@misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Inclusionary und diversit{\"a}tssensibles Public Health in der Pandemie}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {1}, issn = {1876-4851}, doi = {10.1515/pubhef-2020-0112}, pages = {22 -- 26}, abstract = {Othering beschreibt die Markierung von Menschen als „anders" oder „nicht zugeh{\"o}rig". Ausgehend von den Konzepten des exclusionary und inclusionary Othering diskutiert dieser Beitrag drei Ans{\"a}tze zu i) exclusionary Public Health, ii) inclusionary Public Health und iii) diversit{\"a}tssensiblem Public Health. Die Implikationen der Ans{\"a}tze werden am Beispiel des Umgangs mit der COVID-19 Pandemie bei schutzsuchenden Menschen in Aufnahmeeinrichtungen und Sammelunterk{\"u}nften in Deutschland aufgezeigt.}, language = {de} } @incollection{SpallekRazum, author = {Spallek, Jacob and Razum, Oliver}, title = {Epidemiologische Erkl{\"a}rungsmodelle f{\"u}r den Zusammenhang zwischen Migration und Gesundheit}, series = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, booktitle = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, editor = {Spallek, Jacob and Zeeb, Hajo}, edition = {1}, publisher = {Hogrefe AG}, address = {Bern}, isbn = {978-3-456-85995-8}, doi = {10.1024/85995-000}, pages = {81 -- 90}, abstract = {Migration beeinflusst die Gesundheit. Ob sich Migration gesundheitlich positiv oder negativ auswirkt, h{\"a}ngt von einer Vielzahl von Faktoren ab, die in verschiedenen Erkl{\"a}rungsmodellen in einen Zusammenhang gebracht werden. Wichtig bei der Beschreibung des Zusammenhangs sind eine zeitliche Komponente und die Einbeziehung der individuellen Lebensl{\"a}ufe der Migrant*innen mit ihren Lebensabschnitten vor, w{\"a}hrend und nach der Migration.}, language = {de} } @incollection{ScholaskeSpallekEntringer, author = {Scholaske, Laura and Spallek, Jacob and Entringer, Sonja}, title = {Intergenerationale {\"U}bertragung von Migrationserfahrungen und fetale Programmierung von Krankheit und Gesundheit}, series = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, booktitle = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, editor = {Spallek, Jacob and Zeeb, Hajo}, edition = {1}, publisher = {Hogrefe AG}, address = {Bern}, isbn = {978-3-456-85995-8}, pages = {351 -- 368}, abstract = {Gesundheitsdisparit{\"a}ten manifestieren sich in der Nachkommengeneration von Migrant*innen teilweise schon in fr{\"u}hen Lebensjahren. Viele dieser Gesundheits-disparit{\"a}ten werden durch sozio{\"o}konomische Benachteiligung und Akkulturation vermittelt. Anhand des Konzeptes der fetalen Pro-grammierung kann erkl{\"a}rt werden, dass das m{\"u}tterliche Stresserleben - vermittelt {\"u}ber endokrine und immunologische Prozesse - die sp{\"a}tere Gesundheit und Krank-heitsvulnerabilit{\"a}t der Nachkommen bereits in der Schwangerschaft beeinflusst. Es gibt aus der internationalen Forschung zahlreiche Belege daf{\"u}r, dass endokrine und immunologische Prozesse den Zusam-menhang zwischen m{\"u}tterlichen migrationsbezogenen Stressoren und Schwangerschafts-, Geburts- und sp{\"a}teren Gesundheitsoutcomes des Kindes vermitteln. Bei Migrant*innen in Deutschland sind diese Zusammenh{\"a}nge weitestgehend unterforscht.}, language = {de} } @misc{UlrichKohlerSpalleketal., author = {Ulrich, Hanna-Sophie and Kohler, Emma and Spallek, Jacob and Richter, Matthias and Clauß, Daniel and Mlinarić, Martin}, title = {Explaining psychosocial care among unaccompanied minor refugees: a realist review}, series = {European child \& adolescent psychiatry}, volume = {31(2022)}, journal = {European child \& adolescent psychiatry}, number = {12}, issn = {1435-165X}, doi = {10.1007/s00787-021-01762-1}, pages = {1857 -- 1870}, abstract = {Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations.}, language = {en} } @incollection{TallarekMlinarićSpallek, author = {Tallarek, Marie and Mlinarić, Martin and Spallek, Jacob}, title = {Migration - Bedeutung und Implikationen f{\"u}r die Pr{\"a}vention und Gesundheitsf{\"o}rderung}, series = {Springer Reference Pflege - Therapie - Gesundheit}, booktitle = {Springer Reference Pflege - Therapie - Gesundheit}, editor = {Tiemann, Michael and Mohokum, Melvin}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-62426-5}, issn = {2662-6942}, doi = {10.1007/978-3-662-62426-5_28}, pages = {199 -- 211}, abstract = {Die Bev{\"o}lkerungsgruppe der Menschen mit Migrationshintergrund umfasst fast ein Viertel der Gesamtbev{\"o}lkerung in Deutschland und ist h{\"o}chst heterogen. Pauschalisierende Aussagen zum Gesundheitsstatus dieser Gruppe sind daher nicht m{\"o}glich. Menschen mit Migrationshintergrund sind nicht grunds{\"a}tzlich ges{\"u}nder oder kr{\"a}nker als die Mehrheitsbev{\"o}lkerung. Allerdings k{\"o}nnen sie sich aufgrund von Expositionen vor, w{\"a}hrend und nach der Migration in ihren Gesundheitschancen und -risiken von der Mehrheitsbev{\"o}lkerung unterscheiden. Pr{\"a}vention und Gesundheitsf{\"o}rderung sollten daraus resultierende spezifische Bedarfe ebenso ber{\"u}cksichtigen wie die Diversit{\"a}t der Bev{\"o}lkerung insgesamt. Erfolgversprechend ist eine Kombination aus diversit{\"a}tssensiblen, f{\"u}r die Gesamtbev{\"o}lkerung zug{\"a}nglichen Angeboten und migrationsspezifischen Ans{\"a}tzen in besonders risikoreichen Situationen. Kommunale, settingorientierte sowie soziokulturell angepasste Angebote verbessern die Erreichbarkeit der Zielgruppen maßgeblich.}, language = {de} } @misc{ScholaskeSpallekEntringer, author = {Scholaske, Laura and Spallek, Jacob and Entringer, Sonja}, title = {Fetale Programmierung von Gesundheitsdisparit{\"a}ten bei Kindern mit Migrationshintergrund}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {2}, issn = {1876-4851}, doi = {10.1515/pubhef-2021-0015}, pages = {131 -- 134}, abstract = {Kinder von Migrant*innen zeigen bereits in fr{\"u}hen Lebensjahren h{\"a}ufig Gesundheitsdisparit{\"a}ten, die mit m{\"u}tterlicher Gesundheit und migrationsbezogenen Faktoren eng zusammenh{\"a}ngen. Zur Erkl{\"a}rung dieses Ph{\"a}nomens der intergenerationalen Transmission von Gesundheitsdisparit{\"a}ten schlagen wir ein Modell vor, das eine Lebensverlaufsperspektive mit dem Konzept der fetalen Programmierung von Gesundheit und Krankheitsvulnerabilit{\"a}t zusammenbringt.}, language = {de} } @misc{SpallekScholaskeDumanetal., author = {Spallek, Jacob and Scholaske, Laura and Duman, Elif Aysimi and Razum, Oliver and Entringer, Sonja}, title = {Association of maternal migrant background with inflammation during pregnancy - results of a birth cohort study in Germany}, series = {Brain, Behavior, and Immunity}, volume = {Vol. 96}, journal = {Brain, Behavior, and Immunity}, issn = {1090-2139}, doi = {10.1016/j.bbi.2021.06.010}, pages = {271 -- 278}, abstract = {Background Health disparities in children of immigrants are prevalent from birth and are hypothesized to - in part - emerge as a biological consequence of migration's unfavorable social and psychological sequelae. The aim of this study was to examine whether maternal migrant background is associated with inflammation during pregnancy - a key pathway by which maternal states and conditions during pregnancy may influence fetal development and subsequent pregnancy, birth, and child developmental and health outcomes. Material and Methods Data was available from 126 pregnant women who participated in a population based multi-site prospective birth cohort study in Bielefeld and Berlin, Germany. The study included two study visits in mid- and late pregnancy. At each visit, a composite maternal pro-inflammatory score was derived from circulating levels of plasma inflammatory markers (IL-6, CRP). Migrant background was defined by country of origin of participants and their parents' (Turkey or other) and generation status (1st or 2nd generation). We applied hierarchical linear models (HLM) in order to quantify the relationship between different migrant background variables and inflammation during pregnancy after adjustment for potential confounders (including socioeconomic status). Results Migrant background was significantly associated with inflammation during pregnancy. When compared to women without migrant background, levels of inflammation were increased in 1) pregnant women with migrant background in general (B = 0.35, SE = 0.12, p < .01); 2) 1st (B = 0.28, SE = 0.15, p < .10) and 2nd generation (B = 0.40, SE = 0.15, p < .01); 3) women with a Turkish migrant background (B = 0.28, SE = 0.14, p < .10) and women with another migrant background (B = 0.42, SE = 0.15, p <.01); and 4) 2nd generation Turkish origin women (B = 0.38, SE = 0.20, p <.10), 1st generation women with other migrant background (B = 0.44, SE = 0.26, p <.10), and 2nd generation women with other migrant background (B=0.43, SE = 0.17, p <.05). Discussion Our findings support a role for maternal inflammation as a pathway of intergenerational transmission of migration-related health inequalities, suggest that the effect seems to persist in 2nd generation immigrants, and highlight the need for future research and targeted interventions in this context.}, language = {en} } @misc{HintermeierGencerKajikhinaetal., author = {Hintermeier, Maren and Gencer, Hande and Kajikhina, Katja and Rohleder, Sven and Santos-H{\"o}vener, Claudia and Tallarek, Marie and Spallek, Jacob and Bozorgmehr, Kayvan}, title = {SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review}, series = {Journal of Migration and Health}, volume = {4}, journal = {Journal of Migration and Health}, issn = {2666-6235}, doi = {10.1016/j.jmh.2021.100056}, pages = {13}, abstract = {The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesise the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12\% to 2•08\% in non-outbreak settings and from 5•64\% to 21•15\% in outbreak settings. Migrants showed a lower hospitalisation rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.}, language = {en} } @incollection{HoffmannTallarekSpallek, author = {Hoffmann, Stephanie and Tallarek, Marie and Spallek, Jacob}, title = {Gesundheitswissenschaftliche Grundlagen f{\"u}r den Gesundheitsunterricht. Gesundheit und Vielfalt in Schule, Ausbildung und Studium}, series = {Gesundheitsdidaktik}, booktitle = {Gesundheitsdidaktik}, editor = {Goldfriedrich, Martin and Hurrelmann, Klaus}, edition = {1}, publisher = {Beltz Juventa}, address = {Weinheim, Basel}, isbn = {978-3-7799-6371-4}, pages = {134 -- 155}, abstract = {Dieses Kapitel stellt theoretische und empirische Grundlagen der Gesundheit, ihrer Determinanten und der gesundheitlichen Ungleichheit als Gegenstand eines systematischen Gesundheitsunterrichts vor (Goldfriedrich/Hurrelmann in diesem Band, Kern-Wert 2 des Gesundheitsunterrichtes). Das Wissen um die Komplexit{\"a}t menschlicher Vielfalt und deren Einfluss auf die gesundheitliche Situation bildet die Grundlage f{\"u}r das Verst{\"a}ndnis zentraler Gesundheitsdimensionen (u. a. M{\"u}ller/Porges in diesem Band) sowie die didaktische Schwerpunktsetzung in verschiedenen Institutionen im Entwicklungsverlauf, wie dem Gymnasium (Schwegmann in diesem Band), der Berufsschule (Trumpa/Dorn in diesem Band) oder in Hochschulen (Sprenger in diesem Band). In diesem Kontext erl{\"a}utert das Kapitel die Problematik ungleich verteilter Gesundheitschancen und stellt die Bandbreite relevanter Einflussfaktoren am Beispiel der sozialen Lage, des Migrationshintergrunds und des Geschlechts bei Kindern und Jugendlichen vor. Es zeigt auf, wie dieses Wissen im Bildungskontext curricular implementiert werden kann, um bereits im Kindes- und Jugendalter einen Beitrag zur gesundheitlichen Chancengleichheit leisten zu k{\"o}nnen.}, language = {de} } @misc{BlumeRattayHoffmannetal., author = {Blume, Miriam and Rattay, Petra and Hoffmann, Stephanie and Spallek, Jacob and Sander, Lydia and Herr, Raphael and Richter, Matthias and Moor, Irene and Dragano, Nico and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia and Wachtler, Benjamin}, title = {Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {15}, issn = {1660-4601}, doi = {10.3390/ijerph18157739}, pages = {33}, abstract = {This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6-18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.}, language = {en} } @misc{BreckenkampRazumSpalleketal., author = {Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob and Berger, Klaus and Chaix, Basile and Sauzet, Odile}, title = {A method to define the relevant ego-centred spatial scale for the assessment of neighbourhood effects: the example of cardiovascular risk factors}, series = {BMC Public Health}, volume = {21}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-021-11356-w}, pages = {7}, abstract = {Introduction: The neighbourhood in which one lives affects health through complex pathways not yet fully understood. A way to move forward in assessing these pathways direction is to explore the spatial structure of health phenomena to generate hypotheses and examine whether the neighbourhood characteristics are able to explain this spatial structure. We compare the spatial structure of two cardiovascular disease risk factors in three European urban areas, thus assessing if a non-measured neighbourhood effect or spatial processes is present by either modelling the correlation structure at individual level or by estimating the intra-class correlation within administrative units. Methods: Data from three independent studies (RECORD, DHS and BaBi), covering each a European urban area, are used. The characteristics of the spatial correlation structure of cardiovascular risk factors (BMI and systolic blood pressure) adjusted for age, sex, educational attainment and income are estimated by fitting an exponential model to the semi-variogram based on the geo-coordinates of places of residence. For comparison purposes, a random effect model is also fitted to estimate the intra-class correlation within administrative units. We then discuss the benefits of modelling the correlation structure to evaluate the presence of unmeasured spatial effects on health. Results: BMI and blood pressure are consistently found to be spatially structured across the studies, the spatial correlation structures being stronger for BMI. Eight to 22\% of the variability in BMI were spatially structured with radii ranging from 100 to 240 m (range). Only a small part of the correlation of residuals was explained by adjusting for the correlation within administrative units (from 0 to 4 percentage points). Discussion: The individual spatial correlation approach provides much stronger evidence of spatial effects than the multilevel approach even for small administrative units. Spatial correlation structure offers new possibilities to assess the relevant spatial scale for health. Stronger correlation structure seen for BMI may be due to neighbourhood socioeconomic conditions and processes like social norms at work in the immediate neighbourhood.}, language = {en} } @misc{HoffmannSchiebelHufertetal., author = {Hoffmann, Stephanie and Schiebel, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Spallek, Jacob}, title = {COVID-19 among Healthcare Workers: A Prospective Serological-Epidemiological Cohort Study in a Standard Care Hospital in Rural Germany}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {20}, issn = {1660-4601}, doi = {10.3390/ijerph182010999}, pages = {8}, abstract = {Healthcare workers (HCW) play a vital role in the SARS-CoV-2 pandemic control. The aim of this study was to assess the prevalence of SARS-CoV-2 antibodies and the risk of COVID-19 infections in a cohort of HCW from four different risk groups (from intensive care unit to administration) of a hospital of a primary care level in rural Germany. The outcomes were monthly measures of antibody seroprevalence over a period of 6 months. Overall, a seroprevalence of 13.41\% was determined, with significantly higher prevalence rates among HCW working in areas with more frequent contact to confirmed or suspected cases (30.30\%, p = 0.003). The group specific differences in the risk of infection from COVID-19 were detected, as HCW groups with frequent exposure seemed to have an increased risk (RR = 3.18, p = 0.02; CI95 1.09-9.24). The findings contribute to the epidemiological understanding of the virus spread in an unvaccinated population group, which is highly relevant for the pandemic management.}, language = {en} } @misc{ScholzSchimboeckSpallek, author = {Scholz, Lisa and Schimb{\"o}ck, Florian and Spallek, Jacob}, title = {Community Child Health Nursing: Ein Konzept f{\"u}r Deutschland?}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {3}, doi = {10.1515/pubhef-2021-0063}, pages = {209 -- 212}, abstract = {Soziale Ungleichheit f{\"u}hrt bereits im Kindesalter zu gesundheitlicher Benachteiligung. Gesundheitsf{\"o}rdernde Angebote in Deutschland sind noch unzureichend miteinander verkn{\"u}pft und erreichen sozialbenachteiligte Familien nur bedingt. International ist Community Child Health Nursing (CCHN) verbreitet und bietet einen m{\"o}glichen Ansatz, um die gesundheitliche Chancengleichheit von Kindern zu st{\"a}rken. Dieser Beitrag diskutiert das Berufsbild der CCH-Nurses und konzeptionelle Aspekte f{\"u}r die Implementierung in Deutschland.}, language = {de} } @misc{MianiLudwigDoyleetal., author = {Miani, C{\´e}line and Ludwig, Angelique and Doyle, Ina-Merle and Breckenkamp, J{\"u}rgen and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: Results from a German birth cohort study}, series = {Public Health Nutrition}, journal = {Public Health Nutrition}, issn = {1475-2727}, doi = {10.1017/S1368980021003621}, pages = {1 -- 24}, abstract = {Objective: Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socioeconomic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors. Design: We used data (2013-2016) on nutrition and socioeconomic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses. Setting: Bielefeld, Germany. Participants: 947 women (pregnant or who had given birth in the past two months). Results: 16.7\% of the participants (158/947) didn't use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS. Conclusions: Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focussed on family planning.}, language = {en} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Othering in public health using the example of Covid-19 management in German asylum camps}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Issue Supplement_3}, doi = {10.1093/eurpub/ckab164.795}, pages = {2}, abstract = {Issue/problem In 2020, several German reception centers and asylum camps were imposed mass quarantine after single residents had been infected with SARS-CoV-2. Civil and research networks criticized this measure, as crowded housing conditions limited the implementation of infection protection measures, and mass quarantine further increased the risk of infection. This raised the question why public health (PH) measures in these settings differed from those implemented in the general population, and which implications for future PH approaches can be identified. Problem description Considering the epidemiological evidence and ethical perspectives on the PH strategies described above, we applied the concepts of "Exclusionary Othering" and "Inclusionary Othering" to PH. We further discussed the Covid-19 management in German reception centers and asylum camps. Results We identified three conceptual approaches: 1) exclusionary, 2) inclusionary, and 3) diversity-sensitive approaches to PH. Exclusionary PH is characterized by an exclusion of less powerful groups despite negative health consequences. Inclusive approaches seek to empower less powerful groups in order to understand each other's needs, build cooperations, protect everyone and to prevent the development of "hot spots". Diversity-sensitive PH approaches avoid othering and seek to implement measures for everyone, taking into account diverse needs, conditions, and resources. Lessons We propose a paradigm shift towards inclusionary and diversity-sensitive PH that benefits the entire population, including those forced to flee other countries. This requires a critical reflection of power dynamics and discrimination. The proposed concepts can be transferred to other social groups, regions, and areas of PH. Key messages Public health needs to shift its perspective from exclusion and subordination to inclusion and involvement. Inclusionary and diversity-sensitive PH approaches promote health equity.}, language = {en} } @misc{HoffmannSanderBlumeetal., author = {Hoffmann, Stephanie and Sander, Lydia and Blume, Miriam and Schneider, Sven and Herke, Max and Matos Fialho, Paula Mayara and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and Lampert, Thomas and Spallek, Jacob}, title = {Do families have moderating or mediating effects on early health inequalities? A scoping review}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Supplement_3}, publisher = {Oxford University Press}, doi = {10.1093/eurpub/ckab165.506}, abstract = {Background During early childhood, families have a crucial impact on children's health behaviour, health, and development (bhd). However, a family's socioeconomic position (SEP) determines both the parental behaviour, living conditions, and child health. To understand how family characteristics may influence the development of health inequalities, this scoping review synthesised research on their mediating and moderating effects. Methods The review followed the guidelines of the PRISMA Extension for Scoping Reviews. The search included German and English peer-reviewed articles published between January 1st, 2000 and December 19th, 2019. The search in PubMed, PsycINFO, and Scopus used both free text terms in the title/abstract and index terms within linked keyword blocks: (1) family characteristics, (2) inequalities, (3) income, education, occupation, (4) bhd, (5) newborn, infant, toddler, preschooler. Two researchers independently examined eligibility for inclusion in two rounds (title/abstract; full-text). Results Of 7,089 articles identified, ten sources were included that studied family characteristics and health inequalities among 0-6 years olds. Parental rules, stress, and screentime, and TV in bedroom showed mediating effects on inequalities in behaviour problems or children's screentime. Families' negativity, single parenthood, and the number of children in the household moderated differences in impairment, health, behaviour problems, development or breastfeeding initiation. Conclusions The effect of family characteristics on early health inequalities has been sparsely investigated. The evidence supported models of family stress and investment. Further research is needed to comprehensively understand this association. Key messages Family characteristics contribute to health inequalities. Taking families' stress and investment into account could improve targeted prevention efforts aimed at reducing health inequalities.}, language = {en} } @incollection{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Gesundheitliche Situation von Migranten in Deutschland}, series = {Migration \& Gesundheit : Das Wichtigste f{\"u}r {\"A}rztinnen und {\"A}rzte aller Fachrichtungen}, booktitle = {Migration \& Gesundheit : Das Wichtigste f{\"u}r {\"A}rztinnen und {\"A}rzte aller Fachrichtungen}, editor = {Sieberer, Marcel and Jung, Petra and F{\"u}hrmann, Fabienne}, edition = {1}, publisher = {Urban \& Fischer Verlag/Elsevier GmbH}, address = {M{\"u}nchen, Jena}, isbn = {9783437235108}, abstract = {Kernaussagen - Menschen mit Migrationshintergrund sind nicht per se kr{\"a}nker oder ges{\"u}nder als die Bev{\"o}lkerung ohne Migrationshintergrund. Expositionen vor, w{\"a}hrend und nach der Migration k{\"o}nnen aber unterschiedliche Gesundheitsressourcen und Krankheitsrisiken mit sich bringen. - {\"U}ber das Merkmal „Migrationshintergrund" hinaus variiert eine Vielzahl an Krankheitsrisiken abh{\"a}ngig vom sozio{\"o}konomischen Status (SES), dem Alter, Geschlecht und der Aufenthaltsdauer im Zielland. - Bei 11 bis 17-j{\"a}hrigen Kindern und Jugendlichen mit und ohne Migrationshintergrund bestehen kaum Unterschiede in der Selbsteinsch{\"a}tzung der k{\"o}rperlichen Gesundheit. - Erwachsene mit Migrationshintergrund aus spezifischen Herkunftsl{\"a}ndern weisen statistisch ein geringeres Risiko f{\"u}r b{\"o}sartige Neubildungen wie Brust-, Haut- oder Lungenkrebs sowie f{\"u}r Herz-Kreislauf-Erkrankungen auf. Erh{\"o}hte Risiken bestehen f{\"u}r Arbeitsunf{\"a}lle, psychsiche Erkrankungen sowie in einzelnen Sub-Gruppen f{\"u}r Infektionskrankheiten wie Tuberkulose, Hepatitis und HIV. - Ausl{\"a}ndische S{\"a}uglinge, Kinder und Jugendliche in Deutschland weisen eine h{\"o}here Mortalit{\"a}tsrate auf als deutsche Gleichaltrige. Zugewanderte Menschen im Alter von 20 bis 60 Jahren haben eine geringere, im Alter von 65 bis 69 Jahren eine h{\"o}here Mortalit{\"a}tsrate als die nicht-migrierte Bev{\"o}lkerung. - Die Sterblichkeit ausl{\"a}ndischer Personen gleicht sich mit zunehmender Aufenthaltsdauer in Deutschland an das Mortalit{\"a}tsmuster der einheimischen Bev{\"o}lkerung an.}, language = {de} } @incollection{SpallekSchumannReeskeBehrens, author = {Spallek, Jacob and Schumann, Maria and Reeske-Behrens, Anna}, title = {Migration und Gesundheit - Gestaltungsm{\"o}glichkeiten von Gesundheitsversorgung und Public Health in diversen Gesellschaften}, series = {Gesundheitswissenschaften}, booktitle = {Gesundheitswissenschaften}, editor = {Haring, Robin}, edition = {2. Auflage}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-54179-1}, issn = {2662-6942}, doi = {10.1007/978-3-662-54179-1_49-2}, abstract = {Der Zusammenhang zwischen Migration und Gesundheit ist vielschichtig. In aktuellen Erkl{\"a}rungsmodellen werden verschiedene Determinanten und Dimensionen angef{\"u}hrt, die {\"u}ber den Lebenslauf von Migranten zu gesundheitlichen Vor- und Nachteilen f{\"u}hren k{\"o}nnen. Gesundheitsversorgung und Public Health in einem Einwanderungsland wie Deutschland m{\"u}ssen diese gesundheitlichen Unterschiede beachten und - neben den bei besonderen Risikokonstellationen notwendigen gezielten Maßnahmen f{\"u}r Migranten - sich insgesamt so ausrichten, dass sie der Diversit{\"a}t der Bev{\"o}lkerung gerecht werden. Besondere Chancen bieten dabei Ans{\"a}tze, die im Rahmen von integrierten kommunalen Strategien zur Gesundheitsf{\"o}rderung die Bedarfe der Menschen in ihren Lebenswelten aufgreifen.}, language = {de} } @misc{HerkeMoorWinteretal., author = {Herke, Max and Moor, Irene and Winter, Kristina and Hack, Miriam and Hoffmann, Stephanie and Spallek, Jacob and Hilger-Kolb, Jennifer and Herr, Raphael and Pischke, Claudia R. and Dragano, Nico and Novelli, Anna and Richter, Matthias}, title = {Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review}, series = {BMJ Open}, volume = {12}, journal = {BMJ Open}, number = {2}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-052925}, pages = {16}, abstract = {Objectives: To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies. Design: Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities. Results: Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes. Conclusions: School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.}, language = {en} } @misc{HoffmannSanderWachtleretal., author = {Hoffmann, Stephanie and Sander, Lydia and Wachtler, Benjamin and Blume, Miriam and Schneider, Sven and Herke, Max and Pischke, Claudia R. and Matos Fialho, Paula Mayara and Schuettig, Wiebke and Tallarek, Marie and Lampert, Thomas and Spallek, Jacob}, title = {Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high‑income countries - a scoping review}, series = {BMC Public Health}, volume = {22}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-022-12603-4}, pages = {1 -- 14}, abstract = {Background: By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children's health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. Methods: This review followed the methodology of "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator "AND": (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. Results: The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent-child conflicts) are identified to have mediating or moderating effects. While families' living conditions (i.e., TVs in children's bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. Conclusion: Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children's health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.}, 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 = {Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany}, series = {Health \& Place}, volume = {75}, journal = {Health \& Place}, issn = {1353-8292}, doi = {10.1016/j.healthplace.2022.102794}, pages = {8}, abstract = {Background From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration. Method We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high). Results Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation. Conclusion Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.}, language = {en} } @misc{RattayBlumeWachtleretal., author = {Rattay, Petra and Blume, Miriam and Wachtler, Benjamin and Wollgast, Lina 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 female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study}, series = {PloS one}, volume = {17}, journal = {PloS one}, number = {4}, issn = {1932-6203}, doi = {10.1371/journal.pone.0266463}, abstract = {Objective Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family's socioeconomic position and adolescents' self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants. Methods Using data from wave 2 of the"German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents' subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on self-rated health 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 between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained. Conclusion The analysis revealed how a family's position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).}, language = {en} } @misc{TschornSchulzeFoerstneretal., author = {Tschorn, Mira and Schulze, Susanne and F{\"o}rstner, Bernd R. and Holmberg, Christine and Spallek, Jacob and Heinz, Andreas and Rapp, Michael A.}, title = {Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe}, series = {Aging \& Mental Health}, volume = {27 (2023)}, journal = {Aging \& Mental Health}, number = {5}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2076208}, pages = {1001 -- 1010}, abstract = {Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4\% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.}, language = {en} } @misc{JaehnSaskoHolmbergetal., author = {Jaehn, Philipp and Sasko, Benjamin and Holmberg, Christine and Hoffmann, Stephanie and Spallek, Jacob and Kelesidis, Theodoros and Rapp, Michael A. and Westhoff, Timm H. and Ritter, Oliver and Pagonas, Nikolaos}, title = {Levels of high-density lipoprotein lipid peroxidation according to spatial socioeconomic deprivation and rurality among patients with coronary artery disease}, series = {European Journal of Preventive Cardiology}, volume = {29}, journal = {European Journal of Preventive Cardiology}, number = {15}, issn = {2047-4873}, doi = {10.1093/eurjpc/zwac068}, pages = {e343 -- e346}, abstract = {Atherosclerotic coronary artery disease (CAD) is the leading cause of mortality worldwide.1 In this context, the burden of CAD shows considerable regional heterogeneity at the national level. For example, age-standardized mortality rates varied between 106 and 178 deaths per 100 000 at the level of German federal states in 2019.2 The regional heterogeneity of cardiovascular mortality suggests that the residential environment should be considered as an important determinant for successful secondary prevention. Environmental features that were frequently drawn upon to explain regional inequalities of cardiovascular outcomes are spatial socioeconomic deprivation (SSD) and rurality.3 Rurality may impact cardiovascular health due to impaired access to healthcare services. Socioeconomically deprived neighbourhoods, on the other hand, exhibit restricted opportunities to eat healthy, exercise regularly, utilize health care, and avoid environmental hazards such as air pollution.}, language = {en} } @misc{KielWeckmannChenotetal., author = {Kiel, Simone and Weckmann, Gesine and Chenot, Jean-Fran{\c{c}}ois and Stracke, Sylvia and Spallek, Jacob and Angelow, Aniela}, title = {Referral criteria for chronic kidney disease: implications for disease management and healthcare expenditure—analysis of a population-based sample}, series = {BMC Nephrology}, volume = {23}, journal = {BMC Nephrology}, issn = {1471-2369}, doi = {10.1186/s12882-022-02845-0}, pages = {1 -- 11}, abstract = {Background: Clinical practice guidelines recommend specialist referral according to different criteria. The aim was to assess recommended and observed referral rate and health care expenditure according to recommendations from: • Kidney Disease Improving Global Outcomes (KDIGO,2012) • National Institute for Health and Care Excellence (NICE,2014) • German Society of Nephrology/German Society of Internal Medicine (DGfN/DGIM,2015) • German College of General Practitioners and Family Physicians (DEGAM,2019) • Kidney failure risk equation (NICE,2021) Methods: Data of the population-based cohort Study of Health in Pomerania were matched with claims data. Proportion of subjects meeting referral criteria and corresponding health care expenditures were calculated and projected to the population of Mecklenburg-Vorpommern. Results: Data from 1927 subjects were analysed. Overall proportion of subjects meeting referral criteria ranged from 4.9\% (DEGAM) to 8.3\% (DGfN/DGIM). The majority of patients eligible for referral were ≥ 60 years. In subjects older than 60 years, differences were even more pronounced, and rates ranged from 9.7\% (DEGAM) to 16.5\% (DGfN/DGIM). Estimated population level costs varied between €1,432,440 (DEGAM) and €2,386,186 (DGfN/DGIM). From 190 patients with eGFR < 60 ml/min, 15 had a risk of end stage renal disease > 5\% within the next 5 years. Conclusions: Applying different referral criteria results in different referral rates and costs. Referral rates exceed actually observed consultation rates. Criteria need to be evaluated in terms of available workforce, resources and regarding over- and underutilization of nephrology services.}, language = {en} } @incollection{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Die gesundheitliche Situation von eingewanderten Menschen in Deutschland}, series = {Migration \& Gesundheit}, booktitle = {Migration \& Gesundheit}, editor = {Sieberer, Marcel and Jung, Petra and F{\"u}hrmann, Fabienne}, edition = {1}, publisher = {Urban \& Fischer}, address = {M{\"u}nchen}, doi = {10.1016/B978-3-437-23510-8.00007-0}, pages = {31 -- 36}, abstract = {Kernaussagen: - Menschen mit Migrationshintergrund sind nicht per se kr{\"a}nker oder ges{\"u}nder als die Bev{\"o}lkerung ohne Migrationshintergrund. Expositionen vor, w{\"a}hrend und nach der Migration k{\"o}nnen aber unterschiedliche Gesundheitsressourcen und Krankheitsrisiken mit sich bringen. - {\"U}ber das Merkmal „Migrationshintergrund" hinaus variiert eine Vielzahl an Krankheitsrisiken abh{\"a}ngig vom sozio{\"o}konomischen Status (SES), dem Alter, Geschlecht und der Aufenthaltsdauer im Zielland. - Bei 11 bis 17-j{\"a}hrigen Kindern und Jugendlichen mit und ohne Migrationshintergrund bestehen kaum Unterschiede in der Selbsteinsch{\"a}tzung der k{\"o}rperlichen Gesundheit. - Erwachsene mit Migrationshintergrund aus spezifischen Herkunftsl{\"a}ndern weisen statistisch ein geringeres Risiko f{\"u}r b{\"o}sartige Neubildungen wie Brust-, Haut- oder Lungenkrebs sowie f{\"u}r Herz-Kreislauf-Erkrankungen auf. Erh{\"o}hte Risiken bestehen f{\"u}r Arbeitsunf{\"a}lle, psychsiche Erkrankungen sowie in einzelnen Sub-Gruppen f{\"u}r Infektionskrankheiten wie Tuberkulose, Hepatitis und HIV. - Ausl{\"a}ndische S{\"a}uglinge, Kinder und Jugendliche in Deutschland weisen eine h{\"o}here Mortalit{\"a}tsrate auf als deutsche Gleichaltrige. Zugewanderte Menschen im Alter von 20 bis 60 Jahren haben eine geringere, im Alter von 65 bis 69 Jahren eine h{\"o}here Mortalit{\"a}tsrate als die nicht-migrierte Bev{\"o}lkerung. - Die Sterblichkeit ausl{\"a}ndischer Personen gleicht sich mit zunehmender Aufenthaltsdauer in Deutschland an das Mortalit{\"a}tsmuster der einheimischen Bev{\"o}lkerung an.}, language = {de} } @misc{SchulzeMerzThieretal., author = {Schulze, Susanne and Merz, Sibille and Thier, Anne and Tallarek, Marie and K{\"o}nig, Franziska and Uhlenbrock, Greta and N{\"u}bling, Matthias and Lincke, Hans-Joachim and Rapp, Michael A. and Spallek, Jacob and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data}, series = {BMC health services research}, volume = {22}, journal = {BMC health services research}, issn = {1472-6963}, doi = {10.1186/s12913-022-08333-3}, pages = {1 -- 13}, abstract = {Background: The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods: We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions: Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.}, language = {en} } @misc{WandschneiderBatramZantvoortAlazeetal., author = {Wandschneider, Lisa and Batram-Zantvoort, Stephanie and Alaze, Anita and Niehues, Vera and Spallek, Jacob and Razum, Oliver and Miani, C{\´e}line}, title = {Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study}, series = {Women's Health}, volume = {18}, journal = {Women's Health}, issn = {1617-8041}, doi = {10.1177/17455057221114274}, pages = {1 -- 17}, abstract = {Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April-May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it.}, language = {en} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Die Selbstbestimmung Geb{\"a}render: F{\"o}rderliche und begrenzende Faktoren aus der Perspektive von Hebammen in Krankenh{\"a}usern, Geburtsh{\"a}usern und bei Hausgeburten}, series = {21. Deutscher Kongress f{\"u}r Versorgungsforschung : 05.10.-07.10.2022, Potsdam}, journal = {21. Deutscher Kongress f{\"u}r Versorgungsforschung : 05.10.-07.10.2022, Potsdam}, publisher = {Deutsches Netzwerk Versorgungsforschung e.V.}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkvf321}, abstract = {Hintergrund und Stand (inter)nationaler Forschung: Die Forderung nach einer selbstbestimmten Geburt ist in Deutschland und weltweit in den fachlichen und {\"o}ffentlichen Fokus ger{\"u}ckt. Allerdings liegen bisher wenige Forschungsergebnisse zur Selbstbestimmung Geb{\"a}render und ihrer f{\"o}rderlichen und begrenzenden Bedingungen vor. Diese Erkenntnisse sind jedoch essentiell, um Selbstbestimmung gezielt unterst{\"u}tzen und ihre Verletzung vermeiden zu k{\"o}nnen. Fragestellung und Zielsetzung: Die Studie untersucht und vergleicht die Erfahrungen und Perspektiven von Hebammen in Bezug auf f{\"o}rderliche und begrenzende Faktoren einer selbstbestimmten Geburt in Krankenh{\"a}usern, Geburtsh{\"a}usern und bei Hausgeburten in Deutschland. Methode: Es wurde eine qualitative Fallstudie auf der Basis von zehn problemzentrierten Einzelinterviews mit Hebammen durchgef{\"u}hrt. Eingeschlossen wurden Hebammen mit laufender oder abgeschlossener Ausbildung, deren letzte begleitete Geburt nicht l{\"a}nger als sechs Monate zur{\"u}cklag. Die Sampling-Strategie erlaubte die Ber{\"u}cksichtigung unterschiedlicher Geburtshilfe-Settings und Regionen in Deutschland. Alle Interviews wurden aufgezeichnet, transkribiert, anonymisiert und mittels der Thematischen Analyse ausgewertet. Ein positives Ethik-Votum liegt vor. Ergebnisse: Die Ergebnisse legen acht zusammenh{\"a}ngende Kategorien nahe, die jeweils f{\"o}rdernde und begrenzende Faktoren implizieren: 1. Strukturelle/rechtliche Bedingungen auf Meso-/Makroebene; 2. Wahrnehmung von Geburt (z.B. als medizinischer/nat{\"u}rlicher Vorgang, notwendige Kompetenz und Kontrolle); 3. Vertrauen/Atmosph{\"a}re; 4. Kennenlernen/ Beziehungsaufbau mit Geb{\"a}renden; 5. Sozio{\"o}konomische Position (SEP) der Geb{\"a}renden; 6. Information der Geb{\"a}renden; 7. Entscheidungs- und Artikulationsf{\"a}higkeit der Geb{\"a}renden und 8. Verhalten der Begleitpersonen. Zudem wurden Strategien der Hebammen zur Erweiterung des Handlungsspielraums identifiziert. Mehrere Faktoren unterscheiden sich abh{\"a}ngig vom Geburtssetting. Diskussion: Die M{\"o}glichkeiten f{\"u}r eine selbstbestimmte Geburt k{\"o}nnen sich je nach Setting (z.B. institutionelle Routinen), zwischenmenschlichen Beziehungen (z.B. Vertrauen) und individuellen Faktoren (z.B. SEP) unterscheiden. Folglich k{\"o}nnen politische, institutionelle und individuelle Strategien eine selbstbestimmte Geburt - und damit eine personenzentrierte, situativ angemessene Versorgung - unter Ber{\"u}cksichtigung der oben genannten Faktoren unterst{\"u}tzen. Praktische Implikationen: Die Ergebnisse liefern konkrete Anhaltspunkte f{\"u}r Maßnahmen zur Unterst{\"u}tzung einer selbstbestimmten Geburt in verschiedenen Geburtssettings. Empfohlen werden u. a. die Verbesserung von Informationsprozessen vor und w{\"a}hrend der Geburt, die Verbesserung des Zugangs zu Versorgungsangeboten, der Abbau finanzieller H{\"u}rden in der Inanspruchnahme, die F{\"o}rderung von Beziehungsaufbau und eine St{\"a}rkung der hebammengeleiteten Geburt. Appell f{\"u}r die Praxis (Wissenschaft und/oder Versorgung) in einem Satz: Akteur*innen und Entscheidungstr{\"a}ger*innen der Geburtshilfe k{\"o}nnen die Selbstbestimmung Geb{\"a}render durch gezielte individuelle, institutionelle und politische Maßnahmen f{\"o}rdern.}, language = {de} } @misc{EntringerScholaskeKurtetal., author = {Entringer, Sonja and Scholaske, Laura and Kurt, Medlin and Duman, Elif Aysimi and Adam, Emma K. and Razum, Oliver and Spallek, Jacob}, title = {Diurnal cortisol variation during pregnancy in Turkish origin and non-migrant women in a German birth cohort study}, series = {Journal of Psychosomatic Research}, volume = {162}, journal = {Journal of Psychosomatic Research}, issn = {0022-3999}, doi = {10.1016/j.jpsychores.2022.111020}, pages = {1 -- 10}, abstract = {Background Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy. Methods 109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy. Results Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants. Discussion A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group.}, language = {en} } @misc{SchulzeMerzLinckeetal., author = {Schulze, Susanne and Merz, Sibille and Lincke, Hans-Joachim and N{\"u}bling, Matthias and Rapp, Michael A. and Spallek, Jacob and Tallarek, Marie and Thier, Anne Kathrin and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic}, series = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, journal = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkvf025}, abstract = {Background: Nurses' work-related strain and psychological burden increased during the Covid-19 pandemic, resulting in high prevalences of mental health problems among nurses worldwide. Nurses in long-term care facilities seem to be particularly prone to overall heightened burden and poor mental health. Research question: We investigated which work-related psychosocial burdens and potential positive aspects nurses working in nursing homes experience during the Covid-19 pandemic. Method: We conducted a mixed-methods study. Eligible for participation were nurses and nursing assistants working in nursing homes within the state of Brandenburg, Germany. Between August and October 2020, we distributed an anonymous survey containing the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses, drawn from the German COPSOQ databank and kindly shared by the Freiburg Research Centre for Occupational Science. In June 2021, we also conducted semi-structured interviews with geriatric nurses to reach a deeper understanding of their experiences on work-related changes and burdens during the first phases of the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n=177) differed significantly from the reference group in 14 out of 31 COPSOQ scales. Amongst others, our sample scored significantly worse regarding the scales 'support at work', 'recognition', 'quantitative demands', 'hiding emotions', 'role conflicts', 'intention to leave profession', 'burnout' and 'inability to relax'. The interviews (n=17) revealed five main themes related to nurses' psychosocial stress: 'overall working conditions under the hygiene measures', 'concern for isolated residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' and 'meaning of work' were identified as positive effects of the pandemic. Discussion: Results indicate that nurses in nursing homes experience enhanced psychosocial and work-related strain. The comparisons with the pre-pandemic reference group suggest that the situation further aggravated during the pandemic. Nurses exhibited high psychosocial burden, e.g., due to strongly impeded possibilities to fulfill the emotional and social dimensions of care and the constant fear of infection or transmission. Deteriorated working conditions (e.g., higher workload through staff shortages and additional tasks) further exacerbated these burdens. Few positive aspects of the pandemic may be important sources of resilience. Practical implications: The reduction of nurses' strain through psychosocial support and the improvement of working conditions is crucial for the protection of nurses' health. Appeal for practice in one sentence: Political players as well as care facilities should take measures to improve nurses' situation in order to maintain a healthy workforce and high-quality care.}, 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 = {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} } @incollection{TallarekZeebSpallek, author = {Tallarek, Marie and Zeeb, Hajo and Spallek, Jacob}, title = {Psychiatrisch-psychotherapeutische Versorgung von zugewanderten Menschen in Deutschland. Bedarf, Inanspruchnahme und Verbesserungspotenziale}, series = {Handbuch Transkulturelle Psychiatrie}, booktitle = {Handbuch Transkulturelle Psychiatrie}, editor = {Klosinski, Matthias and Castro N{\´u}{\~n}ez, Sandra and Oestereich, Cornelia and Hegemann, Thomas}, edition = {1}, publisher = {Psychiatrie Verlag}, address = {K{\"o}ln}, isbn = {978-3-8252-5945-7}, doi = {10.36198/9783838559452}, pages = {77 -- 92}, abstract = {Dieser Beitrag gibt einen {\"U}berblick {\"u}ber theoretische Konzepte sowie epidemiologisch-empirische Erkenntnisse zu H{\"a}ufigkeit und Determinanten psychischer Erkrankungen bei zugewanderten Menschen sowie zur Inanspruchnahme und Versorgungspraxis. Auf der Basis dieser Erkenntnisse werden vielversprechende Ans{\"a}tze der Versorgungspraxis sowie der weiteren Forschung vorgestellt.}, language = {de} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Factors promoting or limiting self-determined childbirth: midwives' perspectives in Germany}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac131.423}, pages = {1}, abstract = {Background Claims for self-determined childbirth (SDC) have gained increasing scientific, political and societal attention. However, research on SDC is limited. This study analyzes and compares midwives' experiences and perspectives on factors that promote or limit SDC in hospitals, birthing centers and during home births in Germany. We argue that these insights are essential in order to foster self-determination and to avoid its violation. Methods A qualitative case study was conducted based on semi-structured face-to-face interviews with midwives working in hospitals, birthing centers, and offering home births in Germany. In total, nine interviews were conducted in 2021 and have been audiotaped, transcribed, anonymized and analyzed by use of Thematic Analysis. Results The results indicate eight inter-related categories, each of which imply promoting and limiting factors: 1) Structural/ legal conditions; 2) Perception of birth (e. g. as natural or medical process; required competence and control); 3) Trust and atmosphere; 4) Getting acquainted/relationship building; 5) Birthing person's socioeconomic position; 6) Birthing person's preparation/ education; 7) Birthing person's capability of decision making and expression; and 8) Behavior of accompanying persons. Moreover, we identified midwives' strategies to extend possibilities of choice. Several factors clearly differ depending on the birth setting. Conclusions The opportunities for SDC seem to differ according to the setting (e.g. institutional routines), inter-personal relations (e.g. getting acquainted, trust), and individual factors (e.g. socioeconomic position, capabilities). Hence, political, institutional and individual strategies may support SDC in consideration of the above factors. Measures may, among others, include the improvement of information processes, the reduction of economic barriers, relationship building before and during birth as well as respective structural adjustments.}, language = {en} } @misc{IashchenkoSchuettigBammertetal., author = {Iashchenko, Iryna and Sch{\"u}ttig, Wiebke and Bammert, Philip and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Moor, Irene and Pischke, Claudia R. and Sundmacher, Leonie}, title = {The role of regional health policy for socioeconomic inequality in health services utilization}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.584}, pages = {1}, abstract = {Background "J1" is a preventative routine examination in Germany recommended for adolescents at the age of 12-14 years. In contrast to the well-established U1-U9 examinations for younger children, with participation rates above 90\%, the attendance of the J1 examination is approximately only 40\%. The most frequent reason for not attending J1 is the unawareness of this examination. "Ticket to J1" is an intervention including an information leaflet introduced in Bavaria in 2017 to inform adolescents about J1. The aims of the present analysis are to investigate (1) if the regional policy was effective in increasing the attendance in J1, (2) if the effects vary by family socioeconomic status (SES), and (3) which meso-level characteristics of the healthcare system correlate with attendance rates in J1. Methods We used anonymised data of a large statutory health insurance in Germany for the timeframe of 2016-2018. To investigate the effect of the policy, a difference-in-differences design at the individual level was used. Assuming a parallel trend at the level of federal states, the likelihood of attendance in J1 of 13- and 14-year-olds was compared between Bavaria and other federal German states before and after policy introduction. All analyses were additionally stratified by SES. Results The introduction of "Ticket to J1" increased participation in J1 by 1\% after controlling for all confounders. Furthermore, the effect was stronger for children from families with lower SES (an increase of 5\%). Density of pediatricians was positively significantly correlated with participation in J1. Discussion Regional health policy intervention had a significant positive impact on attendance of J1 and appears to have the potential to reduce socioeconomic inequalities in healthcare utilization. Informing adolescents about J1 seems to increase the attendance, in particular for children from families with lower SES.}, language = {en} } @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{ScholaskeEntringerRazumetal., author = {Scholaske, Laura and Entringer, Sonja and Razum, Oliver and Spallek, Jacob}, title = {Elevated stress during pregnancy in women of Turkish origin: Results from a prospective cohort study}, series = {European Journal of Public Health}, volume = {32}, journal = {European Journal of Public Health}, number = {Supplement_3}, issn = {1101-1262}, doi = {10.1093/eurpub/ckac129.608}, pages = {2}, abstract = {Background Ethnic health disparities exist in the context of pregnancy and childbirth, suggesting that women of Turkish origin (i.e., they or their parents born in Turkey) in Germany have higher risks for some adverse maternal health and child developmental outcomes. Stress is believed to be a relevant pathway by which migration may be associated with these risks. In this study, we tested associations of Turkish origin with stress biology and psychological stress experiences during pregnancy. Methods 140 pregnant women (33 of Turkish/26 of other origin) participated in a prospective cohort study that was carried out in Bielefeld and Berlin (Spallek et al., 2020). Inflammatory markers CRP and IL-6 from venous blood samples and diurnal cortisol profiles from salivary cortisol samples were derived and participants completed the Perceived Stress Scale (PSS) and Center for Epidemiologic Studies Depression Scale (CESD) at two study visits during pregnancy (T1: 20-25 weeks of gestation, T2: 30-35 weeks of gestation). Multilevel models were conducted to account for the nested data structure due to repeated measurements. Results Compared to non-migrant women, women of Turkish origin had significantly higher inflammatory levels (b = 0.28, SE = 0.14, p=.052) (Spallek et al., 2021), a blunted cortisol awakening response (b=-0.21, CI=-0.38-0.03, p<.05), a flatter diurnal cortisol slope (b = 0.02, CI = 0.00-0.04, p<.05), and higher PSS (b = 0.46, SE = 0.13, p< .001) and CESD scores (b = 0.29, SE = 0.08, p<.001) during pregnancy after adjusting for socioeconomic factors. Conclusions The results of our study suggest higher stress at the biological and psychological level in pregnant women of Turkish origin. Stress is a risk factor for pregnancy complications and poor birth and child developmental outcomes. To reduce such unequally distributed risks, interventions for stress reduction are needed that are tailored to women of Turkish origin.}, 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} } @misc{ScholaskeAdamSpalleketal., author = {Scholaske, Laura and Adam, Emma K. and Spallek, Jacob and Entringer, Sonja}, title = {Maternal BMI and inflammation during pregnancy: a bi- or unidirectional association?}, series = {Brain, Behavior, and Immunity}, volume = {106}, journal = {Brain, Behavior, and Immunity}, publisher = {Elsevier}, doi = {10.1016/j.bbi.2022.07.049}, pages = {12}, abstract = {Methods: 140 pregnant women participated in a multi-site prospective cohort study in, Germany with two study visits during pregnancy (T1: 24.44 ± 2.34, T2: 32.92 ± 1.72 weeks of gestation). Maternal BMI was derived from body length and current weight and was residualized for gestational week at assessment. Pro-inflammatory markers CRP and IL-6 were analyzed from venous blood samples and combined into a repeatedly measured composite inflammation score. Results: In a path model, T1-BMI significantly predicted T2-inflammation (b=0.53, SE=0.02, p <.001), and T1-inflammation predicted T2-BMI (b=0.46, SE=0.42, p <.001), suggesting a bidirectional relationship between BMI and inflammation. However, further adjustment for pre-pregnancy BMI diminished the association between T1-inflammation and T2-BMI (b=0.004, SE=0.22, p =.922), whereas the relationship between T1-BMI and T2-inflammation remained significant (b=0.20, SE=0.01, p =.004). Thus, adjusting for pre-pregnancy BMI underlined a unidirectional relationship. Conclusions: Based on these results, reducing overweight may be a relevant target for interventions to reduce inflammation and the risk of subsequent adverse outcomes.}, language = {en} } @misc{DeindlDiehlSpalleketal., author = {Deindl, Christian and Diehl, Katharina and Spallek, Jacob and Richter, Matthias and Sch{\"u}ttig, Wiebke and Rattay, Petra and Dragano, Nico and Pischke, Claudia R.}, title = {Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status}, series = {Frontiers in Public Health}, volume = {11}, journal = {Frontiers in Public Health}, issn = {2296-2565}, doi = {10.3389/fpubh.2023.1075142}, abstract = {Health inequalities start early in life. The time of young adulthood, between late teens and early twenties, is especially interesting in this regard. This time of emerging adulthood, the transition from being a child to becoming an adult, is characterised by the detachment from parents and establishing of an own independent life. From a health inequality perspective, the question about the importance of the socio-economic background of parents is important. University students are an especially interesting group. Many students come from a privileged background and the question of health inequality among university students has not yet been properly studied. Based on the National Educational Panel Study (NEPS), we analysed health inequalities among 9,000 students in Germany ({\O} 20 years in the first year of their studies) over a period of eight years. We found that university students in Germany report a good and very good health. Yet, we still found substantial health inequalities. Students whose parents had a higher occupational status also reported less health problems. We were also able to tie health inequality on health behaviour, psychosocial resources, and material conditions.}, language = {en} } @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{ReuterDiehlRichteretal., author = {Reuter, Marvin and Diehl, Katharina and Richter, Matthias and Sundmacher, Leonie and H{\"o}vener, Claudia and Spallek, Jacob and Dragano, Nico}, title = {A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes}, series = {Advances in Lifecourse Research}, volume = {Vol. 59}, journal = {Advances in Lifecourse Research}, issn = {1879-6974}, doi = {10.1016/j.alcr.2024.100593}, abstract = {Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.}, language = {en} } @incollection{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Migration and health. Theoretical foundations, empirical findings, and public health responses using the example of Germany}, series = {Contemporary challenges of social work in Poland and Germany: war migrants as a challenge}, booktitle = {Contemporary challenges of social work in Poland and Germany: war migrants as a challenge}, editor = {Orlowska, Beata and Paetzold, Ulrich}, edition = {1}, publisher = {Akademia im. Jakuba z Paradyża w Gorzowie Wielkopolskim}, address = {Gorz{\´o}w Wielkopolski}, isbn = {978-83-67705-24-0}, pages = {11 -- 31}, abstract = {Migrants and their offspring, referred to as people with a migration background in this article, are an utmost heterogeneous group whose health situation can be better, similar or worse compared to the health of the population without a migration background. A better understanding of the health of people with a migration background requires the consideration of their individual life course as well as several additional explanatory factors. The latter include, for instance, their social position, age, and gender, as well as the policies, health care system, social climate, living situation, and length of stay in the destination country. Particularly promising public health strategies for migrant health include a combination of migration sensitive and migration specific offers, setting approaches, and inclusionary public health approaches that critically reflect on mechanisms of othering, marginalization, and exclusion.}, language = {en} } @misc{BammertSchuettigIashchenkoetal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Iashchenko, Iryna and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Richter, Matthias and Pischke, Claudia R. and Dragano, Nico and Sundmacher, Leonie}, title = {The role of sociodemographic, psychosocial, and behavioral factors in the use of preventive healthcare services in children and adolescents: results of the KiGGS Wave 2 study}, series = {BMC Pediatrics}, volume = {24}, journal = {BMC Pediatrics}, issn = {1471-2431}, doi = {10.1186/s12887-024-04650-0}, abstract = {Background: In Germany, various preventive services are offered to children and adolescents. These include regular standardized examinations (so called U/J examinations) and several vaccinations. Although strongly recommended, most of them are not mandatory. Our aim is to identify factors associated with the use of U/J examinations and vaccination against diphtheria, hepatitis B, Hib, pertussis, polio, and tetanus. While previous research has focused on sociodemographic factors, we also include socioeconomic, behavioral, and psychosocial factors. Methods: We analyzed cross-sectional data from 15,023 participants (aged 0-17 years) of the nationwide representative KiGGS Wave 2 Survey. Participation in U/J examinations was assessed using a questionnaire, filled out by participants and/or their parents. Information on vaccination status was drawn from the participants' vaccination booklets. To identify relevant determinants for the use of preventive examinations and vaccinations, unadjusted and adjusted logistic regression models were employed with up to 16 different independent variables. Results: Various independent variables showed an association with the use of preventive services. Higher socioeconomic status, absence of migration background, and lower household size were associated with significantly higher utilization of U examinations. Parents' marital status, area of residence, behavioral and psychosocial factors yielded insignificant results for most U/J examinations. Higher vaccination rates were found for children with no migration background, with residence in eastern Germany, lower household size, and with married parents. Conclusion: This study attempted to depict the influence of sociodemographic, psychosocial, and behavioral factors on the use of several preventive services. Our results indicate that predominantly sociodemographic variables influence the use of preventive services. Further efforts should be made to investigate the interplay of different determinants of healthcare use in children and adolescents.}, language = {en} } @misc{BammertSchuettigNovellietal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Novelli, Anna and Iashchenko, Iryna and Spallek, Jacob and Blume, Miriam and Diehl, Katharina and Moor, Irene and Dragano, Nico and Sundmacher, Leonie}, title = {The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review}, series = {International Journal for Equity in Health}, volume = {23}, journal = {International Journal for Equity in Health}, number = {1}, issn = {1475-9276}, doi = {10.1186/s12939-024-02122-6}, abstract = {Background: Besides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use. Methods: We used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the 'Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)' recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered. Results: Of the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies. Conclusions: Socioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.}, language = {en} } @misc{KnautheFieberGlauschetal., author = {Knauthe, Nadja and Fieber, Vera and Glausch, Melanie and Geissler, Mark Enrik and Dallal, Anna and Doll, Konrad and Meister, Lisa and Tallarek, Marie and Weigmann-Faßbender, Sandra and Giesemann, Nadine and Hofbauer, Christine and Bornh{\"a}user, Martin and Letsch, Anne and Ratjen, Ilka and Spallek, Jacob and St{\"o}lzel, Friederike}, title = {„Aktiv leben mit Krebs": acceptance and effect of a lowthreshold information on health behavior for cancer patients}, series = {Oncology Research and Treatment 2024 : 36. Deutscher Krebskongress. Fortschritt gemeinsam gestalten, 21.-24. Februar 2024, Berlin: ABSTRACTS}, volume = {47}, journal = {Oncology Research and Treatment 2024 : 36. Deutscher Krebskongress. Fortschritt gemeinsam gestalten, 21.-24. Februar 2024, Berlin: ABSTRACTS}, number = {1}, editor = {B{\"u}ttner, Reinhard}, issn = {2296-5262}, doi = {10.1159/000535363}, pages = {216}, abstract = {Background: In Germany, more than 4.65 million people are currently living with a cancer diagnosis. Patients can benefit from a healthy lifestyle both during and after therapy. In order to provide patients with practical and scientifically based information on health behavior, the authors developed "Aktiv leben mit Krebs" (ALMIK) using participatory program planning. Methods: A non-blinded randomized controlled trial with intervention (IG) and wait list control group (WCG) was conducted at NCT/UCC Dresden and UCCSH in Kiel in 2022/2023 with a convenience sample of n=227 patients during and after therapy (65.7 years ± 11.7, 54.2\% male). IG and WCG received a questionnaire at baseline and after 1 month. IG received the ALMIK brochure and a link to the website with videos. Changes in health literacy (HLS-EU Q) and acceptance were assessed. Result: Acceptance of ALMIK in IG was high: 94.1\% of all n=109 patients in the IG reported having used the brochure. 40.4\% had visited the website. Videos were used by 36.7\%. Almost all patients rated the brochure as understandable (97.8\%), relevant (90.3\%) and clearly presented (98.9\%). Patients also rated the website as well-structured (95.6\%) and attractively designed (97.6\%), and the videos as understandable (93.0\%) and relevant (79.1\%). Overall, 97.8\% were satisfied with the program and 98.9\% would recommend it to others. Patients of IG did not achieve higher HLS-score in comparison to WCG (p=0.75). Discussion: The brochure was used by many patients and was very well accepted. The website and videos were used less frequently, but overall by more than one-third of patients, who were also satisfied with them. Health literacy was not increased by ALMIK, which may be due to the low intervention strength. Conclusion: The high number of participants who used ALMIK indicates a high need for health behavior information for cancer patients. Patient involvement has proven to be an important component in creating well accepted program materials}, 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} } @incollection{SpallekSchumannBrand, author = {Spallek, Jacob and Schumann, Maria and Brand, Tilman}, title = {Pr{\"a}vention und Gesundheitsf{\"o}rderung bei Migrantinnen und Migranten}, series = {Referenzwerk Pr{\"a}vention und Gesundheitsf{\"o}rderung}, booktitle = {Referenzwerk Pr{\"a}vention und Gesundheitsf{\"o}rderung}, editor = {Hurrelmann, Klaus and Richter, Matthias and Stock, Stephanie}, edition = {6., {\"u}berarb. u. erw. Aufl.}, publisher = {Hogrefe}, address = {Bern}, isbn = {978-3-456-86350-4}, doi = {10.1024/86350-000}, pages = {479 -- 494}, language = {de} } @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} }