Bedarfsanalyse für Maßnahmen der Gesundheitsförderung und Prävention im Landkreis Marburg-Biedenkopf bei Erwachsenen und Senioren/Seniorinnen – Bedarf aus der Perspektive relevanter Akteure

In Zeiten des demographischen Wandels und des Vorherrschens von chronischen nicht übertragbaren Erkrankungen in den Industrieländern rücken Prävention und Gesundheitsförderung als Lösungsansätze zur Steigerung des Wohlbefindens der Bevölkerung zunehmend in den Fokus. Während auf internationaler und...

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Bibliographic Details
Main Author: Schwarze, Kerrin
Contributors: Geraedts, Max (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Language:German
Published: Philipps-Universität Marburg 2022
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In times of demographic change and the prevalence of chronic non-communicable diseases in industrialized countries, prevention and health promotion are increasingly coming into focus as solutions for increasing the well-being of the population. While the focus is on developing strategies at the international and national level, projects are often implemented at the local level. The basis for measures is, among other things, the identification of the need for action within the framework of needs analyses. The aim of this dissertation is to obtain an overview of the current situation in the district of Marburg-Biedenkopf with regard to health promotion and prevention with a focus on adults and seniors with the help of a needs analysis within the framework of the project "Promoting Health - Strengthening Care". Subsequently, the results are to contribute to the planning and implementation of health promotion and prevention measures on site according to needs and target groups.A mixed-methods approach was chosen. Quantitative analyses were carried out in the form of a small area estimation, in which prevalences of risk factors and diseases were modeled on the basis of publicly available data, taking into account the locally different population structures. For the variables depression, cancer, obesity, diabetes, back pain, cardiovascular diseases, polypharmacy and multimorbidity, as well as need for care and hospitalization, the distribution of health-related characteristics in the individual municipalities and cities of the county was estimated broken down by age group. Expert interviews were conducted as a qualitative method of analysis. For this purpose, semi-structured guided interviews were conducted in 19 municipalities of the district and 4 districts of Marburg with a total of 70 local actors from various fields to record prevention-related structures, problems and needs. A distinction was made between four age groups and special attention was paid to vulnerable groups in terms of health (e.g. single parents and refugees). The tape-recorded interviews were summarized along thematic complexes, commonalities and differences between municipalities were highlighted and best practice examples were identified. In the Small Area Estimation, the district of Marburg-Biedenkopf presented itself as a typical rural region of Germany. For the diseases studied, only minor inter-municipal differences emerged for the age groups 'adults' and 'seniors/senior citizens'. In the interviews, classic public health topics were frequently named, on the basis of which a need for health promotion and prevention measures can be derived (e.g. lack of exercise, excessive demands on adults, declining involvement in associations/voluntary work, loneliness in old age). Local differences in dealing with the topic area of prevention and health promotion became clear, although overall a great need for prevention and health promotion measures emerged. In some cases, concrete approaches for action were formulated. The importance of settings and inter-community and inter-generational cooperation to meet the needs was often emphasized and some best practices were named. It was difficult to derive locally adaptable strategies from the Small Area Estimation. Regional differences likely came from socioeconomic differences within the county. Thus, measures could be particularly useful in areas of pronounced socioeconomic deprivation, such as neighborhood-based and low-threshold services. The dissemination of knowledge and best practices as well as the networking of actors/stakeholders could be important switches for improving preventive and health-promoting care for adults and seniors/senior citizens in the county. However, some problems cannot be tackled locally but require action at the (inter)national level. Because of the differing approaches, comparisons of the two methods of analysis were limited. The SAE mapped some diseases and risk factors that were not mentioned in the interviews. A limitation of the interviews is that differences between communities may not have been adequately captured, as the selection of interviewees varied widely locally and individual population groups (e.g., vulnerable groups) were poorly represented. For its part, the SAE, as an estimation model, cannot be equated with quantitative data. Overall, the needs assessment is suitable as a starting point for setting-based interventions because it engages actors/stakeholders, reveals local differences and approaches, and identifies regional role models in the form of best practices. The findings of the needs assessment can provide information for practitioners and stakeholders in the district as well as for other researchers and stakeholders in the field of prevention and health promotion and serve as a starting point for future research.