Obesity and depression are highly prevalent diseases that are strongly correlated. At the same time, there is a growing gap in care, and treatment options should be improved and extended. Positive effects of a Mediterranean diet on mental health have already been shown in various studies. In addition to the physiological effects of nutrients, the way food is eaten, such as mindful eating, seems to play a role. The present study investigates the effect of a Mediterranean diet and mindful eating on depression severity in people with clinically diagnosed major depressive disorder and obesity. Participants will be randomised to one of the four intervention groups (Mediterranean diet, mindful eating, their combination and a befriending control group). The factorial design allows investigating individual effects as well as potential synergistic effects of the interventions. The study consists of a 12-week intervention period, where five individual appointments will take place, followed by a 12-week follow-up. The primary outcome is depression severity. Secondary outcomes are remission of depression, assessor-rated depression severity, quality of life, self-efficacy, BMI, waist:hip ratio and body composition; adherence to the Mediterranean diet and mindful eating will also be assessed. Alongside mediator and moderator analysis, a microbiome analysis, a qualitative evaluation and an economic analysis will be conducted. The study investigates an important health issue in a vulnerable target group. It allows to draw valuable conclusions regarding the effectiveness of different interventions and therefore contributes to improving available care options for people suffering from depression and obesity.

BackgroundPostpartum mental health problems are common in women. Screening practice and treatment options are less common, which is a possible threat to health of mothers and children. eHealth interventions might bridge the gap but few validated programs are available. For developing relevant tools, an assessment of user behavior is a relevant step. Users’ acceptance of eHealth interventions can be examined via the Unified Theory of Acceptance and Use of Technology (UTAUT) model.MethodsA cross-sectional study was conducted between October 2022 and June 2023. Acceptance, sociodemographic, medical, psychometric, and eHealth data were assessed. This study included 453 women who had experienced pregnancy. Multiple hierarchical regression analysis and group comparisons (t-tests, ANOVA) were conducted.ResultsHigh acceptance of eHealth interventions in postpartum mental health care was reported by 68.21% (n = 309) of women. Acceptance was significantly higher in women affected by mental illness, t(395) = -4.72, padj < 0.001, d = 0.50, and with postpartum depression (present or past), t(395) = -4.54, padj < 0.001, d = 0.46. Significant predictors of acceptance were Perceived support during pregnancy (β = − 0.15, p = .009), Quality of life (β = − 0.13, p = .022), Postpartum depression (β = 0.40, p = .001), Digital confidence (β = 0.18, p = .002), and the UTAUT predictors Effort expectancy (β = 0.10, p = .037), Performance expectancy (β = 0.50, p < .001) and Social influence (β = 0.25, p < .001). The extended UTAUT model was able to explain 59.82% of variance in acceptance.ConclusionsThis study provides valuable insights into user behavior of women who experienced pregnancy. High acceptance towards eHealth interventions in postpartum mental health care and identified drivers and barriers should be taken into account when implementing tailored eHealth interventions for this vulnerable target group. Specifically women with mental health issues report high acceptance and should therefore be addressed in a targeted manner.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-25297-1.

Purpose: The proposed study will examine how a behaviour analytic framework could be used to evaluate and treat sex offenders with intellectual disabilities (ID). It is concerned with examining how the principles of behaviour analysis, like functional assessment and operant conditioning, can be successfully applied to this group to minimised offending behaviour and maximize the results of rehabilitation. Analysis: It is an empirical study, employing a mixed-methodology, which involves a combination of qualitative case-study analysis and a quantitative analysis. The forensic settings involved in data collection through the use of standardised behaviour analytic assessments, such as functional behavioural analysis (FBA), and interventions based on reinforcement. It is based on the behaviour analytic model, which is concerned with the identification of antecedents, behaviours, and consequences (ABC analysis) and intervention methods like differential reinforcement and shaping. The statistical test applied was paired-sample t-tests to compare the frequency of pre- and post-intervention behaviour and chi-square tests to determine the effectiveness of the intervention in reducing recidivism risk. Findings: The adaptation behaviours and maladaptive behaviours, such as sexual offending tendencies, were found to be significantly improved and reduced, respectively. The results of the statistical analysis revealed that the recidivism risk was lowered by 40 percent (p &lt; 0.01), and paired t-tests demonstrated that the frequency of the offending behaviour was significantly reduced (t(25) = 4.52, p &lt; 0.001). There was also an increase of 30 percent in the level of engagement in pro-social behaviours. Such results imply that behaviour analytic interventions are very effective in decreasing the chances of recidivism and enhancing behavioural outcomes. Conclusion: The research is among the first to synthesize behaviour analytic concepts within the background of sex offenders with intellectual disabilities and offer a new, evidence-based approach to forensic environments. It broadens the application of behaviour analysis in other areas besides the conventional ones, as it can help provide a model to improve the rehabilitation program among this vulnerable target group.

Girls in detention are known as a vulnerable target group with specific treatment needs. This study examined the relationship between living group climate and treatment motivation, among female detained youth (15–23 years, N = 62) in a German youth detention center. Results indicate a positive correlation between various factors of living group climate and treatment motivation among young female detainees in a German youth detention facility. The living environment proved to be a significant predictor of treatment motivation. In future, understanding gender-specific experiences and needs within detention can contribute to the development of gender-specific care and interventions.

BackgroundThe integration of evidence-based research into clinical practice faces several challenges. One major barrier is the effective dissemination of information regarding new interventions. To illustrate this, the CHIMPS-NET (Children of Mentally Ill Parents) program, a family-centered intervention in German psychiatric clinics, is used as an example. This study evaluates the referral criteria, the dissemination of information, and the accessibility of outpatient specialists involved in the gatekeeping process for accessing and referring patients to CHIMPS-NET. This study serves as part of the implementation strategy for the sustainable anchoring of the CHIMPS-NET program.MethodsWe identified all outpatient professionals (n=2828) in each catchment area of the psychiatric specialist clinics that provided the new CHIMPS-NET form of care. We identified them as potential gatekeepers. These professionals worked across a range of fields, some had a psychological professional background. Professionals in the intervention group (n=946) received information from us about the new intervention, while professionals in the control group (n=1882) did not. Before and after the information was sent by post, all participants were asked via a questionnaire about their knowledge of family-centered intervention and its importance for the vulnerable target group of children of mentally ill parents. There was an interval of three months between the first questionnaire and the information being sent out and a further three months after this the final questionnaire was sent.ResultsThere was no significant change in knowledge across the two measurement points. Reaching out to gatekeepers had no influence on knowledge of the CHIMPS-Net intervention. However, awareness of family-centered health interventions was four times higher if the gatekeeper had a psychological professional background.ConclusionDissemination of information by post about CHIMPS-Net was not effective at communicating information or reaching gatekeepers. Knowledge of family-centered health interventions was four times higher among the group of specialists and therapists with a psychological background. We therefore suggest that general (somatic) practitioners, who make up most of the gatekeeper population in Germany, need to be approached more intensively than professionals with a psychological/psychiatric background. It is also recommended that individual clinics address their catchment area more intensively and directly.

Introduction: In Flanders, the Flemish Pharmacists Network (VAN), in collaboration with the Flemish Centre of Expertise in Suicide Prevention (VLESP) will finish the second and final phase of the project on suicide prevention through expertise promotion in public pharmacies at the end of March 2024. This initiative is part of the third Flemish action plan in suicide prevention that aims to reduce deaths by suicide in Flanders by 10 % by 2030 compared to 2022. Background: Suicidal thoughts are a serious and complex issue, often with no single root cause or explanation. Nor is there one simple way to prevent people from having them. Through scientific research and experience, much has already been uncovered about the origins and process of suicide as well as some effective prevention strategies. Reducing access to means of suicide is an effective prevention method. Pharmacists can play an important role in suicide prevention as gatekeepers. Who is it for? Pharmacies are low-threshold and an easily accessible gateway keepers to healthcare for a lot of citizens. The goal is for pharmacists to actively question their patients about possible suicidal ideation and, if necessary, refer them to a health professional who can provide further help. Who did you involve and engage with? In 2022, VAN launched the project among Flemish pharmacists in collaboration with VLESP and with the support of the Flemish government. What did you do? The project started its first phase in 2022. It included a literature review, a needs assessment and the creation, launch and evaluation of the e-learning as a tool for gatekeeper training. In the second phase, participating pharmacies were mentored in a variety of methods to have productive conversations in their pharmacies in the context of suicide prevention. These conversations were measured qualitatively and quantitatively. What results did you get? A survey of the first phase showed a need and willingness of expertise improvement among participating pharmacists. They indicated their preference of an e-learning to learn the necessary skills. Results from the pre and post test of the e-learning showed promising results for the e-learning as gatekeeper training. In the second phase, the number of conversations about suicide in pharmacies was measured, providing further insight into the number of conversations with patients from a vulnerable target group or with a history of suicidal thoughts. In addition, the reason for the conversation, medication use and concrete preventive actions taken were also mapped out. It was also measured how long each conversation lasted on average and where they took place. What is the learning for the international audience? The practical approach taken in this project offers valuable insights for international audiences. The results outline the pharmacist’s potential role in suicide prevention and how this role can be effectively implemented. What are the next steps? Upon completing the final phase of the project in March 2024, a comprehensive report will be prepared for the Flemish government for further implementation in Flanders.

Between 8 and 22% of lifetime cannabis users develop Cannabis Use Disorder (CUD). It is the most frequent reason for first-time drug-related treatment admissions in Europe. Many countries have general substance use treatment programs for individuals with cannabis use disorders. This study presents an updated overview of cannabis-specific treatment availability across Europe. Data on treatment programs in 27 EU member states, United Kingdom, Norway and Turkey was gathered. The study used a mixed-methods approach, combining (1) a quantitative survey among the National Focal Points of the European Drugs Agency (EUDA), (2) a qualitative analysis of “Drug Workbooks 2021” and ‘Treatment Workbooks 2020 and 2021’ published by the National Focal Points of the EUDA. Data for 30 countries on the European continent was analyzed. Sixteen countries reported the existence of specific cannabis-specific programs. Fifteen countries provided specific face-to-face interventions, which mostly have limited national coverage. Cannabis-specific online-treatment has been used more systematically since the COVID-pandemic in some countries. Automated and brief web-based interventions have emerged with a large potential to cover the needs of many clients in rural areas. First Cannabis Clinics opened, but specific forms of treatment for vulnerable target groups (e.g. adolescents, people with mental disorders) are generally still rare. Most programs are not evidence-based. In sum, some growth in cannabis-specific treatments has been observed in the past decade in Europe. Their coverage is still limited.

PurposeThis paper aims to construct a model explaining migrant health and well-being from a salutogenic perspective. Accounting for the relational, interactional factors impacting on the health of forced migrants, the “Relational Model of Sense of Coherence” combines elements from Antonovsky’s theory of salutogenesis with elements from Honneth’s theory of recognition.Design/methodology/approachThe model has been developed from the empirical findings of a two-year qualitative study with 28 forced migrants in Austria. Besides initial and final surveys on the participants’ perception of health, health literacy and participation, data were gathered in a qualitative, participatory action research setting and analysed by the method of interpretative case reconstruction. The model is applied to the case reconstruction of a female refugee from Iraq explaining the dimensions impacting on her self-perceived status of health and well-being.FindingsNext to consistency/comprehensibility and load balance/manageability persons need to experience participation/controllability as well as relatedness/self-confidence, recognition of rights/self-respect and social recognition/self-esteem to develop and/or maintain a strong, relational sense of coherence. All six dimensions contribute to feelings of meaningfulness; all components are necessary for a move towards the healthy end of the health-ease/dis-ease continuum.Originality/valueThe paper contributes to theory building in the fields of salutogenesis and recognition by developing a model based on an in-depth, participatory qualitative study with a vulnerable target group.

The purpose of this study is to identify the effects of multidimensional (fuzzy) inequalities and marginal changes on the Gini coefficients of various factors. This allows a range of social policies to be specifically targeted to reduce broader inequalities, but these policies are focused primarily on health, education, housing, sanitation, energy and drinking water. It is necessary to target policy areas that are unequally distributed, such as those with access to unevenly distributed drinking water policies. The data are from the Household and Consumption Survey of 6695 households in 2003 and 9259 households in 2011. This paper uses Lerman and Yitzhaki’s method. The results revealed that the main contributors to inequalities over the two periods were health and education. These sources have a potentially significant effect on total inequality. Health increases overall inequalities, but sources such as housing, sanitation and energy reduce them. This article provides resources to disadvantaged and vulnerable target groups. Multiple inequalities are analyzed for different subgroups of households, such as place of residence and the gender of the head of household. Analyzing fuzzy poverty inequalities makes it possible to develop targeted measures to combat poverty and inequality. This study is the first to investigate the sources of Gini’s fuzzy inequality in Chad via data analysis techniques, and in general, it is one of the few studies in Saharan Africa to be interested in this subject. Some development policies in sub-Saharan Africa should therefore focus on different sources (negative effect), sources (positive effect) and the equalization effect.

Abstract With over 2 million cases diagnosed annually, breast cancer is a leading cause of cancer-related disability and mortality. Despite global efforts to implement mammography screening programs, uptake rates vary widely across settings due to socioeconomic factors and accessibility challenges. To improve participation, targeted interventions addressing barriers faced by underserved groups are essential for promoting inclusive screening and early detection. As part of the ENTER project, which aims to address disparities in breast cancer screening participation among women with low socioeconomic status (SES) in Flanders, Belgium, we conducted a systematic review and meta-analysis on the effectiveness of interventions to enhance mammography uptake. To explore the differential impact of interventions on mammography uptake among vulnerable groups, including individuals with low SES, underinsured, with immigrant background or part of an ethnic minority, subgroup analyses were performed. 7 databases were searched, resulting in the inclusion of 54 out of 9,366 papers for analysis. 14 types of interventions were identified. The meta-analysis showed significant pooled effects of interventions that increased mammography uptake [OR 1.8 (95%CI 1.6-2.2)], particularly among vulnerable populations [OR 2.2 (95%CI 1.7-2.8)]. The most effective interventions were educational interventions [OR 3.03 (95%CI 2.2-4.9); in vulnerable groups OR 2.7 (95%CI 1.9-3.9)]. As expected, interventions adapted to linguistic needs and culturally sensitive approaches showed a significant effect among vulnerable target groups [OR 2.9 (95%CI 1.1-7.9) and OR 2.5 (95%CI 1.1-5.6), respectively]. Reminders were also highly effective [OR 1.8 (95%CI 1.5-2.1); in vulnerable groups OR 2.5 (95%CI 1.9-3.1)]. This review underscores the critical role of targeted interventions in augmenting screening mammography uptake, particularly among vulnerable populations, where odds of participation can increase by up to 2-3 times. Key messages • Interventions adapted to the linguistic needs of the target population and culturally sensitive approaches, aligned with values and beliefs of a specific community, can greatly enhance screening rates. • Considering costs, practicality and impact, reminder letters with culturally and linguistically adapted content emerged as the most promising option for implementation in the ENTER project.

Abstract Problem Socially vulnerable older adults often face lower health literacy and limited access to health care. Description of the problem Current lifestyle programs are often insufficiently adapted to this socially vulnerable target group. As a result, these older adults are underrepresented in lifestyle programs. From a public health perspective, lifestyle programs that improve the poorer physical and mental health of these older adults, should be made more accessible by involving the expertise, participation and needs of this group. The aim of this study was to develop and implement a lifestyle program adapted to the expectations and needs of socially vulnerable older adults. Results Both the target group and the local community (health) centers were involved during the co-creative phase of development. A neighborhood analysis was used to identify and reach out to the target group. Motivators and barriers for a healthy lifestyle were identified through focus groups. The developed program consisted of 10 weekly group sessions. Various health aspects were integrated, including exercise, nutrition, stress, sleep, positive psychology, meaningful living, and motivation. Nine centers for community dwelling older adults in Flanders and Brussels were included. In total, 93 older adults were recruited out of which 76 completed the full program. In the final phase, the program was evaluated by means of objective and subjective measuring methods. Finally, the local community (health) centers are currently involved in the program’s sustainability through a trainers’ program. Lessons The belongingness, the catering, the empowering attitude of the trainer and the ‘fun’ factor turned out to be success factors for the adherence to the program. The participating centres experienced an increase in numbers of older adults that were attracted to their activities that are focused on healthy lifestyle behaviors. The continuity of the program is currently being examined. Key messages • A neighbourhood analysis in collaboration with local partners helped to reach the target group. • The program was made attractive by the involvement of the older adults, the fun-factor and the small groups.

Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany Abstract: With the Digital Healthcare Act, Germany has taken a decisive step toward promoting high-quality, evidence-based digital health applications (DiHAs). Presently, there is a significant gap in the provision of mental health services throughout Germany, particularly regarding children and adolescents and especially in the aftermath of the COVID-19 pandemic. DiHAs as low-threshold, location- and time-independent additional mental health services - may offer a way to address this situation. Particularly in the emerging generation of digital natives, there is a high demand for digital mental health services. However, despite the rapidly growing supply of DiHAs for adults, there is a lack of approved DiHAs for children and adolescents with mental disorders. Rather, the demand for care is left to the unregulated market of diverse internet- and mobile-based interventions; early studies have questioned the evidence base, safety, and quality. This discrepancy arises from various specific challenges and risks that reduce incentives to develop DiHAs for this particularly vulnerable target group, including (1) limited evidence, (2) high complexity in study execution, (3) high complexity in the development of applications, (4) poorly researched specific risks, and (5) high regulatory requirements. This article discusses these challenges and risks and outlines the perspectives for a high-quality, safe, and evidence-based digital mental healthcare for children and adolescents.

ZusammenfassungDie standardisierte Befragung ist eine zentrale empirische Erhebungsmethode in der Kommunikations- und Medienwissenschaft. Es existieren zahlreiche theoretische Zugänge und empirische Studien, um die methodischen Prinzipien und Standards von Umfragen besser zu verstehen und in ihrer Wirkung zu optimieren. Für die Durchführung empirischer Studien sind Kriterien der methodischen Güte zentrale Entscheidungskriterien. Für die Sicherung wissenschaftlicher Qualität ist eine ausschließliche Beachtung methodischer Aspekte jedoch nicht ausreichend; auch aus den forschungsethischen Prinzipien Selbstbestimmung, Schadensvermeidung und Gerechtigkeit sind Beurteilungskriterien ableitbar. Allerdings können methodische und ethische Anforderungen auch im Widerspruch zueinanderstehen; entsprechende Dilemmata können in jeder Phase des Forschungsprozesses auftreten. In solchen Fällen ist eine systematische Güterabwägung zwischen ethischen Bedenken und methodischen Erfordernissen nötig. In der vorliegenden Studie wurden im Rahmen des BMBF-geförderten FeKoM-Verbundprojekts 29 empirisch arbeitende Kommunikationswissenschaftler*innen aus dem deutschsprachigen Raum interviewt, um zu ermitteln, wie sie diese Herausforderungen wahrnehmen und wie sie mit ihnen im Forschungsalltag umgehen. Die Ergebnisse zeigen, dass die Interviewten keinen der beiden Aspekte priorisieren, sondern danach streben, methodische und ethische Anforderungen miteinander in Einklang zu bringen. Gleichzeitig werden Herausforderungen im jeweiligen Einzelfall sowie grundsätzliche Bedenken hinsichtlich des Stellenwertes von Forschungsethik deutlich.

Summary In Western welfare states, public and non-profit service organizations are increasingly looking for ways to combine the efforts and expertise of professionals and volunteers to provide support and services to vulnerable target groups. However, little is known about how professionals and volunteers collaborate to provide these social services and support. The aim of this qualitative study is to analyze how professionals support volunteers in a befriending project, where volunteers provide support to people after they are released from prison. Therefore, we interviewed social workers (n = 4) and volunteers (n = 13). Findings Our results show that professionals provide tailor-made support to volunteers through different interventions: they share their knowledge and expertise, provide emotional support, and advise and coach the volunteers. Furthermore, in complex cases, professionals intervene to access appropriate social support and realize the rights of those involved. Applications Our findings provide a comprehensive perspective on how complementarity is constructed in the daily practice of collaboration between volunteers and professionals. Although professional interventions and support are necessary to address the needs of vulnerable people, volunteers offer a wider range of support than professionals alone can provide. Consequently, close collaboration between volunteers and professionals can result in a valuable response to the needs of people who have recently left prison. However, when a client's situation becomes complex and volunteers lack the skills, experience, and status to deal with it, professionals are advised to take over.

Introduction: Being health literate is important to get sufficient health information, to navigate the health system, to access appropriate care and to be able to self-manage health. As such it is a key determinant of health. There is a need for innovative measures to improve health literacy among people living in socioeconomically vulnerable circumstances. In response to this need, a low treshold community health literacy hub was developed and implemented in a vulnerable neighbourhood in the city of Antwerp, within a broader project on the prevention of cardiovascular diseases (H2020 SPICES project) The health kiosk provides information on a healthy lifestyle and disease prevention in a low-threshold manner to people and groups in a socially vulnerable situation. These are the people for whom the current preventive offer is insufficiently accessible; because it is not sufficiently attuned to diversity in language and culture, it is insufficiently accessible or available, or because people have so many other concerns on their minds that they have less mental space to actively engage with health. Who is involved? The Health Kiosk is a partnership between Logo Antwerp, University of Antwerp, Antwerp District. Another important collaboration is with the Community Health Workers. These are people from the communities involved who direct people, often non-native speakers, to care. They speak to people in their own language, thus removing an important barrier. This cooperation also allows us to make good links between the preventive offer and primary care. To further operationalise the operation of the kiosk, ELZ Oost will also be involved. The focus will also be on first-line professionals. Results: The health kiosk grew out of the need to increase health literacy among vulnerable target groups, those who live under the radar. Yet the effect of the kiosk appears to go much further. The whole community gets involved: not just residents, but also organisations from different sectors, as well as the working population. Over the past year, the kiosk has become well embedded in the neighbourhood. A broad base of support has been created. Outreach work presupposes a lifeworld perspective. You can only succeed if you really connect with the living environment of local residents. Participative work is therefore indispensable when doing outreach work. It is crucial to involve people from the community right from the start of the project. Next steps: Now we need to take a step further. Looking to the future, it is important to link up even more with first-line professionals such as GPs, pharmacists, home nursing, etc. The pressure on first-line professionals, especially GPs, is high.

At the beginning of 2022, the additional offer of primary psychological care was implemented nationwide in Belgium. The main aim of this new convention is to strengthen local integrated care. In line with the public mental health perspective, an offer is set up based on regional needs around prevention and early intervention to prevent mild mental health problems from escalating. To ensure that this care is easily accessible, outreaching and location/community-oriented work is carried out. Special attention is paid to vulnerable target groups ('equity'). Within the implementation of this innovative approach, change management appears to be an important player. This presentation contains - based on the policy experiences since January 2022 - a preliminary evaluation of the opportunities and barriers in the implementation of this project.

Background: Persons with mental health and substance abuse disorders (MHD/SUD) make up a highly vulnerable target group, particularly affected by social exclusion. Many experience stigmatization, powerlessness and disconnectedness and thus are marginalized when it comes to social participation. A Recovery oriented approach within field of mental health care entails a focus on enabling individuals to connect and interact with their social surroundings, and aid persons striving with mental health, substance abuse or social functioning impairments to full and contributing lives as active citizens. However, many lack knowledge, skills, and abilities to engage in their recovery process and utilize their social and community opportunities. Virtual Reality technology (VRT) shows a promising potential for simulating social environments and interactions to mitigate social impairments and marginalization for persons in recovery from MHD/SUD. However, it is still unclear how the ecological validity of VRT can be harnessed in more sophisticated interventions that target complex social situations. The overall goal of this project is to provide lived-experience based knowledge on how software development and new programming can broaden the range of VRT-based social environments and interactions. Thus, our study aims to explore how service users in MHD/SUD recovery experience social functioning impairments (SFI) and how these affect social participation and citizenship in their daily living. Method: This study is part of the project «Virtual Reality as a facilitator for participation in society among persons with mental health and substance use disorders » which received funding from the Research Council of Norway. User driven innovation is a fundamental principle of the overall project. This entails close collaboration with persons who have lived-experience with MHD/SUD. A peer researcher has participated in developing interview guides, interviews and analysis. We have conducted 2 focus group interviews with municipal service providers and 10 in-depth, semi-structured individual interviews with service user in MHD/SUD municipal services. Preliminary Results: First analysis of the focus groups with service providers suggest, that the particular needs of social functioning training varies across the stages of recovery. The needs of SFI interventions vary from basic instrumental functioning training, such as household skills, personal management, and responsible decision making to more complex social situations, such as work related interactions (customer service, colleague collaboration, leadership), job interviews and engage in meaningful activities in the company of persons without MHD/ SUD experience. Furthermore, our findings suggests needs for basic cognitive training, targeting mentalization capacity, executive functions, emotional regulation and cognitive flexibility. Conclusion: This study will provide knowledge on what hinders or promotes participation in society among persons with MHD/SUD within their recovery process. This understanding will facilitate development of tailored recovery measures, and measures to prevent persons with MHD/SUD being marginalized. Based on the results of this study, VR-designers and peer support researchers jointly develop in the second part of the overall project a VR-prototype, which will be finally evaluated within an RCT. Our study is the first to dedicate VR to persons with MHD/SUD.

Introduction: In Flemish community health centres, we consider oral health as an important aspect of integrated and integral primary care. Meanwhile we see the health gap in terms of oral care increasing among the vulnerable population. This workshop provides an overview of interventions, currently running in Ghent, Leuven and Brussels to close this gap. We focus on projects that improve – bottom- up - the accessibility and the organization of oral care in order to prevent large groups of citizens from falling outside the nationally regulated framework. New healthcare professions are being introduced. In doing so, we run into a number of difficulties in terms of upscaling good practices, changing the financing system, sustainable cooperation with dentists, with partners and certain target groups. Join this workshop to discuss which measures downstream, midstream and upstream are needed to eliminate inequalities in oral health. Background: With regard to oral health, we know that a lack of preventive care and follow-up ultimately leads to more complex problems and rising costs for the patient and the community. The importance of health literacy, (preventive) oral care and adequate oral hygiene for people's general health and quality of life is generally known and has been sufficiently scientifically substantiated. (Mazevet M., 2020) Nevertheless, oral diseases such as caries remain a problem for many population groups throughout Europe, especially the socio-economically vulnerable groups continue to be hit hard. (WHO, 2022) . Belgium is no exception to this, despite the government initiatives, it appears that socially vulnerable target groups find it more difficult to find their way to professional dental care. The challenges in Belgium are great: there is not only the capacity problem among dentists, both dentists and patients experience mutual barriers. In addition, the Belgian system of payment for performance is very complex and not transparent. After all, it consists of various aspects that complicate the financial accessibility of care for many patients. (Bouckaert N., et.al., 2020). That is why several Flemish CHC's invest in oral care and try to reduce the health gap with various interventions and experiment on a mixed financing system, often with support from the local government. Aims: We want to inspire participants to introduce new health professionals in (preventive) oral care, and new ways of financing. This workshop will provide attendees with insight into how this approach was chosen, lessons learned and outcomes. Target: This workshop is open to everyone with interest in oral health and in change strategies at a local level, that seek impact at the macro- level of health care systems. Format : Introduction (5’) Presentation of different case studies (30') Interactive discussion (45’) &amp; summary of key learnings (10’) Key Learnings: Oral care is an important aspect of primary healthcare: - the importance of deploying dental hygienists also for health promotion and prevention in the neighborhood - the possible added value of a mixed financing model - local change strategies with an impact on supra-local health policy

Abstract Background In deprived neighborhoods there is not only an accumulation of public health problems, but also an accumulation of small-scale interventions to address these problems. For evidence based public health policy it is important to know which interventions are most effective. However, many small-scale interventions are not well evaluated because standard research methods are not sufficient to provide information about the vulnerable target group. Therefore in the IGLO Utrecht study we developed an evaluation method for small scale interventions in the living environment of deprived neighborhoods. Methods Principles from the quadruple helix approach were combined with core components of a methodology for reaching a hard to reach population. This was applied in three studies in a deprived neighborhood in Utrecht: health evaluation of the renovation of a social housing flat, a study about redevelopment in the neighborhood and a study about health-related reasons to visit nature. The intervention and the geographical area of the expected effect on residents health were discussed with professionals. Details about the personal approach, choice of words in the announcement letter and questionnaire were developed in collaboration with an advisory group of residents. Results Linking the study to the intervention in the neighorhood was helpful in making contact with residents. The response rate of the questionnaire was 49% (86/174) with reach out by telephone, 34% (140/414) with a combination of telephone and door-to-door and 31% (64/209) with a reach out door-to-door. Participants were representative for the neighborhood regarding migration background and education level. Field notes about the informal contact provided additional information to the questionnaires. Conclusions Close collaboration with professionals and residents contributes to a high response in the health evaluation of small-scale interventions. The personal approach is very time-consuming. Key messages • Close collaboration with professionals and residents contributes to a targeted approach and higher response in the health evaluation of small scale interventions in deprived neighborhoods. • A thorough evaluation of small-scale interventions in deprived neighborhoods is possible, when enough time, budget and capacity can be made available.

Cancer as a whole, but especially childhood cancer, creates a number of psychological, social, and family problems as well as practical and financial issues, which every parent is called upon to solve. This study focuses on childhood cancer and aims at a thorough analysis of the physical/organic, psychological, and social problems associated with the parents and relatives of a child with cancer. The special element in pediatric neoplasms is not only the vulnerable population target group, but also the set of secondary effects it has on the environment of the sick child. The research was conducted on a sample of 133 families of children with cancer, and the results were displayed after statistical processing and data analysis with R statistical software. The results of the study confirm with statistically significant data the effect of childhood cancer on the physical, mental, and social health and behavior of the parent. Thus, 53.8% of the respondents stated 5 and above on the 7-point Likert scale for fatigue issues, 55.6% for sleep disorders, 78.1% for stress, and 82.7% for fear. The key findings are characterized by high specificity as it is a unique study that reveals particular aspects of the Greek parent’s behavior, mind, and body during the period of their child’s illness. Conclusion: The effects of childhood illnesses, particularly when they are severe, such as neoplasms, present a looming threat, ushering in a multitude of adverse alterations in the daily lives of the affected child's family.What is Known – What is New:• We know the effects that a childhood illness brings not only to the sick child, but also to the entire family circle. The new element in the present research is that these data reflect the situation in Greece, for which the research data in this area is quite limited. Our research is one of the few studies that demonstrate with statistical data the change in the psychosomatic health of the parent who has a child with cancer.