[Child health in the COVID-19 pandemic: results from school entry data and a parent survey in the Hanover region]. / Kindergesundheit in der COVID-19-Pandemie: Ergebnisse aus den Schuleingangsuntersuchungen und einer Elternbefragung in der Region Hannover.

INTRODUCTION: With its social contact restrictions, the COVID-19 pandemic can be very burdensome for children and adolescents. The regularly conducted school entry examination in Germany delivers data on the development and health of pre-school children and can deliver indications on the impacts of the pandemic. METHODS: Based on school entry data for the Hannover region, it will be examined if there are more children with noticeable development and health impairment after the first lockdown in 2020 compared to before the COVID-19 pandemic. The prevalence of the results of the 2017/18-2020/21 school entry cohorts are compared. A survey of parents presents information of the everyday life and wellbeing of children and their families during the pandemic. RESULTS: After the first lockdown phase, the data shows a significant increase of noticeable language problems and an increase of children with a need for language support and with inadequate or no German language knowledge in comparison to the years before. Further, an increase of overweight or obesity as well as an increase in noticeable fine motor skill abnormalities and media consumption problems could be observed. The survey shows that the share of children who are more often sad increased to 32.1%, and the share of children who have more frequent rage attacks increased to 24.9%. Children more frequently have problems falling asleep and staying asleep or have stomachaches, headaches, sickness, or loss of appetite. DISCUSSION: These results are in line with other current studies and provide evidence of the possible effects of the COVID-19 pandemic on children's health. However further studies are necessary in order to deliver statistically firm results.

[Factors Associated with Behavioral Problems in Pre-School Age: Secondary Data Analysis of Routine Examination at School Enrolment 2010/2014 in the Hannover Region]. / Welche Faktoren sind mit Verhaltensauffälligkeiten im Vorschulalter assoziiert? Eine Sekundärdatenanalyse der Schuleingangsuntersuchungen von 2010 bis 2014 in der Region Hannover.

BACKGROUND AND AIM: Mental health and the prevalence of behavioral problems in children and adolescents has been gaining increasing concern in the last years. Several studies have addressed this issue in Germany. The aim of the study presented here is to examine factors associated with behavioral problems in pre-school children with focus on untreated morbidity. METHODS: Data from the routine examination at school enrolment from 2010/11 to 2014/15 (n=40,675) in the Hannover region were analyzed. Behavioral problems and socio-emotional competences were assessed by the Strengths and Difficulties Questionnaire (SDQ) for parents and by doctors' observations during examination. Children who had already been treated for behavioral problems at the time of school enrolment were excluded from the study. Using multivariable logistic regression analyses, associations between behavioral problems and sociodemographic factors, duration of kindergarten attendance, family status and gestational age were assessed. RESULTS: Education level of the parents, calculated from both parents' highest school and professional education level, is the strongest predictor for assessing behavioral problems of children at the time of school enrolment examination (OR 2.5; 95%-CI 2.3-2.7). Further factors are male sex (OR 1.5; 95%-CI 1.4-1.6), no kindergarten attendance (OR 1.3; 95%-CI 1.02-1.6) or kindergarten attendance of only one year (OR 1.4; 95%-CI 1.2-1.6), children living without their biological parents (OR 1.7; 95%-CI 1.2-2.4), preterm births (OR 1.5; 95%-CI 1.2-1.8) and age of 5 ½ years and younger (OR 1.4; 95%-CI 1.3-1.6) at the time of examination. CONCLUSION: The results point to the importance of early development support for children from socially disadvantaged families. The results highlight public health-relevant points and enable the region Hannover to improve preventive efforts targeting such pre-school children.

Interventions for increasing uptake in screening programmes.

INTRODUCTION: Opportunities for the early detection of disease are not sufficiently being taken advantage of. Specific interventions could increase the uptake of prevention programmes. A comprehensive analysis of effectiveness and cost-effectiveness of these interventions with reference to Germany is still needed. OBJECTIVES: This report aimed to describe and assess interventions to increase uptake in primary and secondary prevention and to explore the assessment of their cost-effectiveness. METHODS: 29 scientific databases were systematically searched in a wide strategy. Additional references were located from bibliographies. All published systematic reviews and primary studies were assessed for inclusion without language restrictions. Teams of two reviewers identified the literature, extracted data and assessed the quality of the publications independently. RESULTS: Four HTA reports and 22 systematic reviews were identified for the medical evaluation covering a variety of interventions. The economic evaluation was based on two HTA-reports, one meta-analysis and 15 studies. The evidence was consistent for the effectiveness of invitations and reminders aimed at users, and for prompts aimed at health care professionals. These interventions were the most commonly analysed. (Financial) Incentives for users and professionals were identified in a small number of studies. Limited evidence was available for cost-effectiveness showing incremental costs for follow-up reminders and invitations by telephone. Evidence for ethical, social and legal aspects pointed to needs in vulnerable populations. DISCUSSION: The material was heterogeneous regarding interventions used, study populations and settings. The majority of references originated from the United States and focused on secondary prevention. Approaching all target groups by invitations and reminders was recommended to increase uptake in prevention programmes in general. CONCLUSIONS: Further research should aim to focus on primary prevention. Future research should also focus on specific interventions aiming to include vulnerable target groups and individuals, who have not previously made use of opportunities for prevention.