2014 erschienene Artikel in Fachzeitschriften mit Peer-Review
Adamowitsch,M., Gugglberger,L., Dür,W. (2014):
Implementation Practices in School Health Promotion: Findings from an Austrian Multiple-Case Study. Advance Access published in: Health Promotion International.
Abstract | Full Text
Since the 1980s, schools have been recognized as an ideal setting to promote students' and teachers' health. Three decades after the development of the Health Promoting Schools (HPS) approach, however, there is still only limited knowledge about the implementation of health promotion (HP) activities in this setting. Some studies indicate that schools change original concepts significantly when adapting them to local context in the course of implementation. In this paper, we pursue the question how HP is practiced in schools that have agreed to implement HPS concepts from regional service providers (SPs), using data from a multiple-case study conducted in an Austrian province. Furthermore, we explored the HP activities chosen for implementation and the decision-making leading to their implementation. We draw on 22 interviews with members of the school community and provincial HP SPs, 9 group discussions, and 10 observations we have carried out within three schools between November 2010 and January 2012, supplemented by a variety of documents. We have identified 40 different HP activities, of which most targeted students, while mostly focusing on physical activity and/or psychosocial health. Planning, coordination and cooperation at the school level were minimal. Decisions for or against activities were seldom taken together, but taken individually due to personal knowledge, interests and experiences, perceived needs and problems, already existing activities and external influences. The findings suggest that schools rather remain with a traditional topic-based approach instead of realizing an integrated whole-school approach and indicate a need for more support especially during the early phases of implementation.
Bendtsen,P., Damsgaard,M., Huckle,T., Casswell,S., Kuntsche,E., Arnold,P., de Looze,M., Hofmann,F., Hublet,A., Simons-Morton,B., ter Bogt,T., Holstein,B.(2014):
Adolescent alcohol use: a reflection of national drinking patterns and policy? Addiction, 109 (11), 1857-1869.
Abstract | Full Text
Aims: To analyse how adolescent drunkenness and frequency of drinking were associated with adult drinking patterns and alcohol control policies.
Design, Setting and Participants: Cross-sectional survey data on 13- and 15-year-olds in 37 countries who participated in the Health Behaviour in School-Aged Children (HBSC) Study in 2010 (n = 144 788) were linked to national-level indicators on alcohol control policies and adult drinking patterns.
Measurements: Outcome measures were self-reported weekly drinking and life-time drunkenness (drunk once or more). Data were analysed using multi-level logistic regression models.
Findings: In the mutually adjusted models, adolescent drunkenness was associated significantly with high adult alcohol consumption [odds ratio (OR) = 3.15 among boys, 95% confidence interval (CI) = 2.13–4.64, OR girls = 2.44, CI = 1.57–3.80] and risky drinking patterns in the adult population (OR boys = 2.02, CI = 1.33–3.05, OR girls = 1.61, CI = 1.18–2.18). The level of abstainers in the adult population was also associated significantly with girls' drunkenness; a 10% increase in the number of abstainers in a country reduced the odds of drunkenness with 21% (OR = 0.79, CI = 0.68–0.90). Weekly drinking was associated significantly with weak restrictions on availability (OR boys = 2.82, CI = 1.74–4.54, OR girls = 2.00, CI = 1.15–3.46) and advertising (OR boys = 1.56, CI = 1.02–2.40, OR girls = 1.79, CI = 1.10–2.94).
Conclusions: Comparing data cross-nationally, high levels of adult alcohol consumption and limited alcohol control policies are associated with high levels of alcohol use among adolescents.
Christopoulos,D., Vogl,S. (2014):
The Motivation of Social Entrepreneurs: The roles, agendas and relations of altruistic economic actors. Online published in: The Journal of Social Entrepreneurship. DOI: 10.1080/19420676.2014.954254.
Abstract | Full Text
Social entrepreneurs present a contradiction if one accepts that economic motivation is premised on personal gain alone. The economic activity of social entrepreneurs is presumed altruistic, their actions intending to primarily benefit others. The theoretical and actual motivations, social networks and values of these actors are compared in this article. A series of semi-structured interviews of prominent social entrepreneurs in the west of England form the basis of analysis. Subjects were selected through a nomination-referral technique that allows targeting for interview those who are considered prominent in the sector within the chosen location. Two types of analysis are attempted: a narrative exploration of their motivations and a semantic networks analysis of their statements. There is evidence of a conceptual association between those actors’ success, entrepreneurship, motivation and social relations that indicate profitable avenues for future research. Some policy recommendations are offered in the conclusion. The multiple roles of social entrepreneurs and the multiple audiences they address indicate multidimensional agency. The development of the sector depends on comprehending conflict inherent in their multiple agendas.< /i>
Dietscher,C., Pelikan,J.M., Schmied,H. (2014):
Health Promoting Hospitals. In: McQueen,D. (Ed.), Oxford Bibliographies in Public Health New York: Oxford University Press.
Abstract | Full Text
Health Promoting Hospitals” (and health services) (HPH) is a hospital reform concept developed in Europe that has also roots in early initiatives of the 1970s and 1980s in the United States under the label of “hospital health promotion.” HPH, which is based on the Ottawa Charter (1986) of the World Health Organization (WHO) and is promoted by WHO, was developed and started to be implemented in the late 1980s. The current definition of HPH is that it aims at improving the health outcomes of hospital patients, staff, and community, and at enhancing its health impact on the hospital´s environment. HPH can be understood as a policy concept with a strong research tradition< /i>
Gobina,I., Villberg,J., Villerusa,A., Välimaa,R., Tynjälä,J., Ottova-Jordan,V., Ravens-Sieberer,U., Levin,K., Cavallo,F., Borraccino,A., Sigmund,E., Andersen,A., Holstein,B.E. (2014):
Self-reported recurrent pain and medicine use behaviours among 15-year olds: Results from the international study. OnlineFirst published in: European Journal of Pain. European Journal of Pain n/a.
Abstract | Full Text
BACKGROUND: There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries.
METHODS: The World Health Organization (WHO) collaborative international Health Behaviour in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep.
RESULTS: More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were much higher for girls, the association between pain and medicine use was similarly strong for both genders. Adolescents with recurrent pain are more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across countries despite large-country differences in the prevalence of recurrent pain and medicine use.
CONCLUSIONS: Recurrent pain in adolescence is common cross-nationally. Adolescents with recurrent pain are more likely to use medicine in general. Recurrent pain and medicine use should be addressed in adolescent health policies.< /i>
Griebler,U., Rojatz,D., Simovska,V., Forster,R.(2014):
Effects of student participation in school health promotion: a systematic review. Advance Access published in: Health Promotion International. Health Promotion International.
Abstract | Full Text
The aim of this systematic review was to summarize systematically the existing evidence for the effects of student participation in designing, planning, implementing and/or evaluating school health promotion measures. The focus was on the effects of participation in school health promotion measures rather than on student involvement at school in general. Participation is a core value for health promotion but empirical evidence of its outcomes is scarce. We searched major bibliographic databases (including ASSIA, ERIC, PsycINFO, Scopus, PubMed and the Social Sciences Citation Index). Two reviewers independently decided about inclusion and exclusion of the identified abstracts (n = 5075) and full text articles. Of the 90 full text articles screened, 26 papers met the inclusion criteria. We identified evidence for positive effects, especially for the students themselves, the school as organization, and interactions and social relations at school. Almost all included studies showed personal effects on students referring to an increased satisfaction, motivation and ownership, an increase in skills, competencies and knowledge, personal development, health-related effects and influence on student perspective. Given that student participation has more been discussed as a value, or ideal of health promotion in schools, these findings documenting its effectiveness are important. However, further research is needed to consider the level or intensity of involvement, different approaches and stages of participation in the health promotion intervention, as well as mediating factors such as gender, socio-cultural background or academic achievement, in a more systematic manner.
Gugglberger,L., Inchley,J. (2014):
Phases of health promotion implementation into the Scottish school system. doi: 10.1093/heapro/das061. Health Promotion International, 29 (2), 256-266.
Abstract | Full Text
Schools have been identified as ideal settings for health promotion (HP) among children, adolescents and school staff. Most European countries have established strategies to implement HP into their school system, however, little is known about these national strategies and how effective they have been. School HP implementation concerns processes of adoption, adaptation and operation of a complex intervention into a complex setting. This study analyses the processes that have led to school HP implementation in Scotland from the 1980s until now to identify key factors which facilitated and supported effective implementation. In the tradition of case-study research, 14 interviews with representatives of national and local organizations involved in school health, as well as with school staff were conducted. Furthermore, policy documents, reports and guidelines were collected. The data were analysed following a Grounded Theory approach. Four phases of school HP implementation into the Scottish school system were identified: (i) getting started (1980s-1998), (ii) political will and strategic vision (1999-2001), (iii) national leadership (2002-2008), and (iv) integration and embedding into education system (2008-ongoing). Throughout the phases political will and committed actors, the strategy/tradition to give power to the local authorities and individual schools, and the establishment of partnerships and ownership have supported implementation. Scotland is an interesting case giving important insights into the ways and possibilities of negotiating an interdisciplinary and cross-sectoral theme such as HP in schools. Further research concerning different political systems and national implementation processes is important to widen the understanding of national implementation strategies of school HP.
Gugglberger,L., Flaschberger,E., Teutsch,F. (2014):
'Side effects' of health promotion: an example from Austrian schools. Health Promotion International, doi: 10.1093/heapro/dau054, First published online: July 4, 2014.
Abstract | Full Text
While the existence of side effects of medical interventions is common knowledge and widely investigated, possible unintended effects of health promotion (HP) interventions are only sparsely discussed in the HP literature. Drawing on qualitative evaluation data generated within an on-going process evaluation of a regional health-promoting schools network in Austria, we demonstrate which desirable and undesirable effects HP practice can have for teachers. Thirteen group discussions with teachers (n = 63) and headteachers (n = 9) acting as health coordinators in the network schools were conducted between 2010 and 2013. These data were analysed using systems and thematic analyses. In our example, desirable side effects included health coordinators gaining new relationships, new skills and benefiting from improved infrastructure. The undesirable side effects centred on stress, work overload and frustration, due to the additional work brought about by HP practice, negative reactions by colleagues as well as by technicalities of the network. The undesirable side effects of HP predominated in our study, pointing to several implications like the need to accommodate the concept of HP in the teachers' core responsibilities; the participation of all staff members and students in a whole-school approach toward SHP, and the need for changes on an organizational level. Based on this study, we come to the conclusion that a systematic approach to investigating and analysing side effects of HP is currently lacking in HP research and suggest that theoretical examination and more empirical research is needed.
Hartley,J., Levin,K., Currie,C. (2014):
A new version of the HBSC Family Affluence Scale - FAS III: Scottish qualitative findings from the international FAS development study. Accepted for Publication in: Child Indicators Research.
Abstract | in press
Coming soon!
Hofmann,F., Flaschberger,E., Felder-Puig,R. (2014):
Wirkung schulischer Gesundheitsförderung auf soziale Ungleichheit. Systematischer Review. Prävention und Gesundheitsförderung, 9 (1), 16-21.
Abstract | Full Text
HINTERGRUND: Ausgehend von der These, dass gesundheitspolitische Interventionen bei privilegierten Gruppen prinzipiell besser wirken, wurde untersucht, inwiefern dies auch auf die schulische Gesundheitsförderung zutrifft.
METHODE: Auf Basis eines systematischen Reviews sollte beurteilt werden, ob einschlägige Interventionen die soziale Ungleichheit weiter vergrößern. Zwei Reviewer selektierten unabhängig voneinander die Ergebnisse umfassender Datenbankabfragen auf Basis vorab definierter Inklusionskriterien, 25 Arbeiten wurden ausgewählt.
ERGEBNISSE: Die meisten Interventionen zu Ernährungs- und Bewegungsthemen erhöhten die Ungleichheit zwischen den Geschlechtern. Auf ethnische und sozioökonomische Ungleichheit traf dies nur vereinzelt zu. Im Bereich Zahngesundheit fand sich keine Intervention, die die soziale Ungleichheit vergrößerte. In puncto psychische Gesundheit und Substanzkonsum zeigten sich gemischte Effekte, je nach Art der Intervention und Outcomeindikator.
SCHLUSSFOLGERUNG: Die Ausgangsthese lässt sich nur eingeschränkt auf die schulische Gesundheitsförderung übertragen. Bestimmte Maßnahmen können eine Vergrößerung der Ungleichheit offenbar verhindern.
Hofmann,F., Felder-Puig,R. (2014):
Lehrergesundheit in verschiedenen Schultypen: Detailergebnisse der österreichischen Sekundarschullehrerbefragung. Prävention und Gesundheitsförderung, 9 (4), 274-280.
Abstract | Full Text
HINTERGRUND: Auf Basis der Daten aus der österreichischen Sekundarschullehrerbefragung wurde der Einfluss der Faktoren Schultyp, Schulstandort und Schülermerkmale auf das berufsspezifische gesundheitliche Belastungserleben der Lehrkräfte untersucht.
METHODIK: Analysiert wurden die Antworten der 3753 Lehrkräfte auf Fragen nach der beruflichen Beanspruchung, dem Grad der emotionalen Erschöpfung, der eingeschätzten Erreichbarkeit des gesetzlichen Pensionsantrittsalters und anderer Gesundheitsindikatoren wie Lebenszufriedenheit oder subjektiver Gesundheitszustand. Diese wurden in Beziehung gesetzt zur Tätigkeit in 5 verschiedenen Schultypen, einer Kategorisierung des Schulstandorts in Stadt und Land sowie bestimmten Merkmalen der Schüler aus Sicht ihrer Lehrer. Die Zusammenhangsanalysen wurden mittels Odds Ratios durchgeführt.
ERGEBNISSE: Die Lehrkräfte an den Hauptschulen, v. a. jenen im urbanen Bereich, zeigten sich in höherem Umfang beruflich beansprucht, emotional erschöpft und erwarteten einen früheren Pensionsantritt als ihre Kollegen aus anderen Schultypen. Ein ähnliches Bild zeigte sich bei der Lebenszufriedenheit und dem subjektiven Gesundheitszustand. Die Ergebnisse weiterer Analysen stützten zudem die These, dass dies auch auf die ungleiche Verteilung der Schülermerkmale auf die Schultypen zurückgeführt werden kann. Handlungsempfehlungen wurden unter Berücksichtigung aktueller Schulreformen formuliert.
Horn,A., Vogt,D., Kleina,T., Schaeffer,D. (2014):
Konzepte zur Bewegungsförderung in der Langzeitversorgung - Eine Orientierungshilfe für stationäre Pflegeeinrichtungen. Pflege & Gesellschaft, 19 (2), 138-151.
Abstract | Coming soon
Coming soon!
Kleina,T. (2014):
Mobilität und Bewegungsfähigkeiten von Nutzern stationärer Langzeitversorgung. Ergebnisse einer Analyse von Studienergebnissen und Versorgungsdaten. Pflege & Gesellschaft, 19 (2), 101-112.
Abstract | Coming soon.
Coming soon!
Klinger,D.A., Freeman,J., Bilz,L., Liiv,K., Ramelow,D., Sebok,S.S., Samdal,O., Dür,W., Rasmussen,M. (2014):
Cross-National Trends in Perceived School Pressure by Gender and Age from 1994 to 2010: The Health Behaviour in School-aged Children (HBSC) Study. Accepted for publication in: European Journal of Public Health.
Abstract | in press
coming soon
Krajic,K., Cichocki,M., Quehenberger,V.(2014):
Health-promoting residential aged care: a pilot project in Austria. Advance Access published in: Health Promotion International. Health Promotion International doi: 10.1093/heapro/dau012.
Abstract | Full Text
Long-term care for the aged is an area that has not been in the focus of health promotion so far. The paper describes context, concept and project plan of a 2-year pilot project of comprehensive health-promoting setting development in residential aged care in Austria, and provides an overview over main experiences and results. Austria's most relevant health promotion agencies, a specialized scientific institute and Austria's largest provider of aged care acted as partners. The project aimed at developing elements of a comprehensive approach, but also providing evidence for the effectiveness of health promotion. Therefore, the project combined an organizational development approach with a scientific, randomized controlled study on mobility enhancement for residents. A comprehensive settings approach turned out acceptable for the main stakeholders of aged care (owners and management, staff, residents and residents’ relatives). Strategy development, based on a systematic needs assessment, found staff health to be of special interest for the organization (ergonomics, workability over life course), and residents' relatives, got more attention. The mobility study was able to achieve positive results on occupational performance, concerning quality-of-life indicators and reached also formerly inactive groups. After the end of the project, health promotion is still on the agenda of the organization; further developments will be monitored. Good support from the policy level and well-established networking between the aged care provider, health promotion agencies and a network for health promotion in health care seems to have been an important resource for success.
Lawitschka,A., Guclu,E.D., Varni,J.W., Putz,M., Wolff,D., Pavletic,S., Greinix,H., Peters,C., Felder-Puig,R. (2014):
Health-related quality of life in pediatric patients after allogeneic SCT: development of the PedsQL Stem Cell Transplant module and results of a pilot study. doi:10.1038/bmt.2014.96, First published 12. May 2014. Bone Marrow Transplantation.
Abstract | Full Text
With increased survival after pediatric allogeneic hematopoietic SCT health-related quality of life (HRQL) has emerged as an essential health outcome. The impact of transplant and chronic GVHD (cGVHD)-associated morbidity remains a major obstacle. In 2005, the National Institutes of Health (NIH) Consensus Conference on Criteria for Clinical Trials in cGVHD recommended HRQL tools as an independent measure of the impact of disease burden. The NIH recommendations did not provide a cGVHD-specific tool for HRQOL measures in children. This report focuses on the development of an SCT-specific instrument to assess HRQL in children and adolescents. For the assessment of generic HRQL we chose the PedsQL (Pediatric Quality of Life Inventory) Generic Cores Scales, which have been used in a large number of healthy, acutely ill and chronically ill children and adolescents. To capture SCT- and, specifically, cGVHD-related problems, we developed the PedsQL Stem Cell Transplant module by reviewing the literature, taking over some items/scales of other PedsQL modules, interviewing patients, parents and members of the health-care team, and applying the PedsQL measurement methods. The final PedsQL Stem Cell Transplant module consists of the HRQL domains: pain and hurt, fatigue/sleeping problems/weakness, nausea, worry/anxiety about disease/treatment, nutritional problems, neurocognitive problems, communication about disease/treatment, loneliness, physical functioning and additional somatic complaints (pruritus, skin inflammation, oral problems, eyes or breathing) including patients’ and parents’ assessment. It was tested in 35 pediatric patients, who were referred to our SCT Outpatient Clinic about 100 days post SCT. Both the generic PedsQL and the SCT-specific scales showed high internal consistency, with Cronbach alpha levels of greater than or equal to0.70 in almost all scales. Most problems were detected within the HRQL domains of physical functioning and pain. The summary scores of the generic PedsQL and the PedsQL Stem Cell Transplant module showed high correlations (r=0.89 in patients’ and r=0.81 in parents’ assessments). Moreover, both tools discriminated between patients with and without cGVHD. The PedsQL Stem Cell Transplant module is practical for use and suitable across a broad age range (2–18 years) both in patients with and without cGVHD. However, it is still a pilot instrument and needs further development and testing in a larger patient population.
Lee,C.B., Chen,M.S., Chien,S.H., Pelikan,J.M., Wang,Y.W., Chu,C.M.-Y. (2014):
Strengthening health promotion in hospitals with capacity building: a Taiwanese case study. Advance Access published in: Health Promotion International. Health Promotion International.
Abstract | Full Text
Organizational capacity building for health promotion (HP) is beneficial to the effective implementation of HP in organizational settings. The World Health Organization (WHO) Health Promoting Hospitals’ (HPHs) initiative encourages hospitals to promote the health of their stakeholders by developing organizational capacity. This study analyzes an application case of one hospital of the HPH initiative in Taiwan, characterizes actions aiming at building organizational support to strengthen health gains and identifies facilitators of and barriers to the implementation of the HP in this hospital. Case study methodology was used with a triangulation of various sources; thematic analysis was used to analyze qualitative information. This study found a positive impact of the HPH initiative on the case hospital, such as more support from leadership, a fine-tuned HP mission and strategy, cultivated pro-HP habits of physical activities, a supportive intramural structure, an HP-inclusive system, improved management practices and enhanced staff participation. Transformational and transactional enablers are of equal importance in implementing HPH. However, it was also found that the case hospital encountered more transactional barriers than transformational ones. This hospital was hindered by insufficient support from external environments, leadership with limited autonomy and authority, a preference for ideals over professionalism, insufficient participation by physicians, a lack of manpower and time, a merit system with limited stimulating effect, ineffective management practices in weak central project management, a lack of integration, insufficient communication and an inability to inculcate the staff on the importance of HP, and inadequate staff participation. Several implications for other hospitals are suggested.
Levin,K.A., Dundas,R., Miller,M., McCartney,G. (2014):
Socioeconomic and geographic inequalities in adolescent smoking: A multilevel cross-sectional study of 15 year olds in Scotland. Social Science & Medicine, 2014 (107), 162-170.
Abstract | Full Text
The objective of the study was to present socioeconomic and geographic inequalities in adolescent smoking in Scotland. The international literature suggests there is no obvious pattern in the geography of adolescent smoking, with rural areas having a higher prevalence than urban areas in some countries, and a lower prevalence in others. These differences are most likely due to substantive differences in rurality between countries in terms of their social, built and cultural geography. Previous studies in the UK have shown an association between lower socioeconomic status and smoking. The Scottish Health Behaviour in School-aged Children study surveyed 15 year olds in schools across Scotland between March and June of 2010. We ran multilevel logistic regressions using Markov chain Monte Carlo method and adjusting for age, school type, family affluence, area level deprivation and rurality. We imputed missing rurality and deprivation data using multivariate imputation by chained equations, and re-analysed the data (N = 3577), comparing findings. Among boys, smoking was associated only with area-level deprivation. This relationship appeared to have a quadratic S-shape, with those living in the second most deprived quintile having highest odds of smoking. Among girls, however, odds of smoking increased with deprivation at individual and area-level, with an approximate dose–response relationship for both. Odds of smoking were higher for girls living in remote and rural parts of Scotland than for those living in urban areas. Schools in rural areas were no more or less homogenous than schools in urban areas in terms of smoking prevalence. We discuss possible social and cultural explanations for the high prevalence of boys' and girls' smoking in low SES neighbourhoods and of girls' smoking in rural areas. We consider possible differences in the impact of recent tobacco policy changes, primary socialization, access and availability, retail outlet density and the home environment.
Marent,B., Wieczorek,C., Schmied,H., Horn,A., Kleina,T., Schäffer,D., Dür,W. (2014):
Gesundheitsförderung in der stationären Altenbetreuung: Förderliche und hinderliche Faktoren bei der Implementation eines Mobilitätsprogramms. DOI 10.1007/s11553-014-0463-0. Prävention und Gesundheitsförderung, 2014 (4), 298-304.
Abstract | Full Text
HINTERGRUND: Implementationsforschung rückt immer stärker in den Fokus der Gesundheitsförderungsforschung. Sie zielt darauf, innovative und wirksame Gesundheitsprogramme der Praxis zugänglich zu machen und deren effektive Umsetzung sicherzustellen. Für das Setting der stationären Altenbetreuung wurden bislang kaum Studien durchgeführt, die aufzeigen, welche Faktoren den Implementationsprozess von Gesundheitsförderungsprogrammen begünstigen oder behindern.
METHODE: Durch eine qualitative Studie wurde der Implementationsprozess eines Programms zur Mobilitätsförderung für alte Menschen in drei Wiener Pensionisten-Wohnhäusern untersucht. Dabei wurden 12 teilstrukturierte Interviews mit Personen geführt, die bei der Implementation in einer leitenden oder operativen Verantwortung standen.
ERGEBNISSE: Die strategische Verankerung des Programms und die damit verbundene starke Wahrnehmung der Führungsrolle der leitenden Mitarbeiter/innen haben sich als förderliche Faktoren erwiesen. Des Weiteren war das Programm anschlussfähig an das Rollenverständnis und die Expertise der für die Umsetzung verantwortlichen Berufsgruppe und bot dieser Möglichkeiten zur beruflichen Weiterentwicklung sowie Spielräume für Autonomie. Hinderlich war ein zeitgleicher organisationaler Umstrukturierungsprozess, im Zuge dessen die Implementation des Programms von allen befragten Personen als zusätzliche Belastung wahrgenommen wurde. Außerdem fehlten Strukturen für Austausch und Kooperationen.
SCHLUSSFOLGERUNG: Neben der strategischen Verankerung benötigt eine erfolgreiche Implementierung eines Mobilitätsprogramms ein operatives Management, das Koordinationsaufgaben wahrnimmt und notwendige Unterstützungsstrukturen (für Austausch und Kooperation) schafft.
Osrecki,F., Denk,E., Dür,W. (2014):
Steuerung und Autonomie: Bedingungen und Nebenfolgen gelingender Gesundheitsförderung an österreichischen Volksschulen - eine Fallstudie. Online First veröffentlich in: Zeitschrift für Bildungsforschung. Zeitschrift für Bildungsforschung.
Abstract | Full Text
Thema des vorliegenden Beitrags sind institutionell-organisatorische Schulreformen wie sie von der schulischen Gesundheitsförderung gerahmt und umgesetzt werden. Es wird gezeigt, dass sich die schulische Gesundheitsförderung stark an managerialen und kontrollierenden Steuerungskonzepten im Bildungssektor orientiert, die selten Akzeptanzprobleme seitens des Lehrkörpers reflektieren und zudem Schulen einen Akteursstatus unterstellen, den österreichische Volksschulen in der Regel nicht genießen. Dass diese Faktoren in produktiver Weise bei der Umsetzung schulischer GF-Programme beachtet werden können und welche unbeabsichtigten Nebenfolgen dies mit sich führt, wird anhand eines empirischen Falles dargestellt – der Implementation eines Gesundheitsförderungsprogramms an drei österreichischen Volksschulen. Es kann gezeigt werden, dass derartige Maßnahmen dann nachhaltig implementiert werden können, wenn sie der für das österreichische Schulsystem typischen bürokratisch-professionellen Doppelsteuerung Rechnung tragen. Die unbeabsichtigte Nebenfolge dieser Implementationspraxis ist jedoch eine Zweck-Mittel-Verschiebung, die dazu führt, dass solche Maßnahmen nicht nur wegen erwartbarer gesundheitsfördernder Effekte implementiert werden, sondern auch, um höheren Schulverwaltungseben gegenüber Reformwillen zu demonstrieren.
Pförtner,T.-K., Rathmann,K., Elgar,F., de Looze,M., Hofmann,F., Ottova-Jordan,V., Ravens-Sieberer,U., Boskova,L., Currie,C., Richter,M.(2014):
Adolescents' psychological health complaints and the economic recession in late 2007: a multilevel study in 31 countries. Advance Access published in: European Journal of Public Health.
Abstract | Full Text
BACKGROUND: The recent economic recession, which began in 2007, has had a detrimental effect on the health of the adult population, but no study yet has investigated the impact of this downturn on adolescent health. This article uniquely examines the effect of the crisis on adolescents' psychological health complaints in a cross-national comparison.
METHODS: Data came from the World Health Organization collaborative 'Health Behaviour in School-aged Children' study in 2005-06 and 2009-10. We measured change in psychological health complaints from before to during the recession in the context of changing adult and adolescent unemployment rates. Furthermore, we used logistic multilevel regression to model the impact of absolute unemployment in 2010 and its change rate between 2005-06 and 2009-10 on adolescents' psychological health complaints in 2010.
RESULTS: Descriptive results showed that although youth and adult unemployment has increased during the economic crisis, rates of psychological health complaints among adolescents were unaffected in some countries and even decreased in others. Multilevel regression models support this finding and reveal that only youth unemployment in 2010 increased the likelihood of psychological health complaints, whereas its change rate in light of the recession as well as adult unemployment did not relate to levels of psychological health complaints.
CONCLUSION: In contrast to recent findings, our study indicates that the negative shift of the recent recession on the employment market in several countries has not affected adolescents' psychological health complaints. Adolescents' well-being instead seems to be influenced by the current situation on the labour market that shapes their occupational outlook.
Philipp,J., Zeiler,M., Waldherr,K., Nitsch,M., Dür,W., Karwautz,A., Wagner,G. (2014):
The Mental Health in Austrian Teenagers (MHAT) - Study: preliminary results from a pilot study. DOI 10.1007/s40211-014-0131-9. Neuropsychiatrie, 28 (4), 198-207.
Abstract | Full Text
BACKGROUND: No epidemiological data on prevalence rates of mental disorders based on a representative sample are available for Austrian adolescents up to now. However, the knowledge of psychiatric disorders, related risk and protective factors is of great significance for treatment and prevention. The purpose of the MHAT-Study (Mental Health in Austrian Teenagers), the first epidemiological study on mental health in Austria, is to obtain prevalence rates of mental disorders and to examine risk factors, protective factors and quality of life in a representative sample of adolescents aged 10-18. Aims of this pilot study were to evaluate the feasibility and acceptability of the screening instruments, pre-estimate the frequency of mental health problems and estimate possible non-responder bias.
METHODS: Twenty-one schools in eastern Austria were asked to participate. Data on mental health problems were derived from self-rating questionnaires containing standardized screening measures (Youth Self-Report, measuring emotional and behavioral problems and the SCOFF, indicating eating problems. Quality of life as well as related risk and protective factors were also obtained.
RESULTS: Four hundred and eight adolescents of five schools were recruited. The prevalence of mental health problems was 18.9 % [CI 95 %: 14.9-22.7]. Moreover, emotional and behavioral problems were highly correlated with quality of life measures. A Non-Responder Analysis indicated that non-responders (16.7 %) differ from responders with regard of school related problems.
CONCLUSIONS: The results demonstrate that mental health problems affect approximately one fifth of the adolescents. A Non-Responder Analysis suggests that the prevalence of behavioral and emotional problems is underestimated.
Quehenberger,V., Cichocki,M., Krajic,K.(2014):
Sustainable effects of a low-threshold mobility enhancement intervention on health-related quality of life in residential aged care. Clinical Interventions in Aging, 2014 (9), 1853-1864.
Abstract | Full Text
BACKGROUND: Mobility is a main issue for health-related quality of life in old age. There is evidence for effects of physical activity (PA) interventions on several dimensions of health for the aged and also, some specific evidence for vulnerable populations, like residents of residential aged care. Research on low-threshold PA interventions for users of residential aged care and documentation of their sustainability are scarce. “Low threshold” implies moderate demands on the qualification of trainers and low frequency of conduct, implying low demands on the health status and discipline of users. Yet the investigation of low-threshold interventions in residential aged care seems important as they might foster participation of users and implementation in everyday routines of provider organizations. An initial study (October 2011 to June 2012) had found intervention effects on health-related quality of life. The objective of this study was to examine sustainability of the effects of a low-threshold PA intervention on health-related quality of life in residential aged care.
METHODS: Data collection took place in three residential aged care homes in Vienna, Austria. At 1-year follow-up (June 2013), participants from the intervention group were interviewed using a standardized questionnaire. Using general mixed linear models and Friedman tests followed by paired t- and Wilcoxon signed-rank tests, we compared outcome measures at follow-up with measures obtained at baseline and at the end of the intervention.
RESULTS: At the 1-year follow-up assessment, participants’ (mean age 84.7 years; 89.7% female) subjective health status was still significantly increased, equaling a small sustainable intervention effect (Cohen’s d=0.38, P=0.02). In comparison with baseline, a significant decline of reported pain/discomfort (P=0.047) was found. Regarding the subdimensions of health-related quality of life, favorable trends could be observed.
CONCLUSION: The study indicates that effects of a low-threshold PA intervention on health-related quality of life in residential aged care can be sustainable. Addressing hindering factors like poor health status and implementing proactive support and individualization of the program to enable PA for residents might foster sustainability of effects.
Ramelow,D., Gugglberger,L. (2014):
Die Dimensionen eines gesunden Schulklimas für Schülerinnen und Schüler - Eine qualitative Untersuchung. Prävention und Gesundheitsförderung , 2014 (4), 253-258.
Abstract | Full Text
HINTERGRUND: Die Schule gilt als wichtiger Ort, um auf die Gesundheit und das Wohlbefinden von Schülern einzuwirken. Im Zusammenhang mit schulischer Gesundheitsförderung wäre dabei v. a. das Schulklima gut von Schulen beeinflussbar, ist jedoch im deutschsprachigen Raum bislang wenig erforscht.
FRAGESTELLUNG: Mit diesem Artikel gehen wir der Fragestellung nach, welche Dimensionen des Schulklimas für Schüler verschiedener Schultypen in Wien wichtig sind.
MATERIAL UND METHODEN: Es wurden sechs Fokusgruppen mit Schülern verschiedener Altersgruppen an sechs Schulen durchgeführt und mittels Themenanalyse analysiert.
ERGEBNISSE: Die vier wichtigsten Dimensionen eines gesunden Schulklimas sind für Schüler: das Fehlen von Mobbing, eine interessante Unterrichtsgestaltung, gute soziale Beziehungen mit anderen Schülern und Lehrpersonen sowie ein sauberes Schulgebäude. Wenn Schüler eher abstrakt priorisieren (anhand von vorgefertigten Kärtchen), ist ihnen auch das Fehlen von körperlicher Gewalt wichtig.
DISKUSSION: Unsere Ergebnisse lassen sich mit Dimensionen aus der Literatur gut vergleichen, wobei einige Spezifika vorherrschen, die eventuell auf das österreichische Schulsystem zurückzuführen sind.
Sherriff,N., Gugglberger,L. (2014):
A European Seal of Approval for 'gay' business: findings from an HIV-prevention pilot project. Perspectives in Public Health, 134 (3), 150-159.
Abstract | Full Text
AIMS: 'Gay' businesses can be important settings through which to deliver health promotion interventions to vulnerable populations, such as men who have sex with men (MSM) regarding HIV prevention. This article draws on data from the European Everywhere project, which represents the first scheme to develop and pre-test a common framework for HIV/STI prevention in 'gay' businesses across eight European countries.
METHODS: The scientific basis of the Everywhere framework was developed using a comprehensive consensus-building process over 30 months. This process included: formative scoping research; interviews with 54 'gay' businesses; meetings/workshops with representatives from project partners, 'gay' businesses, public health administrations and external experts; 15 interviews and three focus groups with project partners; a five-month pilot action phase in eight countries, together with support from the project's Advisory Group; and all Everywhere project partners including the Scientific Steering Committee.
RESULTS: A voluntary European code setting out differentiated HIV/STI-prevention standards for 'gay' businesses (including sex venues, 'gay' and 'gay' friendly social spaces, travel agencies, hotels, dating websites) was developed and piloted in eight European cities. During a five-month pilot action, 83 'gay' businesses were certified with the Everywhere Seal of Approval representing a considerable increase on the expected pilot target of 30.
CONCLUSIONS: Everywhere offers a major contribution to the public health and/or health promotion field in the form of a practical, policy-relevant, settings-based HIV-prevention framework for 'gay' businesses that is common across eight European countries. Findings suggest that a European-wide model of prevention is acceptable and feasible to businesses.
Sherriff,N., Gugglberger,L., Hall,C., Scholes,J. (2014):
"From Start to Finish": Practical and Ethical Considerations in the Use of Focus Groups to Evaluate Sexual Health Service Interventions for Young People. Qualitative Psychology, 1 (2), 92-106.
Abstract | Full Text
Focus groups have become an important method in qualitative psychological research and are also used widely in evaluation studies. However, there has been a surprising lack of attention in the literature in terms of exploring the entire process of conducting focus groups with young people on potentially psychologically sensitive issues such as sexual health. This article draws on our experiences of using focus groups during a specific piece of qualitative research that involved 3 discrete but interrelated evaluations of sexual health services for young people in the South of England. We focus particularly on the process of using focus groups as an important and useful empirical method to generate primary qualitative data. In doing so, we consider a number of both practical and ethical considerations when planning, facilitating, and following up focus groups with young people that aim to investigate psychologically sensitive issues, in this case, sexual health. As a result, we propose a heuristic framework for conducting focus groups “from start to finish” including preparing focus groups, facilitating focus groups, and following up participants, that offers a contribution to the advancement of qualitative inquiry in psychology. Key recommendations are elicited both for the teaching of qualitative psychological research methods and for the training of qualitative researchers interested in psychological phenomena.
Van den Broucke,S., van der Zanden,G., Chang,P., Doyle,G., Levin,D., Pelikan,J.M., Schillinger,D., Schwarz,P., Sorensen,K., Yardley,L., Riemenschneider,H. (2014):
Enhancing the Effectiveness of Diabetes Self-Management Education: The Diabetes Literacy Project. eFirst published in: Hormone and Metabolic Research. Horm Metab Res.
Abstract | Full Text
Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels.