9.N. Workshop: It Takes Two To Improve European Child Health (Care)

Abstract   Many societal developments have an impact on health care in general and on child health care, in particular. Internationally challenges include an aging population, more cultural diversity and a rising prevalence of chronic diseases among children and adolescents, revealing potential risks for child health care. A strong focus must be placed on prevention strategies that are effective, sustainable and equitable. Planning and implementing prevention strategies may require shifts in the organization of care, such as the forging and strengthening of interdisciplinary and intersectoral partnerships within a country. A promising example of such partnerships is the collaboration of public health with paediatrics. Both professional groups acknowledge the call for greater integration since prevention strategies can only be achieved and sustained by working together. The objectives of this workshop are to: • Provide a selective overview of three partnerships and plans for cooperation between public health and paediatrics. • To exchange experiences and possibilities with the audience to pave the way for further successful partnerships. In this workshop, we outline the partnership and plans for cooperation between public health and paediatrics in three European countries: Netherlands, Finland and Switzerland. In the first presentation, Danielle Jansen and Károly Illy will share the new vision towards the year 2030 of the Dutch Paediatric Society in which building blocks are presented to guarantee accessible, high-quality, timely and effective care for every child. One of the building blocks to be highlighted is the interprofessional collaboration between paediatricians and public health professionals. In the second presentation, Julia Dratva and Susanne Stronski from Switzerland will present a shared paediatric and public health vision of a digital child health booklet. The digital booklet will empower parents and adolescents, provide access to personal health irrespective of place or time, improve sharing health information among care professionals, thus ensuring continuity of care and limiting redundancy of investigations and in addition, and provide data for public health research and monitoring. Challenges and solutions will be shared with the audience. In the third presentation, Silja Kosola from Finland will present a Finnish vision for school health care where professionals trained in public health and medicine collaborate with each other as well as with teachers for the benefit of children and adolescents. This multidisciplinary collaboration across governing bodies is especially important as Finland undergoes a national reform of social and health care services. After the three presentations, we engage the audience by asking for their experiences and sharing the examples of collaborations between public health and paediatrics, as well as barriers and facilitators. At the end of the workshop, we would like to summarize the results of the workshop in an overview of preliminary best practices. Key messages • Global climatic, societal and politic developments reveal potential risks for child health cand health care, which must be countered effectively, sustainably and equitably. • Greater integration of prevention across sectors is elemental and can be achieved through interprofessional partnerships.


Background:
Vaccination is the most effective intervention to prevent influenza. Adults at risk of complications are among the targets of annual vaccination campaigns and can receive different types of quadrivalent influenza vaccines (QIV). To assess the immunogenicity of different QIVs we performed a systematic review of available randomized controlled trials (RCTs) with the aim of indirectly compare them through a network metaanalysis.

Methods:
The systematic review was conducted in accordance with PRISMA-NMA guidelines. We systematically searched RCTs conducted in adults aged 18-64 years that assessed the immunogenicity, namely seroprotection and seroconversion rate (SPR and SCR), of any QIV compared to any comparator. The literature search was performed on three databases (Medline, Cochrane Library and Scopus) until March 30th, 2021.

Results:
Twenty-four RCTs were included in the systematic review. A network meta-analysis was not possible: the assumption of transitivity was not satisfied. Therefore, we decided to combine data on immunogenicity and efficacy of each QIV through single meta-analyses in the presence of at least two studies. Live attenuated QIV showed the worst results in terms of both SCR and SPR. Standard dose egg based, low dose adjuvanted, cell based, recombinant and intradermal QIV showed similar SCR in respect to influenza strain A, whereas low dose adjuvanted QIV showed an overall better profile in respect to B lineages. Regarding SCR, the better results were issued by standard egg based, cell based, recombinant, and low dose adjuvanted QIVs.

Conclusions:
Albeit an indirect comparison among different QIVs was not possible, the assessment of SCR and SPR provided an overview of their respective potentiality and criticality in adulthood. In particular attention should be paid to new generation influenza vaccines that can have an antigen sparing effect and to the collection of real world data to make comparison among different QIVs possible.

Key messages:
Available evidence does not allow to perform indirect comparison of the quadrivalent influenza vaccines for adults. Some QIVs, including new generation ones, elicit a better antibody response. Many societal developments have an impact on health care in general and on child health care, in particular. Internationally challenges include an aging population, more cultural diversity and a rising prevalence of chronic diseases among children and adolescents, revealing potential risks for child health care. A strong focus must be placed on prevention strategies that are effective, sustainable and equitable. Planning and implementing prevention strategies may require shifts in the organization of care, such as the forging and strengthening of interdisciplinary and intersectoral partnerships within a country. A promising example of such partnerships is the collaboration of public health with paediatrics. Both professional groups acknowledge the call for greater integration since prevention strategies can only be achieved and sustained by working together. The objectives of this workshop are to: Provide a selective overview of three partnerships and plans for cooperation between public health and paediatrics.
To exchange experiences and possibilities with the audience to pave the way for further successful partnerships. In this workshop, we outline the partnership and plans for cooperation between public health and paediatrics in three European countries: Netherlands, Finland and Switzerland. In the first presentation, Danielle Jansen and Károly Illy will share the new vision towards the year 2030 of the Dutch Paediatric Society in which building blocks are presented to guarantee accessible, high-quality, timely and effective care for every child. One of the building blocks to be highlighted is the interprofessional collaboration between paediatricians and public health professionals. In the second presentation, Julia Dratva and Susanne Stronski from Switzerland will present a shared paediatric and public health vision of a digital child health booklet. The digital booklet will empower parents and adolescents, provide access to personal health irrespective of place or time, improve sharing health information among care professionals, thus ensuring continuity of care and limiting redundancy of investigations and in addition, and provide data for public health research and monitoring. Challenges and solutions will be shared with the audience. In the third presentation, Silja Kosola from Finland will present a Finnish vision for school health care where professionals trained in public health and medicine collaborate with each other as well as with teachers for the benefit of children and adolescents. This multidisciplinary collaboration across governing bodies is especially important as Finland undergoes a national reform of social and health care services. After the three presentations, we engage the audience by asking for their experiences and sharing the examples of collaborations between public health and paediatrics, as well as barriers and facilitators. At the end of the workshop, we would like to summarize the results of the workshop in an overview of preliminary best practices. Key messages: Global climatic, societal and politic developments reveal potential risks for child health cand health care, which must be countered effectively, sustainably and equitably. Greater integration of prevention across sectors is elemental and can be achieved through interprofessional partnerships. There are many societal developments in The Netherlands that have or will have an impact on Dutch paediatric care. These developments both reveal potential risks in paediatric care and require future improvement of paediatric practices to achieve the best possible outcomes for Dutch children. To realise this, the Dutch Paediatric Society decided in their renewed vision to have a closer focus on prevention and on building partnership with public health, by implementing a building block 'Interprofessional Collaboration between Paediatricians and Other Health Care Providers'. This building block formulates the wish of the Dutch Paediatric Society to work together in networks with other domains of care, such as public health.
Preferably, it will be a flexible network in which the disciplines involved align the needs of the specific child. In order to develop and participate in such a network, pediatricians and public health professionals actively have to invest in connecting, establishing, and further developing professional networks (including patient societies). A first precondition for the development and successful functioning of such a network is the implementation and use of a joint electronic medical record in which all diagnostics, treatment plans and positive health aspects of the child are collected, and which is accessible to all professionals involved. A patient record which guarantees a barrier-free exchange of medical and non-medical information between paediatricians and public health professionals within the framework of the current privacy legislation. A second precondition regards an improvement of the paediatric training curriculum in which the paediatrician of the future will gain knowledge of positive health and integrative medicine. The future paediatrician must be trained to function in networks and to make connections. In this presentation we present an update of the implementation of this building block: what is already realised and how. Public health, paediatrics as well as other health professionals share the interest in providing services and improving conditions to ensure life-long health and well-being of children and adolescents. In this interprofessional setting and aim, parents are central partners, as are adolescents when they take over the responsibility of their own health. Ensuring the availability of health data for parents and adolescents at any given time and place is a key factor to empower and improve health management and literacy, providing continuity of health information along the care chain, and analysing health data of healthy and sick children is of high importance. The digital booklet will have a positive impact on sharing of health information among care professionals, thus ensuring continuity of care and limiting redundancy of investigation, and in addition provide data for public health research and monitoring of health and determinants. The Swiss Society of Paediatrics, the ZHAW/Institute of Public Health and the Kollegium of Hausarztmedizin (general practices) founded an association to digitalize the current paper child and adolescent health booklet with the aims: 1. Empower parents as 'owners' of health data to take responsibility and have greater autonomy in managing their child's health and illness 2. Provide a digital infrastructure for -low-threshold and reliable source of advice -easy update of data/information, digital communication with parents -sharing of data with professionals and non-professionals involved in care of child. 3. Monitoring of children's health data (parental consent provided) The speakers with present their collaboration and project, its current status, as well challenges and solutions found.

Abstract citation ID: ckac129.603
This abstract has been withdrawn.
15th European Public Health Conference 2022