Scandinavian Journal of Public Health最新文献

Aims: The growing burden of non-communicable diseases (NCDs) across Europe highlights the urgent need for robust, high-quality health data. Fragmented monitoring systems and inconsistent standards across Member States hinder coordinated and effective public health action. The European Union-funded Joint Action PreventNCD (JA PreventNCD) work package on monitoring addresses these challenges by promoting harmonised methodologies, exploring innovative technologies and identifying gaps. The work package aims to build capacity at all levels, support evidence-based policymaking and shift the focus towards prevention, contributing to a reduction of the NCD burden and health inequalities throughout Europe.

Methods: The work package strengthens NCD monitoring across Europe through mapping, method harmonisation, knowledge exchange and pilot testing. Activities span clinical and population-level monitoring, healthcare access and costs, and integration of diverse data sources - surveys, registries, biomarkers and citizen-generated data. Innovative tools, including machine learning and risk modelling, support early detection and prevention. Structured into five tasks, the work package promotes cross-border comparability and effective data communication. Pilot actions on pooled surveys, economic modelling and digital tools feed into the development of a Monitoring Assessment Tool long-term interoperable monitoring system.

Conclusion: The JA PreventNCD work on monitoring advances the clinical, individual and populational-level NCD monitoring systems across Europe by identifying gaps in interoperability, sharing protocols and facilitating cross-border learning. By strengthening NCD and risk factor monitoring, the evidence base for prevention policy development improves. Thereby support joint efforts to reduce burden of disease and health inequalities in line with the European Beating Cancer Plan and the Healthier together-initiative.

Aims: The paper presents a novel approach to foster sustained integration of the outcomes of the large-scale JA PreventNCD project into national and European policies.

Methods: We develop an operational definition of sustainability of public health activities that is designed to recognize and analyse the main factors and potential drivers of sustained uptake of the outcomes of public health projects into policies. We use the policy and the accountability cycles as a theoretical basis to conceptualize and develop the sustainability approach for the JA PreventNCD, intended for wider application beyond the end of the project. The accountability cycle is used to analyse how the dynamics of youth engagement as a form of social participation, and of wellbeing economy approaches, could contribute to sustained integration of project outputs into public health practices and policies at national and European levels.

Conclusions: Conceptualized through the policy and the accountability cycles, youth engagement and wellbeing economy should be key principles of the sustainability strand of JA PreventNCD, with the potential to increase the effectiveness and long-term sustainability of public health interventions across Europe. Achieving long-term sustainability of outcomes requires particular attention to be directed toward the latter stages of the accountability cycle - enforcement and improvement - which are often underdeveloped compared with the earlier stages of assessment and communication.

Noncommunicable diseases (NCDs) account for the majority of mortality and morbidity in the World Health Organization (WHO) European region, largely driven by modifiable commercial determinants. Despite strong evidence supporting cost-effective interventions, implementation has been inconsistent due to industry interference, limited resources and policy inertia. To address this, WHO/Europe has identified a set of 'quick buys' capable of producing measurable health outcomes within 5 years. Experience shows that voluntary measures, pilot projects and the exchange of good practices alone are insufficient to achieve the 2030 Sustainable Development Goal (SDG) targets, making mandatory, well-enforced policies urgently needed to deliver the scale and speed of change required. As the 2030 SDG deadline approaches, accelerating policy action, strengthening surveillance systems and safeguarding public health governance from commercial interests are essential to reducing the NCD burden and achieving regional health targets.

Aims: A significant number of children and adolescents are insufficiently physically active and have a sedentary lifestyle, which is associated with adverse health outcomes, necessitating effective interventions. Using a participatory approach, which engages youth in intervention development, may enhance intervention effectiveness, as such interventions are believed to be more tailored to the needs of the target group. This scoping review aimed to provide an overview of the results of process and effect evaluations of studies that developed school-based physical activity and/or sedentary behaviour interventions using a participatory approach among children and adolescents.

Methods: Six databases (MEDLINE, Embase, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus and SPORTDiscus) were searched. Studies were included when they evaluated the participatory process, intervention implementation or health-related intervention effects. A quality assessment was completed using two QualSyst checklists. Extracted data included characteristics of studies, interventions, and participatory processes; characteristics of participants from whom data were collected; outcomes measured and measurement methods used; and key findings.

Results: Twenty-five papers, covering 18 original studies, were included. Studies suggested that participatory processes were generally perceived positively, resulting in pupils feeling empowered, experiencing ownership and gaining certain skills. Participatory developed interventions also seemed to be generally well received, although the intervention dose delivered and intervention reach seemed to vary between studies. Finally, studies generally tended to report no effects on health.

Conclusions: Although a participatory approach could be promising in empowering pupils and promoting intervention acceptance, apparent differences in intervention implementation and limited effectiveness highlight the need to enhance participatory processes and intervention effectiveness.

Aims: Non-communicable diseases (NCDs) account for more than two thirds of the burden of disease in Europe. At the population level, substantial disparities exist based on socioeconomic status, geographical area, age, disability, gender, and ethnicity. A large part of this disease burden is preventable. The aim of the Joint Action PreventNCD is to support strategies, policies, and practices designed to reduce the burden of NCDs and their common risk factors. This is achieved through collaboration between Member States of the European Union, Iceland, Norway, and Ukraine acting on health determinants and increasing protective factors for health and wellbeing, both at a personal and societal level. A critical objective is to contribute to reduced social inequalities associated with NCDs. This paper presents the overall design and rationale behind PreventNCD, highlighting the efforts to provide strategic direction and guidance while fostering consolidated efforts to NCD prevention and health promotion.

Methods: Methods include analyzing opportunities for implementing evidence-informed intersectoral policies for preventing NCDs, pilot-testing innovative practices, and scaling up best practices, including both population-based and targeted prevention efforts. Furthermore, methods include building monitoring capacity in the fields of NCD mortality and morbidity, exposure to risk factors, cost of NCD care, and the impact of health promotion and disease prevention efforts.

Conclusions: This is an ambitious effort to strengthen the European Member States' abilities and efforts related to NCD prevention. Key outputs include the identification and implementation of effective policies and practices, and long-term institutional mechanisms for sustained NCD prevention and health promotion.

Background: The Joint Action Prevent Non-Communicable Diseases (JAPreventNCD) supports strategies and policies to reduce the burden of non-communicable diseases (NCDs) by addressing health determinants and promoting cross-sectoral collaboration, recognizing the complexity of these challenges; the Healthy Living Environments work stream aims to implement and evaluate interventions targeting NCD determinants at the local level across the life course, and this paper outlines the protocol developed to achieve that goal.

Methods: We will develop a guide with the Community Action for Health (CAH) methodology but it will be tailored for the specific use of implementing interventions targeting health determinants (e.g. urbanism) and NCD risk factors (tobacco, alcohol), and implemented in local settings across various sectors such as cities, education, workplaces and health services in Europe; while some pilots test new activities, others adapt existing best practices to new contexts, with shared experiences informing the identification of strengths and limitations.

Results: Fifty-one interventions are expected to adopt the common methodology, enhancing participants' capacities for positive health outcomes through shared experiences, while identified limitations, opportunities and lessons will inform future health promotion efforts. A web-based platform for capacity building will contain all materials that can be used to expand the current practices and the identification of building blocks of supersetting infrastructures for local-level health promotion will be crucial for maximizing the project's impact.

Conclusions: This joint effort, drawing on collective knowledge from diverse countries and institutions as a 'European laboratory of health promotion experiences', fosters social innovation in health and requires sustained commitment to achieve meaningful health impacts.

Aims: This longitudinal study evaluated the association between childhood family structure and health-related quality of life (HRQoL) at middle age.

Methods: The data on childhood family structure at the age of 14 years ('two-parent family', 'one parent not living at home/no information on father' and 'father or mother deceased') and HRQoL (measured by 15D (15-dimensional)) at the age of 46 were collected from the Northern Finland Birth Cohort 1966 using postal questionnaires. We used the binary logistic regression model to estimate the associations between childhood family structures and the lowest 15D quartile (reference: all other quartiles). The associations were adjusted for offspring mothers' factors during pregnancy (mothers' educational and occupational status).

Results: Of the 6375 participants, the offspring belonging to the 'one parent not living at home/no information on father' family structure subgroup had higher odds ratio of belonging to the lowest 15D quartile than the offspring of 'two-parent families' (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.31-2.36, p<0.001 for females; adjusted OR 1.86, 95% CI 1.28-2.70, p=0.001 for males). There were no statistically significant associations between the 'father or mother deceased' subgroup and the lowest 15D quartile among the offspring.

Conclusions: A single-parent family origin (due to reasons other than parental death) in childhood was significantly associated with impaired HRQoL at middle age. These results provide new perspectives for understanding the long-standing associations on living in a single-parent family.

Aims: To explore whether a family-based intervention with playful activities among overweight and obese Norwegian children promoted moderate to vigorous and light physical activity compared with a waiting list control group, and to examine whether gross motor competence, isometric body mass index and motivational factors, as reported by the children and their parents, could explain changes observed during a six-month observation.

Methods: A non-randomized cluster-controlled trial with 131 participants, 76 in the intervention group. Participants were aged 6-12 years, and 55 were boys. We performed linear regressions to compare the intervention and the control groups and adjusted linear models to examine predictors for outcomes with the groups merged into one cohort.

Results: We could not demonstrate any intervention effect from the family-based activities. Moderate to vigorous physical activity levels were satisfactory at the start and were maintained during the observation period. None of the predictors could explain outcome status at six months, nor residual change of moderate to vigorous physical activity during the observation. We revealed that parental educational attainment, parental autonomous motivation and the participants' experience of social support impacted light physical activity negatively after six months. Parental education also impacted the residual change of light physical activity negatively during the observation.

Conclusions: The present family-based intervention to improve physical activity among overweight and obese children was ineffective. Baseline activity levels were already satisfactory. Paradoxically, factors such as parental socioeconomic status, autonomous motivation and self-reported support from parents and peers may be associated with diminished physical activity in such contexts. These unexpected findings need to be validated in further studies.

Background: Child Health Services plays an important role in identifying at-risk children and intervening early to break negative trends in child health. Sociodemographic risk factors can impact the workload of Child Health Services and affect the possibilities of providing the national child healthcare programme.

Aims: This study aims to present the sociodemographic characteristics of families who are registered within the Child Health Services, as defined by the Child adjusted Care Need Index.

Methods: By collecting personal identification numbers from children six years or younger registered at a child healthcare centre, and combining this with their caregiver's sociodemographic background, this study was able to create a sociodemographic index for each child healthcare centre in Sweden.

Results: The study included 687,543 children and 1,335,540 caregivers from 981 child healthcare centres in Sweden. Approximately 21% of all children in the study population had a caregiver born in Southern or Eastern Europe outside the European Union, or in Africa, Asia, or South America, 7% had single parents, 17% had at least one unemployed caregiver, and 9% had at least one caregiver who had not completed high school. The average input values and the average index values varied widely both between and within the regions.

Conclusions: This study displays a large variation in sociodemographics for child healthcare centres both within and between regions. Since several regions and national agencies in Sweden use the Child adjusted Care Need Index, it is necessary to keep the dispersion in mind.

Aims: Non-communicable diseases (NCDs), including cancer, cardiovascular diseases, diabetes, and chronic respiratory diseases, are responsible for 74% of deaths worldwide (2019). In Europe, they account for over 91% of deaths and 87% of disability-adjusted life years (DALYs). Mental disorders, also considered NCDs, rank seventh globally in terms of DALYs. These burdens are exacerbated by socioeconomic and educational inequalities that shape the distribution of risk factors and cause preventable disparities in health and mortality. This article presents the new Joint Action on Cancer and other NCDs (JA-PreventNCD), outlining its objectives and methodological strategies to tackle inequalities in Europe.

Methods: The JA-PreventNCD started in January 2024. It was launched under the EU4Health Programme for the period of 2021-2027, with a specific focus on social inequalities. Over its four-year span, the initiative will: (1) collect evidence on inequalities in major NCDs and their risk factors; (2) review policies targeting these disparities; (3) provide training based on an equity lens approach; (4) enhance health literacy through multi-level activities.

Conclusions: The JA-PreventNCD initiative represents a crucial opportunity to address health inequalities related to NCDs across Europe. Its findings will contribute to evidence-based health policies and promote sustainable strategies aimed at closing the gaps. Enhanced collaboration among European countries and the exchange of best practices will foster informed policy-making, leading to long-term improvements in public health.