bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interactive dashboard development for Irish general practices to visualise and compare patient data
Authors: Garzon-Orjuela N , Vornhagen H , Stasiewicz K , Garcia Pereira A , Vellinga A 
Published: October 2023

Abstract

Background
Health information technology has increased worldwide, transforming health and healthcare programs in which information visualisation and visual analytics processes are central. However, aggregating and comparing patient data remains challenging. Therefore, a dashboard was developed with and for Irish general practitioners (GPs) to improve their understanding of their patient population, disease management and prescribing. This paper describes the design and development process of the CARA dashboard.

Methods
The design and development of the CARA dashboard used an Action Design Research approach, which consists of (1) problem formulation, (2) building, intervention and evaluation, (3) reflection and learning and (4) formalisation of learning. The process included interviews, to explore what type of information GPs need, as well as iterative testing of the CARA dashboard prototype.

Results
Key challenges identified from the interviews (Context, Sense-making, Audits, Relevancy, Action, Engagement and Ease of Use) formed the basis for the development of the CARA dashboard prototype. The first exemplar dashboard focused on antibiotic prescribing to develop and showcase the proposed platform, including automated audit reports, filters (within practice) and between-practice comparisons as well as a visual overview of practice demographics.

Conclusions
User involvement in the design and development of the CARA dashboard is crucial to ensure GPs are enabled and supported to visually access and monitor their patients’ data. Next steps will include an exploratory study on dashboard engagement and the development of additional dashboards for topics such as chronic disease and mental health.

Key messages
• Good knowledge of operating systems, effective use of data, user interaction and context factors are required to design and implement an interactive dashboard.
• Crucial components to make sense of the information provided in dashboards include the context, transparency about the data transformation processes and adherence to design principles.
How do health authorities inform about general practitioner selection? Analysis of Italian Websites
Authors: Vinci A , Pirrotta L , Vainieri M 
Published: October 2023

Abstract

Background
The Next Generation EU and Italian Recovery and Resilience Plan share the common goal of supporting digital transformation. In health, adequate digitalization and web communication strategies are essential to achieve adequate population health outcomes. This work describes the level of digitalization and information of a fundamental primary care service: the choice or change of the General Practitioner (GP).

Methods
The analysis was conducted by consulting websites of Italian Local Health Authorities (LHAs). First, we explored digitalization levels of 105 websites through the Primary Care Digital Information (PCDI) composite index. It comprises four dimensions: informativeness, accessibility, inclusiveness, and adaptability, scoring from 0-5 (low-high digitalization). Second, we conducted a readability analysis of websites. Text quality was measured using the Gulpease and READ-IT indexes and New Basic Italian Vocabulary (NBIV) was used for lexical complexity.

Results
We found a national average of 2,48 for the PCDI (Min 0 - Max 4,38). Nationally, the best performing dimension was adaptability, while the worst was inclusiveness. Half of the LHAs provided several digital alternatives to choose or change the GP, while the remaining provided limited or no options. Most LHAs (70%) displayed directly on their home page a reference on how citizens can choose or change GP. However, 70% lacked specific information for non-residents citizens. Regarding readability, the national average was 48,78 for READ-IT (Min 32 - Max 62), on a scale from 0-100 (good-bad readability).

Conclusions
Overall, our findings depict variable and fragmented digitalization and information levels of a key health service. Despite best practices, several areas require monitoring and intervention. Moreover, some barriers characterize Italian health communication strategies, notably the variability of information across and within regions and on average low website readability.

Key messages
• There are significant digitalization discrepancies in Italy with respect to the primary care service observed. The PCDI scores highlight a fragmented scenario and opportunities for improvement.
• The aspects related to the readability of information remain to be monitored. This study highlights the need to invest more in fostering efficient service comprehension and clarity.
Quantifying the health impacts of alternative urban development scenarios using the HAUS tool
Authors: Hunt A , Eaton E 
Published: October 2023

Abstract

Local authorities face a capacity challenge to balance policy considerations when master-planning an area for redevelopment. Effects of redevelopment on residents’ health comprise one competing priority alongside financial viability, sustainability and employment provision. The challenge is not a lack of data, but a lack of accessible tools to help LAs synthesise and interpret complex information about health effects. We address this by creating a health-economic valuation model which allows the user to understand health trade-offs entailed in alternative scenarios and relative to other costs and benefits. The model applies evidence to quantify and monetise the potential impact on health outcomes related to characteristics of the urban environment. The model is driven by a set of 200+ environment-health impact pathways supported by systematic reviews of evidence relating to building design, natural environment, community infrastructure and transport. We estimate the societal value of changes to health using a database of economic values for 70+ physical and mental health outcomes. Values include costs of treatment, productivity loss and pain & suffering associated with ill health, and are disaggregated according to who bears the costs, e.g. NHS, police. Values are modelled for a synthetic population which can be tailored to local contexts, allowing for aggregation. We apply the model to a regeneration site in Bristol, UK, identifying health outcomes resulting from alternative land use scenarios for the site. Model outputs were used to inform the process of developing a Spatial Regeneration Framework and preferred land use scenarios within the regeneration site. Our research helped to widen out the number of health impacts considered by the design team, and to build a strong case for healthy policy options such as enhanced green space within the strategic framework, ensuring that health data can be built into negotiations with developers in the implementation phase.

Key messages
• Economic valuation of health impacts of urban environment leads to better public health decision-making.
• The HAUS model allows better-informed trade-offs between health and urban investment to be made.
9.H. Workshop: Applying the Supersetting-approach to tackle health inequities in disadvantaged settings
Authors:   Organised by: Health Promotion Research, Steno Diabetes Center Copenhagen (Denmark),   Chair persons: Maria Stougaard (Denmark)
Published: October 2023

Abstract

Inequity in health remains a major urgent global public health challenge, not least concerning noncommunicable diseases (NCDs) including type 2 diabetes (T2D). Peoples’ abilities to live long healthy lives is linked to their social and economic situation and living in disadvantaged neighbourhoods is associated with increased health risk across the life course and increased risk of T2D in adulthood. The risk of ill health is thus deeply rooted in the complex social contexts of people's everyday lives. Thus, addressing the social determinants of health by incorporating a variety of strategies and interventions in the settings where people live is imperative to tackle health inequities. Evidence suggests that multilevel-multicomponent interventions can have a positive impact on a range of health and behavioural outcomes. Moreover, studies show that bottom-up approaches in community interventions constitute important drivers of collaborative action and sustainable solutions to inequity in health at a community level. This workshop presents the Supersetting approach - an intervention strategy for comprehensive community interventions - as one solution to tackle growing health inequities in disadvantaged urban settings focusing on T2D. The approach strives to attain synergistic effects through coordinated engagement of multiple stakeholders in multiple settings to mobilize local resources and strengthen social networks for collective community action. The Supersetting approach has recently gained international recognition as a “a whole-of-society endeavor” approach to health promotion by welcoming complexity at all levels of the intervention. The workshop uses Tingbjerg Changing Diabetes (TCD) a long-term community-based initiative, as a case to unfold the complexity and width of the Supersetting approach (www.tingbjergchangingdiabetes.dk). Beginning with an introduction and conceptualization of the Supersetting approach and characterization of the urban area of Tingbjerg focusing on T2D, we hereafter present three integrated TCD initiatives. These illustrate how the Supersetting approach can be applied in practice as well as how to explore and measure its different impacts through different methodological approaches. The workshop aims to present and discuss the potentials and challenges of using a Supersetting approach to tackle inequalities in health in disadvantaged urban settings.

Key messages
• The rising challenge of inequity in health calls for complex systems approaches.
• The Supersetting approach is presented as a sustainable complex systems approach to tackle growing health inequities in disadvantaged neighborhoods.
Intersectoral health governance during floods: a qualitative case-study into the Dutch 2021 flood
Authors: van Vuuren K , Borst RAJ , de Graaff B , Bal R A 
Published: October 2023

Abstract

Background
With the planetary crisis comes an increasing risk of flooding events. As shown during the 2021 floodings in Limburg, these can have disastrous consequences for the public health system and healthcare organisations. Historically flooding events are often treated as either affecting public health or acute care, but the 2021 events showed the necessity of an intersectoral governance approach. In this study, we investigated how governance actors from different domains collaborate and perform shared sensemaking processes to ensure patient safety continuity of (public health) care.

Methods
For the past months, we conducted a qualitative case-study in the Dutch region of Limburg where we interviewed governance actors from public health, acute healthcare, water management, and safety and crisis management. We also observed and analysed crisis exercises and hospital crisis management meetings, including relevant paper trails. All data were abductively coded and thematically analysed.

Results
Our analysis shows that during and after the flooding event, actors were confronted with numerous vulnerabilities about decisions to evacuate hospitals, care homes, or even villages. These include decisions about what are public health risks, and what are not. To curb such uncertainties, intersectoral sensemaking proofed essential with a central role for the public health crisis system. In our presentation we highlight how such sensemaking was done in practice.

Conclusions
To deal with the effects of the planetary crisis on healthcare, events such as floodings must be approached intersectorally. The public health system plays a central role in perceiving the vulnerabilities in a crisis from all angles.

Key messages
• Floodings are more likely to affect the public health and healthcare system.
• Highly complex crises, such as floodings, require an intersectoral governance response with the public health system in a central role.
Self-care behaviour among arterial hypertension patients: role of a general practitioner in Latvia
Authors: Kursite M , Springe L , Villerusa A 
Published: October 2023

Abstract

Background
Engagement in self-care behaviours is a crucial part of arterial hypertension (AH) management. Yet, now patients practice self-care selectively and with low adherence. This study aimed to determine the association between patients’ experience with a general practitioner (GP) and positive self-care behaviours among people with arterial hypertension in Latvia.

Methods
A cross-sectional study of 950 participants aged 15-74 (median 62, 38.7% male) with AH from a population survey in Latvia in 2022 was conducted. Logistic regression was used to determine respondents’ experience with a GP (overall attitude, providing information and counselling on a lifestyle change) in relation to having positive self-care behaviour (use of medication, weight loss, physical activity (PA), salt intake, smoking cessation) adjusting for age, sex and education.

Results
Most of the participants reported being satisfied with their GP (94.1%) and the information provided about their disease (84.8-89.4%). Regular use of AH medications was reported by 83.6%, and lifestyle change attempts by 5.2-16.1%. Regular medication use increased by receiving information about complications of AH (aOR=4.43, p ≤ 0.001), and being satisfied with the provided information about the treatment plan (aOR=1.91, p = 0.011), and alternative treatment methods (aOR=2.21, p ≤ 0.001). Receiving advice to change eating habits increased adhering to a diet for weight loss (aOR=4.16, p ≤ 0.001), reducing salt intake (aOR=4.64, p ≤ 0.001), and increasing PA (aOR=4.33, p ≤ 0.001). Similarly, advice to increase PA or reduce weight was statistically significantly associated with other self-care behaviours. None of the factors had a statistically significant impact on smoking cessation.

Conclusions
Patients’ experiences with a GP are important factors in determining engagement in positive self-care behaviour regarding medication use, PA, and changes in eating habits. The GP's role in smoking cessation requires to be strengthened.

Key messages
• Arterial hypertension patients are more engaged in self-care when supported by a general practitioner. Yet patients are more focused on medication use than lifestyle change.
• Strengthening the communication skills of general practitioners is crucial for improving the disease-related health literacy of arterial hypertension patients and their ability to practice self-care.
General population knowledge, attitudes, and behaviors (KAB) on hepatitis c screening, Latium, Italy
Authors: Bongiovanni A , Santolini G , Abbondanzieri A , Mantia F E , Ambrosone C , Flammini A M , Marfurt C , De Angelis F , Perra A 
Published: October 2023

Abstract

Background
In 2022, a free-of-charge screening to eliminate the HCV virus circulation was offered countrywide to the citizens born from 1969 to 1989. Recent studies reported low adherence rates to HCV screening campaigns, highlighting the need for policy makers to know the determinants of adherence, aimed to set up more effective communication campaigns.

Methods
A target population random sample answered by phone a questionnaire based on the Health Belief Model (HBF), containing 4 sections on perceived HCV susceptibility and severity, screening benefits and barriers. Each interviewed was finally invited to adhere to the screening. Prevalence was estimated using a 95% C.I., and association between sociodemographic characteristics, HBF attitudes, and screening adherence following the interview were assessed.

Results
Survey involved 641 participants. HCV susceptibility was perceived by 4.8% (C.I.95% 3,23-6,57) and HCV severity by 69,4% (I.C.95% 65,83-72,97), 95% (C.I.95% 93,3-96,6) acknowledged screening benefits and 88% (85,4-90,5) perceived no obstacles. It was found that 49.0% (C.I.95% 45,1-52,8) received no information. Perception of screening barriers was associated with low education level (OR 1.83, P = 0.02). In the 2 months following the interview, 17.6% (C.I.95% 14,6-20,5) carried out the HCV screening. Severity (OR 1.74, P = 0.03) and no barriers perception (OR 2.63, P = 0.01) were associated factors to post phone call adherence to UCV screening.

Conclusions
Insufficient communication campaign toward target population results in poor knowledge of HCV susceptibility and gravity and low adherence to HCV screening. Target population needs to acquire better awareness about HCV and HCV screening, through targeted and effective messages especially focusing on the susceptibility and gravity of HCV infection.

Key messages
• Target population does not feel susceptible to hepatitis c and has poor perception of severity.
• It is necessary to improve communication through effective messages.
Enhancing help-seeking efficacy in a sustainable and adaptive digital environment
Authors: Wright M , Hochgatterer L , Reitegger F , Gasteiger-Klicpera B , Patias I , Peras I , Veldin M , Vidmar M 
Published: October 2023

Abstract

Background
Help-seeking efficacy is directly related to Mental Health Literacy (MHL) as one of its four important components and has been successfully addressed in digital mental health interventions for youth. However, these interventions are often not sustainable and not sufficiently diversity-sensitive. The 3-year Erasmus+ project me_HeLi-D (mental health literacy and diversity) aims to develop a digital, adaptable, diversity-sensitive tool to promote mental health and MHL among youth (12-15 years).

Methods
The tool-development is based on two pillars: thorough literature reviews and the voices of young people. Through a participatory research process, the design and content of the modules are co-created with the target group. The tool is implemented in Moodle to ensure high accessibility and flexibility and to allow updates and monitoring by the IT-department, which guarantees sustainability beyond the project duration. A total of 27 mental health interventions were systematically reviewed for the module addressing help-seeking efficacy, and three of them reported effective improvement in help-seeking behavior. Among these, an app using character vignettes resulted in greater increases in well-being and help-seeking intentions in the intervention group.

Results
Based on these findings and feedback from the participatory activities, an activity promoting help-seeking behavior was developed for the tool using a narrative format. The help-seeking activity, its content, and its goals are presented. In addition, the digital implementation is discussed, addressing issues of adaptability and sustainability in relation to the deployment plan in Moodle.

Conclusions
The importance of a participatory, evidence-based approach and consideration of diversity-sensitivity and digital sustainability in the development of a digital mental health tool was emphasized.
Impact of the covid-19 pandemic on GP contacts for respiratory infections in children under 5 years
Authors: Foley K A , Hargreaves D S , Quint J K , Bottle A , Viner R M , Kenny S E , Majeed A , Saxena S 
Published: October 2023

Abstract

Background
Social distancing measures to reduce transmission of SARS-CoV-2 during the covid-19 pandemic also impacted the transmission of many other respiratory pathogens. We describe the impact of the covid-19 pandemic on general practitioner (GP) contact rates for respiratory tract infections (RTIs) that may have been affected by social distancing in children &lt;5 years in England.

Methods
Trends analysis from 1 April 2016 to 31 March 2021 using electronic health records from a nationally representative primary care database. We included all children aged &lt;5 years registered with a primary care practice during the study period. Our main outcome was GP contact rates for transmissible RTIs including otitis media, tonsillitis, and pneumonia. We also calculated the rates of urinary tract infections as an index non-transmissible condition.
We calculated annual rates for each year of age (&lt;1, 1-&lt;2, 2-&lt;3, 3-&lt;4, 4-&lt;5) by summing the GP contacts divided by the number of days each child was registered with the GP practice.

Results
There were 415 622 RTIs among 1 955 946 children &lt;5 years over the study period. From 2016-2020 GP contact rates for RTIs were falling steadily by ∼14%/ year in all age bands, with rates of otitis media, tonsillitis and pneumonia declining by 5-11% per year. However, in 2021 marked falls of around 80% occurred for all RTIs, otitis media, tonsillitis, and pneumonia. By contrast, trends for GP contact rates for urinary tract infections before and during the covid-19 pandemic steadily declined by ∼5%/year.

Conclusions
Our study shows major reductions in the incidence of RTIs in under 5s during the pandemic, probably a result of SARS-CoV-2 containment measures. The impact of reduced exposure to RTIs during childhood on long term respiratory health is unknown. At the conference, we will report results up to March 2023.

Key messages
• GP contacts for respiratory infections in under 5s fell during the covid-19 pandemic in England.
• Fewer respiratory infections in childhood may impact future health service use and requires monitoring.
Associations between physical activity and digital gaming activity among Finnish adolescents
Authors: Ng K , Karhulahti V-M , Koskimaa R , Sokka M , Husu P , Kokko S P , Koski P 
Published: October 2023

Abstract

Background
Physical activity (PA) for adolescents is an important health promotion habit to develop, yet other activities may be more appealing during this stage in life. According to the displacement hypothesis, time on digital games takes away the opportunity to be physically active. As there is a notable decline in PA levels between the ages of 11y- 15y in Finland, there is an urgent need to investigate potential areas that contribute to the decline. According to the 2021 Finnish Player Barometer, 65% of Finns play digital games regularly. The aims of this study were to investigate the associations between PA and digital gaming, and to examine how these associations may change by gaming genres.

Methods
A Finnish national representative sample (n = 1979) of 11y-15y olds, completed a self-report survey in spring 2022. Variables included PA behaviour, the frequency of digital gameplay, by sport simulation and Esports genres, and various confounders (gender, age, disability, economic status). Analyses were carried out by chi-square tests and multi-logistic regression analyses (no/low activity as reference categories).

Results
A third (32%) reported daily PA. Daily digital gameplay was more common among males (74%) than females (26%) and decreased from 11y (53%), 13y (30%) to 15y (17%) olds. After controlling for confounders, playing ball sport simulations (e.g. FIFA) was associated with taking part in 5 or more days/week of PA, or sport club participation (OR = 2.8, CI = 1.7-4.4), whereas playing a lot of first-person shooter games, as an Esport, was negatively associated with sport club participation (OR = 0.6, CI = 0.4-0.9) when compared to the reference categories.

Conclusions
The displacement hypothesis was supported partly among Esport players, but not by simulated sport gamers. Targeted interventions to promote physical activity with digital gaming, require a genre-specific approach.

Key messages
• Associations between physical activity and digital gaming activity among young adolescents is genre specific.
• Frequent playing of digital games were more common among male 11-15y olds than females.