@misc{ScholaskeSpallekEntringer, author = {Scholaske, Laura and Spallek, Jacob and Entringer, Sonja}, title = {Perceived stress and depressive symptoms during pregnancy and postpartum in Turkish-origin women living in German}, series = {Journal of Psychosomatic Research}, journal = {Journal of Psychosomatic Research}, number = {177}, issn = {0022-3999}, doi = {10.1016/j.jpsychores.2023.111570}, abstract = {Objective: People of Turkish origin (also referred to as "with a Turkish migrant background") are one of the largest migrant groups in Germany and show disparities across different stress-related health outcomes. Specifically, women of Turkish origin in Germany have a greater risk for some mental health issues and adverse pregnancy and birth outcomes compared to women without migrant background. We tested differences between women of Turkish origin and women without migrant background in self-reported pregnancy and postpartum stress experiences and depressive symptoms. Methods: 32 women of Turkish origin (mean age 29.7 years) and 77 women without migrant background (mean age 32 years) participated in a multi-site prospective cohort study with two study visits during pregnancy and one month postpartum. Women provided sociodemographic data and completed the Perceived Stress Scale (PSS) and the Center for Epidemiology - Depression (CESD) scale at each study visit. Results: Using hierarchical linear models, we found that women of Turkish origin (both first and second gen- eration) reported more perceived stress (b = 0.57, CI: 0.29-0.84, p < 0.001) and depressive symptoms (b = 0.32, CI = 0.14-0.49, p < 0.001) compared to women without migrant background across gestation. A linear regression analysis showed that there was also a significant difference in depressive symptoms at one month postpartum (b = 0.35, CI = 0.03-0.66, p < 0.05). Conclusion: Tailored psychosocial interventions are needed to address mental health needs of pregnant Turkish origin women and to intervene on the possible transmission of stress-related health disadvantages to their offspring.}, language = {en} } @misc{HoffmannTschornSpallek, author = {Hoffmann, Stephanie and Tschorn, Mira and Spallek, Jacob}, title = {Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany}, series = {International Journal for Equity in Health}, volume = {23}, journal = {International Journal for Equity in Health}, issn = {1475-9276}, doi = {10.1186/s12939-023-02079-y}, abstract = {Background Social health inequalities are still of great public health importance in modern societies. The COVID-19 pandemic may have affected social inequalities in people's health due to containment measures. As these measures particularly affected children, they might have been particularly vulnerable to increased social inequalities. The aim of the study was to describe health inequalities during the pandemic based on language delay (LD) in children in order to inform public health interventions for a population at risk of long-term health and education inequalities. Methods Data of 5-7 year old children from three consecutive school entry surveys in the German federal state of Brandenburg were used, including data compulsorily collected before the pandemic (2018/2019: n = 19,299), at the beginning of the pandemic (2019/2020: n = 19,916) and during the pandemic (2020/2021: n = 19,698). Bivariate and multivariate binary regression analyses [OR, 95\% CI] cross-sectionally examined the relationship between the prevalence of LD [yes/no] and social inequalities, operationalized by family socioeconomic position [SEP low/middle/high], migration background [native-German language/non-native German language] and length of kindergarten attendance [< 4 years/ ≥ 4 years]. Factors contributing to inequality in LD were examined by socioeconomic stratification. Results Cross-sectionally, LD prevalence has decreased overall (2018/2019: 21.1\%, 2019/2020: 19.2\%, 2020/2021: 18.8\%), and among children from both high SEP and native German-speaking families. As LD prevalence increased among children from families with low SEP and remained stable among non-native German speakers, social inequalities in LD prevalence increased slightly during the pandemic i) by low SEP (2018/2019: OR = 4.41, 3.93-4.94; 2020/2021: OR = 5.12, 4.54-5.77) and ii) by non-German native language (2018/2019: OR = 2.22, 1.86-2.66; 2020/2021: OR = 2.54, 2.19-2.95). During the pandemic, both migration background and kindergarten attendance determined LD prevalence in the high and middle SEP strata. However, the measured factors did not contribute to LD prevalence in children from families with low SEP. Conclusion Social inequalities in LD increased due to opposing trends in prevalence comparing low and high SEP families. To promote health equity across the life course, early childhood should be of interest for tailored public health actions (e.g. through targeted interventions for kindergarten groups). Further analytical studies should investigate determinants (e.g., parental investment).}, 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} } @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} } @incollection{RazumButlerSpallek, author = {Razum, Oliver and Butler, Jeffrey and Spallek, Jacob}, title = {Gesundheitliche Chancen und Risiken von Migrant*innen: Handlungsm{\"o}glichkeiten einer kommunalen Gesundheitspolitik.}, series = {Handbuch Lokale Integrationspolitik.}, booktitle = {Handbuch Lokale Integrationspolitik.}, editor = {Gesemann, Frank and Filsinger, Dieter and M{\"u}nch, Sybille}, edition = {2. Auflage}, publisher = {Springer VS}, address = {Wiesbaden}, isbn = {978-3-658-43195-2}, doi = {10.1007/978-3-658-43195-2_34-1}, pages = {1 -- 23}, abstract = {Migrant*innen haben gesundheitliche Vor- und Nachteile gegen{\"u}ber der nicht-migrierten Bev{\"o}lkerung. Der Zusammenhang zwischen Migration und Gesundheit ist mehrdimensional, weitere - insbesondere soziale - Faktoren m{\"u}ssen bei der Interpretation beachtet werden. Erkl{\"a}rungsmodelle bilden die Komplexit{\"a}t des Zusammenhangs ab. Die zentralen Modelle haben eine Perspektive auf den gesamten Lebenslauf von migrierten Menschen (vor, w{\"a}hrend und nach der Migration). Sie helfen der kommunalen Gesundheitspolitik, geeignete Daten zu erheben und wirksame Interventionen zu entwickeln.}, 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{BammertSchuettigIashchenkoetal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Iashchenko, Iryna and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Richter, Matthias and Pischke, Claudia R. and Dragano, Nico and Sundmacher, Leonie}, title = {The role of sociodemographic, psychosocial, and behavioral factors in the use of preventive healthcare services in children and adolescents: results of the KiGGS Wave 2 study}, series = {BMC Pediatrics}, volume = {24}, journal = {BMC Pediatrics}, issn = {1471-2431}, doi = {10.1186/s12887-024-04650-0}, abstract = {Background: In Germany, various preventive services are offered to children and adolescents. These include regular standardized examinations (so called U/J examinations) and several vaccinations. Although strongly recommended, most of them are not mandatory. Our aim is to identify factors associated with the use of U/J examinations and vaccination against diphtheria, hepatitis B, Hib, pertussis, polio, and tetanus. While previous research has focused on sociodemographic factors, we also include socioeconomic, behavioral, and psychosocial factors. Methods: We analyzed cross-sectional data from 15,023 participants (aged 0-17 years) of the nationwide representative KiGGS Wave 2 Survey. Participation in U/J examinations was assessed using a questionnaire, filled out by participants and/or their parents. Information on vaccination status was drawn from the participants' vaccination booklets. To identify relevant determinants for the use of preventive examinations and vaccinations, unadjusted and adjusted logistic regression models were employed with up to 16 different independent variables. Results: Various independent variables showed an association with the use of preventive services. Higher socioeconomic status, absence of migration background, and lower household size were associated with significantly higher utilization of U examinations. Parents' marital status, area of residence, behavioral and psychosocial factors yielded insignificant results for most U/J examinations. Higher vaccination rates were found for children with no migration background, with residence in eastern Germany, lower household size, and with married parents. Conclusion: This study attempted to depict the influence of sociodemographic, psychosocial, and behavioral factors on the use of several preventive services. Our results indicate that predominantly sociodemographic variables influence the use of preventive services. Further efforts should be made to investigate the interplay of different determinants of healthcare use in children and adolescents.}, language = {en} } @misc{MichalskiTetzlaffHoffmannetal., author = {Michalski, Niels and Tetzlaff, Fabian and Hoffmann, Stephanie and Spallek, Jacob and Hoebel, Jens}, title = {Der German Index of Socioeconomic Deprivation (GISD) - Ein Tool zur Verkleinerung „blinder Flecken" der Sozialepidemiologie in Deutschland?}, series = {BEWEGTE ZEITEN: LEBENSWELTEN IM WANDEL - Programm und Abstract-Band_DGMP-DGMS2023}, journal = {BEWEGTE ZEITEN: LEBENSWELTEN IM WANDEL - Programm und Abstract-Band_DGMP-DGMS2023}, pages = {S. 37}, abstract = {Hintergrund: Die Sozialepidemiologie in Deutschland konnte in den letzten Jahrzehnten in wichtigen Fragen zur internationalen Forschung aufschließen. Dennoch bestehen hierzulande im Vergleich zu vielen anderen L{\"a}ndern weiterhin einige Datenl{\"u}cken und „blinde Flecken", z.B. hinsichtlich sozialer Unterschiede in der ursachenspezifischen Mortalit{\"a}t oder dem Zusammenspiel von individuellen und sozialr{\"a}umlichen Einfl{\"u}ssen auf Gesundheit. Diese h{\"a}ngen u.a. mit fehlenden Verkn{\"u}pfungsm{\"o}glichkeiten von Gesundheits- und Sozialdaten auf Individual- und Raumebene zusammen. Der German Index of Socioeconomic Deprivation (GISD) des Robert Koch-Instituts stellt ein Maß zur Verf{\"u}gung, mit dem ein Beitrag zur Bearbeitung dieser Fragen geleistet werden kann. Methoden: Anhand von Anwendungsbeispielen werden Analysepotentiale des GISD f{\"u}r die Sozialepidemiologie in Deutschland aufgezeigt. Daf{\"u}r wird der GISD mit Daten 1) der amtlichen Statistik (z.B. Todesursachenstatistik), 2) der Schuleingangsuntersuchung sowie 3) der Studie Corona-Monitoring bundesweit (RKISOEP- 2) auf kleinr{\"a}umiger Ebene verkn{\"u}pft. Zur Anwendung kommen epidemiologische Methoden wie die Berechnung altersstandardisierter Raten und relativer Risiken, u.a. mittels (Mehrebenen-)Regressionsmodellen. Ergebnisse: 1) F{\"u}r nahezu alle h{\"a}ufigen Todesursachen zeigt der GISD regionale sozio{\"o}konomische Gradienten in der Mortalit{\"a}t. Bei Krebserkrankungen beispielsweise weisen Frauen und M{\"a}nner, die in sozio{\"o}konomisch hoch deprivierten Kreisen leben, eine bis zu dreimal h{\"o}here Lungenkrebssterblichkeit auf als jene in wohlhabenden Kreisen. 2) Hinsichtlich des allgemeinen Entwicklungsstandes von Kindern bei der Schuleingangsuntersuchung werden bei Kindern aus h{\"o}her deprivierten Gemeinden h{\"a}ufiger Entwicklungsverz{\"o}gerungen festgestellt, selbst nach Kontrolle f{\"u}r den famili{\"a}ren sozio{\"o}konomischen Status. 3) Die niedrigste COVID-19-Impfquote zeigte sich unabh{\"a}ngig von der regionalen sozio{\"o}konomischen Deprivation bei Personen mit niedrigen Bildungsabschl{\"u}ssen. Stratifiziert nach GISD-Quintilen wird ersichtlich sich, dass diese Bildungsunterschiede in der Impfquote mit steigender sozio{\"o}konomischer Deprivation der Wohnregion zunehmen. Diskussion: Der GISD bietet f{\"u}r die sozialepidemiologische Forschung ein breites Analysepotenzial. Insbesondere bei der Analyse gesundheitlicher Ungleichheit kann er f{\"u}r verschiedene Gesundheitsoutcomes und Lebensphasen zur Erschließung bislang ungenutzter Routinedatenquellen (z.B. Todesursachenstatistik) sowie Erg{\"a}nzung von Routine- und Prim{\"a}rdaten dienen, um „blinde Flecke" der Sozialepidemiologie in Deutschland zu verringern.}, language = {de} } @misc{DeSantisMuellmannPanetal., author = {De Santis, Karina Karolina and M{\"u}llmann, Saskia and Pan, Chen-Chia and Hoffmann, Stephanie and Spallek, Jacob and Haug, Ulrike and Zeeb, Hajo}, title = {Use and attitudes toward digital technologies in health context: A nationwide survey in Germany}, series = {Gesundheitswesen}, volume = {85}, journal = {Gesundheitswesen}, number = {809}, doi = {10.1055/s-0043-1770610}, pages = {812 -- 813}, abstract = {Introduction Digital technologies, such as health apps, can contribute to health promotion and disease prevention. This study investigated the use and attitudes toward digital technologies in health context using a nationwide survey. Methods Adult internet users (n=1020) from 16 federal states in Germany participated in computer-assisted telephone interviews in November 2022. Data were analyzed using descriptive statistics and regression analyses. Results Overall, 61\% of participants reported internet use in health context. Among the users, digital technologies were used to obtain general health information by 63\% and to support physical activity or to obtain information on cancer by less than 50\%. Over 90\% of users rated such technologies as easy to use and useful to obtain health information, to support physical activity or to obtain information on cancer. However, confidence in using the internet for health decisions was low. Digital technology use in health context was associated with higher eHealth literacy. Digital technologies were preferred by younger participants to support physical activity and by older participants to obtain information on cancer. Conclusion Although digital technologies are easy to use, the use of digital technologies for health promotion and disease prevention and confidence in using the internet for health decisions were low among internet users in this study. Factors that promote digital technology use for health promotion and prevention need to be investigated in further studies.}, language = {en} }