@incollection{RazumButlerSpallek, author = {Razum, Oliver and Butler, Jeffrey and Spallek, Jacob}, title = {Gesundheitliche Chancen und Risiken von MigrantInnen: Handlungsm{\"o}glichkeiten einer kommunalen Gesundheitspolitik}, series = {Handbuch Lokale Integrationspolitik}, booktitle = {Handbuch Lokale Integrationspolitik}, editor = {Gesemann, Frank and Roth, Roland}, publisher = {Springer Fachmedien}, address = {Wiesbaden}, isbn = {978-3-658-13409-9}, doi = {10.1007/978-3-658-13409-9_25}, pages = {565 -- 584}, language = {de} } @misc{ReeskeSpallek, author = {Reeske, Anna and Spallek, Jacob}, title = {Deeper Analysis Desirable}, series = {Deutsches {\"A}rzteblatt}, volume = {114}, journal = {Deutsches {\"A}rzteblatt}, number = {41}, doi = {10.3238/arztebl.2017.0689c}, pages = {689 -- 690}, abstract = {The Prevalence of Gestational Diabetes A Population-Based Analysis of a Nationwide Screening Program by Dr. phil. Hanne Melchior, Diana Kurch-Bek, Dr. med. Monika Mund in issue 24/2017}, language = {en} } @misc{WeckmannChenotStrackeetal., author = {Weckmann, Gesine and Chenot, Jean-Fran{\c{c}}ois and Stracke, Sylvia and Haase, Annekathrin and Spallek, Jacob and Angelow, Aniela}, title = {Auswirkung von {\"U}berweisungskriterien zum Nephrologen bei chronischer Niereninsuffizienz - Analyse einer Populationsbasierten Stichprobe}, series = {Das Gesundheitswesen}, volume = {79}, journal = {Das Gesundheitswesen}, number = {08/09}, issn = {1439-4421}, doi = {10.1055/s-0037-1605664}, pages = {656 -- 804}, language = {de} } @misc{GrosserHoellerHoltrichterBreckenkampetal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Breckenkamp, J{\"u}rgen and Hoffmann, Renata and Spallek, Jacob and Razum, Oliver}, title = {Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany}, series = {Das Gesundheitswesen}, volume = {79}, journal = {Das Gesundheitswesen}, number = {08/09}, issn = {1439-4421}, doi = {10.1055/s-0037-1605903}, pages = {656 -- 804}, language = {en} } @misc{BerensRederRazumetal., author = {Berens, Eva-Maria and Reder, Maren and Razum, Oliver and Kolip, Petra and Spallek, Jacob}, title = {Informed choice in mammography screening program: a survey among first-time invitees in Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.213}, pages = {S. 83}, language = {en} } @misc{GrosserHoellerHoltrichterMianietal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Miani, Celine and Hoffmann, Renata and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver}, title = {Caesarean birth frequency among women with and without migration background in Germany: the BaBi birth cohort study, Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.466}, pages = {S. 183}, language = {en} } @misc{GrosserHoellerHoltrichterMianietal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Miani, Celine and Hoffmann, Renata and Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob}, title = {Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.467}, pages = {S. 183}, language = {en} } @misc{BerensRiedelRederetal., author = {Berens, Eva-Maria and Riedel, J{\"o}rg and Reder, Maren and Razum, Oliver and Kolip, Petra and Spallek, Jacob}, title = {Postalische Befragung von Frauen mit t{\"u}rkischem Migrationshintergrund - Identifizierung, Stichprobenbereinigung und Response im Rahmen der InEMa-Studie}, series = {Das Gesundheitswesen}, volume = {79}, journal = {Das Gesundheitswesen}, number = {12}, issn = {0941-3790}, doi = {10.1055/s-0035-1564076}, pages = {1000 -- 1003}, language = {de} } @misc{SpallekSchumannZeeb, author = {Spallek, Jacob and Schumann, Maria and Zeeb, Hajo}, title = {Utilization of prevention and health promotion among migrants}, series = {Public Health Forum}, volume = {26}, journal = {Public Health Forum}, number = {2}, issn = {1876-4851}, pages = {116 -- 120}, abstract = {The uptake of existing preventive and health promotion offers by migrants in Germany is rather heterogeneous, and major information gaps are noted. Current results provide limited evidence that migrants and their children seem to use prevention and health promotion services less frequently than non-migrants. In order to improve access to preventive and other health services for migrants, a combination of migrant-specific and migrant-sensitive approaches seems to be useful.}, language = {en} } @misc{GrosserHoellerHoltrichterDoyleetal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Doyle, Ina-Merle and Schmitz, Jutta and Hoffmann, Renata and Ergin-Akkoyun, Emine and Mauro, Antonia and Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob}, title = {Rekrutierungsstrategien f{\"u}r Migrantinnen in einer Geburtskohorte am Beispiel der BaBi-Studie}, series = {Das Gesundheitswesen}, volume = {81}, journal = {Das Gesundheitswesen}, number = {8/9}, issn = {0941-3790}, doi = {10.1055/a-0600-2392}, pages = {621 -- 628}, abstract = {Die Rekrutierung von Studienteilnehmern aller relevanten Bev{\"o}lkerungsgruppen stellt eine der Herausforderungen in der (sozial-)epidemiologischen Forschung dar. Es existiert eine Vielzahl von Strategien, die der Rekrutierung von ethnischen Minderheiten und bestimmter Migrantengruppen dienen k{\"o}nnen. Unklar ist bisher, ob diese Strategien auch bei der Etablierung einer Geburtskohorte geeignet sind. Ziel der vorliegenden Arbeit ist die Darstellung und Evaluation von Rekrutierungsstrategien f{\"u}r Migrantinnen in einer Geburtskohorte am Beispiel der BaBi-Studie. Die Rekrutierung erfolgte von Oktober 2013 bis Oktober 2016. Als Vorbereitung wurden Fokusgruppen mit Schwangeren und M{\"u}ttern und leitfadengest{\"u}tzte Experteninterviews mit Hebammen und Gyn{\"a}kologInnen durchgef{\"u}hrt, um Studienmaterialien, Befragungsinstrumente und Sprachpr{\"a}ferenzen zu pr{\"u}fen. In der Vorstudie wurden unterschiedliche Rekrutierungswege getestet. Im Rekrutierungsverlauf fand eine kontinuierliche Evaluation statt, um erfolgreiche Rekrutierungsstrategien f{\"u}r Teilnehmerinnen mit Migrationshintergrund zu ermitteln und anzupassen. Von den eingeschlossenen 980 Teilnehmerinnen hatten 390 einen Migrationshintergrund (40\%). Es wurden aktive und passive Rekrutierungsstrategien verfolgt, in denen u. a. t{\"u}rkische {\"U}bersetzungen und multikulturelles Personal zum Einsatz kamen. F{\"u}r die passive Rekrutierung {\"u}ber gyn{\"a}kologische Praxen und Hebammen mussten die schwangeren Frauen und W{\"o}chnerinnen eine hohe Motivation f{\"u}r die Rekrutierung mitbringen. Die aktive Rekrutierung in den Geburtskliniken (Ansprache durch Study-Nurses) erh{\"o}hte den Anteil an Teilnehmerinnen mit Migrationshintergrund von 22 auf 49\% aller Teilnehmerinnen. Durch fr{\"u}hzeitige {\"U}berpr{\"u}fungen und Anpassungen der Zugangswege konnte die Teilnahmebereitschaft erh{\"o}ht werden. F{\"u}r die Rekrutierung von Frauen mit Migrationshintergrund sind gr{\"u}ndliche Vorbereitungen in Form von Befragungen (Fokusgruppen, Leitfadeninterviews) und einer Vorstudie sinnvoll. Von Beginn an sind Verfahren zur fr{\"u}hzeitigen Evaluation der unterschiedlichen Rekrutierungsstrategien und ein erh{\"o}hter Personalaufwand (z. B. f{\"u}r (R{\"u}ck-/ {\"U}bersetzungen) einzuplanen). Der Einschluss von Menschen mit Migrationshintergrund in sozialepidemiologischen Studien sollte in Deutschland zur Normalit{\"a}t werden.}, language = {de} } @misc{BerensRederRazumetal., author = {Berens, Eva-Maria and Reder, Maren and Razum, Oliver and Kolip, Petra and Spallek, Jacob}, title = {Informed choice in mammography screening program among migrant and non-migrant women: a survey among first-time invitees in Germany, 2013-2015}, series = {European Journal of Public Health}, volume = {28}, journal = {European Journal of Public Health}, number = {Suppl. 1}, issn = {1464-360X}, doi = {10.1093/eurpub/cky047.107}, pages = {S. 55}, abstract = {Background: In Germany, women aged 50 to 69 are invited biennially to the population-based mammography screening programme (MSP). There is still a broad discussion whether the benefits of the programme outweigh its harms. Hence, the concept of informed choice is of particular importance for MSP. The aim of this survey was to assess the proportion of informed choices among migrant and non-migrant women invited to the German MSP for the first time. Methods: A random sample of 17,349 women aged 50 from a sub-region of North Rhine Westphalia was invited to participate in a postal cross-sectional survey conducted in German and Turkish. Turkish and other migrants were identified by country of birth and German resettlers additionally by self-reported resettler-status. Turkish migrant women were oversampled, due to expected lower response-rates. The effect of migration status on informed choice and on its three components (knowledge, attitude and intention) were assessed by chi-square tests and logistic regression modelling. Results:5,847 (33.7\%) women responded to the postal questionnaire. 4,113 complete cases were included in the analyses. The proportion of women making informed choices was low (27.1\%). Turkish migrant women had the highest odds for making an uninformed choice (OR 5.30, 95\%CI 1.92-14.66) independent of educational level. Other migrant groups only had slightly higher odds for making an uninformed choice (German resettlers: OR 1.50, 95\%CI 1.00-2.25; other migrants: OR 1.57, 95\%CI 0.96-2.57) compared to non-migrant women. Fewer Turkish and other immigrant women intended to participate in the MSP. Immigrant women had a more positive attitude and a lower proportion of sufficient knowledge compared to non-migrant women. Conclusions: The overall proportion of informed choice in the German MSP is low and knowledge is poor. Measures are needed to improve information materials, strengthen health literacy and create a user-friendly environment facilitating informed choices especially for migrant women.}, language = {en} } @misc{MianiBreckenkampGrosseretal., author = {Miani, Celine and Breckenkamp, J{\"u}rgen and Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Ergin-Akkoyun, Emine and Hoffmann, Renata and Doyle, Ina-Merle and Spallek, Jacob and Razum, Oliver}, title = {Socio-economic determinants of breastfeeding uptake and duration intention among women with and without migration background. Results from the BaBi birth cohort study in Bielefeld, Germany}, series = {European Journal of Public Health}, volume = {28}, journal = {European Journal of Public Health}, number = {Vol. 1}, issn = {1464-360X}, doi = {10.1093/eurpub/cky047.093}, pages = {S. 50}, abstract = {Background: Disparities in breastfeeding practices have been observed between migrants and majority populations in many countries. We compared breastfeeding practices among women with and without a migration background in Bielefeld, Germany, using data from a birth cohort. Methods: In 2013-16, we conducted 967 standardised interviews with women aged over 18 during pregnancy or shortly after birth, collecting data on breastfeeding uptake and duration intention, as well as on socio-economic and migration background. Bivariate and multivariate analyses were performed, adjusting for clinical factors (e.g. age, parity, birthweight). Results: Breastfeeding uptake was more common among women with a migration background than among non-immigrants (88.9\% vs. 83\%, p < 0.05). It was particularly high among 2nd and 3rd generation women (92\%). Women with a migration background tended to intend to breastfeed longer than non-immigrants (6.2\% vs 7.6\% between 6 months and one year and 0.67\% vs. 2.53\% beyond one year). When controlling for clinical and socio-economic characteristics, only a statistically significant correlation between breastfeeding uptake and the opinion of the mother and of the partner with regard to breastfeeding remained, with a negative opinion decreasing the chances of uptake (OR 0.5; CI 0.25-0.79 and OR 0.2; CI 0.12-0.36, respectively). Mothers and partners of women with migration background were more likely to strongly support breastfeeding than those of non-immigrants. Duration intention was positively associated with having a migration background (1.98; CI 1.10-3.55) and negatively associated with income, with higher income decreasing likelihood of breastfeeding beyond 6 months (OR 0.6; CI 0.44-0.94). Conclusions: This study found differences in breastfeeding uptake and duration intention among women with and without a migration background. This calls for public health actions targeting different socio-economic groups if one wants to come closer to the WHO recommended breastfeeding rates. Initiatives that are inclusive of the mother and the partner of the expectant women are also worth considering.}, language = {en} } @misc{ScholaskeLindnerMatthesKurtetal., author = {Scholaske, Laura and Lindner-Matthes, Denise and Kurt, Medlin and Duman, Elif Aysimi and Sahbaz, C. and Spallek, Jacob and Entringer, Sonja}, title = {Intergenerational transmission of health disparities among Turkish-origin residents in Germany: role of maternal stress and stress biology during pregnancy. A study protocol}, series = {European Journal of Public Health}, volume = {28}, journal = {European Journal of Public Health}, number = {Suppl. 1}, issn = {1464-360X}, doi = {10.1093/eurpub/cky048.044}, pages = {S. 126}, abstract = {Background:Turkish-origin immigrants constitute one of the biggest migration groups in Germany where they exhibit higher levels of social disadvantage when compared to the majority population. Research has elucidated the underlying mechanisms by which social disadvantage is biologically embedded to impact health over the lifespan. However, relatively little is known about how its effects are transmitted across generations. Aims of the study: To elucidate the effects of maternal migration status and socioeconomic status on stress-related maternal-placental-foetal (MPF) biological processes across gestation and on subsequent infant birth and health outcomes. Methods: We are conducting a longitudinal cohort study of N = 450 child-mother dyads with serial measures across gestation and birth through the first year of life. Our proposed study population will include approximately equal numbers of Turkish-origin women in Germany, German women in Germany, Turkish women living in Turkey and their offspring. Study visits are conducted from the second trimester of pregnancy to the end of the first year of life to assess maternal socio-economic and migration-related information, psychological well-being, nutrition, medical risk variables, and MPF stress biology markers from maternal blood and saliva samples. Infant anthropometric measures, developmental outcomes and stress markers in saliva are assessed throughout the first year of life. Analyses: We will test specific hypotheses regarding the association between migration background, socioeconomic status and MPF stress biology. We will furthermore quantify the association of maternal migration background- and social disadvantage-related MPF stress biology measures on pregnancy and child health outcomes. Discussion: This is the first study on foetal programming of health disparities with a focus on Turkish-origin women in Germany. The significance and impact of this study derives from the importance of achieving a better understanding of underlying mechanisms that alter disease vulnerability in minority and disadvantaged populations.}, language = {en} } @misc{ReeskeBehrensSchumannSpallek, author = {Reeske-Behrens, Anna and Schumann, Maria and Spallek, Jacob}, title = {Integrierte Strategien zur kommunalen Gesundheitsf{\"o}rderung in multikulturellen Gesellschaften}, series = {Das Gesundheitswesen}, volume = {80}, journal = {Das Gesundheitswesen}, number = {08/09}, issn = {1439-4421}, doi = {10.1055/s-0038-1667612}, pages = {772 -- 773}, abstract = {Hintergrund: Der Zusammenhang zwischen Migration und Gesundheit ist komplex. Aktuelle Erkl{\"a}rungsmodelle f{\"u}hren Faktoren an, die bei Migranten zu gesundheitlichen Vor- aber auch Nachteilen f{\"u}hren k{\"o}nnen. Angebote der Gesundheitsf{\"o}rderung m{\"u}ssen sich - neben gezielten Maßnahmen f{\"u}r Migranten - so ausrichten, dass sie der Diversit{\"a}t der Bev{\"o}lkerung gerecht werden. Neue Chancen bieten dabei integrierte kommunale Strategien zur Gesundheitsf{\"o}rderung, die die Bedarfe der Menschen in ihren Lebenswelten adressieren. Methoden: Basierend auf theoretischen und empirischen Arbeiten sowie Praxisbeispielen aus dem Bereich Gesundheitsf{\"o}rderung und Pr{\"a}vention werden anhand von sechs Bausteinen Ans{\"a}tze f{\"u}r eine migrationssensible, integrierte kommunale Gesundheitsf{\"o}rderung entwickelt. Ergebnisse: Wesentliche Bausteine einer integrierten Gesundheitsf{\"o}rderungsstrategie beinhalten: migrationssensible Gesundheitsberichterstattung, ressort{\"u}bergreifende Vernetzung von lokalen Gesundheitsf{\"o}rderungsakteuren unter Einbindung von Migrantenorganisationen, strukturelle Verankerung von „K{\"u}mmererfunktionen" (z.B. Koordinierungsstelle Migration \& Gesundheit), Strukturentwicklung im Quartier, Qualifizierung von Fachkr{\"a}ften zu Diversit{\"a}t und Gesundheit, interkulturelle {\"O}ffnung der kommunalen Verwaltung. Schlussfolgerungen: Die strukturelle Verankerung von Gesundheit mittels integrierter kommunaler Strategien bietet neue M{\"o}glichkeiten f{\"u}r die Umsetzung von Diversity Mainstreamingprozessen, wie einer fachbereichs{\"u}bergreifenden Vernetzung und interkulturellen {\"O}ffnung der Verwaltung. Neben den sechs Bausteinen erfordert integriertes Handeln bei der Entwicklung von gesunden Lebenswelten eine diversit{\"a}tssensible Grundhaltung, interkulturelle Kompetenz und die Partizipation von Menschen mit Migrationshintergrund.}, language = {de} } @misc{FischerHoffmannLoeffleretal., author = {Fischer, Stefanie and Hoffmann, Stephanie and L{\"o}ffler, Antje and Spallek, Jacob}, title = {Ergebnisse einer Querschnittsanalyse zur {\"a}rztlichen Gesundheitsversorgung im l{\"a}ndlichen Raum}, series = {Das Gesundheitswesen}, volume = {80}, journal = {Das Gesundheitswesen}, number = {08/09}, issn = {1439-4421}, doi = {10.1055/s-0038-1667814}, pages = {S. 833}, abstract = {Hintergrund: Herausforderungen, wie die geringste Hausarztdichte Deutschlands und eine ung{\"u}nstige Altersstruktur beeinflussen die {\"a}rztliche Versorgung in strukturschwachen Regionen Brandenburgs. Das Forschungsprojekt DIGILOG untersucht im Rahmen des Gesundheitscampus Brandenburg die Zufriedenheit der {\"a}lteren Bev{\"o}lkerung mit dem Zugang zur Haus- und Facharztversorgung. Methoden: Anfang 2018 wurden per standardisiertem Fragebogen mit sowohl geschlossenen als auch offenen Fragen 3.006 zuf{\"a}llig ausgew{\"a}hlte 50 - 70-j{\"a}hrige Einwohner im Landkreis Oberspreewald-Lausitz zu soziodemografischen Merkmalen sowie zur aktuellen und k{\"u}nftigen Haus- und Facharztversorgung befragt. Die Response betr{\"a}gt 17,5\% und ergibt eine Stichprobe mit einem Durchschnittsalter von 62 Jahren (51\% weiblich). Ergebnisse: Der Zugang gilt als zufriedenstellend (Hausarzt (HA) 93\%, Facharzt (FA) 87,8\%). Es werden k{\"u}nftig Berentung, mangelnde Nachfolge und lange Wartezeiten bef{\"u}rchtet. 84\% haben im letzten Jahr einen FA konsultiert (h{\"a}ufigste: Augenarzt (93 ×), Urologe, Orthop{\"a}de (je 74 ×). Der HA ist in rund x̃ = 4 km [0 - 64] und 10 Min. [0 - 90], der FA in x̃ = 15 km [0 - 338] und 20 Min. [0 - 338] {\"u}berwiegend mit dem Auto (HA 60,9\%; FA 77\%) erreichbar. Beim HA wird 59 Min. [0 - 180], beim FA 57 Min. [0 - 240] gewartet. Schlussfolgerungen: Obwohl derzeit der Zugang trotz offener Arztstellen insgesamt noch zufriedenstellend ist, drohen in naher Zukunft Versorgungsdefizite, zeitnah besonders in der fach{\"a}rztlichen Versorgung. Neue Versorgungskonzepte, wie Community Nurses oder digitale L{\"o}sungen, k{\"o}nnten diese z.T. auffangen und Wartezeiten bei akuten Beschwerden verk{\"u}rzen.}, language = {de} } @misc{BerensMohwinkelEckertetal., author = {Berens, Eva-Maria and Mohwinkel, Lea-Marie and Eckert, Sandra van and Reder, Maren and Kolip, Petra and Spallek, Jacob}, title = {Uptake of Gynecological Cancer Screening and Performance of Breast Self-Examination Among 50-Year-Old Migrant and Non-migrant Women in Germany: Results of a Cross-Sectional Study (InEMa)}, series = {Journal of Immigrant and Minority Health}, volume = {21}, journal = {Journal of Immigrant and Minority Health}, number = {3}, issn = {1557-1920}, doi = {10.1007/s10903-018-0785-7}, pages = {674 -- 677}, abstract = {Our aim was to provide data regarding uptake of gynecological early detection measures and performance of breast self-examinations among migrant women in Germany. Cross-sectional self-reported data were collected using paper-and-pencil questionnaires. Descriptive analyses, Chi square-tests, and logistic regression were applied. Results were adjusted for educational level. Of 5387 women, 89.9\% were autochthonous, 4.1\% German resettlers, 2.8\% Turkish, 3.1\% other migrants. Participation rates regarding cancer screening differed significantly, with the lowest proportion in Turkish migrants (65.0\%), resettlers (67.8\%), other migrants (68.2\%) and autochthonous population (78.2\%). No differences in performance of breast self-examinations were detected. When adjusted for education, results indicated only slight changes in the odds to participate in screening irregularly or not at all. Results support existing evidence by showing lower participation rates in cancer screening among migrant women, but there were no differences regarding breast self-examinations. Migrant women form a potential high-risk group for late-stage diagnosis of cervical or breast cancer.}, language = {en} } @incollection{SpallekSchumannYildirim, author = {Spallek, Jacob and Schumann, Maria and Yildirim, T{\"u}lan}, title = {Pr{\"a}vention und Gesundheitsf{\"o}rderung bei Menschen mit Migrationshintergrund}, series = {Referenzwerk Pr{\"a}vention und Gesundheitsf{\"o}rderung : Grundlagen, Konzepte und Umsetzungsstrategien}, booktitle = {Referenzwerk Pr{\"a}vention und Gesundheitsf{\"o}rderung : Grundlagen, Konzepte und Umsetzungsstrategien}, editor = {Hurrelmann, Klaus and Klotz, Theodor and Richter, Matthias and Stock, Stephanie and Hurrelmann, Klaus}, edition = {5., vollst{\"a}ndig {\"u}berarbeitete Auflage}, publisher = {Hogrefe}, address = {Bern}, isbn = {3-456-85590-7}, pages = {433 -- 448}, 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, Robert}, publisher = {Springer}, address = {Berlin}, isbn = {978-3-662-54179-1}, doi = {10.1007/978-3-662-54179-1}, pages = {1 -- 12}, 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{SpallekBreckenkampKraywinkeletal., author = {Spallek, Jacob and Breckenkamp, J{\"u}rgen and Kraywinkel, Klaus and Schwabe, Wolfgang and Krieg, Volker and Greiner, Wolfgang and Damm, Oliver and Razum, Oliver}, title = {Need for nursing care support in cancer patients: Registry-linkage study in Germany}, series = {South Eastern European Journal of Public Health}, journal = {South Eastern European Journal of Public Health}, number = {11}, issn = {2197-5248}, doi = {10.4119/UNIBI/SEEJPH-2018-204}, pages = {1 -- 10}, abstract = {Aim: In Germany, very little is known about the need for assistance and nursing care support among cancer patients after hospitalization. The aim of this study was to describe nursing care support for cancer patients and to analyse whether these patients need more care assistance than other persons in need for care. Methods: This was a registry linkage study conducted in 2011. Cases were identified from the population-based cancer registry for the Muenster District in north-western Germany and in factually anonymised form linked by a semi-automatic probabilistic procedure (the standard procedure of the cancer registry) with medical examination records of patients applying for assistance and nursing care support from the regional statutory health insurance. The application records of 4,029 patients with colon, breast and prostate cancer were compared to a reference group of 13,104 non-cancer patients. Results: In only 41.7\% of colon, 45.8\% of breast and 37.4\% of prostate cancer patients was the malignancy the main underlying diagnostic cause for the application of assistance and nursing care. These patients were on average younger (mean age 71.1 vs. 76.8 years) than the non-cancer reference group, required higher levels of support (79.5 vs. 58.1\% "considerable" or higher level care need) and their applications were less likely to be rejected (odds ratios [ORs] 0.26, 0.28, and 0.31, respectively). By contrast, the proportion of successful applications and the level of support granted did not differ between multimorbid cancer patients with other main diagnoses as compared to non-cancer applicants. Conclusion: Patients with colon, breast or prostate cancer do not need per se more nursing care than non-cancer patients. Only if cancer is the main underlying diagnosis for nursing care support, higher levels of support are needed.}, language = {en} } @misc{WeckmannStrackeHaaseetal., author = {Weckmann, Gesine and Stracke, Sylvia and Haase, Annekathrin and Spallek, Jacob and Ludwig, Fabian and Angelow, Aniela and Emmelkamp, Jetske M. and Mahner, Maria and Chenot, Jean-Fran{\c{c}}ois}, title = {Diagnosis and management of non-dialysis chronic kidney disease in ambulatory care: a systematic review of clinical practice guidelines}, series = {BMC Nephrology}, journal = {BMC Nephrology}, number = {19}, issn = {1471-2369}, doi = {10.1186/s12882-018-1048-5}, pages = {18}, abstract = {Background: Chronic kidney disease (CKD) is age-dependent and has a high prevalence in the general population. Most patients are managed in ambulatory care. This systematic review provides an updated overview of quality and content of international clinical practice guidelines for diagnosis and management of non-dialysis CKD relevant to patients in ambulatory care. Methods: We identified guidelines published from 2012-to March 2018 in guideline portals, databases and by manual search. Methodological quality was assessed with the Appraisal of Guidelines for Research and Evaluation II instrument. Recommendations were extracted and evaluated. Results: Eight hundred fifty-two publications were identified, 9 of which were eligible guidelines. Methodological quality ranged from 34 to 77\%, with domains "scope and purpose" and "clarity of presentation" attaining highest and "applicability" lowest scores. Guidelines were similar in recommendations on CKD definition, screening of patients with diabetes and hypertension, blood pressure targets and referral of patients with progressive or stage G4 CKD. Definition of high risk groups and recommended tests in newly diagnosed CKD varied. Conclusions: Guidelines quality ranged from moderate to high. Guidelines generally agreed on management of patients with high risk or advanced CKD, but varied in regarding the range of recommended measurements, the need for referrals to nephrology, monitoring intervals and comprehensiveness. More research is needed on efficient management of patients with low risk of CKD progression to end stage renal disease.}, language = {en} } @misc{WeckmannHaaseSpalleketal., author = {Weckmann, Gesine and Haase, Annekathrin and Spallek, Jacob and Chenot, Jean-Fran{\c{c}}ois and Stracke, Sylvia and Angelow, Aniela}, title = {Public health implications of referral criteria for chronic kidney disease, population based analysis}, series = {European Journal of Public Healt}, volume = {28}, journal = {European Journal of Public Healt}, number = {4}, issn = {1101-1262}, doi = {10.1093/eurpub/cky218.167}, pages = {466 -- 466}, abstract = {Background: Chronic Kidney Disease (CKD) has an age-dependent prevalence of 10\% in adults. The majority of CKD patients are treated in general practice. Although international guidelines recommend referral in patients with GFR <30, the German Societies for Nephrology and Internal Medicine recommend specialist referral for all subjects with estimated glomerular filtration rate (eGFR) <45 or eGFR 45-59 ml/min/ 1,73m2 with additional risk factors. This analysis was performed to evaluate the public health implications of lowering the threshold value for referral. Methods: Data of the population based cohort Study of Health in Pomerania (SHIP-2) were analysed to estimate the proportion of subjects who meet different referral criteria, billing data to estimate actual referral rate and public health implications of implementing different referral criteria were estimated with regard to cost and health resources utilization. Results: Data of 2328 subjects from SHIP-2 (53\% female; age M = 57 Jahre, SD = 14)were analyzed. 3\% of subjects had eGFR<45ml/min/1,73m2. 6\% had an eGFR between 45-59 ml/min/1,73m2. Proposed German referral criteria were met by 8\% of subjects, with 41\% in the age group 80+ meeting referral criteria, wheras NICE and KDIGO criteria limited referral to 1-2\%. Yearly referral as estimated from billing data was ca.2\%. Results are preliminary and data comparing cost and health resources utilization will be available at the conference. Conclusions: Adherence to the proposed German referral criteria would greatly increase the number of referrals, especially in the elderly. This can lead to a major increase in cost, as well as serious problems with respect to the capacity of the nephrological workforce. Because of lack of a specific nephrological therapy in earlier stages of CKD in patients without additional risk factors, the benefit of increasing referrals in this group seems doubtful. Referral criteria for common medical conditions should be evaluated rigorously.}, language = {en} }