Migration Background Research Articles

A scoping review on sociodemographic inequalities in breast cancer screening attendance in Germany

Abstract Background Organized breast cancer screening (BCS) programs are effective measures among women aged 50-69 for preventing the fifth cause of death in Germany. However, still participation rates have not yet reached EU standards. It is unclear which and how sociodemographic factors are related to BCS attendance. This scoping review aims to identify sociodemographic inequalities in BCS attendance among 50-69-year-old women following implementing the Organized Screening Program in Germany. Methods Following PRISMA guidelines, we searched the Web of Science, Scopus, MEDLINE, PsycINFO, and CINAHL. We included primary studies with a quantitative study design and reviews examining BCS attendance among women aged 50-69 with data from 2005 onwards in Germany. Harvest plots depicting effect size direction for the different identified sociodemographic inequalities were developed. Results We screened 476 titles and abstracts and 33 full texts. In total, 27 records were analysed, 14 were national reports, and 13 peer-reviewed articles. Eight sociodemographic variables were identified and summarised in the harvest plots: age, education, income, migration status, type of district, employment status, partnership cohabitation and health insurance. Older women, women with lower incomes and migration backgrounds who live in rural areas and lack private insurance, respond more favourably to BCS invitations. However, from a lifetime perspective, these associations only hold for migration background, are reversed for income and urban residency, and are complemented by partner cohabitation. Finally, women living in the federal states of Lower Saxony, Saxony, Mecklenburg-Western Pomerania, Saxony-Anhalt, and Thuringia showed higher attendance rates in the last two years. Conclusions High-quality research is needed to identify women at higher risk of not attending BCS in Germany, particularly as the overall attendance rate still falls below European standards. Key messages • High-quality research is needed to identify women at higher risk of not attending BCS in Germany, particularly as the overall attendance rate still falls below European standards. • Women without migration background, high income, living in rural areas, and not cohabitating with their partners are at higher risk of never attending BCS in Germany.

Which diversity factors influence the attribution of competences and co-operation in nursing teams?

Abstract Background Diversity within nursing teams increases due to staff shortages in Germany, nurse migration and the current academization of the profession. Quality of patient care is associated with intraprofessional teamwork. Little is known about how nurse’s own diversity factors and those of team members impact nurse’s perception and behavior in team situations. Methods A quasi-experimental, cross-sectional study with a factorial online survey with fictional case studies (vignettes) was conducted in two German hospital operators in 2023. Nurses of legal age working in hospitals or nursing homes were eligible to participate. Associations of diversity factors, i.e., gender, age, migration background, and qualification, on the participant and vignette level on perceived competences and willingness to cooperate were preliminary analyzed via multi-level fixed effects models in SPSS. Results N = 684 nurses participated (76% female; mean age: 44.2 years; 88% born in Germany; 75% completed vocational training). Competency of team members in patient’s personal hygiene was rated higher by respondents born in Germany (.36), when fictional colleagues were of middle age (.06) compared to higher age and were from Germany (.22) or France (.08) compared to China. Competency in inserting infusions was rated higher by respondents born in Germany (.56), when fictional colleagues were from Germany (.29) or France (.20) compared to China and when one worked together for months compared to days (-.39). Willingness to swap shifts was affected by the fictional length of collaboration (-.08). All significance levels were p<.02. Conclusions How nurses perceive their colleagues’ competences is mainly influenced by their own and the other’s migration background, while willingness to cooperate is only affected by length of collaboration. Improving the onboarding process of new nurses in teams, and providing the time and space for professional exchange might improve mutual trust and teamwork. Key messages • Diversity in German nursing teams increases due to nurse migration and plurality of qualifications. • Facilitating professional exchange about individual competences might improve team work in nurses.

Heterogeneity in health and lifestyle among preschool children with migrant background in Sweden

Abstract Background Parental country of birth and socioeconomic status affect children’s health, lifestyle, and access to care. But inequality patterns may vary depending on the outcome and indicator being studied. While prior studies have focused on single health outcomes, this study assessed the relationship between parental migrant status and a range of health and lifestyle indicators among 3-year-old children. Methods Using an outcome-wide approach, we analyzed data from cross-sectional population-based surveys of 3-year-old (2014-2018) in Northern Sweden, which included 9,099 children aged 33-42 months. The surveys were administered to parents. Logistic and linear regressions were performed to examine the association between parents’ place of birth and outcome indicators. Additionally, we controlled for parents’ income and education using multiple regression models. Results Children with at least one migrant parent were perceived by their parents to have poorer health (OR:1.5, CI:1.01-2.36) and more socio-emotional problems (OR: 2.8, CI: 2.20-3.59) compared to those with two Swedish parents. While there were no significant differences in estimated BMI, lifestyle indicators showed that these children consumed more sweets (OR:4.5, CI: 3.02-6.58), less milk (OR: 1.3, CI: 1.09-1.55), fewer vegetables (OR:1.6; CI: 1.22-2.05) and brushed their teeth less frequently (OR: 2.8, CI: 2.17-3.53). However, they spent more time playing outdoors on weekdays (OR:1.6, CI:1.22-2.00) and weekends (OR: 1.5, CI: 1.18-1.94), but screen time remained consistent between weekdays and weekends. Conclusions Parental migrant status has varying impacts on children’s health and lifestyle, with some indicators showing worse outcomes for children with migrant parents compared to those with Swedish parents, while others do not. An outcome-wide approach is crucial for targeted actions to strengthen protective factors and mitigate risk factors, and ultimately reduce inequalities in early childhood. Key messages • The link between parental migrant status and children’s well-being is complex. Not all indicators show worse outcomes, inequality patterns vary based on the specific outcome and indicator measured. • An outcome-wide approach is crucial to identify action areas for targeted interventions to reinforce protective factors and mitigate risk factors, and ultimately reduce inequalities during childhood.

Excess mortality in individuals with and without COVID-19 vaccination in the Netherlands in 2021

Abstract Background The COVID-19 pandemic greatly affected public health, evident in higher mortality rates in 2020-2022. COVID-19 vaccinations reduced global mortality, though this may vary across subpopulations. We aimed to study the role of COVID-19 vaccination in excess mortality by examining individuals with and without COVID-19 vaccine while accounting for characteristics such as income and frailty. Methods In this observational study, electronic health record data from general practitioners participating in the Nivel Primary Care Database were linked to demographic data and COVID-19 vaccination data. Patients were categorized in age groups, based on vaccination invitation dates, with the index date set as vaccination date for vaccinated individuals and the expected vaccination date for nonvaccinated ones. Expected mortality rates were calculated using 2015-2018 data, accounting for season, sex, income, migration background, palliative care, and frailty. We compared expected mortality to observed mortality in 2021 to determine excess mortality. Results Preliminary results show that nonvaccinated individuals (n = 160.253) were younger, and less frail, but more often received palliative care than vaccinated individuals (n = 819.363). In nonvaccinated individuals, excess mortality in the three months after expected vaccination ranged from 22-61% for 36-60 year olds to 209-233% for the 81+ year olds. In vaccinated individuals, excess mortality ranged from -64- -61% in 36-60 year olds to 2-4% in 81+ year olds. When not correcting for palliative care, excess mortality estimations increased significantly in nonvaccinated individuals (e.g. for 81+ year olds: 504%-514%). Conclusions Excess mortality was hardly present in vaccinated subgroups, while it was high in all nonvaccinated subgroups. Our study shed light on characteristics of nonvaccinated individuals, who require special attention during future vaccination programs to prevent excess mortality. Key messages • Excess mortality in the three months after (expected) COVID-19 vaccination was high among nonvaccinated individuals and hardly observed amongst vaccinated individuals. • Routine care data could help identify terminally ill individuals, who are overrepresented amongst nonvaccinated individuals, and mitigate the so called healthy vaccinee bias in vaccination research.

The association between traffic noise and self-rated health within the German National Cohort (NAKO)

Abstract Objectives Traffic noise can cause stress and disturb sleep, impacting health in many ways. However, few large studies on this topic exist. We investigated the association between traffic noise and self-rated health (SRH) within the German National Cohort (NAKO). Methods NAKO enrolled >200,000 adults ages 20-74 at 18 sites in Germany. We used logistic regression to test whether 1) annual mean 24-hour ambient traffic noise levels at or above 55 dB(A) within a 10-meter residential buffer and 2) subjectively reported nighttime traffic noise annoyance were associated with higher odds of reporting fair/poor SRH. We calculated these associations within the full sample, stratified by sex, and stratified by age group (≤39 years, 40-59 years, ≥60 years). We adjusted for study site, age, sex, marital status, education level, and migration background. Results Among participants without missing data (n = 121,232), moderate annoyance was associated with 1.27 higher odds (95% CI 1.21-1.32) and strong annoyance with 1.75 higher odds (95% CI 1.65-1.84) of fair/poor SRH, while annual mean noise ≥55 dB(A) was associated with 1.07 higher odds (95% CI 1.03-1.12). Females who reported strong annoyance had especially high odds of fair/poor SRH (OR 1.81, 95% CI 1.69-1.95), as did those aged 40-59 years who reported high annoyance (OR 1.78, 95% CI 1.66-1.92). Those 39 and under had no significant increase in odds of fair/poor SRH if they reported moderate annoyance or if they were exposed to ≥ 55 dB(A) annual mean noise. In single exposure models, noise annoyance and objectively measured noise were both significantly associated with higher odds of reporting fair/poor SRH, but in combined models, the effect of objectively measured noise became insignificant while the effect of annoyance remained strongly significant. Conclusions These findings confirm that traffic noise is an important public health issue. Further analyses on most affected populations should inform noise protection policies. Key messages • Higher levels of traffic noise are associated with worse self-rated health. • Ambient noise is an important public health issue for which more research is needed.

The mental health of European adolescents with vs. without a migration background (2013–2024)–a systematic review

The mental health of European adolescents with vs. without a migration background (2013–2024)–a systematic review

Diversity challenges in German nursing teams: a participatory organizational development approach

Abstract Background Migration of health care professionals, demographic change and the transformation of the health care system result in highly diverse nursing teams in German hospitals and nursing homes. Different orientations (regarding qualification, generation or migration background) collide in a working environment characterized by staff shortage, time pressure and decisions about life and death. But team cooperation not only has a strong impact on patient safety, but on job satisfaction and therefore retention management. Little is known on how teams cope with diversity challenges and how this is linked with organizational structures. Methods Based on qualitative content analysis of 197,5 hours of participatory observation, 8 group discussions and 25 interviews in 6 nursing teams in 2 hospitals and 2 nursing homes situated in a major German city, we developed workshops on the topic of team diversity and cooperation. 10 workshops (4-16 participants each) were in held in 2023/24 both on team- and management-level. Results All teams are struggling with diversity-related problems, but in their specific ways, depending on the particular neighbourhood of the facility and team composition among other things. Due to the strong team spirit and identity, the teams have a fundamental tendency to integrate diverse perspectives and orientations. But they need time capacities and supportive organizational structures. The workshops created a space to discuss the team specific problems. Starting points for structural changes could be identified and further discussed in the workshops at the next higher hierarchical level. Conclusions Organisational structures provide the framework conditions that enable teams to integrate different perspectives resulting from diversity in a productive way. One-fits all solutions are not suitable to address those problems and improve teamwork. A participatory bottom-up process seems to be the most appropriate approach. Key messages • Institutions need to provide structures in which diversity is not perceived as an additional burden. • The best way to initiate improvements is through a participatory bottom-up approach.

Work resumption and economic independence among women with paid employment one year after childbirth

Abstract Background In Europe, women are more likely to be unemployed compared to men. Also, they more often hold part-time employment. After pregnancy and childbirth, women often reduce their working hours further or even exit the workforce altogether. This not only impacts their individual career, financial stability, and economic independence, but also their own health and well-being and that of their offspring. Objectives We aim to study the patterns of women’s work resumption in the first year after childbirth, and if sick leave during pregnancy and birth outcomes small for gestational age (SGA) and preterm birth play a role in this. Data from Statistics Netherlands and the Dutch Perinatal Registry from 114,722 Dutch pregnant women in paid employment (2016) were used for the analyses. Next to descriptive analyses, multivariate regression was used to assess which factors contribute to economic independence one year after childbirth. Results After pregnancy, over 50% of women reduced their working hours, and 12% became unemployed. The largest reduction was found in the group working fulltime (from 31 to 11%), in contrast, the group working 20-25 hours per week increased from 19 to 28% one year after childbirth. Among the women with sick leave during pregnancy (11%), the decrease in working hours was more pronounced and almost 40% of them became unemployed. The percentage of women being economically independent changed from 88% at the onset of pregnancy to 78% one year after childbirth. Next to employment factors (working hours and contract type), migration background and lower education were associated with lower odds of economic independence. Moreover, sick leave during pregnancy and having a SGA baby also reduced the odds of economic independence. Conclusions After pregnancy, women tend to work less than before, or even exit the workforce, with considerable impact on their economic independence. This is even more pronounced in the group with sick leave during pregnancy. Key messages • Despite paid maternity leave, pregnancy and childbirth negatively impact work force participation in women. • The need for sick leave during pregnancy is predictive of reduced work resumption and economic independence one year after pregnancy.

Long-term Survival After Cancer: A Scoping Review of the Health Care Landscape in Germany

Abstract Background Cancer remains a global health concern, with a significant increase in new cases projected in the coming years. Although cancer treatment and diagnosis have advanced, leading to improved survival, survivors often face complex physical, emotional, and cognitive challenges. The objective of this scoping review is to provide an overview of the current landscape of specialized long-term survivorship care services in North Rhine-Westphalia (NRW) with a focus on vulnerable groups. Methods The scoping review involves two search approaches: a manual search performed by two review authors and a systematic search performed by an information specialist following Scoping Review guidance. The protocol was published on the OSF platform. The systematic search was conducted in databases such as LIVIVIO, MEDLINE and Scopus. The manual search involves identifying key categories of survivorship services and conducting online searches based on these categories in duplicate. Data extraction and synthesis is conducted using EPPI-Reviewer software, and focuses on services characteristics, patient demographics, program format, and accessibility. Results The study has identified more than 300 survivorship care services across North Rhine-Westphalia. According to preliminary results some services offer comprehensive care, while others have significant gaps, particularly in addressing the needs of vulnerable groups. One example of these gaps is the lack of tailored services specifically designed for people with a migration background. Most of the services are not available in multiple languages or gender-specific oriented. The results will be presented on the congress in detail. Conclusions This scoping review underscores the importance of tailored survivorship care, especially for vulnerable groups. Public health actions should focus on addressing disparities in access to survivorship services, enhancing existing programs, and developing new policies to support cancer survivors. Key messages • Effective survivorship care requires attention to vulnerable groups. • The care of long-term cancer survivors should receive more attention in research.

Enhance physical, mental and academic wellbeing of pupils in Germany through digital health literacy

Abstract Background Digital health literacy (DHL) involves the ability to find, understand, appraise, and apply health information from digital sources. It serves as the foundation for informed decision-making about one’s health and well-being using digital technology and online health information sources and services. Despite its significance, the role of DHL in relation to schoolchildren’s wellbeing remains underexplored. Therefore, this study aims to investigate how schoolchildren’s DHL influences their physical, mental, and academic well-being. Methods The cross-sectional survey comprised a representative sample of N = 1448 school-aged children (9-18 years) living in Germany. DHL was assessed via a translated and adapted version of the DHL instrument. The assessment of physical, mental, and academic well-being relied on the KINDL questionnaire. Linear regression analyses were conducted, with the scale score of physical, mental, and academic well-being serving as dependent variables and DHL as predictor. Additionally, potential confounding variables such as sex, age, migration background, subjective family wealth, chronic illness, and subjective health status were included in the analyses. Results All three regression models were significant (physical: F(9,1325) = 34.99, p < .001; R2 = 0.19; mental: F(9,1320) = 27.43, p < .001; R2 = 0.16; academic: F(9,1336) = 15.19, p < .001; R2 = 0.09). DHL significantly predicted physical (B=.08, p=.01), mental (B=.17, p<.001), and academic (B=.21, p<.001) wellbeing. Conclusions This study provides the first evidence of the predictive power of DHL for schoolchildren’s physical, mental, and academic well-being. It emphasizes the importance of promoting DHL in schoolchildren to empower them to find, understand, appraise, and apply digital health information effectively. Key messages • Digital health literacy significantly predicts schoolchildren’s physical, mental, and academic well-being. • Promoting digital health literacy can empower schoolchildren to make informed decisions about their well-being.

Impact of loneliness and social support on leisure physical activity in adolescents in Luxembourg

Abstract Background Healthy lifestyle includes a regular practice of vigorous physical activity in adolescents’ leisure time. Engaging in physical activity (PA) depends on individual, social and environmental factors. Previous literature has showed that social support and loneliness can influence the practice of PA. The study aims to analyse the relation between PA during leisure time and social support and loneliness among adolescents in Luxembourg. Methods The study includes 7049 adolescents from the Health Behaviours in School-aged Children (HBSC) Luxembourg 2022 survey. PA in leisure time was categorised according to WHO recommendations for vigorous physical activity. Perceived social support (friends, family, teacher, and classmate) was dichotomised in high support and in low/medium and loneliness in feel often lonely and not feel often lonely. It was executed a binomial logistic regression to analyse the PA levels in leisure time by loneliness and social support, controlling by age, migration background, perceived wealth, and family structure, split by gender. Results In Luxembourg, boys who perceived high support from most of the sources and didn’t feel often lonely had higher chances to reach WHO recommendations for PA during leisure time (e.g. loneliness: OR = 1.38, CI95%[1.11-1.74]; family support: OR = 1.31, CI 95%[1.10-1.56]), except for teacher support (OR = 0.79, CI95%[0.67-0.93]). In contrast, girls who only perceived high support from classmates (OR = 1.21, CI95%[1.05-1.4]) and teachers (OR = 1.19, CI95%[1.01-1.38]) had higher chances to be physically active. Conclusions This is the first study to investigate the impact of social support and loneliness among adolescents in Luxembourg. Future research should investigate social-related barriers and facilitators of PA during leisure time. Key messages • Understanding adolescents social support can guide towards effective strategies that promote physical activity during leisure time. • Boys benefit from several social support sources, while girls thrive with encouragement from classmates and teachers to stay physically active in leisure time.

Don’t pass me by: Tackling vaccine hesitancy among migrants via the RIVER-EU project

Abstract Literature research has suggested that vaccination hesitancy (VH) has been increasing in recent years across migrant populations. It poses various challenges, including risks of outbreaks, and re-emergence of diseases. Nevertheless, only few studies provide an insight of the interventions successful in tackling VH among these groups. This presentation will describe a multi-country research enterprise that aims to respond to these needs. The “RIVER-EU - Reducing Inequalities in Vaccine uptake in the European Region - Engaging Underserved communities” project (funding from EU’s Horizon 2020, Grant Agreement No. 964353) involves several underserved communities, such as Ukrainian migrants (UMs) in Poland, migrants and refugees in Greece, females with Turkish/Moroccan migration background in the Netherlands and the marginalized Roma communities in Slovakia. The project aims at improving child and adolescent HPV/MMR vaccination among these communities by implementing tailored interventions, suitable for each target country. The focus is on removing health system barriers to vaccination. The data regarding VH are an important by-product of the RIVER-EU project, and shows the connection between perceived access barriers and VH. A project-based approach to combat VH among UMs in Poland will serve as a case study to demonstrate the complex process of development of adequate interventions, that could be used to support this migrant group, with disturbingly low vaccination uptake. However, this presentation will go beyond this case study findings - a review of the existing evidence will help generalize our results. Overall, this presentation will show to how investigating various drivers of under-immunization helps to assess what approaches, strategies and interventions are effective to combat VH among marginalized migrant groups.

Association of healthy lifestyle on overweight and obesity among adolescents in Luxembourg

Abstract Background Adolescent overweight and obesity are significant public health challenges. Understanding the impact of healthy lifestyle behaviours is crucial for effective intervention strategies. The aim of this study is to analyse the association between healthy lifestyle behaviours with overweight and obesity among adolescents in Luxembourg. Methods The study was based on the HBSC Luxembourg 2022 survey and includes 8415 adolescents aged 11 to 18 years. Adolescents self-reported the frequency of fruit and vegetable consumption, physical activity, height, and body mass. Eating and physical activity behaviours were categorized based on WHO recommendations. Body Mass Index categorization followed International Obesity Task Force criteria. Binomial logistic regression of obesity and overweight with the interaction between healthy diet and physical activity was performed, controlling for age, gender, family affluence, migration background, and family structure. Results The results indicated a significant protective effect of healthy lifestyle behaviours against overweight and obesity. For overweight, adolescents engaging in either fruit and vegetable consumption (OR = 0.829, 95% CI [0.697-0.986]) or physical activity (OR = 0.719, 95% CI [0.566-0.913]) showed reduced odds compared to those with unhealthy behaviours. For obesity, similar associations were observed. Adolescents engaging in physical activity (OR = 0.407, 95% CI [0.235-0.705]) showed reduced odds compared to those with unhealthy behaviours. Combining both behaviours resulted in the lowest risk of obesity (OR = 0.366, 95% CI [0.177-0.760]) and overweight (OR = 0.473, 95% CI [0.340-0.658]). Conclusions Promoting health eating and physical activity behaviours are important strategies for preventing overweight and obesity in youth in Luxembourg. Implementing targeted interventions aimed to promote these behaviours could mitigate the burden of overweight and obesity in this population. Key messages • Healthy lifestyle matters: Fruit and vegetables consumption or regular physical activity significantly reduce the risk of overweight and obesity among adolescents. • Combining behaviours counts: Concurrent engagement in both fruit and vegetables consumption and physical activity offers the greatest protection against overweight and obesity.

Breastfeeding duration, children’s diet and physical activity in immigrant children living in Lisbon

Abstract Background In 2023, 25% of children born in the Lisbon metropolitan area were from foreign mothers. Children of immigrant parents often face an unbalanced diet and unhealthy lifestyle, preventing them from reaching their full potential. The aim of this study was to analyse the associations between migrant status and breastfeeding duration, fruit and vegetable consumption and physical activity in children living in the Lisbon metropolitan area, Portugal. Methods Cross-sequential cohort study in Lisbon Region. Between May 2022 and April 2024, 729 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected in a face-to-face interview with the parents using a structured questionnaire with information on children’s diet (fruit and vegetable consumption) and physical activity. We used X2, Mann-Whitney U and t-tests to compare immigrant and non-immigrant children. Adjusted odds ratios (aOR) with a 5% level were estimated by logistic regression. Results Immigrant children (49.4%) live in socio-economically disadvantaged families. Breastfeeding practices are more common among migrant mothers with a higher median duration of exclusive breastfeeding (6 versus 4 months, p < 0.001) and a higher median duration of breastfeeding (14 versus 8 months, p < 0.001). Parental migration background is associated with the frequency of fruit (p = 0.039) and vegetable (p < 0.01) consumption and with the practice of physical activity (p < 0.01). The odds of consuming three or more portions of fruit are 1.37 times higher for non-immigrant children, and the odds of consuming two portions of vegetables are higher for non-immigrants than immigrants (aOR=2.04, p < 0.01). Practicing sports is most frequent in non-immigrants (aOR =2.25; p < 0.01). Conclusions Migrant status was associated with a less healthy lifestyle in childhood for children living in the Lisbon metropolitan area. Key messages • Breastfeeding is an essential source of nutrition for children, especially in socio-economically disadvantaged families. • The migrant status is often associated with inequalities in childhood, challenging immigrant children to achieve their full potential.

8.N. Scientific session: Transferability and adaptation of vaccination interventions: Learning from underserved communities

Abstract Removing barriers in the health system that make it difficult for cultural, religious or ethnic minorities to access vaccinations is an urgent concern in order to prevent infectious diseases in the future. Childhood vaccine uptake for MMR and HPV in most underserved communities is lower than in the general population. The project RIVER-EU (Reducing Inequalities in Vaccine uptake in the European region - Engaging Underserved communities) engages the migrant community in Greece, females with a Turkish or Moroccan migration background in the Netherlands, the Ukrainian minority in Poland and marginalized Roma communities in Slovakia to remove health system barriers to vaccination. Barriers include, e.g., lack of culturally and linguistically appropriate information, financial barriers, insufficient capacities, coordination and delivery of health care. Based on a Participatory Action Research (PAR) approach we selected and adapted potentially transferable evidence-based interventions in partnership with the communities. First, we pre-selected 6 useful interventions from a realist review on 36 effective vaccine uptake interventions. Second, we assessed them in depth for their transferability. Building a bridge between evidence on interventions and community needs is not an easy task: We involved various stakeholders in a longitudinal process under consideration of contextual conditions in the primary intervention context and the context of the respective underserved community. We co-created knowledge through 25 workshops and 39 interviews or focus groups for decision-making and determining need for adaptation of selected interventions. The aim of this workshop is to present the results of this co-creative process in each country. Special attention is payed to facilitators and barriers for transferability of evidence-based interventions from the perspective of underserved communities, and contextual commonalities and differences that lead to a specific intervention tailoring. This workshop will contribute to an improved understanding of how to consider contextual needs underserved communities have to remove health system barriers to vaccination on the one hand and suitable evidence on interventions to improve their situation on the other hand. The workshop will include five presentations of eight minutes and a questions and answers session to involve the audience. First, an introductory presentation on transferability of interventions for HPV and MMR vaccine uptake to underserved communities in specific contexts will be given. Then each country will present the intervention(s) to address health system barriers adapted to their context. Thereby, we will underline common key elements that have potential for transferability in all countries. After all presentations, we will discuss the need for context-based decision-making on evidence-based interventions and intervention tailoring to improve vaccine uptake for cultural, religious or ethnic minorities. Key messages • Improving vaccine uptake in underserved communities requires local solutions with tailored interventions. Trusted partnerships with various stakeholders are key to reducing health system barriers. • Participatory approaches to evidence-informed decision-making build bridges between evidence on interventions and needs of underserved communities to understand the transferability of interventions.

Tailoring vaccination interventions for the Turkish and Moroccan communities in the Netherlands

Abstract Background People with a Turkish or Moroccan migration background in the Netherlands have low HPV vaccination uptake. Health system barriers, including a lack of awareness raising initiatives on HPV, health care professionals being insufficiently trained to provide tailored care and insufficient delivery of HPV (vaccination) information, contribute to low uptake. To understand which promising interventions could be transferred, the interventions were discussed with a variety of stakeholders including community members. Methods By interviews and focus groups 33 key stakeholders were engaged to discuss on the promising evidence-based interventions. The interventions were extensively discussed on their effectiveness, cultural appropriateness, and potential transferability for which the Population-Intervention-Environment-Transfer Model of Transferability (PIET-T) model was used. Results Two interventions will be implemented of which one is focusing on the use of health promotors (trusted community members) who will provide parents of vaccine-eligible children with information on HPV and HPV vaccination. The educational sessions will be held together with health professionals in, for example, community centers or at schools. The other intervention focuses on training of healthcare professionals. Conclusions By engagement of key stakeholders including community members following the PIET-T model, final interventions could be developed that are tailored to the specific needs and contexts of people with a Turkish or Moroccan migration background in the Netherlands.

Investigating measurement invariance of the IDS-2 intelligence scales between migrant and non-migrant groups

Intelligence plays a crucial role in various aspects of human life, impacting health, academic achievement, and socio-economic success. However, cultural and linguistic disparities in intelligence testing pose challenges, particularly for individuals from migrant backgrounds. This study replicates and extends the landmark study by Wicherts and Dolan (2010) exploring measurement invariance of the German language intelligence test, the Intelligence and Development Scales – 2 (IDS-2), between children and adolescents from migrant (N = 132) and non-migrant (N = 1898) groups. The results revealed partial strict measurement invariance in the IDS-2 intelligence scale subtests across the examined groups. The breach of full strict measurement invariance is primarily due to intercept differences on the verbally loaded subtests—Naming Categories, Naming Opposites, and Story Recall—highlighting the confounding impact of language complexity on test outcomes. These discrepancies resulted in a cumulative intercept difference disadvantaging migrant participants of approximately 4 IQ points on the Full-Scale IQ Score. The findings indicate that while the IDS-2 scales generally assess intelligence consistently across diverse groups, the influence of language complexity on the verbal subtests may result in a disadvantage for children and adolescents with migration backgrounds. To address these biases, we propose the development of non-verbal and culturally fair intelligence tests.

‘The Little Things’: The Temporality of Young People’s Strategies for Existential, Grounded, and Expansive Wellbeing in Rural Australia

AbstractThis paper is based on research in rural southeast Australia with young people from recent migrant and refugee backgrounds. While existing research on the wellbeing of this group often emphasises successful settlement through education, employment, and belonging as pathways to future wellbeing, this paper asks what we can learn from young people’s own experiences and understandings of wellbeing. Guided by the words, images, and reflections of young people involved in this research, the paper explores everyday wellbeing as an existential, relational, and situated happening that takes both time and place. Young people in the study highlighted the importance of finding beauty, joy, and connection in ‘the little things’ of daily life to bring a sense of meaning into monotonous temporal rhythms and weekly routines structured by work and study. Drawing from Todres and Galvin’s ‘dwelling-mobility’ wellbeing framework, this paper conceptualises young people’s ability to be well as intricately intertwined with their ability to experience their lives over time as grounded and secure, while also having a sense of greater meaning and possibility. Ultimately, the paper illustrates how young people understand their ability to be well as temporally complex, informed by ongoing, non-linear interactions between past, present, and future experiences as they look forward and back over their lives, seeking to transform the passage of time from meaningless to meaningful.

Job Satisfaction Among First-Generation Migrant Physicians in Anesthesiology and Intensive Care Medicine in Germany.

This study examines job satisfaction, burnout, and well-being among first-generation migrant physicians in anesthesiology and intensive care medicine in Germany, comparing them to their native German counterparts. A cross-sectional survey design was utilized, collecting data from 513 physicians, 110 of whom identified as having a migration background. Job satisfaction was measured using the Warr-Cook-Wall (WCW) Job Satisfaction Scale, burnout was assessed with the Copenhagen Burnout Inventory (CBI), and well-being was evaluated using the WHO-5 Well-Being Index. The job satisfaction ratings revealed no significant differences between migrant and German physicians in most dimensions, including physical workload, freedom to choose work methods, satisfaction with colleagues, responsibility, income, skill utilization, and variety in work tasks. However, migrant physicians reported significantly higher satisfaction with recognition received for their work and lower dissatisfaction with working hours. Burnout assessments showed that migrant physicians experienced higher psychological strain, perceiving every work hour as more exhausting and having significantly less energy for family and friends. Migrant physicians reported higher difficulty and frustration in working with patients. Well-being items indicated that migrant physicians felt less energetic and active but found their daily life more filled with interesting activities. Notably, the multivariate analyses of the total scale scores did not show significant associations between migration background and the overall outcome scales. The findings indicate unique challenges faced by migrant physicians, particularly in terms of recognition and patient-related burnout. These results highlight the need for targeted interventions to support migrant physicians, including cultural competence training and flexible working hours to enhance their job satisfaction and overall well-being. Addressing these issues is crucial for maintaining the quality of patient care and the occupational health of migrant physicians in Germany.

Assessing the impact of migration on the happiness of household women left behind: evidence from Punjab, Pakistan

The concept of happiness is becoming an increasingly significant area of focus in the evaluation of overall quality of life. This research examines the impact of migration on the well-being of women who remain in their place of residence following the migration of their family members. The study employs data from the Multiple Indicators Cluster Survey (2017–2018) in Punjab, Pakistan, and addresses sample selection bias through Propensity Score Matching (PSM). Moreover, as the dependent variable is ordinal, the study employed ordered logistic regression to examine the correlation between migration and happiness, taking into account migration status and other variables. The findings indicate that women from migrant backgrounds tend to benefit from migrating, primarily in terms of enhanced financial resources. In order to gain insight into the varying effects of migration on women’s happiness, the study employed heterogeneity analysis, which revealed that the influence of migration on women’s happiness differs across various areas. In conclusion, the combination of propensity score matching (PSM) with ordered logistic regression and heterogeneity analysis represents a robust methodology for evaluating the impact of migration on women’s perceptions of happiness. The study demonstrates that migration has the potential to improve the quality of life of women who remain in their home countries, particularly those residing in financially disadvantaged households.