Health Institutions Research Articles

How the Nursing Practice Environment Influences Retention and Turnover Intention: An Umbrella Review Protocol

Background: Currently, there is a global shortage of nurses, which has a negative impact on health institutions, mainly on the quality of care provided. The quality of nursing care depends on several factors, including the nursing practice environment, which has been stated as a fundamental element for the successful functioning of health systems. Scientific evidence shows that favorable practice environments contribute to nurse retention, and unfavorable environments increase nurses’ turnover intention. Retaining nurses is essential to ensure the sustainability of healthcare organizations and the quality of nurse care. In the current shortage scenario, this issue has become even more significant. Objective: This review aims to identify systematic literature reviews that describe the characteristics of nursing practice environments that contribute to nurse retention or turnover intention in hospitals. Methods: The umbrella review will follow the Joanna Briggs Institute methodology, the Preferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines, and the Preferred Reporting Items for Overviews of Reviews guidelines. A search with indexed terms will be performed in various databases, and two reviewers will identify, select, and extract studies, while a third reviewer will resolve any disagreements. Results: This protocol provides a structured approach for conducting the review, and the initial searches have identified 440 articles, with no previous protocol or umbrella review identified, underscoring the importance of this research. Conclusions: This study will enhance the dissemination of scientific evidence regarding nursing practice environments, thereby contributing to an improved understanding of factors affecting nurse retention and turnover intention.

Expectation, perception, and satisfaction of antenatal care services among pregnant women attending health facilities of Lumbini province, Nepal: a cross-sectional study

Background: Antenatal care (ANC) plays a crucial role in ensuring the health and well-being of pregnant women by providing regular checkups to identify potential complications and deliver important guidance on pregnancy and childbirth. While the expectations surrounding ANC services are shaped by user's individual needs and preferences, the quality of care experienced is largely determined by the service providers. The level of service quality significantly influences the utilization of ANC service, as women are more likely to use services that satisfied their expectations. This study aimed to assess the expectations, perceptions, and satisfaction levels of pregnant women concerning the ANC services offered by health institutions in Lumbini Province. Methods: An institution-based cross-sectional analytical study was carried out involving 2,986 pregnant women, selected through multistage cluster sampling. Quantitative analysis was carried out to calculate the perception, expectation, and satisfaction score. The SERVQUAL tool was utilized to measure expectation, perception and service quality gap. Results: The study involved 2,986 pregnant women, the majority of whom (76.7%) were aged 20-30 years, 38.5% were Janajati, most of them (32.5%) had a secondary level of education, and 78.8% were housewives. The expectation score was higher than the perception. Overall, only 67% of pregnant women were satisfied with the services. Conclusions: Significant disparities exist between the expectations and actual perceptions of ANC users, indicating a lower level of satisfaction among mothers with the ANC services. The study concluded that decreased satisfaction with the service is likely to reduce the trend of service utilization.

Association between prenatal maternal sleep quality, neonatal uncinate fasciculus white matter, and infant negative emotionality

Poor prenatal maternal sleep is a pervasive, yet modifiable, health concern affecting maternal and foetal wellbeing. Experimental rodent studies demonstrate that prenatal maternal sleep deprivation affects offspring brain development and leads to adverse outcomes, including increased anxiety-like behaviour. We examined the relation between prenatal maternal sleep quality and neonatal white matter development and subsequent infant negative emotionality. Participants included 116 mother-infant (53% female) dyads. Prenatal sleep quality was prospectively assessed three times during gestation (16, 29, and 35 gestational weeks) using the Pittsburgh Sleep Quality Index. Neonatal white matter, as indexed by fractional anisotropy (FA), was assessed via diffusion weighted magnetic resonance imaging. Negative emotionality was measured via behavioural observation and maternal report when the infant was 6-months of age. More prenatal sleep problems across pregnancy were associated with higher neonatal FA in the uncinate fasciculus (left: b=0.20, p=.004; right: b=0.15, p=.027). Higher neonatal uncinate FA was linked to infant negative emotionality, and uncinate FA partially mediated the association between prenatal maternal sleep and behavioural observation of infant negative emotionality. Findings highlight prenatal sleep as an environmental signal that affects the developing neonatal brain and later infant negative emotionality. National Institutes of Health (R01MH109662, R01HL155744, P50HD103573, K12AR084226, F32 Training fellowships MH125572, HL165844, MH106440, and diversity supplement R01HL155744-01S1).

Effectiveness of paediatric asthma hubs: a clinical pilot study

BackgroundChildren and young people (CYP) with asthma in the UK are at higher risk of poor outcomes compared with other high-income European countries due to factors including poor access to high-quality asthma reviews, diagnostic testing and inconsistent postattack reviews. The Leicester Integrated Care Board funded the first UK pilot asthma hub for CYP, to investigate the feasibility and effectiveness of hubs, in providing postattack reviews along with providing asthma education, the opportunity to carry out diagnostic lung function tests and optimise treatment.MethodsClinical pilot study including CYP aged 4–17 years referred to the hub with uncontrolled asthma or postattack from November 2021 to April 2022. CYP received a structured clinical assessment including National Institute for Health and Care Excellence (NICE) first-line diagnostic investigations for asthma including spirometry, bronchodilator reversibility (BDR) and fraction of exhaled nitric oxide (FeNO).ResultsOf 312 CYP referred (mean age 8.6±3.2 years; 42% women), 266 (85.3%) attended their appointment. Median time from referral to review was 2 days (IQR 1–3). Three CYP (1.1%) were severely unwell at review and required further hospital treatment. In the 231 CYP who completed first-line tests, asthma was confirmed for 73 (31.6%) based on NICE diagnostic criteria for CYP. Twenty-two per cent of children with normal baseline spirometry had ≥12% BDR.ConclusionPaediatric asthma hubs are a feasible model of care to deliver CYP postasthma attack reviews and identify high-risk patients requiring further treatment. Spirometry, BDR and FeNO testing allowed diagnostic confirmation in a significant proportion of CYP.

Proceedings of the Conference “CMV Vaccine Development—How Close Are We?” (27–28 September 2023)

Congenital cytomegalovirus (cCMV) is the most common infectious cause of disability in children, including sensorineural hearing loss. There is interest in developing a pre-conception vaccine that could confer protective immunity on a woman of child-bearing age, hence resulting in a reduced cCMV disease burden. Other populations, including solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) patients, could also benefit from CMV vaccination. To review and discuss vaccines that are in clinical development, a workshop, sponsored by the National Institutes of Health (NIH) and the National Institute of Allergy and Infectious Diseases (NIAID), was empaneled. At this workshop, correlates of protective immunity against CMV, epidemiologic features of CMV transmission, and vaccine platforms in development were reviewed. Representatives from academia, pharma, and the NIH engaged in discussion on the current state-of-the-art in CMV vaccinology. A summary of the presentations from this is provided in this report.

Best practice in COPD care: a health equity approach

There is a strong evidence base for the best care in chronic obstructive pulmonary disease (COPD) as outlined by the National Institute for Health and Care Excellence in its five fundamentals of COPD care: offer treatment and support to stop smoking; offer pneumococcal and influenza vaccinations; offer pulmonary rehabilitation if indicated; codevelop a personalised self-management plan; and optimise treatment for comorbidities. However, only a minority of those living with COPD receive or engage with all five interventions, with clear implications for outcomes. Further, barriers which prevent people who live with COPD accessing necessary care are unequally experienced. In order to overcome many of these barriers, clinicians caring for people with COPD must prioritise personalised treatment and continuity of care.

The TRIKAFTA to treat the Cystic fibrosis

Cystic fibrosis currently has limited treatment options. This review focuses on the therapeutic potential of TRIKAFTA for treating this disease. We have compiled data from the National Institutes of Health (NIH) and analyzed the composition and mechanism of action of TRIKAFTA. Specifically, we examine how TRIKAFTA targets the F508del mutation, a common genetic variant in cystic fibrosis that results in the deletion of three nucleotides, leading to the loss of phenylalanine at position 508 of the CFTR protein. Our findings indicate that the components of TRIKAFTA effectively address this mutation. While this review provides a general research direction, further studies are necessary to fully understand and treat cystic fibrosis.

Assessment of relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Institutions of North Eastern States of Nigeria

Conflict in health care settings may be effectively managed if nurse managers possess conflict management skills such as reconciliation, listening, and effective communication to bring individuals closer and work together to find fair solutions and meet balanced needs. The study aimed at identifying the relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Facilities, in the Northern States of Nigeria. The objectives of the study are to assess the level of emotional intelligence among nurse managers, also to identify the most common types of conflict, determine the causes of conflict, determine the conflict resolution strategies applied by the nurse managers and to identify relationship between emotional intelligence and conflict resolution among nurse managers in tertiary health institutions of North Eastern States. A mixed methods research design (quantitative and qualitative methods) was used. A total of 188 nurse managers and three Head Nursing Services departments formed the sample size. The nurse managers were given structured questionnaires and the Head of the Nursing Services department was interviewed (key informant interview). Three instruments were employed for data collection; Interview Guide, Structured Questionnaire and Participants Demographics Sheet. A simple random sampling technique was used for the study. The obtained data were coded and computed in an SPSS Version 26 and analyzed using percentages, mean and standard deviation for descriptive statistics while the Pearson Correlation Coefficient was used for the inferential statistics. The result of the study revealed that most of the nurse managers have a fair level of emotional intelligence when dealing with conflict among nurse managers. It also revealed that the most common type of conflict among nurses was related to environmental factors. The working environment was the highest cause of conflict among nurses. Social skill strategy was mostly used in conflict resolution. The study revealed that there was no significant relationship between years of experience and conflict resolution r=0.173. Based on the findings the researcher concluded that most of the respondents highly make use of social awareness in the application of emotional intelligence in conflict resolution, most of the causes of conflict among nurses were related to a working environment, and social skills were mostly used in conflict resolution among nurses. Based on the findings of the study, the researcher recommended that other sources of conflict management should be identified for nurse managers to manage conflict, nurse managers should use the skills they have to solve problems and conflict management to be part of a school of nursing curriculum.

Future health technology trends, policy, and governance perspective: the Turkish case

BackgroundAdvanced health technologies that emerge with the development of technology have an impact on health systems. This study aimed to determine the effects of these technologies on Türkiye’s health system and present policy recommendations to reshape Türkiye’s health system and policies accordingly.MethodsInterviews were conducted with senior managers, bureaucrats, policy-makers and decision-makers from seven different institutions on the subject. Content analysis was performed on the data obtained and evaluative categories were established.ResultsIt was concluded that these technologies would not have a positive impact on two identified themes, a negative impact on seven themes and a predominant impact on five themes in Türkiye.ConclusionsTo adapt to the new health ecosystem in Türkiye, it is recommended to increase digital literacy, conduct economic evaluations of technologies, promote domestic production, ensure up-to-date follow-up, collaborate with the engineering field, enhance health technology evaluation practices, improve access to technologies and ensure that the infrastructures of health institutions are compatible with technologies. Various policy suggestions have been presented for the development of Türkiye’s health system.

11.Q. Round table: A Guide for creating a code of ethics for public health professionals and institutions

Abstract The professional discipline of public health is driven by its values. Public health professionals face decisions that have far-reaching ethical implications. Our norms, values, beliefs and the way we see the world, as individuals, communities and institutions which serve us, do matter and fundamentally affect our decisions, behaviours, policies, and practice. The ability to be aware and reflect on norms and values when taking decisions, is a decisive professional virtue in public health practice. The World Health Organisation (WHO) and Association of Schools of Public Health in the European Region (ASPHER) Roadmap for the professionalisation of the public health workforce, has highlighted ethics as an essential pillar for professionalisation, a core competency, and the need for a Code of Ethics and Professional Conduct for good public health practice. In order to further advance the issue the Global Network for Academic Public Health (GNAPH), ASPHER, the European Public Health Association (EUPHA), the UK Faculty of Public Health and other partners set up an expert international joint working group on public health ethics and law (PHELWG). The PHEL expert working group - which includes senior public health professionals, ethicists, lawyers and academics - has been working to carry out research and develop a guide for creating a Code of Ethics and Professional Conduct for public health professionals and institutions. This has included consideration of the competencies, principles and values for good public health practice. The project has involved literature review, research and the wide professional experience of the international group of experts who have been working on the issue.The development of a guide for creating a code of ethics for public health professionals and institutions is part of the overall objective of the PHELWG to build a ethico-legal competency, capacity and resilience of public health workforce. The proposed Guide and related resources will be a timely resource, practical tool and support for public health professionals, organisations, or regulatory bodies to develop their own local country code of ethics and build further ethico-legal capacity of their public health professional workforce and institutions. Purpose of the roundtable workshop will be to: - present the guide on creating a code of ethics for public health public health professionals and institutions, which will be launched at that time - Share the proposed ethical competencies/skills, principles and values for good public health practice, with particular consideration of Indigenous knowledge and world views - reflect and consult with the workshop participants around the guide and the proposed pilot sites for implementing the Codes in various centres. Key messages • Development of Code of ethics and professional conduct is a key requirement for public health professionalization. • The Guide for creating code of ethics by international expert group provides significant resource for development of codes locally. Speakers/Panelists Kasia Czabanowska Maastricht University, Maastricht, Netherlands Farhang Tahzib Faculty of Public Health, Haywards heath, UK Paul Athanasopoulos Public Health Department, Stirling, UK

A cross-sectional study of data linkage and artificial intelligence practices across European countries

Abstract Background The availability of different data sources is increasing with the possibility to link them with each other. However, linked administrative data can be complex to use and may require advanced expertise and skills in statistical analysis. The main objectives of this study were to describe the use of data linkage and artificial intelligence (AI) in routine public health activities and the constraints to linking different data sources. Methods A cross-sectional survey was performed across European countries to explore the current practices applied by national institutes of public health, health information and statistics for innovative use of data sources (i.e., the use of data linkage and/or AI). Results In Europe, the use of data linkage and AI at national institutes of public health, health information and statistics varies. The use data linkage in routine by applying a deterministic method or a combination of two types of linkages (i.e., deterministic & probabilistic) for public health surveillance and research purposes is common in majority of European countries. The use of AI to estimate health indicators is not frequent among these institutes. The complex data regulation laws, lack of human resources, skills and problems with data governance, were reported by European countries as main constraints to routine data linkage for public health surveillance and research. Conclusions Our study showed that the majority of European countries have integrated data linkage in their routine public health activities but only a few use AI. A sustainable national health information system allowing to link different data sources are essential to contribute to public health research. Moreover, it supports evidence-informed health policy making processes with an overview of various aspects affecting population health and may contribute to European pandemic preparedness.

Experiences with paediatric hospital health care: a cross-sectional study among paediatric patients

Abstract Background The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the paediatric inpatient settings emerged recently. Methods The survey took into account various aspects of inpatient healthcare such as admission, hospital staff, safety, food and discharge from hospital. As part of the study, children/parents were able to give praise and suggestions for improvements. We used three different questionnaires adapted to the cognitive abilities of children - a child questionnaire for the age group 9-13 years in paper form, an online adolescent questionnaire for the age group 14-18 years, and an online parent questionnaire for the age group 0 (1 month)-8 years. The questionnaires were cognitively tested and piloted before national rollout. Results The national survey was conducted between September 2023 and March 2024 and included paediatric patients who spent at least one night in an acute paediatric hospital ward. The survey included 25 paediatric wards and totally 1965 questionnaires were valid for analysis. The rough response rate was 17,6 %. The first preliminary results of the qualitative analysis suggest that surveyed paediatric patients and their parents rate highly inpatient health care services received, however they point out also to areas that need improvement such as environmental factors (noise, temperature), food, infrastructure (outdated facilities & equipment) and in some cases attitude of hospital staff. Conclusions National institute of public health carried out the first national survey on paediatric patient reported experience measures in acute hospitals in Slovenia. The results of this survey will be used to improve the quality of inpatient health care services in paediatric wards, as well renew focus on the requirements of European charter of children rights and United Nations Convention on the Rights of the Child. Key messages • National institute of public health carried out the first national survey on paediatric patient reported experience measures in hospitals in Slovenia. • The results of this survey will be used to drive hospital quality improvements.

Monitoring of mosquito breeding sites in the municipality of Cascais, Portugal

Abstract Culex pipiens is the primary West Nile Virus vector in Portugal. Additionally, in 2017, Aedes albopictus, vector of various arboviruses, was detected in Northern Portugal. To mitigate viral transmission risks, effective surveillance is crucial, including monitoring egg, larva, and pupa stages. Located on the west of Lisbon, Cascais implemented a surveillance based on monitoring invasive species at Points of Entry and, complementarily, on detecting and intervening in breeding sites. Active searches for new breeding sites and monitoring those that were already identified are conducted weekly during the peak mosquito season (May to October) and biweekly during the colder season (November to April), following the methodology outlined below: • Upon detection, samples of immature stages are collected for submission to the National Institute of Health (INSA); • Corrective measures are requested to the managing entities of the locations where the sites are found; • Date of action, location, collection point, date of report, and status (pending or intervened) are recorded on a database; • Locations with pending status undergo continuous monitoring. In 2023, 16 artificial breeding sites were identified. These findings resulted from 23 actions conducted across 8 locations. 35 samples of immatures were collected, followed by their submission and notification to the respective managing entities. Recurrent detections were noted in 9 breeding sites. The managing entities implemented measures at 13 of the identified sites, leaving 3 with pending intervention. The identification of breeding sites demands continuous monitoring efforts and requires an effective coordination between the Public Health services and the management entities. Based on the achieved outcomes, it is evident that the implementation of corrective measures has been successful, making a significant contribution to reducing mosquito density. Key messages • Effective surveillance and intervention strategies are crucial in mitigating West Nile Virus and arbovirus transmission risks in Portugal. • Continuous monitoring and coordination between public health services and management entities are key for maintaining effective vector control measures.

The process of developing a framework for code of ethics

Abstract Issue/Problem The World Health Organisation (WHO) and Association of Schools of Public Health in the European Region (ASPHER) roadmap for the professionalisation of the public health workforce has noted ethics as a pillar for professionalisation. It also highlights the need for code of ethics and professional conduct for all public health professionals and institutions. The Global Network for Academic Public Health (GNAPH), in collaboration with EUPHA, ASPHER, and the UK Faculty of Public Health has been working together for a code of ethics. Description of the problem The WHO/ASPHER group asked for a framework to be developed by the expert group as part of the rollout of the professionalisation agenda. The objective of this work was to develop a guide that is applicable to different countries within Europe to develop their own of code of ethics and conduct. A modified Delphi approach to building consensus amongst professionals in ethics included law, academia, and public health professionals. The questions sought to be answered were what and how to develop a framework and what should be included in the guide for creating a public health code of ethics. Results Throughout this method we developed five values, and twelve principles that are essential for the development of a code of ethics through a consensus building exercise. This framework was the first of its kind as part of the professionalisation agenda for different regions. There will be ongoing work piloting this framework in practice with various professional groups and institutions. Lessons Throughout this process, the need and demand across the public health community for ethical education and development of code of ethics was made evident. Collaboration between academics, ethicist, lawyers, and public health professionals and policy makers were key in developing a public health code of ethics. Identifying the challenges with monitoring and evaluating of its implementation a public health code of ethics. Key messages • Ethics, and a code of ethics are an essential component of the professionalisation agenda of the public health workforce. • There is need for continued collaboration and partnership with public health professionals and institutions in enacting its implementation and evaluation.

The Evolution of Health Information Technology for Enhanced Patient-Centric Care in the United States: Data-Driven Descriptive Study.

Health information technology (health IT) has revolutionized health care in the United States through interoperable clinical care data exchange, e-prescribing, electronic public health reporting, and electronic patient access to health information. This study aims to examine progress in health IT adoption and its alignment with the Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP's) mission to enhance health care through data access and exchange. This study leverages data on end users of health IT to capture trends in engagement in interoperable clinical care data exchange (ability to find, send, receive, and integrate information from outside organizations), e-prescribing, electronic public health reporting, and capabilities to enable patient access to electronic health information. Data were primarily sourced from the American Hospital Association Annual Survey IT Supplement (2008 to 2023), Surescripts e-prescribing use data (2008 to 2023), the National Cancer Institute's Health Information National Trends Survey (2014 to 2022), and the National Center for Health Statistics' National Electronic Health Records Survey (2009 to 2023). Since 2009, there has been a 10-fold increase in electronic health record (EHR) use among hospitals and a 5-fold increase among physicians. This enabled the interoperable exchange of electronic health information, e- prescribing, electronic public health data exchange, and the means for patients and their caregivers to access crucial personal health information digitally. As of 2023, 70% of hospitals are interoperable, with many providers integrated within EHR systems. Nearly all pharmacies and 92% of prescribers possess e-prescribing capabilities, an 85%-point increase since 2008. In 2013, 40% of hospitals and one-third of physicians allowed patients to view their online medical records. Patient access has improved, with 97% of hospitals and 65% of physicians possessing EHRs that enable patients to access their online medical records. As of 2022, three-fourths of individuals report being offered access to patient portals, and over half (57%) report engaging with their health information through their patient portal. Electronic public health reporting has also seen an increase, with most hospitals and physicians actively engaged in key reporting types. Federal incentives have contributed to the widespread adoption of EHRs and broad digitization in health care, while efforts to promote interoperability have encouraged collaboration across health care entities. As a result, interoperable clinical care data exchange, e-prescribing, electronic public health reporting, and patient access to health information have grown substantially over the past quarter century and have been shown to improve health care outcomes. However, interoperability hurdles, usability issues, data security concerns, and inequitable patient access persist. Addressing these issues will require collaborative efforts among stakeholders to promote data standardization, implement governance structures, and establish robust health information exchange networks.

The Africa CDC Guidance for Strengthening NCDI-MH Surveillance Systems: The role of HIS assessments

Abstract Deaths due to NCDs, injuries and mental health conditions are expected to at least triple by 2063 in the region of the African Union. Population-based data for NCDI/MH and their determinants remain scarce in many AU MS; therefore, NCDI/MH surveillance is a flagship initiative in the Africa CDC NCDI/MH Strategy. In a survey conducted by Africa CDC and RKI in 2022 on the impact of COVID-19 on NCDI/MH in 10 AU MS, countries signaled the need for a continental guidance document. In 2023, Africa CDC and RKI performed desk reviews and facilitated peer-to-peer multi-country HIS assessment workshops, based on modified WHO and IANPHI tools. The first workshop took place in Zambia with experts from Botswana, Democratic Republic of Congo/DRC, Kenya and Zambia. The second workshop was hosted in Ghana and included DRC, Ghana, Morocco, Nigeria, Senegal and Sierra Leone. Participants came i.a. from ministries of health, national public health institutes or academia. The process included a virtual introductory meeting as well as half-day training sessions at the physical meeting for participants to familiarize themselves with the tools. Peer-to-peer assessment sessions took place on days 2 and 3. Day 4 was reserved for site visits to (public) health institutions of the hosting countries. On day 5, participants presented their findings to the plenary, which included high-level representations from host countries. The combined results from the survey, desk reviews and workshops informed the development of the continental Africa CDC Guidance for strengthening surveillance for NCDI/MH, launched at the 3rd Conference on Public Health in Africa. In four chapters, the Guidance covers recommendations on indicators, data sources and data types; surveillance system capacities; surveillance integration with existing systems; and data use. Implementation of the Guidance, including development of core health indicators, has been initiated by Africa CDC in 2024.

Beyond the like button: how european public health institutions use social media in 2024?

Abstract Background In 2024, 62% of world’s population actively use social media (SM), with people aged 16 to 64 spending an average of 2 hours and 23 minutes daily across 6,7 SM platforms - most people use Facebook but spend more time on TikTok. While these platforms are essential for disseminating public health information, this study aims to explore their use by public health institutions in European countries. Methods We analysed the SM engagement of 32 health institutions recognized by ECDC across 29 European countries. Data collected focused on Facebook, Instagram, X, LinkedIn, TikTok, and YouTube, including SM presence on official websites, number of followers, and posts from January to March 2024. Additional data included followers per 100.000 residents, with population statistics from Worldometer and SM usage from DataReportal. Results Most institutions (30) are active on SM, particularly on Facebook (28), X (23), Instagram (22), YouTube (22), and LinkedIn (21). Spain and Slovenia’s institutions are active on all analysed platforms, while only four institutions are on TikTok. The most used platforms were Facebook and X, with averages of 59,7 and 58,1 publications, respectively. There are disparities in engagement across platforms, with Facebook having the highest average followers (177.241) and TikTok the lowest (1.961) among all platforms. Notably, the most followed platform within ten institutions did not match country’s most popular platform, indicating a misalignment in SM platforms’ strategy. There was an average of 2.756 followers per 100.000 residents among analysed countries. Conclusions Public health institutions in Europe are actively using SM platforms to disseminate health information, mainly Facebook, X, LinkedIn, and Instagram. Despite high engagement on Facebook and X, there is a need for strategic alignment with audience’s preferences, particularly in underutilized platforms like TikTok, to optimize the effectiveness of public health communication. Key messages • The majority of European public health institutions actively use social media, with Facebook leading; however, newer platforms like TikTok are underutilized. • There is a need for public health institutions to realign their social media strategies to better match the platforms preferred by their audiences to maximize the effectiveness of their communication.

The Relationship between Job Satisfaction and Work Performance in Health Institutions

The Relationship between Job Satisfaction and Work Performance in Health Institutions

10.A. Round table: Transforming public health systems at large scale: no pain, no gain

Abstract The COVID-19 pandemic, acceleration of climate change, and geopolitical turmoil have triggered discussions about how public health systems in Europe need to transform to be adequately equipped for the so-called “permacrisis”. The challenges to policy makers, health institutions and health services have become so multifaceted, that single solutions from the health sector alone no longer work. Yet, despite the complexity, countries seek to get its own house in order whilst building on inter-sectoral and European approaches in parallel. Germany, Ireland, and Ukraine have all embarked upon ambitious public health services and institutional reforms, leading to transformative change in public health systems. WHO has been accompanying these reforms. The workshop will provide a platform to draw insights and lessons on transforming public health systems from all three countries, although their population size, their socioeconomic and political situation and their public health system design is so different. As the smallest of the three countries in population, Ireland created coherence and is aligning public health actors within “Healthy Ireland” and the Sláintecaire and the Crowe Horwath public health reforms. Germany’s “Pact for the Public Health Services” has been one of the greatest public health investment programs in Europe that was initiated following lessons from the COVID-19 pandemic. And Ukraine has undertaken important legal steps to adopt a Public Health System Law, in the middle of a war of aggression on its territory. The workshop will exhibit the process of large-scale public health system transformation in each of the three countries. The purpose is to identify the enablers that make large scale system transformation possible and addressing some of the pains and gains. The workshop will have three parts. Part one consists of three presentations on large scale system reforms from each of the participating countries. Part two consists of a moderated Q&A session. Part three will focus on the synthesis of enablers for large scale public health system reforms through interaction with the workshop participants, using a digital white board. Key messages • Disruptive times can create enabling conditions for large scale public health system transformation. • Designing and implementing large scale public health system reforms is complex, requiring passion, resilience, and collaborative leadership.

11.P. Scientific session: Behavioural Science of Emergency Preparedness across Europe

Abstract The COVID-19 pandemic highlighted the critical role of human behaviour in times of crisis. However, it also revealed that the behavioural sciences were not optimally prepared to provide actionable insights to policy makers to support preventive and coping behaviours in a crisis context. To ensure that the behavioural sciences can provide timely and effective advice to policy makers during future emergencies, it is key to act before a crisis occurs. The current workshop chaired by the Behavioural and Cultural Insights Unit of the WHO, will offer five perspectives to explore how behavioural science as a discipline is being applied to our understanding of pandemic and emergency preparedness and what concrete actions can and are already being taken now. Following five short presentations, a discussion with the panel and the audience will take place. The Dutch National Institute of Public Health and the Environment (RIVM) will start by presenting their approach toward embedding behavioural science of pandemic preparedness: the organisation of a national stakeholder network, the development of a conceptual framework, and3) development of a quantitative survey monitor for individual level behaviour. monitoring pandemic preparedness. f The Spanish Carlos III Health Institute and Slovenian Public Health institute will present insights about operationalising this monitor in their given context. They will present results of the first two rounds of this monitor on behalf of the four European member states, focusing on comparative insights on perceptions and states of preparedness, vaccination, citizen wellbeing and resilience with respect to their context. Next, the Competence Centre on Behavioural Insights of the European Commission will present an experimental approach toward preparedness. They will present results based on a scenario study, focused on understanding behaviours in the broader context of pandemic and disaster preparedness. The last two presentations will reflect on qualitative approaches. The Behavioural and Cultural Insights Unit of the WHO will present their qualitative study on health-service access, needs and behaviours of Ukrainian refugees in neighbouring countries, and reflect on operating under emergency constraints. In the final presentation the RIVM will present their findings of qualitative methods to study perceived emergency readiness. In particular, their study focuses on what citizens understand by pandemic preparedness, and to what extent they perceive their government as prepared for a future pandemic. Overall, the workshop aims to equip participants with a comprehensive understanding of the importance of behavioural science in pandemic and disaster preparedness and inspire collaborative action towards building resilient and effective strategies for future crises. Key messages • The workshop underlines the importance of behavioural science in preventing and responding to infectious disease outbreaks. • Participants learn how behavioural sciences can already be applied now to prepare citizens and organisations for future pandemics and crises.