Group Interviews Research Articles

Future workforce skills for hospitality and tourism business in Thailand

Currently, the hospitality and tourism industry in Thailand is at a state of great flux. This, therefore, calls for a highly competent and versatile workforce to deal with this situation. For this paper, we shall attempt at providing an overview of the current skill set from the current workforce involved in the hospitality and tourism industry in Thailand. We also attempt to identify the prevailing opinions of the managerial personnel on different work aspects, which include the perception of the skills that Thai workers possess. Moreover, the paper looks at what the managers would want and hope for in the future workforce, and the strategies applied to develop such skills in workers soon. This qualitative research approach is employed to dig deep into the minds of key decision makers in Thailand by way of in-depth, one-on-one, or small group interviews to document and consolidate the insights and viewpoints of distinguished executives and top-level decision makers belonging to prestigious hotel and tourism conglomerates in Thailand. The findings of our research unmistakably indicate that the hospitality industry in the country is doubtless in a growth and prosperous period, where it successfully meets various and constantly changing preferences among tourists coming for different purposes. With the tourism industry in Thailand mushrooming, it is vital to establish what has contributed to such success. With more and more people globe-trotting and with tourists pouring in droves into Thailand, the need for a skilled workforce within the hospitality industries is at an all-time high. It therefore becomes relevant during these times of change to identify the skillset of the personnel at work within this vibrant industry. Deep inside the minds of managerial professionals, we can gain a clear insight into how they perceive the current workforce. By conducting comprehensive interviews on an individual and small group basis, we hope to capture the capability and strengths of the Thai workforce with a great degree of subtlety. Second, we also attempt to find out what aspirations and expectations the managers have from the future workforce. The resulting skills and competencies will have to be identified as the industry continues to evolve, but by exploring strategies utilized to develop such skilled labor, we expose the preparations being made for the workforce of tomorrow. Our qualitative research methodology enables us to interact directly with key decision-makers in the industry. We have thus gathered much information and opinion by involving those senior executives and senior-level decision makers of reputed hotel and tourism conglomerates. Their valuable insights helped us to closely look into the current scenario and aspects which still needed to be improved. Our findings clearly revealed that the hospitality industry in Thailand is one of the fastest growing and most successful sectors. It has satisfactorily adapted to the increasing and changing tastes and preferences of the tourists coming from different parts of the world. On the other hand, innovation and high-quality service have allowed this industry to satisfactorily address the needs and desires of its guests. Conclusion Our study puts light on the change which the hospitality and tourism industry of Thailand is experiencing at present. The following sections provide a broad outline of the skillset of the workforce, based on in-depth interviews with managerial professionals. We have taken a closer look at what industry leaders expect and/or hope for in the future workforce, and how they are developing the skills necessary to meet those expectations. This research supports the notion that the hospitality industry is increasing its growth to meet the demands of a multifaceted global customer base.

Validating the place of Underutilized Indigenous Vegetable (UIV) Marketers: A case of Agrarian Communities, Southwestern Nigeria

Over the years, staple crops have faced several challenges, and a step away from over-reliance on them is very important to achieve food security in Nigeria. Indeed, underutilized vegetables are usually indigenous ancient crops that are still used reasonably in local, national, and even international communities. Hence, this study validates the spatial pattern and network of underutilized indigenous vegetable (UIV) marketers in Ondo State, southwestern, Nigeria with emphasis on fluted pumpkin (Telfaria occidentalis), African eggplant (Solanum macrocarpon) and Amaranth (Amaranthus virides). A multi-stage sampling technique was used to select a total of 120 UIV marketers from 5 villages. Primary data were collected and gathered using structured questionnaires and responses from the interview were coded and analyzed with STATA and UCINET. The study further examines the factors influencing the performance of the UIV marketers and determines the predictors driving association membership using multiple linear regression and binary logistic regression, respectively. The analysis results revealed that the majority (90.83%) of the UIVs marketers are female with a large proportion of the marketers within the age range of 51-60 years. The primary occupation of most of the respondents is trading (51.67%). From the regression results, belonging to a vegetable association is not statistically significant and thus it can be concluded that being a member of a vegetable association does not affect the income of the marketers. This is in sync with the information gathered from the focus group interviews that the association only serve as a medium to get firsthand information on price, product quality, and vegetables demanded. However, from social network analysis, it can also be concluded that the major actors involved in UIV marketing are interrelated and that they transfer information between themselves with the association being the common ground for such exchange. The study recommends that the government should consciously push for the wide acceptance of vegetable cultivation and provide good network roads in rural areas.

A Real-Life Laboratory Setting for Clinical Practice, Education, and Research in Family Systems Care: Protocol for a Transformational Action Research Study.

Burdening health and illness issues such as physical or mental illnesses, accidents, disabilities, and life events such as birth or death influence the health and functioning of families and contribute to the complexity of care and health care costs. Considerable research has confirmed the benefits of a family systems-centered care approach for patients, family caregivers, families, and health care professionals. However, health care professionals face barriers in working with families, such as feeling unprepared. Family systems-centered therapeutic conversations support families' day-to-day coping, resilience, and health. A family systems care unit (FSCU) was recently established as a real-life laboratory at one of the Swiss Universities of Applied Sciences. In this unit, health care professionals offer therapeutic conversations to families and individual family members to support daily symptom management and functioning, soften suffering, and increase health and well-being. These conversations are observed in real time through a 1-way window by other health care professionals, students, and trainees and are recorded with video for research and education. Little is known about how therapeutic conversations contribute to meaningful changes in burdened families and the benefits of vicarious learning in a real-life laboratory setting for family systems care. In this research program, we aim to deepen our understanding of how therapeutic conversations support families and individuals experiencing burdening health and illness issues and how the FSCU laboratory setting supports the learning of students, clinical trainees, and health care professionals. Here we apply a transformational action research design, including parallel and subsequent substudies, to advance knowledge and practice in family systems care. Qualitative multiple-case study designs will be used to explore the benefits of therapeutic conversations by analyzing recordings of the therapeutic conversations. The learning processes of students, trainees, and professionals will be investigated with descriptive qualitative study designs based on single and focus group interviews. The data will be analyzed with established coding methods. Therapeutic conversations have been investigated in 3 single-case studies, each involving a sequence of 3 therapeutic conversation units. Data collection regarding the second research question is planned. Preliminary results confirm the therapeutic conversations to support families' coping. This renders the FSCU a setting for ethically sensitive research. This program will not only support the health and well-being of families, but also contribute to relieving the financial and workforce burdens in the health and social care system. DERR1-10.2196/53090.

Transdisciplinary teaching and learning in a master’s program in urban agriculture

Purpose This study aims to explore transdisciplinary teaching and learning in a transdisciplinary master’s course in an urban agriculture master’s program. Design/methodology/approach An action research approach was used, applying qualitative methods, such as reflection notes, classroom dialogues, focus group discussions and interviews. Findings The students expressed high-level inter- and intrapersonal competencies and provided thorough insights into how they developed ideas across disciplines. However, the potential for collaborating with partners outside the university (case owners) was not fully exploited and needs further development. Originality/value The study constitutes a detailed example of the benefits and challenges of transdisciplinary teaching and learning, suggesting an integral education. It adds to the knowledge of how to develop academia further to facilitate competence for sustainable development.

A novel operational protocol for the establishment of a medical facility for receiving returning hostages: structure, process and outcomes

BackgroundOn October 7, 2023, Hamas carried out an unprecedented attack on the State of Israel and kidnapped 251 people into captivity to the Gaza Strip. Several months later, as part of a humanitarian exchange deal, 105 hostages were released in five phases and admitted to one of six hospitals throughout the country for treatment. Shamir Medical Center (SMC) was one of these facilities. This study aims to describe the structure, process and outcomes of establishing a comprehensive, multi-step, operational protocol for receiving hostages returning from captivity.MethodThe process of preparing SMC as a receiving center, the establishment of procedures for implementation of the medical protocol, and the assessment of multi-disciplinary team preparedness and implementation and outcomes in an institutional protocol are described.Results24 returning hostages were received at SMC. Social workers, dietitians and translators were used by 100% of the majority group of returning hostages from the same country of origin and the sole individual from the other country of origin utilized a dietitian, social worker, ENT consultations, and a hearing test. Among the majority group, orthopedic and dermatological consultations were utilized by 17.4% and 13% received an ENT consultation. Of the administered imaging, 13% received a chest X-ray, 8.7% received a limb X-ray, 17.4% received a head CT scan, and 4.3% received an abdominal CT. In addition, 21.7% were provided antibiotic therapy. Protocol efficacy was measured by assessing time to various operational aspects of protocol implementation and medical procedures such as mean hours to room assignment, primary physician evaluation and social worker session. No correlation between age and operational variables was found.ConclusionThis novel operational protocol was successfully implemented and may serve as a framework for managing similar unpredictable sensitive events in the case of future need.

Self-Leadership and Associated Factors in Nursing Students

Background: Nurse leaders face high pressure, but self-leadership can help them thrive. Nursing students, therefore, should develop this skill before graduation. Purpose: To investigate nursing students’ self-leadership perceptions and associated factors, and to reveal when and how self-leadership strategies are utilized. Methods: An explanatory sequential mixed-methods design with interpretative description; 943 nursing students were surveyed and 13 were selected for qualitative analysis. Descriptive data were collected, and self-leadership was assessed using the Revised Self-Leadership Questionnaire. Focus group interviews were analyzed through thematic and content analysis. Results: Students who were employed, were involved in student clubs or organizations, held managerial roles, and had career goals exhibited higher self-leadership perceptions. Qualitative findings revealed that staying in comfort zones, overthinking, and procrastination hinder self-leadership, while self-respect, self-awareness, and self-determination enhance it. Conclusions: Nurse educators should design interventions that enable students to take on planning roles, advance at their own pace, and engage in opportunities to develop their self-leadership skills.

On the relationship between students’ overall satisfaction with higher education STEM courses, and university teachers’ didactical practice. An empirical analysis

In this article, we discuss the relationship between students' overall satisfaction with higher education STEM courses (Science, Technology, Engineering, and Mathematics), and the teachers' didactical practice. We analyzed student feedback from 4,683 digital course evaluations which spanned the period from fall 2020 to fall 2021 at the Faculty of Science and Technology (TN-faculty), University of Stavanger (UiS). Additionally, we collected 1854 open-ended written responses in spring and fall 2022, and conducted two focus group interviews in spring 2023 with eight students from the same population. We raise the research questions: What is the connection between students´ overall satisfaction with STEM courses, found in an institutional student evaluation procedure at UiS, and the university teachers’ didactical practice? And what can we learn from students´ evaluations and feedback that is relevant to how we perceive and strive for teaching and educational quality enhancement in higher education? Our analysis shows that there are strong correlations between students´ overall satisfaction, the evaluation questions, and how they understand what being prepared for teaching means.

Stakeholders’ Perspectives on Rehabilitation Services in KwaZulu-Natal Province, South Africa: A Mixed-method Study

Background and Objectives: South Africa is committed to enhancing rehabilitation services by 2030 through the National Rehabilitation Policy and the United Nations Convention on the rights of persons with disabilities. However, limited research focuses on rehabilitation services in KwaZulu-Natal (KZN) Province, South Africa. This study aims to provide insights from stakeholders on rehabilitation services in KZN Province focused on infrastructure, referrals, human resources, and multidisciplinary practices. Methods: Using mixed methods, we conducted focus group discussions, interviews, and surveys involving 99 stakeholders, including rehabilitation practitioners, district and provincial managers, and social development representatives from eThekwini, AmaJuba, and King Cetshwayo in South Africa. Descriptive statistics and thematic analysis were used for quantitative and qualitative data. Results: Public institutions reported inadequate referral pathways (2.9 out of 5) compared to private institutions (3.4 out of 5). Acute rehabilitation referrals primarily targeted secondary or tertiary facilities. Disjointed pathways, a lack of protocols, delayed referrals due to various factors and insufficient staff were identified. Physiotherapists were disproportionally more prominent, while social workers, psychologists and bio-kineticists were scarce. Both public (93%) and private (73%) care exhibited high doctor-to-patient ratios. Rehabilitation service disciplines were limited and fragmented, especially in rural areas. Thirty-four respondents (81%) stated no designated rehabilitation services units in their respective institutions. Conclusion: Rehabilitation services, though present at all care levels in KZN, mostly begin at tertiary levels. Local-level rehabilitation is non-existent, with the public healthcare system relying on community rehabilitation workers. Referral pathways require standardization, especially at the local level. Enhancing primary healthcare’s rehabilitation focus by bolstering workforce recruitment can significantly improve multidisciplinary practices. Expanding intermediate care facility licenses can alleviate system strain on KZN’s public health sector.

Cultural filters in processing information on COVID vaccines among minoritized groups in London, UK

Abstract Introduction Vaccination coverage among minoritized groups, including migrants, is low in the United Kingdom. Cultural factors are often cited as barriers, yet the broader impact of minoritization on vaccine acceptance remains understudied. We explored the intersection of culture with individual, familial, and systemic factors in shaping trust and perceptions of COVID-19 vaccines in East London, UK. Methods We conducted focus group discussions (n = 6) and interviews (n = 19) with individuals from minoritized backgrounds in East London to elicit their perceptions and experiences of COVID-19 and the vaccination programme. Thematic analysis was used to identify individual, social, and systemic factors influencing the processing of perceived value of information on COVID vaccines. Findings Culture was rarely cited as an explicit barrier to vaccine uptake. Instead, participants’ linked their perceived vulnerability and immunity to COVID-19 with age, sex and health status. Information about COVID vaccines was processed and acted upon in the context of gendered family dynamics and support. Community identity, gatekeepers and social networks further influenced the perceived legitimacy of information received. Some participants voiced how their minoritized status shaped trust/mistrust in the national health system’s and government’s delivery of the COVID-19 information and vaccination campaigns Conclusions Unpacking cultural filters is crucial for addressing vaccine-related information barriers in minoritized groups. Going beyond mere language translation, tailored communication materials should address social enablers and systemic barriers. Further, closer collaboration between community gatekeepers and healthcare professionals to facilitate optimal use of these materials is needed to improve vaccine uptake. Key messages • Culture should not be assumed to be the main factor contributing to non-adherence and non-uptake of public health vaccine. • Vaccine uptake can be improved by healthcare workers and key community gate-keepers working collaboratively with minoritized groups.

Tracing applications for the control of virus dispersal - COVID-19 experience

Abstract Tracing apps have been promoted as an effective tool for the monitoring and control of the spread of COVID-19. Although the correlation between the use of mobile tracking apps and reducing the spread of the virus has been demonstrated, the success of these apps depends on a number of factors, such as the number of app users, the rate at which new systems get adopted, as well as concerns related to anonymity and privacy. The aim of the research was to analyse the pattern of adaptation and use of a COVID-19 tracing app in the context of Polish society. The research used a qualitative approach, data were collected through focus group and individual interviews. The sample consisted of 34 respondents, aged 23-61, with different educational levels and backgrounds. The study followed two phases. First, a model with a set of questions was proposed on the basis of the unified theory of technology acceptance and use. Secondly, using the set of questions, interviews were conducted. In order to examine the data, thematic analysis was applied. To summarise the results of the survey, the respondents have clear expectations towards the app, which are not fulfilled. They are afraid of new technologies. However, they use them frequently and willingly without thinking about the security of their personal data. They expect applications to provide reliable information, but at the same time do not want to enter necessary data that they consider sensitive. They are negative about government actions without losing trust in government applications. It can also be speculated that a lack of information and understanding of the app may have contributed to some of the objections. In conclusion, we need to better understand users and be able to accommodate often conflicting characteristics in order to design more effective tracking applications in the future. Key messages • Technology offers ways to successfully prevent viruses from spreading. • Getting the technology right, based on customer behaviour, is key to the effectiveness of tracking applications.

Exploring Spectacle Usage Patterns: A Thematic Analysis of Refractive Disorder Patients in Medan, Indonesia

Objectives: This study explores the behavioral patterns of spectacle users with refractive errors in Medan City, Indonesia, and identifies the key factors influencing the decision-making process in choosing and using glasses, contributing to SDG 3 (Good Health and Well-being) by addressing vision health. Theoretical Framework: The research is guided by the Precede-Proceed model and the Theory of Planned Behavior, which provide a framework for understanding health-related behaviors, including spectacle usage and its impact on overall well-being. Method: A qualitative methodology was employed, involving in-depth interviews with 30 Medan City residents diagnosed with refractive errors. This was supplemented by focus group discussions and consultations with eyewear experts. Data were analyzed using a descriptive-analytical approach. Results and Discussion: Key themes influencing spectacle usage behavior were identified, including needs, comfort, fashion, quality, perception, economy, and knowledge. Among these, needs, comfort, and quality emerged as the most significant factors influencing users’ choices of glasses. The findings suggest that people with refractive errors should prioritize glasses that meet health standards to ensure comfort and improve visual impairments, aligning with the goals of SDG 3 to promote health and well-being. Research Implications: Health practitioners, particularly optometrists, play a critical role in educating the community about the importance of using high-quality eyewear and addressing common misconceptions related to spectacle use, thus contributing to SDG 3 (Good Health and Well-being). Originality/Value: This study provides novel insights into the behavioral patterns of spectacle users in a specific cultural context, offering valuable information for health professionals and policymakers to improve vision care services in Medan City in support of SDG 3.

Immigrants and nurses’ perspectives on the barriers in using health promotion services in Finland

Abstract Background The incidence of chronic diseases and health disparities is high among immigrants. Lack of access to health promotion services targeting the needs of the immigrant population was reported. This study aimed to explore the perspectives of immigrants and nurses on the barriers to using health promotion services in Finland. Methods A qualitative study with 12 focus group interviews was conducted in various cities across Finland. A total of 69 participants, including 46 adult immigrants and 23 registered nurses, were selected through purposive sampling. A semi-structured interview was used. Interviews were transcribed verbatim and analyzed using content analysis. Results The analysis generated four themes: insufficient individual factors (i.e., knowledge, skills), restraining cultural norms (i.e., unhealthy cultural habits, gender disparities), inadequate health promotion services (i.e., lack of resources, structural limitations), and negative environmental impacts on health behavior (i.e., sweet foods and beverages, cold weather). Conclusions The findings suggest reinforcing health promotion services to prevent chronic diseases among the immigrant community. Providing health education resources that are culturally tailored helps improve immigrants’ knowledge to make healthier decisions in their own lives after migration. Moreover, it is recommended to introduce the health care system of the host country and healthy habits during the integration process, along with language training. Key messages • Improving equity in using health promotion services for immigrants requires reforms. • More strategies are needed to prevent chronic diseases among immigrants in Finland.

The role of the organisational context in the implementation of a complex mental health intervention

Abstract Introduction The 2021 framework for complex interventions introduced by the UK Medical Research Council highlights context as one of the core elements. In the implementation phase, context is considered especially critical as it affects the intervention’s effect, sustainability, and transferability. However, in public health implementation research, there is a lack of understanding of the interrelatedness between intervention and context conditions. This study aimed to explore the role of the organisational context in implementing a complex mental health intervention. Methods The study was designed as an ethnographic case study. This design enabled a comprehensive exploration of the relation between the case and its context by providing insights into the process of change implied in the implementation and how this collides with the organisational norms, culture, and structure. Four general practices participating in The Healthy Mind Intervention were included as cases. One-person interviews with clinic owners, focus group interviews with personnel, and observations of intervention activities and everyday life in the practices were used to collect data. Results Three themes were identified. First, existing organisational norms, ideals, and values were replicated in the implementation process and either inhibited or facilitated the process of change. Second, different narratives of both implementation and context existed among some of the professional groups, which complicated the collaborative efforts in the implementation. Last, conflicts in the organisations were actualised in the implementation process, which enabled a discussion and improvement of these issues. Conclusions Ethnographic case studies provide extensive insights into the role of the organizational context in implementing complex interventions, which is critical for the implementation to be effective, qualified, and sustainable.

Polish midwives’ experiences of providing maternity care to Ukrainian women in Poland

Abstract Background Migrants’ health has attracted the attention of researchers for many years, particularly from the perspective of barriers in access to healthcare systems. Providing high quality care to migrants and refugees, especially in contexts of significant and sudden arrivals, may be particularly challenging. Aim The aim of our research was to learn about the experiences and strategies of midwives providing maternity care for Ukrainian migrant women in Poland after the outbreak of the full-scale war in Ukraine. Methods Five focus group interviews with 32 midwives providing maternity care in Poland were conducted. The interviews were thematically analysed. Results Healthcare personnel experiences a number of barriers to the provision of high-quality care to the migrant population. Polish midwives expressed mainly experience of two groups of barriers on: (1) individual and interpersonal, (2) management and organization levels. Firstly, at the individual and interpersonal level midwives experienced: fear for life and well-being related to the threat of war in a neighbouring country, depleting resources and post-pandemic fatigue, language barriers, lack of knowledge on caring for woman fleeing the war. Secondly, at the management and organizational level midwives experienced: lack of organizational support, interpreting services and documentation in any other language than Polish. In the first months after the outbreak of the full-scale war in Ukraine, most strategies to improve the provision of maternity care for women fleeing the war took the form of grassroots initiatives by the staff of individual care units. Conclusions The Polish health care services need systemic solutions prepared jointly by state and local authorities and considering the voices of midwives to support the provision of high-quality care to migrant population. Key messages • Midwives were left to their own devices. • Midwives need better preparation for providing high-quality care to migrant population.

Implementation evaluation of a school-based intervention on HPV vaccination (the PrevHPV study)

Abstract Background HPV vaccine coverage (VC) remains lower than expected in many countries, particularly France. We developed and evaluated the PrevHPV multicomponent intervention to improve HPV VC among French adolescents. We evaluated the implementation of the school-based components of the intervention. Methods We carried out a mixed-method study embedded in a cluster randomized controlled trial (July 2021-April 2022; 14/25 French school districts). The cluster was the municipality (n = 91). The school-based components of the intervention were ‘education and motivation’ and ‘at-school vaccination’. Quantitative data were collected through standardized activity reports and self-administered questionnaires; the implementation outcomes were fidelity, dose, reach, acceptability and sustainability. Qualitative data were collected through semistructured group interviews with school staff and analyzed using the Consolidated Framework for Implementation Research. Results We found high rates for: fidelity (e.g., 69% of the targeted classes had two educational sessions and 89% of schools invited all pupils for at-school vaccination, as planned); acceptability (e.g., pupils’ participation satisfying in 90% of the sessions, 96% of vaccinated pupils and 78% of school staff satisfied with at-school vaccination); and sustainability (e.g., respectively 91% and 76% of schools considered conducting sessions and vaccination days during the following year). However, the withdrawal of 1/3 of schools before the trial started and difficulties in mobilizing parents negatively impacted dose and reach. Several facilitators and barriers influenced the implementation of the components; they were related to the components’ design, the characteristics of both the external and internal environment of the school, the numerous stakeholders and individuals involved, and the implementation strategies used. Conclusions These results can guide policy making on school-based HPV vaccine promotion in France and Europe. Key messages • The PrevHPV study is supported by the French health authorities and conducted by a multidisciplinary consortium to tackle a long-lasting public health concern in France. • These findings have practical implications for implementing effective and acceptable school-based interventions in real life to improve HPV vaccine uptake and reduce HPV-associated burdens.

An integrated work health intervention among cleaners in Denmark

Abstract Introduction Work-related diseases are increasing and considered a global health challenge. Meanwhile, work-related risk factors and diseases are not equally distributed across occupational groups. Previous work health interventions have not succeeded in reducing the prevalence of work-related diseases. Therefore, integrated approaches combining prevention of disease and promotion of health in work health interventions have been developed. The aim of the Integrated Approach to Health, Wellbeing, and Productivity at Work (ITASPA) intervention was to prevent work-related injuries and diseases and promote the health, safety and wellbeing of cleaners. Methods The ITASPA intervention was implemented at two Danish workplaces among cleaners. At each workplace a committee of employees was established to develop their own initiatives to promote the health of the workers. By use of the British Medical research Council’s framework, a process evaluation was conducted. Qualitative data (focus group interview and field notes) and quantitative data (questionnaires) of participants evaluated the implementation. Results A total of 91 cleaners participated in health checks, and three workshops were held at each workplace. The development and implementation of activities was affected by mechanisms, such as lack of information about the intervention, new power dynamics, and lack of motivation for behavior changes, and contextual factors, such as many replacements, time pressure and absence of managers. Conclusions Integrated approaches in work health interventions among employees with short or no education may positively impact employees’ health, wellbeing and safety if comprehensively implemented. However, attention should be drawn to interventions that adapt a participatory design, as unintended power dynamics may occur when employees are given the tasks of implementing behavior changes among colleagues. The role of managers to obtain successful implementation should be highlighted.

Development of a tool for generating comprehensible, individualized and digitalized outpatient letter

Abstract Background Patients often remember little from a medical consultation or a conversation with a doctor. A comprehensible, individual patient letter summarizing the consultation can support, as a German project which successfully implemented a digital tool to generate such a letter in inpatient care showed. Based on this, our aim is to develop a tool for letters in outpatient care in Switzerland, to support understanding of the consultation and increase patient’s health literacy (HL). Methods The development of the tool was conducted participatively with targeted health professionals (HP) and patients with a chronic disease to 1) identify specific patient groups and situations, 2) confirm eligibility and receive concrete input regarding structure and content, and 3) to ensure the technical practicality and usability by the target groups. Concretely, several expert and patient interviews, a focus group and consultation observations were performed. Further workshops and usability tests are planned. Results We first defined 8 criteria to identify situations suitable for the development of the letter (e.g. high information need) and interviewed 5 experts on selected topics. Based on this, chronic back pain was chosen for a deeper feasibility analysis: A focus group interview (n = 4 HP) and 5 telephone interviews with patients confirmed the eligibility and provided information on the structure and content of the letter. Observations of 5 consultations provided further insights. Then, a first concept for the letter’s content was developed and is currently being finalized. It consists of: 1) summary; 2) background; 3) diagnosis; 4) treatment; and 5) next steps and includes infoboxes and a glossary. Conclusions The tool for patient letters can be adapted to other diseases (e.g. chronic back pain) and settings (outpatient care). In a next phase, the letter will be piloted in an outpatient clinic and evaluated with HP and patients. The effect on HL will also be assessed. Key messages • Comprehensible, individualized, and digitalized patient letters can help patients to deal with health information and take better decisions for their health and well-being. • The developed patient letter and the corresponding tool should be easily adaptable for other diseases and settings.

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.

Professional support for children or adolescents whose mental well-being is at risk

Abstract Background Children and adolescents’ mental health issues are globally among the most significant concerns. Research on the topic often focuses on already manifested mental health problems, and research concerning mental well-being and the preferences of service users regarding early-stage support is scarce. This study aimed to define what professional support experts-by-experience hope for a child or adolescent in situations where mental well-being is threatened. Methods The qualitative study with focus group interviews was conducted in Finland during the autumn of 2022. Participants (n = 26) were experts-by-experience who had experienced threats to mental well-being either during their own childhood (before the age of eighteen years) (n = 19) or through the perspective of being a parent (n = 3), or both (n = 4). The data was analyzed using inductive content analysis. Results In situations where the mental well-being of children or adolescents is at risk, professionals working with families were expected to 1) demonstrate an appreciative and compassionate attitude, 2) provide a daycare environment or school environment that supports mental well-being, 3) support the participation of children and adolescents, 4) involve and support family, 5) organize peer support, and 6) provide services that are seamless and need-adapted. Conclusions The results help to develop services supporting mental well-being, considering the perspective and preferences of service users. During the study, one model identified to meet the participants’ desires was the Open Dialogue Approach originally developed in Finland. Key messages • In services supporting mental well-being, ensuring the child’s or adolescent’s participation and involving parents is important. • In addition to the support provided by professionals, the significance of peer support was highlighted. Professionals should actively refer service users to peer support.

A Personal Health Record for patients with multiple sclerosis: A 2-year evaluation study

Abstract Background Multiple sclerosis (MS) is a chronic disease impacting the central nervous system, affecting 2.8 million people worldwide. Effective self-management is crucial for treating chronic diseases, including MS. Personal health records (PHRs) show promise in supporting self-management, potentially empowering patients and enhancing their engagement in treatment and health. However, implementation challenges persist. Objectives This study aimed to) assess the feasibility and usability of the PHR according to patients and healthcare professionals (HCPs), and 2) evaluate implementation determinants, and exploring preliminary effects on a range of outcomes related to the quality, efficiency, and costs of care, as well as health-related outcomes. Methods A mixed-methods study was conducted in a Dutch hospital. Quantitative data from 80 patients and 12 HCPs were collected via questionnaires at baseline (T0), after one (T1) and 2 years (T2). Focus group interview were conducted at T2 with 7 patients and 4 HCPs. Results Most patients never logged in during the first year and logged in a couple of times during the second year, with 15 minutes per log-in session. The HCPs mainly logged in a couple of times per year, averaging six minutes per session. Patients’ and HCPs’ usability and satisfaction scores were below average and moderate respectively. Various facilitators and barriers were identified, including knowledge gaps, staff capacity issues, and ICT obstacles. No significant differences were found in preliminary effects. Qualitative data highlighted benefits in terms of gaining insight into health data but revealed challenges with log-in issues and information retrieval. Conclusions Implementation challenges hindered PHR adoption. The evolving nature of PHRs requires ongoing evaluation and adaptation to optimize their potential benefits. Utilizing a participatory design approach and a dedicated implementation team could enhance adoption and maximize benefits. Key messages • A personal health record (PHR) for patients with MS was evaluated within the care setting of a Dutch hospital, demonstrating limited usability and moderate satisfaction. • Diverse obstacles impeded the adoption and uptake of the PHR, but potential solutions lie in continuous development with a participatory design approach and dedicated implementation team.