The effect of postmigration stressors on the prevalence of depressive symptoms among refugees in Germany. Analysis of the IAB-BAMF-SOEP Survey 2016

Nutsch N, Bozorgmehr K. Der Einfluss postmigratorischer Stressoren auf die Prävalenz depressiver Symptome bei Geflüchteten in Deutschland. Analyse anhand der IAB-BAMF-SOEP-Befragung 2016. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz . 2020;63:1470–1482.BACKGROUND: International studies prove the high burden of mental illnesses among refugees. Postmigration stressors in the country of refuge may affect the mental health and result in depression.; OBJECTIVES: The study examines whether postmigration stressors are associated with the prevalence of depressive symptoms among adult refugees in Germany.; METHODS: Secondary data analysis based on cross-sectional data of the IAB-BAMF-SOEP Survey of Refugees 2016 (N =4465) that is representative for Germany. Depressive symptoms were measured using the Patient Health Questionnaire‑2 (PHQ-2). Unadjusted and adjusted odds ratios (ORs) and confidence intervals (CIs) were calculated with binary logistic regression models to examine associations between depression and sociodemographic, postmigration, and psychosocial factors.; RESULTS: Depressive symptoms show 19.4% of the surveyed refugees. Almost all selected postmigration stressors are significantly associated with depression after adjustment for sociodemographic and psychosocial factors. Unemployment (aOR =1.48 [1.04-2.12]), loneliness (aOR =1.14 [1.10-1.18]), and arejected or undecided asylum application (aOR =1.34 [1.06-1.70]) increase the odds of depressive symptoms, whereas asylum interviews (aOR =0.71 [0.56-0.91]) and higher housing satisfaction (aOR =0.94 [0.91-0.98]) lower the odds of depression.; CONCLUSIONS: Postmigration stress is associated with the occurrence of depressive symptoms. Sociopolitical interventions considering stressful and protective factors of the postmigration phase can reduce the burden of mental disorders in refugee populations.Einleitung Internationale Studien belegen eine hohe psychische Krankheitslast bei Geflüchteten. Postmigratorische Stressoren im Zufluchtsland können die psychische Gesundheit beeinträchtigen und zu Depressionen führen. Ziel Die Studie untersucht, ob postmigratorische Stressoren mit der Prävalenz depressiver Symptome bei erwachsenen Geflüchteten in Deutschland assoziiert sind. Methoden Sekundärdatenanalyse basierend auf für Deutschland repräsentativen Querschnittsdaten der IAB-BAMF-SOEP-Befragung von Geflüchteten 2016 (N = 4465). Depressivität wurde mit dem Patient Health Questionnaire‑2 (PHQ-2) erfasst. Unadjustierte und adjustierte Odds Ratios (OR) und 95 %-Konfidenzintervalle (KI) wurden anhand binär logistischer Regressionsmodelle berechnet, um Zusammenhänge zwischen Depressivität und soziodemografischen, postmigratorischen und psychosozialen Faktoren zu untersuchen. Ergebnisse Depressive Symptome weisen 19,4 % der befragten Geflüchteten auf. Fast alle einbezogenen Postmigrationsstressoren sind nach Adjustierung für soziodemografische und psychosoziale Faktoren statistisch signifikant mit Depressivität assoziiert. Erwerbslosigkeit (aOR = 1,48 [1,04–2,12]), Einsamkeit (aOR = 1,14 [1,10–1,18]) und ein abgelehnter oder noch nicht entschiedener Asylantrag (aOR = 1,34 [1,06–1,70]) erhöhen die Chance für depressive Symptome, während eine stattgefundene Anhörung (aOR = 0,71 [0,56–0,91]) und eine höhere Wohnzufriedenheit (aOR = 0,94 [0,91–0,98]) die Chance für Depressivität verringern. Diskussion Postmigrationsstressoren bei Geflüchteten sind mit dem Vorkommen depressiver Symptome assoziiert. Die Berücksichtigung belastender und protektiver Faktoren der Postmigrationsphase in sozialpolitischen Maßnahmen kann die psychische Krankheitslast in Flüchtlingspopulationen reduzieren

Promoting physical activity in everyday life of people with intellectual disabilities: An intervention overview

Nutsch N, Bruland D, Latteck Ä-D. Promoting physical activity in everyday life of people with intellectual disabilities: An intervention overview. Journal of Intellectual Disabilities. 2021: 174462952110264.People with intellectual disabilities show significantly lower levels of physical activity than the general population in respect to all consequences for health. A positive effect of physical activity on health preservation has been proven, but interventions for physical activity in everyday life seem to be rare for people with intellectual disabilities. Based on a previously conducted scoping review the Template for Intervention Description and Replication (TIDieR) checklist was prepared. This article describes and compares physical activity interventions in everyday life for individuals with intellectual disabilities with the aim to of identifying successful strategies and areas for improvement. The 12 included interventions are heterogeneous, but commonalities and similarities can be identified. There are suggestions for successful strategies to implement physical activity interventions. However, much information could not be found. The promotion of healthier lifestyles is important to improve the overall health in this population

Interventions to improve physical activity in daily life of people with intellectual disabilities. Detailed results presentation of a Scoping Review

Bruland D, Schulenkorf T, Nutsch N, Nadolny S, Latteck Ä-D. Interventions to improve physical activity in daily life of people with intellectual disabilities. Detailed results presentation of a Scoping Review. Bielefeld: Universität Bielefeld; 2019.Today, low levels of physical activity are a major health problem for society and are associated with an increased risk for chronic diseases especially by people with intellectual disability. To our knowledge, target group concepts to promote physical activity addressing daily life are rarely. For this, the aim of our research project is to develop, test and validate a multi-modal target-group-oriented intervention. This intervention will promote a physically active lifestyle by promoting health-related literacy, Physical activity-related health competence and self-efficacy. The first step of the project is to review the current state of interventions promoting physical activity in people with intellectual disability with a focus on daily life activities. This article describes the approach and the findings of the conducted scoping review. In general, 33 articles could be included. They were sorted by overviews, systematic reviews, studies, and curriculum. For a good overlook and comparision data were mapped for each category, except the single curriculum. Likewise, for all categories the results were summarized via a qualitative thematic analysis in a narrative format. For this, we identify relevant statements in the articles according to our research questions: a) How is motivation of the participants discussed? b) How are the needs of participants integrated in the intervention? c) Are competencies/physical requirements for physical activity of users analyzed and if so, how? d) How are the interventions evaluated? We added categories if we think that they are important for our own intervention development. This report has three goals: a) It is a tool-box (pool of ideas) mainly with basic concepts and tested strategies for our own development but also with other information about e.g. barriers and facilitator. b) Above that, with the detailed results presentation, we would like to achieve good transparency on which data basis our intervention will be developed. c) We like to share our results with interested

Effects of restrictive asylum-seeker healthcare policies: systematic review of evidence from Germany

Gottlieb ND, Gold AW, Nutsch N, Duwendag S, Bozorgmehr K. Effects of restrictive asylum-seeker healthcare policies: systematic review of evidence from Germany. European Journal of Public Health . 2023;33(Suppl. 2): ckad160.726

Associations between postmigration living situation and symptoms of common mental disorders in adult refugees in Europe: updating systematic review from 2015 onwards

Nowak AC, Nutsch N, Brake T-M, Gehrlein L-M, Razum O. Associations between postmigration living situation and symptoms of common mental disorders in adult refugees in Europe: updating systematic review from 2015 onwards. BMC Public Health. 2023;23(1): 1289.Background Refugees and asylum seekers have a high prevalence of psychiatric disorders such as post-traumatic stress disorder (PTSD), anxiety, and depression. The postmigration context inheres different risk and protective factors for mental health of refugees and asylum seekers in host countries. We conducted a systematic review to update knowledge on the association between characteristics of the postmigration living situation (PMLS) and mental health outcomes in Europe since 2015. Methods We searched in five databases according to the PRISMA statement. From a total of 5,579 relevant studies published in 2015–22, 3,839 were included for title and abstract screening, and 70 full texts screened for eligibility. Out of these, 19 studies on refugees and asylum seekers conducted in European countries after 2014 were included in this systematic review. The quality of studies was assessed by using the Mixed Methods Appraisal Tool (MMAT) – version 2018. We performed a narrative synthesis using the four layers of the social determinants of health framework. Results A wide range of risk and protective factors for mental health in the PMLS were identified as exposure measures, which included individual factors (e.g., language skills), social and community networks (e.g., family concerns, loneliness and social support, discrimination), living and working conditions (e.g., legal status, duration of residence, unemployment and financial hardship, housing) as well as general socio-economic, cultural and environmental factors (e.g., social status, acculturation). We found postmigration stressors are positively associated with symptoms of depression, anxiety, and PTSD, albeit not consistently so. Especially, the general socio-economic, cultural and environmental factors showed weak associations with mental health. Conclusions Heterogenous study characteristics likely explain the inconsistent associations between characteristics of the PMLS and mental health outcomes. However, broken down in its component layers, most risk and protective factors of the PMLS were significantly associated with symptoms of mental disorders showing the same direction of association across the included studies, while the association between some stressors or resources of the PMLS and mental health turns out to be less homogeneous than expected. Characteristics of the PMLS contribute to the high prevalence of mental diseases of refugees and asylum seekers. Disadvantages in general socio-economic conditions, living and working conditions, in access to social and community networks need to be redressed, in addition to better access to health care

Covid-19 Pandemic Policy Monitor (COV-PPM) - European level tracking data of non-pharmaceutical interventions

Bozorgmehr K, Rohleder S, Duwendag S, et al. Covid-19 Pandemic Policy Monitor (COV-PPM) - European level tracking data of non-pharmaceutical interventions. Data in Brief. 2021;39: 107579.The Covid-19 Pandemic Policy Monitor (COV-PPM) dataset prospectively documents non-pharmaceutical interventions (NPIs) taken to contain SARS-Cov-2 transmission across countries in EU27, EEA and UK. In Germany, measures have also been recorded at the federal state and, partially, at the district levels. NPIs implemented since January 2020 have been retrieved and updated weekly from March 2020, from official governments webpages, Ministries of Health, National (Public) Health Institutes or Administrations. NPI categories collected refer to restrictions, closures or changes in functioning implemented in 13 domains: public events (gatherings in indoor or outdoor spaces); public institutions (kindergartens, schools, universities); public spaces (shops, bars, restaurants); public transport (trains, buses, trams, metro); citizens movement/mobility (e.g. pedestrians, cars, ships); border closures (air, land or sea, all incoming travels, from high-risk regions, only non-nationals); measures to improve the healthcare system (e.g. human resources or technical reinforcement, redistribution, material or infrastructural); measures for risk/vulnerable groups (e.g. elderly, chronically ill, pregnant); economic measures (e.g. lay-off rules establishment, actions to avoid job-loss, tax relaxation); testing policies (e.g. testing criteria changes); nose and mouth protection rules, vaccination and others/miscellaneous measures