Strengthening Health Literacy of Vulnerable Groups-Introduction of Two New Modules Within the Communal Health Guides Intercultural in Frankfurt am Main Project.

Health literacy is limited among most of the German population. Among vulnerable groups, including people with a migration history, it is necessary to provide support. Thus, the public health department of the city of Frankfurt am Main initiated a project called communal health guides intercultural [Kommunale Gesundheitslotsen interkulturell] where health guides are trained to strengthen the health literacy of people with a migration background as well as of people with poor socioeconomic living conditions. Health guides are trained on specific health topics to pass on their knowledge as multipliers in different target groups. We are introducing two new modules complementing the existing health guide project from conceptualization to evaluation. The first module aims to strengthen health literacy among parents of children younger than age 10 years and the second module addresses inhabitants of community accommodations and aims to improve health communication and information, currently focusing on coronavirus disease 2019 and vaccinations. Another aim of the two modules is to find out the specific information needs of the target populations. The newly added modules aim to reduce health inequities for all citizens of Frankfurt am Main. [HLRP: Health Literacy Research and Practice. 2022;6(3):e239-e246.] Plain Language Summary: Health literacy is often limited among the German population. Especially for socially disadvantaged groups, the public health department of the city of Frankfurt am Main would like to provide support. A project called Communal Health Guides Intercultural was initiated. Health leaders are trained to strengthen the health literacy of people who are socially disadvantaged. This project consists of two modules. One module is aimed at parents of children younger than age 10 years; the other module is aimed at residents in community accommodation. The project aims to reduce health inequities.

[School Entrance Examination for Lateral Entrants - What Can and What Should They be Able to Do? A Discussion Contribution Based on the Data from the Health Authority Frankfurt am Main 2006-2016]. / Schuleingangsuntersuchung bei Seiteneinsteigenden ­ was kann, was soll sie leisten? Ein Diskussionsbeitrag auf Grundlage der Daten aus dem Gesundheitsamt Frankfurt am Main 2006­2016.

QUESTION: The medical investigation of school beginners is one of the essential tasks of the child and youth services of the health authorities. While in all federal states in Germany, the examination of all school beginners is legally clearly stipulated, the situation for "lateral entry", that is, children of school age, who are moving from a foreign country to a local German community and attending school there, is not clearly regulated in the respective school laws. This article presents the experiences of the lateral entry investigations in Frankfurt am Main. METHOD: All children of school age who moved to Frankfurt from abroad undergo a health check. This encompasses a standardized questionnaire-based history with the help of interpreters, including a review of the available vaccination document (case history sheets are available in different languages), an eye examination, hearing test and a physical examination. Children over the age of 15 who came from countries with a high prevalence for tuberculosis had chest x-ray. RESULTS: Between 2006 and June 2016, a total of 8245 children and adolescents were examined, in 4% of the children abnormalities in hearing, and in 22% in visual screening showed noticeable problems, with an increasing trend in recent years. The vaccination status was unknown in two-thirds of the children, one quarter of the children were sufficiently vaccinated against tetanus, diphtheria, polio and pertussis, and 19.5% were immunized against measles (vaccine or disease). Diseases of the respiratory tract, the heart and the circulation were predominant with a total of 4%, followed by musculoskeletal disorders with 3%. Lice infestation was found in 1.7% of children. In 0,7% of 2171 children with chest-X-rays, a conspicuous pulmonary lesion was diagnosed, but no tuberculosis. CONCLUSION: The focus of the lateral entrance examination is a school-related health status. On the basis of experience gained in Frankfurt am Main, it should be pointed out that investigations by the lateral entrants from other countries seem necessary, in particular visual and hearing screening, physical examination and checking the vaccination status, possibly in combination with vaccination. On the other hand, a detailed developmental screening does not appear to be urgent in the case of pupils who will be starting compulsory school, in whom there is no chance for additional encouragement before the start of school.

Mortality during heatwaves 2003-2015 in Frankfurt-Main - the 2003 heatwave and its implications.

Heatwaves have always occurred, but they are expected to intensify in frequency, duration and intensity due to climate change. Germany (like most European countries) experienced a distinct heatwave in 2003. Afterwards local heat health action plans (HHAP) were implemented in numerous regions (for example in Hesse). This analysis was designed to compare the heat wave of 2003 with the following ones in 2006, 2010 and 2015. We discuss whether measures from the Hessian HHAP were effective in reducing mortality and identify specific characteristics of the 2003 heatwave which did not allow direct comparison. Mortality and temperature data from the city of Frankfurt collected between 2003 and 2015 was used to answer the question of whether the implemented HHAP were effective, or if the mortality in 2003, pre-HHAP implementation, was especially high due to other factors. Excess mortality in 2003 was considerably higher for the overall population than in the heatwaves of the following years (2003: 77.8%, 2006: 12%, 2010: 22.7%, 2015: 38.1%). Heatwaves did not result in a significant excess mortality at all in some years, e.g. in 2006. Aside from the mortality rate, the duration of the heatwave (2003: 12days; 2006: 5days; 2010: 5days; 2015: 5days) was the only differing characteristic, leading to the hypothesis that heatwave duration might be a better indicator of mortality during heatwaves, than other characteristics, alone or combined. In summary regarding the effectiveness of the HHAP remains inconclusive since the pre-HHAP heatwave of 2003 differed in certain characteristics (especially the longer duration). Furthermore, the activities representing the HHAP were diverse and were implemented stepwise over some years. The effects on mortality of individual activities cannot be evaluated. Further research should consider differences, e.g. between places (climate zones etc.) and heatwave definitions.