Public Health Challenge Research Articles

Combating drug abuse through pharmacist-led public health campaigns strategic initiatives for global prevention

The global drug abuse crisis continues to pose significant public health challenges, necessitating comprehensive prevention strategies. Pharmacists, as accessible and trusted healthcare professionals, are increasingly recognized for their pivotal role in drug abuse prevention. This paper explores pharmacist-led public health campaigns and interventions designed to mitigate drug abuse, particularly through education, outreach, and collaboration with other healthcare providers. It examines core components of effective campaigns, including targeting at-risk populations such as youth and high-risk communities. Additionally, the paper discusses global prevention strategies, addressing the cultural, economic, and legal barriers that pharmacists face while highlighting opportunities for their leadership in international drug prevention efforts. The conclusion emphasizes the need for policy recommendations to enhance the pharmacist’s role in drug abuse prevention, alongside future directions leveraging digital health technologies and international collaboration to achieve more effective global outcomes.

A sales force effectiveness framework for enhancing healthcare access through pharmaceutical sales and training programs

This paper introduces a conceptual framework aimed at enhancing sales force effectiveness within the pharmaceutical industry, specifically focusing on improving healthcare access through optimized sales training programs and customer relationship management (CRM) systems. The proposed framework recognizes the critical role that pharmaceutical sales teams play in facilitating healthcare delivery, particularly during public health crises. It emphasizes the integration of effective training strategies and advanced CRM tools to enhance engagement with healthcare professionals, thereby improving product distribution and patient outcomes. The framework comprises three essential components Sales Force Training Enhancement, which focuses on developing targeted training programs that equip sales representatives with the necessary skills and knowledge to effectively communicate the value of pharmaceutical products to healthcare providers. This includes understanding clinical data, addressing healthcare providers’ concerns, and fostering a consultative selling approach. Secondly, CRM System Implementation, which underscores the significance of adopting robust CRM systems that streamline interactions between sales teams and healthcare professionals. By leveraging data analytics and customer insights, pharmaceutical companies can tailor their approach to meet the specific needs of healthcare providers, thereby enhancing relationship-building and communication. Thirdly, engagement and Outcome Measurement, which highlights the importance of measuring engagement levels and patient outcomes resulting from effective sales strategies. This component advocates for the use of key performance indicators (KPIs) to assess the impact of training and CRM initiatives on product distribution and healthcare access. The framework ultimately aims to foster a more collaborative environment between pharmaceutical sales teams and healthcare professionals, ensuring that patients receive timely access to essential medications and services. By focusing on the strategic integration of training and CRM systems, this framework presents a comprehensive approach to improving sales force effectiveness in the pharmaceutical sector. Future research and practical applications of this framework can further explore its implications for enhancing healthcare access, particularly in times of public health challenges.

Time-trends of blood lead levels from 2020 to 2023 in pregnant and breastfeeding women from Adjara, Georgia—A birth registry-based study

BackgroundIn response to substantial lead exposure, the autonomous republic of Adjara in Georgia initiated complementary blood lead level (BLL) testing for pregnant women as part of their antenatal care services in 2020. ObjectivesTo study the background BLLs in pregnant and breastfeeding women in Adjara and explore the time-trends of BLLs from September 2020 to July 2023. MethodsWe used data on BLLs during pregnancy or postpartum from the lead screening program in Adjara, combined with data from the Georgian Birth Registry, totaling 9,510 women. To study the temporal changes in BLLs, we used independent samples t-tests and chi-square tests. ResultsIn 2020, the mean (standard deviation [SD]) BLL was 8.8 (5.4) μg/dL, declining annually by 1.0–2.2 μg/dL to reach 3.6 (2.5) μg/dL in 2023. The prevalence of pregnant women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL also decreased from 2020 to 2023. Specifically, 21.2% of women in their first trimester had BLLs ≥10 μg/dL in 2020, compared with 2.3% in 2023. Similarly, 73.5% had BLLs ≥5.0 μg/dL in 2020, which declined to 20.4% in 2023. Lastly, 89.1% had BLLs ≥3.5 μg/dL in 2020, decreasing to 38.6% in 2023. DiscussionIn 2023, nearly 40% of women in their first trimester had BLLs of ≥3.5 μg/dL, a level considered the reference value in the United States (US) and corresponding to the 97.5th percentile among US children. From 2020 to 2023, the mean BLL in pregnant women decreased by 59%, accompanied by a considerable decline in the prevalence of women with BLLs ≥3.5, ≥5.0, and ≥10.0 μg/dL. Despite the encouraging downward trend in BLLs throughout the study period, our data indicate that a considerable number of fetuses continue to be exposed to harmful levels of lead and that lead exposure remains a significant public health challenge in Adjara.

A strategic brand development framework for expanding cardiovascular and endocrinology treatments in emerging markets

This paper introduces a conceptual framework for strategic brand development in the pharmaceutical industry, specifically targeting the cardiovascular and endocrinology treatment sectors in emerging markets. The framework explores how stakeholder engagement, market segmentation, and brand positioning can enhance access to critical treatments, addressing growing public health challenges in these regions. Cardiovascular and endocrinological disorders, such as heart disease and diabetes, are rising rapidly in emerging markets due to lifestyle changes, urbanization, and increased life expectancy. Pharmaceutical companies face unique challenges in expanding their market presence in these regions, including varying healthcare infrastructure, economic disparities, and regulatory environments. The proposed framework emphasizes the importance of engaging key stakeholders—such as healthcare professionals, policymakers, and patients—through targeted educational campaigns, partnerships, and advocacy. Effective stakeholder engagement fosters trust and collaboration, which is essential for expanding access to life-saving treatments. In addition, market segmentation is a critical component of this strategy, allowing companies to tailor their marketing efforts to specific demographic groups, economic conditions, and healthcare needs in each region. By identifying the most relevant segments and understanding their unique needs, companies can ensure that their treatments reach the populations most at risk for cardiovascular and endocrinological diseases. Brand positioning is another cornerstone of this framework. By clearly defining and communicating the value of their treatments in terms of efficacy, affordability, and accessibility, pharmaceutical companies can differentiate themselves in increasingly competitive markets. Strategic positioning not only enhances brand visibility but also builds long-term customer loyalty, which is crucial for sustaining market growth in emerging economies. Overall, this conceptual framework provides a roadmap for pharmaceutical companies to strategically develop their brands in the cardiovascular and endocrinology sectors, ultimately contributing to improved public health outcomes in emerging markets.

Competency mapping among Rashtriya Bal Swasthya Karyakram nurses in Kerala

Background: In India, birth defects, nutritional deficiencies, disabilities, and developmental delays among children cause significant public health challenges. The Ministry of Health and Family Welfare, aims to address these issues through the Rashtriya Bal Swasthya Karyakram (RBSK) program. RBSK nurses are the crucial part of this program. They screen the children between zero to eighteen years as a part of early intervention. This study mainly aimed to map the competencies among RBSK nurses from randomly selected districts of Kerala. Methods: This qualitative study employed key informant interviews with the state nodal officer, district early intervention centre managers, and district coordinators; and in-depth interviews (IDIs) with RBSK nurses, as well as report and document review. Inductive coding was applied to two selected interview transcripts from each district, followed by deductive coding with the rest of the transcribed data to derive themes. Results: The findings are presented using the ‘core competencies of public health professionals’ as revised and adopted by the council on linkages between academia and public health practice in 2021. RBSK nurses in Kerala exhibited proficiency in multiple domains, including knowledge of child health issues, clinical skills, communication, patient education, care for vulnerable population, organizing activities, electronic health record usage, multitasking, teamwork, and problem-solving skills. Conclusions: This dedication and proficiency demonstrated by RBSK nurses in Kerala, serve as a global model for emphasising the importance of early intervention and comprehensive care for children.

Confidence on COVID-19 vaccine and its associated factors among people living with HIV: a cross-sectional survey in selected regions of Tanzania

BackgroundSeveral vaccines were introduced in Tanzania to combat the COVID-19 pandemic. While studies have explored the acceptability and hesitancy of COVID-19 vaccines within the general population, there is limited research focusing on the confidence and associated factors among People Living with HIV (PLHIV). This study aims to fill that gap by investigating vaccine confidence and its determinants in this demographic group.MethodsA cross-sectional study was conducted in centres for care and treatment in four regions of mainland Tanzania using structured questionnaires. A generalized linear mixed model was fitted to determine the factors associated with confidence in the COVID-19 vaccine.ResultsA total of 1,100 participants were interviewed; 761 (69.2%) were female. The mean age and standard deviation were 41.6 ±12.1 years. The overall level of confidence in COVID-19 vaccines was 55.3%. Females were less likely to express confidence compared to males (aOR = 0.77; 95% CI: 0.72–0.84). Participants with primary (aOR = 1.79; 95% CI: 1.65–1.94), secondary (aOR = 1.81; 95% CI: 1.57–2.09), and university-level education (aOR = 2.14; 95% CI: 0.17–26.54) were more likely to report confidence in COVID-19 vaccines. Attending a dispensary-level health facility (aOR = 1.32; 95% CI: 1.27–1.38) and living in rural areas (aOR = 1.43; 95% CI: 1.23–1.66) were significantly associated with confidence in COVID-19 vaccines.ConclusionAlthough COVID-19 is no longer a global public threat, these findings highlight the significance of being prepared in public health and the necessity of continuous efforts to comprehend and enhance vaccine acceptance and confidence among people living with HIV. By tackling the factors that impact vaccine attitudes in this group, we can improve our preparedness for future public health challenges where vaccine uptake may once again become crucial.

“Cough was Extremely Excruciating”: A Qualitative Study of Pre-Diagnosis Experience among Individuals with Tuberculosis in Samarinda, Indonesia

Tuberculosis (TB) is a global public health challenge. It's critical to comprehend how an infected person lives with the disease for TB control initiatives to be successful. Identifying the experiences before being diagnosed with tuberculosis needs to be done. This study aimed to explore the pre-experiences among individual that survive from TB. The qualitative method of descriptive phenomenology was utilized in this study. Purposive sampling was used in the sample process, and 16 tuberculosis survivors were included. This study found two themes that were pre-diagnosis symptoms (cough symptom, nutrition problem, hyperthermia and breathing problem) and health seeking behavior prior to being diagnosed with tuberculosis (visit health services, treatment behavior and ignore the symptoms felt). This study revealed that some individuals were still unable to identify the signs of tuberculosis and seek inappropriate treatment before receiving a diagnosis. Particularly for those who are at high risk, interventions aimed at enhancing the community's capacity to identify tuberculosis symptoms and adopt appropriate treatment-seeking behavior must be refined and implemented.

Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study

Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using “glory holes” (aOR: 19.82; 95% CI: 1.60–245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52–16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72–9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27–7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13–3.30) also showed a higher likelihood of vaccine hesitancy. Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Assessing the Quality and Accuracy of Syphilis-related Content on TikTok and YouTube: A Comprehensive Analysis.

Sexually transmitted infections (STIs), including syphilis, pose a significant public health challenge. The advent of social media platforms has revolutionized health information dissemination, with YouTube and TikTok emerging as prominent sources. However, concerns persist regarding the reliability of syphilis-related content on these platforms. This study aimed to evaluate the quality and accuracy of syphilis-related content on TikTok and YouTube, employing established tools such as DISCERN, Accuracy in Digital-health Instrument (ANDI), and Global Quality Scale (GQS). We conducted a thorough search on TikTok and YouTube on November 26, 2023, using the keyword "syphilis." Inclusion criteria comprised videos in English, less than 20 minutes in duration, and relevance to syphilis. Two dermatologists independently rated 98 eligible videos using DISCERN, ANDI, and GQS. Statistical analyses included Chi-square tests, mean comparisons, and interclass correlation. TikTok videos exhibited higher mean views (222,519 ± 412,746) compared to YouTube (127,527 ± 223,622). However, TikTok videos had lower mean GQS (2.3 ± 0.9), ANDI (2.19 ± 0.99), and DISCERN (28.7 ± 6.56) scores compared to YouTube (GQS: 2.9 ± 1.1, ANDI: 2.90 ± 0.97, DISCERN: 38.8 ± 9). Non-professional uploaders were 40.8% on TikTok, while YouTube were (53.1%). This study reveals disparities in the quality and accuracy of syphilis-related content on TikTok and YouTube. Despite higher popularity on TikTok, content quality, as assessed by DISCERN, ANDI, and GQS, was generally lower compared to YouTube. Targeted interventions are needed to improve the reliability of syphilis-related information on social media platforms.

5.I. Scientific session: Epidemiological insights into vaccine hesitancy in Europe: building bridges and overcoming barriers

Abstract Vaccine hesitancy remains a pivotal challenge in public health, undermining immunization efforts and the containment of infectious diseases across Europe. This scientific session aims to dissect the complex nature of vaccine hesitancy, uncovering epidemiological trends and barriers to vaccine acceptance, particularly in diverse demographic contexts. The objective is to facilitate a comprehensive understanding among public health stakeholders and to foster actionable strategies through enriched dialogue and interaction. This session will delve into recent studies and projects that highlight the variability of vaccine hesitancy within Europe. First, an exploration of COVID-19 vaccine acceptance will reveal how sociodemographic factors influence vaccine-related behaviors across 20 European nations. This will be complemented by an analysis of targeted interventions designed to enhance vaccine uptake among migrant populations, drawing lessons from the RIVER-EU project. Additionally, a focus on national efforts to combat measles vaccine hesitancy will provide a case study on the challenges and successes in altering public health narratives. Based on the feedback received on last year’s session, the format is intended not only to provide a platform to present empirical evidence and insights but also to encourage a participatory environment where attendees can exchange ideas and propose innovative solutions. For this reason, the session will engage the audience through an interactive discussion period at the end of each of the three presentations, stimulating thought-provoking dialogues that could lead to effective and innovative public health practices. Fostering international and interdisciplinary collaboration in the field of vaccine hesitancy is key for continued monitoring and reporting on the vaccine hesitancy phenomenon and inspiring actionable solutions. Key messages • Sociodemographic factors are associated with vaccine hesitancy across Europe indicating the potential for targeted strategies. • A platform to share insights and inspire actionable public health solutions to combat vaccine hesitancy amomg European public health professionals is needed.

Life course prevention - challenges for public health lying ahead

Abstract Issue/problem Demographic and epidemiological transitions have now shifted the focus from vulnerable population groups onto the active population, in particular young adults. At the same time lessons from the covid-19 pandemic taught us about missing actions on the elderly. While the latter have shown compliance and have followed most preventative activities, we observe scepticism and reluctance in the young adults. Description of the problem The covid-19 pandemic showed that young to middle-aged adults were the most reluctant group to adhere to preventative measures but in complying to the recommendations concerning vaccination. Since European activities are now focusing on addressing determinants of NCDs and are hoping to mobilise all population strata, including young and middle-aged adults, it would be important to explore how this mindset might affect the overall attitude to prevention. Results Health policy should explore specifically the needs of young to middle-aged adults (e.g. ages 30 to 44) to list their specific needs, expectations from preventative activities. On the other hand, it would be necessary to find out about the concerns, reluctance, and objections. The interplay of these will play a significant role in acceptance of present and future preventative activities. Exploration on these topics presents the following challenges: 1. Multiple sources of information on given health problems; 2. Lack of structured accessible and well-understandable explanations of advantages and benefits; 3. Inappropriate communication by health professionals or agencies on their behalf; 4. Complexity of the problem, which is then translated into complex and not easily understood messages. Lessons Learning about the specific needs of young adults, their expectations from the health systems in terms of prevention and health care as these will shape their overall attitude to prevention and have an impact on their families, particularly children. Key messages • Knowledge about expectations, needs, concerns, and reserves with respect to prevention is essential for the future activities on prevention. • Involving young and middle-aged adults in the preparation of the future preventative activities for their population groups is essential.

Review on Spirulina and Health Benefit

Undernutrition is a challenge for public health, especially in developing nations. Many years ago, it was proposed to employ algae, namely spirulina, as a functional food. This was because spirulina is a high-protein food source with an amino acid profile that is thought to have a high biologic-value protein content. Free-floating filamentous microalgae that thrive in alkaline water sources are known as spirulina. In Central Africa, spirulina has been eaten for millennia due to its high nutritional content. Today, it is a commonly utilized food supplement in the area of nutraceuticals. Its therapeutic advantages on a variety of sick situations, such as hypercholesterolemia, hyperglycerolemia, cardiovascular illnesses, inflammatory diseases, cancer, and viral infections, have recently attracted a lot of attention and significant research. The main causes of spirulina's cardiovascular health advantages are its hypolipidemic, antioxidant, and anti-inflammatory properties. Information from preclinical research using different animal models Continually show that spirulina has hypolipidemic properties.

Navigating Crisis: Resilience and Mental Well-being in Post-COVID Cyprus Students

Abstract Background The mental health of university students is identified as a major challenge in public health, exacerbated by the COVID-19 pandemic. The pandemic and its aftermath have brought forth several stresses, which have had a substantial influence on university students’ mental health. Understanding how resilience, which is crucial in coping with adversity, influences students’ responses to these difficult circumstances is critical. Objectives This study aims to examine the relationship between resilience and mental health outcomes among university students in the Republic of Cyprus after the COVID-19 pandemic. Methods Using a parallel embedded mixed methods approach, resilience was measured using the Conner-Davidson Resilience Scale (CD-RISC) while mental health outcomes were assessed using the Symptom Checklist 90-Revised (SCL 90-R) among a preliminary sample of 470 students. The association between the two was assessed by linear regression analysis, adjusting for potential confounders, and also stratifying by gender. Results Preliminary findings from this ongoing study revealed a significant inverse relationship between resilience and mental health (beta= -0.58, 95% CI -0.88, -0.29), regardless of gender, age, or socioeconomic status. Stratifying by gender revealed for males, the association between resilience and mental health is (beta= -0.50, 95% CI -0.98, -0.32), whereas for females, it is (beta= -0.63, 95% CI -1.04, -0.22). In short, the influence of resilience on protecting mental health appears to be slightly more prominent in women than in males. Discussion This study enriches our understanding of the intricate interplay between the COVID-19 pandemic, resilience, and mental health outcomes among university students. By prioritizing the psychological well-being of this population group, our findings resonate with the World Health Organization’s advocacy for heightened mental health awareness during crises. Key messages • Prevalence of mental health issues post pandemic era among university students. • Resilience as a buffer for mental health crisis in young adults.

Innovation in border regions: from inequality to equity! Starting with acknowledgment in policy

Abstract Living in a border area can create health inequalities due to limited access to healthcare compared to people in central regions. In centrally located areas, citizens can choose healthcare providers 360 degrees around them, benefiting from full prevention and health promotion coverage. In contrast, border residents have only 180 degrees of access, leading to partial inclusion in health services. National systems typically prioritize health equality but not necessarily equity, especially for those living in border regions. To address this gap, innovative policies that account for cross-border interactions are needed, benefiting over 35% of the EU population living in border areas. A key question is how to ensure health equity in border regions. To explore this, cross-border case studies, like air pollution, food purchases, antibiotic availability and q fever were looked at to identify the situation, the public health challenges it entails and existing solutions. The Essential Public Health Functions (EPHF) framework, developed by the World Health Organization and the International Association of National Public Health Institutes, was used to evaluate public health functions with a focus on achieving greater equity and inclusiveness. Currently in cross-border health key EPHF functions such as health promotion and disease prevention are emphasized, while others like public health governance and community participation need improvement. To better implement health equity in border regions, for use of the EPHF framework an additional and short guideline was developed on how border regions should be considered in national, regional, and local public health policies. This approach offers a pathway to addressing health inequalities in these unique environments: a crucial step towards creating health equity. Key messages • The EPHF framework as an innovative tool to strengthen public health in border regions. • Take the geographical living space of citizens in a border region into account to achieve health equity.

10.I. Scientific session: A National E-Infrastructure for Aging Research to Improve Public Health

Abstract Global life expectancy gains over the last half-century are remarkable. Yet the resulting demographic shift towards an older population poses substantial public health challenges, particularly in healthcare. To address these challenges, a profound and scientifically-based understanding of older adults’ health and care requirements is needed. Recognizing the need for a better understanding of the aging process and public health challenges, the National E-infrastructure for Aging Research (NEAR) was founded in 2018. NEAR seeks to promote and support aging research by facilitating longitudinal population-based data usage from 15 well-known Swedish cohort studies on aging and health. It is based on a collaboration between eight Swedish universities and includes 15 databases with individual assessments. NEAR comprises a broad range of biomedical, clinical, social, and psychological health data from more than 90,000 adults who are 50+ years old. These individuals have been followed between 12 and 52 years. The objective of this workshop is to give an overview of the NEAR infrastructure, present results from three ongoing NEAR projects, and their implications for public health: 1) Temporal trends in dementia incidence in Sweden; 2) Personality and biomarkers of neurodegeneration and Alzheimer’s disease in Swedish older adults, and 3) Characterizing risk profiles and transitions across living and care settings in Sweden. Infrastructures such as NEAR offer high-quality epidemiological data for achieving broad, interdisciplinary research goals that single databases often cannot provide. Moreover, the value added to these kinds of data includes enhanced sample sizes, variations, representativeness, and generalizability. In turn, this can address an aging society’s public and clinical health demands. Eventually, this could lead to sustainable intervention strategies for improving older persons’ health in the coming decades. Key messages • Discover new avenues in public health aging research: Gain insights into cutting-edge aging research opportunities in Sweden, exploring key NEAR projects. • Recognize the value of national infrastructures using high-quality epidemiological data in fostering collaborative and nationally representative public health research.

10.Y.2. Unlocking innovation: trustworthy co-creation for tackling complex public health challenges

Abstract Background Public health interventions often have limited effects, with few achieving large-scale implementation. Moreover, these interventions frequently fail to replicate their effects in real-world settings, possibly due to an overemphasis on generating universal knowledge through theory building and testing in controlled conditions. An alternative approach involves developing interventions within specific contexts, fostering collaborative knowledge generation, and establishing equitable partnerships. Co-creation offers a transformative strategy for addressing complex public health issues by generating real-world solutions. However, utilizing co-creation in public health presents challenges, including a lack of guidance on implementation and evaluation in public health settings. This underscores the need to integrate real-world co-creation with rigorous research to establish a reliable methodology grounded in both scientific evidence and participatory principles. Workshop This Pecha Kucha-style workshop will explore the essence of an evidence-based co-creation methodology developed through rigorous research by the European-funded H2020 Marie Sklodowska-Curie Innovative Training Network, Health CASCADE, and its partners. Emphasizing the significance of fostering innovative solutions to public health challenges, the workshop will provide key considerations for designing co-creation projects. It will also examine the role of enabling technologies in optimizing hybrid intelligence for effective co-creation, highlighting their contribution to collaboration enhancement. Perspectives from co-creators will be presented to offer unique insights into their experience of the co-creation process. Additionally, the workshop will elucidate the adaptation of co-creation processes within the Danish context, exploring collaborative efforts across sectors and shedding light on cross-sectoral cooperation intricacies. A moderated panel discussion will conclude the workshop, facilitating deeper engagement with the presented topics. Delegates will gain insight into applying co-creation in health promotion and behaviour change research, navigating prevalent challenges through Health CASCADE’s systematic approach, and discovering strategies for fostering effective and inclusive co-creation. They will also acquire strategies and resources to overcome potential obstacles, fostering more effective and inclusive approaches to complex public health challenges. Key messages • Co-creation presents a powerful approach to addressing complex public health challenges by fostering collaboration, creativity, and inclusivity across diverse stakeholders and communities. • Effective and trustworthy implementation of co-creation requires an understanding of its principles and methods, enabling technologies, and strong partnerships across sectors and institutions.

2.G. Practice session: Africa and Europe: peer-to-peer HIS assessments for NCD, mental health and injuries surveillance

Abstract Public health surveillance is the basis for evidence-informed decision-making and health (systems) research, globally. Without robust data, public health challenges cannot be tackled. NCDs, mental health conditions and injuries (NCDI/MH) are among the biggest global public health challenges. Their risk and protective factors, including social, political and commercial determinants of health, transcend borders and require multi-disciplinary, multi-stakeholder and long-term responses. Since 2006, comparable national data on NCDI/MH are being collected in Europe on the basis of European Core Health Indicators (ECHI) and the European Health Interview Survey (EHIS). Currently, EU and WHO EURO are working together to set up a new Health Information Network. At EU level, a sustainable health information infrastructure is still lacking, despite extensive preparations in EU-funded projects. Part of these project activities were health information system (HIS) assessments, applying the WHO EURO Support tool to strengthen health information systems for peer-to-peer assessments. In the African region, the Africa Centres for Disease Control and Prevention (Africa CDC), founded in 2017, made NCDI/MH prevention and control a strategic priority. In 2021, it launched its first continental NCDs, Injuries Prevention and Control and Mental Health Promotion Strategy (2022-26) under which the organization supports its Member States. At the 3rd International Conference on Public Health in Africa (Zambia, Nov. 2023), Africa CDC presented a continental Guidance to strengthen NCDI/MH surveillance. The Guidance was developed in collaboration with Robert Koch Institute (RKI) and is based on desk reviews, surveys and national HIS assessments. Both Europe and Africa performed HIS assessments to strengthen NCDI/MH surveillance; standardized tools from WHO EURO and from the International Association of National Public Health Institutes (IANPHI) were used and adapted to fit peer-to-peer approaches and regional contexts. This workshop will present and discuss methodological approaches, experiences and lessons learned, thereby initiating knowledge exchange across continents. The presentations will address the following points: - From top-down to peer-to-peer: methods & tools used in HIS assessments - From paper to practice: the importance of site visits in HIS assessments - From educated guesses to evidence: outcomes of HIS assessments at country level - From evidence to action: translation of HIS assessment outcomes into HIS improvements - From pilot to scale-up: challenges, lessons learned, sustainability of HIS developments To our knowledge, this workshop is the first one at the EPH to bring together practitioners in HIS strengthening for NCDI/MH from Africa and Europe. The workshop offers a unique opportunity to engage with the audience and to explore options for international collaboration. Key messages • Interregional collaboration helps reduce health information inequalities, facilitating better global management of high burden health challenges, such as NCDs, mental health conditions and injuries. • Peer-to-peer HIS assessments in Africa and Europe strengthen NCDI/MH surveillance. They build evidence for policy advice, research and health education and add the benefit of forging expert networks.

6.A. Round table: Building a Public Health Innovation Ecosystem in the WHO European Region

Abstract Background In the WHO European region, challenges persist in bridging the gap between innovative health solutions and their widespread implementation at a population scale. Despite advancements in AI, digital systems, precision medicine, genomics, and social innovations, these potential solutions often go underutilized. Immediate action is necessary to address the multifaceted issues faced by health systems, such as aging populations, noncommunicable diseases, antimicrobial resistance, and climate change impacts on health. To effectively tackle these challenges, it is essential to develop and implement innovations that respond to critical health issues in a contextual manner. Establishing an innovation ecosystem that fosters collaboration, strategic partnerships, and effective scaling of innovative solutions is crucial. Robust policy frameworks and governance mechanisms are needed to engage with the private sector and other nontraditional public health partners to drive equitable and value-driven innovations in public health. Rationale The workshop at the 17th European Public Health Conference 2024 aims to explore the role of public-private collaborations in driving innovative solutions for public health. By examining synergies between sectors, the workshop seeks to accelerate innovation, improve preventive services, and enhance health delivery to address pressing public health challenges. Leveraging the private sector’s expertise and resources is crucial in addressing complex health issues and improving public health outcomes. The workshop will provide a platform to strategize on utilizing these collaborations for sustainable innovation in public health. Overall Objective Foster a deeper understanding of the benefits and challenges of public-private collaborations in advancing public health innovation. Specific Objectives - Facilitate knowledge exchange on successful collaboration models between the private sector and public health entities. - Identify key strategies to utilize private sector resources for innovative public health solutions. Outcomes: - Inspire the formation of new partnerships to drive innovation in public health. - Develop actionable insights to enhance collaboration between the private sector and public health stakeholders for sustainable innovation. Workshop Structure: The workshop will begin with a Scene-setting presentation of Dr Gauden Galea, Strategic Advisor to the Regional Director, WHO Europe, on WHO Europe’s approach to leveraging innovation for public health outcomes (10 mins). Panelists will then discuss concrete examples of public-private collaboration leading to improvements in public health outcomes (40 mins). Key success factors for meaningful partnerships with the private sector will be explored, emphasizing policy considerations and the importance of behavioral and cultural insights in innovation. Interactive Q&A session with audience will close the meeting (10 mins). Key messages • Establishing an innovation ecosystem fosters partnerships that drive equitable and sustainable solutions in public health. • Public-private collaborations accelerate innovation for public health, vital for addressing complex challenges effectively. Speakers/Panelists Götz Gottschalk, YouTube, Berlin, Germany Götz Gottschalk (Head of Health, YouTube Germany) will discuss the role of technology, particularly YouTube, in disseminating accurate health information to the public. He will also share insights on how digital platforms can be utilized to promote public health initiatives, address misinformation, and engage with diverse audiences effectively. His talk will also focus on the importance of collaboration between the public and private sectors in leveraging technology for public health outcomes, emphasizing the need for responsible and accurate health communication in the digital age. Phillippe Menu SOPHiA Genetics, Rolle, Switzerland Phillippe Menu (Chief Medical Officer and Chief Product Officer, SOPHiA Genetics, Switzerland) will discuss how data-driven approaches, artificial intelligence, and genomic insights can revolutionize diagnostics, treatment decisions, and personalized medicine. His talk will highlight the potential of integrating advanced technologies into public health to improve patient outcomes, enhance clinical decision-making, and drive innovation in the field of precision medicine. Els Torreele Institute for Innovation and Public Purpose, University College London, London, UK Els Torreele (Policy Associate, UCL Institute for Innovation and Public Purpose) will discuss policy frameworks, governance structures, and strategies to promote equitable access to public health innovations, particularly in low- and middle-income countries. Her talk will shed light on the intersection of innovation, public policy, and global health, emphasizing the importance of addressing systemic barriers to ensure that innovative healthcare solutions reach those who need them the most. Andrew Nerlinger Global Security Fund, Geneva, Switzerland Andrew Nerlinger (Executive Director, Global Security Fund) will discuss pandemic preparedness, biosecurity measures, and the role of non-profit organizations in addressing global health threats. His talk will explore how innovative approaches, partnerships, and funding mechanisms can strengthen global health security, mitigate risks, and build resilience in the face of emerging health crises. Susan Michie Centre for Behaviour Change, University College London, London, UK Susan Michie (Professor of Health Psychology and Director of the UCL Centre for Behaviour Change) will discuss evidence-based strategies for promoting behavior change, improving health outcomes, and addressing public health challenges through behavioural and cultural insights. Her talk is expected to highlight the importance of understanding human behavior, motivations, and decision-making processes in designing effective health interventions and shaping public health policies.

1-year outcomes of patients presenting with acute coronary syndromes in Western Cape, South Africa: findings from the PERFUSION ACS registry

Abstract Background Cardiovascular disease(CVD), particularly acute myocardial infarction(MI), has emerged as a public health challenge in South Africa(SA), however, there is a paucity of data regarding long-term clinical outcomes such as CVD mortality, heart failure, stroke and recurrence of MI in this region. Purpose To determine 1-year major adverse cardiac outcomes among individuals discharged alive following admission for troponin-positive Acute Coronary Syndromes(ACS) in Western Cape, SA. Methods Between February 2021 and May 2022, 838 adults(≥18 years) with a diagnosis of ACS were prospectively enrolled into the investigator-initiated, multi-center PrEsentation, Rationale, and impact of reperFUSION for Acute Coronary Syndromes (PERFUSION ACS) registry. Participants were enrolled at a tertiary-care referral center and four secondary-level healthcare facilities. Key data elements were measured at index admission, including baseline demographics, risk factors, clinical presentation, complications, laboratory tests, revascularization strategies, and discharge medication. Survivors at discharge provided consent for 30-day and 12-month telephonic evaluations for major adverse cardiovascular events(MACE), which were captured on a web-based system that was centrally managed and analyzed. Results Of 838 participants, 39% were female, one-third were <55 years of age, 76% had a history of smoking, 74% had hypertension, 58% had dyslipidemia, and 56% were obese. STEMI accounted for 51% of cases, with NSTEMI in 49%. Baseline data for the cohort, stratified into two categories of MI, are provided in Table 1. Median duration from symptom onset to hospital presentation was 10.42 (±15.26) hours, with a majority(80%) presenting first to a non-PCI-capable facility. Among STEMI cases, two-thirds received thrombolysis(65%), primarily with Streptokinase; 49% underwent angiography via a pharmacoinvasive strategy, and 3% received primary percutaneous coronary intervention(PCI). Overall, 57% of patients with NSTEMI were treated with an invasive approach. The one-year all-cause mortality was 21%, with 88% attributable to cardiovascular disease-related death. Cumulative MACE rate at one year was 57%. Event rates for the individual MACE components were 32% for heart failure, 19% for non-fatal MI, and 6% for non-fatal stroke. 6% of participants died in-hospital, while 30-day mortality was 9%. There were no significant differences in all-cause mortality between STEMI and NSTEMI at 1 year. Conclusion Troponin-positive ACS are associated with a high rate of 12-month mortality and non-fatal major adverse cardiac events in Western Cape, SA. The concerning registry findings emphasize the need to prioritize ischemic heart disease prevention and management, and highlight important gaps in care which can serve as targets for improvement throughout the country.PERFUSION: Table 1PERFUSION: All-cause mortality and MACE

Bridging the gap: mapping co-creation methods for public health impact and innovation

Abstract Background Co-creation offers a promising approach to public health innovation, particularly for tackling complex issues. However, the lack of a standardized methodology limits its reliability and reproducibility, especially across diverse contexts. This study explores co-creation methods used by researchers and practitioners, aiming to shed light on their implications for public health. Understanding this methodological landscape can enhance the effective implementation of co-creation processes to address complex challenges. Methods Utilizing the Systematic Methods Overview approach, we examined co-creation methods. Data were gathered from the Health CASCADE Co-Creation Database and grey literature using an artificial intelligence-assisted recursive search strategy and a two-step screening process. We conducted textual, comparative, and bibliometric analyses to evaluate methodological underpinnings and relationships between methods. Results Analysis of 2,627 academic articles and grey literature sources identified over 900 co-creation methods. While surveys, focus groups, and group discussions were prevalent, participatory methods were underutilized. Notably, 91.3% of methods co-occurred, with a predominant combination of qualitative approaches. Furthermore, a significant discrepancy between research and practice was evident, with only 10.2% convergence. Conclusions This study revealed a critical gap between co-creation in research and practice, emphasizing the need to bridge this methodological divide for advancing co-creation as a reliable approach in public health. The over-reliance on qualitative methods raises concerns about tokenistic engagement and undermines meaningful public participation in co-creation. Addressing this trend is vital to preserve the essence of true co-creation and maximize its potential for addressing complex public health challenges. Key messages • Mapping the diverse methods of co-creation in public health reveals both richness and disparities in approach, from surveys to participatory methods. • Addressing the discrepancy between co-creation in research and practice is vital for establishing a reliable and effective approach to tackling public health challenges.