Health-related Goals Research Articles

Using NLP to ascertain changes in the fast-fashion industry based on UN sustainable development goals

The fast fashion industry largely contributes to pollution and global emissions, which can be mitigated through strengthening policy. Policy change requires knowledge of the changing conditions of the fast fashion industry that can be evaluated through the sustainability reports published by fast fashion companies. However, due to the reports’ variations in details and lengths, it is difficult to find trends that promote the United Nations Sustainable Development Goals (UN SDGs), such as “Responsible Consumption and Production” and “Climate Action”. Therefore, we ask if fast fashion companies have changed their sustainability focuses in terms of the UN SDGs from 2018–2019 to 2020–2021. We hypothesized that the later years would showcase higher similarities towards the UN health-related goals due to COVID-19. After checking the reports’ similarities against the keywords of each UN SDG, we found that the similarity percentage of the “Good Health and Well-Being” goal had more than doubled from 2018–2019 to 2020–2021. This is important because it shows how the industry reacts to global changes like a pandemic. We also noticed that the three most frequently addressed goals were the same for both time periods. Specifically, the most dominant topic was “Responsible Consumption and Production,” with a similarity score of 15.54% for 2018–2019 and 14.1% for 2020–2021. This suggests that the industry may have some consistent focuses on sustainability over time. With these insights, policymakers can better address what changes the fast fashion industry needs to make.

Exploring exercise adherence and quality of life among veteran, novice, and dropout trainees.

The purpose of this study was to identify and reveal the different contexts, variables, and factors that may influence adherence to physical activity among veteran, novice, and dropout trainees, such as the frequency of the weekly training units, the trainees preferred type of exercise, the purpose of the physical activity, and the relationship between support and supervision by fitness instructors and professionals. This study also examined the relationships between trainees, seniority and the strength of the habit and adherence to physical activity, the effects of personal variables such as age and gender on adherence to physical activity, and how the seniority and adherence of trainees may affect their quality of life. A total of 460 participants drawn from the broader Israeli exercise community, which encompasses a diverse range of individuals within the general adult population, were engaged in this study. These participants included seasoned exercisers, individuals who had recently initiated exercise routines, and those who had previously engaged in physical activity. Each participant completed a comprehensive set of questionnaires, including the Self-Report Habit Index, the Exercise Adherence Rating Scale, and the World Health Organization (WHO) Quality of Life Scale. In addition to the questionnaire responses, demographic data and inquiries concerning their physical activity were also collected. The results show that the average frequency of the weekly training units of veteran trainees was significantly higher than that of novice trainees: 3.95 and 2.93, respectively (p < 0.0001). We found no significant differences between novice and veteran trainees regarding their training goal preferences (p = 0.07). Veteran trainees who had been in training for more than a year appeared to have higher self-efficacy since 31.16% reported receiving no supervision compared to 16.67% among novice trainees. In addition, people over 45 appear to have more health-related goals compared to their younger counterparts (p < 0.001). The quality of life scores of the trainees was related to their seniority in physical training, but only by a small magnitude (R2 = 0.06), p < .001). Those who trained in resistance training showed the greatest rate of adherence in relation to flexibility and aerobic training (p < 0.001), and women preferred more body toning and had more weight loss goals than men (p < 0.001). The results indicate that there are central and important factors that may affect adherence to physical activity, and that all these aspects must be taken into account when planning a training program or when there is a desire to maintain or increase adherence to physical activity. The research findings indicate that the main factors that can influence adherence to physical activity are identifying and increasing the trainee's self-efficacy, maintaining weekly training units with sufficient frequency to form a habit and incorporating resistance training into the training regime, as resistance training has shown high levels of adherence. Moreover, it seems that people with different degrees of experience in physical training have distinct and varied training goals, and there is no one goal that fits all. In addition, specific factors such as age and gender must also be taken into account, because the age and gender of the trainees may significantly affect the goals of physical training.

Elements of management and leadership strengthening in health systems: a qualitative study from Iran

PurposeThe importance of management capacity in the health sector has been increasingly recognized. The World Health Organization (WHO) (2008) has claimed that limited “management capacity” in low-income countries is one of the main obstacles toward achieving health-related goals. The aim of this study is to answer the research question: “What are the elements of management and leadership capacity of senior managers from the perspective of senior managers.”Design/methodology/approachSemi-structured individual interviews were conducted with 20 senior health managers. Sampling method was purposive. Data were collected using a researcher-made interview guide. The transcribed text was analyzed using framework analysis.FindingsFive main themes emerged from the analysis are: (1) competencies required for managers; (2) selection and appointment of managers; (3) establishment of managers' database; (4) deployment of functional support system; and (5) environmental sensitivity. Each of these themes contains sub-themes.Research limitations/implicationsDue to the COVID-19 pandemic, the interviews were conducted virtually. This may have had an impact on obtaining wealthy data because in a face-to-face interview, it is possible to question and answer, get additional explanations and understand the interviewee's mentality.Practical implicationsExtracting elements of management and leadership capacity helps managers to assess management capacity and leadership comprehensively and effectively. In addition, effective and useful operations can be done to strengthen the management and leadership capacity.Originality/valueThis is the first study that has identified the main elements of management and leadership capacity from the perspective of senior health managers in Iran. This article provides the components of the health system management and leadership capacity that can be used at top management level.

A GBD 2019 study of health and Sustainable Development Goal gains and forecasts to 2030 in Spain

This study aimed to report mortality, risk factors, and burden of diseases in Spain. The Global Burden of Disease, Injuries, and Risk Factors 2019 estimates the burden due to 369 diseases, injuries, and impairments and 87 risk factors and risk factor combinations. Here, we detail the updated Spain 1990–2019 burden of disease estimates and project certain metrics up to 2030. In 2019, leading causes of death were ischaemic heart disease, stroke, chronic obstructive pulmonary disease, Alzheimer’s disease, and lung cancer. Main causes of disability adjusted life years (DALYs) were ischaemic heart disease, diabetes, lung cancer, low back pain, and stroke. Leading DALYs risk factors included smoking, high body mass index, and high fasting plasma glucose. Spain scored 74/100 among all health-related Sustainable Development Goals (SDGs) indicators, ranking 20 of 195 countries and territories. We forecasted that by 2030, Spain would outpace Japan, the United States, and the European Union. Behavioural risk factors, such as smoking and poor diet, and environmental factors added a significant burden to the Spanish population’s health in 2019. Monitoring these trends, particularly in light of COVID-19, is essential to prioritise interventions that will reduce the future burden of disease to meet population health and SDG commitments.

Patient Satisfaction with Intrapartum Care Provided by Nurse-Midwives in Civil Service Hospital, Ilorin, Kwara State, Nigeria

Half a million women are estimated to die each year from pregnancy and childbirth. Greater than half of maternal and child deaths occur in Africa. Most of these deaths are caused by complications during or just after delivery and most of the complications are avoidable. Also, when reimbursement and performance policy is becoming a thing of need, patient experience and satisfaction is one of the ways of assessing and measuring the quality of care received in the health facility. This study attempted to explore patients’ satisfaction with intrapartum care provided by nurse-midwives in Civil Service Hospital, in Ilorin, Kwara State, Nigeria. This is to enhance understanding of patients’ perception and values of pregnant women during delivery, as well as factors influencing their satisfaction in other to guide nurse-midwives in providing quality care. Hence, working towards health-related Sustained Development Goals (SDGs) to reduce child mortality by two-thirds. The study employed a qualitative research design and a purposive sampling technique was used to select 16 mothers who just delivered in Civil Service Hospital, Ilorin, Kwara State. A semi-structured interview guide was used to collect the data. In-depth Interviews were done which comprised 16 participants. A qualitative method (thematic analysis) was used to analyse the data. Findings from the discussions revealed that the majority of the women said that they are highly satisfied with the provided by the nurse-midwives because of the type of care received from the competent nurses. it was also discovered that expectation is highly linked with satisfaction. Based on the findings; the participants recommended that the toilet facility, labour rooms and hospital beds should be renovated; electricity and water supply should be improved.

Support marshaling strategies among college students with anxiety and depression

Objective: The purpose of this study is to identify ways in which college students use support-seeking strategies to improve mental health-related goals. Participants: Participants included college students from a Mid-Atlantic university who identified as having experienced anxiety or depression in their lifetime. Method: Using a support marshaling framework and thematic analysis, this paper analyzed qualitative responses (n = 330) that detailed individuals’ experiences with network members when trying to gain support or avoid barriers surrounding their mental health. Results: This analysis revealed new support marshaling strategies specific to a mental health context. Participants frequently employed indirect avoidance strategies (e.g., decreased interaction time; 12.66%) and direct approach strategies (e.g., soliciting mental health support; 43.33%). Conclusions: College students equally experience opposition and support when trying to achieve mental health-related goals. Future research might consider which network members express support and opposition, and how these newly identified strategies apply in support marshaling contexts outside mental health.

Examining Use Behavior of a Goal-Supporting mHealth App in Primary Care Among Patients With Multiple Chronic Conditions: Qualitative Descriptive Study.

Although mobile health (mHealth) apps are increasingly being used to support patients with multiple chronic conditions (multimorbidity), most mHealth apps experience low interaction and eventual abandonment. To tackle this engagement issue, when developing an mHealth program, it is important to understand the social-behavioral factors that affect patients' use behavior. The aim of this study was to explore the social and behavioral factors contributing to patients' use behavior of an mHealth app called the electronic Patient-Reported Outcome (ePRO). The ePRO app supports goal-oriented care delivery in interdisciplinary primary care models. A descriptive qualitative study was used to analyze interview data collected for a larger mixed methods pragmatic trial. The original 15-month trial was conducted in 6 primary care teams across Ontario, Canada, between 2018 and 2019. The eligibility criteria for patients were being aged ≥60 years with ≥10 visits within the previous 12 months of study enrollment. For this analysis, patients were classified as long-term or short-term users based on their length of use of the ePRO app during the trial. The Social Cognitive Theory by Bandura was used to categorize social-behavioral factors that contributed to patients' decision to continue or discontinue using the app. The patient-provider relationship emerged as a key factor that shaped patients' experiences with the app and subsequent decision to continue using the app. Other factors that contributed to patients' decision to continue using the app were personal and social circumstances, perceived usefulness, patients' previous experience with goal-related behaviors, and confidence in one's capability. There was an overlap of experience between long- and short-term app users but, in general, long-term users perceived the app to be more useful and their goals to be more meaningful than short-term app users. This observation was complicated by the fact that patient health-related goals were dynamic and changed over time. Complex patients' use behavior of a goal-supporting mHealth app is shaped by an array of sociobehavioral factors that can evolve. To tackle this dynamism, there should be an emphasis on creating adaptable health technologies that are easily customizable by patients and able to respond to their changing contexts and needs. ClinicalTrials.gov NCT02917954; https://clinicaltrials.gov/ct2/show/NCT02917954.

The right of access to healthcare: an analysis of how legal and institutional frameworks constrain or facilitate access to healthcare for residents in border areas in the East African Community

BackgroundDespite many countries working hard to attain Universal Health Coverage (UHC) and the Health-related Sustainable Development Goals, access to healthcare services has remained a challenge for communities residing along national borders in the East Africa Community (EAC). Unlike the communities in the interior, those along national borders are more likely to face access barriers and exclusion due to low health investments and inter-state rules for non-citizens. This study explored the legal and institutional frameworks that facilitate or constrain access to healthcare services for communities residing along the national borders in EAC.MethodsThis study is part of a broader research implemented in East Africa (2018–2020), employing mixed methods. For this paper, we report data from a literature review, key informant interviews and sub-national dialogues with officials involved in planning and implementing health and migration services in EAC. The documents reviewed included regional and national treaties, conventions, policies and access rules, regulations and guidelines that affect border crossing and access to healthcare services. These were retrieved from official online and physical libraries and archives.ResultsOverall, the existing laws, policies and guidelines at all levels do not explicitly deal with cross border healthcare access especially for border residents, but address citizen rights and entitlements including health within national frameworks. There is no clarity on whether these rights can be enjoyed beyond one’s country of citizenship. The review found examples of investments in shared health infrastructure to benefit all EAC member countries – a signal of closer cooperation for specialized health care, this had not been accompanied by access rule for citizens outside the host country. The focus on specialized care is unlikely to contribute to the every-day health care needs of border resident communities in remote areas of EAC. Nevertheless, the establishment of the EAC entail opportunities for increased collaboration and integration beyond the trade and customs union to included health care and other social services. The study established active cooperation aimed at disease surveillance and epidemic control among sub-national officials responsible for health and migration services across borders. Health insurance cards, national identification cards and official travel documents were found to constrain access to health services across the borders in EAC.ConclusionIn the era of UHC, there is need to take advantage of the EAC integration to revise legal and policy frameworks to leverage existing investments and facilitate cross-border access to healthcare services for communities residing along EAC borders.

Association of Perceived Health Competence With Cardiac Rehabilitation Initiation.

Cardiac rehabilitation (CR), a program of supervised exercise and cardiovascular risk management, is widely underutilized. Psychological factors such as perceived health competence, or belief in one's ability to achieve health-related goals, may play a role in CR initiation. The aim of this study was to evaluate the association of perceived health competence with CR initiation among patients hospitalized for acute coronary syndrome (ACS) after adjusting for demographic, clinical, and psychosocial characteristics. The Vanderbilt Inpatient Cohort Study (VICS) characterized the effect of psychosocial characteristics on post-discharge outcomes in ACS inpatients hospitalized from 2011 to 2015. The primary outcome for this analysis was participation in an outpatient CR program. The primary predictor was the two-item Perceived Health Competence Scale (PHCS-2), which yields a score from 2 to 10 (higher scores indicate greater perceived health competence). Multiple logistic regression was used to evaluate the relationship between the PHCS-2 and CR initiation. A total of 1809 VICS participants (median age: 61 yr, 39% female) with ACS were studied, of whom 294 (16%) initiated CR. The PHCS-2 was associated with a higher odds of CR initiation (OR = 1.15/point increase: 95% CI, 1.06-1.26, P = .001) after adjusting for covariates. Participants with comorbid heart failure had a lower odds of CR initiation (OR = 0.31: 95% CI, 0.16-0.60, P < .001) as did current smokers (OR = 0.64: 95% CI, 0.43-0.96, P = .030). Perceived health competence is associated with outpatient CR initiation in patients hospitalized with ACS. Interventions designed to support perceived health competence may be useful for improving CR participation.

The effect of catchment based mentorship on quality of maternal and newborn care in primary health care facilities in Tigray Region, Northern Ethiopia: A controlled quasi-experimental study.

In Ethiopia, quality of maternal and newborn care is poor. This situation has persisted, despite the wide implementation of several capacity building-oriented interventions including clinical mentoring for skilled birth attendants that were anticipated to translate in to high-quality maternal and newborn care on each encounter. The effectiveness of mentoring programs is not yet well documented in the research literature. Therefore, we evaluated the effect of a catchment based clinical mentorship in improving the quality of maternal and newborn care in primary level facilities of Tigray, Northern Ethiopia. We conducted a controlled quasi-experimental pre-post study among 19 primary health care facilities, with 10 facilities assigned to the group where the catchment based clinical mentorship program was implemented (intervention group), and 9 facilities to the control group. We assigned the group based on administrative criteria, number of deliveries in each facility, accessibility, and ease of implementation of the intervention. A sample of 1320 women(662 at baseline; 658 at post intervention) and 233 skilled birth attendants(121 at baseline and 112 at end line) were included. We collected data from mothers, skilled birth attendants and facilities. The first round of data collection (baseline) took place two weeks prior the inauguration of the intervention, 05 October to 04 November 2019. The end line data collection occurred from 22 May to 03 July 2020. The primary Outcome was "receipt quality of maternal/newborn care". We analyzed the data using difference in differences (DiD) and logistic regression with Generalized Estimating Equation. The level of significance of predictors was declared at p-value less than 0.05in the multivariable analysis. We deployed a team of local clinical mentors working at primary hospitals to provide clinical mentorship, and direct feedback in routine and emergency obstetrical and newborn care to the mentees (all skilled birth attendants performing maternal and newborn health services) functioning in their catchment rural health centers for duration of six months. While visiting a facility, mentors remain at the facility each lasting at least five to seven days per month, over the course of intervention period. A significantly higher proportion of women at intervention facilities received quality of care services, compared with women at comparison facilities. (DiD = 18.4%, p<0.001). Moreover, following the implementation of the intervention we detected a difference in the occurrences of maternal complication outcome during delivery and immediately after birth. This was decreased by 4.5%, with significant differences between intervention and comparison sites (DiD = 4.5%, p = 0.013). We also found a favorable difference in occurrences of neonatal obstetric complications, with a decrease of 4.8% in the intervention site and almost no change in the comparison site (DiD = 4.8%, p = 0.002). Among the determinants of quality of care, we found that providers' job satisfaction (AoR = 2.95, 95%CI: 1.26 to 6.91), and making case presentation at regular basis(AoR = 1.89, 95%CI: 1.05 to 3.39) were significantly associated to improve the quality of care. However, delivery load(AoR = 0.95, 95%CI: 0.93 to 0.98) was negatively associated with quality of care. We conclude that the catchment based clinical mentorship intervention is effective to improve quality of care and reduce childbirth complications in northern Ethiopia. This finding further elaborated that incorporating maternal and newborn health catchment based clinical mentorship activities into the existing health system strengthening strategies can catalyze improvement processes to quality practice and health systems. This is seen as a necessary step to achieve the effective quality universal health care required to meet the health-related Sustainable Development Goals. Besides, more attention needs to be given to develop interventions and strategies that directly enhance providers' job satisfaction and reduce delivery work load.

Do I Really Want to Change? The Effectiveness of Goal Ambivalence Feedback on Dieters’ Motivation

Becoming committed to a new health-related goal and pursuing it is difficult for many people. The present study (a) developed and tested the psychometric properties of a brief Goal Ambivalence Scale (GAS) in a sample of dieters and (b) tested the effectiveness of providing dieters with feedback on their scores on the GAS. In Study 1, dieters (n = 334, 74% females) completed the GAS and a measure of Health-Related Concerns and Actions (HRCA). The standardization of the GAS was supported by CVR and CVI, the results of a PCA, and strong reliability and validity statistics. In Study 2, the experimental group of dieters (n = 107; 67.50% female) received feedback on their GAS scores, but the control group did not (n = 111; 62.30% female). Compared with the control group, the experimental group reported a greater need for information, greater readiness to change, and higher perceived situational confidence in resisting food that was inconsistent with their dieting goals. To conclude, the GAS could be used in health settings to provide clients and providers with an objective, fast measure of commitment to achieving health-related goals. Moreover, immediate feedback on health-related goals may improve change motivation.

Effectiveness of an online support program to help female cancer patients manage their health and illness: Protocol for a randomized controlled trial

BackgroundThe aim of the trial is to evaluate the effectiveness of interventions provided by online support program apps, adopting health-related quality of life (HR-QOL) scores as indicators. MethodsThe design is as an open, randomized, parallel-group trial with longitudinal data collection. The subjects will be female cancer patients receiving treatment in a Japanese National Cancer Hospital. Patients assigned to the experimental group will use three apps: an app for them to monitor their own health (monitoring app), an app to assess their understanding of their diagnosis and treatment and their readiness to receive treatment (confirmation app), and an app to address mental health issues (writing app); patients assigned to the control group will use only the monitoring app. At baseline (before patients undergo cancer treatment) and three other times during the study, evaluation indicators will be obtained from three different standardized HR-QOL scales that are incorporated in the monitoring app. The study hypothesis is that at 6 months after patients’ baseline health monitoring, patients in the experimental group will have improved HR-QOL as compared with patients in the control group. ConclusionThis study is based on self-regulation theory, so it is important that the online support program works in an efficient way with respect to patients finding and setting their own health-related goals and adapting their behaviors to achieve those goals. Verifying the effectiveness of the combination of the three apps will show that it is a scientifically valid approach to maintaining or improving the HR-QOL of cancer patients.

Abstract 15516: A Nationally Representative Evaluation of Patients With Established Cardiovascular Disease and Cardiovascular Risk Factors Achieving Health Goals With Electronic Devices in the United States

Background: Electronic devices, like tablets and smartphones, may help users track and manage cardiovascular (CV) risk factors. However, data on their effectiveness and equitable distribution are scarce. We aimed to investigate the patterns and predictors of achieving health goals using tablets/smartphones among patients with CVD or with CV risk factors. Methods: We used data from the nationally representative Health Information National Trends Survey 5 (HINTS5) from 2017 to 2020. In a validated questionnaire, tracking a health-related goal (quitting smoking, losing weight, or increasing physical activity) using tablets/smartphones was assessed in patients with CVD (ischemic heart disease and congestive heart failure) or CV risk factors (smoking, obesity, hypertension, and diabetes), for magnitude and demographic predictors of success. Results: Among 16,092 participants of HINTS5, 1,606 had CVD (68±14 years, 47% women), and 8,984 were at risk of CVD (59±15 years, 59% women). During 2017-2020, compared with an estimated 46% (95% CI: 44-47%) of the US adult population, 33% (95% CI: 28-38%) of patients with CVD and 43% (95%CI: 41-45%) of patients at-risk of CVD successfully reported tracking their progress to achieve a CV health goal using tablets/smartphones. Younger age, female sex, non-Hispanic Black race, and higher income were significantly associated with higher proportion reporting improving their CV health, among patients with and at-risk of CVD. Discussion: Nearly half of patients with CV risk factors successfully manage health habits using electronic devices, but given large underuse among demographic groups with frequent adverse cardiovascular outcomes, a systematic approach to their use in clinical care may help improve patient outcomes.

Non-communicable Disease-Related Sustainable Development Goals for 66 Belt and Road Initiative Countries.

Since 2015, the Global Burden of Disease Study (GBD) has measured progress in achieving health-related Sustainable Development Goals (SDGs) annually worldwide. Little is known about the status and attainment of indicators of non-communicable diseases (NCDs) by 65 countries from the Belt and Road Initiative (BRI) proposed by China in 2013. Data from GBDs were used to estimate 24 NCD-related SDG indicators in BRI countries from 1990 to 2017. Each indicator was scored from 0 to 100 to compare multiple indicators over the study period. The natural log of the annual change in each location and year and weighted annual rates of change were used to generate projections for 2030. National-level estimates were determined by socio-demographic index (SDI) quintiles in BRI countries with more than 1 million inhabitants. In 2017, the median overall score of NCD-related SDG index for the 66 BRI countries was 60 points, ranging from 29 points in Afghanistan to 84 points in Israel. More than 80% of countries achieved the SDG 2030 maternal mortality (MM) rate target in 2017, and the national skilled birth attendance rate was above 99% in more than 59% countries. However, none of the BRI countries achieved the goal for children's overweight, modern methods of contraception, and universal health coverage. It was predicted that 80.4% of NCD-related SDG targets would be achieved in these countries by 2030. The overall score of NCD-related SDG index were positively associated with SDI quintiles. For many indicators, the achieved progress in many countries is less than the annual rate necessary to meet SDG targets, indicating that substantial efforts need to be made in the coming years. Progress should be accelerated through collaborations between countries, implementation of NCD prevention and control strategies, and monitoring of inequalities in NCD-related SDGs within populations.

3.C. Workshop: The WHO European Health Report 2021: overcoming gaps in data and health information systems

Abstract The publication of the European Health Report every three years gives readers a vital snapshot of health in the WHO European Region and progress towards health and well-being for all. The European Health Report 2021 (EHR2021) shows trends in and progress towards the health-related Sustainable Development Goals (SDGs) and the goals of the European Programme of Work 2020-2025 (EPW). It reveals gaps in progress, persistent health inequalities and other areas of concern and uncertainty, where action must be taken. The Report also lays bare, and not for the first time, considerable data gaps for key indicators, as well as operational problems in Member States’ (MS) health information systems (HISs). As strong HIS are a prerequisite for evidence-informed policy-making, overcoming these issues is critical. In this workshop, we will first present the main findings of the EHR2021, showing which challenges the European Region is facing related to the three core priorities of the EPW: moving towards universal health coverage (UHC), protecting people better against health emergencies and ensuring healthy lives and well-being. Although from the EHR2021 it shows that data for many SDG indicators can be reported, there are also many areas that we cannot monitor well due a lack of data. Such data gaps are not stand-alone problems but relate to wider issues with the functioning of HISs. In the second presentation we will present an overview of the most important data gaps for key indicators and common issues in national HISs in the European Region, providing insight into where concretely action needs to be taken to ensure a stronger evidence-base for policy-making. Supporting MS in strengthening their HIS has traditionally been an important focus in WHO Regional Office for Europe's (WHO-Euro's) work and continues to be so under the EPW. One important tool that WHO-Euro uses for this purpose is a HIS assessment. Such an assessment provides insight into the strengths and weaknesses of the HIS and is the starting point for an evidence-informed process of HIS strengthening. In the third presentation, we will present WHO-Euro's HIS assessment approach. Lacking or incomplete digitalisation is a common issue in HISs in the Region, and the COVID-19 pandemic has emphasized the need for implementing digital solutions to improve the efficiency of HISs. Therefore, supporting Member States in the further digitalisation of their HIS is an important focus of WHO-Euros HIS strengthening work for the coming years. In the final presentation, we will present WHO-Euro's existing tools and planned activities related to this. Participants of this workshop will get a comprehensive overview of current challenges related to achieving the health-related SDGs in Europe, with a specific focus on challenges related to health information. They will learn about WHO-Euro's approaches and plans for how to tackle these challenges. Key messages • Although the European Health Report 2021 shows data for many health-related SDGs, there are important areas that we cannot monitor well due to a lack of data and issues in health information systems. • Overcoming these issues is crucial for a strong evidence-base for health policy, and therefore WHO Regional Office for Europe has a series of tools and activities to support Member States in this.

Use of Assistive Technologies and Alternative Means by Older People: The "Actional Model of Older People´s Coping with Health-Related Declines".

This paper presents the "Actional Model of Older people´s Coping with Health-Related Declines" to explain the use of a broad range of action alternatives of older persons for dealing with current or anticipated diseases, functional declines, activity limitations and participation restrictions. The general background is the action-theoretical model of intentional self-regulation of human development (e.g., Brandtstädter, 2006; Rothermund & Brandtstädter, 2019). Yet, our model provides an increased specification of major model components toward the situation of older people coping with current or anticipated health-related declines. The model development follows an adapted theory construction methodology (TCM) by Borsboom et al. (Perspectives on Psychological Science, 16(4), 756-766, 2021) and adapted principles for constructing practically useful theories by Berkman & Wilson (Perspectives on Psychological Science, 16(4), 864-874, 2021). Regarding content, we further draw on models of the use of assistive technologies (ATs) and medical services, qualitative studies on reasons for using ATs, and quantitative studies on health-related goals. The resulting model includes these components: (1) Discrepancies between perceived or anticipated and desired health-related development, (2) health-related discrepancy reduction and prevention goals, (3) action possibilities for reducing or preventing health-related discrepancies, (4) further motivating and demotivating goals, (5) beliefs about effective means for reaching the goals (2) and (4), (6) generation of the particular coping actions by goals (2) and (4) in combination with beliefs about effective means, (7) external context factors, and (8) modes of joint decision-making and decision-making on behalf of older people. The explanatory and practical value of the model are discussed as well as its implications for future research and geropsychology teaching.

Development of the multidimensional health perceptions questionnaire in English and Spanish

PurposeTo develop the novel multidimensional health perceptions questionnaire (MHPQ), a self-reported assessment of health perceptions inclusive of (1) individuals beliefs about the causes and consequences of health conditions, benefits and barriers to maintaining and improving health, ability to accomplish health-related goals and control health circumstances, and the role of God and/or spirituality in health and healthcare, (2) anticipated discrimination in the healthcare systems, and (3) trust in healthcare providers and medicine, illustrated in our newly proposed Multidimensional Health Perceptions Conceptual Model.MethodsWe developed an initial MHPQβ item set, corresponding to domains of our conceptual model, using a patient-centered outcomes development approach. This include literature review, expert and end-user feedback, translation and language validation (specifically to Latin American Spanish), and cognitive interviewing.ResultsThe initial 104 items of MHPQβ had excellent content validity, with a Content Validity Index of 98.1%. After expert (n = 13) feedback, translation and language validation, and cognitive interviewing among community-dwelling English-speakers (n = 5) and Spanish-speakers (n = 4), the final MHPQβ comprised 93 items rated on a five-point agreement scale (1 = Strongly disagree to 5 = Strongly agree), with a reading grade level of 6th grade in English and 8th grade in Spanish.ConclusionThe MHPQβ is a promising tool to assess individuals’ health perceptions. It has excellent content validity and good reading accessibility. Future work will establish the factor structure and final item set of the MHPQ.

Pushing Yourself Harder: The Effects of Mobile Touch Modes on Users’ Self-Regulation

Mobile health interventions are widely used to facilitate individuals’ management of their health behavior. A notable issue is that health interventions with obvious persuasive intent may cause negligence and reactance. In this study, we propose a subtle but powerful way to bolster self-regulation in maintaining healthy behavior by leveraging embodied interaction design. Our study shows that bodily actions in interacting with digital devices can trigger thoughts about prior associated experiences and, thus, be strategically designed to affect individuals’ judgments, decisions, and behavior. Specifically, in three experiments, we find that firmly pressing a touchscreen during mobile interaction (as compared with gently tapping a touchscreen) can activate users’ approach motivation and, thus, induce their preference for a healthy over a tasty beverage, lead to more challenging exercise goals and more exercise, and reduce personal hygiene lapses after receiving hygiene education. Hence, designers of digital health products may consider designing interaction with pressing gestures to facilitate users’ self-regulation and attainment of health-related goals. Policymakers can also encourage the adoption of relevant app designs to improve citizens’ health wellbeing.

Exploring emergent barriers to hospital-based violence intervention programming during the COVID-19 pandemic

National rates of gun violence have risen during the COVID-19 pandemic. There are many contributing factors to this increase, including the compounding consequences of social isolation, unstable housing, decreased economic stability, and ineffective and violent policing of communities of color. The effects of these factors are exacerbated by the pandemic's impact on the provision and availability of psychosocial services for individuals in marginalized communities, particularly those who have been violently injured. Hospital-based violence intervention programs (HVIPs) have been identified as a crucial intervention strategy in reducing repeat violent injury. The ongoing COVID-19 pandemic has engendered, significant barriers in HVIPs' attempts to assist program participants in achieving their health-related and social goals. This research offers insight into the complexities of providing social services during the convergence of two public health crises—COVID-19 and gun violence—at the HVIPs associated with the two busiest trauma centers in the state of Maryland. In considering the effects of inadequate financial support and resources, issues with staffing, and the shift to virtual programming due to restrictions on in-person care, we suggest possible changes to violence prevention programming to increase the quality of care provided to participants in a manner reflective of their unique structural positions.

Use of Technology for Health-Related Tasks among Older Adults: Trend Analysis of Pre-&amp;-during COVID

The rapid digitization of health care during the Covid-19 pandemic has increased the concern of the ‘digital divide,’ particularly for older adults. This study captures the trend of technology use among older populations before and during the Covid-19 pandemic. The study also measures the impact of the pandemic, healthcare technologies, and health status on older adults’ likelihood of communicating with the doctors, making independent treatment decisions, and achieving health-related goals. According to the study, older adults during the Covid-19 pandemic were less likely to communicate with their doctors or achieve their health-related goals by a factor of 1.158 and 1.130, respectively. Older adults who had depression were more likely to make independent treatment-related decisions by a factor of 0.744. We noted an increased usage of mHealth appli- cations and the internet during the Covid-19 pandemic. However, fewer people had access to smartphones and tablet computers. We also reported a significant increase in the proportion of older adults who did not use or understand online medical records over the years. The study emphasizes that as more older adults adopt technology, it is imperative to consider human factors’ methodologies and considerations. Authorities should consider technology affordance and affordability for patients across various socio-economic gradients and with different physical and cognitive capabilities.