e.g., diagnoses, social situation). Information and application documents were provided in case of identified needs. Applications (primary outcome) and approvals (secondary outcome) of rehabilitation and prevention services were recorded using routine data.

Results
In the intervention group, 64.2% were women, compared to 63.0% in the control group (mean age 52.1 (SD 4.3) and 52.5 (SD 4.4) years). In the intervention group, 85 applications (12.0%) for medical rehabilitation or prevention services were submitted within two months after the study participation, compared to 20 applications (2.9%) in the control group (p &lt; 0.001). The number of approvals for these services was 59 vs. 17 (p &lt; 0.001).

Conclusions
The application rate for rehabilitation and prevention services was significantly higher in the intervention group compared to the control group, with a relative risk difference by a factor of 4 and an absolute risk difference of 9.1%pt.

Key messages
• The implementation of a check-up 45+ in primary care leads to a higher rate of applications for rehabilitation and prevention services compared to usual care.
• The check-up 45+ may assist general practitioners in systematically identifying rehabilitation and prevention needs of their patients and in applying for these services.
Support mechanisms and obstacles for developing public health practitioners’ core competences
Authors: Parder M 
Published: October 2024

Abstract

Community health needs assessment is one of the central activities for local governments in Estonia, specifically under the health promotion strategic planning, and this includes developing health and well-being profiles for evidence-based public health promotion. For effective implementation of the profile, sufficiently trained public health practitioners are needed. Therefore, analysis of the needs of the additional study programmes according to the core competences of professional standard for health promotion was carried out among public health practitioners and the leaders of local governments. The study was based on the 19 semi-structured interviews carried out in 2022-2023 with leaders (10) and public health practitioners (9) in Estonian local governments. Based on the local government’s size, status of the health and well-being profile and the employment and educational background of the public health practitioner three sub-groups were developed. The collected data was analysed using qualitative content analysis with focus on support mechanisms and obstacles of core competences of public health practitioners. The respondents indicated the need for training on communication (leadership and advocacy) and analytical skills (evaluation and research). Core competence training is however limited by resources (time, energy, motivation, funding), employer expectations (overload at work) and working full-time. Training is supported by personal motivation (e.g., wish to stay competent, understanding the need for training), employer support (including flexible work arrangements), and curriculum support (funding is covered). The results indicate there is a need for flexible education as the need for developing and maintaining core competences emerges in practical work. The results can be used for developing the public health curriculum, to assess and provide training for public health practitioners to better meet the needs of the labor market in the future.

Key messages
• Local government employees performing health promotion tasks feel the need to upgrade various core competences: e.g., communication, management, data analysis and assessment.
• In health promotion, there is a growing need for flexible education, which creates challenges for higher educational institutions to meet the needs of the labor market.
Exploring health-related quality of life in Portuguese Informal Caregivers
Authors: Pedro A R , Brandão D , Raposo B , Cunha A S , Escoval A 
Published: October 2024

Abstract

Background
Caregiving can be associated with several adverse health impacts, such as in terms of mental health, health services use, or health-related quality of life (HRQoL). This study assessed HRQoL levels in Portuguese Informal Caregivers, and their relationship with caregiver psychosocial characteristics (e.g., perceived general and mental health; perceived level of support) and caregiving circumstances (e.g., caregiving duration, caregiving hours).

Methods
A cross-sectional study was conducted through an online survey directed to informal caregivers. HRQoL was measured using the Portuguese translation of the EQ-5D-5L. This instrument yields two values for HRQoL: a health profile (EQvalue) covering five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), and a visual analogue scale (EQvas). Bivariate analyses were performed and results with p-values below 0.05 were considered statistically significant.

Results
A total of 760 informal caregivers were surveyed (mean age 57 years (±9.9), 92.5% female, 41.5% at least university level, 44.4% works full or part-time). The mean total score for EQvalue (n = 733) was 0.8 (SD = 0.2). The mean total score for EQvas (n = 760) was 63.1 (SD = 21.5). The perceived general (p &lt; 0.001) and mental (p &lt; 0.001) health status, and the perceived access to healthcare (p &lt; 0.001) were associated with EQvalue score. Also, EQvalue score was found to be directly correlated with the perceived level of support (r = 0.142; p &lt; 0.001) and competence (r = 0,237; p &lt; 0.001), and inversely correlated with the number of caregiving hours per day (r= -0,150; p = &lt; 0,001) and the caregiving duration (r= -0,109; p = 0.008).

Conclusions
A significant relationship between caregiver HRQoL and several caregiver psychosocial variables was identified. Investing in and promoting the use of respite care services, as well as ensuring better access to healthcare for caregivers, appears important for improving caregivers’ HRQoL.

Key messages
• Improving caregivers’ access to healthcare and education or training programs (promoting a greater sense of competence) can be important in helping them maintain their quality of life.
• Increasing the availability and promoting the use of respite care services by caregivers can be important in helping them maintain their quality of life.
Influencers as a new source of health information: Insights from an Austrian youth survey
Authors: Engel E , Gell S , Heiss R , Karsay K 
Published: October 2024

Abstract

Background
Social media influencers (SMIs) have become the dominant source of health information for youth. While some SMIs may share valuable content, critics raise concerns that they lack expertise, have commercial motives, or hold personal biases. Yet, little is known about the epidemiology of the health influencer phenomenon. This study offers first insights into the reach of SMIs among Austrian youth, informing public health strategies to promote positive health behaviors in young populations.

Methods
A cross-sectional study was conducted with a representative sample of 1003 Austrian adolescents and young adults aged 15-25. Key research questions focus on the epidemiology of health influencers, engagement with SMIs, prevalent health topics, advertising, and perceived impact of SMIs on health.

Preliminary results
Participants estimate that over 51% of social media posts they see are from SMIs, and 75.37% follow at least one SMI. Additionally, 37.19% follow SMIs who specifically share health content, and 30.91% have purchased health products recommended by them (e.g., foods, supplements, beauty products). Moreover, 40.27% trust their followed SMIs for health information, similar to trust in traditional media (43.47%). Finally, over a third find SMI content beneficial for health (32.34%), while 29.20% find it harmful, and 33.83% neither.

Conclusions
The study provides first insights into the epidemiology of health influencers, revealing their extensive reach and positive reception among young people. Despite concerns about conflicts of interest or expertise, SMIs are perceived as trusted sources for health information and product purchases. This research enhances our understanding of influencers’ impact and informs public health strategies aimed at promoting positive health behaviors among youth. The insights from Austrian youth can inform future studies across Europe, deepening our understanding of the health influencer phenomenon and its implications for public health.

Key messages
• This cross-sectional study shows the high reach of social media influencers among youth and their important role as emerging sources of health information.
• The study breaks new ground by investigating adolescents’ engagement with health influencers, offering insights for public health to promote positive health outcomes among young populations.
Physical activity promotion as intersectoral planning in Milan Health Protection Agency
Authors: Calloni L , Elisa F , Bertolini E , Cassatella C , Pullano M , Melis C , Galessi L , Ieva B , Iannaccone N , Boni R 
Published: October 2024

Abstract

Issue/problem
Physical activity is a protective factor for preventing Noncommunicable diseases (NCDs) and, for this reason, it plays an important role in all the different guidelines for prevention and health promotion. The Italian Regional Prevention Plans and in particular the Lombardy one promote physical activity with a systemic approach, through both upstream and downstream actions to encourage the role of communities.

Description of the problem
Based on the regional plan, the Health Protection Agency (HPA) of the Metropolitan City of Milan developed locally validated actions and best practices for the promotion of physical activity, through the cross-sectoral involvement of different stakeholders (health system, companies, universities, local authorities, sports associations, etc.).

Results
Physical activity is embedded in all lines of health promotion activities in local planning documents. Sustainable and active mobility activities have been implemented in companies and schools with a comprehensive approach. Validated regional programs (Pedibus, Walking Groups, ecc.) have been implemented in the local community, along with the construction of permanent local laboratories for physical activity, structured through the development of specific territorial networks and providing for integration with the socio-sanitary setting.

Lessons
Promoting physical activity becomes an opportunity to both consolidate territorial networks and to develop evidence-based health promotion actions able to meet the different health needs of the population and to produce a structural change in living contexts.

Key messages
• Physical activity is both a protective factor for health promotion and a tool for implementing intersectoral and equity-oriented system actions from a life-course perspective.
• Promoting physical activity becomes an opportunity to consolidate territorial networks.
How does a Smoke-Free campus initiative generates changes in smoking? A theory-based evaluation
Authors: Gnonlonfin E , Gallopel-Morvan K , Breton E 
Published: October 2024

Abstract

Background
Smoke-free campuses (SFC) prohibit smoking and vaping on all university grounds and for all users. Despite their effectiveness in reducing smoking prevalence, passive smoking, and denormalizing tobacco use, the complex interplay between the programme activities and their impact on users and campus environments remain unclear. This study aims to improve our understanding of the transformation processes associated with SFC expected outcomes.

Methods
We conducted a retrospective qualitative study on the first SFC implemented in France by the EHESP School of Public Health. Guided by Mayne’s theory of change framework that includes ten dimensions of an impact pathway (e.g. activities, reach/reaction, capacity, behaviour changes, etc.), the research examined the chain of effects and hypotheses driving this SFC. Our dataset included internal documents (e.g. minutes of meetings, administrative documents) and semi-structured interviews with stakeholders (n = 16) involved in the development and implementation of the analysed SFC. Data is currently being analysed.

Results
Initial results suggest that the EHESP’s SFC activities included communication initiatives, student ambassadors, cessation support for smokers, installation of smoking shelters on campus periphery, etc. These activities were geared on capacity change (e.g. securing support and compliance among campus users, reduce smoking opportunities, promoting the use of cessation aids) and were intended to drive behaviour change (reducing smoking and facilitating cessation among students and staff). The goal of this SFC was not only to impact behaviors but also to educate future health service managers at EHESP to implement SFC policies and set an example for other institutions in France.

Conclusions
This study identifies some of the transformations that activities of the EHESP’s SFC can generate in students and staff in order to fulfil its outcomes. It also highlighted its expected impact on other institutions.

Key messages
• Understanding how a smoke-free campus generates its changes is essential in facilitating transferability of experiences to other universities.
• Smoke-free campus policies can also generate a broader impact on other institutions.
Exploring co-creator’s experiences: a multiple case study addressing workplace sedentary behaviour
Authors: McCaffrey L , Vogelsang M , de Boer J , McCann B , Giné-Garriga M , Dall P 
Published: October 2024

Abstract

Co-creation is an innovative approach for addressing complex public health issues. Co-creator’s experience of participating in co-creation can impact engagement yet research investigating co-creation experience is limited. A better understanding of co-creation experiences can inform optimal design and implementation of the co-creation process. This study’s objective was to conduct a cross-case analysis of co-creator’s experiences from 3 co-creation processes aimed at addressing workplace sedentary behaviour within 3 different small-to-medium sized companies in Scotland. Thirty-one co-creators were involved in the case study companies from Oct 2022 to Jun 2023. Data sources included observations, interviews, and researchers’ reflections. A multiple case study design enabled the exploration of co-creator’s experience across cases. A within-case thematic analysis was conducted to develop a deep understanding of cases before comparing findings between cases using Miles and Huberman’s guide to cross-case analysis. Preliminary findings indicate co-creation experiences are associated with events occurring before, during and after the co-creation process and are influenced by company context (i.e., company structure, resources and demands) and co-creation context (i.e., design and facilitation of the process). Co-creators had various motivations for their involvement. During the co-creation process there was a range of common experiences such as a sense of belonging, enjoyment and frustration. After co-creation, there was an overall sense of satisfaction accompanied by positive outcomes, including an intention to adopt healthier behaviours. Insights into co-creator’s experiences support the use of co-creation for addressing workplace sedentary behaviour. The findings have implications for researchers planning co-creation processes at small-to-medium sized companies. Tailoring co-creation to co-creator’s needs and wider company context can enhance its innovative potential.

Key messages
• This study’s significance lies in its qualitative cross-case analysis of co-creation experiences which enhances research rigour and enables contextualised generalisation.
• The innovative potential of co-creation can be enhanced by tailoring it to meet the needs and preferences of the co-creators and considering the wider company context.
Analysis of parents’ needs regarding sexual and reproductive health issues of their children
Authors: Gazzetta S , Iop I , Cherpessi S , Cudiz I , Bastiani E , Pascut S , Brunelli L , De Carlo L , Parpinel M 
Published: October 2024

Abstract

Background
Promoting sexual and reproductive health is a key intervention for young people’s health and well-being. Studies have shown that young people have a need to be supported by a strong network and that parents are considered an important source of information. The aim of our work was to understand the needs and critical issues parents face when raising the topic of sexual and reproductive health with their children in order to strengthen their skills and provide the best tools to support young people.

Methods
A qualitative focus group research methodology was used; a sexual psychologist facilitated the meetings. Parents of children attending secondary schools in Udine (Italy) in the 2022/2023 school year were invited to participate in the project. The meetings were recorded and transcribed verbatim by two independent researchers. Following an inductive method, recurring themes were extrapolated to represent the main categories and more specific subcategories.

Results
46 parents participated in the focus group; 76% of them had no experience with sexual and affective education. Parents felt that sex education was useful in providing accurate information, preventing risks and promoting respect and relationships with others; however, there were concerns that the values taught were not consistent with those of the family. The topic was found to be difficult to discuss with children, both in terms of technical/scientific aspects and addressing issues such as gender identity and sexual orientation. Parents would like to understand what the right communication key is to discuss with their children in an atmosphere of trust.

Conclusions
Parents recognized the importance of the topic and saw the need to deepen some aspects, especially in terms of relationship and communication. The results of this work will be a useful starting point for the creation of ad hoc pathways aimed at parents to strengthen the relationship with their children.

Key messages
• Parents want to overcome difficulties by finding the right key to communicate with their children.
• Supporting young people and their network to promote sexual and reproductive health is essential.