bluuebunny/crossref_metadata_2025_split huggingface dataset:
People, places and the climate emergency – the Scottish Place Standard Tool with a climate lens
Authors: Hasler K , Whitmore S , Wolstenholme R , Payne C , Hutton A , Fingland C , Tarvit G 
Published: October 2022

Abstract
Since the launch of the Place Standard tool (PST) in Scotland in 2015 awareness has increased of the critical impact of the climate emergency on health and equity. A 2019 review of the PST, informed by emerging evidence and community and stakeholder feedback, confirmed the need to strengthen its contribution towards place-based climate action. This was partly achieved by integrating enhanced prompts within the PST itself, however with the increased focus of policy and action around climate adaptation and mitigation a knowledge and resource gap remained. So in 2020 PST partners* began work with experts from environmental organisations (Sniffer, Sustainable Scotland Network) and other partners to develop a “Place Standard with a climate lens” (PST CL). The PST CL toolkit was created through an iterative process integrating feedback from 10 pilot projects chosen to represent the varied communities, scales, landscapes and placemaking projects being undertaken across Scotland. It provides a suite of materials to use alongside existing PST resources to help placemaking conversations consider how climate change might play out in a local area. This ensures that local responses to climate change are designed holistically, delivered collaboratively, and helps achieve on other local priorities such as health, wellbeing and equity. This presentation will provide a brief overview of the project background, describe the Scottish PST with a climate lens, share case study examples from the piloting phases, and enable exploration of the learning from Scotland around the value of integrating health and climate in place-based approaches. While the Place Standard tool was not originally designed as a climate change tool, it is an effective method to support the design of local responses to the climate emergency. A “climate lens” can help us to plan the future of our places to maximise the health benefits and minimise the negative consequences of a changing climate.
Results from the TEHDAS country visits: State-of-play of 12 EU member states in relation to the EHDS2
Authors: Abboud L , Cosgrove S , Kesisoglou I , Bogaert P 
Published: October 2022

Abstract
Successfully launching a sustainable EHDS requires a clear understanding of the current situation in Member States, taking into account the existing diversity. With this in mind, country visits are being carried out in a group of 12 countries: Denmark, Belgium, Hungary, Netherlands, Estonia, Ireland, Portugal, Finland, Czech Republic, Slovenia, Sweden, Germany. The aim of the country visits is to map the state-of-play of health data management in different countries and explore their preparedness to join the EHDS. The topics explored include: the health data sources available, the health data infrastructure (storage, access and interoperability), data quality assurance mechanisms, data governance, as well as resource and training needs and opportunities. Another aim of the country visits is to explore needs and expectations at national level, and how the EHDS can respond to them. This presentation will include an overview of the health data management systems of the 12 countries mapped, providing a snapshot of the situation across Europe. It will then present the findings on their preparedness to join the EHDS. Preparedness takes into account a variety of factors, including political will, as well as legal and technical factors. The presentation will further share the lessons learnt and best practices highlighted from the country visits. Finally, based on these findings, the presentation will close with an overarching view on the preparedness across Europe to deploy the EHDS for the secondary use of health data, EHDS2, as well as planned actions that would facilitate the implementation of the EHDS2 in different member states.
The Vienna self-assessment questionnaire for hospitals: Three explorative case studies in Belgium
Authors: Henrard G , Rademakers J 
Published: October 2022

Abstract

Background
One way to develop adequate health literacy responsive policy and strategies in hospitals is the use of self-assessment tools to raise awareness, help prioritize action and mobilize stakeholders. In this study we have piloted the French version of the Vienna Health Literate Organisation (V-HLO-fr) tool in three hospitals to explore its feasibility.

Methods
We performed explorative case studies in the three main hospitals of Liège (Belgium). Our mode of application of the V-HLO-fr was inspired by the ‘RAND Appropriateness’ method: first, individual members of an internal multidisciplinary panel filled out the questionnaire and then the results were discussed collectively in each hospital during a ‘round table’ meeting. The feasibility of the process was assessed by direct observation of the round tables and with semi-structured phone interviews

Results
The V-HLO-fr tool was fully applied in the three targeted hospitals and the process seems to be acceptable, practicable and integrable. Its mode of application, formalized by taking inspiration from the RAND method, could be further improved, e.g. by paying more attention to recruiting and supporting participants. Strengths (e.g. the facilitation of patient navigation to the hospital) and weaknesses (e.g. the provision of easy to read, understand and act on health information materials) in terms of health literacy responsiveness have been highlighted.

Conclusions
V-HLO-fr could be a suitable tool to create awareness and formulate targeted actions to further strengthen hospitals health literacy responsiveness.
Those explorative case studies give:
– an overall positive signal about the feasibility of the V-HLO-fr
– useful feedback to further formalize and refine its procedure of application.
A multi-component health literacy intervention addressing needs of kidney patients and professionals
Authors: Boonstra M , Reijneveld SA , Westerhuis R , Tullius JM , Vervoort JPM , Navis G , de Winter AF 
Published: October 2022

Abstract

Background
Limited health literacy (LHL) is associated with faster kidney deterioration. To maintain kidney function, health care professionals (HCPs) promote self-management. However, in chronic kidney disease (CKD) care organizations, patients with LHL report multiple communication and self-management barriers. The need for health literacy responsive organizations, and multi-component interventions targeted at patients and HCPs, is recognized. We aimed to determine the objectives and strategies of such an intervention, and to co-create and evaluate it.

Methods
First, we performed a longitudinal qualitative study among CKD patients with LHL (n = 24) and HCPs (n = 37) from general practices and nephrology clinics to assess needs and barriers, and to identify promising intervention objectives. Second, we included patients (n = 19), HCPs (n = 15), educators (n = 3) and students (n = 4) in an Intervention Mapping (IM) process to co-create and evaluate the intervention.

Results
Grip on Your Kidneys (GoYK) addresses the competences of patients with LHL to self-manage CKD on the long-term, and the communication competences of patients and HCPs. Based upon patients’ preferences, GoYK encompasses a visually attractive website and brochures to optimize self-management and a card to contribute to consultations. With HCPs, we developed a training to optimize their competences to support patients with LHL. Evaluation revealed the intervention was useful, comprehensive and fitting needs.

Conclusions
Mapping the needs of CKD patients and HCPs, combined with a process of intervention co-creation, resulted in a multi-component, positively evaluated intervention. Implementation of this type of interventions in organizations is promising to improve care for patients with LHL. However, the effectiveness of these interventions requires further assessment.
Viral hepatitis micro-elimination: models of care and barriers to implementation in 5 EU/EEA prisons
Authors: Seyler T , Montanari L , Ceccarelli L , Torri E , Mazzilli S , Tavoschi L 
Published: October 2022

Abstract

Introduction
Coverage of essential prevention and control services and adequate monitoring schemes for viral hepatitis are often suboptimal in prison settings. Yet, evidence shows that targeted interventions are feasible and effective in reducing viral hepatitis burden and decreasing virus circulation among people living in prison and the community at large. To promote transferability and improvement of prison health quality in EU/EEA the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) will identify and disseminate models of care for viral hepatitis elimination in prisons.

Methods
The models of care were gathered using a data collection tool that has been designed for this purpose based on the literature review and agreed with an expert advisory group. Based on the results of the data collection, a survey for healthcare staff working in 5 selected prison institutions in the EU/EEA has been developed.

Results
The following models of care were collected: HCV micro-elimination in prison; transitional care for HCV treatment or HBV prevention/treatment; HCV or HBV care services tailored to women living in prison; HBV or HAV/HBV vaccination in prison settings. Harm reduction and drug treatment services in the prison are essential at all steps of the prevention and continuum of care. Among barriers identified were: engagement of people living in prison and prison governance structure, availability of infrastructural and human resources, daily prison organisation, inter-sectorial collaboration within prison and between prison and community services, training for prison staff and lack of systematic monitoring.

Conclusions
Evidence of effective and acceptable interventions in prison to prevent and control viral hepatitis is essential to foster inclusion of prison setting within national elimination programmes. Intra-EU benchmarking may help promote awareness, to allocate adequate resources, monitor of impact and ultimately the achievement of the elimination goal.
Contraception free of charge for young women in Tuscany: an interrupted time series analysis
Authors: Ferrari A , Bonciani M , Corazza I , Tortù C , Vainieri M 
Published: October 2022

Abstract

The Regional Health Authority of Tuscany, ITALY, launched in November 2018 a public program providing all contraceptive methods free of charge to all young residing women after medical evaluation at free family counselling centres. We aimed to explore the effect of the regional program on five outcomes - abortions, contraception provision, access to family counselling centres, conception, and outpatient service utilization for six sexually transmitted diseases (STDs). These outcomes were retrospectively computed from January 2016 to December 2020 using regional administrative databases, and then expressed as both annual rates per 1,000 and monthly rates per 100,000 women aged 14 to 25 years and residing in Tuscany. We ran interrupted time series (ITS) models to analyze how the trends in monthly rates changed over time after the intervention (set in November 2018). The decline in annual abortion rates per 1,000 women doubled from 2016-2018 (-9%, from 7.0 to 6.4) to 2018-2020 (-17%, from 6.4 to 5.3). ITS models revealed a significant post-intervention decrease in monthly abortion rates (-0.61, -1.11 to -0.12) and a significant increase in both access rates to counselling centres (87.60, 77.77 to 97.43) and contraception provision rates (16.75, 0.31 to 33.19). Conception rates fell significantly just in under-18 women (-0.84, -1.39 to -0.28). A significant reduction in outpatient service utilization rates for STDs emerged for N. gonorrhoeae, HSV, and HPV. As a prime example of similar initiatives in Italy, the free contraception program of Tuscany promoted access to counselling and contraception services among young under-25 women, empowering the entire care pathway. As a result, abortion rates declined significantly in this group. The wider access to counselling centres to obtain free contraception and overall enhancement of the pathway might have fostered sexual education and reproductive health, leading to a reduction in teenage conception and STD spread.

Key messages
• This study proves the effectiveness of the free contraception campaign of Tuscany in reducing abortions and empowering the entire care pathway, providing further evidence for policy accountability.
• Therefore, this study supports the maintenance of this program and suggests the potential benefits of implementing and promoting similar initiatives in other Regions.
An integrated care pathway for maternal and childcare: evidence from Ethiopia, Tanzania, and Uganda
Authors: Corazza I , Belardi P , Bonciani M , Manenti F , Abebe D , Santini S , Azzimonti G , Nsubuga J , Dall'Oglio G , Vainieri M 
Published: October 2022

Abstract

Performance monitoring and evaluation are key to quality improvement in maternal and child healthcare in Sub-Saharan Africa. This study presents the experience of designing and implementing bottom-up and integrated performance evaluation tools for care pathway to monitor and manage maternity healthcare services. The research project involved four health districts and relative reference hospitals, supported by the NGO Doctors with Africa CUAMM in Ethiopia, Tanzania, and Uganda. The maternal and childcare pathway developed consists of 23 indicators, calculated at hospital and district level, relating to pregnancy, childbirth and first year of life phases. The authors developed staves and performance maps, as graphical representation tools, to display longitudinally integrated health services provision performance along the continuum of care. Substantial variation was observed between the phases of each maternal and childcare pathway and across the care pathways of the different analysed settings. The most impressive results across the four settings are: 1) regarding pregnancy phase, that women tend to attend more than four antenatal classes, still with a quite high drop-out rate, and are largely tested for syphilis, 2) with respect to childbirth, that there are varying percentage levels in terms of C-sections, episiotomies and peri/intra-partum asphyxia cases, and 3) as it regards first year of life, there emerges scope for improvement considering the vaccination coverages attained for pentavalent, measles and polio vaccinations. Thanks to the collaboration with local managers and health professionals, the maternal and childcare pathway allowed to monitor the changes in the quality of maternity services provided within the analysed contexts. The benchmarking approach encouraged local professionals to learn from other settings. The use of such tool allowed the development of targeted quality improvement actions, shared among all involved stakeholders.

Key messages
• In collaboration with local professionals, we designed and implemented an integrated pathway for maternal and childcare, covering the phases of pregnancy, childbirth and first year of life.
• Benchmarking performance results encouraged collaboration among professionals and allowed the identification of actions to improve the provision of maternal and childcare services.
Reducing educational inequalities in mortality: a comparative risk assessment approach
Authors: Eikemo TA 
Published: October 2022

Abstract
Educational inequalities in mortality are increasingly recognized as one of the main challenges for health policy. Studies comparing European countries have shown that such inequalities are substantial almost everywhere, but that there are important variations between countries, suggesting great scope for reduction. However, identifying this scope is difficult because it requires comparative information about the educational distribution of mortality rates, risk factors and relative risks. In this presentation I show how this can be done, by quantifying the impact of a theoretical equalization of the distribution of several known risk factors for mortality, in a comparative risk assessment approach. Harmonized data set on mortality (from register data) and risk factors (from survey data) by educational level for 21 European populations in the early 2000s were applied. The impact of the risk factors on mortality in each educational group was determined using Population Attributable Fractions (PAF). The impact on inequalities in mortality was estimated applying two counterfactual scenarios: a theoretical upward levelling scenario in which it is assumed that inequalities in the risk factor were completely eliminated, and a more realistic best practice scenario, in which it is assumed that inequalities in a risk factor were to be reduced to those seen in the country with the smallest inequalities for that risk factor. The analysis shows how information on risk factors, mortality rates and relative risks can be combined from different data sources and provide a meaningful analysis of the European mortality burden that can be linked to educational inequalities in risk factors. The analysis also shows that upward levelling scenarios and best practice scenarios demonstrate a theoretical potential for reducing inequalities in mortality.
Implementing an eHealth tool to improve referral services for obstetric emergencies in Sierra Leone
Authors: Theuring S , Lewally A , Shepherd J , Williamson Taylor R 
Published: October 2022

Abstract

Background
Maternal health remains a major issue of concern in Sierra Leone. In the main referral maternity institution, Princess Christian Maternity Hospital (PCMH), up to 25% of maternal deaths occur during or shortly after transit from another health facility. There is an urgent need to improve referral systems between peripheral health units (PHUs) and PCMH. Our aim was to pilot and evaluate an eHealth tool facilitating referral of obstetric emergency cases through effective teleconsultation between PHUs and PCMH.

Methods
A web application was designed to capture unclear or complicated delivery cases at PHUs and request respective telemedical counselling from the referral institution PCMH. The eHealth tool was piloted at 10 PHUs in Western area urban and rural in August 2021. Necessary devices were provided and delivery staff was trained to use the app. In December 2021, we conducted focus group discussion with 3-6 delivery staff at five PHUs and at PCMH to evaluate utilization and outcomes of the tool.

Results
All participants perceived the eHealth tool as an improvement of referral procedures. Response time from PCMH after a request for counselling from a PHU was mostly &lt;30 minutes. The main perceived advantage of the tool was the systematic documentation of obstetric complications and procedures. This relieved staff from fear of wrong treatment accusations, and recorded communication with PCMH made processes and responsibilities transparent. Another important benefit was PCMH staff being already prepared to receive a specific emergency case after use of the app, thus reducing the ‘third delay’ within the referral facility. As a major obstacle to smooth referral despite the eHealth tool, a lacking ambulance system was mentioned as a critical gap.

Conclusions
Exceedingly positive user experiences with this simple tool seem to make an expansion to more PHUs worthwhile. Benefits of using the app in more remote districts in Sierra Leone should be further investigated.

Key messages
• Delivery staff in Sierra Leone was capable of using a web app for telemedical counselling in a useful and effective manner.
• The eHealth tool was perceived as very helpful in systematically and transparently documenting emergency delivery cases and treatment procedures.
Application of the patient navigation model with people experiencing homelessness: a scoping review
Authors: Grabovac I , Carmichael C , Smith L , Aldasoro E , Gil-Salmeron A , Alhambra-Borras T , Donate-Martinez A , Seiler-Ramadas R 
Published: October 2022

Abstract

Background
Barriers in accessing healthcare services are a common issue that contributes to the disproportionately poor health outcomes in people who experience homelessness. A possible way to overcome these barriers and meaningfully engage with this under-served population is through the implementation of the so called patient navigation (PN) models. We conducted a systematic scoping review to gain a better understanding on how PN models are utilized with people experiencing homelessness and other comparable populations and to identify their features, barriers and facilitators to their implementation and their outcomes.

Methods
A systematic scoping review was done based on a predetermined protocol. We conducted a search of Web of Science, PubMed/Medline and Scopus databases on the 15th of June 2021. A narrative analysis of the included studies was conducted.

Results
Our search yielded 1203 hits, and after removing 475 duplicates, we were left with 728 publications of interest. Finally, 21 studies have been included in the review, comprising of nine review articles and 12 individual studies, with most studies stemming from the USA. Results show that PN models are consistently associated with improvements in a wide range of health related outcomes, mostly with timely access to healthcare services. Implementation strategies and measurements used in assessing PN models show heterogeneity between studies. However, a number of consistencies were found including; a longitudinal approach, using of non-clinical navigators who share similarities to the participant groups and who engage as facilitators. Additional considerations for gender and age may further improve the outcomes.

Conclusions
In order to improve on the success of the PN models and their application in removing barriers to healthcare access for people experiencing homelessness, more research is needed that focuses on the feasibility, acceptability and scalability of the approach outside the USA.

Key messages
• People experiencing homelessness experience considerable barriers in accessing healthcare service leading to disproportionately larger burden of disease as well as lower life expectancy.
• Patient navigation models have a great potential in removing barriers and facilitating timely access to healthcare services in people experiencing homelessness.