Health Promotion Interventions Research Articles

Workplace health promotion interventions in EU-27 public administrations.

The objective of this article is to make an exploratory study about European public administrations (public administration, public agencies, public law entities, entities dependent on the public administration and public universities) in relation to workplace health promotion interventions. The sample was extracted from the ESENER-3 (Third European Survey of Enterprises on New and Emerging Risks) (EU-OSHA, 2019) and consists of 7,981 public entities from the EU-27 countries. Four WHPI have been studied: healthy nutrition interventions, sports activities after working hours, back exercises at work and prevention of addictions. This is an exploratory study. The sample was extracted from the ESENER-3 (Third European Survey of Enterprises on New and Emerging Risks) (EU-OSHA, 2019) and consists of 7,981 public entities from the EU-27 Public Administration. In total, 45,420 establishments were interviewed. Different patterns have been observed when implementing workplace health promotion interventions in the EU-27 public administration. The promotion of sports activities outside working hours is the one with the highest level of implementation in European public administration. On the other hand, the measure with the least implementation level is the promotion of healthy nutrition. The limitations of the study are that the studied items are nominal and comprise more than two categories, so it has not been possible to develop a correlation analysis. The EU-27 public administrations can see which workplace health promotion interventions need to be improved. Differences that may exist in the adopted workplace health promotion interventions by European public administrations have not yet been addressed in depth by the literature.

Young Black and White adults prefer in-person to telehealth for primary care visits and group health promotion programs.

Telehealth utilization has increased since the coronavirus disease 2019 pandemic, reducing barriers to healthcare and, potentially, reducing participation in group health-promotion interventions. However, preferences for telehealth versus in-person formats have not been established. To examine preferences for telehealth and in-person format for primary care and group health-promotion interventions among Black and White women and men aged 20-39. We hypothesized that respondents would report a higher preference for telehealth than in-person appointments. This cross-sectional survey study recruited participants to answer questions about access to technology and preferences for telehealth and in-person formats of primary care and group health promotion. Respondents (n = 404) included similar proportions of White women (24.3%, 26.4 ± 4.3 years), Black women (25.0%, 29.0 ± 6.1 years), White men (25.9%, 32.8 ± 4.5 years), and Black men (24.8%, 30.6 ± 5.2 years). About 98.5% reported having a smartphone, and 80.4% had access to a computer with a camera. Preference ratings were higher for in-person visits, compared to telehealth visits, for both primary care (M = 3.86 ± 1.13 vs. M = 2.87 ± 1.18) and group health promotion (M = 3.72 ± 1.12 vs. M = 3.04 ± 1.20) F's(1,400) > 59.0, P's < .001. Most young adults have access to technology, supporting the feasibility of telehealth interventions. However, telehealth preference ratings were lower than in-person appointments. Preferences for delivery formats should be considered when designing behavioral interventions to promote health and prevent disease.

Sense of Community in the context of disease prevention and health promotion: A scoping review of the literature

BackgroundThe centrality of community engagement in disease prevention and health promotion interventions highlights the need to understand the contextual factors that shape participation. Sense of Community (SoC), characterized by feelings of belonging, connection, and interdependence among members of a community, has emerged as a key component of community capacity and is therefore expected to influence engagement outcomes. However, empirical evidence is needed to assess its actual impact on community engagement. Additionally, the literature lacks a broader synthesis of the role and implications of SoC in this context. This study aims to review the empirical literature on SoC in disease prevention and health promotion, with a special focus on its association with community engagement.MethodsA scoping review was conducted following the PRISMA guidelines, searching for empirical studies published between 1974 and 2023 via Scopus, Web of Science, and PubMed.ResultsNineteen studies were included in the review, revealing three key themes: (1) the community to which SoC refers – among intervention participants, within community coalitions, and defined by the place of residence; (2) the interpretation of SoC, either as a generic, intuitive concept or as a theoretically defined construct; (3) the ways in which SoC is studied – as a predictor of engagement but also as an outcome of the interventions. Generic SoC among intervention participants emerged as a positive outcome and a factor contributing to engagement. However, as the scope expanded to encompass broader communities and SoC became more theoretically grounded, these dynamics shifted. SoC related to the place of residence did not exhibit significant improvement after interventions. Broader community-level SoC showed positive associations with engagement among members of community coalitions, but evidence was less consistent among the individuals targeted by interventions.ConclusionsThe review highlighted a scarcity of empirical research on SoC despite its recognition as a key component of community capacity. Contextualizing SoC is crucial, as its interpretation significantly influences its role in disease prevention and health promotion interventions. Further research is needed to clarify whether SoC can foster engagement at all community levels, especially among the general population. This is particularly relevant amid the current context of escalating health needs and strained traditional resources, where community engagement is increasingly essential to ensuring the sustainable delivery of disease prevention and health promotion efforts. If SoC can drive widespread engagement, it could play a pivotal role in building more proactive and autonomous health-promoting communities.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages

BackgroundIn many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue. To address these challenges, the World Health Organization has introduced the Health Promoting School (HPS) framework, a comprehensive model designed to integrate health into all aspects of school life and promote physical, mental, and social well-being. We sought to assess the perceived health status of school-aged children, identify associated factors, and explore the role of community health workers (CHWs) in public schools in rural Rwanda.MethodsWe carried out a convergent mixed methods study among teachers and community members in rural areas of Musanze, Rwanda. Data collection instruments were adapted from the World Health Organization’s HPS framework and the literature. We conducted six in-depth interviews and three focus group discussions. We performed a logistic regression analysis to examine the factors associated with perceived health. Thematic analysis was used to analyze the qualitative data.ResultsA total of 479 individuals participated in this survey. Of these, 425 (89%) were community members, while 54 (11%) were employed as teachers at Nyabirehe or Rwinzovu public schools. Almost half of respondents 221 (46%) described the children’s health as poor. Many factors were associated with perceived children’s health, including having an established leadership team for school-based health promotion (OR = 1.97, 95%CI: 1.01,3,84), and being familiar with school-based health promotion (OR = 4.77, 95%CI: 2.27,10.0). Qualitative results described the CHW as a bridge between communities, schools, and primary healthcare centers.ConclusionThis study revealed that the health of schoolchildren needs particular attention. In resource-limited settings, HPS presents a promising opportunity to address the health and well-being of children at rural public schools. However, adapted policies, the establishment of health promotion teams, and hands-on orientation for teachers and community members are necessary to ensure an effective implementation of HPS. In Rwanda and other low-income countries where public schools lack nursing staff, CHWs could play a vital role in enhancing HPS and the linkage between schools and primary healthcare facilities.

Community Health Worker Videoconferencing Interventions for Disease Management and Health Promotion: Protocol for a Scoping Review.

Public health interventions delivered by community health workers (CHWs) have been proven effective in improving health outcomes across multiple fields, particularly in populations that are underserved by traditional health care systems. To date, little research is available about how CHW-led interventions could be successfully delivered virtually, despite many other health care services being offered via telehealth. This paper details a scoping review protocol that aims to assess the existing literature on CHW-led interventions using videoconferencing technology. The scoping review protocol was developed using the Joanna Briggs Institute's guidelines on conduct of scoping reviews. Included papers will describe a direct intervention to manage disease or improve health, delivered by CHWs via videoconferencing. Multiple literature databases and gray literature will be searched. Abstracts and then full texts will be reviewed to determine inclusion by 2 independent reviewers; conflicts at each stage will be resolved by a third reviewer. A data extraction tool will be used by reviewers to independently chart data from included studies; results will be reviewed for accuracy by a second reviewer. Included papers will be analyzed to identify the breadth of the available evidence, including barriers, facilitators, effectiveness, and best practices described in the literature. Data will be summarized in a narrative review. This study commenced in April 2022, and the study protocol was finalized in November 2022. A preliminary search of the published literature (excluding gray literature) in July 2024 revealed 276 reports after removal of duplicates. The formal literature search will commence in August 2024, with results available by December 2024. We intend to publish results in the academic literature as well as creating a report accessible to nonacademic and community audiences. This review will illuminate the breadth of the evidence available on CHW videoconferencing interventions, with specific focus on strategies for implementation success and equity of access. and will be of great value to organizations that offer CHW services. DERR1-10.2196/55160.

Community-based Disease Prevention and Health Promotion: Promoting Digital Health Literacy among People in Precarious Living Conditions

The rapidly advancing digital transformation is opening up innovative opportunities for disease prevention and health promotion, particularly through sociotechnical innovations. Digitally-enabled interventions serve as augmentative tools for disseminating health-related information and promoting individual empowerment and self-efficacy. Despite their potential, digital media in community-based disease prevention and health promotion face challenges, such as the need for low-threshold design and consideration of technological acceptance factors. People in precarious life situations, who often face limited access and lower literacy towards digital technologies, could benefit from targeted measures geared to their specific needs. At the same time, it is important to highlight the risks of insufficient digital health literacy, which can have a negative impact on health. Promoting digital health literacy therefore appears to be an essential tool for improving the health situation of people in precarious living circumstances. This article argues for evidence-based and targeted further development of digital interventions for health promotion that are tailored to the needs of people in precarious living conditions and emphasizes the central role of digital health literacy in this process. In this contribution, the area of early childhood intervention is considered for exemplification.

Validity and reliability of the short-form adolescent health promotion scale among adolescents and young adults in Ghana: methodological study

Background and aimAssessing health promotion among adolescents and young adults is vital to identify healthy and unhealthy behaviours as well as to evaluate health promotion interventions. However, there is no valid and reliable scale to assess health promotion among Ghanaians. For the first time, this study determined the validity and reliability of the original version of the Short‐Form Adolescent Health Promotion (AHP) scale among adolescents and young adults in Ghana.MethodThis cross-sectional methodological study included 617 adolescents and young adults within Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. A well-structured questionnaire was used to collect sociodemographic data from study participants. The AHP-Scale was also used to collect data on participants health promoting behaviors. The scale’s validity was evaluated using Kaiser-Meyer-Olkin (KMO), Bartlett’s test of sphericity and Exploratory Factor Analysis (EFA), whilst the reliability was assessed using the Cronbach’s ɑ coefficient. Statistical analysis was performed using SPSS software version 26.ResultsThe KMO and the Bartlett’s test of sphericity were reported to be 0.899 and χ2 (276) = 6682.338 respectively, allowing for EFA with orthogonal rotation. The EFA revealed five factors covering 54.62% of the total variance. The factor loading order of the items did not exactly correspond to the order obtained in the original version of the scale’s validity analysis as the original scale had six factors. This six-factor loading scale was valid in regards to construct validity. The obtained factors included: life appreciation, exercise, stress management, nutrition, and social support. In this current study, Cronbach’s ɑ was calculated at 0.87 for the whole scale and between 0.71 and 0.92 for its subscales. Thus, indicating the current scale reliable.ConclusionThe six-factor loading scale of the Adolescent Health Promotion scale developed in the present study is acceptable for the validity and reliability assessment. However, the construct validity of this scale should be checked in other samples as it did not cover a large variance of the population. Large population wide studies are also needed to augment the current study findings with additional modifications for the adopted AHP scale.

Evaluation of a school-based health promotion intervention in a resource-constrained community

The purpose of this study was to evaluate the outcome of a school-based health promotion intervention that was implemented in three primary schools in a resource-constrained community in Bronkhorstspruit, South Africa, among Grade 4 to 6 learners. I accordingly investigated the learners’, teachers’ and parents’ experiences, perceptions and potential behavioural changes in terms of healthy food practices after the implementation of the Win-LIFE (Wellness in Lifestyle, Intake, Fitness and Environment) intervention. The study forms part of a broader institutional project. I followed an evaluation research design, applying Participatory Reflection and Action (PRA) principles, an interpretivist paradigm and a qualitative approach. The conceptual framework was based on Bronfenbrenner’s (1979) bio-ecological theory and Bandura’s (1986) social cognitive learning theory. A purposeful sample of 31 learners, 18 teachers and 31 parents participated in PRA-based data-generation and documentation activities. In addition, I used observation-as-context-of-interaction, field notes, research diaries and audio-visual techniques. In terms of results, the teacher-participants valued the PRA-based nature and their involvement as partners in developing and implementing the intervention. They also perceived the intervention as valuable to others, experienced some challenges during the implementation and made certain recommendations for future implementation. The parent-participants indicated that they gained knowledge about healthy food practices because of the Win-LIFE intervention. They started applying their newly gained knowledge yet required additional guidelines. Finally, the learner-participants’ experiences (reported as part of two master’s studies) of the enriched Life Skills curriculum (Bentley, 2016) and Natural Sciences and Technology curriculum (De Vos, 2017) were positive. They valued the experiential and cooperative learning approach and supportive facilitators, resulting in positive learning outcomes and their application of the newly gained knowledge, despite some challenges they identified. The findings thus indicate that the Win-LIFE intervention was valuable to teachers, learners and parents, increasing their awareness of, as well as their knowledge and skills regarding healthy eating practices (food choice, production, preparation and storage) and healthy living, thereby enabling them to adopt a healthier lifestyle. Furthermore, the teachers’ repertoire ofteaching strategies was extended. The learners, on the other hand, began to engage in their own learning more actively, based on the confidence, discipline and ability that they gained to retain information. Learners also transferred their knowledge and skills to their parents and other family members.

Identifying the Relationship Between Residential Type and Health Outcomes of the Community-Dwelling Thai Older Adults in the Baseline Analysis of a Cluster-Randomized Controlled Trial

Background/Objectives: As people age, their environment plays a critical role in shaping their health. With Thailand’s rapidly aging population, it is crucial to understand how different living environments affect the well-being of older adults. This study examines differences in biopsychosocial health indicators between older adults living in village communities and private housing estates in Chiang Mai, Thailand. Methods: A cross-sectional study was conducted using baseline data from the Community-Integrated Intermediary Care (CIIC) Service Model, a Cluster Randomized Controlled Trial in Thailand (TCTR20190412004). The study included 2788 older adults (aged 60+). Of these, 89.49% resided in village communities, and 10.51% in private housing estates. Validated instruments were used to assess health indicators. Descriptive statistics, multivariate analysis of variance, and multiple logistic regression analyses were performed. Results: Older adults in private housing estates had significantly lower odds of experiencing pain or discomfort (Adj OR: 0.64, 95% CI: 0.49–0.84) and were 1.36 times more likely to report positive perceived health. However, they had lower odds of perceiving themselves as physically and socially active (Adj OR: 0.74, 95% CI: 0.57–0.97) and were 0.30 times less likely to rate their quality of life higher (Adj OR: 0.30, 95% CI: 0.22–0.40) compared to their village community counterparts. Conclusions: The residential environment significantly influences older adults’ health and well-being. Tailored health promotion interventions should leverage the unique strengths of both village communities and private housing estates to enhance social connections, physical activity, and quality of life, promoting healthy, active aging across diverse settings.

The most optimal school recruitment strategies for school-based obesity prevention and health promotion research in the United States: A systematic review with Delphi study.

This systematic review with the Delphi study aimed to identify effective and resource-efficient (optimal) strategies for recruiting schools into health promotion interventions in the United States. A literature search was conducted in PubMed, Cochrane Library, and CINAHL (EBSCO). A total of 116 interventions reported in 160 articles were included. Most school-based interventions did not report data regarding school recruitment duration (81%), target school size (63%), and school recruitment strategies (78%). Further, no details were provided regarding the reasons for declining to participate despite being eligible. For the Delphi, responses from 23 researchers in school-based clinical trials were collected. A qualitative descriptive approach was used for coding responses and collapsed into higher-order categories based on school recruitment strategies. Delphi participants reported that (1) creating new or leveraging pre-existing partnerships, (2) intervention champion, (3) minimal school disruptions, (4) working with open mind/flexibility, and (5) transparent communication are the most optimal school recruitment strategies. Staff time and travel were the most frequently reported costs for implementing those strategies. The overall trend in school-based obesity prevention intervention studies illustrates the importance of a better understanding school recruitment. Improved reporting can allow researchers to budget their time and resources better and provide greater confidence in reaching their target school size.

Health promotion intervention in at-risk South African primary schools

Background: Interventions to promote health have been implemented in some urban settings. However, school-based health promotion interventions in at-risk urban schools have not been thoroughly investigated. Objective: This article investigates teachers’ perceptions regarding health promotion interventions with the main goal of establishing social change in at-risk school communities. Design: The study used phenomenology as a theoretical lens supported by the use of a qualitative research approach. As a theoretical framework, the researchers utilised Vygotsky’s sociocultural theory. Setting: The investigation used a descriptive case study design to select 17 teachers from 2 at-risk urban primary schools in Pretoria. Methods: Visual data including participatory reflection action posters and photographs, and field notes were part of the data collection techniques. Findings: Teachers’ responses informed how school-based health promotion interventions can be developed in the foundation phase of education. Themes relevant to this included recognition of the importance of education in bringing about social change; involving the whole community in developing health promotion projects; working closely with parents; promoting physical activity; and advocating for nutritional literacy. Goals can best be achieved through a focus on nutritional needs, physical health and social needs of at-risk communities. Conclusion: Findings from this study can be used to inform at-risk communities about food consumption, optimum physical activities and positive socio-emotional actions. Beyond this, young professionals entering the field of education should be encouraged to develop awareness of how school-based health promotion programmes can benefit the health and well-being of children.

Visualizing patterns of factors influencing school health promotion implementation

Abstract Background The school setting offers a special opportunity for health-promotion (HP) interventions, as children spend 1/3 of their daily time there. Yet, implementing HP remains challenging due to the complexity of schools and unique contextual factors influencing implementation. While common influencing factors have been described, the aim of this study is to explore how influencing factors co-occur within and vary across schools, forming potential patterns of barriers and facilitators. Methods As part of a school HP program involving 258 institutions across Germany, nine schools were selected using maximum heterogeneity sampling for in-depth interviews on influencing factors by employing the Consolidated Framework for Implementation Research (CFIR). The interviews were transcribed verbatim and analyzed deductively using the CFIR as category system. Identified influencing factors were quantified [-5; +5] whether being a major barrier (-5) or a major facilitator (+5). To visualize potential patterns, a matrix heat map (MHM) displaying all influencing factors across all schools was created. Preliminary results Influencing factors in almost all CFIR categories were identified and all schools reported factors as barriers, such as parental engagement or (in)sufficient time. From the MHM, patterns of influencing factors, co-occurring within and differing across schools, emerged. For instance, some schools found the physical environment to be a barrier, while others considered it a facilitator, often in conjunction with financing as another facilitator. Conclusions Qualitative analysis and visualization of results with a MHM served as a way to navigate the complexity of the school setting and to highlight patterns of factors influencing implementation. Understanding these patterns can enhance tailoring implementation strategies, thereby improve implementation of school HP interventions and, ultimately, foster child health outcomes. Key messages • Influencing factors for school HP implementation manifest in varied patterns of barriers and facilitators across schools, which has implications for tailoring implementation strategies. • Using qualitative analysis guided by the CFIR and a MHM for visualization can aid in navigating the complexity of schools.

Health promotion interventions for children and adolescents using e-health: a systematic review

Abstract Background The utilization of e-health in healthcare interventions has become increasingly prevalent due to its cost-effectiveness. Nevertheless, there is a paucity of evidence regarding the use of e-health in children, as the majority of e-health interventions are focused on adults. This study aimed to identify the components and effects of e-health intervention for the promotion of children’s health and to suggest strategies for their implementation. Methods A systematic review was conducted in accordance with the PRISMA guidelines. A literature review of relevant studies published between January 2013 and November 2023 was conducted. A search of databases including PubMed, EMBASE, CINAHL, MEDLINE, and Cochrane Review Library was conducted using a combination of medical subject headings (MeSH) and keywords. A qualitative appraisal of the studies was conducted using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Results Sixteen studies were selected. Most studies showed good methodological quality. The majority of studies (n = 15) focused on improving children’s physical health, while only one study focused on mental health. There were a variety of components to the intervention, including internet education, web-based home-exercise, serious games, mobile apps, email counseling, and active video games, and only one type of intervention was provided, or a combination with additional methods such as phone calls and counseling. A review of the literature indicates that e-health interventions have been effective in increasing children’s physical activity, reducing weight, relieving stress, and reducing depression. Conclusions This study identified the effectiveness of e-health interventions for improving children’s physical and mental health. The use of e-health to promote children’s health should be actively developed and implemented in a variety of clinical and community settings. Key messages • E-health interventions have been demonstrated to be an effective means of improving the physical and mental health of children and adolescents. • It is recommended that health promotion interventions utilizing e-health be developed and tested in a variety of communities and settings for children and adolescents.

In development intervention, professionals aim to enhance working practices and interaction

Abstract Background The social services and healthcare professions are experiencing a global labor shortage. Enhancing the appeal and retention requires the development of work and processes through community-level interventions that reduce workload and bolster resources. Further research into such interventions is necessary. This study focuses on a systematic community-based practice development model (Breakthrough Collaboratives) to evaluate the change in alignment with the development intervention’s objectives and the prerequisites for change. The evaluation will utilize the process evaluation model for well-being at work projects and health promotion interventions. Methods This qualitative process evaluation employs a multi-case study approach to depict the changes occurring during the development intervention. It assesses the development processes of fifteen workplaces across Finland. The research material includes recorded group discussions from the initial workshop, where professionals establish goals and development targets for their work. The qualitative data are analyzed using content analysis. The analysis is guided by questions such as: What goals and development objectives do participants set for their work? What workplace-specific characteristics inform these objectives? Results Preliminary findings indicate that the work units’ development objectives concentrate on updating the unit’s common rules, enhancing the induction process for new employees, improving work behavior, and refining meeting practices. Workplace-specific characteristics differ based on the work unit’s sector, the level of trust among professionals, and their willingness to critically evaluate management. Additionally, competence and professionalism emerge as prominent themes in group discussions. Conclusions In a workplace development intervention, professionals aim to enhance common working practices and interaction, with the goal of improving well-being at work. Key messages • Enhancing operational practices and promoting positive interpersonal conduct among colleagues constitutes a pivotal goal in advancing social and health care work units. • The Community based intervention provides workplaces with concrete models to support co-creation and permanent changes in working practices.

Correlates of using behavioural sciences to design health promotion interventions and programs

Abstract Background The World Health Organization highlighted the need to better integrate behavioural science in the field of public health. Based on the theoretical domains framework, this study examined correlates of public health practitioners’ use of behavioural science principles to plan public health actions aim at promoting physical activity and healthy eating. Methods This study adopted a cross-sectional design. A convenience sample of 160 public health practitioners were recruited from different public health agencies (non-profit organizations, governmental and para-governmental agencies). They were asked to complete a survey questionnaire online and self-reported their use of behavioural science to plan health promotion interventions. Regression analyses were conducted to examine correlates of behaviour and behavioural intentions. All analyses were controlled for sex, number of years of experience in public health and the type of organization they work for. Results Skills (OR = 4.1, 95%CI: 1.3, 13.5) and intentions/goals (OR = 9.2, 95%CI: 2.3, 36.1) were the two domains significantly associated with the use of behavioural science. Perceived capacity to overcome the fact that none of their colleagues rely on behavioural sciences in their organization (OR = 7.2, 95%CI: 1.7, 30.3) was also associated with behaviour. Knowledge (OR = 8.6, 95%CI: 1.9, 39.1) and beliefs about consequences (OR = 4.0, 95%CI: 1.1, 14.7) were in turn associated with intentions/goals. Conclusions This unique study provides important insights for the development of future knowledge transfer activities aim at supporting positive attitudes and motivations toward the use of behavioural science as well as developing competencies and a normative use of behavioural science. The development of a strong knowledge basis would also need to be a core component of trainings to support the integration of behavioural science in public health to design physical active lifestyles and healthy eating interventions. Key messages • Increasing knowledge and skills in behavioural sciences is a key for a better integration in public health practices. • Changes in norms and attitudes toward the use of behavioural sciences will also support a better uptake.

Involving stakeholders in planning the scale-up of a health promotion intervention: a practical example

Abstract Scaling up health promotion interventions is complex. Despite the potential effects and impact on society, factors related to the intervention itself, potential adopters or implementers, and contextual factors can hinder or promote widespread scale-up. Frameworks such as the PRACTIS (PRACTical planning for Implementation and Scale-up) guide and approaches such as Design Thinking offer practical guidance for researchers to increase the likelihood for successful scale up. SuperFIT is an integrated intervention approach aiming to promote healthy energy balance-related behaviours in children aged 2-4 years. To date, SuperFIT has been implemented in over one hundred childcare locations, reaching at least 1800 children per day. A local PA-providing organisation is responsible for the implementation of SuperFIT. The aim of this project was twofold: to identify the needs of future adopters and implementers of SuperFIT (i.e. What information and materials do you need?) and to develop the relevant tools and implementation strategies. We used a co-creation approach, combining stakeholder interviews (n = 6) based on the PRACTIS guide to identify gaps and needs, with creative sessions (participants n = 8) and multiple thinking-out-loud sessions (participants n = 6) to generate solutions that would be relevant to implementers. Stakeholders included researchers with experience in SuperFIT and implementation science, implementers and managers of the current and new PA-providing organisations. Gaps were identified and summarised under three main themes: 1) a lack of clarity what SuperFIT entails, 2) SuperFIT adaptations to new implementation contexts, 3) the skills and implementation capacity required to ‘train the trainer’. Creative sessions assisted the generation of prototype tools. We have learnt the value of patience and perseverance, as some obstacles need time to be overcome.

NCD prevention and control in Kenya: feasibility study of health kiosks in markets “HEKIMA Study”

Abstract Introduction Non-communicable diseases (NCDs) account for 50% of hospital admissions and 55% of hospital mortality in Kenya. Cardiovascular diseases (CVDs) lead NCD mortality at 14% due to high prevalence of multiple risk factors. Community markets are social institutions with untapped potential for public health. HEKIMA is a multi-phased theoretically driven intervention exploring whether health kiosks in community markets, manned by community health workers (CHWs) and supervised by health centre (HC) nurses, can improve the reach of preventive care to vulnerable communities. Methods A mixed methods study in Vihiga County targeting 320 participants aged 15 years and above. Nurses and CHWs were trained to deliver evidence-based CVD health promotion, risk screening, and early intervention. Multi-sector stakeholder consultations, readiness assessments of markets and HCs, and semi-structured interviews informed intervention development. Evaluation use the Re-AIM framework. Results At 6 months of intervention there 2224 kiosk users which exceeded target of 300; 61% primary school education; 77% females; median age - males 48y, females 52y. Proportion with high blood pressure, overweight, obesity, and diabetes 48%, 32%, 25% and 12% respectively. 30% were referred to HC, and 34% followed up at least once at the kiosk. High acceptability of HEKIMA among CHWs, nurses and market users led to HEKIMA kiosks being integrated in the primary healthcare pathway. Key enablers were multi-sectoral alliance of government, civic organisations, community market champions, local businesses and health sector; culture centred coproduction and capacity building Challenges included understaffing, commodity supplies and seasonality. Conclusions HEKIMA successfully promoted NCD prevention and control, particularly among vulnerable populations. Scaling up across Kenya is planned to explore translational impacts in different contexts. Key messages • Multisectoral alliance critical for prevention of NCDs. • Theoretically underpinned complex systems interventions addresse inequities.

The “noise” of suicide attempts – relating LGBTQ+-specific vs. non-specific factors

Abstract Background Despite the numerous research on the determinants and risk factors of suicide attempts, an understanding of suicide attempts as a process that holistically captures the perspectives of the actors involved is still lacking. Our study, therefore, aimed to better understand, from different perspectives, how (process) and why (subjective meaning, patterns of interpretation) (a) suicide attempt(s) among LGBTQ+ youth happen and to relate LGBTQ+-specific vs. non-specific factors. Methods From 2021 to 2024, we interviewed LGBTQ+ youth in Switzerland who had attempted suicide between the ages of 14 and 25. As part of a multi-perspective approach, we also interviewed people from their social environment where possible. Data were collected and analysed using Grounded Theory Methodology, including theoretical sampling. The final sample consisted of 41 people: 7 bisexual/lesbian cis women, 4 bisexual/gay cis men, 15 trans/non-binary people of different sexual orientations, 3 heterosexual cis people, and 12 people from their social environment. Results Sexual orientation and gender identity (SOGI) emerged as either background or foreground “music” of the suicidal processes. In some LGBTQ+ youth, SOGI were key factors influencing their suicidality, e.g. experiencing a major lack of acceptance and barriers to accessing gender-affirming transition (foreground music type). In others, suicidality was mainly related to other aspects than SOGI, especially fundamental ones such as unsafe familial circumstances or sexualised violence, which were accentuated by SOGI-related factors e.g. feeling a lack of belonging (background music type). Further, a mixed type was identified, with SOGI and non-SOGI-related factors being equally important for suicide attempt(s). Conclusions Our study implies the need to adapt health promotion, suicide prevention, and early detection and intervention strategies according to the identified types of suicidal processes.

Effectiveness of Cartoons, Comics, and Animation-Based Sexual Health Promotion and Education Interventions: A Scoping Review

Objective Sexual health education is crucial for promoting healthy sexual behaviors among people of all ages. Interventions involving cartoons, comics, and animations have emerged as effective tools due to their engaging and accessible nature. This scoping review explores the effectiveness of these interventions across different time frames and age groups. Methods Using the PICOS framework and PRISMA guidelines for scoping reviews, a review was conducted across 14 databases to include relevant studies published between 2000 and 31 May 2024. Results Analyzing 51 intervention studies meeting the inclusion/exclusion criteria revealed varied outcomes in interventions that highlight a significant shift in focus from developing educational tools and empowering youth in the earlier period (2000–2010) to implementing advanced technology-based cartoons, comics, and animations interventions and addressing diverse populations in the later period (2011–2024). The results of these studies were predominantly positive, with many reporting significant improvements in knowledge, behaviors, and engagement. Conclusion While many studies report positive outcomes, further investigation is needed into the long-term impact of digital-based cartoons, comics, and animation interventions on behavior change and health outcomes. Research should also explore the effectiveness of these tools in different cultural and socioeconomic contexts to ensure their broad applicability. Ongoing research and iterative development are warranted to ensure that these interventions continue to evolve and meet the changing needs of users in an increasingly digital world across diverse populations

Determinants and strategies for successful scale-up of health interventions in the Netherlands

Abstract Background Although many evidence-based health interventions are proven effective, the process of scaling up is often complex and challenging. Yet, some interventions have managed to achieve successful scale-up. This provides a window of opportunity to learn from those experiences to inform future scale up processes. Objectives This mixed-methods study aimed to assess determinants and scale-up strategies contributing to successful scale-up of health promotion interventions in the Netherlands. Methods Semi-structured interviews were conducted with intervention owners (i.e. the individual or team taking the responsible for several aspects related to implementation and scale-up) (N = 25) of successfully scaled interventions (implemented across various health behaviours and different settings), and other relevant stakeholders (N = 10) involved in scaling up. Additionally, a survey was distributed among interventions (N = 306) registered in a national intervention database to assess scale-up experiences. Results Scale-up is often the result of a combination of determinants, such as persistent commitment of intervention owners and stakeholders, new funding opportunities, and accreditation by institutions. Several scale-up strategies were identified related to funding (e.g. reducing costs by setting up collaborations), organizational processes (e.g. infrastructure to support implementation), monitoring and evaluation, and dissemination and advocacy. Conclusions Achieving successful scale-up does not happen automatically and continuous effort of the intervention owner is crucial. There is no such thing as one successful scaling strategy which succeeds across all contexts. The intervention owner typically takes the lead in diverse scaling pathways, where sufficient time, funding, the right moment and added value form the critical ingredients for success. Funding: This study was funded by ZonMw. Key messages • Crucial elements of achieving scale-up are the continuous effort of the intervention owner, sufficient time, funding, the right moment and added value of the intervention. • Funding should not me allocated for new initiatives but also for continuous development of interventions, ongoing evaluation and covering overhead costs.