bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empowerment and interprofessional collaboration in health promotion centre Murska Sobota
Authors: Atalaia A , Fischill-Neudeck V , Betznec P , Gorjan R , Peinhaupt C , Wiesinger H-P , Habacher W 
Published: October 2024

Abstract

Background
Health promotion centres (HPCs) were introduced in Slovenian primary health care centres to provide interventions against risk factors for noncommunicable diseases (NCDs). HPCs integrate a multidisciplinary and community-based primary care approach to the prevention of NCDs and provide free lifestyle intervention programmes. This study aims to explore the perspectives of health care professionals on promoting health of local community members, as well as their perceptions of interprofessional collaboration in HPCs.

Methods
Two group discussions were conducted with a total of 11 health care professionals at the HPC Murska Sobota. Data collection was accompanied by a dual role interpreter in accordance with the principles of cross-language qualitative research. The data was transcribed, semantically translated and thematically analysed.

Results
Health care professionals emphasize the importance of health-related empowerment of individuals for the success of health promotion activities and therefore for the improvement of individuals’ quality of life. This is based on shared decision-making, self-management and educational measures in a combination of population- and individual-based approaches. The need for efficient interprofessional communication, characterized by a flat hierarchy, is stressed. Structured cooperation with other health care facilities, as well as close collaboration with communities and local media, are described as crucial for reaching all individuals and promoting health equity.

Conclusions
Interprofessional collaboration, health-related empowerment of individuals and collaboration with local communities are fundamental for the success of health promotion activities, achieving health equity and preventing NCDs. Understanding how these activities are implemented from the health care professionals’ perspective can help other health facilities developing and improving local health promotion strategies.

Key messages
• Slovenian health care professionals see interprofessional collaboration as fundamental for the implementation of health-promotion strategies.
• Health-related empowerment of individuals and collaboration with local communities play an important role in achieving health equity in health promotion activities.
Enhancing stroke awareness in schools: efficacy of the HOBIT program in Czechia’s disadvantaged areas
Authors: Volevach E , Maršálková H , Mikulik R 
Published: October 2024

Abstract

Background
For stroke treatment to be effective, it must be given as soon as possible. Delays are often caused by stroke bystanders failing to recognize symptoms and activate emergency medical services (EMS). This is especially a problem in socially excluded localities. This study evaluated the efficacy of a school-based intervention (HOBIT) in improving determinants and behavior intentions of EMS activation for suspected stroke in Czech socially excluded localities.

Methods
The quasi-experiment was conducted from May to June 2023 in the Moravian-Silesian region, Czechia. Schools were allocated to the intervention or control group (1:1). The HOBIT is a school-based intervention used to change health-seeking behavior when stroke is suspected. The primary outcome was the percentage change from the pretest to the follow-up test in the intervention group compared to the control group. The primary outcome was assessed in 4 domains: 1) knowledge, 2) behavioral intentions, 3) self-efficacy, and 4) outcome expectations. The intervention and control groups were compared using an unpaired t-test.

Results
We recruited 138 students aged 10-16 from 4 schools. The absolute differences in improvement between the control and intervention groups were 18% (95% CI 9-26, P &lt; 0.001) for knowledge, 15% (95% CI 2-26, P = 0.01) for behavioral intentions, 6% (95% CI -4-15, P = 0.24) for self-efficacy, and 13% (95% CI 5-21, P &lt; 0.001) for outcome expectations. The subgroup analysis showed that the intervention effect on self-efficacy, outcome expectations, and stroke behavior intentions was significant only in females.

Conclusions
The HOBIT improved stroke determinants and behavior intentions of EMS activation at schools in socially excluded areas. This study presents a health promotion practice that has the potential to improve stroke outcomes on a community level. It underscores the potential of school settings as an appropriate way to reduce health inequalities in socially excluded communities.

Key messages
• The HOBIT intervention improved determinants and behavior intentions of EMS activation for suspected stroke among students in socially excluded localities.
• The study underscores the potential of school settings in reducing health inequalities and improving stroke-related outcomes in socially excluded localities.
Facilitators and barriers to improving beverage consumption among primary school children in Belgium
Authors: Desbouys L , Assakali W , Thiébaut I , Castetbon K 
Published: October 2024

Abstract

Background
School is seen as a relevant setting to intervene in children’s health behaviour, including their beverage consumption. A randomized controlled trial (DRINK) has been implemented to compare nutrition and sustainability-based interventions to reduce sugary beverages and to increase tap water consumptions among primary school children in French-speaking Belgium. The aim of this qualitative study was to describe the context before the intervention implementation and to identify the facilitators and barriers to implementing the project.

Methods
In 2021, the 48 schools included in the trial responded to a semi-structured interview prior to the intervention, and 30 were interviewed one year later. School characteristics (including socioeconomic index, SEI) and contextual components were summarised. The qualitative corpus was analysed using thematic content methods to identify emerging themes, then classified into obstacles and facilitators.

Results
Of the 48 schools, 70.8% were Walloon, 76.6% had a medium or high SEI, and 41.7% included less than 90 pupils. The majority had already implemented nutrition and sustainable development initiatives before the trial. While taps were available in classrooms and reusable bottles were used, the initiatives could be extended, e.g. to increasing the number of water points. The main facilitators were the interest to receive additional support by the schools already involved in other projects, and the flexibility of the intervention. The main barriers were related to lack of access to tap water; insufficient support for the implementation of the intervention; and poor availability of school staff to get involved in such a project.

Conclusions
Alongside the main trial findings, understanding the facilitators and barriers will enable the intervention to be further adapted and extended. Considering the school context and perceptions is essential to ensure effective and durable school health initiatives.

Key messages
• Largely involved in promoting nutrition and sustainability, the schools were keen to receive support to continue.
• Strengthening access to water, communication and support for schools are essential.
Unlocking Health Literacy: investigating Parental Health Literacy and Child Weight Outcomes
Authors: Rosário R , Silva M J , Duarte A , Martins J , Martins S , Augusto C 
Published: October 2024

Abstract

Background
While parental health literacy (HL) is widely recognized as crucial for child health, research on its impact on children’s weight-related outcomes remains limited. This study aims to fill this gap by investigating the associations between parental HL and children’s anthropometric measurements, with a focus on child BMI Z-score and waist-to-height ratio (WHtR).

Methods
As part of a cluster randomized trial in primary schools serving vulnerable populations, 735 children (51.7% boys, mean age 7.7 years) participated. Parental HL was assessed using the HLS-Q12 questionnaire, comprising 12 items. Health literacy levels, standardized from 0 to 100, were categorized into ‘inadequate,’ ‘problematic,’ ‘sufficient,’ and ‘excellent’ HL. General HL and three specific domains-health promotion, disease prevention, and healthcare-were computed. Children’s weight, height, and BMI were measured following standardized procedures. Regression analyses examined HL’s impact on BMI Z-scores and WHtR.

Results
Parents with higher HL in disease prevention and health promotion had children with significantly lower BMI Z-scores, even after adjusting for parental education and children’s sex sex [-0.010 (-0.18; -0.0001) and -0.10 (-0.019; 0.01). Similar associations were found for WHtR [-0.0004 (-0.001; -0.0001)]. Parents with excellent HL in general and health promotion had significantly lower WHtR [-0.027 (-0.046; -0.008)] and BMI Z-score [-0.74 (-1.2; -0.28)].

Conclusions
This study highlights the significant role of parental health literacy in shaping children’s weight-related outcomes. Higher levels of parental HL in disease prevention and health promotion were linked to lower BMI Z-scores and WHtR in children, independent of parental education and children’s sex. Enhancing parental HL, alongside promoting healthy behaviors and environments for children, could lead to more effective approaches for addressing this public health issue.

Key messages
• Parental health literacy is associated with children’s weight outcomes, emphasizing the need for HL-focused interventions.
• Higher parental HL is associated with lower child BMI Z-scores and waist-to-height ratios, highlighting potential HL’s role in combating childhood obesity.
Needs and opportunities for developing health and well-being profiles in Estonian local governments
Authors: Riisenberg L 
Published: October 2024

Abstract

The creation and implementation of health and wellbeing profile, an evidence-based framework for planning health promotion as holistic process, is the responsibility of public health practitioners, who tend work part-time and sometimes lack professional competences. The current study maps the level of awareness, attitudes, needs and possibilities of local government leaders and public health practitioners to develop and implement profiles effectively in Estonian local governments. Semi-structured interviews with leaders in local governments (10) and practitioners (9) were conducted in 2022-2023. Data was analysed using qualitative content analysis. Sample included representatives from all Estonian local governments (79 in total) and were categorized into subgroups based on local governments size, status of the profile, public health specialist employment, and educational background. Preliminary results indicate that leaders find as a supportive factors for enabling and encouraging profile compilation process for example: mandatory requirement; motivated implementors; well organized and effective workplan. Specialists find supportive factors to be cooperation on the national level, good communication practices and joint responsibility. Barriers for health promoters are the lack of time, motivation, financial resources, stakeholders understanding and meaningful action. The first qualitative study on these topics in Estonia highlight that creating a profile is supported by previous positive experience and have per contra an opposite negative effect to start the process. In general, the profile was considered necessary for helping identify problems and support decision-making processes for managing resources, however, assessment whether the profile should be obligatory is needed. In addition, there is a need for further support for the evidence-based decision-making process on the local level in health promotion by offering education and guidance from the national level.

Key messages
• Knowledge about the importance of public health, barriers and decision-making principles of local government leaders and specialists helps to develop interventions based on actual needs.
• Continuously updated health and well-being profile ensures sustainability of health promotion action and is useful knowledge to policymakers, local government leaders and public health practitioners.
Exploring factors of HPV self-sampling acceptance:a qualitative study with hard-to-reach women
Authors: Kinaan W , Gama A , Heleno B , Marques P , Vega Crespo B , Ortiz J , Verberckmoes B , Vermandere H , Degomme O , Dias S 
Published: October 2024

Abstract

Background
Cervical cancer disproportionately affects socially disadvantaged women, who tend to be underscreened and are generally called “hard-to-reach”. HPV DNA testing based on self-sampling test is an alternative strategy to address women’s low screening uptake and reduce inequalities. Psychosocial factors like self-efficacy, ethicality, and testing conditions should be considered when assessing the acceptability of HPV self-sampling. However, research on the acceptability of HPV self-sampling is scarce among hard-to-reach women. Our study aims to explore self-efficacy beliefs, perceptions of how well HPV self-sampling fits participants’ values and their preferred testing conditions and understand how these factors influence the acceptability of HPV self-sampling test among hard-to-reach women.

Methods
This qualitative study used a semi-structured guide based on three constructs of the Theoretical Framework of Acceptability. Focus group discussions (FGD) were conducted with n = 63 hard-to-reach women in Portugal (2 FGD), Ecuador (4 FGD), and Belgium (3 FGD). Data were analysed using deductive content analysis.

Results
While some women viewed HPV self-sampling as acceptable, others questioned its compatibility with their ethical views and moral principles, stressing that the test cannot replace the clinical examination. Participants held conflicting views, with some expressing confidence in their sampling abilities while others feared making errors when taking the sample. Cultural disparities in preferred testing conditions emerged: Ecuadorian women preferred solo testing, while those in Europe preferred assistance.

Conclusions
This study indicated ambivalent attitudes towards self-sampling. Further research on HPV self-sampling acceptability is needed to explore socio-cultural nuances. Our study emphasises the importance of culturally attuned interventions to address these populations’ needs and reduce inequalities.

Key messages
• Hard-to-reach women harbour conflicting views about self-sampling.
• Screening policies may include opportunities for self- and clinician sampling.
Evidence-Based Programs in France: Insights and Strategies for Implementation Support
Authors: Delescluse T , Berdougo F , Van Hoye A , Krache A , Villeval M 
Published: October 2024

Abstract

Issue
In France, both regional and national health institutions increasingly support and fund the implementation of evidence-based programs (EBP), promoted at the national level by the French Public Health agency.

Description of the problem
practitioners who implement EBP face several operational questions: scaling issues, implementation in specific and varying contexts, integration and adjustment to daily regional practices.

Results/effects
In 2023, the French Society for Public Health initiated a collaborative effort to create a platform for discussion among practitioners, researchers, and decision-makers involved in EBP implementation. The first step was to assess EPB implementation experiences, using 3 types of data: an analysis of 6 documented EBP (capitalization works), an online questionnaire answered by 29 stakeholders, and four focus groups with funders, researchers, practitioners, and institutions. Data analysis was based on thematic content analysis and structural data analysis.

Lessons
Different ways to implement EBP were identified through a typology. The results highlight favorable conditions and levers for EPB implementation in France: • Facilitate access and adoption of EBP by concerned stakeholders, including through clear communication and knowledge sharing; • Strengthen and value support for implementation support (i.e., providing necessary resources and continuous monitoring); • A ‘favorable environment’ is also required (i.e. regional context acceptability and information on program themes or topics); • Breadthen perspectives and promote mutual learning through sharing and comparing implementation experiences across regions; • Value transferability and adaptation studies, which are key to enable EBP adaptations to account for context specificities while maintaining effectiveness. The platform’s next steps are to develop deployment tools and structure an advocacy strategy to mobilize stakeholders around the issue.

Key messages
• Achieving wide-scale implementation of EBP requires to tackle key implementation issues such as scaling, context adaptation, etc. and to give support to implementing stakeholders.
• A collaborative assessment helped identify levers and barriers to EBP implementation in France. Involvement in EBP fosters an evidence-based mindset among practitioners.
Understanding influences of cervical screening attendance among women of low socio-economic position
Authors: Mulcahy Symmons S , Drury A , De Brun A 
Published: October 2024

Abstract

Women of lower socio-economic position (SEP) have a higher incidence of cervical cancer and lower uptake of cervical screening. The Integrated Screening Action Model (I-SAM) is a behaviour model aimed to guide intervention development that considers how individuals engage with screening through their environment, capability, opportunity, and motivation. The I-SAM can be used to understand behaviour of cervical screening. We aimed to understand perceptions and awareness of HPV screening among women aged 25-65 of low SEP living in an urban area in Ireland. Semi-structured interviews were conducted with women who self-reported regular or irregular screening attendance, no university-level education, low-income employment or not working, aged 25-65 and living in Dublin. Participants were recruited via community organisations. Data were analysed using I-SAM in a framework analysis to map barriers and enablers of attendance of regular and irregular attenders. Of the seventeen women interviewed, seven attended screening irregularly. Participants thought they had opportunity to attend when they were reminded and supported to attend by peers and healthcare professionals. Participants wanted to promote screening in the community and to normalise conversations on sexual health. Participants felt fear of cancer was a driver and deterrent to attend screening due to cancer running in the family, past health issues and abnormal cell treatments, and wanting to be there for their family. Few were aware of HPV or the switch to HPV screening. Irregular attenders were unsure how to book or find information on screening. Campaigns should involve communities that are less likely to attend to improve visibility of screening. Healthcare professionals could opportunistically promote HPV screening in primary care and community settings. Campaigns should be aimed at improving literacy of HPV screening, address concerns of cancer risk and support navigation through screening.

Key messages
• Understanding of HPV cervical screening is limited and campaigns are needed to improve awareness and literacy.
• Public health campaigns should engage with communities to promote screening via community groups and healthcare professionals.
Quality of life and adherence to healthy lifestyle factors among breast cancer survivors in Cyprus
Authors: Koshiaris C , Cannas A , Demetriou C , Quattrocchi A , Philippou E , Mosquera M C , Papageorgiou E , Kolokotroni O , Marcou Y , Constantinou C 
Published: October 2024

Abstract

Breast cancer is a prevalent disease for women globally, with rising survival rates highlighting the need to address the breast cancer survivors’ (BCS) quality of Life (QoL). Furthermore, adherence to a healthy lifestyle is associated with decreased mortality in BCS. Mapping the Lifestyle Medicine pillars and the World Cancer Research Fund/American Institute for Cancer Research recommendations identifies 7 healthy lifestyle components: weight management, physical activity, healthy eating, restorative sleep, avoidance of risky substances, positive social connections and stress management. This study examines adherence to these healthy lifestyle components and QoL among BCS. A cross-sectional study conducted in 2022-23 recruited primary adult BCS from the Bank of Cyprus Oncology Centre. Participants completed a survey assessing self-reported QoL and adherence to the aforementioned 7 healthy lifestyle components, through validated questionnaires. Out of 349 BCS approached, 272 were included in the final analysis. Mean age and time since main treatment completion were 51 (SD: 7.4) and 3.6 (SD: 2.5) years respectively. Amongst study participants 58% were classified as bad sleepers, 53.3% were overweight or obese, 23% were stressed, 78% reported to have moderate/high physical activity, and 60% adhered to the Mediterranean diet. Regarding substance use, 16% were current smokers, and 18% were hazardous drinkers. Median score for social support was 75 (IQR: 53-97; max score=100) and for QoL was 67 (IQR: 50-97; max score:100). BCS in Cyprus generally exhibit moderate adherence to the Mediterranean diet, engage in fairly active lifestyles and enjoy high levels of social support and QoL. On the other hand, a substantial proportion smoke or drink, are overweight or obese, are stressed and have poor sleep quality. Targeted interventions to increase the adherence of breast cancer survivors to the 7 healthy lifestyle components are required.

Key messages
• Overall variability exists in the adherence to healthy lifestyle components among BCS in Cyprus.
• This population can benefit from intervention targeting sleep, stress and weight management.