A whole-of-community approach to promote cardiovascular health: Healthy Communities in Moldova

Abstract   A low-income country, Moldova is facing a rapidly growing burden of non-communicable diseases with a cardiovascular disease mortality rate of 202.2 per 100'000. Scarce resources require urgent preventative actions and involvement of communities and patients in the definition and design of locally relevant health promoting activities. Our intervention is a holistic, whole-of-community approach to foster local leadership in health promotion for the prevention of cardiovascular risks. The Healthy Life project to reduce the burden of non communicable diseases, funded by the Swiss Agency for Development and Cooperation (SDC), operates since 2016 in rural communities of Moldova. We present a 5-step model towards initiating Healthy Communities in Moldova based on 5 complementary steps: 1. Raising awareness on cardiovascular risk factors through community education seminars tailored to audience needs 2. Building multisectoral community coalitions for health between local elected leaders and community representatives around local health data and locally defined health priorities 3. Fostering community leadership in defining local health solutions through health asset mapping exercises 4. Community-led small projects based on identified needs and assets to improve local cardiovascular health 5. Empowering chronic patients for healthy behavior change through community-based self-management workshops The Healthy Communities intervention was rolled out to 40 communities in 20 districts, reaching 1332 direct beneficiaries. Important learning emerged from social accountability mechanisms embedded in community coalitions which ensure regular, health-focused dialogue on community health. Using local assets to health problem solving is changing the perspective on the resourcefulness of community actors in health. Progress towards sustainability is achieved by local public authorities and community making a matching contribution to start-up funding to small projects. Key messages • Our Healthy Communities model proposes a strength-based vision of health promotion which empowers community coalitions to self-organize for the prevention of cardiovascular risk factors. • We promote bottom-up approaches that strengthen local health governance and community leadership into defining and addressing local health priorities.

The International Network of Health Promoting Hospitals and Health Services (HPH) was initiated by the World Health Organization as a settings approach toward reorienting health services.Over 600 members from 30 countries promote the integration of health promotion into the hospital/ health service setting.The International HPH Network developed the 2020 Standards for Health Promoting Hospitals and Health Services, representing years of experience and expertise reflected in 5 standards, 18 substandards, and 85 standard statements.Complementary self-assessment tools were developed to operationalize the standards and to identify concrete measurable elements against which each standard can be measured.The aim of the tools is to assist hospitals and health services in transforming the setting into a health promoting one.The standards are comprehensive and address topics to encourage the complete refocusing of an organization's strategy and to stimulate a process of continuous internal improvement.Standards address management, patient-centered care, occupational health, health literate organizations, environmental sustainability, and target groups such as the elderly and children and adolescents.Excel and pdf tools may be utilized by institutions to measure and track progress in implementing each of the standards.The tools state measurable elements for each standard that were identified by an expert panel of HPH members and external subject experts to be directly observable and applicable across various regional and institutional contexts.As part of internal and external assessment processes, standards can be rated on a scale from 1 (not implemented) to 10 (fully implemented).The tools store data and generate graphs that allow organizations to assess their level of performance, identify areas for improvement, and devise data-driven action plans.

Key messages:
Progress towards transforming the setting must be tracked and included in an organization's continuous internal improvement processes.
The transformation of the hospitals/health service setting into a health promoting environment results in better health outcomes for patients, families, the community, and the environment.

Background:
Little is known about the impact of alcohol marketing on people with, or at risk of, an alcohol problem.A rapid review of primary studies was conducted with the aim of exploring the effect of alcohol marketing in this population.

Methods:
People with, or at risk of an alcohol problem were defined as people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers.Searches for relevant literature were conducted through Medline, EMBASE and PsychINFO; reference list scanning and citation tracking of included studies; and grey literature searching of relevant websites.A narrative synthesis of included studies was undertaken.

Results:
The review included 11 studies, which focused on participants recovering from an alcohol use disorder (AUD, 6 studies) and those with hazardous or harmful consumption levels of alcohol (5 studies).7 studies were quantitative and 4 were qualitative.
The effect of alcohol advertising on alcohol use was only assessed in one small experimental study of young adult heavy 15th European Public Health Conference 2022 Infodemics happen when an excess of information makes it difficult for people to discern what they see and hear to make good health decisions.Several challenges limit the usefulness of applying infodemiology research to the practice of managing infodemics including inconsistency in how information exposure is measured and a lack of focus on assessing associations with health behaviors.
disease mortality rate of 202.2 per 100'000.Scarce resources require urgent preventative actions and involvement of communities and patients in the definition and design of locally relevant health promoting activities.Our intervention is a holistic, whole-of-community approach to foster local leadership in health promotion for the prevention of cardiovascular risks.The Healthy Life project to reduce the burden of non communicable diseases, funded by the Swiss Agency for Development and Cooperation (SDC), operates since 2016 in rural communities of Moldova.We present a 5step model towards initiating Healthy Communities in Moldova based on 5 complementary steps: 1. Raising awareness on cardiovascular risk factors through community education seminars tailored to audience needs 2. Building multisectoral community coalitions for health between local elected leaders and community representatives around local health data and locally defined health health.Using local assets to health problem solving is changing the perspective on the resourcefulness of community actors in health.Progress towards sustainability is achieved by local public authorities and community making a matching contribution to start-up funding to small projects.Key messages:Our Healthy Communities model proposes a strength-based vision of health promotion which empowers community coalitions to self-organize for the prevention of cardiovascular risk factors.Tina Purnat A Ishizumi 1 , AG Dunn 2 , T Purnat 1 , B Yau 1 , C Bertrand-Ferrandis 1 , B White 1 , S Briand 1 , T Nguyen 1 1 Epidemic & Pandemic Preparedness & Prevention, WHO, Geneva, Switzerland