Health Policy Development Research Articles

MHealth Apps in German Outpatient Mental Health Care: Protocol for a Mixed Methods Approach

Background Mental disorders are complex diseases that affect 28% (about 17.8 million people) of the adult population in Germany annually. Since 2020, certain mobile health (mHealth) apps, so-called digital health applications (DiGA), are reimbursable in the German statutory health insurance system. A total of 27 of the 56 currently available DiGA are approved for the treatment of mental and behavioral diseases. An indicator of existing problems hindering the use of DiGA is the rather hesitant prescribing behavior. Objective This project aims to develop health policy recommendations for the optimal integration of DiGA into outpatient psychotherapeutic care. The project is funded by the Innovation Fund of the Joint Federal Committee (grant 01VSF22029). The current status quo of the use of DiGA will be analyzed. Furthermore, concepts for the integration of mHealth apps, as well as their transfer into the care process will be investigated. In addition, barriers will be identified, and existing expectations of different perspectives captured. Methods The project will be based on a mixed methods approach. A scoping review and a qualitative analysis of focus groups and expert interviews will be carried out. Additionally, an analysis of claims data of the statutory health insurance will be conducted. This will be followed by a written survey of insured persons and health care providers. Finally, health policy recommendations will be derived in cooperation with stakeholders. Results The scoping reviews and qualitative analyses have been completed, and the quantitative surveys are currently being carried out. The target number of responses in the survey of insured persons has already been achieved. Furthermore, the analysis claims data of the statutory health insurance is currently being conducted. Conclusions There is a need for research on how DiGA can be optimally integrated into the care process of patients with mental disorders as evidence regarding the topic is limited and prescribing behavior low. Although the potential of DiGA in mental health care has not yet fully unfolded, Germany serves as a model for other countries regarding reimbursable mHealth apps. This project aims to explore the potentials of DiGA and to describe the organizational, institutional, and procedural steps necessary for them to best support mental health care. International Registered Report Identifier (IRRID) DERR1-10.2196/56205

Young men's everyday life experiences with contraception and unintended pregnancy in Papua New Guinea.

Unintended adolescent pregnancy is a public health priority in Papua New Guinea (PNG), where national policies specify need for easier access to reliable modern contraceptives. To reduce young people's experiences of unintended pregnancy in PNG, improved understandings of use of modern and other forms of contraception within young people's relationships is required to support the development of new sexual and reproductive health (SRH) programs and policies. The aim of this paper is to understand young men's use of modern and other contraceptives. This qualitative study involved semi-structured interviews with 35 sexually active young men aged 15-24 years, who were sampled purposively from the general population within community-based settings. Data were analysed using inductive thematic analysis techniques. Our analysis of young men's everyday experiences of using condoms and other contraceptives highlights clear drivers of unintended adolescent pregnancies. Across three settings, these included non-use of any modern method at first sex or during early sexual experiences; inconsistent use of condoms, often only after first pregnancy experiences; difficulties accessing condoms from health service providers, pharmacies and stores; a lack of understanding of other modern contraceptive strategies; inconsistent use of the withdrawal method; and inconsistent and incorrect use of calendar approaches due to misunderstandings about women's fertile period. Ten young men had never used any form of contraception. These occurred largely because young men's sexual agency is constrained within sexual and peer relationships, and community, school and health service settings, in ways that inhibit pregnancy prevention. It is important to engage meaningfully with young men to build sexual and reproductive health policies and programs that pay honest, respectful attention to young people's everyday sexual and social lives. Young men's everyday stories provide a unique lens through which we can identify mechanisms of change required to address the health and social inequities associated with unintended pregnancy among young men and young women in PNG and beyond.

Spatial analysis of malaria cases and Anopheles species in East Java region, Indonesia

Malaria remains a significant public health challenge worldwide, including in Indonesia, particularly in the East Java region. This study aimed to analyse the spatial distribution of malaria cases and Anopheles species that act as vectors in the area. Using an observational design with a cross-sectional approach, data on malaria cases were collected from tiers from the Community Health Centre, District Health Office and Province, all of which were documented on the Ministry of Health's malaria information system for the period 2021–2023. Malaria Vector Distribution Data from the East Java Health Office and the research team directly. Sampling of mosquitoes and larvae was carried out by researchers using a purposive sampling method, which prioritised locations with districts that have a high risk factor for the presence of breeding Anopheles sp., namely, Treggalek District, Malang District and Pacitan District with diverse topography, such as coastal (lagoon), rice fields and hills. The results of the analysis show that the distribution of imported malaria cases in East Java is uneven, with hotspots identified in several areas that have working population mobility from outside the East Java region. The presence of Anopheles species, particularly An. sundaicus and An. maculatus, contributes to their potential as vectors of malaria transmission, with An.sundaicus being more common in coastal areas and An. maculatus in valley and paddy fields. Environmental factors, such as topography of the region, temperature, humidity, and rainfall, influence the variation of Anopheles species. This study emphasises the importance of an ecosystem-based approach to malaria control, as well as the need to improve access to health services and community education. The findings provide important insights for the development of more effective and sustainable health policies in an effort to maintain malaria elimination areas in East Java.

La Haute Autorité de santé (HAS), mise en perspective internationale

The international presence of the HAS constitutes a real strategic issue in the short, medium and long term, particularly in the areas of health technology assessment (HTA) and hospital certification. Its offer of international expertise can constitute a privileged instrument of French influence in areas that are becoming global, whether for the dissemination of French norms and standards and for the influence of our organizational model and our values. Finally, the presence of the HAS in European and international bodies, notably the World Health Organization (WHO), continues to strengthen, particularly in the European and community framework where its involvement is growing. The international and European involvement of the High Authority of Health (HAS) is an asset for the harmonization of health practices, particularly within the European Union. By actively participating in international and European networks, such as EUnetHTA, and by collaborating with the European Commission, HAS contributes to the evaluation of health technologies, the development of quality standards, and the development of common health policies. However, it faces challenges linked to the diversity of national health systems and the harmonization of practices between Member States. Nevertheless, its growing role in cross-border cooperation and sharing of expertise places it as a key player in the structuring of health policies in Europe.

‘Worm Wars’: The Unravelling of the Randomised Control Trial Success Story

What counts as evidence in global health? What happens when evidence is contested? This article concentrates on the ‘Worm Wars’, a public academic debate in 2015 on the effectiveness of health interventions to treat populations with parasitic worms, to assess how health interventions are appraised by different disciplinary perspectives. I discuss what happens when a success story about randomised control trials (or RCTs) – often hailed as the ‘gold standard’ of evidence adjudication – is contested but left unresolved. Questioning the prominence of RCTs through the unravelling of this evidence success story offers insights into how these forms of measurement are utilised in practice, first in the medical field and then more widely in economic development and global health policy. I address what a gold standard is within a hierarchy of evidence, as well as the standards that are imbued into RCTs by different disciplinary researchers, and the evidence requirements for health interventions in determining the impact of deworming medication. With the Worm Wars, I show how important measurement standards have become in defining and advocating for global health problems and what this means for the production of evidence.

Industry influence on public health policy formulation in the UK: a complex systems approach.

Unhealthy commodity industries (UCIs) such as tobacco, alcohol, gambling, ultra-processed food and beverage producers are known to influence policy-making to advance their interests, often to the detriment of public health goals. This study mapped the complex system underpinning UCI's influence on public health policy formulation in the UK and identified potential interventions to shift the system towards being able to better attain public health goals. We conducted a participatory systems mapping workshop with ten experts to build a causal loop diagram (CLD) and identify potential interventions to address UCI's influence on public health policy development. The resulting CLD depicts a highly interconnected and reinforcing system driving UCI's involvement in public health policy formulation across five thematic areas. Among the most connected elements were the 'dominance of market mechanisms', 'perception of partnership as good governance principle', 'industry involvement lending perceived legitimacy to the policy formulation process', 'industry is seen as part of the solution' and 'industry ties to policy-makers'. Participants identified a total of 22 interventions within this system. Analysis of the CLD and interventions identified the potential for two key paradigmatic changes in this complex system: de-normalizing the perception of unhealthy commodity industry actors as legitimate stakeholders in policy formulation; and prioritizing public health and wellbeing objectives over profit and economic gain. In order to shift the system towards better attaining public health goals, interventions should reinforce each other and be supportive of these two key paradigmatic shifts.

Development of Sustainable Industrial Safety and Health Policy for Electronic Industry in Korea: A Study on the Relationship Between Safety Leadership of Managers, Safety Climate, and Safety Behavior

This study aimed to identify the relationship between the safety leadership of safety and health managers, the safety climate of the organization, and the safety behavior of workers in the electronics industry in order to develop a sustainable industrial safety and health policy. The study included 842 individuals working at electronics industry cooperators. After analyzing the correlation between safety leadership of managers, safety climate, and safety behavior using SPSS 23.0, measurement model analysis and structural equation modeling (SEM) were performed using AMOS 26.0 to evaluate their relationships. We observed that the safety leadership of managers was associated with safety climate and safety behavior. Additionally, among the sub-dimensional variables of safety climate, the management’s commitment to safety and health and the delivery and communication of safety and health information were related to safety behavior. Therefore, enhancing worker participation and behavior requires strengthening the safety leadership of managers, increasing management’s commitment to safety and health, and improving the effectiveness of safety and health information delivery and communication.

The burden and trends of heart failure caused by ischemic heart disease at the global, regional, and national levels from 1990 to 2021.

Ischemic heart disease (IHD) is a major cause of heart failure (HF), a condition expected to increasingly affect global health and economics. This study evaluates the global burden, trends, and disparities of HF linked to IHD, aiming to inform health policy development. Data from the Global Burden of Disease Study 2021 (GBD2021) is analyzed using Joinpoint regression, decomposition analysis, and Bayesian age-period-cohort analysis (BAPC). Health disparities are assessed through the Socio-demographic Index (SDI) via the Slope Index of Inequality (SII) and the Concentration Index (CI), with future trends projected from 2022 to 2045. In 2021, global HF cases due to IHD were over 19.16 million, with an age-standardized prevalence rate (ASPR) of 228.31 per 100 000 [95% UI, 188.18 to 279.55] and age-standardized years lived with disability (ASYLDs) rate of 20.43 per 100 000 [95% UI, 13.55 to 28.7].In 2021, there was a 2.87% increase in ASPR and ASYLDs compared to 1990, primarily driven by population growth and aging.Significant reductions in global ASPR and ASYLDs disparities are observed, though the disease burden has intensified in countries with lower SDI levels. Projections indicate that by 2045, while the prevalence and YLDs for HF caused by IHD will increase, while the ASPR and ASYLDs are expected to decrease. The global burden of HF from IHD remains a significant concern. Urgent improvements in the allocation of medical resources and the implementation of effective prevention and management strategies are necessary to address this issue.

Abstract 4122008: Bayesian modeling to forecast mortality due to Ischemic Heart Disease, Stroke, and Peripheral Artery Disease in Brazil until 2040

Introduction: Atherosclerotic cardiovascular disease, specifically ischemic heart disease (IHD), stroke, and peripheral artery disease (PAD) together are among the leading causes of cardiovascular mortality in Brazil. As the obesity, hypertension, and diabetes rates in the Brazil continue to increase, projecting mortality rates related to these conditions are important for guiding health policy. Hypothesis: We hypothesized that there are differences in the future trends of IHD, stroke and PAD in Brazil. Aims: We sought to forecast the trends in IHD, stroke, and PAD in Brazil until 2040 to fill in this important knowledge gap and inform public health policy development. Methods: We collected the annual death counts for IHD, stroke, and PAD and the mid-year population estimates in 5-year age brackets (40 – 79 years) between 1990 and 2019 from the Global Burden of Disease. We calculated the annual crude and age-standardized mortality rates (per 100 000 residents) for IHD, stroke and PAD between 1990 and 2019. Using this observed data, we estimated the projected mortality rates for these conditions till 2040 using Bayesian age-period-cohort (BAPC) models. Results: Brazil`s population (aged 40-79 years) will increase by 237.5% between 1990 and 2040. Nationally, compared to 2019, the age standardized IHD mortality is projected to reduce by 31.66 % [2019: 131.13, 2040:89.6 (IQR: 65.83, 113.37)] and stroke rates are estimated to reduce by 16.75% [2019: 91.09, 2040: 75.83 (IQR: 51.68, 99.98)]. However, PAD rates are projected to increase by 1.2% in the same period [2019: 1.58, 2040: 1.66 (IQR: 1.24, 2.07)]. The age standardized IHD and stroke mortality rates will reduce in males and females. However, the age standardized PAD rates will increase in females [2019: 1.33, 2040: 1.48 (IQR: 1.06, 1.89), 11.28% difference] and remain reasonably constant among males. Conclusion: In Brazil, the age standardized rates for IHD and stroke mortality are projected to decline till 2040. However, PAD related mortality is likely to be an important issue among females. Our findings highlight the need for early and targeted interventions to address these potential cardiovascular health disparities.

Quality of Life of Adolescents and Young Adult Survivors of Childhood Cancer: A Qualitative Study.

To analyse how adolescents and young adults who survived childhood cancer experience their quality of life and to explore their meanings and conceptualisations of quality of life. Narrative design following Squire's method. In-person and virtual recruitment, due to the global COVID-19 pandemic, was carried out in Brazil between May and November 2021. Eighteen semi-structured virtual interviews were conducted with childhood cancer survivors. These data were analysed using reflexive thematic analysis and employing a triangulation of investigators. Four subthemes were identified, encompassing participants' perceptions and meanings of quality of life. Through the reflection and synthesis of these subthemes, a central theme emerged entitled 'New self', capturing the profound impact of the cancer and survival experience on every aspect of the self, along with participants' sense of having gained 'a new life' and a 'second chance'. The study provides a rich and nuanced understanding of quality of life for childhood cancer survivors. The results highlight that after all the changes in life due to cancer, integrating the new self becomes a central aspect of quality of life for survivors. Recognising the profound shifts in self-perception that survivors of childhood cancer undergo, nurses should engage early in empowering patients and families, offering education, space and support to help adolescents and young adults grow throughout their journey. The richness and depth inherent in qualitative data on quality of life can inform the development of care standards and health policies for survivors, guide the allocation of strategic resources and shape the development of plans and interventions focusing on childhood cancer survivors. The COREQ checklist was used. No patient or public contribution.

Medical Practitioner’s experiential knowledge of the roles of Medical Social Workers at the Benjamin Mkapa Hospital, Tanzania

Medical social work is focused on improving patient treatment results by analyzing the bio-psycho-social-spiritual components of medicine. However, medical practitioners in Tanzanian hospitals do not acknowledge medical social workers' functions in healthcare environments. This study, which investigates the roles of medical social workers in Tanzanian hospitals, has the potential to significantly impact the development of new task-sharing and health policies. Using mixed methods, 94 practitioners filled out questionnaires and interviewed 11 key informants. The study revealed that nearly three-quarters of the respondents, 66(70%) indicate that the role of hospital social workers is the mental health practitioner. More than half of the respondents that is 64(68%), indicate that hospital social workers provide patient and family counseling, 58(62%) indicate providing emotional support to patients and families, and 54(57%) indicate facilitating decision-making on behalf of patients and families. Five major themes were identified: connecting patients with members of the community, performing patients' financial analysis, maintaining the social welfare of patients and hospital staff, handling cases of abuse and violence, and diagnosing the psychosocial-spiritual problems of patients. These findings will enable groups of healthcare professionals to rationally reorganize medical social workers’ roles and improve patients’ treatment outcomes in Tanzania hospitals.

Clinical Factors Affecting the Quality of Life of Women With Endometriosis.

The study aimed to analyse selected clinical data affecting the quality of life of women with endometriosis. A cross-sectional study. The study was conducted in 2020-2022 among 425 women with endometriosis receiving health care. A diagnostic survey method with a questionnaire technique was used. The research tools are the Endometriosis Health Profile and a standardised interview questionnaire. Infertility, medical treatment and sexual intercourse were the dimensions of quality of life most poorly rated by respondents with endometriosis. Lower quality of life was linked to the presence of painful periods, the presence of pain during intercourse and having surgery for endometriosis. The main clinical variables influencing the quality of life of women with endometriosis include problems with getting pregnant, the necessity for long-term therapy and sexual problems caused by the condition. The occurrence of painful menstruation, dyspareunia and having undergone surgery for endometriosis is associated with lower ratings of women's general quality of life. The study will help to develop a more holistic approach to caring for endometriosis patients. This will result in a better diagnosis, individualised therapy and psychological support, all of which will enhance the overall quality of life. The study's results may impact the development of health policies, endometriosis support services for women and public awareness initiatives. The study highlighted key determinants affecting health-related quality of life for women with endometriosis. The analysis of clinical data revealed that infertility, treatment and dyspareunia are the dimensions of quality of life most poorly rated by women with endometriosis. These findings are significant for those providing care to women with endometriosis, as well as for policymakers responsible for the organisation of health care systems. The STROBE guidelines. No patient or public contribution.

Integrating Reproductive Health and Nutrition: A Breakthrough Solution to Combat Stunting

Objective: This study aims to explore the importance of integrating reproductive health and nutrition as a strategic approach in addressing stunting in Indonesia. Materials & Methods: Using a qualitative study, this research analyzed findings from observation and from various scientific journals, reports of international and national health organizations, and policies related to stunting, reproductive health, and nutrition. The study emphasizes the importance of comprehensive perinatal interventions and supports the strengthening of maternal and child health systems. Findings: The analysis shows that a comprehensive approach that integrates nutrition interventions and reproductive health initiatives can significantly reduce the prevalence of stunting. This approach highlights the importance of adequate nutritional supplementation, quality perinatal health care, and health education programs for expectant mothers. Conclusion: The findings of this study are expected to contribute to the development of health policies that aim to sustainably reduce stunting rates with a holistic approach that focuses on maternal and child health.

English

Introduction: The prison population in Peru exceeds 90,000 individuals, many of whom face conditions that increase their vulnerability to human immunodeficiency virus (HIV), such as exposure to illicit substances, risky sexual behaviors, and discrimination. Materials and Methods: A secondary analysis was carried out, using data from the 2016 national prison population census to identify factors associated with HIV risk in the incarcerated population of Peru. A total of 75,613 male inmates from prisons across the country participated, answering a comprehensive questionnaire consisting of 405 items. Multivariable regression Poisson models were used to calculate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Results: Our findings revealed significant associations between HIV risk and sexual orientation, with homosexual (aPR: 5.50; CI: 2.62-11.56) and bisexual (aPR: 4.92; 95% CI: 2.26-10.72) individuals being at higher risk. Additionally, a history of tuberculosis (aPR: 2.82; 95% CI: 1.75-4.56) and sexually transmitted diseases (aPR 48.14; 95% CI: 31.07-74.56) were strongly correlated with increased HIV risk. Marital status, specifically being widowed, divorced, separated, or single, also showed a statistically significant association with HIV infection in both raw and adjusted regression models. Discussion: Our study highlights important risk factors for HIV infection among the male prison population in Peru. The identified associations will inform the development of effective health policies aimed at identifying and addressing HIV transmission within the country’s prisons. Furthermore, our findings provide a basis for future research in similar settings with a comparable male prison population profile.

Art-Based Approaches to Health Promotion Policy Development

This paper examines the intersection of art and health promotion policy development, highlighting the role of arts-based approaches in shaping health interventions. By examining various case studies and methodologies, the paper discusses how arts, particularly visual and performing arts, have been utilized to communicate health messages, foster community engagement, and influence public health policy. The power of art to transcend cultural and social boundaries, provoke emotional responses, and offer new ways of thinking is emphasized. The paper concludes that while arts-based approaches show promise in health policy development, further research and sustained support are needed to enhance their long-term effectiveness and scalability. Keywords: Art-based health promotion, Health policy development, Community engagement, Visual and performing arts, Public health interventions.

THE RELATIONSHIP BETWEEN ELDERLY PEOPLE AND NATURE: IMPACTS OF TRADITIONAL KNOWLEDGE ON PROMOTING WELL-BEING AND QUALITY OF LIFE

This study aimed to explore the relationship between older adults and nature and the impacts of this interaction on promoting well-being and quality of life. To this end, a systematic literature review was conducted to identify recent studies that analyzed older adults’ perceptions of natural environments and the consequences of outdoor activities on the physical, mental, and emotional health of this population group. The results demonstrated that contact with nature significantly contributes to reducing feelings of loneliness and depression, in addition to favoring the strengthening of social bonds and promoting a renewed sense of belonging and identity. In addition, studies indicate that older adults who maintain a connection with nature tend to have higher levels of subjective happiness and a greater willingness to participate in sustainable practices and environmental conservation. Based on these findings, it is concluded that nature plays a crucial role in promoting active and healthy aging, and that initiatives aimed at facilitating older adults’ access to natural environments are fundamental to the development of public health and well-being policies.

Inequalities in the diagnosis of 275 chronic conditions in UK primary care between 2006 and 2021: a cohort study

BackgroundHealth inequalities in the UK have been brought to the forefront of public health concerns, especially disparities in life expectancy and health quality of socioeconomically deprived and minority ethnic populations. This study systematically examined the incidence and prevalence of 275 chronic conditions which present in UK primary care, describing inequalities across diverse population subgroups. MethodsWe conducted a population-based retrospective cohort and cross-sectional study using primary care data from Clinical Practice Research Datalink Gold (986 general practices), from Jan 1, 2006 to Dec 31, 2023. We studied chronic conditions responsible for over 10 000 days of hospital activity. Incidence and prevalence estimates were calculated annually, stratified by sex, age, ethnicity (UK high-level), and GP practice deprivation, and standardised using UK mid-year population estimates for 2021. We used statistical process control to describe variation and identify outlier conditions in population subgroups. A public dashboard was created to explore the outputs. FindingsThe study included 13 419 645 participants. Hypertension was the most prevalent condition in 2019 (22·47%). Black, Asian, Others, and Mixed had over 30% lower chance of any given diagnosis than overall population. Depression showed a gradient of increasing prevalence with increasing deprivation, but for actinic keratosis, a condition associated with sun exposure, prevalence increased in less deprived populations. In a cardiometabolic conditions deep dive, minority groups had increased diabetes prevalence, but lower rates of myocardial infarction. InterpretationThis study provides a crucial resource for addressing health disparities in the UK. Lower prevalence in Black, Asian, and Mixed ethnicities is likely to be underdiagnosis and not a 30% lower disease prevalence, highlighting an urgent need across many conditions for tailored healthcare strategies to ensure equitable diagnosis and treatment access. Detailed population breakdowns in this dataset generates insight that can guide the development of more inclusive health policies, ultimately reducing health inequalities and improving public health outcomes. FundingNone.

Knowledge, attitudes and practices of meat hygiene among slaughterhouse workers and retail meat sellers in Bangladesh

Inadequate handling of raw meat leading to cross-contamination, often stemming from insufficient knowledge and practices among meat handlers, poses a significant global health challenge, especially in developing nations where food-borne diseases are prevalent. Effective understanding and implementation of preventive measures by meat handlers are essential in reducing the incidence of food-borne illnesses and the contamination of raw meat. This study aimed to assess the knowledge, attitudes, and practices regarding meat hygiene among retail meat sellers and slaughterhouse personnel in the Bogura district of Bangladesh. A descriptive, cross-sectional survey was conducted, encompassing 408 meat handlers selected through a multistage sampling approach. Data on their knowledge, attitudes, and practices of meat hygiene were collected using a structured questionnaire, and then analyzed. The participants had a mean age of 34.63 years with a standard deviation of 13.44. The majority of participants demonstrated good knowledge (70.70 %) and positive attitudes (53 %). However, no significant differences were observed in good (49.80 %) or poor (50.20 %) practices regarding meat hygiene. Interestingly, significant associations were observed between knowledge and age (p = 0.022), location (p < 0.001), and borderline significance in training (p = 0.051). Similarly, a statistically significant association was found between the practice of meat hygiene and age (p = 0.041), level of education (p = 0.008), and training (p = 0.004). Furthermore, a significant association existed between knowledge and practices of meat hygiene (p < 0.001). Older meat handlers with training exhibited better knowledge and practices of meat hygiene compared to their younger counterparts. This study underscores the importance of public health education, policy development, and regular training and retraining programs for meat handlers to ensure safe meat handling practices and overall hygiene.

Data dashboards in health inequalities monitoring - A qualitative study of subnational policy-makers

Abstract Background Despite sustained improvements in life expectancy and health during past decades, substantial health inequalities persist. Subnational jurisdictions are increasingly recognised for their pivotal role in addressing health inequalities. While data dashboards offer a promising solution for monitoring health inequalities, their utilisation in supporting local policies to reduce inequalities remains largely unexplored. This study examines the utilisation of health equity data and data dashboards (i.e. Sotkanet, Sotekuva, Tietotarjotin and Hyvinvointivajemittaristo) for health policy-making in Finnish wellbeing services counties, identifies barriers in using existing dashboards and determines the data needs for improved health inequalities monitoring. Methods A qualitative case study design with reflexive thematic analysis will be used. The study will be pre-registered in the OSF framework. Semi-structured interviews will be conducted with policy-makers involved in health policy development. Data analysis will involve open and axial coding to identify themes in participants’ responses. Themes will be organised into a coding framework, and the analysis will continue iteratively until data saturation is achieved. The study will include a pre-approved interview guide and peer debriefing sessions. Findings will be reported according to the Consolidated criteria for reporting qualitative research (COREQ) guidelines, with thematic diagrams illustrating key themes and sub-themes. The study is expected to reveal varying levels of utilisation of data and data dashboards among local policymakers, along with specific challenges and gaps in their current use. Policymakers may express needs for additional data or new features in dashboards to better monitor health inequalities. The study will conclude with recommendations for improvements in current data dashboards. Work is under development but by funders requirement the results will be ready by November 2024. Key messages • Data dashboards offer a promising solution for monitoring health inequalities, but their utilisation in supporting local policies to reduce inequalities remains largely unexplored. • This study examines the utilisation of data dashboards for health policy-making subnationally, identifies barriers for use and determines the data needs for improved health inequalities monitoring.

Key Factors Influencing Quality of Life in the Disabled Based on Multifaceted Life Satisfaction

Abstract Background Healthy life of the disabled is considered a global social issue, and enhancing the quality of life (QoL) of the disabled is an important task. The disabled have lower multifaceted life satisfaction due to various daily restrictions, which negatively affects their QoL. Research on the QoL of the disabled is ongoing, but there are few comprehensive studies addressing multifaceted life satisfaction. To enhance the QoL of the disabled, it is essential to understand their multifaceted life satisfaction and investigate key factors influencing their QoL. Methods We used data from the 2021 Disability and Life Dynamics Panel (nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of multifaceted life satisfaction of the disabled on their QoL by using multiple regression analysis adjusted for gender, age, education level, daily living activities, type and severity of disability, and presence of multiple disabilities. Results The satisfaction with social relationships(β=.535, p&amp;lt;.0001), income(β=.146, p&amp;lt;.0001), housing environment(β=.132, p&amp;lt;.0001), occupation(β=.130, p&amp;lt;.0001), and health(β=.111, p&amp;lt;.0001) was found to have a significant positive impact on the QoL of the disabled. Particularly, satisfaction with social relationships exerted the greatest impact on their QoL. Conclusions Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. These findings can support the government in prioritizing health policy development for the disabled and contribute to improving the QoL for the disabled through a comprehensive and integrated approach. The government should develop health policies to enhance social connections and support networks for the disabled, while also considering aspects for improving income, housing environment, occupation, and health. Key messages • Not only health satisfaction, but also social relations, income, housing environment, occupation had a substantial impact on the QoL of the disabled. • The government should prioritize developing health policies aimed at enhancing social relations for the disabled, while also considering income, housing environment, occupation, and health.