Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[How to overcome barriers to care with digital health applications (DiGA)? A review of the patient pathway for unipolar depression].","authors":"Brit S Schneider, Florian Koerber, Cordula C J Kreuzenbeck, Sophie Brenner","doi":"10.1007/s00103-024-04007-z","DOIUrl":"10.1007/s00103-024-04007-z","url":null,"abstract":"<p><p>Digital health applications (DiGA) can play an important role in the treatment of unipolar depression. In Germany, the demand is high, but less than 1% of patients use DiGA, indicating existing barriers to their use. This article provides an overview of access and usage barriers along the patient pathway and discusses possible solutions to improve the dissemination and use of digital therapies.Based on the National Care Guideline (NVL) Unipolar Depression (2022), a patient pathway with the phases of \"decision,\" \"access,\" and \"usage\" was developed. Using this structure, existing care barriers were identified based on current literature, and solutions were derived. The narrative review shows that various factors hinder the effective use of DiGA. In the decision phase, lack of knowledge about DiGA and lack of trust in their effectiveness are central challenges. In the access phase, data protection concerns and bureaucratic hurdles are significant barriers. During the usage phase, difficulties in application and low adherence lead to limited effectiveness.Several solutions are proposed to overcome these barriers. Comprehensive education about the effectiveness of digital therapies could strengthen trust in DiGA. Improvements in user-friendliness and greater involvement of healthcare providers could increase acceptance and adherence. Additionally, targeted training for professionals and patients could promote the use of DiGA. These insights are also relevant for other areas of digital therapies.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"336-344"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of citizen involvement and participation in knowledge processes of integrated municipal health promotion: a systematic scoping review].","authors":"Susanne Hartung, Stefanie Houwaart, Ursula von Rüden, Ina Schaefer","doi":"10.1007/s00103-025-04013-9","DOIUrl":"10.1007/s00103-025-04013-9","url":null,"abstract":"<p><strong>Background: </strong>Participation and its preliminary stages are recognized requirements in various fields of public health. By means of a scoping review, the impact of participation and its preliminary stages of residents in knowledge-generating processes in integrated municipal health promotion are systematically investigated and presented.</p><p><strong>Methods: </strong>The scoping review was conducted in accordance with the PRISMA framework and extended by systematic manual research. An analysis grid was developed based on the impact model of community-based participatory research and the PHINEO impact model.</p><p><strong>Results: </strong>In total, 30 publications from six subprojects of research alliances (also publications across research consortia) and six independent projects were analysed. Impact was mostly shown regarding positive changes in awareness and skills for the residents and stakeholder that were directly involved. To a smaller extent, impact was also reported for residents and stakeholders that did not participate in the projects. Changes in conditions and life circumstance for residents resulted from changes in the awareness and actions of the stakeholders involved in the projects.</p><p><strong>Discussion: </strong>The impact of participation and its preliminary stages of residents in knowledge-generating processes of integrated municipal health promotion is broad and exceeds the target group of the (sub)project. At the same time, impact going beyond the directly involved residents or stakeholders is rarely described. Adequate funding and resources are necessary to systematically facilitate, evaluate and disseminate participatory knowledge-generating processes.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"323-335"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health literacy and health behaviour-insights into a developing field of research and action for public health].","authors":"Susanne Jordan, Maike Buchmann, Julika Loss, Orkan Okan","doi":"10.1007/s00103-025-04016-6","DOIUrl":"10.1007/s00103-025-04016-6","url":null,"abstract":"<p><p>The research and action field of health literacy and health behaviour is increasingly differentiating. General health literacy is established and focuses on population-based studies. Specific health literacy for health behaviour offers topic-related starting points for interventions and public health strategies.There are various concepts, definitions and measurement instruments for general health literacy and specific health literacy in the areas of nutrition and physical activity. These differ in terms of the levels of action and areas of application of health literacy.Most studies show a positive association between health literacy and various health behaviours. Higher health literacy is more often associated with improved health-promoting behaviour. This applies to both general as well as specific health literacy regarding nutrition and exercise (physical activity). Some studies found no correlation for certain behaviours, while others only found correlations for certain groups, which may be due to the different measuring instruments and research contexts. This points to the importance of always considering the interaction between behaviour and circumstances in order to improve the fit between the individual and the everyday demands of dealing with health information.The behavioural and cultural insights (BCI) approach can provide insights into how to promote health literacy with regard to various health behaviours, individual barriers and facilitators that arise from life circumstances and conditions, and that take social practice into account. BCI and health literacy complement each other and have the potential to make strategies for improving health behaviour more effective and targeted.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"255-263"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Measuring health literacy: methods and tools for assessing general health literacy in adults].","authors":"Robert Griebler, Thomas Link, Denise Schütze, Christa Straßmayr","doi":"10.1007/s00103-025-04010-y","DOIUrl":"10.1007/s00103-025-04010-y","url":null,"abstract":"<p><p>The measurement of health literacy (HL) began in the 1990s with instruments that focused on a functional understanding of HL. Since then, the understanding of HL and the measurement of HL have evolved. This article reviews two particularly well-validated instruments for measuring comprehensive general health literacy: The Health Literacy Questionnaire (HLQ) and the HLS₁₉-Q12 questionnaire.The HLQ consists of nine scales with a total of 44 items covering different HL aspects of coping with illness. The HLQ has been validated in numerous studies and translated into 47 languages. It has high content and criterion validity and is used, for example, in the WHO European Action Network on Health Literacy for Prevention and Control of Noncommunicable Diseases and in the European Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). The nine scales can be used to create HL profiles of strengths and challenges.The HLS₁₉-Q12 is a short questionnaire to measure general HL and is based on the HLS₁₉-Q47. It consists of 12 items, has been validated in more than 20 countries, and has been translated into more than 30 languages. The HLS₁₉-Q12 also has high content and criterion validity and is used in the Health Literacy Surveys of the WHO Action Network on Measuring Population and Organizational Health Literacy (M-POHL) and the European Joint Action Prevent Non-Communicable Diseases. Based on the 12 items, a total score is calculated that can be categorized into four levels of HL.In order to create a comparable database in the long run, it is recommended that these two instruments be used in studies, evaluations, and monitoring of HL.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"247-254"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aktualisiertes Konzept der Referenzwertableitung in der Umweltmedizin : Stellungnahme der Kommission „Human-Biomonitoring“ des Umweltbundesamtes.","authors":"","doi":"10.1007/s00103-025-04011-x","DOIUrl":"10.1007/s00103-025-04011-x","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"68 3","pages":"346-348"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514786","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":"[Designing participation-promoting digital health literacy : Experiences from developing a course programme for people with chronic diseases].","authors":"Gabriele Seidel, Anabel Bornemann, Antje Meyer, Jürgen Kretschmer, Jens Krug, Marie-Luise Dierks","doi":"10.1007/s00103-025-04015-7","DOIUrl":"10.1007/s00103-025-04015-7","url":null,"abstract":"<p><strong>Background: </strong>Patient organisations are increasingly calling for a participatory approach to health research. In the \"KundiG - Klug und digital durch das Gesundheitswesen\" project, the perspective of chronically ill people was included in the development of a training programme for digital health literacy (dGK). The aim of this work is to show the personal effort involved in the participatory development of a training programme and the prerequisites for this.</p><p><strong>Methods: </strong>During the project period (April 2021 to March 2023), a basic concept was developed by the researchers and continuously refined in a structured participatory process with regard to content, depth of topics, procedure, didactics and course materials. A participation model was created for this purpose. A formative evaluation took place as part of eight pilot courses.</p><p><strong>Results: </strong>A total of 20 people were involved in the working groups and the evaluation, including 6 from organised self-help, 3 from BARMER and 11 from the Hannover Medical School. The participatory collaboration was labour intensive and tightly scheduled, meaning that not all members were able to participate to the same extent. The result was an internet-based training programme that received positive feedback and suggestions for improvement from the participants in the pilot courses. The result was a 15-hour online course to promote dGK, a 300-page course manual and six digital, accessible booklets.</p><p><strong>Discussion: </strong>Participation meant the active involvement of all participants in the entire process, a high number of appointments, the consideration of different perspectives and a constant endeavour to reach a consensus. Prior training of the participants could be helpful in future projects. The roll-out of the programme and continuous evaluation in the context of self-help are in preparation.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"313-322"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Learning digital health literacy in school: results of a representative survey of pupils in Germany].","authors":"Denise Renninger, Lisa Stauch, Lisa Fischer, Anja Hartmann, Pia Rangnow, Kevin Dadaczynski, Orkan Okan","doi":"10.1007/s00103-024-03991-6","DOIUrl":"10.1007/s00103-024-03991-6","url":null,"abstract":"<p><strong>Background: </strong>Digital information sources provide adolescents with quick access to health-related information. Schools are ideal for promoting digital health literacy and enabling students to handle such information safely. The aim of this paper is to present initial results from a representative study on learning digital health literacy in schools, with a focus on sociodemographic and socioeconomic differences.</p><p><strong>Methods: </strong>The cross-sectional study was conducted in Germany with 1448 students (aged 9 to 18 years) as part of the DURCHBLICKT!</p><p><strong>Project: </strong>Bivariate and multivariate analyses were used to examine differences and relationships in the learning of digital health literacy in school and gender, age, migration background, and subjective social status.</p><p><strong>Results: </strong>Approximately 50% of students reported that they had not (or only to a limited extent) learned digital health literacy in school. The chi-square test reveals significant differences in terms of gender, age, migration background, and social status. Regression analyses indicate that age and subjective social status are significant factors for acquiring digital health literacy.</p><p><strong>Discussion: </strong>The high number of students who do not learn digital health literacy in school is concerning, especially given their often low levels of digital health literacy. The results highlight the need for targeted educational strategies-especially those tailored to gender and socioeconomic status-to promote digital health literacy and reduce social inequalities.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"293-301"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Development and evaluation of an assessment tool for organisational health literacy].","authors":"Daniel Lüdecke, Olaf von dem Knesebeck, Martin Härter, Izumi Klockmann, Johanna Heeg","doi":"10.1007/s00103-025-04018-4","DOIUrl":"10.1007/s00103-025-04018-4","url":null,"abstract":"<p><strong>Background: </strong>In research on organisational health literacy (OHL), there is a lack of standardised assessment tools for measuring and comparing the OHL of different organisations. This article therefore examines (1) which criteria for assessing OHL can be derived from research and practice, (2) how these are implemented in organisations and (3) the psychometric properties of a questionnaire developed from them.</p><p><strong>Methodology: </strong>OHL criteria were identified by means of literature research and workshops. The criteria were agreed upon in a Delphi study and an assessment tool was developed. An online questionnaire was developed and psychometrically tested. Measures such as Cronbach's alpha, item selectivity and difficulty, and floor/ceiling effects were used for the analysis.</p><p><strong>Results: </strong>Over 500 criteria were identified and an assessment tool of 77 criteria (5 main categories and 17 sub-categories) was developed. The subject of \"Barrier-free access and navigation\" was best implemented in healthcare organisations. The psychometric properties showed a good to excellent internal consistency of the questionnaire structure. Only one main category showed significant floor effects; there were no ceiling effects. At the item level, ceiling effects were found for 13 items, and 39 items showed a satisfactory discriminatory power.</p><p><strong>Discussion: </strong>OHL is a multidimensional construct that is well represented by the assessment tool. Further validation with larger samples is necessary for the use of the tool as a questionnaire for measuring OHL and for comparison between institutions. A reduction in the number of criteria can improve the consistency of the content of the main and sub-categories.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"274-281"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405773","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":"[Health literacy as a prerequisite for dealing with health-related information and services].","authors":"Ursula von Rüden, Uwe Koch-Gromus","doi":"10.1007/s00103-025-04009-5","DOIUrl":"10.1007/s00103-025-04009-5","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"68 3","pages":"229-230"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514785","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":"[The concept of health literacy in transition].","authors":"Saskia Maria De Gani, Elena Alder, Anna-Sophia Beese","doi":"10.1007/s00103-024-04004-2","DOIUrl":"10.1007/s00103-024-04004-2","url":null,"abstract":"<p><p>Health literacy is a central resource for health-related decisions. Since the 1970s, however, the understanding of this term has changed in several ways. Initially, health literacy was considered only from the point of view of individual competencies, but in recent decades it has evolved into a more contextual understanding. Despite this conceptual evolution, current social and health challenges are still not adequately addressed.This article reflects on the developments in the understanding of the concept and on the relevance of health literacy in the face of the current polycrisis. Reference is made to a recent concept paper developed by the authors, which shows that health literacy is a central resource at the interface of healthcare, disease prevention, and health promotion and that it can occur at different levels and in different forms. The discussion on health literacy also highlights the need to consider the challenges of systems, organizations, and settings, as decisions about health and well-being are made in all these contexts.The importance of health literacy as a key resource is increasing, particularly in addressing current social challenges, and is gaining additional relevance as a social determinant of health. Health literacy interventions can only be effectively developed, implemented, and evaluated if a shared understanding of health literacy exists, current challenges and contexts are considered, and key stakeholders act together when implementing measures.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"240-246"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}