Analyse des Bedarfs an Maßnahmen der Gesundheitsförderung und Prävention bei Kindern und Jugendlichen im Landkreis Marburg-Biedenkopf
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Philipps-Universität Marburg
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Abstract
Background
Since the enactment of the German Prevention Act (Präventionsgesetz; PrävG) in 2015, resources for setting-based health promotion and prevention in Germany have significantly increased. Special attention has been directed towards interventions in childhood and adolescence, as they have the potential to influence lifelong health trajectories and combat health inequality. The effectiveness of such interventions can be enhanced through participative, locally-oriented planning, which is why the Prevention Act and its associated federal guidelines mandate local community health needs assessments. Against this background, the district of Marburg-Biedenkopf commissioned a needs assesment, which is the subject of this paper.
Research Questions
This study examines the health promotion and prevention needs of children and adolescents in the Marburg-Biedenkopf district, considering local issues and resources, focusing on the following main question and related research questions:
What is the structure of health promotion and prevention needs for children and adolescents in the Marburg-Biedenkopf district?
1. Are there differences in the health status of municipal populations that suggest locally differentiated needs?
2. Where do stakeholders identify areas of need?
3. How are the needs of Vulnerable Groups (people with migration background as well as impoverished and disabled people) represented?
4. Are the results suitable as a basis for evidence-based intervention planning?
Methods
The study employed a mixed-methods approach that combined quantitative and qualitative methods:
1. Small Area Estimation (SAE): Expected prevalence rates of health characteristics were calculated using publicly available data. Known epidemiological associations were adjusted for local population structures (sex, age, income). Results were disaggregated by municipalities and graphically represented.
2. Expert Interviews: Local stakeholders in the 22 municipalities were identified, and semi-structured interviews were conducted to assess local prevention-related structures, issues, and needs. The interviews addressed specific age groups and health-Vulnerable populations (migration background, poverty, disability). Results were condensed into categories, highlighting commonalities and differences between municipalities, as well as naming Good Practices.
Results
The results of the SAE revealed significant health disparities, primarily between the most socioeconomically disadvantaged and advantaged municipalities.
In 23 interviews (two municipalities did not respond, but four neighborhood interviews were conducted in Marburg), 70 stakeholders identified structures, problems, and local needs related to crucial settings (childcare facilities, youth work, associations, municipalities) and specific health factors (physical activity, nutrition, mental health). Findings indicated setting-based regional disparities between rural and urban areas. For instance, youth work in urban areas was highly professionalized but struggled to meet the persistent high demand. In contrast, professionalized youth work was scarce in rural areas, leading to a need to establish such structures. Good Practices were named and included initiatives like a professionalized program that supports self-managed youth spaces. With regard to specific health factors, stakeholders emphasized a broad demand for increased physical activity opportunities, including the restoration of recreational sports facilities. Concerns were raised about inadequate kindergarten-based nutrition, while school-based nutrition was not discussed. A wide variety of needs regarding mental health were documented. These included furthering sexual health and addiction prevention, while the other-wise often discussed topic of bullying was not discussed. Limited information was gathered on schools and the needs of individuals with disabilities. In rural areas this applied as well to indivi-duals from migrant backgrounds and those living in poverty. However, the statements made indicated a comprehensive need for intervention.
Discussion & Conclusion
The SAE revealed health inequalities on municipality-level which can inform plannings for intervention prioritizations. The interview-based findings related to settings and health factors provide diverse starting points for local intervention planning. However, the significance of the study is limited in some population groups and settings due to low information density, stemming from the composition of the interviewee group. Possible biases may influence the reliability of the good practice nominations. Additional local investigations for needs assessment were recom-mended. From the limitations, methodological improvements were derived, contributing to the methodological advancement of local community health needs assessments.
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Dates
Created: 2024Issued: 2025-01-08Updated: 2025-01-08
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
marburghealth promotiongraefegräfepreventioncommunity healthcommunity health needs assesmentchildrenneeds assesmentcommunitygeraedtsyouthbiedenkopf
DFG-subjects
BedarfsermittlungBiedenkopfPräventionsgesetzGraefeGräfeKinderBedarfsanalyseLandkreisMarburgGeraedtsMarburg-BiedenkopfJugend
DDC-Numbers
610
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von Graefe, Gabriel: Analyse des Bedarfs an Maßnahmen der Gesundheitsförderung und Prävention bei Kindern und Jugendlichen im Landkreis Marburg-Biedenkopf. : Philipps-Universität Marburg 2025-01-08. DOI: https://doi.org/10.17192/z2024.0395.