Abstract Background Trust is key to healthcare, including all types of health information. This applies not only to the process of healthcare delivery, but also to health-related behaviors and the utilization of healthcare services. Trust in health information sources has been shown to vary by social and health characteristics. Therefore, the research question is: Are there social and health-related differences in perceptions of trust in sources of information (government agencies or physicians) about digital health technologies? Methods The analysis is based on a cross-sectional online survey (STELLAR) conducted in 2022 (N = 1,200), Participants were asked whether they perceive trust (1= fully agree- 4= not at all) in information about digital health technologies provided by government agencies (institutional trust) or physicians (interpersonal trust). For the analysis, binary logistic regressions (references: traditionalists, low education level, poor self-perceived health) were used. Results Institutional Trust. Overall, 43.9% of the participants perceived trust in this information source. Baby Boomers (OR 2.022), Generation Y (OR 2.544), and Generation Z (OR 2.566), as well as medium (OR 2.526) and high (OR 3.823) educational level, increased the odds of perceived trust; the same was found for better self-perceived health (OR 1.569). Interpersonal Trust. In general, 94.8 % of the participants expressed trust physicians. Belonging to Generation Z decreased the chance (OR 0.097) and a better subjective health status increased the chance (OR 4.250) of perceiving trust. Education did not emerge as a significant determinant. Conclusions The study confirmed that interpersonal and institutional trust varies by social and health characteristics. There seems to be a need to strengthen efforts to explain the process of trust building in different population groups., e.g. to find explanations for why educational level was only relevant for institutional trust but not for interpersonal trust. Key messages • Trust in sources of information about digital health technologies differ by generation, educational level, and subjective health status. • Given the existing differences in perceptions of trust, it is worthwhile to explore the unknown mechanisms of the trust-building process among different population groups.

Einleitung Angesichts der hohen Prävalenz von Übergewicht bei Kindern und Jugendlichen, sind gemeindebasierte Interventionsstrategien erforderlich. Die Abstimmung dieser Strategien auf die Bereitschaft der Gemeinschaft (Community Readiness, CR) ist für ihre Wirksamkeit und Nachhaltigkeit entscheidend. CR beschreibt den Grad, zu dem eine Gemeinschaft bereit ist, ein Gesundheitsproblem aktiv anzugehen und wird nach dem Community Readiness Model (CRM) in den Dimensionen 1) Knowledge of efforts, 2) Leadership, 3) Community climate, 4) Knowledge of the issue und 5) Resources gemessen. Ziel dieser Arbeit ist es, die CR zur Prävention von Kinderübergewicht in Kommunen zu analysieren. Auf dieser Grundlage werden partizipative Strategien zur CR-Erhöhung für Präventionsbemühungen entwickelt.

Abstract Background A large proportion of the European population seeks information about the COVID-19 vaccination on the internet. The population seems to split into those with positive stance on the vaccination and those with negative stance, but there are still individuals who do not have a final position yet. By now, there is a lack of understanding about the online information seeking behavior in these three groups. The current analysis sheds light on differences in internet usage and requested qualities of online information regarding the COVID-19 vaccination. Methods An online survey with N = 1,000 people (18-74 years) living in Germany was conducted between November 26 and December 8, 2021. The questionnaire included closed questions about frequency, information channels, formats and reasons of online information seeking, as well as one open question about requested qualities of online content. We conducted bivariate analysis for differences in information seeking behavior and content analysis for the requests. Results Information seeking behavior differed significantly by attitude towards the vaccination regarding frequency, almost all types of formats, three of ten listed information channels, and three of six reasons for online information seeking. Undecided participants and those who support COVID-19 vaccination used the internet more often than participants who are against the vaccination. Individuals supporting vaccination preferred reading text contributions (e.g. online articles). Informative videos were more often consumed by those who are undecided or against vaccination. Those who have not decided yet preferred online resources providing full information about side-effects and showing reliable facts by credible sources. Conclusions Our findings support an online vaccination communication that is tailored to target groups with different attitudes towards the vaccination. Overall, online campaigns should focus on transparent, reliable and complete information. Key messages • Online information seeking behavior regarding COVID-19 vaccination varies between individuals with different attitudes towards the vaccination. • Online information about the COVID-19 vaccination should focus on transparency and reliable information.

Einleitung Trotz der überall präsenten Informationen zur Impfung gegen COVID-19 bestanden und bestehen nach wie vor Informationsbedarfe und Wissenslücken. Vor allem bei den unter 60-Jährigen zählen digitale Medien zu den bevorzugten Informationsmedien. Bisher wurde kaum untersucht, wie und aus welchen Gründen digitale Möglichkeiten zur Informationsgewinnung zur Impfung verwendet wurden. Ziel ist es daher, herauszufinden, in welcher Weise das Internet bezüglich der Impfung gegen COVID-19 genutzt wurde. Zusätzlich sollen Nutzertypen mit unterschiedlichen Informationsverhaltensmustern identifiziert werden.

Abstract Background The German government undertakes efforts to implement DiGA into the statutory health insurance to improve its quality. DiGA are physician-prescribed applications for patients with certain diagnosed diseases, whose costs are covered by the statutory health insurers. DiGA have the potential to improve healthcare, but it is also possible, that the usage of these applications perpetuates existing health inequalities, summarized by the term Digital Divide; meaning that socially deprived populations are less able to benefit from digital technologies. The aim of this analysis is to determine whether differences exist in DiGA use by sociodemographic/socioeconomic characteristics. Methods The results based upon the analysis of an online survey involving 1,200 people (18-74 years) living in Germany between March 10 and March 18, 2022. The sample composition reflects the current distribution of age, gender, and place of residence in the federal states (uncrossed). The questionnaire focused, among other aspects, on the use of DiGA. A binary logistic regression was used for the analysis. Results Compared to the lowest subjective social status (SSS), probands with a medium (OR 2.865) or a high SSS (OR 4.085) are more likely to use DiGA. Compared to the reference group (60 years and older), the 18-29-year- (OR 2.044) and the 30-39-year-olds (OR 1.952) tend to have a higher likelihood of using DiGA. The likelihood of the use decreases among probands with medium (OR 0.632) and high educational degree (OR 0.580) compared to the reference group (low education). Conclusions In accordance with the results of existing studies, social differences could be identified regarding known determinants of health inequalities, like age and SSS. In this analysis, the highest degree of education does not appear as a predictor for an increased likelihood of use. Thus, further analyses are needed to address the influence of education, especially to develop a broader understanding of the DiGA use. Key messages • It appears that DiGA are not equally accessible or used across different population groups, and thus indicating an already existing or emerging Digital Divide regarding the use of DiGA. • Contrary to the broad assumption that higher expressions of health determinants are related to a higher likelihood of using DiGA, a higher degree of education decreases the likelihood of using DiGA.

Einleitung Studienergebnisse deuten darauf hin, dass digitale Gesundheitsapplikationen (dGA) Personen dabei unterstützen können, gesundheitsbezogene Entscheidungen zu treffen und einen gesünderen Lebensstil zu führen [1] [2] [3] [4]. Allerdings scheinen sozial benachteiligte Gruppen und Ältere den Nutzen von onlinebasierten Gesundheitsdiensten geringer wahrzunehmen und folglich weniger von den potenziellen Vorteilen zu profitieren [5].

Abstract Background The development of theory-based prevention efforts is complex and often not feasible in the daily work of project planners. Planning tools such as the Intervention Mapping Approach (IMA), which is a gold standard for project planning, cannot be used in practice without preconditions. How can prevention planning be evidence-based but also practical? Against this background, the research project WEPI was developed, funded by the Federal Ministry of Health, Germany. WEPI is a digital planning tool based on the IMA, that guides municipalities and schools in planning childhood obesity prevention efforts. Methods From April 2019 to October 2020, the planning tool was developed. In October 2020 and February 2021, WEPI was tested for the first time by selected municipalities (n = 4) in Bavaria and schools (n = 4) in Lower Saxony. Based on this, the modified planning tool was tested for a second time throughout Germany (05-11/2021). Handling and acceptance were evaluated in a questionnaire survey. Results The first test showed that content and technical aspects needed to be optimised in order to bring scientific demands and practical feasibility together. Six municipalities and eight educational institutions participated in the second test phase. The respondents (n = 14) indicated that WEPI facilitates structured project planning (86%) and supports collaboration with colleagues (64%). 93% would use the planning tool again. WEPI offers evidence-based methods for practical implementation as well as a download area, including a template for a project application or a project summary. This service was also evaluated as very helpful (64%). Conclusions Through step-by-step guidance, WEPI facilitates evidence-based project planning and ensures planning quality. Effort and benefit are in good proportion. Further optimisations are needed to improve the user-friendliness. Key messages • WEPI provides a comprehensive roadmap, helping practitioners to approach a structured project planning. • Practitioners’ participation promotes acceptance and provides a user-friendly development.

Abstract Background Essential for the success of prevention efforts is the readiness to address a health problem (community readiness). Aim of this study is to analyze the stage of community readiness for the prevention of childhood obesity in municipalities using the Community Readiness Model (CRM). Based on this, strategies will be developed to improve community readiness for the prevention of obesity in childhood and youth. Methods A systematic literature review (SLR) was conducted in the databases PubMed, LIVIVO, Cochrane and Google Scholar to identify studies that used the CRM for the prevention of childhood obesity. In order to assess community readiness, the CRM, a structured interview guide and scoring system, was used. Following the CRM protocol, guided interviews were conducted with key informants that were identified in a modified stakeholder analysis. The transcribed interviews were analyzed by two scientists following the CRM scoring system. Results The SLR revealed 270 hits. In 28 international studies the CRM has been applied to childhood obesity prevention, predominantly in the Anglo-American language area. In Germany, no studies could be identified using the CRM for the prevention of childhood obesity. Key informant interviews (n = 28) were conducted in five Bavarian municipalities from January to April 2021. The key informant sample comprised administration departments, health and educational facilities. Conclusions The CRM enables a multidimensional analysis of a municipality's material and immaterial infrastructure. In workshops with the participating municipalities the results of the community readiness assessment will be reflected. The aim is to develop an action plan with strategies to increase the stage of readiness and support prevention efforts in order to address childhood obesity. Key messages The CRM provides a theoretical basis to understand and improve community readiness. It enables the analysis of assets and weaknesses that can influence obesity prevention in municipalities.

Abstract Background The systematic and theory-based development of interventions is complex and requires time and personnel resources. WEPI is a web-based planning tool for municipalities and schools, that follows the evidence-based intervention mapping approach (IMA) but also supports the planning process of obesity prevention user oriented. The project is supported by the Federal Ministry of Health, Germany. Methods Data of a systematic literature review (SLR), expert interviews and focus group discussions served as the foundation for the first version of WEPI. Two further SLR were conducted in the databases Pubmed, LIVIVO and Cochrane on evidence-based determinants of obesity development and on proven obesity intervention methods, to meet the requirements of the IMA. In October 2020 the second version of WEPI was tested with selected municipalities and schools. The prototype as a third version was tested by three municipalities and two schools in February 2021. Feedback was collected through questionnaires and interviews. Results In a total of 806 hits of the first SLR, determinants for the development of obesity were identified in 8 guidelines and 37 reviews. They were adopted in form of 15 problem areas which support the WEPI user to conduct an evidence-based problem analysis. Result of the second SLR are 25 obesity prevention interventions which were developed using the IMA. Based on this, 192 evaluated methods were identified and integrated as good practice examples into WEPI. In the first trial the expert feedback revealed aspects of content and user-friendliness as well as technical aspects that should be optimized. The feedback of the municipalities and schools underlines, that scientific findings need to be translated into practical logic. Conclusions WEPI provides a comprehensive roadmap to the planning process, guiding the user step by step. Acceptance and usability of the planning tool will be evaluated with municipalities and schools from April to November 2021. Key messages WEPI enables user oriented, structured and evidence-based planning of prevention interventions. Requirements resulting from practice were considered in the development of the planning tool.

Abstract Background The COVID-19 pandemic has had effects on populations worldwide. The social determinants of health affect an individual's capacity to cope during a crisis which could potentially impact on their wellbeing. The aim of this study was to examine the relationship between wellbeing and the social determinants of health among Australian adults during the COVID-19 pandemic. Methods A cross-sectional study of adults residing in Australia was conducted using SurveyMonkey (an online survey) between August - October 2020. Participants were recruited via social media. Wellbeing was measured using the 10-item Multicultural Quality of Life Index and social determinants of health were measured using validated tools and investigator developed questions. Data were analysed using SPSS version 25. Inferential statistics, including independent t-test and one-way ANOVA were undertaken. Multiple regression analysis was used to investigate the predictors of wellbeing. Results In total, 1211 responses were received. Females accounted for 80.7% of the responses, men 16.7% and transgender/non-binary 2.6%. The mean age of the respondents was 43 years (SD 14.5). The mean score for total wellbeing was 62.58 (SD 21.22). Housing insecurity (p = 0.000), food insecurity (p = 0.000, social support (p = 0.000) and access to health care (p = 0.000) were all predictors of poor total wellbeing. Being a male (p = .0380) was the only predictor of higher wellbeing. Conclusions This study demonstrates that adults in Australia who had poor social support, had difficultly accessing health care, had insecure housing and food insecurity had significantly poorer wellbeing during the COVID-19 pandemic. This study exposes the social determinants of health that are responsible for health and social inequalities. It shows that the COVID-19 pandemic has exacerbated the social vulnerabilities and highlights the need take action on the social determinants of health and inequalities. Key messages The COVID-19 pandemic has further exposed the longstanding health and social inequalities that exist in Australia. Action on social determinants of health is required in a post COVID-19 world to rebuild social protection and safeguard populations from any future public health emergencies.

Einleitung Die Planung qualitativ guter Präventionsmaßnahmen ist komplex und erfordert zeitliche Ressourcen. Mit der webbasierten Planungshilfe WEPI soll Kommunen und Schulen eine evidenzbasierte Planung nach dem Intervention Mapping Ansatz (IMA) ermöglicht werden, wobei der Planungsprozess zeitsparend und nutzerorientiert angeleitet wird. Das Projekt wird durch das Bundesministerium für Gesundheit gefördert.

Abstract Background Studies have shown that interventions to prevent excess weight gain in children and teenagers are often planned unsystematically and not evidence-based. Planning high-quality interventions to prevent childhood obesity is a complex process requiring time and personnel, both limited resources in health promotion. The aim of this project is to develop an evidence-based, user-oriented planning tool to support and optimize the planning process of interventions to prevent excess weight gain in children and teenagers. Methods To identify existing tools for planning interventions, a systematic literature review (SLR) was first conducted in the databases PubMed, LIVIVO and Cochrane. In addition, seven interviews were carried out with practitioners in schools and communities to determine difficulties encountered during the planning process. This data served as the foundation for the design of an initial draft of the planning tool, which was subsequently tested in focus group discussions (FGD) with potential users. Results The SLR identified a total of 23 planning tools. Of these, four comprehensive and evidence-based ones were chosen to compare planning steps and context requirements. The interviews revealed that practitioners require support with problem and needs analysis, target setting and the development of theory-based strategies. The first planning step of the tool was tested in FGD and modified in response to group feedback. An optimized version of the tool can be presented. Future work will focus on converting the tool into a web-based application and pretesting it in schools and communities. Conclusions The planning tool will support the systematic development of evidence-based prevention interventions. It provides a comprehensive roadmap to the planning process, guiding the user step by step. The conversion into a web-based application will simplify and support these planning steps. This project is supported by the Federal Ministry of Health, Germany. Key messages The tool enables time-saving, structured and quality-assured planning of prevention interventions. Requirements resulting from practice were considered in the development of the planning tool.

Zusammenfassung Kinder und Jugendlichen mit Migrationshintergrund nehmen einen großen prozentualen Anteil unter den Kinder und Jugendlichen in Deutschland ein. Ihre Bedürfnisse und Bedarfe werden jedoch bis dato noch nicht ausreichend wahrgenommen. Dies trifft auf alle gesellschaftlichen Systeme zu, so auch das Gesundheitssystem. Der Einfluss des Migrationshintergrundes auf die Gesundheit der Kinder und Jugendlichen ist nicht für alle Erkrankungen negativ; es zeigen sich jedoch besonders große Differenzen bei Erkrankungen, die unter den Begriff der sogenannten neuen Morbidität gefasst sind, wie die Adipositas und psychische Auffälligkeiten und Störungen. Kinder und Jugendliche mit beidseitigem Migrationshintergrund sind signifikant häufiger von Übergewicht und Adipositas betroffen als Kinder und Jugendliche ohne Migrationshintergrund (8,8 % vs 5,9 %). Im Gegensatz dazu sind sie in Programmen zur Prävention und Therapie der Adipositas deutlich unterrepräsentiert. Zudem ist das derzeitige Angebot solcher Programme weitgehend migrationsund kulturunspezifisch, was zur Folge hat, dass den Problemlagen von Kindern bzw. Jugendlichen und ihren Familien unzureichend begegnet wird. Anforderungen an solche zielgruppenspezifischen Programme können gut beschrieben werden; ihre flächendeckende Umsetzung steht noch aus.

Das vom Bundesministerium für Gesundheit geförderte Forschungsprojekt „WEPI“ hat zum Ziel, die Planung, Umsetzung und Kontrolle von Präventionsmaßnahmen zu verbessern. Dies wird durch die Entwicklung und Erprobung einer evidenz- sowie nutzerorientierten und webbasierten Planungshilfe für Maßnahmen der universellen Prävention des Kinderübergewichts – Schwerpunkt Schule und Kommune – realisiert.

Die Ermöglichung eines gesunden Aufwachsens von Kindern und Jugendlichen ist ein Ziel, welches durch unterschiedliche Akteur*innen und Strategien in Deutschland verfolgt wird. Auch im internationalen Kontext werden Anstrengungen unternommen, um das Recht auf Bildung und gute Bedingungen für Gesundheit für alle Kinder Teil ihrer jeweiligen Lebensrealität werden zu lassen. Dies findet unter anderem seinen Ausdruck in den Millenniums-Entwicklungszielen, bei denen sehr konkret die zu erreichenden Veränderungen benannt sind.