Federal Office Research Articles

The empowering role of health literacy in combatting fake news, misinformation and infodemics

Abstract Background In times of the rapid digital transformation, people need to acquire specific knowledge, skills and attitudes to deal with data, digital information and technology. Such skills are particularly important in times of crisis, as the COVID-19 pandemic has shown. Alongside the pandemic, a so called “infodemic” has emerged, i.e., an overabundance of information, accompanied by misinformation, which impedes sound decision-making processes, affects health literacy (HL) and impacts public health. However, while misinformation poses a well-known threat to our health and well-being, we still lack viable concepts and approaches to satisfactorily solving this issue. Thus, we aimed at reviewing the concept of HL in view of the infodemic and health-related challenges. Methods In a 12-month participatory process in Switzerland in 2023, we investigated the empowering role of HL in light of the polycrisis. On behalf of the Swiss Federal Office of Public Health, we conducted a literature review on existing HL definitions. Then, we conducted 6 expert interviews and 2 focus group interviews with other 10 experts in HL and associated domains, which guided and informed the review process. Results As a result, HL can be understood as a bundle of competencies to proactively deal with health-related information, services, and challenges and thereby empowers people to manage their and other’s health and well-being. Thus, HL empowers people to better manage digital information and services and promotes critical thinking. This in turn is necessary to assess information quality, uncover misinformation and to adequately manage health data and information. Conclusions HL represents a crucial prerequisite for individuals, professionals, and decision-makers to find trustworthy health information, to reflect upon the quality and credibility of sources and content, and to understand the complex interrelations of the determinants of health and is therefore crucial for public health. Key messages • Health literacy empowers people to adequately deal with fake news, misinformation and infodemics. • Strengthening health literacy offers great potential for public health to promote critical thinking and to rebuild trust.

Measuring Vaccine Literacy in Switzerland: How is the situation after COVID-19?

Abstract Background Vaccinations are one of the most effective medical health interventions and one of the most important preventive measures. However, the population is often unsure about vaccination, and the roles and responsibilities of the key actors seem often unclear. To adequately protect the population against vaccine-preventable diseases, the Swiss Confederation, the Cantons and other stakeholders have developed the National Vaccination Strategy and an associated action plan. For its implementation, studies on the population’s knowledge, attitudes, skills, and vaccination behavior are crucial. Thus, the Swiss Federal Office of Public Health launched a study to assess vaccine literacy and its relation to vaccination readiness and behavior in the adult population in Switzerland. Methods A representative sample of 2,500 people living in Switzerland will be surveyed in summer 2024. The online questionnaire will include validated instruments, e.g. the HLS19-VAC Instrument to measure vaccine literacy or the 7C Vaccination Readiness Scale, as well as questions on correlates of vaccine literacy, vaccination readiness and behavior. Results The results of the survey will be presented, with a focus on vaccine literacy, vaccination readiness and behavior and their correlates. Specifically, differences among the three main language regions and between specific population groups will be shown. Further, a comparison with data from previous studies will be presented. Conclusions Despite having an advanced healthcare system, to date Switzerland has only partially reached its objectives in terms of vaccination, both for individual protection and collective immunity. New data on vaccine literacy, vaccination readiness and behavior as well as on the influencing factors are needed, especially after the pandemic, to guide effective future actions and measures to improve the vaccine coverage and public health in Switzerland. Key messages • Due to the COVID-19 pandemic the topic of vaccination in general has received increasing attention and may has changed people’s knowledge and attitudes towards vaccination. • Newest data on vaccine literacy, vaccination readiness and behavior are necessary to inform future, targeted actions and increase vaccine uptake.

Assessing the severity of COVID-19 waves: beware of surveillance bias

Abstract Background Indicators to assess the severity of epidemic waves during the COVID-19 pandemic were influenced by differences in detection modalities over time, leading to surveillance bias. We compared four indicators across three pandemic periods to assess surveillance bias. Methods We used data from one region of Switzerland. We compared seroprevalence, cases, hospitalizations, and deaths during three periods (period 1: Feb-Oct 2020, including the 1st wave; period 2: Oct 2020-Feb 2021, including the 2nd wave; period 3: Feb-Aug 2021, including the 3rd wave and after the start of the vaccination campaign). Data were retrieved from the Swiss Federal Office of Public Health or population-based studies. We compared each indicator to a reference indicator (seroprevalence during periods 1 and 2 and hospitalizations during period 3). We also assessed the timeliness of the indicators, i.e., the duration from data generation to the availability of the information to decision-makers. Results According to seroprevalence estimates, the severity of the 2nd wave was slightly larger (by a ratio of 1.4) than the severity of the 1st wave. Compared to seroprevalence, cases largely overestimated the 2nd wave severity (2nd vs 1st wave ratio: 6.5) while hospitalizations (ratio: 2.2) and deaths (ratio: 2.9) were more suitable to compare the severity of these waves. According to hospitalizations, the 3rd wave severity was slightly smaller (by ratio of 0.7) than the 2nd wave. Compared to hospitalizations, cases or deaths slightly underestimated the 3rd wave severity (3rd vs 2nd wave ratio for cases: 0.5; for deaths: 0.4) and seroprevalence was very biased due to high vaccination rates. Across all waves, timeliness for cases and hospitalizations was better than for deaths or seroprevalence. Conclusions To assess the severity of pandemic waves accounting for surveillance bias, different types of indicators must be used across time. Key messages • Differences in detection modalities over time can skew the assessment of the severity of COVID-19 pandemic waves, leading to surveillance bias. • The effectiveness of indicators in describing the severity of COVID-19 pandemic waves depends on the type of indicator used and the stage of the pandemic.

A National Analysis of P–12 Equity Director Role Establishment

District “equity director” (ED) roles have grown rapidly over the past decade. Drawing on interviews and surveys with over 70 EDs across nearly 30 states, this study documents dramatic ED role growth from 2018 to 2022 specifically and examines why, according to EDs, such roles were established locally. Findings, drawing on scholarship on social activism, demonstrate how insider influence from district educators and leaders; intermediate pressure from community coalitions, parents, and students; and external coercion from state and federal education departments and civil rights agencies spurred ED role establishment. Challenges to ED efficacy are discussed, including ED role establishment as “checkbox” work and politicized attacks on district diversity, equity, and inclusion work.

Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: a scoping review

BackgroundAs a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles.MethodsThis scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups.ResultsA total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection.ConclusionsMost interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.

Social forces shaping evidence production: A study of the swiss cannabis pilot trials

AimThe evidence-based policy paradigm has been criticized for poorly representing drug and other health policy processes, with evidence showing various social forces influencing knowledge translation. However, less research has examined the social forces influencing knowledge production. Applying a social constructivist lens, this study investigates how politics, power, economics, philosophy, and discourse influence the evidence generating processes related to drug policy. MethodsUsing Swiss cannabis pilot trials as a case study, thematic content analysis was conducted on qualitative interview data from 18 stakeholders, including scientists, policy makers, pharmacists, physicians, cannabis producers, and current and former employees of the Swiss Federal Office of Public Health. ResultsThe study reveals how social forces collectively shape scientific evidence generating processes, with political imperatives and stakeholder interests often taking precedence over purely scientific considerations. Contrary to the presumed opposition between positivist and interpretivist stances, informants demonstrated a commitment to both, dedicating themselves to positivist research agendas while highlighting the influence of harm reduction discourse on the pilot trials. ConclusionsThe Swiss cannabis pilot trials illustrate how social forces can shape the production of policy-relevant evidence, transforming evidence-based policy into policy-based evidence. Asymmetries in actor resources and power, along with the adjustment of evidence production to align with contextual realities, play significant roles in this process. Recognizing the complex social dimensions of evidence generating processes is crucial for a more reflexive and power-sensitive understanding of drug policymaking.

Migration Medicine: infectious and non-infectious diseases

Approximately one third of the German population has a migration background.According to the federal office for migration, in 2022 around 2,7 million people have taken refuge or have immigrated to Germany, causing major challenges for our health system. In this article, important infectious diseases, and non-infectious conditions like hemoglobinopathies are presented. To date, especially the latter are not common in Germany and must therefore move more into focus when taking care of migrants. Furthermore, new treatment options for hemoglobinopathies have been approved in the last couple of years, starting with the introduction of Luspatercept a few years ago for Beta-Thalassemias and in 2023 the introduction of Voxelotor for sickle cell disease. In 2024 the gene therapy with Exagamglogen-Autotemcel using the CRISPR/Cas molecular scissor was authorized as a new promising treatment for both conditions.

ASH and Federal Officials Hold Town Hall on Sickle Cell Disease

ASH and Federal Officials Hold Town Hall on Sickle Cell Disease

Interview with Franz Perrez

Franz Perrez is Director-General of the Directorate of International Law at the Federal Department of Foreign Affairs (FDFA), Switzerland. He is responsible for the development and interpretation of international law and ensuring that Switzerland's strategic rights are respected abroad. As a member of the FDFA senior management, Mr Perrez is also jointly responsible for the FDFA's strategic approach and advises the Federal Council, Switzerland's representatives abroad and other Federal Administration offices on international law issues. Prior to his new role Mr Perrez was appointed Switzerland's Ambassador for the Environment and Head of the International Affairs Division at the Federal Office for the Environment (FOEN) in 2010. In this capacity, he headed the Swiss delegations to international environmental and climate negotiations for thirteen years. After studying law in Bern and Paris, Mr Perrez worked at the FDFA's Directorate of International Law from 1993 to 1995. He went on to study at New York University, where he gained a master of laws focusing on international law and completed a PhD thesis on the topic of sovereignty as a principle of cooperation. On returning to Switzerland, he took up a position at the World Trade Organization (WTO) Division of the State Secretariat for Economic Affairs, before joining the FOEN in 2001. Mr Perrez has proven expertise in international law. He has widely published in the area of international environmental law, international environmental governance, the relationship between trade and the environment, and public international law. Since 2008, Mr Perrez has also lectured on international environmental law at the University of Bern School of Law. He served as a panellist on the newest WTO tuna–dolphin dispute between Mexico and the United States, and as Switzerland's Ambassador for the Environment and Chief Negotiator for Environmental Issues, namely climate change, biodiversity, chemicals and waste, he led the Swiss delegation to the Rio+20 conference and to the Paris Climate Change Conference in 2015. He was President of the Basel Convention (COP 11 in 2013) and President of the Rotterdam Convention (COP 8 in 2017) and facilitated the negotiations on mitigation of the Paris Agreement. Through his work within and outside of Switzerland, he has built strong networks around the world and within the Federal Administration.

Pandemic Palliatives and COVID-19 Coping: Toward the Development of a “Coping with Crisis Communications” (COCCO) Scale

ABSTRACT The COVID-19 pandemic underscored the critical role of coping strategies during global crises and demonstrated how official communications shape public responses. This study evaluates the psychometric validity of a novel pentadic “Coping with Crisis Communication” (COCCO) Scale, which categorizes coping behaviors into five behavioral responses: moving-with, moving-against, moving-outward, moving-away, and moving-inward. A national representative survey of 742 Swiss residents, conducted in February 2022, measured these coping responses to official COVID-19 communications from the Swiss Federal Office of Public Health (FOPH) and traditional Swiss news media (TNM). Items were developed to assess how participants engaged with, opposed, reached outward for support, distanced from, or internalized the messages. Confirmatory factor analyses tested multiple models (5-, 6-, 7-, and 8-factor structures) based on both the initial pentadic theory and data-driven refinements. While the original 5-factor model showed insufficient fit, a 7-factor model (moving-with, moving-toward, moving-against, moving-outward, moving-away, negative-moving-inward, positive-moving-inward) provided a satisfactory factor solution. This model exhibited measurement invariance across the three language versions of the scale (French, Italian, German) and across the two communication contexts (FOPH, TNM). The COCCO scale offers an effective, movement-based assessment of coping strategies in response to crisis communications, serving as a valuable tool for understanding public behavior during global crises.

Numerical evaluation of rail track noise and vibration and components optimization

In the context of a project commissioned by the Swiss Federal Office for the Environment, an open-source modelling toolbox was developed to simulate and analyze rail tracks dynamics. In particular, a vibro-acoustic multi-sleeper model, which is based on advanced finite element modelling techniques, was used to investigate the effects of components properties on track noise and vibration. Considering changes around a reference construction (60E2 rail, SBB hard pad, B91 sleeper), parametric studies were performed on the dominant parameters identified for the acoustic and ballast protection performance indicators defined. The following sweet spot for the component properties of the track have been identified as using a rail pad of medium stiffness (1000 kN/mm at 1kHz, 300 kN/mm static stiffness) and high damping (at least 0.5) combined with soft Under Sleeper Pads (250 kN/mm). Based on the present models, such combination could provide both a significant noise reduction and a marked improvement in ballast protection compared to current track construction.

Attitudes and preferences of the Swiss population towards noise abatement measures: Results from a nationwide panel survey

As part of the Swiss Environmental Panel (SEP) survey, conducted jointly by ETH Zurich and the Swiss Federal Office for the Environment (FOEN), we aimed at obtaining a representative picture of the Swiss people's attitudes regarding noise and noise sources as well as their opinions and preferences about the currently implemented institutional noise protection measures. Knowledge of people's attitudes in this domain is very useful for policy makers, the public administration and the wider public. Survey topics included: degree of satisfaction with the current state of noise abatement, annoyance by emerging new sources, the attitudes vis à vis speed reductions and other noise abatement measures at source, the reasons one is in favor or against these measures, the sanctioning of excessively loud car enthusiasts ("posers" as they are also called), or the installment of "noise radars" to catch and punish noise offenders. Stratified analyses consider political and environmental orientation, age group, degree of urbanization, and socioeconomic status. Data gathering was carried out between May and August 2023 and involved more than 7000 respondents across whole Switzerland.

A-124 Sustainable Transport: Assessing Environmental Impact in Medical Sample Transit via Drones and Vehicles

Abstract Background This research explores the ecological implications associated with different methods of transporting medical samples, specifically focusing on drones, combustion cars, and electric cars within two laboratories in central European countries. With the primary goal of assessing and comparing CO2 consumption, delivery time, and overall environmental impact, the study aims to provide a basis for adopting sustainable practices in healthcare logistics. Methods The transportation of medical samples occurred between two laboratories in the Principality of Liechtenstein and Switzerland, utilizing authorized aerial and road routes. Various weather conditions and distances were considered for sample transports using different vehicles (8 combustion cars, two electric cars, and one drone model). Energy consumption was documented, and the CO2 footprint was calculated based on data from the Swiss Federal Office for the Environment (FOEN) for both imported and renewable electricity. Comparative analyses were conducted to quantify the environmental impact of each transportation method. Results In terms of CO2 footprint, combustion cars exhibited a CO2 release of 159.5 g/km, while electric cars showed 3.43g (2.15 to 4.08% of combustion cars). Drones demonstrated a minimal 0.09g CO2 emission per kilometer (0.066% of combustion car CO2 emission; 2.6% of electric car CO2 emission). The distance traveled by drones was significantly shorter (16.7% to 50%). Additionally, the efficiency of drone transport was emphasized by its ability to avoid traffic jams and associated detours, resulting in time savings ranging from 31.25 to 50% per delivery when comparing transport times during rush hour and regular hours in the selected setting. Conclusions The integration of drone technology emerges as a crucial strategy for establishing a “green laboratory.” The substantial reduction in CO2 emissions and enhanced delivery efficiency position drone transport as a sustainable and operationally effective solution for medical sample logistics, offering shorter delivery times. These findings highlight the potential for transformative change in healthcare logistics, aligning with the global shift towards sustainability and green practices.

Are Prompts All You Need?: Chatting with ChatGPT on Disinformation Policy Understanding

ABSTRACTChatGPT has shown promise in assisting qualitative researchers with coding. Previous efforts have primarily focused on datasets derived from interviews and observations, leaving document analysis, another crucial data source, relatively unexplored. In this project, we address the rapidly emerging topic of disinformation regulatory policy as a pilot to investigate ChatGPT's potential for document analysis. We adapt our existing qualitative research framework, which identifies five key components of disinformation policy: context, actors, issue, instrument, and channel, to sketch out policy documents. We then designed a two‐stage experiment employing a multi‐layer workflow using a dataset with highly relevant policy documents from US federal government departments. Through iteratively developing and refining six different prompt strategies, we identified an effective few‐shot learning strategy that achieved 72.0% accuracy and a 70.8% F‐score with the optimal prompt. Our experimental process and outcomes explore the feasibility of using ChatGPT to support manual coding for policy documents and suggest a coding approach for conducting explicit document analysis through an interactive process between researchers and ChatGPT. Furthermore, our results initiate a wider debate on how to integrate human logic with ChatGPT logic, along with the evolving relationship between researchers and AI tools.

High-ranking officials of the plenipotentiary representative offices of the President of the Russian Federation in the federal districts: recruitment channels and careers

The article covers the analysis of the main recruitment channels for high-ranking officials of the plenipotentiary representative offices of the President of the Russian Federation in the federal districts. As the empirical basis of the study serves the biographical database, that includes information on 154 presidential bureaucrats as of April 2023. Recruitment of people from various socio-professional groups to the apparatus of the plenipotentiary representative offices reveals a number of trends caused by interacting push (specific features of the candidate's position and associated resources and interests) and pull (place in the power system and functional specialisation of the plenipotentiary representative offices, specifics of leadership positions in them, as elements of the opportunity structure, as well as personal connections) factors. One of the most important trends is militarisation: most officials of the plenipotentiary representative offices have work experience in law enforcement agencies and even spent there most of their previous careers. Recruiting security officials who are, in terms of career, “ideal-typical” federal officials and professionally socialised within the framework of rigid, centralised hierarchies probably strengthens the autonomy of the plenipotentiary representations from actors and interests external to federal power, including regional administrations, that these bodies are called upon to control. The logic of autonomisation is also in line with the fact that one of the main suppliers (especially direct) of key officials of the plenipotentiary representations is the Presidential Administration, first of all, the apparatus of the representations themselves. However, a significant minority of presidential officials have experience working in regional administrations (especially among deputies and assistants to plenipotentiaries), as well as in business, both public and private (especially among plenipotentiaries and their deputies). At the same time positions in these structures rarely serve as a direct springboard to a key position in the plenipotentiary representations. Finally, the role of legislative bodies as a channel for recruiting presidential officials is insignificant. In general, the author's findings are consistent with the results of previous studies, indicating the relative stability of recruitment trends.

A Comparative Approach to Explaining Gender Disparities in Asian American and Asian Canadian Politics

In 2020, Asian Americans were the least descriptively represented at all levels of elected office compared to whites, Blacks, and Latinos (Sedique, Bhojwani, and Lee 2020). In this context, Asian women lagged behind Asian men in holding local-level positions, yet they surpassed Asian men in holding federal and statewide offices, and they led 81% of state- and local-level Asian civil rights organizations (AAPI Power Fund 2020; Reflective Democracy Campaign 2021). Do gender disparities in Asian American political representation arise because Asian women are less likely to run for office than Asian men, or because they are less likely to win elections? Do these disparities vary across levels of office? And are they unique to Asian Americans?

National Guard Command Authority and the Black Lives Matter Protests of 2020: Domestic Security Debates for a New Generation of Military Veterans

This study explores connections between the military experiences of a new generation of War on Terror (WoT) veterans elected to the U.S. Congress and controversial policy decisions on domestic security during the Black Lives Matter (BLM) protests. WoT veterans became the largest cohort of lawmakers with common military experiences on Capitol Hill in 2020, and this article examines their engagement through two original case studies of legislative debates over command and control of the National Guard mobilization during BLM protests. Confrontations between federal law enforcement officers and BLM protestors led some WoT veterans to propose legislation to restrict executive authority over National Guard deployments, including reforms of Titles 10 and 32 of the U.S. Code and the Insurrection Act, but other WoT veterans challenged these positions. This exploratory study of events and circumstances links the timely topic of domestic security to traditional debates in the civil–military relations literature on whether veterans are more or less likely to support the use of military force and try to expand congressional oversight of presidential powers. By bridging the gap between research areas and crossing generations, this article offers lessons for past, present, and potentially future debates about the use of troops for domestic security operations.

Evidence of Reputational Priorities of a Sample of U.S. Federal Offices of Inspector General: A Mixed Methods Analysis of Workforce, Budgetary Data, and Statutes

Offices of inspector general (OIGs) have become an important part of the United States government, located in virtually every agency and providing oversight through audits and investigations that examine fraud, waste, abuse, ineffectiveness, and inefficiency. Yet, scholars know little about their activities. Conventional wisdom suggested that investigations would be favored over audits partially because the OIGs would want to bolster their reputation with Congress and the public. This research examines 11 departmental OIGs to explore whether investigations are prioritized over audits, especially in the context of declining budgets. Quantitative workforce data from the U.S. Office of Personnel Management show that contrary to expectation these OIGs largely prioritize auditing through an allocation of more full-time equivalent (FTE) employees. Budget data, adjusted for inflation, show that funding since the 2010s was flat followed by marked increases for some OIGs during the Trump Administration, which doesn’t help explain these priorities; however, a qualitative analysis of statutes shows Congress assigns auditing tasks more often than investigative tasks. Overall, this mixed methods research provides preliminary evidence that OIGs’ desire to maintain or improve their reputation and be responsive to Congress leads them to focus on improving agency performance and helping their agencies fulfill their missions.

Medical Sovereignty of Russia: the Problem of Dependence of Domestic Elites on Therapy Abroad

The article considers the problem of dependence of Russian elite groups on foreign medicine. The analysis of world practice has shown that the foreign medical dependence of elites is characteristic of a number of developing countries, as well as countries with an "oil curse", when foreign economic dependence and foreign medical dependence complement each other. Over the past decades, including the period of anti-Russian sanctions since 2014, publicly available information on cases of medical care provided to federal and regional high-level officials, well-known artists and professional athletes has been systematized. Using the example of the accessibility of foreign medicine for the political and managerial establishment of Russia, the selectivity of anti-Russian sanctions, convenient for external opponents, is shown. At the same time, Russia did not decide on a directive ban on elites using medical care abroad. The stories of media pressure on politicians and businessmen (E.M. Primakov, O.Y. Tinkov) have been revealed, showing the personal vulnerability of people who have become dependent on foreign medicines and therapy. At the same time, a number of examples have confirmed the operability of a possible scenario of a complete ban on elites receiving medical care abroad as a catalyst for the development of domestic medicine, pharmaceutical and medical industries, as well as a way to equalize elites before the "collective West" in the rights to external medical care.

Watch those OD numbers!

In a comment entitled “the new math,” Rob Kent, former general counsel for the federal Office of National Drug Control Policy, and before that general counsel for the New York Office of Addiction Services and Supports (OASAS), sent us this.