Health Inequalities XII: Closing the Gap in Health Inequalities – Quo vadis?

On Friday, the 17th of March 2017 the Health Inequalities XII Panel took place on the German Public Health Congress “Poverty and Health” at the Technical University Berlin.
Under the title: Closing the gap in health inequalities – Quo vadis? the lectures and discussions focussed on possible strategies to close the gap.
Therfor the recommendations formulated by the Commission on Social Determinants of Health (CSDH) launched by the World Health Organization in 2005 gave the discussion framework:

The Commission`s overarching recommendations are to:

  1. improve the daily living conditions,
  2. tackle the inequitable distribution of power, money, and resources, and
  3. measure and understand the problem and assess the impact of action.

In this context, the development, implementation and evaluation of interventions and programmes are seen as a key vehicle to reduce health inequalities and raise health equity.

This year`s the panel shed light on both national (Germany) and international perspectives in order to reflect and discuss upon the status quo of current efforts to reduce health inequalities and raise health equity.

Selected webinares of the panels you can see here:

Taking action on health inequalities and improving health equity: The International perspective von Prof. Dr. Peter Goldblatt, University College London, Institute of Health Equity, England


Improving health Literacy to take action on health equity with Prof. Dr. Luis Saboga-Nunes, National School of Public Health, Universidade NOVA de Lisboa, Portugal


Prof. Dr. Ullrich Bauer, Dr. Paulo Pinheiro, Orkan Okan (Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI)
Prof. Dr. Uwe Bittlingmayer (University of Education Freiburg, Institute of Sociology)
Prof. Dr. Diana Sahrai (University of Applied Sciences and Arts Northwestern Switzerland, School of Education)
Dr. Irene Moor (Martin Luther University of Halle-Wittenberg, Institute of Medical Sociology)
Jens Hoebel, MSc (Robert Koch Institute Berlin)

The HLCA team from Bielefeld visited the German Paediatric Pain Center in Datteln

Foto 1_end

We have enjoyed a beautiful day with our hosts Prof. Dr. Boris Zernikow, Dr. Julia Wager, Lorin Stahlschmidt and Ann-Kristin Ruhe at the German Paediatric Pain Centre Datteln at the Vestische Children’s and Adolescents’ Clinic, Univeristy of Witten/Herdecke.

During our visit we could gain insights into their research and practice in context of chronic pain management of children and adolescents. We better understand now the importance of early interventions for successful treatment and care of children and adolescents affected by chronic pain. Currently, there is only insufficient care available for this target group in Germany. Psychosomatic complaints and how affected children and families deal with the burdens in daily life is an important public health topic and, therefore, also increasing importance for health promotion and primary prevention in childhood and adolescence. This is especially related to the fact that chronic pain has negative impact on the quality of life of affected as well as on physical health and mental well-being.

Therefore, the Institute has developed an important contact point for children and adolescents with severely disabling pain, and has established itself over time as the German centre for the care of children with chronic pain conditions. In recognition of its long-standing and successful work, the children’s outpatient clinic received the distinction of “Select Place 2011”. This was followed by the founding of the German Paediatric Pain Centre in January 2012.

Foto 2_end

In order to improve the situation of affected children, adolescents, and families, the German Paediatric Pain Centre is involved in various research activities and projects. These mainly focus on chronic pain in children and adolescents, palliative situations and the evaluation of further education programs. Besides studies of symptoms, methods of measurement or the effectiveness of medications, studies in the areas of care research and evaluation projects are carried out. Members of the research team also supervise diploma and doctoral students in the completion of their degree and doctoral work.

To safeguard quality, research projects led by multi-professional teams follow patient care. Significant milestones towards the improvement of the situation of children with chronic pain conditions have been achieved in projects conducted to date.

Foto 3_end

From the viewpoint of child pain therapy, health literacy in children and adolescents is increasing importance, especially in context of chronic pain management. Holistically, for this type of health care, and from a whole setting perspective, besides the health literacy of children and adolescents also the health literacy of parents and health professionals involved in research and care is of significant importance, which has to be highlighted in this context.

We are glad and very thankful to have been introduced to the team of the German Paediatric Pain Centre and that we could explore their great facilities in Datteln , NRW.
For more information:
German Paediatric Pain Centre:
Child pain therapy and paediatric palliative care at University of Witten/Herdecke:

Kenneth Yongabi Anchang visiting HLCA-Team at Bielefeld University


Dr. Paulo Pinheiro, Orkan Okan, Dr. Kenneth Yongabi Anchang, Janine Bröder,
On the 09th of December 2016 the HLCA-Team had the pleasure to welcome Kenneth Yogabi Anchang. He is the director of research at the Catholic University of Cameroon in Bamenda with a PhD in public health infectiology and PhD in bio (medical) engineering. He gave a great lecture about health literacy as an indispensable key component of ensuring a healthy condition in individuals and communities, especially in countries with high rates of endemic disease and in settings in which resources are limited. Therefor, he emphasizes a transition from (top-down) health promotion interventions to (community-based) health literacy interventions.
The whole lecture you find here:  Appropriate Health Literacy Interventions to improve Health Outcomes

HL Intervention for Kids and Professionals

Promoting sexual health literacy in children and strengthening child resilience and empowerment: Development, implementation and evaluation of a school-based sexual abuse prevention programme in the primary school setting (IGEL)

This IGEL project was a collaborative team science effort involving professionals from research and practice that followed the public health action cycle model for interventions and policy development. The scientific research progress was led by educationalists, psychologists, sociologists, and socialisation researchers from the Faculty of Educational Science at the University of Duisburg-Essen who teamed up with public health researchers from the Bielefeld University. The IGEL project was conducted between 01.09.2012 – 31.10.2015 and was funded by the German Federal Ministry of Education and Research (BMBF).

Target population and interventional approach

The intervention is based on an asset-based and eco-systematic approach that aims at primary school children attending the 3rd grade and their social environment comprising parents, teachers and professional school staff.

IGEL Objectives

The IGEL intervention aims at promoting a culture of awareness in context of sexual health and sexual violence including assault, abuse, and rape. While the target population comprises both teachers and children, in children the application of the programme will enhance self-protection skills by teaching them practical and theoretical knowledge and action competencies in context of sexual health and violence. During the programme children will be equipped with capabilities to recognise dangerous situations and take action to better protect themselves. The components aiming at teachers will help to raise awareness for sexual violence against children and enable them to better understand and recognise cases. They will be equipped with reflexive and reactive abilities in order to better deal with sexual assault against children. Overall, the programme will support better protection against all kinds of sexual violence against children and improve empowerment in the participants to raise their voices and to actively seek for help. On the long term basis the programme aims at changing school infrastructure towards better networking strategies and prevention concepts as well as improving cooperation with professional health support and first aid systems in case of sexual violence against children.

  • Raising awareness about sexual abuse and sexual health in professionals and children
  • Strengthening empowerment and responsibility among participants
  • Improving theoretical and practical knowledge on sexual health and health promotion
  • Improving action competencies
  • Improving self-protection skills
  • Improving knowledge about support and first aid services, and preventive measures
  • Practicing of defence strategies
  • Enhancing better sexual health related behaviour (behavior-based preventive component)
  • Participative approach to actively involve and engage children’s social environment (environmental preventive component)
  • Changing school infrastructure and implementation of cooperation with professionals health service for victims of sexual violence

Implementation of the IGEL programme

  • Five hours training programme for teachers
  • A series of six classes (each 45 minutes) plus one reviving class (45 minutes)
  • Classes can be run in a row or distributed over weeks/months

IGEL comprises seven sequenced classes each focusing a specific topic. The programme is easy to use during school hours while one class perfectly fits into a 45 minutes session and is also easily adaptable in case more or less time is needed during the implementation.

The IGEL classes

  1. Introduction to the programme
  2. Working on a definition
  3. My body
  4. Physical contacts
  5. Secrets
  6. Identifying and understanding of “Okay!” and “Hey, stop!” (no-go)-situations
  7. Becoming an IGEL professional

Programme didactics and implementation methods

  • Music and art based methods: IGEL Rap (dancing and singing)
  • Case vignettes
  • Individual, partner, and group work
  • Practice work: Identification and naming, working with materials, drawings
  • Contemplation and theme cards
  • Parent letters
  • IGEL-professional certificate

Unique  features

  • Providing basic information for teachers for self-reliant learning, working, and reviving
  • Checklist in case of emergency for suspicion for or crises related to sexual violence
  • Support for developing blueprints and templates for parental work and engagement
  • Additional information on further types of child abuse and neglect

The research progress within the IGEL project was divided into two researcher stages that built up on each other

  1. concept development and preparation of the evaluation
  2. implementation, evaluation and concept adaptation

The intervention which is designed as a primary prevention programme consists of two modules:

  1. preventative measures for teachers and parents
  2. preventative measures for pupils

The implementation took place in eight primary schools while in each two 3rd grade classes were involved at a time (n=16 classes). For assessing effectiveness of the IGEL intervention four control groups were recruited.


The evaluation study conducted by Bielefeld University has proven the high effectiveness of the IGEL programme. Further, the study shows that the programme is user friendly and easy to use. See: Link here.

  • Ina Kreuz, School Teacher for primary and secondary classes, she was involved within the development of the life skills intervention “Lions Quest: Erwachsen handeln”, a programme that is based on the principles of proportionate universalism.
  • Ullrich Bauer, Professor of Socialisation Research, Head of the Centre for Prevention and Intervention in Childhood and Adolescence (CPI) at Bielefeld University, he is training teachers for ten years
  • Wilhelm Körner holds a doctors degree in psychology and specialised in psychological psychotherapy for children and adolescents, he has vast experience in educational counselling and school psychology

EUSPR Newsletter featuring an Overview of German Prevention Research Networks

“BMBF is currently funding seven larger prevention research networks that were positively evaluated in a competitive call in 2014. The networks usually comprise of research and implementation partners, and are geographically spread all over Germany. A joint umbrella project to support collaboration across networks is likely to be launched in 2017. These projects are probably the largest currently funded prevention projects in Germany, and will continue (given a positive mid-term evaluation) up to 2020.” read more

Luís Saboga-Nunes and Orkan Okan have been elected president and co-president of EUPHA’s Health Promotion Section

Luís Saboga-Nunes from our advisory board and consortium´s member Orkan Okan have been elected president and co-president, respectively, of EUPHA’s Health Promotion Section at 2016´s EPH annual meeting in Vienna. EUPHA, the European Public Health Association, is by far the largest organisation for public health experts in Europe and brings together around 14.000 people for professional exchange and collaboration throughout Europe. For at least the next two years, Luís and Orkan will be in charge of the health promotion section representing the voices of more than 2,500 section members.
The HLCA consortium congratulates Luís and Orkan in the warmest possible way for this tremendous success.


REPORT: HLCA at the 22nd International Union of Health Promotion and Education World Conference on Health Promotion in Curitiba, Brazil

Health literacy researchers, Janine Bröder and Orkan Okan have attended the 22nd International Union of Health Promotion and Education World Conference on Health Promotion. They presented two posters, one oral presentation, and organized a symposium on child and youth health literacy with international partners from Denmark, Canada, and Portugal. Janine, participated in a health literacy discussion group on building capacity and sharing knowledge in health literacy, and Orkan led, together with Evelyn McElhinney from Scotland, a discussion group on health literacy across the life span. Further, with partners from Portugal another presentation within a discussion circle was accepted on adolescent’s concept of health literacy.

Additionally, they participated in three pre-conferences on health literacy. The first pre-conference they attended was the preconference on “Taking the Global Health Literacy Agenda into Portuguese speaking communities” organized by Luis Saboga-Nunes, advisor to the HLCA research consortium, together with the South American health literacy group. Kristine Sørensen and Diane Levin-Zamir gave short introductions to past health literacy research in Europe. In the “Diabetes Literacy: Integrating Health Literacy and Health Systems Change In Diabetes Self-Management Education” pre-conference, Stephan van den Broucke reported on the results and experiences his group made during their research. The last pre-conference was implemented as a workshop on health literacy organized by the Global Working Group on Health Litercay (IUHPE GWG-HL) titled “Taking the Global Health Literacy Agenda Forward for Health Promotion – From Position Paper to Action.” The aim of this pre-conference was to improve the working group’s collaboration among the members, to introduce health literacy activities around the world the members are engaged with, and to develop contents for the GWG-HL position paper by discussion groups on:

  • Identifying and engaging relevant stakeholders for collaborative health literacy action, research and policy
  • Health literacy as a community-based consumer education and empowerment process
  • Funding, producing and promoting research to contribute to the evidence base
  • Building capacity and sharing knowledge
  • Ensuring the inclusion of health literacy in global, national and regional discussions on health promotion and social determinants of health
  • Health literacy across the life span.

The IUHPE conference was rich on health literacy presentations. There have been two poster walks, several further poster presentations in physical and digital formats, sessions on community approaches to health literacy, on the health literacy toolkit, on workforce capacity development for improving professional health literacy skills and needs, two sub plenaries on health literacy in policies, and improving health literacy across low-, middle- and high-income countries, a conversation circle towards an international perspective on health literacy, and a lot more presentations, discussions, posters, and cross referencing to health literacy all across the conference. Unfortunately not all health literacy activities could be attended as there were some conflicting schedules.

Summarizing the conference towards health literacy, we understand that health literacy is given high priority in the global setting not only at IUHPE but at WHO, UN, and further NGO and governmental organisations and health promotion activities across the countries. While in the conference opening session the importance of children to processes of health promotion and for sustainably improving health equity was highlighted prominently, during the closing session of the conference, health literacy received a prominent place in the conference summary. It can be expected that health literacy will be a priority area again at the 23th IUHPE conference 2019 in New Zealand.

UPCOMING: EUHPA Pre-Conference

Various members of the HLCA-consortium will participate at the 9th European Public Health Conference “All for Health – Health for All” , November 9–12, 2016 in Vienna, Austria. The EUPHA Section on Health promotion will organize a pre-conference on the topic of Operationalizing health promotion on the life course through the health literacy approach: where we stand 30 years after Ottawa? The pre-conference will be organized by members of the HLCA consortium and  memebres of its Advisory Board:

  • Luis Saboga-Nunes and Christiane Stock – EUPHA Section on Health promotion
  • Ullrich Bauer, Paulo Pinheiro, Orkan Okan – Health Literacy in Childhood and Adolescence Research Consortium (HLCA) und
  • Kristine Sørensen, health consultant and founder of Global Health Literacy Academy

UPCOMING: Summer School and Consortium Meeting in Freiburg

The next meeting of the HLCA consortium will take place in Freiburg, September 29th & 30th, 2016 under the topic of  Half-time of HLCA under the Framework of Health Inequalities: Projects Findings and Recent Developments. Previous to the consortium meeting, a summer school will be organized.


Organizing Committee (in alphabetical order): Ullrich Bauer (Bielefeld University) Uwe H. Bittlingmayer (responsible), Eva-Maria Bitzer (University of Education Freiburg), Orkan Okan, Paulo Pinheiro (Bielefeld University) Luis Saboga-Nunes (New University of Lisbon), Diana Sahrai (FHNW University of Education Basel)

The general objectives of the summer school 2016 in Freiburg is to inform national and international MA-students and PhD-candidates about the state of the art of health literacy research; that means:

  • Make participants familiar with literacy concept, especially with concepts of social literacy
  • Discuss with the participants whether health literacy is an outcome or an explaining variable to outcomes
  • Present the participants different forms of measurement health literacy, quantitative as well as qualitative
  • Make the participants conduct own empirical analysis according to health literacy by making them quantitative data as well as interview material available
  • Let the participants be part of the HLCA-meeting to get an idea about ongoing research work

REPORT: HLCA Consortium Meeting, March 3rd and 4th, Essen, Germany

The 3rd meeting of the “Health Literacy in Childhood and Adolescence” Consortium (HLCA) focussed on the presentation and discussion on Empirical Findings of the joint research project.

The meeting started with a summary and critical reflection on the past half year’s HLCA activities with a special focus on the implementation of the consortium`s dissemination, communication, public engagement and networking strategy.
Particular consideration in the various sessions was given to the projects related to mental health literacy (NePP, Provider-MHL, Teacher-MHL) and eHealth literacy (MEDIA PROTECT, ELMi, PrettY). Insights into the recent development of these projects were presented on the first day of the meeting. In the morning of the second day, progress reporting was complemented by the basic research projects (TeCoMo, MOHLAA and MoMChild).
The aims were to present and discuss the empirical findings from the field research. The researchers from the projects provided insights into their recent work. Each presentation was followed by a fruitful discussion with additional recommendations by both, project members and the scintific advisory board. In addition, members of the ELMi-CH project that will launch in spring 2016 in Switzerland introduced thir project.
Further session adressed the content-specific understandings of eHealth literacy and mental health literacy, respectively. These sessions aimed to outline the current conceptual understanding within these projects, to figure out common characteristics among the projects as well as to present open questions for discussions.
In the second workshop of the TeCoMo project, a first conceptualisation of health literacy in childhood and adolescence was presentes and put up for discussion.
As usual, closed session of the steering committee and the advisory board  took place to discuss future organisational and administrative issues, and the progress of projects.

The 3rd HLCA meeting was closed by summing up the meeting, introducing the recommendations from the SAB, and giving an outlook to the upcoming meeting in Freiburg.

UPCOMING: 22nd IUHPE World Conference on Health Promotion

Orkan Okan and Janine Bröder, both members of the HLCA-consortium, will participate at the 22. IUHPE World Conference on Health Promotion, May 22–26 in Curritiba, Brazil. They will present the recent findings of their MoMChild and TeCoMo projects in both, poster session ( (TeCoMo: Exploring Health literacy in Childhood and Adolescence – Results and Implications from a Systematic Lietrature Review, MoMChild: The “Methods of Measuring Health Literacy inof children: Project (MoMChild): Preliminary results of a Systematic Literature Review, and conclusions for concept construction and questionnaire development) and workshop (CHILD AND YOUTH HEALTH LITERACY – A DISCUSSION ON CONCEPTUALIZATIONS, METHODOLOGIES AND KNOWLEDGE TOWARDS ACTION).


REPORT: HLCA Consortium Meeting, October 8th and 9th 2015, Bielefeld

The 2nd meeting of the “Health Literacy in Childhood and Adolescence” Consortium (HLCA) focussed on selected issues and challenges linked to the research methodologies used in the individual subprojects of the joint research project. Rather than evaluating the projects’ methodological approaches, the project teams to shared first experiences and selected open questions. This framework provided the opportunity to seek advice and recommendations from the colleagues and the attendant scientific advisory board in order to support the further implementation of the methodologies.
The meeting started with a guided poster walk to inform on the ongoing research activities in the individual projects (session 1). Gender, diversity and intersectionality aspects were addressed as themes of cross cutting relevance in session 2 followed by a key note presentation (session 3) by Emma Bond, University Campus Suffolk, England, providing an overview of methodological and ethical requirements of child research.

The second part of the first day was covered with various “One on One” sessions, focussing on selected methodological issues in the individual projects. Particular questions were presented and discussed in an interactive and participatory mode by making use of two way communication. These “One on One” sessions provided a good framework for new input (project member), feedback (experts from advisory board) and fruitful dialogues (project member, expert, and audience).

The second day started with a key note presentation on “Empirical Research with and/or for Children? Highlighting Challenges and Framing Methodological and Ethical Requirements” by Graça S. Carvalho, Research Centre on Child Studies, University of Minho, Braga, Portuga which aimed at addressing challenges when placing methods and methodologies at the centre of research with the child and youth population. The following session has been designed as a workshop that aimed to gain insights into the components and conceptual elements of the current health literacy understanding in childhood and adolescence. All the participants of the second meeting were invited to review the presented literature review and to contribute with their individual perspectives to the mapping of the concept for children and adolescents.


NEWS: New members – Scientific Advirsory Board

After its successful meeting in Bielefeld on October 8th and 9th, 2015, the HLCA consortium decided to invite two further internationally recognized colleagues to its Scientific Advisory Board:

  • Emma Bond, Institute for Social, Education and Enterprise Development, University
    Campus Suffolk, England link
  • Prof. Dr. Graça S. Carvalho, Research Centre on
    Child Studies, University of Minho, Braga, Portugal link

We are looking forward to fruitful collaboration!

PUBLICATION: Health literacy – main topic in Bundesgesundheitsblatt, September issue

Health literacy is the main topic in the September issue of the Bundesgesundheitsblatts. The September issue provides an overview of the state of discussion on health literacy and its application in research, prevention and patient care, primarily in German-speaking countries. Unfortunately, articles are only available in German.

REPORT: Health Promotion Conference in Galway

HLCA members from Bielefeld and Freiburg attended the Health Promotion Conference on Health Literacy

Galway, 18th June 2015

The Health Promotion Conference ‘Health Literacy: Research, Policy and Practice’, hosted by the National University of Ireland, Galway took place on June 18th 2015. Representatives of HLCA were invited to orally present a synopsis and first results of their sub-projects. The team from Bielefeld University was represented by Janine Bröder (TeCoMo), Dirk Bruland (Teacher-MHL) and Orkan Okan (MoMChild) from the Center for Prevention and Intervention (CPI). Inga Kloß and Zeynep Islertas from the HLCA team at Freiburg University of Education (ELMi and PrettY), presented results of an earlier project on “Social Determinants, Life Skills and Health Literacy – Some Surprising Empirical Results of German Students Aged 15+”. The conference has explored the importance of health literacy and how it can be enhanced as a priority area for Health Promotion, including the implementation of health literacy interventions across sectors.

Further information and presentations from speakers and sessions are available online.