Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"Tätigkeitsbericht der Zentralen Ethik-Kommission für Stammzellenforschung (ZES) : 22. Bericht nach Inkrafttreten des Stammzellgesetzes (StZG) für den Zeitraum vom 01.01.2024 bis 31.12.2024.","authors":"","doi":"10.1007/s00103-025-04084-8","DOIUrl":"10.1007/s00103-025-04084-8","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the national community health policy in Guinea: a decision space analysis of the roles and responsibilities of community health workers.","authors":"Alexandre Delamou, Fassou Mathias Grovogui, Facely Camara, Delphin Kolié, Tohaninzé Goumou, Lior Miller, Amy Nye, Thomas Bossert","doi":"10.1007/s00103-025-04076-8","DOIUrl":"https://doi.org/10.1007/s00103-025-04076-8","url":null,"abstract":"<p><strong>Introduction: </strong>Community health workers (CHW) are crucial for universal health coverage (UHC) in low- and middle-income countries. Decentralization supports this goal but can cause issues if local actors misunderstand their roles. This study explores how Guinea's local health system actors understood and executed their responsibilities in delivering community health services from 2017 to 2021.</p><p><strong>Methods: </strong>This is a subanalysis of 168 CHW from a larger study of 522 respondents on the implementation of community health policy in Guinea. We used a sequential explanatory mixed-methods design to assess the knowledge, involvement, and decision space of national community health policy actors, focusing on CHW and community volunteers (Relais communautaires [RECO]). This analysis was guided by decision space theory and explored both de jure (formal) and de facto (actual) decision-making. De jure decision space refers to the choices authorized by official strategies, policies, or laws, while de facto decision space reflects the choices reported by local actors in practice.</p><p><strong>Results: </strong>Across all commune types, CHW and RECO demonstrated high knowledge and implementation levels of their roles in community health. Contrary to the initial hypothesis that fully implemented communes would have the highest decision-making space, commune type was not the primary determinant of decision-making space for CHW and RECO. The presence of CHW was positively associated with greater de jure and de facto decision-making space and enhanced capacity (p = 0.050). Univariate analysis showed that increased BCG vaccination coverage (vaccine to protect against tuberculosis) was significantly associated with expanded de jure decision-making space (p = 0.041). Bivariate (p = 0.014) and multivariate (p = 0.011) analyses revealed that higher pentavalent vaccination coverage (vaccine to protect against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b) was also significantly associated with a larger de jure decision-making space.</p><p><strong>Conclusion: </strong>In countries with decentralized responsibilities, it is crucial for community health actors to understand their decision-making range to improve health outcomes. Also, ensuring sufficient and consistent capacity and funding is essential to enhance health services.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Participation and co-creation in implementation research].","authors":"Anja Zscheppang, Christiane Falge, Silke Betscher, Anna Köster-Eiserfunke, Jonas Fiedler, Claudia Czernik, Claudia Hoevener, Anna Kuehne","doi":"10.1007/s00103-025-04085-7","DOIUrl":"https://doi.org/10.1007/s00103-025-04085-7","url":null,"abstract":"<p><p>The aim of implementation research is to transfer evidence-based interventions from research into practice. Successful transfer requires acceptance of the interventions by users and implementers. Research processes are increasingly focussing on participatory approaches in which various stakeholders are involved in research and implementation, thereby increasing the acceptability of interventions. Depending on the intervention, participation may draw from users, research, care providers or policy and funding bodies. Citizens and patients play a crucial role in participatory processes. Participatory implementation research is a collaborative approach that combines implementation research with the co-creation of knowledge by systematically involving participants in the research process and beyond. In this way, user-centred, tailor-made, lifeworld-oriented interventions in health promotion and healthcare can be scientifically developed under real-life conditions and permanently transferred into real-world practice. This review article examines the status of participatory implementation research in Germany and outlines the concepts and framework of participatory implementation research. To this end, projects from the fields of patient care, health promotion and the community setting are described. Two examples of the long-term participation of citizens of a neighbourhood in research conducted in the urban district laboratories in Bochum and Hamburg show how continuous participation and co-creation in implementation research for prevention, health promotion and health care can succeed.An English full-text version of this article is available at SpingerLink as Supplementary Information.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Reflections on implementing population-based measures for the prevention of non-communicable diseases].","authors":"Lisa M Pfadenhauer, Kerstin Sell, Stephan Voss, Eva A Rehfuess","doi":"10.1007/s00103-025-04078-6","DOIUrl":"https://doi.org/10.1007/s00103-025-04078-6","url":null,"abstract":"<p><strong>Background: </strong>In view of the global burden of non-communicable diseases (NCDs), the focus is shifting increasingly towards structural prevention measures. Effective implementation of these measures is crucial. Using the Context and Implementation of Complex Interventions (CICI) Framework, this article reflects on the implementation of two ratio prevention measures and discusses challenges in the application of implementation science approaches.</p><p><strong>Methods: </strong>Case 1 (Collaboration for Evidence-Based Healthcare and Public Health in Africa-CEBHA+) examined measures for the prevention of NCDs and road traffic accidents in sub-Saharan Africa. Case 2 (\"Präventionskette Freiham\") evaluated a community network in Germany that aims to enable children and adolescents from socially disadvantaged families to grow up well and healthy. Data published in project-related publications served as the basis for the analysis, supplemented by a questionnaire-based reflection by the researchers involved. For both data sources, the data collected were coded inductively and assigned to the deductive categories of the CICI Framework.</p><p><strong>Results: </strong>In both cases, contextual and structural conditions, implementation agents, and strategies were assessed on multiple levels, with an emphasis on implementation agents. While Präventionskette Freiham pursued a systematic process evaluation with explicit use of implementation science approaches, this was only implicitly considered in CEBHA+, which makes comparability, classification in the literature, and overarching consideration more difficult.</p><p><strong>Discussion: </strong>Implementation science approaches should be given a stronger focus in the field of relationship prevention in order to fully exploit their potential.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextual factors of implementing APOL1 genetic testing into living kidney donor clinical evaluation.","authors":"James L Merle, Marissa C Kuo, Jessica Gacki-Smith, Akansha Agrawal, John Friedewald, Elisa J Gordon, Justin D Smith","doi":"10.1007/s00103-025-04068-8","DOIUrl":"https://doi.org/10.1007/s00103-025-04068-8","url":null,"abstract":"<p><strong>Background: </strong>Living donor kidney transplantation (LDKT) is the preferred treatment for patients with end-stage kidney disease, offering longer graft survival and improved quality of life. However, LDKT poses risks to living donors. Black living donors face disproportionately higher risks of postdonation kidney disease than White counterparts, necessitating deeper understanding of the factors contributing to this disparity. This study evaluated the implementation of the APOL1 Genetic Testing and Counseling Program at two transplant centers to improve donors' informed decision-making, which entailed examining the contextual factors influencing its adoption and sustainment.</p><p><strong>Methods: </strong>We conducted a mixed-methods evaluation involving semistructured interviews guided by the Consolidated Framework for Implementation Research and surveys with transplant nephrologists to identify facilitators and barriers of intervention implementation.</p><p><strong>Results: </strong>Eleven nephrologists participated. Key facilitators included alignment with clinical priorities, strong organizational support, and value attributed to the intended goal of enhancing donors' informed consent process and to the integration of culturally sensitive counseling practices. Key barriers included time constraints and the need for clear evidence-based guidelines. Participants reported high acceptability, appropriateness, feasibility, and sustainability of the APOL1 Program.</p><p><strong>Conclusion: </strong>Our study identified facilitators and barriers that should be addressed to ensure the APOL1 program's sustainment and potential to improve donors' informed consent. Future research should leverage system-level implementation strategies to overcome identified barriers when taking the APOL1 Genetic Testing and Counseling Program to scale.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling schistosomiasis in fisherfolk communities in Uganda: Enablers and challenges for implementing paediatric schistosomiasis mass drug administration from the perspective of district health authorities.","authors":"Lisa Sophie Reigl, Isabelle L Lange, Orkan Okan, Stella Neema, Andrea S Winkler","doi":"10.1007/s00103-025-04066-w","DOIUrl":"https://doi.org/10.1007/s00103-025-04066-w","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis remains a significant public health issue in Uganda, particularly among fishing communities. This study, nested within a larger community-based study (ADOPT) on introducing a new child-friendly praziquantel formulation for schistosomiasis, arpraziquantel, explored enablers and challenges perceived by district health authorities for implementing a mass drug administration (MDA) programme with arpraziquantel.</p><p><strong>Methods: </strong>Respondents in this cross-sectional study were purposively selected in Bugiri and Hoima districts, Uganda. Key informant interviews were conducted in July 2022 and thematically analysed using the World Health Organization health system building blocks framework.</p><p><strong>Results: </strong>In general, arpraziquantel is expected to be widely accepted, though some may oppose it for religious or political reasons, belief in witchcraft as a cause of schistosomiasis, or fear of side effects. High awareness of disease burden and the acceptance of the existing schistosomiasis MDA for adults and school-aged children were identified as enablers for successful implementation. Key implementation challenges include limited resources for sustained biannual MDAs, adequate remuneration of village health teams (VHTs), inadequate staff training, time constraints, uneven VHT workload, and weaknesses in the referral systems. Migration, difficulties sensitising mobile parents, and delayed meals due to poverty-complicating drug absorption requiring a full stomach-further hinder efforts.</p><p><strong>Discussion: </strong>This study underscores the importance of addressing health systems' challenges through targeted measures to ensure effective and sustainable MDA of arpraziquantel, including enhanced training of VHTs and other staff, sensitisation of parents and key stakeholders at all levels, and adequate responses to potentially emerging side effects.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[More efficient use of resources in research laboratories through quality management].","authors":"Sophia Sohns, Janine Kleymann-Hilmes","doi":"10.1007/s00103-025-04074-w","DOIUrl":"https://doi.org/10.1007/s00103-025-04074-w","url":null,"abstract":"<p><p>At first glance, research and quality management (QM) could hardly be more different. Research is characterized by freedom, creativity, and flexibility. QM often appears rigid, strict, and bureaucratic. Nevertheless, research laboratories can benefit significantly from the principles of QM, especially when it comes to increasing the quality and efficiency of research and thus making the best possible use of resources that are constantly limited.High research quality depends on various factors. These different influencing factors were examined in detail and implemented in a specific research quality management system (QMS) in pilot laboratories of the Robert Koch Institute (RKI) and at a university institution. The research QMS is based on the requirements of good scientific practice. It was shown that many laboratories have already established processes that can be further optimized and made more efficient by a QMS.A self-assessment tool for laboratory managers was developed to assess the maturity level of laboratory processes. This report provides an overview of the quality in research and shows ways in which this can be improved at the level of the working groups, tailored to their individual framework conditions. For this purpose, a QMS is proposed and a tool for the self-assessment of one's own processes is presented. The report is based on a comprehensive literature review and a cross-departmental and cross-institutional project of the RKI.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging community-engaged research and implementation science methods to advance public health practice.","authors":"Margaret A Handley, Lucía Abascal Miguel, Lisa Marie Thompson, Jennifer Velloza","doi":"10.1007/s00103-025-04079-5","DOIUrl":"https://doi.org/10.1007/s00103-025-04079-5","url":null,"abstract":"<p><p>Addressing public health challenges through equitable, evidence-based strategies remains a pressing global need. Implementation science bridges research and practice, offering methods to improve intervention design, delivery, and evaluation. Concurrently, community-engaged research embeds equity and trust into public health initiatives. This paper introduces selected community engagement methods and related implementation science approaches to address characteristic common constraints in public health practice, illustrated with real-world examples. Adapting the Knowledge to Action framework, we present a discussion of community-engaged methods and accompanying case studies. The discussion follows four phases present in applied public health research: (1) identifying and defining the problem, (2) designing and modifying the intervention, (3) evaluating the intervention, and (4) communicating and disseminating findings. For each phase, we highlight common barriers, recommend methods, and present case studies such as rapid qualitative methods, human-centered design, and participatory data analysis. Case studies demonstrate these methods' effectiveness in addressing common constraints. These approaches ensured that interventions were culturally tailored, contextually relevant, and evidence-based.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Estimations of incidences of mental disorders in statutory health insurance routine data: methodology and trends from 2006 to 2022].","authors":"Thomas G Grobe, Timm Frerk, Felicitas Vogelgesang, Lukas Reitzle, Frank Jacobi, Julia Thom","doi":"10.1007/s00103-025-04080-y","DOIUrl":"https://doi.org/10.1007/s00103-025-04080-y","url":null,"abstract":"<p><strong>Introduction: </strong>Routine data from statutory health insurance (SHI) are to be used for the surveillance of non-communicable diseases (NCDs) at the Robert Koch Institute (RKI), including for the estimation of administrative incidences of mental disorders. The aim of the study is to identify a methodology that is as sensitive and practicable as possible.</p><p><strong>Methods: </strong>Using data available from 2005 onwards from the BARMER health insurance fund, with which approximately 10% of the German population was insured, cumulative incidences were determined for the years 2006 to 2022 after gradual exclusion of persons with previous diagnoses in 1 to 17 previous years for depression, anxiety disorders, schizophrenia spectrum disorders, and mental disorders with uniform population-based standardization by gender, age, and region of residence.</p><p><strong>Results: </strong>With an extension of the prior observation period, a similar relative decline in the incidence estimates can be observed for all four diagnostic groups in different observation years. From a prior observation period of two years, the values of the incidence estimators differ with further extension of the prior observation period, but relative changes and thus trends are depicted almost identically. A large proportion of the persons identified as incident already had diagnoses of other mental disorders in previous years.</p><p><strong>Discussion: </strong>For the estimation of administrative incidence rates, the exclusion of persons with a previous diagnosis in two previous years appears to be sufficient to depict trends. Comparisons and interpretations of incidence estimates should only ever be made with similar prior observation and methodology. Further methodological aspects and results for the four diagnosis groups are discussed.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Point-of-care tests for sexually transmitted infections-what is the current status?]","authors":"Viviane Bremer, Heinrich Scheiblauer, Maximilian Muenchhoff, Christian Schüttler, Jörg Timm, Michael Baier, Susanne Buder, Kristin Meyer-Schlinkmann, Thomas Neiße, Roger Dumke, Thomas Meyer, Gyde Steffen, Klaus Jansen, Norbert Brockmeyer","doi":"10.1007/s00103-025-04067-9","DOIUrl":"https://doi.org/10.1007/s00103-025-04067-9","url":null,"abstract":"<p><p>Point-of-care tests (PoCTs) enable the rapid diagnosis of sexually transmitted infections (STIs) directly at the point of care and play a central role in achieving the goals of the World Health Organization (WHO) for the global elimination of AIDS and hepatitis and the reduction of STIs by 2030.The European Union's new regulation for in vitro diagnostics raises the quality standards for PoCTs. All STI tests must now undergo more rigorous reviews. Advances in PoCT development have improved testing options for HIV, syphilis, and hepatitis C, particularly through WHO prequalified tests. However, the HIV self-tests available in Germany only detect the antibody component, which means that a negative result is only reliably conclusive 12 weeks after exposure. For syphilis, PoCTs are available for antibody screening, but these still require subsequent laboratory confirmation. For infections with chlamydia, gonococci, and mycoplasma, the quality of PoCTs is still largely inadequate. Further developments in the field of nucleic acid amplification tests (NATs) show promising approaches.PoCTs are particularly beneficial for low-threshold services aimed at marginalized groups, as they enable swift diagnosis and timely treatment within the test setting. However, challenges remain, including quality assurance and potential psychological stress due to false-positive results. There remains a need for continuous development and the integration of PoCTs into the healthcare system in order to improve access to diagnostics and to reduce the spread of infections.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}