@misc{ReeskeKutschmannRazumetal., author = {Reeske, Anna and Kutschmann, Marcus and Razum, Oliver and Spallek, Jacob}, title = {Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007}, series = {BMC Pregnancy and Childbirth}, volume = {11}, journal = {BMC Pregnancy and Childbirth}, issn = {1471-2393}, doi = {10.1186/1471-2393-11-63}, pages = {63}, language = {en} } @misc{ReissSpallekRazum, author = {Reiss, Katharina and Spallek, Jacob and Razum, Oliver}, title = {'Imported risk' or 'health transition'? Smoking prevalence among ethnic German immigrants from the Former Soviet Union by duration of stay in Germany - analysis of microcensus data}, series = {International Journal for Equity in Health}, volume = {9}, journal = {International Journal for Equity in Health}, issn = {1475-9276}, doi = {10.1186/1475-9276-9-15}, pages = {15}, language = {en} } @misc{BrzoskaVoigtlaenderSpalleketal., author = {Brzoska, Patrick and Voigtl{\"a}nder, Sven and Spallek, Jacob and Razum, Oliver}, title = {Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany}, series = {European Journal Epidemiology}, volume = {25}, journal = {European Journal Epidemiology}, number = {9}, issn = {1573-7284}, doi = {10.1007/s10654-010-9468-y}, pages = {651 -- 660}, language = {en} } @misc{SpallekArnoldHentscheletal., author = {Spallek, Jacob and Arnold, Melina and Hentschel, Stefan and Razum, Oliver}, title = {Cancer incidence rate ratios of Turkish immigrants in Hamburg, Germany. A registry based study}, series = {Cancer Epidemiology}, volume = {33}, journal = {Cancer Epidemiology}, number = {6}, issn = {1877-7821}, doi = {10.1016/j.canep.2009.10.006}, pages = {413 -- 418}, language = {en} } @misc{ReeskeSpallekRazum, author = {Reeske, Anna and Spallek, Jacob and Razum, Oliver}, title = {Changes in smoking prevalence among first- and second-generation Turkish migrants in Germany - an analysis of the 2005 Microcensus}, series = {International Journal for Equity in Health}, volume = {8}, journal = {International Journal for Equity in Health}, issn = {1475-9276}, doi = {10.1186/1475-9276-8-26}, pages = {26}, language = {en} } @misc{SpixSpallekKaatschetal., author = {Spix, Claudia and Spallek, Jacob and Kaatsch, Peter and Razum, Oliver and Zeeb, Hajo}, title = {Cancer survival among children of Turkish descent in Germany 1980-2005: a registry-based analysis}, series = {BMC Cancer}, volume = {8}, journal = {BMC Cancer}, issn = {1471-2407}, doi = {10.1186/1471-2407-8-355}, pages = {355}, language = {en} } @misc{SpallekSpixZeebetal., author = {Spallek, Jacob and Spix, Claudia and Zeeb, Hajo and Kaatsch, Peter and Razum, Oliver}, title = {Cancer patterns among children of Turkish descent in Germany: a study at the German Childhood Cancer Registry}, series = {BMC Public Health}, volume = {8}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/1471-2458-8-152}, pages = {152}, language = {en} } @misc{BergSpallekSchuezetal., author = {Berg, Gabriele and Spallek, Jacob and Sch{\"u}z, Joachim and Schlehofer, Brigitte and B{\"o}hler, Eva and Schlaefer, Klaus and Hettinger, Iris and Kunna-Grass, Katharina and Wahrendorf, J{\"u}rgen and Blettner, Maria}, title = {Occupational exposure of radiofrequency radiation and risk of brain tumors}, series = {American Journal of Epidemiology}, volume = {164}, journal = {American Journal of Epidemiology}, number = {6}, issn = {1476-6256}, doi = {10.1093/aje/kwj247}, pages = {538 -- 548}, language = {en} } @incollection{SpallekZeebRazum, author = {Spallek, Jacob and Zeeb, Hajo and Razum, Oliver}, title = {Conceptual Models for the Study of Migration and Health}, series = {Migration and Health: A Research Methods Handbook}, booktitle = {Migration and Health: A Research Methods Handbook}, editor = {Schenker, Marc B. and Casta{\~n}eda, X{\´o}chitl and Rodriguez-Lainz, Alfonso}, publisher = {UC Press}, address = {Los Angeles}, isbn = {978-0-520-27794-6}, language = {en} } @incollection{ReeskeSpallekRazum, author = {Reeske, Anna and Spallek, Jacob and Razum, Oliver}, title = {Migrant and Ethnic Health Observatory (MEHO): Migrant-sensitive Cancer Registration in Europe - Results of a Survey Conducted among European Cancer Registries}, series = {Network EuroLifestyle}, booktitle = {Network EuroLifestyle}, editor = {Neumann, Grit and Kirch, Wilhelm}, publisher = {Thieme}, address = {Stuttgart [u.a.]}, isbn = {978-3-13-146461-3}, pages = {11 -- 18}, language = {en} } @incollection{SpallekRazum, author = {Spallek, Jacob and Razum, Oliver}, title = {Migrants, Social Inequalities}, series = {Encyclopedia of Public Health}, booktitle = {Encyclopedia of Public Health}, editor = {Kirch, Wilhelm}, publisher = {Springer}, address = {Berlin}, isbn = {978-1-4020-5613-0}, pages = {947 -- 949}, language = {en} } @misc{DoyleBorrmannGrosseretal., author = {Doyle, Ina-Merle and Borrmann, Brigitte and Grosser, Angelique and Razum, Oliver and Spallek, Jacob}, title = {Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis}, series = {Public Health Nutrition}, journal = {Public Health Nutrition}, issn = {1475-2727}, doi = {10.1017/S1368980016002937}, pages = {1 -- 20}, language = {en} } @incollection{ForaitaSpallekZeeb, author = {Foraita, Ronja and Spallek, Jacob and Zeeb, Hajo}, title = {Directed Acyclic Graphs}, series = {Handbook of Epidemiology}, booktitle = {Handbook of Epidemiology}, editor = {Ahrens, Wolfgang and Pigeot, Iris}, publisher = {Springer}, address = {New York}, isbn = {978-0-387-09833-3}, pages = {1481 -- 1517}, language = {en} } @incollection{ReeskeSpallek, author = {Reeske, Anna and Spallek, Jacob}, title = {Obesity among migrant children and adolescents: A life-course perspective on obesity development}, series = {Health inequalities and risk factors among migrants and ethnic minorities}, booktitle = {Health inequalities and risk factors among migrants and ethnic minorities}, editor = {Ingleby, David}, publisher = {Garant}, address = {Antwerpen}, isbn = {90-441-2928-7}, pages = {237 -- 256}, language = {en} } @incollection{BerensSpallekRazum, author = {Berens, Eva-Maria and Spallek, Jacob and Razum, Oliver}, title = {Using the Wiki Technology for Knowledge Management in Public Health - The Example of MIGHEALTHNET}, series = {Network EuroLifestyle}, booktitle = {Network EuroLifestyle}, editor = {Neumann, Grit and Kirch, Wilhelm}, publisher = {Thieme}, address = {Stuttgart [u.a.]}, isbn = {978-3-13-146461-3}, pages = {19 -- 26}, language = {en} } @incollection{SpallekReeskeZeebetal., author = {Spallek, Jacob and Reeske, Anna and Zeeb, Hajo and Razum, Oliver}, title = {Models of migration and health}, series = {Handbook of migration and health}, booktitle = {Handbook of migration and health}, editor = {Thomas, Felicity}, publisher = {Edward Elgar}, address = {Cheltenham}, isbn = {978-1-78471-477-2}, pages = {44 -- 58}, language = {en} } @misc{SpallekZeebRazum, author = {Spallek, Jacob and Zeeb, Hajo and Razum, Oliver}, title = {What do we have to know from migrants' past exposure to understand their health status? A life course approach}, series = {Emerging Themes in Epidemiology}, volume = {8}, journal = {Emerging Themes in Epidemiology}, issn = {1742-7622}, doi = {10.1186/1742-7622-8-6}, pages = {6}, language = {en} } @misc{SpallekZeebRazum, author = {Spallek, Jacob and Zeeb, Hajo and Razum, Oliver}, title = {Prevention among Immigrants: The example of Germany}, series = {BMC Public Health}, volume = {10}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/1471-2458-10-92}, pages = {92}, language = {en} } @misc{ErnstReeskeSpalleketal., author = {Ernst, Sinja Alexandra and Reeske, Anna and Spallek, Jacob and Petersen, Knud and Brand, Tilman and Zeeb, Hajo}, title = {Care-related factors associated with antepartal diagnosis of intrauterine growth restriction: a case-control study}, series = {BMC Pregnancy and Childbirth}, volume = {14}, journal = {BMC Pregnancy and Childbirth}, issn = {1471-2393}, doi = {10.1186/s12884-014-0371-5}, pages = {371}, language = {en} } @misc{RazumSpallek, author = {Razum, Oliver and Spallek, Jacob}, title = {Addressing health-related interventions to immigrants: migrant-specific or diversity-sensitive?}, series = {International Journal Public Health}, volume = {59}, journal = {International Journal Public Health}, number = {6}, issn = {1661-8556}, doi = {10.1007/s00038-014-0584-4}, pages = {893 -- 895}, language = {en} } @misc{BerensReederKolipetal., author = {Berens, Eva-Maria and Reeder, Maren and Kolip, Petra and Spallek, Jacob}, title = {A cross-sectional study on informed choice in the mammography screening programme in Germany (InEMa): a study protocol}, series = {BMJ Open}, volume = {4}, journal = {BMJ Open}, number = {9}, issn = {2044-6055}, doi = {10.1136/bmjopen-2014-006145}, pages = {006145}, language = {en} } @techreport{BrzoskaVoigtlaenderReutinetal., author = {Brzoska, Patrick and Voigtl{\"a}nder, Sven and Reutin, Barbara and Yilmaz-Aslan, Y{\"u}ce and Barz, Irina and Starikow, Klara and Reiss, Katharina and Dr{\"o}ge, Angela and Hinz, Julia and Exner, Anne and Striedelmeyer, Lena and Krupa, Elzbieta and Spallek, Jacob and Berg-Beckhoff, Gabriele and Schott, Thomas and Razum, Oliver}, title = {Rehabilitative Versorgung und gesundheitsbedingte Fr{\"u}hberentung von Personen mit Migrationshintergrund in Deutschland}, publisher = {Bundesministerium f{\"u}r Arbeit und Soziales}, address = {Bonn}, pages = {143}, language = {de} } @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{ErnstBrandReeskeetal., author = {Ernst, Sinja Alexandra and Brand, Tilman and Reeske, Anna and Spallek, Jacob and Petersen, Knud and Zeeb, Hajo}, title = {Care-Related and Maternal Risk Factors Associated with the Antenatal Nondetection of Intrauterine Growth Restriction: A Case-Control Study from Bremen,Germany}, series = {BioMed Research International}, journal = {BioMed Research International}, issn = {2314-6141}, doi = {10.1155/2017/1746146}, pages = {1746146}, language = {en} } @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{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} } @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} } @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} } @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} } @misc{LampertKuntzSchneideretal., author = {Lampert, Thomas and Kuntz, Benjamin and Schneider, Sven and Spallek, Jacob}, title = {Soziale Ungleichheit und Gesundheit: die Entwicklung sozialepidemiologischer Forschung in Deutschland}, series = {Public Health Forum}, volume = {26}, journal = {Public Health Forum}, number = {3}, issn = {0944-5587}, doi = {10.1515/pubhef-2018-0062}, pages = {212 -- 215}, abstract = {Die Sozialepidemiologie befasst sich mit der sozialen Verteilung von Erkrankungsrisiken und Gesundheitschancen und den daraus resultierenden gesundheitlichen Ungleichheiten. F{\"u}r die letzten 20 Jahre l{\"a}sst sich ein kontinuierlicher Zuwachs an sozialepidemiologischen Forschungsbefunden in Deutschland konstatieren. Mit den gesundheitlichen Ungleichheiten und den sozialen Determinanten der Gesundheit adressiert die Sozialepidemiologie Kernbereiche von Public Health, deren Bearbeitung auch in Zukunft erheblichen Einfluss auf die wissenschaftlichen, politischen und praxisorientierten Perspektiven des Fachs haben d{\"u}rfte.}, language = {de} } @misc{HoffmannSpallek, author = {Hoffmann, Stephanie and Spallek, Jacob}, title = {Migration, Gesundheit und soziale Lage}, series = {Public Health Forum}, volume = {26}, journal = {Public Health Forum}, number = {4}, issn = {1876-4851}, doi = {10.1515/pubhef-2018-0107}, pages = {345 -- 348}, abstract = {Das Zusammenspiel zwischen Migration, Gesundheit und sozialer Lage ist durch verschiedene Wirkmechanismen gekennzeichnet. Die soziale Lage beeinflusst gesundheitliche Chancen und Risiken sowie die Migration selbst und tr{\"a}gt dazu bei, ob migrationsbedingte Einfl{\"u}sse auf die Gesundheit verst{\"a}rkt oder abgeschw{\"a}cht werden. Migration ist bedeutend f{\"u}r die Erkl{\"a}rung gesundheitlicher Ungleichheit, obgleich Verzerrungen und Messartefakte bei Interpretationen ber{\"u}cksichtigt werden m{\"u}ssen.}, language = {de} } @misc{BerensKaucherEckertetal., author = {Berens, Eva-Maria and Kaucher, Simone and Eckert, Sandra van and Reder, Maren and Kolip, Petra and Spallek, Jacob}, title = {Knowledge about mammography screening in Germany by education and migrant status - results of a cross-sectional study (InEMa)}, series = {Applied Cancer Research}, volume = {39}, journal = {Applied Cancer Research}, number = {6}, issn = {1980-5578}, doi = {10.1186/s41241-019-0076-1}, pages = {8}, abstract = {Background: The population-based mammography screening program (MSP) is aimed to reduce breast cancer mortality, to detect breast cancer at an early stage, and to allow for less invasive treatment. However, it also has some potential harms, such as overdiagnosis and overtreatment. Therefore, it is necessary that women receive sufficient and balanced information to enable informed decision-making. We examined knowledge about benefits and harms of the MSP in Germany among first-time invitees of different socio-demographic backgrounds. Methods: This observational study assessed knowledge about benefits and harms of the MSP among women who were invited to the MSP for the first time by six multiple choice items, using a postal survey. We investigated (i) single items of knowledge, (ii) the distribution of sufficient knowledge stratified by education, migration status and invitation, and (iii) possible determinants of sufficient knowledge by analyzing Odds Ratios (ORs) using bivariate and multivariate logistic regression. Results: In total, 5397 women included in the analyses. 46.1\% of the study population had sufficient knowledge about benefits and harms of the MSP. However, women with low educational level and migration background had higher proportions of insufficient knowledge and used most frequently the option "don't know". Women had the most difficulties answering the numeric question and the question about the target group correctly. Results from the logistic regression showed that the odds of having sufficient knowledge were higher among well-educated women (OR 3.84, 95\%CI 3.24-4.55), among women who already received the MSP invitation (OR 1.38, 95\%CI 1.20-1.59) and lowest among Turkish women (OR 0.14, 95\%CI 0.07-0.25). Conclusions: Women with low education and migration background need adapted information regarding benefits and harms of the MSP and are important target groups for further developing the information material about mammography screening to reduce disparities in knowledge and enable informed decision-making.}, language = {en} } @misc{ScholaskeBroseSpalleketal., author = {Scholaske, Laura and Brose, Annette and Spallek, Jacob and Entringer, Sonja}, title = {Perceived discrimination and risk of preterm birth among Turkish immigrant women in Germany}, series = {Social Science \& Medicine}, volume = {236}, journal = {Social Science \& Medicine}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2019.112427}, pages = {7}, abstract = {Background: Health disparities, including adverse birth outcomes, exist between Turkish immigrants and the autochthonous population in Germany. The state of research on the risk of preterm birth (PTB, defined as <37 weeks of gestation), the leading cause of infant mortality and morbidity, among Turkish immigrant women is mixed. Perceived discrimination is discussed in the context of health disparities related to migration. We examined whether PTB risk is also increased in Turkish immigrant women in Germany and whether perceived discrimination due to origin contributes to this risk. Methods: We selected a sample from the German Socio-Economic Panel (SOEP) study of German autochthonous and Turkish immigrant women who recently gave birth (between 2002 and 2016) (N = 2,525, incl. n = 217 Turkish immigrant women of which n = 111 completed an item on perceived discrimination). The included variables of central interest were immigrant status, perceived discrimination, gestational age, and socioeconomic situation. Results: Logistic regression models indicated that PTB risk was significantly higher for Turkish immigrant women than autochthonous women (OR: 2.75, 95\% CI [1.79-4.16]), even when adjusting for socioeconomic status. Within the subsample of Turkish immigrant women, perceived discrimination was related to a significantly higher PTB risk (OR: 4.91, 95\% CI [1.76-15.06]). Conclusions: Our study provides evidence for a higher PTB risk in Turkish immigrant women compared to autochthonous women in Germany. Perceived discrimination may contribute to this higher risk. The findings represent an important first step towards developing targeted interventions to improve pregnancy and birth outcomes in minority groups.}, language = {en} } @misc{LoefflerGrosserMianietal., author = {L{\"o}ffler, Antje and Grosser, Angelique and Miani, Celine and Doyle, Ina-Merle and Razum, Oliver and Spallek, Jacob}, title = {Einflussfaktoren auf die Einf{\"u}hrung von Beikost bei S{\"a}uglingen - Ergebnisse der BaBi-Geburtskohorte in Deutschland}, series = {Gesundheitswesen 2019}, volume = {81}, journal = {Gesundheitswesen 2019}, number = {08/09}, publisher = {Georg Thieme Verlag KG}, address = {Stuttgart}, doi = {10.1055/s-0039-1694423}, pages = {686 -- 686}, abstract = {Hintergrund: Im ersten Lebensjahr erfolgt ein schrittweiser {\"U}bergang von Muttermilch bzw. S{\"a}uglingsmilchnahrung zur Familienkost, wobei die erste Gabe von Beikost zwischen 5. und 7. Lebensmonat erfolgen soll. Es ist wenig bekannt {\"u}ber soziodemographische bzw. klinische Einflussfaktoren auf die Beikosteinf{\"u}hrung. Methodik: Datengrundlage der vorliegenden Untersuchung waren Baseline und erstes Follow-Up der Bielefelder Geburtskohorte BaBi (2013 - 2016, n = 777). Angaben zur Stilldauer, Einf{\"u}hrung von Beikost sowie der Getr{\"a}nkegabe vor und w{\"a}hrend der Einf{\"u}hrung von Beikost wurden telefonisch erhoben, als die S{\"a}uglinge zwischen neun und 12 Monaten alt waren. Einflussfaktoren auf die Beikosteinf{\"u}hrung wurden mittels bi-und multivariater Datenanalyse untersucht. Ergebnisse: Bei Einf{\"u}hrung der Beikost waren die S{\"a}uglinge im Mittel 5,4 ± 1,2 Monate alt. 2,6\% der S{\"a}uglinge waren j{\"u}nger als vier Monate, 12,5\% der S{\"a}uglinge waren {\"a}lter als 6,5 Monate. Lineare Regressionsanalysen zeigten eine direkte Assoziation zwischen der ausschließlichen Stilldauer bzw. dem S{\"a}uglingsalter bei letzter Mutter-/S{\"a}uglingsmilchgabe und dem Beikostbeginn (b = 0,31 [95\%KI = 0,26 - 0,36; p ≤ 0,001; b = 0,12 [95\% KI 0,07 - 0,18], p ≤ 0,001). M{\"u}tterliche Determinanten wie Alter, Bildungsstatus, Migrationsstatus, Familienstand, Parit{\"a}t, pr{\"a}nataler BMI und Rauchstatus vor und w{\"a}hrend der Schwangerschaft hatten keinen Einfluss auf den Beginn der Beikostgabe. 73,6\% der befragten Frauen gaben an, schon einmal Probleme mit dem F{\"u}ttern seit Beginn der Beikosteinf{\"u}hrung gehabt zu haben. Diskussion: In der vorliegenden Analyse erfolgte der Beikostbeginn unabh{\"a}ngig von soziodemographischen und klinischen Parametern, jedoch f{\"u}hrte l{\"a}ngeres ausschließliches Stillen bzw. l{\"a}ngere Mutter-/S{\"a}uglingsmilchgabe zu einem sp{\"a}teren Beikostbeginn. Weitere Untersuchungen sind notwendig, um Art, Umfang und m{\"o}gliche Auswirkungen berichteter Probleme bei der Beikosteinf{\"u}hrung bzw. eines verz{\"o}gerten Beikostbeginns auf Mutter und Kind zu quantifizieren.}, language = {de} } @misc{SchneiderSpallekMauletal., author = {Schneider, Sven and Spallek, Jacob and Maul, Holger and Schilling, Laura}, title = {Schwangere, Nikotin und E-Zigaretten}, series = {Gesundheitswesen 2019}, volume = {81}, journal = {Gesundheitswesen 2019}, number = {08/09}, publisher = {Georg Thieme Verlag KG}, address = {Stuttgart}, doi = {10.1055/s-0039-1694440}, pages = {691 -- 691}, abstract = {Einleitung: In Deutschland raucht noch immer etwa jede f{\"u}nfte junge Frau Tabakzigaretten. Gleichzeitig erfreuen sich E-Zigaretten auch in Deutschland insbesondere unter jungen Erwachsenen zunehmender Beliebtheit. Maternaler Nikotinkonsum birgt schwerwiegende Risiken f{\"u}r die Schwangere und das Kind. Das Ziel dieser Studie war es, den Konsum von Tabak- und E-Zigaretten sowie die Risikowahrnehmung bez{\"u}glich E-Zigaretten unter Schwangeren zu erfassen. Methode: In der STudy on E-cigarettes and Pregnancy (STEP) wurden im Rahmen eines quantitativen Studienteils f{\"u}r 575 Schwangere an einer Geburtsklinik in Hamburg von April 2018 bis Januar 2019 die Tabak- und die E-Zigarettennutzung erfasst. In einem qualitativen netnographischen Studienteil wurden insgesamt {\"u}ber 1.000 Posts in webbasierten Schwangerschaftsforen inhaltsanalytisch ausgewertet. Ergebnisse: Unmittelbar vor der Schwangerschaft nutzten 26,9\% der Schwangeren Tabakzigaretten und 7,8\% E-Zigaretten. Die Pr{\"a}valenzen reduzierten sich dann im ersten Trimenon auf 9,0\% f{\"u}r Tabakzigaretten und 0,5\% f{\"u}r E-Zigaretten. Am Ende der Schwangerschaft rauchten noch 3,1\% aller Befragten Tabakzigaretten - darunter jede Vierte mehr als 10 Zigaretten/Tag - und 0,2\% nutzten durchg{\"a}ngig E-Zigaretten. Die netnographische Analyse zeigte eine große Verunsicherung bei Schwangeren hinsichtlich der Risiken der E-Zigarettennutzung. Diskussion: Die Ergebnisse zeigten f{\"u}r das hier untersuchte Kollektiv, dass noch immer etwa jede zehnte Schwangere zu Beginn der Schwangerschaft Tabakzigaretten raucht. Dagegen ist E-Zigarettenkonsum in der Schwangerschaft nur wenig verbreitet, wenngleich er im Internet teilweise als unsch{\"a}dlich, harmlos und als Alternative zur Tabakzigarette diskutiert wird. Im Rahmen der Pr{\"a}vention sollten die potenziellen Gesundheitsgefahren und die umstrittene Wirksamkeit der E-Zigarette als Tabakentw{\"o}hnungshilfe thematisiert und von der E-Zigarettennutzung in der Schwangerschaft dringend abgeraten werden.}, language = {de} } @misc{SchillingSchneiderKarlheimetal., author = {Schilling, Laura and Schneider, Sven and Karlheim, Christoph and Maul, Holger and Tallarek, Marie and Spallek, Jacob}, title = {Perceived threats, benefits and barriers of e-cigarette use during pregnancy. A qualitative analysis of risk perception within existing threads in online discussion forums}, series = {Midwifery}, volume = {79}, journal = {Midwifery}, issn = {0266-6138}, doi = {10.1016/j.midw.2019.102533}, pages = {8}, abstract = {Objective Previous studies have shown that e-cigarettes are perceived as being less harmful than tobacco cigarettes by pregnant women and might be used to quit smoking during pregnancy. Our aim was to further explore and characterise perceived threats, benefits and barriers of e-cigarette use during pregnancy. Methods Our STudy on E-cigarettes and Pregnancy (STEP) was, among others, based on a netnographic approach of analysing existing threads in German-speaking online discussion forums dealing with perceived threats and benefits of e-cigarette use during pregnancy. For the analysis, we used an inductive-deductive qualitative content analysis. Findings Based on 25 online discussion threads containing 1552 posts, we identified perceived threats, perceived benefits and perceived barriers to e-cigarette use during pregnancy, among others, as main themes. Subthemes identified within the main theme perceived threats were severe nicotine related health risks, potential health risks of additional ingredients, relative risks and lack of knowledge and research studies. As perceived benefits, we identified possibility and facilitation of smoking cessation, harm reduction and financial benefits. Perceived barriers were lack of satisfaction and social stigma. Conclusion Our qualitative results suggest that the perception of the health threats related to e-cigarette use during pregnancy varies according to the nicotine content and the perception of relative risks compared with tobacco cigarettes. In addition to this, risk perception is defined through further health and non-health related barriers and benefits (e.g. suitability of e-cigarettes as a smoking cessation aid, social stigma).}, language = {en} } @misc{LoefflerHoffmannFischeretal., author = {L{\"o}ffler, Antje and Hoffmann, Stephanie and Fischer, Stefanie and Spallek, Jacob}, title = {Ambulante Haus- und Facharztversorgung im l{\"a}ndlichen Raum in Deutschland - Wie stellt sich die Versorgungssituation aus Sicht {\"a}lterer Einwohner im Landkreis Oberspreewald-Lausitz dar?}, series = {Das Gesundheitswesen}, volume = {83 (2021)}, journal = {Das Gesundheitswesen}, number = {1}, issn = {0941-3790}, doi = {10.1055/a-1010-6277}, pages = {47 -- 52}, abstract = {Ziel der Studie: Die medizinische Versorgung der Bundesrepublik Deutschland ist von Verteilungsproblemen gepr{\"a}gt. Vor allem in l{\"a}ndlichen Regionen droht Unterversorgung. In dieser Studie wurde untersucht, wie {\"a}ltere Bewohner des Landkreises Oberspreewald-Lausitz (OSL) des Bundeslandes Brandenburg ihre derzeitige medizinische Versorgungssituation einsch{\"a}tzen und welche W{\"u}nsche und Bedenken sie hinsichtlich deren zuk{\"u}nftigen Entwicklung im Jahr 2030 haben. Methodik: In der vorliegenden Querschnitterhebung wurden 3006 Einwohner im Alter von 50-56 Jahren und von 65-71 Jahren des Landkreises OSL befragt. Ein Fragebogen mit geschlossenem und offenem Antwortformat wurde zur Erfassung der Zielstellung eingesetzt. Ergebnisse: In der vorliegenden Untersuchung {\"a}ußerten sich die Einwohner des Landkreises OSL aktuell zufrieden oder sehr zufrieden mit der haus{\"a}rztlichen (93,1\%) und der fach{\"a}rztlichen Versorgung (83,3\%). Innerhalb des Landkreises zeigen sich in einigen Regionen Defizite. Im Gebiet Lauchhammer/Schwarzheide {\"a}ußerten sich insbesondere zur fach{\"a}rztlichen Versorgung 27,1\% der Befragten unzufrieden oder sehr unzufrieden. Alternative und erg{\"a}nzende Versorgungsangebote wie die Community Nurse sind akzeptierte, jedoch derzeit unterrepr{\"a}sentierte Maßnahmen zur Sicherstellung der zuk{\"u}nftigen medizinischen Versorgung. Schlussfolgerung: Derzeit zeigen sich Bewohner des l{\"a}ndlichen, metropolenfernen Landkreises OSL zufrieden mit der ambulanten medizinischen Versorgung, jedoch stellen sich in einigen Regionen Defizite, insbesondere bei der zuk{\"u}nftigen Facharztversorgung dar. Alternative Versorgungsangebote wie Telemedizin sind seitens der Bewohner gew{\"u}nschte Maßnahmen zur Erg{\"a}nzung und Sicherstellung der zuk{\"u}nftigen medizinischen Versorgung im l{\"a}ndlichen Raum.}, language = {de} } @misc{MianiRazumSpallek, author = {Miani, C{\´e}line and Razum, Oliver and Spallek, Jacob}, title = {Health of the offspring of immigrants: the BaBi birth cohort study}, series = {Public Health Forum}, volume = {27}, journal = {Public Health Forum}, number = {4}, issn = {1876-4851}, doi = {10.1515/pubhef-2019-0062}, pages = {298 -- 300}, abstract = {Children with a migration background are more at risk of health-related problems than those without a migration background. The German health system still does not adequately meet the challenges of on increasingly heterogeneous population, not least due to a lack of adequate epidemiological data and models. The BaBi study contributes to gaining new insights in the development of health inequalities due to cultural diversity in Germany, with a focus on pregnancy and early childhood.}, language = {en} } @misc{SchroederHoebelRoicketal., author = {Schr{\"o}der, Sara Lena and Hoebel, Jens and Roick, Julia and Markert, Jenny and Spallek, Jacob and Knesebeck, Olaf von dem and Richter, Matthias}, title = {Inequalities in the utilisation of primary and specialist physicians in Europe - a systematic review}, series = {European Journal of Public Health}, volume = {29}, journal = {European Journal of Public Health}, number = {4}, issn = {1101-1262}, doi = {10.1093/eurpub/ckz186.377}, abstract = {Background: The evidence on inequalities in health clearly shows that people with lower socioeconomic status (SES) have poorer health and higher mortality. Nevertheless, generalized evidence for inequalities in healthcare is lacking. So far, the international literature was only summarised with regard to inequalities in the utilisation of disease-specific treatment. Therefore, our aim was to synthetize the literature on socioeconomic inequalities in the utilisation of primary and specialist physicians in the general population. Methods: This systematic review searched Medline und Web of Science from 2004 to 2018. Articles that reported quantitative data on the association of SES with utilisation of primary or specialist physicians in Europe were included. Title and abstract screening were performed by two independent researchers and 50 full texts are currently sifted whether they fulfil the inclusion criteria. Results: The studies analysed utilisation of physicians in terms of probability or frequency. The initial check of the studies indicates that socioeconomic inequalities in the utilisation of physicians differ between primary and specialist care. Specialist physicians were found to be visited with a higher probability and more often by the least disadvantaged in most studies. Inequalities in the utilisation of primary physicians revealed to be more diverse with a weak pattern of equally distributed probability of GP visits and more frequent utilisation by the disadvantaged. Conclusions: The preliminary results indicate that pro-rich utilisation seems to be more pronounced in visiting specialists compared to primary health care. Aiming to reduce inequalities in healthcare, public health actions might primarily focus on reaching a needs-based consultation of specialist physicians.}, language = {en} } @misc{SauzetZolitschkaSpalleketal., author = {Sauzet, Odile and Zolitschka, Kim Alexandra and Spallek, Jacob and Breckenkamp, J{\"u}rgen and Razum, Oliver}, title = {An ego-centred approach for the evaluation of health inequalities in urban areas}, series = {European Journal of Public Health}, volume = {29}, journal = {European Journal of Public Health}, number = {4}, issn = {1101-1262}, doi = {10.1093/eurpub/ckz186.243}, pages = {1}, abstract = {Background: Neighbourhood possesses attributes, structural, physical and social, for which pathways to health inequalities could be hypothesized. Hence, neighbourhood is a complex mixture of factors which cannot be simply defined by a delineation on a map, making common definitions of neighbourhood (e.g. administrative borders) problematic. We present a new concept for the evaluation of contextual health inequalities in an urban setting. Methods: An ego-centred approach to neighbourhood effects on health allows to establish to what degree the health outcomes of a person are on average correlated to the health outcomes of his/her neighbours. This approach does not necessitate the definition of what a neighbourhood is, or of its boundaries. Using data from the BaBi birth cohort following up 958 mother-child pairs in Bielefeld/Germany we illustrate how the method provides information about the spatial structure of a possible association between unmeasured neighbourhood factors and birthweight. Spatially correlated birthweight indicates a neighbourhood effect on maternal health. Results: A parametric model of the correlation structure gives two indicators: a distance after which health outcomes are no longer correlated (practical range), and the strength of correlation (RSV). We modelled birthweight directly and residuals after controlling for (spatially correlated) covariates. After adjusting for the mother's demographics and neighbourhood characteristics, birthweights remained spatially correlated with RSV of 11\% and a practical range of 128 m. Conclusions: Modelling the spatial correlation of a health outcome provides a measure of the degree of health correlation, thus offering new evidence on the production of health inequalities while incorporating current modelling approaches. Moreover, it measures heterogeneity in a city. This could be used as an indicator for policy makers or town planners to identify areas in need of socioeconomic investment.}, 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 = {Pr{\"a}vention und Gesundheitsf{\"o}rderung. Springer Reference Pflege - Therapie - Gesundheit}, booktitle = {Pr{\"a}vention und Gesundheitsf{\"o}rderung. Springer Reference Pflege - Therapie - Gesundheit}, editor = {Tiemann, Michael and Mohokum, Melvin}, edition = {1}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-55793-8}, issn = {2662-6942}, doi = {10.1007/978-3-662-55793-8_28-1}, pages = {1 -- 13}, 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{SpallekScholaskeKurtetal., author = {Spallek, Jacob and Scholaske, Laura and Kurt, Medlin and Lindner-Matthes, Denise and Entringer, Sonja}, title = {Intergenerational transmission of health disparities among Turkish-origin immigrants in Germany: study protocol of a multi-centric cohort study (BaBi-stress and BaBeK study)}, series = {BMC pregnancy and childbirth}, volume = {20}, journal = {BMC pregnancy and childbirth}, number = {1}, doi = {10.1186/s12884-020-2853-y}, pages = {158}, abstract = {Background: Immigrants in Germany exhibit higher levels of social disadvantage when compared to the non-immigrated population. Turkish-origin immigrants constitute an important immigrant group in Germany and show disparities in some health domains that are evident from birth onwards. Several studies have shown the mechanisms by which social disadvantage is biologically embedded to affect health over the lifespan. Relatively little, however, is still known about if and how the maternal social situation is transmitted to the next generation. This study therefore aims to analyse the effects of maternal socioeconomic status and migration status on stress-related maternal-placental-fetal (MPF) biological processes during pregnancy on infant birth and health outcomes. Methods: This longitudinal cohort study of N = 144 child-mother dyads is located at two study sites in Germany and includes pregnant women of Turkish origin living in Germany as well as pregnant German women. During pregnancy, MPF stress biology markers from maternal blood and saliva samples, maternal socio-economic and migration-related information, medical risk variables and psychological well-being are assessed. After birth, infant anthropometric measures and developmental outcomes are assessed. The same measures will be assessed in and compared to Turkish pregnant women based on a collaboration with BABIP study in Istanbul. Discussion: This is the first study on intergenerational transmission of health disparities in Germany with a focus on women of Turkish-origin. The study faces similar risks of bias as other birth cohorts do. The study has implemented various measures, e.g. culturally sensitive recruitment strategies, attempt to recruit and follow-up as many pregnant women as possible independent of their social or cultural background. Nevertheless, the response rate among lower-educated families is lower. The possibility to compare results with a cohort from Turkey is a strength of this study. However, starting at different times and with slightly different recruitment strategies and designs may result in cohort effects and may affect comparability of the sub-cohorts.}, 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{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{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{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{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} }