bluuebunny/crossref_metadata_2025_split huggingface dataset:
Piloting a Health System Performance Assessment for Germany - insights from trend and equity analyses
Authors: Achstetter K , Blümel M , Hengel P , Schwarzbach V , Busse R 
Published: October 2022

Abstract

Background
Health System Performance Assessment (HSPA) is a tool for the evaluation of the performance and efficiency of a health system and can be used for evidence-based policymaking. For the first time, a country specific HSPA for the German health system is piloted with a focus on trend and equity analyses.

Methods
Based on the conceptual framework developed in a feasibility study, the pilot study in Germany has being conducted between 2020 and 2023. The framework includes 90 internationally compatible indicators, each of which can be assigned to one of nine dimensions (e.g., access, quality, population health, responsiveness, efficiency). The aim of this pilot study is to conduct trend analyses over the period 2000-2020 and equity analyses (e.g., age, gender, region, education). Data from 56 different national and international secondary data sources (e.g., epidemiologic registry data, claims data, and survey data) were collected, analyzed, and compiled in a report.

Results
In total, 84 of the 90 indicators could be analyzed with data for Germany. The indicators (e.g., access to acute care, 30-day mortality, amenable mortality rate) are prepared as a trend analysis for Germany for up to 20 years and with regard to various equity aspects. Most indicators can be presented in international comparison with eight selected European countries (e.g., Denmark, France). Furthermore, recommendations were derived to improve the availability and/or quality of data.

Conclusions
The first German HSPA pilot study provides valuable insights into the performance of the health system. The results based on the analysis of the 90 indicators are an important basis for identifying inequities and needs for improvement. In the future, the lessons learned from the pilot study can be helpful for a permanent implementation of a German HSPA. However, the fragmented data structure in Germany will be a future challenge.

Key messages
• The first country specific health system performance assessment for the German health system was conducted as a pilot study.
• Trends over time, inequities, and needs for improvement can be derived from the analysis of 90 indicators.
Feasibility of a social network-based physical activity intervention targeting vocational students
Authors: Guenther L , Schleberger S , Pischke CR 
Published: October 2022

Abstract

Background
Globally, four of five adolescents do not meet the recommendations for physical activity (PA). This is a public health concern because moving large segments of young adults from inactivity to activity, is essential to reach the global target of a 15% relative reduction of inactivity by 2030 worldwide. This study aimed to pilot a social network-based PA intervention in a sample of young adults enrolled at vocational schools.

Methods
Fourteen students from one vocational school located in Duesseldorf were encouraged to walk 10.000 steps per day over an intervention period of six weeks. In the WALK2gether intervention, students received general information on PA in a Facebook group and were instructed to use the pedometer app Pacer to monitor their individual steps and compare their daily step count with fellow participants. The framework by Thabane et al. (2010) was was taken as a basis for examining the feasibility of the methods and procedures employed and for estimating the magnitude of potential intervention effects.

Results
The WALK2gether intervention turned out to be minimally resource intensive with, in total, 92 hours spent by the study staff on development and implementation. The recruitment rate was 19.2% and loss-to-follow was 28.6%. Descriptively analysed data revealed no noteworthy changes from baseline to follow-up neither in PA nor in other health outcomes, such as body mass index and quality of life. The target population did not interact in the Facebook group, while a moderate interaction with Pacer was noted.

Conclusions
This pilot study and intervention were only partially feasible. Although the results ought to be interpreted with caution due to the small sample size, our results suggest that the target group would rather benefit from a structured PA regimen with regular check-ins and PA counselling, possibly by vocational school teachers, than the very autonomous approach piloted in this study.

Key messages
• Results of this pilot study can inform the development and implementation of future social media-based PA interventions targeting young adults in vocational schools.
• Optimization of the intervention and studies on a larger scale are necessary.
Making Every Contact Count with people with MSK conditions: Exploring physiotherapist acceptability
Authors: Parchment A , Lawrence W , Rahman E , Townsend N , Wainwright E , Wainwright D 
Published: October 2022

Abstract

There are known risk factors that are associated with the onset and exacerbation of musculoskeletal (MSK) conditions and pain. Physiotherapists are uniquely placed to deliver brief interventions with their patients. Healthy Conversation Skills is the main training component of the Wessex approach to Making Every Contact Count. Despite its potential for promoting MSK health and wellbeing, there is no evidence to support its acceptability within MSK services. This is the first known study to explore the use and perceptions of the Wessex model of MECC HCS within MSK services. A mixed method design was used. Phase one employed an online questionnaire, open to all professionals trained in MECC HCS, consisting of items relating to implementation outcomes. Barriers and facilitators to delivery were explored and mapped to the Theoretical Domains Framework. Phase two invited physiotherapists for a follow-up interview and qualitatively explored their acceptability of delivering MECC HCS to patients with MSK conditions. MECC HCS was found to be highly acceptable, appropriate, and feasible. Physiotherapists reported using their skills at least daily but missed opportunities for delivering MECC HCS were evident. Barriers mapped mostly to ‘Environmental Context and Resources’ on the Theoretical Domains Framework. Qualitative themes developed during phase two were: ‘Recognising the patient as the expert supports change', ‘MECC HCS improves physiotherapy practice', ‘MECC HCS shared problem solving reduces workload', ‘time as a perceived barrier to MECC HCS’ and ‘system-level support needed to sustain MECC HCS'. MECC HCS is a promising brief intervention for supporting people with MSK conditions. Further rollout of this intervention may be beneficial for meeting the goals of the NHS and Public Health England in prevention of MSK conditions and promotion of MSK health. Barriers associated with sustainability must, however, be addressed.

Key messages
• Making Every Contact Count Healthy Conversation Skills is considered a highly acceptable brief intervention for supporting behaviour change in people with musculoskeletal conditions.
• Organisational, system-level barriers to implementation must be addressed in order to increase sustainability and enhance future roll out of the brief intervention.
Use of TikTok by nutrition healthcare professionals: analysis of the Italian context
Authors: Durbano A , Bert F , Pivi A , Lo Moro G , Scaioli G , Siliquini R 
Published: October 2022

Abstract

Background
Over the past 20 years, Social Media (SM) have become fundamental tools for quickly and effectively spreading health information in Europe. One of the most popular topics in the health sector is food and nutrition. TikTok is one of the most recent-born and most popular SM. Our study aims to analyze how healthcare professionals in the nutrition sector communicate through TikTok, and to assess characteristics of their accounts and videos.

Methods
We included in the present study 53 Italian healthcare professionals who post videos on TikTok through a search on this SM using nutrition-related keywords. For each tiktoker, we described the characteristics of their last 10 videos, through an ad hoc checklist. We performed multilevel multivariable linear regression models in order to identify factors (healthcare professional or video related) that could be associated with a higher popularity of the video.

Results
The 67.7% of the tiktokers considered were female; 46% had more than 30 years, 62.3% were biologists. The median number of likes was 300 (IQR 75 - 1070). The linguistic register was “formal” in the 11.3% of the videos. In the 31.9% of them, the location was the office of the healthcare professional. In the 67.3%, the topic was “diet-related”. Multilevel multivariable linear regression models showed that “diet-related” topics were associated with more likes (coeff 1111.63, p = 0.048), and comments (coeff 13.42, p = 0.018).

Conclusions
Many Italian nutrition professionals are present on TikTok, and perform videos in their offices discussing mainly diet-related topics. There are no specific factors associated with the popularity of their videos, other than the presence of “diet-related” topics. Since the TikTok audience is very young, and wrong messages on this topic could lead to serious health-related consequences, there is the need to pay a specific attention on the contents of the videos, to avoid the spread of potentially dangerous information.

Key messages
• Italian healthcare nutrition professionals are present on TikTok and perform videos with diet-related contents in their workplaces.
• Since wrong information on diet and nutrition could lead to serious health consequences for the audience, it is important to monitor the content of the videos to avoid the spread of dangerous messages.
Training Needs and Quality of Public Health Inspectors in Greece during the COVID-19 pandemic
Authors: Adamopoulos I , Lamnisos D , Syrou N , Boustras G 
Published: October 2022

Abstract

Background
Public Health Inspectors (PHI) task is to promote health, respond to emerging threats in Public Health and prevent and control of the communicable and environmental diseases. During the COVID-19 pandemic, PHI and other Healthcare Workers faced greater biological risks of infections and therefore personal protection was of great importance for their health and safety. Staff education and training is an important factor of disaster management capability and may help prevent and control pandemics. This study took place during the COVID-19 pandemic and aimed to investigate the training needs and training quality of Greek Public Health Inspectors.

Methods
A nationwide cross-sectional study was conducted between March and June 2021 in Greece. An online survey was distributed to respondents by email through the National Public Health Inspectorate Administration. The survey included seven Likert scale items for assessing the training needs (health and safety of work, stress management, health services administration, crisis management in the health sector, natural disasters, personal protective equipment and protection against biological agents and protection from chemical agents) and two Likert scale items for assessing the training quality.

Results
The response rate was 30.5 % (185/606 PHI). The 62.2% were females with a mean age of 49 years old (sd = 8.2) and a mean work experience of 15.9 years (sd = 8.5). Most participants (64.51%) reported high training needs on health and safety at work, stress management and personal protective equipment. Most participants (43.78%) also reported low training quality. Training needs were higher for women and in urban and semi-urban workplace environments.

Conclusions
High training needs and low rate in training quality are important issues for PHI in all workplace environments. PHI need training in health and safety at work, stress management and personal protective equipment.

Key messages
• High training needs and low rate in training quality are important issues for Public Health Inspectors in all workplace environments in Greece.
• Future training for Greek Public Health Inspectors should focus on health and safety at work, stress management and personal protective equipment.
Associations between social support and physical activity among postpartum women: a cohort study
Authors: Bennetter KE , Waage CW , Richardsen KR , Jenum AK , Vøllestad NK , Robinson HS 
Published: October 2022

Abstract

Background
Moderate-to-vigorous physical activity (MVPA) enhances postpartum women’s health, and social support is associated with higher self-reported physical activity (PA) postpartum. It is unknown if this association exist across ethnic groups. Our research questions are: are overall family or friends’ support associated with objectively recorded MVPA postpartum, 2) are specific types of family or friends’ support associated with MVPA and 3) does the association differ across ethnic groups?

Methods
We used data from 662 women participating in the STORK Groruddalen cohort study (2008-2010). MVPA in bouts ≥ 10 minutes was recorded by SenseWear ArmbandTM Pro3 14 weeks postpartum. Family and friends’ support was measured by the Social Support for Exercise Scale. We used single items and mean score for family (6 items) and friends’ (6-items) support in separate linear regression models, and adjusted for age, ethnicity, education, parity, weeks since birth and body mass index. We tested for interactions between social support and ethnicity. Analyses were performed on complete cases and imputed data due to missing MVPA data.

Results
Based on imputed data we observed an association between family support and MVPA (β = 4.0, 95% CI, 0.18 to 7.74, p = 0.040). Women reporting high family support on two specific items spent 9 MVPA minutes/day more than women reporting low support (‘discuss PA': β = 8.6, 95% CI: 0.37 to 16.87 and ‘co-participation': β = 8.8, 95% CI: 1.79 to 15.86). Associations were not modified by ethnicity. No statistically significant association between friends’ support and MVPA was observed. Similar results were found in complete case analyses, with few exceptions.

Conclusions
Overall family support and specific form of family support (i.e., PA discussion and co-participation) were associated with MVPA postpartum across ethnic groups. Friends’ support was not associated with MVPA.

Key messages
• Postpartum health may be improved across ethnic groups through increased PA facilitated through overall family support for PA and specifically through PA discussions and co-participation from family.
• Friends’ support for PA was not associated with PA.
Removing barriers to utilisation of support services for abused female adolescents in Nigeria slums
Authors: Ikuteyijo OO , Akinyemi AI , Merten S , Fetters MD 
Published: October 2022

Abstract

Background
Female adolescents in urban slums experience a plethora of violence. The inherent health inequalities in the urban slums also present barriers to adolescents’ access to support services that can alleviate the impact of violence and bring perpetrators to justice. Health facilities can play key proactive roles in facilitating effective responses to address the problems of violence. This research sought to answer the questions: what support services are available to female adolescents in the event of violence; what are the barriers to accessing these services; and what roles can health workers play in removing these barriers?

Methods
The study used an ethnographic approach involving 40 in-depth interviews and 9 focus group discussions with female adolescents, 17 in-depth interviews were conducted with health providers and community leaders. The study setting comprised intentionally sampled slum communities in Lagos and Oyo states, southwest Nigeria. Thematic data analysis was conducted to address the study questions.

Results
Potential support services available to female adolescents in the study setting included the Community Development Association, police, family members, and health facilities. Identified barriers to utilizing available support services included stigmatization, non-formalization of police reports of violence, ambiguous attitudes of health workers to abused adolescents, and unfamiliarity on the part of adolescents. Although resources are available to adolescents in the event of violence, the lack of coordination of services has led to gross inefficiency for intervening.

Conclusions
To address the inefficiency of services, the health sector is best positioned to ensure synergy among the key stakeholders to reduce stigma and stop abuse experience among adolescent girls. Beyond a reactionary, curative approach, health providers need to play a preventive role through education, advocacy, and coordination of interventions at the community level.

Key messages
• Health workers at primary health facilities need to support adolescents who experience violence, especially those who using their services.
• In addition, health workers are best positioned to create synergy among available support services to alleviate and mitigate the impact of violence on female adolescents in the community.
Co-production in public health research grant writing: engaging underserved migrant mothers in the UK
Authors: Stevenson K , Ogunlana K , Ciftici Y , Knight M , Aldridge R , Stevenson F 
Published: October 2022

Abstract

Background
In the UK, one in three births is to a non-UK born woman, but there is a gap in co-produced research to explore their experiences. The National Institute for Health and Care Research (NIHR) defines co-production as ‘an approach in which researchers, practitioners, and members of the public work together, sharing power and responsibility'. This project co-produced a grant proposal to improve maternity care for underserved migrant women in the UK. We reflect on transferrable learning for engaging those whose voices are less often heard in grant writing.

Methods
An expert by experience, an underserved migrant woman who gave birth in the UK, joined the research team. Four online engagement workshops were conducted; two involved only migrant women, two were multi-disciplinary. 26 underserved migrant women attended. NIHR INVOLVE public involvement guidance was consulted.

Results
Women said they were often asked about negative experiences which felt disempowering, and rarely asked about solutions. Thus, we shifted the focus of our work to co-designing solutions. Women said that having an expert by experience co-host workshops encouraged engagement, so we integrated this into our methods. Some women were uncomfortable in professional groups. Thus, our proposed steering and focus groups will have an expert by experience subgroup with elected members attending multi-disciplinary groups. We will engage mostly online as women preferred this to enable flexibility with childcare. The lead expert by experience helped form the proposal through brainstorming, co-drafting, and feedback; experts by experience commented on the draft via email and workshops. The lead expert by experience wished to gain further experience of research methods, for which we requested additional funding.

Conclusions
This project highlights the immense potential for co-production in public health research, and the value of adapting research planning to maximise the voices of the less often heard.

Key messages
• Engaging experts by experiences in public health research planning is key to ensuring our work addresses the needs of underserved communities.
• Co-Production of research requires determination to involve those whose voices are less often heard from the beginning of the research process, and to commit to joined working throughout.
Implementation of integrated knowledge translation in NCD research: Examining intervention components
Authors: Sell K , Rehfuess EA , Pfadenhauer LM 
Published: October 2022

Abstract

Background
Integrated knowledge translation (IKT) has been a cornerstone of the Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) with partners in Ethiopia, Germany, Malawi, Rwanda, South Africa, and Uganda. The consortium conducts research on preventing and treating non-communicable diseases as well as road traffic injuries. IKT is understood as the continuous engagement of decision-makers throughout the research process in order to build equitable, mutually beneficial partnerships to conduct policy-relevant research and, ultimately, strengthen evidence-informed decision-making (EIDM). Gradually, a structured “CEBHA+ IKT approach” was developed, including systematic stakeholder mapping and analysis, and the development of local IKT strategies.

Methods
We conducted a mixed-methods process and outcome evaluation of this IKT intervention. This comprised structured interviews, an online survey, and document analyses at two time points, two and four years after IKT initiation.

Results
Preliminary results show that partnerships with decision-makers were successfully established or strengthened. While continuous engagement was implemented, fidelity to formalised IKT strategies was variable. The development, monitoring and updating of the IKT strategies, originally conceptualised as an essential intervention component, has been helpful for some CEBHA+ researchers and may facilitate implementation. However, the vision for decision-maker engagement as well as emphasis on continuous engagement (defined as a deliverable) emerged as more important intervention drivers and may be conceptualised as intervention components.

Conclusions
A strong vision and continuous engagement with decision-makers are critical for strengthening EIDM. Formalised IKT strategies proved to be of moderate importance in current CEBHA+ research activities, but may turn out to be an essential intervention component if implemented from the start of a research project.

Key messages
• Continuous engagement with decision-makers has successfully strengthened or established partnerships between researchers and decision-makers.
• Formal IKT strategies to plan stakeholder engagement were developed but continuous stakeholder engagement and a strong vision proved to be of greater importance.