Programmes and calls for public health research in European countries

Introduction: Public health research, at population and organizational level, needs to be identified independently within 'health' research from biomedicine and life sciences. In PHIRE (Public Health Innovation and Research in Europe), we investigated the extent and character of public health research calls and programmes in European countries. METHODS: Country respondents, identified through national member associations of the European Public Health Association completed a standardized recording instrument. Public health research was defined, and the call period limited to the latest full year (2010). Of the 30 countries included (EU 27 plus Iceland, Norway and Switzerland), there were reports for 25 countries A simple classification of the calls was developed. RESULTS: There were 75 calls and programmes included. Of these, 41 (55%) together were in France and the UK, and 34 in a further 14 countries, while 9 countries reported there were no calls or programmes opened in 2010. Calls were categorized across diseases, behaviours, determinants, services and methodologies. Some calls were broad, while others-particularly in the countries with several calls-were more detailed towards specific issues. Levels of funding varied markedly and were difficult to define. Where stated, in 32 responses, 19 calls were only open to national applicants and 13 from abroad. CONCLUSIONS: Most European countries have competitive programmes and calls relevant for public health research, but they are poorly identified. Only a minority of countries present a wide range of topics and specific fields. Effort is needed to develop classifications for public health programmes and calls for public health research, improve information (including financial) collection to enable systematic comparisons and build greater recognition of public health research within research communities, with national and European research funding organizations, and for practitioners and policymakers.PHIRE received co-funding from the European Union Health Programme, agreement no. 2009 12 14

Are area-level and individual-level socioeconomic factors associated with self-rated health in adult urban citizens? Evidence from Slovak and Dutch cities

Background: Evidence shows that living in disadvantaged areas is associated with poor health. This may be due to the socioeconomic (SE) characteristics of both these residents and the areas where they live. Evidence regarding this on Central European (CE) countries is scarce. Our aim was to assess whether the prevalence of poor self-rated health (SRH) was higher in deprived urban areas, whether this can be explained by individual SE status (SES) and whether this differed between Slovakia and the Netherlands per age group. Methods: We examined the association of urban-level data and individual-level SE factors from different urban areas in different countries (Slovakia, the Netherlands) using comparable urban health indicators and area indicators. We also obtained unique data from the EU-FP7 EURO-URHIS 2 project. Results: Multilevel logistic regression showed that poor SRH was associated with area deprivation in both countries. Regarding age by country, poor SRH occurred more frequently in the more deprived areas for the younger age group (>= 64) in the Netherlands but for the older age group (>= 65 years) in Slovakia. Moreover, Slovak citizens reported poor SRH significantly more often than Dutch residents. Individual SES was significantly associated with poor SRH in both age groups and both countries for most area-level SE measures. Conclusion: Individual SES is associated with SRH more strongly than area deprivation. Therefore, it is important to account for relative deprivation at an individual level when considering health-enhancing activities. Moreover, the effect of urban-area deprivation seems to differ between CE and WE countries

Elderly from lower socioeconomic groups are more vulnerable to mental health problems, but area deprivation does not contribute:A comparison between Slovak and Dutch cities

BACKGROUND: Little is known about factors associated with mental health problems (MHP) of the elderly in socioeconomically deprived neighbourhoods, and comparisons between Central European and Western European countries on this topic are lacking. We examined whether MHP occurred more frequently in deprived neighbourhoods and among deprived people. Next, we examined whether the association of MHP with area deprivation differed by country and whether this could be explained by the socioeconomic (SE) characteristics of the residents. METHODS: We obtained data on non-institutionalized residents aged 65 years and above from the EU-FP7: EURO-URHIS 2 project from Slovak (N = 665, response rate 44.0%) and Dutch cities (N = 795, response rate 50.2%). An elevated score on General Health Questionnaire-12 (≥2) indicated MHP. Education and household income with financial strain were used as measures of individual SE status. We employed multilevel logistic regression. RESULTS: Overall rates of MHP were significantly higher in Slovakia (40.6%) than in the Netherlands (30.6%). The neighbourhood unemployment rate was not associated with the mental health of elderly in either country. Rates of MHP were significantly higher among elderly with low and medium income [odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.16-2.62; OR = 1.64, 95% CI = 1.12-2.41, respectively] and financial strain (OR = 2.26, 95% CI = 1.56-3.28) when compared with those with high income and no strain, respectively. Individual-level SE characteristics explained differences between the two countries. CONCLUSION: The risk of MHP among the elderly is associated with their individual-level SE position but not with neighbourhood deprivation in both Slovakia and the Netherlands

Facilitators and barriers to behavior change in overweight and obesity management using the COM-B model

IntroductionIncreasing overweight and obesity rates represent one of the global public health challenges. COM-B is a theoretical model used to identify areas to target to achieve behavior change. It identifies three factors that are needed for any behavior to occur: capability, opportunity, and motivation. We aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B.MethodsThe study included 139 people with overweight and obesity (mean age 48.81 ± 14.49 years; 64.5% female; body mass index 32.64 ± 6.51 kg/m2; waist-to-height ratio 0.62 ± 0.10) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Overall Evaluation of Health (OEH). Multiple linear regression was performed to analyse the data.ResultsThe associations between sociodemographic and clinical variables and COM-B domains attenuated or were no longer significant when psychological resources were added to the regression models. Self-efficacy was identified as a stronger facilitator of health behavior change (p < 0.001) when compared to self-esteem (p < 0.05). No associations between automatic motivation and psychological resources were identified, however. Automatic motivation was found to be associated with higher age, being in a relationship, and better health.DiscussionBehavioral interventions for weight management should specifically target different components of COM-B. Self-efficacy and self-esteem may play a significant role in individual capabilities, opportunities, and reflective motivation and should be included in tailored public health interventions. Health programs targeting younger and single people, and people with chronic conditions may help to promote sustainable behavior change

Strategies, processes, outcomes, and costs of implementing experience sampling-based monitoring in routine mental health care in four European countries:study protocol for the IMMERSE effectiveness-implementation study

BACKGROUND: Recent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users' daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia).METHODS: In this hybrid effectiveness-implementation study, a parallel-group, assessor-blind, multi-centre cluster randomized controlled trial (cRCT) will be conducted, combined with a process and economic evaluation. In the cRCT, 24 clinical units (as the cluster and unit of randomization) at eight sites in four European countries will be randomly allocated using an unbalanced 2:1 ratio to one of two conditions: (a) the experimental condition, in which participants receive a Digital Mobile Mental Health intervention (DMMH) and other implementation strategies in addition to treatment as usual (TAU) or (b) the control condition, in which service users are provided with TAU. Outcome data in service users and clinicians will be collected at four time points: at baseline (t0), 2-month post-baseline (t1), 6-month post-baseline (t2), and 12-month post-baseline (t3). The primary outcome will be patient-reported service engagement assessed with the service attachment questionnaire at 2-month post-baseline. The process and economic evaluation will provide in-depth insights into in-vivo context-mechanism-outcome configurations and economic costs of the DMMH and other implementation strategies in routine care, respectively.DISCUSSION: If this trial provides evidence on reach, effectiveness, adoption, implementation and maintenance of implementing ESM-based monitoring, reporting, and feedback, it will form the basis for establishing its public health impact and has significant potential to bridge the research-to-practice gap and contribute to swifter ecological translation of digital innovations to real-world delivery in routine mental health care.TRIAL REGISTRATION: ISRCTN15109760 (ISRCTN registry, date: 03/08/2022).</p

New challenges in public health education and training in the Slovak Republic

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt;: The Slovak Republic joined the European Union (EU) on May 1st 2004. The public health system&lt;br /&gt;of the country is under continuous transition including public health education and training. The aim of the presented paper is to describe and discuss how far the transition of public health education of the country&lt;br /&gt;went during last time period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt;: Web site review, documentation search and curriculum content analysis were the main methods&lt;br /&gt;employed within presented paper.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;: There are 7 universities offering public health education on bachelor, master and doctoral level.&lt;br /&gt;Among them 6 could be found in list of accredited universities of the Ministry of Education by Accreditation&lt;br /&gt;Committee of the Government of the Slovak Republic. The three levels of education are fully harmonized with&lt;br /&gt;the Bologna principles. The Accreditation Committee of the Government of the Slovak Republic describes very detailed aims of a public health education program including recommended study subjects. Universities add to additional, mostly clinical medicine or hygiene subjects to recommend study subjects leaving likely very&lt;br /&gt;little time for research at universities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: Despite large progress further effort is needed to clarify what is public health, what kind of subject should be included in curricula and on introduction of public health research at universities.&lt;/p&gt

Associations between self-rated health, mental health problems and physical inactivity among urban adolescents

Self-rated health is a valid and reliable subjective indicator of general health. We aimed to assess the associations between self-rated health, mental health problems, physical activity, sedentary behaviour and BMI among Slovak urban adolescents. Data were collected within the EU-FP7: EURO-URHIS 2 (The European Health Indicator System Part 2) project in two largest Slovak cities: Bratislava and Kosice. Sample included 1111 adolescents (response rate 73.7%, mean age 14.32 +/- 0.48 years, 52.8% boys). Self-rated health was measured with the first item from the Short Form Health Survey 36 questionnaire, mental health problems were assessed by the Strengths and Difficulties Questionnaire and for physical activity and sedentary behaviour questions from the WHO HBSC questionnaire were used. Logistic regression was performed to determine the associations between self-rated health and the independent variables. Self-rated health was found to be significantly associated with mental health problems, sedentary behaviour and BMI. However, the strongest association was found with engagement in physical activity every day (OR 8.0; 95% CI 1.6-39.9). Previous research revealed that self-rated health was associated with various mental health problems. Our findings add to these results by showing that physical activity and sedentary behaviour are also very important additional factors related to self-rated health. Better understanding of these associations can help in developing more effective public health intervention programmes for adolescents

Competitive funding and structures for public health research in European countries

The European Union is giving increasing emphasis to research as a driver for innovation and economic development. The European collaborative study PHIRE (Public Health Innovation and Research in Europe) investigated the funding and structures of public health research at national level in European countries.PHIRE was undertaken with the support of the Governing Council of EUPHA. We thank the PHIRE partners, EUPHA Section presidents and country informants, and national public health associations, country experts and officials who gave their time and knowledg