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Helmer SM, Rogge AA, King R, Canella C, Pach D, Witt CM. Effects of blended learning training for oncology physicians to advise their patients about complementary and integrative therapies: results from the multicenter cluster-randomized KOKON-KTO trial. BMC Cancer 2023; 23:836. [PMID: 37679678 PMCID: PMC10483860 DOI: 10.1186/s12885-023-11348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Many oncology physicians are confronted with the topic of complementary and integrative medicine (CIM) by cancer patients. This study examined whether a blended learning (e-learning and a workshop) to train oncology physicians in providing advice on CIM therapies to their cancer patients, in addition to distributing an information leaflet about reputable CIM websites, had different effects on physician-reported outcomes in regard to consultations compared with only distributing the leaflet. METHODS In a multicenter, cluster-randomized trial, 48 oncology physicians were randomly allocated to an intervention group (CIM consultation and an information leaflet) or a control group (information leaflet only). After the training, the oncology physicians conducted 297 consultations with their cancer patients. Measurements were assessed at oncology physician, physician-patient-interaction (measured by external reviewers), and patient levels. This analysis focused on the physician outcomes of stress reaction and perceived consultation skill competency. In addition, qualitative interviews were conducted with a subsample of oncology physicians who experienced both, the intervention and control condition. RESULTS The oncology physicians in the intervention group showed a lower stress reaction in all measured dimensions after CIM consultations than those in the control group. There was no significant difference between oncology physicians in the intervention and control groups regarding the perceived consultation skill competency (overburden: intervention 1.4 [95% CI: 0.7;2.1]; control 2.1 [95% CI: 1.4;2.7], tension: 1.3 [95% CI: 0.7;2.0] vs. 1.9 [95% CI: 1.3;2.5], and discomfort with consultation situations: 1.0 [95% CI: 0.4;1.7]; vs. 1.7 [95% CI: 1.2;2.3]). The qualitative data showed that only providing the leaflet seemed impersonal to oncology physicians, while the training made them feel well prepared to conduct a full conversation about CIM and provide the information leaflet. CONCLUSIONS In our exploratory study providing structured CIM consultations showed positive effects on the perceived stress of oncology physicians, and the training was subjectively experienced as an approach that improved physician preparation for advising cancer patients about CIM, however no effects regarding perceived consultation skill competency were found. TRIAL REGISTRATION The trial registration number of the KOKON-KTO study is DRKS00012704 in the German Clinical Trials Register (Date of registration: 28.08.2017).
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Affiliation(s)
- Stefanie M Helmer
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Public Health and Nursing Research, Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Alizé A Rogge
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ryan King
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Canella
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland
| | - Daniel Pach
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland
| | - Claudia M Witt
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
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Thomae AV, Rogge AA, Helmer SM, Icke K, Witt CM. Development, Implementation, and Evaluation of an e-Learning in Integrative Oncology for Physicians and Students Involving Experts and Learners: Experiences and Recommendations. J Cancer Educ 2023; 38:805-812. [PMID: 35776378 PMCID: PMC9247929 DOI: 10.1007/s13187-022-02189-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 06/02/2023]
Abstract
In this project, an e-Learning program for complementary and integrative medicine in oncology was systematically developed, implemented, and evaluated in a stepwise procedure. Learning objectives and content were defined within the KOKON project network, considering the educational competencies for integrative oncology. To design a valuable e-Learning, experts were involved in all relevant steps of the process, as well as stakeholders from various target groups (undergraduates: medicine students, postgraduates: oncology physicians). We used mixed methods including quantitative surveys, progress tests, and qualitative focus groups. The developed e-Learning program led to a significant measurable knowledge gain about complementary and integrative medicine. In parallel, physicians and students were subjectively satisfied with the training. For the majority of e-Learning elements, the needs of both target groups are comparable. Furthermore, both groups emphasized the value of formative assessment tools for gaining knowledge. From the various surveys and experiences collected in this project, we derive recommendations for others developing e-Learning programs.
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Affiliation(s)
- Anita V Thomae
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
| | - Alizé A Rogge
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Stefanie M Helmer
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353, Berlin, Germany
| | - Katja Icke
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany
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Heumann E, Trümmler J, Stock C, Helmer SM, Busse H, Negash S, Pischke CR. Study Conditions and University Students' Mental Health during the Pandemic: Results of the COVID-19 German Student Well-Being Study (C19 GSWS). Int J Environ Res Public Health 2023; 20:5286. [PMID: 37047902 PMCID: PMC10094523 DOI: 10.3390/ijerph20075286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
University students are generally vulnerable to mental health problems. This was exacerbated during the COVID-19 pandemic, when students experienced decisive changes and restrictions in their academic lives. Our study aimed at (a) analysing associations between study conditions and symptoms of depression and anxiety and (b) determining the extent of use and motivation to use student counselling services. The C19 GSWS is a cross-sectional study conducted at five universities in Germany (N = 7203). Descriptive analyses and linear regression models were performed to estimate the associations between study conditions and mental health outcomes. A total of 42.4% of the students felt down, depressed, or hopeless on several days over the past 14 days. Between a third and 44.1% of the students felt burdened by their study conditions. Worse perceived study conditions were associated with higher levels of depressive symptoms and anxiety. Only 7.1% indicated that they had utilised student counselling services, and female gender, enrolment in a bachelor's programme, and having more than 1 reason for utilisation were factors associated with use. The results of our research underline the need for universities to review their study conditions and to provide targeted intervention strategies and counselling services to promote students' mental well-being.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Jannis Trümmler
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark
| | - Stefanie M. Helmer
- Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, 06112 Halle (Saale), Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University Duesseldorf, 40225 Duesseldorf, Germany
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Heumann E, Helmer SM, Busse H, Negash S, Horn J, Pischke CR, Niephaus Y, Stock C. Anxiety and depressive symptoms of German university students 20 months after the COVID-19 outbreak - A cross-sectional study. J Affect Disord 2023; 320:568-575. [PMID: 36220498 PMCID: PMC9547656 DOI: 10.1016/j.jad.2022.09.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Given the long duration of the COVID-19 pandemic, monitoring mental health remains important. This study aimed to determine (1) the prevalence of anxiety and depressive symptoms among university students 20 months after the first COVID-19 restrictions and (2) which factors were associated with these outcomes. METHODS The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) collected data of 7025 students at five German universities. Associations between anxiety and depressive symptoms with sociodemographic and other factors were analysed using multivariable logistic regression models. RESULTS The mean age of the participants was 23.9 years (SD = 4.9), 67 % were female and 31 % male. The prevalence for depressive symptoms was 29 % (PHQ-2) and 12 % (CES-D 8) and 32 % for anxiety. A complicated relationship status, the lack of a trusted person, and financial difficulties were associated with anxiety and depressive symptoms. University students who were worried about (re-) infection with COVID-19 had a 1.37-times higher chance for reporting anxiety (GAD-2: OR, 95 % CI: 1.09-1.71). Those with pre-existing cardiovascular health conditions had an up to 3.21-times higher chance for reporting depressive symptoms (OR, CESD-D 8, 95 % CI: 1.44-7.14). LIMITATIONS The study design is cross-sectional and uses self-reported outcomes. CONCLUSIONS Concepts for prevention and counselling to tackle mental health problems in students are needed and programmes should take specific stressors related to the pandemic into account.
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Affiliation(s)
- Eileen Heumann
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Claudia R Pischke
- Institute of Medical, Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University of Siegen, Siegen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany; Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
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Trümmler J, Heumann E, Helmer SM, Busse H, Stock C, Negash S, Pischke CR. Determinants of vaccination behavior among university students 20 months after the COVID-19 outbreak: Results of the COVID-19 German Student Well-being Study (C19 GSWS). Hum Vaccin Immunother 2022; 18:2141497. [PMID: 36509741 PMCID: PMC9766462 DOI: 10.1080/21645515.2022.2141497] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of COVID-19 related complications compared to the general population in Germany. However, little is known about the other determinants of COVID-19 vaccination behavior for the population of German university students. This study aimed to investigate determinants of vaccination behavior in this population. The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities from October 27th to November 14th, 2021, via an online survey (n=7,267). Multiple logistic regressions were calculated to examine associations of psychological antecedents of vaccination (5Cs: confidence, complacency, constraints, calculation, collective responsibility), Critical Health Literacy in a Pandemic (CHL-P), and additional determinants (previous infection, trust in the health care system, feeling informed about the COVID-19 vaccine) and vaccination status (not vaccinated vs. fully vaccinated). All 5Cs were associated with reporting to be vaccinated, except for complacency. Regarding the CHL-P, students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had higher odds for reporting being vaccinated (OR=3.02; 95% CI: 2.26-4.04). Students who felt well informed about the COVID-19 vaccines were also more likely to report being fully vaccinated (OR=2.20; 95% CI: 1.51-3.21). Due to our finding that the 5Cs are associated with vaccination status among university students, we recommend that the different components of the 5Cs should be considered in future vaccination campaigns implemented in the university context.
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Affiliation(s)
- Jannis Trümmler
- Centre for Health and Society, Medical Faculty, Institute of Medical Sociology, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Eileen Heumann
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
| | - Stefanie M Helmer
- Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin.,Unit of Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Claudia R Pischke
- Centre for Health and Society, Medical Faculty, Institute of Medical Sociology, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
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Herinek D, Woodward-Kron R, Huber M, Helmer SM, Körner M, Ewers M. Interprofessional peer-assisted learning and tutor training practices in health professions education-A snapshot of Germany. PLoS One 2022; 17:e0278872. [PMID: 36516177 PMCID: PMC9749977 DOI: 10.1371/journal.pone.0278872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Peer-assisted learning (PAL)-especially peer tutorials-are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and individuals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors' social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.
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Affiliation(s)
- Doreen Herinek
- Charité–Universitätsmedizin, Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- * E-mail:
| | - Robyn Woodward-Kron
- Department of Medical Education, University of Melbourne, Parkville, Victoria, Australia
| | - Marion Huber
- Zurich University of Applied Sciences (ZHAW), School of Health Sciences, Institute of Public Health IPH, Center for Interprofessional Learning and Practice IPLP, Winterthur, Switzerland
| | - Stefanie M. Helmer
- Charité–Universitätsmedizin, Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
- Department 11: Human and Health Sciences, Univesity of Bremen, Bremen, Germany
| | - Mirjam Körner
- Medical Faculty, Albert-Ludwigs-University, Institute of Medical Psychology and Medical Sociology, Freiburg, Germany
| | - Michael Ewers
- Charité–Universitätsmedizin, Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
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Helmer SM, Mergenthal L, De Santis K, Matthias K. Dissemination of knowledge from Cochrane systematic reviews in public health: Cross-sectional study. Eur J Public Health 2022. [PMCID: PMC9594328 DOI: 10.1093/eurpub/ckac131.565] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Appropriate dissemination of public health evidence is of high importance to ensure that relevant knowledge reaches potential stakeholders and relevant population groups. A wide distrust towards science and its findings indicates that communication thereof remains below its potential. Cochrane Public Health (CPH) provides an important source of high-quality scientific evidence. This study aimed to identify (1) dissemination strategies and (2) possible stakeholders of Cochrane Public Health reviews. Methods This is a cross-sectional, meta-research study. All 68 records (reviews or protocols) listed on the CPH website https://ph.cochrane.org/cph-reviews-and-topics up to 08.03.2022 were included. Record characteristics, dissemination strategy information and potential stakeholder details were coded by one author and 10% of records were checked by another author. Data were descriptively analysed. Results 53 reviews (46 systematic reviews, 6 rapid reviews, 1 scoping review) and 15 review protocols were included. The 53 reviews were published between 2010-2022 and included 1-153 primary studies. All reviews had an open-access plain language summary (PLS) in English with translations in 3-13 other languages. Although 16 of 53 reviews and 4 of 15 protocols reported any involvement in the review process of an advisory group, only 3 of 68 records included a dissemination plan aiming to inform non-academic audiences or policy. Conclusions All identified records can be considered as relevant to a wide range of stakeholders and population groups. However, CPH reviews or protocols rarely report their dissemination strategies. It is unclear what dissemination strategies are used after CPH reviews are published. High relevance of CPH evidence for non-academic stakeholders and the general population highlights the need for adequate knowledge translation beyond academia. Key messages • Dissemination plans and implementation is rarely reported in CPH reviews. • Evidence from CPH reviews is relevant for a multitude of stakeholders.
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Affiliation(s)
- SM Helmer
- Human and Health Sciences, University Bremen , Bremen, Germany
- Cochrane Public Health Europe , Bremen, Germany
| | - L Mergenthal
- Department of Prevention and Evaluation, Leibniz BIPS , Bremen, Germany
| | - K De Santis
- Department of Prevention and Evaluation, Leibniz BIPS , Bremen, Germany
- Cochrane Public Health Europe , Bremen, Germany
| | - K Matthias
- Faculty of Electrical Engineering, University of Applied Science Stralsund , Stralsund, Germany
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Trümmler J, Heumann E, Helmer SM, Stock C, Busse H, Heinrichs K, Negash S, Horn J, Niephaus Y, Pischke CR. Attitudes towards vaccination are associated with vaccination behaviour among university students. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Vaccination behaviour is influenced by various determinants. Evidence indicates a higher COVID-19 vaccine hesitancy among university students due to their age and a lower risk of complications compared to the general population in Germany. However, little is known about other COVID-19-related determinants for the population of German university students. This study aimed to investigate determinants of vaccination behaviour among German university students.
Methods
The cross-sectional COVID-19 German Student Well-being Study was conducted at five German universities at the end of 2021 via an online survey (n = 7.267). Multiple logistic regressions were calculated to examine associations of vaccination behaviour (not vaccinated vs. fully vaccinated) and attitudes towards vaccination (5Cs: confidence in the safety of the vaccine, complacency - not perceiving diseases as high risk, constraints - structural and psychological barriers, calculation - engagement in information seeking, collective responsibility - willingness to protect others), health literacy in a pandemic (CHL-P), and additional determinants.
Results
All 5Cs were associated with the vaccination status ‘fully vaccinated’, except for complacency. Regarding CHL-P, we found that students who felt that the current scientific knowledge about COVID-19 in terms of the policy decisions on pandemic measures was very complex had a higher odds for being vaccinated (OR = 3.02; 95% CI: 2.26-4.04). Regarding additional determinants, the analysis revealed that students who had been previously infected had in all regressions a lower odds for being vaccinated compared to students with no previous infection.
Conclusions
Due to the strong association of the attitudes towards vaccination and vaccination behaviour among university students, we recommend that the different components of the 5Cs should be considered in future COVID-19 vaccination campaigns in the university context.
Key messages
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Affiliation(s)
- J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - E Heumann
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - C Stock
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
- Unit of Health Promotion Research, University of Southern Denmark , Esbjerg, Denmark
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - K Heinrichs
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin , Berlin, Germany
| | - S Negash
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - J Horn
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - Y Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
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Negash S, Horn J, Heumann E, Helmer SM, Busse H, Heinrichs K, Pischke CR, Trümmler J, Niephaus J, Mikolajczyk R. Change in the financial situation of students during COVID-19 and its impact on depressive symptoms. Eur J Public Health 2022. [PMCID: PMC9619890 DOI: 10.1093/eurpub/ckac130.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Students faced unique challenges during the COVID-19 pandemic that may have affected their financial situation as well as their mental health. This study sought to examine whether changes in financial situation before and during the COVID-19 pandemic were associated with depressive symptoms among German university students. Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS; N = 7,267) was implemented at five German universities between 27.10. and 14.11.2021. Students were asked if they had had sufficient financial resources to cover monthly expenses before the pandemic, as well as during the first and third waves of the pandemic. Depressive symptoms were assessed using the CES-D 8 (score ranges 0-24) and the PHQ-2 (0-6); higher scores indicating more severe depressive symptoms. Linear regression models were used to examine associations between variables. Results A worsened financial situation between the first and the third wave of the pandemic was associated with a one point (0.95) increase on the CES-D 8 scale (95% CI: 0.61, 1.29) and an improved financial situation with a decrease by 0.81 points (95% CI: -1.20, -0.42). A worsened financial situation was associated with a 0.26-point increase in PHQ-2 (95% CI: 0.14, 0.37) and an improved financial situation with a -0.12-point decrease (95% CI: -0.25, 0.01). Similarly, worsened financial situation in the third wave compared to prior to the pandemic, was also associated with an increase in CES-D 8 score and PHQ-2 and an improved financial situation with a decrease in CES-D 8 and PHQ-2. Conclusions Our findings suggest associations between students’ financial situation during the COVID-19 pandemic and their mental health. Due to their instable financial situation, students are a vulnerable group in need of mental and financial support during pandemic crises. Key messages
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Affiliation(s)
- S Negash
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - J Horn
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
| | - E Heumann
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - K Heinrichs
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - R Mikolajczyk
- Institute for Medical Epidemiology, Martin-Luther University Halle-Wittenberg, Halle ( Saale), Germany
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10
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Heumann E, Helmer SM, Busse H, Negash S, Pischke CR, Trümmler J, Niephaus Y, Stock C. Anxiety among students during the pandemic - Results from the C-19 German Student Well-being Study. Eur J Public Health 2022. [PMCID: PMC9594184 DOI: 10.1093/eurpub/ckac131.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Anxiety is widespread among university students. The COVID-19 pandemic af-fected students’ mental health negatively. Given the long duration of the pandemic monitoring mental health remains important. This study aims to determine to which extent anxiety is preva-lent among students (1), what factors are associated with it (2) and which student groups are mostly affected (3). Methods The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) sur-veyed mental health and well-being of students at five universities in Germany from 27.10.-14.11.21. Anxiety was assessed using the GAD-2. Associations between anxiety and sociodem-ographic, socioeconomic/social support factors as well as health- and COVID-19-related factors were determined using multiple binary logistic regression models. Results The mean age of students was 24.1 years (SD = 4.9), 67% were women and 31% men. The prevalence of anxiety was 32% and diverse gender (OR = 3.98, 95% CI: 1.71-9.23), a com-plicated relationship status (OR = 1.66, 95% CI: 1.06-2.60), the lack of a confidant (OR = 2.50, 95% CI: 1.80-3.46), and financial difficulties (e.g., being able to cover monthly expenses; OR = 1.76, 95% CI: 1.36-2.29) were associated with anxiety. Participants who were worried about (re)infection with COVID-19 had a 1.28-times higher chance (OR, 95% CI: 1.03-1.59) for anxie-ty. Students who were (rather) not worried that a relative would become severely ill with COVID-19 had a lower chance to experience anxiety (OR = 0.72, 95% CI: 0.53-0.98) as well as those who were confident receiving medical care in case of an infection with COVID-19 (OR = 0.80, 95% CI: 0.65-0.98). Conclusions Concepts for prevention and counselling in terms of mental health problems in students should be developed considering specific stressors due to the pandemic. Key messages • This study shows that anxiety is widespread among university students and associated with a variety of stressors. • The findings can help to develop specific concepts for prevention and counselling.
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Affiliation(s)
- E Heumann
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
| | - SM Helmer
- Human and Health Sciences, University of Bremen , Bremen, Germany
| | - H Busse
- Department Prevention and Evaluation, Institute for Prevention Research and Epidemiology , Bremen, Germany
| | - S Negash
- Institute for Medical Epidemiology, Martin Luther University Halle-Wittenberg , Halle (Saale), Germany
| | - CR Pischke
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - J Trümmler
- Institute of Medical Sociology, Heinrich Heine University Duesseldorf , Duesseldorf, Germany
| | - Y Niephaus
- Department of Social Sciences, University of Siegen , Siegen, Germany
| | - C Stock
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin , Berlin, Germany
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11
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Rogge AA, Helmer SM, Kiessling C, Witt CM. Development and Implementation of Situational Judgment Tests as an Evaluation Method for Training Oncology Physicians: Application in the KOKON-KTO Training. J Cancer Educ 2022; 37:1414-1421. [PMID: 33655466 PMCID: PMC9550743 DOI: 10.1007/s13187-021-01973-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 06/12/2023]
Abstract
Situational judgment tests (SJTs) are often used in aptitude testing and present practice-specific challenges. Their implementation into online training programs provides the opportunity to assess learning progress and improve training quality. In this study, text-based SJTs for oncology physicians were developed, validated, and implemented into the KOKON-KTO training which uses a blended learning training format to teach oncology physicians how to consult cancer patients on complementary and integrative medicine (CIM). The SJT was implemented to measure the e-learning results. In the development and validation phase, a total of 15 SJTs (each SJT including 1 best choice answer based on training content and 4 distractors; 9 SJTs for oncologists and 6 SJTs for oncology gynecologists only) were developed by an interprofessional team (n=5) using real-case vignettes and applying an in-depth review process. Best answers were validated by experts (oncologists and oncology gynecologists) with experience in advising cancer patients on CIM. In the implementation and evaluation phase, SJTs were answered by KOKON-KTO training participants (n=19) pre- and post e-learning. Results were analyzed using descriptive measurements, item difficulties, and Cohen's d for effect size pre- and post-training. The experts (n=12, 49.8% gynecologists) agreed with best choice answers (69.4% for oncology gynecology; 81.5% for oncology) in 12 out of 15 SJTs. Comparing pre- and post-training scores, KOKON-KTO training participants were able to improve knowledge substantially (effect sizes for oncologists d=1.7; oncology gynecologists d= .71). Future studies need to increase the number of experts and SJTs in order to apply further psychometric measurements. As part of the KOKON-KTO study, this project is registered as DRKS00012704 on the "German Clinical Trials Register" (Date of registration: 28.08.2017).
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Affiliation(s)
- Alizé A Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefanie M Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Institute for Health and Nursing Science, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Kiessling
- Chair for Personal and Professional Development in Health Profession Education, Faculty for Health, Department for Human Medicine, University of Witten/Herdecke, Witten, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
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12
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Stock C, Helmer SM, Heinrichs K. COVID-19 related disruption in higher education students' health and wellbeing: Implications for university action. Front Public Health 2022; 10:1015352. [PMID: 36187608 PMCID: PMC9520463 DOI: 10.3389/fpubh.2022.1015352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 01/27/2023] Open
Abstract
The COVID 19 pandemic has led to substantial disruptions in the lives of students in higher education. Partial or full closures of institutions for face-to-face teaching or consultations over a long-lasting period of time in many countries have had significant consequences on the psychosocial health and wellbeing of many students. This perspectives article summarizes the implications on mental, social, and behavioral aspects of students' wellbeing. Moreover, the need for health promoting und supportive services, programmes, structures, and policies is outlined with recommendations for institutional actions on the level of teaching practice, counseling services, and health monitoring, and with the call to re-affirm the wider policy-oriented approach of the Health Promoting University.
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Affiliation(s)
- Christiane Stock
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany,Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark,*Correspondence: Christiane Stock
| | | | - Katherina Heinrichs
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
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13
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Heumann E, Helmer SM, Busse H, Negash S, Pischke CR, Trümmler J, Niephaus Y, Stock C. Depressive Symptome Studierender während der dritten Welle
der COVID-19-Pandemie – Ergebnisse der COVID-19 German Student
Well-being Study (C19 GSWS). Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Heumann
- Charité – Universitätsmedizin Berlin, Institut
für Gesundheits- und Pflegewissenschaft, Berlin,
Deutschland
| | - SM Helmer
- Universität Bremen, Fachbereich Human- und
Gesundheitswissenschaften, Bremen, Deutschland
| | - H Busse
- Leibniz-Institut für Präventionsforschung und
Epidemiologie – BIPS, Abteilung Prävention und Evaluation,
Bremen, Deutschland
| | - S Negash
- Martin-Luther-Universität Halle-Wittenberg, Institut
für Medizinische Informatik, Biometrie und Epidemiologie, Halle (Saale),
Deutschland
| | - CR Pischke
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - J Trümmler
- Heinrich-Heine-Universität Düsseldorf, Institut
für Medizinische Soziologie, Düsseldorf,
Deutschland
| | - Y Niephaus
- Universität Siegen, Seminar für Sozialwissenschaften,
Siegen, Deutschland
| | - C Stock
- Charité – Universitätsmedizin Berlin, Institut
für Gesundheits- und Pflegewissenschaft, Berlin,
Deutschland
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14
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Witt CM, Balneaves LG, Carlson LE, Cohen M, Deng G, Fouladbakhsh JM, Kinney AY, Mehta A, Mailman J, Pole L, Rogge AA, O'Toole C, Zick SM, Helmer SM. Education Competencies for Integrative Oncology-Results of a Systematic Review and an International and Interprofessional Consensus Procedure. J Cancer Educ 2022; 37:499-507. [PMID: 32783117 PMCID: PMC7876161 DOI: 10.1007/s13187-020-01829-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Integrative oncology is a burgeoning field and typically provided by a multiprofessional team. To ensure cancer patients receive effective, appropriate, and safe care, health professionals providing integrative cancer care should have a certain set of competencies. The aim of this project was to define core competencies for different health professions involved in integrative oncology. The project consisted of two phases. A systematic literature review on published competencies was performed, and the results informed an international and interprofessional consensus procedure. The second phase consisted of three rounds of consensus procedure and included 28 experts representing 7 different professions (medical doctors, psychologists, nurses, naturopathic doctors, traditional Chinese medicine practitioners, yoga practitioners, patient navigators) as well as patient advocates, public health experts, and members of the Society for Integrative Oncology. A total of 40 integrative medicine competencies were identified in the literature review. These were further complemented by 18 core oncology competencies. The final round of the consensus procedure yielded 37 core competencies in the following categories: knowledge (n = 11), skills (n = 17), and abilities (n = 9). There was an agreement that these competencies are relevant for all participating professions. The integrative oncology core competencies combine both fundamental oncology knowledge and integrative medicine competencies that are necessary to provide effective and safe integrative oncology care for cancer patients. They can be used as a starting point for developing profession-specific learning objectives and to establish integrative oncology education and training programs to meet the needs of cancer patients and health professionals.
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Affiliation(s)
- Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland.
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
| | - Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Misha Cohen
- Chicken Soup Chinese Medicine, San Francisco, CA, USA
- American College of Traditional Chinese Medicine at California Institute of Integral Studies, San Francisco, CA, USA
| | - Gary Deng
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Anita Y Kinney
- Department of Epidemiology, School of Public Health and Rutgers, Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | | | - Laura Pole
- Smith Center for Healing and the Arts, Institute for Integrative Oncology Navigation, Washington, DC, USA
| | - Alizé A Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany
| | - Carole O'Toole
- Smith Center for Healing and the Arts, Washington, DC, USA
| | - Suzanna M Zick
- Department of Family Medicine and Nutritional Sciences Schools of Medicine and Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Stefanie M Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany
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15
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Spatafora F, Matos Fialho PM, Busse H, Helmer SM, Zeeb H, Stock C, Wendt C, Pischke CR. Fear of Infection and Depressive Symptoms among German University Students during the COVID-19 Pandemic: Results of COVID-19 International Student Well-Being Study. Int J Environ Res Public Health 2022; 19:ijerph19031659. [PMID: 35162681 PMCID: PMC8834840 DOI: 10.3390/ijerph19031659] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/07/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has a significant psychological impact at the population level and fear of infection is one of the stressors involved. The study aimed to examine fear of infection and associations with university students’ depressive symptoms, substance use, and social contacts during the COVID-19 outbreak in Germany in May 2020. A cross-sectional online survey was conducted at four German universities (n = 5.021, 69% female, mean age: 24 years) as part of the COVID-19 International Student Well-being Study. Fear of infection was assessed using self-generated items, depressive symptoms were assessed using the Center of Epidemiologic Studies Scale (CES-D-8). Associations between fear of infection and depressive symptoms were analyzed with linear regressions, controlling for sociodemographic variables. A total of 34% of the participants reported feeling worried about getting infected themselves, 75% were worried about someone from their personal network getting infected, and 78% feared that individuals close to them would get severely ill after infection. Sixteen percent of the variance of depressive symptoms could be explained by fear of infection (p ≤ 0.001). Students’ fear of infection should be considered in student communication and counseling to prevent worsening of mental health in this population.
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Affiliation(s)
- Franca Spatafora
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany; (F.S.); (P.M.M.F.)
| | - Paula M. Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany; (F.S.); (P.M.M.F.)
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (H.B.); (H.Z.)
| | - Stefanie M. Helmer
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.M.H.); (C.S.)
| | - Hajo Zeeb
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany; (H.B.); (H.Z.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.M.H.); (C.S.)
- Unit of Health Promotion Research, University of Southern Denmark, 6705 Esbjerg, Denmark
| | - Claus Wendt
- Sociology of Health and Health Care Systems, University Siegen, 57076 Siegen, Germany;
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, 40225 Duesseldorf, Germany; (F.S.); (P.M.M.F.)
- Correspondence:
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16
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Busse H, Fialho PM, Stock C, Pischke CR, Buck C, Spatafora F, Kühne L, Zeeb H, Wendt C, Helmer SM. Mental wellbeing and engagement in health risk behaviours in German university students during the COVID-19 pandemic: Findings of a cross-sectional study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Daily life of higher education students across the world changed profoundly in 2020 with the implementation of governmental and institutional measures to control the COVID-19 pandemic. We investigated mental wellbeing and engagement in health risk behaviours (HRB) in German university students at the start of the COVID-19 pandemic.
Methods
Data stem from the COVID-19 International Student Wellbeing Study (C19 ISWS). The web-based survey was conducted in May 2020 at four German universities. HRBs included tobacco and cannabis use, alcohol consumption, and engagement in physical activity. All HRBs were assessed retrospectively and at the time of data collection. Mental wellbeing was assessed using the 8-item Center for Epidemiologic Studies-Depression Scale (CES-D 8). We conducted multinomial regression analyses to investigate factors associated with changes in HRBs and latent transition analysis to identify substance use profiles.
Results
5021 students completed the survey (69% female; mean age 24.4 years, SD = 5.1). The mean score for depressive symptoms was 9.25 (SD = 0.67, range 0-24). Sixty-one percent of students reported consuming alcohol, 46% binge drinking, 44% inactivity, 19% smoking and 11% cannabis use. While smoking and cannabis use remained unchanged during the COVID-19 pandemic, 24% reported a decrease in binge drinking. Changes to physical activity were frequently reported, with 31% reporting an increase and 19% reporting a decrease in vigorous physical activity. Higher depressive symptoms were found to be associated with changes in HRBs. Five substance use behaviour profiles were identified, which remained fairly unchanged.
Conclusions
Engagement in HRBs remains at high level during the COVID-19 pandemic among German students. Depressive symptoms were found to be associated with changes in HRBs. Efforts to promote student health and wellbeing are needed in times of the COVID-19 pandemic and thereafter to prevent longer-term consequences.
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Affiliation(s)
- H Busse
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - P M Fialho
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - C Stock
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - CR Pischke
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - C Buck
- Department Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - F Spatafora
- Institute of Medical Sociology, Centre for Health and Society, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - L Kühne
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - H Zeeb
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Siegen, Germany
| | - C Wendt
- Department Sociology of Health and Health Care Systems, University Siegen, Siegen, Germany
| | - SM Helmer
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Matos Fialho PM, Spatafora F, Kühne L, Busse H, Helmer SM, Zeeb H, Stock C, Wendt C, Pischke CR. Perceptions of Study Conditions and Depressive Symptoms During the COVID-19 Pandemic Among University Students in Germany: Results of the International COVID-19 Student Well-Being Study. Front Public Health 2021; 9:674665. [PMID: 34178930 PMCID: PMC8222519 DOI: 10.3389/fpubh.2021.674665] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Results of previous studies examining the impact of the SARS-CoV-1 epidemic in 2003 on university students' mental well-being indicated severe mental health consequences. It is unclear how the current COVID-19 pandemic and the changes in study conditions due to federal regulations affected mental well-being in the German student population. We examined university students' perceptions of study conditions during the COVID-19 pandemic and investigated associations between study conditions and depressive symptoms. Methods: A cross-sectional online survey was conducted in Germany in May 2020 at four universities (N = 5,021, 69% female, mean age: 24 years, SD: 5.1). Perceived study conditions, as well as sociodemographic information, were assessed with self-generated items and the CES-D 8 scale was used to determine depressive symptoms. Associations between perceived study conditions (academic stress and academic satisfaction), in general, and confidence to complete the semester, in particular, and depressive symptoms were analyzed using generalized linear regressions. Results: Fifty-four percent of survey participants felt that the university workload had significantly increased since the COVID-19 pandemic; 48% were worried that they would not be able to successfully complete the academic year; 47% agreed that the change in teaching methods caused significant stress. Regarding depressive symptoms, the mean score of the CES-D 8 scale was 9.25. Further, a positive association between perceived study conditions and depressive symptoms was found (p < 0.001), indicating that better study conditions were associated with fewer depressive symptoms. Results of the generalized linear regression suggest that better student mental well-being was related to higher confidence in completing the semester. Conclusions: This study provides first insights into perceived study conditions and associations with depressive symptoms among students during the COVID-19 pandemic in Germany. Findings underline the need for universities to provide intervention strategies targeting students' mental well-being during the course of the pandemic.
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Affiliation(s)
- Paula Mayara Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Franca Spatafora
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Lisa Kühne
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | - Stefanie M. Helmer
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Hajo Zeeb
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Claus Wendt
- Sociology of Health and Health Care Systems, University Siegen, Siegen, Germany
| | - Claudia R. Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
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18
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Rogge AA, Helmer SM, King R, Canella C, Icke K, Pach D, Witt CM. Effects of training oncology physicians advising patients on complementary and integrative therapies on patient-reported outcomes: A multicenter, cluster-randomized trial. Cancer 2021; 127:2683-2692. [PMID: 33905536 DOI: 10.1002/cncr.33562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/19/2021] [Accepted: 03/12/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Many patients with cancer do not disclose complementary medicine use but want their physician's advice on this matter. This study evaluated whether using blended learning (e-learning plus a workshop) to train oncology physicians in providing advice on complementary and integrative medicine (CIM) therapies to their patients with cancer, in addition to distributing an information leaflet on reputable CIM websites, had different effects on patient-reported outcomes for the consultation than only distributing the leaflet. METHODS In this multicenter, cluster-randomized trial, patients from private practices/hospital departments, recruited by 48 oncology physicians randomly allocated to an intervention group (CIM consultation plus information leaflet) or a control group (information leaflet), received CIM information. Patient-reported outcomes included satisfaction (Patient Satisfaction With Information on Cancer Treatment), readiness to make a decision (Preparation for Decision Making), and physician-patient communication (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and Communication 26 [EORTC QLQ-COMU26]) for the consultation. Qualitative interviews were conducted with a physician subsample. RESULTS A total of 291 patients (128 in the intervention group and 169 in the control group) advised by 41 physicians participated. Patients in the intervention group rated physician-patient communication higher on all EORTC QLQ-COMU26 scales (mean total score, 84.3 [95% CI, 79.5-89.2] vs 73.6 [95% CI, 69.3-78.0]; P = .002), were more satisfied with the advice (mean, 4.2 [95% CI, 4.0-4.4] vs 3.7 [95% CI, 3.5-3.8]; P < .001), and were readier to make a decision (mean, 63.5 [95% CI, 57.4-69.6] vs 53.2 [95% CI, 47.8-58.7]; P = .016) than the control group. Physicians who reported patients in both settings seemed satisfied with the advice given. CONCLUSIONS This study evaluated a novel education intervention for training oncology physicians in providing CIM advice in routine care. Providing structured CIM consultations had positive effects on patient satisfaction, readiness to make decisions, and physician-patient communication.
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Affiliation(s)
- Alizé A Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefanie M Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute for Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ryan King
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Katja Icke
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel Pach
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Helmer SM, Burkhart G, Matias J, Buck C, Engling Cardoso F, Vicente J. "Tell Me How Much Your Friends Consume"-Personal, Behavioral, Social, and Attitudinal Factors Associated with Alcohol and Cannabis Use among European School Students. Int J Environ Res Public Health 2021; 18:ijerph18041684. [PMID: 33578655 PMCID: PMC7916343 DOI: 10.3390/ijerph18041684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/31/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
Background: Substance use in European adolescents remains a serious health concern. Assessing what affects adolescents’ substance use is crucial for implementing effective prevention. This study aims to examine alcohol and cannabis use-related behavioral, social, and attitudinal variables that might directly be considered to guide prevention responses for adolescents. Methods: Cross-sectional data of 78,554 15–16-year-old school students from the 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) from 26 European countries were analyzed. Self-reported drunkenness in the last 30 days and cannabis use in the last 12 months served as dependent variables. To investigate which factors are associated with risky substance use, multivariable logistic regressions were used. Results: 17.7% of respondents reported drunkenness in the last 30 days, and 14.9% used cannabis in the last 12 months. The most important predictor for risky substance use was the perception that most/all of their friends engaged in substance use behavior, followed by lack of parental support, low personal adherence to rules, and low school performance. Conclusion: Interventions addressing the perceived descriptive norms either directly or by changing environmental cues, opportunities, and regulations, as well as effective parenting and academic support may prevent and reduce risky substance use behavior among adolescents.
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Affiliation(s)
- Stefanie M. Helmer
- Institute for Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-529078
| | - Gregor Burkhart
- European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal; (G.B.); (J.M.); (F.E.C.); (J.V.)
| | - João Matias
- European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal; (G.B.); (J.M.); (F.E.C.); (J.V.)
| | - Christoph Buck
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, 28359 Bremen, Germany;
| | - Feline Engling Cardoso
- European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal; (G.B.); (J.M.); (F.E.C.); (J.V.)
| | - Julian Vicente
- European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal; (G.B.); (J.M.); (F.E.C.); (J.V.)
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20
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Negash S, Kartschmit N, Mikolajczyk RT, Watzke S, Matos Fialho PM, Pischke CR, Busse H, Helmer SM, Stock C, Zeeb H, Wendt C, Niephaus Y, Schmidt-Pokrzywniak A. Worsened Financial Situation During the COVID-19 Pandemic Was Associated With Depressive Symptomatology Among University Students in Germany: Results of the COVID-19 International Student Well-Being Study. Front Psychiatry 2021; 12:743158. [PMID: 34975561 PMCID: PMC8716444 DOI: 10.3389/fpsyt.2021.743158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Previous findings suggest that university students are at an elevated risk to experience financial hardship and to suffer from depressive symptoms. This vulnerability may have substantially increased during the coronavirus disease 19 (COVID-19) pandemic which might have affected students' socio-economic situation but possibly also their mental well-being. We examined whether the financial situation changed during the COVID-19 pandemic among German university students, and whether changes were associated with mental well-being. Methods: We conducted a cross-sectional online survey in May and July 2020 at five German universities. Participants were asked, if they had sufficient financial resources to cover monthly expenses before and during the pandemic. The answer options were dichotomized into worsened and no change/better financial situation compared to before the COVID-19 pandemic. Depressive symptoms were assessed using the CES-D 8 scale. For examining associations between sociodemographic, study-related, and financial factors and "worsened financial situation," we ran a generalized linear mixed model. To assess associations between depressive symptoms and worsened financial situation, we performed a linear mixed model. Results: We included 7,199 participants in the analyses (69% female, 30% male, 1% diverse, mean age: 24 years, standard deviation: 4.7). Overall, 25% of the participants reported to have a worsened financial situation at the time of the survey than in the time before COVID-19. Factors associated with a worsened financial situation were migration background, parents not being academics, not being able to borrow money, and payment of tuition fee by student and loan [odds ratios (OR) ranging from 1.20 to 2.35]. Factors associated with lower odds were: being single, living with others, studying a health-related field, being enrolled in a doctoral/Ph.D. or state exam program, and publicly funded tuition/tuition paid with a scholarship (OR ranging from 0.42 to 0.80). A worsened financial situation was associated with 1.02 points more on the CES-D 8 scale (95% CI: 0.80-1.24). Conclusion: Our results suggest that the pandemic put a number of students under financial strain with detrimental consequences for their mental well-being. Renewed attention must be paid to this vulnerable group to prevent the potentially damaging effects on their mental health.
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Affiliation(s)
- Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nadja Kartschmit
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael T Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Stefan Watzke
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, University Hospital Halle-Saale, Halle (Saale), Germany
| | - Paula Mayara Matos Fialho
- Medical Faculty, Institute of Medical Sociology, Centre for Health and Society, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Claudia R Pischke
- Medical Faculty, Institute of Medical Sociology, Centre for Health and Society, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Heide Busse
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Stefanie M Helmer
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hajo Zeeb
- Department Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Claus Wendt
- Department of Social Sciences, University Siegen, Siegen, Germany
| | - Yasemin Niephaus
- Department of Social Sciences, University Siegen, Siegen, Germany
| | - Andrea Schmidt-Pokrzywniak
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
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21
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McAlaney J, Dempsey RC, Helmer SM, Van Hal G, Bewick BM, Akvardar Y, Guillén-Grima F, Orosová O, Kalina O, Stock C, Zeeb H. Negative Consequences of Substance Use in European University Students: Results from Project SNIPE. Eur Addict Res 2021; 27:75-82. [PMID: 32375145 PMCID: PMC7845427 DOI: 10.1159/000507438] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 03/21/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND University students are a risk group for heavy substance use and the experience of various potentially severe negative substance use consequences which may impact on their health, social, and academic functioning. Whilst the experience of negative consequences of substance use is well understood in North American student samples, there is little data on these experiences in European students. In order to develop effective harm prevention and reduction interventions for students' substance use, there needs to be an understanding of the types of consequences experienced in European student samples. OBJECTIVES The aim of the study was to investigate the prevalence and predictors of the experience of negative substance use-related consequences amongst university students in 7 European countries. METHODS University students (n = 4,482) in Belgium, Denmark, Germany, the Slovak Republic, Spain, Turkey, and the UK completed an online survey of their substance use behaviours and the experience of associated negative consequences. RESULTS European students reported that experiencing a hangover or illness, missing class, being short of money, and experiencing memory loss were the most commonly experienced negative consequences of substance use. Not living with other students and using alcohol, cannabis, sedatives, and cocaine were also associated with higher odds of experiencing these negative consequences. CONCLUSIONS In contrast to North American data, European university students tended to experience consequences that are associated with lower level health risks rather than more severe consequences (e.g., drink-driving and physical injury). Harm prevention and reduction interventions for students should be targeted towards those consequences that are most salient to the target group to ensure feedback is relevant and potentially more effective in changing students' substance use behaviours.
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Affiliation(s)
- John McAlaney
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Robert C. Dempsey
- Staffordshire Centre for Psychological Research, School of Life Sciences & Education, Staffordshire University, Stoke-on-Trent, United Kingdom,Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Stefanie M. Helmer
- Institute of Health and Nursing Science, Charité − Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,*Stefanie M. Helmer, Institute of Health and Nursing Science, Charité − Universitätsmedizin Berlin, Augustenburger Platz 1, DE–13353 Berlin (Germany),
| | - Guido Van Hal
- Social Epidemiology and Health Policy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Bridgette M. Bewick
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Yildiz Akvardar
- Department of Psychiatry, School of Medicine, Marmara University, Istanbul, Turkey
| | - Francisco Guillén-Grima
- Department of Health Sciences, Public University of Navarra, Pamplona, Pamplona, Spain,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain,Preventive Medicine, University of Navarra Clinic, Madrid, Spain,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Ol'ga Orosová
- Department of Educational Psychology & Health Psychology, Faculty of Arts, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia
| | - Ondrej Kalina
- Department of Educational Psychology & Health Psychology, Faculty of Arts, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité − Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology − BIPS, Bremen, Germany,Health Sciences Bremen, University of Bremen, Bremen, Germany
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22
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Prediger C, Helmer SM, Stock C. Virtual Reality-based and gender-sensible alcohol prevention in adolescents: a systematic review. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Virtual Reality (VR)-simulations offer new opportunities for alcohol prevention in adolescents. As an innovative medium VR can be attractive for young people, and avatar-based pathways offer possibilities of tailoring prevention in a gender-specific manner. At the same time, tailoring can reproduce gender stereotypes and be exclusive. Therefore, this review aims (1) to identify and summarize existing evidence regarding VR-simulations for alcohol prevention targeting adolescents and (2) to examine if and how gender is taken into account.
Methods
A systematic review was conducted. 7 medical, psychological, and educational research databases were searched, including all research designs to assure all studies of the emergent research field are detected. Two reviewers independently performed screening and data extraction. Results are reported in a narrative way.
Results
Of 224 search hits, 4 publications met inclusion criteria. These derived out of an Australian and a Danish project. Designs were qualitative (2), mixed methods (1) and review (1). In all studies, gender was assessed in male-female dichotomy. The Australian project scripted a gender-specific simulation, while the Danish project was to a larger degree gender neutral. In the Australian project during development differences occurred between the homogenous and mixed gender groups: Gender homogeneous groups showed greater degree of involvement, which could be due to higher homogeneity of group composition or higher sensitization incentive, as the authors acknowledge.
Conclusions
So far 2 VR-based approaches for alcohol prevention in adolescents are developed. Gender is partly considered during development and application, but not discussed or reported as a central aspect. Further gender-sensitive research is needed to develop and test the possibilities and pit falls of tailoring VR-simulations. Hence, cooperation with previous developers and researchers as well as the target group can be promising.
Key messages
VR-simulations offer new opportunities for gender-specific alcohol prevention programmes in adolescents. This review serves as foundation for researchers, developers and future applications. So far 2 VR-simulations for alcohol prevention in adolescents have been developed. Cooperation for and further gender-sensitive research is needed to develop and enhance existing programmes.
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Affiliation(s)
- C Prediger
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S M Helmer
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Stock
- Institute of Health and Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Witt CM, Helmer SM, Schofield P, Wastell M, Canella C, Thomae AV, Rogge AA. Training oncology physicians to advise their patients on complementary and integrative medicine: An implementation study for a manual‐guided consultation. Cancer 2020; 126:3031-3041. [DOI: 10.1002/cncr.32823] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/12/2019] [Accepted: 11/28/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Claudia M. Witt
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
| | - Stefanie M. Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
| | - Penelope Schofield
- Department of Psychology and Iverson Health Innovation Research Institute Swinburne University Melbourne Victoria Australia
- Behavioral Sciences Unit, Department of Cancer Experiences Research Peter MacCallum Cancer Center Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology The University of Melbourne Parkville Victoria Australia
| | - Marisa Wastell
- Faculty of Behavioral and Social Sciences Institute of Sociology University of Technology Chemnitz Germany
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
| | - Anita V. Thomae
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
| | - Alizé A. Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
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Helmer SM, Rogge AA, Fischer F, Pach D, Horneber M, Roll S, Witt CM. Evaluation of a blended-learning training concept to train oncology physicians to advise their patients about complementary and integrative medicine (KOKON-KTO): study protocol for a prospective, multi-center, cluster-randomized trial. Trials 2019; 20:90. [PMID: 30696465 PMCID: PMC6352447 DOI: 10.1186/s13063-019-3193-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 01/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many cancer patients are interested in complementary and integrative medicine during and after regular cancer treatment. Given the high number of users it is important that physicians and patients engage in a dialog about useful complementary and integrative medicine therapies during cancer treatment. In a prospective, multi-center, cluster-randomized evaluation study we will develop, implement and evaluate a training program for oncology physicians advising their patients on complementary and integrative medicine. The main objective of the study is to evaluate whether training physicians in a blended-learning approach (e-learning + skills-training workshop) in providing advice to their cancer patients on complementary and integrative medicine, in addition to handing out an information leaflet about reputable websites, has different effects on the outcomes of patients, physicians, and their interaction level, compared to only giving out the information leaflet. METHODS/DESIGN Forty-eight oncology physicians will be included into a cluster-randomized trial to either participate or not in the blended-learning training. Physicians will then advise 10 cancer patients each, resulting in 480 patients participating in the trial. The blended learning consists of nine units of up to 45 min of e-learning and 18 units of up to 45 min of on-site skills-training workshop focusing. Outcomes will be measured on the physician, patient, and physician-patient-interaction level. DISCUSSION A blended-learning program for oncology physicians to advise their cancer patients in a systematic way and a reasonable time frame on complementary and integrative medicine will be evaluated in depth in a large cluster-randomized trial. TRIAL REGISTRATION German Clinical Trials Register, ID: DRKS00012704 . Registered on 28 August 2017.
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Affiliation(s)
- Stefanie M Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alizé A Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel Pach
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Markus Horneber
- Department of Internal Medicine, Division of Oncology and Hematology, Paracelsus Medical University, Klinikum Nuremberg, Nuremberg, Germany
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Institute for Complementary and Integrative Medicine, University of Zurich and UniversityHospital Zurich, Zurich, Switzerland. .,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
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Lehne G, Zeeb H, Pischke CR, Mikolajczyk R, Bewick BM, McAlaney J, Dempsey RC, Van Hal G, Stock C, Akvardar Y, Kalina O, Orosova O, Aguinaga-Ontoso I, Guillen-Grima F, Helmer SM. Personal and perceived peer use and attitudes towards use of non-prescribed prescription sedatives and sleeping pills among university students in seven European countries. Addict Behav 2018; 87:17-23. [PMID: 29940387 DOI: 10.1016/j.addbeh.2018.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 06/05/2018] [Accepted: 06/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of non-prescribed prescription sedatives and sleeping pills (NPPSSP) among university students has been described as an important public health issue. However, the impact of perceived social norms on students' use and attitudes towards use of NPPSSP is still unclear. Our aim was to investigate whether perceptions of peer use and approval of use are associated with students' personal use and approval of NPPSSP use. METHODS Cross-sectional data from the Social Norms Intervention for the prevention of Polydrug Use (SNIPE) project containing 4482 university students from seven European countries were analyzed to investigate self-other discrepancies regarding personal use and attitudes towards NPPSSP use. Associations between personal and perceived peer use and between personal and perceived approval of use were examined using multivariable logistic regression. RESULTS The majority (51.0%) of students perceived their peers' NPPSSP use to be higher than their personal use. 92.6% of students perceived their peers' approval of NPPSSP use to be identical or higher than their personal approval. Students perceiving that the majority of peers had used NPPSSP at least once displayed higher odds for personal lifetime use (OR: 1.95, 95% CI: 1.49-2.55). Perceived peer approval of NPPSSP use was associated with higher odds for personal approval (OR: 5.49, 95% CI: 4.63-6.51). CONCLUSIONS Among European university students, perceiving NPPSSP use and approval of use to be the norm was positively associated with students' personal NPPSSP use and approval of use, respectively. Interventions addressing perceived social norms may prevent or reduce NPPSSP use among university students. Final trial registration number: DRKS00004375 on the 'German Clinical Trials Register'.
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Dempsey RC, McAlaney J, Helmer SM, Pischke CR, Akvardar Y, Bewick BM, Fawkner HJ, Guillen-Grima F, Stock C, Vriesacker B, Van Hal G, Salonna F, Kalina O, Orosova O, Mikolajczyk RT. Normative Perceptions of Cannabis Use Among European University Students: Associations of Perceived Peer Use and Peer Attitudes With Personal Use and Attitudes. J Stud Alcohol Drugs 2016; 77:740-8. [DOI: 10.15288/jsad.2016.77.740] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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27
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Helmer SM, Sebena R, McAlaney J, Petkeviciene J, Salonna F, Lukács A, Mikolajczyk RT. Perception of High Alcohol Use of Peers Is Associated With High Personal Alcohol Use in First-Year University Students in Three Central and Eastern European Countries. Subst Use Misuse 2016; 51:1224-31. [PMID: 27219473 DOI: 10.3109/10826084.2016.1162810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The objectives of this study were to assess discrepancies between estimated peer and personal drinking behavior and to determine associations between perceptions of peer and personal drinking behavior among university students from Hungary (HU), Lithuania (LT), and the Slovak Republic (SK). METHODS 2,554 freshman university students completed an online questionnaire on the frequency of their personal alcohol use, the number of heavy drinking occasions and on their perception concerning the corresponding drinking behavior of a typical student. Associations between perceived peer and personal use were analyzed by means of logistic regression, adjusting for sex. RESULTS The majority of students across all countries thought their peers drink more frequently and are more often involved in heavy drinking occasions than themselves. Students who perceived the frequency of peer alcohol use to be higher were more likely to drink alcohol twice a week or more often (SR: OR = 3.81, 95% CI = 2.51-5.79; LT: OR = 3.16, 95% CI = 2.11-4.75; HU: OR = 2.10, 95% CI = 1.53-2.87) compared with students who drink alcohol monthly or less. Those who perceived the number of peer heavy drinking occasions as high were more likely to report heavy drinking weekly or more often (SR: OR = 3.16, 95% CI = 1.92-5.20; LT:OR = 3.56, 95% CI = 2.14-5.94; HU:OR = 1.41, 95% CI = 0.79-2.51) compared with students who report heavy drinking less than monthly. CONCLUSIONS/IMPORTANCE University students perceived peer alcohol use to be higher than their personal use. Given the association between perceptions and personal alcohol use, future research should investigate if targeting perceptions in the surveyed countries may have an impact on alcohol use.
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Affiliation(s)
- Stefanie M Helmer
- a Department of Prevention and Evaluation , Leibniz Institute for Prevention Research and Epidemiology (BIPS) , Bremen , Germany
| | - Rene Sebena
- b Department of Psychology , PJ Safarik University , Košice , Slovak Republic
| | - John McAlaney
- c Department of Psychology , Bournemouth University , Bournemouth , United Kingdom
| | - Janina Petkeviciene
- d Faculty of Public Health, Lithuanian University of Health Sciences , Kaunas , Lithuania
| | - Ferdinand Salonna
- e Institute of Active Lifestyle, Palacký University of Olomuoc , Olomuoc , Czech Republic
| | - Andrea Lukács
- f Institute of Basic Health Sciences, University of Miskolc , Miskolc , Hungary
| | - Rafael T Mikolajczyk
- g Helmholtz Centre for Infection Research , Braunschweig , Germany.,h Hannover Medical School , Hannover , Germany
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Helmer SM, Muellmann S, Zeeb H, Pischke CR. Development and evaluation of the efficacy of a web-based 'social norms'-intervention for the prevention and reduction of substance use in a cluster-controlled trial conducted at eight German universities. BMC Public Health 2016; 16:252. [PMID: 26969585 PMCID: PMC4788857 DOI: 10.1186/s12889-016-2898-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research suggests that perceptions of peer substance use are associated with personal use. Specifically, overestimating use in the peer group is predictive of higher rates of personal substance use. 'Social norms'-interventions are based on the premise that changing these misperceived social norms regarding substance use by providing feedback on actual norms is associated with a reduction in personal substance use. Studies conducted in the U.S.A. suggest that 'social norms'-feedback is an effective strategy for reducing substance use among university students. It is unknown whether the effects of a 'social norms'-feedback on substance use can be replicated in a sample of German university students. The objective of this article is to describe the study design and aims of the 'INternet-based Social norms-Intervention for the prevention of substance use among Students' (INSIST)-study, a cluster-controlled trial examining the effects of a web-based 'social norms'- intervention in students enrolled at four intervention universities with those enrolled at four delayed intervention control universities. The INSIST-study is funded by the German Federal Ministry of Health. METHODS/DESIGN Eight universities in four regions in Germany will take part in the study, four serving as intervention and four as delayed intervention control universities (randomly selected within a geographic region). Six hundred students will be recruited at each university and will be asked to complete a web-based survey assessing personal and perceived substance use/attitudes towards substance use at baseline. These data will be used to develop the web-based 'social norms'-feedback tailored to gender and university. Three months after the baseline survey, students at intervention universities will receive the intervention. Two months after the launch of the intervention, students of all eight universities will be asked to complete the follow-up questionnaires to assess changes in perceptions of/attitudes toward peer substance use and rates of personal substance use. DISCUSSION This study is the first German cluster-controlled trial investigating the influence of a web-based 'social norms'-intervention on perceptions of/attitudes towards substance use and substance use behavior in a large university student sample. This study will provide new information on the efficacy of this intervention strategy in the German university context. TRIAL REGISTRATION DRKS00007635 at the 'German Clinical Trials Register' (17.12.2014).
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Affiliation(s)
- Stefanie M Helmer
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| | - Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Pischke CR, Helmer SM, McAlaney J, Bewick BM, Vriesacker B, Van Hal G, Mikolajczyk RT, Akvardar Y, Guillen-Grima F, Salonna F, Orosova O, Dohrmann S, Dempsey RC, Zeeb H. Normative misperceptions of tobacco use among university students in seven European countries: baseline findings of the 'Social Norms Intervention for the prevention of Polydrug usE' study. Addict Behav 2015; 51:158-64. [PMID: 26275842 DOI: 10.1016/j.addbeh.2015.07.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/14/2015] [Accepted: 07/22/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Research conducted in North America suggests that students tend to overestimate tobacco use among their peers. This perceived norm may impact personal tobacco use. It remains unclear how these perceptions influence tobacco use among European students. The two aims were to investigate possible self-other discrepancies regarding personal use and attitudes towards use and to evaluate if perceptions of peer use and peer approval of use are associated with personal use and approval of tobacco use. METHODS The EU-funded 'Social Norms Intervention for the prevention of Polydrug usE' study was conducted in Belgium, Denmark, Germany, Slovak Republic, Spain, Turkey and United Kingdom. In total, 4482 students (71% female) answered an online survey including questions on personal and perceived tobacco use and personal and perceived attitudes towards tobacco use. RESULTS Across all countries, the majority of students perceived tobacco use of their peers to be higher than their own use. The perception that the majority (>50%) of peers used tobacco regularly in the past two months was significantly associated with higher odds for personal regular use (OR: 2.66, 95% CI: 1.90-3.73). The perception that the majority of peers approve of tobacco use was significantly associated with higher odds for personal approval of tobacco use (OR: 6.49, 95% CI: 4.54-9.28). CONCLUSIONS Perceived norms are an important predictor of personal tobacco use and attitudes towards use. Interventions addressing perceived norms may be a viable method to change attitudes and tobacco use among European students, and may be a component of future tobacco control policy.
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Affiliation(s)
- Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - Stefanie M Helmer
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - John McAlaney
- Division of Psychology, University of Bradford, Bradford, BD7 1DP, United Kingdom.
| | - Bridgette M Bewick
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, 101 Clarendon Road, West Yorkshire, LS2 9LJ, Leeds, United Kingdom.
| | - Bart Vriesacker
- Research & Development, Occupational Health Services Mensura, Italiëlei 2, 2000 Antwerp, Belgium; Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Guido Van Hal
- Epidemiology and Social Medicine, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Rafael T Mikolajczyk
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 33824 Braunschweig, Germany.
| | - Yildiz Akvardar
- Department of Psychiatry, Marmara University School of Medicine, 34899 Istanbul, Turkey.
| | - Francisco Guillen-Grima
- Department of Health Sciences, Faculty of Health Sciences, Public University of Navarra, Avda de Baranain s/n, 31008 Pamplona, Navarra, Spain.
| | - Ferdinand Salonna
- Institute of Active Lifestyle, Palacky University of Olomouc, 771 47 Olomouc, Czech Republic.
| | - Olga Orosova
- Department of Educational Psychology and Health Psychology, PJ Safarik University, Kosice, Slovakia.
| | - Solveig Dohrmann
- Unit for Health Promotion Research, University of Southern Denmark, Niels Bohrs Vej 9, 6700 Esbjerg, Denmark.
| | - Robert C Dempsey
- Division of Psychology, University of Bradford, Bradford, BD7 1DP, United Kingdom; School of Psychology, Sport and Exercise, Staffordshire University, Science Center, Leek Road, Stoke-On-Trent ST4 2DF, United Kingdom.
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
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Helmer SM, Pischke CR, Zeeb H. Reduktion und Prävention des legalen und illegalen Substanzkonsums von Studierenden durch Teilnahme an ‚Soziale Normen‘-Interventionen: Erfahrungen und erste Ergebnisse einer internationalen Machbarkeitsstudie in 7 europäischen Ländern (SNIPE-Studie) und der in vier Regionen Deutschlands umgesetzten Nachfolgestudie (INSIST-Studie). Suchttherapie 2015. [DOI: 10.1055/s-0035-1557538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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McAlaney J, Helmer SM, Stock C, Vriesacker B, Van Hal G, Dempsey RC, Akvardar Y, Salonna F, Kalina O, Guillen-Grima F, Bewick BM, Mikolajczyk R. Personal and Perceived Peer Use of and Attitudes Toward Alcohol Among University and College Students in Seven EU Countries: Project SNIPE. J Stud Alcohol Drugs 2015; 76:430-8. [DOI: 10.15288/jsad.2015.76.430] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Helmer SM, Mikolajczyk RT, McAlaney J, Vriesacker B, Van Hal G, Akvardar Y, Guillen-Grima F, Salonna F, Stock C, Dempsey RC, Bewick BM, Zeeb H. Illicit substance use among university students from seven European countries: a comparison of personal and perceived peer use and attitudes towards illicit substance use. Prev Med 2014; 67:204-9. [PMID: 25091880 DOI: 10.1016/j.ypmed.2014.07.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/26/2014] [Accepted: 07/23/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare European students' personal use and approval of illicit substance use with their perceptions of peer behaviours and attitudes, and investigate whether perceptions of peer norms are associated with personal use of illicit substances and attitudes. METHOD This study used baseline data from the Social Norms Intervention for the prevention of Polydrug usE (SNIPE) project involving 4482 students from seven European countries in 2012. Students completed an online survey which included questions on personal and perceived peer illicit substance use and personal and perceived peer attitude towards illicit substances. RESULTS 8.3% of students reported having used illicit substances at least once in their life. 49.7% of students perceived that the majority of their peers have used illicit substances more frequently than themselves. The perception was significantly associated with higher odds for personal illicit substance use (OR: 1.97, 95% CI: 1.53-2.54). The perception that the majority of peers approve illicit substance use was significantly associated with higher odds for personal approval of illicit substance use (OR: 3.47, 95% CI: 2.73-4.41). CONCLUSION Students commonly perceived that their peers used illicit subtances more often than themselves. We found an association between the perceived peer norms/attitudes and reported individual behaviour/attitudes.
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Affiliation(s)
- S M Helmer
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), 28359 Bremen, Germany.
| | - R T Mikolajczyk
- Department of Epidemiology, Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany; Hannover Medical School, 30625 Hannover, Germany
| | - J McAlaney
- Division of Psychology, University of Bradford, Bradford BD7 1DP, United Kingdom
| | - B Vriesacker
- Medical Sociology and Health Policy, University of Antwerp, 2610 Antwerp, Belgium; Research & Development, Occupational Health Services Mensura, 2000 Antwerp, Belgium
| | - G Van Hal
- Medical Sociology and Health Policy, University of Antwerp, 2610 Antwerp, Belgium
| | - Y Akvardar
- Department of Psychiatry, Marmara University Medical School, 34722 Istanbul, Turkey
| | - F Guillen-Grima
- Department of Health Sciences, Public University of Navarra, 31008 Pamplona, Navarra, Spain
| | - F Salonna
- Institute of Active Lifestyle, Palacky University of Olomouc, 771 47 Olomouc, Czech Republic
| | - C Stock
- Unit for Health Promotion Research, University of Southern Denmark, 6700 Esbjerg, Denmark
| | - R C Dempsey
- Division of Psychology, University of Bradford, Bradford BD7 1DP, United Kingdom; School of Psychology, Sport and Exercise, Staffordshire University, Stoke-On-Trent ST4 2DF, United Kingdom
| | - B M Bewick
- School of Medicine, Leeds Institute of Health Sciences, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds LS2 9LJ, United Kingdom
| | - H Zeeb
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
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Helmer SM, Krämer A, Mikolajczyk RT. Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany. BMC Res Notes 2012; 5:703. [PMID: 23273039 PMCID: PMC3544606 DOI: 10.1186/1756-0500-5-703] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 12/12/2012] [Indexed: 11/27/2022] Open
Abstract
Background Health control beliefs were postulated to be associated with health behaviour. However, the results of studies assessing these associations suggest that they might not be universal. Among young adults associations have been reported, but the evidence is limited. The objective of this analysis was to re-examine these associations in a sample of university students in Germany. Findings Data from a multicentre cross-sectional study among university students in North Rhine-Westphalia, Germany was used (N=3,306). The Multidimensional Health Locus of Control Scale with three dimensions (one internal and two external) and six aspects of health behaviour (smoking habits, alcohol use, drug consumption, being over-/ or underweight, physical activity, and importance of healthy nutrition) were evaluated. Students with stronger internal locus of control paid more attention to healthy nutrition and displayed a higher level of physical activity. Individuals with a stronger belief in health professionals were less likely to use drugs and paid more attention to healthy nutrition. Furthermore, higher scores in the second external locus of control dimension (beliefs in luck or chance) were associated with a higher likelihood of current smoking, lower physical activity and less attention to healthy nutrition. Conclusions Students engaged more strongly in unhealthy behaviour if they believed that luck determines health. In contrast, believing in having control over one’s own health was associated with more healthy behaviour. These findings support the need to consider health control beliefs while designing preventive strategies in this specific population.
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Affiliation(s)
- Stefanie M Helmer
- Bremen Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany
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Pischke CR, Zeeb H, van Hal G, Vriesacker B, McAlaney J, Bewick BM, Akvardar Y, Guillén-Grima F, Orosova O, Salonna F, Kalina O, Stock C, Helmer SM, Mikolajczyk RT. A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students. BMC Public Health 2012; 12:882. [PMID: 23075043 PMCID: PMC3534014 DOI: 10.1186/1471-2458-12-882] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 10/14/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. METHODS/DESIGN An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. DISCUSSION This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. FINAL TRIAL REGISTRATION NUMBER: DRKS00004375 on the 'German Clinical Trials Register'.
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Affiliation(s)
- Claudia R Pischke
- BIPS - Institute for Epidemiology and Prevention Research, Achterstraße 30, 28359, Bremen, Germany.
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