Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.

Background: Nursing staff are often involved in counseling patients with regard to health behavior. Although care promoting healthy lifestyle choices is included in the curriculum of nursing students in Germany, several studies of nursing students have reported a high prevalence of unhealthy behavior. This paper focuses on the behavior of female nursing students with regard to body mass index (BMI), physical activity, and cigarette and alcohol consumption. It describes trends through the comparison of results from 2008 and 2013. Methods: Data was collected in two waves at a regional medical training college. First, 301 nursing students were asked to fill out a 12 page questionnaire on health behavior in 2008. The questioning was repeated in 2013 with 316 participating nursing students using the previous questionnaire. Results: 259 female nursing students completed the questionnaire in 2013. 31.6% of them were either overweight or obese, 28.5% exercised less than once a week, 42.9% smoked between 10 and 20 cigarettes a day and 72.6% drank alcohol, wherefrom 19.7% consumed alcohol in risky quantities. In comparison to the data of 266 female nursing students from 2008, there were significant differences in the BMI and alcohol consumption: The percentage of overweight and obese students and the percentage of alcohol consumers at risk increased significantly. Conclusions: Health behavior of female nursing students is often inadequate especially in regard to weight and cigarette and alcohol consumption. Strategies are required to promote healthy lifestyle choices.

Background: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods: 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results: BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student’s risk profile. Knowledge did not serve as a mediator for intention building. Conclusions: The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student’s risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.

Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.

Heutzutage erfüllen nur 35 % der Deutschen das empfohlene Maß an körperlicher Bewegung (Robert Koch Institute, 2015). Ein möglicher Grund für diese Inaktivität ist, dass die körperliche Betätigung am Arbeitsplatz sich in den letzten Jahren um insgesamt 28% verringert hat (Wilke, Ashton, Elis, Biallas, & Froböse, 2015). Um dieser Entwicklung entgegenzuwirken, evaluiert die vorliegende Dissertation eine mHealth Intervention bestehend aus Fitnessarmbändern und einem Online Coach, welche die Bewegung von inaktiven Beschäftigten mit Gesundheitsrisiko fördern soll. Zusätzlich wird das Occupational Health Behavior Change (OHBC) Modell als theoretische Grundlage für Veränderungen von Gesundheitsverhalten im betrieblichen Kontext entwickelt. Das OHBC Modell verbindet ein gesundheitspsychologisches Modell mit einem Modell aus dem Bereich der Arbeits-& Organisationspsychologie und stellt die Grundlage für die beiden veröffentlichten Studien der Dissertation dar. Studie I bewertet den Effekt der Intervention auf körperliche Gesundheit und arbeitsbezogenem Wohlbefinden anhand eines randomisiert kontrollierten Studiendesigns und unter Berücksichtigung von Langzeiteffekten. Beschäftigte in der Interventionsgruppe zeigten eine Verbesserung ihrer physischen Gesundheit bis zu einem Jahr nach der Intervention, jedoch wurde kein Effekt auf arbeitsbezogenes Wohlbefinden gefunden. Studie II zeigt, dass die Schrittanzahl und die Beeinträchtigung des Wohlbefindens während der Intervention verbessert werden und beantwortet weiterführende Fragen über die Effektivität der Intervention anhand von modernen statistischen Methoden. Abschließend werden die Ergebnisse der beiden Studien diskutiert und dabei die Struktur des neu kreierten OHBC Modells überprüft. Insgesamt zeigt die vorliegende Dissertation, dass Fitnessarmbändern kombiniert mit einem Online Coach eine effektive Intervention darstellen, um körperliche Aktivität, physische Gesundheit und das Wohlbefinden von Beschäftigten zu fördern. / Nowadays only 35% of the German population performs the recommended amount of physical activity (Robert Koch Institute, 2015). A reason for this inactivity might be that the amount of moderate to vigorous physical activities at work (e.g., brisk walking or moving heavy loads) has diminished by about 28% within the last decades (Wilke et al., 2015). To counteract this alarming development, this dissertation evaluates an mHealth intervention that aims to promote physical activity in the working environment. In particular, this intervention combines activity trackers with an online coach to promote physical activity among inactive employees at risk. Furthermore, this dissertation creates the Occupational Health Behavior Change (OHBC) model as a theoretical framework for changing health behavior within a work setting by combining a model of the health psychology with a model of the industrial and organizational psychology. The model functions as the basis for the two published studies of the dissertation. Study 1 evaluated the intervention by using a randomized controlled trial design and assessed long-term effects on employees’ physical health and work-related well-being. The results show that employees in the intervention group improved their physical health up to one year after the intervention whereas no effect was found for work-related well-being. Study 2 shows that the number of steps and impaired well-being were improved during the intervention and clarified several additional questions about the intervention’s efficacy by applying modern statistical methods. Finally, the findings of the studies were discussed and the theoretical structure of the newly created OHBC model was reviewed based on the studies’ results. Taken together, the overall findings show that combining activity trackers with an online coach constitutes an effective intervention for occupational health promotion with the aim of promoting physical activity, health and well-being among employees.

Das Gesundheitsamt des Landkreises Zwickau veröffentlicht zum zweiten Mal seit 2011 Gesamtergebnisse zum Gesundheitszustand unserer Vorschulkinder im Landkreis Zwickau. Der Gesundheitsbericht beinhaltet die Ergebnisse der Kindergartenuntersuchungen und der Schulaufnahmeuntersuchungen. Die Schwerpunkte liegen dabei auf der Darstellung der Veränderungen der gesundheitlichen Situation der Kinder im zeitlichen Verlauf und der Vergleichmder Entwicklung in unserem Landkreis mit dem im Freistaat Sachsen.

Das »Sächsische Aktionsprogramm zur HIV/AIDS- und STI-Bekämpfung« wurde erstmals im Jahr 2008 durch das Sozialministerium veröffentlicht. Im Jahr 2013 wurde das Programm überarbeitet und angepasst. Jetzt – 2023 – liegen das Sächsische Aktionsprogramm zu HIV / Aids und sexuell übertragbaren Infektionen – Maßnahmen, Handlungsfelder und Strategien, vor. Das Papier beinhaltet weiterhin Leitgedanken der Strategien des Bundes, angepasst an die Verhältnisse des Freistaates Sachsen. Die Inhalte wurden umfassend überarbeitet. Redaktionsschluss: 31.08.2023

Background: Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. Method: A mixed method study was conducted. A standardised survey (n = 92) of experts in chronic care using mail responses to open-ended questions was conducted to analyse existing chronic care programs focusing on effective, problematic and missing components. An expert workshop (n = 22) of professionals and scientists of a European funded research project MANAGE CARE was used to define a limited number of unmet needs and priorities of elderly patients with type 2 diabetes mellitus and comorbidities. This list was validated and ranked using a multilingual online survey (n = 650). Participants of the online survey included patients, health care professionals and other stakeholders from 56 countries. Results: The survey indicated that current care models need to be improved in terms of financial support, case management and the consideration of social care. The expert workshop identified 150 patient needs which were summarised in 13 needs dimensions. The online survey of these pre-defined dimensions revealed that financial issues, education of both patients and professionals, availability of services as well as health promotion are the most important unmet needs for both patients and professionals. Conclusion: The study uncovered competing demands which are not limited to medical conditions. The findings emphasise that future care models need to focus stronger on individual patient needs and promote their active involvement in co-design and implementation. Future research is needed to develop new chronic care models providing evidence-based and practical implications for the regional care setting.

Ein gesundes Alter(n) ist sowohl auf individueller Ebene als auch auf gesellschaftlicher Ebene von großer Relevanz. So wächst die Bedeutung von Prävention und Gesundheitsförderung bis ins hohe Alter – einerseits, um die Autonomie, Selbstbestimmtheit, soziale Teilhabe und Lebensqualität des älteren Menschen aufrecht zu erhalten und andererseits, um den durch den demografischen Wandel bedingten gesundheitspolitischen Herausforderungen begegnen zu können. Dabei weist der gesundheitliche Status im Alter neben hoher Vulnerabilität eine Vielzahl an Ressourcen und somit Ansatzpunkte für präventive und gesundheitsförderliche Interventionen auf. Technische Innovationen bieten hier ein wachsendes Potenzial, um Maßnahmen dieser Art zu stützen. Zur Erschließung des neuartigen Themenfeldes werden die Ergebnisse dreier Einzeluntersuchungen berichtet, in welchen sowohl qualitative als auch quantitative Methoden angewandt werden. Mit Hilfe der Durchführung von Expertinneninterviews werden Bedarf und Potenzial innovativer Technik in Prävention und Gesundheitsförderung für Ältere und erste Anforderungen an eine solche Technik erfasst. Eine innovative Möglichkeit zur Umsetzung präventiver und gesundheitsförderlicher Interventionen bieten digitale Bewegungsspiele. So werden darauffolgend im Rahmen einer quasi-experimentellen Kohortenstudie gesundheitsbezogene Veränderungen durch das Spielen sog. Serious Games im Setting (teil-)stationäres Pflegewohnen evaluiert. Die Ergebnisse zeigen erste gesundheitsförderliche Tendenzen. Innerhalb einer Fokusgruppe werden abschließend drei digitale Bewegungsspielsysteme unter Beachtung zielgruppenspezifischer Bedarfe bewertet und notwendige Ressourcen für den erfolgreichen Einsatz im Anwendungskontext erarbeitet. Um die neugewonnenen Erkenntnisse in nachhaltiger Form nutzbar zu machen, werden diese in einem Anforderungskatalog für die erfolgreiche Implementierung eines digitalen Bewegungsspiels im Kontext der Pflege zusammengefasst. / Being healthy in old age and aging healthily is of great relevance at both the individual and societal level. Thus, the importance of prevention and health promotion even in an old age is growing - on the one hand, to maintain the autonomy, self-determination, social participation and quality of life of the elderly and, on the other hand, to be able to meet the health policy challenges caused by demographic change. Health in old age is not only highly vulnerable but also offers a multitude of resources and starting points for preventive and health-promoting interventions. Technical innovations offer a growing potential to support measures of this kind. In order to open up this new field of research, the results of three individual studies are reported, in which both qualitative and quantitative methods are applied. By conducting expert interviews, the need and potential of innovative technology in prevention and health promotion for the elderly as well as first requirements for such a technology are identified. Digital exercise games offer an innovative possibility for the implementation of preventive and health-promoting interventions. Subsequently, health-related changes caused by playing digital exercise games, so-called serious games, in the setting of nursing care are evaluated within the framework of a quasi-experimental cohort study. The results show first health-promoting tendencies through playing serious games. Last, three digital exercise game systems will be evaluated in a focus group on the basis of the needs of the target group. Additionally, the necessary resources for successful use of such systems in a real application context are developed in a participatory way. In order to make the newly gained knowledge usable in a way that is sustainable and relevant for practical use, it is then summarized in a catalogue of requirements for the successful implementation of a digital exercise game in the nursing environment.

El present treball aborda la promoció de la salut psicosocial des del paradigma de la resiliència i les aportacions de la logoteràpia de Viktor Frankl. El seu objectiu ha estat descriure i analitzar com es desenvolupa un procés resilient en l'àmbit laboral docent. Concretament, es descriu el procés de canvi experimentat per un institut d'educació secundària enfrontat a un context de dificultat i de quina manera ha estat capaç de renéixer i sortir-ne enfortit. Hem analitzat com s'activa el procés resilient, la naturalesa dels factors implicats, la relació que s'estableix entre aquests i com interactuen per aconseguir una adaptació positiva. Hem optat per una metodologia qualitativa mitjançant un mètode d'estudi de casos d'orientació etnogràfica.El treball aporta un model d'anàlisi del procés resilient que ha resultat útil per precisar el concepte de resiliència en l'àmbit laboral així com per integrar les dades recollides en el treball de camp. En les conclusions es discuteix el paper de la dimensió noètica o espiritual, la recerca del sentit i la vinculació positiva en l'activació del procés resilient. Igualment s'emfasitza la importància del lideratge i la interacció existent entre la resiliència personal i la organitzativa. També s'apunten possibles estratègies per potenciar, facilitar o estimular el procés resilient en una situació laboral. Finalment, s'examinen les repercussions de l'activació d'un procés resilient en la promoció de la salut laboral. / El presente trabajo aborda la promoción de la salud psicosocial desde el paradigma de la resiliencia y las aportaciones de la logoterapia de Víktor Frankl. Su objetivo ha sido describir y analizar cómo se desarrolla un proceso resiliente en el ámbito laboral docente. Concretamente, se describe el proceso de cambio experimentado por un instituto de educación secundaria enfrentado a un contexto de dificultad y de qué manera ha sido capaz de renacer y salir fortalecido. Hemos analizado cómo se activa el proceso resiliente, la naturaleza de los factores implicados, la relación que se establece entre éstos y cómo interactúan para lograr una adaptación positiva. Hemos optado por una metodología cualitativa mediante un método de estudio de casos de orientación etnográfica.El trabajo aporta un modelo de análisis del proceso resiliente que ha resultado útil para precisar el concepto de resiliencia en el ámbito laboral, así como para integrar la información recogida en el trabajo de campo. En las conclusiones se discute el papel de la dimensión noética o espiritual, la búsqueda del sentido y la vinculación positiva en la activación del proceso resiliente. Igualmente se enfatiza la importancia del liderazgo y la interacción existente entre la resiliencia personal y la organizativa. También se apuntan posibles estrategias para potenciar, facilitar o estimular el proceso resiliente en una situación laboral. Finalmente, se examinan las repercusiones de la activación de un proceso resiliente en la promoción de la salud laboral. / The present work tackles psychosocial health's promotion through resilience's paradigm and Viktor Frankl logotherapy's contributions. Its aim has been to describe and to analyze how a resilient process is developed in the educational labour environment. Concretely, it describes the change process experienced by a secondary school faced by a difficult context and in what way it has been able to be reborn and to leave strengthened. We have analyzed how the resilient process is activated, the nature of the implied factors, the relationship that is settled down among these and how they interact in order to achieve a positive adaptation. We have opted for a qualitative methodology by means of an ethnographic orientated case study method.The work contributes an analysis model of the resilient process that has been useful to specify the resilience concept in the labour environment, as well as to integrate the picked up information in the field work. In the conclusions it discusses the noethic or spiritual dimension, the search for meaning and the positive linking in the activation of the resilient process. It is equally emphasized the importance of leadership and the existing interaction between personal and organizational resilience. Possible strategies are also suggested for strengthening, facilitating or stimulating the resilient process in a labour situation. Finally, repercussions of resilient process activation are examined in the promotion of labour health. / In der hier vorliegenden Doktorarbeit geht es um die Förderung der psychosozialen Gesundheit, ausgehend von dem Resilienzparadigma und Viktor Frankls Logoteraphie. Ziel der Arbeit ist die Beschreibung und Analyse, wie sich ein Resililenzablauf im Lehrarbeitszusammenhang entwickelt. Im Konkreten wird der Wandelprozess beschrieben, den eine Realschule in einem Schwierigkeitszussammenhang erfährt und wie sie wiedergeboren und erstarkt aus dieser Situation hervorgehen könnte. Wir haben analysiert, wie der Resilienzablauf aktiviert wird, die Natur der betroffenen Faktoren, die zwischen ihnen begründete Beziehung, und wie sie interagieren, um eine positive Anpassung zu erreichen. Wir haben uns für eine qualitative Methodologie entschieden, mittels einer ethnographisch orientierten Fallstudie.Die Arbeit liefert ein Untersuchungsleitbild des Resilienzablaufs, das bei der Präzisierung des Resilienzbegriffs im Arbeitsbereich, sowie für die Integration der in der Vorortarbeit gesammelten Daten als nützlich erwiesen hat. In den Schlussfolgerungen wird über die Rolle der nicht-ethischen oder geistlichen Dimension, die Sinnsuche und die positive Verbindung in der Resilienzablaufsaktivierung diskutiert. Ebenfalls wird die Bedeutung der Führung und der vorhandene Interaktion zwischen die eigenen und der organisatorischen Resilienz betont. Ferner werden mögliche Strategien vorgestellt, um den Resilienzablauf in einer Arbeitssituation zu verstärken, zu ermöglichen oder zu motivieren. Schlie&#946;lich werden die Auswirkungen der Aktivierung eines Resilienzablaufs in der Förderung der Arbeitsgesundheit übergeprüft.