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Effective lifestyle health promotion interventions require the identification of groups sharing similar behavioural risk factors (BRF) and socio-demographic characteristics. This study aimed to identify these subgroups in the Polish population and check whether local authorities’ health programmes meet their needs. Population data came from a 2018 question survey on a random representative sample of 3000 inhabitants. Four groups were identified with the TwoStep cluster analysis method. One of them (“Multi-risk”) differed from the others and the general population by a high prevalence of numerous BRF: 59% [95% confidence interval: 56–63%] of its members smoke, 35% [32–38%] have alcohol problems, 79% [76–82%] indulge in unhealthy food, 64% [60–67%] do not practice recreational physical activity, and 73% [70–76%] are overweight. This group, with an average age of 50, was characterised by an excess of males (81% [79–84%]) and people with basic vocational education (53% [50–57%]). In 2018, only 40 out of all 228 health programmes in Poland addressed BRF in adults; only 20 referred to more than one habit. Moreover, access to these programmes was limited by formal criteria. There were no programmes dedicated to the reduction of BRF exclusively. The local governments focused on improving access to health services rather than on a pro-health change in individual behaviours.

Background: The participation of older adults in population health interventions constitutes a key factor in their physical, mental and social health. The aim of this study was to determine variables considered as enablers and barriers to participation in health programmes. Methods: The conceptual framework of the study was developed and population health interventions were operationalised as health programmes. A total of 805 older adults participated in a questionnaire survey. The questionnaire included questions about socio-demographic, health and social connectedness-related factors as well as participation in population health interventions/programmes. Multiple logistic regression was used to examine the relationship between respondents’ characteristics and participation in the intervention. Results: Participation in health programmes was declared by 316 respondents. The enablers of participation were general practitioner’s affability (OR = 2.638 [1.453–4.791], p = 0.001), three or more social activities (OR = 3.415 [1.477–7.894], p = 0.004), taking part in support groups (OR = 4.743 [1.255–17.929], p = 0.022) and involvement in Universities of the Third Age (OR = 2.829 [1.093–7.327], p = 0.032). The barriers were primary education (OR = 0.385 [0.215–0.690], p = 0.001), infrequent general practitioner’s appointments (OR = 0.500 [0.281–0.888], p = 0.018) and lack of social activity (OR = 0.455 [0.299–0.632], p < 0.001). Conclusion: The enablers of participation appeared to solely include variables regarding health service utilisation, patient experience and social activity, i.e., interpersonal and community relationships, not intrapersonal factors.

According to the WHO, healthy adults aged 18-64 should perform at least 150 min of moderate-intensity aerobic physical activity (PA), or at least 75 min of vigorous-intensity PA, throughout the week, or an equivalent combination of moderate and vigorous activity. These recommendations should be promoted and involved in primary health care (PHC) staff daily practice. Tailoring the education message depends on peoples' perspective on PA, but in Poland there is no research on the subject.The aim of the study was to explore and compare the perception of lay people (LP) and health professionals (HP) of PA to find similarities and differences in their perspective - as this may have an impact on PHC-based education on PA (favourable or unfavourable).Six mini FGIs were carried out. Research sample consisted of 16 LP from urban settings and 10 HP (doctors, nurses).LP and HP appreciated PA as important and considerably controllable health determinant. LP attributed the main gains of PA to psycho-social benefits, and HP strictly to diseases risk reduction. Both groups had difficulties in defining PA and doubts abounded about PA and exercise. Optimal dose (volume) of PA was generally unclear and the WHO recommendation were unknown. HP seemed to be more eager than LP to appreciate simple forms of PA, e.g. walking. Barriers to PA perceived by LP were described in terms of 'real life' factors (sportswear, access, job), and HP mostly by cognition (knowing, judging) and social status. LP preferred positive, rewarding motivation for PA, but HP one that was negative and fear-based.Referring to activity, LP and HP were like travellers in parallel universes. This created challenges in PHC-based education. Some suggestion for PA education were given. More qualitative and quantitative research are needed.

Background: Health promotion and disease prevention programme registries (HPPR), or ‘best practice portals’, serve as entry points and practical repositories which enable decision-makers to have easy access to (evidence-based) practices. However, there is limited knowledge of differences or overlaps in the functioning of current national HPPRs in Europe, the context and circumstances in which these HPPRs were developed, and the mechanisms utilised by each HPPR for assessment, classification and quality improvement of included practices. The aim of the study was to prepare an overview of different approaches in several national HPPRs and the EU Best Practice Portal (EU BPP) as well as to identify commonalities and differences among core characteristics of the HPPRs. Methods: A descriptive comparison – focused on six European countries with an existing or recently developed/implemented national HPPR and the EU BPP – was conducted to create a comparative overview. Coding mechanisms were used to identify commonalities and differences, and data management, collection and building consensus were performed during EuroHealthNet Thematic Working Group meetings. Results: All HPPRs offer a broad range of health promotion and disease prevention practices and are designed to support practitioners, policy makers and researchers in selecting practices. Almost all HPPRs have an assessment process in place or planned, requiring the application of assessment criteria that differ among the HPPRs. While all HPPRs collect and share recommendable practices, others have implemented further measures to improve the quality of submitted practices. Different dissemination tools and strategies are employed to promote the use of the HPPRs, including social media, newsletters and publications as well as capacity building workshops for practice owners or technical options to connect citizens/patients with local practices. Conclusions: Collaboration between HPPRs (at national and EU levels) is appreciated, especially in terms of using consistent terminology to avoid misinterpretation and facilitate cross-country comparison, as well as to facilitate discussion on the adaption of assessment criteria by national HPPRs. Greater efforts are needed to promote the actual implementation and transfer of practices at national level in order to address public health challenges with proven and effective practices.

Introduction: The scope and schedule of immunization in Poland is regulated by the Immunization Programme prepared and announced by the State Sanitary Inspector. There are two kinds of vaccines: compulsory vaccines, financed by the state budget at the disposal of the Minister of Health, and vaccines recommended by the central health authorities but financed by local governments within health policy programmes. Compulsory vaccines cover people up to 19 years of age and individuals at higher risk of infections. The public health programmes organized and financed by local governments play an important role in infectious disease control in the country. Objective: The objective of this study is to analyse health policy programmes including immunization programmes, which were developed, implemented and financed by local government units of all levels in Poland between 2016 and 2019. Material and Methods: This analysis covers data compiled by voivodes and submitted to the Minister of Health as annual information on public health tasks carried out by local government units. From the aggregate information, data on all health policy programmes conducted by individual local government units between 2016 and 2019, including immunization, were extracted and analysed. The data were obtained pursuant to the provisions of the act on access to public information. Results: In the analysed period, local government units implemented a total of 1737 health policy programmes that financed the purchase of vaccines, qualification tests for immunization and carrying out immunization by authorized medical entities. Among the vast majority of programmes, promotional activities were also implemented. Conclusions: In Poland, local governments are deeply engaged in the immunization of their citizens by organizing and financing specific health care programmes. These programmes are an essential addition to the state financial resources in infectious disease control. This engagement expresses local government maturity regarding the health needs of the population and public health measures. Communes are the most engaged units among all levels of local governments. It is probably due to close mutual communication between the people and local governments. The growing awareness of the important role of HPV immunization in the prevention of cervical cancer among local government units is reflected in the increase in the number of girls vaccinated against HPV and the increase in financial resources allocated for primary HPV prevention. The decrease in the number of people vaccinated against pneumococci may result from including pneumococcal vaccines in the compulsory immunization schedule.

Background: In the face of a sudden influx of several million migrants and war refugees from Ukraine to other European countries, knowledge about the health of Ukrainian citizens becomes increasingly important. The aim of the study is to identify the main health problems of hospitalized Ukrainian citizens residing in Poland in the period from 2014 to June 2022. Methods: This study is based on hospitalization data of Ukrainian patients in Poland taken from the Nationwide General Hospital Morbidity Study. Results: The study group covered 8591 hospitalization records. We observed two hospitalization peaks, one in patients aged 0–5 and the other one in those aged 20–35. After the official outbreak of the war, 2231 Ukrainian citizens were hospitalized in Poland. At this time, the most often reported principal reasons for the hospitalizations of adult women were diseases related to pregnancy, childbirth and the puerperium, whereas in groups of adult men diseases were related to injury, poisoning and certain other consequences of external causes, and in children and adolescents diseases were infectious and parasitic diseases. Conclusions: Our findings may have implications for healthcare policies and service provision to newly arrived migrants and war refugees in target European countries.

Background: Poland is witnessing a migration crisis caused by the ongoing military conflict in Ukraine. In addition to housing and necessities, 1.8 million Ukrainians that had taken refuge in Poland must have access to medical care. We aim to propose a strategy for implementing the changes in the Polish health care system in response to the Ukrainian refugee crisis. Methods: A literature review on organizational changes in the functioning of health care systems during the migration crises worldwide in recent years and brainstorming in order to develop a strategy for implementing changes in the Polish health care system in response to the Ukrainian refugee crisis. Results: The proposed strategy for implementing the changes in the Polish health care system is based on building health care resilience and adaptation to different crises. The operational objectives of organization-related activities are: (1) preparation of medical facilities to provide help for refugees, (2) development and implementation of the communication system, (3) implementation of available digital solutions, (4) organization of the diagnostic and medical services, (5) and implementation of changes in the management of medical facilities. Conclusions: Urgent reorganization is required to respond to an unavoidable increase in the demand for health care services.

Community-acquired pneumonia (CAP) is a common infection with significant morbidity and mortality. In January 2017, Poland introduced pneumococcal conjugate vaccine (PCV) into their national immunisation programme to protect children against invasive pneumococcal disease. This study was designed to investigate pneumonia-related hospitalisation rates and trends from 2009 to 2016 prior to the introduction of nationally funded PCV vaccination.Using national public statistic data available from the National Institute of Public Health - National Institute of Hygiene, annual hospitalisation rates for pneumonia were analysed, categorised by aetiology and age (2, 2-3, 4-5, 6-19, 20-59, 60+ years). Trends over time were assessed, as well as in-hospital mortality.The overall hospitalisation rate due to pneumonia varied between 325.9 and 372.2/100,000 population. Higher rates of hospitalisation were seen in older adults and children ≤5 years. Trends were observed when analysing hospitalisations by pneumonia aetiology within age groups: between 2009 and 2016, Streptococcus pneumoniae hospitalisations significantly increased for children aged2, 2-3, and 4-5 years, from 5.3 to 12.4, 5.2 to 8.2, and 1.9 to 4.6/100,000 population respectively. Whereas hospitalisations due to Haemophilus influenzae pneumonia decreased significantly from 7.8 to 1.8 and 4.8 to 1.9/100,000 children aged2 and 2-3 years respectively. The numbers of in-hospital deaths increased from 5578 in 2009 to 8149 in 2016, with85% of deaths in the 60+ age group.This is the first national study of pneumonia hospitalisations in Poland, providing the baseline data from which to investigate the impact of the change in vaccination policy on pneumonia hospitalisations in Poland.

Congenital herpes simplex virus infection (cHSV) is a rare entity and may pose a life-threatening disease for the newborns. Due to the public health and clinical importance of cHSV infection in infants, the recent data on this disease in Poland should be investigated. The aim of the study was to evaluate the incidence and other factors related to cHSV.The study is retrospective, population-based that utilised the hospital discharge records of cHSV patients. Data were obtained from National Institute of Public Health NIH - National Research Institute in Warsaw, Poland, covering the period 2014-2019.The study group consisted of 1,573 cHSV newborns (841 males and 732 females). Among this group, 70.1% were infants up to 90 days of age and 3.6% were neonates up to 28 days of age. The mean and median age was 98 days (95% CI: 94.5-101.8, SD 74) and 70 days (IQR: 53-104), respectively. Based on the hospital registry the overall average cHSV incidence over the study period was estimated to be 69 per 100,000 live births. The number of cHSV infection fluctuated over the years 2014-2019 with a significant decreasing trend from 2015-2019 (P0.01). A significantly higher cHSV incidence was observed among patients from urban than rural areas of Poland (88 vs 40/100,000 live births; P0.001).CHSV incidence may be related to multifactorial conditions for the occurrence of this disease. Further studies on changes in the incidence of cHSV are needed.

Introduction. Public health is a specific field, which deals with an improvement of population health. It is an interdisciplinary and intersectoral activity and requires participation of various workers. All current documents and acts in public health field in Poland emphasize on the performance of specific tasks, but leave aside personal status and competencies. Many aspects were not resolved till now, e.g. which domains should be included in public health workforce, the problem of workforce enumeration: how large this group should be and what competencies should have. Aim. The aim of the study was an attempt to indicate some professional identity components for public health workers. Material and methods. The study was performed applying the semi-structured interviews method using a hermeneutic approach. The informants were a purposeful sample of 12 people who obtained the master’s degree in public health and already took up professional work and graduated from two universities. The basic research question was: how do interviewees perceive the public health worker? Results. All respondents, regardless of the place of work, perceived themselves as public health workers and presumably as specialists. Attempts to describe a public health worker led to non-specific and generalized statements. There were no answers revealed to the responsibility issue for effects of work among interviews. Respondents tended to characterize public health worker competencies vertically, by domain categories, not functionally, by public health services, so the issue of key competencies importance for identity is controversial. Conclusions. There are no strong evidences that particular workplaces or core competencies are related to professional identity of public health workers. Universities have an important role in professionalization of such workers.

COVID-19 pandemic challenged both public health specialists and authorities to implement non-pharmaceutical interventions aimed at limiting the spread of SARS-CoV-2 infections. The concept of social distancing is about limiting contacts between people, which breaks virus transmission chains, delays the increase in the number of infected people in the population and prevents overloading of health care systems. Many countries, including Poland, implemented a number of interventions aimed at limiting the number of infections and slowing down the tempo of the pandemic's spread. These are, among others, mass-scale testing, isolation of infected individuals, hand hygiene, breath etiquette and wearing mascs. Apart from these, a number of restrictions were enforced to ensure social distancing, such as closing down schools and universities, forbidding organising large parties and mass gatherings, limiting travels and use of public transport, increasing awareness of the public opinion on the necessity to stay at home, up to even introducing full lockdown with only the right to go out to buy food and medication or use the health care system. These interventions were gradually introduced in particular countries, in different ways, to a greater or lesser extent. Their effectiveness is largely influenced by the socio-economic and cultural factors, the nature of political and healthcare systems as well as the operating procedures used during their implementation. The implemented social distancing strategies prove to be effective, especially when combined with such actions as mass-scale testing, tracking contact chains, isolation and quarantine. The current work aims at making an overview of selected social distancing strategies and assessing their effectiveness in slowing down COVID-19 epidemic.

Background A seasonal variation in the incidence of cerebrovascular diseases still remains inconsistently evidenced. Herein, we analyse the monthly patterns of two health phenomena: hospital admissions and deaths due to these diseases. Methods We identified 69 511 cases of hospital admissions and 14 956 deaths due to cerebrovascular diseases (ICD10: I60-I69 and G45) among the inhabitants of five Polish voivodeship capitals in 2004-13. The method of time series analysis (exponential smoothing with linear trend and monthly additive seasonality) was applied to calculate the monthly specific seasonal indices. The monthly variation in an in-hospital fatality and nonhospital deaths were also analysed. Results A summer season reduction in number of cases was observed for hospital admissions and deaths. Interestingly, the winter season effect is much more complex, mainly due to the contribution of December, when a high mortality is accompanied by a substantial decrease in the hospitalisation level. This unique discrepancy was observed for all the studied cities. Moreover, this month is characterised by a notably high in-hospital fatality. However, neither the number of non-hospital deaths nor the average length of hospital stay or the kind of hospitalised diseases evidenced that cerebrovascular problems were more serious in December than in any other month. Conclusion The obtained results confirmed a seasonal variation in cerebrovascular diseases among the inhabitants of Polish cities. Habitual and administrative limitations in hospital activities observed every December do not seem indifferent from the patient health's perspective since they may lead to a low hospitalisation level and a high in-hospital fatality.

Job satisfaction comprises positive attitudes held by an individual in respect to a work. Job satisfaction of physicians is closely related to the perception of their professional role and thus their place in the health care system. Work satisfaction among physicians is very important issue for physicians themselves, for medical associations and general public because it is associated with physician well-being and health, physician turnover, and with patient satisfaction and quality of medical care in general. The survey was conducted to investigate the level of physicians' work satisfaction with their current professional context (general work satisfaction) as well as satisfaction with particular aspects of work, taking into account socio-demographic and professional factors and also to assess which aspects of the physician's work have a statistically significant effect on the general level of work satisfaction. 800 respondents received 17-item questionnaire that measured five facets of work satisfaction. 520 completed questionnaires were returned, resulting in response rate of 65%. In general, physicians were more satisfied with the following aspects of their current work situation: patient care, professional relations and personal rewards. The lowest satisfaction scores were found for work-related burden and work-related income and prestige of the profession. The relationship of the various dimensions of job satisfaction were also explored across socio-demographic and job characteristics of the surveyed physicians. Physician career satisfaction appears to be a complex function of a number of variables and has multiple dimensions.

Aim: The aim of the study was to evaluate the hospitalization trends in children aged 0-6 suffering from bacterial pneumonia in the years 2007-2011 in Poland. Methods: The data pertained to the hospitalized patients diagnosed with the diseases registered as J13-J15 according to ICD-10. Results: In the years 2007-2011, the hospitalization rate increased from 16.3/10,000 to 44.1/10,000 for boys and from 13.8/10,000 to 33.0/10,000 for girls. The most frequently hospitalized children were between 1 and 2 years of age (90.6/10,000 for boys and 58.0/10,000 for girls in 2011). The average length of stay (LOS) of the investigated children fell from 10.1 days in 2007 to 8.2 days in 2011. The longest stays were recorded for the youngest children, under 2 years of age (from almost 11 days in 2007 to around 9 days in 2011). Conclusion: Bacterial pneumonia is a serious problem of public health and especially babies are at high risk of this disease. Given the effects of vaccinations against Streptococcus pneumoniae conducted all over the world and to a limited extend in Poland as well, further steps towards vaccinating children against pneumococci should be taken in Poland.

Patients' health education involves forming their knowledge, attitudes and skills as well as exercising impact on their behaviour in order to maintain or improve one's health. Here, a special role is to be played by primary care physicians.to estimate conditioning factors and frequency of undertaking health education of patients by primary care physicians.A survey study was executed with 800 family physicians, with 520 respondents actually returning the questionnaire (response rate--65%). The instrument contained questions concerning socio-demographic and professional situation of physicians, their health state, health behaviours and undertaking health education to patients in their own professional practice. The assessment of the strength of relationships between characteristic features and attitudes of physicians and their undertaking health education to patients was conducted with multinomial logistic regression.Almost 60% of the respondents declare undertaking health education of patients. Facilitating factors here are family medicine specialization (OR=1.68 [1.11-2.53]), workload of under 50 hours a week (OR=1.67 [1.14-2.43]), living in a town under 100,000 inhabitants (OR=1.56 [1.08-2.27]), staying married (OR=1.55 [1.03-2.33]) and being on a diet (OR=3.22 [1.78-5.85]). Those physicians who work in their profession less than 10 years undertake health education significantly less frequently than their colleagues with a longer work experience (OR=0.57 [0.36-0.90]).Many physicians (40.1%), especially young inhabitants of cities, do not undertake health education of patients at all. A considerable obstacle in undertaking educational activities seems to be physicians' excessive workload. Those physicians who declare undertaking health education of patients use the knowledge acquired during specialization training (family medicine) or work experience connected with the length of work in the profession. Thus, in order to intensify and optimise primary care physicians' activities with respect to health education of patients it is essential to include this topic in the curricula ofpre- and post-diploma courses as well as family medicine specialty training.

The purpose of the present work is to make an assessment of generalized self-efficacy of general practitioners and to investigate its relationship with socio-demographic factors and undertaking risky behaviours taking smoking as an example. The participants of the research encompassed 500 general practitioners aged 27-75 living in Poland. The participants' level of generalized self-efficacy was measured first, then, the relationship between generalized self-efficacy, socio-demographic variables and GP's attitudes towards smoking was investigated. The averaged level of GP's generalized self-efficacy was 29.425 +/- 3.64, which is within high referential values. There have been statistically significant relationships between self-efficacy and sex of the participants (men achieved higher scores than women). There have been no significant differences found in the perception of self-efficacy in terms of age and marital status. Statistically significant relationships between generalized self-efficacy and smoking were found only with general practitioners addicted to smoking and smoking every day (in this group, the GSES score was 29.34; SD = 3.60, while in the non-smokers' group the score is significantly higher and is 31.19; SD 4.23). When implementing protective actions related to smoking special attention needs to be devoted to the psychological resources stimulating pro-health activity, including generalized self-efficacy.