Action Plan Research Articles

Pre-Service Science Teachers’ Conceptual Integration Understandings in Explaining the Subject of Metabolism with the Concepts of Physics and Chemistry

This study focuses on exploring pre-service science teachers’ conceptual integration understandings in explaining the subject of metabolism with the concepts of physics and chemistry. Action research was employed in this study. Nine pre-service science teachers taking the General Biology II course participated. Participants were taught metabolism considering conceptual integration. Data were collected via paper-and-pencil questionnaire administered before and after the intervention. The results showed that the pre-service science teachers could not understand physics and chemistry concepts at a sufficient level while explaining metabolism. Although the activities and practices were executed for conceptual integration in the action plan, only three participants achieved complete conceptual understanding for better conceptual integration at the end of the course in the first question. Thus, future studies could design interventions to be effective in conceptual integration. Further research could also design experimental investigations to examine how conceptual integration is necessary for establishing the relationship between science and other fields.

How to improve the inclusion of the elderly in the local community for better mental health?

Abstract Issue/problem Social exclusion, ageism and low health/digital literacy intertwine with growing trends in mental disorders, including abuse in Slovenian elderly. To cope with these issues, besides rising competencies, there is a need for stable and continuous partnerships of all relevant stakeholders in the local communities. Description of the problem Despite previous efforts of the Interdisciplinary Working Group (IWG) for mental health promotion in the elderly (established according to the Resolution of the National Mental Health Program, 2018-2028), there was a need for reconsidering approaches in the next Action plan (2024-2028). A national conference on decreasing social exclusion in the elderly contributed as a road map. Results Previous activities (events in the local communities, supported materials) were upgraded with a broad destigmatization campaign, (recruitment of the >>ambassadors <<) and collection of culturally adapted good practices. Better availability of information through >>info-spots << and easier participation of the elderly in cultural events was enabled. Activities of the reinforced IWG were promoted. Lessons Empowerment of key actors and their continuous cooperation could improve information flow, competencies, the inclusion of the elderly in the local community, and decrease ageism and discrimination. Developing local strategies with the crucial involvement of elderly representatives is the opportunity for more intensive and better cooperation between local policy/stakeholders, public health experts, and the target population. Regular financial support will prevent additional inequities. Key messages • The empowered, connected, and proactive community is key to preventing the elderly’s exclusion. • Approaches should be fresh, accessible, and tailored to the heterogeneous population.

A guide for policy and decision makers on health literacy policies

Abstract Supported by supranational organizations such as the WHO or the European Union, governments across the world have begun to work systematically on developing and implementing action plans, strategies and policies to improve the health literacy of their citizens and the health literacy friendliness/responsiveness of health organizations. In 2023, a first project on evidence-based policies and practices was initiated by the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) and financially supported by the Swiss Ministry of Health. In this project a guide on how health literacy policies can be developed and implemented was developed by an international working group. This guide brings together insights from existing literature on national health literacy strategies, action plans and interventions, including an expert snowball search within the M-POHL network and among other partners, experiences and case examples collected from M-POHL members and other countries. Feedback on the guide was collected in interactive webinars with policy representatives and decision-makers and addressed. The structure of the guide follows an adapted version of the Public Health Action Cycle model, assisting step-by-step action on health literacy policy development: situation analysis; agenda setting; developing policies, strategies and interventions; implementation; evaluation and monitoring. Each phase is described, and best practices and recommendations provided. The guide closes with a checklist for self-assessment which follows the structure of this document. It supports reflection on the state of policies in a country. This innovative guide contributes to supporting evidence-informed policies and practice. This can be of interest to experts and practitioners who have data on challenges relating to the health literacy levels of population groups and who wish to develop or adjust their policies, services and communications accordingly.

Optimizing vaccination to reduce waste and boost coverage in Primary Health Care Units

Abstract Background In immunization, vaccine consumption typically exceeds the number of recipients. The number of doses per vial influences wastage and vaccination coverage goals. In Brazil, 48% of the National Immunization Program’s vaccines are multidose, with 4 having limited shelf-life post-opening. Strategies to reduce wastage aim to optimize dose utilization, enhance process quality, and broaden coverage effectiveness. The objective was to outline strategies for reducing wastage and expanding coverage for children under 5 in 14 São Paulo city Primary Health Care Units (PHCUs). Methods The Lean Six Sigma approach guided the stages. A group conducted contextual analysis to identify PHCU barriers. Data on wasted doses and vaccination were gathered. Weekly meetings for data analysis began in May 2023, following DMAIC phases: Define, Measure, Analyze, Improve, Control. An action plan stemmed from these phases for PHCU implementation. Results Data analysis, from January 2022 to June 2023, revealed a significant vaccine wastage trend, reaching 59% from January to December 2022 and increasing to 63% from January to June 2023. This wastage incurs an average annual cost of R$614,416.26, due to lost doses from expiration after vial opening and expiration of shelf life. The vaccines analyzed were BCG, Oral Polio Vaccine (OPV), Measles, Mumps, and Rubella (MMR), and Yellow Fever. At the project start in May 2023, vaccination coverage was 90%, increasing to 93% afterward. This rise resulted from actions taken and improved data monitoring. Post-project, vaccine wastage reduced by 7 percentage points (from 62% to 56%). Conclusions Addressing vaccine wastage and expanding vaccination coverage for children under 5 are critical in healthcare. Utilizing Lean Six Sigma, key issues in PHCUs were identified, leading to an action plan that reduced wastage, increased coverage, and standardized processes. Key messages • Vaccines are valuable resources and wasting them means reducing financial resources in health. • Vaccination coverage is crucial to protect the population’s health, prevent disease outbreaks, and maintain the country’s economic health, reducing costs for treating preventable diseases.

Introducing innovative policy instrument to reduce antibiotics use. Relevant evidence from Bulgaria

Abstract Background of the public health challenge Excessive individual consumption of antibiotics (ABs) increases global antimicrobial resistance (AMR). Therefore, shaping consumers’ behaviors towards responsible ABs use is an essential strategy in the battle with the silent pandemic of AMR. The EU One Health (OH) Action Plan against AMR targets making Europe a best-practice region. Overall consumption of ABs in the EU decreased significantly, especially during the COVID-19 pandemic. Bulgaria is the only EU country that has reported an annual increase in ABs use during this period (ECDC data). A growing part of Bulgarians, believe that ‘ABs kill viruses’ and is unaware that ‘unnecessary use of ABs makes them ineffective’ (Eurobarometer 2022). This limited understanding of adequate ABs use resulted in counterproductive behaviors that demand change. Introducing innovative policy instrument as a tool for behavioral change: Undeniably, drug prescription monitoring has the potential to change consumers’ behaviors. In October 2023 mandatory electronic prescribing (e-Rx) for ABs was introduced in Bulgaria at a primary healthcare level. Consequently, there was an observed decline exceeding 30% in ABs sales (IQVIA Bulgaria data), evidencing a reduction in ABs consumption. However, there were negative reactions by the stakeholders, due to time-consuming procedures, nonoptimal IT infrastructure, etc., and that led to e-Rx-moratorium. Finally, in April 2024, the e-Rx is sustainably introduced. Conclusions Legislative measures, like e-Rx, can hinder the chaotic use of ABs. Moreover, Bulgarians need to reflect on their behaviors and values of solidarity which OH offers. Herewith, a multidisciplinary team of academic educators unite their OH efforts in raising awareness related to AMR and the rational use of ABs. Years of national endeavors toward healthcare digitalisation led to the introduction of e-Rx for ABs in Bulgaria. Research will prove its relevance for the rest of Europe. Key messages • To the European community: The introduction of the innovative policy tool (e-Rx for antibiotics) in Bulgaria is a significant national effort in making Europe a best-practice region regarding AMR. • To the Bulgarian society: Antibiotics are not bonbons! Responsible ABs use of every one of us can contribute to the EU efforts to manage AMR. In the context of AMR, every person is a stakeholder.

Climate change health challenges – a study on heat health-related adaption measures in Germany

Abstract Problem Increasing extreme heat events of summer 2003, 2010 and 2015 induced a rising impact on heat health morbidity and mortality in Germany. A considerable proportion of urban population is affected by thermal discomfort due to the urban heat island burden during summer, particularly vulnerable people at risk. Concerted action to develop appropriate heat health adaptation measures is needed. Description As part of the National Adaptation Strategy to Climate Change an expert working group published ‘Recommendations for Action for the Preparation of Heat Action Plans’ for Germany in 2017. A first country-wide project had been conducted between 2019 and 2023 which investigated the status and impact of current or planned Heat Health Action Plans (HHAP), and adaptation measures appropriate to protect and prevent human health. As part of this project an online survey was conducted in May/June 2020 on the awareness and degree of use of the 2017 recommendations and the development and implementation of HHAP. Results This survey had been carried out to assess the current state of affairs as well as factors of success and barriers in the development and implementation of HHAP, with a particular focus on municipal environment and health administrations. In total 116 questionnaires had been responded, mainly by participants from the environment sector (53%), and 32% from the public health sector. More than half of the respondents indicated to be aware of the recommendations (very well-known at the federal state level: 90%, at county level known by 43%), which were identified as very helpful by 81%. Respondents from large cities (> 100 000 inhabitants) were main contributors to the study (41 of 81 large cities replied; 34 rural counties responded). Key messages • The 2017 recommendations had been identified and used to start with HHAP. • Decision makers should develop structures for regulations that anchor HHAP as a nationwide instrument to be established timely.

The adoption of a place-based framework to inform municipal health strategies

Abstract Background Health is a place-based issue. Research shows that inequalities in health are significantly influenced by social, economic, and environmental factors, making local policies related to these domains critical determinants. Yet, place-based health planning remains underutilized by local practitioners, not receiving adequate attention from policy-makers. Departing from the Municipal Health Strategy of Coimbra, this presentation aims to showcase the framework used for guiding municipal health planning, addressing multidimensional factors, geographic analysis, intersectoral collaboration and participatory approaches. Methods The conceptual and methodological framework followed a population health approach with a geographic lens, looking at how the health outcomes and health determinants were geographically distributed across the municipality (data disaggregated at sub-municipal level), as well as the extent to which policies from multiple sectors can address them. The planning cycle followed an iterative seven-stage process based in five key actions: 1 - Assess (Health Profile), 2 - Prioritize (Priorities), 3 - Plan (Objectives and Strategies), 4 - Implement (Action Plan) and 5 - Monitor (Targets and Measures, Monitoring Plan). Participatory processes were conducted involving local stakeholders and citizens to identify needs, establish priorities and actions. Results The framework for action integrates 14 goals and 94 actions across six policy domains: Sustainable Mobility and Public Places, Safe and Adequate Housing, Accessible Healthcare, Social Cohesion and Participation, Education and Health Literacy and Intersectoral and Collaborative Leadership. Conclusions Adopting a place-based framework to health planning, involving a geographical and multidimensional health assessment as well as the participation of local stakeholders and citizens, was considered effective in turning evidence into practice. Key messages • Municipal health strategies should be developed with a place-based perspective, prioritizing health as the focal point across various intersectoral municipal policies. • The integrated framework shed light on the experience of co-creation to inform health-oriented planning, ensuring that actions address specific needs of localities.

Bridging gaps: A closer look at the health of sexual and gender minorities in Austria

Abstract Austria has long lacked comprehensive data on the health and well-being of sexual and gender minorities (SGMs). The 2022 LGBTIQ+ Health Report addresses this gap by presenting a comprehensive overview of the health status of SGMs in Austria. To contextualize SGM health issues, a review of the literature, health surveys, and action plans across Europe was conducted in the initial project phase. Then a questionnaire was developed in collaboration with an expert group for quantitative data collection. A total of 1,047 individuals participated in the survey; analyses of the quantitative data were enriched by insights from ten qualitative interviews. Detailed findings cover SGMs’ health status and experiences of discrimination as well as access to healthcare and health-promoting factors. Participants rated their health status lower than the average in Austria. A high number reported encountering discrimination in healthcare, especially among intersex and trans participants. While approximately half of the respondents were satisfied with healthcare provision, around 16% expressed dissatisfaction. Finally, a significant proportion of participants reported having foregone healthcare services at least once despite having health issues. Our work underscores the importance of recognizing the diverse needs of distinct groups within the SGM spectrum. It is crucial to avoid oversimplification by grouping them into a single SGM category as this obscures the unique challenges and inequalities faced by each subgroup. The rapid evolution of terms adds complexity to this work. Moreover, attention should be directed towards intersectionality within these groups as some are hard to reach with an online survey. Navigating the seas of public health innovation, our exploration of SGM health in Austria reveals not only the challenges but also the imperative for inclusive and tailored healthcare strategies. Key messages • The 2022 LGBTIQ+ Health Report Austria reveils SGM health realities: lower health status, discrimination, and unmet healthcare needs, urging targeted interventions. • Acknowledging diverse SGM groups and evolving terminologies, our study underscores the need for nuanced, intersectional healthcare approaches.

Empowering health literacy: Turkiye’s Health Literacy Action Plan 2022-2026

Abstract Issue/Problem The ‘Health Literacy Action Plan 2022-2026’ of the Turkish Ministry of Health addresses the critical public health issue of limited health literacy, leading to increased hospital admissions, inappropriate emergency department use, and poor health outcomes. This underscores a significant challenge in individual health self-management and higher healthcare expenditure within the country. Description of the Problem The Health Literacy Action Plan aims to tackle disparities in health literacy levels among people. It employs customized teaching schemes, digital communication, and inclusive healthcare practices to reach every demographic group. The plan seeks to enhance health knowledge and empowerment among Turkish people by increasing access to medical information, simplifying clinician instructions, and promoting closer communication between patients and healthcare professionals. Results Comparative evaluation of nationwide surveys conducted in 2017 and 2023 with 15,000 participants shows remarkable improvements. Despite delays due to the pandemic, the action plan led to a notable increase in adequate health literacy levels from 31.9% in 2017 to 46.1% in 2023. Additionally, significant improvements were observed in ailment prevention and health promotion, with health literacy levels in disease prevention increasing from 28.4% to 45.7%. Lessons The Health Literacy Action Plan plays a crucial role in developing and implementing multifaceted public health strategies based on data and stakeholder participation. These interventions, requiring continuous monitoring and adjustment, are essential steps toward achieving high-level health literacy. Key messages • Strategic health literacy interventions are essential for improving health outcomes and optimizing the use of public resources. • Evidence-based interventions and ongoing evaluation are key to promoting health literacy.

Strengthening urban deer management with structured decision making

Urban deer management (UDM) decision‐makers face social, ecological, regulatory, and economic pressures when creating an agreeable deer management plan for stakeholders. Historically, decision making techniques (e.g. consensus‐based analyses) have not effectively balanced UDM elements leading to short‐lived management progress. Structured decision making (SDM) is a formal, values‐based approach to identifying an optimal management solution. Although SDM has been applied to other wildlife management decisions, it has not been applied in UDM. We provide the first case‐study of SDM‐based UDM and streamline the process for wildlife managers. We focused on one suburban and one semi‐rural community near Atlanta, Georgia, USA. We established a problem statement to capture what decision‐makers must address in UDM programs and reviewed the primary literature and UDM plans from five states to establish four fundamental objectives. We then utilized a support–effectiveness analysis to identify acceptable UDM alternatives and gathered expert insights to calculate the consequences of alternatives on objectives. Finally, we asked each community's decision‐makers to weigh objectives against each other. Using this framework, education was the most optimal UDM technique to implement in the suburban community, and sharpshooting was the most optimal UDM technique to implement in the semi‐rural community. This paper positions SDM as a transparent, defensible, inclusive, and adaptive approach to UDM. Furthermore, our SDM framework provides managers with the means and justification to create an optimal plan of action for communities in need of UDM.

Finding cool spaces in Frankfurt/Main–a heat protection measure for the population of a major city

Abstract With the European continent heating up faster than ever, cities are facing major challenges protecting their population from the effects of climate change. Heat can have devastating effects on people’s physical and mental health with particular significance for the known vulnerable groups - the elderly and young children, people with pre-existing conditions, those who are pregnant and those who cannot protect themselves sufficiently for various reasons plus of course people working outdoors. Following the 2003 heat wave, the city of Frankfurt/Main registered a significant rise in mortality and morbidity, leading the Health Protection Authority to be increasingly concerned with heat-related health problems in the Frankfurt metropolitan area. The city has since developed various systems to protect the population from extreme heat and developed an all-encompassing climate change action plan (CCAP). Part of the CCAP is the provision of cool spaces to provide refuge from the heat for the public and implementation of this project started in the summer of 2022. However, with no legislative basis on which to build such a platform, some creative measures were required to ensure its success. Here, we will not only present the challenges we faced but the solutions we found - and the results of our currently ongoing evaluation of the actual use of our cool spaces to help other cities make their journey to similar measures easier. Starting with a brief overview of the CCAP, we will show the cool spaces’ place within the strategy, followed by our original plan of action and what happened when this plan came into contact with the reality of life in a large and diverse city. We will touch on climate injustice and the difficulties in reaching those parts of the population who actually need protection the most. Finally, we present our evaluation strategy and results together with the adjustments we are considering in moving forward with this climate change protection measure. Key messages • (Establishment of) climate change adaptation measures should urgently be enshrined in law. • Health inequality corresponds to climate inequality and continiously challenges adaptation measures.

Loneliness and Social Isolation: qualitative study among youth in vulnerable situations

Abstract Background Loneliness and social isolation are increasing among young people, particularly those in vulnerable NEET (Not in Education, Employment or Training) situations, potentially leading to poor health and well-being outcomes. We aim to explore these challenges from the perspective of NEET youngsters and link workers who support them in co-creating individual action plans for their social and economic integration. Methods Data were collected through in-depth and semi-structured interviews with 15 young people in NEET situations, aged 18-34, and 7 link workers from several social organisations in rural and urban areas in Portugal. The young participants were selected based on their age, educational level, mental health needs, and urban/rural regions. Thematic analysis was used to analyse the interviews. Results The results showed a convergence between the perspectives of young people and link workers on the factors that influence social isolation and loneliness, including social and emotional skill deficits, excessive use of social media platforms, and mental health problems. Young people reported to being heavily involved in social media platforms, which often did not translate into meaningful relationships in real life. Youngsters also highlighted the lack of local support and community resources in rural areas. Link workers identified specific challenges young migrants face in community integration, including language barriers (for the youth with a migrant origin) and lack of familiarity with local resources. Conclusions This study highlights social media platforms, mental health and social and emotional skill deficits as main factors contributing to the social isolation and loneliness of young people in a NEET situation. This emphasizes the importance of integrated proximity-based interventions that incorporate community resource mapping and local support networks, including mental health support services, and promote multi-sector collaboration. Key messages • Social media platforms, mental health needs, and social and emotional skill deficits drive social isolation in NEET youth, stressing integrated, community-focused interventions. • Proximity-based strategies with community mapping and mental health support enhance NEET youths’ social integration, urging cross-sector collaboration.

Future-Proofing Analysis of the 2017 EU AMR Action Plan

Abstract Antimicrobial resistance (AMR) is a serious public health concern and has been deemed a top priority amongst public health authorities internationally. AMR is a complex issue, which is affected by a wide range of diverse factors including antimicrobial use, vaccines, surveillance, climate change and global conflicts. In thinking about how to address AMR, it is important to not only consider how multiple factors interact to contribute to the issue, but also how these factors may develop in the future. In 2017, the European Commission published the European One Health Action Plan against AMR, which set out objectives and priory areas for actions across EU/EEA Member States. This presentation will discuss the results of a future proofing study of this Plan. The study included a series of scenarios for how AMR might develop over the next ten years, in order to gather stakeholder perspectives on how the Plan can be improved to mitigate against future risks, take advantage of future opportunities and move towards more favorable futures. In particular, this presentation will focus on how this futures method was used to arrive at specific and actionable recommendations about how to better prepare for the future of AMR.

Protocolizing social prescribing in mental health and addiction services: barriers and opportunities

Abstract Issue Social Prescribing (SP) is a structured approach where health professionals recommend community activities to enhance well-being. Starting in Catalonia in 2012, it expanded to the entire primary care network by 2016. By 2023, 23,338 patients received SP, showing a 2.3-fold increase from 2022. Two-thirds experienced improvement in mental well-being. Now, efforts focus on applying SP to mental health and addiction services (MHAS), where SP can be used for restoring health and well-being. Description A literature review was conducted and a working group was initiated with MHAS professionals was initiated to exchange experiences and identify needs and best practices. This was done in preparation for designing a pilot experience, which will include a qualitative study through focus groups to validate the action plan and determine barriers and facilitators in MHAS. The groups will be segmented into MHAS users and frontline professionals. Results The results of the review process and the working group sessions demonstrated that SP can be useful and beneficial for the health MHAS users. However, barriers and opportunities were identified. The main barriers detected include: the need for strong support during referrals to community activities; increased awareness of addiction among activity providers to reduce stigmatization; define inclusion and exclusion criteria; determining monitoring and evaluation tools; and mapping and updating community assets. Regarding opportunities, the following were highligthed: the interest of MHAS professionals in promoting and implementing a SP program in this area; the existence of organizations already conducting community activities focused MHAS users; and political prioritization of this issue. Lessons The implementation of a SP program protocol in MHAS is considered beneficial. It is necessary to analyse barriers to effectively address them and to identify opportunities to leverage them. Key messages • Social Prescribing has significantly enhanced mental health outcomes in Primary Care, which can imply a potential improvement in well-being of mental health and addiction services users. • Implementing Social Prescribing in mental health and addiction services offers promising integrated care opportunities, requiring barriers resolution and maximizing existing prospects.

Changes of lifestyle and mental health among COVID-19 situation: resident-centered health promotion

Abstract Background Yuzawa town, located in the Niigata prefecture of Japan, is famous for its hot springs and ski resorts. A sustainable action plan for resident-centered regional health promotion (Yuzawa family health plan) was initiated in 2002. Surveys have been conducted every five years. This study aims to evaluate changes of their habits and mental health status between in 2017 and in 2022. Methods The survey of Yuzawa family health plan was conducted in 2017 and in 2022. Questionnaires were composed with living alone, living with marriage partner, living with son or daughter, living with grandchildren, living with brother or sister, health consciousness, attention to health, health concern, awakening in a morning, clockwork life, fitness habits, smoking, taking alcohol, anxiety, loneliness, consultation, resolve suffering, economic problem, handle stress, taking a rest, risk breaching, communication, life satisfaction, talking with family, job at home, intercommunion with friends, greeting with neighbors, relationship with neighbors, occupations, good sleep, taking breakfast, nutritional balance, mastication status, confirmation of food compositions, exercise habits, yearly health check-up, dental check-up, brushing teeth habits, and sleep satisfactions. Chi square tests were used to evaluate changes between in 2017 and in 2022. This study was approved by the ethics committee of Tokyo Women’s Medical University. Results Passive smoking, intercommunions with neighborhood and friends, exercises, and Salt reduction awareness reduced in 2022. Talking with family, taking a rest, attention to health, clockwork life, and sleep satisfactions increased. Conclusions Many changes were shown between in 2017 and in 2022. Because elderly has been able to use a mobile phone, loneliness was not increased. But numbers of elderly living alone have been increased from 2002. Health promotion programs giving health information for elderly is needed. Key messages • Many lifestyle changes were shown between in 2017 and in 2022. • Passive smoking reduced. Taking a rest and attention to health increased.

An Overview of Tobacco Control Policies in China

The tobacco epidemic is a global public health concern as the toxic substances in tobacco pose a severe threat to human health. In response to this issue, countries around the world have adopted various strategies to control tobacco use. The Chinese government began to pay attention to the health hazards of smoking in the 1970s and joined the international community in tobacco control endeavors by becoming a signatory of the World Health Organization Framework Convention on Tobacco Control in the early 21st century. It has further intensified its tobacco control measures in recent years with its “Healthy China” strategy. This article gives an overview of tobacco control policies released by the Chinese government over the years, with a separate analysis of the provisions on smoking control stipulated in the Health China Action Plan (2019-2030). Also discussed are the outcomes of those policies and the challenges China faces in tobacco control, as well as the lessons China can learn from international experiences in this regard.

A monitoring framework for reinforcing policies against antimicrobial resistance in Europe

Abstract In an attempt to overcome barriers to the effective implementation of policies against antimicrobial resistance (AMR) in the EU Member States, Norway and Iceland, One Health national action plans (NAPs) need to show improvements in both their formulation and their implementation. Research conducted by Tetra Tech, funded by the EU4Health Programme, has identified shortcomings to One Health national policies across all countries, such as limited political focus and awareness of the challenges brought by AMR; lack of operational plans for delivering on the NAPs; and lack of harmonised indicators and inadequate information systems for monitoring the implementation of plans. On this last issue, subsequent reseach by Tetra Tech has supported the design and development of monitoring indicators for reinforcing the expected improvements of NAPs and the implementation of policies aimed at EU Member States in the 2023 “Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach”. While drawing on existing data sources at EU and global level, the study has also worked with Member States representatives in identifying indicators for the monitoring framework and proposed new data collection activities at the national level. Key messages • EU countries face common barriers to the effective implementation of One health policies against AMR, and need to reinforce their national action plans. • Stepping up the fight against AMR in the EU requires a strong monitoring framework for following up on EU recommendations.

How Can Land Use Management in Traditional Cultural Landscapes Become a Policy Instrument for Soil Organic Carbon Sequestration and Climate Change Mitigation? A Transylvanian Case Study

Changes in land use from high-nature-value grasslands to arable fields reduce the organic carbon stock in soil, increasing atmospheric carbon concentrations. Maintaining grasslands through traditional agricultural techniques can mitigate climate change by transferring atmospheric carbon to the soil. Benefits of soil organic carbon sequestration include improved soil properties and enhanced ecosystem services and biodiversity. With Romania’s ratification of the Paris Agreement, it is crucial to review climate-related agricultural policies and incentivize carbon sequestration practices in organic soils. This paper presents a soil carbon study in Transylvania’s Târnava Mare region, Romania, known for its preserved cultural landscapes. Soil samples were taken at a depth of 60 cm to assess organic carbon pools under grassland and arable land management across three soil classes: Cernisoils, Hidrisoils, and Luvisoils. Several statistical tests were applied to evaluate the most significant drivers of soil organic carbon sequestration including land use, soil class, and soil depth. The results indicate that land management has the largest impact, with grasslands storing 45% more carbon than arable land on average. This finding should be integrated into national climate action plans, prioritizing the preservation of grasslands and sustainable agricultural practices to support soil organic carbon sequestration.

9.C. Round table: The Global Oral Health Action Plan – Integrating Oral Health into the global health agenda

Abstract Oral diseases (OD) are a global public health problem affecting 3.5 billion people, with a global prevalence of 45%, higher than the prevalence of any other non-communicable disease (NCD). Recognizing the global public health importance, the 76th World Health Assembly (WHA) (May 2023) adopted the WHO’s Global Oral Health Action Plan (GOHAP) 2023-2030; a crucial step to bring momentum and mobilise all actors to address the burden of OD and common risk factors for all NCDs, while integrating oral health (OH) as part of general health and promoting cross-sectoral cooperation on good OH worldwide to reach UHC. Drawing insights from other successful global health action plans, this roundtable (RT) will explore key lessons learned in implementing effective strategies to improve OH outcomes at European and global levels, ensuring access to quality care for all. The objectives of the RT are: 1.To present the GOHAP 2023-2030, incl. challenges and opportunities; 2. To draw insights from other global health action plans; 3. To present good examples of civil society organization (CSO) actions supporting the GOHAP’s implementation - The Manifesto of the Platform for Better Oral Health, calling for policy actions by EU policymakers; 4. To present findings from the EU DELIVER (DELiberative ImproVEment of oRal care quality) and PRUDENT projects, funded by the European Commission, aiming to provide and implement a blueprint model for ensuring access to quality OH care for all; 5. To inform follow-up actions and collaboration across EUPHA sections, its strategy, as well as that of European Member States (MS), CSOs and other institutional partners, and to raise awareness across the European public and global health communities. The structure of the RT will include brief interactive presentations with real-time polling to maximize participant engagement and to consolidate key messages to present at the end of the session, incl. to inform follow-up actions across EUPHA. The first brief presentation on GOHAP will highlight the aims and evidence-informed actions, followed by: 1. Insights from other global health action plans, exploring lessons learned in implementing effective strategies, examining the approaches, opportunities, challenges and outcomes; 2. Good examples of actions taken by CSOs; 3. Preliminary findings from the EU DELIVER and EU PRUDENT will be presented, incl. key co-creation tools of deliberative dialogues and the development of a set of quality indicators for applicability on the practice, community and policy levels. Guided discussion will focus on opportunities and challenges in GOHAP implementation, with the targeted questions to panellists on: What can countries learn from other global health action plans? What should be the priorities of EU MS? What is the role the public health community can play? What are key steps needed to eliminate common NCD risk factors to drastically reduce the prevalence and burden of ODs? Key messages • There is an urgent need in the global and public health communities to better understand the processes involved in implementing the GOHAP, incl. challenges and opportunities. • Interdisciplinary and cross-sectoral collaboration is key to address the common risk factors of NCDs, to inform concerted action and evidence-informed policymaking to improve oral health care. Speakers/Panelists Pauline Vassallo European Association of Dental Public Health, Valletta, Malta Benoit Varenne Dental Officer, Prevention of Non Communicable Disease Department, WHO, Geneva, Switzerland Dympna Kavanagh Chief Dental Officer, Platform for Better Oral Health in Europe, Dublin, Ireland Neville Calleja Department of Health Information and Research, G’Mangia, Malta

Fairer Training in public health, the UK FPH example

Abstract Background Public Health (PH) advocates for health equity and social justice. The UK Faculty of Public Health (FPH) is committed to tackling inequalities across the public health career pathway. The Fair Training project is a multi-phased programme which focuses on fair recruitment into PH, reducing differential attainment during PH training and postgraduate examinations. Objectives • Analyse available data from various sources; • Identify gaps in fair training culture and any biases; • Identify where support or interventions may best be focussed to minimise disadvantages; • Identify improvements in data that could be used to monitor actions; • Identify areas of good practice. Variables explored were demographic characteristics e,g, age, sex, ethnicity, disability status, professional background, candidate status (UK or overseas), place of primary qualification. Results Results show that candidates from ethnic minority backgrounds, those who are older, from international medical graduate backgrounds and backgrounds other than medicine are under-represented at the end of recruitment. Multivariable analysis of the diplomate exam shows that an attainment gap exists across increase with age, and those from black, Asian or white other ethnicity, professional background other than medicine, and overseas candidates. For the membership exam, multivariable analysis shows the attainment gap persists across those of increasing age and black ethnicity. Conclusions Recognising differential attainment as a structural problem requires organisational and individual leadership. Recommendations include an action plan to ensure: • Equality of opportunity for learning and career progression; • Collaborative working to eliminate discrimination in the design of education; • Ensure that training and the working environment are inclusive and diverse; • Inform future PH workforce planning; • Share good practice. FPH will implement the recommendations and share with other organisations and countries. Key messages • Structural causes of differential attainment during recruitment and training in public health do exist and should be mitigated. • FPH aims to promote Fair Training and excellence in public health practice.