Audience Discussion Research Articles

Lived experiences: What made or would have made a difference to me when growing up?

Abstract We sometimes forget the people behind the numbers and those affected by our research. The video on lived experiences aims to put a human face on childhood social care ahead of the panel and audience discussion. Rather than asking care experienced people specifically about their health, which people may find intrusive or even irrelevant for their experience, we will seek to understand what did or would have made a difference to their lives. Dr. Allik, who has led and facilitated a number of knowledge exchange and engagement activities related to childhood social care, will take the responsibility of organising the collection different video recordings on lived experienced of childhood social care. We will work in collaboration with already existing organisations that advocate for (care experienced) children’s rights to produce the video. Dr. Allik will also be supported by the knowledge exchange team at the UofG, including choosing the appropriate methods of seeking recordings, compiling, and curating the video.

7.N. Round table: Social media & smartphones: Threats to child & adolescent health and public health solutions

Abstract The daily lives of children and adolescents in 2024 are heavily influenced by social media and smartphones, which is unprecedented in previous generations. While this technology offers undoubted benefits, there is strong evidence on the negative effects of social and cognitive development of infants and primary school aged children, and mental health impacts in adolescents including depression, anxiety, sleep disruption, addictive behaviours and self-harm. Internet companies are financially incentivised to maximise screen time of users to generate advertising revenue, and more time spent by young people on these devices in a largely unregulated online domain increases risk of consequences like bullying and harassment, body dysmorphia, gambling addiction, porn addiction, sexual predation and suicide. Comprehensive solutions are urgently needed to regulate the activities of social media and tech companies and support young people to protect themselves from serious harms. Governments have been slow to introduce policies such as smartphone bans or enhanced privacy laws, perhaps because they are perceived as unpopular infringements on the rights of adult users and/or due to a potential detrimental effect on commercial interests. Guidance can be disseminated to young people, schools, families and institutions on how to reduce screen time and smartphone addiction, and improve coping and self-regulation to mitigate these risks. Information campaigns with positive health messages in this area, to compete with the advertising dominance of social media companies, are another opportunity to improve behaviours and reduce adverse health effects. The objectives of this round table workshop are to share examples of strategies, guidance and policies from across Europe, and discuss with the audience how the public health community can collaborate to tackle this problem. Members of the EUPHA Child and Adolescent Public Health (CAPH) section will outline the latest available evidence on the negative impacts of social media and screens, present examples of innovative public health responses and strategies to protect children, and engage conference participants for their input and discussion. Five panellists will present. First, John will start with a quiz of the audience which will include presentation of current data and trends relating to social media and smartphone usage. The second presentation by Cecilia will highlight in detail evidence of both benefits and adverse effects of these technologies in the lives of young people. The third speaker Karin will discuss examples of effective policies to reduce this impact, with a focus on the role of schools. The fourth speaker Jean will give further examples of public health actions, and share recommendations directly from children and young people. The fifth panellist Silja will re-quiz the audience, to gauge the reaction and support of solutions that were covered, and this will lead into the interactive discussion. Key messages • Popularity of smartphones and social media has increased dramatically in recent years, particularly among minors, with significant impacts on mental and physical health. • Public health solutions are urgently needed, and this workshop will share examples of effective innovative responses in European contexts, followed by an interactive audience discussion.

4.D. Scientific session: From policy to implementation: Learnings around health system reforms and Universal Health Coverage

Abstract In this session, the authors and audience have the opportunity to engage in discussions around health policy integrity and reform implementation. Introducing and implementing health system reform has been a perennial issue for countries around the world over the past number of decades. Recently, the introduction and implementation of Universal Health Coverage (UHC) has been of particular focus, with 193 countries committed to introducing UHC by 2030. At the same time, European countries that previously established national health systems are introducing new reforms in the hope of making their health systems more efficient and equitable. However, there are a number of challenges along the path of policy development and implementation with which all countries must grapple, and how individual countries go about reforming their health systems depends on their social, political, cultural and economic contexts. Learnings from around the world have highlighted that reforms can be challenged or stalled in both the design and implementation phases. This workshop, which conceptualises implementation as the “acid test” of a policy, thus explores, through three case studies, the factors that facilitate or challenge the implementation of reforms. At the same time, we discuss policy integrity, exploring reasons for why policies pivot away from original design and intent. Furthermore, we discuss the implications of health reform on equity, cognisant that the primary objective of this collective reform work is to reduce the financial burden of healthcare on households and improve access. The first presentation will provide the framework for audience discussions, outlining international lessons in relation to UHC reforms and equity. The second presentation will provide a snapshot of the Finnish experience of introducing a “big bang” structural reform. The third presentation highlights lessons from the Portuguese experience of primary healthcare reforms, the opportunity these offer for creating patient-centred care and the integral role that politics and governance play in the reform process. Finally, the Irish case study highlights the experiences of a High Income County attempting to introduce UHC much later than its European counterparts, and negotiations between the public and private sectors. Through this, we hope to hold the tensions and stimulate debate about policy robustness and resilience, and reform implementation. Each presenter will be given a strict deadline of 10 minutes each by the chair and then the audience will be invited to debate the problems identified and strategies proposed to discuss: (i) what are the facilitators and barriers to reform implementation, (ii) what are the factors that encourage policy integrity and change and (iii) whether greater cooperation across Europe regarding health reforms can be more effective in supporting robust health systems. Key messages • For reforms to be facilitated, there must be cohesion and commitment across the political, social, economic and cultural systems, and no fragmentation across health system functions. • As policy implementation is attempted, there is a tension between remaining true to key values and adapting to new circumstances.

Health Misinformation Research

ABSTRACTHealth misinformation research has dramatically increased since the start of the COVID‐19 pandemic, although not all of this work has taken advantage of the rich theoretical and methodological background information science as a discipline has to contribute. This panel presentation will feature information scientists conducting health misinformation research from and in various settings, to showcase the value and range of information science approaches to health misinformation research. Each panelist will describe their work in the area of understanding and/or addressing health misinformation in institutions such as libraries and schools, health systems and interventions such as vaccination or public health promotion, or the general public in their online or offline information environments. Presentations will also highlight the ways researchers are applying information science theory, methods, and/or approaches to health misinformation topics, as well as lessons panelists have learned through this work. The panel will conclude with an interactive audience discussion that will center on the ways in which information science can help understand and address health misinformation challenges around the world.

11.H. Round table: Moving the agenda forward on the Commercial Determinants of Health

Abstract Commercial actors play a vital role in society, yet there is growing evidence that they are responsible for escalating levels of avoidable ill health, planetary damage and social and health inequity. These problems are increasingly referred to as the ‘commercial determinants of health’ (CDOH). A recent Lancet Series on CDOH brought together a global intergenerational and multidisciplinary team of researchers and thought leaders to help consolidate thinking around the CDOH. It defined the CDOH as “the systems, practices and pathways through which commercial actors drive health and equity”. This workshop brings together one of the three lead authors from the CDOH Lancet series, with leading members of the civil society and intergovernmental organisations (including the WHO CDOH Lead and WHO European lead for NCDs) to discuss and engage with the audience on this complex and urgent issue. By bringing together these experts, this workshop explores the role that different agencies can play in tackling the CDOH. The workshop will consist of a presentation based on the lessons from the Lancet Series on Commercial Determinants of Health followed by a panel discussion among participants enabled by the workshop chair who will encourage audience discussion and participation. Discussants will be asked to comment on challenges and considerations for addressing CDOH in the WHO European Region, the role of civil society in the EU policy making context and the way forward in a global agenda. By convening these experts, the workshop aims to engage the audience in a discussion that builds their understanding of the CDOH and what they can do to respond to this problem. While much of the Lancet series is quite conceptual in its approach to CDOH, this workshop supports the public health community to move beyond simply understanding the systematic nature of the CDOH. In particular, the workshop aims to support researchers, practitioners, and policy makers to collaboratively develop possible solutions to CDOH and practical next steps to drive the CDOH agenda forward in the European Region. We recognise that this is a large amount of content to discuss in this workshop; however, we see this workshop (and the lancet CDOH series) as initiating a larger and ongoing conversation within the public health community. Key messages • CDOH is a complex and systematic issue that is hurting the health of people in Europe with low awareness of how they manifest and impact public health issues. • Despite the complexity of CDOH, there are practical measures that the public health community can implement at local, national, regional, and global level to tackle them. Speakers/Panelists Anna Gilmore University of Bath, Bath, UK Gauden Galea WHO, Beijing, China Monika Kosinska WHO, Guildford, UK Florence Berteletti EuroCare, Brussels, Belgium

1.Q. Workshop: Work, health, and migration: understanding the health impacts of precarious and exploitative work

Abstract The ILO estimates that of the 169 international migrant workers globally, the largest share resides in Europe, where increasing numbers are at substantial risk of precarious, exploitative, and hazardous work conditions. While the right to health and decent work of migrants is recognised by European member states, COVID-19 has exposed how some low-wage migrant workers are compelled to accept exploitative and precarious employment terms and conditions, with implications for their health. The vulnerability of migrants to labour exploitation is influenced by both personal factors (such as age and gender) as well as situational factors (such as risk environments across the migration journey and national legislation). Hazardous, precarious, and exploitative work is an entrenched driver of poor health. Data show that low-wage migrant workers have higher injury and mortality rates compared to host workers and face barriers to occupational and mainstream health and vaccination systems. In this workshop, we will discuss the patterns of precarious work and labour exploitation in migrants residing in Europe, physical and mental health effects of labour exploitation, research and policy gaps, and models of good practice to ensure that the health and rights of migrant workers are protected. Workshop plan The workshop will start with 10-minute presentations by each of the 4 speakers (including a short Q&A after each talk). This will then move into a 20-minute audience discussion centred around exploring how to foster intersectoral collaboration across the work, migration, and health research communities to begin addressing some of the evidence and policy gaps in the European region. Key messages • Migrant workers have worse health outcomes than native workers, including higher rates of occupational injury and deaths. • Labour exploitation is an important social determinant of health among migrants which requires greater recognition in research and practice.

6.P. Workshop: Responding to violence and abuse across the life-course

Abstract Much research on the mental health effects of violence focus on domestic violence as experienced in adulthood. The mental health impacts are often gauged using cross-sectional studies and focus on current associations between violence and health. This workshop presents a range of analyses - drawing on data from New Zealand, Germany and the UK - that address the ways in which violence and abuse manifest at different life stages, including in childhood, among working-age adults, and in later life. The presentations highlight differences across the life course, as well as commonalities. They provide evidence of the long-term, even life long, shadow that violence and abuse can cast over people's health, and provide evidence of the extensive costs for society. Health impacts are shown to be broad, not only anxiety and depression, but substance dependence, chronic physical health conditions, and related health risks such as obesity. This workshop comprises four presentations that each consider violence and abuse prevalent at a particular stage of life, and provide evidence to inform the sensitive tailoring of responses from and for families, schools, health and social services, workplace human resource employees, and care and residential homes. The format of the workshop comprises brief presentations, with a focus on extended audience discussions. We invite engagement from people from a range of disciplines interested in how different forms of violence and abuse present at different life stages, the impacts on health, and the ways in which society should respond. This workshop is submitted on behalf of the EUPHA Public Mental Health Section. Key messages • Violence occurs across the life course. While its prevalence and form often vary between life stages, at every stage it has major, long-term, and diverse implications for health. • Interventions need to be tailored to the life course and sensitive to changing context, including domestic, workplace, and care home environments.

The Contested Nature of the Public in Policy

Co-sponsored by the Information Policy and Information Ethics special interest groups (SIGs), this proposal is for a pair of traditional 90-minute speaker panels, facilitated by the respective SIG convenors and supporting interlocutors, which will address the contested nature of the public in policy and implications for educators, including the ALISE community.
 The first co-sponsored panel explores the past decade’s ramped-up effort among activists to defund or use punitive measures against public institutions that support and enact diversity, equity, inclusion, and decolonization (DEID) efforts. For example, many libraries have purposefully endeavored to increase the diversity of their collections and programs with respect to BIPOC and LGBTQ+ authors, speakers, and themed displays. Many school systems have invested in DEID curriculum and resources to better serve their students, and universities have invested in staff and faculty development to support students, staff, and faculty of color. However, some community members and politicians are opposed to any DEID efforts and thus seek to eliminate them, using either legal or punitive financial means. This panel will give attention to the historical context of DEID efforts and current implications for public institutions; lobbying; advocacy work in public institutions; and legislation and states/provincial/territory rights and federalism. The Information Policy SIG convenor, with the support of interlocutors, guides the audience in a critical discussion of implications for multiple constituent groups (e.g., library users, people working within library and information institutions, trustees, mayors, legislators, police and security workforce, journalists). At the close, participants are encouraged to surface connecting topics and potential conversationalists for ongoing engagement co-hosted by the Information Policy and Information Ethics SIGs.
 The second co-sponsored panel pivots attention to instances of censorship and self-censorship among some of the people who work in higher education and K-12 public educational institutions and their libraries therein in various national contexts. The topics covered in this panel include the effect of censorship and self-censorship on teaching, learning, and curriculum; the contested nature of intellectual freedom, represented through specific cases of censorship, challenge and critique; implications for ethical AI in research and higher education; workplace expression, and employer; rights and responsibilities of academic freedom; and the use and abuse of civility codes. The Information Ethics SIG convenor, with the support of interlocutors, will guide the audience in a discussion of implications for the education of library and information professionals and those individuals who are engaged in teaching them. This includes critical discussion with respect to: employees and scholars at risk (e.g., equity deserving, precariously employed or under-employed, international work); threats on tenure and tenured members of academic staff (e.g. faculty, archivists, librarians); bargaining and job action; curtailing of academic freedom; declining collegial/shared governance in higher education; the importance of strong administrative and trustee support in our educational institutions; and related legislative priorities. At the close, participants are encouraged to surface connecting topics and potential conversationalists for ongoing engagement co-hosted by the Information Policy and Information Ethics SIGs.

The Contested Nature of the Public in Policy

Co-sponsored by the Information Policy and Information Ethics special interest groups (SIGs), this proposal is for a pair of traditional 90-minute speaker panels, facilitated by the respective SIG convenors and supporting interlocutors, which will address the contested nature of the public in policy and implications for educators, including the ALISE community.
 The first co-sponsored panel explores the past decade’s ramped-up effort among activists to defund or use punitive measures against public institutions that support and enact diversity, equity, inclusion, and decolonization (DEID) efforts. For example, many libraries have purposefully endeavored to increase the diversity of their collections and programs with respect to BIPOC and LGBTQ+ authors, speakers, and themed displays. Many school systems have invested in DEID curriculum and resources to better serve their students, and universities have invested in staff and faculty development to support students, staff, and faculty of color. However, some community members and politicians are opposed to any DEID efforts and thus seek to eliminate them, using either legal or punitive financial means. This panel will give attention to the historical context of DEID efforts and current implications for public institutions; lobbying; advocacy work in public institutions; and legislation and states/provincial/territory rights and federalism. The Information Policy SIG convenor, with the support of interlocutors, guides the audience in a critical discussion of implications for multiple constituent groups (e.g., library users, people working within library and information institutions, trustees, mayors, legislators, police and security workforce, journalists). At the close, participants are encouraged to surface connecting topics and potential conversationalists for ongoing engagement co-hosted by the Information Policy and Information Ethics SIGs.
 The second co-sponsored panel pivots attention to instances of censorship and self-censorship among some of the people who work in higher education and K-12 public educational institutions and their libraries therein in various national contexts. The topics covered in this panel include the effect of censorship and self-censorship on teaching, learning, and curriculum; the contested nature of intellectual freedom, represented through specific cases of censorship, challenge and critique; implications for ethical AI in research and higher education; workplace expression, and employer; rights and responsibilities of academic freedom; and the use and abuse of civility codes. The Information Ethics SIG convenor, with the support of interlocutors, will guide the audience in a discussion of implications for the education of library and information professionals and those individuals who are engaged in teaching them. This includes critical discussion with respect to: employees and scholars at risk (e.g., equity deserving, precariously employed or under-employed, international work); threats on tenure and tenured members of academic staff (e.g. faculty, archivists, librarians); bargaining and job action; curtailing of academic freedom; declining collegial/shared governance in higher education; the importance of strong administrative and trustee support in our educational institutions; and related legislative priorities. At the close, participants are encouraged to surface connecting topics and potential conversationalists for ongoing engagement co-hosted by the Information Policy and Information Ethics SIGs.

Translating Practice to Positively Transform our Information Workforce

The Archival / Preservation Education SIG session offers pedagogical insights on master’s-level information science and archival education. Five ten-minute individual presentations and audience discussion elucidate educators’ roles in developing competent new professionals; presenters bring perspectives from multiple states. “Curricular Integration of Audiovisual Archiving and Preservation” by Sarah Buchanan explores connections between coursework and professional experiences completed by MLIS graduate students. Students actively contribute to curriculum maintenance through their digitization and documentation activities, metadata creation, and perhaps most significantly community-based dialogues around project progressions and expert input – collectively ensuring the preparedness of today’s archivists to address technical challenges. “Operationalizing the Value of Legacy Research Data” by Gretchen Stahlman and Inna Kouper explores the need for a more systematic understanding of legacy research data efforts and the value of legacy data as perceived by various research, library, and data communities. To illuminate relevant considerations, two legacy data preservation case study sites are analyzed, further situating the socio-technical processes and impact of working with and curating legacy data, as well as the role of equity, fairness, and justice. “The Need for Archival Triage” by Jeff Hirschy and Jessica Herr demonstrates how new archivists and educators could benefit from expanded mental models of archival workplace realities. The presentation emphasizes the values of flexibility and adaptability on the part of new archivists and educators, as they strengthen tenuous connections between “perfect” archival theory (in settings with full funding and full staff), professional problem-solving, continuing education, and the definitions of preservation and oral history. “Bridging Gaps between Archival Studies and Social Justice Scholarship: Training of Community-Embedded Paraprofessional Archivists Who Are Black, Indigenous, and People of Color” by Bharat Mehra, Robert Riter, and Ron Harris highlights ongoing experiences in bridging gaps between archival studies and social justice scholarship via curricular development/implementation, strategic collaborations, and project design in the IMLS-funded “Archival Studies Social Justice Master’s Scholarship Program (SJ4A).” SJ4A addresses current gaps in diversifying the workforce and operationalizing the how-to’s of social justice in archival practice while proposing systematic, intentional, action-oriented, community-engaged, and impact-driven education. “AI and the Future of Archival/Preservation Education” by Suliman Hawamdeh and Manar Alsaid discusses the types of training, competencies and practices which need to be integrated into archival and preservation education to harness the power of artificial intelligence (AI) and yet protect the authenticity and originality of archival material. Generative AI natural language tools and chatbots such as ChatGPT have the potential to enhance archival education and research by identifying sources, gathering and processing large amount of historical material / data in a timely manner, and assisting with methodological problems and computational tasks. The recent issues concerning document classification of presidential records and gaps in the National Archives’ tracking of information highlight the magnitude of spaces where AI could be the sword with two sharp edges. The moderator will facilitate Q&A within and across the presentations.

Advancing Clinical Trial Design for Non-Muscle Invasive Bladder Cancer.

Despite recent drug development for non-muscle invasive bladder cancer (NMIBC), few therapies have been approved by the US Food and Drug Administration (FDA), and there remains an unmet clinical need. Bacillus Calmette-Guerin (BCG) supply issues underscore the importance of developing safe and effective drugs for NMIBC. On November 18-19, 2021, the FDA held a public virtual workshop to discuss NMIBC research needs and potential trial designs for future development of effective therapies. Representatives from various disciplines including urologists, oncologists, pathologists, statisticians, basic and translational scientists, and the patient advocacy community participated. The workshop format included invited lectures, panel discussions, and opportunity for audience discussion and comment. In a pre-workshop survey, 92% of urologists surveyed considered the development of alternatives to BCG as a high drug development priority for BCG-naïve high-risk patients. Key topics discussed included definitions of disease states; trial design for BCG-naïve NMIBC, BCG-unresponsive carcinoma in situ, and BCG-unresponsive papillary carcinoma; strengths and limitations of single-arm trial designs; assessing patient-reported outcomes; and considerations for assessing avoidance of cystectomy as an efficacy measure. The workshop discussed several important opportunities for trial design refinement in NMIBC. FDA encourages sponsors to meet with the appropriate review division to discuss trial design proposals for NMIBC early in drug development.

An exploratory study of English as a Second Language students’ “citation” patterns in multimodal writing

This study explores how English as a Second Language (ESL) students make reference to outside sources and incorporate textual repetition using multimodal resources in a video project. ESL students’ source use and citation practices have been studied extensively in the context of traditional text-based writing. However, little attention is paid to the issue of making citations in multimodal writing, despite the fact that multimodal writing has been a popular topic in recent decades. The current study bridges this gap by analyzing the cases of multimodal citation in 14 videos created by ESL students in a first-year composition course, accompanied by insights from two students. The analysis yields three patterns of incorporating sources—concurrently afforded, verbally afforded, and visually afforded citations—that employ different combinations of visual and audio resources. Direct quotations are incorporated as part of the narration as well as the visual representation. These multimodal citations and quotations fulfill three broad rhetorical functions: attribution, exemplification, and establishing links between sources. There is also evidence of knowledge transfer across genre and cultural boundaries. This study provides insights into how modal affordances could be leveraged to acknowledge propositional content in creative and rhetorically effective ways. It provides pedagogical ideas for designing multimodal assignments to engage students in the critical discussion of audience, intertextuality, and discourse community.

Designing for Older Adults with Cognitive Impairment: A Panel Discussion

The population is aging and a subset of older adults will have some level of cognitive impairment. Human factors/ergonomics (HF/E) practitioners must consider them in the design process but often are not prepared to do so, lacking relevant experience or training. In this panel, an interdisciplinary team with expertise in aging, in general, and cognitive impairment, in particular, will (a) provide insights into cognitive challenges confronting older adults with cognitive impairments; (b) discuss impacts of these challenges on everyday performance (e.g., transportation, computer use, health); (c) explore the design cycle as it relates to cognitive impairment; and (d) provide examples of accommodations necessary for research and user testing for this population. Interactive audience discussion will focus on future directions and challenges for design and testing of emerging technologies for persons aging with cognitive impairment. This panel will be of interest to a broad range of HF/E domains.

Early Childhood Education Teacher Psychophysiology and Teacher Stress: Prior Findings, Current Studies, and Future Directions

Early Childhood Education Teacher Psychophysiology and Teacher Stress: Prior Findings, Current Studies, and Future Directions

Enhancing Expert Panel Discussions in Pediatric Palliative Care: Innovative Scenario Development and Summarization With ChatGPT-4.

This study presents a novel approach to enhance expert panel discussions in a medical conference through the use of ChatGPT-4 (Generative Pre-trained Transformer version 4), a recently launched powerful artificial intelligence (AI) language model. We report on ChatGPT-4's ability to optimize and summarize the medical conference panel recommendations of thefirst Pan-Arab Pediatric Palliative Critical Care Hybrid Conference, held in Riyadh, Saudi Arabia.ChatGPT-4 was incorporated into the discussions in two sequential phases: first, scenarios were optimized by the AI model to stimulate in-depth conversations; second, the model identified, summarized, and contrasted key themes from the panel and audience discussions. The results suggest that ChatGPT-4 effectively facilitated complex do-not-resuscitate (DNR) conflict resolution by summarizing key themes such as effective communication, collaboration, patient and family-centered care, trust, and ethical considerations. The inclusion of ChatGPT-4 in pediatric palliative care panel discussions demonstrated potential benefits for enhancing critical thinking among medical professionals. Further research is warranted to validate and broaden these insights across various settings and cultures.

HOUSING, AGING, AND HEALTH: NEW FINDINGS AND FRAMEWORKS FROM HOUSING-FOCUSED RESEARCH IN THE CONTEXT OF COVID-19

Abstract Older adults have been the most vulnerable population to severe illness, hospitalization, or death from COVID-19. During the pandemic, housing became a site of health and safety for some, while reinforced inequities for others due to underlying problems of affordability, accessibility, safety, and service access. This symposium showcases five housing-focused studies reflecting the pandemic context, including research by early-career investigators. The first speaker will present findings from a study of materials preserving promising practices and policy ideas generated by housing-focused pandemic responses to middle-income and low-income community-dwelling older adults. The second speaker will discuss narrative lessons from “avoidance hotels” – an infection-reduction strategy that transferred older adults from shelters to hotel rooms – with potential to guide planning for the needs of older adults facing homelessness and serious illness. The third speaker will analyze findings from multi-city research on the pandemic housing experiences of lower-income Black women, who faced severe intersectional threats to housing security. The fourth speaker will share data from a qualitative study of a Medicare-financed home care program for residents of HUD housing, including recommendations for improving experiences of participants and providers. The fifth speaker will describe the evolution of the pandemic-response roles of HUD service coordinators, based on findings from surveys in 2020 and 2021. We will conclude with audience discussion about ways for age-focused researchers to collaborate in crafting policy solutions and effective public narratives about housing equity in America's aging society.

Using scenario videos with Theatre Testing method to adapt a peer navigation model to improve street-connected youth's access to HIV care in Kenya and Canada.

Theatre testing (TT) method demonstrates whole or portions of an evidence-based intervention to stakeholders to elicit feedback on context-specific adaptations and future implementation. The Peer Navigator Project (PNP) studied the adaptation and implementation of Peer Navigators in five urban sites to increase street-connected youth (SCY) access to HIV prevention, testing, and treatment in Canada and Kenya. TT was used with SCY, healthcare providers, and community stakeholders to collect feedback on the optimal characteristics of the PNs (e.g., social identities) and their professional activities and responsibilities in each site. Sites scripted unique scenarios of PNs supporting SCY and interacting with social service providers. Local actors were employed, and the scenarios were filmed and edited into videos alongside audience discussion questions. Videos were screened to separate audiences of SCY (n = 40), healthcare providers (n = 12), and community stakeholders (n = 59). Facilitated discussion about the scenarios were recorded as data, and transcripts were analyzed thematically by the research team. The scenario videos are presented as a unique adaptation to the TT method. The adaptations were time-consuming and limited the ability to present responsive changes while presenting the method to different audiences. They were also effective at maintaining presentation fidelity and eliciting diverse and meaningful responses from different stakeholder groups. One site successfully adapted the method for use in a physically distanced manner that complied with COVID-19 public health regulations. TT using video scenarios is an engaging approach that garners rich responses from diverse stakeholder groups about the adaptation of evidence-based interventions preparing for implementation in international settings.

4.B. Workshop: Addressing backlogs and managing waiting lists during and beyond the COVID-19 pandemic

Abstract As COVID-19 cases started to rise in early 2020 and hospitalisation rates increased, health systems began to postpone non-emergency (elective) procedures to keep capacity available for COVID-19 patients, and to avoid elective patients being infected. This has subsequently led to longer waiting lists and waiting times in virtually all countries. Issues around staff recruitment and retention, which have been exacerbated by the COVID-19 pandemic, have further aggravated the problem. For patients with common elective surgeries, such as hip and knee replacements, the backlog in care means that improvements in health and quality of life are postponed. For urgent care, such as missed chemotherapy sessions for cancer care, the delays can have more severe consequences. For other patients, the postponement of specialist appointments may lead to missed referrals for serious ailments. Increasingly also primary care has become affected leading to late diagnosis of chronic diseases, as well as inadequate follow up and control of these patients. Each delay in diagnosis and treatment may worsen health problems, prolong recovery and decrease the patients’ chances of survival. Countries are now left playing catch-up on these backlogs. There is however great uncertainty regarding the size of the backlogs, how much current and future capacity will be required to address them, and how much provider and workforce capacity will be needed for COVID-19 patients which will detract capacity for non-COVID patients. If health systems do not manage to reduce the backlog, they risk worsening health outcomes and wasting important health gains made in the last years. This workshop will discuss what we know about (1) the level of service disruptions and resulting backlog, (2) the drivers of backlog, and (3) which policies countries are using to address this. The workshop will conclude with an audience discussion about how to measure the true size of the backlog, the policy options for overcoming backlog and key priorities for further research. Key messages • The COVID-19 pandemic has led to substantial disruptions in care delivery leading to care backlogs in virtually all countries. • Countries have various policy options to tackle backlogs and bring down waiting times in the wake of the pandemic.

10.A. Workshop: Integrated primary care: reform experiences from Estonia, Poland, and Slovenia

Abstract The rising burden of multiple chronic diseases requires countries to change the reactive approach of their health systems, originally designed to cure acute illness, to a proactive approach that scales up preventive interventions and integrates cure (health care) and care (long term care and social care). This requires a central coordination role for primary health care (PHC). PHC is the foundation for delivering health services to the population. It mainly encompasses the first level of professional health care and includes PHC practitioners and other health workers. Together, PHC providers can satisfy most curative and preventative health needs, ideally providing integrated services. In this way, PHC has the potential to agilely respond to population health needs; help individuals navigate their way to good health and stay healthy; prevent disease by identifying risk factors; and manage chronic disease outside of hospital settings. Yet PHC in many countries is not designed to fully realize these promises and ongoing reforms aim to strengthen it. Meanwhile, this potential was on display in several countries during the COVID-19 pandemic, when primary care doctors played a key role in making an early diagnosis; helping vulnerable people cope with their anxiety about the virus; reducing the demand for hospital services; and delivering vaccinations-all while reaching out to vulnerable patients and maintaining access to essential (non-COVID) services for the wider population using new in-person protocols or new digital solutions. This workshop will update the audience on recent PHC reforms across the EU and provide insights from three key examples-Estonia, Poland, and Slovenia. An introductory presentation sets the stage by putting PHC reforms in a wider context of reforms introduced across the 31 countries of the Health Systems and Policy Monitor network of the European Observatory on Health Systems and Policies between 2018 and 2021. A second presentation describes how Estonia has introduced a series of PHC reforms over time and used financial incentives to encourage multidisciplinary care. A third presentation looks to Poland, which from mid-2018 through 2021 piloted a multi-professional model of PHC organization in around 40 PHC practices, with an emphasis on care coordination and disease prevention. A final presentation highlights Slovenia, where a multidisciplinary, community-based, prevention-oriented service delivery model is being expanded to play a larger role in the prevention and management of chronic diseases as well as the country's COVID-19 response. The workshop concludes with an audience discussion on lessons learned from the three case studies and potential implications for other countries. Key messages • Strengthening primary health care is a key priority of many countries as they seek to improve integration of care. • Implementation of primary care reforms in shaped by the legacy of care delivery and requires a strong workforce, ongoing financial support, sustained policy focus, and collaborative governance.

2.O. Workshop: Initial health assessments and catch-up vaccination for forcibly displaced migrants to Europe

Abstract Objectives Recent crises in Ukraine, Afghanistan, Syria and other countries have, again, resulted in large populations of asylum seekers and other migrant groups arriving in Europe. However, European countries still grapple with questions about what level of health care should be offered to forcibly displaced people (emergency care, preventative care, multi-disease screening and catch-up vaccination?), and when and where in the migration trajectory provision should be made (should it be at borders, reception centres, once settled via the national health system, via specialist or routine services, or left to non-governmental organisations?), and what their subsequent level of right to access the mainstream health-care system should be. Countries do not have a uniform approach to the provision of health care for these populations, with some countries more inclusive than others, and wide discrepancies between evidence and implementation in policy and practice. In this workshop we will discuss current approaches, implementation, research and policy gaps, and models of good practice from the clinic to the community to ensure both the immediate and long-term health needs of these diverse mobile populations are met. Workshop plan The workshop will start with 10-minute presentations by each of the 4 speakers (to include a short Q&A after each talk). This will then move into a 20-minute audience discussion centred seeking specific feedback on examples of successful interventions, good practice, and lessons learned across EU/EEA countries in delivering multi-disease and catch-up vaccination and holistic and inclusive healthcare approaches. Key messages • Governments should develop clear short-term and long-term policy and evidence-led research strategies to ensure the equitable provision of health services. • Strategies must include multi-disease and catch-up vaccination approaches, alongside meaningful access to mainstream health systems.