TY - GEN A1 - Blume, Miriam A1 - Rattay, Petra A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Sander, Lydia A1 - Herr, Raphael A1 - Richter, Matthias A1 - Moor, Irene A1 - Dragano, Nico A1 - Pischke, Claudia R. A1 - Iashchenko, Iryna A1 - Hövener, Claudia A1 - Wachtler, Benjamin T1 - Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics T2 - International Journal of Environmental Research and Public Health N2 - This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence. KW - health inequalities KW - socioeconomic position KW - health KW - health behavior KW - moderation KW - mediation KW - school-age parenting KW - parent-child relationship KW - family conflict Y1 - 2021 UR - https://www.mdpi.com/1660-4601/18/15/7739 U6 - https://doi.org/10.3390/ijerph18157739 SN - 1660-4601 VL - 18 IS - 15 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Schiebel, Juliane A1 - Hufert, Frank A1 - Gremmels, Heinz-Detlef A1 - Spallek, Jacob T1 - COVID-19 among Healthcare Workers: A Prospective Serological-Epidemiological Cohort Study in a Standard Care Hospital in Rural Germany T2 - International Journal of Environmental Research and Public Health N2 - 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. KW - SARS-CoV-2 KW - immunity KW - antibody KW - healthcare KW - staff KW - COVID-19 KW - seroprevalence KW - pandemic Y1 - 2021 UR - https://www.mdpi.com/1660-4601/18/20/10999 U6 - https://doi.org/10.3390/ijerph182010999 SN - 1660-4601 VL - 18 IS - 20 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Blume, Miriam A1 - Schneider, Sven A1 - Herke, Max A1 - Matos Fialho, Paula Mayara A1 - Pischke, Claudia R. A1 - Schüttig, Wiebke A1 - Lampert, Thomas A1 - Spallek, Jacob T1 - Do families have moderating or mediating effects on early health inequalities? A scoping review T2 - European Journal of Public Health N2 - 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. KW - Family KW - health inequalities KW - moderation KW - mediation KW - scoping review KW - early childhood Y1 - 2021 U6 - https://doi.org/10.1093/eurpub/ckab165.506 VL - 31 IS - Supplement_3 PB - Oxford University Press ER - TY - GEN A1 - Herke, Max A1 - Moor, Irene A1 - Winter, Kristina A1 - Hack, Miriam A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Hilger-Kolb, Jennifer A1 - Herr, Raphael A1 - Pischke, Claudia R. A1 - Dragano, Nico A1 - Novelli, Anna A1 - Richter, Matthias T1 - Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review T2 - BMJ Open N2 - Objectives: To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies. Design: Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities. Results: Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes. Conclusions: School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes. KW - community child health KW - health policy KW - public health Y1 - 2022 UR - https://pubmed.ncbi.nlm.nih.gov/35105578/ U6 - https://doi.org/10.1136/bmjopen-2021-052925 SN - 2044-6055 VL - 12 IS - 2 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Wachtler, Benjamin A1 - Blume, Miriam A1 - Schneider, Sven A1 - Herke, Max A1 - Pischke, Claudia R. A1 - Matos Fialho, Paula Mayara A1 - Schuettig, Wiebke A1 - Tallarek, Marie A1 - Lampert, Thomas A1 - Spallek, Jacob T1 - Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high‑income countries – a scoping review T2 - BMC Public Health N2 - Background: By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children’s health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. Methods: This review followed the methodology of “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews”. To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator “AND”: (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. Results: The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent–child conflicts) are identified to have mediating or moderating effects. While families’ living conditions (i.e., TVs in children’s bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. Conclusion: Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children’s health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth. KW - Child KW - family KW - health KW - Health status disparities KW - infant KW - Socioeconomic factors KW - Socioeconomic health inequalities Y1 - 2022 UR - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12603-4 U6 - https://doi.org/10.1186/s12889-022-12603-4 SN - 1471-2458 VL - 22 SP - 1 EP - 14 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany T2 - Health & Place N2 - 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. KW - Health inequalities KW - Spatial analysis KW - Regional deprivation KW - Rurality KW - Developmental delay KW - Children Y1 - 2022 UR - https://www.sciencedirect.com/science/article/pii/S1353829222000557 U6 - https://doi.org/10.1016/j.healthplace.2022.102794 SN - 1353-8292 VL - 75 ER - TY - GEN A1 - Rattay, Petra A1 - Blume, Miriam A1 - Wachtler, Benjamin A1 - Wollgast, Lina A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Herr, Raphael A1 - Herke, Max A1 - Reuter, Marvin A1 - Novelli, Anna A1 - Hövener, Claudia T1 - 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 T2 - PloS one N2 - 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). KW - Socioeconomic position KW - self-rated health KW - adolescents KW - familial determinants KW - health inequalities Y1 - 2022 UR - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266463 U6 - https://doi.org/10.1371/journal.pone.0266463 SN - 1932-6203 VL - 17 IS - 4 ER - TY - GEN A1 - Jaehn, Philipp A1 - Sasko, Benjamin A1 - Holmberg, Christine A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Kelesidis, Theodoros A1 - Rapp, Michael A. A1 - Westhoff, Timm H. A1 - Ritter, Oliver A1 - Pagonas, Nikolaos T1 - Levels of high-density lipoprotein lipid peroxidation according to spatial socioeconomic deprivation and rurality among patients with coronary artery disease T2 - European Journal of Preventive Cardiology N2 - 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. KW - spatial socioeconomic deprivation KW - rurality KW - coronary artery disease KW - lipoprotein lipid peroxidation Y1 - 2022 UR - https://pubmed.ncbi.nlm.nih.gov/35574936/ U6 - https://doi.org/10.1093/eurjpc/zwac068 SN - 2047-4873 VL - 29 IS - 15 SP - e343 EP - e346 ER - TY - GEN A1 - Herr, Raphael A1 - De Bock, Freia A1 - Diehl, Katharina A1 - Wiedemann, Eva A1 - Sterdt, Elena A1 - Blume, Miriam A1 - Hoffmann, Stephanie A1 - Herke, Max A1 - Reuter, Marvin A1 - Iashchenko, Iryna A1 - Schneider, Sven T1 - Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers’ BMI in Germany T2 - BMC Public Health N2 - Background The number of obese children is rising worldwide. Many studies have investigated single determinants of children’s body mass index (BMI), yet studies measuring determinants at different potential levels of influence are sparse. The aim of this study is to investigate the independent role of parental socioeconomic position (SEP), additional family factors at the micro level, as well as early childhood education and care (ECEC) centre characteristics at the meso level regarding BMI. Methods Analyses used the baseline data of the PReschool INtervention Study (PRINS) including up to 1,151 children from 53 ECEC centres. Multi-level models first estimated the associations of parental SEP indicators (parental school education, vocational training, and household income) with the children’s standard deviation scores for BMI (SDS BMI, standardised for age and gender). Second, structural (number of siblings), psychosocial (strained family relationships), and nutrition behavioural (soft-drink consumption, frequency of fast-food restaurant visits) family factors at the micro level were included. Third, characteristics of the ECEC centre at the meso level in terms of average group size, the ratio of overweight children in the group, ECEC centre type (all-day care), and the location of the ECEC centre (rural vs urban) were included. All analyses were stratified by gender and adjusted for age, migration background, and parental employment status. Results Estimates for boys and girls appeared to differ. In the full model, for boys the parental SEP indicators were not related to SDS BMI. Factors related to SDS BMI in boys were: two or more siblings; B = -.55; p = 0.045 [ref.: no sibling]), the characteristics of the ECEC centre in terms of average group size (20 – 25 children; B = -.54; p = 0.022 [ref.: < 20 children]), and the ratio of overweight children (more overweight children B = -1.39; p < 0.001 [ref.: few overweight children]). For girls the number of siblings (two and more siblings; B = .67; p = 0.027 [ref.: no sibling]) and average group size (> 25 children; B = -.52; p = 0.037 [ref.: < 20 children]) were related to SDS BMI. Conclusions The BMI of preschool children appears to be associated with determinants at the micro and meso level, however with some gender differences. The identified factors at the micro and meso level appear largely modifiable and can inform about possible interventions to reduce obesity in preschool children. KW - BMI KW - Obesity KW - Preschool children KW - ECEC centres KW - Kindergarten KW - Meso level KW - Socioeconomic position Y1 - 2022 UR - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13814-5 U6 - https://doi.org/10.1186/s12889-022-13814-5 SN - 1471-2458 VL - 22 SP - 1 EP - 13 ER - TY - GEN A1 - Matos Fialho, Paula Mayara A1 - Dragano, Nico A1 - Reuter, Marvin A1 - Deindl, Christian A1 - Schleberger, Sarah A1 - Metzendorf, Maria-Inti A1 - Hoffmann, Stephanie A1 - Diehl, Katharina A1 - Wachtler, Benjamin A1 - Schüttig, Wiebke A1 - Herke, Max A1 - Richter, Matthias A1 - Pischke, Claudia R. T1 - School-to-work and school-to-university transition and health inequalities among young adults: a scoping review T2 - BMJ Open N2 - Objectives The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16–24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours. Design Scoping review. Study selection Relevant literature was systematically searched following the methodological framework proposed by Arksey and O’Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered. Data extraction To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment). Results A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible. Conclusions This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited. KW - School-to-work transition KW - school-to-university transition KW - health inequalities KW - young adults KW - scoping review Y1 - 2022 UR - https://bmjopen.bmj.com/content/12/7/e058273 U6 - https://doi.org/10.1136/bmjopen-2021-058273 SN - 2044-6055 VL - 12 IS - 7 SP - e058273 ER - TY - GEN A1 - Reuter, Marvin A1 - Herke, Max A1 - Richter, Matthias A1 - Diehl, Katharina A1 - Hoffmann, Stephanie A1 - Pischke, Claudia R. A1 - Dragano, Nico T1 - Young people’s health and well-being during the school-to-work transition: a prospective cohort study comparing post-secondary pathways T2 - BMC Public Health N2 - Background: At the end of secondary education, young people can either start vocational training, enter university, directly transition to employment or become unemployed. Research assumes that post-secondary pathways have immediate and/or long-term impacts on health and well-being, but empirical investigations on this are scarce and restricted to few countries. Therefore, this study traced the development of health and well-being throughout the highly institutionalised school-to-work transition (STWT) in Germany. Methods: We used longitudinal data of the National Educational Panel Study (NEPS), a representative sample of 11,098 school-leavers (50.5% girls) repeatedly interviewed between 2011 and 2020. We estimated the effect of post-secondary transitions on self-rated health and subjective well-being by applying fixed-effects (FE) regression, elimi-nating bias resulting from time-constant confounding and self-selection into different pathways. A multiple-sample strategy was used to account for the increasing diversity of STWTs patterns. Models were controlled for age, as well as household and residential changes to minimise temporal heterogeneity. Results: Findings indicate that leaving school was good for health and well-being. Compared with participants who did not find a training position after school, direct transitions to vocational training or university were linked to higher absolute levels of health and well-being, but also to a lower relative decline over time. Furthermore, upward transi-tions (e.g. to programs leading to better education or from unemployment to employment) were associated with improvements in health and well-being, while downward transitions were followed by deteriorations. Conclusion: Findings suggest that school-leave is a sensitive period and that post-secondary pathways provide young people with different abilities to maintain health and well-being. Youth health interventions might benefit when setting a stronger focus on unsuccessful school-leavers. KW - School-to-work transition KW - Institutional context KW - Vocational training KW - Apprenticeship KW - University KW - Prevocational preparation KW - Self-rated health KW - Subjective well-being KW - National Educational Panel Study KW - NEPS Y1 - 2022 U6 - https://doi.org/10.1186/s12889-022-14227-0 SN - 1471-2458 VL - 22 SP - 1 EP - 13 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Regionale sozioökonomische Deprivation, Ruralität und kindliche Entwicklung: Analyse von Daten der Schuleingangsuntersuchung des Bundeslandes Brandenburgs T2 - 17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK N2 - Einleitung Die gesundheitliche Entwicklung von Kindern wird neben der sozioökonomischen Position (SEP) der Familie auch von Merkmalen der Lebensumgebung geprägt. Ruralität oder regionale sozioökonomische Deprivation werden als mögliche unabhängige Einflussgrößen postuliert, ohne dass bisher ausreichende empirische Ergebnisse vorliegen. In dieser Studie wurde untersucht, ob regionale sozioökonomische Deprivation und Ruralität unabhängig von familiärer SEP mit der Entwicklung von Kindern assoziiert sind. Methoden Daten des Sozialpädiatrischen Entwicklungsscreenings im Rahmen der Einschulungsuntersuchungen aus dem Jahr 2018/2019 in Brandenburg (n=22.801 Kinder) wurden verknüpft mit Daten zur regionalen Bevölkerungsdichte (Ruralität) sowie mit dem German Index of Socioeconomic Deprivation (regionale Deprivation). Mittels gemischter Modelle wurde der Zusammenhang einer Allgemeinen Entwicklungsverzögerung (AEV) mit Ruralität und mit regionaler Deprivation analysiert (OR=Odds Ratio (95% Konfidenzintervall)), wobei für familiäre SEP (hoch, mittel, niedrig) adjustiert und nach Geschlecht (M=Mädchen, J=Jungen) stratifiziert wurde. Ergebnisse Kinder mit hoher familiärer SEP zeigten geringere Chancen einer AEV als Kinder mit mittlerer familiärer SEP (ORM=4,26(3,14-5,79); ORJ=3,46(2,83-4,22)) und niedriger familiärer SEP (ORM=16,58(11,90-23,09); ORJ=12,79(10,13-16,16)). Größere regionale Deprivation war unabhängig von familiärer SEP und Ruralität mit AEV assoziiert (ORM=1,35(1,13-1,62); ORJ=1,20(1,05-1,39)). Neben familiärer SEP und regionaler Deprivation zeigte Ruralität keine Assoziation mit AEV. Schlussfolgerung Neben der familiären SEP wirkt sich die regionale sozioökonomische Deprivation auf Entwicklungsverzögerungen von Kindern aus. Sozialepidemiologie und Public Health sollten daher neben den individuellen sozioökonomischen Voraussetzungen auch die regionalen sozioökonomischen Bedingungen als Determinante der gesundheitlichen Entwicklung über den Lebenslauf berücksichtigen. Y1 - 2022 UR - https://www.researchgate.net/publication/364213456_Regionale_soziookonomische_Deprivation_Ruralitat_und_kindliche_Entwicklung_Analyse_von_Daten_der_Schuleingangsuntersuchung_des_Bundeslandes_Brandenburgs ER - TY - GEN A1 - Rattay, Petra A1 - Blume, Miriam A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Herr, Raphael A1 - Herke, Max A1 - Reuter, Marvin A1 - Novelli, Anna A1 - Hövener, Claudia T1 - Socioeconomic position and self-rated health among adolescents: the mediating role of the family T2 - European Journal of Public Health N2 - Background Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining adolescents’ health inequalities. The study aimed to explore whether the association between socioeconomic position and self-rated health (SRH) was mediated by familial determinants. Methods Using data from wave 2 of the KiGGS study (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of parents’ education, occupation, income, socioeconomic position index, and adolescents’ subjective social status on SRH into direct effects and indirect effects through familial determinants (family cohesion, parenting styles, parental well-being, stress, obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on SRH 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 of parental education, the socioeconomic position index and subjective social status with SRH were also mediated by familial determinants (family cohesion, parental smoking and obesity). However, a significant direct effect of subjective social status remained. Conclusions The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions, community-based strategies, as well as programs to improve parenting and family functioning. KW - Socioeconomic position KW - self-rated health KW - adolescents KW - family Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.580/6765541?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.580 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Rattay, Petra A1 - Blume, Miriam A1 - Hövener, Claudia A1 - Schneider, Sven A1 - Moor, Irene A1 - Pischke, Claudia R. A1 - Schüttig, Wiebke A1 - De Bock, Freia A1 - Spallek, Jacob T1 - Do family characteristics explain a social gradient in overweight in early childhood? T2 - European Journal of Public Health N2 - Background Children's overweight is associated with many factors, including their living situation, in particular their family's socioeconomic position (SEP) and family characteristics. Research on the extent to which family characteristics account for a social gradient in overweight in early life is scarce. This study evaluated whether family characteristics explain SEP differences in the risk of overweight in early childhood. Methods The study used baseline data of 3-6 year-old children (n = 1,116) from the intervention ‘Ene mene fit’ conducted at kindergartens in Baden-Württemberg, Germany. Data included overweight (body mass index > 90 percentile) and parents’ reports on their education and family characteristics associated with overweight (child consumes: sweets in front of TV, soft drinks; family joined time: outdoor, breakfast, sports; cooking; child sets table; role model). Model-based single mediation analyses decomposed the total effect of highest parental education on overweight into direct (unmediated) and indirect (mediated) effects (OR, 95% CI). Results Girls and boys with low parental education had higher odds for overweight than children with high/medium education. Among boys, low education influenced the risk of overweight via indirect effects of i. ‘sweets consumption in front of TV’ (OR = 1.31, 1.05-1.59) and ii. ‘no joined sports’ (OR = 1.14, 1.00-1.44). The direct effect of low education only remained significant when ‘no joined sports’ was considered (OR = 2.19, 1.11-5.19). Among girls, family characteristics measured here did not explain SEP differences in overweight. Conclusions The family characteristics ‘sweets consumption in front of TV’ and ‘no joined sports’ contribute to inequalities in overweight among boys, but not among girls. Therefore, more gender-sensitive research is needed to identify family risk and protective characteristics that explain health inequalities among both boys and girls. KW - family characteristics KW - social gradient KW - obesity KW - early childhood Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.581/6765540?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.581 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Do regional characteristics predict developmental delay? Analyses of German school entry examination T2 - European Journal of Public Health N2 - Background Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP. Methods The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP. Results Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP. Conclusions In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP. KW - regional characteristics KW - developmental delay KW - school entry examination KW - Germany Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.342/6766047?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.342 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - RPRT A1 - Goldfriedrich, Martin A1 - Hoffmann, Stephanie A1 - Müller, Yvonne A1 - Schmidt, Andrea C. A1 - Spallek, Jacob A1 - Stroß, Annette M. A1 - Tallarek, Marie ED - Goldfriedrich, Martin ED - Hurrelmann, Klaus T1 - Konzeptpapier für einen Modellstudiengang „Gesundheitspädagogik und Gesundheitsdidaktik" N2 - Angesichts der immer stärker werdenden Diskussion um die Bedeutung von Gesundheit für den schulischen und außerschulischen Bildungs- und Lernprozess und der Risiken wachsender gesundheitlicher Ungleichheit bei Kindern und Jugendlichen (Hurrelmann/Richter 2013, Lampert et al. 2019) ist die Etablierung eines Studienganges „Gesundheitspädagogik und Gesundheitsdidaktik“ längst überfällig und von besonderer Bedeutung für gesundheitliche Chancengleichheit (Goldfriedrich & Hurrelmann, 2021a; 2021b). Dieses Konzeptpapier stellt einen Modellstudiengang vor, bei dem insbesondere die Vermittlungsebenen – also die gesundheitsdidaktischen Gegenstandsbereiche – im Vordergrund stehen. Die Ausarbeitungen des Entwurfs basieren auf der Grundlage politischer Bestrebungen, der bisherigen Forschung zur Gesundheitspädagogik und Gesundheitsdidaktik, den Erkenntnissen der Erziehungs- und Gesundheitswissenschaften sowie wissenschaftlichen und interprofessionellen Beiträgen des Netzwerks Gesundheitsdidaktik (bestehend aus 33 Expert*innen aus 24 Fachbereichen). KW - Gesundheitspädagogik KW - Gesundheitsdidaktik KW - Didaktik KW - Erziehungswissenschaften KW - Gesundheitswissenschaften KW - Lehrerbildung KW - Außerschulischer Lernort KW - Curriculum KW - Curriculumforschung Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:gbv:547-202200367 UR - https://www.db-thueringen.de/receive/dbt_mods_00052342 PB - Universität CY - Erfurt ER - TY - RPRT A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Digitalisierung und Gesundheit: Ergebnisse einer zweiten bundesweiten Befragung in Deutschland N2 - 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 verändert haben. Y1 - 2024 UR - https://www.researchgate.net/publication/377635793_Digitalisierung_und_Gesundheit_Ergebnisse_einer_zweiten_bundesweiten_Befragung_in_Deutschland ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Spallek, Lena A1 - Bangert, Benjamin A1 - Dragano, Nico A1 - Ben-Shlomo, Yoav A1 - Spallek, Jacob T1 - Area-level living environment and developmental delay in early childhood : a scoping review protocol for examining life course theories and empirical research. T2 - Open Science Framework Y1 - 2024 UR - https://osf.io/rx2ek/ U6 - https://doi.org/10.17605/OSF.IO/RX2EK SP - 1 EP - 16 ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Muellmann, Saskia A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Digitisation and health: Second nationwide survey of internet users in Germany T2 - Digital Health N2 - Objective: Rapid digitisation of health occurred during the COVID-19 pandemic worldwide. In October 2020, we conducted a survey on digital health technology use in Germany. This study aimed to conduct a second survey to investigate in more detail the internet use in health context and digital technology use for health promotion and disease prevention in Germany. Methods: A cross-sectional, nationwide telephone survey was conducted in November 2022. Anonymous data on internet and digital technology use, digital health literacy, and sociodemographic characteristics were analysed using descriptive statistics and binary logistic regressions. Results: The 1020 participants were aged 18–92 years, 53% were male, 62% completed primary or secondary education, 71% resided in large cities, and 45% reported a country-average net household income. Overall, 61% reported internet use in health context via 1–4 devices. Among those, more than 50% used the internet and apps to obtain general health information and less than 50% used digital technologies for physical activity promotion or cancer prevention. Overall, 34% were confident in using the internet for health decisions and 71% preferred to receive health information non-digitally (e.g. on paper). Internet, app, and digital technology use were associated with higher digital health literacy and income, and residence in larger cities. Digital technologies were used for physical activity promotion by younger and for cancer prevention by older participants. Conclusion: The internet and digital technologies were predominantly used to obtain health information, but less often for health promotion and disease prevention in 2022 in Germany. While health app and digital technology use for physical activity promotion increased, the confidence in using online information for health decisions decreased in 2022 relative to 2020. Factors that promote confidence in online health information and digital technology use for health promotion and disease prevention need to be investigated in future studies. Y1 - 2024 U6 - https://doi.org/10.1177/20552076241301457 VL - Volume 10 ER - TY - GEN A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Stabler, Martin A1 - Hecht, Henriette A1 - Bangert, Benjamin A1 - Martens, Lea A1 - Irrgang, Christopher A1 - Ladewig, Katharina A1 - Zeeb, Hajo T1 - Digital Public Health in ländlichen Regionen Deutschlands mit relativer sozioökonomischer Deprivation: das Beispiel des Lausitzer Zentrums für Digital Public Health T2 - German Medical Sciences N2 - Einleitung: Digitale Gesundheitstechnologien - wie online Plattformen und tragbare Geräte - bieten vermehrt Möglichkeiten zur Verbesserung von Prävention, Gesundheitsförderung und Gesundheitsversorgung. Europäische Studien haben aber auch gezeigt, dass sie nicht für alle Bevölkerungsgruppen und Gebiete gleichermaßen zugänglich, nutzbar und wirksam sind, um die Gesundheit zu verbessern. Vor allem Menschen, die in ländlichen Gebieten leben, Sprachbarrieren haben oder sozioökonomisch benachteiligt sind, profitieren seltener vom digitalen Wandel [1]. Um das Potenzial digitaler Gesundheitstechnologien für die Gesundheit der Bevölkerung auszuschöpfen, sollten sie passgenau auf die relevanten Bevölkerungsgruppen zugeschnitten sein und die regionalen Lebensbedingungen berücksichtigen. Ziel des Lausitzer Zentrums für Digital Public Health (LauZeDiPH) ist es, den digitalen Wandel unter dem Aspekt der gesundheitlichen Chancengerechtigkeit zu erforschen und zu unterstützen. Methoden: Die Forschung des LauZeDiPH [2] basiert mit Fokus auf die Bevölkerung in der Lausitz sowohl auf Primär- und Sekundärdaten aus bevölkerungsbasierten Erhebungen als auch auf gezielt und partizipativ erhobenen Daten von spezifischen Gruppen, wie z.B. Patienten mit chronisch obstruktiver Lungenerkrankung (COPD) oder Menschen mit geringer digitaler Kompetenz. Relevante Zielgrößen sind dabei u.a. der allgemeine Gesundheitszustand der lokalen Bevölkerung, der Zugang zur und die Inanspruchnahme von Gesundheitsversorgung, der Zugang zu digitalen Gesundheitstechnologien, die digitale Gesundheitskompetenz und die Versorgungspräferenzen der Bevölkerung in der Region. Ergebnisse: Die bisherigen Analysen in der Gesamtschau betonen die Bedeutung sozialer und regionaler Gesundheitsdeterminanten von der frühen Kindheit an in Brandenburg insgesamt sowie in der Lausitz, z.B. bei Beschäftigten der Gesundheitsversorgung [3], [4], und damit die spezifischen Anforderungen für (Digital) Public Health in der Region. Neue Technologien werden oftmals in urbanen Settings für urbane Settings entwickelt und evaluiert. Maßgeschneiderte, regional eingebettete Maßnahmen sind daher essentiell, um bedarfsgerecht auch bisher nicht gut erreichte Bevölkerungsgruppen und die Bevölkerung in weniger erschlossenen Regionen zu erreichen. Die Ergebnisse zeigen die Notwendigkeit der partizipativen Entwicklung und Evaluation von neuen Instrumenten für Public Health und die Gesundheitsversorgung, insbesondere mit der Unterstützung von Menschen mit eingeschränktem digitalem Zugang, niedrigem Bildungshintergrund, wenigen digitalen Fähigkeiten oder mangelndem Vertrauen in die Forschung und digitale Technologien. Schlussfolgerung: Die Anwendung partizipativer regionaler Ansätze kann einen gerechteren digitalen Wandel im Gesundheitsbereich erleichtern. Die Einbeziehung marginalisierter und schwer erreichbarer Gruppen in digitale Public Health Interventionen kann neue Möglichkeiten für Prävention, Gesundheitsversorgung und Forschung eröffnen und ist aus Sicht der gesundheitlichen Chancengerechtigkeit essentiell [5]. Künftige digitale Ansätze sollten so gestaltet werden, dass sie den spezifischen Bedürfnissen benachteiligter Gruppen und Regionen gerecht werden. Literatur 1. WHO. Neue Studie belegt: Digitale Gesundheit ist nicht für alle gleich zugänglich. 2022 [zuletzt aufgerufen: 23.04.2024]. Verfügbar unter: https://www.who.int/europe/de/news/item/21-12-2022-digital-health-not-accessible-by-everyone-equally-new-study-finds 2. Lausitzer Zentrum für Digital Public Health. Forschung. [zuletzt aufgerufen: 23.04.2024]. Verfügbar unter: https://www.b-tu.de/digital-public-health/forschung 3. Hoffmann S, Tschorn M, Spallek J. 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. Int J Equity Health. 2024;23(1):2 4. Hoffmann S, Schulze S, Löffler A, Becker J, Hufert F, Gremmels HD, et al. Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers. Int J Soc Psychiatry. 2024;70(1):87–98 5. Bammert P, Schüttig W, Novelli A, Iashchenko I, Spallek J, Blume M, et al. The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use – results of a scoping review. Int J Equity Health. 2024;23:37 KW - Digital Public Health KW - Sozioökonomische Deprivation KW - Zugang zur Gesundheitsversorgung KW - Gesundheitliche Ungleichheiten Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds6307 ER - TY - GEN A1 - Hecht, Henriette A1 - Hoffmann, Stephanie A1 - Bangert, Benjamin A1 - Irrgang, Christopher A1 - Ladewig, Katharina A1 - Martens, Lea A1 - Stabler, Martin A1 - Spallek, Jacob T1 - Making digital health services in the real world: ein partizipatives, human-centered-design-framework für eine erreichende Innovationsentwicklung am Beispiel der Lausitz T2 - Wen erreichen wir mit digitaler Prävention und Gesundheitsförderung? Und wie? : German Medical Science N2 - Für digitale Programme und Angebote der Prävention und Gesundheitsförderung besteht die Herausforderung darin, unterschiedliche Dialoggruppen zu erreichen und sie effektiv zu einzubinden. Barrieren bestehen u. a. aus der digitalen Kluft, da die Zugänglichkeit besonders für ältere Menschen, Menschen mit niedrigem Einkommen oder aus ländlichen Gebieten eingeschränkt sein kann. Außerdem haben verschiedene Dialoggruppen unterschiedliche kulturelle Hintergründe, sodass digitale Angebote diese Vielfalt berücksichtigen und kultursensibel gestaltet sein sollten, um die Akzeptanz und Teilnahme zu fördern. Wissen über Barrieren der Zugänglichkeit sind relevant, um digitale Gesundheitsangebote attraktiv und ansprechend gestalten zu können und die langfristige Teilnahme zu fördern. Das Symposium will anhand von Projekten aus Wissenschaft und Praxis thematisieren, wie digitale Angebote sowie die Kontexte und Prozesse ihrer Implementierung gestaltet sein müssen, damit digitale Prävention und Gesundheitsförderung einen großen Kreis von Nutzenden in ihrer Lebenswirklichkeit erreichen können. Dazu werden Evaluationsergebnisse von Nutzerinnen und Nutzern einer digitalen Prävention zur Alkoholprävention im Rahmen einer suchtpräventiven Kunstausstellung vorgestellt. Außerdem werden am praktischen Beispiel eines digitalen Elternprogramms verschiedene Möglichkeiten der Ansprache, Bereitstellung und Begleitung präsentiert. Ein weiterer Beitrag stellt vor, wie im Rahmen des Projekts „Reallabor AI4U“ unter Einbeziehung verschiedener Dialoggruppen ein digitales Training zur Förderung der psychischen Gesundheit und Resilienz bei Jugendlichen erprobt wurde. Das Training kann im Alltag auf dem Smartphone genutzt werden und bietet auf Person, Moment und Kontext zugeschnittene Übungen an. Die Weiterentwicklung einer bestehenden spielerischen Intervention zur Förderung der navigationalen Gesundheitskompetenz für ältere Menschen ist Gegenstand des nächsten Vortrags. Abschließend wird ein partizipatives, human-centered-design Konzept auf den Kontext der Lausitz projiziert, um einen Beteiligungsraum zu schaffen, in dem die Übertragbarkeit von digitalen Gesundheitsinnovationen für die Region geprüft werden kann. Die gemeinsame Darstellung der Beiträge ermöglicht die Erörterung des komplexen Themas der Erreichbarkeit durch digitale Gesundheitsförderung und Prävention aus unterschiedlichen wissenschaftlichen, praxisnahen und prozessbegleitenden Sichtweisen und schafft die Grundlage für eine facettenreiche angewandte Diskussion zusammen mit interessierten Personen aus dem Plenum. Über die inhaltliche Diskussion der Beiträge hinaus sollen Synergien und Möglichkeiten zukünftiger Zusammenarbeit zwischen den Fachbereichen der DGSMP und der DGPH im Themenfeld ausgelotet werden. KW - Partizipation KW - Gesundheitsforschung Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds8890 ER - TY - GEN A1 - Bangert, Benjamin A1 - Stabler, Martin A1 - Hoffmann, Stephanie A1 - Herath, Tim A1 - Martens, Lea A1 - Hecht, Henriette A1 - Spallek, Jacob A1 - Zeeb, Hajo A1 - Ladewig, Katharina A1 - Irrgang, Christopher T1 - Assessing accessibility: a comprehensive multimodal study of primary care accessibility across Germany T2 - German Medical Science N2 - Background: In the context of healthcare, primary care physicians represent the initial point of contact with the healthcare system [1]. In Germany, the use of motorised private transport for day-to-day travel remains the dominant mode of transport [2]. However, a range of factors, including environmental concerns, socio-economic challenges, and health-related issues, may act as deterrents for citizens from utilising these vehicles. This study aims to assess the geographical accessibility of primary care physicians by using alternative transportation modes, such as public transport or walking, to identify regions in Germany with limited accessibility to primary care physicians in order to ensure the equitable distribution of healthcare. Methods: A state-of-the-art routing engine [3] based on the RAPTOR algorithm is employed to calculate travel times from census grid cells to primary care physicians. The routing process incorporates multimodal transportation, including walking, biking, public transport and motorised private transport. Various metrics like the cost to closest facility, Hansen’s accessibility measure, and the balanced floating catchment area [4], are utilised to analyse and compare the accessibility and distribution of primary care physicians when using different transportation modes. The data on travel times and frequencies are collected, analysed and visualised using R and Python implementations. Results: A preliminary analysis revealed disparities in how different modes of transport allow individuals to access primary care physicians within a reasonable travel time. It is notable that while public transport has the potential to replace motorised private transport in urban areas, the analysis indicates that it falls short in rural regions and smaller cities. In these key regions the coverage of services and the transport network do not meet the primary care demand as well as they do in urban areas. The preliminary study indicated that regions with higher socio-economic deprivation have less efficient access to primary care physicians by alternative transportation modes. The findings are visualised through heat maps, which highlight key regions where alternatives to motorised private transport do not adequately meet the needs of the population. Conclusion: The study suggests that in Germany, public transport may not yet be sufficient to ensure accessibility to primary care physicians for those without access to motorised private transport, particularly in smaller cities and rural regions. This is probably of particular relevance for the elderly and parents with children likely to have higher primary care needs. Enhanced public transport options could be pivotal in addressing these gaps in equitable healthcare access, especially for rural regions. Although mobile health services suffer from inherent limitations, such as gaps in adaptation for different socio-economic groups [5], they could be employed to address existing scarcities in the transportation networks and ensure that all citizens have the opportunity to access essential healthcare services in an efficient manner. References 1. World Health Organization; UNICEF. Operational framework for primary health care: transforming vision into action. Geneva: World Health Organization, UNICEF; 2020 [cited 2024 Apr 27]. p. 13. Available from: https://www.who.int/publications/i/item/9789240017832 2. European Commission: Directorate-General for Mobility and Transport. EU transport in figures: Statistical pocketbook 2023. Luxembourg: Publications Office of the European Union; 2023. p. 49 3. Higgins C, Palm M, DeJohn A, Xi L, Vaughan J, Farber S, et al. Calculating place-based transit accessibility: Methods, tools and algorithmic dependence. JTLU. 2022; 15(1):95–116. 4. Paez A, Higgins C, Vivona SF. Demand and Level of Service Inflation in Floating Catchment Area (FCA) Methods. PLOS ONE. 2019;14(6):e0218773. 5. Kumar D, Hemmige V, Kallen MA, Giordano TP, Arya M. Mobile Phones May Not Bridge the Digital Divide: A Look at Mobile Phone Literacy in an Underserved Patient Population. Cureus. 2019;11(2):e4104. Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds8122 ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Increased use of digital health technologies but reduced digital health literacy: a comparison in results of two nationwide surveys in 2020 and 2022 in Germany T2 - German Medical Science N2 - Objective: Digital technologies with internet access, including computers or mobile devices, can contribute to health promotion and disease prevention. This study aimed to compare the results of two nationwide surveys of internet users in Germany that investigated the use pattern, the attitudes towards, and the factors associated with digital technology use in health context. Methods: This study adheres to the ethical guidelines according to the Declaration of Helsinki. Two cross-sectional surveys of internet users living in Germany were performed in 2020 (survey 1) and 2022 (survey 2). Participants were recruited from two different consumer panel samples owned by a market research institute (Cerner Enviza GmbH). Participants provided verbal informed consent for participation in the study according to the Cerner Enviza data privacy policy. Computer-assisted telephone interviews were conducted by Cerner Enviza using questionnaires with 28-30 items developed by study authors. Anonymous data were purchased and analysed by study authors using descriptive statistics. Associations between digital technology use and participant characteristics were tested using binary logistic regression analyses. Results: The participants were adult internet users (survey 1: n=991; survey 2: n=1020). Participant characteristics were similar in both surveys (47-52% female, 50-55% aged 40-65 years, 62-66% with less than tertiary education, 42-45% with less than country-average household income, 81-82% residents in former West Germany, and 67-71% residents in large cities). A similar number of participants in both surveys reported digital technology use in any health context (57-61%) and rated digital technologies for physical activity promotion as easy to use (87-92%). Digital technology use increased in 2022 relative to 2020. Specifically, more participants reported health app (63% vs. 36%) and digital technology use for physical activity promotion (any use: 44% vs. 31%; weekly-daily use: 91% vs. 64%) in 2022 vs. 2020. In contrast, digital health literacy decreased in 2022 relative to 2020. Specifically, less participants had high digital health literacy (57% vs. 69%) and were confident in using online information for health decisions (34% vs. 43%) in 2022 vs. 2020. Digital technology use was associated with higher digital health literacy and younger age (in both surveys), higher income (in survey 1) and residence in larger cities (in survey 2). Conclusion: Digital technologies targeting some health domains, such as physical activity promotion are frequently used and accepted by the users. However, digital health literacy and especially the confidence in using online information for health decisions appear to have decreased in 2022 relative to 2020. Factors that promote digital technology use for health promotion and disease prevention need to be investigated in future studies. Considering that digital health literacy is associated with digital technology use, further research on user needs and preferences is required to understand the reasons for reduction in such literacy in this study. Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds6319 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - Soziale Ungleichheiten in der frühkindlichen Sprachentwicklung während der COVID-19-Pandemie im Bundesland Brandenburg T2 - German Medical Science N2 - Einleitung: Die Entwicklung von Kindern unter sechs Jahren hängt nicht nur von ihren individuellen Eigenschaften ab, sondern auch von den sozialen Umständen, in denen sie leben [1]. Es besteht ein Forschungsbedarf zu möglichen Veränderungen der frühkindlichen Sprachentwicklung aufgrund sozialer Ungleichheiten während der COVID-19 Pandemie. Diese Studie [2] beschreibt die Prävalenz der Verzögerung in der Sprachentwicklung von Kindern bei der Einschulung und deren Zusammenhänge mit a) der sozioökonomischen Position der Familie (SEP), b) der Muttersprache und c) der Jahre des Kindergartenbesuchs vor und während der Pandemie. Methoden: Verwendet wurden Daten der Schuleingangsuntersuchung im Land Brandenburg aus drei aufeinanderfolgenden Kohorten 5–7-jähriger Kinder (2018|19: n=19.299; 2019|20: n=19.916; 2020|21: n=19.698). Der öffentliche Gesundheitsdienst erfasst routinemäßig die Sprachentwicklung mit validierten Instrumenten des ‘Sozialpädiatrischen Entwicklungsscreenings für Schuleingangsuntersuchungen‘ [3]. Deskriptive bivariate und multivariate Querschnittsanalysen [OR, 95%CI] untersuchten die Sprachentwicklungsverzögerung [SE ja|nein] mit SEP [niedrig|mittel|hoch], deutscher Muttersprache [ja|nein] und den Jahren des Kindergartenbesuchs [<4|≥4]. Die Analysen wurden stratifiziert nach SEP wiederholt. Ergebnisse: Die SE Prävalenz sank über die Jahre insgesamt (21,1%2018|19; 19.2%2019|20; 18,8%2020|21) sowie bei Kindern mit hoher SEP (14,3%2018|19; 13,0%2020|21) und mit deutscher Muttersprache (20,2%2018|19; 17,8%2020|21). Bei Kindern mit niedrigem SEP stieg die SE Prävalenz über die Jahre (42,4%2018|19; 43,4%2020|21) und bei Kindern mit nicht-deutscher Muttersprache blieb sie konstant (36,0%2018|19, 35,5%2020|21). Die Chancen für eine SE unterscheiden sich dementsprechend nach SEP (2018|19: ORniedrig|hoch=4,41;3,93-4,94; 2020|21: ORniedrig|hoch=5,12;4,54-5,77) und Muttersprache (2018|19: ORnicht-deutsch|deutsch=2,22;1,86-2,66; 2020|21: ORnicht-deutsch|deutsch=2,54;2,19-2,95). Die Jahre des Kindergartenbesuchs trugen nicht zu Unterschieden in der SE Prävalenz bei. Schlussfolgerung: Soziale Ungleichheiten bei der SE Prävalenz aufgrund der SEP und der Muttersprache nahmen während der Pandemie leicht zu. Für Familien mit sozioökonomischen Nachteilen sind Risiko- und Schutzfaktoren für SE der Kinder während der Pandemie unklar. Weitere Forschung sollte in Längsschnittbeobachtungen die Auswirkungen der COVID-19 Pandemie auf die frühe Kindheit vertiefend betrachten. Literatur 1. Hoff E, Ribot KM. Language Development: Influence of Socio-Economic Status. In: Wright JD, editor. International encyclopedia of the social & behavioral sciences. Second edition. Amsterdam, Boston, Heidelberg, London, New York, Oxford, Paris, San Diego, San Francisco, Singapore, Sydney, Tokyo: Elsevier; 2015. p. 324–8. 2. Hoffmann S, Tschorn M, Spallek J. 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. Int J Equity Health. 2024;23(1):2. 3. Daseking M, Oldenhage M, Petermann F, Waldmann HC. Die Validität der Sprachskala des SOPESS unter Berücksichtigung der Erstsprache [Social Pediatric Screening of Developmental Status for School Entry (SOPESS): Validity in the Domain of Speech and Language]. Gesundheitswesen 2009;71(10):663–8. KW - Gesundheitliche Ungleichheit KW - Kinder KW - Sozioökonomische Position Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds6030 UR - https://www.egms.de/static/en/meetings/gmds2024/24gmds603.shtml ER - TY - GEN A1 - Tschorn, Mira A1 - Arntz, Fabian A1 - Hoffmann, Stephanie A1 - Wölke, Maxi A1 - Cohrdes, Caroline A1 - Spallek, Jacob A1 - Rapp, Michael T1 - Regionale sozioökonomische Deprivation und Gesundheit bei Kindern und Jugendlichen T2 - 53rd DGPs Congress / 15th ÖGP Conference, September 16 - 19, 2024, Wien/Vienna, Abstract-Band N2 - Hintergrund: Von Geburt an sind die Gesundheit und die psychomotorische Entwicklung eng mit der familiären sozioökonomischen Lebenssituation verbunden. Wir stellen Ergebnisse aus unseren Studien vor, in denen wir den Zusammenhang sozioökonomischer Deprivation mit verschiedenen Outcomes aus dem Bereich Entwicklung und psychische Gesundheit untersuchen. Methoden: Anhand linearer gemischter Modelle und Mehrebenenmodelle wird untersucht, ob ein zusätzlicher Zusammenhang regionaler sozioökonomischer Deprivation auf die Outcomes Einschulalter, globale Entwicklungsverzögerung und psychische Gesundheit über den Effekt individueller sozioökonomischer Faktoren hinaus besteht. Die vorgestellten Analysen beziehen sich auf die EMOTIKON Studie (171.916 Drittklässler aus 533 Schulen in 11 Kohorten aus Brandenburg von 2011 bis 2019), Daten der Schuleingangsuntersuchung im Bundesland Brandenburg (Vollerhebung des Vorschuljahrgangs 2018/2019, N=22.801) sowie die KiGGS Kohorte (bevölkerungsrepräsentative Stichprobe am Robert Koch-Institut, N=17.641 Kinder von 0-17 Jahre zur Baseline in 2003-2006). Regionale Deprivation wird mittels des German Index of socioeconomic Deprivation (GISD, Robert Koch-Institut) operationalisiert. Für einzelne Analysen wird zudem der Einfluss der drei GISD Subfaktoren Einkommen, Bildung und Beruf auf die untersuchten Faktoren berichtet. Globale Entwicklungsverzögerung wurde standardisiert mittels des SOPESS (Sozialpädiatrisches Entwicklungsscreening für Einschulungsuntersuchungen) im Rahmen der Schuleingangsuntersuchungen erhoben, psychische Auffälligkeiten wurden in der KiGGS Studie anhand des Strengths and Difficulties Questionnaire (SDQ) erhoben. Ergebnisse: Die Ergebnisse deuten darauf hin, dass die regionale Deprivation am Wohn- bzw. Schulort der Kinder einen Einfluss auf das Einschulalter und die globale Entwicklungsverzögerung hat und dass dieser Einfluss über den Effekt der individuell familiären sozioökonomischen Bedingungen hinaus besteht. Außerdem werden erste Ergebnisse der Analysen der KiGGS Kohorte vorgestellt. Y1 - 2024 UR - https://dgps2024.univie.ac.at/fileadmin/user_upload/k_dgps2020/Abstractband_13092024.pdf UR - https://dgps2024.univie.ac.at/program/ SP - 1493 EP - 1494 CY - Wien ER - TY - GEN A1 - Blume, Miriam A1 - Schienkiewitz, Anja A1 - Wollgast, Lina A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Spallek, Jacob A1 - Herr, Raphael A1 - Moor, Irene A1 - Pischke, Claudia R. A1 - Iashchenko, Iryna A1 - Hövener, Claudia A1 - Rattay, Petra T1 - Association between socioeconomic position of the family and adolescent obesity in Germany - analysis of the mediating Role of familial determinants T2 - Journal of Obesity N2 - Background. Obesity’s negative impact on young people’s health has long been known. The family and its socioeconomic position (SEP) are key determinants in adolescent obesity. However, understanding which familial determinants explain the association remains limited. Method. The analyses are based on data from the “German Health Interview and Examination Survey for Children and Adolescents” (KiGGS) (1,384 females and 1,332 males aged 11 to 17 years). Logistic regression models explored how familial determinants (family stress, family cohesion, parental smoking, parental sporting activity, and parental overweight) mediated the association between family SEP (parental education, occupational status, and household income) and adolescent obesity. Results. Significant total effects for the associations between family SEP in childhood and adolescent obesity were found. Splitting the total effect of the family SEP on obesity into direct and indirect effects, all direct effects turned out to be significant. However, all associations involved also indirect effects of familial determinants, except for household income for female adolescents. Parental smoking and overweight were the most relevant mediators for males and females. For male adolescents, parental sporting activity additionally mediated the association between SEP and obesity. Conclusion. A low SEP in childhood was associated with adolescent obesity. Parental health and health behaviors partly explained the association. For increasing health equality in adolescent health, the consideration of parental health behavior in the planning and implementation of health promotion programs seem to be important. Y1 - 2024 U6 - https://doi.org/10.1155/2024/7903972 SN - 2090-0708 SN - 2090-0716 VL - 2024 IS - 1 PB - Wiley ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - Did social inequalities in child development change during the COVID-19 pandemic in Germany? T2 - European Journal of Public Health N2 - Background Early childhood development (aged <6 years) is dependent on the social conditions in which children live and strongly affect their life course trajectory. This study describes changes in social inequalities in language development during the COVID-19 pandemic based on data from the legally prescribed school entry examination in the German federal state of Brandenburg. The aim is to inform public health interventions for individuals at risk of long-term health inequalities. Methods Secondary data from three cohorts of 5-7-year-olds were used [n = 19,2992018|19; n = 19,9162019|20; n = 19,6982020|21]. Language development was assessed as delayed compared to peers [LD yes/no], measured by public health services using validated instruments. Descriptive bivariate and multivariate analyses [OR, 95%CI] examined language delay [%] with social inequalities defined by (1) an index composed of parents’ reported education and occupation [SEP low|high], (2) ‘German native language’ [yes|no] and (3) ‘years of kindergarten attendance’ [<4|≥4]. Results Overall, the proportion of LD decreased over the years (21.1%2018|19; 19.2%2019|20; 18.8%2020|21), both among children from families with high SEP (14.3%2018|19; 13.0%2020|21) and from German-speaking families (20.2%2018|19; 17.8%2020|21). LD rates among children increased with low SEP (42.4%2018|19; 43.4%2020|21) and remained constant with a non-German native language (36.0%2018|19; 35.5%2020|21). The probability for LD differed only for SEP (2018|19: ORlow|high=4.4, 3.93-4.94; 2020|21: ORlow|high=5.12, 4.54-5.77) and for native language (2018|19: ORnon-German|German=2.22, 1.86-2.66; 2020|21: ORnon-German|German=2.54, 2.19-2.95). Conclusions Social inequalities in language development based on SEP and native language increased slightly during the pandemic compared to the pre-pandemic period. Research should examine the effects of the pandemic on early development as well as protective and risk factors on a longitudinal basis. Y1 - 2024 UR - https://academic.oup.com/eurpub/article/34/Supplement_3/ckae144.079/7844119 U6 - https://doi.org/10.1093/eurpub/ckae144.079 VL - 34 IS - Supplement 3 ER - TY - GEN A1 - Blume, Miriam A1 - Rattay, Petra A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Sander, Lydia A1 - Herr, Raphael A1 - Moor, Irene A1 - Pischke, Claudia R. A1 - Iashchenko, Iryna A1 - Hövener, Claudia T1 - Zusammenhang zwischen der sozioökonomischen Position der Familie und Adipositas bei Jugendlichen in Deutschland – welche Rolle hat die Familie? T2 - Gesundheitswesen N2 - Einleitung Die gesundheitlichen Folgen von Adipositas für junge Menschen können schwerwiegend sein. Bei der Entwicklung verschiedener Gesundheitsoutcomes wie Adipositas spielt für junge Menschen die Familie als auch ihre sozioökonomische Position (SEP) eine große Rolle. In dieser Analyse wird untersucht, welche familiäre Determinanten den Zusammenhang zwischen SEP der Familie und Adipositas bei Jugendlichen erklären. Methoden Die vorliegende Analyse wurde mit Daten der "Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland" (KiGGS) (Basiserhebung, Welle 1 und 2) durchgeführt (1301 weibliche und 1232 männliche 11- bis 17-Jährige). Mittels logistischer Regressionsmodelle (KHB-Methode) wurden für den Zusammenhang zwischen der SEP der Familie (Einkommen, berufliche Stellung, Bildung, SES-Index) und Adipositas (Ja/Nein) bei Jugendlichen die mediierenden Effekte von familiären Determinanten (elterliches Rauchen, elterliche sportliche Aktivitäten, elterliches Übergewicht, familiärer Stress und familiärer Zusammenhalt) analysiert. Ergebnisse Die Prävalenz von Adipositas betrug 7,9 % bei den weiblichen und 8,4 % bei den männlichen Jugendlichen. Es zeigen sich signifikante Zusammenhänge zwischen Adipositas und SEP zu Ungunsten von jenen mit niedriger sozioökonomischer Position. Familiäre Determinanten erklären teilweise oder vollständig den Zusammenhang zwischen SEP und Adipositas bei Jugendlichen. Es wurden geschlechtsspezifische Unterschiede im Ausmaß der Mediation der Familie gefunden. Bei Jungen erklären familiäre Determinanten vollständig den Zusammenhang zwischen Adipositas und Einkommen sowie zwischen Adipositas und der beruflichen Stellung der Eltern. Bei männlichen Jugendlichen lässt sich der indirekte Effekt abhängig von der jeweiligen SEP-Variable zu 20,8 – 27,9 % auf das elterliche Rauchen, zu 14,8 – 26,3 % auf die elterliche sportliche Aktivität und zu 42,6 – 63,6 % auf das elterliche Übergewicht zurückführen. Bei Mädchen wurde der Zusammenhang zwischen der SEP und Adipositas teilweise durch familiäre Determinanten erklärt. Bei weiblichen Jugendlichen lässt sich der indirekte Effekt abhängig von der jeweiligen SEP-Variable zu 26,0 – 52,2 % auf das elterliche Rauchen und zu 41,6 – 67,6 % auf das elterliche Übergewicht zurückführen. Schlussfolgerung Die Adipositas-Prävalenz von Jugendlichen variiert nach dem SEP. Familiäre Determinanten sind wichtige mediierende Faktoren für gesundheitliche Ungleichheiten bei Adipositas von Jugendlichen. Es zeigt sich, dass sich Unterschiede in der Adipositas nach SEP insbesondere durch das elterliche Gesundheitsverhalten (v.a. elterliches Rauchen, elterliches Übergewicht und elterliche sportliche Aktivität) erklären lassen. Die Berücksichtigung und Einbindung der Familie bei der Planung und Umsetzung von Gesundheitsförderungs- und Präventionsprogrammen für gesundheitliche Chancengleichheit bei Jugendlichen ist essentiell. KW - sozioökonomische Position KW - Familie KW - Adipositas KW - Jugendliche Y1 - 2022 UR - https://www.thieme-connect.de/products/ejournals/html/10.1055/s-0042-1753866 U6 - https://doi.org/10.1055/s-0042-1753866 VL - 84 IS - 08/09 SP - 826 ER - TY - GEN A1 - Mayer, Alena A1 - Herr, Raphael A1 - Klein, Thomas A1 - Wiedemann, Eva A1 - Diehl, Katharina A1 - Hoffmann, Stephanie A1 - Blume, Miriam A1 - Jepsen, Dennis A1 - Sundmacher, Leonie A1 - Andreas, Marike A1 - Schneider, Sven T1 - Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference? T2 - Frontiers in Public Health N2 - Background: Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI. Methods: We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents. Results: Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus. Conclusion: We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity. KW - BMI KW - children KW - meso-level KW - sport KW - early childhood education and care center KW - pre-school KW - health equalities Y1 - 2023 U6 - https://doi.org/10.3389/fpubh.2023.1079871 SN - 2296-2565 VL - Vol. 11 ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Use and attitudes toward digital technologies in health context: A nationwide survey in Germany T2 - Gesundheitswesen N2 - 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. Y1 - 2023 UR - https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1770610 U6 - https://doi.org/10.1055/s-0043-1770610 VL - 85 IS - 809 SP - 812 EP - 813 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Schulze, Susanne A1 - Löffler, Antje A1 - Becker, Juliane A1 - Gremmels, Heinz-Detlef A1 - Holmberg, Christine A1 - Rapp, Michael A. A1 - Entringer, Sonja A1 - Spallek, Jacob T1 - Did the COVID-19 pandemic affect depressive symptoms? Longitudinal analysis of health worker data T2 - 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 N2 - 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. Y1 - 2023 U6 - https://doi.org/10.1093/eurpub/ckad160.334 SN - 1101-1262 SN - 1464-360X VL - 33 IS - 2 ER - TY - CHAP A1 - Nowak, Anna Christina A1 - Tallarek, Marie A1 - Hoffmann, Stephanie A1 - Hövener, Claudia A1 - Razum, Oliver A1 - Spallek, Jacob ED - Hartung, Susanne ED - Wihofszky, Petra T1 - Nachhaltigkeit in der Gesundheit(sversorgung) von zugewanderten Menschen T2 - Gesundheit und Nachhaltigkeit N2 - In diesem Beitrag wird facettenartig eine Brücke zwischen Zuwanderung und Gesundheit(-sversorgung) unter besonderer Berücksichtigung der globalen Ziele zur nachhaltigen Entwicklung geschlagen. Um Migrationserfahrungen als (potenziellen) Einflussfaktor auf gesundheitliche Chancengleichheit zu verstehen, wird die politisch-rechtliche Situation von Menschen mit Einwanderungsgeschichte im Zugang zur Gesundheitsversorgung und zu Präventions- und Gesundheitsförderungsmaßnahmen beschrieben. Dabei zeigt sich, dass sich die gesundheitliche Versorgungssituation durch soziale, politische, institutionelle und strukturelle Ungleichheiten und Benachteiligungen auszeichnet, die weder in den globalen Zielen zur nachhaltigen Entwicklung noch in der deutschen Nachhaltigkeitsstrategie angemessene Berücksichtigung finden. KW - Nachhaltigkeit KW - Gesundheit KW - Gesundheitsversorgung KW - Migration KW - zugewanderte Menschen Y1 - 2023 SN - 978-3-662-64954-1 U6 - https://doi.org/10.1007/978-3-662-64954-1_22-1 PB - Springer CY - Berlin, Heidelberg ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Rattay, Petra A1 - Blume, Miriam A1 - Hövener, Claudia A1 - Schneider, Sven A1 - Richter, Matthias A1 - Pischke, Claudia R. A1 - Schüttig, Wiebke A1 - De Bock, Freia A1 - Spallek, Jacob T1 - Do family characteristics contribute to a socioeconomic gradient in overweight in early childhood? – Single mediation analyses of data from German preschool children T2 - Preventive Medicine Reports N2 - Children’s overweight is strongly associated with family socioeconomic position (SEP) and family characteristics (FC). There is limited research on the extent to which FC account for a socioeconomic gradient in childhood overweight. This study examined whether FC explain SEP differences in the prevalence of overweight. The study used baseline data of preschool-aged children from the German ‘PReschool INtervention Study’. The sample (n = 872, 48% girls) was recruited at kindergartens in Baden-Württemberg, Germany. Data included children’s measured weight status and parents’ reports on socioeconomic indicators (e.g., school education, vocational education, income) and FC. Variables represent main determinants of overweight (nutrition: sweets consumption in front of TV, soft drink consumption, regular breakfast, child sets table; physical activity: outdoor sports; parental role model). In single mediation analyses indirect effects of SEP on overweight were analysed (OR[95%CI]). Preschool girls and boys with low parental education had higher odds for overweight than children with high parental education. Among boys, low levels of parental education contributed to the odds of overweight via indirect effects by both factors ‘sweets consumption in front of TV’ (OR = 1.31[1.05–1.59]) and ‘no sports’ (OR = 1.14[1.01–1.38]). Among girls, FC measured did not explain SEP differences in overweight. Family nutrition and parental/family physical activity contribute to inequalities in overweight among preschool boys, but not girls. Research is needed to identify FC that explain inequalities in overweight for both. KW - Child KW - Family KW - Overweight KW - Socioeconomic factors KW - Socioeconomic health inequalities Y1 - 2023 U6 - https://doi.org/10.1016/j.pmedr.2023.102178 SN - 2211-3355 VL - 33 ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Digital technology use for physical activity promotion: Results of a nationwide survey in Germany T2 - 37th Annual Conference of the European Health Psychology Society N2 - Background. Digital technologies can contribute to healthy behaviour. We aimed to investigate a digital technology use for physical activity (PA) promotion using a nationwide survey. Methods. Our cross-sectional survey was conducted using a panel sample of 1020 adult internet users living in Germany (age: 18-92 years, 47% female). Computer-assisted telephone interviews were conducted using a self-developed questionnaire in November 2022. Survey data were analysed using relative frequencies and bivariate logistic regression. Findings. Among all participants, 626/1020 reported internet use in health context and 278/626 (44%) reported digital technology use for PA promotion. Most of the 278 users for PA promotion reported that such technologies are easy to use (92%) and use them at least once a week (91%). The reasons for using digital technologies were to measure own PA (74%) or to find exercise ideas (57%). Most participants reported using mobile devices (e.g., smartphones, 77%, or activity trackers, 58%) and rated device feedback as helpful (69%). Among sociodemographic factors (age, gender, education, household income), health status and eHealth literacy, younger age was the only significant predictor (OR=.98, 95% CI: .97-.99) of digital technology use for PA promotion. Discussion. Despite their availability, the prevalence of digital technology use for PA promotion is still low among adult internet users in Germany. Such technologies are likely to support PA behaviour change because users rate them as easy to use, their feedback as helpful and use them frequently. Health interventions are necessary to encourage digital technology use for PA promotion among adults in Germany. Y1 - 2023 U6 - https://doi.org/10.13140/RG.2.2.22062.48967 ER - TY - GEN A1 - Müllmann, Saskia A1 - De Santis, Karina Karolina A1 - Pan, Chen-Chia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Haug, Ulrike A1 - Zeeb, Hajo T1 - Attitudes towards digital technology use in health context according to a nationwide survey in Germany T2 - 37th Annual Conference of the European Health Psychology Society N2 - 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. Y1 - 2023 U6 - https://doi.org/10.13140/RG.2.2.24579.07200 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Schulze, Susanne A1 - Löffler, Antje A1 - Becker, Juliane A1 - Hufert, Frank A1 - Gremmels, Heinz-Detlef A1 - Holmberg, Christine A1 - Rapp, Michael A. A1 - Entringer, Sonja A1 - Spallek, Jacob T1 - Depressive Symptome bei Beschäftigten im Gesundheitswesen während der COVID-19-Pandemie: Ergebnisse einer Kohortenstudie in einem Krankenhaus der Regelversorgung in Deutschland T2 - Gesundheitswesen N2 - Einleitung Bisher liegen in Deutschland wenig empirische Ergebnisse zu den Auswirkungen der COVID-19 Pandemie auf die seelische Gesundheit von Beschäftigten 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 Beschäftigten (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 Symptommodalitäten (u.a. somatisch) wurde nach beruflicher Exposition analysiert. Ergebnisse Die Depressionswerte stiegen insgesamt während des Studienzeitraums an (b=.03, .02-.05). Stressempfinden war mit depressiven Symptomen assoziiert (b=.12, .10-.14). Eine eigene Infektion war mit einem höheren 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 Beschäftigten mit beruflichem Kontakt zu COVID-19 zeigt einen Bedarf an Forschung über und Ressourcen für Gesundheitsschutz und -förderung. Das Bewusstsein für Schutzmaßnahmen sollte gestärkt werden. Y1 - 2023 UR - https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1770597 U6 - https://doi.org/10.1055/s-0043-1770597 VL - 85 IS - 809 ER - TY - GEN A1 - Löffler, Antje A1 - Hoffmann, Stephanie A1 - De Santis, Karina Karolina A1 - Müllmann, Saskia A1 - Pan, Chen-Chia A1 - Haug, Ulrike A1 - Zeeb, Hajo A1 - Spallek, Jacob T1 - Digitale Gesundheitskompetenz und Interesse an digitalen Gesundheitstechnologien im ländlichen Raum – eine Querschnitterhebung T2 - Gesundheitswesen N2 - Einleitung Digitale Gesundheitstechnologien könnten einen bedeutenden Beitrag zur Sicherstellung einer hochwertigen und effizienten Gesundheitsversorgung insbesondere im ruralen, dünnbesiedelten Raum leisten. Diese Studie untersucht die Zusammenhänge zwischen Ruralität, digitaler Gesundheitskompetenz und Interesse an digitalen Gesundheitstechnologien. Methoden Daten einer deutschlandweiten telefonischen Befragung Erwachsener zu Einstellung und Nutzung digitaler Gesundheitstechnologien wurden mit Ruralität (Einwohnerdichte/km²) verlinkt (n=941). Zusammenhänge zwischen digitaler Gesundheitskompetenz (eHEALS-Skala), Interesse an digitalen Gesundheitstechnologien (gering/hoch) und Ruralität wurden mit bi- und multivariaten Verfahren, adjustiert für Alter, Sozialstatus und Geschlecht analysiert. Ergebnisse Digitale Gesundheitskompetenz und Interesse an digitalen Gesundheitstechnologien sind im ländlichen Raum schwächer ausgeprägt als im urbanen Raum (t (877) =-3.13, p=.002, d =-.254; Chi² (1, N=936) =6.04, p=.014). Geringere Einwohnerdichte ist mit einer niedrigeren Gesundheitskompetenz (β=.07; p=.043) und mit weniger Interesse an digitalen Gesundheitstechnologien assoziiert (OR=1.21; 95%KI 1.084-1.352). Schlussfolgerung Bewohnende des ländlichen Raums unterscheiden sich hinsichtlich ihrer digitalen Gesundheitskompetenz und ihres Interesses an digitalen Gesundheitstechnologien von urbanen Regionen. Räumliche Faktoren sollten als mögliche Zugangsbarrieren bei der Implementierung digitaler Gesundheitstechnologien berücksichtigt werden. Y1 - 2023 UR - https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0043-1770604 U6 - https://doi.org/10.1055/s-0043-1770604 VL - 85 IS - 811 ER - TY - GEN A1 - Michalski, Niels A1 - Tetzlaff, Fabian A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Hoebel, Jens T1 - Der German Index of Socioeconomic Deprivation (GISD) – Ein Tool zur Verkleinerung „blinder Flecken“ der Sozialepidemiologie in Deutschland? T2 - BEWEGTE ZEITEN: LEBENSWELTEN IM WANDEL - Programm und Abstract-Band_DGMP-DGMS2023 N2 - 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 Ländern weiterhin einige Datenlücken und „blinde Flecken“, z.B. hinsichtlich sozialer Unterschiede in der ursachenspezifischen Mortalität oder dem Zusammenspiel von individuellen und sozialräumlichen Einflüssen auf Gesundheit. Diese hängen u.a. mit fehlenden Verknüpfungsmöglichkeiten von Gesundheits- und Sozialdaten auf Individual- und Raumebene zusammen. Der German Index of Socioeconomic Deprivation (GISD) des Robert Koch-Instituts stellt ein Maß zur Verfügung, mit dem ein Beitrag zur Bearbeitung dieser Fragen geleistet werden kann. Methoden: Anhand von Anwendungsbeispielen werden Analysepotentiale des GISD für die Sozialepidemiologie in Deutschland aufgezeigt. Dafür 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 kleinräumiger Ebene verknüpft. Zur Anwendung kommen epidemiologische Methoden wie die Berechnung altersstandardisierter Raten und relativer Risiken, u.a. mittels (Mehrebenen-)Regressionsmodellen. Ergebnisse: 1) Für nahezu alle häufigen Todesursachen zeigt der GISD regionale sozioökonomische Gradienten in der Mortalität. Bei Krebserkrankungen beispielsweise weisen Frauen und Männer, die in sozioökonomisch hoch deprivierten Kreisen leben, eine bis zu dreimal höhere Lungenkrebssterblichkeit auf als jene in wohlhabenden Kreisen. 2) Hinsichtlich des allgemeinen Entwicklungsstandes von Kindern bei der Schuleingangsuntersuchung werden bei Kindern aus höher deprivierten Gemeinden häufiger Entwicklungsverzögerungen festgestellt, selbst nach Kontrolle für den familiären sozioökonomischen Status. 3) Die niedrigste COVID-19-Impfquote zeigte sich unabhängig von der regionalen sozioökonomischen Deprivation bei Personen mit niedrigen Bildungsabschlüssen. Stratifiziert nach GISD-Quintilen wird ersichtlich sich, dass diese Bildungsunterschiede in der Impfquote mit steigender sozioökonomischer Deprivation der Wohnregion zunehmen. Diskussion: Der GISD bietet für die sozialepidemiologische Forschung ein breites Analysepotenzial. Insbesondere bei der Analyse gesundheitlicher Ungleichheit kann er für verschiedene Gesundheitsoutcomes und Lebensphasen zur Erschließung bislang ungenutzter Routinedatenquellen (z.B. Todesursachenstatistik) sowie Ergänzung von Routine- und Primärdaten dienen, um „blinde Flecke“ der Sozialepidemiologie in Deutschland zu verringern. Y1 - 2023 UR - https://www.uni-giessen.de/de/fbz/fb11/institute/med_psych/bewegtezeiten/programm/programm-und-abstract-band_dgmp-dgms2023.pdf/view SP - S. 37 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Schulze, Susanne A1 - Löffler, Antje A1 - Becker, Juliane A1 - Hufert, Frank A1 - Gremmels, Heinz-Detlef A1 - Holmberg, Christine A1 - Rapp, Michael A. A1 - Entringer, Sonja A1 - Spallek, Jacob T1 - Did the prevalence of depressive symptoms change during the COVID-19 pandemic? A multilevel analysis on longitudinal data from healthcare workers T2 - International Journal of Social Psychiatry N2 - 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. KW - Depressive symptoms KW - COVID-19 KW - pandemic KW - healthcare workers Y1 - 2023 U6 - https://doi.org/10.1177/00207640231196737 SN - 0020-7640 VL - 70 IS - 1 SP - 87 EP - 98 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Spallek, Jacob T1 - Regionale Deprivation und Entwicklungsverzögerung bei Kindern T2 - Public Health Forum N2 - Die psychische Gesundheit junger Menschen hängt mit ihrer psychosozialen Entwicklung (z. B. Sprache) zusammen, für die Unterschiede anhand sozioökonomischer Bedingungen der Familie beschrieben werden. Die Deprivation der Wohnregion ist additiver Risikofaktor für die kindliche Entwicklung (ORweibl. = 1,35[1,13–1,62]; ORmännl. = 1,20[1,05–1,39]). Beide sind von besonderem Interesse für Public Mental Health und Förderung der Gesundheit von Kindern in der frühen Kindheit und im Lebensverlauf. KW - Entwicklungsverzögerung KW - Gesundheitliche Ungleichheiten KW - Kinder KW - Räumliche Analyse KW - Regionale Deprivation Y1 - 2023 U6 - https://doi.org/10.1515/pubhef-2023-0071 SN - 1876-4851 VL - 31 IS - 3 SP - 188 EP - 191 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Michalski, Niels A1 - Dragano, Nico A1 - Spallek, Jacob T1 - Does individual-level socio-economic position modify the association between area-level deprivation and early childhood language development? : a multilevel analysis of cross-sectional population data from Germany T2 - European journal of public health N2 - Early childhood is a public health priority for enhancing health equity across the life course. Children are susceptible to individual-level socio-economic position (SEP) and the socio-economic deprivation of their place of residence, both of which contribute to differences in psychomotor development, including language. This study investigates whether individual-level SEP modifies the association between area-level deprivation and language development. This study used population-based, cross-sectional data from a School Entry Survey in Germany (2021; female: n = 9751, male: n = 10 623; age in years: ≤6 n = 11 423; 6-≤7 n = 8 746; >7 n = 205; native language: German n = 18 752; not German n = 943; bilingual n = 679), which was linked to the 'German Index of Socioeconomic Deprivation' (GISD). Binary multilevel models [odds ratio (OR), 95% CI] were used to analyse the interaction of GISD (measured continuously) with individual-level SEP (categorized as high/medium/low) according to delayed language development (DLD in % yes/no), which was assessed using validated instruments of 'social-pediatric screening of developmental status for school entry'. Individual SEP was tested as a moderator by stratifying the analyses. The interaction of GISD with SEP was associated with DLD (ORmediumSEP*GISD = 1.13; 1.04-1.24; ORlowSEP*GISD = 1.27; 1.13-1.43), with the main effect of GISD (OR = 0.85; 0.77-0.93). In SEP stratification, GISD was only partially associated with DLD (ORhighSEP = 0.81; 0.73-0.91; ORmediumSEP = 0.97; 0.89-1.07; ORlowSEP = 1.14; 0.99-1.32). This study demonstrates an association between area-level deprivation and DLD that is modified by individual-level SEP. The findings underscore the importance of stratification by individual-level SEP in analysing area-level effects on health, as the area-level effects can be contradictory according to individual-level SEP. Y1 - 2025 UR - https://pubmed.ncbi.nlm.nih.gov/40456517/ U6 - https://doi.org/10.1093/eurpub/ckaf082 SP - 1 EP - 6 PB - Oxford University Press CY - Oxford ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - 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 T2 - International Journal for Equity in Health N2 - 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). Y1 - 2024 U6 - https://doi.org/10.1186/s12939-023-02079-y SN - 1475-9276 VL - 23 IS - 2 SP - 1 EP - 13 PB - BioMed Central CY - London ER - TY - GEN A1 - Maaß, Laura A1 - Dockweiler, Christoph A1 - Hocke-Bolte, Zora A1 - Hoffmann, Stephanie A1 - Fischer, Florian A1 - Forberger, Sarah A1 - Gebert, Janika A1 - Holl, Felix A1 - Hrynyschyn, Robert A1 - Kernebeck, Sven A1 - Pischke, Claudia R. A1 - Posselt, Jacqueline A1 - Spallek, Jacob T1 - Digital Public Health in Deutschland : Status quo, Herausforderungen und Zukunftsperspektiven T2 - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - Dieses Positionspapier des Fachbereichs Digital Public Health der Deutschen Gesellschaft für Public Health e. V. definiert Digital Public Health (DiPH) und beschreibt deren Ziele sowie Potenziale. Ferner geht es auf die derzeitige Situation und Herausforderungen sowie Handlungsbedarfe in Deutschland ein. Der Schwerpunkt liegt hierbei auf der Darstellung der flächendeckenden Förderung der (digitalen) Gesundheitskompetenz, der Anwendung von DiPH in der Prävention, Gesundheitsförderung und Versorgung, dem Einsatz innovativer, präventiver Strategien zur Vorbeugung nichtübertragbarer Krankheiten und der Lehre von DiPH innerhalb von Public-Health-Studiengängen. Zudem werden notwendige Maßnahmen und Forderungen zur Stärkung von DiPH in Deutschland resümiert. N2 - This position paper from the Digital Public Health Section of the German Public Health Association defines digital public health (DiPH) and describes its goals and potential. It also addresses the current situation and challenges as well as the need for action in Germany. The focus here is on the presentation of the nationwide promotion of (digital) health literacy; the application of DiPH in prevention, health promotion, and healthcare; the use of innovative preventive strategies for the prevention of non-communicable diseases; and the teaching of DiPH in academic public health programs. Finally, relevant measures and demands to strengthen DiPH in Germany are summarized. Y1 - 2024 U6 - https://doi.org/10.1007/s00103-024-03989-0 VL - 68 SP - 176 EP - 184 PB - Springer CY - Berlin ; Heidelberg ER - TY - GEN A1 - Pan, Chen-Chia A1 - De Santis, Karina Karolina A1 - Muellmann, Saskia A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Pedros Barnils, Nuria A1 - Ahrens, Wolfgang A1 - Zeeb, Hajo A1 - Schütz, Benjamin T1 - Sociodemographics and digital health literacy in using wearables for health promotion and disease prevention : cross-sectional nationwide survey in Germany T2 - Journal of prevention N2 - Background Wearable technologies have the potential to support health promotion and disease prevention. However, it remains unclear how the role of social determinants of health (SDoH) and digital determinants of health (DDoH) plays in this context. Objective This study investigates differences in sociodemographic factors and digital health literacy between wearable users and non-users, whether the association with wearable use varies across age groups and its potential mediator. Methods A cross-sectional nationwide telephone survey was conducted in November 2022 in a panel of adult internet users in Germany. Assessments included self-reported wearable use, sociodemographic factors (sex, age, education, household size and income, and residence region), and digital health literacy (measured with the eHealth Literacy Scale, eHEALS). Associations between wearable use, sociodemographic factors and digital health literacy were analyzed using binomial logistic regression models in the total sample and with age group stratification, with a supplementary mediation analysis examining digital health literacy as a mediator in the relationship between age and wearable use. Results Overall, 24% (223/932) of participants (52% male, mean age 55.6 years) reported using wearables for health. Wearable use was lower among participants aged 65 and above, with lower educational attainment, living in 1–2 person households, with below-average household income, and residing in smaller cities or former East Germany. Wearable use prevalence is substantially lower in older age groups (18–40: 36%; 41–64: 26%; 65+:14%). Wearable users reported higher levels of digital health literacy (mean: 30.7, SD = 5) than non-users (mean: 28.3, SD = 6). Stratified analyses indicate that the association between digital health literacy and wearable use varies by age group, with significant positive association observed in older age groups (OR = 1.00, 95% CI: 0.94 to 1.07 in age group 18–40; OR = 1.07, 95% CI: 1.03 to 1.12 in age group 41–64; OR = 1.11, 95% CI: 1.04 to 1.19 in age group 65+). Mediation analysis indicated that digital health literacy partially mediates the relationship between age and wearable use (indirect effect: coefficient = -0.0156, 95% CI: -0.0244 to -0.00791, p <.001). Conclusions This study indicates sociodemographic disparities in wearable use among the German population and differences in digital health literacy between wearable users and non-users. A generational divide in wearable use was identified, with older adults being less likely to embrace this technology. This was especially true for older adults with lower digital health literacy. Future public health initiatives employing health technologies should take SDoH and DDoH into consideration to ensure effective and equitable impacts. Y1 - 2024 U6 - https://doi.org/https://doi.org/10.1007/s10935-024-00821-y SN - 2731-5533 SN - 2731-5541 VL - 46 IS - 3 SP - 371 EP - 391 PB - Springer US CY - New York ER - TY - GEN A1 - De Santis, Karina Karolina A1 - Martens, Lea A1 - Christianson, Lara A1 - Bangert, Benjamin A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Zeeb, Hajo T1 - Attitudes of older people towards telerehabilitation : a scoping review protocol T2 - Open science framework Y1 - 2025 UR - https://osf.io/f965z/ UR - https://osf.io/y2wrv U6 - https://doi.org/10.17605/OSF.IO/F965Z SP - 1 EP - 8 PB - Center for Open Science CY - Charlottesville, VA ER -