[Influencer Marketing in Healthcare: A Review]. / Influencer-Marketing im Gesundheitswesen: Eine Übersicht.

BACKGROUND: Social media influencers play an important role in the (digital) life of millions of Germans. In the health sector, these protagonists and their channels are used not only with commercial intentions, but also increasingly for the communication of health messages. We want to investigate if influencers can play an important role in promoting health. We summarize the current scientific evidence on the use of influencer marketing in health communication. METHODS: Selective literature search on PubMed with the search terms "Influencer marketing" and "health" and summary of the results. RESULTS: We identified 173 publications, from which four fulfilled the inclusion criteria. For the classification of health influencers, we propose 5 categories. CONCLUSION: So far, there is only weak evidence for health-promoting effects through the communication of influencers. Both in practice and in science, more knowledge about the health-promoting use of influencers needs to be gained.

[The AEIOU Model: Effective Health Behaviour Change in Practice Based on Behavioural Insights]. / Das AEIOU-Modell: Gesundheitsverhalten mit Erkenntnissen der Verhaltenswissenschaften effektiv in der Praxis steuern.

BACKGROUND: The use of Behavioural Insights (BI) is gaining increasing attention in the German health landscape. Abstract English-language models provide assistance in the application of BI. However, so far there is no model which (1) is specifically suitable for the health sector and (2) is based on the German language. In this context, the goal was to develop a comprehensive German-language BI model for the design of interventions that can change health behaviour. METHODS: The basis for the development were the two models MINDSPACE and EAST as well as the authors' own practical experiences. RESULTS: The developed AEIOU model consisted of five categories with a total of 20 instruments, the categories being (1) address (Ansprache), (2) simplicity (Einfachheit), (3) incentivisation (Incentivierung), (4) orientation (Orientierung), and (5) immediacy (Unmittelbarkeit). CONCLUSION: The AEIOU model forms the basis for the first German-language compilation of possible BI applications for the development of interventions in the health sector. The model has now to be tested in practice and examined for its usefulness.

What do Germans really think about health-nudges?

BACKGROUND: In recent years, policymakers have increasingly used behaviourally informed policies, including 'nudges'. They have been implemented to produce desirable social outcomes such as healthier eating and physical activity. In Germany, a small research team at the Federal Chancellery acts as the central unit to promote the introduction of nudges in the design of public life. Despite this, the nudging concept itself as well as the understanding around it has not spread widely among German citizens. When reporting about the concept, German media is often very critical of the concept. METHODS: Using a for age, sex and educational level nationally representative online survey with 1000 participants, we investigate whether German citizens know about the concept of nudging. We also explore if they approve of the theoretical concept as well as a list of seven specific interventions regarding healthy eating and physical activity. A particular focus is placed on whether the level of approval is dependent on the target group of the intervention, as well as different intervention-initiators. RESULTS: We find that nearly 80% of the respondents have never heard of nudging. However when being provided with a definition, we find that a strong majority (90%) supports the concept of nudging as well as all the specific interventions. Acceptance rates are higher if interventions are targeted at the general population compared to only children. All initiators - statutory health insurers, the government, private companies, and independent experts - are accepted as nudge initiators. CONCLUSION: Amongst Germans nudges are an accepted method to promote health behaviours. Policy makers from various fields in Germany should take that into account to improve future health policy.

[Public Health in Germany From The Perspective of Young Professionals]. / Öffentliche Gesundheit in Deutschland: Eine Perspektive des Nachwuchses.

The current reform process of Germany's public health system has opened a window of opportunity for strengthening this field in research, policy and practice in Germany. The present article discusses challenges and necessary measures from the perspective of young professionals. The authors argue that public health education and training in Germany needs to be strengthened and reformed. Moreover, Germany's public health community must create and strengthen structures and processes needed to make its voice heard more strongly in politics and society, including an effective professional organization. Discussions on these challenges have begun in a number of fora and should be translated into concrete actions soon.

[Disease Prevention and Health Promotion in Germany: A Qualitative Analysis of the Federal Goverment's Coalition Agreement]. / Prävention und Gesundheitsförderung im Koalitionsvertrag: Eine qualitative Analyse.

BACKGROUND: The creation of healthful living conditions has contributed to improving health and prolonging life in Germany and worldwide. Despite this progress, avoidable behavioural, occupational and environmental risk factors still contribute considerably to the burden of disease in Germany. Many of these risk factors are strongly influenced by political determinants. The coalition agreement outlining the agenda of Germany's federal government for 2018-2022 provides insights regarding relevant political priorities and plans. METHODS: We performed qualitative content analysis of the coalition agreement signed on March 12, 2018 by Germany's governing parties with regard to content related to disease prevention and health promotion. We present results in tables and narratively and discuss them against the background of evidence-based scientific recommendations and in the national and international political context. RESULTS: The coalition agreement discusses various measures to strengthen disease prevention in and health promotion in general, to support the prevention of specific disease groups, and to reduce the burden of a number of behavioural, occupational and environmental risk factors. This includes an evaluation and reform of Germany's Law for Health Promotion and Prevention, a strengthening of relevant research capacities, the development of a national obesity strategy, and measures to increase vaccination rates. DISCUSSION: The extensive discussion of health promotion and disease prevention in the coalition agreement is laudable. However, the agreements fail to mention a number of important approaches, such as the regulation of tobacco and alcohol marketing and food and beverage taxation. Moreover, many statements remain vague. Adoption and implementation of effective measures will therefore require the attention and political pressure from the scientific community, civil society, the media, and members of the parliament from both government and opposition parties. The mid-term evaluation of the coalition agreement will be an opportunity to critically examine the government's achievement to date.

[The Use of Nudging for Primary Prevention: A Review and Perspectives for Germany]. / Nudging in der Primärprävention: Eine Übersicht und Perspektiven für Deutschland.

Nudging as a means of influencing human behaviour has received increasing attention by policy makers, including those in the field of public health. Nudges are generally understood as specific aspects of a choice architecture that make certain behaviours more likely to occur without mandating them through binding rules, and without relying on economic incentives. Following the example of the United States and Great Britain, the German government has established a working group tasked with advising the federal government on the use of nudging and other behavioural interventions in policy making. The working group's inception in February 2015 inspired a lively public debate. While numerous opportunities for the use of nudging in primary prevention and health promotion in Germany exist, the concept has not yet been widely used in practice. We discuss the basic theoretical concepts of nudging, relating the underlying ideas to the terminology used in prevention and health promotion. In addition, we present typologies and practical examples for nudging interventions, and discuss criticisms raised in the academic and public debate. Finally, we discuss implications for research and policy, highlighting how nudging and related approaches can be used to strengthen primary prevention in Germany.

Electroconvulsive therapy in a patient after radiation treatment of a brain metastasis: a case report.

Major depression has a high incidence in patients with cancer, but treatment guidelines for this vulnerable population are missing and antidepressants seem to be less effective than in patients not affected by cancer. We report the case of a patient with bronchial cancer with a single temporo-occipital brain metastasis that had been treated by radiotherapy (whole-brain radiation, 40 Gy, followed by a stereotactic radiotherapy, 15 Gy). The patient developed a major depressive episode and was successfully treated with electroconvulsive therapy without relevant adverse events. This case further underscores the safety and effectiveness of electroconvulsive therapy after radiotherapy of the brain and demonstrates a viable alternative for severely depressed patients with cancer who do not adequately respond to psychotherapy or pharmacotherapy alone.