bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organizational health literacy in health care: Results from a participatory project in Germany
Authors: Rathmann K , Salewski LD , Zelfl LV 
Published: October 2022

Abstract

Background
Health care facilities (i.e., hospitals, care facilities and integration assistance) play an important role in providing health-related information and strengthening health literacy (HL) of patients/clients, staff and at the organizational level. The project “Development of Health Literacy in Health Care Facilities (EwiKo)’ aims at implementing tools to promote and strengthen organizational health literacy (OHL) in health care institutions in Germany. Objectives are 1) to assess needs for strengthening OHL in pilot facilities and 2) to examine factors that are beneficial to strengthen OHL in health care facilities.

Methods
N = 6 pilot institutions (n = 2 hospitals, n = 2 care homes for elderly people, n = 2 facilities for people with disabilities) and their members of the “working groups on HL” filled in a self-assessment tool to assess the level of OHL, accompanied by focus group interviews (n = 6-9 persons per pilot facility). Regarding conducive and obstructive factors when implementing tools to strengthen OHL, focus group interviews (n = 6-9 persons per pilot facility) and semi-structured interviews (n = 1 coordinator per organization) were conducted.

Results
Results of the self-assessment tool showed a need to strengthen OHL in all types of health care facilities, particularly in the fields of action ‘training of employees in HL tools’, “communication” and ‘participatory development and testing of documents, materials and services on HL’. Results of the focus group interviews showed a special need to strengthen OHL in the area ‘HL of employees’. Beneficial factors by implementing tools to strengthen OHL are, for instance a supporting management, resources, a participatory approach and trainings by the project team.

Conclusions
Due to the ongoing corona pandemic and accompanying challenges (e.g., personnel resources), it is comprehensible that health care facilities emphasize a need for strengthening HL of employees.
6.L. Round table: Digitally literate health workforce for a resilient future
Authors:   Organised by: Young Forum Gastein, EUPHAnxt,   Chair persons: Matthias Wismar (European Observatory)
Published: October 2022

Abstract

Currently, health systems worldwide are experiencing an unprecedented challenge after the shock caused by the COVID-19 pandemic. However, there lies an opportunity for renewal to strengthen health systems. The importance of collaboration becomes imperative in times of health workforce (HWF) shortages and demanding working conditions. This workshop, organised in partnership by the Young Forum Gastein and EUPHAnxt, will focus on connecting generations to explore, discover and share best practices for HWF education and (re)training in digital skills to deliver better patient care. The COVID-19 pandemic has accelerated digitalisation across many sectors including healthcare. Yet it has also served to highlight the digital divide, which has the potential to hinder health experts in providing optimal care. Concurrently, the demanding working conditions of the HWF can be improved by making use of digital tools. It is high time to discuss how digital literacy can be improved across a multi-generational HWF and how to empower the next generation of healthcare leaders to re-imagine health services. The workshop will bring different perspectives to the table - policy-making, science & academia, and governance - on the approaches for better intergenerational collaboration by making use of digital literacy. At the end of the session, participants will understand the realistic potential of digital literacy and how it can be used to ensure effective communication across the HWF, support the resilience of health systems, and ultimately, safeguarding patient care.

Key messages
• Digital literacy is not a stable level of knowledge - the health workforce needs opportunities to advance their knowledge and (digital) skills.
• Acknowledging the shortages in health workforce planning, it is essential to ensure adequate skills of the health workforce personnel.

Speakers/Panellists
Natasha Azzopardi Muscat
WHO Regional Office for Europe, Copenhagen, Denmark
Marius-Ionut Ungureanu
Department of Public Health of the Babeș-Bolyai University, Cluj-Napoca, Romania
Brian Wong
EUPHA-DH
GHFutures2030, I-DAIR, London, UK
Ellen Kuhlmann
Medizinische Hochschule Hannover, Hannover, Germany
Overview of availability of harm reduction interventions in European prisons
Authors: Montanari L , Mazzilli S , Tarján A , Hasselberg I , Hall W , Vandam L , Vernooij A , Stöver H 
Published: October 2022

Abstract

Introduction
Prisons are high-risk environments for the transmission of drug related infections, due to over-incarceration of people who inject drugs; often inadequate healthcare, substandard prison conditions; and others. An overview of the availability and coverage of prison-based harm reduction interventions in Europe is presented.

Methods
National Focal Points of the EMCDDA (30) collected 2019 data, which were integrated with findings from the European funded project HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction).

Results
Prison based harm reduction interventions are available in European countries, but only few of them are available in most countries and often with a low coverage (e.g. less than 10% of prison population in Opioid Substitution Treatment (OST) in most countries). Interventions available in most countries (20 or more) include: HIV, HBV, HCV testing (29), OST continued from community (29), Referral to HIV treatment upon release (28), HIV treatment (27), Referral to HCV treatment upon release (25), HCV antiviral treatment (25), Testing for TB (23), HBV antiviral therapy (25), OST initiated in prison (22), Treatment for TB (21), Vaccination for HBV (20). Interventions available in 10 to 19 countries are: condom distribution (19), OST (re)initiated before release (17), prison/community guidelines for implementation of OST (13). Interventions provided in &lt; 10 countries include: distribution of disinfectant (9), condom with lubricant (9), take-home naloxone (5), needles and syringes programs (3).

Conclusions
Compared to the community, the availability and coverage of harm reduction interventions in European prisons are limited and large information gaps exist. Scaling up harm reduction in prison can achieve important individual and public-health benefits.
Predictors of delayed vaccination in infants born in Tuscany, Italy: an area based cohort study
Authors: Lastrucci V , Puglia M , Pacifici M , Rusconi F , Buscemi P , Alderotti G , Sica M , Belli G , Berti E , Voller F 
Published: October 2022

Abstract

Background
Timely vaccination is essential to protect infants from vaccine-preventable diseases. The aim of the study was to evaluate the determinants of vaccination timeliness for hexavalent (HEXA) and measles-mumps-rubella (MMR) vaccines.

Methods
The study is part of the PREHMO project funded by Tuscany Region, Italy. Data on the 2017 and 2018 full birth cohorts of Tuscany (N = 41,493) were retrieved from the Birth Registry and linked to those of the Vaccine Registry up to 24 months after birth. Sociodemographic and at birth characteristics of mothers and infants were retrieved. The primary outcome was the timeliness of HEXA 1st and 3rd doses, and MMR 1st dose. Timeliness was defined as the administration of the dose a day after the period recommended by the vaccination schedule. Multiple logistic regression models were performed.

Results
For all the vaccines considered, a significantly increased risk of delayed vaccination was observed in preterm infants and in infants born in hospital of second level of newborn care, while infants conceived by assisted reproductive technologies and first-born infants showed a significantly decreased risk for delayed vaccination. Multiple births, small for gestational age status, maternal unemployment, and rural residence were significantly associated with an increased risk of delayed HEXA-1 vaccination (OR 1.31, 95%CI 1.13-1.51; OR 1.12, 95%CI 1.03-1.22; OR 1.06, 95%CI 1.01-1.13; and OR 1.1, 95%CI 1.03-1.16). As for MMR vaccination, a low maternal education was significantly associated with high risk of delay (OR 1.12, 95%CI 1.06-1.18), while rural residence, maternal foreign nationality and female sex were significantly associated with a decreased risk of delay (OR 0.91, 95%CI 0.87-0.96; OR 0.82, 95%CI 0.78-0.87; and OR 0.95, 95%CI 0.91-0.99).

Conclusions
Several common and vaccine-specific predictors of vaccination timeliness were identified. Strategies to improve a timely vaccination should take into account these predictors.

Key messages
• Several maternal and infants factors may influence vaccination timeliness of routine immunization in childhood.
• Tailored vaccination strategies are needed to improve vaccination timeliness in infants at high-risk of delayed vaccination.
Potentials of participatory approaches for urban mental health
Authors: Wasmer A , Müller H , Rehn-Groenendijk J 
Published: October 2022

Abstract
Aspects of mental health, society, space and environment share entangled relations being studied in health geography. Recreational spaces as well as places that are commonly perceived as strenuous, unsafe, or highly stressful are unevenly distributed within urban areas, which is also associated with spatial differences in mental disorders. Spaces in general represent social constructions that reflect power inequalities; they are filled with subjective emotional resonances and sometimes visualize stigmatization of specific groups. As such, the interplay of socio-demographic factors, socio-economic factors and built environment is complex. To capture these entanglements represented in heterogeneous user groups, participatory approaches promise valuable insights. Yet, despite their great potential for fostering mental health in urban space, participatory approaches are still less common in health geography. Therefore, critical voices question whether the limitations of marginalized groups have been sufficiently considered in this field of study so far. Similar challenges arise in urban planning processes: Specific (vulnerable) groups such as children, women, foreign residents, and people with disabilities or elderly people are insufficiently included in planning processes, leading to an underrepresentation of their needs in the resulting environments. To tackle this shortcoming, the approach of co-creation offers a process in which participants jointly develop a solution without being the object of research or interview partners, but creators. Using rather practical or creative (e.g., joint mapping of the built environment, photo-elicitation) than discursive techniques allows contributions from population groups otherwise often excluded from planning processes. Despite certain limitations, participatory approaches promise the possibility to develop appropriate and just solutions in urban mental health.
6.P. Skills building seminar: Children and young people: engaging the unheard stakeholder
Authors:   Organised by: EUPHA-CAPH, EUPHAnxt,   Chair persons: Hellen Skirrow (UK), Jinane Ghattas (EUPHAnxt)
Published: October 2022

Abstract

Global shocks from the COVID 19 pandemic have disproportionately impacted children and young people (CYP) and their families. Underlying health disparities have widened as a result of disruptions to healthcare, education and economic impacts. There are compelling arguments to engage children and young people in rebuilding society and systems from emerging public health threats including the covid 19 pandemic, the climate crisis and conflicts. Children and young people like others in society have a right to be involved in decisions that impact their lives and health but are too often unheard. Engaging those affected most by health policy ensures relevance and can improve adoption of interventions. Involving children and young people in strategic decision making can also improve their citizenship skills and improve health literacy. Although many children and young people have contributed to debates and publicly demonstrated their collective views on a variety of issues such as climate change, movements including #timesup, #Blacklivesmatter and #Metoo, their voices are seldom heard in policy and decision making arenas. In 2021, EUPHA CAPH and EUPHANxt sections collaborated to host the inaugural Engaging the Unheard Stakeholder workshop, supporting 2 young people aged &lt;25 to attend the EPH and lead the workshop. (links). CAPH is now committed to make this a regular feature as part of our action plan to support young voices in public health.

Learning outcomes
• Develop insight into innovative ways to support and engage young people in public health policy making.
• Practise advocacy skills to facilitate young people's voices in research & policy

Activities
Participants will hear from young people who are championing activism or have been involved in shaping public policy.
Interactive skills building breakout session involving role play and scenarios to challenge their unconscious bias and learn skills as ‘active bystanders’ to empower young people

Key messages
• Despite major movements where children and young people have demonstrated their views on a variety of issues such as climate change, their voices are seldom heard in policy and decision making arenas.
• Public health professionals can advocate, support and engage children and young people in public health policy making but lack awareness and skills in advocacy to do this effectively.
6.Q. Skills building seminar: Integrating social inequalities in the burden of disease framework
Authors:   Organised by: COST Action CA18218– European Burden of Disease Network,   Chair persons: Brecht Devleesschauwer (Belgium)
Published: October 2022

Abstract

Driven by the influential Global Burden of Disease (GBD) study, the burden of disease (BOD) approach has gained wide interest at national and international level to quantify the state of health and health inequalities. Central to the BOD approach is the Disability-Adjusted Life Year (DALY) metric, which quantifies the health impact of diseases, injuries and risk factors as the number of healthy life years lost compared to a counterfactual scenario of perfect health all life long. The BOD approach offers a valuable platform to quantify social inequalities in health, i.e., differences in health status by socioeconomic and sociodemographic characteristics. This is highly relevant, as health inequalities penalising socially disadvantaged groups are one of the most consistent, and persistent, findings in epidemiology, for almost every health outcome and socioeconomic indicator. Monitoring social inequalities in health is therefore a key priority for national health authorities. There are different ways by which social inequalities can be integrated in the BOD framework, but all come with important data challenges. Individual-level stratification is a common approach for quantifying inequalities by age and sex, but is more challenging for other sociodemographic and socioeconomic indicators. Area-level stratification allows for ecological analyses between BOD estimates and indices of social deprivation. Social inequalities can also be assessed using comparative risk assessment, by which the relative risk for adverse health outcomes in function of social position is to be quantified. This skills building workshop will present the methods that have been applied in different national burden of disease studies to include social inequalities, including a discussion of their strengths and weaknesses. By providing a step-by-step presentation of how the methods have been applied, attendees will gain unique insights in the different ways by which social inequalities can be integrated in the BOD framework.

Key messages
• The burden of disease framework offers a valuable platform to quantify and monitor social inequalities in health, which is a key priority for health authorities.
• Attendees will receive an overview of the different ways by which social inequalities can be integrated in the burden of disease framework, including a discussion of their strengths and weaknesses.
Assessing determinants of SARS-CoV-2 infection in a large older adult representative sample
Authors: Mosconi G , Stival C , Signorelli C , Amerio A , Cavalieri d'Oro L , Iacoviello L , Stuckler D , Zucchi A , Odone A , Gallus S 
Published: October 2022

Abstract
Most COVID-19-related deaths occurred in older adults, however to date, evidence on determinants of SARS-CoV-2 infection in this population is limited and mostly based on case series without a comparison group. A telephone-based cross-sectional study was conducted in November 2020 on a representative sample of 4,400 people aged ≥65 years from the Italian region of Lombardy. We determined the prevalence of participants reporting a SARS-CoV-2 infection in the period between the onset of the pandemic and the time of the interview. To investigate the determinants of the infection, we estimated odds ratios (OR) and their corresponding 95% confidence intervals (CI) thorough unconditional multiple logistic models. We further evaluated if the infection was a determinant of a worsening in mental health wellbeing. Overall, 4.9% of participants reported a history of SARS-CoV-2 infection. No significant relationship between sex and infection was observed. SARS-CoV-2 infection was less frequently reported in subjects aged ≥70 (OR = 0.55; 95% 0.41-0.74) compared to 65-69 years. We didn't observe any trend after 70 years of age. Participants reporting at least one chronic condition had a lower infection rate compared to healthy subjects (OR = 0.68 95% CI: 0.49-0.93). Separated/divorced subjects more frequently reported infection than married/cohabiting ones (OR = 2.33 95% CI: 1.29-4.20). Self-reported history of SARS-CoV-2 infection resulted being a determinant of an increase in depressive symptoms (OR = 1.57; 95% CI: 1.17-2.10). In this large study - among the few assessing the determinants of SARS-CoV-2 infection in a representative sample of older adults -, the prevalence of a history of infection in November 2020 approached 5%. We found that persons aged 70 and above and those with chronic conditions, thus individuals with likely less social interactions, were less frequently exposed to SARS-CoV-2 infection.
mHealth platform improved health worker's compliance to WHO’s IMNCI guideline in Nairobi, Kenya
Authors: Shah M , Sang E , Afeworki A , McLaughlin M , Finette B , Kwamboka L , Ogaro D 
Published: October 2022

Abstract

Poor access to quality health services, especially in urban slums, is a global challenge. Given similar challenges in Nairobi's Kibra informal settlement area, we collaborated with the Langata/Kibra sub-county health management team to conduct a pilot program for improving the quality of child health services delivered by health care providers (HCPs). The pilot introduced a digital mHealth platform to HCPs working in Kibra informal settlement area in Nairobi. This mHealth platform was compliant to WHO's recommended guideline for integrated management of newborn and child illnesses (IMNCI) and was designed to help sick child assessment, diagnosis and management by HCPs. We aimed to determine if using this digital platform, coupled with supportive supervision and community outreach, would lead to improve compliance to the IMNCI guideline for assessment, diagnosis and treatment of sick children. We conducted baseline (February 2019) assessment, trained selected HCPs on the mHealth platform on handheld android tablets, conducted end line (March 2020) and measured any change in HCP's compliance to IMNCI guidelines. Total 89 HCPs were the mHealth platform users during end line assessment. When asked about the choice of antibiotic for treating childhood pneumonia, we found proportion of HCPs who preferred Amoxycillin dispersible tablet, the recommended treatment for childhood pneumonia, increased from 3% at baseline to 38% at end line. Proportion of HCPs who were aware that antibiotics should NOT be used for the management of simple diarrhea increased from 14% (at baseline) to 50% (at end line). At end line, more than 90% HCPs were found compliant in their practice to IMNCI guidelines for sick child assessment, diagnosis and management. These results demonstrate the use of the IMNCI compliant mHealth platforms as a potential important effective way to improve capacity and compliance among HCPs who are serving communities like Kibra informal settlement in Nairobi, Kenya.

Key messages
• WHO recommended IMNCI compliant mHealth platform enables health care providers to offer quality child health care.
• Using mHealth platform to ensure WHO’s IMNCI guideline implementation by health care providers might have potential impact on saving sick children’s lives from preventable deaths.
Cost-effectiveness of two psychological treatments for the reduction of alcohol consumption
Authors: Flores S , Feldman I , Sampaio F 
Published: October 2022

Abstract

Background
Up to 7% of the Swedish population meets criteria for harmful use or alcohol dependency but only 10-20% seek treatment. One of the most recommended psychological treatments for controlled drinking is Motivational Enhancement Therapy (MET). Behavioural Self-Control Training (BSCT) is another treatment that is unique in that it is based on the psychology of learning and specifically focused on skills training. To our knowledge, no previous studies exist that evaluated the cost-effectiveness of BSCT for alcohol use disorders (AUD). The aim of this study is to assess the cost-effectiveness of BSCT compared to MET for patients with AUD aiming for controlled drinking over the longer-term from a societal perspective.

Methods
We modelled a cohort of patients with AUD who aim for controlled drinking, over a 10 year time horizon, and estimated the expected costs and outcomes of BSCT and MET. The model reflects the epidemiological transitions between drinking states, which reflect different levels of daily alcohol intake. Each drinking state is connected to temporary or long-term complications attributable to alcohol consumption, different costs and utilities. The data was sourced from a randomized trial evaluating the effectiveness of MET vs BSCT. Risks for complications and associated costs, utilities and mortality were sourced from the literature.

Results
Compared to MET, BSCT resulted in less total QALYs gained (4,7 vs 6,6 QALYs per patient). MET remains a cost effective treatment compared to BSCT [incremental cost-effectiveness ratio (ICER) = SEK 8497,79 per gained QALY] and a No Intervention scenario BSCT [incremental cost-effectiveness ratio (ICER) = SEK 16321,07 per gained QALY] at a threshold of 500.000 SEK per QALY.

Conclusions
This study suggests that MET should remain the recommended treatment for AUD patients with a goal of controlled drinking in favor of BSCT.

Key messages
• Motivational Enhancement Therapy should remain the recommended treatment for AUD patients with controlled drinking as their goal.
• A future study comparing Motivational Enhancemente Therapy to Behaivoral Self Control Training as recommended treatment in patients wanting to achieve abstinenece is suggested.