Silke Kramer

Communicating the Benefits and Harms of Colorectal Cancer Screening Needed for an Informed Choice: A Systematic Evaluation of Leaflets and Booklets

Objective Evidence-based health information (EBHI) can support informed choice regarding whether or not to attend colorectal cancer (CRC) screening. The present study aimed to assess if German leaflets and booklets appropriately inform consumers on the benefits and harms of CRC screening. Methods A systematic search for print media on CRC screening was performed via email enquiry and internet search. The identified documents were assessed for the presence and correctness of information on benefits and harms by two reviewers independently using a comprehensive list of criteria. Results Many of the 28 leaflets and 13 booklets identified presented unbalanced information on the benefits and harms of CRC screening: one-third did not provide any information on harms. Numeracy information was often lacking. Ten cross-language examples of common misinterpretations or basically false and misleading information were identified. Discussion Most of the CRC screening leaflets and booklets in Germany do not meet current EBHI standards. After the study, the publishers of the information materials were provided feedback, including a discussion of our findings. The results can be used to revise existing information materials or to develop new materials that provide correct, balanced, quantified, understandable and unbiased information on CRC screening.

Do preschools differ in promoting children’s physical activity? An instrument for the assessment of preschool physical activity programmes

BackgroundPreschools offer high potential for preventive interventions. However, little is known about the structure of preschool programmes to promote physical activity (PA) in preschoolers although almost all children aged three to six years spend one third of the day at preschool. The aim of this study was to determine whether and to what extent preschools implement systematic PA promotion measures using an instrument specifically developed to assess and systematize preschool PA programmes.MethodsIn the cross-sectional study a baseline survey of preschool education policies was conducted to identify and assess the type and extent of PA programmes and opportunities in preschools in the State of Lower Saxony, Germany. An assessment instrument was developed to identify preschools with systematic PA programmes (type 1) and those without PA programmes (type 2) based on the following quality criteria: A) written PA policy, B) structured weekly PA offerings for all children; C) at least one qualified physical education teacher; D) PA-friendly indoor and outdoor facilities (exercise room, situational PA opportunities, outdoor areas, play equipment etc.), and E) structured PA promotion in place for at least two years. A third type of preschool that promotes PA in children to some extent (i.e., that meets the criteria partially but not completely) was classified as “preschools with limited PA programmes”.Results2415 preschools participated in the survey (response rate: 59%). The results show that 26% (n = 554) have a systematic PA programme while 3% (n = 64) have no PA programme. Most (71%, n = 1514) were classified as limited PA programme preschools. All three types of preschools differed significantly (p = .000) from each other in terms of size (small vs. large). Most of the preschools without PA programmes are small half-day preschools.ConclusionsThe study investigated an assessment-instrument providing extensive insight into the nature, extent and routine practical implementation of PA promotion in preschools. The criteria used to evaluate preschool PA programmes are well-suited to identify the different preschool PA programme types and target areas in the field of PA promotion in which specific measures (teacher education, structured PA offerings, etc.) can be implemented in future interventions.

Do Children's Health Resources Differ According to Preschool Physical Activity Programmes and Parental Behaviour? A Mixed Methods Study

Preschool can have positive effects on the development of a healthy lifestyle. The present study analysed to what extent different conditions, structures and behavioural models in preschool and family—children’s central social microsystems—can lead to differences in children’s health resources. Using a cross-sectional mixed methods approach, contrast analyses of “preschools with systematic physical activity programmes” versus “preschools without physical activity programmes” were conducted to assess the extent to which children’s physical activity, quality of life and social behaviour differ between preschools with systematic and preschools without physical activity programmes. Differences in children’s physical activity according to parental behaviour were likewise assessed. Data on child-related outcomes and parent-related factors were collected via parent questionnaires and child interviews. A qualitative focused ethnographic study was performed to obtain deeper insight into the quantitative survey data. Two hundred and twenty seven (227) children were interviewed at 21 preschools with systematic physical activity programmes, and 190 at 25 preschools without physical activity programmes. There was no significant difference in children’s physical activity levels between the two preschool types (p = 0.709). However, the qualitative data showed differences in the design and quality of programmes to promote children’s physical activity. Data triangulation revealed a strong influence of parental behaviour. The triangulation of methods provided comprehensive insight into the nature and extent of physical activity programmes in preschools and made it possible to capture the associations between systematic physical activity promotion and children’s health resources in a differential manner.

Participation in a prostate cancer support group and health literacy

To cope with prostate cancer (PC) and its consequences and to be certain about therapeutic alternatives, some patients seek mutual help in prostate cancer support groups (PCSGs), where they share information and find social support. Our study was intended to assess whether group participation is associated with health literacy (HL).

Potentials of physical activity promotion in preschools – an overview of results of an ethnographic observation

This article addresses exemplary differences between preschools with systematic physical activity (PA) programmes and preschools without PA programmes in Germany. Two preschools from each group were visited in the context of a focused ethnographic observation to examine the educational practice, PA and social behaviour of preschool children. The observation showed that children engage in PA in preschool under certain conditions (e.g. a structure providing a wide range of PA offerings that can be selected according to interest). Potentials of PA promotion can also be seen in the areas of rule-teaching and the promotion of self-confidence in children. A structure-providing policy in conjunction with the provision of exercise rooms and the promotion of children’s independence seem to have special influence on the social behaviour of children. Promoting children’s independence serves to strengthen the children’s sense of self-efficacy and may contribute to improving their social skills and reducing the burden on teachers.

Plötzlicher Säuglingstod — Ein Beispiel für erfolgreiche Prävention

Mit plotzlichen Sauglingstod (Sudden Infant Death Syndrom, SIDS) wird der plotzliche und unerwartete Tod eines Kindes im ersten Lebensjahr nach der ersten Lebenswoche aus scheinbarer Gesundheit heraus bezeichnet, der meistens wahrend des Schlafes oder im zeitlichen Zusammenhang mit Einschlaf- oder Aufwachphasen eintritt. SIDS stellt nach wie vor in Deutschland und den meisten anderen Industrielandern die haufigste Einzeltodesart fur Sauglinge nach der ersten Lebenswoche im ersten Lebensjahr dar. SIDS ist eine Ausschlussdiagnose, die nur gestellt werden darf, wenn eine sorgfaltig durchgefuhrte Diagnostik nach dem Tod nicht zu dem Nachweis einer adaquaten Todesursache fuhrt. Als problematisch ist die nur auf Leichenschau gestutzte Diagnose der Todesursache »plotzlicher Sauglingstod« anzusehen, da aus wissenschaftlichen Studien bekannt ist, dass durch eine Obduktion etwa 10–15% der plotzlichen Todesfalle als SIDS ausgeschlossen werden konnen, weil eine anders definierte Todesursache nachweisbar ist.

Shaken-Baby-Syndrom — Prävention, aber wie?

Das Shaken-Baby-Syndrom (Schutteltrauma, SBS) gehort zu der Gruppe der auf Kindesmisshandlung zuruckzufuhrenden Kopfverletzungen. Der haufigste Ausloser fur diese Form der Kindesmisshandlung ist lang anhaltendes und unstillbares Schreien eines Sauglings, das zu einem Kontrollverlust der Betreuungsperson und zum Schutteln des Kindes im Affekt fuhren kann (Barr et al., 2006; Reijneveld et al., 2004). Die Lebensphase vom 2. bis 5. Lebensmonat, in dem die meisten Falle von SBS auftreten, ist zugleich auch das Hauptschreialter von Sauglingen. Belastende Situationen wie z. B. Arbeitslosigkeit, finanzielle Probleme und soziale Isolation konnen die Frustrationsgrenze der Eltern absenken.