bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hybrid accountability in global health public-private partnerships: a literature and case study
Authors: Hein J , Bekker M 
Published: October 2024

Abstract

Background
Recent global health public-private partnerships (PPPs) offer novel approaches to public health issues, yet they lack clear public accountability. Hence, it remains unclear how accountability is organised and practiced. This research examines accountability in global health PPPs, how it is manifested, and derives lessons for developing an accountability framework.

Methods
The study utilized both a scoping literature review, examining the databases SCOPUS, Web of Science and MEDLINE, which yielded 35 eligible articles from 334 records, and an exploratory case study focused on an accountability event within the Global Stop Tuberculosis Partnership (STBP), incorporating a document analysis and an expert interview to enhance insights from the literature review.

Results
Authors studying PPPs often conceptualized accountability broadly and favoured a view tied to hierarchical state-led governance and democracy. However, at the global level, this political accountability is largely absent. In PPPs, it is replaced by a mix of bureaucratic, legal, social, audit, fiscal, and rather soft accountability mechanisms. Also, PPPs' accountability landscape is dynamic, shaped by different normative considerations and by the interdependence among partners. In 2020, the allegations for misconduct at the STBP exemplified public reputational accountability, followed by audit accountability leading to an enforced soft accountability to STBPs' mission & purpose.

Conclusions
This study highlights the necessity for rethinking accountability in global health PPPs due to the limitations of existing structuralist frameworks. A new hybrid accountability framework is proposed. It considers a strong accountability focus on PPPs' purpose, their processual dynamics, and normative aspects. Lastly, it is recommended to further investigate the trade-off between transparent accountability mechanisms and the practical necessity for confidential backstage processes in PPPs.

Key messages
• Exploring a hybrid accountability framework in global health PPPs beyond only static accountability snapshots, helps to understand PPPs’ true dynamic, purpose-driven and individualized accountability.
• Without regulatory mechanisms and state governance, individual action and new collaboration become essential, requiring soft accountability mechanisms as increased trust and cooperation among partners.
Governing the Slovenian National Cancer Control Programme - Key Lessons Learnt
Authors: Tomsic S , Duratovic Konjevic A , Plantosar K , Torkar K , Zgajnar J , Zakotnik B 
Published: October 2024

Abstract

Issue
Strategic documents addressing major public health concerns should extend beyond health sector. Cancer control is commonly perceived only as a health issue, thus involving diverse stakeholders is challenging.

Description of the problem
The inclusion of stakeholders within and beyond the health sector is crucial in the preparation, and through implementation of National Cancer Control Programmes (NCCP). Lessons learned on how to involve and maintain fruitful collaboration with diverse stakeholders in Slovenian NCCP are presented.

Results
Over the past 14 years Slovenia’s NCCP has built a reliable and reputable partnership with diverse stakeholders, a collaboration that continues to evolve. Efforts extend across multiple sectors, encompassing health, education, employment, research, environment, technology, and non-governmental organizations. NCCP has set up multistakeholder governance structures: an advisory board, board of experts, specialised expert groups, and a group of representatives of cancer hospitals. These groups engage a diverse range of experts and institutions nationwide. Whenever feasible, representatives of patient organizations are included. All these structures hold regular meetings, complemented by an annual event that convenes all stakeholders and also provides an invaluable platform for informal networking. To ensure seamless coordination of all activities, a dedicated team is essential. Our approach has evolved to embrace a dual leadership, comprising both a public health specialist and a clinical expert. Additionally, we benefit from the expertise of communication experts, who offer valuable insights into effectively reaching diverse audiences.

Lessons
Governing Slovenia’s NCCP by involving diverse stakeholders in planning and implementation activities has demonstrated its effectiveness. Furthermore, we are witnessing an increasing number of new stakeholders actively seeking out to participate in the NCCP.

Key messages
• Slovenia’s NCCP is recognized for its credibility and strategic approach.
• Involving diverse stakeholders in cancer control endeavours has proven effective, fostering trust and partnerships.
How to improve the inclusion of the elderly in the local community for better mental health?
Authors: Stanojevic-Jerkovic O , Oreski S 
Published: October 2024

Abstract

Issue/problem
Social exclusion, ageism and low health/digital literacy intertwine with growing trends in mental disorders, including abuse in Slovenian elderly. To cope with these issues, besides rising competencies, there is a need for stable and continuous partnerships of all relevant stakeholders in the local communities.

Description of the problem
Despite previous efforts of the Interdisciplinary Working Group (IWG) for mental health promotion in the elderly (established according to the Resolution of the National Mental Health Program, 2018-2028), there was a need for reconsidering approaches in the next Action plan (2024-2028). A national conference on decreasing social exclusion in the elderly contributed as a road map.

Results
Previous activities (events in the local communities, supported materials) were upgraded with a broad destigmatization campaign, (recruitment of the &gt;&gt;ambassadors &lt;&lt;) and collection of culturally adapted good practices. Better availability of information through &gt;&gt;info-spots &lt;&lt; and easier participation of the elderly in cultural events was enabled. Activities of the reinforced IWG were promoted.

Lessons
Empowerment of key actors and their continuous cooperation could improve information flow, competencies, the inclusion of the elderly in the local community, and decrease ageism and discrimination. Developing local strategies with the crucial involvement of elderly representatives is the opportunity for more intensive and better cooperation between local policy/stakeholders, public health experts, and the target population. Regular financial support will prevent additional inequities.

Key messages
• The empowered, connected, and proactive community is key to preventing the elderly’s exclusion.
• Approaches should be fresh, accessible, and tailored to the heterogeneous population.
Content validation of a test battery for assessing sleep quality in adolescents in Slovenia
Authors: Mlakar A , Kukec A , Rejc T , Šmigoc M , Gril Rogina K , Gnidovec Stražišar B 
Published: October 2024

Abstract

Background
Sleep constitutes a fundamental biological necessity, occupying approximately one-third of our lifespan. Consequently, the field of sleep research has experienced an increase in interest, prompted by the recognition of insufficient sleep as a significant public health challenge. As the majority of existing questionnaires in Slovenia have yet to undergo official translation and validation processes, the aim of our study was to conduct content validation of a questionnaire designed to assess the sleep quality among adolescents.

Methods
We developed a test battery for assessing the sleep quality of adolescents by combining a diverse array of questionnaires. We employed the Adolescent Sleep-Wake Scale, Pediatric Daytime Sleepiness Scale, Epworth Sleepiness Scale for Children and Adolescents, and Children’s Morningness-Eveningness Scale. Following the development of the entire test battery, a process of back-translation from English to Slovene occurred, followed by cultural adaptation.

Results
The designed questionnaire underwent content validation by a panel of 10 experts drawn from diverse disciplines. Evaluation of questionnaire items followed a planned methodology tailored for the content validation of measurement instruments, focusing on content relevance, clarity, and classification into subscales or factors. Our analysis revealed that the individual questionnaires demonstrate content validity, supported by notably high indices of content validity.

Conclusions
Translated questionnaires demonstrate decent content validity, thus rendering them valid clinical and research tools for assessing sleep quality in adolescents in Slovenia.

Key messages
• Our research indicates the availability of content-valid tools for sleep research.
• Further investigation is needed to determine the reliability, specificity, sensitivity, and appropriateness of the factorial structure of measures for the quality of sleep.
Protocolizing social prescribing in mental health and addiction services: barriers and opportunities
Authors: Olivella-Cirici M , Casajuana Kögel C , Segura L , Alonso J , Colom J 
Published: October 2024

Abstract

Issue
Social Prescribing (SP) is a structured approach where health professionals recommend community activities to enhance well-being. Starting in Catalonia in 2012, it expanded to the entire primary care network by 2016. By 2023, 23,338 patients received SP, showing a 2.3-fold increase from 2022. Two-thirds experienced improvement in mental well-being. Now, efforts focus on applying SP to mental health and addiction services (MHAS), where SP can be used for restoring health and well-being.

Description
A literature review was conducted and a working group was initiated with MHAS professionals was initiated to exchange experiences and identify needs and best practices. This was done in preparation for designing a pilot experience, which will include a qualitative study through focus groups to validate the action plan and determine barriers and facilitators in MHAS. The groups will be segmented into MHAS users and frontline professionals.

Results
The results of the review process and the working group sessions demonstrated that SP can be useful and beneficial for the health MHAS users. However, barriers and opportunities were identified. The main barriers detected include: the need for strong support during referrals to community activities; increased awareness of addiction among activity providers to reduce stigmatization; define inclusion and exclusion criteria; determining monitoring and evaluation tools; and mapping and updating community assets. Regarding opportunities, the following were highligthed: the interest of MHAS professionals in promoting and implementing a SP program in this area; the existence of organizations already conducting community activities focused MHAS users; and political prioritization of this issue.

Lessons
The implementation of a SP program protocol in MHAS is considered beneficial. It is necessary to analyse barriers to effectively address them and to identify opportunities to leverage them.

Key messages
• Social Prescribing has significantly enhanced mental health outcomes in Primary Care, which can imply a potential improvement in well-being of mental health and addiction services users.
• Implementing Social Prescribing in mental health and addiction services offers promising integrated care opportunities, requiring barriers resolution and maximizing existing prospects.
An integrated approach to enhance vaccine uptake in chronic patients – the VacciNetwork project
Authors: Adamo G , Colaiocco G , Diedenhofen G , Amoriello Lamberti P , Gherardi S M , Trani F , Mallamace N R , Isidori C , De Angelis G , Fano V 
Published: October 2024

Abstract

Issue/problem
Individuals with chronic illnesses are at a higher risk of infections and their complications. Vaccinations are crucial in reducing this risk and their integration in chronic care pathways can enhance vaccine uptake, but it requires a collaborative approach and increased awareness in care personnel, caregivers and patients.

Description of the problem
The Local Health Authority of Rome 2 (ASL Roma 2, with approx. 1.3 million residents) initiated an active promotion plan for recommended vaccinations in chronic patients in January 2023, and a Clinical Vaccinology Workbook was produced to guide healthcare workers in promoting vaccinations across various care settings. The plan aims to establish collaborative agreements with hospitals and territorial structures that manage these patients, integrating vaccination plans with clinical and healthcare pathways for a more holistic approach to chronic disease management, a model that could benefit similar populations globally.

Results
Data was extracted from administrative databases regarding vaccinations performed in 2022 and 2023 on fragile subjects, i.e., those with a marked ‘risk condition’, aged ≥18 years. The results showed that vaccine uptake was more than doubled (6675 vs. 2041; +227%). Notably, vaccinations rose among those with oncological-hematological diseases (+212%), asplenia (+185%), chronic kidney failure or on dialysis (+190%) and those with an HIV infection (+160%). Increases were also significant in other immunocompromised conditions (+194%).

Lessons
The practice underlines the importance of targeted vaccination programs within chronic care management. Collaborative healthcare frameworks can significantly improve vaccination rates, reducing the burden of infectious diseases in high-risk populations. These results underscore the potential applicability of such a model in other regions and countries, highlighting the universal relevance of integrated healthcare solutions.

Key messages
• Collaborative, integrated frameworks between clinical and vaccination services can represent a model for increasing vaccine uptake in chronic disease patients.
• Strategic partnerships and education in healthcare settings can improve vaccination rates and contribute to more holistic chronic disease management.
Active aging, autonomy, and mental health among older adults with chronic illness - focus on optimism
Authors: Karai V , Rózsa S , Kiss ECS 
Published: October 2024

Abstract

Background
In the active aging framework, the focus has shifted to the quality of life of the elderly, where autonomy plays an important role. Chronic illnesses often lead to autonomy limitations, impacting activities of daily living (ADL) and increasing the risk of depression. Fostering an optimistic outlook can mitigate depression’s severity and promote healthy aging.

Methods
The data is from a cross-sectional survey in Hungary (n = 832). 60,1% of the sample had at least one chronic illness. Measurements included the EQ-5D-5L, Mental Health Continuum-SF, Life Orientation Test, and the Geriatric Depression Scale.

Results
We found worse mental health (p = 0,024), lower levels of optimistic outlook (p = 0,002), and higher levels of depression (p &lt; 0,001) among those who reported ADL limitations. ADL limitations (ß = -0,27, p &lt; 0,001) showed the strongest association with perceived health status, followed by mobility (ß = -0,22, p &lt;; 0,001) and self-care (ß =-0,14, p &lt; 0,001). Considering mental health, only ADL limitations (ß = -0,15, p &lt; 0,001) were a significant predictor from the above-mentioned dimensions. Additional analysis showed that depression affected mental health both directly (effect = -1,90, p &lt; 0,001) and indirectly, mediated by an optimistic outlook (effect = -0,88).

Conclusions
1. Limitations in autonomy were negatively linked to perceived health status and mental health. 2. The optimistic orientation toward life can mediate the association between depression and mental health among the elderly with chronic conditions. 3. The Implications of the results could enlighten the necessity of preventive initiatives on autonomy preservation and enhance an optimistic outlook to maintain healthy aging and a favorable quality of life.

Key messages
• Preventive interventions focusing on health-preserving behaviors could be designed for specific groups with a higher risk of ADL limitations in the future.
• Optimism could mediate depression’s impact on the mental health of the elderly with chronic illnesses, suggesting that interventions should target enhancing optimism for improving active aging.
Association between a new healthcare access index and life expectancy in Japan: A nationwide study
Authors: Nakamura A , Takezawa K , Satoh E , Kotani K 
Published: October 2024

Abstract

Background
Access to medical institutions is crucial to healthcare systems. Japan has universal health coverage and unrestricted access to medical institutions; patients can visit any medical institution without requiring referral letters. We developed the Japan- Spatial Accessibility Scale for Medical Institutions (J-AMI) to provide integrated spatial accessibility to multiple sized healthcare institutions. We also examined the association between the J-AMI and life expectancy.

Methods
This study included 220,621 administrative census mesh blocks defined by address; 89,248 clinics and 8,181 hospitals across 47 provinces in Japan, with a total population of approximately 126 million. The road distance between the centre of each block and the nearest clinic was calculated and scored every 1 km. Hospitals were classified as secondary and tertiary hospitals based on the availability of emergency and critical care centres. Secondary and tertiary hospitals were scored every 2 and 4 km, respectively. The scores for clinics and secondary and tertiary hospitals (1-8 points each) were aggregated and scored using a mesh. The population-weighted municipal J-AMI (PWM-J-AMI) scores were calculated for each municipality. Correlations between the PWM-J-AMI scores and life expectancy by municipality were examined. Geographic information was analysed using ArcGIS Pro.

Results
Median life expectancies for male and female individuals were 81.4 years (interquartile range [IQR]: 80.9-81.9 years) and 87.5 years (IQR: 87.2-88.0 years), respectively. The median PWM-J-AMI score was 9.5 (IQR: 5.4-14.5). The PWM-J-AMI scores were negatively correlated with male and female individual’s life expectancy by municipality (r=-0.29, p &lt; 0.01 and r = 0.18, p &lt; 0.01, respectively).

Conclusions
The results suggest that the better a region’s access to medical care, the longer its life expectancy. Efficient medical institution allocation and telemedicine promotion may be essential to improving access.

Key messages
• We developed the Japan- Spatial Accessibility Scale for Medical Institutions (J-AMI) to provide integrated spatial accessibility to multiple sized healthcare institutions, using ArcGIS Pro.
• The PWM-J-AMI scores were negatively correlated with male and female individual’s life expectancy by municipality, which suggest that the better a region’s access, the longer its life expectancy.
Contemporary understanding of health literacy across the Island of Ireland
Authors: Smith C , Murray M , Behan S , Goss H 
Published: October 2024

Abstract
This presentation will detail two reviews that provided contextual understanding for this project. The first, an umbrella review which explored i) How is health literacy currently defined and operationalised nationally and internationally? And ii) What are the key components and principles of health literacy? The search was limited, most notably, to systematic reviews published after 2012. A total of 12 studies were included for data extraction and narrative analysis. Findings provided an update of the conceptual understanding of health literacy, emphasising the complex and multidimensional nature of the concept. Dimensions are common, but growing, and moving beyond just individual capabilities. The second, moving beyond the definition, details a systematic review that aimed to gain a contemporary understanding of health literacy through identifying and appraising existing research conducted in an Irish context. Seven electronic databases were searched between October and December 2023. Initial search identified 551 records, following screening, 37 studies were included in this review. Narrative analysis indicated that across the Island of Ireland in the last decade, many studies had narrow populations of focus (i.e. Dublin based, adults, chronic illness populations), limited research design and methodologies (cross-sectional, narrative, and primary research with short time frames), and lacked rigorous monitoring and evaluation of health literacy as a primary or secondary outcome. While studies highlighted clinical, education and community implications, a limited focus on mental health was also observed. Findings from this systematic review offer valuable insights and recommendations for future efforts to enhance health literacy and the health and well-being of individuals across the island of Ireland.
Creating opportunities for community voices to be heard
Authors: Murray M , Smith C , Meegan S , Behan S , Goss H 
Published: October 2024

Abstract
This presentation will showcase the importance of community based participatory research in developing health literacy in Ireland. Purposeful sampling (n = 105: 71% female) in two contrasting Sláintecare Healthy Community areas in Ireland (Finglas & Cabra and Mayo), recruited participants to take part in semi-structured focus groups, or individual interviews. Using reflective thematic analysis, and a critical friend approach, five key themes were identified that demonstrated the strengths, needs and challenges in health literacy in urban and rural communities in Ireland. This included: i) Accessing and understanding health information; ii) Health literacy changing over time; iii) Perceiving health literacy as an individual responsibility; iv) Interpersonal and community influences on health literacy; and v) Health access through a rural or urban infrastructure. There were many similarities between rural and urban, young and old. Equally, there were unique challenges that required local solutions. As such, the next phase of this project utilised a co-design process to check, challenge, collaborate and create recommendations for health literacy solutions in each case study area. A specific method of experience-based co-design, the Double Diamond Design Approach (DDDA) was used. With DDDA, stakeholders progress through a four-stage reflective process to discover, define, develop, and deliver an innovative solution to a problem. Two Co-design Workshops took place in March 2024 aiming to revise the strengths, barriers, needs, and propose potential recommendations for health literacy in each Sláintecare Healthy Community, using an adapted DDDA. Within the rural setting, solutions to promote health literacy spanned across transport, health access, and community based needs. Within an urban context specific suggestions around community engagement, information sharing, and earlier educational intervention were called for.