•Civic literacy refers to the ability to engage meaningfully with one's community.•Digital, health, and civic literacy are key predictors for digital health literacy.•The extent to which these three ...affect digital health literacy remains unclear.•Building digital health literacy is vital to limit inequalities from expanding.
The COVID-19 pandemic has highlighted the importance of local evidence ecosystems in which academia and practice in the Public Health Service (PHS) are interconnected. However, appropriate ...organizational structures and well-trained staff are lacking and evidence use in local public health decision-making has to be integrated into training programs in Germany. To address this issue, we developed a framework incorporating a toolbox to conceptualize training programs designed to qualify public health professionals for working at the interface between academia and practice. We conducted a scoping review of training programs, key-informant interviews with public health experts, and a multi-professional stakeholder workshop and triangulated their output. The resulting toolbox consists of four core elements, encompassing 15 parameters: (1) content-related aspects, (2) context-related aspects, (3) aspects relevant for determining the training format, and (4) aspects relevant for consolidation and further development. Guiding questions with examples supports the application of the toolbox. Additionally, we introduced a how-to-use guidance to streamline the creation of new training programs, fostering knowledge transfer at the academia-practice interface, equipping public health researchers and practitioners with relevant skills for needs-based PHS research. By promoting collaborative training development across institutions, our approach encourages cross-institutional cooperation, enhances evidence utilization, and enables efficient resource allocation. This collaborative effort in developing training programs within local evidence ecosystems not only strengthens the scientific and practical impact but also lays a foundation for implementing complex public health measures effectively at the local level.
Abstract
Background
Health Impact Assessment (HIA) is promoted as a decision-informing tool by public health and governmental agencies. HIA is beneficial when carried out as part of policy ...development but is also valuable as a methodology when a policy is being implemented to identify and understand the wider health and well-being impacts of policy decisions, particularly when a decision needs to be taken rapidly to protect the population. This paper focusses on a HIA of the ‘Staying at Home and Social Distancing Policy’ or ‘lockdown’ in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA.
Methods
A HIA was conducted following a standard HIA five step process. A literature review was undertaken alongside 15 qualitative semi-structured interviews with key stakeholders, and relevant health and demographic data were collated. The results were triangulated and analysed to form a holistic assessment of the policy decision and its impacts.
Results
A wide range of major health and well-being impacts of the lockdown in Wales were identified across the determinants of health, which included positive and negative social, economic, environmental and mental well-being impacts beyond the impact on direct health. Populations affected included children and young people, those on low incomes and women as well as those whose health has been directly impacted by COVID-19 such as older people. The work highlighted the benefit that HIA can bring in emphasizing impacts which can inform policy and shared learning with others.
Conclusion
HIA is a largely underused tool to understand the impact of policy and political decisions, particularly when a decision has been taken at speed. This case study highlights how HIA provide evidence and information for advocacy and further work by public health institutes, health agencies and policy makers.
Making the case for investing in public health by illustrating the social, economic and environmental value of public health interventions is imperative. Economic methodologies to help capture the ...social value of public health interventions such as Social Return on Investment (SROI) and Social Cost-Benefit Analysis (SCBA) have been developed over past decades. The life course approach in public health reinforces the importance of investment to ensure a good start in life to safeguarding a safe, healthy and active older age. This novel review maps an overview of the application of SROI and SCBA in the existing literature to identify the social value of public health interventions at individual stages of the life course.
A systematic scoping review was conducted on peer-reviewed and grey literature to identify SROI and SCBA studies of public health interventions published between January 1996 and June 2019. All primary research articles published in the English language from high-income countries that presented SROI and SCBA outputs were included. Studies were mapped into stages of the life course, and data on the characteristics of the studies were extracted to help understand the application of social value methodology to assess the value of public health interventions.
Overall 40 SROI studies were included in the final data extraction, of which 37 were published in the grey literature. No SCBA studies were identified in the search. Evidence was detected at each stage of the life course which included; the birth, neonatal period, postnatal period and infancy (n = 2); childhood and adolescence (n = 17); adulthood (main employment and reproductive years) (n = 8); and older adulthood (n = 6). In addition, 7 studies were identified as cross-cutting across the life course in their aims.
This review contributes to the growing evidence base that demonstrates the use of social value methodologies within the field of public health. By mapping evidence across stages of the life course, this study can be used as a starting point by public health professionals and institutions to take forward current thinking about moving away from traditional economic measures, to capturing social value when investing in interventions across the life course.
Abstract Objective Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans. ...Methods A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12–15 years. A structured self-administered and anonymous questionnaire inquired about the children’s attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children’s ability to maintain health. Results Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0–1.3), middle/low maternal education (OR=1.2, 95%CI=1.1–1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2–1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1–1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4–2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1–1.4). Conclusions Almost 1/3 rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.
ContextThere is a global Human Papillomavirus (HPV) vaccine shortage until 2024. The World Health Organization recommended a temporary suspension of HPV vaccination for boys until all girls who need ...the vaccine can get it. In the European Union (EU), practices to define and monitor HPV vaccine shortages differ between the Member States. Prior policy initiatives were insufficient to address current vaccine shortages.Policy optionsDifferent policy options are recommended, divided into three self-developed clusters: prevention, response, and supply side. The policy options for the prevention part include decentralised surveillance and centralised surveillance. The policy options for the response part include dose sparing, EU joint procurement, postponing injection for young children, postponing vaccination for boys, and prioritisation in favour of low- and middle-income countries. The policy option for the supply side part is novel procurement agreements.RecommendationsA traffic light system to assist policymakers has been developed. The traffic light system recommends when policymakers should implement the suggested policy options. The traffic light system describes four stages: Green light (shortage prevention); Amber light (imminent shortage prevention); Red light (shortage management); Shortage lessons. These recommendations will improve EU crisis management.
Making the case for investing in preventative public health by illustrating not only the health impact but the social, economic and environmental value of Public Health Institutes is imperative. This ...is captured by the concept of Social Value, which when measured, demonstrates the combined intersectoral value of public health. There is currently insufficient research and evidence to show the social value of Public Health Institutes and their work across the life course, population groups and settings, in order to make the case for more investment.
During July 2021, a quantitative online self-administered questionnaire was conducted across international networks. Semi-structured interviews were also carried out with nine representatives to gain a deeper understanding. A thematic analysis was undertaken on the data collected.
In total, 82.3% (
= 14) were aware of the terminology of social value and 58.8% (
= 10) were aware of the economic method of Social Return on Investment. However, only two Institutes reported capturing social and community impacts within their economic analysis and only 41.2% (
= 7) currently capture or measure the social value of their actions. Interviews and survey responses indicate a lack of resources, skills and buy-in from political powers. Finally, 76.5% (
= 12) wanted to do more to understand and measure wider outcomes and impact of their actions. It was noted this can be achieved through enhancing political will, developing a community of best practice and tools.
This research can inform future work to understand how to measure the holistic social value of Public Health Institutes, in order to strengthen institutional capacity and impact, as well as to achieve a more equitable society, and a more sustainable health system and economy, making the case for investing in public health, as we recover from COVID-19.
Objective
This study aims to describe the factors related to the individual, the system and their interaction, which can affect eHealth literacy from the perspective of people living with one or ...multiple chronic diseases. As digital solutions are increasingly used in healthcare, perspectives of patients with chronic diseases must be considered.
Methods
The study design was a qualitative, descriptive interview study, gathering the insights of people living in Finland with chronic disease. The individual semi-structured interviews (n = 17) were conducted via telephone. The eHealth Literacy Framework was used in the data analysis, with a deductive–inductive approach.
Results
The range of skills included in the eHealth Literacy Framework was widely applied by participants who described themselves as adept at using eHealth environments to manage health-related needs. The participants evaluated online information and took an active role in self-management of their chronic disease. Most importantly, even participants possessing many of the skills in the eHealth Literacy Framework experienced difficulties in using eHealth environments, and the accessibility of eHealth environments was highlighted.
Conclusions
eHealth environments could be useful for health promotion and self-management for people with chronic diseases, but only presuming the environments are adapted to their level of eHealth literacy skills.
Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do ...not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety. Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered. Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge. Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake. Acknowledgments: We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process Authors’ contributions: All authors contributed equally to this work. Conflict of interest: None declared Source of funding: None declared
These days we see the first assessments on the EU’s role as crisis manager. Commentators differ in their view whether the EU has failed, been late or has finally come to a substantial response. We ...should bear in mind that there is a limited EU role in crisis response specifically and for Public Health in general. With regard to the first, Member States (MS) and even sub-national levels are the first and key crisis managers addressing the responses to the pandemic. Moreover, despite some responsibilities and institutions for supporting the immediate crisis response (e.g. ECDC, Early Warning & Response System, Health Security Committee, Decision on serious cross-border threats), the EU role is with coordination, sharing information and building supporting structures for MS to be prepared better for an emergency response. With regard to Public Health in general, the EU has a narrow mandate3 with limited law-making powers. There is a strong reluctance by MS to hand over responsibilities, because health(care) is close to their citizens.
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