European Journal of Public Health最新文献

{"title":"Healthcare claims and health interview survey data for chronic disease surveillance: agreement and comparative validity of prevalence indicators for 20 chronic conditions in a general population sample in France.","authors":"Joël Coste, Laurence Mandereau-Bruno, Panayotis Constantinou, Valérie Olié, Anne Thuret, Mathias Bruyand, Tatjana T Makovski, Laure Carcaillon-Bentata","doi":"10.1093/eurpub/ckaf040","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf040","url":null,"abstract":"<p><p>Healthcare claims data are increasingly used to derive chronic condition (CC) surveillance indicators, although comparative evidence with self-reported data remains scarce. We explored the agreement and comparative validity (concurrent and predictive) of 20 CC prevalence indicators independently constructed using the French National Health Data System (SNDS) and Health, Health Care, and Insurance Survey (ESPS 2010-2014). Individual data from 5039 ESPS participants aged ≥25 years, representative of the 2010 French general population, were linked to the SNDS. Follow-up data included a 2014 health self-assessment and 5-year mortality. We considered 20 CCs with corresponding SNDS case-identifying algorithms and self-reported information from ESPS, including most cardiovascular diseases and frequent cancers. Kappa statistics assessed agreement between CC indicators across databases. Polytomous and dichotomous logistic regression assessed determinants of disagreement between sources and associations of indicators with health outcomes (concurrent and predictive validity). Prevalence values were much higher with survey data except for hypertension, diabetes, thyroid disorders, epilepsy, and most cancers for which they were closer (±20%) to claims data. Agreement between CC indicators varied from the strongest (hypertension, diabetes, thyroid disorders, most cancers) to the weakest (cardiac rhythm disorders, peptic ulcer, chronic liver diseases). Sex, age, and multimorbidity strongly influenced agreement. Most claims database indicators were more strongly associated with health outcomes. Health interview surveys and healthcare claims-derived indicators are not interchangeable given their specific determinants. Since no general rule applies to all CCs, the advantages and disadvantages of each data source should be closely considered in case-to-case analysis.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping susceptibility to air pollution and its association with birth defects: a tool for public health intervention.","authors":"Carlos Aniceto, Paula Braz, Ausenda Machado, Carlos Matias-Dias","doi":"10.1093/eurpub/ckaf077","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf077","url":null,"abstract":"<p><p>Epidemiological studies evaluating the relation of environmental air pollution (AP) and birth defect (BD) are relevant to public health. Some limitations on these studies may derive from multiple factors contributing to the spatial variation of AP. This study aimed to integrate multifactorial AP indicators into an index and explore its application in a case-control study conducted in Portugal between 2016 and 2021. Spatial multicriteria analysis was employed to identify areas susceptible to AP. Variables included: (i) Euclidean distance to industrial units; (ii) kernel estimation of industrial units density; (iii) land occupation; (iv) Euclidean distance to main roads; and (v) areas conductive to radiation fog formation. Variables were classified into high, moderate, and low susceptibility. An AP susceptibility map was generated using the weighted linear combination method, with the analytic hierarchy process assigning weights to the variables. Georeferenced BD cases and controls were overlaid with environmental exposure variables and the AP index. Three AP susceptibility areas were identified: consolidated urban, peri-urban area, and a residential-industrial area. In areas of high susceptibility, 47 cases (29%) and 65 controls (31%) were observed; and in areas of low susceptibility 25 cases (15%) and 21 controls (10%) were observed. The development of the AP susceptibility map has been demonstrated to be a valuable tool for identifying patterns, generating hypotheses regarding the potential environmental exposure of NB to AP agents during pregnancy. When integrated into more complex analyses, these findings may contribute to assess the potential risk factors that play a major role in BD.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing alcohol dependence in primary care: longitudinal registry-based study of practitioner activity following new policy and access to training.","authors":"Karin Hyland, Anders Hammarberg, Erik Hedman-Lagerlöf, Olle Wiklund, Ingvar Rosendahl, Sven Andreasson, Per Nilsen","doi":"10.1093/eurpub/ckaf060","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf060","url":null,"abstract":"<p><p>The present study aimed to investigate the extent to which two new implementation strategies-a new policy mandating alcohol interventions in primary care and access to online training, impacted alcohol-related clinical activities in primary care in Stockholm. This was a prospective longitudinal register-based study. One hundred twenty-nine primary care clinics in Region Stockholm agreed to provide data. The new healthcare policy was introduced in February 2021. A brief digital training for primary care professionals on managing harmful alcohol use and dependence was launched 10 months later. Seven indicators that reflect alcohol-related clinical activities were obtained from electronic case files: structured documentation on alcohol habits, the AUDIT instrument, ordering of blood tests for biomarkers of heavy drinking, prescription of medicines for alcohol dependence, registered alcohol-related diagnoses, completed advice regarding alcohol use disorder (AUD), and referrals to specialized care. Data from registers were collected before and after the policy and training was available. At baseline low levels of alcohol-related clinical activities were found in primary care. A modest, clinically non-significant increase was seen for all indicators except for frequency of prescription of medicines for alcohol dependence, over the whole follow-up. The digital training was not associated with an increase in alcohol-related clinical activities. While a policy making alcohol interventions mandatory, combined with a training program, has strong support from implementation science, only a modest, clinically non-significant increase in alcohol-related clinical activities was found. Stronger implementation strategies seem necessary to improve management of alcohol dependence in primary care.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and prevalence of type 2 diabetes in a nationwide study of women.","authors":"Elísabet U Gísladóttir, Hilda B Daníelsdóttir, Huan Song, Marín D Bjarnardóttir, Arna Hauksdóttir, Arna Guðmundsdóttir, Diego Yacamán-Méndez, Edda B Thordardottir, Gunnar Tomasson, Harpa Rúnarsdóttir, Jóhanna Jakobsdóttir, Fang Fang, Unnur A Valdimarsdóttir, Thor Aspelund","doi":"10.1093/eurpub/ckaf079","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf079","url":null,"abstract":"<p><p>We aimed to examine the association between adverse childhood experiences (ACEs) and type 2 diabetes in a nationwide cohort of Icelandic women, and to assess the mechanisms through which it is mediated. We used cross-sectional data from the nationwide-representative Stress-And-Gene-Analysis cohort, including 26 952 Icelandic women aged 18-69 years who self-reported exposure to 13 types of ACEs and adult diagnosis of type 2 diabetes. Modified Poisson regression was used to quantify the association between ACEs and type 2 diabetes, adjusting for age and childhood deprivation. We used causal mediation analysis to test whether adult body mass index (BMI), smoking, and socioeconomic factors mediated the association. Among a sample with a mean age of 44.2 (13.6), 780 (2.9%) women reported a diagnosis of type 2 diabetes. We observed a dose-response relationship between the number of ACEs and type 2 diabetes, of which women with five or more ACEs had almost double the prevalence compared to those with no ACEs (2.0% vs. 3.9%; prevalence ratio 1.90 [1.50-2.42]). Mediation analysis suggested adult BMI, smoking, and socioeconomic factors collectively explained 35.3% (16.5-53.6%) of the association but ACEs remained directly associated with type 2 diabetes (natural direct effect odds ratio 1.64 [1.25-2.26]). Bullying and sexual abuse were independently associated with a higher prevalence of type 2 diabetes. These findings suggest that adverse childhood experiences are associated with type 2 diabetes in adult women, partially mediated through adult BMI, smoking, and socioeconomic factors.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the link between perceived job insecurity and sickness absence for common mental disorders.","authors":"Sandra Blomqvist, Robin S Högnäs, Kristin Farrants, Emilie Friberg, Linda L Magnusson Hanson","doi":"10.1093/eurpub/ckaf023","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf023","url":null,"abstract":"<p><p>Perceived job insecurity is associated with poor mental health, but whether it affects sickness absence is not well understood. The present study examines the association between perceived job insecurity and sickness absence due to common mental disorders and whether changes in perceived job insecurity affects the risk of sickness absence due to common mental disorders. Data are from the Swedish Longitudinal Occupational Survey of Health and include those who participated at least once between 2010 and 2020 (n = 24 049). Two different types of analyses were conducted: (1) logistic regression with adjustments for baseline covariates and (2) pooled logistic regression with inverse probability weights, across 5 emulated target trials assessing onsets and/or offsets of job insecurity versus stable security or stable insecurity, on the risk of sickness absence for common mental disorders. Perceived job insecurity was associated with increased odds of sickness absence for common mental disorders over a 2-year period (odds ratio = 1.38, 95% confidence intervals (CI) 1.13-1.68). We found no statistically significant associations for an onset of job insecurity versus being stably secure (risk ratio (RR) 1.484, 95% CI 0.913-2.055) nor for offset versus stable insecurity (RR 0.855, 95% CI 0.308-1.402). The findings from our emulated target trials were, however, uncertain. Findings suggest that perceived job insecurity increases the risk of sickness absence for common mental disorders. The study implies that efforts to increase employee's sense of security may help reduce rates of sickness absence for common mental disorders if job insecurity is reduced long-term.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is equitable priority vaccination of vulnerable people feasible in a real-world context? The case of Belgium.","authors":"Elias Vermeiren, Charlotte Scheerens, Veerle Stouten, John Crombez, Jan De Maeseneer, Joris A F van Loenhout","doi":"10.1093/eurpub/ckaf075","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf075","url":null,"abstract":"<p><p>Belgium has implemented a strategy to prioritize vaccination at population level during the COVID-19 pandemic, targeting individuals with pre-existing health conditions at increased risk of severe COVID-19. We aimed to evaluate whether prioritized groups were vaccinated sooner, and which socio-demographic and -economic characteristics were related to the speed of vaccine uptake. We calculated the time to vaccination between the start of the prioritization (1 April 2021) and receiving a first COVID-19 vaccine dose, using this interval as a proxy for evaluating the strategy's early impact. A multivariate regression model, incorporating priority status, age, sex, region of residence, income, and migration background, described the natural logarithm of this time gap. The sample included 4 472 873 individuals vaccinated between 1 April and 31 December 2021, of which 26.4% were prioritized. The results show a 34.6 days earlier vaccination for prioritized individuals versus non-prioritized ones. The time difference between the prioritized and non-prioritized groups was larger in the younger age groups compared to the older age groups (28.2 days versus 19.3 days). Based on the multivariate model estimates, being prioritized [βpriority = -0.37, 95% CI (-0.38; -0.36)], older age [β55-64 = -0.57, 95% CI(-0.58; -0.56)], residency in Brussels or Wallonia [βBrussels = -0.18, 95%CI (-0.20; -0.16); βWallonia = -0.18, 95% CI (-0.19; -0.17)], having a high income [βhigh income = -0.11, 95% CI (-0.12; -0.10)], being a Belgian national (βbelgian = reference), having had a recent prior infection (βno prior infection = reference) and being female (βfemale = reference) are associated with a shorter time to vaccination. Developing and implementing a prioritization vaccination strategy accelerated vaccination for the high-risk population with health conditions, demonstrating its feasibility in promoting equitable access to COVID-19 vaccines.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistently high impact of alcohol use on fatal violence in Lithuania despite strengthening alcohol control policies, 2004-19.","authors":"Domantas Jasilionis, Laura Miščikienė, Shannon Lange, Huan Jiang, Daumantas Stumbrys, Olga Meščeriakova, Mindaugas Štelemėkas, Jürgen Rehm","doi":"10.1093/eurpub/ckaf083","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf083","url":null,"abstract":"<p><p>A strong association between alcohol and violence and homicide has been well established. Much less is known about the relationship between alcohol policies and the perpetration of alcohol-involved homicides, especially in the Central and Eastern European region. Despite recent progress, Lithuania still has one of the highest alcohol per capita consumption and homicide rates in the European region. Using quarterly data on homicide perpetrators in Lithuania for 2004-19, interrupted time-series were performed to evaluate whether the 2017 and 2018 alcohol control policies had an impact on the rate of perpetrators of homicide and the proportion of perpetrators under the influence of alcohol using a generalized additive model and generalized linear model, respectively. Although a rapid decline was observed in both the absolute numbers of homicides and rates of homicide perpetrators between 2004 and 2019, the proportion of homicide perpetrators under the influence of alcohol remained high. The analyses revealed that there was no significant effect of either of the two alcohol control policies on the rate of homicide perpetrators or the proportion of perpetrators under the influence of alcohol. The problem of persistently high occurrence of alcohol-involvement in homicides cannot be addressed by implementing alcohol control policies alone and thus, requires more inter-sectorial policy actions. More research is needed to understand homicide contexts and factors from both the victim and perpetrator perspectives.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All-cause and cause-specific mortality differences between migrant workers and local workers: a population-based cohort study in Denmark.","authors":"Karen Lau, George F Mkoma, Bertina Kreshpaj, Ligia Kiss, Cathy Zimmerman, Marie Norredam, Sally Hargreaves","doi":"10.1093/eurpub/ckaf058","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf058","url":null,"abstract":"<p><p>Migrants are prone to poor working conditions in high-risk industries, yet little is known about their mortality risk compared to local-born workers. This study compares all-cause and cause-specific mortality between foreign-born and local-born workers, and identifies at-risk foreign-born workers. A nationwide register-based cohort study was performed using data on migrant workers obtaining residence permits in Denmark during 2015-22. Comparison group comprised Danish-born workers matched by age and sex. Survival analysis using extended Cox model was used to estimate all-cause and cause-specific mortality. Subgroup analysis was conducted by region of birth, economic sector, and occupation. Male migrant workers from Central Europe, Eastern Europe, and Central Asia had higher risk of all-cause mortality than Danish-born workers (HR = 1.30 [95% CI: 1.09-1.54]), attributed to accident deaths (HR = 1.64 [1.06-2.53]), whereas migrants from other regions had lower risk. Migrant workers from these regions were more likely to work in high-risk economic sectors and occupations, such as agriculture and construction. When stratified by economic sector and by occupation, among the elementary occupations, migrant workers from these regions still had a higher risk of all-cause mortality (HR = 1.70 [1.10-2.64]) and accident mortality (HR = 1.51 [1.22-1.85]) than Danish-born workers. Migrant workers from Central Europe, Eastern Europe, and Central Asia are more likely to die from accidents than Danish-born workers. This increased risk was partially explained by their higher representation in at-risk sectors and occupations. There is a need to better understand the structural determinants of health faced by these migrants, particularly in elementary occupations, to prevent avoidable deaths.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a large language model (ChatGPT) versus human researchers in assessing risk-of-bias and community engagement levels: a systematic review use-case analysis.","authors":"Marcello Di Pumpo, Maria Teresa Riccardi, Vittorio De Vita, Gianfranco Damiani","doi":"10.1093/eurpub/ckaf072","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf072","url":null,"abstract":"<p><p>Large language models (LLMs) like OpenAI's ChatGPT (generative pretrained transformers) offer great benefits to systematic review production and quality assessment. A careful assessment and comparison with standard practice is highly needed. Two custom GPTs models were developed to compare a LLM's performance in \"Risk-of-bias (ROB)\" assessment and \"Levels of engagement reached (LOER)\" classification vs human judgments. Inter-rater agreement was calculated. ROB GPT classified a slightly higher \"low risk\" overall judgments (27.8% vs 22.2%) and \"some concern\" (58.3% vs 52.8%) than the research team, for whom \"high risk\" judgments were double (25.0% vs 13.9%). The research team classified slightly higher \"low risk\" total judgments (59.7% vs 55.1%) and almost double \"high risk\" (11.1% vs 5.6%) compared to \"ROB GPT\" (55.1%), which rated higher \"some concerns\" (39.4% vs 29.2%) (P = .366). With regards to LOER analysis, 91.7% vs 25.0% were classified \"Collaborate\" level, 5.6% vs 61.1% as \"Shared leadership\", and 2.8% as \"Involve\" vs 13.9% by researchers, while no studies classified in the first two engagement level vs 8.3% and 13.9%, respectively, by researchers (P = .169). A mixed-effect ordinal logistic regression showed an odds ratio (OR) = 0.97 [95% confidence interval (CI) 0.647-1.446, P = .874] for ROB and an OR = 1.00 (95% CI = 0.397-2.543, P = .992) for LOER compared to researchers. Partial agreement on some judgments was observed. Further evaluation of these promising tools is needed to enable their effective yet reliable introduction in scientific practice.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informing prostate cancer screening policy makers in the European Union: lessons from cancer screening governance and policymaking.","authors":"Sarah Collen, Arunah Chandran, Paolo Guglielmetti, Ondřej Májek, Monique J Roobol, Hendrik Van Poppel, Sergio Torres-Rueda","doi":"10.1093/eurpub/ckaf066","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf066","url":null,"abstract":"<p><p>Prostate cancer (PCa) poses a significant global health threat, with high incidence and mortality rates. In 2022, the Council of the European Union (EU) updated its screening recommendations, prioritizing PCa screening. This signals a crucial step towards establishing new early detection programmes in EU member states. This study investigates the role of policy makers and governance in cancer screening to inform the development of PCa screening. We had a mixed-method study design. First, a rapid review was conducted on policy making and governance in EU-funded cancer screening initiatives. Second, a focus group discussion reviewed study concepts and methods. Third, a systematic literature review was performed and, fourth, a series of in-depth interviews with actors involved in PCa screening pilots was conducted. Data were analysed thematically and the findings are used to propose 10 recommendations for policy makers. The results of the rapid review and focus group discussion framed the study in the context of existing cancer screening programmes across the EU, and highlighted what already exists in terms of governance tools and methodology. The literature review and in-depth interviews presented key learnings from the literature and real-life settings. These findings are reported using a pre-existing conceptional framework for effective health system governance. The study underscores the critical importance of governance in effective cancer screening programmes. Ten recommendations are proposed, including: defining cancer screening governance, allocating budgets and defining common approaches and key performance indicators for evaluation, establishing methods to enhance citizen participation, and reinforcing network governance.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}