Holger Muehlan

Environmental health literacy (EHL) encompasses the skills and competencies to search for, understand, assess, and apply information and knowledge about the environment and its impact on human health. The development and availability of concept-based, psychometrically sound methods to measure EHL are crucial for advancing research and assessing the impact of public health programs in prevention. Guided by the PRISMA-COSMIN guidelines, a systematic search of three databases was conducted (MEDLINE, LIVIVO, PsycINFO). Information on the characteristics, operationalization of EHL, and psychometric criteria was extracted. According to COSMIN, the psychometric properties were evaluated. Of 1,872 records, nine studies were included. Eight different EHL measures were identified. The instruments target either general EHL (n = 4) or specific environmental issues (n = 4), such as air pollution, drinking water contaminants, and phthalate exposure. Some instruments reported sufficient structural validity (n = 4) and internal consistency (n = 2), while content validity remained indeterminate (n = 8). Information on responsiveness, measurement error, and intercultural validity could not be obtained. Based on the quality assessment, no general recommendation for use can be derived. Future studies should focus on validating existing instruments, while the development of new tools should more comprehensively address relevant environmental factors. We also recommend that previously underexplored dimensions of EHL, such as self-efficacy and collective agency, should be given greater consideration.

Introduction: Gestational diabetes mellitus (GDM) is the most common medical complication in pregnancy. Its onset puts a heavy strain on the positive connotation of pregnancy and is accompanied by feelings of fear, uncertainty, stress, a sense of losing control, a poorer perception of health and a reduced quality of life (QoL). QoL has a significant impact on the success of therapy because of its link to adherence and clinical outcomes. Therefore, its measurement has been suggested to be implemented as a clinical standard in GDM care. Since the Persian GDMQ-36 is the only GDM-specific questionnaire so far, the aim of our study was to develop a disease-specific QoL questionnaire in German. Methods: After translating the GDMQ36, we assessed the comprehensibility as well as face and content validity by an expert rating ( n = 20) and conducted two pre-tests, including cognitive debriefings and structured interviews with women suffering from GDM ( n = 30, n = 12). Results: The translated questionnaire had to be adapted and revised due to linguistic and cultural comprehension difficulties. Based on the findings of our qualitative studies, 33 questions about missing aspects were added, while most existing phrases needed to be modified or some even excluded. The preliminary version of the questionnaire contains 69 items within three domains (physical, psychological, social) and is subdivided into six facets (medical, treatment associated, emotional, behavioral, motivational, and social aspects). Conclusion: The questionnaire has the potential to provide a more comprehensive overview of women’s expectations, needs, impairments, and problems related to illness and treatment. It is planned, to prospectively test the newly developed GDM-QOL questionnaire to evaluate its psychometric performance in terms of validity and reliability.

Background: Healthcare satisfaction (HCS) is a crucial patient-reported outcome that is essential for evaluating medical care quality from the patient’s viewpoint and may also significantly impact other patient-reported outcome measures. However, currently validated German instruments lack a generic focus, which is essential for treating various diagnoses in pediatric surgery contexts. This study presents the translation and cultural adaptation of the PedsQL Healthcare Satisfaction Generic Module (HCSGM) for Germany. Methods: The PedsQL 3.0 HCSGM is a 24-item questionnaire assessing six dimensions: information, family inclusion, communication, technical skills, emotional needs, and overall satisfaction. After two independent forward translations and a back translation, a preliminary version was tested with caregivers of 10 patients who provided feedback using the thinking-aloud technique while completing the questionnaire. Interviews were analyzed using qualitative content analysis (QCA), leading to the final German version of the HCSGM. Results: The initial consensus meeting after the forward translations identified five areas for improvement. The backward translation was approved with no further changes. QCA revealed ten major and nine minor issues, which resulted in ten modifications to item wordings, question-wording, verbal anchors of answer options, and layout during a second consensus meeting. Those modifications resulted in the final version also being approved by the original authors. Conclusion: The German version of the PedsQL HCSGM is now available to measure HCS, a crucial PROM for clinical research and patient management. While qualitative methods have been employed to ensure equivalence, further studies should evaluate psychometric properties.

This contribution introduces the novel concept of Eco-Salute Infrastructure in the Built Environment (ESI) as a framework for urban planning that focuses on promoting environmental health and improving human well-being. The ESI framework expands on previous concepts that explore the relationship between human well-being and urban design with the aim to create healthier cities and enhance people’s quality of life. The paper presents existing evidence from research literature that supports the notion that ESI can foster human well-being in urban areas. Overall, implementing an ESI approach, which involves designing infrastructure and architecture that support active mobility and physical activity, creating appealing public spaces that encourage outdoor activities, and providing urban residents with increased access to high-quality, biodiverse green spaces holds significant potential for enhancing human health and well-being, in general, and in the face of additional threats caused by the climate crisis. Further research is needed to provide more evidence for the health effects of ESI and to uncover synergies between human and environmental health in regard to urban design.

This contribution introduces the novel concept of Eco-Salute Infrastructure in the Built Environment (ESI) as a framework for urban planning that focuses on promoting environmental health and improving human well-being. The ESI framework expands on previous concepts that explore the relationship between human well-being and urban design with the aim to create healthier cities and enhance people's quality of life. The paper presents existing evidence from research literature that supports the notion that ESI can foster human well-being in urban areas. Overall, implementing an ESI approach, which involves designing infrastructure and architecture that support active mobility and physical activity, creating appealing public spaces that encourage outdoor activities, and providing urban residents with increased access to high-quality, biodiverse green spaces, holds significant potential for enhancing human health and well-being in general and in the face of additional threats caused by the climate crisis. Further research is needed to provide more evidence for the health effects of ESI and to uncover synergies between human and environmental health in regards to urban design.

Background: Continuum beliefs of mental health and illness are robustly negatively correlated with mental illness stigma. However, there is a lack of multidimensional and validated measures, not entirely relying on vignettes. Methods: To develop such a scale, a pool of 37 items adapted from other studies on continuum beliefs, was initially examined in expert discussions and a convenience sample (N = 227, M _age=32 years, 80.6% female). Items were selected based on theoretical tenability and assigned to pre-defined facets of “State”, “Person”, and nosological “Concept” in relation to mental illness. In a second sample (N = 1375; M _age=42 years; 65.2% female), the Continuum Beliefs of Mental Illness Scale (CB-MIS) was psychometrically tested (i.e. factorial, convergent, discriminant validity). Results: The scale comprises three subscales with three items, and one optional vignette-based item each, rated on a 5-point Likert scale. It showed very good factorial and discriminant validity, associations with stigma were moderately negative. The scale exhibited good test-retest reliability over a period of six months. Conclusions: A validated, practical, multifaceted measure is offered to evaluate beliefs regarding the continuum of mental health and illness. Future studies should conduct subgroup-specific investigations regarding sociodemographic and illness variables, and could apply this measure to anti-stigma interventions. Trial registration: German Clinical Trials Register: DRKS00023557. Registered 11/12/2020. World Health Organization, Universal Trial Number: U1111–1264–9954. Registered 16/02/2021.