[Structures and quality assurance of preventive care and health promotion in Germany]

[Quality management and development in primary prevention and health promotion: status, challenges, and perspectives]

In the past three decades, quality development in primary prevention and health promotion have developed significantly. A major contribution to this has been their legal anchoring. The reintroduction of prevention and health promotion in the statutory health insurance and the Prevention Act gave this development an additional boost. The discourse that had already begun in the run-up to this, involving numerous researchers and stakeholders from different fields of prevention and health promotion, contributed to an increased understanding of central aspects of quality development. Comprehensive procedures for quality assurance and development are available for prevention and health promotion. In addition, recommendations for action, checklists, and instruments, for example, have been edited and are easily accessible for all four quality dimensions - planning, structural, process, and outcome quality. Certifications and quality seals for interventions and health promoting institutions are available.However, none of these procedures is used comprehensively and continuously. The fields in prevention and health promotion differ significantly with regard to the implementation of quality assurance. Obstacles are, among other things, insufficient human and financial resources with simultaneous discontinuity and intra-facility quality management systems. There is a need for action to further develop the implementation of quality on site, especially in the community setting, and to better integrate quality assurance into existing structures. Qualification, intensive exchange, and small-scale prevention reporting should promote quality development.

[Quality prevention and health promotion programming in long-term care: the QualiPEP Project]

With the demographic shift, the number of persons in need of long-term care is continuing to grow, as is the need for nursing care staff and specialists. Stress levels within the long-term care sector are very high. Multiple legislative reforms have given rise to societal and political awareness of the resulting challenges: Preventive Health Care Act (2015), First and Second Acts and Third Bill to Strengthen Long-term Care (2015-17), Federal Participation Act (2017), and the Bill to Strengthen Nursing Care Staff (2019).To meet these challenges, in May 2017 the four-year project quality-oriented prevention and health promotion in institutions for persons with disabilities and of long-term care (QualiPEP) was founded. It is administered by the AOK-Bundesverband and promoted by the federal health ministry. The project addresses part- and full-stationary residential long-term care settings and residential home settings for persons with disabilities. It pursues three goals: 1. Developing a quality concept to improve effectiveness and sustainability of prevention and health-promotion programming; 2. Strengthening the health literacy of home residents, employees and organizations (therefore, a framework concept will be developed); 3. Expanding upon existing workplace health-promotion measures for employees. The ultimate impact objective is to increase health-related quality of life for the target groups.The process of developing quality indicators begins with a needs assessment, followed by phases of conceptualization, implementation, evaluation and adaptation. The present article illustrates QualiPEP project objectives with a specific focus on long-term care facilities and further describes the project's research design and planned execution.

Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London

BACKGROUND AND AIM

There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants.

MATERIAL AND METHODS

This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used.

RESULTS

Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants.

CONCLUSIONS

The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.