bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving students’ mental health literacy: evaluation of an adapted school intervention in Germany
Authors: Kirchhoff S , Fretian A , Okan O 
Published: October 2023

Abstract

Background
Mental health problems and mental illness are central concerns for young people's health. As most mental illnesses emerge before the age of 25, young people are considered a key target group for preventive measures. Mental health literacy (MHL) is considered a set of resources and capacities for positive mental health and mental health care. MHL encompasses specific mental health knowledge, positive attitudes towards mental illness, and effective help-seeking behaviors. School-based MHL interventions seem to be promising in reaching young people and educating and empowering them regarding the topic of mental health.

Methods
An evidence-based Canadian MHL school intervention was adapted for German schools and evaluated for its effectiveness in terms of strengthening different dimensions of MHL (mental health knowledge, stigmatizing attitudes, help-seeking efficacy) as well as its acceptability. The evaluation study included a pre-post intervention control group design. Paired sample t-tests were conducted separately for the intervention and control group in order to verify the improvements in the different dimensions of MHL.

Results
The sample comprises 251 students aged Ø 15.6 years, with 9 intervention classes (IC) and 5 control classes (CC). The analysis showed significant improvements in the MHL dimensions knowledge, attitudes towards mental illness (personal stigma) and help-seeking for the IC. In addition, the students’ reception of the intervention was highly positive which reflects high acceptance.

Conclusions
Despite the rather small sample size (due to the COVID-19 pandemic), the evaluation offers insights into the effectiveness in terms of improving the different MHL-dimensions, and applicability of the adapted MHL intervention for students in Germany. Further evaluations are needed to confirm the intervention's effectiveness, especially with regard to long-term effects.
Racial implicit biases among obstetric care providers and associated differential care
Authors: Azria E , Sauvegrain P , Anselem O , Bonnet M P , Deneux-Tharaux C , Fischer C , Rousseau A , Richetin J 
Published: October 2023

Abstract

Background
The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. One hypothesis is the existence of implicit biases among caregivers through which the women's ethno-racial belonging can influence medical decisions and engender healthcare disparities. Their existence and their role in the generation of non-medically justified differential care is being more and more documented in the United States but remains largely unexplored in Europe.

Objectives
The aims of the BiP research program are to test and quantify the existence of implicit biases toward African migrant women among obstetric care providers and to explore the association between implicit biases and differential care.

Study design
This study is a national web-based survey to which French obstetricians, midwives, and anesthetists were invited to take part by eight professional societies and networks. The potential existence of implicit biases toward African versus French was quantified through Implicit Association Tests (IAT) for valence and strength. The association between implicit biases and clinical decisions was then assessed using six clinical vignettes. For each, the patient's origin, African/French, was suggested by using typical surnames.

Results
The survey was completed by 887 professionals. The IATs showed that caregivers in the three professional categories had strong implicit biases with a preference for French versus African women in terms of valence, while they implicitly tended to attribute more strength to African women. We did not observe any association between Patient's name (French vs. African), caregiver's biases (implicit valence or strength) and the behavioral intention captured through vignettes responses.

Conclusions
This study shows a high level of implicit racial biases among obstetric care providers, but these biases were not associated with differential clinical decisions.

Key messages
• This study shows a high level of racial implicit bias among healthcare providers.
• No association between implicit bias and clinical behavioral intentions were observed.
Empowerment-based intervention and immigrant awareness of biomedical HIV prevention tools in France
Authors: Coulibaly K , Bousmah M-Q , Ravalihasy A , Taéron C , Mbiribindi R , Senne J-N , Gubert F , Gosselin A , Desgrées du Loû A ,   For The Makasi study group
Published: October 2023

Abstract

Background
Sub-Saharan African immigrants are particularly affected by HIV in France and social hardship is an indirect factor of HIV acquisition. While biomedical HIV prevention tools are available for HIV prevention, evidence suggests a lack of knowledge of these tools among immigrants from Sub-Saharan Africa. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), Pre Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) among a population of precarious sub-Saharan African immigrants.

Methods
Data were collected in the Makasi research project. Participants were recruited in public places based on their precarious situations, they were randomised into two groups (intervention and control) followed during six months between 2018 and 2021. We described the knowledge of biomedical HIV prevention tools at each follow-up time (0, 3, 6 months) and used random-effects logistic regression models to analyse the intervention effect on the level of knowledge of these tools.

Results
The majority of the participants were men (77.5%) and almost half of them arrived in France within 2 years prior to inclusion (49.3%). At the time of inclusion, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing PEP (aOR=2.02 [1.09-3.75]; p &lt; 0.026). Intervention effect were observed for TasP and PrEP only after 6 six months. We observed significant time effect for PEP (at 3 months aOR=4.26 [2.33-7.80]; p &lt; 0.001; at 6 months aOR=18.28 [7.39-45.24]; p &lt; 0.001) and PrEP (at 3 months aOR=4.02 [2.10-7.72]; p &lt; 0.001; at 6 months aOR=28.33 [11.16-71.91]; p &lt; 0.001). This time effect is linked to the associations outreach activities.

Conclusions
Our results suggest that exposure to the Makasi intervention combined with associations activities contributed to increase knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.

Key messages
• The Makasi intervention improved the knowledge of biomedical HIV prevention tools.
• One-shot empowerment-based intervention shows encouraging result for HIV prevention.
Nutrient values and sustainability of omnivorous, vegetarian and vegan choices in a hospital canteen
Authors: Menis D , Fiori F , Zago D , Cautero P , Lesa L , Scarpis E , Brunelli L , Parpinel M 
Published: October 2023

Abstract

Background
A plant-based diet has a lower environmental impact than an omnivorous diet and, when balanced, may reduce the risk of certain non-communicable diseases. The aim of our work is to evaluate the nutritional profile and sustainability of omnivorous, vegan and vegetarian choices in an Italian hospital canteen.

Methods
We photographed the midday meals of users in the hospital canteen of Palmanova (Italy) for 5 consecutive days in September 2022. We examined the recipes provided by the canteen and divided the meal trays in omnivorous, vegan and vegetarian. For each tray we estimated the carbon and water footprint using the SU-EATABLE LIFE database and the energy and nutrient content using the Italian Food Composition Database for Epidemiological Studies.

Results
We analysed 228 trays (167 omnivorous, 7 vegan, 54 vegetarian). Median energy content was higher (p &lt; 0.05) in the omnivorous trays (942 kcal/tray) than the plant-based trays (813 kcal/tray). The omnivorous trays contained more fats (42 %E) and less carbohydrates (36 %E) than the plant-based trays (fats: 35 %E; carbohydrates: 44 %E) (p &lt; 0.05). The carbon and water footprint were higher (p &lt; 0.05) for the omnivorous meals (1202 gCO2eq/tray, and 1370 LH2O/tray) than for the plant-based meals, which had a median value of 687 gCO2eq/tray and 907 LH2O/tray.

Conclusions
Vegan and vegetarian meals were more in line with the Italian dietary reference values and more sustainable than omnivorous meals. Nutrition education is needed to improve the sustainability and quality of workers’ lunches and to ensure an adequate choice of plant-based meals.

Key messages
• Even if plant-based meals were more sustainable and nutrionally balanced than the omnivorous ones, they were less chosen.
• Improving food choices can help achieve the Sustainable Development Goals.
Pediatric injuries classification using openAI: new opportunities for epidemiological surveillance
Authors: Lorenzoni G , Sciannameo V , Baldan G A , Bressan S , Da Dalt L , Berchialla P 
Published: October 2023

Abstract

Background
The burden of unintentional pediatric injuries remains a significant concern for healthcare systems worldwide. Timely and accurate surveillance is critical for injury prevention and resource allocation. However, the diagnosis reported in the emergency department records is often not coded, and the manual coding of these records is labor-intensive, time-consuming, and prone to errors. To implement an automatic coding system using GPT-based models to extract and classify injury data in the Italian language from pediatric emergency department records.

Methods
The study included 283,468 admission records to the pediatric Emergency Department of Padova University Hospital from 2007 to 2018. Each access is mandatorily registered in an electronic data collection system. For each emergency department access, both coded (administrative and demographic data) and free-text (diagnosis) information are reported. A random subset of 40,030 records underwent classification of free-text diagnosis (as injury or not) by an expert clinician (gold standard). OpenAI was used for the classification task. OpenAI is an extensive language model based on the GPT architecture. Specifically, the GPT-3.5 variant was employed for the present work. openAI was accessed through a public application programming interface (API) using R software.

Results
Preliminary results showed a classification accuracy of 96.2%. The tool's ability to correctly classify the injuries (sensitivity) was 95%, while the specificity was 96.5%.

Conclusions
The performance of the classification task was excellent. The present results demonstrate the feasibility of GPT-based models for processing unstructured free text information from medical records.

Key messages
• OpenAI would represent a promising opportunity to improve pediatric injuries surveillance
• OpenAI would improve the classification of unstructured information from medical records
Climate change and public health: barriers and levers for implementation of climate adaptation in Europe
Authors: Turner G , de’Donato F , Hoeben A , Nordeng Z , Otto I , Stackpole Dahl M , Aunan K , Kovats S 
Published: October 2023

Abstract

Background
Climate adaptation policies (to reduce health impacts from climate change) are being implemented across Europe driven by political action, public support, and more extreme weather. All EU countries have national climate adaptation policies but the the role of addressing public health in implementation varies by country and is often undervalued.

Aim
Identify key issues in climate adaptation implementation by public health professionals in Europe.

Methods
Key informant interviews were undertaken with decision makers in international, national, and local government across 20 European countries. Participants were recruited if working in public or environmental health, and in climate adaptation policy. Interviews addressed these key themes: barriers, health agenda, levers, networks, evidence needs. Interviews were conducted online, recorded, transcribed, and analysed thematically.

Results
32 interviews were completed between June-October 2021; 4 international, 5 national level and 23 city-level stakeholders. Most reported inadequate resources for health adaptation implementation (funding, training, and personnel) and the marginal role of health in climate adaptation policy development. A clear mandate to act was key for adaptation implementation and resource allocation. A reported challenge was departmental cross-collaboration, and city-level stakeholders’ awareness of the public health role in climate policy. European-level stakeholders reported strength in ability to coordinate expertise to national and regional-level governance partners highlighting the importance of interagency collaboration.

Conclusions
Across Europe, there is varied progress in implementation of climate-health adaptation. Providing appropriate resources, inter-departmental collaboration, training, knowledge mobilisation, and multi-level governance support will facilitate climate and health policy implementation.
Stakeholder mapping: regional comparisons in adaptation implementation
Authors: Natukunda J , Turner G , Wright C , Mawanda S , Pagiwa V , Muthoni C , de’Donato F , Hajat S , Kovats S 
Published: October 2023

Abstract

Background
Health adaptation planning is rapidly progressing but implementing actions on key health and climate change priorities is slow. We summarise and compare findings on progress in health adaptation in Europe and East and Southern African regions.

Methods
A desk-review of national health adaptation plans and strategies (NAPs) was conducted in 20 European countries and 14 East and Southern African countries to identify adaptation priorities. Key informant interviews were conducted with government representatives, non-governmental organizations, development partners, and civil society organisations. Participants were identified through partner networks and snowballing. The WHO framework was followed in mapping stakeholders’ interests, knowledge, and influence on health adaptation. Interview responses were transcribed and analysed in Nvivo to identify key themes.

Results
34 NAPs were reviewed (20 in Europe, 14 in Africa). Interviews were conducted with 48 stakeholders (32 in Europe, 16 in Africa). Across Europe, more than half of the countries have policies addressing infectious diseases (12) and heat-related risks (14). In Africa, infectious diseases were a national priority for all countries, but heat management plans were largely absent (only one nation had a heat management plan). In both regions, adaptation action was driven by national policies, high stakeholder interest and knowledge, and the presence of focal points or joint working groups. Key barriers included: limited interagency or institutional collaborations, a need for evidence-based practice-oriented research, and funding for health adaptation activities.

Conclusions
There are similarities in drivers and barriers to health adaptation in Europe and Africa. Progress on implementation is uneven, with heat-health planning largely lacking in East and Southern Africa.
Testing the resilience of the Greek health system faced by a Human Resources in Health (HRH) shock scenario
Authors: Kaitelidou D , Konstantakopoulou O , Panteli D , Vildiridi L 
Published: October 2023

Abstract
Greece holds the highest density per capita of doctors and the lowest density per capita of nurses among the EU countries. There is significant health worker maldistribution leading to understaffing of primary healthcare and an overabundance of specialists. However, there are numerical and geographical imbalances and shortages in specific specialties. A shock event scenario with respect to a sudden shortage of HRH (especially of doctors and nurses) crisis due to hypothetical upcoming changes to legislation regarding pension thresholds, salaries and insurance for health professionals will be piloted in May 2023. The resilience test is based on the resilience testing tool developed by the European Observatory on Health Systems and Policies, the OECD and the European Commission. Participants will include government and MoH representatives, health professionals from the hospital and PHC sector, academics, patient representatives etc. This sudden and massive loss of health workforce scenario entails a significant strain on the healthcare system mainly with regard to governance (e.g., increased need for reliable data and intelligence reporting on the distribution and availability of the remaining healthcare professionals), resource generation (e.g., health units forced to operate under unfavorable and below safety limits staffing ratios), service delivery (e.g., long waiting times for surgeries and hospitalizations and PHC units struggling to meet the demand for visits) and financing (e.g., rising healthcare costs due to the need to purchase services from the private sector).
Expected outcomes refer to highlighting challenges that the Greek health system would encounter during this scenario and good practices that could be implemented to alleviate short- and long-term implications of health workforce shortage and strengthen system's resilience in view of future crises. The presentation will share actual outcomes, which will be available by the time of the conference.
Process evaluation of the Greek nationwide school health education program
Authors: Sakellari E , Prapas Ch , Perifanou D , Chatzicharalampous E , Lagiou A 
Published: October 2023

Abstract

Background
Schools can play a significant role in promoting health of the school community. Process evaluation is always needed to gain valuable insights on how next health promotion interventions could be improved. In Greece, the first effort to organize health education interventions in the schools at national level, was in 2019 by the Ministry of Health. The aim of the current study was to evaluate the process of a national school health education program in Greece.

Methods
The health education interventions took place during school year 2019-2020. They included the following themes: oral health, healthy eating, mental health, sexual health, bullying, and online safety. Multidisciplinary teams co-developed all health education material. A representative sample of teachers and health professionals filled in the structured questionnaires developed for the current study, after their informed consent. Statistical analysis was conducted using SPSS statistical software (version 22.0).

Results
Most teachers evaluated as excellent (83.6%) the cooperation with the school principal and the health education coordinator (77.6%), while the general satisfaction from the intervention was evaluated as excellent by 69.8% of them. In addition, most of the health professionals (90.7%) perceived as excellent the cooperation with the health education coordinator and the other health professionals (86.3%) as well as the cooperation with the school principal (87%).

Conclusions
Even though this was the first effort in Greece to organize school health education interventions at a national level, the results of the process evaluation have been positive. Therefore, the Greek Ministry of Health has adopted this program which is implemented until today.

Key messages
• Process evaluation of school health education interventions is important to improve future initiatives.
• Centrally organized school health education interventions may be the key for their success.
Overview of key findings on CSE status in 4 countries
Authors: Ivanova O 
Published: October 2023

Abstract
We used SERAT to assess the implementation of CSE in four countries. The data collection took place between December 2021 and July 2022. All four countries teach sexuality education, which is supported by adequate legal and policy frameworks, and integrate it into their school curricula. The comprehensiveness of the curriculum, teacher training and learning methods differ across the four countries. The integration of the sexuality education concepts varies across countries. Relationships and values topics are generally more present in the curricula across all age groups. Topics with lesser attention are gender, sexual behavior and sexuality. The content is more comprehensive for the age group 12-15, followed by 15-18 in all countries. All countries integrate learner-centred learning techniques and employ different teaching strategies for sexuality education, including participatory methods. Overall, there is a lack of school-based SRH services and commodities, including contraception. In countries where school-based health services exist, nurses often do not have guidelines or a mandate to provide relevant information. Monitoring and evaluation is one of the weakest components of all programmes in three of the four countries. To conclude, there is a need to enhance the content in all age groups, improve teacher training and provide materials to teachers and students, strengthen links with health services, involve relevant stakeholders in curricula development and introduce measurable monitoring and impact indicators.
6.P. Workshop: Responding to violence and abuse across the life-course
Authors:   Organised by: EUPHA-PMH,   Chair persons: Jutta Lindert (EUPHA-PMH), Anastasia Fadeeva (UK)
Published: October 2023

Abstract

Much research on the mental health effects of violence focus on domestic violence as experienced in adulthood. The mental health impacts are often gauged using cross-sectional studies and focus on current associations between violence and health. This workshop presents a range of analyses - drawing on data from New Zealand, Germany and the UK - that address the ways in which violence and abuse manifest at different life stages, including in childhood, among working-age adults, and in later life. The presentations highlight differences across the life course, as well as commonalities. They provide evidence of the long-term, even life long, shadow that violence and abuse can cast over people's health, and provide evidence of the extensive costs for society. Health impacts are shown to be broad, not only anxiety and depression, but substance dependence, chronic physical health conditions, and related health risks such as obesity. This workshop comprises four presentations that each consider violence and abuse prevalent at a particular stage of life, and provide evidence to inform the sensitive tailoring of responses from and for families, schools, health and social services, workplace human resource employees, and care and residential homes. The format of the workshop comprises brief presentations, with a focus on extended audience discussions. We invite engagement from people from a range of disciplines interested in how different forms of violence and abuse present at different life stages, the impacts on health, and the ways in which society should respond. This workshop is submitted on behalf of the EUPHA Public Mental Health Section.

Key messages
• Violence occurs across the life course. While its prevalence and form often vary between life stages, at every stage it has major, long-term, and diverse implications for health.
• Interventions need to be tailored to the life course and sensitive to changing context, including domestic, workplace, and care home environments.