Tatiana Görig

Prevalence of sun‐protective behaviour and intentional sun tanning in German adolescents and adults: results of a nationwide telephone survey

The incidence rate of melanoma in the Caucasian population is rising worldwide. One of the major environmental risk factors for melanoma is the exposure to ultraviolet (UV) radiation. To prevent skin damage caused by UV exposure, several organizations recommend wearing protective clothing, staying in the shade, avoiding the outdoors during midday and using sunscreen.

Modifying Health Behavior to Prevent Cardiovascular Diseases: A Nationwide Survey among German Primary Care Physicians

Cardiovascular diseases (CVD) are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs) were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72%) and alcohol (61%) consumption, to encourage them to increase their levels of physical activity (72%), and to assist them in adjusting to a more healthy diet (66%), and in achieving a healthy body weight (69%). However, only between 23% (quitting smoking) and 49% (diet modification) of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.

Physician gender and lifestyle counselling to prevent cardiovascular disease: a nationwide representative study

Background Primary care physicians (PCPs) have a key role in the prevention of cardiovascular diseases (CVD). However, it is not clear whether lifestyle counselling behaviour differs between female and male PCPs. Nonetheless, this information might be helpful to develop need-based advanced training for female and male PCPs. Therefore, our aim was to identify potential gender differences in the implementation of health promotion and the prevention of CVD in primary care. Design and Methods In a Germany-wide survey called the ÄSP-kardio Study, we collected data from 4074 PCPs (40% female; from October 2011 to March 2012). We compared the provision of prevention measures, the attitude towards counselling, and the potential barriers in counselling among female and male German PCPs. We used chi2 tests, Mann-Whitney U tests, and logistic regression analysis. Results We found differences in all of the above-mentioned aspects. Female PCPs were less likely to perceive barriers than male and more likely to ask patients about lifestyle, for example, nutrition (OR=1.62, P≤0.001). Additionally, female PCPs were more likely to feel well prepared (84.2% vs. 76.0%, P≤0.001) and successful (75.6% vs. 68.0%, P≤0.001). Male PCPs were more likely to mention barriers in daily practice that hinder lifestyle counselling. Conclusions Overall, both female and male PCPs had a positive attitude towards lifestyle counselling. Nevertheless, in view of the barriers that they indicated, incentives such as better reimbursement may help output-oriented PCPs to translate their positive attitude into action. Moreover, awareness of gender differences may help PCPs to acquire the specific advanced training that they need for effective lifestyle counselling in CVD. Significance for public health Lifestyle counselling is an important instrument to reduce the burden of cardiovascular disease. Here, primary care physicians (PCPs) play an important role as health advisors. Our study was able to identify deficits in the health promotion behaviour of PCPs. Because of the gender differences revealed in our study, male PCPs in particular should be sensitized to the importance and the potentials of prevention and health promotion. Overcoming the barriers of prevention and health promotion identified by the PCPs may be an important starting point. If, for instance, PCPs were better financially compensated for offering lifestyle counselling, which was rated as the most important barrier, it is conceivable that more PCPs would start to incorporate such measures into their daily routine. Additionally, a stronger focus on prevention and health promotion during advanced training programs for PCPs could increase the use of lifestyle counselling.

Are tanning salons in compliance with German law? An evaluation based on a nationwide representative survey

Given the evidence for increased skin cancer risk due to the sunbed use, a regulation of hazardous artificial ultraviolet radiation (UVR regulation) was passed in Germany in 2012. The aim of this study was to explore the advisory services in tanning studios as reported by sunbed users and to evaluate the information provided by the personnel of tanning salons after the UVR regulation was enacted.

Deutsches „Nationales Krebshilfe-Monitoring“ 2015–2019 – Studienprotokoll und erste Ergebnisse

Das Projekt „Nationales Krebshilfe‐Monitoring zur Solariennutzung“ (National Cancer Aid Monitoring of Tanning Bed Use, NCAM) ist eine deutsche Großstudie mit dem Ziel, die wichtigsten Risikofaktoren für Hautkrebs zu beobachten: natürliches Sonnenlicht und künstliche UV‐Strahlung.

E-Zigaretten in aller Munde? – Aktuelle repräsentative Daten zur Nutzung unter Jugendlichen und Erwachsenen

Background International data suggest an increase in e-cigarette use. However, there are still significant deficits in the reporting of its current prevalence. The present study reports representative data on e-cigarette use that make it possible to differentiate users both by the nicotine content of the e-cigarette liquids being used and by their smoking status. Methods and material The underlying data are taken from the National Cancer Aid Monitoring (NCAM). In its first wave, 3000 persons aged between 14 and 45 were interviewed by telephone. Point estimates, confidence intervals and determinants of use will be presented. Results Overall, 20 % of respondents had used an e-cigarette before, of which 80 % used liquids containing nicotine. Men, younger persons, persons with a migrant background and persons with a lower education level were more likely to have used an e-cigarette before than their respective reference groups. Half of all ever users of e-cigarettes also smoked tobacco cigarettes, while roughly one third had never used tobacco products before. Conclusions For the first time, a representative study was conducted combining questions on the use of e-cigarettes with questions on smoking tobacco cigarettes and the nicotine content of the liquids being used. Target groups for future prevention measures are adolescents, as they had the highest prevalence of e-cigarette use, as well as non-smokers, since one third of e-cigarette users had never used a tobacco product before. Both groups also seem to be relevant target groups for which the introduction to e-cigarettes should be prevented.

Die Aufnahme des Screenings auf Gestationsdiabetes mellitus in die Mutterschaftsrichtlinien aus Sicht niedergelassener Gynäkologen: Eine qualitative Studie

BACKGROUND In March 2012, the screening for gestational diabetes was included as a 2-step screening into the German maternity directive. However, up to now it is unclear what resident gynaecologists, who are affected directly by this change in the maternity directive, think about the inclusion of the screening and the kind of screening introduced. METHODS In order to approach this topic from a scientific point of view, gynaecologists in the German cities Mannheim, Ludwigshafen, and Heidelberg were interviewed face-to-face using a semi-structured interview guide with open-ended questions (mean interview length: 33:12 min). The interviews were audiotaped, transcribed verbatim (191 pages), coded by 2 independent reviewers, and analysed using qualitative content analysis. RESULTS The majority of the gynaecologists supported the introduction of the screening into the maternity directives. However, some gynaecologists felt that this amendment is not strong enough criticising the GCT with 50 g glucose. Many gynaecologists would prefer an oral glucose tolerance test (OGTT, 75 g glucose). But there were also some gynaecologists who thought that the OGTT would strain pregnant women too much and thus deemed it unsuitable for a screening. Additionally, the gynaecologists named difficulties concerning the implementation of the test such as, for example, the non-availability of a ready-made glucose syrup for the GCT and the delayed introduction of billing codes. DISCUSSION In the framework of this qualitative study, resident gynaecologists--the main actors in the conduct of the screening--had the possibility to offer their opinion on this current topic. The results provide a first insight into the conduct of the screening and may serve as a basis for larger, quantitative studies.

Screening for gestational diabetes mellitus in Germany: A qualitative study on pregnant women's attitudes, experiences, and suggestions

OBJECTIVE to explore pregnant womens experiences with the recently implemented screening for gestational diabetes mellitus (GDM). DESIGN qualitative study. SETTING Rhine-Neckar Metropolitan region, Germany. PARTICIPANTS 20 pregnant women aged 27-41 years (mean: 32.6 years) who were at least in gestational week 29, i.e., those who should have already been screened for GDM. MEASUREMENTS AND FINDINGS semi-structured interviews with open-ended questions were conducted via telephone between November 2013 and February 2014. All interviews were audiotaped, transcribed verbatim and subsequently analyzed using qualitative content analysis according to Mayring. The screening was seen as an important instrument to detect GDM and thus to prevent possible health problems in both mother and child. Some deviations from the recommended screening procedure were reported in the interviews, e.g., collecting capillary blood instead of venous blood during an oral glucose tolerance test (OGTT); offering an OGTT without a prior glucose challenge test (GCT); conducting a GCT after an overnight fast. Two women had to actively ask for the screening to be done. One woman reported that her gynaecologist advised her against the screening. CONCLUSION AND IMPLICATION FOR PRACTICE this qualitative study reflects the womens experiences with the new screening for GDM. Our findings show that two years after the introduction of universal GDM screening in Germany the screening procedure does not always seem to meet the standards of the German maternity guidelines.

Stadt-Land-Unterschiede im Angebot von Lebensstilberatung zur Prävention kardiovaskulärer Erkrankungen in der Hausarztpraxis. Ergebnisse einer bundesweiten Hausärztebefragung

AIMS In Germany, shortages in primary care physicians (PCPs) were reported in some rural regions. In this paper, we explored if regional differences in the distribution of PCPs are associated with the provision of lifestyle counseling in primary care. METHODS In a nationwide study, a total of 4,074 randomly selected PCPs were asked about provision of lifestyle counseling to their patients, their attitudes, and perceived barriers. RESULTS PCPs from rural regions provided less frequently lifestyle advice for cardiovascular disease prevention. Compared to their colleagues in urban areas, more PCPs from rural regions believed that were inadequately qualified for the lifestyle counseling and that they had been less successful in helping patients to modify their lifestyles. Physicians from rural practices named more often than PCPs from urban practices a lack of adherence by the patients (65 vs. 57%), insufficient opportunities to collaborate with providers of preventive services (62 vs. 55%), and lack of time (66 vs. 52%; all p<0.001) as barriers in providing patients with lifestyle counseling. CONCLUSION Taking into account the expected increased shortages in PCPs in rural regions, the results show the need for targeted interventions for improving lifestyle counseling in rural practices.

Profile of sunless tanning product users: Results from a nationwide representative survey

Sunless tanning products (STPs) are often seen as “healthy alternative” to sunbathing and indoor tanning. However, STP use may entail indirect risks such as overestimating an individuals natural skin type, resulting in risky (natural and artificial) tanning behavior. We aimed to explore STP use in combination with other health‐related risk behaviors (eg, smoking), skin cancer risk, risk awareness of ultraviolet radiation, and preventive behavior.