Abstract Background Despite the growing evidence on positive effects of built environment interventions, including bicycle infrastructure interventions, on physical activity, research methods employed in studies continue to be heterogeneous and the evidence on effective strategies is still lacking. The main objective of this rapid review was to systematically map the evidence regarding the effects of bicycle infrastructure interventions on physical activity in the general population of high-income countries. Methods This rapid review adhered to Cochrane guidelines. A systematic search of PubMed was conducted using a predefined search strategy with the following key terms: bicycle infrastructure, multi- or single-strategic intervention and physical activity. Only English-language articles published between August 1st, 2013 and November 21st, 2025, were included. A pre-piloted data extraction spreadsheet was used to extract and summarize key information from the selected studies. Results A total of 980 articles were screened for eligibility. Of these, 32 studies met the inclusion criteria and were included in the final analysis. The evidence revealed predominantly positive effects of bicycle infrastructure interventions on physical activity (n = 21). However, in 11 studies, no effects (n = 9) or decreased physical activity (n = 2) were found. Conclusion These findings suggest that implementation of bicycle infrastructure may positively affect physical activity at the population level. Regional sociodemographic differences still have to be investigated to support current policy actions.

to answer the following research questions: (1) What is the prevalence of CC at preschool age, according to the school entry examination (SEE) and health professional assessment? (2) Which is the most common CC at preschool age? (3) Which health determinants (HD) are associated with CC? This cross-sectional study included all preschool children residing in Duesseldorf, Germany, who began school in summer 2024. CC were self-reported based on questionnaires and verified by health professionals during SEE. HD included neighbourhood deprivation, employment of caregivers, family status, daily time of the child’s media use, and physical activity participation. Poisson regression models were used with 95

Abstract Background Children with special healthcare needs (CSHCN) live with long-term physical, developmental, behavioural, or mental conditions that affect everyday functioning and require specialized care. According to the International Classification of Functioning, Disability and Health (ICF), such conditions may cause impairments in body functions and structures, limitations in activities, and restrictions in participation, shaped by environmental factors. Evidence on social participation and its correlates in CSHCN remains limited. Therefore, we aimed to identify which correlates are associated with social participation across different conditions and indications in a multi-site sample of CSHCN in Social Paediatric Centres (SPCs) in Germany. Methods This study analysed parent-reported data of CSHCN (3–18 years) from the baseline of the PART-CHILD cohort collected in routine care in 15 SPCs in Germany (2019–2020). Social participation (outcome) in home, community, school, and living activity domains was assessed using the German Child and Adolescent Scale of Participation (CASP). In the regression analysis, independent variables included environmental factors (parental educational attainment, German native language) and health-related factors (impairment type and complexity reported as reason for referral to the SPCs, health-related quality of life (HRQoL)), as well as age (operationalised in groups [3–6; 7–10; 11–18 years]) and sex as covariates. Linear complete case regression models were performed, and β-coefficients and 95% confidence intervals were reported. Results Five hundred fifty-one families of CSHCN (68.24% female; 44.46% aged three to six and 34.66% from seven to ten years old) were available for analysis (10.99% missing outcome). CASP total mean score was 75.99 (± 20.03; range: 25–100), the lowest in living activities subscale (68.07 ± 24.81), including household activities, shopping, transportation. In the complete case regression analysis (n = 350), older child age and higher HRQoL were associated with higher social participation score across all domains. Children with both physical and cognitive impairments had lower CASP scores in the total, home, and school models, with a trend to association in the community model. Lower parental educational attainment was significantly associated with reduced social participation in the living activities subscale. Conclusions In this study, we confirmed previous findings on factors determining social participation in CSHCN, such as age and higher HRQoL. Impairment complexity (combined physical and cognitive impairments) decreased participation in home and school. The lower participation in daily living activities for lower educated parents confirms, that social environment significantly influences social participation. This highlights that to improve social participation, strategies are needed that address family-level and broader environmental barriers to lessen social and functional disadvantages in particularly vulnerable subgroups. Trial registration PART-CHILD cohort, German Clinical Trials Register - Deutsches Register Klinischer Studien (DRKS), DRKS00015054, registered on 16 November 2018.

Regelmäßige intensive körperliche Aktivität fördert die Gesundheit, ist aber auch mit einem erhöhten Verletzungsrisiko verbunden, insbesondere im Tennissport. Neben medizinischen Präventionsansätzen rückt die Bedeutung sozialer Faktoren in Sportvereinen in den Fokus. Soziales Kapital, verstanden als Vertrauen, Netzwerke und Reziprozität innerhalb eines Kollektivs, hängt mit gesundheitsförderndem Verhalten zusammen, wurde jedoch bislang kaum im Kontext der Verletzungsprävention untersucht. Ziel der Studie ist es, Kenntnis und Umsetzung von Empfehlungen zur Verletzungsprävention (EzV) im Tennis und die Rolle des sozialen Kapitels (sK) hierbei zu erfassen und zu untersuchen, inwiefern diese beiden im Zusammenhang stehen. Die Untersuchung wurde anhand folgender Forschungsfragen durchgeführt: Kennen Vereinsmitglieder EzV? Setzen Vereinsmitglieder, welche die EzV kennen, sie um? Welches sK haben Vereinsmitglieder? Gibt es einen Zusammenhang zwischen dem sK und der Kenntnis/Umsetzung von EzV? In der Querschnittstudie wurden n = 287 Mitglieder fünf Heinsberger Tennisvereine online befragt. Die Umfrage erhob Daten zur Kenntnis/Umsetzung von 10 EzV, zum sK und zu möglichen Confoundern. Anhand linearer und logistischer Regressionsanalysen wurde der Zusammenhang von sK und der Kenntnis/Umsetzung von EzV überprüft. Die EzV waren den Mitgliedern meist bekannt, die Umsetzung war jedoch seltener. Das sK der Vereinsmitglieder ist hoch. Das soziale Kapital hängt signifikant mit der Kenntnis von EzV beim Aufwärmen (β = 0,527) und Fitness/Belastung (β = 0,610) sowie mit der Umsetzung von Trainerempfehlung (OR = 2,685) zusammen. Das Bewusstsein für spezifische Bereiche der Verletzungsprävention kann zwar noch gesteigert werden, insbesondere aber haben Trainer:innen eine Rolle als Vorbilder in der Verletzungsprävention.

Physical inactivity is a persistent public health challenge with 52

Evidence-informed decision-making (EIDM) is essential for developing and implementing health policies and public health measures that promote, maintain and protect population health. Effective EIDM requires equitable collaboration between academia and practice to foster bilateral knowledge translation and exchange (KTE). This study analyses the barriers and facilitators influencing engagement in such research collaborations within Germany’s public health service (PHS). We conducted 23 key informant interviews with 24 experts engaged in or collaborating with Germany’s PHS to explore experiences with PHS research, knowledge transfer, collaboration and training. The interviews, conducted in pairs, were transcribed verbatim and analysed thematically via a coding frame developed through a deductive‒inductive approach. The COM-B Model of Behaviour Change was applied to categorize barriers and facilitators affecting individuals’ and organizations’ capability, opportunity and motivation to engage in academia‒practice collaboration. The analysis revealed the importance of combined approaches that integrate informal networks, formal partnerships, research collaborations and capacity-building initiatives to foster local evidence ecosystems, ensuring bilateral KTE between academia and practice to support EIDM at the local level. Ten key barriers and 35 facilitators capable of addressing these challenges were identified. Strategies to address capability and opportunity barriers included workforce development with dedicated research time, on-the-job training, streamlined administrative processes, long-term funding mechanisms, strengthened relationships between academia and PHS and improved access to research infrastructure and local settings. Financial and educational incentives, adequate incentive structures, an evidence-informed culture within the PHS, and equitable partnerships based on mutual recognition were highlighted as essential motivators. Based on these findings, we developed a conceptual framework reflecting the interconnected nature of barriers and facilitators. Sustainable academia‒practice collaboration is crucial for bridging the knowledge‒action gap and thereby strengthening EIDM in PHS. However, Germany’s PHS lacks institutionally anchored partnerships to strengthen bilateral KTE and EIDM at the local level. The proposed KTE framework provides actionable pathways to bridge gaps between academia and PHS, fostering sustainable and effective collaboration. It can be used to systemically assess factors influencing engagement in equitable partnerships and guide the development of solutions tailored to local needs, supporting EIDM processes at the local level.

Despite approximately half of the German general population not meeting the physical activity (PA)-guidelines of the World Health Organization with further decreases noted during the pandemic, population-based intervention strategies to tackle this public health problem remain sparse. This study aimed to replicate the successfully delivered “10,000 Steps Ghent” intervention and research trial conducted in Belgium, two research questions were examined: (1) Do individuals located in the city that a complex PA intervention is implemented in (Duesseldorf) engage in more PA compared to individuals located in the control city (Wuppertal) after one year? (2) Is the proportion of those reaching 10,000 steps/day higher in the intervention than in the control city after the intervention? A nonrandomized controlled intervention trial was conducted among residents of two German cities. The 12-month intervention ‘10,000 Steps Duesseldorf’ was designed as a multicomponent intervention targeting different socioecological levels: at the intrapersonal level, a website allowed participants to self-monitor their steps; at the organizational level, workplaces and community groups were engaged through step count competitions; and at the community and policy levels, a city-wide media campaign to increase awareness regarding PA benefits was rolled out and street signage indicating walking routes were posted in different city district of Duesseldorf. To investigate intervention effects, PA was assessed via pedometers in two representative samples of adults aged 25–75 years from Duesseldorf (intervention) and Wuppertal (control). Measurements were taken at baseline (April 2021-March 2022) and again one year later (May–November 2023) and the same participants recorded their steps over a 7-day period at both time points. Baseline differences in socio-demographic and health-related variables between intervention and control were adjusted for in a propensity score model with matching weights. 627 adults completed baseline and 553 the follow-up assessment (60

Seit mehr als 30 Jahren illustriert das Modell der sozialen Determinanten der Gesundheit (SDG) die gesellschaftlichen Einflüsse auf die Gesundheit der Bevölkerung. Diese Einflüsse bedingen auch die Gesundheit von Kindern und Jugendlichen. Sie wirken bereits vorgeburtlich, über Generationen hinweg und manifestieren sich in der sozialen Ungleichverteilung der Kindergesundheit. Neben den politischen Entscheidungsträger:innen haben Kinderärzt:innen die Chance, günstig auf die SDG einzuwirken.

INTRODUCTION:A science-based approach in local public health services (PHS) requires robust structures both for generating practice-relevant research and for integrating this knowledge into routine public health practice. To strengthen this interface, an academia-practice research consortium developed, piloted, and evaluated the part-time trainee-rotation program "EvidenzOGD." METHODS:The formative process evaluation of the six-month pilot was guided by a theory-based logic model and employed a mixed-methods design, including document analysis, standardized online surveys, and workshops. Findings were synthesized using method and data triangulation. RESULTS:Trainees and mentors reported substantial gains in competencies and identified impulses for anchoring sustainable evidence transfer. At the institutional level, new forms of cooperation and structural developments were initiated. At the same time, several areas for improvement emerged, including an overly short rotation period, high documentation workload, unclear role expectations, and coordination challenges. These issues were systematically addressed, leading to adaptations of key program components, such as the rotation structure, the implementation of a unified logbook, the expansion of the training modules, and the improved integration of the trainee research project. DISCUSSION:The program is considered a promising approach to promoting evidence-informed practice and strengthening institutional cooperation within the PHS. Its modular structure allows for flexible implementation in different local contexts. Future research should explore its long-term effects on competency development and the institutionalization of evidence-based approaches.

Der neue „M.Sc. in Public Health/Öffentliches Gesundheitswesen“ der Heinrich-Heine-Universität Düsseldorf verbindet Praxis und Wissenschaft in der ÖGD- und Public Health-Ausbildung. Fachärztliche Weiterzubildende im Öffentlichen Gesundheitswesen an der Akademie für Öffenliches Gesundheitswesen können dort ergänzende Module (Epidemiolgogie, Versorgung) besuchen und den Abschluss erwerben. Erste Erfahrungen zum Studiengang zeigen das langfristige Potential dieser Kooperation.

Dieses Logbuch enthält alle wesentlichen Inhalte zur Umset-zung des EvidenzÖGD Trainee-Rotationsmodells. Zusätzlich benötigen Sie das Handbuch, in dem das Rahmenkonzept des Modells dargelegt wird. Trainees und Mentor:innen füllen die-ses Logbuch gemeinsam aus, verwaltet und koordiniert wird dieser Prozess von dem:r Trainee.

Für eine wissenschaftsbasierte Arbeitsweise im Öffentlichen Gesundheitsdienst (ÖGD) sind tragfähige Strukturen zur Generierung praxisrelevanter Forschung sowie zur Integration selbiger in die Praxis erforderlich. Um diese Schnittstelle zu stärken, wurde im Forschungsverbund Öffentliche Gesundheit das berufsbegleitende Trainee-Rotationsprogramm „EvidenzÖGD“ entwickelt, pilotiert und evaluiert. Die formative Prozessevaluation der 6‑monatigen Pilotierung beruhte auf einem theoriebasierten Wirkmodell und kombinierte qualitative und quantitative Methoden: Dokumentenanalysen, standardisierte Online-Befragungen und Workshops. Die Ergebnisse wurden mittels Methoden- und Datentriangulation zusammengeführt. Trainees und Mentor:innen berichteten über substanzielle Kompetenzzuwächse und identifizierten Impulse für die Verankerung eines nachhaltigen Wissenstransfers. Auf institutioneller Ebene wurden neue Kooperationsansätze und strukturelle Entwicklungen angestoßen. Gleichzeitig zeigten sich Optimierungspotenziale, etwa eine zu knappe Rotationsdauer, hoher Dokumentationsaufwand, unklare Rollenerwartungen sowie organisatorische Herausforderungen. Diese wurden systematisch aufgearbeitet und führten zur Anpassung zentraler Modellkomponenten, wie der Rotationsstruktur, zur Einführung eines einheitlichen Logbuchs, zur Ausweitung der Fortbildungsreihe und zur besseren Integration des Trainee-Forschungsprojekts. Das Programm wird als vielversprechender Ansatz zur Förderung wissenschaftsbasierter Praxis und zur Stärkung institutioneller Kooperationen im ÖGD bewertet. Die modulare Struktur erlaubt eine flexible Anwendung. Künftige Forschung sollte die langfristige Wirkung auf Kompetenzaufbau und die Etablierung evidenzbasierter Ansätze untersuchen.

BACKGROUND:Early childhood intervention is intended to systematically network and customise support services, particularly for socio-economically disadvantaged families. The programmes are universal or selective, but the evidence on their effectiveness is limited. AIMS:The aims of this study were to exemplary analyse whether participants in early childhood intervention services had better development than non-participants using the school entry examination (SEE) as well as to discuss to what extent the SEE can be used to assess the impact of early childhood intervention services. METHODS:We analysed three typical offers of early childhood intervention services (family education; Zukunft für Kinder (ZfK); Kita-U) in relation to full vaccination coverage and age-appropriate development at U9. Data from 4579 Düsseldorf first graders were included. Propensity score matching was used to calculate percentage differences (average treatment effect on the treated; ATT) in terms of immunisation coverage and development between comparable intervention and control groups. RESULTS:All programmes are associated with a slightly increased probability of full vaccination protection (ATT 2.1 for family education; 2.5 for ZfK; 5.3 for Kita-U). Family education is also associated with a slightly higher probability of age-appropriate development (ATT 1.6), while the probability of age-appropriate development is lower for participants in ZfK (-10.1) and Kita‑U (-4.5). DISCUSSION:The evaluation of early childhood intervention, especially selective services, is a methodological challenge due to confounding and suitable comparison groups. However, the SEE could be a framework for impact analyses under specific conditions.

Gesundheitsschutz, Gesundheitsförderung / ​Prävention und Gesundheitsmanagement sind Aufgabenbereiche des Öffentlichen Gesundheitsdienstes (ÖGD) in Bund, Ländern und Kommunen. Angesichts gesundheitlicher Ungleichheiten in der Bevölkerung arbeitet der ÖGD sozialkompensatorisch. Ziel des Beitrages ist einzuschätzen, inwiefern diese Funktion des ÖGD in jüngerer Zeit erfüllt worden ist. Dies erfolgt exemplarisch am Beispiel der kommunalen Gesundheitsämter und mit dem Schwerpunkt Kindergesundheit. Die Autorin geht dabei zunächst auf Frühe Hilfen, Schuleingangsuntersuchungen, Kindergartenuntersuchungen, Gruppenprophylaxe und kommunale Gesundheitsförderung ein. Dies wird ergänzt durch Aspekte, die von Personen in Leitungsfunktion eines kommunalen Gesundheitsamtes eingebracht wurden: Fachkräftemangel, Zugänge und Evidenzbasierung. Insgesamt stand die sozialkompensatorische Arbeit des ÖGD vor großen Herausforderungen, es gab aber auch immer Wege, vulnerable Personengruppen zu erreichen. Die Autorin plädiert dafür, diese Wege weiterzuentwickeln und auszubauen. Evidenzbasierung, besonders an der Schnittstelle von Wissenschaft und Praxis, sei hierbei vordringlich.

Abstract Background Despite marked decreases in physical activity (PA) in Germany due to the pandemic, population-based intervention strategies to tackle this public health problem remain sparse. The 12-month PA intervention ‘10,000 Steps Duesseldorf’ was composed of multiple components: at individual level, website to self-monitor steps; organizational level, step count competitions; environmental level, city-wide media campaign to increase awareness regarding benefits of PA and street signage indicating walking routes. This study aimed to replicate a research trial from Belgium addressing two questions: (1) Do individuals located in the city that the intervention is implemented in (Duesseldorf) engage in more PA compared to individuals located in the control city (Wuppertal) after one year? (2) Is the proportion of those reaching 10,000 steps/day higher in the intervention than in the control city after the intervention? Methods To investigate intervention effects, PA was assessed via pedometers in two representative samples of adults aged 25-75 years in the cities of Duesseldorf (intervention) and Wuppertal (control) at baseline (April 2021 - March 2022) and one-year follow-up (May-November 2023). Baseline differences in socio-demographic and health-related variables between intervention and control were adjusted for in a propensity score model with matching weights. Results 627 adults participated in the study at baseline and 553 at follow-up (60% female, 60% intervention). The results of the propensity score analyses revealed that intervention participants walked 462 steps more (95% confidence interval: -146 to 1070) than controls at follow-up. However, the proportion of residents reaching 10,000 steps/day was comparable between intervention and control city after the intervention (26%, both cities). Conclusions Our results suggest an intervention effect on daily steps taken in Duesseldorf experiencing intervention activities compared to the control city after one year. Key messages • The complex PA intervention from Belgium was successfully adapted and implemented in Germany resulting in a higher level of daily steps taken in the intervention city (compared to control). • A limitation of the study is that the recruitment process was hampered by the ongoing pandemic, resulting in selection bias, i.e. already active individuals were more likely to enrol in the study.

Background. Early childhood intervention is intended to systematically network and customise support services, particularly for socio-economically disadvantaged families. The programmes are universal or selective, but the evidence on their effectiveness is limited. Aims. The aims of this study were to exemplary analyse whether participants in early childhood intervention services had better development than non-participants using the school entry examination (SEE) as well as to discuss to what extent the SEE can be used to assess the impact of early childhood intervention services. Methods. We analysed three typical offers of early childhood intervention services (family education; Zukunft f & uuml;r Kinder (ZfK); Kita-U) in relation to full vaccination coverage and age-appropriate development at U9. Data from 4579 D & uuml;sseldorf first graders were included. Propensity score matching was used to calculate percentage differences (average treatment effect on the treated; ATT) in terms of immunisation coverage and development between comparable intervention and control groups. Results. All programmes are associated with a slightly increased probability of full vaccination protection (ATT 2.1 for family education; 2.5 for ZfK; 5.3 for Kita-U). Family education is also associated with a slightly higher probability of age-appropriate development (ATT 1.6), while the probability of age-appropriate development is lower for participants in ZfK (-10.1) and Kita-U (-4.5). Discussion. The evaluation of early childhood intervention, especially selective services, is a methodological challenge due to confounding and suitable comparison groups. However, the SEE could be a framework for impact analyses under specific conditions.

Background: Municipal networks of early childhood intervention coordinate services to promote healthy child development. The (re)establishment of these networks is unsystematic and network maps are sometimes used. However, it is not yet clear how such network maps should be used. The aim of this project was therefore to pilot and evaluate a process for the use of network maps in the development of early childhood intervention networks. Methods: The process was tested on the basis of five network meetings with early childhood intervention professionals (n = 17; n = 14; n = 21; n = 13; n = 22) in various D & uuml;sseldorf neighborhoods in 2022 and 2023. Network maps were to act as a narrative generator here. They were embedded in a process that consisted of various phases, including interactive ones. The experiences were then discussed with the people responsible for the network meetings (n = 3) in a focus group. The transcribed recordings were analyzed using content-structuring qualitative content analysis. Results: The evaluation by the focus group took place along the various phases of the network meetings, including planning, introductions, filling out the cards, hanging up the cards, break, group discussion, and conclusion. The overall evaluation resulted in an idealized process of an early help network meeting in which the network cards are embedded and in which organizational aspects must be taken into account. Conclusion: These limited experiences and evaluations of the use of the network maps convey the impression that the network map instrument works as a narrative trigger. The process piloted here can be used to systematically (re)establish municipal early help networks.

Vor dem Hintergrund gesundheitlicher Ungleichheiten und der COVID-19 Pandemie stellt sich die Frage nach dem Hilfebedarf vulnerabler und schwer erreichbarer Gruppen. Ein partizipatives Projekt erprobte Feldzugang und Datenerhebung in der Sozialberatung. Die Evaluation zeigt: 45 Familien mit Problemlagen berichteten Hilfebedarf, die Methode ist aber mit Herausforderungen, insbesondere zeitlicher und personeller Art, verbunden. Insgesamt erscheint der Zugang über die Sozialberatung vielversprechend.

BACKGROUND:COVID-19 pandemic has influenced all children's motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. METHODS:Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). RESULTS:Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018-6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2-10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. CONCLUSION:Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children.