The Health and Quality of Life Development Plan as a policy advisory tool for municipalities

Abstract Issue In 2019, the Portuguese government established the autonomy of local authorities and the decentralisation of public administration. Consequently, a process that includes the transfer of health competencies from the central government to the municipalities began. The newly acquired competencies enable local governments to play a crucial role in defining health policies and strategic partnerships with special focus on disease prevention, promotion of healthy lifestyles and active ageing. That said, several municipalities established a collaboration protocol with the National School of Public Health (NSPH) for the development of the Health and Quality of Life Development Plan (HQLDP) as a contribution to their strategic planning. Results NSPH has developed a solidified methodology for municipalities to substantiate their health planning and priorities, based on a deep health diagnosis, from existing demographic, economical, health and environmental data in a given timeline. HQLDP is a medium-term reference that will support strategic action in the area of health and social determinants. The general objective of the HQLDP is to contribute to the improvement of the health status, in the different stages of the life cycle, based on the evaluation of the health profile and social determinants and to define a set of strategic objectives that promote the reduction of inequalities, the promotion and protection of health and the prevention of disease. The developed plan also includes public and stakeholders’ scrutiny, to define key areas of action in the health sector. Lessons The HQLDP takes into account the vocation of local authorities to act on determinants through policies that intervene in the environmental, socio-economic, educational, urban planning and mobility contexts; assuming an active, influential and local role in health policies. Municipal intervention requires a strong and concerted local action and the definition of territorialized development strategies. Key messages • HQLDP has a crucial role on the situational diagnosis and set of priorities of the quality of life and health indicators to assess the priorities at council level. • HQLDP provides the knowledge for the development of public policies and interventions that comply with the population characteristics by reducing health inequalities and inequities.


Background:
Late diagnosis of HIV remains a challenge and the construction workforce has several risk factors for HIV.In the Test@Work programme, we delivered HIV tests embedded within a general health check to construction workers, with high uptake and acceptability.Here, we report the experiences of construction managers and health professionals involved in Test@Work and explore the suitability of construction worksites as a venue for opt-in HIV testing.Methods: Qualitative interviews (n = 24) were conducted with construction managers who facilitated events (n = 13), and HIV/ health check delivery partners (n = 11) at 21 Test@Work events held on construction sites.Interviews explored experiences of events and views towards workplace HIV testing.Event exit questionnaires (n = 107) completed by delivery partners provided qualitative data identifying facilitators and barriers to effective delivery.Thematic analysis identified themes that were mapped against a socioecological framework (individual, interpersonal, organisational, industry, public health).

Results:
Delivery partners reported high engagement of construction workers with workplace HIV testing, peer-to-peer encouragement for uptake, and value for accessibility of onsite testing.HIV professionals valued the opportunity to reach an untested population, many of whom had a poor understanding of their exposure to HIV risk.Managers valued the opportunity to offer workplace health checks to employees but some identified challenges with event planning, or provision of private facilities.

Conclusions:
The construction sector is complex with a largely male workforce.Providing worksite HIV testing and education to

Issue:
In 2019, the Portuguese government established the autonomy of local authorities and the decentralisation of public administration.Consequently, a process that includes the transfer of health competencies from the central government to the municipalities began.The newly acquired competencies enable local governments to play a crucial role in defining health policies and strategic partnerships with special focus on disease prevention, promotion of healthy lifestyles and active ageing.That said, several municipalities established a collaboration protocol with the National School of Public Health (NSPH) for the development of the Health and Quality of Life Development Plan (HQLDP) as a contribution to their strategic planning.

Results:
NSPH has developed a solidified methodology for municipalities to substantiate their health planning and priorities, based on a deep health diagnosis, from existing demographic, economical, health and environmental data in a given timeline.HQLDP is a medium-term reference that will support strategic action in the area of health and social determinants.The general objective of the HQLDP is to contribute to the improvement of the health status, in the different stages of the life cycle, based on the evaluation of the health profile and social determinants and to define a set of strategic objectives that promote the reduction of inequalities, the promotion and protection of health and the prevention of disease.The developed plan also includes public and stakeholders' scrutiny, to define key areas of action in the health sector.

Lessons:
The HQLDP takes into account the vocation of local authorities to act on determinants through policies that intervene in the environmental, socio-economic, educational, urban planning and mobility contexts; assuming an active, influential and local role in health policies.Municipal intervention requires a strong and concerted local action and the definition of territorialized development strategies.

Key messages:
HQLDP has a crucial role on the situational diagnosis and set of priorities of the quality of life and health indicators to assess the priorities at council level.

Background:
Despite having a high healthcare need, persons with complex conditions are less likely to receive comprehensive care.Individuals with SCI experience difficulties accessing services 2-4 times more than the general population.There is little agreement concerning the factors that influence these access restrictions.Few studies focus on health system impact on characteristics on access.
2. By June 2022, we will have the results of the second analysis: the association of system characteristics with access and how it is modified by socio-demographic and medical factors.

Expected conclusions:
The study identifies factors a country could modify in order to improve access and strengthen the system for persons with

Issue:
Addressing and reducing health inequalities is a major challenge in public health.Actively involving the most vulnerable populations groups in research projects in order to assess and address their needs is an important step towards reducing health inequalities.However, the most vulnerable groups are often perceived as the most difficult to reach for researchers.

Description:
We conducted a research project to assess and address the health effects of the COVID-19 pandemic in vulnerable population groups.In three neighbourhoods, we identified the 2-3 most vulnerable population groups.We aimed to interview at least 20 participants per neighbourhood, evenly distributed among the groups, using creative and adaptive recruitment methods.

Results:
Successful strategies differed per group.Strategies that proved successful were: rewriting information and consent letters together with the target population to help make them more accessible and attractive; using simple language in texts and while interviewing; asking the target population what type of compensation for the interview they would find most attractive; identifying persons who function as social hubs in the neighbourhood, asking them to help recruit participants, and providing them with financial compensation for their time; asking professionals in care and welfare organisations to help recruit among their clients; interviewing people in the places they would normally go to; snowball sampling.We met our recruitment goals.

Lessons:
When working with 'hard to reach' populations, it takes researchers time, flexibility and creativity to find the right strategy to recruit participants while still respecting the boundaries set by GDPR and ethics committees.We recommend researchers to think about various possible recruitment strategies before starting a project, and to be prepared to change strategies during a project if necessary.Key messages: 'Hard to reach' populations are not really hard to reach, they just require a different mindset and skillset from the researcher.
We encourage researchers to be creative and flexible in finding the right recruitment strategies in their project, and to think about various possible strategies before starting a project.
15th European Public Health Conference 2022