@misc{HoffmannTschornMichalskietal., author = {Hoffmann, Stephanie and Tschorn, Mira and Michalski, Niels and Hoebel, Jens and F{\"o}rstner, Bernd R. and Rapp, Michael A. and Spallek, Jacob}, title = {Regionale sozio{\"o}konomische Deprivation, Ruralit{\"a}t und kindliche Entwicklung: Analyse von Daten der Schuleingangsuntersuchung des Bundeslandes Brandenburgs}, series = {17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK}, journal = {17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK}, abstract = {Einleitung Die gesundheitliche Entwicklung von Kindern wird neben der sozio{\"o}konomischen Position (SEP) der Familie auch von Merkmalen der Lebensumgebung gepr{\"a}gt. Ruralit{\"a}t oder regionale sozio{\"o}konomische Deprivation werden als m{\"o}gliche unabh{\"a}ngige Einflussgr{\"o}ßen postuliert, ohne dass bisher ausreichende empirische Ergebnisse vorliegen. In dieser Studie wurde untersucht, ob regionale sozio{\"o}konomische Deprivation und Ruralit{\"a}t unabh{\"a}ngig von famili{\"a}rer SEP mit der Entwicklung von Kindern assoziiert sind. Methoden Daten des Sozialp{\"a}diatrischen Entwicklungsscreenings im Rahmen der Einschulungsuntersuchungen aus dem Jahr 2018/2019 in Brandenburg (n=22.801 Kinder) wurden verkn{\"u}pft mit Daten zur regionalen Bev{\"o}lkerungsdichte (Ruralit{\"a}t) sowie mit dem German Index of Socioeconomic Deprivation (regionale Deprivation). Mittels gemischter Modelle wurde der Zusammenhang einer Allgemeinen Entwicklungsverz{\"o}gerung (AEV) mit Ruralit{\"a}t und mit regionaler Deprivation analysiert (OR=Odds Ratio (95\% Konfidenzintervall)), wobei f{\"u}r famili{\"a}re SEP (hoch, mittel, niedrig) adjustiert und nach Geschlecht (M=M{\"a}dchen, J=Jungen) stratifiziert wurde. Ergebnisse Kinder mit hoher famili{\"a}rer SEP zeigten geringere Chancen einer AEV als Kinder mit mittlerer famili{\"a}rer SEP (ORM=4,26(3,14-5,79); ORJ=3,46(2,83-4,22)) und niedriger famili{\"a}rer SEP (ORM=16,58(11,90-23,09); ORJ=12,79(10,13-16,16)). Gr{\"o}ßere regionale Deprivation war unabh{\"a}ngig von famili{\"a}rer SEP und Ruralit{\"a}t mit AEV assoziiert (ORM=1,35(1,13-1,62); ORJ=1,20(1,05-1,39)). Neben famili{\"a}rer SEP und regionaler Deprivation zeigte Ruralit{\"a}t keine Assoziation mit AEV. Schlussfolgerung Neben der famili{\"a}ren SEP wirkt sich die regionale sozio{\"o}konomische Deprivation auf Entwicklungsverz{\"o}gerungen von Kindern aus. Sozialepidemiologie und Public Health sollten daher neben den individuellen sozio{\"o}konomischen Voraussetzungen auch die regionalen sozio{\"o}konomischen Bedingungen als Determinante der gesundheitlichen Entwicklung {\"u}ber den Lebenslauf ber{\"u}cksichtigen.}, language = {de} } @misc{RattayBlumeSpalleketal., author = {Rattay, Petra and Blume, Miriam and Spallek, Jacob and Hoffmann, Stephanie and Sander, Lydia and Herr, Raphael and Herke, Max and Reuter, Marvin and Novelli, Anna and H{\"o}vener, Claudia}, title = {Socioeconomic position and self-rated health among adolescents: the mediating role of the family}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.580}, pages = {1}, abstract = {Background Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining adolescents' health inequalities. The study aimed to explore whether the association between socioeconomic position and self-rated health (SRH) was mediated by familial determinants. Methods Using data from wave 2 of the KiGGS study (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of parents' education, occupation, income, socioeconomic position index, and adolescents' subjective social status on SRH into direct effects and indirect effects through familial determinants (family cohesion, parenting styles, parental well-being, stress, obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on SRH was found, except for income in male adolescents. In female adolescents, more than 70\% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations of parental education, the socioeconomic position index and subjective social status with SRH were also mediated by familial determinants (family cohesion, parental smoking and obesity). However, a significant direct effect of subjective social status remained. Conclusions The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions, community-based strategies, as well as programs to improve parenting and family functioning.}, language = {en} } @misc{HoffmannRattayBlumeetal., author = {Hoffmann, Stephanie and Rattay, Petra and Blume, Miriam and H{\"o}vener, Claudia and Schneider, Sven and Moor, Irene and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and De Bock, Freia and Spallek, Jacob}, title = {Do family characteristics explain a social gradient in overweight in early childhood?}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.581}, pages = {1}, abstract = {Background Children's overweight is associated with many factors, including their living situation, in particular their family's socioeconomic position (SEP) and family characteristics. Research on the extent to which family characteristics account for a social gradient in overweight in early life is scarce. This study evaluated whether family characteristics explain SEP differences in the risk of overweight in early childhood. Methods The study used baseline data of 3-6 year-old children (n = 1,116) from the intervention 'Ene mene fit' conducted at kindergartens in Baden-W{\"u}rttemberg, Germany. Data included overweight (body mass index > 90 percentile) and parents' reports on their education and family characteristics associated with overweight (child consumes: sweets in front of TV, soft drinks; family joined time: outdoor, breakfast, sports; cooking; child sets table; role model). Model-based single mediation analyses decomposed the total effect of highest parental education on overweight into direct (unmediated) and indirect (mediated) effects (OR, 95\% CI). Results Girls and boys with low parental education had higher odds for overweight than children with high/medium education. Among boys, low education influenced the risk of overweight via indirect effects of i. 'sweets consumption in front of TV' (OR = 1.31, 1.05-1.59) and ii. 'no joined sports' (OR = 1.14, 1.00-1.44). The direct effect of low education only remained significant when 'no joined sports' was considered (OR = 2.19, 1.11-5.19). Among girls, family characteristics measured here did not explain SEP differences in overweight. Conclusions The family characteristics 'sweets consumption in front of TV' and 'no joined sports' contribute to inequalities in overweight among boys, but not among girls. Therefore, more gender-sensitive research is needed to identify family risk and protective characteristics that explain health inequalities among both boys and girls.}, language = {en} } @misc{HoffmannTschornMichalskietal., author = {Hoffmann, Stephanie and Tschorn, Mira and Michalski, Niels and Hoebel, Jens and F{\"o}rstner, Bernd R. and Rapp, Michael A. and Spallek, Jacob}, title = {Do regional characteristics predict developmental delay? Analyses of German school entry examination}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.342}, pages = {2}, abstract = {Background Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP. Methods The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP. Results Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP. Conclusions In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP.}, language = {en} } @techreport{GoldfriedrichHoffmannMuelleretal., author = {Goldfriedrich, Martin and Hoffmann, Stephanie and M{\"u}ller, Yvonne and Schmidt, Andrea C. and Spallek, Jacob and Stroß, Annette M. and Tallarek, Marie}, title = {Konzeptpapier f{\"u}r einen Modellstudiengang „Gesundheitsp{\"a}dagogik und Gesundheitsdidaktik"}, editor = {Goldfriedrich, Martin and Hurrelmann, Klaus}, publisher = {Universit{\"a}t}, address = {Erfurt}, doi = {10.22032/dbt.52342}, url = {http://nbn-resolving.de/urn:nbn:de:gbv:547-202200367}, pages = {23}, abstract = {Angesichts der immer st{\"a}rker werdenden Diskussion um die Bedeutung von Gesundheit f{\"u}r den schulischen und außerschulischen Bildungs- und Lernprozess und der Risiken wachsender gesundheitlicher Ungleichheit bei Kindern und Jugendlichen (Hurrelmann/Richter 2013, Lampert et al. 2019) ist die Etablierung eines Studienganges „Gesundheitsp{\"a}dagogik und Gesundheitsdidaktik" l{\"a}ngst {\"u}berf{\"a}llig und von besonderer Bedeutung f{\"u}r gesundheitliche Chancengleichheit (Goldfriedrich \& Hurrelmann, 2021a; 2021b). Dieses Konzeptpapier stellt einen Modellstudiengang vor, bei dem insbesondere die Vermittlungsebenen - also die gesundheitsdidaktischen Gegenstandsbereiche - im Vordergrund stehen. Die Ausarbeitungen des Entwurfs basieren auf der Grundlage politischer Bestrebungen, der bisherigen Forschung zur Gesundheitsp{\"a}dagogik und Gesundheitsdidaktik, den Erkenntnissen der Erziehungs- und Gesundheitswissenschaften sowie wissenschaftlichen und interprofessionellen Beitr{\"a}gen des Netzwerks Gesundheitsdidaktik (bestehend aus 33 Expert*innen aus 24 Fachbereichen).}, language = {de} } @techreport{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and M{\"u}llmann, Saskia and Pan, Chen-Chia and Spallek, Jacob and Hoffmann, Stephanie and Haug, Ulrike and Zeeb, Hajo}, title = {Digitalisierung und Gesundheit: Ergebnisse einer zweiten bundesweiten Befragung in Deutschland}, pages = {21}, abstract = {Diese Studie untersuchte Einstellungen zu und Nutzung von digitalen Technologien im Gesundheitskontext anhand einer zweiten bundesweiten Befragung von Internetnutzenden in Deutschland. Unser Ziel war es zu ermitteln, ob und wie sich Einstellungen zu und Nutzung von digitalen Technologien im Gesundheitskontext zwei Jahre nach der ersten Befragung ver{\"a}ndert haben.}, language = {de} } @misc{HoffmannSpallekBangertetal., author = {Hoffmann, Stephanie and Spallek, Lena and Bangert, Benjamin and Dragano, Nico and Ben-Shlomo, Yoav and Spallek, Jacob}, title = {Area-level living environment and developmental delay in early childhood : a scoping review protocol for examining life course theories and empirical research.}, series = {Open Science Framework}, journal = {Open Science Framework}, doi = {10.17605/OSF.IO/RX2EK}, pages = {1 -- 16}, language = {en} } @misc{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and Muellmann, Saskia and Pan, Chen-Chia and Hoffmann, Stephanie and Spallek, Jacob and Haug, Ulrike and Zeeb, Hajo}, title = {Digitisation and health: Second nationwide survey of internet users in Germany}, series = {Digital Health}, volume = {Volume 10}, journal = {Digital Health}, doi = {10.1177/20552076241301457}, pages = {16}, abstract = {Objective: Rapid digitisation of health occurred during the COVID-19 pandemic worldwide. In October 2020, we conducted a survey on digital health technology use in Germany. This study aimed to conduct a second survey to investigate in more detail the internet use in health context and digital technology use for health promotion and disease prevention in Germany. Methods: A cross-sectional, nationwide telephone survey was conducted in November 2022. Anonymous data on internet and digital technology use, digital health literacy, and sociodemographic characteristics were analysed using descriptive statistics and binary logistic regressions. Results: The 1020 participants were aged 18-92 years, 53\% were male, 62\% completed primary or secondary education, 71\% resided in large cities, and 45\% reported a country-average net household income. Overall, 61\% reported internet use in health context via 1-4 devices. Among those, more than 50\% used the internet and apps to obtain general health information and less than 50\% used digital technologies for physical activity promotion or cancer prevention. Overall, 34\% were confident in using the internet for health decisions and 71\% preferred to receive health information non-digitally (e.g. on paper). Internet, app, and digital technology use were associated with higher digital health literacy and income, and residence in larger cities. Digital technologies were used for physical activity promotion by younger and for cancer prevention by older participants. Conclusion: The internet and digital technologies were predominantly used to obtain health information, but less often for health promotion and disease prevention in 2022 in Germany. While health app and digital technology use for physical activity promotion increased, the confidence in using online information for health decisions decreased in 2022 relative to 2020. Factors that promote confidence in online health information and digital technology use for health promotion and disease prevention need to be investigated in future studies.}, language = {en} } @misc{SpallekHoffmannStableretal., author = {Spallek, Jacob and Hoffmann, Stephanie and Stabler, Martin and Hecht, Henriette and Bangert, Benjamin and Martens, Lea and Irrgang, Christopher and Ladewig, Katharina and Zeeb, Hajo}, title = {Digital Public Health in l{\"a}ndlichen Regionen Deutschlands mit relativer sozio{\"o}konomischer Deprivation: das Beispiel des Lausitzer Zentrums f{\"u}r Digital Public Health}, series = {German Medical Sciences}, journal = {German Medical Sciences}, doi = {10.3205/24gmds630}, url = {http://nbn-resolving.de/urn:nbn:de:0183-24gmds6307}, abstract = {Einleitung: Digitale Gesundheitstechnologien - wie online Plattformen und tragbare Ger{\"a}te - bieten vermehrt M{\"o}glichkeiten zur Verbesserung von Pr{\"a}vention, Gesundheitsf{\"o}rderung und Gesundheitsversorgung. Europ{\"a}ische Studien haben aber auch gezeigt, dass sie nicht f{\"u}r alle Bev{\"o}lkerungsgruppen und Gebiete gleichermaßen zug{\"a}nglich, nutzbar und wirksam sind, um die Gesundheit zu verbessern. Vor allem Menschen, die in l{\"a}ndlichen Gebieten leben, Sprachbarrieren haben oder sozio{\"o}konomisch benachteiligt sind, profitieren seltener vom digitalen Wandel [1]. Um das Potenzial digitaler Gesundheitstechnologien f{\"u}r die Gesundheit der Bev{\"o}lkerung auszusch{\"o}pfen, sollten sie passgenau auf die relevanten Bev{\"o}lkerungsgruppen zugeschnitten sein und die regionalen Lebensbedingungen ber{\"u}cksichtigen. Ziel des Lausitzer Zentrums f{\"u}r Digital Public Health (LauZeDiPH) ist es, den digitalen Wandel unter dem Aspekt der gesundheitlichen Chancengerechtigkeit zu erforschen und zu unterst{\"u}tzen. Methoden: Die Forschung des LauZeDiPH [2] basiert mit Fokus auf die Bev{\"o}lkerung in der Lausitz sowohl auf Prim{\"a}r- und Sekund{\"a}rdaten aus bev{\"o}lkerungsbasierten Erhebungen als auch auf gezielt und partizipativ erhobenen Daten von spezifischen Gruppen, wie z.B. Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) oder Menschen mit geringer digitaler Kompetenz. Relevante Zielgr{\"o}ßen sind dabei u.a. der allgemeine Gesundheitszustand der lokalen Bev{\"o}lkerung, der Zugang zur und die Inanspruchnahme von Gesundheitsversorgung, der Zugang zu digitalen Gesundheitstechnologien, die digitale Gesundheitskompetenz und die Versorgungspr{\"a}ferenzen der Bev{\"o}lkerung in der Region. Ergebnisse: Die bisherigen Analysen in der Gesamtschau betonen die Bedeutung sozialer und regionaler Gesundheitsdeterminanten von der fr{\"u}hen Kindheit an in Brandenburg insgesamt sowie in der Lausitz, z.B. bei Besch{\"a}ftigten der Gesundheitsversorgung [3], [4], und damit die spezifischen Anforderungen f{\"u}r (Digital) Public Health in der Region. Neue Technologien werden oftmals in urbanen Settings f{\"u}r urbane Settings entwickelt und evaluiert. Maßgeschneiderte, regional eingebettete Maßnahmen sind daher essentiell, um bedarfsgerecht auch bisher nicht gut erreichte Bev{\"o}lkerungsgruppen und die Bev{\"o}lkerung in weniger erschlossenen Regionen zu erreichen. Die Ergebnisse zeigen die Notwendigkeit der partizipativen Entwicklung und Evaluation von neuen Instrumenten f{\"u}r Public Health und die Gesundheitsversorgung, insbesondere mit der Unterst{\"u}tzung von Menschen mit eingeschr{\"a}nktem digitalem Zugang, niedrigem Bildungshintergrund, wenigen digitalen F{\"a}higkeiten oder mangelndem Vertrauen in die Forschung und digitale Technologien. Schlussfolgerung: Die Anwendung partizipativer regionaler Ans{\"a}tze kann einen gerechteren digitalen Wandel im Gesundheitsbereich erleichtern. Die Einbeziehung marginalisierter und schwer erreichbarer Gruppen in digitale Public Health Interventionen kann neue M{\"o}glichkeiten f{\"u}r Pr{\"a}vention, Gesundheitsversorgung und Forschung er{\"o}ffnen und ist aus Sicht der gesundheitlichen Chancengerechtigkeit essentiell [5]. K{\"u}nftige digitale Ans{\"a}tze sollten so gestaltet werden, dass sie den spezifischen Bed{\"u}rfnissen benachteiligter Gruppen und Regionen gerecht werden. Literatur 1. WHO. Neue Studie belegt: Digitale Gesundheit ist nicht f{\"u}r alle gleich zug{\"a}nglich. 2022 [zuletzt aufgerufen: 23.04.2024]. Verf{\"u}gbar unter: https://www.who.int/europe/de/news/item/21-12-2022-digital-health-not-accessible-by-everyone-equally-new-study-finds 2. Lausitzer Zentrum f{\"u}r Digital Public Health. Forschung. [zuletzt aufgerufen: 23.04.2024]. Verf{\"u}gbar unter: https://www.b-tu.de/digital-public-health/forschung 3. Hoffmann S, Tschorn M, Spallek J. Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany. Int J Equity Health. 2024;23(1):2 4. Hoffmann S, Schulze S, L{\"o}ffler A, Becker J, Hufert F, Gremmels HD, et al. Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers. Int J Soc Psychiatry. 2024;70(1):87-98 5. Bammert P, Sch{\"u}ttig W, Novelli A, Iashchenko I, Spallek J, Blume M, et al. The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review. Int J Equity Health. 2024;23:37}, language = {de} } @misc{HechtHoffmannBangertetal., author = {Hecht, Henriette and Hoffmann, Stephanie and Bangert, Benjamin and Irrgang, Christopher and Ladewig, Katharina and Martens, Lea and Stabler, Martin and Spallek, Jacob}, title = {Making digital health services in the real world: ein partizipatives, human-centered-design-framework f{\"u}r eine erreichende Innovationsentwicklung am Beispiel der Lausitz}, series = {Wen erreichen wir mit digitaler Pr{\"a}vention und Gesundheitsf{\"o}rderung? Und wie? : German Medical Science}, journal = {Wen erreichen wir mit digitaler Pr{\"a}vention und Gesundheitsf{\"o}rderung? Und wie? : German Medical Science}, doi = {10.3205/24gmds889}, url = {http://nbn-resolving.de/urn:nbn:de:0183-24gmds8890}, abstract = {F{\"u}r digitale Programme und Angebote der Pr{\"a}vention und Gesundheitsf{\"o}rderung besteht die Herausforderung darin, unterschiedliche Dialoggruppen zu erreichen und sie effektiv zu einzubinden. Barrieren bestehen u. a. aus der digitalen Kluft, da die Zug{\"a}nglichkeit besonders f{\"u}r {\"a}ltere Menschen, Menschen mit niedrigem Einkommen oder aus l{\"a}ndlichen Gebieten eingeschr{\"a}nkt sein kann. Außerdem haben verschiedene Dialoggruppen unterschiedliche kulturelle Hintergr{\"u}nde, sodass digitale Angebote diese Vielfalt ber{\"u}cksichtigen und kultursensibel gestaltet sein sollten, um die Akzeptanz und Teilnahme zu f{\"o}rdern. Wissen {\"u}ber Barrieren der Zug{\"a}nglichkeit sind relevant, um digitale Gesundheitsangebote attraktiv und ansprechend gestalten zu k{\"o}nnen und die langfristige Teilnahme zu f{\"o}rdern. Das Symposium will anhand von Projekten aus Wissenschaft und Praxis thematisieren, wie digitale Angebote sowie die Kontexte und Prozesse ihrer Implementierung gestaltet sein m{\"u}ssen, damit digitale Pr{\"a}vention und Gesundheitsf{\"o}rderung einen großen Kreis von Nutzenden in ihrer Lebenswirklichkeit erreichen k{\"o}nnen. Dazu werden Evaluationsergebnisse von Nutzerinnen und Nutzern einer digitalen Pr{\"a}vention zur Alkoholpr{\"a}vention im Rahmen einer suchtpr{\"a}ventiven Kunstausstellung vorgestellt. Außerdem werden am praktischen Beispiel eines digitalen Elternprogramms verschiedene M{\"o}glichkeiten der Ansprache, Bereitstellung und Begleitung pr{\"a}sentiert. Ein weiterer Beitrag stellt vor, wie im Rahmen des Projekts „Reallabor AI4U" unter Einbeziehung verschiedener Dialoggruppen ein digitales Training zur F{\"o}rderung der psychischen Gesundheit und Resilienz bei Jugendlichen erprobt wurde. Das Training kann im Alltag auf dem Smartphone genutzt werden und bietet auf Person, Moment und Kontext zugeschnittene {\"U}bungen an. Die Weiterentwicklung einer bestehenden spielerischen Intervention zur F{\"o}rderung der navigationalen Gesundheitskompetenz f{\"u}r {\"a}ltere Menschen ist Gegenstand des n{\"a}chsten Vortrags. Abschließend wird ein partizipatives, human-centered-design Konzept auf den Kontext der Lausitz projiziert, um einen Beteiligungsraum zu schaffen, in dem die {\"U}bertragbarkeit von digitalen Gesundheitsinnovationen f{\"u}r die Region gepr{\"u}ft werden kann. Die gemeinsame Darstellung der Beitr{\"a}ge erm{\"o}glicht die Er{\"o}rterung des komplexen Themas der Erreichbarkeit durch digitale Gesundheitsf{\"o}rderung und Pr{\"a}vention aus unterschiedlichen wissenschaftlichen, praxisnahen und prozessbegleitenden Sichtweisen und schafft die Grundlage f{\"u}r eine facettenreiche angewandte Diskussion zusammen mit interessierten Personen aus dem Plenum. {\"U}ber die inhaltliche Diskussion der Beitr{\"a}ge hinaus sollen Synergien und M{\"o}glichkeiten zuk{\"u}nftiger Zusammenarbeit zwischen den Fachbereichen der DGSMP und der DGPH im Themenfeld ausgelotet werden.}, language = {de} } @misc{BangertStablerHoffmannetal., author = {Bangert, Benjamin and Stabler, Martin and Hoffmann, Stephanie and Herath, Tim and Martens, Lea and Hecht, Henriette and Spallek, Jacob and Zeeb, Hajo and Ladewig, Katharina and Irrgang, Christopher}, title = {Assessing accessibility: a comprehensive multimodal study of primary care accessibility across Germany}, series = {German Medical Science}, journal = {German Medical Science}, doi = {10.3205/24gmds812}, url = {http://nbn-resolving.de/urn:nbn:de:0183-24gmds8122}, abstract = {Background: In the context of healthcare, primary care physicians represent the initial point of contact with the healthcare system [1]. In Germany, the use of motorised private transport for day-to-day travel remains the dominant mode of transport [2]. However, a range of factors, including environmental concerns, socio-economic challenges, and health-related issues, may act as deterrents for citizens from utilising these vehicles. This study aims to assess the geographical accessibility of primary care physicians by using alternative transportation modes, such as public transport or walking, to identify regions in Germany with limited accessibility to primary care physicians in order to ensure the equitable distribution of healthcare. Methods: A state-of-the-art routing engine [3] based on the RAPTOR algorithm is employed to calculate travel times from census grid cells to primary care physicians. The routing process incorporates multimodal transportation, including walking, biking, public transport and motorised private transport. Various metrics like the cost to closest facility, Hansen's accessibility measure, and the balanced floating catchment area [4], are utilised to analyse and compare the accessibility and distribution of primary care physicians when using different transportation modes. The data on travel times and frequencies are collected, analysed and visualised using R and Python implementations. Results: A preliminary analysis revealed disparities in how different modes of transport allow individuals to access primary care physicians within a reasonable travel time. It is notable that while public transport has the potential to replace motorised private transport in urban areas, the analysis indicates that it falls short in rural regions and smaller cities. In these key regions the coverage of services and the transport network do not meet the primary care demand as well as they do in urban areas. The preliminary study indicated that regions with higher socio-economic deprivation have less efficient access to primary care physicians by alternative transportation modes. The findings are visualised through heat maps, which highlight key regions where alternatives to motorised private transport do not adequately meet the needs of the population. Conclusion: The study suggests that in Germany, public transport may not yet be sufficient to ensure accessibility to primary care physicians for those without access to motorised private transport, particularly in smaller cities and rural regions. This is probably of particular relevance for the elderly and parents with children likely to have higher primary care needs. Enhanced public transport options could be pivotal in addressing these gaps in equitable healthcare access, especially for rural regions. Although mobile health services suffer from inherent limitations, such as gaps in adaptation for different socio-economic groups [5], they could be employed to address existing scarcities in the transportation networks and ensure that all citizens have the opportunity to access essential healthcare services in an efficient manner. References 1. World Health Organization; UNICEF. Operational framework for primary health care: transforming vision into action. Geneva: World Health Organization, UNICEF; 2020 [cited 2024 Apr 27]. p. 13. Available from: https://www.who.int/publications/i/item/9789240017832 2. European Commission: Directorate-General for Mobility and Transport. EU transport in figures: Statistical pocketbook 2023. Luxembourg: Publications Office of the European Union; 2023. p. 49 3. Higgins C, Palm M, DeJohn A, Xi L, Vaughan J, Farber S, et al. Calculating place-based transit accessibility: Methods, tools and algorithmic dependence. JTLU. 2022; 15(1):95-116. 4. Paez A, Higgins C, Vivona SF. Demand and Level of Service Inflation in Floating Catchment Area (FCA) Methods. PLOS ONE. 2019;14(6):e0218773. 5. Kumar D, Hemmige V, Kallen MA, Giordano TP, Arya M. Mobile Phones May Not Bridge the Digital Divide: A Look at Mobile Phone Literacy in an Underserved Patient Population. Cureus. 2019;11(2):e4104.}, language = {en} } @misc{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and M{\"u}llmann, Saskia and Pan, Chen-Chia and Hoffmann, Stephanie and Spallek, Jacob and Haug, Ulrike and Zeeb, Hajo}, title = {Increased use of digital health technologies but reduced digital health literacy: a comparison in results of two nationwide surveys in 2020 and 2022 in Germany}, series = {German Medical Science}, journal = {German Medical Science}, doi = {10.3205/24gmds631}, url = {http://nbn-resolving.de/urn:nbn:de:0183-24gmds6319}, abstract = {Objective: Digital technologies with internet access, including computers or mobile devices, can contribute to health promotion and disease prevention. This study aimed to compare the results of two nationwide surveys of internet users in Germany that investigated the use pattern, the attitudes towards, and the factors associated with digital technology use in health context. Methods: This study adheres to the ethical guidelines according to the Declaration of Helsinki. Two cross-sectional surveys of internet users living in Germany were performed in 2020 (survey 1) and 2022 (survey 2). Participants were recruited from two different consumer panel samples owned by a market research institute (Cerner Enviza GmbH). Participants provided verbal informed consent for participation in the study according to the Cerner Enviza data privacy policy. Computer-assisted telephone interviews were conducted by Cerner Enviza using questionnaires with 28-30 items developed by study authors. Anonymous data were purchased and analysed by study authors using descriptive statistics. Associations between digital technology use and participant characteristics were tested using binary logistic regression analyses. Results: The participants were adult internet users (survey 1: n=991; survey 2: n=1020). Participant characteristics were similar in both surveys (47-52\% female, 50-55\% aged 40-65 years, 62-66\% with less than tertiary education, 42-45\% with less than country-average household income, 81-82\% residents in former West Germany, and 67-71\% residents in large cities). A similar number of participants in both surveys reported digital technology use in any health context (57-61\%) and rated digital technologies for physical activity promotion as easy to use (87-92\%). Digital technology use increased in 2022 relative to 2020. Specifically, more participants reported health app (63\% vs. 36\%) and digital technology use for physical activity promotion (any use: 44\% vs. 31\%; weekly-daily use: 91\% vs. 64\%) in 2022 vs. 2020. In contrast, digital health literacy decreased in 2022 relative to 2020. Specifically, less participants had high digital health literacy (57\% vs. 69\%) and were confident in using online information for health decisions (34\% vs. 43\%) in 2022 vs. 2020. Digital technology use was associated with higher digital health literacy and younger age (in both surveys), higher income (in survey 1) and residence in larger cities (in survey 2). Conclusion: Digital technologies targeting some health domains, such as physical activity promotion are frequently used and accepted by the users. However, digital health literacy and especially the confidence in using online information for health decisions appear to have decreased in 2022 relative to 2020. Factors that promote digital technology use for health promotion and disease prevention need to be investigated in future studies. Considering that digital health literacy is associated with digital technology use, further research on user needs and preferences is required to understand the reasons for reduction in such literacy in this study.}, language = {en} } @misc{HoffmannTschornSpallek, author = {Hoffmann, Stephanie and Tschorn, Mira and Spallek, Jacob}, title = {Soziale Ungleichheiten in der fr{\"u}hkindlichen Sprachentwicklung w{\"a}hrend der COVID-19-Pandemie im Bundesland Brandenburg}, series = {German Medical Science}, journal = {German Medical Science}, doi = {10.3205/24gmds603}, url = {http://nbn-resolving.de/urn:nbn:de:0183-24gmds6030}, abstract = {Einleitung: Die Entwicklung von Kindern unter sechs Jahren h{\"a}ngt nicht nur von ihren individuellen Eigenschaften ab, sondern auch von den sozialen Umst{\"a}nden, in denen sie leben [1]. Es besteht ein Forschungsbedarf zu m{\"o}glichen Ver{\"a}nderungen der fr{\"u}hkindlichen Sprachentwicklung aufgrund sozialer Ungleichheiten w{\"a}hrend der COVID-19 Pandemie. Diese Studie [2] beschreibt die Pr{\"a}valenz der Verz{\"o}gerung in der Sprachentwicklung von Kindern bei der Einschulung und deren Zusammenh{\"a}nge mit a) der sozio{\"o}konomischen Position der Familie (SEP), b) der Muttersprache und c) der Jahre des Kindergartenbesuchs vor und w{\"a}hrend der Pandemie. Methoden: Verwendet wurden Daten der Schuleingangsuntersuchung im Land Brandenburg aus drei aufeinanderfolgenden Kohorten 5-7-j{\"a}hriger Kinder (2018|19: n=19.299; 2019|20: n=19.916; 2020|21: n=19.698). Der {\"o}ffentliche Gesundheitsdienst erfasst routinem{\"a}ßig die Sprachentwicklung mit validierten Instrumenten des 'Sozialp{\"a}diatrischen Entwicklungsscreenings f{\"u}r Schuleingangsuntersuchungen' [3]. Deskriptive bivariate und multivariate Querschnittsanalysen [OR, 95\%CI] untersuchten die Sprachentwicklungsverz{\"o}gerung [SE ja|nein] mit SEP [niedrig|mittel|hoch], deutscher Muttersprache [ja|nein] und den Jahren des Kindergartenbesuchs [<4|≥4]. Die Analysen wurden stratifiziert nach SEP wiederholt. Ergebnisse: Die SE Pr{\"a}valenz sank {\"u}ber die Jahre insgesamt (21,1\%2018|19; 19.2\%2019|20; 18,8\%2020|21) sowie bei Kindern mit hoher SEP (14,3\%2018|19; 13,0\%2020|21) und mit deutscher Muttersprache (20,2\%2018|19; 17,8\%2020|21). Bei Kindern mit niedrigem SEP stieg die SE Pr{\"a}valenz {\"u}ber die Jahre (42,4\%2018|19; 43,4\%2020|21) und bei Kindern mit nicht-deutscher Muttersprache blieb sie konstant (36,0\%2018|19, 35,5\%2020|21). Die Chancen f{\"u}r eine SE unterscheiden sich dementsprechend nach SEP (2018|19: ORniedrig|hoch=4,41;3,93-4,94; 2020|21: ORniedrig|hoch=5,12;4,54-5,77) und Muttersprache (2018|19: ORnicht-deutsch|deutsch=2,22;1,86-2,66; 2020|21: ORnicht-deutsch|deutsch=2,54;2,19-2,95). Die Jahre des Kindergartenbesuchs trugen nicht zu Unterschieden in der SE Pr{\"a}valenz bei. Schlussfolgerung: Soziale Ungleichheiten bei der SE Pr{\"a}valenz aufgrund der SEP und der Muttersprache nahmen w{\"a}hrend der Pandemie leicht zu. F{\"u}r Familien mit sozio{\"o}konomischen Nachteilen sind Risiko- und Schutzfaktoren f{\"u}r SE der Kinder w{\"a}hrend der Pandemie unklar. Weitere Forschung sollte in L{\"a}ngsschnittbeobachtungen die Auswirkungen der COVID-19 Pandemie auf die fr{\"u}he Kindheit vertiefend betrachten. Literatur 1. Hoff E, Ribot KM. Language Development: Influence of Socio-Economic Status. In: Wright JD, editor. International encyclopedia of the social \& behavioral sciences. Second edition. Amsterdam, Boston, Heidelberg, London, New York, Oxford, Paris, San Diego, San Francisco, Singapore, Sydney, Tokyo: Elsevier; 2015. p. 324-8. 2. Hoffmann S, Tschorn M, Spallek J. Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany. Int J Equity Health. 2024;23(1):2. 3. Daseking M, Oldenhage M, Petermann F, Waldmann HC. Die Validit{\"a}t der Sprachskala des SOPESS unter Ber{\"u}cksichtigung der Erstsprache [Social Pediatric Screening of Developmental Status for School Entry (SOPESS): Validity in the Domain of Speech and Language]. Gesundheitswesen 2009;71(10):663-8.}, language = {de} } @misc{TschornArntzHoffmannetal., author = {Tschorn, Mira and Arntz, Fabian and Hoffmann, Stephanie and W{\"o}lke, Maxi and Cohrdes, Caroline and Spallek, Jacob and Rapp, Michael}, title = {Regionale sozio{\"o}konomische Deprivation und Gesundheit bei Kindern und Jugendlichen}, series = {53rd DGPs Congress / 15th {\"O}GP Conference, September 16 - 19, 2024, Wien/Vienna, Abstract-Band}, journal = {53rd DGPs Congress / 15th {\"O}GP Conference, September 16 - 19, 2024, Wien/Vienna, Abstract-Band}, address = {Wien}, pages = {1493 -- 1494}, abstract = {Hintergrund: Von Geburt an sind die Gesundheit und die psychomotorische Entwicklung eng mit der famili{\"a}ren sozio{\"o}konomischen Lebenssituation verbunden. Wir stellen Ergebnisse aus unseren Studien vor, in denen wir den Zusammenhang sozio{\"o}konomischer Deprivation mit verschiedenen Outcomes aus dem Bereich Entwicklung und psychische Gesundheit untersuchen. Methoden: Anhand linearer gemischter Modelle und Mehrebenenmodelle wird untersucht, ob ein zus{\"a}tzlicher Zusammenhang regionaler sozio{\"o}konomischer Deprivation auf die Outcomes Einschulalter, globale Entwicklungsverz{\"o}gerung und psychische Gesundheit {\"u}ber den Effekt individueller sozio{\"o}konomischer Faktoren hinaus besteht. Die vorgestellten Analysen beziehen sich auf die EMOTIKON Studie (171.916 Drittkl{\"a}ssler aus 533 Schulen in 11 Kohorten aus Brandenburg von 2011 bis 2019), Daten der Schuleingangsuntersuchung im Bundesland Brandenburg (Vollerhebung des Vorschuljahrgangs 2018/2019, N=22.801) sowie die KiGGS Kohorte (bev{\"o}lkerungsrepr{\"a}sentative Stichprobe am Robert Koch-Institut, N=17.641 Kinder von 0-17 Jahre zur Baseline in 2003-2006). Regionale Deprivation wird mittels des German Index of socioeconomic Deprivation (GISD, Robert Koch-Institut) operationalisiert. F{\"u}r einzelne Analysen wird zudem der Einfluss der drei GISD Subfaktoren Einkommen, Bildung und Beruf auf die untersuchten Faktoren berichtet. Globale Entwicklungsverz{\"o}gerung wurde standardisiert mittels des SOPESS (Sozialp{\"a}diatrisches Entwicklungsscreening f{\"u}r Einschulungsuntersuchungen) im Rahmen der Schuleingangsuntersuchungen erhoben, psychische Auff{\"a}lligkeiten wurden in der KiGGS Studie anhand des Strengths and Difficulties Questionnaire (SDQ) erhoben. Ergebnisse: Die Ergebnisse deuten darauf hin, dass die regionale Deprivation am Wohn- bzw. Schulort der Kinder einen Einfluss auf das Einschulalter und die globale Entwicklungsverz{\"o}gerung hat und dass dieser Einfluss {\"u}ber den Effekt der individuell famili{\"a}ren sozio{\"o}konomischen Bedingungen hinaus besteht. Außerdem werden erste Ergebnisse der Analysen der KiGGS Kohorte vorgestellt.}, language = {de} } @misc{BlumeSchienkiewitzWollgastetal., author = {Blume, Miriam and Schienkiewitz, Anja and Wollgast, Lina and Hoffmann, Stephanie and Sander, Lydia and Spallek, Jacob and Herr, Raphael and Moor, Irene and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia and Rattay, Petra}, title = {Association between socioeconomic position of the family and adolescent obesity in Germany - analysis of the mediating Role of familial determinants}, series = {Journal of Obesity}, volume = {2024}, journal = {Journal of Obesity}, number = {1}, publisher = {Wiley}, issn = {2090-0708}, doi = {10.1155/2024/7903972}, pages = {9}, abstract = {Background. Obesity's negative impact on young people's health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. Method. The analyses are based on data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Results. Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. Conclusion. A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important.}, language = {en} } @misc{HoffmannTschornSpallek, author = {Hoffmann, Stephanie and Tschorn, Mira and Spallek, Jacob}, title = {Did social inequalities in child development change during the COVID-19 pandemic in Germany?}, series = {European Journal of Public Health}, volume = {34}, journal = {European Journal of Public Health}, number = {Supplement 3}, doi = {10.1093/eurpub/ckae144.079}, abstract = {Background Early childhood development (aged <6 years) is dependent on the social conditions in which children live and strongly affect their life course trajectory. This study describes changes in social inequalities in language development during the COVID-19 pandemic based on data from the legally prescribed school entry examination in the German federal state of Brandenburg. The aim is to inform public health interventions for individuals at risk of long-term health inequalities. Methods Secondary data from three cohorts of 5-7-year-olds were used [n = 19,2992018|19; n = 19,9162019|20; n = 19,6982020|21]. Language development was assessed as delayed compared to peers [LD yes/no], measured by public health services using validated instruments. Descriptive bivariate and multivariate analyses [OR, 95\%CI] examined language delay [\%] with social inequalities defined by (1) an index composed of parents' reported education and occupation [SEP low|high], (2) 'German native language' [yes|no] and (3) 'years of kindergarten attendance' [<4|≥4]. Results Overall, the proportion of LD decreased over the years (21.1\%2018|19; 19.2\%2019|20; 18.8\%2020|21), both among children from families with high SEP (14.3\%2018|19; 13.0\%2020|21) and from German-speaking families (20.2\%2018|19; 17.8\%2020|21). LD rates among children increased with low SEP (42.4\%2018|19; 43.4\%2020|21) and remained constant with a non-German native language (36.0\%2018|19; 35.5\%2020|21). The probability for LD differed only for SEP (2018|19: ORlow|high=4.4, 3.93-4.94; 2020|21: ORlow|high=5.12, 4.54-5.77) and for native language (2018|19: ORnon-German|German=2.22, 1.86-2.66; 2020|21: ORnon-German|German=2.54, 2.19-2.95). Conclusions Social inequalities in language development based on SEP and native language increased slightly during the pandemic compared to the pre-pandemic period. Research should examine the effects of the pandemic on early development as well as protective and risk factors on a longitudinal basis.}, language = {en} } @misc{BlumeRattayHoffmannetal., author = {Blume, Miriam and Rattay, Petra and Hoffmann, Stephanie and Spallek, Jacob and Sander, Lydia and Herr, Raphael and Moor, Irene and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia}, title = {Zusammenhang zwischen der sozio{\"o}konomischen Position der Familie und Adipositas bei Jugendlichen in Deutschland - welche Rolle hat die Familie?}, series = {Gesundheitswesen}, volume = {84}, journal = {Gesundheitswesen}, number = {08/09}, doi = {10.1055/s-0042-1753866}, pages = {826}, abstract = {Einleitung Die gesundheitlichen Folgen von Adipositas f{\"u}r junge Menschen k{\"o}nnen schwerwiegend sein. Bei der Entwicklung verschiedener Gesundheitsoutcomes wie Adipositas spielt f{\"u}r junge Menschen die Familie als auch ihre sozio{\"o}konomische Position (SEP) eine große Rolle. In dieser Analyse wird untersucht, welche famili{\"a}re Determinanten den Zusammenhang zwischen SEP der Familie und Adipositas bei Jugendlichen erkl{\"a}ren. Methoden Die vorliegende Analyse wurde mit Daten der "Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland" (KiGGS) (Basiserhebung, Welle 1 und 2) durchgef{\"u}hrt (1301 weibliche und 1232 m{\"a}nnliche 11- bis 17-J{\"a}hrige). Mittels logistischer Regressionsmodelle (KHB-Methode) wurden f{\"u}r den Zusammenhang zwischen der SEP der Familie (Einkommen, berufliche Stellung, Bildung, SES-Index) und Adipositas (Ja/Nein) bei Jugendlichen die mediierenden Effekte von famili{\"a}ren Determinanten (elterliches Rauchen, elterliche sportliche Aktivit{\"a}ten, elterliches {\"U}bergewicht, famili{\"a}rer Stress und famili{\"a}rer Zusammenhalt) analysiert. Ergebnisse Die Pr{\"a}valenz von Adipositas betrug 7,9 \% bei den weiblichen und 8,4 \% bei den m{\"a}nnlichen Jugendlichen. Es zeigen sich signifikante Zusammenh{\"a}nge zwischen Adipositas und SEP zu Ungunsten von jenen mit niedriger sozio{\"o}konomischer Position. Famili{\"a}re Determinanten erkl{\"a}ren teilweise oder vollst{\"a}ndig den Zusammenhang zwischen SEP und Adipositas bei Jugendlichen. Es wurden geschlechtsspezifische Unterschiede im Ausmaß der Mediation der Familie gefunden. Bei Jungen erkl{\"a}ren famili{\"a}re Determinanten vollst{\"a}ndig den Zusammenhang zwischen Adipositas und Einkommen sowie zwischen Adipositas und der beruflichen Stellung der Eltern. Bei m{\"a}nnlichen Jugendlichen l{\"a}sst sich der indirekte Effekt abh{\"a}ngig von der jeweiligen SEP-Variable zu 20,8 - 27,9 \% auf das elterliche Rauchen, zu 14,8 - 26,3 \% auf die elterliche sportliche Aktivit{\"a}t und zu 42,6 - 63,6 \% auf das elterliche {\"U}bergewicht zur{\"u}ckf{\"u}hren. Bei M{\"a}dchen wurde der Zusammenhang zwischen der SEP und Adipositas teilweise durch famili{\"a}re Determinanten erkl{\"a}rt. Bei weiblichen Jugendlichen l{\"a}sst sich der indirekte Effekt abh{\"a}ngig von der jeweiligen SEP-Variable zu 26,0 - 52,2 \% auf das elterliche Rauchen und zu 41,6 - 67,6 \% auf das elterliche {\"U}bergewicht zur{\"u}ckf{\"u}hren. Schlussfolgerung Die Adipositas-Pr{\"a}valenz von Jugendlichen variiert nach dem SEP. Famili{\"a}re Determinanten sind wichtige mediierende Faktoren f{\"u}r gesundheitliche Ungleichheiten bei Adipositas von Jugendlichen. Es zeigt sich, dass sich Unterschiede in der Adipositas nach SEP insbesondere durch das elterliche Gesundheitsverhalten (v.a. elterliches Rauchen, elterliches {\"U}bergewicht und elterliche sportliche Aktivit{\"a}t) erkl{\"a}ren lassen. Die Ber{\"u}cksichtigung und Einbindung der Familie bei der Planung und Umsetzung von Gesundheitsf{\"o}rderungs- und Pr{\"a}ventionsprogrammen f{\"u}r gesundheitliche Chancengleichheit bei Jugendlichen ist essentiell.}, language = {de} } @misc{MayerHerrKleinetal., author = {Mayer, Alena and Herr, Raphael and Klein, Thomas and Wiedemann, Eva and Diehl, Katharina and Hoffmann, Stephanie and Blume, Miriam and Jepsen, Dennis and Sundmacher, Leonie and Andreas, Marike and Schneider, Sven}, title = {Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference?}, series = {Frontiers in Public Health}, volume = {Vol. 11}, journal = {Frontiers in Public Health}, issn = {2296-2565}, doi = {10.3389/fpubh.2023.1079871}, abstract = {Background: Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI. Methods: We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents. Results: Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus. Conclusion: We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity.}, language = {en} } @misc{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and M{\"u}llmann, Saskia and Pan, Chen-Chia and Hoffmann, Stephanie and Spallek, Jacob and Haug, Ulrike and Zeeb, Hajo}, title = {Use and attitudes toward digital technologies in health context: A nationwide survey in Germany}, series = {Gesundheitswesen}, volume = {85}, journal = {Gesundheitswesen}, number = {809}, doi = {10.1055/s-0043-1770610}, pages = {812 -- 813}, abstract = {Introduction Digital technologies, such as health apps, can contribute to health promotion and disease prevention. This study investigated the use and attitudes toward digital technologies in health context using a nationwide survey. Methods Adult internet users (n=1020) from 16 federal states in Germany participated in computer-assisted telephone interviews in November 2022. Data were analyzed using descriptive statistics and regression analyses. Results Overall, 61\% of participants reported internet use in health context. Among the users, digital technologies were used to obtain general health information by 63\% and to support physical activity or to obtain information on cancer by less than 50\%. Over 90\% of users rated such technologies as easy to use and useful to obtain health information, to support physical activity or to obtain information on cancer. However, confidence in using the internet for health decisions was low. Digital technology use in health context was associated with higher eHealth literacy. Digital technologies were preferred by younger participants to support physical activity and by older participants to obtain information on cancer. Conclusion Although digital technologies are easy to use, the use of digital technologies for health promotion and disease prevention and confidence in using the internet for health decisions were low among internet users in this study. Factors that promote digital technology use for health promotion and prevention need to be investigated in further studies.}, language = {en} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data}, series = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, volume = {33}, journal = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, number = {2}, issn = {1101-1262}, doi = {10.1093/eurpub/ckad160.334}, abstract = {Background Health workers play a vital role in response to outbreaks under pandemic circumstances, but are also highly vulnerable to stress-related mental health issues (e.g., due to pandemic workload). There are knowledge gaps regarding temporal development of the emergence of depressive symptoms among health workers during the COVID-19 pandemic and their determinants. This study examined the trajectory of depressive symptoms and their association with a) stress perception, b) own COVID-19 infection and c) COVID-19 exposure at work. Methods This cohort study with 91 health workers (90\% female, x⎯⎯=45 years) from a German general hospital included (1) medical, nursing and therapeutic staff and (2) administrative staff. Data were collected longitudinally every month from July to December 2020. Linear multilevel models were used to evaluate associations between trajectories of depression scores (German 'General Depression Scale') with perceived stress ('Perceived Stress Scale'). Laboratory-confirmed COVID-19 infection was tested as a moderator of depressive symptom development. Trajectoires of depressive symptom modalities (e.g., somatic, emotional) were analysed stratified by COVID-19 exposure at work. Results Depression scores increased across the study period (b=.03, .02-.05). Perceived stress was associated with depression scores (b=.12, .10-.14). The presence of health workers' own COVID-19 infection was associated with a higher increase (b=.06, .01-.10). Somatic symptoms of depression increased over time only among health workers directly exposed to COVID-19 patients at work (b=.25, .13-.38). Conclusions The increase in depressive symptomatology among health workers exposed to COVID-19 in the workplace points to the need for further research. Since the infection with COVID-19 is associated with an increase of depressive symptoms across time, awareness should be raised about measures to protect against virus transmission, especially during a pandemic. Exposure to COVID-19 in the workplace is associated with increased somatic depressive symptoms.}, language = {en} } @incollection{NowakTallarekHoffmannetal., author = {Nowak, Anna Christina and Tallarek, Marie and Hoffmann, Stephanie and H{\"o}vener, Claudia and Razum, Oliver and Spallek, Jacob}, title = {Nachhaltigkeit in der Gesundheit(sversorgung) von zugewanderten Menschen}, series = {Gesundheit und Nachhaltigkeit}, booktitle = {Gesundheit und Nachhaltigkeit}, editor = {Hartung, Susanne and Wihofszky, Petra}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-64954-1}, doi = {10.1007/978-3-662-64954-1_22-1}, pages = {11}, abstract = {In diesem Beitrag wird facettenartig eine Br{\"u}cke zwischen Zuwanderung und Gesundheit(-sversorgung) unter besonderer Ber{\"u}cksichtigung der globalen Ziele zur nachhaltigen Entwicklung geschlagen. Um Migrationserfahrungen als (potenziellen) Einflussfaktor auf gesundheitliche Chancengleichheit zu verstehen, wird die politisch-rechtliche Situation von Menschen mit Einwanderungsgeschichte im Zugang zur Gesundheitsversorgung und zu Pr{\"a}ventions- und Gesundheitsf{\"o}rderungsmaßnahmen beschrieben. Dabei zeigt sich, dass sich die gesundheitliche Versorgungssituation durch soziale, politische, institutionelle und strukturelle Ungleichheiten und Benachteiligungen auszeichnet, die weder in den globalen Zielen zur nachhaltigen Entwicklung noch in der deutschen Nachhaltigkeitsstrategie angemessene Ber{\"u}cksichtigung finden.}, language = {de} }