Partizipation ist ein Grundprinzip der Gesundheitsförderung. 40 Jahre nach der Ottawa-Charta ist jedoch weitgehend ungeklärt, wie Partizipation in Förder- und Steuerungsinstrumenten der Gesundheitsförderung institutionalisiert ist. Dieser Beitrag untersucht, inwieweit Partizipation in Policies, Programmen sowie Forschungs- und Praxisförderleitlinien der Gesundheitsförderung im D‑A-CH-Raum (Deutschland, Österreich, Schweiz) abgebildet ist. Wir haben eine qualitativ-strukturierende Dokumentenanalyse von 35 Dokumenten aus Deutschland (n = 12), Österreich (n = 12) und der Schweiz (n = 11) durchgeführt und diese anhand einer Partizipationsheuristik entlang der Dimensionen Institutionalisierung und Definitionen von Partizipation, Partizipationskultur/-haltung, Partizipationsprozessen als Verankerung von Partizipation in den Phasen des Public Health Action Cylce (PHAC), adressierte Akteursgruppen, angestrebten Veränderungen und Ressourcen bzw. Ermöglichungsbedingungen für Partizipation ausgewertet. Partizipation ist normativ anerkannt, wird in den untersuchten Dokumenten jedoch überwiegend auf der Ebene von Anhörung und Einbezug selektiver Akteursgruppen operationalisiert. Partizipative Machtteilungsformen sind selten und strukturell kaum abgesichert. Partizipation fehlt in bestimmten PHAC-Phasen weitgehend. Ressourcen die Partizipation ermöglichen, sind in der Mehrheit der Dokumente nicht ausgewiesen. Die größte Operationalisierungstiefe zeigen einzelne Forschungsförderleitlinien; Policies und Programme weisen die stärkste normative, aber geringste operative Verankerung auf. Die Befunde zeigen eine systematische Diskrepanz zwischen normativem Anspruch und Umsetzung in den untersuchten Dokumenten. Partizipation ist dabei durchgängig als institutionell eingeräumter Top-down-Prozess angelegt; strukturelle Räume für emanzipatorische, community-initiierte Ansätze fehlen weitgehend. Forschungs- und Praxisförderungsleitlinien sollten Partizipationstiefe präzisieren, Partizipation in allen PHAC-Phasen verankern, Ressourcen standardisieren und Verbindlichkeit einführen, sowie Förderlogiken entwickeln, die Zielgruppen und Communities als eigenständige Initiatorinnen von Gesundheitsförderung anerkennen.

Purpose: Health literacy (HL) is critical during adolescence, as this life stage is characterised by increasing autonomy in health-related decision-making alongside exposure to complex information environments. This study addresses the gap between adult-oriented conceptualisations of HL and youths’ lived experiences by co-developing a conceptual HL model grounded in young people’s perspectives. Methods: A co-research approach was applied. Youth co-researchers were recruited using purposive, convenience, gatekeeper, and snowball sampling across diverse educational and community settings. 57 youth co-researchers aged 14–22 and four adult co-researchers participated in the co-research, reaching 182 adolescents. Peer interviews, focus groups, surveys, and co-research workshops were conducted by youth co-researchers independently and together with adult co-researchers. A photovoice sub-study addressed remaining data gaps. The data were analysed using grounded theory, combining initial coding by adult co-researchers with validation meetings and participatory analysis workshops involving youth co-researchers. Results: A youth-centred conceptual model of HL—the ‘House of Health Literacy’—was developed, conceptualising HL as interconnected dimensions which, like the elements of a house, build upon and stabilise one another. Four dimensions are represented as floors of the house: (1) individual characteristics as the foundation; (2) spaces for information and communication on an online–offline continuum; (3) trust and relationships, which mediate how information is accessed and assessed; and (4) health information and health-related decision-making as the top layer, symbolising that the core HL process is built on the other dimensions. The fifth dimension, (5) society and trends, operates as an overarching influence, shaping all other dimensions. Conclusions: The Youth-centred House of Health Literacy offers a novel perspective that challenges the adult-centred conceptualisations of adolescent HL. The model aligns with dimensions of existing frameworks while adding and highlighting youths’ priorities on HL.

Introduction Social prescribing is an approach to addressing non-medical issues affecting people’s health and well-being (eg, loneliness, housing or financial problems). It has gained international traction over recent years as complementary to medical care. A larger research project, comparing social prescribing across European countries, is considering how to tailor provision for the following groups: (a) LGBTIQ+persons, (b) refugees and first-generation immigrants and (c) older adults living alone. As part of this research, a qualitative study will address the question: What are the enabling and limiting factors associated with implementing social prescribing, across different European countries, from the perspective of key stakeholders?Methods and analysis Five European countries (Austria, England, Germany, Poland, Portugal) will be involved. Researchers from each country will conduct approximately 20 semi-structured interviews (total number will be 100). Interviewees will be people receiving, delivering, managing and funding/commissioning social prescribing. Interviews will be audio-recorded and transcribed. A cross-country analysis will be undertaken; framework analysis will support this process, with a chart developed in Excel in which data from across the five countries is summarised by the researchers involved. Summaries will be based on a thematic framework that researchers from the five countries develop together after initially analysing their own data.Ethics and dissemination Ethical approval was initially secured through the University of Oxford’s Medical Sciences Interdivisional Research Ethics Committee (IDREC 1806086) for data collection in England. This approved application was then used to secure ethics approval in Austria (through Ludwig Boltzmann Gesellschaft), Germany (through Bergische Universität Wuppertal), Poland (through Wroclaw Medical University) and Portugal (through NOVA University of Lisbon). Dissemination will include an academic journal article and presentation at relevant conferences. It will also include short videos, written summaries/policy briefs and an infographic.This project has received funding from the European Union’s Horizon Europe Research and Innovation Programme under grant agreement No 101155873. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HADEA). Neither the European Union nor the granting authority can be held responsible for them.

Wenn Versorgung auf Gesundheitsförderung trifft, stellen sich viele Fragen. Das Zukunftsbild „Gesundheitsfördernde Primärversorgung“ gibt Orientierung für die Umsetzungspraxis.

Background In its resolution on social participation, the World Health Assembly called on member states to involve patients and the population in decision-making processes in the healthcare system. Furthermore, the resolution calls for the monitoring of participation processes. The survey of examples of participation in the context of health, which was carried out in 2023, comes closest to such monitoring for Austria. The article summarises lessons learned from the survey.Methodology The learning experiences are based on the analysis of process-produced data from a questionnaire survey on examples of patient and population participation in the healthcare system commissioned by the Federal Ministry of Social Affairs, Health, Care and Consumer Protection in Austria. Data included were pretest results, workshop protocols to reflect on the survey instrument and results as well as limitations in the survey report. The contents of the documents included were paraphrased and analysed thematically.Results The results of the questionnaire survey showed that central to the planning and implementation of a survey were (1) the objective of the survey, including clarification of the objective and the areas to be covered, (2) the target group, including clarification of the target group and requirements adapted to it, and (3) reaching the target group, including motivators, choice of words and dissemination channels. The learning experiences were summarised in ten key questions for the development of similar survey instruments.Discussion and Conlcusion A survey of examples of participation is possible and provides an overview of which groups are involved in which areas and how. Without concrete specifications as to which groups should be involved, the survey remains exploratory and does not allow any conclusions to be drawn about representativeness. The design of the survey is also caught between breadth (short questionnaire with potentially high response rate) and depth (long questionnaire with lower response rate). The checklist presented here is intended to support similar surveys. Without an orientation framework as to where participation should take place and who acts as the contact person for these processes, such surveys remain exploratory.

Existing models of health literacy have included a limited perspective of children and adolescents. We conducted a meta-ethnography to develop a child- and adolescent-centered conceptualization of health literacy. We dually screened 3564 abstracts, 205 full texts, assessed the 40 included studies’ methodological limitations, and considered 25 data-rich studies in our synthesis. We assessed our confidence in each finding using GRADE-CERQual. Our model shows that health literacy development involves active information seeking (moderate confidence), passive information receiving (very low confidence), processing information (moderate confidence), and (not) taking action (moderate confidence). This process is embedded in a socio-cultural environment, educational system, healthcare system, internet/media, and living environment (very low to moderate confidence). Our model shows that children’s and adolescents’ health literacy is influenced by cognitive psychological (moderate confidence) and sociodemographic factors (moderate confidence). Social relationships play a crucial role (moderate confidence). Our model supports the development of evidence-based interventions and policies that promote youth and child well-being, laying the foundation for lifelong health literacy. This approach also provides a basis for future research to explore health literacy concepts that are grounded in young people’s real-life contexts. Registration: Before writing this manuscript, we developed a study protocol and registered it on PROSPERO: CRD4202343090.

In recent years, emphasis has grown on involving children and adolescents in research. Co-research allows these age groups to be equal partners in research, ensures that their perspectives and experiences are considered, and empowers them to express their views and expertise on their own lives. However, involving children and young people in co-research poses complex challenges and raises multifaceted issues. This review provides insights from previous co-research processes and outlines the characteristics of an ideal co-research process. A rapid qualitative evidence synthesis was conducted to synthesize the qualitative research on co-research experiences with children and adolescents. We searched three electronic databases up to May 2023 and carried out supplementary searches. Two reviewers screened 742 abstracts and 169 full-text articles to select studies that met our eligibility criteria. From 48 eligible studies, we sampled 30 to synthesize based on the data richness for qualitative content analysis. Our synthesis highlights key factors that are crucial in co-research processes with children and adolescents. We developed a framework consisting of six key themes: the sociocultural factors, ethics, setting factors, project management, interpersonal factors, and individual factors of the young co-researchers. These themes involve various factors (e.g., children’s and adolescents’ rights, power imbalances, support structures, remuneration/incentives, trust, and time availability) that must be considered. The challenges and facilitators encountered throughout the co-research process were synthesized. In addition, we provide an overview of targeted co-research methods for young age groups, which offers valuable guidance for future co-research initiatives.

Background: Social prescribing connects patients with community resources to improve their health and wellbeing. It is gaining momentum globally due to its potential for addressing non-medical causes of illness while building on existing resources and enhancing overall health at a relatively low cost. The COVID-19 pandemic further underscored the need for policy interventions to address health-related social issues such as loneliness and isolation. Aim: This paper presents evidence of the conceptualisation and implementation of social prescribing schemes in twelve countries: Australia, Austria, Canada, England, Finland, Germany, Portugal, the Slovak Republic, Slovenia, the Netherlands, the United States and Wales. Methods: Twelve countries were identified through the Health Systems and Policy Monitor (HSPM) network and the Euro Health Net Partnership. Information was collected through a twelve open-ended question survey based on a conceptual model inspired by the WHO's Health System Framework. Results: We found that social prescribing can take different forms, and the scale of implementation also varies significantly. Robust evidence on impact is scarce and highly context-specific, with some indications of cost effectiveness and positive impact on well-being. Conclusions: This paper provides insights into social prescribing in various contexts and may guide countries interested in holistically tackling health -related social factors and strengthening community -based care. Policies can support a more seamless integration of social prescribing into existing care, improve collaboration among sectors and training programs for health and social care professionals.

Social prescribing has become a global phenomenon. A Delphi study was recently conducted with 48 social prescribing experts from 26 countries to establish global agreement on the definition of social prescribing. We reflect on the use and utility of the outputs of this work, and where we go from here.