INTRODUCTION Preventive behaviors in the first three years of life may reduce the onset of allergic conditions. Midwives support families closely during this time and hence could play a key role in strengthening parental health literacy regarding early childhood allergy prevention. The aim of this study was to develop, content-validate and pilot a questionnaire to improve the currently low level of evidence on practices, barriers and facilitators of providing advice on early childhood allergy prevention in a health literacy responsive way by midwives in Germany. METHODS We developed a 64-item online questionnaire informed by the findings of a previous qualitative study. Subsequently, the content of the questionnaire was tested in cognitive interviews with midwives and public health experts. The focus was on: overall impression, comprehensibility, response options, relevance, completeness, and ideas for improvement. Then, two versions were piloted in two German federal states on acceptability and to learn more about recruiting midwives for research. RESULTS Data from the cognitive interviews (n=8) and the piloting (n=59) indicated that the questionnaire is understandable, feasible and relevant for the target group. Suggestions for improvement focused mainly on midwifery specific terms. The 'no answer' option was considered important for all questions. Response options appeared appropriate and scales were mostly fully used. CONCLUSIONS Following minor adaptions, the questionnaire can now be applied on a larger scale, as a nationwide survey in Germany addressing all midwives. In order to reach midwives to participate in research, a multifaceted but personal approach seems advisable.

Summary PPI may add value to the planning, conduct and translation of findings of allergy prevention trials. Reporting of PPI in allergy prevention trials is invisible although clearly advocated for by research funding bodies and others.

The increasing digitalization of healthcare systems presents both opportunities and challenges for patients. A key challenge lies in cultivating e-health literacy, defined as the capacity to locate, comprehend, appraise, and use digital health information and services. This study employs a mixed-methods approach to investigate social and structural factors perceived as shaping patients' capability to use digital health services. A mixed-method approach guided the design, data collection, data analysis, and synthesis. This included semi-structured interviews and an online survey to corroborate findings and enhance credibility. The objective of the study was to examine the perspectives and dispositions of members and representatives of patient organizations regarding digital health services identifying key factors associated with e-health literacy. Findings indicate that respondents view social factors as crucial. Motivation to engage with digital health services is seen as a pivotal factor to shape the development of e-health literacy. However, motivation is not solely an individual trait; it is shaped by social contexts and trust in digital systems. Ensuring the highest standards of data security and transparency is imperative for cultivating this trust. Furthermore, patients must feel a sense of autonomy regarding their personal health data to engage confidently with digital health services. Structured learning environments, offered by social actors such as governments, patient organizations, and health insurance providers, also play a crucial role. These insights are relevant for practitioners in healthcare and public administration. To develop e-health literacy, it is imperative to establish inclusive learning opportunities, ensure data protection, and cultivate patient empowerment. Government agencies, healthcare providers, and insurance companies should collaborate with relevant stakeholders to design and implement supportive measures that reflect patients' lived realities. This approach can help ensure that all individuals are equipped to participate meaningfully in a digitalized healthcare environment.

BackgroundPatient organizations (POs) are an integral part of the health care landscape, serving as advocates and support systems for patients and their families. As the digitalization of health care accelerates, POs are challenged to adapt their diverse roles to digital formats. However, the extent and form of POs’ digital adaptation and the challenges POs encounter in their digital transformation remain unexplored. ObjectiveThis study aims to investigate the digital transformation processes within POs. We examined the types of digital activities and processes implemented, people involved in respective tasks, challenges encountered, and attitudes toward the digitalization of POs. MethodsThe study was carried out by the multicenter interdisciplinary research network Pandora. We adopted a qualitative exploratory approach by conducting 37 semistructured interviews and 2 focus groups with representatives and members of POs in Germany. Results were obtained using a deductive-inductive approach based on a qualitative content analysis. Methods and results were reported in accordance with the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist. ResultsPOs primarily apply basic digital tools to engage in communication, health education, and information dissemination. Some also develop specific mobile apps and collect health data through patient registries. Volunteers cover a considerable part of the workload. Sometimes, POs collaborate with external partners, such as health professionals or other nonprofit organizations. Furthermore, many (13/46, 28%) interviewees referred to the importance of involving members in digitalization efforts to better meet their needs. However, they described the actual practices used to involve members in, for example, developing digital services as limited, passive, or implicit. When evaluating digital transformation processes, representatives and members of POs expressed generally positive attitudes and acknowledged their potential to improve the accessibility of support services, management efficiency, and outreach. Still, resource constraints; the complexity of digital initiatives; and accessibility issues for certain demographic groups, especially older persons, were frequently mentioned as challenges. Several (15/46, 33%) interviewees highlighted POs’ increasing responsibility to support their members’ digital competencies and digital health literacy. ConclusionsPOs are actively involved in the digital transformation of health services. To navigate challenges and further shape and sustain digital activities and processes, POs may benefit from governance frameworks, that is, a clear plan outlining with whom, how, and with what objectives digital projects are being realized. Support from public, scientific, and policy institutions to enhance the process through training, mentorship, and fostering collaborative networks seems warranted.

BACKGROUND:When seeking advice on allergy prevention in early childhood (Early Childhood Allergy Prevention, ECAP), parents often turn to health and social care providers, such as paediatricians, midwives, and family centres. However, these actors fulfil various, often care-related, roles, and cannot be considered 'health information providers' by default. In addition, although the scientific evidence for ECAP is often known by health professionals, it is not actively communicated. In this study protocol, we describe the planned procedure for the development and implementation of a process to communicate ECAP information to parents, with a focus on reaching out to those from migrant communities. Thereby, we also aim to contribute to the understanding of how to design more robust approaches to deliver health information. METHODS:We have chosen the Implementation Research Logic Model as our framework for a multi-stage process. Firstly, we will map regional and local health and social care providers to find potential providers of ECAP information. We will then approach actors from each mapping category for qualitative interviews to assess facilitators and barriers to implementation. Next, we will define actions to ease the implementation process, develop exemplary ECAP information materials for parents, and deliver these to pre-selected health and social care individuals and organizations. Each step will be adapted to meet the needs and preferences of culturally and linguistically diverse populations. Finally, the process will be evaluated for key implementation outcomes (e.g., acceptability, feasibility, effectiveness) by interviewing information providers and surveying information recipients. DISCUSSION:From a Public Health perspective, studies seem warranted that investigate how evidence from health research may be effectively communicated to the public, rather than merely focusing on, e.g., intervention development. Also, it has often been highlighted that the dissemination of health information needs to better target those who face the greatest difficulties when seeking advice, i.e. individuals/parents who recently migrated. ECAP is a good use case, as scientific evidence is constantly evolving, and the communication of information is hampered by low awareness of high quality sources.

Introduction:As the digital transformation of healthcare progresses, key actors such as patient organizations (POs) are adapting their activities and services to digital formats. This study explores how PO members are involved in developing digital services, focusing on their general willingness, actual involvement, and associated factors. Methods:A nationwide online survey was conducted among members of German POs from August to November 2023. Participants were recruited through 300 national POs. Data analysis included descriptive statistics and multivariate logistic regression analyses to examine potential predictors of three involvement variables. Results:Of the 1,334 participants, the majority were female (67.2%) and aged ≥50 years (65.6%). While only 22.4% of respondents had been approached by their PO to contribute to digital services - most commonly to PO websites, focusing primarily on content development - 81.2% emphasized the importance of member involvement, and nearly half (48%) expressed willingness to engage. Members volunteering within their PO were significantly more likely than non-volunteers to express willingness (OR = 2.905, 95% CI: 2.163-3.901, p < 0.001) and to be approached by their PO (OR = 5.227, 95% CI: 3.765-7.256, p < 0.001). Additionally, members not engaged in volunteer roles were significantly less likely to agree to such a request (OR = 0.076, 95% CI: 0.032-0.181, p < 0.001). Members with poor self-rated digital skills were significantly less likely to express willingness (OR = 0.235, 95% CI: 0.135-0.407, p < 0.001) or to be involved (OR = 0.070, 95% CI: 0.016-0.300, p < 0.001) than those with strong digital skills. Other factors, such as age, gender, educational attainment, and membership duration, were significantly associated with specific aspects of involvement. Conclusion:The findings highlight a notable gap between the broad willingness of PO members to engage in digital service development and the limited actual involvement opportunities currently provided by POs. This suggests that structured involvement processes may not yet be fully established, leaving substantial potential untapped. To gain a more comprehensive understanding, future research should explore POs' perspectives on the feasibility of member involvement, as well as structural and organizational factors that shape these opportunities.

Abstract Background Focus groups (FGs) are an established method in health research to capture a full range of different perspectives on a particular research question. The extent to which they are effective depends, not least, on the composition of the participants. This study aimed to investigate how published FG studies plan and conduct the recruitment of study participants. We looked at what kind of information is reported about recruitment practices and what this reveals about the comprehensiveness of the actual recruitment plans and practices. Methods We conducted a systematic search of FG studies in PubMed and Web of Science published between 2018 and 2024, and included n = 80 eligible publications in the analysis. We used a text extraction sheet to collect all relevant recruitment information from each study. We then coded the extracted text passages and summarised the findings descriptively. Results Nearly half (n = 38/80) of the studies were from the USA and Canada, many addressing issues related to diabetes, cancer, mental health and chronic diseases. For recruitment planning, 20% reported a specific sampling target, while 6% used existing studies or literature for organisational and content planning. A further 10% reported previous recruitment experience of the researchers. The studies varied in terms of number of participants (range = 7–202) and group size (range = 7–20). Recruitment occurred often in healthcare settings, rarely through digital channels and everyday places. FG participants were most commonly recruited by the research team (21%) or by health professionals (16%), with less collaboration with public organisations (10%) and little indication of the number of people involved (13%). A financial incentive for participants was used in 43% of cases, and 19% reported participatory approaches to plan and carry out recruitment. 65 studies (81%) reported a total of 58 limitations related to recruitment. Conclusions The reporting of recruitment often seems to be incomplete, and its performance lacking. Hence, guidelines and recruitment recommendations designed to assist researchers are not yet adequately serving their purpose. Researchers may benefit from more practical support, such as early training on key principles and options for effective recruitment strategies provided by institutions in their immediate professional environment, e.g. universities, faculties or scientific associations.

INTRODUCTION:Health literacy (HL) is essential for making informed health-related decisions, for example enabling parents to reduce their child's allergy risk. Health literacy does not, however, rely solely on an individual's capacities, but is strongly influenced by external factors. Midwives provide important health advice to families, particularly since their relationship is close during a time of significant transition. This offers them a unique opportunity to positively influence the HL of parents, which in turn may support the health and well-being of the whole family. The aim of this study is to develop and evaluate an intervention that can support midwives in providing allergy prevention advice in a way that is in line with the concept of HL. METHODS AND ANALYSIS:In accordance with the recommendations of the Medical Research Council framework in the first phase of this study, we will survey midwives (target sample size=379) in Germany regarding their practices, the potential barriers they face and enabling factors in providing advice on early childhood allergy prevention in an HL-responsive way. The data will be subjected to descriptive statistical analysis. Two co-design workshops will then be conducted with various stakeholders in two regions (Rhineland-Palatinate and Saxony) of Germany. Following the protocol proposed by the Stanford Design Thinking School, we will use design thinking to collect ideas for the intervention. Based on these ideas and our previous qualitative and quantitative study, we will develop an intervention in collaboration with didactic experts. The intervention will be piloted in three groups (midwives=10-15, midwives working as practice supervisors=5-10, students of midwifery=10-20). For the process evaluation, we will use observation protocols of the intervention conduct and qualitative interviews. For the outcome evaluation, we will use a questionnaire and observations in simulation laboratories with students of midwifery. ETHICS AND DISSEMINATION:This study protocol was approved by the Ethics Committee of the University of Regensburg (ID 23-3441-101) and is in compliance with the Declaration of Helsinki. Participation in the study will only be possible after informed consent has been given. Our results will be presented at national and international conferences and published in scientific journals. Additionally, once it has been finalised, we will make the intervention available to educational institutions for (future) midwives.

Abstract:Patients, as central actors in healthcare, should be enabled to actively participate in health services research processes. In addition, other stakeholders, such as professionals from healthcare practice, are also essential for a comprehensive participatory approach. This DNVF memorandum focuses on participatory approaches in the context of health services research. It begins by outlining the key characteristics of participatory health services research and describing its current development and institutionalization in Germany. The DNVF memorandum also highlights the potential and benefits of participatory research. Finally, it addresses two cross-cutting topics that are particularly relevant for further development in this field: the theoretical and conceptual foundations, and the investigation of effects and effectiveness of participatory approaches.

Background. Organizational health literacy (OHL) defines requirements and activities in health care organizations, such as hospitals, to enable patients to make good health-related decisions. During the COVID-19 pandemic, hospitals were also required to make it easier for their patients to access and use health information and services. Objective. The aim of this article is to provide an overview of OHL activities in German hospitals during the COVID-19 pandemic. The focus is on the comparison of OHL activities in hospitals during and outside the pandemic period. Methods. An online survey of medical, nursing, and administrative hospital management was conducted in November and December 2022. OHL was collected using the health literate health care organization 10 item (HLHO-10) questionnaire, which was successfully adapted to the COVID-19 pandemic (good internal consistency: alpha = 0.89). Analysis was performed with SPSS 28 using variance and correlation analysis. It was also possible to provide open-ended information on OHL activities, which was analyzed using MAXQDA and qualitative content analysis. Results. Of 3301 invited hospital managers, 328 participated (response rate 10%). Hospital managers stated to take necessary care in hospitals to ensure patients can easily find their way around during the pandemic. However, we found little evidence of patients being actively involved in the design and evaluation of health information. At the time of the COVID-19 pandemic, significantly more staff were trained in health literacy (p < 0.001). The respondents' open-ended responses indicate that there is a need for optimization, but that they are struggling to meet this need due to a lack of resources. Conclusion. Hospital managers are aware that not all aspects of health literacy are equally well implemented. It is crucial to consistently integrate health literacy into organizational activities and prioritize the topic.

Background: The first 3 years of life offer an opportunity to prevent allergic diseases. Pediatricians are an important source of health information for parents. However, a certain degree of health literacy is necessary to understand, appraise, and apply preventive behavior, which can be supported by health literacy (HL) sensitive consultations and a HL friendly environment. Objective: In this study, we want to shed light on how pediatricians in outpatient care in Germany advise on early childhood allergy prevention (ECAP) and how they consider parental HL. Methods: We conducted 19 semi-standardized telephone interviews with pediatricians from North-Rhine-Westphalia and Bavaria. The interviews were audio-recorded, transcribed, pseudonymized, and subjected to content analysis. Key Results: Current ECAP recommendations were well known among our sample. Despite the shift of evidence from avoidance of allergens toward early exposure, providing advice on ECAP was considered non-controversial and it was widely assumed that recommendations were easy to understand and apply for parents. However, ECAP was treated as an implicit topic resonating among others like infant nutrition and hygiene. Regarding HL, our interview partners were not aware of HL as a concept. However, they deemed it necessary to somehow assess parental information level and ability to understand provided information. Formal HL screening was not applied, but implicit strategies based on intuition and experience. Concerning effective HL-sensitive communication techniques, interviewees named the adaptation of language and visual support of explanations. More advanced techniques like Teach Back were considered too time-consuming. Medical assistants were considered important in providing an HL-sensitive environment. Time constraints and the high amount of information were considered major barriers regarding HL-sensitive ECAP counseling. Conclusion: It seems warranted to enhance professional education and training for pediatricians in HL and HL-sensitive communication, to reach all parents with HL-sensitive ECAP counseling. [HLRP: Health Literacy Research and Practice. 2024;8(2):e47–e61.]

BACKGROUND:The lack of therapeutic treatment options for depressive disorders increases the relevance of digital interventions for patients and general practitioners (GPs), particularly to bridge waiting times. However, patients may require adequate (digital) health literacy (HL) to partake in such interventions. OBJECTIVE:This study contrasts expected benefits and risks of digital mental health interventions, specifically digital therapeutics on prescription (DTx), among GPs and patients with depression according to HL dimensions (access, understanding, appraisal, and application) and patients' personal determinants. METHODS:We conducted semi-structured interviews with purposively sampled GPs (n = 17) and patients with mild or moderate depression (n = 17) in Germany. The interviews were audio-recorded, transcribed verbatim, and coded. Data were analyzed using qualitative content analysis. KEY RESULTS:DTx include benefits to access health information and promote HL as DTx can improve understanding of health content and foster self-management skills. But DTx also implies risks for routine care distribution and creates new media barriers. During waiting times patients appraise DTx for themselves as more positive than GPs expect. However, digital- and disease-specific challenges such as non-commitment, listlessness or lethargy appear to hinder the use of DTx in practical situations. While GPs were not convinced about the digital skills of their patients, patients raised concerns that depressive symptoms may inhibit them from actual use. CONCLUSION:In the context of DTx for depressive disorders, patients' mental health needs are seldom noticed and rarely promoted. To foster (digital) HL, DTx should be comprehensively embedded in supply situations. [HLRP: Health Literacy Research and Practice. 2024;8(4):e236-e245.].

Abstract Background Organizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers. Methods Between November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data. Results Of 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials. Conclusions Given their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.

Zusammenfassung Hintergrund Organisationale Gesundheitskompetenz (OGK) beschreibt Bedingungen und Maßnahmen in Einrichtungen der Gesundheitsversorgung, wie z. B. Krankenhäusern, die Patient:innen dabei unterstützen sollen, gute gesundheitsbezogene Entscheidungen zu treffen. In der COVID-19-Pandemie waren auch Krankenhäuser gefordert, ihren Patient:innen den Zugang zu und den Umgang mit Gesundheitsinformationen und -dienstleistungen zu erleichtern. Ziel Zielsetzung des Beitrags ist eine Bestandsaufnahme der OGK-Aktivitäten in deutschen Krankenhäusern während der COVID-19-Pandemie. Fokussiert wird dabei der Vergleich der OGK-Aktivitäten in Krankenhäusern während und außerhalb pandemischer Zeiten. Methodik Zwischen November und Dezember 2022 wurde eine Online-Befragung von ärztlichen, pflegerischen und kaufmännischen Krankenhausleitungen durchgeführt. Die OGK wurde anhand des HLHO-10-Fragebogens erhoben, wobei dieser für die COVID-19-Pandemie erfolgreich adaptiert wurde (gute interne Konsistenz: α = 0,89). Die Auswertung erfolgte mit SPSS 28 mittels Varianz- und Korrelationsanalysen. Zudem bestand die Möglichkeit einer Freitextangabe zu OGK-Aktivitäten, welche mithilfe von MAXQDA und einer qualitativen Inhaltsanalyse ausgewertet wurden. Ergebnisse Von 3301 eingeladenen Krankenhausleitungen nahmen 328 an der Befragung teil (Rücklaufquote 10 %). Die Krankenhausleitungen geben an, dass in ihren Häusern während der Pandemie darauf geachtet wurde, dass sich Patient:innen einfach zurechtfinden. Jedoch ist eine aktive Einbindung von Patient:innen bei der Gestaltung und Evaluierung von Gesundheitsinformationen kaum umgesetzt. Zum Zeitpunkt der COVID-19-Pandemie wurden statistisch signifikant mehr Mitarbeitende zum Thema Gesundheitskompetenz geschult ( p < 0,001). Aus den Freitexten wird deutlich, dass die Befragten Optimierungsbedarf sehen, dem sie aufgrund mangelnder Ressourcen nur schwer nachkommen können. Schlussfolgerung Den Krankenhausleitungen ist bewusst, dass nicht alle Teilaspekte der OGK gleichmäßig gut umgesetzt sind. Es ist entscheidend, GK kontinuierlich in das organisatorische Handeln zu integrieren und dem Thema Priorität einzuräumen.

Digitale Gesundheitsanwendungen (DiGA) in die Versorgung zu integrieren und so die (digitale) Gesundheitskompetenz (GK) der Patient*innen zu stärken, sind Ziele der Digitalisierungsstrategie des Bundesministeriums für Gesundheit. Bisherige Ergebnisse zeigen jedoch, dass Gesundheitsprofessionen es als herausfordernd empfinden, Patient*innen bei der Suche nach relevanten digitalen Angeboten zu unterstützen. Auf Basis einer Befragungsstudie mit Hausärzt*innen und Patient*innen wird der Frage nachgegangen, wie der DiGA-Einsatz im hausärztlichen Setting gefördert werden kann. Mit Hausärzt*innen und mit Patient*innen mit leichten bis mittelgradigen Depressionen wurden 34 halbstrukturierte, leitfadengestützte Interviews geführt und inhaltsanalytisch ausgewertet. Die erwarteten Chancen und Risiken einer DiGA-Versorgung unterscheiden sich deutlich: Für Patient*innen ist der Zugang zu Wissen über verfügbare Angebote wichtig, um eine DiGA-Nutzung in Wartezeiten zu erwägen. Hausärzt*innen wiederum sehen in DiGA eine Chance, das erkrankungsbezogene Verständnis zu erhöhen. Patient*innen favorisieren Behandelnde als Anlaufstelle für Informationen über DiGA. Im Rahmen der professionellen (digitalen) GK und der Stärkung der GK der Patient*innen sollten Bedarfe, Bedürfnisse und verfügbaren Versorgungsoptionen folglich in Behandlungsgesprächen stärker thematisiert werden. Für eine patientenorientierte Entscheidungsfindung über einen DiGA-Einsatz müssen zunächst das gegenseitige Verständnis von Patient*innen und Verordnenden gefördert und die Erwartungen zum DiGA-Einsatz geklärt werden. Auf Basis der Ergebnisse wurde eine Diskussionsgrundlage zur Förderung von GK in Beratungssituationen entwickelt. Diese könnte in einem nächsten Schritt in der Versorgungspraxis erprobt werden.

Zusammenfassung Hintergrund Digitale Gesundheitsanwendungen (DiGA) in die Versorgung zu integrieren und so die (digitale) Gesundheitskompetenz (GK) der Patient*innen zu starken, sind Ziele der Digitalisierungsstrategie des Bundesministeriums fur Gesundheit. Bisherige Ergebnisse zeigen jedoch, dass Gesundheitsprofessionen es als herausfordernd empfinden, Patient*innen bei der Suche nach relevanten digitalen Angeboten zu unterstutzen. Auf Basis einer Befragungsstudie mit Hausarzt*innen und Patient*innen wird der Frage nachgegangen, wie der DiGA-Einsatz im hausarztlichen Setting gefordert werden kann. Methode Mit Hausarzt*innen und mit Patient*innen mit leichten bis mittelgradigen Depressionen wurden 34 halbstrukturierte, leitfadengestutzte Interviews gefuhrt und inhaltsanalytisch ausgewertet. Ergebnisse Die erwarteten Chancen und Risiken einer DiGA-Versorgung unterscheiden sich deutlich: Fur Patient*innen ist der Zugang zu Wissen uber verfugbare Angebote wichtig, um eine DiGA-Nutzung in Wartezeiten zu erwagen. Hausarzt*innen wiederum sehen in DiGA eine Chance, das erkrankungsbezogene Verstandnis zu erhohen. Patient*innen favorisieren Behandelnde als Anlaufstelle fur Informationen uber DiGA. Im Rahmen der professionellen (digitalen) GK und der Starkung der GK der Patient*innen sollten Bedarfe, Bedurfnisse und verfugbaren Versorgungsoptionen folglich in Behandlungsgesprachen starker thematisiert werden. Schlussfolgerung Fur eine patientenorientierte Entscheidungsfindung uber einen DiGA-Einsatz mussen zunachst das gegenseitige Verstandnis von Patient*innen und Verordnenden gefordert und die Erwartungen zum DiGA-Einsatz geklart werden. Auf Basis der Ergebnisse wurde eine Diskussionsgrundlage zur Forderung von GK in Beratungssituationen entwickelt. Diese konnte in einem nachsten Schritt in der Versorgungspraxis erprobt werden. Abstract Background Integrating digital health applications on prescription (DTx) into routine care and strengthening digital health literacy are objectives of the German Federal Ministry of Health's digitization strategy. So far, it has become apparent that it is challenging for health professionals to support patients due to online healthcare seeking. This situation can hinder DTx integration in ambulatory care. Based on the perspectives of primary care physicians and patients, we aim to identify approaches to support informed DTx use in the primary care setting. Methods In all, 34 semi-structured, guided interviews with general practitioners (GPs; n=17) and patients with mild to moderate depression were conducted, fully transcribed, and qualitatively analyzed for content. Results GPs' and patients' perspectives on DTx for depressive disorders differ substantially according to opportunities and potential risks: For patients, access to knowledge about available services is important to consider DTx during waiting times. GPs see DTx as an opportunity to increase disease-related knowledge. Patients favor healthcare professionals for information about DTx. To strengthen professional (digital) health literacy, needs and available treatment options should be addressed during consultations. Conclusion For patient-oriented DTx-implementation, it is important to promote patients' and GPs' understanding to clarify the expectations on DTx use. Based on the findings, the main topics for healthcare consultancy were identified and integrated into a discussion guideline to promote health literacy in consultations. In the next step, this could be tested in healthcare practice.

Background Patient organizations (POs) play a crucial role in supporting individuals with health conditions. Their activities range from counseling to support groups to advocacy. The COVID-19 pandemic and its related public health measures prompted rapid digital transformation efforts across multiple sectors, including health care. Objective This study aimed to explore how POs digitally responded to pandemic-related circumstances, focusing on aspects such as the technologies used, positive outcomes, and challenges encountered. Methods This scoping review followed the methodological guidance of the JBI (Joanna Briggs Institute) Scoping Review Methodology Group and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guidelines. A systematic search of PubMed, the Web of Science Core Collection, and the WHO (World Health Organization) COVID-19 database, supplemented by a citation search approach, was conducted. The initial search was performed on November 10, 2022, and updated on November 8, 2023. Publications were eligible if they were published after November 30, 2019, and addressed pandemic-related digitalization efforts of POs, defined as nonprofit organizations with a focus on health-related support. A 2-step screening process was used to identify relevant literature. Data were extracted using a standardized table to capture aspects such as digital adaptation activities (eg, types of technologies implemented, positive outcomes, challenges, and facilitating factors) and coded inductively to identify similarities across included publications, and the findings were synthesized narratively. Results The search and its subsequent update yielded 2212 records, with 13 articles included in this review. These articles revealed a range of PO services that were digitally adapted during the pandemic, with videoconferencing software emerging as the most commonly used tool (n=9 articles). The digital adaptation of group-based support activities was the most frequently reported transformation (n=9). Other adaptations included the digitalization of counseling services (n=3) and the delivery of information and education (n=3), including educational workshops, weekly webinars, and the dissemination of information through digital newsletters. While the use of digital formats, particularly for POs’ group activities, often increased accessibility by breaking down preexisting barriers (n=5), they also created new barriers for certain groups, such as those lacking digital skills or resources (n=4). Some participants experienced a loss of interpersonal aspects, like a sense of community (n=3). However, further findings suggest that the digital delivery of such group activities preserved essential interpersonal aspects (n=7) and a preference among some participants to continue digital group activities (n=4), suggesting the potential for sustainability of such options post the COVID-19 pandemic. Conclusions The rapid digitalization efforts of POs demonstrate their adaptability and the potential of digital technologies to improve support services, despite some challenges. Future digitalization strategies should focus, among other things, on promoting digital literacy to ensure the accessibility and inclusiveness of digital services. Trial Registration OSF Registries, https://osf.io/anvf4

BackgroundWhen parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences.MethodsWe conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview.ResultsParents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of “good” health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition.ConclusionOne suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs—provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.