Developing the 2020-2030 mental health strategy for Malta: Addressing the needs of a small island state undergoing rapid socioeconomic transition.

Malta has embarked on a renewed national endeavour to reform the mental health sector, prioritising mental health in the context of the national health strategy post 2020. Past attempts at reforming this sector were stifled due to insufficient and unsustained political commitment, leaving it direly under-resourced. An interplay of factors over recent years has rekindled political and public interest in mental health. These include: the establishment of a mental health commissioner; indictment from a National Audit Office report; and coordinated public pressure from local media, non-governmental organisations and professionals. Government responded by publishing a mental health strategy to address both long-standing and new challenges arising from rapid socioeconomic changes which have put further strain on an already overstretched system, demanding urgent action. The concept of strengthening resilience is put forward as a central tenet in the strategy and a combination of initiatives were proposed for the prevention of mental illness, investment in physical and human resources and the creation of a new service framework. Successful implementation of this strategy is dependent on continued political commitment, visible leadership, ongoing investment commitment, and meaningful engagement by key stakeholders. Ongoing stakeholder advocacy appears to be crucial to ensure that mental health continues to be considered as a national priority.

Privacy-Preserving Partner Notification Service to Control Sexually Transmitted Infections.

Partner Notification (PN) processes are typically part of wider combination prevention efforts and focus on the notification of sexual partners to prevent Sexually Transmitted Infections (STIs), including Human Immunodeficiency Viruses and viral hepatitis. We present a free, voluntary, anonymous and GDPR-compliant Partner Notification service that offers enhanced security and privacy through a web and mobile application via a unique random codes.

A GDPR-Compliant Partner Notification Service.

Partner Notification processes focus on the notification of sexual partners to prevent the transmission of Sexually Transmitted Infections (STIs). The INTEGRATE Joint Action provides an integrated platform called RiskRadar, for combination prevention activities targeting STIs, including an anonymous, free and voluntary Partner Notification service. The presented service information flow ensures privacy, security and GDPR compliance which were identified as vital with similar tools. The service is available via web and mobile interfaces using a unique random code provided from authorised healthcare professionals to support privacy.

RiskRadar: development and pilot results of a technical intervention targeting combination prevention regarding HIV, viral hepatitis, sexually transmitted infections and tuberculosis.

BACKGROUND: The HIV pandemic impacts the lives of millions and despite the global coordinated response, innovative actions are still needed to end it. A major challenge is the added burden of coinfections such as viral hepatitis, tuberculosis and various sexually transmitted infections in terms of prevention, treatment and increased morbidity in individuals with HIV infection. A need for combination prevention strategies, tailored to high-risk key populations arises and technology-based interventions can be a valuable asset. The COVID-19 pandemic challenged the delivery of existing services and added stress to existing public health and clinical structures but also highlighted the potential of exploiting technical solutions for interventions regarding infectious diseases. In this paper we report the design process, results and evaluation findings from the pilots of 'RiskRadar'-a web and mobile application aiming to support combination prevention, testing and linkage to care for HIV, viral hepatitis, various sexually transmitted infections and tuberculosis. METHODS: RiskRadar was developed for the INTEGRATE Joint Action's aim to improve, adapt and pilot innovative digital tools for combination prevention. RiskRadar was designed iteratively using informed end-user-oriented approaches. Emphasis was placed on the Risk Calculator that enables users to assess their risk of exposure to one or more of the four disease areas, make informed decisions to seek testing or care and adjust their behaviours ultimately aiming to harm/risk reduction. RiskRadar has been piloted in three countries, namely Croatia, Italy and Lithuania. RESULTS: RiskRadar has been used 1347 times across all platforms so far. More than 90% of users have found RiskRadar useful and would use it again, especially the Risk Calculator component. Almost 49.25% are men and 29.85% are in the age group of 25-34. The application has scored 5.2/7 in the User Experience Questionnaire, where it is mainly described as "supportive" and "easy-to-use". The qualitative evaluation of RiskRadar also yielded positive feedback. CONCLUSIONS: Pilot results demonstrate above average satisfaction with RiskRadar and high user-reported usability scores, supporting the idea that technical interventions could significantly support combination prevention actions on Sexually Transmitted Infections.