@misc{SchillingSpallekMauletal., author = {Schilling, Laura and Spallek, Jacob and Maul, Holger and Schneider, Sven}, title = {E-Zigaretten und Tabakzigaretten in der Schwangerschaft - eine Analyse von aktiver und passiver Exposition und Einstellung unter Schwangeren in Deutschland}, series = {14. Jahrestagung der DGEpi, 11.-13. Septmeber 2019, Ulm}, journal = {14. Jahrestagung der DGEpi, 11.-13. Septmeber 2019, Ulm}, pages = {117 -- 117}, abstract = {Hintergrund: In Deutschland greift ein Zehntel der Schwangeren zur Tabakzigarette. Gleichzeitig verbreiten sich E-Zigaretten insbesondere unter jungen Erwachsenen in Deutschland zunehmend. Das Ziel dieser Studie war es, die aktive und passive Exposition durch E-Zigaretten- und Tabakzigaretten sowie die Einstellung zur E-Zigarette unter Schwangeren in Deutschland zu erforschen. Methoden: Im Rahmen der STEP (STudy on E-cigarettes and Pregnancy) beantworteten 575 Schwangere an einer Geburtsklinik in Hamburg von April 2018 bis Januar 2019 Fragen zur E-Zigaretten- und Tabakzigarettenexposition sowie ihren Einstellungen zur E-Zigarette. Ergebnisse: Insgesamt nutzten 1,2\% der Befragten ausschließlich E-Zigaretten, 6,7\% E- und Tabakzigaretten und 20,3\% ausschließlich Tabakzigaretten vor der Schwangerschaft. In der Schwangerschaft nutzten 0,5\% E-Zigaretten und 9,1\% Tabakzigaretten. 86,9\% aller Schwangeren waren der Ansicht, dass E-Zigaretten nicht als Alternative zu Tabakzigaretten genutzt werden sollten. Befragte, die die Tabakzigarette w{\"a}hrend der Schwangerschaft nutzten, vertraten seltener diese Einstellung als Nichtnutzer (78,0\% vs. 88,0\%; p=0,045). Der aktuelle Konsum der E-Zigarette (bzw. Tabakzigarette) durch den Partner erfolgte bei 5,5\% (bzw. 24,4\%) der Befragten. 18,5\% (bzw. 9,3\%) der Partner mit E-Zigarettenkonsum (bzw. Tabakzigarettenkonsum) konsumierten zuhause. Schlussfolgerungen: Die aktive E-Zigarettenexposition ist - im Gegensatz zur aktiven Tabakzigarettenexposition - in der Schwangerschaft bisher gering. Gleichzeitig kommt eine passive Exposition durch den konsumierenden Partner von Schwangeren h{\"a}ufiger bei der E-Zigarette vor. Die Ergebnisse betonen die Wichtigkeit der weiterf{\"u}hrenden Tabakpr{\"a}vention und der Erforschung der Gesundheitsrisiken des Passivdampfes in der Schwangerschaft.}, language = {de} } @misc{SchroederHoebelSpalleketal., author = {Schr{\"o}der, Sara Lena and Hoebel, Jens and Spallek, Jacob and Knesebeck, Olaf von dem and Richter, M.}, title = {Sozio{\"o}konomische Unterschiede in der Inanspruchnahme haus- und fach{\"a}rztlicher Versorgung - Ergebnisse einer systematischen Literaturrecherche}, series = {Gesundheitswesen 2019}, volume = {81}, journal = {Gesundheitswesen 2019}, number = {08/09}, publisher = {Georg Thieme Verlag KG}, address = {Stuttgart}, doi = {10.1055/s-0039-1694561}, pages = {730 -- 730}, abstract = {Hintergrund: Sozio{\"o}konomische Ungleichheiten in der gesundheitlichen Versorgung werden h{\"a}ufig krankheitsspezifisch untersucht, w{\"a}hrend die Evidenz zu Unterschieden in der Inanspruchnahme in der Gesamtbev{\"o}lkerung bislang unzureichend ist. Ziel der Arbeit ist es, den internationalen Stand zum Zusammenhang zwischen dem Sozialstatus und der Inanspruchnahme von Haus- und Fach{\"a}rzten systematisch aufzubereiten. Methode: In den Datenbanken Medline und Web of Science wurde eine systematische Literaturrecherche durchgef{\"u}hrt, um quantitative Studien aus den Jahren 2003 bis 2018 zu identifizieren. Von 1214 Treffern werden aktuell 69 Volltexte in Hinblick auf die Einschlusskriterien {\"u}berpr{\"u}ft. Ergebnisse: Die Inanspruchnahme wird entweder als „Anzahl der Arztkontakte" gemessen oder zwischen Nutzung und Nicht-Nutzung eines Haus- oder Facharztes in einem bestimmten Zeitraum unterschieden. Die bisher gesichteten Studien deuten darauf hin, dass sich die sozio{\"o}konomischen Ungleichheiten in der Inanspruchnahme der haus- und fach{\"a}rztlichen Versorgung unterscheiden. W{\"a}hrend Fach{\"a}rzte seltener von Menschen mit niedrigem Sozialstatus aufgesucht werden, sind die Ungleichheiten bei Haus{\"a}rzten geringer und die Studien konnten entweder keine sozio{\"o}konomischen Unterschiede aufzeigen oder fanden, dass Menschen mit niedrigem Sozialstatus h{\"a}ufiger eine Prim{\"a}rversorgung in Anspruch nehmen. Diskussion: Sozio{\"o}konomische Unterschiede zu Ungunsten der sozial benachteiligten Bev{\"o}lkerung bestehen m{\"o}glicherweise deutlicher bei Fach{\"a}rzten im Vergleich zu Haus{\"a}rzten. Gerade in der Inanspruchnahme von Fach{\"a}rzten besteht daher Handlungsbedarf zur Verringerung der Ungleichheiten, um eine bedarfsgerechte Inanspruchnahme der Versorgung zu gew{\"a}hrleisten. M{\"o}gliche Gr{\"u}nde f{\"u}r die Unterschiede sollen bei einem Vergleich der Studien untersucht werden, um Implikationen f{\"u}r eine Verbesserung der Versorgung abzuleiten.}, language = {de} } @misc{WandschneiderSauzetBreckenkampetal., author = {Wandschneider, Lisa and Sauzet, Odile and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver}, title = {Kleinr{\"a}umige Merkmale und ihr Einfluss auf ein niedriges Geburtsgewicht - eine theoriegeleitete Analyse}, series = {14. Jahrestagung der DGEpi, 11-13. September, Ulm}, journal = {14. Jahrestagung der DGEpi, 11-13. September, Ulm}, pages = {113 -- 113}, abstract = {Hintergrund: Der Wohnort kann eine Dimension sozialer Ungleichheiten darstellen, und es gibt Hinweise daf{\"u}r, dass sich dieser bereits auf die perinatale Entwicklung auswirken k{\"o}nnte. Die zugrunde liegenden Wirkmechanismen sind nach wie vor unbekannt; theorie-basierte und hypothesengeleitete Analysen fehlen. Um diesen Herausforderungen zu begegnen, untersucht diese Studie, inwieweit kleinr{\"a}umige Merkmale zu einem niedrigen Geburtsgewicht beitragen, unabh{\"a}ngig von individuellen Merkmalen. Auf der Grundlage eines konzeptionellen Modells1 wurden kleinr{\"a}umige Merkmale ausgew{\"a}hlt, erhoben und deren Auswirkungen auf niedriges Geburtsgewicht analysiert. Methoden: Die Individualdaten stammen aus der Geburtskohortenstudie „Gesundheit von Babys und Kindern in Bielefeld". Die Stichprobe besteht aus 958 Frauen und ihren S{\"a}uglingen, verteilt auf 80 statistische Bezirke in Bielefeld. Kleinr{\"a}umige Daten wurden anhand von lokalen L{\"a}rmkarten, dem Emissionskataster, Google Street View und dem Melderegister erhoben. Zur Quantifizierung des Einflusses kleinr{\"a}umiger Merkmale wurde eine lineare Mehrebenenanalyse mit einer Zwei-Ebenen-Struktur (Individuen, die in statistische Bezirke eingebettet sind) durchgef{\"u}hrt. Ergebnisse: Insgesamt sind die Auswirkungen der ausgew{\"a}hlten kleinr{\"a}umigen Merkmale gering bis nicht existent, es zeigen sich keine signifikanten Effekten f{\"u}r niedriges Geburtsgewicht. Tendenziell weisen Neugeborene aus {\"a}sthetisch weniger ansprechenden und subjektiv unsicher wahrgenommenen Stadtteilen einen h{\"o}heren Anteil an niedrigem Geburtsgewicht auf. Schlussfolgerungen: Die Analyse liefert keine eindeutigen Hinweise auf negative Auswirkungen kleinr{\"a}umiger Faktoren auf ein niedriges Geburtsgewicht. Auf methodischer Seite best{\"a}tigt die Studie, dass ein angemessener Stichprobenumfang, eine zuverl{\"a}ssige Expositionsabsch{\"a}tzung und die Operationalisierung des kleinr{\"a}umigen Kontextes mit Blick auf die verf{\"u}gbaren Daten die zentralen Herausforderungen des Forschungsfeldes darstellen.}, language = {de} } @incollection{ZeebHuebnerSpallek, author = {Zeeb, Hajo and H{\"u}bner, W. and Spallek, Jacob}, title = {Migration und gesundheitliche Ungleichheit}, series = {Diversit{\"a}t und gesundheitliche Chancengleichheit}, booktitle = {Diversit{\"a}t und gesundheitliche Chancengleichheit}, editor = {Pundt, Johanna and Cacace, Mirella}, edition = {1. Auflage}, publisher = {APOLLON University Press}, address = {Bremen}, isbn = {978-3-943001-40-2}, language = {de} } @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{ReuterDiehlRichteretal., author = {Reuter, Marvin and Diehl, Katharina and Richter, Matthias and Sundmacher, Leonie and H{\"o}vener, Claudia and Spallek, Jacob and Dragano, Nico}, title = {A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes}, series = {Advances in Lifecourse Research}, volume = {Vol. 59}, journal = {Advances in Lifecourse Research}, issn = {1879-6974}, doi = {10.1016/j.alcr.2024.100593}, abstract = {Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.}, language = {en} } @misc{BammertSchuettigNovellietal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Novelli, Anna and Iashchenko, Iryna and Spallek, Jacob and Blume, Miriam and Diehl, Katharina and Moor, Irene and Dragano, Nico and Sundmacher, Leonie}, title = {The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review}, series = {International Journal for Equity in Health}, volume = {23}, journal = {International Journal for Equity in Health}, number = {1}, issn = {1475-9276}, doi = {10.1186/s12939-024-02122-6}, abstract = {Background: Besides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use. Methods: We used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the 'Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)' recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered. Results: Of the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies. Conclusions: Socioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.}, language = {en} } @misc{KnautheFieberGlauschetal., author = {Knauthe, Nadja and Fieber, Vera and Glausch, Melanie and Geissler, Mark Enrik and Dallal, Anna and Doll, Konrad and Meister, Lisa and Tallarek, Marie and Weigmann-Faßbender, Sandra and Giesemann, Nadine and Hofbauer, Christine and Bornh{\"a}user, Martin and Letsch, Anne and Ratjen, Ilka and Spallek, Jacob and St{\"o}lzel, Friederike}, title = {„Aktiv leben mit Krebs": acceptance and effect of a lowthreshold information on health behavior for cancer patients}, series = {Oncology Research and Treatment 2024 : 36. Deutscher Krebskongress. Fortschritt gemeinsam gestalten, 21.-24. Februar 2024, Berlin: ABSTRACTS}, volume = {47}, journal = {Oncology Research and Treatment 2024 : 36. Deutscher Krebskongress. Fortschritt gemeinsam gestalten, 21.-24. Februar 2024, Berlin: ABSTRACTS}, number = {1}, editor = {B{\"u}ttner, Reinhard}, issn = {2296-5262}, doi = {10.1159/000535363}, pages = {216}, abstract = {Background: In Germany, more than 4.65 million people are currently living with a cancer diagnosis. Patients can benefit from a healthy lifestyle both during and after therapy. In order to provide patients with practical and scientifically based information on health behavior, the authors developed "Aktiv leben mit Krebs" (ALMIK) using participatory program planning. Methods: A non-blinded randomized controlled trial with intervention (IG) and wait list control group (WCG) was conducted at NCT/UCC Dresden and UCCSH in Kiel in 2022/2023 with a convenience sample of n=227 patients during and after therapy (65.7 years ± 11.7, 54.2\% male). IG and WCG received a questionnaire at baseline and after 1 month. IG received the ALMIK brochure and a link to the website with videos. Changes in health literacy (HLS-EU Q) and acceptance were assessed. Result: Acceptance of ALMIK in IG was high: 94.1\% of all n=109 patients in the IG reported having used the brochure. 40.4\% had visited the website. Videos were used by 36.7\%. Almost all patients rated the brochure as understandable (97.8\%), relevant (90.3\%) and clearly presented (98.9\%). Patients also rated the website as well-structured (95.6\%) and attractively designed (97.6\%), and the videos as understandable (93.0\%) and relevant (79.1\%). Overall, 97.8\% were satisfied with the program and 98.9\% would recommend it to others. Patients of IG did not achieve higher HLS-score in comparison to WCG (p=0.75). Discussion: The brochure was used by many patients and was very well accepted. The website and videos were used less frequently, but overall by more than one-third of patients, who were also satisfied with them. Health literacy was not increased by ALMIK, which may be due to the low intervention strength. Conclusion: The high number of participants who used ALMIK indicates a high need for health behavior information for cancer patients. Patient involvement has proven to be an important component in creating well accepted program materials}, language = {en} } @misc{WandschneiderBatramZantvoortAlazeetal., author = {Wandschneider, Lisa and Batram-Zantvoort, Stephanie and Alaze, Anita and Niehues, Vera and Spallek, Jacob and Razum, Oliver and Miani, C{\´e}line}, title = {Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study}, series = {Women's Health}, volume = {18}, journal = {Women's Health}, issn = {1617-8041}, doi = {10.1177/17455057221114274}, pages = {1 -- 17}, abstract = {Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April-May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it.}, language = {en} } @misc{SpallekKaatschSpixetal., author = {Spallek, Jacob and Kaatsch, Peter and Spix, Claudia and Ulusoy, Nazan and Zeeb, Hajo and Razum, Oliver}, title = {Namensbasierte Identifizierung von F{\"a}llen mit t{\"u}rkischer Herkunft im Kinderkrebsregister Mainz}, series = {Gesundheitswesen}, volume = {68}, journal = {Gesundheitswesen}, number = {10}, issn = {1439-4421}, doi = {10.1055/s-2006-927166}, pages = {643 -- 649}, language = {de} }