bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-health-targeted promotions and step counts of smartphone-based mall walking program users
Authors: Matsuoka Y , Yoshida H , Hanazato M 
Published: October 2024

Abstract

Background
The COVID-19 pandemic changed lifestyles and raised concerns regarding physical inactivity among adults. Mobile health interventions for physical activity may be a potential solution. However, the effects may diminish over time. This study investigated whether incorporating non-health-targeted promotions into an existing mobile health-walking program could stimulate users to walk.

Methods
We used nationwide cohort data of smartphone users participating in a shopping mall walking program in Japan. We focused on existing users registered in the program until October 31, 2022. A Japanese anime tie-in promotion was conducted by the shopping mall company from December 3 to 25, 2022, offering additional rewards alongside the regular program. We collected step count records of existing users 1 month before and after (November 1 to December 2, 2022, and December 26, 2022 to January 31, 2023, respectively), and during the promotion period. Propensity score matching was applied to ensure balance in the baseline characteristics of existing users in terms of gender, age, and pre-promotion program participation frequency. Next, we analyzed the association between participation in the promotion program and the average daily step counts during and after the promotional period using mixed effects models for repeated measures, while adjusting for the same covariates.

Results
Among the 18,156 users included in the study, 13,386 (73.7%) were women, with a mean (SD) age of 45.2 (12.7) years, and a mean (SD) pre-promotion program participation frequency of 9.7 (9.6) per month. During the promotion period, the participants walked 87 (95% CI: 50-125) more steps per day than non-participants, after adjusting for covariates. No clear association was observed 1 month post-promotion.

Conclusions
These findings indicate that non-health-targeted promotions may be short-term motivators for existing app users to walk. Ongoing monitoring is necessary to assess the long-term impact.

Key messages
• Mobile health intervention effects may diminish over time.
• A non-health-related promotion could stimulate existing mall walking program app users to increase their daily step count temporarily.
Cost per kilogram weight-lost - Lifestyle change program at the Public Health Institute in Croatia
Authors: Kovačević J , Zombori D 
Published: October 2024

Abstract

According to the 2019 European Health Survey, 42% and 23% of the Croatian adult population were affected by overweight or obesity, respectively. Counselling services are available in some Public Health Institutes for free or paid out-of-pocket. The estimated cost per kilogram lost in programs in Europe and the USA ranges from 100-340€, with a justifiable cost estimation for a weight loss intervention being 120-210€. Aim was to demonstrate the cost of losing one kilogram by analysing necessary initial material and human resources, including equipping counselling centres, and estimating the cost of continuous implementation. In the year 2023, 47 participants (31F,10M) with a BMI higher than 30 kg/m2 enrolled in the three-month free Program in the County Public Health Institute in Pozega. The program consisted of personalized assessment, habit change plan, education, counselling and follow-up. An analysis of the minimal required equipment and working hours of physician and a nurse (contracted gross hourly wage rates) was conducted. The main outcome measure was the cost of one kilogram lost by participants at the end of the Program. Program was completed by 41 (22F, 9M) participants (87.2%). Their initial BMI ranged from 30.3 to 47.4 kg/m2. Collectively, they lost 323.2 kg (1.3-24.4kg), with an average of 7.9 kg or 7.4% (1.7-19.8%) of their initial weight lost. The estimated total cost of medical, IT and office equipment, was 9363€. The human resources cost was 9509€, with a specialist and nurse spending 249 and 116 hours, respectively (27.6€/hour and 13€/hour). The initial cost per kilogram lost, including the prerequisites for the work of the counselling centre, was 58.4€. The continuous program cost with equipment already in place is estimated at 27.9€ per kilogram lost. We have shown that the lifestyle management program in the Croatia without extra cost to patients delivers results with a cost of 27.9€ per kilogram weight-lost in continuous implementation.

Key messages
• The significant impact of obesity on premature mortality and healthcare systems calls for the systematic implementation of effective weight management programs that are available to patients for free.
• It is possible to implement effective weight management program in Croatia without extra cost to patients for 27.9 € per kilogram weight-lost.
Cost-effectiveness of respiratory syncytial virus adjuvanted vaccine in Portuguese aged ≥ 60 years
Authors: Zarkadoulas L , Bota P , Silva F , Coelho A , Castanheira R 
Published: October 2024

Abstract

Background
Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract disease among adults aged ≥60 years in Europe. This study aims to assess the potential public health impact of the RSVPreF3 OA adjuvanted vaccine, the first approved preventive intervention for the older adult population in Portugal.

Methods
A monthly-cycle static Markov model was developed to assess RSVPreF3 OA adjuvanted vaccine impact on adults aged 60 years and older in Portugal. A single dose of RSVPreF3 OA adjuvanted vaccine was compared to no-vaccination over a three-year time-horizon. The model captures lower respiratory tract disease (LRTD) RSV cases, hospitalizations, deaths, and healthcare resource utilization. Data inputs were based on local published literature, supplemented by the best available data when local information was lacking.

Results
Based on preliminary analysis considering 75% vaccine coverage, model outputs estimate that RSVPreF3 OA adjuvanted vaccine can prevent 71,433 LRTD cases requiring medical attendance, 11,067 hospitalizations, 1,793 intensive care unit admissions and 1,003 deaths. The model estimates that 32 adults need to be vaccinated to avoid one RSV LRTD case, 207 adults need to be vaccinated to avoid one hospitalization and 2,283 adults need to be vaccinated to avoid one death. The incremental cost-effectiveness ratio was estimated at 9,541€, hence the RSVPreF3 OA adjuvanted vaccine is cost-effective compared to no vaccination.

Conclusions
The results demonstrate a strong preventive impact of the RSVPreF3 OA adjuvanted vaccine on health outcomes and healthcare resource utilization in adults ≥60 years, leading to a significant public health benefit. This result emphasizes the importance of preventing RSV to preserve the health and well-being of Portugal’s older adults. In addition, data from ongoing studies may enhance precision and extensive sensitivity analyses validate the robustness of the model’s input assumptions.

Key messages
• This study shows the robust evidence of RSVPreF3 OA adjuvanted vaccine to improve public health by preventing thousands of hospitalizations and deaths among ≥60 years, in Portugal.
• Vaccinating adults aged ≥ 60 years with RSVPreF3 OA adjuvanted vaccine in Portugal is a cost-effective strategy.
Decision-analytic modelling of costs & benefits of adding sigmoidoscopy to CRC screening in Germany
Authors: Krueger K , Schaubert K , Brinkmann M , Schramm W , Dreier M , Krauth C 
Published: October 2024

Abstract

Background
In Germany, a colorectal cancer (CRC) screening programme is in place that entitles individuals to a stool test or colonoscopy. However, less than half of those eligible participate. The inclusion of an additional screening option, such as the evidence-based sigmoidoscopy, could lead to a higher overall participation rate, but also to individuals preferring the additional option to the more effective colonoscopy. The objective of this modelling study is to estimate the impact of offering sigmoidoscopy as an additional option for CRC screening in Germany.

Methods
A life-time mathematical model (Markov model) is developed to analyse the long-term effects of the additional offer of sigmoidoscopy on benefits (prevalence, mortality, health-related quality of life (HRQoL)), costs, and cost-effectiveness. The model is based on systematic literature reviews and real-world healthcare data. It incorporates disease development, sensitivity and specificity of the options, compliance rates, survival probabilities and background mortality. A discrete choice experiment (DCE) was conducted to estimate the future uptake of the options (stool test, colonoscopy, sigmoidoscopy, no screening) based on stated preferences of n = 666 individuals.

Results
Adding sigmoidoscopy leads to greater effectiveness of the CRC screening programme in terms of increased screening participation, increased adenoma detection, decreased disease-specific mortality, and improved discounted HRQoL. However, it also incurs higher costs. The incremental cost-effectiveness ratios (ICER) for men and women are €507 per quality-adjusted life year gained (QALYg) and €74 per QALYg, respectively.

Conclusions
The results indicate that the inclusion of sigmoidoscopy in the German CRC screening programme would be cost-effective and that sigmoidoscopy should be piloted in practice. The expanded programme has the potential to enhance the program’s effectiveness, improve health outcomes, and reduce the burden of CRC.

Key messages
• Expanding the CRC screening programme may increase overall participation, resulting in higher costs, but also greater effectiveness in detecting more adenomas, reducing mortality, improving HRQoL.
• Introducing sigmoidoscopy in Germany appears cost-effective and justifies practical piloting to enhance CRC screening efficacy and health outcomes.
Polish midwives’ experiences of providing maternity care to Ukrainian women in Poland
Authors: Nenko I , Baranowska B , Szlendak B , Sahraoui N , Węgrzynowska M 
Published: October 2024

Abstract

Background
Migrants’ health has attracted the attention of researchers for many years, particularly from the perspective of barriers in access to healthcare systems. Providing high quality care to migrants and refugees, especially in contexts of significant and sudden arrivals, may be particularly challenging.

Aim
The aim of our research was to learn about the experiences and strategies of midwives providing maternity care for Ukrainian migrant women in Poland after the outbreak of the full-scale war in Ukraine.

Methods
Five focus group interviews with 32 midwives providing maternity care in Poland were conducted. The interviews were thematically analysed.

Results
Healthcare personnel experiences a number of barriers to the provision of high-quality care to the migrant population. Polish midwives expressed mainly experience of two groups of barriers on: (1) individual and interpersonal, (2) management and organization levels. Firstly, at the individual and interpersonal level midwives experienced: fear for life and well-being related to the threat of war in a neighbouring country, depleting resources and post-pandemic fatigue, language barriers, lack of knowledge on caring for woman fleeing the war. Secondly, at the management and organizational level midwives experienced: lack of organizational support, interpreting services and documentation in any other language than Polish. In the first months after the outbreak of the full-scale war in Ukraine, most strategies to improve the provision of maternity care for women fleeing the war took the form of grassroots initiatives by the staff of individual care units.

Conclusions
The Polish health care services need systemic solutions prepared jointly by state and local authorities and considering the voices of midwives to support the provision of high-quality care to migrant population.

Key messages
• Midwives were left to their own devices.
• Midwives need better preparation for providing high-quality care to migrant population.
Patients’ experiences of racism in German inpatient healthcare
Authors: Brunnett R , Meshkova K 
Published: October 2024

Abstract

Background
Racism is recognised as a social determinant of health. An evolving concern in research and policymaking has been the impact of racism in the healthcare system, particularly regarding the quality of healthcare and barriers for healthcare. Little is known about patients’ experiences of racism in hospitals and rehabilitation facilities in Germany and their coping strategies in dealing with racism.

Methods
As part of a joint project on racism in healthcare (RiGeV) funded by the Federal Ministry of Education and Research, twenty qualitative interviews and two group discussions with patients and their next of kin about their experiences in hospitals and rehabilitation facilities were conducted and analysed using the documentary method. Ethical approval for this study was obtained from the Ethics Committee of Fulda University of Applied Sciences.

Results
Interviews with patients and their next of kin revealed that the most significant experiences of racism in hospitals are attributions of dramatisation and exaggeration of pain, embedded in a general perception of not being taken seriously and/or being ignored. Patients try to avoid such experiences that compromise their trust and sense of security, as well as the quality of treatment they receive. Healthcare for refugees is impacted by structural barriers (AsylBLg) which jeopardise the healing process and represent a considerable psychosocial burden.

Conclusions
Recommendations for policies and practice include a mission statement for non-discriminatory treatment and the sanctioning of racism within healthcare institutions. A complaints office should manage implementation and offer support for affected patients. The topic of racism must be addressed in the training and further education of doctors and healthcare professionals. Patient trust in a safe and high-quality form of healthcare should be strengthened by addressing their complaints. Health care for refugees has to be improved.

Key messages
• Racism in German inpatient healthcare represents a considerable psychosocial burden for patients and impairs the quality of treatment they receive.
• Policies for reducing racism inpatient healthcare have to be implemented.
Educational and employment for adults with a history of migration and foster care in Finland
Authors: Malin M , Miettinen J , Anand J , Joubert N , Batbaatar E 
Published: October 2024

Abstract

Several studies document the adverse educational prospects for both immigrant-origin as well as out of home placed children and youth. Few studies have examined the educational and employment outcomes of migrant-origin young adults with a history of out-of-home care (OHC), which is the aim of our study. Methods. We studied all subjects born in 1976 to 1995 abroad and immigrated to Finland as underage persons prior to 2010 (N = 20 037), comparing them to children born in Finland to foreign born parents (N = 3198) and a matched random sample of host population (N = 23 187) according to register data 1991 to 2015. We formed OHC alumni and non-OHC alumni groups among refugee-origin born abroad and in Finland, non-refugee-origin born abroad and in Finland as well as native Finns group. Logistic regression analysis was used in which age of the child in the first placement, number of placements and the type of the first place were adjusted. Results.Minors both with refugee and non-refugee background born in Finland were more likely than native Finns to be placed in OHC. A history of OHC predicted less chance of degrees completed and being employed compared to non-OHC peers in all study groups. Refugee background born abroad having history in OHC had lower educational and employment outcomes as young adults compared to other OHC groups. Education made difference since immigrant background having OHC history and post-compulsory degree had two times higher likelihood of being employed. The first OHC during teenage years decreased odds for post-compulsory education but increased odds for employment. Multiple placements in OHC decreased a youth’s chances of completing degrees and employment

Key messages
• Education made difference since persons with OHC history and degrees done had two times higher likelihood of being employed.
• Refugee origin OHC alumni were in the most vulnerable position with less degrees and less employment, and thus they need any support in their studies.
Prevalence of Mental health and Receipt of Services in Latino Immigrants Living in Philadelphia
Authors: Guariglia B , Yamasaki Y , Perez C , Zumaeta-Castillo C , Lazo M , Bakely L , Martinez-Donate A 
Published: October 2024

Abstract

Background and Purpose
Research shows that Latino populations are less likely to seek formal mental health services, these attitudes combined with difficulty finding affordable services impact the ability to receive a mental health diagnosis. This project examines mental health symptoms, utilization of mental health services, and socio-ecological barriers to receive mental health services among Latino immigrants, including region of origin, health insurance, immigration status, and English proficiency.

Methods
Data was collected between 2021-2022 by Drexel University’s CRISOL lab using a cross-sectional respondent-driven sample survey of Latinos born outside the U.S. mainland and residing in Philadelphia. The final sample included 420 Latino/a/e immigrants. Descriptive statistics and bivariate associations using Chi-square analyses were computed.

Outcomes
The findings revealed that 29.1% of the surveyed individuals exhibited signs of Depression, 36.1% experienced symptoms of Anxiety, 8.7% showed signs of PTSD, and 43.4% possessed one or more mental health conditions. The findings show that country of origin (p&lt;.01), health insurance (p&lt;.05), immigration status (p&lt;.01), and language proficiency (p&lt;.001) are significantly associated with whether an individual has received mental health services in the past year or in their lifetime. Of the survey population, only 39.5% of individuals with one or more mental issues had received mental health services in their lifetime.

Conclusions
Interventions to increase access to mental health services for Latino communities are needed. Solutions addressing disparities in access to mental health services must address systemic, cultural, and language barriers.

Key messages
• Region of origin, health insurance, immigration status, and English proficiency impact the utilization of mental health services.
• Immigrant populations face stressors that increase the risk for mental health disease and experience multiple barriers to access mental health services.
Gender stereotypes in Ukrainian healthcare: results of the mixed methods study
Authors: Boiko A , Peresada M , Duda M , Pavlenko P , Hinchey B , Avaliani N , Polomoshnova E , Elkins D , Samko M , Tokar A 
Published: October 2024

Abstract

Background
A good interpersonal patient-provider relationship is crucial for quality care, still patients frequently perceive interface as discriminatory and marginalizing, reinforcing societal gender roles and hindering healthcare quality. This becomes even more critical for healthcare systems with limited resources and prolonged emergencies, such as Ukraine during the COVID-19 pandemic and full-scale war. We explore gender stereotypes of healthcare workers in Ukraine.

Methods
This mixed-methods study was conducted in August-September 2022, and included: 1)16 online focus group discussions with 93 healthcare workers; 2)survey conducted face-to-face with 1,529 physicians and 502 nurses; modified Nijmegen Gender Awareness in Medicine Scale questionnaire was used. Qualitative data was transcribed and inductively analyzed. Survey results were analyzed in SPSS using descriptive statistics and correlation analyses.

Results
Healthcare workers perceived women patients as ‘more demanding’ and ‘less accommodating’ compared to men. Thus, 64% of healthcare workers perceived female patients as overusing health services; 44%-believed women have higher expectations than male patients; 61%-thought they expected excessive empathy; and 58%-noticed women veering off-topic during consultations. Also, respondents who supported the belief that male patients better understand doctors’ recommendations were more likely to also support the statement that female patients, compared to male patients, more often have higher expectations from doctors (rs = 0.4, p &lt; 0.001). With age prevalence of gender stereotypes increased among healthcare workers; there were no significant differences by sex of healthcare workers, healthcare facility type, position, or geographical location.

Conclusions
It is crucial to develop and implement gender-sensitive approaches in Ukrainian health facilities, rooted in comprehensive training and continuous professional development targeting prevalent gender stereotypes.

Key messages
• Gender stereotypes are prevalent among healthcare workers in Ukraine.
• Gender-sensitive approaches and comprehensive training should target prevalent gender stereotypes.
Association between all-cause mortality and diabetic avoidable hospitalization among older patients
Authors: Lee W-R , Chun S-Y , Son N , Son Y , Yoo K-B 
Published: October 2024

Abstract

Background
In South Korea, the prognosis of avoidable hospitalization in diabetes has not been evaluated, even though the incidence rate is considerably high compared to the Organization for Economic Co-operation and Development average. This study investigated the association between diabetic avoidable hospitalization after the diagnosis of type 2 diabetes mellitus and short- and long-term all-cause mortality.

Methods
Participants were type 2 diabetes mellitus patients aged 60 years and older and gathered through the National Health Insurance Services Senior cohort data from 2008 to 2019. The outcome measures included five-year and overall period all-cause mortality. The main independent variable was the first-year experience of diabetic avoidable hospitalization after type 2 diabetes mellitus diagnosis. Regression analysis was performed using the Cox proportional hazard model. To enhance the robustness of the study results, a sensitivity analysis and inverse probability of treatment weighting method were conducted.

Results
Among 31 222 participants, 2343 (7.5%) died within 5 years of type 2 diabetes mellitus diagnosis and 5314 (17.0%) died in the overall study period after type 2 diabetes mellitus diagnosis. Participants who experienced diabetic avoidable hospitalization one year after being diagnosed with type 2 diabetes mellitus had a higher risk of all-cause mortality compared to those who did not (Five-year: hazard ratio 1.84, 95% confidence interval 1.54-2.21; Overall period: hazard ratio 1.81, 95% confidence interval 1.60-2.06).

Conclusions
Enhancing accessibility and quality of primary care to prevent avoidable hospitalization in older patients with type 2 diabetes mellitus is necessary.

Key messages
• Older patients with T2DM who experienced avoidable hospitalization exhibited higher all-cause mortality rates in both the short and long terms.
• Enhancing the accessibility and quality of primary care to prevent avoidable hospitalization in older patients with type 2 diabetes mellitus is necessary.