Health Programs Research Articles

The Relationship Between Nutritional Status And The Development Of Children Aged 4-60 Months

Child development is an important aspect of human life, especially in the early period of life, which is often referred to as the critical or golden period as the child's brain undergoes rapid growth. Developmental disorders in children under five, especially in terms of motor skills, have a long-term impact on their development, and a child's nutritional status has been shown to play a role in the process. Therefore, this study aims to determine the relationship between nutritional status and development of children aged 4-60 months in Jember Regency. The research method used was a quantitative correlational approach with a cross-sectional approach, involving a total of 57 children who had a Kartu Menuju Sehat (KMS) as the population. From the results of the formula calculation, the sample size was determined as 50 respondents using a non-randomized (non-probability) method, namely purposive sampling based on certain criteria. The research instruments involved the Kartu Menuju Sehat (KMS) to assess children's nutritional status and the Developmental Pre-Screening Questionnaire (KPSP) to identify children's development. The results of the chi-square statistical test revealed a significant relationship between nutritional status and development of children aged 4-60 months in Jember District. [ Children with good nutritional status show more optimal developmental progress, while children with poor nutritional status tend to experience slower or inappropriate development for their age. This finding supports theories that emphasize the importance of adequate nutrition for children's growth and development. Therefore, efforts to improve children's nutritional status should be a top priority in various child health and education programs. With the right understanding and action, we can help create a healthier and more potential future generation.

Research on the reasons and ways that successful entrepreneurs benefit society

Successful entrepreneurs such as Warren Buffett and Jack Ma have built thriving businesses and donated a portion of their earnings to charitable organizations that promote education, health care, and the environment. This paper first theoretically explores how successful business people benefit society by making and spending money. Then, this paper takes Chinese listed companies that have generated positive accounting profits in the past three years as samples to explore the relationship between environmental investment and intangible assets of listed companies and empirically verifies whether CEOs increase CSR investment out of strategic motives. Regression results show that when environmental investment increases by 1%, intangible assets of listed companies increase by 0.053%, indicating that CEOs may benefit others strategically to maximize the wealth of stakeholders and increase profits. Therefore, this paper finally draws the conclusion that successful business people not only make a positive contribution to society but also benefit the whole society. They fulfill their social responsibility by supporting global health, development, and sustainability programs, and the modern economy is critical to incentivizing this philanthropy.

Detecting climate anxiety in therapy through natural language processing

A well-documented consequence of global warming is increased psychological distress and climate anxiety, but data gaps limit action. While climate anxiety garners attention, its expression in therapy remains unexplored. Natural language processing (NLP) models can identify climate discussions in therapy, aiding therapists and informing training. This study analyzed 32,542 therapy sessions provided by 849 therapists to 7,916 clients in U.S. behavioral health programs between July 2020 and December 2022, yielding 1,722,273 labeled therapist-client micro-dialogues. Climate- and weather-related topics constituted a mere 0.3% of the sessions. Clients exhibiting higher levels of depressive or anxiety symptoms were less likely to discuss weather and climate compared to those with mild or no symptoms. Findings suggest that although global warming is known to impact mental health, these issues are not yet adequately addressed in psychotherapy. This study suggests a potential gap between the documented mental health concerns associated with climate change and their representation in psychotherapy. NLP models can provide valuable feedback to therapists and assist in identifying key moments and conversational topics to inform training and improve the effectiveness of therapy sessions.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

Mental Illnesses and Stigma among Medical Undergraduates in India.

The current Medical Education system of India, with its enormous workload and academic demands tend to cause the medical students stress. There is evidence showing medical students at a higher risk of depression, anxiety and burnout compared to other Indian students. Despite, the huge reported numbers, the proportion of students and doctors who seek help for their problems is alarmingly low. One of the reasons provided for the same is stigma towards mental health and an apprehension regarding labels and treatment history on the careers of the students. Increased awareness and with a National Health Programme catered towards mental health, there has been a boost in the utilization and provision of mental health services but it rarely translates into better mental health facilities for the healthcare providers. The special set of challenges faced by a medical students are gradually being recognized and efforts are being made to address them. Curriculum guidelines, teaching methods, student welfare centres and helplines have been the areas of intervention. There should also be changes in approaches towards the students who face problems and providing a safe environment for them to discuss their problems, including encouraging peer support. Thus, a fine balance needs to be present between ensuring the protection of the mental health of a medical student and ensuring a quality medical education for them. Further exploration to address stigma and building empathy among the students and evaluation of the intervention methods devised to address the same becomes very necessary to ensure fruitful interventions. It is the need of the hour to help Indian Medical students overcome their struggles with mental health.

Stakeholders’ perspectives on informed decision-making for migrant women in CC prevention programs

Abstract Background This study gathered the perspectives of stakeholders regarding participation in cervical cancer (CC) screening and human papilloma virus (HPV) vaccination among migrant women in the Netherlands. Considering their perspectives by developing interventions that are tailored to migrant women’s information needs regarding CC screening and HPV vaccination will support informed decision-making. Methods In total five focus group discussions were held with community leaders, healthcare professionals and communication experts separately. The focus group discussions were transcribed verbatim in Dutch, and analyzed thematically according to the Grounded Theory. Results The analysis resulted in six themes. The first theme describes the existing views and misconceptions regarding CC (screening) and HPV vaccination in the target population according to the stakeholders. The second theme is about the current approach of informing about these health programs, and its belonging barriers. Theme three dives into the differences within the target population, such as generations and level of language. Theme four describes the conditions to which interventions should adhere. In theme five and six suggestions for interventions were introduced, focused on the target population and their (social) network respectively. Conclusions The results of this study showed that stakeholders are willing to play a role to support informed decision-making regarding CC (screening) and HPV vaccination among migrant women, but they need more training to support. Community leaders express a need for training to gather more medical knowledge of CC and its prevention programs. Healthcare professionals expressed a need for more insight into the practical, cultural, religious and emotional aspects that play a role within this target population. Communication experts emphasize the need for customized information materials and a more district-oriented approach. Key messages • Stakeholders operating at different levels are willing to play a role in increasing informed decision-making regarding CC screening and HPV vaccination. • Migrant women’s (social) network need more training and support to be able to provide tailored information regarding CC screening and HPV vaccination.

Availability of Adolescent and Young Adult-Specific Sexual and Reproductive Health Programs and Resources: A Review of the Websites of National Cancer Institute-Designated Cancer Centers.

Adolescent and young adult (AYA) cancer survivors often search online for information about cancer-related sexual and reproductive health concerns. A review of the websites of National Cancer Institute-designated cancer centers (n = 9) and comprehensive cancer centers (n = 58) was conducted to identify the presence of AYA-specific sexual and reproductive health programming and resources. No AYA-specific sexual health programs were found. Oncofertility programs were presented on 56% (n = 5) of cancer centers and 50% (n = 29) of comprehensive cancer center websites. As the population grows, it is imperative that cancer centers provide services to meet AYAs' sexual and reproductive health needs and highlight these services on their websites.

Evaluating mental health care initiatives after Ghana’s mental health act: a systematic analysis

Abstract Mental health disorders affect 970 million people worldwide. Particularly in Africa, mental health is a growing concern, as it faces poverty and limited healthcare services. The Ghana Mental Health Act (GMHA 2012) marked a significant milestone in the development of a legislative framework supporting the provision of mental healthcare. However, evidence of progress since then is scarce. This systematic review examines the mental health initiatives that have been implemented since GMHA. Bronfenbrenner’s Socio-Ecological and Vygotsky’s Sociocultural Theory are used as frameworks to organize the interventions by ecological layers and cultural practices. All peer-reviewed articles published since the GMHA were retrieved from PubMed, Cochrane and Science Direct, using “mental health interventions,” “-collaborations,” “-health programs” and “Ghana” as keywords. The search yielded 3839 articles. Next, publications that were not conducted in Ghana or did not focus on mental health were excluded yielding a final sample of 69 articles for the review. Consistent with the GMHA’s guidelines interventions were conducted in communities (n = 56; 81%) rather than hospitals (n = 13; 19%). Most of them focused on institutional ecological levels (i.e., schools, health centers, traditional healing conventions; n = 29; 42%), followed by interpersonal (n = 14; 20%) and community-level (n = 14; 20%) approaches. Half (n = 33; 48%) entailed some form of cultural responsiveness, such as adapting educational tools to cultural contexts or accounting for spiritual beliefs. Only 23% (n = 16) of the interventions targeted children or adolescents. The findings of this review suggest three implications for future mental health research. First, stigma reduction and mental health literacy need to become a stronger focus. Second, research on children and adolescents needs to be increased. Third, interventions led by European partners must be tailored carefully to the Ghanaian beliefs system. Key messages • Assessing the community-based approach of mental health interventions following the Mental Health Act’s legalization in Ghana. • European partners need to understand the context and the local culture before planning to research or implement intervention materials. Adaptation is key in the effectiveness of the intervention.

Cardiometabolic risk factor clusters in older adults using latent class analysis on the Bushehr elderly health program

Metabolic syndrome (MetS), comprising obesity, insulin resistance, hypertension, and dyslipidemia, increases the risk of type II diabetes mellitus and cardiovascular disease. This study aimed to identify the prevalence and determinants of specific clusters of the MetS components and tobacco consumption among older adults in Iran. The current study was conducted in the second stage of the Bushehr Elderly Health (BEH) program in southern Iran—a population-based cohort including 2424 subjects aged ≥ 60 years. Latent class analysis (LCA) was used to identify MetS and tobacco consumption patterns. Multinomial logistic regression was conducted to investigate factors associated with each MetS class, including sociodemographic and behavioral variables. Out of 2424 individuals, the overall percentage of people with one or more components of MetS or current tobacco use was 57.8% and 20.8%, respectively. The mean (SD) age of all participants was 69.3(6.4) years. LCA ascertained the presence of four latent classes: class 1 (“low risk”; with a prevalence of 35.3%), class 2 (“MetS with medication-controlled diabetes”; 11.1%), class 3 (“high risk of MetS and associated medication use”; 27.1%), and class 4 (“central obesity and treated hypertension”; 26.4%). Compared to participants with a body mass index (BMI) < 30, participants with BMI ≥ 30 were more likely to belong to class 3 (OR 1.91, 95% CI 1.31–2.79) and class 4 (OR 1.49, 95% CI 1.06–2.08). Polypharmacy was associated with membership in class 2 (OR 2.07, 95% CI 1.12–3.81), class 3 (OR 9.77, 95% CI 6.12–15.59), and class 4 (OR 1.76, 95% CI 1.07–2.91). The elevated triglyceride-glucose index was associated with membership in class 2 (OR 12.33, 95% CI 7.75–19.61) and class 3 (OR 12.04, 95% CI 8.31–17.45). Individuals with poor self-related health were more likely to belong to class 3 (OR 1.43; 95% CI 1.08–1.93). Four classes were identified among older adults in Iran with distinct patterns of cardiometabolic risk factors. Segmenting elderly individuals into these cardiometabolic categories has the potential to enhance the monitoring and management of cardiometabolic risk factors. This strategy may help reduce the severe outcomes of metabolic syndrome in this susceptible population.

Policies and programs on children’s health promotion in the EU in the context of the JA Health4EUKids

Abstract Background Overweight and obesity prevalence are a global public health challenge. The prevalence is rapidly increasing, with significant health risks such as cardiovascular disease, type 2 diabetes, and cancer. Objectives To describe the state of the art of policies and programs (PPs) on children’s health promotion and responsive parenthood (children 0-12 years) in the EU, and to identify their gaps. Methods A cross-sectional study was carried out through an online survey, as part of the Health4EUKids Joint Action (JA) (HADEA n.101082462), between October and December 2023, targeting all EU member states (MSs) involved. Results The survey collected information about 74 PPs from 11 EU MSs of the JA. The PPs are primarily focused on healthcare (62.1%), education (24.1%), and social sectors (10.3%), with a focus on children aged 6-11 years. The settings for PPs include primary schools, communities, secondary schools, and healthcare services. The PPs are characterized by different degrees of innovation, controversy, equity, transferability, and sustainability, although the structural or systemic impact and public visibility appear to be lower among other characteristics. The formulation and design of PPs include problem analysis (73%), based on national or local data and on stakeholder consultation. As for implementation, most PPs are implemented upon release, but recommended action and allocated human resources are not fully adequate. Regular monitoring and evaluation (47.3%) are based on defined outcomes, standards, and indicators (63.5%). The results are disseminated to decision-makers and stakeholders (37.8%), through media, and to the general population (32.4%). Conclusions Most PPs are variable and context-dependent. It is necessary to align the policies with the implementation, in all its aspects, and to strengthen monitoring, evaluation, and communication with the relevant stakeholders, which currently appear to be the most lacking aspects. Key messages • Most European policies and programs are context-dependent, mainly in healthcare. Yet, a cross-sectoral trend involving health, education, and social sectors emerges. • The study stresses the need for better alignment between policy formulation and implementation to enhance the effectiveness of EU children’s health programs.

Consumer Preferences for Health Services Offered by Health Insurance Companies in Germany

Abstract German health insurance companies increasingly strive to position themselves as health partners to their customers to improve customers’ health and contain costs. However, there is uncertainty about customers’ preferences for health services offered by health insurance companies. Therefore, this paper studies consumer preferences for health services that are or could be provided by health insurance companies in Germany. An online survey was conducted using two stated preference techniques to collect and analyze the data (namely, rating and ranking of health services considered by insurance companies). A sample of 880 German health insurance customers between 18 and 65 years old filled out the online questionnaire, of which 860 submitted complete responses. Ordinal logistic regression analysis was used for the rating and ranking. Preliminary examinations, care management, and health programs were the three health services most important to the respondents. The results suggest that people want their health insurance to support them with preventive health services that offer direct therapeutic value and not just informational, economic, access-related, or convenience-related benefits. These preferences for health services are homogeneous for most subgroups of the population, implying that health insurance companies could consider an overall strategy to address these preferences for all clients by focusing on the important health services. Key messages • People value health services provided by health insurers that offer direct therapeutic value over those that offer only informational, economic, access or convenience benefits. • As preferences are homogeneous across the population, insurers could consider an overall strategy by focusing on the important health services.

8.M. Skills building seminar: Mental health and substance use in Europe

Abstract The impact of social factors on individual and population mental health are well established (Kirkbride, et al., 2024). The same social factors may trigger the substance use behavior developing into substance use disorders. Mental health disorders can contribute to the substance use and substance use disorders with worsening effects over time (EMCDDA, 2016). This association between substance use, substance use disorders and mental health disorders is a key objective for the scientific consideration and policy development. Respective phenomena are universal and a broader perspective would be useful for a better understanding of how the issue of comorbidities of substance use and mental disorders are addressed on a European level. Identification of the substance use problem, especially among populations in vulnerable situations, like migrants, becomes utterly important. Heterogenous systematic reviews show that there is a need for socially and culturally refugee sensitive instruments to measure the substance use in migrants. Oftentimes substance use is followed by the substance use disorders and drug use related infections. Injecting drug use is also a risk factor for having drug use related infections, such as hepatitis B and C, HIV, tuberculosis. Assessment of risk behaviour patterns among people who inject drugs may contribute to a higher participation in treatment and health programmes, reduce the burden of substance use and tackle comorbidities of substance use and mental health disorders. The skill building seminar aims to increase the knowledge and capacities on substance use and comorbidities, applied methodological approaches and tools in different European contexts. This workshop will support researchers, policy makers, public health planners by providing evidence base to address substance use and mental health issues. The added value of this workshop is based on the structure, content and mode of presentations - presentations will be followed by questions from participants and short discussions. The workshop will start with the general introduction to the topic of comorbidities of substance use and mental health disorders (EUPHA-PMH and EUDA). Then the European level perspective on comorbidities of substance use and mental health disorders will be presented including recent policy developments (1 presentation by Linda Montanari, EUDA). It will be supported with research results from the study conducted in Germany on substance use assessment tool development in migrant population (2 presentation by Kim-Julian Behr, Germany) and behavioural risk factor assessment study among people who inject drugs in Lithuania (3 presentation by Marija Jakubauskiene, Lithuania). Key messages • Participatory approach is useful to address the substance use problem in assessment tool development and further monitoring. • Better understanding of comorbidity of substance use and mental disorders leads to a more effective prevention.

Occupational Stress, Psychological Distress, and Coping Strategies of First-Level Judges in the Philippines: Examining the Influence of Demographics and Caseloads

Judges worldwide face intense pressure from heavy workloads, emotionally charged cases, and limited resources, leading to burnout and decreased public trust in the justice system. While individual coping is important, systemic change is crucial. This descriptive-correlational study investigated occupational stress, psychological distress, and coping strategies among 357 first-level judges in the Philippines. The study employed three standardized instruments: the Occupational Stress Scale, the Kessler Psychological Distress Scale (K10), and the Filipino Coping Strategies Scale (FCSS). This study revealed that first-level judges in the Philippines experience high levels of occupational stress and psychological distress. However, they also utilize a range of coping strategies to manage these challenges. The study found no significant relationship between occupational stress, psychological distress, and coping strategies and the demographic profile of the first-level judges. This suggests that these challenges are inherent to the judicial role itself rather than influenced by individual differences. The study concludes that interventions and support systems tailored to the specific demands of the profession are needed to address these challenges. The findings served as the basis for the Wellness Program for the first-level court judges in the Philippines.

Eight Dimensions of Wellness: Undergraduate Student Behavior

Background: Mental health and well-being are important public health issues. College students are vulnerable to mental health and other wellness issues as this population is often making lifestyle choices autonomously for the first time and many are balancing new responsibilities, priorities, and situations in life. Aim: This study sought to gain an understanding of college students’ behavior when provided time and autonomy to focus on their wellness needs. Methods: Students completed a self-selected activity that corresponded to a dimension of wellness. A chi-square goodness-of-fit test was performed to determine distribution of responses. A chi-square test of independence was performed to examine relationships between dimension of wellness and gender, year of enrollment, and the interaction of gender by year of enrollment. Results: All dimensions of wellness were reflected in student responses with physical, social, and emotional dimensions selected more frequently. A significant relationship was found between dimension of wellness and gender and the interaction effect of gender by year of enrollment. No significant relationship was found between dimension of wellness and year of enrollment. Conclusions: This study highlights the need for diversity in wellness programming and provides valuable insights to optimize student support.

The Influence of Emotional Instability on Weight Fluctuations

This study examines the relationships between psychological factors, specifically mood fluctuations, short temper, and feelings of negativity, and their impact on weight gain or loss among individuals. The objective is to determine how these emotional states individually and collectively influence weight changes, focusing on understanding their predictive power. A quantitative, cross-sectional design was employed. The analysis involved correlation and multiple regression techniques to explore the relationships between the variables. Results revealed that moodiness has the strongest positive correlation with weight changes and is the most significant predictor, explaining a substantial portion of the variance. Short temper and feelings of negativity also contributed to body weight variations, though to a lesser extent. The model explained the variance in weight outcomes, highlighting the meaningful role of psychological factors in weight management. This study contributes to the growing body of research emphasizing the need to integrate mental health support in weight management programs and policy interventions, recognizing the critical role of mental well-being in influencing physical outcomes such as weight fluctuations. The findings have important implications for healthcare providers, policymakers, and wellness programs aiming to address health's psychological and physical aspects.

Enhancing Interprofessional Skills with SKY Campus: A Pilot Study on Mental Well-being at UCD

Abstract Background Public health professionals and students face increasing mental health challenges. Sudarshan Kriya Yoga (SKY), known for its mental health benefits such as stress reduction and improved emotional regulation, offers a promising strategy for enhancing well-being in public health education. Objectives To evaluate the immediate effects of a three-day participatory SKY workshop on mental well-being of Master of Public Health students at University College Dublin, Ireland. Methods A non-randomized, controlled pilot study will involve MPH students at UCD. Participants, aged 18 and above, enrolled in the MPH programme, will provide informed consent to attend a three-day SKY workshop in September 2024. The workshop, delivered by certified trainers, includes three sessions of three hours each. Standardised and validated Patient-Reported Outcome Measures (PROMs) such as the Perceived Stress Scale (PSS-10) and WHO-Five Well-being Index (WHO-5) will be used to assess perceived stress and mental wellbeing at baseline and immediately after the workshop. Results Based on previous literature, it is hypothesized that participants will show a significant reduction in perceived stress and improvement in mental wellbeing scores. Data will be analysed using descriptive statistics and Wilcoxon signed-rank tests to evaluate changes in PROM scores. Conclusions This pilot study aims to provide preliminary evidence on the effectiveness of SKY in improving mental wellbeing among public health students. Successful outcomes could support integrating SKY into the public health curriculum, promoting its adoption across other institutions, and enhancing the professional skills development of future public health professionals. This component is proposed in the ASPHER core curriculum programme for public health as an important cross curricular subject area Key messages • Integrating SKY Campus workshops into public health education enhances interprofessional skills and mental well-being, offering a holistic approach to professional development in global health. • This study uses standard PROMs to assess the SKY workshop’s impact, aiming for significant improvements in stress and mental well-being to shape global public health curricula.

The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health

Abstract Issue/problem In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved. Description of the problem Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts). Results From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers. Lessons The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution. Key messages • Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers. • To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.

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.

7.D. Scientific session: Digital health divide in access, use, and effectiveness: Examples from three countries

Abstract The increasing digitalisation of the healthcare system opens up a wide range of opportunities but also poses challenges in reducing inequalities due to unequal technological access as well as social and demographic differences of populations. This so-called digital divide is the opposite of digital inclusion, defined by the United Nations as “equitable, meaningful, and safe access to use, lead, and design of digital technologies, services, and associated opportunities for everyone, everywhere”. Indeed, digitalisation is a global phenomenon that permeates all levels of determinants of health inequities, leading to several populations being more disadvantaged. Age, gender, education, and economic status are significant factors amplifying the digital divide’s impact, with older individuals, women, less educated individuals, and economically deprived populations bearing disproportionate effects. Prior literature suggests three levels of digital divide: 1) access to internet and digital technology, 2) individual cognitive and technical competencies in utilizing digital tools, and 3) effectiveness or the optimal functionality and reach of digital technologies. Although there is less consensus with regards to the scope of the divide in the health sector, the three levels are the common reference. Nonetheless, this lack of agreement resulted in existing literature to be concentrated around digital health literacy, or the cognitive and technical abilities to use digital technologies. In addition, while tools such as the Global Digital Health Monitor are valuable to track, monitor, and assess the enabling environment for digital health worldwide, it does not capture the lived experience of the population, including the disadvantaged population groups. This workshop aims to 1) generate discussion on digital health divide and how it can be operationalized and 2) reflect on potential actions to counteract these injustices. Case studies from Germany, Indonesia and Argentina will be presented to diversely contextualize the inequities in digital health and assess plausible interventions. The workshop will be divided into four parts. First, an introduction to the digital health divide will be presented as well as its public health relevance (10 minutes). Second, researchers representing three countries (i.e., Germany, Indonesia, and Argentina) will present digital health divide case studies within their context of expertise (15 minutes). Third, a case-based discussion will be conducted with participants. Participants will be allocated into groups based on the three levels of the digital health divide (i.e., access, use, and effectiveness) and work on recommendations to best operationalize and narrow the digital health divide (25 minutes). Finally, the workshop will conclude with a wrap-up of the group discussion results (10 minutes). Key messages • The digital health divide affects all regions, regardless of income levels. Narrowing the gap is crucial to reduce health inequity and achieve universal health coverage. • By clearly defining the scope and operationalization of the digital health divide, its measurability and usefulness to inform health policies and programs to address this issue can be enhanced.

From crisis to chronic: a comparative analysis of Long COVID impact in Italy and the United States

Abstract Background The aftermath of COVID-19 is bringing about socio-economic consequences, such as diminished quality of life (QoL), decreased productivity, and considerable healthcare expenditures. Despite the emerging acknowledgment of a clinical syndrome following COVID-19 disease, known as Long COVID (LC), notable research gaps persist. This study aims to assess the epidemiological and economic impact of LC in both Italy and the United States (US). Methods This ecological analysis comprises epidemiologic and economic data from 2020 to January 2023, regarding working-age individuals (18-64 years). An Italy/US incidence rate ratio (eIRR) was estimated to compute LC cases in each country. The product between the value of a year spent in good health, individual Quality-Adjusted Life Year (QALY) loss, and LC cases yielded total lost QoL. Temporary productivity loss (TPL) was calculated through the Human Capital Approach. All estimates were deemed significant at a p-value less than 0.05. Results Up to date, the eIRR was 0.78 [0.43 - 0.91] implying 22% fewer LC cases in Italy with respect to the US. Total LC cases were 11 [8.7 - 13.5] and 1.8 [0.9 - 2.1] million in the US and Italy, respectively. The relative QALYs loss was 1.5 [0.8 - 3.1] and 0.2 [0.1 - 0.9] million. Reduced QoL cost roughly $189 [164 - 214] billion in the US and €6 [1 - 11] billion in Italy. TPL amounted to $37 [21 - 57] billion in the US and €2.8 [1.2 - 7.4] billion in Italy. Americans aged 30-39 years showed the largest income loss (26.6%), while in Italy it occurred in the age group 50-64 years (38%). Conclusions LC places a substantial burden in Italy and the US, impacting both the productivity of the working-age population and influencing the younger generation, who constitute the future workforce. Our study underpins the necessity for comprehensive health policies, programs, and interventions alongside effective tertiary prevention strategies to tackle the challenges posed by LC. Key messages • According to this analysis, both countries show significant productivity and quality-adjusted life years loss due to LC among working age individuals. • Steering the formulation of evidence-based sounding health policies to address LC burden, among working age individuals, both in Italy and in the US.