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Climate change and public health in Germany - A synthesis of options for action from the German status report on climate change and health 2023.

This article represents the conclusion of the updated German status report on climate change and health, which was jointly written by authors from over 30 national institutions and organisations. The objectives are (a) to synthesise the options for action formulated in the report, (b) to combine them into clusters and guiding principles, (c) to address the success factors for implementation, and (d) to combine the options for action into target parameters. The options for action from the individual contributions of the status report were systematically recorded and categorised (n=236). Topical clusters were then formed with reference to Essential Public Health Functions, and options for action were assigned to them. Eight topical clusters of options for action and ten guiding principles were identified. These can be summarised in four overarching meta-levels of action: (a) cross-sectorally coordinated structural and behavioural prevention, (b) monitoring, surveillance, and digitalisation (including early warning systems), (c) development of an ecologically sustainable and resilient public health system, and (d) information, communication, and participation. The main success factors for implementation are the design of governance, positive storytelling and risk communication, proactive management of conflicting goals, and a cross-sectoral co-benefit approach. Based on the status report, systematically compiled target parameters and concrete options for action are available for public health.

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Taking stock of the pre-pandemic patterns of demographic and psychological antecedents of vaccination intention and behaviour – Results from representative surveys in 2016 and 2018

Abstract Background: There are many reasons why people decide for or against vaccination. Besides socio-demographic characteristics, the 5C antecedents of vaccination (confidence, complacency, constraints, calculation and collective responsibility) are a helpful tool for identifying target groups and the public’s broader informational needs. In this study, the 5C antecedents were used to explain vaccination behaviour (a) in general over the last five years, (b) for specific vaccines and (c) for target groups, such as the elderly, parents, and healthcare workers. The intention to get an influenza vaccination was also analysed for certain target groups. Methods: The 5C antecedents of vaccination, self-reported vaccination behaviour and intention to vaccinate were collected in two representative telephone surveys – one in 2016 (n1 = 5,012) and another in 2018 (n2 = 5,054). Logistic regressions reveal the predictive value of socio-demographic variables and psychological antecedents for vaccination behaviour and intention. Results: Confidence in safety and effectiveness was always an important predictor. Furthermore, complacency (the underestimation of risk) and even structural barriers were important psychological predictors of vaccination behaviour. Overall, psychological antecedents had higher explanatory power than socio-demographic variables. Conclusions: The pattern of vaccine hesitancy slightly differed between vaccinations and target groups, and an understanding of pre-pandemic patterns is urgently needed to detect changes in vaccine hesitancy patterns caused by the pandemic and to target vaccination deficits that it has caused.

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Open Access
Criteria for best practice in health promotion

Abstract There are many interventions that take a health-promoting approach. But are they really good and do their implementation lead to results that are also a sustainable improvement for the target group in a setting? Can this improvement be scientifically evaluated and even measured or is it based on a well-intentioned perception only? The criteria for good practice from Germany, which were developed in 2003 by the Advisory Working Group of the nationwide Collaborative Network for Equity in Health of BZgA, aim in particular for professionals in community health promotion to reflect on their work and to support them in further developing and strengthening the quality of their health promotion services. The (twelve) good practice criteria, in practical language and in the form of twelve fact sheets, each contain a definition, implementation stages of the criterion, their explanation (illustrated with examples from practice) as well as further literature. The good practice criteria include conception and target group reference and take into account participation and empowerment, but also sustainability and cost-effectiveness. These criteria also serve as selection criteria for interventions to be included in the German Good Practice Portal which has a particular focus on tackling health inequalities. In a brief presentation these criteria will be presented to the participants of the workshop in order to subsequently discuss and exchange approaches from other countries.

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Elterliche Sexualaufklärung und sexuelles Risikoverhalten bei Töchtern und Söhnen: Befunde aus der Repräsentativbefragung „Jugendsexualität“

ZusammenfassungHintergrundSexualaufklärung im Elternhaus soll laut Sozialisationstheorie zu mehr sexueller Handlungskompetenz bei Jugendlichen führen. Aktuelle Daten für Deutschland fehlen jedoch.Ziel der ArbeitVor diesem Hintergrund war es Ziel der vorliegenden Studie, erstmals das allgemeine Sprechen über Sexualität im Elternhaus (Forschungsfrage 1, F1) sowie speziell die Verhütungsberatung durch die Eltern (F2) mit dem sexuellen Risikoverhalten der Jugendlichen in Verbindung zu setzen.Material und MethodenDatengrundlage ist die 9. Welle der Repräsentativbefragung „Jugendsexualität“ der Bundeszentrale für gesundheitliche Aufklärung (BZgA). Analysiert wurden Daten aller sexuell aktiven 14- bis 17-jährigen Jugendlichen im Sample, von denen eigene Angaben zum Sexualverhalten sowie Angaben ihrer Eltern zum Aufklärungsverhalten vorliegen (N = 357). Zur Beantwortung der beiden Forschungsfragen wurden logistische Regressionsanalysen mit 4 zentralen Merkmalen des jugendlichen Sexualverhaltens gerechnet.ErgebnisseEs zeigte sich, dass das Sprechen über Sexualität im Elternhaus bei Mädchen und Jungen positiv korreliert mit 1. dem erreichten Konsensalter beim ersten Geschlechtsverkehr, 2. einem positiven Erleben des ersten Geschlechtsverkehrs, 3. einem zuverlässigen Verhütungsverhalten und 4. einer geringen Anzahl an Sexualpartner*innen (F1). Das gleiche Ergebnismuster ergab sich für die Verhütungsberatung durch die Eltern (F2).DiskussionDie positiven Zusammenhänge zwischen elterlicher Sexualaufklärung und risikoärmerem jugendlichen Sexualverhalten gilt es hinsichtlich der zugrunde liegenden Kausalmechanismen genauer zu untersuchen.

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Implementation of interventions to maintain and promote the functional mobility of nursing home residents – a scoping review

BackgroundTo provide an overview of the available evidence on the implementation of direct and capacity-building interventions to promote and maintain the functional mobility of nursing home residents.MethodsWe conducted a scoping review following the methodological guidance for the conduct of scoping reviews as described by the Joanna Briggs Institute. We searched for studies in MEDLINE (via PubMed) and CINAHL (via EBSCO). We conducted a qualitative content analysis of the included studies with deductive categories based on the Consolidated Framework for Implementation Research (CFIR).ResultsUltimately, we included 8 studies on direct interventions, 6 studies on capacity-building interventions, and 2 studies on both types of interventions in our review. Seven studies provided evidence on implementation strategies comprising discrete as well as multifaceted, multilevel strategies. Most of the studies did not systematically evaluate the strategies but remained at a descriptive level. All 16 studies provided evidence of influencing factors. We identified 32 of the 37 influencing factors of the CFIR. The five most frequent influencing factors were available resources (n = 14), access to knowledge and information (n = 12), patient needs and resources (n = 10), knowledge and beliefs about the intervention (n = 10) and compatibility (n = 9).ConclusionsThe available evidence on the implementation of functional mobility interventions in nursing homes is rather limited. This emphasizes the need for further research. Regarding implementation strategies, the systematic evaluation and further development of the reported promising approaches might be a starting point.

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Ein geschlechterspezifischer Blick auf das gesundheitsbezogene Informationshandeln, seine Treiber und Barrieren

ZusammenfassungHintergrundVor dem Hintergrund der Geschlechterperspektive als relevante Ebene effektiver Gesundheitskommunikation wird das gesundheitsbezogene Informationshandeln fokussiert. Ergänzend zur Informationssuche wird die Informationsvermeidung einbezogen. Beide Formen des Informationshandelns werden geschlechterspezifisch beschrieben und sollen anhand verschiedener Ressourcen wie der Gesundheit, dem Wohlbefinden, dem Empowerment, dem Involvement und der sozialen Unterstützung erklärt werden.MethodeEs wurde eine Online-Befragung einer für die deutsche Bevölkerung stratifizierten Stichprobe (N = 3000) durchgeführt. Erfasst wurden die beiden Formen des Informationshandelns sowie ihre theoretisch abgeleiteten Prädiktoren. Neben deskriptiven Analysen dienen blockweise Regressionsanalysen dazu, geschlechterspezifisch die Prädiktoren der Suche und Vermeidung zu identifizieren.ErgebnisseDie Informationssuche findet häufiger statt als die Informationsvermeidung. Beide unterscheiden sich nur in geringem Maß zwischen Männern und Frauen. Für Suche und Vermeidung zeigen sich die stärksten Zusammenhänge mit dem Involvement der Befragten. Für die Suche sind zudem auch Ressourcen des Bedrohungsmanagements bedeutsam, während die Vermeidung mit dem psychischen Wohlbefinden und der sozialen Unterstützung assoziiert ist. Geschlechterübergreifend zeigen sich ähnliche Assoziationsmuster.DiskussionGeschlechterübergreifend zeigt sich, dass mittels gesundheitskommunikativer Maßnahmen das Involvement der Bevölkerung unterstützt und Ressourcen des Bedrohungsmanagements gestärkt werden müssen, um die Suche zu fördern und der Vermeidung entgegenzuwirken. Zudem wird deutlich, dass Vermeider*innen als eine zentrale Zielgruppe mehr Aufmerksamkeit erhalten sollten.

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