v966 European Journal of Public Health, Volume 30 Supplement 5, 2020
The overall quality of evidence is low as it is based on a small
number of studies with inconsistent and imprecise results. Due
to the short follow-up periods of the included trials, the long-
term safety of ECs is unclear from this review.
Key messages:
 Limited evidence that electronic cigarettes are an effective
smoking cessation intervention.
 Further well-designed randomised controlled trials are
required to investigate the efficacy of ECs for smoking
cessation.
Training of the spiritual dimension of health in India –
an innovative ‘thought model’ approach
Mahesh Bhatt
M Bhatt1
1
Health Education, MMB Trust, Dehradun, India
Contact: mpmbhatt@gmail.com
Background:
The complexities in defining Spirituality, its association with
religions, and misfit in modern scientific healthcare settings are
the reasons behind the neglected attitude in training of
spiritual dimension of health in religiously diverse and secular
India.
Objectives:
To define spirituality independent from religious views and
scientifically sound for modern healthcare practices in a
diverse society of India. For this, a ’Thought Model’ developed
with spirituality as the most evolved thought in the form of
humanity and human values with transcendence, connected-
ness, and purpose of human life, which works as a controlling,
communicating, and correcting thought in the ecosystem of
human thought processes. Review and testing with healthcare
professionals (completed in Nov 2019), leading to few pilot
projects (in progress till Sept 2020), and finally working with
academia to finetune it for training curricula for health
systems.
Results:
The ’thought model’ presented to health experts from July to
October 2019. 98% [80 out of 82(N)] considered this simple,
comfortable to belief systems, and practice. 96% found it
helpful in solving the issues where the physician and patient or
the members of the medical team are from different religions.
99% considered this model scientific and useful in responding
to the spiritual needs of all, including atheists. So, we planned
to start a pilot project in two selected medical institutions for
medical interns with the new session; results are awaiting.
Conclusions:
Review results by health experts indicated that the ’thought
model’ can address the complexities and ambiguities in
defining spirituality on religious grounds by simplifying its
definition and independent of religious beliefs for the training
of the spiritual dimension of health and healthcare in diverse
and secular societies makes it easy to discuss spiritual aspects
of health in communities with various religions and belief
systems.
Key messages:
 Religiosity makes spirituality complex, communal, and
unscientific in religiously diverse societies leading to
reluctance in public health practices and training.
 Simplifying spirituality as an evolved thought can change
the perspective by abolishing religiosity; it becomes
comfortable with belief systems and science and suitable
for training and research.
Using theory of change to assess impact of
knowledge translation initiatives
Maureen Dobbins
C Howarth1, S Neil-Sztramko1
1
National Collaborating Centre for Methods and Tools, Hamilton, Canada
Contact: dobbinsm@mcmaster.ca
Issue:
The National Collaborating Centre for Methods and Tools
(NCCMT) offers high quality supports to public health
professionals on evidence-informed decision making
(EIDM). We developed a theory of change evaluation frame-
work to guide evaluations of our programs and services to
ensure that the NCCMT’s resources and training continue to
be high quality and meet the needs of public health
professionals globally.
Description of the Problem:
Our objective was to develop an evaluation framework that
illustrates our reach, quality, and impact. The NCCMT
contracted an external program evaluation expert to assist in
developing a revised framework to better capture these aspects.
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An inductive approach was used to identify evaluation themes
through internal document review, and a review of applicable
program evaluation literature.
Results:
A revised evaluation framework, influenced by theory of
change, was developed and is being implemented at the
NCCMT. The theory of change visualizes how the NCCMT
influences EIDM and public health practice through four
stages that progress from creation of products and services, to
knowledge and awareness, to engagement and capacity
development, and finally to policy and practice changes
embedded within organizational structures. Specific
outcome indicators include: public health professionals’
confidence, knowledge, and skills; improved public
health programs; organizational support for evidence-
informed decision making; and workforce engagement and
competence.
Lessons:
This innovative evaluation framework informed by a theory of
change resulted in significant streamlining of the centre’s
evaluation activities, and has provided clearer direction with
respect to the purpose of evaluation, as well as enhanced ability
to capture the centre’s reach, quality and impact. The lessons
of the importance of using theory of change to underpin
evaluation activities can be applied to other public health
organizations globally.
Key messages:
 Applying an evaluation framework supports effective and
efficient programming.
 The evaluation framework demonstrates the NCCMT’s
impact and reach in public health.
Sharing place and space to promote wellbeing for old
and young people in a neighbourhood
Norma Raynes
N Raynes1
1
Head office, From Generation 2 Generation, Whitchurch, UK
Contact: norma.raynes@fromgeneration2generation.org.uk
The increasing number of older people in many countries is
often seen as a burden. Alternatively, these numbers can be
seen as a longevity dividend, providing a resource for our
communities. We sought to find a way to use the resource by
working with schools in a range of socio- economic
neighbourhoods & explore the benefit for all stakeholders &
the sustainability of such an approach. The issues we addressed
are of relevance in most of Europe, despite the variations in the
school systems.
Intergen is the name of the model developed over 20 years in
England.
 3 schools in a neighbourhood work in partnership.
 An older person is appointed by the school to recruit older
people in the neighbourhood with the skills and knowledge
the schools require to enhance the learning opportunities of
their pupils.
 Coordinators in each school meet once a term to review
progress, problems & organise a social gathering for
volunteers.All stakeholders’ views of the value of the

programme were collected. Key questions to be answered
are:
Can older people be a resource for pupils to improve
performance & wellbeing in both the younger & older
populations?
Is the model sustainable and affordable?
How can it be mainstreamed?Results:
26 schools, primary and secondary in 7 municipalities engaged
in the project after 10 years development phase with 10 schools
in one municipality.
Schools in London and Greater Manchester areas.
15 schools remained in the programme paying for the service
for 5 years.
A review of the impact of the programme showed all head
teachers thought it innovative, & made a difference in their
pupils’ wellbeing.
Older people were seen as a positive resource by both teachers
& pupils.
Older people felt valued & part of community.
Reduction of negative stereotypes occurred.
Interactions went beyond the operational tasks set for the older
people.
Only a public health approach can promote sustainability of
the model & its benefits for communities.
Key messages:
 A tried and tested model sharing place and space to promote
wellbeing in neighbourhoods for old and young citizens.
 The important role of Public Health in promoting
innovative practice in silo ridden health and social care
systems building the evidence base and building bridges.
Unveiling barriers and facilitators to physical activity
participation among urban Indian men
Neha Rathi
N Rathi1, M Kulkarni1
1
Department of Humanities & Social Sciences, Indian Institute of
Technology Bombay, Mumbai, India
Contact: neha.nutri01@gmail.com
Purpose:
Regular participation in physical activity is critical for
nurturing optimum health and well-being. It also prevents
the onset of obesity and associated non-communicable
diseases. Indeed, urban Indian men are more prone to these
chronic illnesses as most of them lead a very sedentary lifestyle.
Thus, a public health priority is to increase physical activity
levels among sedentary urban Indian men. With this objective
in mind, an exploratory study was designed to understand
men’s perspective of physical activity and the factors influen-
cing physical activity participation.
Methods:
Five focus group discussions (FGDs) were conducted with
adult men (n = 26; age: 20-60 years) between August and
November 2019. The participants were recruited from
Mumbai Metropolitan Area through snowballing. All the
FGDs were audio-recorded and conducted in both Hindi and
English. The audio recordings were transcribed and translated.
Content analysis was used to obtain frequencies of different
barriers and facilitators. Thematic analysis was applied to
cluster responses, identify themes in the data, and build an
explanation from the FGDs.
Results:
All the participants perceived the need to participate in
physical activity as it was associated with a better quality of life.
Commonly identified facilitators were health benefits, physical
appearance, and adequate facilities in the neighbourhood to
engage in physical activity. Self-reported barriers included lack
of time because of hectic work schedules and commuting,
laziness, physical activity not viewed as a priority, and
engagement with mobile phones.
16th World Congress on Public Health 2020 2020–01 v967
Conclusions:
The emerging findings can inform the development of a
physical activity intervention to support behaviour change as
well as ensure its sustainability among inactive urban Indian
men. This qualitative inquiry contributes to the body of
knowledge on physical activity in a culture that is relatively
underrepresented in the current literature.
Key messages:
 Physical activity was influenced by multiple factors at
multiple levels i.e. intrapersonal level, interpersonal level,
and community level.
 There is a need to design effective public health interven-
tions to increase physical activity and thereby control the
prevailing disease burden.
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Risk Management in nursing homes: an Italian
experience in 2019
Maria Francesca Furmenti
MF Furmenti1,2, F Bert1,2, M Rucci1, U Fiandra2, A Scarmozzino2,
A Guerrieri3, F Ripa4, R Siliquini1,2
1
Department of Public Health Sciences, University of Turin, Department of
Public Health, Turin, Italy
2
Department of Healthcare’s Quality and Safety, A.O.U. City of Health and
Science of Turin, Turin, Italy
3
SHAM, SHAM Italy, Turin, Italy
4
Assessorato alla Sanità, Regione Piemonte, Turin, Italy
Contact: mariafrancesca.furmenti@unito.it
Background:
The ageing of the European population leads to an increasing
demand for Long-Term Care services. The security and well-
being of the elderly population hosted in nursing homes (NHs)
needs an effective Risk Management policy, officially sanc-
tioned in Italy by the so-called ‘‘Legge Gelli’’ n.24 (March 8th,
2017) and the Directive 2011/24/EU on the application of
patients’ rights in cross-border healthcare. In order to verify
the effective application of common ‘‘best practices’’ in terms
of Risk Management in NHs, a tool useful to analyse risk
management attitudes in Northern Italy was conceived and
applied in a sample of NHs.
Methods:
The tool, developed in collaboration with the health insurance
company SHAM Italia, is composed of 124 items (with a
dichotomous answer -YES/NO) on topics related to various
Risk Management practices. This tool was submitted in a face-
to-face interview to several Directors (Health Directors or
Nursing Coordinators) of NHs in the Piedmont Region. A list
of randomly-chosen NHs was contacted: 4 of them were
selected for the pilot study and compiled the questionnaire.
Answers were gathered and analyzed through Microsoft Excel.
Results:
Only the 25% of NHs has a Risk Management plan with
objectives and indicators of effectiveness and uses Risk Analysis
instruments for a pre- and post-’’ risk detection. Only one has
employees working mainly on Risk Management alone. The
75% of the reported events were ‘‘Adverse Events’’, and all the
NHs (100%) have a protocol for a patient voluntary departure
or for fall prevention or for bedsores prevention; while 50%
have a protocol for prevention of aggressions towards
operators or for patients’ suicide prevention.
Conclusions:
This work provides a starting point to face new challenges that
are looming on the European Health-care Systems: the care for
the elderlies needs to be perfected to reduce inefficiencies, cut
useless costs and improve safety of patients in the NHs setting.
Key messages:
 Despite safety of older patients in nursing homes is not only
important but mandatory in Italy, risk management tools
for this setting are lacking in literature.
 A new tool applied in Italian nursing homes showed that
risk management needs to be implemented in practice and
these results can be extended to European context.