@misc{MuellmannDeSantisPanetal., author = {M{\"u}llmann, Saskia and De Santis, Karina Karolina and Pan, Chen-Chia and Hoffmann, Stephanie and Spallek, Jacob and Haug, Ulrike and Zeeb, Hajo}, title = {Attitudes towards digital technology use in health context according to a nationwide survey in Germany}, series = {37th Annual Conference of the European Health Psychology Society}, journal = {37th Annual Conference of the European Health Psychology Society}, doi = {10.13140/RG.2.2.24579.07200}, pages = {1}, abstract = {Background Digitalization has led to a proliferation of digital health technologies and online health information. We aimed to assess the attitudes towards digital technology use in health context using a nationwide survey. Methods A cross-sectional nationwide survey of a panel sample of adult internet users living in Germany was conducted in November 2022. Participants completed computer-assisted telephone interviews using a self-developed, 30-item questionnaire. Survey data were analysed using frequencies and univariate multiple regression analysis. Findings Among 1,020 participants (18-92 years, 56±16 years, 47\% female), 62\% completed up to tertiary education and 42\% reported the household income of up to 3500 Euro/month. The minority of participants reported that they trust health websites when recommended by friends and family (39\%), that their social network relies on the internet for health information (35\%), that they consider the internet as the immediate source of health information (39\%) and that they are interested in digital health technologies (40\%). Most participants (71\%) reported that they prefer to receive health information in person or on paper. The preference for such sources of health information was associated with lower eHealth literacy (β= -.12, p<.001), worse health status (β= -.08, p=.026) and female gender (β= -.08, p=.033). Discussion The trust in the internet as the source of health information and the interest in digital health technologies were low among internet users in Germany. Interventions should strengthen eHealth literacy to empower adults to find, understand and assess reliable health information on the Internet.}, language = {en} } @techreport{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and M{\"u}llmann, Saskia and Pan, Chen-Chia and Spallek, Jacob and Hoffmann, Stephanie and Haug, Ulrike and Zeeb, Hajo}, title = {Digitalisierung und Gesundheit: Ergebnisse einer zweiten bundesweiten Befragung in Deutschland}, pages = {21}, abstract = {Diese Studie untersuchte Einstellungen zu und Nutzung von digitalen Technologien im Gesundheitskontext anhand einer zweiten bundesweiten Befragung von Internetnutzenden in Deutschland. Unser Ziel war es zu ermitteln, ob und wie sich Einstellungen zu und Nutzung von digitalen Technologien im Gesundheitskontext zwei Jahre nach der ersten Befragung ver{\"a}ndert haben.}, language = {de} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data}, series = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, volume = {33}, journal = {European Journal of Public Health,16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023}, number = {2}, issn = {1101-1262}, doi = {10.1093/eurpub/ckad160.334}, abstract = {Background Health workers play a vital role in response to outbreaks under pandemic circumstances, but are also highly vulnerable to stress-related mental health issues (e.g., due to pandemic workload). There are knowledge gaps regarding temporal development of the emergence of depressive symptoms among health workers during the COVID-19 pandemic and their determinants. This study examined the trajectory of depressive symptoms and their association with a) stress perception, b) own COVID-19 infection and c) COVID-19 exposure at work. Methods This cohort study with 91 health workers (90\% female, x⎯⎯=45 years) from a German general hospital included (1) medical, nursing and therapeutic staff and (2) administrative staff. Data were collected longitudinally every month from July to December 2020. Linear multilevel models were used to evaluate associations between trajectories of depression scores (German 'General Depression Scale') with perceived stress ('Perceived Stress Scale'). Laboratory-confirmed COVID-19 infection was tested as a moderator of depressive symptom development. Trajectoires of depressive symptom modalities (e.g., somatic, emotional) were analysed stratified by COVID-19 exposure at work. Results Depression scores increased across the study period (b=.03, .02-.05). Perceived stress was associated with depression scores (b=.12, .10-.14). The presence of health workers' own COVID-19 infection was associated with a higher increase (b=.06, .01-.10). Somatic symptoms of depression increased over time only among health workers directly exposed to COVID-19 patients at work (b=.25, .13-.38). Conclusions The increase in depressive symptomatology among health workers exposed to COVID-19 in the workplace points to the need for further research. Since the infection with COVID-19 is associated with an increase of depressive symptoms across time, awareness should be raised about measures to protect against virus transmission, especially during a pandemic. Exposure to COVID-19 in the workplace is associated with increased somatic depressive symptoms.}, language = {en} } @misc{JaehnSaskoHolmbergetal., author = {Jaehn, Philipp and Sasko, Benjamin and Holmberg, Christine and Hoffmann, Stephanie and Spallek, Jacob and Kelesidis, Theodoros and Rapp, Michael A. and Westhoff, Timm H. and Ritter, Oliver and Pagonas, Nikolaos}, title = {Levels of high-density lipoprotein lipid peroxidation according to spatial socioeconomic deprivation and rurality among patients with coronary artery disease}, series = {European Journal of Preventive Cardiology}, volume = {29}, journal = {European Journal of Preventive Cardiology}, number = {15}, issn = {2047-4873}, doi = {10.1093/eurjpc/zwac068}, pages = {e343 -- e346}, abstract = {Atherosclerotic coronary artery disease (CAD) is the leading cause of mortality worldwide.1 In this context, the burden of CAD shows considerable regional heterogeneity at the national level. For example, age-standardized mortality rates varied between 106 and 178 deaths per 100 000 at the level of German federal states in 2019.2 The regional heterogeneity of cardiovascular mortality suggests that the residential environment should be considered as an important determinant for successful secondary prevention. Environmental features that were frequently drawn upon to explain regional inequalities of cardiovascular outcomes are spatial socioeconomic deprivation (SSD) and rurality.3 Rurality may impact cardiovascular health due to impaired access to healthcare services. Socioeconomically deprived neighbourhoods, on the other hand, exhibit restricted opportunities to eat healthy, exercise regularly, utilize health care, and avoid environmental hazards such as air pollution.}, language = {en} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers}, series = {International Journal of Social Psychiatry}, volume = {70}, journal = {International Journal of Social Psychiatry}, number = {1}, issn = {0020-7640}, doi = {10.1177/00207640231196737}, pages = {87 -- 98}, abstract = {Background: Healthcare workers (HCW) are at high risk to develop mental health problems during the COVID-19 pandemic because of additional work load, perceived stress, and exposure to patients with COVID-19. Currently, there are few studies on change over time in the prevalence of depressive symptoms during pandemic start among HCW. Thus, the aims of the current study were to examine whether depressive symptoms increased during the pandemic and were associated with perceived stress and own COVID-19 infection and workplace exposure to virus-infected patients. Methods: The cohort study used longitudinal data from HCW collected monthly (July 2020 till December 2020) during the first year of the pandemic before vaccination became available. The sample of n = 166 was drawn from a German hospital and included medical (e.g. nurses, therapists, and physicians) and administrative staff. Using multilevel models, we analyzed the change in depressive symptoms [assessed with General Depression Scale (GDS), a validated German version of the Center for Epidemiological Studies Depression Scale (CES-D)] and its association with perceived stress across the study period. Laboratory-confirmed own infection was tested as a potential moderator in this context. Subscales of the GDS were used to examine change over time of depressive symptom modalities (e.g. emotional, somatic, and social interactions (β, 95\% confidence interval). Results: Depression scores increased significantly during the study period (β = .03, 95\% CI [0.02, 0.05]). Perceived stress was associated with depressive symptoms (β = .12, 95\% CI [0.10, 0.14]) but did not change over time. Exposure to COVID-19 infection was associated with a higher increase of depressive symptoms (β = .12, 95\% CI [0.10, .14]). Somatic symptoms of depression increased among medical HCW with workplace exposure to COVID-19 (β = .25, 95\% CI [0.13, 0.38]), but not in administrators (β = .03, 95\% CI [-0.04, 0.11]). Conclusion: Research is needed to identify factors that promote the reduction of depressive symptoms in medical HCW with exposition to COVID-19 patients. Awareness of infection protection measures should be increased.}, language = {en} } @misc{HoffmannSchulzeLoeffleretal., author = {Hoffmann, Stephanie and Schulze, Susanne and L{\"o}ffler, Antje and Becker, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Holmberg, Christine and Rapp, Michael A. and Entringer, Sonja and Spallek, Jacob}, title = {Depressive Symptome bei Besch{\"a}ftigten im Gesundheitswesen w{\"a}hrend der COVID-19-Pandemie: Ergebnisse einer Kohortenstudie in einem Krankenhaus der Regelversorgung in Deutschland}, series = {Gesundheitswesen}, volume = {85}, journal = {Gesundheitswesen}, number = {809}, doi = {10.1055/s-0043-1770597}, abstract = {Einleitung Bisher liegen in Deutschland wenig empirische Ergebnisse zu den Auswirkungen der COVID-19 Pandemie auf die seelische Gesundheit von Besch{\"a}ftigten im Gesundheitswesen vor. In dieser Studie wird die zeitliche Entwicklung depressiver Symptome und der Zusammenhang mit a) der Stresswahrnehmung, b) der eigenen COVID-19-Infektion und c) der arbeitsplatzbezogenen COVID-19-Exposition untersucht. Methoden Die Kohortenstudie mit 91 Besch{\"a}ftigten (90\% wbl, x̅=45 Jr) eines Krankenhauses schloss (1) medizinisches, pflegerisches und therapeutisches sowie (2) administratives Personal im Zeitraum von Juli 2020 bis Dezember 2020 ein. Gemischte Modelle analysierten zeitliche Depressionswerte ('Allg. Depressionsskala') mit wahrgenommenem Stress ('Perceived Stress Scale'). Eine eigene COVID-19-Infektion (Laborbefund) wurde als Moderator getestet. Die zeitliche Entwicklung von Symptommodalit{\"a}ten (u.a. somatisch) wurde nach beruflicher Exposition analysiert. Ergebnisse Die Depressionswerte stiegen insgesamt w{\"a}hrend des Studienzeitraums an (b=.03, .02-.05). Stressempfinden war mit depressiven Symptomen assoziiert (b=.12, .10-.14). Eine eigene Infektion war mit einem h{\"o}heren Anstieg assoziiert (b=.06, .01-.10). Somatische Depressionssymptome nahmen nur bei beruflichem Kontakt mit COVID-19 zu (b=.25, .13-.38). Schlussfolgerung Die Zunahme somatischer depressiver Symptome bei Besch{\"a}ftigten mit beruflichem Kontakt zu COVID-19 zeigt einen Bedarf an Forschung {\"u}ber und Ressourcen f{\"u}r Gesundheitsschutz und -f{\"o}rderung. Das Bewusstsein f{\"u}r Schutzmaßnahmen sollte gest{\"a}rkt werden.}, language = {de} } @misc{RattayBlumeWachtleretal., author = {Rattay, Petra and Blume, Miriam and Wachtler, Benjamin and Wollgast, Lina and Spallek, Jacob and Hoffmann, Stephanie and Sander, Lydia and Herr, Raphael and Herke, Max and Reuter, Marvin and Novelli, Anna and H{\"o}vener, Claudia}, title = {Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study}, series = {PloS one}, volume = {17}, journal = {PloS one}, number = {4}, issn = {1932-6203}, doi = {10.1371/journal.pone.0266463}, abstract = {Objective Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family's socioeconomic position and adolescents' self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants. Methods Using data from wave 2 of the"German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents' subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70\% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained. Conclusion The analysis revealed how a family's position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).}, language = {en} } @misc{WachtlerHoffmannBlumeetal., author = {Wachtler, Benjamin and Hoffmann, Stephanie and Blume, Miriam and Rattay, Petra and Herr, Raphael and Deindl, Christian and Sundmacher, Leonie and Richter, Matthias and Spallek, Jacob and Lampert, Thomas}, title = {The impact of the family on health inequalities in children - A systematic scoping review}, series = {European Journal of Public Health}, volume = {30}, journal = {European Journal of Public Health}, number = {Supplement_5}, publisher = {Univ. Press}, address = {Oxford}, issn = {1101-1262}, doi = {10.1093/eurpub/ckaa166.898}, pages = {1}, abstract = {Background Health inequalities in school-aged children and adolescents were repeatedly reported across Europe but less is known about the contextual and compositional factors of families that might influence and reproduce those health inequalities. In this systematic scoping review we aim to provide a comprehensive overview of the available international literature on the mediating and moderating influence of the family on health inequalities in children and adolescents in Europe and North America. Methods This review follows the PRISMA guidelines for scoping reviews. After defining the research question a search strategy was developed in cooperation with a scientific librarian and the study protocol was registered. A search of three databases (Pubmed, Scopus, PsycINFO) was conducted to identify relevant literature in English or German published between the year 2000 and 2019. A qualitative data charting process was used to extract the relevant data. Results In total 11.838 records were identified through the multi database search (Pubmed n = 6370, PsycINFO n = 3505, Scopus n = 1963). After elimination of duplicates and records from excluded countries, 8862 abstracts were screened by two researchers independently. Different cluster of evidence of family influences on health inequalities were identified: Parental behaviors and children's obesity, parents' smoking and drinking habits and adolescents' risk behaviors, parenting style and children's common mental disorders, parental resources and children's quality of life. Conclusions There are different aspects of family's contextual and compositional characteristics on health inequalities identifiable in the international literature. These characteristics might be new targets for family-focused health promotion strategies. Key messages: -A systematic scoping review found different family aspects that influence health inequalities in children and adolescents. - The identified family traits are promising targets for family-focused health promotion strategies to reduce health inequalities.}, language = {en} } @techreport{WachtlerHoffmannRattayetal., author = {Wachtler, Benjamin and Hoffmann, Stephanie and Rattay, Petra and Sander, Lydia}, title = {Systematic review of qualitative and quantitative studies on the mediating and moderating role of family characteristics on health inequalities in school-aged children and adolescents in countries with developed economies}, publisher = {National Institute for Health Research - PROSPERO}, pages = {4}, abstract = {PROSPERO International prospective register of systematic reviews: registered study protocol. Review question: Which family characteristics mediate or moderate the association between the family's socioeconomic position and health in school-aged children and adolescents in countries with developed economies?}, language = {en} } @misc{HoffmannSanderBlumeetal., author = {Hoffmann, Stephanie and Sander, Lydia and Blume, Miriam and Schneider, Sven and Herke, Max and Matos Fialho, Paula M. and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and Lampert, Thomas and Spallek, Jacob}, title = {Do families have moderating or mediating effects on early health inequalities? A scoping review}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Supplement_3}, publisher = {Oxford University Press}, doi = {10.1093/eurpub/ckab165.506}, abstract = {Background During early childhood, families have a crucial impact on children's health behaviour, health, and development (bhd). However, a family's socioeconomic position (SEP) determines both the parental behaviour, living conditions, and child health. To understand how family characteristics may influence the development of health inequalities, this scoping review synthesised research on their mediating and moderating effects. Methods The review followed the guidelines of the PRISMA Extension for Scoping Reviews. The search included German and English peer-reviewed articles published between January 1st, 2000 and December 19th, 2019. The search in PubMed, PsycINFO, and Scopus used both free text terms in the title/abstract and index terms within linked keyword blocks: (1) family characteristics, (2) inequalities, (3) income, education, occupation, (4) bhd, (5) newborn, infant, toddler, preschooler. Two researchers independently examined eligibility for inclusion in two rounds (title/abstract; full-text). Results Of 7,089 articles identified, ten sources were included that studied family characteristics and health inequalities among 0-6 years olds. Parental rules, stress, and screentime, and TV in bedroom showed mediating effects on inequalities in behaviour problems or children's screentime. Families' negativity, single parenthood, and the number of children in the household moderated differences in impairment, health, behaviour problems, development or breastfeeding initiation. Conclusions The effect of family characteristics on early health inequalities has been sparsely investigated. The evidence supported models of family stress and investment. Further research is needed to comprehensively understand this association. Key messages Family characteristics contribute to health inequalities. Taking families' stress and investment into account could improve targeted prevention efforts aimed at reducing health inequalities.}, language = {en} }