Child Health Research Articles

Born in Ethiopia

Abstract Background Goal 3 of the United Nation 2030 Agenda states that we want to ensure health and well-being for all. This is even more true for countries in the IV World. The aim of our study is to investigate the timing of childbirth in Ethiopia. Methods The stages of our ethnographic study include: choosing the study topic and location, participating in group life, collecting and analysing data. The field experience, led by a midwife, took place from September 2023 to October 2023 in Ethiopia, within the Saint Luke Catholic Hospital in Wolisso. Results The instruments that the midwives have at their disposal are few and obsolete: the most is Pinard’s stethoscope. The mothers are all very young: the youngest woman was fourteen years old while the oldest woman was thirty-eight years old. As for parity, the fertility rate is around 4.6 live births per woman. Women’s family members take care of them in all aspects of care. Pregnant and new mothers receive support from their attendants, an all-female network. Pregnancy monitoring is almost non-existent. There is no prenatal diagnosis. In 2022, St. Luke’s hospital saw a 20% caesarean section rate, an increase from the previous two years. Poverty and the lack of government facilities that can support a problem child are two of the reasons why many of these children are abandoned. In terms of maternal and child health, mortality indicators are still too high for mothers and children. There are 353 mothers dying per 100,000 live births and 41 babies dying per 1,000 live births. Conclusions The biomedical model exported from the Western world, as shown for example by the increase in caesarean sections, has led to a slow but progressive hospitalisation of childbirth in the search for safety from maternal and neonatal mortality. Key messages • Poverty, malnutrition, lack of sanitation and drinking water, as well as early pregnancies and high parity remain among the leading causes of mortality in Ethiopia. • The biomedical model exported from the Western world has led to a slow but progressive hospitalisation of childbirth in the search for safety.

Agenda 2030 for sustainable development in Portuguese Speaking Countries, indicators inequalities

Abstract Background Achieving the SDG Sustainable Development goals represents a major global challenge. The Community of Portuguese Speaking Countries (CPLP) is made up of countries: Angola, Cape Verde, Guinea-Bissau, Equatorial Guinea, Mozambique, São Tomé and Príncipe, Brazil, Portugal, and East Timor. Studies on SDG indicators are little studied among these countries. The study analyzes SDG health indicators in the Community of Portuguese Speaking Countries (CPLP) and their projections for 2030, and investigates the correlation between the countries’ level of development and the performance of these indicators. Methods Ecological epidemiological study. Estimates from the Global Burden of Disease (GBD) study between 1990 and 2021 were analyzed, referring to fifteen indicators: universal health coverage, sanitation, smoking, maternal and child health, vaccination coverage and communicable diseases. The GBD study generated projections by calculating the annual change since 1990 for each country and year and then calculating the weighted annualized rate of change. The correlation between the Sociodemographic Index (SDI) and the SDG indicators was investigated using the Spearman test, at a significance level of 5%. Results The best performances of the analyzed indicators were seen for Portugal, followed by Brazil, Cape Verde and São Tomé and Príncipe. In other countries, high rates of infectious diseases, maternal and childhood mortality, malnutrition, low vaccination coverage and sanitation were observed. There was a negative correlation between the SDI and the indicators of childhood mortality rate (R=-0.82; p < 0.05), malnutrition (R=-0.7; p < 0.05), incidence of tuberculosis (R =-0.73; p < 0.05) and positive between SDI and sewage coverage (R=-0.83; p < 0.05). Conclusions The CPLP presents internal differences regarding the health indicators analyzed, making it essential to advance cooperation between countries to achieve the SDG targets in 2030. Key messages • There are great inequalities between SDG indicators in Portuguese-speaking countries. • It is important to advance technical cooperation between countries to formulate solutions and leave no one behind.

Maternal health in conflict-affected settings: a case study from a frozen conflict zone

Abstract Background Reproductive, maternal, newborn and child health are negatively impacted in conflict-affected settings, and may be acutely affected in frozen conflicts due to fragile health systems and uncertain geopolitical contexts. To better understand maternal health in a frozen conflict zone, we examined maternal health outcomes in Nagorno-Karabakh during a ceasefire period prior to the forced displacement of the entire population. Methods Multistage cluster sampling was used to sample 1023 households in Nagorno-Karabakh during the summer of 2022. From each household, one woman, age 18 to 49, participated in an interviewer-administered survey. Maternal health outcomes were assessed among all married women who had ever given birth. Women with at least one child under 5 years were also asked about their most recent pregnancy. Results Among all married women, 85.5% had ever given birth, 19.0% ever had a miscarriage, and 2.8% ever had a stillbirth. Of the 299 women with at least one child under 5, 97.7% received antenatal care, of which 90.4% had at least 4 visits. Over half experienced toxicosis (51.8%), 16.4% high blood pressure, 13.0% anemia, and 6.4% hemorrhage during their most recent pregnancy. The most common delivery complications were uterine scarring (19.7%), breached birth (7.0%), prolonged labor (6.4%) and hemorrhage (5.7%). Age was found to be a significant factor, with the odds of toxicosis (p = 0.039) and breached birth (p = 0.009) decreasing, yet the odds of miscarriage (p = 0.001) and hypertension (p = 0.007) increasing with age. Conclusions Almost all women reported adequate antenatal care with birth outcomes comparable to global statistics, demonstrating the ability of Nagorno-Karabakh to provide sufficient maternal healthcare while in a frozen conflict. Fortifying and ensuring access to maternal and reproductive healthcare, particularly antenatal care, is vital for ensuring the health and wellbeing of women and children in conflict-affected settings. Key messages • Women in Nagorno-Karabakh received antenatal care and experienced birth outcomes similar to global rates, demonstrating the value of access to reproductive healthcare in conflict-affected settings. • Future studies should examine the impact of forced displacement on the women of Nagorno-Karabakh to better understand the effect of conflict on reproductive and maternal health.

Implications of Big Data Analytics, AI, Machine Learning, and Deep Learning in the Health Care System of Bangladesh: Scoping Review.

The rapid advancement of digital technologies, particularly in big data analytics (BDA), artificial intelligence (AI), machine learning (ML), and deep learning (DL), is reshaping the global health care system, including in Bangladesh. The increased adoption of these technologies in health care delivery within Bangladesh has sparked their integration into health care and public health research, resulting in a noticeable surge in related studies. However, a critical gap exists, as there is a lack of comprehensive evidence regarding the research landscape; regulatory challenges; use cases; and the application and adoption of BDA, AI, ML, and DL in the health care system of Bangladesh. This gap impedes the attainment of optimal results. As Bangladesh is a leading implementer of digital technologies, bridging this gap is urgent for the effective use of these advancing technologies. This scoping review aims to collate (1) the existing research in Bangladesh's health care system, using the aforementioned technologies and synthesizing their findings, and (2) the limitations faced by researchers in integrating the aforementioned technologies into health care research. MEDLINE (via PubMed), IEEE Xplore, Scopus, and Embase databases were searched to identify published research articles between January 1, 2000, and September 10, 2023, meeting the following inclusion criteria: (1) any study using any of the BDA, AI, ML, and DL technologies and health care and public health datasets for predicting health issues and forecasting any kind of outbreak; (2) studies primarily focusing on health care and public health issues in Bangladesh; and (3) original research articles published in peer-reviewed journals and conference proceedings written in English. With the initial search, we identified 1653 studies. Following the inclusion and exclusion criteria and full-text review, 4.66% (77/1653) of the articles were finally included in this review. There was a substantial increase in studies over the last 5 years (2017-2023). Among the 77 studies, the majority (n=65, 84%) used ML models. A smaller proportion of studies incorporated AI (4/77, 5%), DL (7/77, 9%), and BDA (1/77, 1%) technologies. Among the reviewed articles, 52% (40/77) relied on primary data, while the remaining 48% (37/77) used secondary data. The primary research areas of focus were infectious diseases (15/77, 19%), noncommunicable diseases (23/77, 30%), child health (11/77, 14%), and mental health (9/77, 12%). This scoping review highlights remarkable progress in leveraging BDA, AI, ML, and DL within Bangladesh's health care system. The observed surge in studies over the last 5 years underscores the increasing significance of AI and related technologies in health care research. Notably, most (65/77, 84%) studies focused on ML models, unveiling opportunities for advancements in predictive modeling. This review encapsulates the current state of technological integration and propels us into a promising era for the future of digital Bangladesh.

Urban Green Spaces on Maternal Sleep Quality One Year Postpartum Amid COVID-19 Alert Level Changes

Abstract Background Benefits of green spaces (GS) on sleep quality were found, particularly for mothers, which, in turn, contributed to maternal health and offspring development. However, the COVID-19 pandemic imposed restrictions on environmental access, potentially altering the influence of urban GS on sleep quality. This study aims to explore the impact of urban GS on maternal sleep quality one year postpartum during the pandemic. Methods Participants were drawn from the Longitudinal Examination across Prenatal and Postpartum Health in Taiwan study, tracking individuals from early pregnancy across five hospitals in Taipei since 2011. We utilized data spanning from 2019 to 2024, with May 2021 (the initial soft lockdown due to community spread) serving as the cutoff point to delineate early and late pandemic stages. Self-reported sleep quality one year postpartum was assessed using the Pittsburgh Sleep Quality Index. Residential GS was evaluated using the Normalized Difference Vegetation Index (NDVI) within various radii (250m to 2000m). Multiple logistic regression was utilized. Results From the 311 participants, in the early stage of the pandemic, an increase of 0.1 units in NDVI within a 250m radius during both prenatal and postnatal periods (0-12 months) was associated with improved maternal sleep quality (OR = 1.57; 95% CI = 1.08, 2.32, and OR = 1.58; 95% CI = 1.07, 2.30) after adjustments. The impact diminished as the radius increased. Additionally, no significant association was found during the late stage of the pandemic across any of the studied radii. Conclusions The findings suggest a positive correlation between proximity to urban GS and maternal sleep quality during the early stages of the pandemic, with more significant benefits observed at shorter distances, likely due to restricted movement and access. These results underscore the importance of proximity in urban planning and environmental improvement initiatives aimed at enhancing maternal and child health. Key messages • Urban green spaces significantly enhance maternal sleep quality one year postpartum in the early stages of the pandemic, highlighting the importance of proximity for health benefits. • As the radius of green spaces decreased, their positive impact on maternal sleep quality during the early pandemic intensified, underscoring the need for adaptive urban planning strategies.

Protecting Young Lives: A Systematic Review of the Impact of Secondhand Smoke Exposure and Legislative Measures on Children's Health

Protecting Young Lives: A Systematic Review of the Impact of Secondhand Smoke Exposure and Legislative Measures on Children's Health

What long-term health outcomes can we anticipate for children who have been in social care?

Abstract The concept of cumulative disadvantage suggests that setbacks in one area of life not only lead to further challenges within that domain but also increase vulnerability to adversities across different domains, as highlighted in life course studies. In the context of children with a history of childhood social care (CSC) experience, research consistently shows poorer long-term health outcomes compared to peers without such experiences. This disparity persists into middle age and can affect subsequent generations, underscoring the enduring impact of early-life adversity. Dr Viviane S. Straatmann, a social epidemiologist based in Sweden and enriched by her experience in studying the health and social life of vulnerable children in diverse international settings, will offer insights from life-course and intergenerational epidemiological studies. She will explore the intricate web of disadvantages preceding children’s entry into social care, shedding light on the complex interplay between early-life adversity, cumulative disadvantage, and long-term health outcomes. Participants will engage in reflective dialogue on pertinent questions, such as how cumulative disadvantage informs interventions for children with CSC backgrounds, the potential mechanisms underlying the contribution of early-life adversities to long-term health disparities, and the ways intergenerational studies can inform strategies for breaking the cycle of disadvantage.

Breastfeeding knowledge, attitudes and practices of HIV-positive women in Africa, a systematic review

Abstract Background Breastfeeding (BF) is essential to ensure the health and survival of children, especially in regions where diarrhoea, pneumonia and malnutrition are common causes of child mortality. The WHO currently recommends, along with antiretroviral treatment, exclusive BF (EBF) for the first six months and mixed BF for the next six months and extending it to 24 months. In sub-Saharan Africa, more than one million HIV-positive women face the challenge of infant feeding due to limited access to treatment and safe water. The aim of this study was to understand the knowledge, attitudes, and practices of HIV-positive mothers in Africa to provide evidence for public health strategies. Methods We conducted a systematic review of studies on Knowledge, Attitudes and Practices of BF among HIV-exposed children in African countries, following the principles of the PRISMA statement and identified by searching major databases of records published between 2013 and 2023. Results Of the 498 articles identified, 21 met the inclusion criteria. 70% of the studies were conducted in Ethiopia, South Africa, and Kenya. 95% of the studies were conducted in health care facilities. Mothers showed good knowledge, attitudes and practices regarding EBF of HIV-exposed children, but low knowledge and fear of continuing to practice BF later on. The HIV-positive mothers mentions a range of recommendations received from health workers, identified as their main source of information. Stigma against mothers who practice EBF was found. The primary reason for early cessation of BF was due to work. Conclusions Knowledge, attitudes, and practices of the infant feeding currently recommended by WHO for HIV-positive mothers was weak. There is little evidence of what happens in other African countries and in women with limited access to the health system. Public health policies need to be strengthened to ensure that health workers are trained in the current guidelines to improve HIV-positive women’s BF. Key messages • HIV-positive mothers are afraid to continue breastfeeding their babies after 6 months. • More studies about the breastfeeding practices of children of HIV-positive mothers with limited access to health services are needed.

Long-term effects of unintended pregnancies carried to term on mothers and children

Abstract Background Research on psychological effects of unintended pregnancies that are carried to term presents mixed results, and evidence on long-term associations is scarce. The aim of the current study was to examine effects of unintended pregnancies carried to term on both mothers and children, up to 16 years postpartum. Methods This study is based on the Dutch population-based birth cohort study ‘Amsterdam Born Children and their Development’ (ABCD-study), which included pregnant people in 2003 (n = 7784) and is still following these mothers and their children. Structural Equation Models were analyzed per time-point, examining associations between unintended pregnancy and maternal psychosocial distress, and children’s internalizing- and externalizing problems, while controlling for co-occurring risks. Further, mediating effects via maternal mental health and bonding on children were assessed. Results Around 5 years postpartum, pregnancy mistiming was positively associated to maternal psychological distress. Antenatal psychological distress was a much stronger predictor of maternal psychological distress than unintended pregnancy. Pregnancy mistiming was a significant predictor of internalizing and externalizing problems and unwanted pregnancy of internalizing problems in the children from these pregnancies, around 5 years postpartum. These associations were mostly mediated by maternal mental health and poorer maternal bonding. All associations were no longer present at 12 and 16 years postpartum. Conclusions Unintended pregnancies often coincide with maternal mental health problems, and results showed that associations between unintended pregnancy and both mother’s and children’s psychosocial problems are strongly influenced by maternal mental health. Therefore it is important to improve maternal mental health for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy. Key messages • Carrying an unintended pregnancy to term impacts psychological health in both mothers and their children up to 5 years but no longer at 12 or 16 years postpartum. • The effects of unintended pregnancy on psychological health in mothers and children are mostly explained by maternal mental health and bonding, so the focus should be on improving these.

Electromagnetic fields exposure and neuropsychological effects in young people

Abstract Background In recent years, there has been a large increase in the use of communication/connected devices and technologies. This raises a question about radiofrequency electromagnetic fields (RF-EMF) exposure levels and neuropsychological effects of RF-EMF in young people. The aim of this study was to assess the pattern of use of communication/connected devices and technologies and its impact on cognition and mental health of early school age children in Poland. Methods The study population consists of 293 children from Polish Mother and Child Cohort (REPRO_PL). The study was based on questionnaire data covering type and duration of usage of communication/connected devices and technologies by mothers during pregnancy and children at age of 7 years. The environmental exposure to RF-EMF was also taken into account. Based on such data RF-EMF exposure was assessed. Child emotional and behavioral assessment was done by Strengths and Difficulties Questionnaire whereas IQ and psychomotor development of children was performed by psychologist using Intelligence and Development Scales. Results About 75% of young people used smartphones (2% for voice calls and 7% for Internet browsing at least one hour per day). Tablet or laptop use was declared by 59% and 56% of respondents, respectively. More than 10% declared that they use these devices at least one hour a day. The main factors determining the use of new technology devices were parental age and education (p < 0.05) and the age at which youth started school education (p = 0.06). In multivariable regression model higher level of RF-EMF was associated with total difficulties and emotional problems (p < 0.05). Conclusions This study presents the pattern of use of new technology devices by early school age children in Poland and the association between the exposure to RF-EMF and child mental health. Key messages • The use of communication/connected devices and technologies is common among young people in Poland. • The exposure to RF-EMF can increase mental health problems among young people.

5.Y.1. Refugees and mental health

Abstract Research suggests an elevated risk of mental health conditions (depression, posttraumatic stress disorder, anxiety) among refugees, due to exposure to trauma, displacement, and the challenges of adapting to new environments. Children and adolescents with refugee background face additional challenges, including family disruptions, education interruptions, and uncertain futures. However, the data are heterogeneous and more detailed data are needed. To address this gap, we present data on refugee’s mental health and resilience. First, data on resilience and mental health from Germany are presented. These data are adjusted for demographics and suggest that in case data are adjusted to the living situation in the host country the migrant status is less relevant. The second study presents the mental health of refugee adolescents and children in Greece. The third study presents results based on a Portuguese prospective cohort study Perinatal Health in Migrants: Barriers, Incentives, and Outcomes (baMBINO). This study investigates postpartum depression among refugee women in Portugal highlighting the need for access to care. Last, a systematic review and meta-analysis provides data on depression, anxiety and stress of 62,522 refugees from more than 30 countries. This data suggests that life experiences are critical for refugees’ mental health. Based on the presentations the audience will be engaged in discussion on how to better early prevent mental health conditions in refugees. Key messages • Mental health of refugees is a Public Health challenge. • Pre- and post migration experiences impact refugees and migrants mental health conditions.

THE COMORBIDITY OF DEPRESSION AND PTSD IN SEXUALLY ABUSED CHILDREN: A SYSTEMATIC REVIEW

<p><strong>Background and Purpose: </strong>In recent years, the incidence of child sexual abuse (CSA) has significantly increased, particularly among younger children. Such traumatic experiences can have profound and long-lasting effects on a child's mental health, often leading to an increased risk of developing disorders such as depression and post-traumatic stress disorder (PTSD). This study aims to investigate the comorbidity of depression and PTSD in children who have experienced sexual abuse. The primary objective is to examine whether these two disorders frequently coexist in children subjected to CSA.<strong> Method: </strong>This study follows the PRISMA 2020 guidelines and employs a systematic review methodology. No statistical analysis methods were utilized. The research sample also included adolescents, providing a broader understanding of the effects of CSA across different age groups.<strong> Results: </strong>The findings revealed a strong correlation between child sexual abuse and the comorbidity of depression and PTSD, indicating that children who have been sexually abused are at a heightened risk of developing both disorders simultaneously.<strong> Conclusion: </strong>Children who have experienced sexual abuse are highly likely to develop both depression and PTSD. However, further research is necessary to deepen our understanding of this comorbidity and to explore effective interventions.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0791/a.php" alt="Hit counter" /></p>

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

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

Paid Family and Medical Leave: Policy Statement.

Paid family and medical leave (PFML) helps parents balance the competing obligations of work, personal illness, and family. PFML is needed when adding a new member of the family or when a family member or individual becomes acutely or chronically ill. The United States lacks universally available PFML, despite the benefits for child and family health and well-being. Universally available PFML is a key component of improving the health of children and families and is critically needed in the United States.

Screening for congenital Chagas disease in a non-endemic area: a cost-effectiveness analysis

Abstract Background Due to climate changes, immigration, and globalization, Chagas Disease (CD) also afflicts nations without vector transmission. In Europe, congenital CD (cCD) is a significant public health issue, perpetuating the disease: it is crucial to perform CD screening in pregnant women at risk, as the treatment of infants is effective in eradicating the infection. Only a few European regions have a definite algorithm for diagnosing cCD, but no official guidance has been published at the national or European level. To support policymakers, this study aims to outline a cost-effectiveness analysis of CD screening in non-endemic areas, such as Italy, in pregnant women born or arriving from endemic countries and in their newborns. Methods To measure the economic impact of cCD screening, a decision tree model will be used to compare the test option (screening, diagnosis, treatment, follow-up) with no test option (no screening, progression of disease). Model parameters will be taken from relevant scientific literature. The primary outcome will be the Incremental Cost-Effectiveness Ratio (ICER) between the two options. Sensitivity analyses will be conducted to determine how changes in prevalence, transmission rate, screening adherence, and treatment adherence may affect the ICER. Results We expect the ‘test’ option to be cost-effective even with significant reductions in prevalence, transmission rate, adherence to screening or treatment. Threshold levels of these variables will allow to critically extend the results to areas with reduced immigration, patchy distribution of migrants at risk, health logistical limitations, and limited access to care for immigrants. Conclusions Our findings can help policymakers implement official screening programs and diagnostic algorithms for cCD in Italy and other non-endemic countries. This contributes to SDG 3 by combating the spread and burden of neglected tropical diseases and contributing to maternal, child, and migrant health. Key messages • Screening for congenital Chagas Disease in a non-endemic area may be cost-effective and cost-saving. • Study findings could provide useful information for health policymakers to combat Chagas Disease in Europe.

The changing association between pandemic-related stressors and child and adolescent mental health during the waning phase of the COVID-19 pandemic

This study examined the relation between pandemic-related stressors and mental health among young people (YP) in India during two time points in the waning phase of the pandemic. We use data from two cross-sectional waves of over 20,000 YP aged 5–19 in February 2022, during the peak of the Omicron wave, and October 2022, during a reduction in infections and easing of restrictions. COVID illness/death in the family’s social network, current lockdown stringency, and significant change in household income were examined in relation to adult respondents’ reports of YP internalizing symptoms. Internalizing symptoms declined slightly from February to October 2022. COVID-19 illness/death in the family’s network was generally associated with more internalizing symptoms. Higher lockdown stringency was associated with lower levels of internalizing symptoms. YP in households with increases in income tended to have more internalizing symptoms. Many associations were driven by older adolescents and were stronger during the earlier (Feb-2022) than later (Oct-2022) data collection time-points. The findings illustrate the importance of anchoring results within a study’s specific geographic context, including concurrent events during the study period. Importantly, findings that may initially seem counterintuitive ultimately illuminate the dynamic and complex processes underlying child and adolescent mental health.

Data-driven insights using decision trees and K-nearest neighbors (KNN) for improving child and women's health

Data-driven insights using decision trees and K-nearest neighbors (KNN) for improving child and women's health

11.K. Scientific session: Roots of public health: school health literacy to enhance population health outcomes in Europe

Abstract This workshop will present empirical results from three representative studies on health literacy and digital health literacy conducted in primary and secondary schools in Wales and Germany: (1) Digital Health Literacy in Schools, (2), HLCA HL-Kids, (3) WHO HBSC Wales. While research on child and adolescent health literacy has gained traction in the past decade, only a few studies focus on health literacy in schools. While the European Commission and WHO, as well as most European governments, highlight the importance of schools to support children’s health literacy, schools remain neglected as a research context. With only little evidence available, it is difficult to derive strategies and programs to promote health literacy in schools. We aim to provide practical novel knowledge and contribute to closing the school health literacy gap that is prevalent in Europe. In turn, this will also contribute to European public health development and population health outcomes. Levels of health literacy in child and adolescent populations across European countries and age groups are alarmingly low, making low health literacy a severe risk factor for health outcomes. Low health literacy is associated with worse health conditions and unhealthy behaviours, and in turn, impacts school attainment and educational outcomes. Evidence suggests that health literacy acts as a determinant of health and itself is influenced by other social determinants of health, such as education, intertwining health and education. All studies conducted so far provide evidence that low health literacy follows a social gradient, with children from less affluent families being more likely to have lower health literacy, widening preexisting health inequities observed in almost all health domains within Europe. While effective interventions on the individual and system levels are needed to enhance health literacy, implementation and evaluation research concerning children’s health literacy is rare. Workshop objectives The aim of this workshop is to present findings from three representative studies on health literacy and digital health literacy in primary and secondary schools: (i) The 1st speaker will introduce a study on health literacy and health behaviours of children aged 8-11 (ii) The 2nd speaker will discuss the influence of living environments on health literacy in 4th-grader school kids (iii) The 3rd presentation will have its focus on navigating the infodemic through digital health literacy in adolescent students (iv) The 4th speaker will show links between digital health literacy and health behaviour in adolescent students The format of this workshop will be 4x10-minute presentations followed by a 20-minute panel discussion with the audience, reflecting the relevance of the results to public health research, practice, and policy. The chairs will provide a brief introduction to the concept and moderate the presentations and panel discussion. Key messages • Our results show that health literacy should be addressed as early as in primary schools and that the places, households, and environments children grow up are critical social determinants of health. • Digital health literacy has proven to be a valid learning topic in secondary schools and is linked to digital and media literacy, allowing us to define it as a targeted curriculum item.

Digital health literacy and health behaviour of schoolchildren: A representative study in Germany

Abstract Background Health information is increasingly available and plays a crucial role in making health decisions and developing healthy behaviours. Digital health literacy (DHL) enables one to distinguish between true and false health information online. Studies have found higher health literacy to be associated with healthier behaviour. However, there is no research on child DHL and health behaviour. This study aims to investigate the relationship between DHL and selected health behaviour of schoolchildren in Germany. Methods This cross-sectional study is based on a representative sample of (N = 1448) secondary schoolchildren (aged 9-18 years) in Germany across all 16 federal states and school forms. DHL was assessed using the child and adolescent version of the Digital Health Literacy Instrument developed and pretested in this study. Selected health behaviours (eating, teeth brushing, smoking, and alcohol consumption) were measured using self-report scales. Chi-square tests were conducted to measure differences between DHL and health behaviour. Results Associations were found between DHL and all eating behaviours (fruits; vegetables and salad; whole-grain products; other animal-based products; chocolate or other sweets; sugary drinks; fast food), except for eating meat and sausages. Schoolchildren with higher levels of DHL reported more often about regular consumption of fruits and vegetables (X2 (2)=17.06, p = <.001). salads (X2 (2)=56.54 p = <.001) and whole-grain-products (X2 (2)=98.81 p = <.001). While DHL was associated with teeth brushing (X2 (2)=44.46, p = <.001), no differences were observed for smoking (X2 (2)=1.93, p=.381) and drinking alcohol within the last 30 days (X2 (2)=2.62, p=.270). Conclusions These findings indicate that most health behaviours of schoolchildren may benefit from enhancing DHL in schools. Programs should build around these topics. However, more research is needed to investigate associations between DHL and health behaviours comprehensively.

Healthy Community Healthy Mind: An Evidence-based Culturally Sensitive Aboriginal Child and Adolescent Mental Health Program

Healthy Community Healthy Mind: An Evidence-based Culturally Sensitive Aboriginal Child and Adolescent Mental Health Program