Search

Background: To undertake an overview of health promotion research in the EEA to inform the collaborative study--SPHERE (Strengthening Public Health Research in Europe). Methods: A 'filter' (search strategy) was used to search Medline and Embase for a 10-year period from 1995 to 2005. A 32% (6000) sample of the filter output was assessed for proportion constituting health promotion. Output was analysed by country, population, gross domestic product (GDP) and health need (disability-adjusted life years, DALYs). Disease prevention (screening and immunization) and health improvement papers were separately identified. The latter were classified by methodology, level of intervention and topic area. Results: 18862 papers were identified. One-third was identified as health promotion (2206/6000, 36.7%) equivalent to 6935 (CI 6651-7230). Production varied: Nordic countries were highest producers per million population; the UK the largest net producer. There was a weak relationship between health promotion publication and population size (r²=0.38); a weak inverse relationship with relative health (DALYs per million population) (r²=0.07) and a slightly stronger relationship with GDP (r²=0.45). Twenty-eight percent (626/2206) of the papers identified were disease prevention (screening and immunization). The largest topic areas of the remainder (1580) were diet and exercise, smoking and tobacco, and cardiovascular disease reduction. Accidents and violence, alcohol and mental health each accounted for <5% of total output. Intervention studies were a minority; with less aimed at the regional/national or policy or legal and fiscal levels. Conclusion: Health promotion research production varies across Europe. Research commissioning should stress interventional and policy level research. [ABSTRACT FROM AUTHOR]

This paper discusses the work of the EUHPID Project to develop a European Health Promotion Monitoring System based on a common set of health promotion indicators. The Project has established three working groups to progress this task -- health promotion policy and practice-driven, data-driven and theory-driven. The work of the latter group is reviewed in particular. EUHPID has taken a systems theory approach in order to develop a model as a common frame of reference and a rational basis for the selection, organization and interpretation of health promotion indicators. After reviewing the strengths and weaknesses of those health promotion models currently proposed for indicator development, the paper proposes a general systems model of health development, and specific analytical, socio-ecological models related to public health and health promotion. These are described and discussed in detail. Taking the Ottawa Charter as the preferred framework for health promotion, the socio-ecological model for health promotion adopts its five action areas to form five types of systems. The structure and processes for each of these five systems are proposed to form the basis of a classification system for health promotion indicators. The paper goes on to illustrate such a system with reference to indicators in the workplace setting. The EUHPID Consortium suggest that their socio-ecological model could become a common reference point for the public health field generally, and offer an invitation to interested readers to contribute to this development. [ABSTRACT FROM AUTHOR]

Background Before the COVID-19 pandemic, a need for a uniform approach to health information (HI) knowledge in population health analysis across Europe was evident. The Population Health Information Research Infrastructure (PHIRI) emerged as a proactive initiative to strengthen European HI capacities. This article describes the achievements of PHIRI, highlighting its capacity-building activities and their contribution towards a sustainable strategy for the implementation of the European Health Data Space (EHDS). Methods PHIRI collaboration established a work package for skill-building activities in population health in partnership with other organizations. Activities included webinars, workshops, sessions, training schools and courses for researchers and public administration workers from Europe and beyond. The primary goal of the activities was to examine the impact of COVID-19 on European health systems at both local and national levels, including healthcare facilities and policymaking entities. Results Twelve activities were organized between October 2020 and the summer of 2023. In March 2023, the Spring School on Health Information was organized to share the knowledge achieved from PHIRI and other European Union-related projects. This event also validated the European Health Information Training Programme. Conclusions PHIRI's findings emphasized the importance of equipping the workforce with core HI skills to improve health systems' preparedness and resilience. Through this research, it is possible to propose a strategy for building capacity that emphasizes the importance of providing training in human-machine dynamics. This approach will contribute to the sustainable implementation of the EHDS. [ABSTRACT FROM AUTHOR]

Background Resilience of national health systems in Europe remains a major concern in times of multiple crises and as more evidence is emerging relating to the indirect effects of the COVID-19 pandemic on health care utilization (HCU), resulting from de-prioritization of regular, non-pandemic healthcare services. Most extant studies focus on regional, disease specific or early pandemic HCU creating difficulties in comparing across multiple countries. We provide a comparatively broad definition of HCU across multiple countries, with potential to expand across regions and timeframes. Methods Using a cross-country federated research infrastructure (FRI), we examined HCU for acute cardiovascular events, elective surgeries and serious trauma. Aggregated data were used in forecast modelling to identify changes from predicted European age-standardized counts via fitted regressions (2017–19), compared against post-pandemic data. Results We found that elective surgeries were most affected, universally falling below predicted levels in 2020. For cardiovascular HCU, we found lower-than-expected cases in every region for heart attacks and displayed large sex differences. Serious trauma was the least impacted by the COVID-19 pandemic. Conclusion The strength of this study comes from the use of the European Population Health Information Research Infrastructure's (PHIRI) FRI, allowing for rapid analysis of regional differences to assess indirect impacts of events such as pandemics. There are marked differences in the capacity of services to return to normal in terms of elective surgery; additionally, we found considerable differences between men and women which requires further research on potential sex or gender patterns of HCU during crises. [ABSTRACT FROM AUTHOR]

Background There is substantial evidence on the importance of voluntary activities for the health of middle-aged and older adults. Evidence on the effects of health and well-being on volunteering is more limited. This study examines reciprocal longitudinal associations between voluntary and/or charity activities and 21 indicators related to physical health, well-being, cognitive impairment and daily life functioning among middle-aged and older adults. Methods Longitudinal data were collected between 2011 and 2020 from a sample of 19 821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing and Retirement in Europe. An outcome-wide analysis and an exposure-wide analysis were applied and generalized estimating equations were used. Robustness analyses were conducted. Results Voluntary and/or charity activities almost every week or more often were prospectively associated with greater emotional well-being, reduced risks of limitations in activities of daily living and of being diagnosed with Alzheimer's disease at a 6-year follow-up. Positive reverse associations were found from emotional well-being to volunteering. Limitations in daily life activities, increased loneliness, high blood cholesterol, hypertension and chronic lung disease were found to impede participation in voluntary and/or charity activities over time. Feedback loops between voluntary and/or charity activities and well-being and limitations in daily activities may exist. Conclusion Understanding the reciprocal nature of the relationship between volunteering and health and well-being can help identify strategies to encourage volunteering among middle-aged and older adults with specific health conditions and to target health promotion efforts towards volunteers. [ABSTRACT FROM AUTHOR]

Background: The worksite is a promising setting for health promotion. This review summarizes the evidence of effect of intervention studies in European countries promoting a healthy diet solely and in combination with increasing physical activity at the workplace. Methods: A systematic review of published literature was carried out. Inclusion criteria were: studies conducted in European countries; papers published from 1 January 1990 to 1 October 2010; worksite-based interventions promoting a healthy diet solely or in combination with physical activity; primary prevention; measurement of anthropometrical or behavioural change and adults (≥18 years old). Levels of evidence for intervention effectiveness on behavioural determinants, nutrition and physical activity behaviours and body composition and the quality of the included interventions were assessed. Results: Seventeen studies solely focusing on promotion of a healthy diet were identified. Eight were educational, one used worksite environmental change strategies, and eight used a combination of both (multi-component). None of the interventions were rated as ‘strong’; seven met the criteria for ‘moderate’ quality. The reviewed studies show moderately evidence for effects on diet. Thirteen studies focusing both on nutrition and physical activity (nine educational and four multi-component studies) were identified. Ten were rated as having ‘weak’ and three as having ‘moderate’ methodological quality, providing inconclusive evidence for effects. Conclusion: Limited to moderate evidence was found for positive effects of nutrition interventions implemented at the workplace. Effects of workplace health promotion interventions may be improved if stronger adherence to established quality criteria for such interventions is realized. [ABSTRACT FROM PUBLISHER]

An introduction to the journal is presented which discusses topics related to the Sustainable Development Goals (SDG) set by the United Nations (UN) and featured within the issue, including the SDG framework for action, the health-related SDG in Europe, and the political aspects of the SDG.

Background Many countries have sought to incentivise soft drinks manufacturers to reduce sugar in their products as part of efforts to address a growing prevalence of obesity. Are their policies effective? Methods Using a difference-in-differences design, we compared trends in the sugar content of 10 695 new sugar-sweetened beverages (SSB) launched between 2010 and 2019 in six European markets, including the UK and France (taxes designed to incentivise reformulation), the Netherlands (policy based on voluntary agreements to reduce sugar), Germany, Italy and Spain (no national policies). Results The announcement in 2016 and adoption in 2018 of the UK tax led to yearly reductions in average sugar content of 17% (95% CI: 15–19%) to 31% (13–48%) between 2016 and 2019, compared to 2015, while the 2018 French tax produced a 6% (95% CI: 5–7%) sugar reduction only in 2018, compared to 2017, shortly after it was redesigned to provide a stronger incentive for reformulation. Voluntary agreements implemented in the Netherlands in 2014 led to an 8% (95% CI: 4–13%) sugar reduction only in 2015, compared to 2013. Conclusion The analysis supports the conclusions that sugar reductions in new SSBs have been greater in countries that have adopted specific policies to encourage them; a sugar-based tax design encourages more sugar reductions than a volume-based tax design; the tax rate and the amount of the tax reduction from switching to the next lower tier in a sugar-based tax design may be critical to incentivize reformulation. [ABSTRACT FROM AUTHOR]

This paper addresses the issue of student participation and learning about health from the perspective of health-promoting schools. The combination of the democratic approach to health-promoting schools, characterized by the concepts of student participation and action competence, and the sociocultural theory of learning provides the conceptual framework for the discussion. The two sets of concepts help the building of a heuristic that views teaching and learning as mutually constitutive, establishing an integrated unit of analysis. Data are generated from a Web-based international project 'Young Minds exploring links between youth, culture and health'. The project has its roots in the European Network of Health Promoting Schools (ENHPS). The methodological framework is constructed as theoretically based qualitative case study, using Web contents analysis and interviews with the participating teachers and students. A model distinguishing between two different qualities of student participation—token and genuine—is used as an analytical tool in analyzing the empirical data. The analysis of the case study illuminated the trajectories of participation in which students learned about health in intentional, relational and purposeful ways. These participation trajectories were viewed as situated in activity structures consisting of a variety of mutual interactions and different forms of participation. [ABSTRACT FROM AUTHOR]

The article discusses vaccination hesitancy among people in Europe and U.S. with reference to the article published in "Journal of Public Health". Topics discussed include development of strategic approach against widespread misinformation and conspiracy theories on COVID-19 vaccines, research published by EU agency Eurofound on the vaccine hesitancy among adults in Europe, and progress on COVID-19 vaccination campaigns in US.

The article presents abstracts of working papers to be presented at the 14th Annual European Public Health Conference of the European Public Health Association in November 2006. They include "The history of Public Health: How and Why?," "Sleep and health: Gender, socioeconomic circumstances, and inequalities in sleep," and "The prevention of disease and promotion of health--The need for a new approach."

The European Policy Evaluation Network (PEN), initiated in autumn 2018, aimed at advancing the evidence base for public policies impacting dietary behaviour, physical activity and sedentary behaviours in Europe. This is needed because non-communicable diseases—the leading cause of global mortality—are substantially caused by physical inactivity and unhealthy dietary behaviours, which in turn are driven by upstream factors that have not yet been addressed effectively by prevention approaches. Thus, successful policy interventions are required that target entire populations and tackle the 'causes of the causes'. To advance our knowledge on the effective implementation of policies and their impact in terms of improving health behaviours, PEN focused on five research tasks: (i) Adaptation and implementation of a Food Environment Policy Index (Food-EPI) and development of a Physical Activity Environment Policy Index (PA-EPI); (ii) Mapping of health-related indicators needed for policy evaluation and facilitating a harmonized pan-European approach for surveillance to assess the impact of policy interventions; (iii) Refining quantitative methods to evaluate the impact of public policies; (iv) Identifying key barriers and facilitators of implementation of policies; and (v) Advance understanding the equity impact of the development, implementation and evaluation of policies aimed at promoting physical activity and a healthy diet. Finally, and in order to provide concrete evidence for policymaking, existing exemplary policies, namely sugar-sweetened beverages taxation, active transport policies and school policies on nutrition and physical activity were assessed in consideration of these five tasks. At the end of the PEN project's formal runtime, considerable advancements have been made. Here, we present an overview of the most important learnings and outputs. [ABSTRACT FROM AUTHOR]

Background The Policy Evaluation Network (PEN) is a multidisciplinary Pan-European research consortium focussing on policies affecting dietary intake, physical activity and sedentary behaviour. At the start, the PEN consortium expressed the need for an overarching, system-based framework covering the complexities between the different domains of the policy process (design, implementation and outcomes) in order to execute all research activities in a coherent way. This article describes the PEN framework itself and its development process. Methods A staged approach to the development of a system-based framework was executed between February 2019 and February 2022. We started with a point-of-departure framework, made use of existing models, collected PEN outputs at different project stages (through online meetings, e-mail exchanges and workshops with PEN researchers) and drew updated versions of the framework, which resulted in the system-based PEN framework. Results The system-based PEN framework depicts the policy process as a complex system, visualizing the dynamic interrelations between and within policy domains (i.e. policy design, policy implementation and policy outcomes), the ways they interact with the context, and how to assure a focus on equity in each domain. Conclusions The system-based PEN framework may guide researchers and professionals involved in the evaluation of health- or sustainability-related policies to consider their evaluation in a comprehensive picture, including domain interactions, contextual influences and equity considerations, as these can have important implications for the scope of their research. The stage-based process as applied for the development of the PEN framework can serve as a template for other research projects wishing to develop their own framework. [ABSTRACT FROM AUTHOR]

The article presents a viewpoint on the issues with the European health strategy, which was intended to provide an overarching strategic framework, spanning core issues in health. Accordingly, the new health strategy has been structured as four principles and three objectives that are closely similar to the three of the first health strategy, given the fact that medical care as well as health systems are clearly included and also the health promotion and protection. It is being noted that strategy proposes two main dimensions for implementation such as structured cooperation between Member States and finance. However, the author stresses that while these existing strands of health policy have become embodied within the Strategy, a new theme has become politically significant.

Background Tobacco-control policies have been suggested to reduce smoking among adolescents. However, there is limited evidence on the real-world costs of implementation in different settings. In this study, we aimed at estimating the costs of school smoking bans, school prevention programmes and non-school bans (smoking bans in non-educational public settings, bans on sales to minors and bans on point-of-sale advertising), implemented in Finland, Ireland, the Netherlands, Belgium, Germany, Italy and Portugal, for 2016. Methods We retrospectively collected costs related to the inspection, monitoring and sanctioning activities related to bans and educational activities related to smoking prevention programmes. We used an 'ingredients-based' approach, identifying each resource used, quantity and unit value for one full year, under the state perspective. Costs were measured at national, regional, local and school-level and were informed by data on how these activities were performed in reality. Results Purchasing power parities adjusted-costs varied between €0.02 and €0.74 (average €0.24) per person (pp) for bans implemented outside schools. Mean costs of school smoking bans ranged from €3.31 to €34.76 (average €20.60), and mean costs of school educational programmes from €0.75 to €4.65 (average €2.92). Conclusions It is feasible to estimate costs of health policies as implemented in different settings. Costs of the tobacco control policies evaluated here depend mainly on the number of person-hours allocated to their implementation, and on the scale of intervention. Non-school bans presented the lowest costs, and the implementation of all policies cost up to €36 pp for 1 year. [ABSTRACT FROM AUTHOR]

Background The purpose of this article is to report on a comparative analysis of the official food-based dietary guidelines (FBDG) that were applicable in 2015 in 25 EU Member States. We assess FBDG in relation to the main guidelines established by the FAO/WHO, the EURODIET project and the EFSA, with a particular focus on identifying strengths and limitations of current FBDG in Europe towards addressing diet-related health inequalities. Methods This is a review research, in which a mixed-methods sequenced procedure was utilized. In each EU country key informants, including sociologists, economists, dietitians and nutritionists were asked to provide data regarding: (i) current dietary guidelines and national health priorities, (ii) model of health promotion currently available, (iii) results of the latest food consumption survey. All documents were reviewed by the coordinating team. Full data were analysed by two nutritionists, using a tabulated sheet to organize and compare the results. Results While all countries have national FBDG, the level of detail and quality varies substantially with regard to: time of last update; availability of recommendations for specific target groups; specification of frequency and portion size; the graphical representation; recommended amounts and limits of foods consumed; and recommendations regarding physical activity. Conclusions European countries have great opportunities to improve FBDG to better serve Public Health policy through a more consistent foundation of how these guidelines are developed, the inclusion of different population subgroups as a target for recommendations and the implementation of monitoring systems. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to assess the evidence regarding economic evaluations of worksite health promotion programs in Europe. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the literature search, study selection, data extraction and quality appraisal were performed independently by two researchers. Full economic evaluations of worksite health promotion programs carried out in a European workplace were included. Results From 1728 search results, 39 articles describing 37 studies were included. Regarding methodological quality, 9 studies were rated as strong, 15 as moderate and 15 as weak. Six of the studies fulfilled the minimum standard for health economic evaluations. Worksite health promotion was applied in many different forms for a wide range of settings. Cost-effectiveness, cost-benefit and cost-utility analyses were performed from different perspectives. Effects on health outcomes tended to be small and uncertain. Only 9 out of 21 cost-benefit analyses reported a financial benefit and 10 out of 23 cost-effectiveness analyses concluded that the intervention was cost-effective. Two out of eight cost-utility analyses were found to be cost-effective. Productivity loss accounted for more than 85% of the total costs and thus, was the main cost driver in the analyses. Conclusions Due to considerable heterogeneity, no specific type of intervention could be identified to be particularly effective and the economic value of worksite health promotion remains uncertain. Further studies, investigating comprehensive worksite health promotion programs are needed to provide evidence on their efficiency. Guidelines to perform economic evaluations in the field of worksite health promotion, especially for valuation of productivity loss, are required. [ABSTRACT FROM AUTHOR]

Background The scope of this work was to investigate socioeconomic inequalities among European adults aged 50 or older in chronic diseases and behavioural risk factors for these diseases, namely, smoking habits, obesity and physical inactivity, between 2004 and 2015. Methods Data for this study were drawn from the Survey of Health, Ageing and Retirement (SHARE) in Europe, which is a panel database of microdata on health, socioeconomic status and social and family networks of people aged 50 years or older, covering most of the European Union. The predicted number of non-communicable diseases (NCDs) was used to estimate the concentration index and to find the contributions of determinants to socioeconomic inequalities in chronic diseases. Results The inequality disfavoured the poor in both years, but the effect was stable from 2004 (C = −0.071) to 2015 (C = −0.081). Inequality was shown to be attributed mostly to physical inactivity and obesity and this contribution increased during the study period. Among socioeconomic status (SES) determinants, education and marital status were the most concentrated in both years, while physical inactivity and obesity were the most concentrated behavioural risk factors in both years. Conclusions To prevent chronic diseases, health policy should aim not only to improve individual health behaviours in the population, but also to reduce socioeconomic inequality. Our study suggests promoting a healthy lifestyle in the most disadvantaged socioeconomic classes as a strategy to improve the health conditions of the whole population. [ABSTRACT FROM AUTHOR]

The author reflects on the public health effort to reduce tobacco use in Europe. He talks about the impact assessment of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) adopted in 2004, the decision by the Finnish Parliament in the first paragraph of the amended tobacco law in 2010 about the aim of the legislation, and the amendment of the Finnish tobacco law in 2016.

The article highlights the role of public policy actions from policy researchers, policymakers and governments in promoting physical activities and healthy diets of the population in Europe. Topics mentioned include the creation of a Policy Evaluation Network to identify and evaluate policies to address sedentary behavior and health inequities, the value of policy monitoring and surveillance system to determine policy impact, and the call for agencies to prioritize and finance policy research.

The article offers information on activities of the European Public Health Association (EUPHA) in 2017. It highlights the move by the EUPHA to further its strong voice for public health in Europe, including its effort to encourage European Union (EU) institutions to assert the importance of public health and health systems research. Also discussed is the decision of the association to join a public health campaign initiated by the European Public Health Alliance.

Background Unemployment in early adulthood is associated with higher rate of disability due to common mental disorders (CMDs). We investigated to what extent the association between unemployment and sub-sequent long-term sickness absence due to CMDs is direct or whether it is dependent on accumulation of mental health problems and socioeconomic disadvantage. Methods In this longitudinal study, a population-based 60% sample of Finnish young adults born between 1983 and 1985 (N = 116 878) was followed up for the incidence of CMDs from 2006 to 2010. Sociodemographic and health-related covariates were identified using several nationwide registers. Hazard ratios (HRs) with 95% confidence intervals (CIs), and survival and cumulative hazard functions for CMD were calculated. A matching procedure was applied to account for the systematic differences in the distribution of the baseline characteristics. Results A total of 1416 (2.4%) of men and 2539 (4.4%) of women were granted a long-term sickness allowance for CMD during the follow-up. After matching, HR (95% CI) of CMD for men decreased from 2.38 (2.12–2.68) to 1.31 (1.03–1.67) and for women from 1.97 (1.79–2.18) to 1.39 (1.18–1.65). Approximately half of the effect of the unemployment on CMDs was explained by the background variables. Conclusion Using a causal approach, our study suggests that unemployment is consistently associated with an increased risk of work disability due to CMDs. Considering the young unemployed as a risk group may help in targeting interventions promoting mental health and improving educational and employment opportunities. [ABSTRACT FROM AUTHOR]

Background: In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. Methods: In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. Results: The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Conclusion: Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discusses articles within the issue on topics including ecosystems approach for promoting health-enhancing physical activity, the European Union (EU) Physical Activity Focal Points Network and physical activity interventions in type 2 diabetes management.

Background. In order to promote healthful nutrition, insight is needed in the behavioural determinants of nutrition behaviours. Most research on behavioural determinants has been restricted to individual-level motivational factors. However, health behaviour is influenced by individual motivation and abilities, as well as environmental opportunities. [ABSTRACT FROM PUBLISHER]

Background: The European Union (EU) lacks adequate capacity for public health monitoring. The creation of a stable European Health Information System would help Member States to carry out evidence-based health policy. Such a system would also benefit EU health priorities by providing European wide comparable information. This study is the first comprehensive assessment of the availability of general health data in Europe. Methods: The main aim was to assess the availability of the European Community Health Indicators (ECHI) in each EU Member State. This was done by means of a review of international health databases, an online survey and face-to-face discussions with experts in 31 European countries. Results: The European average availability score for all ECHI indicators was 74% ranging from 56% to 84%. In most countries, about half of the ECHI indicators can be derived from routinely collected health information. This is true for demographic information, mortality and hospital discharge-based morbidity. However, many important ECHI indicators are lacking in most European countries. These include population representative data for health determinants, the provision and use of health care services, injuries, the quality of health care and health promotion. Conclusion: Valid health information is essential for improving people's health across Europe. There is an urgent need to develop harmonized methods for gathering and disseminating representative health data. These methods should be developed jointly by DG Health and Consumers, Eurostat and EU Member States. [ABSTRACT FROM PUBLISHER]

In this article the author discusses the health services research (HSR) and public health research in Europe. She states that the HSR studied the effect of social factors, personal behaviours, and health technologies on health care access, cost, and quality. She says that the HSR which is funded by the European Commission (EC) has identified the research priorities in various targeted areas including health technology assessment, benchmarking and performance indicators, and health-care systems.

Background: This comparative study is intended to provide a better understanding of how health promotion services are organized in school settings in Europe and to show how health professionals involved outside or within the school setting help to improve young people's health. Methods: This study was based on an analysis of school health policies and the organization of school health services, where these existed, as well as on interviews with health and education professionals. The countries concerned were Belgium (French-speaking community), Denmark, France, Spain (Catalonia), Switzerland (Jura), Poland and Portugal. Results: Although the provision of health services for children and adolescents varied considerably, the health services available were very similar in each of the countries. The emphasis put on particular aspects of these services varied depending on the political and institutional culture in each country. Three different types of school health service provision were identified: community-based, school-based or health needs-focused. Conclusion: All countries had health education and health promotion services but the provision of these services varied considerably from country to country. They were provided either by a specific category of professionals (health personnel or teachers) or considered to be the responsibility of the educational community as a whole. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics which include developing and validating disease management evaluation methods for European health-care systems, innovative issues in public health education and training devoted to strategic management, and the relationship between family income and postponement of needed medical care.

The article presents abstracts on European workplace health promotion topics which include sleep complaints, working conditions and health behaviors, classification of functioning, disability and health in a Swedish sick-listed population, and explanation of social gradient in long term sickness absence.

The article presents abstracts on topics about politics and policies in health promotion in Europe including the impact of information on women's participation in mammography screening program in Lithuania, Polish tool for ensuring quality of community-based health promotion program, and the impact of the European Union Common Agricultural Policy on public health.

The article presents abstracts of studies on health promotion. They include "Health Promotion in Europe: A Comparison Between Different Countries and Health Care Systems," by Susanne Weinbrenner and colleagues, "Demographic and Socioeconomic Heterogeneity in Tobacco Risk Perception and Beliefs About Smoking and Health in Armenia," by Karine Sahakyan and colleagues, and "Health Promotion Action: Comparative Analysis of Social and Primary Health Care Personnel in Four Municipalities," by Nina Simonsen-Rehn and colleagues.

Presents abstracts of studies presented in one of the workshops during the 11th Annual Conference of the European Public Health Association in November 2003. "Reducing Health Inequalities Through Health Promotion," by S. Van den Broucke, G. Scheerder, L. De Boeck, and C. Ancion; "Responding to inequality in the health of elderly people: A national collaborative program of health promotion (UK)," by Gaye Heathcote; Promoting health in poor and noninformed social groups - adequate access to health services at practitioner level," by Laurentia Mihaela Andronache.

In this article, the author discusses the effort of Health Services Research into European Policy and Practice (HSREPP) to establish health services research (HSR) community in the European Commission. He says that HSREPP aims to elicit priorities in health systems, to analyze the relationship of research and the European Commission (EC), and to contribute in building HSR community in Europe. HSREPP's partners will also develop a standing committee that will serve as the voice of HSR in EC.

The article presents abstracts on topics about the Northern Dimension Partnership in Public Health & Social Well-being (NDPHS) in Europe including working against HIV/AIDS epidemic in the Northern Dimension area, background, activities and priorities in NDPHS, and promotion of healthy lifestyles in the Northern Dimension area.

The article presents abstracts on European primary health care topics which include private practice and a major dental care reform in Finland, determinants of health promotion action in primary health care in Finland, and the effect of workload on general practitioners' adherence to clinical guidelines.

In this article the author discusses the initiatives of the European Public Health Association (EUPHA) to publish a new journal for the European health systems research (HRS). The author states that there has been a concept drift on the "European Journal of Public Health," which is the official journal of the EUPHA since public health possessed other meanings in different countries. He reveals that the journal publishes good HRS but majority of the topics are health promotion and epidemiology.

The article highlights a workshop organized by the publication "Social & Preventive Medicine: International Journal of Public Health," which focused on survey, surveillance and health promotion research in Europe. A study on the psychosocial mediators of socioeconomic differences in self-rated health among adolescents will be presented. The subject of strengthening the process of cross-cultural transfer of International Health Promotion Policy in Bulgaria will also be explored.

This article presents updates on the sections of the European Public Health Association (EUPHA) as of April 2005. The ten existing EUPHA sections are very active. Not only have they planned workshops and annual meetings, but they are also working on a number of projects. The section on public health epidemiology is working on a restart. The sections infectious diseases control and social security health are planning pre-conference activities in Graz. The section health promotion is presenting EUPHA at the International Union of Health Promotion and Education meeting. The section youth is working on a Web site for teen health. The section migrant health is planning a conference on migrant health in 2006. The section public health practice and policy has the leadership in project of the Strengthening Public Health Research in the European Union. And the section on health services research is planning training modules around EUPHA conferences. Several proposals for EUPHA sections are also presented. It concerns a possible section on public health genetics, health economics and chronic diseases.

Presents abstracts of studies dealing with health promotion which were presented at one of the parallel sessions during the 11th Annual Conference of the European Public Health Association in November 2003. "Time for healthy living: Health promotion for specific target groups," by J. Jansen, A.J. Schuit and F. Van der Lucht; "Autonomy and obedience: Contradictions in health promotion messages in late 20th century Denmark and Sweden," by S. Vallgårda; "Evaluation of a new media convergence concept of health behavior intervention," by K. Helweg-Larsen, F. Kamper-Joergensen, A. Borglykke and M. Davidsen.

The article focuses on the establishment of the general practitioner (GP) cluster model, a program for the development of primary health care in Hungary. The program aims to encourage GPs to participate in public health services. It notes that the primary care practices can provide disease-preventive and health-promotive services by sharing the time and cost of employing staff working in the clusters such as public health professionals, physiotherapists and health psychologists.