TY - CHAP A1 - Brzoska, Patrick A1 - Spallek, Jacob A1 - Voigtländer, Sven A1 - Razum, Oliver ED - Biffl, Gudrun ED - Rössl, Lydia T1 - Sozioökonomischer Status, Gesundheit und Gesundheitsversorgung von Menschen mit Migrationshintergrund in Deutschland T2 - Migration & Integration, Band 3 Y1 - 2012 SN - 978-3-99031-011-3 SP - 85 EP - 94 PB - Omninum CY - Bad Vöslau ER - TY - GEN A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Wie gesund sind Migranten? Erkenntnisse und Zusammenhänge am Beispiel der Zuwanderer in Deutschland T2 - Focus Migration : Kurzdossier Y1 - 2009 SN - 1864-5704 IS - 12 SP - 1 EP - 9 ER - TY - CHAP A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Das deutsche Konzept „Staatsangehörigkeit“ T2 - Migrationssensible Studiendesigns zur Repräsentation des Migrationsstatus in der Gesundheitsforschung Y1 - 2006 SN - 978-3-89606-098-3 SN - 3-89606-098-8 SP - 23 EP - 29 PB - Robert Koch Institut CY - Berlin ER - TY - BOOK A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Reutin, Barbara A1 - Yilmaz-Aslan, Yüce A1 - Barz, Irina A1 - Starikow, Klara A1 - Reiss, Katharina A1 - Dröge, Angela A1 - Hinz, Julia A1 - Exner, Anne A1 - Striedelmeyer, Lena A1 - Krupa, Elzbieta A1 - Spallek, Jacob A1 - Berg-Beckhoff, Gabriele A1 - Schott, Thomas A1 - Razum, Oliver T1 - Rehabilitative Versorgung und gesundheitsbedingte Frühberentung von Personen mit Migrationshintergrund in Deutschland : Abschlussbericht Y1 - 2010 PB - Bundesministerium für Arbeit und Soziales CY - Bonn ER - TY - GEN A1 - Spallek, Jacob A1 - Berens, Eva-Maria A1 - Kolip, Petra T1 - Früherkennung – Herausforderung der „Informierten Entscheidung“ im Kontext des Mammografie-Screening-Programms T2 - Geburtshilfe und Frauenheilkunde Y1 - 2016 U6 - https://doi.org/10.1055/s-0042-112118 SN - 1438-8804 VL - 76 IS - 11 SP - 1117 EP - 1120 ER - TY - GEN A1 - Tallarek, Marie A1 - Jost, Annemarie A1 - Spallek, Jacob T1 - How do midwives deal with women’s preferences during childbirth in Germany? An action model T2 - European Journal of Public Health N2 - Background Midwifery care is increasingly discussed in terms of its ability to promote a self-determined childbirth. The degree of self-determination (SD) depends on the extent to which women's preferences are negotiated and implemented. From the perspective of midwives in different obstetric settings in Germany, this study answered the research question: “How do midwives deal with women's preferences during birth?”. Methods 11 semi-structured face-to-face interviews were conducted with active midwives. The sample showed a high variance in terms of obstetric settings (clinics, birth centers, home births), regions, and participants’ characteristics (e. g. experience, age). All interviews were recorded, transcribed, anonymized, and analyzed using the Grounded Theory Methodology (Strauss/Corbin, 1994). Results A model consisting of 7 steps was developed: 1) Interpret the situation; 2) Prioritize relevant parameters; 3) Determine a frame of possibilities; 4) Match the preference(s) to the frame of possibilities; 5) Negotiate preference(s); 6) Continuously monitor contextual/situational changes; 7) Adjust the frame of possibilities. The actions are related to contextual conditions (structural; interpersonal; personal; health situation; course of birth; understanding of birth). The model shows how midwives can promote SD even if prior preferences are discarded or modified at birth. Conclusions The model describes how midwives in Germany deal with women's preferences during birth, which factors they consider decisive in doing so, and how SD may be promoted despite of discarded or modified preferences. Further research should examine the role of relationship building, test the model with regard to its generalizability, and use it to analyze and support person-centered midwifery care. Key messages • The model describes how midwives in different obstetric settings in Germany deal with women’s preferences during birth and, thereby, influence self-determination. • Midwives can promote self-determination also if prior preferences are discarded, modified, or redeveloped at birth. KW - midwifery KW - self-determination KW - preferences KW - birthing centers KW - home birth KW - hospital KW - interview study KW - action model KW - obstetric care KW - self-determined birth Y1 - 2023 UR - https://academic.oup.com/eurpub/article/33/Supplement_2/ckad160.1512/7327229 U6 - https://doi.org/10.1093/eurpub/ckad160.1512 SN - 1788-7119 SN - 1788-4934 N1 - 16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8–11 November 2023 VL - 33 IS - Supplement 2 SP - S. ii603 ER - TY - GEN A1 - Höpker, T. A1 - Lampert, Thomas A1 - Spallek, Jacob T1 - Identifizierung und Charakterisierung von Gesundheitsverhaltenstypen bei 11- bis 17-jährigen Jungen und Mädchen. Eine Clusteranalyse auf Basis der Daten des Kinder- und Jugendgesundheitssurveys (KiGGS) T2 - Gesundheitswesen Y1 - 2014 U6 - https://doi.org/10.1055/s-0034-1372619 SN - 1439-4421 SN - 0941-3790 VL - 76 IS - 7 SP - 453 EP - 461 ER - TY - GEN A1 - Makarova, Nataliya A1 - Reiss, Katharina A1 - Zeeb, Hajo A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Verbesserte Möglichkeiten zur Identifikation von Menschen mit Migrationshintergrund für die Mortalitätsforschung am Beispiel Bremens T2 - Gesundheitswesen Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1321767 SN - 1439-4421 SN - 0941-3790 VL - 75 IS - 6 SP - 360 EP - 365 ER - TY - GEN A1 - Spallek, Jacob A1 - Reeske, Anna A1 - Grosser, Angelique A1 - Schwabe, Wolfgang A1 - Rieger, Michael A1 - Krahn, U. A1 - Razum, Oliver T1 - Pflegebedürftigkeit bei türkischstämmigen und nicht-türkischstämmigen Säuglingen. Eine Analyse der Pflegegutachten des MDK-Westfalen-Lippe von 2004 bis 2008 T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1286276 SN - 1439-4421 SN - 0941-3790 VL - 74 IS - 8-9 SP - 485 EP - 487 ER - TY - GEN A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Kraywinkel, Klaus A1 - Krieg, V. A1 - Schwabe, Wolfgang A1 - Greiner, Wolfgang A1 - Damm, Oliver A1 - Hense, H. W. A1 - Razum, Oliver T1 - Abgleich von Verwaltungsdaten des Medizinischen Dienstes der Krankenversicherung mit Krebsregisterdaten T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1286274 SN - 1439-4421 SN - 0941-3790 VL - 74 IS - 7 SP - e52 EP - e60 ER - TY - GEN A1 - Reiss, Katharina A1 - Makarova, Nataliya A1 - Spallek, Jacob A1 - Zeeb, Hajo A1 - Razum, Oliver T1 - Identifizierung und Rekrutierung von Menschen mit Migrationshintergrund für epidemiologische Studien in Deutschland T2 - Gesundheitswesen Y1 - 2013 U6 - https://doi.org/10.1055/s-0032-1321768 SN - 1439-4421 SN - 0941-3790 VL - 75 IS - 6 SP - e49 EP - e58 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 - Scholaske, Laura A1 - Adam, Emma K. A1 - Spallek, Jacob A1 - Entringer, Sonja T1 - Maternal BMI and inflammation during pregnancy: a bi- or unidirectional association? T2 - Brain, Behavior, and Immunity N2 - Methods: 140 pregnant women participated in a multi-site prospective cohort study in, Germany with two study visits during pregnancy (T1: 24.44 ± 2.34, T2: 32.92 ± 1.72 weeks of gestation). Maternal BMI was derived from body length and current weight and was residualized for gestational week at assessment. Pro-inflammatory markers CRP and IL-6 were analyzed from venous blood samples and combined into a repeatedly measured composite inflammation score. Results: In a path model, T1-BMI significantly predicted T2-inflammation (b=0.53, SE=0.02, p <.001), and T1-inflammation predicted T2-BMI (b=0.46, SE=0.42, p <.001), suggesting a bidirectional relationship between BMI and inflammation. However, further adjustment for pre-pregnancy BMI diminished the association between T1-inflammation and T2-BMI (b=0.004, SE=0.22, p =.922), whereas the relationship between T1-BMI and T2-inflammation remained significant (b=0.20, SE=0.01, p =.004). Thus, adjusting for pre-pregnancy BMI underlined a unidirectional relationship. Conclusions: Based on these results, reducing overweight may be a relevant target for interventions to reduce inflammation and the risk of subsequent adverse outcomes. KW - BMI KW - inflammation KW - pregnancy Y1 - 2022 UR - https://www.sciencedirect.com/science/article/pii/S0889159122002239?via%3Dihub U6 - https://doi.org/10.1016/j.bbi.2022.07.049 VL - 106 SP - 12 PB - Elsevier ER - TY - GEN A1 - Lueckmann, Sara Lena A1 - Hoebel, Jens A1 - Roick, Julia A1 - Markert, Jenny A1 - Spallek, Jacob A1 - Knesebeck, Olaf von dem A1 - Richter, Matthias T1 - Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review T2 - International journal for equity in health N2 - Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare. KW - Socioeconomic inequalities KW - primary-care KW - specialist physician KW - systematic review Y1 - 2021 U6 - https://doi.org/10.1186/s12939-020-01375-1 SN - 1475-9276 VL - 20 ER - TY - GEN A1 - Schilling, Laura A1 - Spallek, Jacob A1 - Maul, Holger A1 - Schneider, Sven T1 - Study on E-Cigarettes and Pregnancy (STEP) – Results of a Mixed Methods Study on Risk Perceptionof E-Cigarette Use During Pregnancy T2 - Geburtshilfe und Frauenheilkunde N2 - Introduction E-cigarette use during pregnancy is a risk factor for maternal and fetal health. Early studies on animals showed that in utero exposure to e-cigarettes can have negative health outcomes for the fetus. There has been only limited research into the risk perceptions of e-cigarette use during pregnancy. This study was conducted to comprehensively characterize the constructs of risk perceptions with regard to e-cigarette use during pregnancy using an Integrated Health Belief Model (IHBM). Methods Our STudy on E-cigarettes and Pregnancy (STEP)used a mixed methods approach, with the study divided intoan initial qualitative part and a quantitative part. A netno-graphic approach was used for the first part, which consistedof the analysis of 1552 posts from 25 German-language on-line discussion threads on e-cigarette use during pregnancy. Using these qualitative results, a quantitative questionnaire was developed to explore risk perception constructs about e‑cigarette use during pregnancy. This questionnaire was subsequently administered to pregnant women (n = 575) in onehospital in Hamburg, Germany. Descriptive and bivariate analysis was used to examine differences in risk perception ac-cording to participantsʼ tobacco and e-cigarette user status before and during pregnancy. While the study design, methods and sample have been extensively described in our recently published study protocol in the January 2020 issue of Geburtshilfe und Frauenheilkunde, this paper is devoted to apresentation of the results of our mixed methods study. Results Themes related to perceived threats identified in the qualitative study part were nicotine-related health risks and po-tential health risks of additional ingredients. Perceived benefits were possibility and facilitation of smoking cessationand a pre-sumed potential to reduce harm. The subsequent quantitative part showed that nearly all participants (99.3%) perceivede‑cigarettes which contained nicotine as constituting a threat to the health of the unborn child. The most commonly perceived barrier was health-related (96.6%), while the most commonly perceived benefit was a reduction in the amount of tobacco cigarettes consumed (31.8%). We found that partic-ularly perceived benefits varied depending on the partici-pantʼs tobacco and e-cigarette user status. Conclusion When considering future prevention strategies, the potential health risks and disputed effectiveness of e-cigarettes as a tool for smoking cessation need to be taken intoaccount and critically discussed. KW - electronic cigarette KW - pregnancy KW - risk perception KW - Health Belief Model KW - online forums KW - mixed methods Y1 - 2021 UR - https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-1308-2376.pdf U6 - https://doi.org/10.1055/a-1308-2376 SN - 0016‑5751 VL - 81 IS - 02 SP - 214 EP - 223 ER - TY - GEN A1 - Miani, Céline A1 - Batram-Zantvoort, Stephanie A1 - Wandschneider, Lisa A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Potential of Standard Perinatal Data for Measuring Violation of Birth Integrity T2 - Frontiers in global women's health N2 - Background: Measuring the phenomenon of violation of birth integrity (vBI) (e.g., obstetric violence) relies in part on the availability and content of maternity care providers' data. The population coverage and linkage possibilities that these data provide make for a yet untapped potential. Although vBI is a complex phenomenon best measured with dedicated instruments, we argue that maternity care providers' data could contribute to enhance our knowledge of the manifestations and frequency of vBI, and allow for analyses across different sub-groups of the population. Looking into the German standardized perinatal data, we investigate which variables are relevant to vBI-related research, and how complete their reporting is. Methods: First, we analyse state-of-the-art frameworks and recommendations, and, for each vBI-related domain, we search for and list corresponding variables in the perinatal data which could contribute to a better understanding of vBI issues. Second, we use an example and analyse the content of perinatal data obtained between 2013 and 2016 in the context of the BaBi birth cohort study set in Bielefeld, Germany. We use descriptive statistics to assess the completeness of the data. Results: The vBI-related variables can be classified in three main categories: discrimination based on specific patient socio-demographic attributes (e.g., height and weight to calculate BMI before pregnancy, foreign origin), indication for medical interventions (i.e., medicalization-related variables: indication for cesarean sections and induction), and supportive care, in particular the mobilization dimension (e.g., continuous fetal heartbeat monitoring). The data analyses included 876 births, of which 601 were vaginal birth. We found poor reporting on demographic variables in terms of completeness. Medicalization and mobilization variables are better documented, although limited in scope. Conclusions: Putting more emphasis on the completeness of standardized data could increase their potential for vBI-related research. Perinatal data alone are insufficient to assess vBI, but a broader, theory-informed discussion of indicators to be included in standardized datasets would contribute to capturing the different aspects of integrity violation in a more systematic way and expand the evidence-base on different types of vBI. KW - childbirth KW - respectful maternity care KW - mistreatment KW - perinatal data KW - Germany KW - birth integrity KW - obstetric violence Y1 - 2021 U6 - https://doi.org/10.3389/fgwh.2020.581244 SN - 2673-5059 IS - 1 ER - TY - CHAP A1 - Razum, Oliver A1 - Reeske, Anna A1 - Spallek, Jacob ED - David, Matthias ED - Borde, Theda T1 - Schwangerschaft, Geburt und erstes Lebensjahr in der Migration: gesundheitliche Herausforderungen T2 - Schwangerschaft, Geburt und frühe Kindheit in der Migration N2 - Dieser Artikel beschäftigt sich mit den, durch mangelnde Akkulturation oder geringe Integration bedingte, Risikofaktoren für Gesundheitsprobleme während der Schwangerschaft, in der Perinatalzeit und im ersten Lebensjahr. KW - Migranten KW - Gesundheit KW - Schwangerschaft KW - Gesundheitsversorgung Y1 - 2011 SN - 979-3-940529-91-6 SP - 57 EP - 72 PB - Mabuse-Verlag CY - Frankfurt am Main ER - TY - CHAP A1 - Spallek, Jacob A1 - Zeeb, Hajo ED - Hegemann, Thomas ED - Salman, Ramazan T1 - Bedarf und Inanspruchnahme psychiatrischer Versorgung durch Menschen mit Migrationshintergrund in Deutschland T2 - Handbuch transkulturelle Psychiatrie N2 - Obwohl die Migration ein offensichtlich psychisch stark belastender Vorgang ist, gibt es zu dem Bedarf und der Inanspruchnahme psychiatrischer Versorgung durch Menschen mit Migrationshintergrund in Deutschland wenig erforschtes Wissen. Dieser Artikel zeigt ein Modell auf, wie diese Belastung wirkt, wo Hindernisse und wo noch Bedarf in der Forschung für dieses Thema liegen. KW - Migranten KW - psychiatrisch KW - Gesundheitsversorgung KW - Deutschland Y1 - 2010 SN - 978-3-88414-467-1 SP - 58 EP - 68 PB - Psychiatrie-Verlag CY - Bonn ET - 1. Auflage ER - TY - BOOK A1 - Spallek, Jacob T1 - Migrantengesundheit - Die Sicht der Life-Course-Epidemiologie am Beispiel von Krebs bei türkischen Zuwanderern N2 - Die Gesundheit von Zuwanderern und von der nicht eingewanderten Bevölkerung unterscheidet sich zum Teil erheblich. Mögliche Ursachen dafür können während des ganzen Lebenslaufs der Zuwanderer aufgetreten sein. Dieses Buch beschäftigt sich mit dieser Lebenslaufperspektive anhand der empirischen Ergebnisse von zwei epidemiologischen Untersuchungen zu Krebsrisiken von türkischen Zuwanderern in Deutschland. KW - Migranten KW - Migration KW - Gesundheit KW - Krebs KW - türkische Zuwanderer KW - Deutschland Y1 - 2012 SN - 978-3-7799-1983-4 PB - Beltz Juventa CY - Weinheim und Basel ET - 1. Auflage ER - TY - GEN A1 - Spallek, Jacob A1 - Tempes, Jana A1 - Ricksgers, Hannah A1 - Marquardt, Louisa A1 - Prüfer-Krämer, Luise A1 - Krämer, Alexander T1 - Gesundheitliche Situation und Versorgung unbegleiteter minderjähriger Flüchtlinge – eine Näherung anhand qualitativer und quantitativer Forschung in der Stadt Bielefeld T2 - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz N2 - Unbegleitete minderjährige Flüchtlinge (UMF) sind Kinder oder Jugendliche unter 18 Jahren, die sich ohne Begleitung eines für sie zuständigen Vormundes auf die Flucht begeben. Internationale Studien zeigen, dass minderjährige unbegleitete Flüchtlinge eine besondere Risikogruppe darstellen. Empirische Ergebnisse über die gesundheitliche Situation von unbegleiteten minderjährigen Flüchtlingen in Deutschland in der aktuellen Situation sind kaum vorhanden. Ziel dieses Beitrags ist die Beschreibung der gesundheitlichen Situation und Versorgung von unbegleiteten minderjährigen Flüchtlingen in Bielefeld. Dafür werden zwei qualitative und eine quantitative Studie aus Bielefeld genutzt. Die Ergebnisse zeigen, dass die gesundheitliche Versorgung von unbegleiteten minderjährigen Flüchtlingen Besonderheiten unterliegt und weisen vor allem auf zwei spezifische (medizinische) Bedarfe hin: die psychische/psychiatrische Versorgung und die Versorgung von Infektionskrankheiten. Weitere Herausforderungen in der gesundheitlichen Versorgung ergeben sich aus der spezifischen Situation der unbegleiteten minderjährigen Flüchtlinge und schließen die rechtlichen Rahmenbedingungen sowie sprachliche und kulturelle Kompetenzen auf Seiten der Versorger und auf Seiten der unbegleiteten minderjährigen Flüchtlinge ein. N2 - Unaccompanied minor refugees are children or adolescents below the age of 18 years who are not accompanied by their parents. International studies show that unaccompanied minor refugees represent a special risk group. Currently, empirical study results about the health status of unaccompanied minor refugees barely exist for Germany. Therefore, the goal of this article is an assessment of the health status and health care of unaccompanied minor refugees in Bielefeld, Germany. For this purpose, two qualitative studies and one quantitative study from Bielefeld are used. Results demonstrate that the health care of unaccompanied minor refugees underlies certain peculiarities that indicate major medical needs: Firstly, the need for psychological/psychiatric care and secondly the need for health care regarding infectious diseases. Further challenges in the health care needs of this population group result from its specific situation, and comprise legal conditions, as well as language and cultural competencies on behalf of the health care providers and the unaccompanied minor refugees themselves. KW - Unbegleitete minderjährige Flüchtlinge KW - Gesundheitliche Versorgung KW - Gesundheitssituation KW - Medizinische Bedarfe KW - Infektionskrankheiten Y1 - 2016 U6 - https://doi.org/10.1007/s00103-016-2339-2 SN - 1436-9990 VL - 59 IS - 5 SP - 636 EP - 641 ER - TY - GEN A1 - Schilling, Laura A1 - Spallek, Jacob A1 - Maul, Holger A1 - Tallarek, Marie A1 - Schneider, Sven T1 - Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy T2 - Maternal and Child Health Journal N2 - Objectives Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-cigarettes among pregnant women. The objective of our current STudy on E-cigarettes and Pregnancy (STEP) was to advance and complement the current knowledge regarding active and passive exposure to tobacco and e-cigarettes before pregnancy and during early and late pregnancy. Methods One element of the STEP study was a quantitative cross-sectional design: A sample of 540 pregnant women recruited at an obstetrician clinic in Hamburg from April 2018 to January 2019 were surveyed once via a standardized questionnaire and provided complete information regarding their consumption of tobacco and e-cigarettes. We performed a descriptive analysis of tobacco and e-cigarette use before pregnancy and during early and late pregnancy, as well as bivariate analysis of these variables with sociodemographic determinants. Passive exposure was assessed by asking the participating pregnant women about the consumption of tobacco and e-cigarettes by their partners, in general, and in their homes. Results Before pregnancy, 20.0% of the participants used tobacco cigarettes exclusively, 1.3% used e-cigarettes exclusively, and 6.5% were dual users. Educational level was significantly associated with tobacco cigarette use (p < 0.001) and dual use (p = 0.047) before pregnancy. During early (late) pregnancy, 8.7% (2.8%) used tobacco cigarettes and 0.4% (0.0%) used e-cigarettes exclusively. Twenty-point nine percent of women’s partners consumed tobacco cigarettes exclusively, 2.7% consumed e-cigarettes exclusively, and 2.7% consumed both. A total of 8.5% (16.7%) of the partners who consumed tobacco cigarettes exclusively (e-cigarettes exclusively) did so in the women’s homes. Conclusions for Practice Among pregnant women, the use of tobacco cigarettes remains prominent before and during pregnancy, while e-cigarette use predominately occurs before pregnancy. Our study shows that pregnant women are frequently exposed to their partners’ tobacco and e-cigarette use within their homes. Strategies to reduce such exposure should be further intensified. Significance In the last decade, e-cigarettes have become popular, and e-cigarette use has been increasing, even among pregnant women. However, there is a lack of knowledge concerning the exposure to e-cigarettes before pregnancy and during early and late pregnancy, as well as studies comparing e-cigarettes and tobacco cigarettes. The current study found that active exposure to e-cigarettes before pregnancy is high, while exposure during pregnancy is marginal. In contrast, exposure to tobacco cigarettes before and in early pregnancy is high but decreases during late pregnancy. In addition, the results of our study show that pregnant women are passively exposed to tobacco and e-cigarettes at home. Pregnant women should be advised against exposing themselves, actively or passively, to tobacco and e-cigarette smoke. KW - E-cigarette KW - Tobacco cigarette KW - Nicotine KW - Passive exposure KW - Pregnancy Y1 - 2020 U6 - https://doi.org/10.1007/s10995-020-03037-8 SN - 1092-7875 SN - 1573-6628 VL - 25 IS - 4 SP - 656 EP - 665 ER - TY - GEN A1 - Ulrich, Hanna-Sophie A1 - Kohler, Emma A1 - Fach, Eva-Maria A1 - Spallek, Jacob A1 - Richter, Matthias A1 - Mlinarić, Martin T1 - Healthcare needs among unaccompanied minor refugees: a study protocol of a qualitative study explaining access and utilisation across place and gender T2 - BMJ Open N2 - Introduction: Several studies have identified that unaccompanied minor refugees (UMRs) are allegedly ‘vulnerable’ and belong to a high-risk group in terms of psychological distress and post-traumatic stress disorder due to their preflight, periflight and postflight experiences. Psychosocial care (PSC) is of high importance for UMRs, but little is known about barriers to access and utilisation of PSC across place and gender. The aims of this gender-sensitive qualitative study will be to build on the existing body of literature and to provide qualitative evidence on the contexts and mechanisms of PSC for male and female UMRs in Germany by comparing two German regions. Methods and analysis: Following the study preparing realist review, a qualitative study will be undertaken in Berlin and Central German cities. Approximately 24 experts from the field of PSC and 12 lay UMRs will participate in face-to-face, semistructured interviews. Data will be transcribed and analysed based on the grounded theory research paradigm. Ethics and dissemination: Only participants who have been informed in both German and their native tongue and who have signed a declaration of consent will be included in the study. The study will comply rigorously with German data protection standards. Approval from the Ethical Review Committee at Martin Luther University Halle-Wittenberg, Germany has been obtained and granted. The results of the study will be presented at several conferences and will be published in high-quality, peer-reviewed international journals. The results will display a differentiated picture of the PSC of UMRs in Germany. Such knowledge is a precondition for a ‘science of change’ that translates explanations into practical recommendations on how to improve healthcare policies. KW - Healthcare KW - unaccompanied minor refugees KW - access KW - utilisation KW - gender Y1 - 2020 UR - https://bmjopen.bmj.com/content/10/9/e038882 U6 - https://doi.org/10.1136/bmjopen-2020-038882 SN - 2044-6055 VL - 10 IS - 9 ER - TY - GEN A1 - Ludwig, Angelique A1 - Miani, Céline A1 - Breckenkamp, Jürgen A1 - Sauzet, Odile A1 - Borde, Theda A1 - Doyle, Ina-Merle A1 - Brenne, Silke A1 - Höller-Holtrichter, Chantal A1 - David, Matthias A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies T2 - Maternal and Child Health Journal N2 - Objective: Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of non-medical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. Methods: Baseline data of the Bielefeld BaBi birth cohort (2013–2016) and the Berlin perinatal study (2011–2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status.ResultsIn Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. Conclusions for Practice: Our study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups. KW - Non-medical antenatal care KW - Migration background KW - Education KW - Socioeconomic status KW - Pregnancy Y1 - 2020 U6 - https://doi.org/10.1007/s10995-020-02937-z SN - 1573-6628 SN - 1092-7875 VL - 24 IS - 7 SP - 943 EP - 952 ER - TY - GEN A1 - Wandschneider, Lisa A1 - Sauzet, Odile A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Small-Area Factors and Their Impact on Low Birth Weight—Results of a Birth Cohort Study in Bielefeld, Germany T2 - Frontiers in Public Health N2 - Introduction: The location of residence is a factor possibly contributing to social inequalities and emerging evidence indicates that it already affects perinatal development. The underlying pathways remain unknown; theory-based and hypothesis-driven analyses are lacking. To address these challenges, we aim to establish to what extent small-area characteristics contribute to low birth weight (LBW), independently of individual characteristics. First, we select small-area characteristics based on a conceptual model and measure them. Then, we empirically analyse the impact of these characteristics on LBW. Material and methods: Individual data were provided by the birth cohort study “Health of infants and children in Bielefeld/Germany.” The sample consists of 892 eligible women and their infants distributed over 80 statistical districts in Bielefeld. Small-area data were obtained from local noise maps, emission inventory, Google Street View and civil registries. A linear multilevel analysis with a two-level structure (individuals nested within statistical districts) was conducted. Results: The effects of the selected small-area characteristics on LBW are small to non-existent, no significant effects are detected. The differences in proportion of LBW based on marginal effects are small, ranging from zero to 1.1%. Newborns from less aesthetic and subjectively perceived unsafe neighbourhoods tend to have higher proportions of LBW. Discussion: We could not find evidence for negative effects of small-area factors on LBW, but our study confirms that obtaining adequate sample size, reliable measure of exposure and using available data for operationalisation of the small-area context represent the core challenges in this field of research. KW - low birth weight KW - small-area analysis KW - multilevel analysis KW - virtual audit KW - noise pollution KW - fine particulate matter KW - socioeconomic deprivation KW - cohort study Y1 - 2020 U6 - https://doi.org/10.3389/fpubh.2020.00136 SN - 2296-2565 VL - 8 ER - TY - GEN A1 - Tallarek, Marie A1 - Spallek, Jacob T1 - Othering in public health using the example of Covid-19 management in German asylum camps T2 - European Journal of Public Health N2 - Issue/problem In 2020, several German reception centers and asylum camps were imposed mass quarantine after single residents had been infected with SARS-CoV-2. Civil and research networks criticized this measure, as crowded housing conditions limited the implementation of infection protection measures, and mass quarantine further increased the risk of infection. This raised the question why public health (PH) measures in these settings differed from those implemented in the general population, and which implications for future PH approaches can be identified. Problem description Considering the epidemiological evidence and ethical perspectives on the PH strategies described above, we applied the concepts of “Exclusionary Othering” and “Inclusionary Othering” to PH. We further discussed the Covid-19 management in German reception centers and asylum camps. Results We identified three conceptual approaches: 1) exclusionary, 2) inclusionary, and 3) diversity-sensitive approaches to PH. Exclusionary PH is characterized by an exclusion of less powerful groups despite negative health consequences. Inclusive approaches seek to empower less powerful groups in order to understand each other's needs, build cooperations, protect everyone and to prevent the development of “hot spots”. Diversity-sensitive PH approaches avoid othering and seek to implement measures for everyone, taking into account diverse needs, conditions, and resources. Lessons We propose a paradigm shift towards inclusionary and diversity-sensitive PH that benefits the entire population, including those forced to flee other countries. This requires a critical reflection of power dynamics and discrimination. The proposed concepts can be transferred to other social groups, regions, and areas of PH. Key messages Public health needs to shift its perspective from exclusion and subordination to inclusion and involvement. Inclusionary and diversity-sensitive PH approaches promote health equity. KW - SARS-CoV-2 KW - Covid-19 KW - Othering KW - Public Health KW - Inclusionary Othering KW - asylum camps KW - mass quarantine KW - reception centers Y1 - 2021 UR - https://academic.oup.com/eurpub/article/31/Supplement_3/ckab164.795/6406172?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckab164.795 VL - 31 IS - Issue Supplement_3 ER - TY - GEN A1 - Kaucher, Simone A1 - Khil, Laura A1 - Kajüter, Hiltraud A1 - Becher, Heiko A1 - Reder, Maren A1 - Kolip, Petra A1 - Spallek, Jacob A1 - Winkler, Volker A1 - Berens, Eva-Maria T1 - Breast cancer incidence and mammography screening among resettlers in Germany T2 - BMC public health N2 - Background – European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. Methods – Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994–2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. Results – Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08–5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005–2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. Conclusions – MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study. KW - Resettlers KW - Migrants KW - Breast cancer KW - Stage at diagnosis KW - Mammography screening programme KW - Participation Y1 - 2020 U6 - https://doi.org/10.1186/s12889-020-08534-7 VL - 20 IS - 1 ER - TY - GEN A1 - Scholaske, Laura A1 - Rodriguez, Norma A1 - Sari, Nida Emel A1 - Spallek, Jacob A1 - Ziegler, Matthias A1 - Entringer, Sonja T1 - The German Version of the Multidimensional Acculturative Stress Inventory (MASI) for Turkish-Origin Immigrants. Measurement Invariance of Filter Questions and Validation T2 - European Journal of Psychological Assessment N2 - The Multidimensional Acculturative Stress Inventory (MASI) is an established measure of acculturative stress for people of Mexican origin living in the USA that has been associated with mental health outcomes in this population. We translated the MASI into German and adapted it for use with Turkish-origin immigrants in Germany. The MASI includes filter questions asking if a potentially stressful event had actually occurred before reporting the stress appraisal of these situations. Measurement invariance testing has become a standard practice to evaluate questionnaire translations, however, measurement invariance of filter questions has been scarcely studied. In Study 1, we evaluated measurement invariance of the filter questions between a German-based Turkish sample (N = 233) and the Mexican-origin sample from the original study (N = 174) and could show partial strong factorial invariance for three of the four factors. In Study 2, a validation study, relations between the German MASI scores and measures of acculturation and stress indicated discriminant validity. This study contributes to research on measurement invariance of filter questions, thereby providing a measure of acculturative stress that can be used in future research to understand the etiology of health disparities in Turkish-origin immigrants in Germany. KW - German Multidimensional Acculturative Stress Inventory KW - Measurement invariance KW - Validation KW - Filter questions KW - Turkish-origin immigrants Y1 - 2020 U6 - https://doi.org/10.1027/1015-5759/a000567 SN - 2151-2426 VL - 36 IS - 5 SP - 889 EP - 900 ER - TY - GEN A1 - Miani, Celine A1 - Ludwig, A. A1 - Breckenkamp, Jürgen A1 - Sauzet, Odile A1 - Doyle, Ina-Merle A1 - Höller-Holtrichter, Chantal A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study T2 - BMC pregnancy and childbirth N2 - BACKGROUND: Women with a migration background are reportedly at a higher risk of emergency caesarean section. There is evidence that this is due in part to suboptimal antenatal care use and quality of care. Despite the fact that migrant women and descendants of migrants are often at risk of socioeconomic disadvantage, there is, in comparison, scarce and incomplete evidence on the role of socioeconomic position as an independent risk factor for emergency caesarean delivery. We therefore investigate whether and how migration background and two markers of socioeconomic position affect the risk of an emergency caesarean section and whether they interact with each other. METHODS: In 2013-2016, we recruited women during the perinatal period in Bielefeld, Germany, collecting data on health and socioeconomic and migration background, as well as routine perinatal data. We studied associations between migration background (1st generation migrant, 2nd/3rd generation woman, no migration background), socioeconomic status (educational attainment and net monthly household income), and the outcome emergency caesarean section. RESULTS: Of the 881 participants, 21% (n = 185) had an emergency caesarean section. Analyses showed no association between having an emergency caesarean section and migration status or education. Women in the lowest (< 800€/month) and second lowest (between 800 and 1750€/month) income categories were more likely (aOR: 1.96, CI: 1.01-3.81; and aOR: 2.36, CI: 1.27-4.40, respectively) to undergo an emergency caesarean section than women in the higher income groups. CONCLUSIONS: Migration status and education did not explain heterogeneity in mode of birth. Having a low household income, however, increased the chances of emergency caesarean section and thereby contributed towards producing health disadvantages. Awareness of these findings and measures to correct these inequalities could help to improve the quality of obstetric care. KW - Acculturation KW - Birth cohort KW - Caesarean section KW - Education KW - Emergency KW - Germany KW - Income KW - Migration KW - Obstetric care KW - Socioeconomic determinants Y1 - 2020 U6 - https://doi.org/10.1186/s12884-020-2725-5 SN - 1471-2393 VL - 20 ER - TY - GEN A1 - Schilling, Laura A1 - Schneider, Sven A1 - Maul, Holger A1 - Spallek, Jacob T1 - STudy on E-Cigarettes and Pregnancy (STEP)–Study Protocolof a Mixed Methods Study on Risk Perception of E-Cigarette UseDuring Pregnancy and Sample Description T2 - Geburtshilfe und Frauenheilkunde N2 - Introduction: During pregnancy, the motherʼs healthy life-style is crucial for the health of the fetus. Potential risk factorsfor maternal and child health should therefore be identifiedand reduced as early as possible. The consumption of e-ciga-rettes represents one of these potential risk factors. Exploringrisk perceptions about e-cigarette use during pregnancy canprovide early indications of possible user motives. Therefore,our mixed methodsSTudy onE-cigarettes andPregnancy(STEP) aimed to comprehensively analyze risk perceptionsabout e-cigarette use during pregnancy based on anInte-gratedHealthBeliefModel (IHBM). This paper describes thestudy design, methods, sample population and limitations ofSTEP. Methods: Our sequential mixed methods study combinedqualitative and quantitative approaches. In the qualitativesection of the study which preceded the quantitative part ofthe study, we aimed to characterize risk perceptions aboute‑cigarette use during pregnancy. We used a netnographic re-search approach which analyzed discussion threads in onlineforums dealing with e-cigarette use during pregnancy. Theanalysis was based on an IHBM. Identified themes were incor-porated in the questionnaire which was developed for the quantitative part of the study. The quantitative section aimedto quantify, among other things, perceived threats, barriersand benefits and to explore differences in risk perception ac-cording to sociodemographic characteristics and tobacco ande-cigarette usage. Results: In the qualitative section, 1552 posts in 25 online dis-cussion threads dealing, inter alia, with e-cigarette use duringpregnancy were identified. The quantitative part looked atthe responses in the questionnaires handed in by 575 preg-nant women who attended a hospital in Hamburg (Germany)from April 2018 to January 2019 (response rate: 27.5%). Conclusion: Data collection was successful for both the qual-itative and quantitative parts of the study. When interpretingthe results of STEP, different limitations should be taken intoaccount. The results of STEP provide starting points for thedevelopment of tailored preventive measures for pregnantwomen. KW - e‑cigarette KW - pregnancy KW - risk perception KW - mixed methods study KW - Health Belief Model Y1 - 2020 UR - https://www.thieme-connect.de/products/ejournals/pdf/10.1055/a-1061-7288.pdf U6 - https://doi.org/10.1055/a-1061-7288 SN - 1438-8804 SN - 0016-5751 VL - 80 IS - 01 SP - 66 EP - 75 ER - TY - GEN A1 - Scholaske, Laura A1 - Brose, Annette A1 - Spallek, Jacob A1 - Entringer, Sonja T1 - The role of discrimination for the risk of preterm birth among Turkish immigrant women T2 - European Journal of Public Health N2 - Background: Preterm birth (PTB) is one of the most severe risk factors for early child death and developmental impairment. Epidemiological research suggests that immigrants from lower to higher income countries exhibit a health decline over time that is transmitted to the offspring generation in which health disparities become prevalent already at a very early age in terms of adverse birth outcomes. Perceived discrimination (PD) is discussed in the context of health disparities related to migration. The relationship between PD and health outcomes is still understudied among Turkish immigrants in Germany. We examined whether PD contributes to PTB risk in Turkish immigrant women. Methods: We used data from the German Socio-Economic Panel (SOEP). The newborn questionnaire (“Mother-Child: Age 0-1”, 2003 – 2016, v33) provided information on birth outcomes and we included information on maternal socioeconomic situation, migration background and PD due to origin (for Turkish immigrant women only) that were collected in the survey before birth. The final sample comprised N = 2,525 (8.60% Turkish immigrant women). A dummy variable indicating occurrence of PTB (0 = non PTB, i.e. ≥ 37 wks of gestation, 1 = PTB, i.e. < 37 weeks of gestation) was used as the outcome variable in logistic regression models. Results: Logistic regression models on the whole sample indicated a higher risk of PTB among Turkish compared to German native women (OR: 2.75) that remained after adjusting for socioeconomic status. Within the subsample of Turkish women, prenatal PD was related to a higher risk for PTB (OR: 4.91). Conclusions: Unlike in other studies we found evidence for a higher prevalence of PTB among Turkish immigrant women in the SOEP data. PD may explain the prevalence of PTB among Turkish immigrant women in Germany. There is a need for further research examining the impact of discrimination on the intergenerational transmission of health disparities among Turkish immigrants in Germany. KW - premature birth KW - immigrants KW - turkish Y1 - 2018 U6 - https://doi.org/10.1093/eurpub/cky213.566 SN - 1464-360X SN - 1101-1262 VL - 28 IS - 4 SP - 192 EP - 192 ER - TY - GEN A1 - Hintermeier, Maren A1 - Gencer, Hande A1 - Kajikhina, Katja A1 - Rohleder, Sven A1 - Santos-Hövener, Claudia A1 - Tallarek, Marie A1 - Spallek, Jacob A1 - Bozorgmehr, Kayvan T1 - SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review T2 - medRxiv N2 - The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesise the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0.12% to 2.08% in non-outbreak settings and from 5.64% to 21.15% in outbreak settings. Migrants showed a lower hospitalisation rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs. KW - SARS-CoV-2 KW - migrants KW - displaced populations KW - rapid systematic review Y1 - 2020 UR - https://www.medrxiv.org/content/10.1101/2020.12.14.20248152v1.full.pdf+html U6 - https://doi.org/10.1101/2020.12.14.20248152 ER - TY - GEN A1 - Reder, Maren A1 - Berens, Eva-Maria A1 - Spallek, Jacob A1 - Kolip, Petra T1 - Development of the Informed Choice in Mammography Screening Questionnaire (IMQ): factor structure, reliability, and validity T2 - BMC Psychology N2 - Background: Informed choice is of ethical and practical importance in mammography screening. To assess the level to which decisions regarding such screening are informed is thus imperative, but no specific instrument has been available to measure informed choice in the German mammography screening programme. The aims of this study were to develop the Informed Choice in Mammography Screening Questionnaire (IMQ) and to find first evidence for the factor structure, reliability and validity of its different components. Methods: The IMQ was sent to 17.349 women aged 50 in Westphalia-Lippe, Germany. The instrument has been developed after consideration of (1) the results of qualitative interviews on decision making in the mammography screening programme, (2) relevant literature on other informed choice instruments and (3) a qualitative study on influencing factors. The IMQ comprises 3 scales (attitude, norms, and barriers), 1 index (knowledge) and singular items covering intention to participate and sociodemographic variables. To assess the psychometric properties of the components of the IMQ, confirmatory factor and item response theory analyses were conducted. Additionally, reliability, validity and item statistics were assessed. Results: 5.847 questionnaires were returned (response rate 33.7%). For attitude, the confirmatory factor analysis supported a one-factor structure. For norms, the model fit was not acceptable. Reliability levels were good with a Cronbach‘s α of.793 for attitude (4 items) and.795 for norms (5 items). For barriers, 9 items were deleted because of low discrimination indices; 6 items remained. The hypothesised assumption-subscale and the importance-subscale were confirmed, but these subscales showed poor reliabilities with Cronbach‘s α=.525 (4 items) and.583 (2 items). For the knowledge index, item response theory analysis showed that 6 out of 7 items were suitable. Hypotheses concerning the correlations between the different components were confirmed, which supported their convergent and divergent validity. Conclusion: The results of this study demonstrated that the IMQ is a multidimensional instrument. Further development of the barriers and norms scales is necessary. The IMQ can be utilised to assess the level of informed choices as well as influencing factors. KW - Mammography screening KW - Informed choice KW - Confirmatory factor analysis KW - Reliability KW - Validity Y1 - 2019 U6 - https://doi.org/10.1186/s40359-019-0291-2 SN - 2050-7283 VL - 7 IS - 1 ER - TY - GEN A1 - Grosser, Angelique A1 - Doyle, Ina-Merle A1 - Löffler, Antje A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Razum, Oliver A1 - Miani, Celine T1 - The impact of psychosocial factors on breastfeeding duration in the BaBi cohort study, Germany T2 - European Journal of Public Health N2 - Background: Breastfeeding is considered beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, a goal reached by only 34% of mothers in 2012. The WHO’s recommendation of exclusively breastfeeding for six months was met by 19% only. Hardly modifiable factors such as socio-economic status and migration background have been associated with duration of breastfeeding but little is known about the impact of psychosocial factors such as personality traits and social support. We hypothesise that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding. Methods: We analyse baseline and follow-up data of the Bielefeld BaBi birth cohort (2013-16). They include detailed migration and socio-economic backgrounds, as well as three measures of psychological characteristics: the optimism scale, the Big Five inventory and the locus of control scales. We perform bivariate and multivariate analyses in order to identify psychosocial determinants of fully breastfeeding for four and six months. Results: Out of 780 BaBi study participants, 548 fully breastfed for four months (70.3%), of which 279 continued until at least six months (35.8%). Logistic regression analyses show that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed and the attendance of antenatal class during this or previous pregnancies. Personality characteristics, social status and migration background show however no significant association with breastfeeding duration. Conclusions: Our study results support the promotion of individuals’ breastfeeding intention and attendance to antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in maternal and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration. KW - breastfeeding KW - cohort study KW - psychosocial Y1 - 2019 U6 - https://doi.org/10.1093/eurpub/ckz187.122 SN - 1464-360X SN - 1101-1262 VL - 29 IS - 4 ER - TY - GEN A1 - Grosser, Angelique A1 - Höller-Holtrichter, Chantal A1 - Miani, Celine A1 - Hoffmann, Renata A1 - Breckenkamp, Jürgen A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany T2 - European Journal of Public Health Y1 - 2017 U6 - https://doi.org/10.1093/eurpub/ckx187.467 SN - 1464-360X SN - 1101-1262 VL - 27 IS - Suppl. 3 SP - S. 183 ER - TY - GEN A1 - Richter, M. A1 - Dragano, Nico A1 - Lampert, Thomas A1 - Schneider, Sven A1 - Spallek, Jacob A1 - Sundmacher, Leonie T1 - Understanding the institutional context of health inequalities among young people: Study protocol for a multi-center research unit T2 - Gesundheitswesen 2019 N2 - Background: While health inequalities among young people are well described, the underlying mechanisms have been explored far less. Compositional and contextual characteristics of institutional contexts (e.g. kindergartens, schools) are likely to shape health inequalities among young people and may have an impact above and beyond individual-level determinants. The general research objectives of the research unit are to empirically study if characteristics of different institutional contexts are associated with the emergence of individual-level inequalities in health and c) to integrate findings from different life stages into a comprehensive theoretical model about the key mechanisms at individual and contextual levels. Methods and analysis: Building upon reviews of the existing evidence, each of the five subprojects of the research unit will analyse secondary data (cross-sectional and longitudinal surveys). The subprojects will focus on institutional contexts that serve as major socialization agents in society, such as the family, kindergarten, school, tertiary education/work, as well as the health care system. Linear or logistic multilevel modelling will be applied in order to examine the role of institutional characteristics for young people's health and health inequalities at the individual level. Ethics and dissemination: The dissemination activities include the publication of results in peer-reviewed journals, at international and national scientific conferences, as well as press releases in written and broadcast media to inform relevant stakeholders and the lay public. In the first funding stage, the research unit only uses secondary data of existing datasets. Therefore, ethical approval is not required. KW - Health inequalities KW - young people Y1 - 2019 U6 - https://doi.org/10.1055/s-0039-1694623 VL - 81 IS - 08/09 SP - 750 EP - 751 PB - Georg Thieme Verlag KG CY - Stuttgart ER - TY - GEN A1 - Grosser, Angelique A1 - Doyle, Ina-Merle A1 - Löffler, Antje A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Razum, Oliver A1 - Miani, Celine T1 - The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany T2 - Gesundheitswesen 2019 N2 - Background: Breastfeeding is beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, which has only been reached by 34% in 2012. The WHO's aim of exclusively breastfeeding for six months was reached by 19% only. Socio-economic status and migration background have been identified to be associated with duration of breastfeeding but little is known about the impact of psychosocial factors e.g. personality traits and social support. We hypothesized that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding. Methods: Baseline and follow up data of the Bielefeld BaBi birth cohort (2013 – 16) were analysed. Bivariate and multivariate analyses were performed in order to identify psychosocial determinants for fully breastfeeding for four and six months. Results: Out of 780 BaBi study participants, 548 fully breastfeed for four months (70.3%) and 279 continued until at least six months (35.8%). Logistic regression analyses shows that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed (OR 7.3 [C.I. 4.54.-11.21) and the attendance of antenatal class (OR 1.4 [C.I. 1.01.-2.06). Personality characteristics, social status und migration background showed no significant association with breastfeeding duration. Conclusion: Our study results suggest to promote individuals' breastfeeding intention and the attendance of antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in mother and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration. KW - Breastfeeding Y1 - 2019 U6 - https://doi.org/10.1055/s-0039-1694422 VL - 81 IS - 08/09 SP - 686 EP - 686 PB - Georg Thieme Verlag CY - Stuttgart ER - TY - GEN A1 - Miani, Celine A1 - Breckenkamp, Jürgen A1 - Grosser, Angelique A1 - Höller-Holtrichter, Chantal A1 - Ergin-Akkoyun, Emine A1 - Hoffmann, Renata A1 - Doyle, Ina-Merle A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Socio-economic determinants of breastfeeding uptake and duration intention among women with and without migration background. Results from the BaBi birth cohort study in Bielefeld, Germany T2 - European Journal of Public Health N2 - Background: Disparities in breastfeeding practices have been observed between migrants and majority populations in many countries. We compared breastfeeding practices among women with and without a migration background in Bielefeld, Germany, using data from a birth cohort. Methods: In 2013-16, we conducted 967 standardised interviews with women aged over 18 during pregnancy or shortly after birth, collecting data on breastfeeding uptake and duration intention, as well as on socio-economic and migration background. Bivariate and multivariate analyses were performed, adjusting for clinical factors (e.g. age, parity, birthweight). Results: Breastfeeding uptake was more common among women with a migration background than among non-immigrants (88.9% vs. 83%, p < 0.05). It was particularly high among 2nd and 3rd generation women (92%). Women with a migration background tended to intend to breastfeed longer than non-immigrants (6.2% vs 7.6% between 6 months and one year and 0.67% vs. 2.53% beyond one year). When controlling for clinical and socio-economic characteristics, only a statistically significant correlation between breastfeeding uptake and the opinion of the mother and of the partner with regard to breastfeeding remained, with a negative opinion decreasing the chances of uptake (OR 0.5; CI 0.25-0.79 and OR 0.2; CI 0.12-0.36, respectively). Mothers and partners of women with migration background were more likely to strongly support breastfeeding than those of non-immigrants. Duration intention was positively associated with having a migration background (1.98; CI 1.10-3.55) and negatively associated with income, with higher income decreasing likelihood of breastfeeding beyond 6 months (OR 0.6; CI 0.44-0.94). Conclusions: This study found differences in breastfeeding uptake and duration intention among women with and without a migration background. This calls for public health actions targeting different socio-economic groups if one wants to come closer to the WHO recommended breastfeeding rates. Initiatives that are inclusive of the mother and the partner of the expectant women are also worth considering. KW - breast feeding Y1 - 2018 U6 - https://doi.org/10.1093/eurpub/cky047.093 SN - 1464-360X SN - 1101-1262 N1 - 1st World Congress on Migration, Ethnicity, Race and Health VL - 28 IS - Vol. 1 SP - S. 50 ER - TY - GEN A1 - Berens, Eva-Maria A1 - Reder, Maren A1 - Razum, Oliver A1 - Kolip, Petra A1 - Spallek, Jacob T1 - Informed choice in mammography screening program among migrant and non-migrant women: a survey among first-time invitees in Germany, 2013-2015 T2 - European Journal of Public Health N2 - Background: In Germany, women aged 50 to 69 are invited biennially to the population-based mammography screening programme (MSP). There is still a broad discussion whether the benefits of the programme outweigh its harms. Hence, the concept of informed choice is of particular importance for MSP. The aim of this survey was to assess the proportion of informed choices among migrant and non-migrant women invited to the German MSP for the first time. Methods: A random sample of 17,349 women aged 50 from a sub-region of North Rhine Westphalia was invited to participate in a postal cross-sectional survey conducted in German and Turkish. Turkish and other migrants were identified by country of birth and German resettlers additionally by self-reported resettler-status. Turkish migrant women were oversampled, due to expected lower response-rates. The effect of migration status on informed choice and on its three components (knowledge, attitude and intention) were assessed by chi-square tests and logistic regression modelling. Results:5,847 (33.7%) women responded to the postal questionnaire. 4,113 complete cases were included in the analyses. The proportion of women making informed choices was low (27.1%). Turkish migrant women had the highest odds for making an uninformed choice (OR 5.30, 95%CI 1.92-14.66) independent of educational level. Other migrant groups only had slightly higher odds for making an uninformed choice (German resettlers: OR 1.50, 95%CI 1.00-2.25; other migrants: OR 1.57, 95%CI 0.96-2.57) compared to non-migrant women. Fewer Turkish and other immigrant women intended to participate in the MSP. Immigrant women had a more positive attitude and a lower proportion of sufficient knowledge compared to non-migrant women. Conclusions: The overall proportion of informed choice in the German MSP is low and knowledge is poor. Measures are needed to improve information materials, strengthen health literacy and create a user-friendly environment facilitating informed choices especially for migrant women. KW - mammography Y1 - 2018 U6 - https://doi.org/10.1093/eurpub/cky047.107 SN - 1464-360X SN - 1101-1262 N1 - 1st World Congress on Migration, Ethnicity, Race and Health VL - 28 IS - Suppl. 1 SP - S. 55 ER - TY - GEN A1 - Scholaske, Laura A1 - Lindner-Matthes, Denise A1 - Kurt, Medlin A1 - Duman, Elif Aysimi A1 - Sahbaz, C. A1 - Spallek, Jacob A1 - Entringer, Sonja T1 - Intergenerational transmission of health disparities among Turkish-origin residents in Germany: role of maternal stress and stress biology during pregnancy. A study protocol T2 - European Journal of Public Health N2 - Background:Turkish-origin immigrants constitute one of the biggest migration groups in Germany where they exhibit higher levels of social disadvantage when compared to the majority population. Research has elucidated the underlying mechanisms by which social disadvantage is biologically embedded to impact health over the lifespan. However, relatively little is known about how its effects are transmitted across generations. Aims of the study: To elucidate the effects of maternal migration status and socioeconomic status on stress-related maternal-placental-foetal (MPF) biological processes across gestation and on subsequent infant birth and health outcomes. Methods: We are conducting a longitudinal cohort study of N = 450 child-mother dyads with serial measures across gestation and birth through the first year of life. Our proposed study population will include approximately equal numbers of Turkish-origin women in Germany, German women in Germany, Turkish women living in Turkey and their offspring. Study visits are conducted from the second trimester of pregnancy to the end of the first year of life to assess maternal socio-economic and migration-related information, psychological well-being, nutrition, medical risk variables, and MPF stress biology markers from maternal blood and saliva samples. Infant anthropometric measures, developmental outcomes and stress markers in saliva are assessed throughout the first year of life. Analyses: We will test specific hypotheses regarding the association between migration background, socioeconomic status and MPF stress biology. We will furthermore quantify the association of maternal migration background- and social disadvantage-related MPF stress biology measures on pregnancy and child health outcomes. Discussion: This is the first study on foetal programming of health disparities with a focus on Turkish-origin women in Germany. The significance and impact of this study derives from the importance of achieving a better understanding of underlying mechanisms that alter disease vulnerability in minority and disadvantaged populations. KW - maternal stress KW - pregnancy KW - health disparity Y1 - 2018 U6 - https://doi.org/10.1093/eurpub/cky048.044 SN - 1464-360X SN - 1101-1262 N1 - 1st World Congress on Migration, Ethnicity, Race and Health VL - 28 IS - Suppl. 1 SP - S. 126 ER - TY - GEN A1 - Grosser, Angelique A1 - Höller-Holtrichter, Chantal A1 - Miani, Celine A1 - Hoffmann, Renata A1 - Breckenkamp, Jürgen A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Caesarean birth frequency among women with and without migration background in Germany: the BaBi birth cohort study, Germany T2 - European Journal of Public Health Y1 - 2017 U6 - https://doi.org/10.1093/eurpub/ckx187.466 SN - 1464-360X SN - 1101-1262 VL - 27 IS - Suppl. 3 SP - S. 183 ER - TY - GEN A1 - Spallek, Jacob A1 - Grosser, Angelique A1 - Höller-Holtrichter, Chantal A1 - Doyle, Ina-Merle A1 - Breckenkamp, Jürgen A1 - Razum, Oliver T1 - Early childhood health in Bielefeld, Germany (BaBi study) : study protocol of a social-epidemiological birth cohort T2 - British Medical Journal Open Y1 - 2017 U6 - https://doi.org/10.1136/bmjopen-2017-018398 SN - 2044-6055 VL - 7 IS - 8 ER - TY - GEN A1 - Grosser, Angelique A1 - Höller-Holtrichter, Chantal A1 - Breckenkamp, Jürgen A1 - Hoffmann, Renata A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany T2 - Das Gesundheitswesen Y1 - 2017 U6 - https://doi.org/10.1055/s-0037-1605903 SN - 1439-4421 SN - 0941-3790 VL - 79 IS - 08/09 SP - 656 EP - 804 ER - TY - GEN A1 - Berens, Eva-Maria A1 - Reder, Maren A1 - Razum, Oliver A1 - Kolip, Petra A1 - Spallek, Jacob T1 - Informed choice in mammography screening program: a survey among first-time invitees in Germany T2 - European Journal of Public Health Y1 - 2017 U6 - https://doi.org/10.1093/eurpub/ckx187.213 SN - 1464-360X SN - 1101-1262 VL - 27 IS - Suppl. 3 SP - S. 83 ER - TY - JOUR A1 - Reeske, Anna A1 - Spallek, Jacob T1 - Deeper Analysis Desirable JF - Deutsches Ärzteblatt N2 - The Prevalence of Gestational Diabetes A Population-Based Analysis of a Nationwide Screening Program by Dr. phil. Hanne Melchior, Diana Kurch-Bek, Dr. med. Monika Mund in issue 24/2017 Y1 - 2017 U6 - https://doi.org/10.3238/arztebl.2017.0689c VL - 114 IS - 41 SP - 689 EP - 690 ER - TY - GEN A1 - Doyle, Ina-Merle A1 - Spallek, Jacob T1 - Determinants of dietary behaviour during pregnancy T2 - Public Health Forum Y1 - 2016 U6 - https://doi.org/10.1515/pubhef-2016-0063 SN - 1876-4851 SN - 0944-5587 VL - 24 IS - 3 SP - 231 EP - 233 ER - TY - JOUR A1 - Zeeb, Hajo A1 - Spallek, Jacob A1 - Jahn, Ingeborg T1 - Gender agenda: positive steps taken in Germany JF - Nature Y1 - 2010 U6 - https://doi.org/10.1038/466315b SN - 0028-0836 SN - 1476-4687 VL - 466 IS - 7304 SP - 315 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 - CHAP A1 - Spallek, Jacob A1 - Brzoska, Patrick A1 - Yilmaz-Aslan, Yüce A1 - Exner, Anne-Kathrin A1 - Voigtländer, Sven A1 - Razum, Oliver ED - Wansing, Gudrun ED - Westphal, Manuela T1 - Medizinische Rehabilitation und Leistungen zur Teilhabe am Arbeitsleben bei Menschen mit Migrationshintergrund T2 - Behinderung und Migration N2 - Eine Bestandsaufnahme zur Zugänglichkeit und Qualität der Versorgung. KW - Medizinische Rehabilitation KW - Migrationshintergrund Y1 - 2014 SN - 978-3-531-19401-1 SN - 978-3-531-19400-4 U6 - https://doi.org/10.1007/978-3-531-19401-1 SP - 253 EP - 262 PB - Springer VS CY - Wiesbaden ER - TY - CHAP A1 - Tallarek, Marie A1 - Spallek, Jacob ED - Orłowska, Beata ED - Paetzold, Ulrich T1 - Migration and health. Theoretical foundations, empirical findings, and public health responses using the example of Germany T2 - Contemporary challenges of social work in Poland and Germany: war migrants as a challenge N2 - Migrants and their offspring, referred to as people with a migration background in this article, are an utmost heterogeneous group whose health situation can be better, similar or worse compared to the health of the population without a migration background. A better understanding of the health of people with a migration background requires the consideration of their individual life course as well as several additional explanatory factors. The latter include, for instance, their social position, age, and gender, as well as the policies, health care system, social climate, living situation, and length of stay in the destination country. Particularly promising public health strategies for migrant health include a combination of migration sensitive and migration specific offers, setting approaches, and inclusionary public health approaches that critically reflect on mechanisms of othering, marginalization, and exclusion. KW - Migration KW - Health KW - Public health KW - Germany Y1 - 2023 UR - http://cwn.ajp.edu.pl/2024/03/231/ SN - 978-83-67705-24-0 SP - 11 EP - 31 PB - Akademia im. Jakuba z Paradyża w Gorzowie Wielkopolskim CY - Gorzów Wielkopolski ET - 1 ER -