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Wrona KJ, Heckes K, Aschentrup L, Fischer F. Community-bezogene Prävention und Gesundheitsförderung: Förderung digitaler Gesundheitskompetenz bei Menschen in prekären Lebenslagen. Gesundheitswesen 2024. [PMID: 38452808 DOI: 10.1055/a-2283-4440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Die rasant fortschreitende digitale Transformation eröffnet innovative Möglichkeiten zur Prävention und Gesundheitsförderung, insbesondere durch soziotechnische Innovationen. Digital unterstützte Interventionen dienen als erweiternde Werkzeuge zur Verbreitung gesundheitsrelevanter Informationen und zur Förderung des individuellen Empowerments und der Selbstwirksamkeit. Trotz ihres Potentials sind digitale Medien in der Community-bezogenen Prävention und Gesundheitsförderung mit Herausforderungen konfrontiert, wie der Notwendigkeit einer niedrigschwelligen Gestaltung und der Berücksichtigung technologischer Akzeptanzfaktoren. Menschen in prekären Lebenslagen, die häufig mit eingeschränktem Zugang und geringerer digitaler Kompetenz konfrontiert sind, könnten von zielgerichteten, an ihren spezifischen Bedarfen und Bedürfnissen ausgerichteten Maßnahmen profitieren. Gleichzeitig gilt es die Risiken einer unzureichenden digitalen Gesundheitskompetenz hervorzuheben, die sich negativ auf die Gesundheit auswirken können. Die Förderung der digitalen Gesundheitskompetenz erscheint daher als ein wesentliches Instrument zur Verbesserung der Gesundheitssituation von Menschen in prekären Lebenslagen. Dieser Artikel plädiert für eine evidenzbasierte und zielgerichtete Weiterentwicklung von digitalen Interventionen zur Gesundheitsförderung, die auf die Bedürfnisse von Menschen in prekären Lebenslagen abgestimmt sind, und betont die zentrale Rolle der digitalen Gesundheitskompetenz in diesem Prozess. Beispielhaft wird hierfür die Gruppe der Frühen Hilfen in den Blick genommen.
The rapidly advancing digital transformation is opening up innovative opportunities for disease prevention and health promotion, particularly through sociotechnical innovations. Digitally-enabled interventions serve as augmentative tools for disseminating health-related information and promoting individual empowerment and self-efficacy. Despite their potential, digital media in community-based disease prevention and health promotion face challenges, such as the need for low-threshold design and consideration of technological acceptance factors. People in precarious life situations, who often face limited access and lower literacy towards digital technologies, could benefit from targeted measures geared to their specific needs. At the same time, it is important to highlight the risks of insufficient digital health literacy, which can have a negative impact on health. Promoting digital health literacy therefore appears to be an essential tool for improving the health situation of people in precarious living circumstances. This article argues for evidence-based and targeted further development of digital interventions for health promotion that are tailored to the needs of people in precarious living conditions and emphasizes the central role of digital health literacy in this process. In this contribution, the area of early childhood intervention is considered for exemplification.
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Affiliation(s)
- Kamil J Wrona
- Fachbereich Ingenieurwissenschaften und Mathematik, Hochschule Bielefeld, Bielefeld, Germany
| | - Kolja Heckes
- Fachwissenschaft Soziale Arbeit, Katholische Hochschule Nordrhein-Westfalen, Koln, Germany
| | - Leona Aschentrup
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Germany
| | - Florian Fischer
- Bayerisches Zentrum Pflege Digital, Hochschule für angewandte Wissenschaften Kempten, Kempten, Germany
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Aschentrup L, Steimer PA, Dadaczynski K, Mc Call T, Fischer F, Wrona KJ. Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review. BMC Public Health 2024; 24:69. [PMID: 38167010 PMCID: PMC10763397 DOI: 10.1186/s12889-023-17517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Though still a young field of research, gamified digital interventions have demonstrated potential in exerting a favourable impact on health and overall well-being. With the increasing use of the internet and digital devices, the integration of game elements presents novel opportunities for preventing mental disorders and enhancing mental health. Hence, this review aims to assess the effectiveness of gamified interventions focusing on preventing mental disorders or promoting mental health among adults. METHODS Based on a scoping review across four databases (MEDLINE, Embase, PsycInfo and Web of Science), 7,953 studies were initially identified. After removing duplicates and screening titles, abstracts and full texts, 16 studies were identified as suitable for inclusion in a narrative synthesis of findings. We included interventional studies encompassing an intervention and a control group aiming to investigate the effectiveness of the use of gamified digital mental health interventions and the use of gamified digital elements. RESULTS Overall, positive effects of gamified interventions on mental health-related outcomes were identified. In particular, beneficial consequences for psychological well-being and depressive symptoms were observed in all studies. However, further outcomes, such as resilience, anxiety, stress or satisfaction with life, showed heterogenous findings. Most game elements used were reward, sensation and progress, whilst the quantity of elements was not consistent and, therefore, no substantiated conclusion regarding the (optimal) quantity or composition of game elements can be drawn. Further, the outcomes, measurements and analyses differed greatly between the 16 included studies making comparisons difficult. CONCLUSION In summary, this review demonstrates the potential of integrating digital game elements on mental health and well-being with still a great gap of research. A taxonomy is needed to adequately address relevant game elements in the field of mental health promotion and prevention of mental disorders. Therefore, future studies should explicitly focus on the mechanisms of effect and apply rigorous study designs.
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Affiliation(s)
- Leona Aschentrup
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Pia Anna Steimer
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Global Public Health, Karolinska Institute, Solna, Sweden
| | - Kevin Dadaczynski
- Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Sciences, Leuphana University Lueneburg, Lueneburg, Germany
| | - Timothy Mc Call
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Medical School OWL, Bielefeld University, Bielefeld, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, Kempten, Germany.
| | - Kamil J Wrona
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
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Leiße A, Dötzer J, Ruhnau A, Aschentrup L, Fischer F, Wrona KJ. Pregnancy Care during the COVID-19 Pandemic in Germany: A Public Health Lens. Int J Environ Res Public Health 2023; 20:2721. [PMID: 36768087 PMCID: PMC9916077 DOI: 10.3390/ijerph20032721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has led to various challenges in German health care, including pregnancy care. This paper aims to provide an overview of the pandemic-related challenges faced by pregnant women, new mothers, and their families in maternal and newborn care. A literature review was performed by including international literature as well as recommendations of institutions and official stakeholders. These challenges refer to restrictions at all stages of pregnancy, including wearing masks during labour, limitations of a companion of choice during birth, and restrictions of unvaccinated women from attending, e.g., antenatal classes. Compared with the general population, COVID-19 vaccination of pregnant women was recommended later, as pregnant women were initially excluded from clinical trials. Women who gave birth during the COVID-19 pandemic also reported mental health issues. The findings stress the importance of the inclusion of pregnant women in clinical trials. This might also help to overcome vaccine hesitancy among pregnant women and women seeking family planning. Taking the COVID-19 pandemic as an example, one must weigh the changes and restrictions associated with the potential disadvantages for mothers, newborns, and their families in pregnancy care against the measures to control the pandemic.
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Affiliation(s)
- Antonia Leiße
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Julia Dötzer
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Alice Ruhnau
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Leona Aschentrup
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
- Faculty of Engineering and Mathematics, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
- Faculty of Health, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
| | - Florian Fischer
- Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Kamil J. Wrona
- Faculty of Engineering and Mathematics, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
- Faculty of Health, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
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Aschentrup L, Dadaczynski K, McCall T, Steimer PA, Fischer F, Wrona K. Wirksamkeit von gamifizierten Anwendungen der psychischen
Gesundheitsförderung und Prävention: Ergebnisse eines
systematischen Reviews. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- L Aschentrup
- Fachhochschule Bielefeld, Fachbereich Ingenieurswissenschaften und
Mathematik, Bielefeld, Deutschland
- Universität Bielefeld, Fakultät für
Gesundheitswissenschaften, Bielefeld, Deutschland
| | - K Dadaczynski
- Hochschule Fulda, Fachbereich Gesundheitswissenschaften, Fulda,
Deutschland
- Leuphana Universität Lüneburg, Zentrum für
Angewandte Gesundheitswissenschaften, Lüneburg,
Deutschland
| | - T McCall
- Universität Bielefeld, Medizinische Fakultät OWL,
Arbeitsgruppe 1, Bielefeld, Deutschland
| | - PA Steimer
- Universität Bielefeld, Fakultät für
Gesundheitswissenschaften, Bielefeld, Deutschland
| | - F Fischer
- Leuphana Universität Lüneburg, Zentrum für
Angewandte Gesundheitswissenschaften, Lüneburg,
Deutschland
- Charité – Universitätsmedizin Berlin, Institut
für Public Health, Berlin, Deutschland
| | - K Wrona
- Fachhochschule Bielefeld, Fachbereich Ingenieurswissenschaften und
Mathematik, Bielefeld, Deutschland
- Fachhochschule Bielefeld, Fachbereich Gesundheit, Bielefeld,
Deutschland
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Klemme I, Wrona KJ, de Jong IM, Dockweiler C, Aschentrup L, Albrecht J. Integration of people with diabetes’ vision in the development process to improve self-management via diabetes Apps: A qualitative study (Preprint). JMIR Diabetes 2022; 8:e38474. [PMID: 37104003 PMCID: PMC10176130 DOI: 10.2196/38474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/29/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Diabetes is a major global epidemic and serious public health problem. Diabetes self-management is a 24/7 challenge for people with type 1 diabetes that influences their quality of life (QoL). Certain apps can support the self-management of people with diabetes; however, current apps do not meet the needs of people with diabetes appropriately, and their safety is not ensured. Moreover, there are a multitude of hardware and software problems associated with diabetes apps and regulations. Clear guidelines are required to regulate medical care via apps. In Germany, apps must undergo 2 examination processes to be listed in the Digitale Gesundheitsanwendungen directory. However, neither examination process considers whether the medical use of the apps is sufficient for users' self-management. OBJECTIVE This study aims to contribute to the technology development process of diabetes apps by exploring individual perspectives on desired features and content of diabetes apps among people with diabetes. The vision assessment conducted is a first step toward creating a shared vision among all relevant stakeholders. To ensure adequate research and development processes for diabetes apps in the future, guiding visions from all relevant stakeholders are required. METHODS In a qualitative study, 24 semistructured interviews with patients with type 1 diabetes were conducted, among whom 10 (42%) were currently using an app. To clarify the perceptions of people with diabetes regarding the functions and content of diabetes apps, a vision assessment was conducted. RESULTS People with diabetes have concrete ideas of features and content in apps to improve their QoL and allow them to live as comfortably as possible, such as informative predictions through artificial intelligence, improvements in signal loss and value delay through smartwatches, improved communication and information-sharing capabilities, reliable information sources, and user-friendly and discreet messaging options through smartwatches. In addition, according to people with diabetes, future apps should show improved sensors and app connectivity to avoid incorrect values being displayed. They also wish for an explicit indication that displayed values are delayed. In addition, personalized information was found to be lacking in apps. CONCLUSIONS People with type 1 diabetes want future apps to improve their self-management and QoL and reduce stigma. Desired key features include personalized artificial intelligence predictions of blood glucose levels, improved communication and information sharing through chat and forum options, comprehensive information resources, and smartwatch alerts. A vision assessment is the first step in creating a shared vision among stakeholders to responsibly guide the development of diabetes apps. Relevant stakeholders include patient organizations, health care professionals, insurers, policy makers, device manufacturers, app developers, researchers, medical ethicists, and data security experts. After the research and development process, new apps must be launched while considering regulations regarding data security, liability, and reimbursement.
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Affiliation(s)
- Isabel Klemme
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Athena Institute, VU University Amsterdam, Amsterdam, Netherlands
| | - Kamil J Wrona
- Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany
- Faculty of Health, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | | | - Christoph Dockweiler
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
| | - Leona Aschentrup
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Faculty of Engineering and Mathematics, Bielefeld University of Applied Sciences, Bielefeld, Germany
- Faculty of Health, Bielefeld University of Applied Sciences, Bielefeld, Germany
| | - Joanna Albrecht
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany
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Raschke N, Mohsenpour A, Aschentrup L, Fischer F, Wrona KJ. Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence. BMC Public Health 2022; 22:129. [PMID: 35042490 PMCID: PMC8765829 DOI: 10.1186/s12889-022-12498-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background The economic and human costs of suicide to individuals, families, communities, and society make suicide a major public health problem around the world. Suicide rates in South Korea are among the highest in the world. This paper is the first systematic review investigating socioeconomic risk factors for suicidal behaviors (suicidal ideation, attempted suicides, and completed suicides) in South Korea. Methods We performed a systematic review in Medline and Web of Science. Empirical studies and peer-reviewed articles on the association between individual socioeconomic factors and suicidal behaviors have been included. A total of 53 studies were included in a descriptive synthesis. Results Overall, 35 studies focused on the association between individual socioeconomic factors and suicidal ideation, 16 were related to suicide attempts, while 10 addressed completed suicides. Low income, unemployment, and financial difficulties were identified as risk factors for all suicidal behaviors. Working in precarious conditions, long working hours, self-employment, changes in employment status, shift work/night-time work, and occupational stress were associated with an increased risk for suicidal ideation. Low educational attainment appears to increase the risk for suicide attempts and completed suicide, but the significance of educational attainment on the reporting of suicidal ideation could not be verified. The primary studies were unable to ascertain whether the place of residence impacts on suicidal behaviors. Conclusions The results highlight the relevance of socioeconomic factors for suicidal behaviors in South Korea. Governmental social spending must be increased and redirected more efficiently so that the economically most vulnerable groups are financially protected and income inequality does not widen. Furthermore, comprehensive prevention strategies at the community level are needed. Future research needs to focus on identifying vulnerable groups for whom the effects of low socioeconomic status may have particularly serious consequences with regard to suicidal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12498-1.
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