Public Health Programs Research Articles

GAMETERAPIA NA FISIOTERAPIA: UM RECURSO PARA REDUZIR O RISCO DE QUEDAS EM IDOSOS DA COMUNIDADE - REVISÃO DE LITERATURA.

The aging population worldwide has led to an increased prevalence of falls among older adults, resulting in fractures, loss of mobility, and increased dependency. This systematic review analyzed the effectiveness of gamification and virtual reality in preventing falls and improving balance in older adults, promoting active aging. Studies published between 2019 and 2024 were analyzed in the Google Scholar, PubMed (Medline), and Lilacs (BVS) databases, considering clinical trials and observational studies with individuals over 65 years of age. The results indicate that the inclusion of gamification with conventional physiotherapy can be effective in improving balance, muscle strength, and cognitive function in older adults, reducing the risk of falls and promoting independence. Due to its playful and motivating nature, it facilitates adherence, just as virtual reality offers an immersive experience that reduces the fear of falling. It is concluded that these interventions require more research to personalize the games and adapt the technologies to the specific needs of the elderly population. Furthermore, it is essential to investigate the long-term effects of gamification and its integration into public health programs.

Key influencers of mass drug administration implementation and scale-up: a social network analysis of soil-transmitted helminth intervention platforms in Benin, India, and Malawi

IntroductionLarge community-based public health programs, like mass drug administration (MDA), require coordination across many stakeholders. We used social network analysis (SNA) to systematically identify the network of stakeholders who influence delivery of school-based and community-wide MDA for soil-transmitted helminths (STH) in Benin, India, and Malawi and determine how network dynamics may impact implementation and scale-up across these delivery platforms.MethodsThis study was embedded within the implementation science research of the DeWorm3 Project, a hybrid clinical trial in Benin, India, & Malawi testing the feasibility of STH transmission interruption via community-wide MDA. Sites developed lists of stakeholders engaged in both MDA programs and indicated stakeholders’ attitudes towards the intervention and influence over intervention delivery. We developed digital sociograms for both MDA networks by site, comparing baseline vs. endline. We descriptively compared changes over time in stakeholder attitudes and influence and key SNA measures, including centrality, centralization, and density.ResultsAcross sites, we identified an expansive network of stakeholders involved in delivery of school-based (N= 139, 63, 58 vs. N=139, 162, 63) and community-wide MDA programs (N=52, 137, 54 vs. N=54, 136, 60) at baseline vs. endline in Benin, India, and Malawi, respectively. At both timepoints, a majority (>70%) of stakeholders held positive attitudes towards both programs. For both programs, stakeholders with the highest degree centrality scores (i.e., the most connected individuals) were those responsible for implementation such as community drug distributors or school teachers, while those with the highest betweenness centrality scores (i.e. those who controlled resource or information flow across networks) were responsible for policy-making & program leadership (e.g., NTD Program Managers). Low density scores indicated networks had poor overall connectedness due to minimal connectivity across administrative levels, while low centralization scores reflected stable networks where no single individual exhibited high control over resource flow.ConclusionDuring stages of innovation, redesign, or scale-up, analyzing the network of policymakers and implementers provides an opportunity to optimize effectiveness and efficiency of public health programs. Study findings provide useful insight for NTD policymakers and implementers in STH-endemic countries aiming to successfully interrupt STH transmission by transitioning from school-based to community-wide MDA.

Insights into Health Program Implementation and Evaluation in Iran: A Brief Review of National Healthcare Programs in Iran.

Healthcare program monitoring can play a key role in evaluating their implementation and identifying their strengths and weaknesses. This study was performed with the exploratory sequential mixed methods design in 2023 at Tehran, Iran. The information was categorized into indicators, refining, analysis, interpretation, reporting, and proposed challenges and recommendations. Medical Sciences Department of Public Health (TUMSDoPH) evaluation of its public health programs revealed a comprehensive approach covering a wide spectrum from disease management to health promotion, emphasizing electronic health records, targeted disease interventions, and strategies for non-communicable diseases, alongside efforts to enhance community health. There is a need for initiating "the monitoring committee" under the supervision of the deputy chancellor for public health to monitor key performance indicators and policies to discover the problems of each part of the health system and provide recommendations.

PREVENTION AND CONTROL OF CHRONIC DISEASES IN VULNERABLE POPULATIONS

Chronic diseases such as diabetes, hypertension and cardiovascular diseases are prevalent in vulnerable populations, who often face difficulties in accessing adequate medical care. Primary care, especially family medicine, plays a central role in the prevention and control of these diseases, as it offers continuous, comprehensive and personalized care, focused on health promotion and the prevention of complications. This model of care is especially effective in communities that face economic, social and cultural barriers, allowing for early intervention and appropriate management of chronic conditions. The aim of this study is to analyze strategies for the prevention and control of chronic diseases in vulnerable populations, with a focus on family medicine. The aim is to identify effective approaches that can be used to improve the quality of life of these populations and reduce the incidence and progression of chronic diseases. The research was carried out through a qualitative literature review, focusing on articles published between 2017 and 2022. The aim was to explore the advances and challenges in the management of chronic diseases, with an emphasis on primary health practices, the impact of social determinants of health, and the role of technologies such as telemedicine in the management of these conditions. By providing continuous and comprehensive care, family medicine uses various strategies to prevent and control chronic diseases. These include regular patient follow-up, early screening for conditions such as hypertension and diabetes, and health education, which guides individuals on healthy behaviors and self-care. In addition, disease monitoring programs and interventions such as modifying eating habits and promoting physical activity have shown positive results in the management of chronic diseases. However, there are still significant challenges, such as the scarcity of resources and the lack of qualified professionals, which limit the effectiveness of these approaches in certain regions and social groups. Overcoming these barriers requires a joint effort between health professionals, managers and public policies. It is concluded that family medicine is a fundamental approach to the control and prevention of chronic diseases, especially in vulnerable populations. The strategies adopted in this model of care, such as continuous monitoring, health education and early intervention, have shown significant results in improving quality of life and reducing complications associated with chronic diseases. However, in order to optimize the results, it is necessary to overcome challenges related to access and the training of professionals, as well as ensuring adequate support for the implementation of public health programs that favour the population in situations of vulnerability. Implementing efficient public policies and expanding access to primary health care are essential to achieving effective control of chronic diseases.

Te Mauri—whānau mana motuhake: supportive care for whānau Māori living with cancer

This article describes the origins and development of Te Mauri (the life essence), a unique Māori (Indigenous people of New Zealand) public health and well-being programme aimed at addressing critical gaps in knowledge about supportive cancer care for whānau (families) living with cancer in Aotearoa (New Zealand). Te Mauri is a kaupapa Māori (Māori philosophy) public health initiative having a whānau ora (family well-being) approach, so is based not on the individual, or patient, but within whānau and the core role of communities in relation to the provision of cancer care, the promotion of recovery from cancer, and the maintenance of well-being for current and future generations. Te Mauri makes an important contribution to expanding mātauranga Māori (Māori knowledge) and the range of Indigenous models of care so that cancer service provision is improved for the benefit of all those who are on a cancer journey.

Promises and challenges of genomic newborn screening (NBS) - lessons from public health NBS programs.

Newborn screening (NBS) in the United States began in the 1960s to detect inborn errors of metabolism that benefited from presymptomatic treatment compared with treatment after the development of symptoms and diagnosis. Over time, it expanded to include endocrinological disorders, hematological disorders, immunodeficiencies, and other treatable diseases such as lysosomal storage diseases (LSD), cystic fibrosis, X-linked adrenoleukodystrophy, and spinal muscular dystrophy. This expansion has been driven by new technologies (e.g., tandem mass spectrometry) and novel treatments (e.g., enzyme replacement therapy and stem cell transplant for LSDs). Advances in next-generation gene sequencing (NGS) enable rapid identification of many additional conditions that might benefit from early presymptomatic intervention. We review the NGS technologies that evolved as diagnostic testing and suggest issues to be resolved before their potential application to screening the asymptomatic population. We illustrate the importance of selecting diseases to be screened and propose recommendations to follow when variants of uncertain significance are found. We address ethical issues around achieving equity in the sensitivity of genomic NBS, access to follow-up and management, especially for people from diverse backgrounds, and other considerations. Finally, we discuss the potential benefits and harms of genomic NBS to the overall health of children with monogenic diseases. IMPACT: Genomic newborn screening programs are ongoing worldwide. Public discussion is needed as to whether genomic newborn screening should be offered as a public health program and, if so, what conditions should be screened for. Providers should understand that the sensitivity of genomic newborn screening is especially low for newborns from non-European populations. Methylation, large structural variants and repeat expansion variants are not amenable to next-generation sequencing-based genomic newborn screening. The article serves as a comprehensive guide to understanding issues that need to be solved before genomic newborn screening is implemented as a public health program.

Beyond accreditation: unraveling the narrative of public health through a critical race praxis lens.

Recognizing and addressing health inequities among minority populations are pivotal to public health. Further, public health strives to understand the complexities between race and health without limiting discussions around race as a trivial variable. This commitment toward equity demonstrates considerable similarities to Critical Race Theory (CRT) which led to the creation of the Public Health Critical Race (PHCR) Praxis to instill CRT within public health. However, the literature on how public health education incorporates critical race studies remains limited. The goal of this study was to examine how public health curriculum currently aligns with the PHCR praxis and meets public health's goal of health equity. This qualitative study employed document analysis to evaluate academic syllabi from CEPH-accredited MPH programs. Stratified random sampling was applied across two sampling pools, Schools of Public Health (SPH), and Public Health Programs (PHP). Course overviews, course objectives, course curricular information, and course policies were identified and extracted from each syllabus for analysis. A total of 53 syllabi were obtained from a final sample of nine public universities and one private. Through inductive and directed content analysis, a priori themes of Structural Determinism, Voice, Critical Approaches, Ordinariness of Racism, Social Construction of Knowledge, Intersectionality, Disciplinary Self-Critique, Primacy of Racialization, Race as a Social Construct, Race Consciousness, and their respective categories arose as salient. Two new themes, Antiracism Practices and Culture of Inclusivity, were also present. This study is the first to explore public health education's current curricular practices concerning CRT and antiracist praxes. The results confirm the interwoven nature of public health education with critical race studies, as all principles of PHCR praxis were present. However, the prevalence of these principles varied, suggesting gaps in the alignment of public health curricula and CRT. It is essential that public health educators ensure that the foundational competencies students are expected to display align with public health's goal of health equity. This work can equip MPH programs and public health educators with the ability to revise or bolster their current curricular and instructional efforts to support the pursuit of health, racial equity, and social justice.

Leaky Vaccines: A Wicked Problem in Accelerated Vaccine Development

While no vaccine can provide 100 percent protection, a high standard of regulatory safety, efficacy and quality is essential for public trust and the uptake of vaccines as essential global public health tools. This article addresses a growing concern that suboptimal “leaky” vaccines threaten emergency response to pandemics as well as routine public health programs. Agile regulatory standards now advance earlier approval of vaccines and therapeutics that may have suboptimal effectiveness. The benefit-harm trade- offs that play an enormous role in regulatory assessment and all stages of vaccine development and delivery deserve better public scrutiny, transparency, and accountability. Drawing on the case of the first licensed malaria vaccine, RTS,S Mosquirix™, in light of the rapid approval of COVID-19 vaccines, we consider the socio-technical implications of leaky vaccines in global vaccine logics and suggest possibilities for building legitimacy to inform the next generation of regulatory technology policy.

Detection of the 1016Gly and 989Pro Knockdown Resistance Mutations in Florida, USA Aedes aegypti.

Aedes aegypti is a major arboviral disease vector and is therefore a critical target for control by public health programs. Early eradication efforts have shown that Ae. aegypti can rapidly build insecticide resistance, and, now, resistance to pyrethroids, the major class of adulticides used for operational control, is common in many populations. A major contributor to this resistance is a group of knockdown resistance (kdr) SNPs that normally exist in distinct ensembles in the Western Hemisphere and the Indopacific with little known mixing. In this study, we detected, and confirmed, using multiple methods, the Indopacific kdr SNPs, both V1016G and S989P, in three recent collections from Osceola County, Florida. This represents a large expansion of the geographic range of the Indopacific kdr SNPs. We consider the implications of this finding on future insecticide resistance surveillance studies, including assessing the ability of our current screening tools to detect these SNPs. We find that the presence of the Indopacific SNPs requires the modification of existing resistance screening protocols and requires further work to understand the operational implications for mosquito control.

Impact of Sensitization on School Teachers' Knowledge and Attitudes Towards Adverse Drug Reaction Reporting During National Deworming Day: A Prospective Quasi-Experimental Study.

School teachers play a crucial role in executing administration of single dose albendazole to school children on National Deworming Day (NDD). Effective reporting of adverse drug reactions (ADRs) during such mass administration of medicines at the time of such public health programmes is vital for several policy decisions on safety. The study aims to evaluate teachers' knowledge and attitudes on ADR reporting regarding NDD and assess the impact of a sensitization program. A total of 163 school teachers from 94 schools in the district, who gave informed consent were included. The study utilized a pretested and prevalidated questionnaire, scored on a 0-10 scoring scale. Employing a prospective quasi-experimental one-group pre-test and post-test research design, the primary aim was to evaluate the impact of the awareness program, with secondary objectives focused on demographic correlations with program effectiveness. The study shows a significant improvement in participants' scores from the pre-test (mean score of 5.60) to the post-test (mean score of 8.28), resulting in a mean deviation of -2.68±1.74 (p < .001), suggesting that the intervention significantly enhanced outcomes. Additionally, the results indicate that the mean post-test score was slightly higher among urban participants in comparison to rural participants, with mean scores of 8.45 and 8.10, respectively. The sensitization program significantly improved the knowledge and attitude of school teachers engaged in NDD regarding ADR reporting. However, long-term studies on the impact of this improvement in knowledge and attitude on actual ADR reporting need to be planned.

The impact of screening for tuberculosis exposure in the household in children with tuberculosis disease: A difficult riddle to solve.

Tuberculosis (TB) infection is transmitted by sharing the same airway with people with active TB. Children are often not considered the source of TB bacilli, and index case investigation is carried out after diagnosis. Here, we describe the impact of the presence of a household index case on childhood TB disease. The data of patients aged between 1 month and 18 years who were diagnosed with TB were collected. We compared patients according to whether they had an index case in the household or not. A total of 202 TB patients were enrolled, of whom 62 (30.7%) had a household index case. There was no significant difference in having a household index case between TB patients under the age of five (23.3%) and older children (33.8%) (p = .140). Pulmonary TB was present in 61.4% of the cases, and extrapulmonary TB was present in 38.6% of the cases. The rate of patients who had a household index case was significantly higher in pulmonary TB (46.8%) compared to extrapulmonary TB (5.1%) (p < .001). Pulmonary TB patients with a history of household contact were more likely to have diagnostic radiological findings (93.1%) compared to those without (75.8%) (p = .009). However, pulmonary TB patients without household contact history had a higher rate of diagnostic microbiological findings (59.1%) and constitutional symptoms (63.6%) (p = .019 and p = .013, respectively). Household contact research is an important epidemiological tool. However, considering the contact rates in the household, new and more comprehensive public health programs are required to prevent the spread of childhood tuberculosis.

Infant feeding practices: an analysis of sociodemographic characteristics and dietary patterns in early life

The significant rise in childhood obesity is a public health challenge, and it is estimated that nearly 25% of children in England start school with overweight or obesity1; those from ethnic minorities and more disadvantaged areas are disproportionately affected2. The transition from exclusive milk feeding to the introduction of solid foods is an important stage in a child’s growth and development as eating habits and behaviours established in early life have been shown to continue into late childhood3. Given the increase in prevalence of childhood obesity, the aim of this study was to describe the weaning diet of infants and explore associations between sociodemographic characteristics.The analysis included mother-infant pairs from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), an antenatal diet and physical activity intervention which recruited women with obesity from ethnically diverse inner-city settings4. Maternal sociodemographic characteristics were recorded at baseline (15-18 weeks’ gestation). Infant dietary patterns were derived using factor analysis of a parent reported interviewer-administered food-frequency questionnaire at 6-months of age. To explore relationships between infant dietary patterns and sociodemographic characteristics, a multiple linear regression model was developed and included the following maternal exposures; age, body mass index (BMI), time spent in education, ethnicity, parity, smoking and breastfeeding prevalence at the 6-month follow-up. The model was also adjusted for age of introduction of solids and the UPBEAT intervention arm.720 mother-infant pairs were recruited at 6-months postpartum, and 542 were included in this analysis as weaning had started. There was no effect of the UPBEAT intervention on infant dietary patterns. The average age of introduction of solid foods was 5 ± 0.87 months. Two dietary patterns were identified in the infants. The first pattern defined as ‘Processed’ was high in rusks, baby pouches, porridge, fruit puree, yoghurt, juice, desserts, snacks and meat, fish or savoury-based meals. The second pattern, defined as ‘Healthy’ was high in breakfast cereals, potatoes, yoghurt, biscuits, fruit, vegetables, bread, meat and fish-based meals and pasta. The Processed pattern in the infant was associated with lower maternal age (beta-coefficient −0.01; 95% confidence interval −0.03, −0.003), higher maternal BMI (0.02; 0.003, 0.04), less time spent in education (−0.06; −0.09, −0.02), lower breastfeeding prevalence (−0.28; −0.51, −0.05) and a lower infant age of introduction of solid foods (−0.20, −0.30, −0.10). Women of Black ethnicity were less likely to adhere to a Healthy pattern (−0.40, −0.63, −0.15).A processed dietary pattern at 6-months of age is associated with several maternal sociodemographic factors, including lower educational attainment, lower age at birth and higher BMI. These results support the need to for targeted public health programmes which promote healthier weaning practices.

Trends in new hepatitis C virus infections among repeat blood donors – Georgia, 2017–2023

Background and objectivesBlood donor cohorts are an underappreciated resource for surveillance and public health programming for infectious diseases. The incidence of hepatitis C virus (HCV) infection was evaluated in repeat blood donors in Georgia. Materials and methodsUsing data from the national hepatitis C screening registry, we calculated overall hepatitis C incidence for 2017–2023 and annual incidence during 2017–2022 among adults who donated blood at least twice and had a nonreactive HCV antibody (anti-HCV) test result upon first screening and a subsequent anti-HCV test conducted in any location. Rates of anti-HCV seroconversion and current infection were calculated by year, sex, age group, and location of last HCV screening and expressed per 100,000 person-years (PY). ResultsOf 101,443 blood donors with ≥ 2 anti-HCV results,775 (0.8%) seroconverted to anti-HCV reactive, of whom 403 (52.0%) had current infection. Incidence of anti-HCV seroconversion decreased from 408 per 100,000 PY in 2017 to 218 per 100,000 PY in 2022 and incidence of infection decreased from 172 per 100,000 PY in 2017 to 118 per 100,000 PY in 2022. Males, persons aged 18–39 years, and people last tested for HCV in prisons had the highest incidence rates for anti-HCV seroconversion and HCV infection, while persons last screened in blood banks and during antenatal care had the lowest. ConclusionDespite the observed decline, incidence of HCV infection among repeat blood donors remains high in specific subgroups. Hepatitis C prevention, screening and treatment interventions need to particularly focus on incarcerated populations and young adults in Georgia.

A conceptual framework for digital health marketing strategies to enhance public health outcomes in underserved communities

This paper proposes a conceptual framework for integrating digital health marketing strategies with public health initiatives to enhance healthcare access and outcomes in underserved communities. The framework focuses on leveraging digital marketing tools such as social media, mobile applications, email campaigns, and search engine optimization to disseminate critical health information, promote preventive measures, and engage communities in healthier behaviors. It addresses the persistent challenges faced by underserved populations, including limited healthcare access, low health literacy, and cultural barriers, by utilizing the accessibility and broad reach of digital channels. The proposed framework incorporates three core components: (1) Health Information Dissemination, which explores the use of targeted digital campaigns to provide culturally relevant and accessible health education; (2) Community Engagement, which leverages interactive platforms such as social media and mobile apps to foster participation in preventive healthcare initiatives and healthy lifestyle practices; and (3) Behavioral Change Promotion, which emphasizes using digital tools to influence health behaviors through personalized messaging, reminders, and virtual support groups. By integrating digital marketing strategies into public health programs, the framework aims to improve healthcare outcomes by increasing awareness of preventive measures, enhancing early diagnosis, and promoting disease management. It also underscores the role of data analytics in refining outreach efforts by identifying specific health needs, tracking engagement, and measuring the effectiveness of interventions. This conceptual framework holds promise for healthcare providers, policymakers, and digital marketers seeking to enhance public health outcomes in underserved communities. It provides a structured approach to combining the strengths of digital marketing with public health goals, creating more inclusive, accessible, and effective health interventions. Future research and case studies can build on this model to refine digital health marketing strategies and assess their long-term impact on public health in underserved populations.

9.Y.2. Leveraging GenAI and Deep Learning for the Analysis of Public Health Data: A Global Perspective

Abstract The evolution from Artificial Intelligence (AI) to Generative Artificial Intelligence (Gen AI) represents a significant advancement in technological capabilities and applications. Advancements in computing power, algorithmic complexity, and data availability have enabled Gen AI to exhibit broader cognitive abilities such as reasoning, problem-solving, and learning across diverse domains. Private sector investment and innovation is advancing capability in this space at a rapid pace, trending toward a complete paradigm shift towards machines capable of autonomously adapting and learning in dynamic environments, promising profound impacts across industries from education and finance to healthcare and beyond. Yet harnessing the power of GenAI remains out of reach for most public health entities. Questions like “How to start” and “What to do”, let alone concerns regarding cost, security, and ethics, often thwart an agency from endeavoring to even begin their journey to the program improvement they visualize through the lens and promise of AI. Conduent’s longstanding presence and pioneering work in AI across various sectors, has led to a simple, underlying philosophy: we leverage Gen AI technologies to assist and enable humans to improve business processes. Instead of developing Gen AI technologies ourselves, we focus our efforts on making advanced technologies accessible to our clients and enabling them to achieve their outcomes. This session focuses on accessibility and enablement for public health agencies looking to jump start their journey to AI and evolve their public health programs with the use of Gen AI, covering topics such as: • The evolution of GenAI in the private sector; • Visualizing objectives in public health outcomes and improved business processes; • What to do about data; • Using human intelligence to drive machine learning; • Managing security, ethics, and equity; • Roadmap your Journey to Gen AI. For Conduent, Gen AI is not intended to replace humans but to harness its potential to support and empower humans in creating innovative, additive opportunities that enhance business process outcomes. In the public health space, its impact is immense and far reaching. Let’s shift from “How do I start” to tackling the questions that improve programs and their outcomes. So how will you optimize your program with Gen AI? Let’s get started. Key messages • Private sector Gen AI capability is expanding at a rapid pace yet many public health agencies are struggling just to start. Conduent offers an informed perspective to jump start your Gen AI journey. • Accessibility and enablement for public health agencies looking to jump start their journey to AI and evolve their public health programs with the use of GenAI. Speakers/Panelists Mark Marostica Conduent Public Health Solutions, Florham Park, USA Dianna Lydiard Conduent, Florham Park, USA Tarun Khatri Conduent, Burlington, Canada

How much digital public health is taught in German public health programs? A qualitative analysis

Abstract Background Digital public health (DiPH) professionals are crucial for a successful digital transformation in social and health care. However, the extent to which academic professionals are taught DiPH-related content in their public health studies in Germany remains unclear. Methods We used a systematic module handbook analysis to assess accredited full-time public health-oriented degree programs at German Universities for DiPH-related modules. Programs were identified through the Hochschulkompass platform and among the German Public Health Association member programs. We used MAXQDA for the content analysis of the included module handbooks. Results We identified 79 public health programs. Of these, 10 Bachelor’s and 6 Master’s offered at least one DiPH module, all being highly heterogeneous in their overall addressed public health subfields. Regarding DiPH, 6 programs lectured on the ethics of digitalizing health and data protection, 5 programs each offered modules on DiPH in health policy, on data science in healthcare and software used for eHealth, or on the digital determinants of health. 4 programs each included modules on digital health promotion and alternative evaluation methods. 3 programs each addressed digital science communication and health technology assessment. Finally, 2 programs had modules on digital epidemiology. We found differences between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focused mainly on technical areas. Social and health science content was only marginally present. Conclusions The diverse DiPH study programs allow academic public health specialists in Germany to develop specific profiles. There is a need for further development of modules with relevance to the respective degree program to achieve comprehensive competencies in DiPH. We encourage the uptake of our analysis to develop a core curriculum in DiPH among European public health programs. Key messages • Digitalization affects all areas of life, including healthcare systems and public health. Preparing the future workforce already during their training is crucial to enable them to lead the change. • German public health programs are not fit to prepare students for their professions. Developing DiPH curricula with pre-defined and updated competencies will strengthen programs in Germany and beyond.

A Good Practice for Learning with Public Health Professionals Globally: Humphrey Fellowship Program

Abstract Background International collaborations are valuable yet often undervalued assets that enhance the quality of public health education and bolster the development of the public health workforce. Objectives The Humphrey Fellowship Program, part of the Fulbright Exchange Program, facilitates mid-career professionals’ visits to US-based host universities for an academic year. Fellows engage in a semi-structured fellowship period to achieve self-defined goals, emphasizing professional development, expanded experience, and intercultural exchange. This study advocates for the program’s contribution to enhancing public health education. Results Currently, two universities host fellows in public health. Over decades, fellows have engaged with faculty and professionals, participated in classes and meetings, visited institutions for development purposes, and completed US-based affiliations, contributing significantly to their own and the public health workforce’s advancement. This interaction-based learning approach aids in navigating social and ethical challenges by fostering a deeper understanding of public and global health issues across countries. Conclusions The Humphrey Fellowship Program in public health stands as a commendable model. Similar initiatives could be beneficially replicated in the European region, leveraging local and global successes to strengthen ties with public health education institutions, student communities, and beyond. Key messages • Programs that facilitate international interactions can enhance public health professionals’ understanding of global perspectives. • The Humphrey Fellowship Program in the US stands as a commendable practice for mid-career public health professionals, contributing significant value to the education at host universities.

Postgraduate medical education in Public Health: the Italian scenario and a call to action

Abstract Introduction Public health training in Italy takes place within postgraduate medical training in Hygiene and Preventive Medicine. With 39 university schools of public health, spread across 17 of Italy’s 20 regions, the landscape is diverse. The government determines the number of available contracts annually. This study aims to provide an up-to-date analysis of the saturation of places in Public Health programmes, as well as an assessment of mobility trends between northern and southern Italy from 2017 to 2023. Methods Data on admissions, withdrawals and resignations were obtained from the Ministries of Universities and Health and from the archives of the ‘Associazione Liberi Specializzandi’ (ALS). Mobility was assessed as moving from the central-northern regions to the southern-islands of Italy, and vice versa, between registration with the Medical Council and specialisation programme enrollment. Results Between 2017 and 2023, a total of 2301 residents enrolled across Italy, out of 2953 available positions nationwide. During this period the number of available national places, increased from 180 to 576, impacting overall seat saturation. In 2017, 98.3% of positions were covered, compared to only 46.5% in 2023. Regarding the mobility trend, southern students attending northern schools increased from 8.3% in 2017 to 22.4% in 2023, while northern students attending southern schools decreased from 17.9% to 1%. However, the number of dropouts and withdrawals was higher in the North. Mobility students scored lower than non-mobility students nationally. Key messages • From 2017 to 2023, the number of residents enrolled increased, while the allocation rate decreased. There was a shift in mobility patterns, with more southern students moving north. • Addressing the identified inequalities and understanding the underlying factors driving mobility patterns is crucial for effective planning and allocation of resources.

Impact of digital health literacy on public health: an umbrella review

Abstract Background Digital health literacy (DHL) is increasingly important for public health initiatives in the digital era. However, its impact on public health outcomes remains unclear. This umbrella review synthesizes evidence on relationships between DHL and public health. Methods Electronic databases were searched from 2010 to January 2024 for reviews evaluating associations between DHL and public health outcomes. Two independent reviewers screened records and extracted data. Results were narratively synthesized and screened respect quality using Amstrar 2 check list. Results 12 reviews met the inclusion criteria. Higher population DHL was consistently linked to positive health behaviors like preventive screening uptake, medical adherence, chronic disease management, and vaccination. However, lower DHL correlated with health disparities and exacerbated risk of mis/disinformation. DHL interventions improved eHealth skills and health status. Conclusions Digital Health Ltieracy shapes engagement with digital public health tools and programs. Integrating DHL assessments into planning can help identify at-risk groups and optimize interventions. Developing population DHL through education represents an avenue to advance health equity and resilience against digital health threats. However, more evidence and more digital maturity of tools appear to be necessary. Key messages • Digital Health Literacy as milestone of next health generation. • Health outcomes are clearly linked to digital and digital health literacy.

Public health resilience and recovery in Ukraine: Academic partnerships to improve population health

Abstract Background Strengthening the public health workforce is among top priorities for the transformation of Ukraine’s public health system. As part of the USAID Public Health System Recovery and Resilience Activity, an Academic Partnership Collaborative brought together three Ukrainian universities (National University Kyiv-Mohyla Academy, I. Horbachevsky Ternopil National Medical University, Sumy State University), two American universities (Temple University and Drexel University), and the All-Ukrainian Association of Public Health Specialists (UPHA) to enhance the competencies of public health graduates in Ukraine. Objectives The collaborative focuses on strengthening the Ukrainian universities’ public health curricula and the teaching and research competencies of the Ukrainian faculty, making the curricular changes in Ukraine better aligned with US and European academic standards. The university partners are collaborating with the newly established UPHA in building partnerships with peer organizations in the US (American Public Health Association) and Europe (EuPHA) and sharing advancements in public health education with the broader community of public health practitioners in Ukraine to enhance their competencies to improve population health and align with European systems of public health. Results We have established linkages among all partners via an initial meeting in Uzhhorod, Ukraine in April 2024. We anticipate results by November 2024 to include curriculum review recommendations, coaching on prioritized topics for the Ukrainian partners, faculty development plans, and the establishment of continuing professional development programs in collaboration with UPHA. Conclusions Through this partnership, selected Ukrainian universities will have an enhanced and sustainable capacity to train the public health workforce and will become leading examples for other public health programs to simulate and collaborate with beyond the project. Key messages • Ukraine’s resilience and recovery relies upon the strength of the current and future public health workforce; mechanisms for building public health training are essential to a healthy population. • A collaborative process of strategic activities among American and Ukrainian universities and professional associations can be effective in building a resilient public health system in Ukraine.