bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of the Behavioral Determinants of Deprescribing Questionnaire (BDDQ)
Authors: Alves Jorge S , Van den Broucke S 
Published: October 2024

Abstract

Background
Deprescribing is a strategy to optimize medication use. While health behaviour can successfully be predicted by health behavior theories, the literature on deprescribing relies almost exclusively on questionnaires that measure attitudes only, such as the Beliefs about Medicines Questionnaire and the Patients Attitudes Towards Deprescribing, resulting in poor predictive validity. The aim of this study was to develop a new tool to measure the psychological determinants of deprescribing among people aged over 60, based on concepts derived from health behaviour theories.

Methods
A draft self-report questionnaire was developed consisting of 64 questions measuring 11 dimensions representing determinants of deprescribing. As well as previous deprescribing experience, current deprescribing behaviour and willingness to deprescribe. Face validity was assessed by asking 10 health professionals and 13 of older people to complete the questionnaire and comment in a small group discussion, resulting in the removal of 18 items. Construct validity was assessed on a sample of 103 participants aged over 60, using exploratory factor analysis (EFA). Internal consistency was assessed via Cronbach’s alpha.

Results
The EFA could confirm 11 dimensions explaining 70,5% of the total variance, but revealed poor loadings for several items and inadequate alphas (&lt;.50) for two factors. Removal of items and these two dimensions resulted in 26 items measuring 9 dimensions, all showing acceptable internal consistencies (between .52 and .77): perceived risk; relatives’ involvement; deprescribing concerns; attitudes; medication beliefs; healthcare support; perceived difficulties; motivation to comply; communication accessibility.

Conclusions
This study produced a conceptually based and psychometrically validated questionnaire to assess behavioural determinants of deprescribing. It provides for a more comprehensive investigation of deprescribing intentions and behaviour of older adults.

Key messages
• A conceptually sound, psychometrically validated questionnaire (BDDQ) was developed.
• BDDQ can be used for a more comprehensive study of de-prescribing in older people.
Is harmonizing to social drinking norms associated with alcohol use in Danish high school students?
Authors: Vallentin-Holbech L , Feldstein Ewing S , Rømer Thomsen K 
Published: October 2024

Abstract

Background
Alcohol use is positively linked with perceived drinking norms within the peer group and the social plasticity hypothesis proposes that youth are very good at harmonizing to social norms (social attunement). Youth with high social attunement may adjust their drinking habits to the perceived drinking norms of the peer group to a higher extent potentially leading to a larger impact on personal alcohol use. This study examined if frequency of personal alcohol use was associated with perceived peer approval of drinking and the role of social attunement in Danish high school students aged 15-19 years.

Methods
An online survey was administered to 2977 first-year students from 16 public high schools in Denmark. Students reported past month alcohol use (drinking days, using TLFB) and perceived approval of alcohol use among peers of their grade. Social attunement was calculated as a sum score of the 11-item Dutch Social Attunement Questionnaire (SAQ) (range: 11-77; α = 0.81). Number of drinking days was analysed as dependent variable, with age, gender, perceived peer approval and SAQ-score as independent variables.

Results
Older students were more likely to perceive peers to approve drinking (β = 0.25; p = 0.004) and getting drunk (β = 0.22; p = 0.003). More females (83.2%) than males (81.8%; p = 0.003) perceived peers to approve youth getting drunk. Multilevel regressions showed increased drinking days for students perceiving peers to approve of drinking (β = 1.68; p &lt; 0.001) and getting drunk (β = 1.80; p &lt; 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p &lt; 0.001) indicating that perceived peer approval had less effect on drinking days for students with high SAQ-score.

Conclusions
Social attunement explained additional variance in the association between personal alcohol use and perceived drinking norms. Our findings stress the importance of addressing the influence of behavioural adaptation in e.g. school-based health promotion programs.

Key messages
• Students perceiving peers to approve of youth alcohol use drink more frequent, but the link is weakened when the need to harmonize to perceived drinking norms are high.
• Social attunement needs to be considered when examining the link between individual alcohol consumption and perceived drinking norms and should be addressed in e.g. school health programs.
Culturally-relevant physical activity for public health promotion: global evidence synthesis
Authors: Sentell T , Look M , Pirkle C , Ylli A , Heil D , Schmid S , Câmara S 
Published: October 2024

Abstract

Background
The WHO has noted the importance of cultural insights for health. Culturally-relevant physical activity has a growing evidence base in many regions and specific populations, but the scope and scale for global health promotion is underexplored.

Methods
A multinational expert team used a critical literature review method to: (1) define culturally-relevant physical activity; (2) delineate relevant characteristics supporting inclusion in population-level health promotion and surveillance; and (3) provide agenda setting in research, policy, and practice from a global public health promotion perspective. The critical review method, which evaluates rather than summarizes literature, was chosen as the research evidence is complex, broad, and has not been synthesized previously from this perspective.

Results
Culturally-relevant physical activity was defined as practices that include physical activity based on a population’s cultural customs. These can be Indigenous (e.g., hula, an Indigenous dance of Native Hawaiians) or regional (e.g., Shota (Shotë), an Albanian folk dance). Practices have shared characteristics that support multi-dimensional value for health, engagement, and healing. These include a collectivist, intergenerational component, passed from elders and shared forward with children as part of a community. Many have foundations in nature, a strength for health and wellbeing in green and blue spaces. Many include traditional art, clothing, accessories, and music with deep significance, including care for the tools and location of practice (e.g, drums, boats, land). Many practices would not be captured in harmonized public health surveillance systems despite their value. From this synthesis, research hypotheses were created and next steps proposed.

Conclusions
This evidence synthesis supports engagement, planning, uptake, policy, surveillance, and study of culturally-relevant physical activity for public health promotion locally and globally.

Key messages
• An important strength of culturally-relevant physical activity is that it is context and population specific. However, this may hide the scope and scale of the existing evidence supporting this work.
• This evidence synthesis confirms how culturally-relevant physical activity is valuable globally across shared assets in research and practice, supporting next steps for public health promotion.
A global research agenda for understanding the role of alcohol consumption in older women’s lives
Authors: McCarthy S , Pittt H , Benjamin K , Stafford J , Keric D , Arnot G , Thomas S 
Published: October 2024

Abstract

Background
The alcohol industry has targeted women for profit and resisted global efforts to address the impact of alcohol on women’s health. Scholars have called for research that moves beyond individual determinants of alcohol consumption in women, to investigate the range of social, environmental, and commercial factors that may contribute to women’s alcohol attitudes, risk/benefit perceptions, and consumption behaviours. While qualitative research has explored younger and midlife women’s perspectives on alcohol consumption, there is a notable lack of research focusing on older women.

Methods
This study investigated the factors that influence how older Australian women drinkers conceptualised the role of alcohol in their lives, using data collected from an online qualitative survey with n = 144 women aged 60-88 years. Qualitative responses were analysed using a ‘Big Q’ reflexive approach to thematic analysis.

Results
Participants perceived alcohol consumption as a socially accepted and normalised activity within Australian culture. For some women, alcohol served as a coping mechanism for life changes, such as retirement, and for managing stressful situations. Alcohol also formed part of daily routines and rituals, such as having wine with dinner. Participants had personal expectancies regarding ‘responsible drinking’, often aligning with alcohol industry messaging and resulting in a reduced perception of alcohol-related risks.

Conclusions
This research provides global lessons for future public health research examining the factors that may shape older women’s alcohol consumption beliefs and behaviours. The authors consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry. Further public health research and policy attention should focus on the impact of alcohol industry messaging on older women’s knowledge, attitudes, and behaviours about alcohol risks and harms.

Key messages
• This research highlights the role of alcohol in older women’s lives, urging further public health research and policy attention to prevent alcohol-related harms in older women.
• Older women’s perceptions of responsible alcohol consumption mirror the ambiguous messaging employed by the alcohol industry, highlighting the necessity for targeted interventions.
The Workplace Health Promotion project in an Italian manufacturing
Authors: Marconi D , Moscatelli C , Centi L , Erba F , Lazzeri G , Nante N 
Published: October 2024

Abstract

Introduction
The Workplace Health Promotion (WHP) program aims to improve employee’s health and well-being in the workplace by intervening in lifestyles. The objective of our study was to assess the impact of the WHP promoted by the Local Health Authority Tuscany South-East at a manufacturing.

Methods
The program was set at the STOSA Company in Radicofani (Siena, Italy) between 31 May 2017 to 31 December 2021, with a one-year interruption due to the COVID-19 pandemic. Based on an assessment of the workers’ health status, we identified nutrition and fighting smoking as areas of intervention. The WHP project was integrated into the company policy and targeted all staff. Evaluation of interventions was conducted using an anonymous paper questionnaire (Regional Decree no. 1565, Annex 3) administered in three moments: at the beginning of the project (T0), one year later (T1), and at the end (T2). We conducted a descriptive and inferential analysis (chi-square test) with R.

Results
We collected 131 (T0), 136 (T1), and 123 (T2) responses. The cohort is composed entirely of males (T0 M:F 122:8, T1 130:6, T2 109:14). The median age is 40 years (SD 8.24 (T2)). There is a statistically significant difference in the perception of health status by education (p&lt;.001), type of work (p&lt;.001), smoking habit (p&lt;.001), and the change in smoking habit (p&lt;.001). The whole sample positively evaluated the interventions on nutrition and fighting to smoke. Moreover, the entire sample reported improvements in their diet since the beginning of the project.

Conclusions
The COVID-19 pandemic caused difficulties in carrying out the project and possible changes in workers’ lifestyles. However, positive outcomes were observed in the targeted areas. The company has evaluated positively the WHP’s project and decided to maintain the good practices acquired.

Key messages
• The workplace represents a privileged setting to promote healthy lifestyles and prevent non-communicable diseases.
• Collaborations between health authorities and other sectors are strategic to reach the general population.
Vaccines are coming closer to you: the experience of the Corporate Healthcare Company (ASL) Rome 4
Authors: Sinopoli M T , Fusillo C , Scognamiglio D , Belfiori G , Marini M , Razzetti L , Ursino S , Matranga C 
Published: October 2024

Abstract

Issue
The post-Covid period is characterised by vaccine fatigue and declining coverage, especially among children. Access to vaccination for adults and the elderly, outside of the influenza vaccination campaign, has historically been very low due to limited awareness of opportunities and difficulties in accessing vaccination centres.

Description of the problem
ASL Roma 4 is characterised by a dispersed population across a large territory of 28 municipalities, many of which are small and predominantly populated by elderly people. In order to reach this population, ‘proximity clinics’ were opened in 6 small municipalities in 2023, where the vaccination service offers a wide range of vaccines every 1-2 months. Since June 2023, two mobile vaccination units have also been used to extend the reach of vaccination activities.

Results
In 2023, vaccination activities at nearby clinics reached 343 people (166 males and 177 females), with a total of 473 vaccines administered. More than 70% of those vaccinated were over 65 years of age, including 47% over 80 years of age. Between September and December 2023, vaccination vans were deployed in high-traffic areas such as markets, supermarkets, squares, or in locations with hard-to-reach populations such as migrant reception centres, volunteer centres, and senior centres. As a result, 1183 people (585 men and 557 women) with an average age of 49 years were reached and 1699 vaccines were administered. 62% were over 65, 37% over 80, 41 were homeless and 87 were migrants. 56% of the vaccines administered were influenza and covid, but all types were provided.

Lessons
Although this method of vaccine delivery is still being implemented, its value lies mainly in vaccinating people who would not have voluntarily sought vaccination services, demonstrating the need to bring prevention as close to the user as possible.

Key messages
• The post-Covid period is characterised by vaccine fatigue and declining coverage.
• It is necessary to bring vaccination prevention as close to the user as possible.
How can we measure labour exploitation and develop interventions to protect migrant workers’ health? Insights from intervention-focused research on cattle ranching in Brazil and child domestic work in Liberia and Nigeria
Authors: Zimmerman C , Keaveny E 
Published: October 2024

Abstract
Much of our food and services rely on the work of migrants, which is often carried out under exploitative terms. Exploitative work results in work-related injuries and illnesses and mental ill-health. Yet, the global health community has been negligent in detecting migrant workers in the general population, and in measuring the effects of their work terms on their health. For instance, the International Labour Organization’s global labour force and forced labour surveys capture few health data. Conversely, health surveys, such as the Demographics and Health Survey (DHS), include few questions on exploitative and hazardous work conditions or aspects of migration status. Studies are even more remiss when it comes to developing evidence for work-related health interventions. This presentation will draw on two recent mixed-methods studies - on cattle ranching in the Amazon region of Brazil (Pará State) (n = 1,241), and on child domestic work in Liberia (n = 1,088) and Nigeria (n = 1,088). Findings suggest some necessary improvements to the measurement of migrant labour exploitation and its health effects, and approaches to gathering intervention-focused evidence. Each study highlights the value of re-thinking data collection beyond disciplinary silos and narrow dichotomous measures (e.g., forced/unforced labour), towards generating a more specific understanding of the different dimensions of labour exploitation (e.g., pay conditions, hours, occupational health and safety training and PPE), various types of associated harm, and how they compare across sectors and contexts. Further, each study demonstrates the benefits of intervention-focused research methods that are designed to feed directly into participatory intervention development processes. On this basis, we will suggest shifts in measurement and research designs to foster operationalizable evidence on migrant workers’ working conditions, health, and worker-informed interventions.
Key Factors Influencing Quality of Life in the Disabled Based on Multifaceted Life Satisfaction
Authors: Choi E H , Cho J H , Yeob K E , Kim S Y , Lee Y S , Park J H 
Published: October 2024

Abstract

Background
Healthy life of the disabled is considered a global social issue, and enhancing the quality of life (QoL) of the disabled is an important task. The disabled have lower multifaceted life satisfaction due to various daily restrictions, which negatively affects their QoL. Research on the QoL of the disabled is ongoing, but there are few comprehensive studies addressing multifaceted life satisfaction. To enhance the QoL of the disabled, it is essential to understand their multifaceted life satisfaction and investigate key factors influencing their QoL.

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 multifaceted life satisfaction of the disabled on their QoL by using multiple regression analysis adjusted for gender, age, education level, daily living activities, type and severity of disability, and presence of multiple disabilities.

Results
The satisfaction with social relationships(β=.535, p&lt;.0001), income(β=.146, p&lt;.0001), housing environment(β=.132, p&lt;.0001), occupation(β=.130, p&lt;.0001), and health(β=.111, p&lt;.0001) was found to have a significant positive impact on the QoL of the disabled. Particularly, satisfaction with social relationships exerted the greatest impact on their QoL.

Conclusions
Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. These findings can support the government in prioritizing health policy development for the disabled and contribute to improving the QoL for the disabled through a comprehensive and integrated approach. The government should develop health policies to enhance social connections and support networks for the disabled, while also considering aspects for improving income, housing environment, occupation, and health.

Key messages
• Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled.
• The government should prioritize developing health policies aimed at enhancing social relations for the disabled, while also considering income, housing environment, occupation, and health.
Health-promoting school. Mediation effects on health behaviors and the socio-economic level of pupils
Authors: Simar C , Coudert Chevreau R , Monier M , Cury P H , Pironom J 
Published: October 2024

Abstract

Pupils health indicators and behaviors are marked by social and territorial inequalities which develop early (DREES, 2015, 2019). In order to combat these inequalities and improve the health behaviors and well-being of pupils, the “health-promoting school” approach is recognized as convincing. It is endorsed by the World Health Organization (Langford, 2015; WHO, 2021). The health policy currently implemented in French schools is convergent (MEN, 2018, 2021). In order to disseminate this policy, since 2019, the Alliance project has been implemented in 101 French schools (9 - 12 years old) and 97 municipalities in the AURA region. Each school and community are trained and supported to promote the development of professional practices and a health promotion project to improve the health behaviors of pupils. The question arises as to the extent to which the development of health-promoting teaching projects and practices participating in the strengthening of health protective factors - life skills and health literacy - of pupils would have a mediating effect from the point of view of socio-economic level and health behaviors of pupils? Each year, data are collected from pupils by questionnaire, mesuring their well-being, health habits, psychosocial competencies and their families’ socio-economic level. 11500 questionnaires collected during 3 years have been analyzed. Descriptive and bivariate analysis indicate sevreral improvements between years in their health habits like for example daily physical activities (6% for T0 and 16% for T2) or daily consumption of sweets (17% for T0 and 13% for T2). They confirm negative influence of risk factors as low socio-economic level on health habits. But mediation analysis show that psychosocial competencies, especially emotionnal and social competencies, mediate significatively this influence (mediation effect range from 5% to 21%).

Key messages
• The health indicators and behaviors of young people are marked very early on by social and territorial health inequalities.
• Health-promoting school approach and particularly – life skills and health literacy – would have a mediation effect on health behaviors and the socio-economic level of students.
Forecasting the future demand on health workforce – the Austrian model
Authors: Rappold E 
Published: October 2024

Abstract

Background
An aging population and upcoming retirements of health care professionals pose new challenges to the Austrian health care system. On the one hand the health care and nursing needs will increase while at the same time a shortage on health care personnel threatens adequate supply. We as the Austrian Public Health Institute estimate the risk of an undersupply with model-based health workforce forecasting and are therefore able to advise the federal states and the ministry of health on early measures.

Methods
We developed a forecasting model to estimate the future supply and demand. The main influencing factors are the demographic development as well as the upcoming retirements and graduates. Different environments and needs in different federal states (e.g. changing future skill mix) are considered and can be implemented as additional influencing factors. Usually a baseline scenario as a forward projection of the status quo is developed for defined professions and workplace settings. Then depending on the stakeholder needs additional scenarios are calculated and discussed. A usual forecast horizon is 10 to 15 years.

Results
Model output are time series of yearly workforce personnel numbers (heads and full-time equivalents) and demand in the defined settings. An analysis of possible gaps shows the need for action.

Conclusions
The Austrian health workforce model is a flexible tool to estimate future needs on health workforce based on different assumptions. But as assumptions and influencing factors must be represented as data, the data collection can be quite laborious. Comprehensive data is the basis for a comprehensive health workforce planning. Further work is needed to develop practical and evidence-based nursing-sensitive indicators for nursing workfoce reportings on a country level. In Austria the health professionals register forms the basis for the description of the nursing workforce structure, but that there is a need for data sources on care effectiveness.

Key messages
• Comprehensive data is the basis for a comprehensive health workforce planning.
• An aging population and upcoming retirements of health care professionals pose new challenges to the Austrian health care system.