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Copyright of Wirtschafts- und Sozialwissenschaftliches Institut Mitteilungen is the property of Nomos Verlagsgesellschaft mbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The JOBS Program Germany is a labor market integrative and health promotion intervention for unemployed people. This study examines JOBS Program Germany trainers' view of (1) the theoretical concept of the JOBS Program, (2) its practical implementation in Germany on-site, (3) its acceptance by participants, and (4) the training effects. The study aimed at identifying potential for adaption allowing adjustments to improve the practical implementation and the training effectiveness. Methods: JOBS Program Germany trainers (two for each training) were interviewed via voluntary survey (computer-assisted web interviews) after each training. Results: Fourteen JOBS Program trainings have been conducted and all trainers responded resulting in 28 interviews. 78.5% and 85.7% of the respondents were rather or very satisfied with the theoretical contents and its practical implementation, respectively. Almost all trainers (96.4–100.0%) were satisfied with the on-site coordination, the cooperation with the organizer's employees, the room equipment, the training room size, and the environmental conditions in the training rooms. In 89.3% of all responses the trainers rated the last training a success. However, the trainers also provided valuable suggestions for further improvement in Germany. This concerns the revision of the training manual, the adjustment of the trainer training and the preparation of participants. Conclusion: Besides the trainers' positive view on the different dimensions of the training content and implementation, their suggestions can help ensure that many unemployed people in Germany could benefit from a continued regular implementation of the JOBS Program Germany in the future. Trial Registration: German Clinical Trials Register (DRKS), DRKS00022388. Registered on 20 July, 2020. [ABSTRACT FROM AUTHOR]

Copyright of Public Health Forum is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Social Work is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Wirtschafts- und Sozialwissenschaftliches Institut Mitteilungen is the property of Nomos Verlagsgesellschaft mbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Krankenhäuser stellen ein ursprünglich von der WHO initiiertes und unterstütztes Setting der Gesundheitsförderung dar. Gesundheitsfördernde Krankenhäuser versuchen aktiv, sich zu gesunden Organisationen zu entwickeln und zu vernetzen. In Deutschland ist die Beteiligung der Krankenhäuser sehr gering und die Maßnahmen sind stark verhaltensorientiert. Internationale Reviews eruierten die Implementierungsbedingungen in Krankenhäusern und die Hemmfaktoren. Zur Evidenzbasierung ist noch weitere Präventionsforschung nötig. The WHO initiated and supported an approach for health-promoting hospitals. Health promoting hospitals are actively trying to become healthy organizations and building networks. In Germany, there is a very low involvement of hospitals. Furthermore, they have focused on behaviour-oriented health promotion. International reviews provide information on implementing health promotion in hospitals and the obstacles. Prevention research is needed to strengthen the evidence base. [ABSTRACT FROM AUTHOR]

Barrierefreiheit in der ambulanten Gesundheitsversorgung umfasst als komplexe Intervention bauliche, personelle, organisatorische und räumliche Maßnahmen für behinderte Menschen im Sinne der UN-Behindertenrechtskonvention. Dieser Artikel exploriert, inwieweit den Menschen mit Behinderungen ein barrierefreier Zugang in der ambulanten Gesundheitsversorgung in Deutschland ermöglicht wird. Er zeigt Datendefizite bei der Erfassung von Barrierefreiheit und den Handlungs- und Forschungsbedarf auf. In accordance with the Convention on the Rights of Persons with Disabilities, the freedom from barriers in outpatient care includes as a complex intervention appropriate building accessibility, spatial planning, personnel and organisational measures. This article explores the barriers which people with disabilities have in accessing to ambulant health care services in Germany. It shows missing data sources and points out needs for action and health services research. [ABSTRACT FROM AUTHOR]

Purpose: Based on survey data from the IAB Establishment Panel, the investigation aims to examine the prevalence of workplace health promotion among German establishments and its determinants. Methods: The IAB Establishment Panel 2012 comprises interviews with 15,556 establishments of all sizes and industrial sectors in Germany. We first present some descriptive statistics and then analyse the determinants of the prevalence of workplace health promotion by means of a probit regression. Results: In 2012, 27 % of the interviewed establishments reported providing workplace health promotion measures on a voluntary basis. 64 % of all employees do work in establishments with workplace health promotion. From 2002 to 2012, the share of establishments with workplace health promotion increased by 8 % points. The strongest increase was observed in establishments in Western Germany and establishments with work councils. Most popular among the measures of workplace health promotion are employee surveys and analysis of the sickness absence. The vast majority of establishments provide only single measures. The econometric analysis shows that industrial sector, size of establishment, expected problems with human resources and the existence of a work council are important factors for workplace health promotion. Conclusions: Only a minority of establishments are committed to workplace health promotion, while these establishments provide the majority of jobs in Germany. Our analysis displays considerable disparities in terms of prevalence as well as potential for further extensions. This could be taken more into account when discussing innovative approaches of workplace health promotion. [ABSTRACT FROM AUTHOR]

A university is a living environment that can influence people's health. This study aims to analyze health and health literacy of Bachelor of Social Work (BSW) students in comparison with students in other study programs. A survey was conducted among all students at the University of Kassel regarding their health and health literacy. The survey evaluated general health status, disability, and health literacy. In this study, BSW students had an adverse health status compared to other students. Only 66.9% of the BSW students rated their general health as very good or good (vs. 79.7% in other study programs). BSW students are also more likely to be moderately or severely limited in daily activities due to chronic health conditions than students in other study programs. In contrast, health literacy levels differ little between BSW students and other students. This study highlights the need for health (literacy) promotion in social work studies.

Compared to the employed, the unemployed suffer from poorer health, especially in terms of mental health. At the same time, health promotion rarely reaches unemployed people. The "JOBS Program" is an intervention to promote health and labor market integration and has shown positive effects in the USA and Finland. In this confirmatory study, we investigated whether the JOBS Program achieves similar effects in Germany. We applied a randomized controlled trial to compare an intervention group (IVG) with a waiting control group (WCG) before (T0; N = 94) and shortly after (T1; n = 65) the intervention. Concerning our primary outcomes, the JOBS Program Germany was beneficial: Compared to the WCG, the regression estimated that the IVG had (1) a 2.736 scale point higher level of life satisfaction ( p = 0.049), (2) a 0.337 scale point higher level of general health ( p = 0.025), and (3) a 14.524 scale point higher level of mental well-being ( p = 0.004). Although not statistically significant, job search-specific self-efficacy also appeared to be positively associated with the intervention. This study provides evidence of the effectiveness of JOBS Program on the abovementioned outcomes, including for older and long-term unemployed people, supporting the benefits of regular implementation of this program for a wide range of unemployed people in Germany.

Aim of the Study: This secondary analysis aims to investigate the prevalence and uptake of workplace health promotion (WHP) in Germany., Methods: Our data base was the 2018 BIBB-/BAuA Survey in Germany, which is a randomized representative CATI survey of 20,012 employed persons aged 15 and older. Proportions were compared among different groups and a binary logistic regression model was estimated., Results: 47% of the employees reported that WHP interventions had been implemented in their company in the last two years. 25% of the employees had taken up the offer of WHP. The proportion of employees who confirmed that WHP was offered in their company increased sharply with the company size, but the take-up rates decreased. Employees in companies with a works/staff council stated a disproportionately high rate of implementation of WHP. However, employees with a low socioeconomic status reported WHP offer to a relatively small extent. In particular, employees without a vocational qualification, in a fixed-term employment, at risk of dismissal and temporary agency workers reported a relatively low implementation of WHP in their company. Logistic regression analyses aimed to identify predictors for the WHP offer. Compared to small companies, workers in medium-sized companies were more than twice as likely (OR=2.17) to have a WHP offer in their company and more than five times as likely (OR=5.64) in large companies. In the public sector, the chances of employees having WHP in their company were significantly better than in industry, crafts, trade or other sectors. Compared to German employees, employees with a foreign citizenship had a significantly lower chance of WHP being offered in their company (OR=0.78). A very good or excellent health status was associated with a slightly increased OR of 1.15 for WHP in the company. In companies in which employees were very satisfied with their work overall, the probability of a WHP offer was significantly increased (OR=1.70)., Conclusion: The analysis reveals large disparities in the WHP. There is a need for WHP strategies for targeting the small companies and the employees with a low socioeconomic status within the companies., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht, (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Goals for health and health care are an indispensable basic requirement for a functioning health care system. The dilemma of the German health care system is that it has not been designed in a planned way, but that it has grown historically. In recent years, it has developed through the free play of forces into what it is today. The OECD characterizes the current state as follows: The costs of the German health system do not correspond to the often only average health outcomes for the population. To meet the legal requirements (especially SGB V §§ 12, 27 and 70), health care/the health system in Germany needs concrete goals. An orientation towards health care goals entails measures on all levels of health care: on the macro level (overall system/total population), on the meso level (subdivided according to regions, specific population groups, etc.) as well as on the micro level (patients and health care providers). Based on national and international experiences, this position paper of the DNVF e.V. (German Network for health services research) shows the potential of how operationalised health care targets can ensure effective, affordable and high-quality health care. The coalition agreement of the current government propagates a reorientation with patient-related health care goals. Now it is important to derive concrete and realisable goals from this declaration of intent and to involve all important groups in the process. In addition, values and ethical standards for implementation shall be agreed upon in this process. The Health Ministry (BMG) should facilitate and promote the process of societal will-building for the definition of national health care goals. This requires a clear political will. As a result, the National Health Care Goals are available at the end of the process, which are published and maintained together with evidence-based facts as well as valid and resilient data in a Manual "National Health Care Goals". The operational responsibility for implementation could lie with the newly to be founded Federal Institute of Public Health, as already announced in the agreement of the governing coalition. The DNVF is willing to actively participate in the development of health care targets., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Background: Compared to the employed, the unemployed are characterized by a substantially worse health status, particularly with regards to mental health. At the same time, conventional offers of prevention and health promotion rarely reach the unemployed. The JOBS Program is a health promotion program that combines job application training with elements of social learning theory and self-efficacy. Randomized field studies in the USA and Finland found significant positive effects on reintegration into the labor market and health amongst the unemployed. In this confirmatory study, we analyze whether the JOBS Program produces similar positive effects for the unemployed in Germany., Methods: This study is designed as a country-wide, multi-center, non-blinded, two-armed, parallel-group, randomized controlled trial over 6 months. A total of approximately 1500 unemployed, who are willing to participate, are randomly assigned either to an intervention group or a waiting control group with an allocation ratio of 1:1. Guided by a team of two trainers, the intervention group completes JOBS Program Germany in small groups of 8 to 15 unemployed for a period of 1 week in units of 5 h a day. Primary outcome measures are the reintegration into the labor market, self-efficacy, life satisfaction, subjective state of health, depressive symptoms, and psychological distress. Of secondary interest are moderating variables such as socio-demographic characteristics, the duration of unemployment, and the job-search intensity. Outcomes will be repeatedly assessed via computer-assisted telephone interviews at three points in time: immediately before the intervention (pre-test), immediately after the intervention (post-test), and 6 months after the intervention has ended (6-months follow-up)., Discussion: This confirmatory study will provide empirical evidence on the effectiveness of the JOBS Program on the reintegration and (mental) health of the unemployed in Germany. If our results from the randomized controlled trail in a country-wide field experiment confirm its effectiveness, the JOBS Program Germany could, perspectively, be implemented into the German employment promotion and social security system on a long-term basis., Trial Registration: German Clinical Trials Register (DRKS), DRKS00022388 . Registered on 20 July, 2020.

Objectives: This secondary analysis aims to investigate the implementation of the legally required company integration management ("BEM") in case of an incapacity for work of at least six weeks and to identify predictors., Methods: Database is the representative randomized 2018 BIBB/BAuA Employment Survey of 20 012 employed persons in Germany., Results: Of the 1367 employees entitled to company integration management, 40% received an offer from their employer and 27% accepted it. In the public sector, half of those who were entitled reported an offer. Among those entitled to company integration management, employees under the age of 30, at risk of dismissal, or with fixed-term employment contract received an offer particularly rarely. Entitled employees with disabilities or in companies with works/staff councils received disproportionately often an offer of company integration management. Logistic regression analyses reveal strong associations between company integration management offer and the duration of incapacity to work. The probability of receiving an offer is almost halved for those entitled in medium-sized compared to small companies. The higher the level of educational qualification, the higher are odds ratios for an offer. In companies in which employees were less or not satisfied with their work overall, the chance of a company integration management offer is significantly reduced almost by half. The chance of an offer is more than three times higher in companies with workplace health promotion compared to those without., Conclusions: Only a minority of eligible employees received an offer that is closely associated with health-promoting corporate culture and job satisfaction., (© 2021 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Purpose: In the area of the Asylum Seeker Benefits Act (AsylbLG), there are two options for granting benefits that have practical relevance to health care (depending on the period of previous residence): minimum provision and benefits in special cases, analogous to the Social Code Book XII (SGB XII)., Method: This secondary data analysis examines the performance of benefits in the case of illness among benefit recipients according to the AsylbLG at the Research Data Centre of the Federal and State Statistical Offices. The examined group of individuals have not yet been granted refugee status or asylum entitlement., Results: As of 31 December 2018, 423,201 persons in Germany were receiving benefits according to the AsylbLG. A good third of these were women. The average age was 24 years, and more than half came from Asia. More than one-third of all benefit recipients were in outpatient (33.5%) or inpatient treatment (1.3%). Among the federal states, benefits for assistance in the case of illness as well as the health-related per capita gross expenditure varied considerably. The provision of illness benefits in reception facilities was relatively low. With the health card, the use of inpatient treatment was higher. The standard health-related provision of assistance in special cases (§2 AsylbLG analogous to SGB XII) reached a higher share of people entitled to benefits at the end of the year (42.7%) than the minimum provision according to §3 AsylbLG (29.0%). Nevertheless, it caused comparatively less gross expenditure., Conclusion: It is recommended to apply §2 AsylbLG for a prestay period of three months or longer in order to be able to grant assistance analogous to Chapters 5 to 9 SGB XII earlier. Nationwide introduction of an electronic health insurance card for asylum seekers would improve access.

More than half of the German population has difficulties in dealing with health information. It is an important task of health services research to examine how healthcare professionals and health care organizations can meet this challenge. This short version of the DNVF Memorandum Health Literacy (Part 1) defines the terms of individual and organizational health literacy, presents the national and international state of research and ethical aspects of health literacy research in health care settings. Central research topics and future research desiderata are derived., Competing Interests: Dr. Christoph Kowalski ist Mitarbeiter der Deutschen Krebsgesellschaft. Alle anderen Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: This study aims to analyze self-perceived health and chronic illness in the working population and to explore disparities between social groups., Methods: The annual EU-SILC Survey has been conducted in Germany since 2005. The reference population is defined as all private households. In the EU-SILC 2014, a random sample of 22,695 persons aged 16 years and older was interviewed in Germany (860 unemployed and 11,390 employed)., Results: In accordance to the EU-SILC-Surveys 2005 until 2014, the self-perceived general health of the population has improved in Germany. 65.2% of the population (aged 16 years and older) in Germany assessed their health as very good or good in 2014 vs. 60.7% in 2005, despite an ageing population. However, there was an increase in health inequalities between employment status groups. In 2014, only 37.2% among unemployed persons vs. 77.1% of the employed perceived their general health as very good or good (53.8 vs. 73.2% in 2005). Multivariate logistic regression models revealed strong associations of subjective general health and chronic illness with age groups and social determinants on the EU-SILC-Survey 2014. Cross-sectional analysis showed unemployed persons to be much less likely to have very good or good self-perceived health (OR=0.26) and more likely to have chronic illness (OR=3.99) compared to employed people after adjustment for sociodemographic characteristics. The probabilities of better health and lower chronic illness rose with the increasing disposable (net) income as well as educational levels. 78.8% of the household members in the highest income quintile vs. 51.7% of the household members in the lowest income quintile said they had very good or good health (OR=2.53). In all investigated age groups, members of the households at risk of poverty were more likely to have poor health on average. High educational level (ISCED 5-8) was associated with higher positive self-rated health (OR=1.78)., Conclusion: The EU-SILC-Survey shows distinct health developments and inequalities in Germany. EU-SILC is useful as an annual general population survey to monitor public health targets and reduce health inequalities., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Eigentümer und Copyright ©Georg Thieme Verlag KG 2018.)

Organizational health services research in Germany is of increasing relevance. Based on the guide on methods for organizational health services research of the Memorandum III, part 1 from the year 2009, the fundamentals and standards have now been refined. The memorandum captures the theoretical framework, basic methodological approaches and methods in health services research for the design, evaluation and implementation of complex interventions in healthcare organizations., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Eigentümer und Copyright ©Georg Thieme Verlag KG 2018.)

Organizational health services research is still a relatively young field of research in Germany which is of increasing interest. The German Network Health Services Research e.V. (DNVF e.V.) published in 2009 - supported by expert associations and individual members of the DNVF - a guide on "Methods for organizational health services research" of the Memorandum III, part 1 [1]. Originating from this publication and facilitated by the increasing relevance of the field, a necessity to refine the conceptual and methodological basis became evident. The update and extension of the publication from 2009 consists of three chapters: (1) Definition and concept of organizational health services research, (2) Methodological approaches in organizational health services research: indicators, data sources, data collection and data analysis, (3) Methodological approaches for the design, evaluation and implementation of complex interventions in health care organizations. The aim of the third chapter is to present methods for intervention design, evaluation of effectiveness and efficacy as well as implementation research with particular regard to the organizational context of interventions to improve health care., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Eigentümer und Copyright ©Georg Thieme Verlag KG 2019.)

Introduction: The unmet medical need is an important indicator for the quality assessment of a health system on an international level., Methods: The EU-SILC-Survey was launched in 2005 and is performed yearly in Germany. In EU-SILC-2014, 22 695 people (over 17 years) in 12 744 households have been interviewed., Results: In accordance to the EU-SILC-waves 2005 and 2014, the unmet medical or dental need has been decreased strongly in Germany. 8.5 % of the population (aged 16 and over) reported either an unmet need for medical (6.4 %) or dental care (3.8 %). The main causes for not making use of unmet dental need are financial and of unmet medical need are personal reasons. In the multivariate logistical regression models, a bad health state has the biggest influence on the likelihood of occurrence of an unmet medical or dental need. Higher disposable (net) income and educational levels are associated with lower probability for non-utilization. Unemployment and migration are accompanied by a higher unmet medical and dental need. Middle-aged people are especially affected., Conclusion: The analyses reveal improvements in unmet needs for medical and dental care over time in Germany but also large social disparities. There are action approaches in financial regulation in the health system and strengthening individual health literacy., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Healthcare professionals are confronted with specific work-related demands that influence work-family relations and might indirectly affect the quality of healthcare. This paper seeks to provide an overview of the current state of research on this topic of relevance to health services research. The overview may serve as a starting point for modifying structures in the healthcare system (especially in rural regions) with the aim of improving work-family compatibility., Methods: A systematic national and international literature search was conducted in terms of a scoping review. The following criteria/contents to be covered in publications were defined: work-family compatibility; work-family interface and work-family conflict in employees working in healthcare; healthcare professions in rural areas and links with work-family issues; interventions to improve work-family compatibility. 145 publications were included in the overview., Results: The available literature focuses on physicians and nursing staff while publications on other professions are largely lacking. The methodological quality of existing studies is mostly low, including a lack of meta-analyses. Several studies document dissatisfaction in physicians and nursing staff regarding reconciliation of work and family life. Only few intervention studies were found that seek to improve work-life compatibility; few of them focus on employees in healthcare. There are also deficits with respect to linking work-family issues with aspects of healthcare in rural areas., Conclusions: There is a shortage of systematic national and international research regarding work-family compatibility, especially when it comes to the evaluation of interventions. The overview provides starting points for improving work-family compatibility in healthcare., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Eigentümer und Copyright ©Georg Thieme Verlag KG 2017.)

Aim of the study: Health conferences offer opportunities for better cooperation and coordination in local health management. The aim of the explorative evaluation study was to assess structures, processes and results of "Regional Health Conferences (RGK)" in 3 model regions, to inform about potential for development and to test their transferability to other regions. Method: After the model project had been up and running for 18 months (08/2013 to 12/2014), a survey of 80 participants of the RGK in 3 regions was conducted, based on a semi-standardized questionnaire. The response rate was 90%. The results were complemented by document analysis and an additional survey of the managers of the RGK. Results: The 3 RGK were established with their agencies and 13 working groups on health care. Almost all participants felt that the number of members was appropriate and that the main stakeholders were represented. According to a large part of the respondents, the majority actively took part in the RGK and usually everyone had the equal opportunity to propose a topic. Although almost half of the respondents reported conflicts, the atmosphere was constructive for 3-quarters of them. Nearly all the interviewees confirmed the importance of a chairman and a manager of the agency, as well as the positive influence of the moderator. Almost everyone agreed that RGK are suited to improve health care and cooperation. From the participants' point of view, the main problems were identified; 94% of the respondents agreed that the previous work could be regarded as successful and 91% were satisfied or rather satisfied with the processes of the RGK. The level of satisfaction was similar among the three model regions, but it varied among the member groups; 98% of the interviewees would also take part in the future. Conclusion: According to this survey, RGK are an appropriate platform for coordination, exchange und cooperation of stakeholders and a good instrument for cooperation. In Bavaria, the approach will be further improved as well as extended to other regions based on a new concept called "Health Regions plus "., Competing Interests: Interessenkonflikt:: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions., Results: The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system., Discussion: Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich"., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Health services research aims to generate knowledge about care processes of people with illnesses who access health-care services. In addition, the consequences of those processes in the care routine concerning the involved persons and the health system are analyzed. CONCEPT OF THE THEORETICAL WORK: In the first part of the manuscript, an overview concerning the current definitions and subsumptions of the concept of health services research is given. The second part of the manuscript focuses on demonstrating how evidence-based health services research can be used to enable optimization of the care system. The concept is called the "circle of care optimization". In the first step the current care situation concerning its deficits and their reasons is analyzed. In the second step a relevant care goal is defined. In the third step an improvement of an existing care process is developed to achieve the defined care goal. In the fourth step, a comparative empirical study with a high-quality study design is carried out, to assess whether the improved care process is superior to the current care as usual. A health economic evaluation will be performed if applicable. If the results show no or only small advantages, the "circle" starts again with step 3. However, if the results show a significant effect in favour of the new care process and are relevant for the delivery of care and efficient in the context of health economics, a fifth step will be performed which involves developing and testing strategies for implementation. Where relevant, the consequences of implementation are investigated in a sixth step. A "best-practice" practical example is demonstrated to illustrate the "circle of care optimization"., Conclusions: conclusions are derived by illustrating future challenges for health services research., (© Georg Thieme Verlag KG Stuttgart · New York.)

The aim of the memorandum on the development of health services research (HSR) in Bavaria is to operationalise the global objectives of the State Working Group "Health Services Research" (LAGeV) and to collectively define future topics, specific implementation steps, methods as well as ways of working for the future course of the LAGeV. The LAGeV is an expert committee that integrates and links the competencies of different actors from science, politics and health care regarding HSR and facilitates their cooperation. The memorandum is based on an explorative survey among the LAGeV members, which identified the status quo of health services research in Bavaria, potential for development, important constraints, promoting factors, specific recommendations as well as future topics for the further development of HSR in Bavaria. From the perspective of the LAGeV members, the 12 most important future topics are: 1) Interface and networking research, 2) Innovative health care concepts, 3) Health care for multimorbid patients, 4)Health care for chronically ill patients, 5) Evaluation of innovations, processes and technologies, 6) Patient orientation and user focus, 7) Social and regional inequalities in health care, 8) Health care for mentally ill patients, 9) Indicators of health care quality, 10) Regional needs planning, 11) Practical effectiveness of HSR and 12) Scientific use of routine data. Potential for development of HSR in Bavaria lies a) in the promotion of networking and sustainable structures, b) the establishment of an HSR information platform that bundles information and results in regard to current topics and aims to facilitate cooperation as well as c) in the initiation of measures and projects. The latter ought to pinpoint health care challenges and make recommendations regarding the improvement of health care and its quality. The cooperation and networking structures that were established with the LAGeV should be continuously expanded and be used to work on priority topics in order to achieve the global objectives of the LAGeV., (© Georg Thieme Verlag KG Stuttgart · New York.)

Health conferences are a special management instrument of health policy. Less is known about the distribution. There is a lack of systematic evaluation methods.This overview is based on comprehensive literature, data base and internet searches about health conferences in Germany.The establishment of structured conferences is derived from funding projects of the federal states or local initiatives which began in different phases and with various emphases. The strategies varied from individual actions to an implementation in the whole state. Currently there are altogether 130 health conferences in Germany for approximately one third of the county and city districts in 13 federal states. The federal states assist health conferences by providing financial support, health policy, support by health authorities and regulations in the law. In the majority of the cases the office is located within the public health service. There is a great diversity in the composition of the stakeholders and in the contents. A systematic monitoring and outcome evaluation was conducted only in a few cases. Those studies predominantly report positive results but also promoting and inhibiting factors. They referred to restrictions.Health conferences are broadly disseminated, especially in west Germany. They offer opportunities for a community health management. There is a need for more intensive exchange and evaluation to improve their development., (© Georg Thieme Verlag KG Stuttgart · New York.)

In 2011, the Bavarian Parliament decided to advance health services research (HSR) in Bavaria by bundling scientific competencies in a State Working Group and integrating other actors in it. The establishment of such a State Working Group "Health Services Research" -(LAGeV) together with members from science, health care and politics followed in 2012. The objective of this study is to identify the status quo of HSR in Bavaria including its determinants and potential for development based on the actors' perspective.After the inaugural meeting a semi-structured questionnaire was sent to all 36 members from 28 organisations. Items comprise information on the respondent's background as well as status quo, future topics and potential for development of HSR in Bavaria.27 members took part in the survey, resulting in a response rate of 75.0%. Satisfaction of actors with the status quo of HSR is rather low, especially regarding the effectiveness of policy advice. Researchers and health care providers are also not much satisfied with the HSR environment. For the future of HSR, respondents prioritise the topics interface and networking research, followed by innovative care concepts, care for patients with multiple or chronic conditions as well as evaluation of innovations, processes and technologies. Potential for development and thus improvement of care is primarily seen in the abolishment of existing constraints by an overall HSR concept (including selective research promotion), networking and cooperation, research funding as well as improving the interface between politics and science. Respondents assess the benefit of an increased networking within the LAGeV as high.Status quo of HSR in Bavaria is not very satisfactory. The survey reveals important constraints as well as promoting factors based on the viewpoints of different groups of actors. It also prioritises future HSR topics and identifies potential for development, which are important for the LAGeV. The findings can be used for advancing HSR in Bavaria and beyond., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Objective: There are only few data about regional and social disparities in obesity, the related diseases, and related morbidity in Germany., Methods: The 2009 Microcensus regional file North Rhine-Westphalia was used for this analysis. The Microcensus represents a decentralised household survey. The selection rate of the random sample survey was 1 % of the population. RESULTS can be extrapolated at state and community levels in North Rhine-Westphalia. The body weight and the height were reported by 72 % of the interviewees above 18 years in the voluntary health supplementary programme (N = 10 705 000)., Results: About 11 % of the adults above 18 years in North Rhine-Westphalia are obese class I, further 3 % of the adults are obese class II and 1 % are obese class III according to Body-Mass-Index classification. After adjustment for age, male and female adults with obesity have a highly significantly elevated odds ratio of 1.4 and 1.7 for illness or accident injury at the survey date. Obesity prevalence is associated with officially confirmed disability.There is a social gradient in the prevalence of obesity in the population of employable age (18-64 years). The probability of obesity decreases with the rise of the level of education. Male and female blue-collar workers and female jobseekers were more often obese. The Microcensus shows distinct disparities in obesity prevalence between the communities in the population of employable age., Conclusion: The Microcensus may have potential for a harmonized monitoring concerning obesity. But there is a need for further research in regard to the methods. The regional and social disparities in obesity prevalence reveal needs for interventions to combat obesity., (© Georg Thieme Verlag KG Stuttgart · New York.)

The health-for-all policy framework needs data for action. Results from the German Microcensus can be extrapolated to the population at the country, state ("Bundesländer"), and community levels. Most of the information in the 2009 Microcensus was given under the statutory obligation; providing health information in the supplementary program was optional. The selection rate was 1% of the population. The Microcensus' continuous sampling method during the year, thus, determines illness rates as an average for the year. There are distinct health disparities between not only the states but also between communities in North Rhine-Westphalia. Annual average illness rates for 2009 are associated in NRW with influencing social factors, e.g., education. Illness rates rise with decreasing net income for the past month. Blue-collar workers suffered more often from illness or accident injuries at the time. The levels of illness in the overall employable population increase in the communities of NRW with the proportion of inhabitants who receive governmental financial aid or unemployment benefits to secure their basic livelihood. The Microcensus has the potential to be a source for systematic and harmonized monitoring concerning health in the country, states, and communities of Germany.

According to the answers of employers to the representative IAB establishment panel 2004, one-fifth of the companies in Germany voluntarily carried out or financially supported measures for the protection or promotion of the health and well-being of their work force. The proportion of health-promoting companies was above average in all East German federal states as well as in Bavaria, in Saarland and in Lower Saxony. North Rhine-Westphalia was precisely average. In East Germany, almost one-fourth and in West Germany just under one-fifth of all companies surveyed carry out health-promoting measures.Work-site health promotion varies considerably depending on the corresponding federal states, industrial branches and company sizes. Work-site health promotion has ,up to now, been concentrated in big companies and groups. An under-representation of work-site health promotion is observed above all in small and very small companies and particularly in the catering trade. Work-site health promotion was principally determined by analyses of sickness leaves and surveys on health protection in the work place which were mentioned in about 9% and 8% of the companies interviewed. 6% of the companies provided courses on health-relevant ways of behaviour. About 4% of the companies maintain health circles and 5% realised other health promoting measures. Further correlation analyses reveal that in companies with a workers council/staff council, work-site health promotion was significantly much more common. This correlation is especially strong in small and medium-size companies. The longitudinal analysis of the IAB establishment panel 2002 and 2004 reveals much dynamism in work-site health promotion. On the one hand, half of the companies involved in work-site health promotion in 2002 had stopped their commitment to work-site health promotion by 2004. Sustainability remains one of the biggest challenges in work-site health promotion. On the other hand, a bit more than one tenth of the repeatedly interviewed companies started health-promoting activities in 2004. According to the longitudinal data set, altogether 29% of the companies were reached by work-site health promotion measures (for the years 2002 and 2004).

In the context of the health promotion programme 'Klasse2000', 483 health experts gave specific lessons to pupils from the first to the fourth grade of the elementary school. Following the classes a survey was conducted as to the valuation of the programme, its translation into practice and co-operation between class teachers and health experts. Those questioned considered the programme as really applicable and were absolutely content with the organisation. They regarded direct working with pupils as fairly positive. Co-operation with class teachers was seen as ambivalent. The findings of this survey trigger further optimisation of the programme, especially to enlarge the time spent on efforts by the health experts and to intensify parent co-operation.