Chair of Health Services Research
Short description
The Chair of Health Services Research in the IMVR was founded on 1.11.2022. The chair is home to the working group of PD. Dr. Nadine Scholten. The entire interdisciplinary team of the chair brings expertise from the fields of psychology, sociology, nursing science, health care science, health economics and others.
In our participatory research projects we use both quantitative and qualitative methods of empirical health services research. We work with primary research data, with clinical routine data, quality reports or routine data of the social insurance carriers (GKV, DRV).
We investigate medical, nursing or psychosocial care structures and processes as well as communication with patients, relatives and the care team. The research results are incorporated into concepts for improving care. The focus is on measures that
- facilitate the handling of the disease,
- improve health literacy,
- increase patient safety
- improve health-related quality of life, or
- promote social participation.
Team
Prof. Dr. Nicole Ernstmann
Chair of Health Services Research
Priv.-Doz. Dr. Nadine Scholten
Working group leader “LiVe”
Dr. Christian Heuser
Research Associate
Dr. Kati Hiltrop
Research Associate
Kaan Karacan
Research Associate
Kai Keller
Research Associate
Dr. Laura Mause
Research Associate
Anna Moritz
Research Associate
Charlotte Oberröhrmann
Research Associate
Mi-Ran Okumu
Research Associate
Tim Ohnhäuser
Research Associate
Jannika Rother
Research Associate
Dr. Isabella Schwab
Research Associate
Dr. Barbara Schellenberger
Research Associate
Lisa Bach
Research Associate
Jannika Rother
Research Associate
Projects
Projects WG PD Dr. Nadine Scholten
Project team members (IMVR)
Consortium leadership
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Funding institution
Project description
In Germany, almost eleven percent of all girls and over seven percent of all boys aged three to six are overweight, with three percent of girls and one percent of boys being obese. The risk of further weight gain during childhood and adolescence, as well as the risk of subsequent health problems, is significantly increased for these children.
The frühstArt project is developing and evaluating a structured, cross-sector care concept for overweight children and their parents. In addition to motivational counseling by pediatricians, coaches who visit families at their homes form the core of the new concept. Furthermore, family-centered, home-visiting counseling is complemented as needed by linking families to additional local prevention, rehabilitation, and support services.
The goal of frühstArt is to reduce overweight and obesity in children aged three to six by changing their everyday lifestyle and optimizing cross-sectoral networking.
As part of the formative evaluation, the IMVR is conducting a nationwide survey to assess the utilization potential of this new form of care, as well as potential promoting factors and implementation barriers from the perspective of pediatricians. In follow-up workshops, the survey results will be discussed with pediatricians, and regional peculiarities will be identified. This will allow concrete recommendations for the integration of frühstArt into regular care to be derived.
Further information
Scientific project management
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Project description
The type of delivery and the quality of care has short-term and long-term consequences for the psychological well-being of women, as well as for the early mother-child relationship. Among other things, the patient-centeredness and maternal autonomy during birth is instrumental for satisfaction. The WHO guidelines promote respectful maternity care for all women, i.e. care that ‘respects dignity, privacy and confidentiality, ensures freedom from harm and maltreatment, and allows informed choice and continuous support during labour and delivery’. In Germany, as well as worldwide, the relevance of this complex of topics, which is often referred to as ‘Obstetric Violence’, has been emphasized. The topic of maternal involvement, safety and care in obstetrics is still a scientifically under-investigated area in Germany.
The first aim of this study is to learn more about maternal involvement, safety and the prevalence of obstetric violence in Germany from the perspective of mothers, doctors and midwives by a quantitative survey. In the sense of an explanatory mixed-method design, qualitative interviews with mothers, doctors and midwives will be conducted to complement the quantitative survey.
The evaluation of hospital billing data (DRG statistics provided by the German Research Data Center of the Federal Statistical Office) and quality assurance data (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen: IQTiG) will provide further information on the current status of obstetrics in Germany. The focus is on the mode of birth (primary and secondary caesarean section, instrumental delivery), the use of episiotomies and the occurrence of perineal tears.
In a second project phase from 2025, a pilot study will be conducted. It includes an intervention based on the results from the first phase to promote patient-centeredness, Shared-Decision Making (SDM) and, therefore, reduce Obstetric Violence in German hospitals.
Scientific and operational project management, consortium management
Project employees (IMVR)
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Project description
Background: It is undisputed that mother’s milk is the best nutrition for new born infants. Especially for prematurely born infants, mother’s milk is crucial to prevent life-threatening infections (like e.g. necrotizing enterocilitis (NEC)), the modulation of the immune system and the cognitive development. For over 15 years, the WHO has been recommending exclusive feeding of mother’s breast milk. In this regard, there is need for a structured promotion of breastfeeding that targets the education of parents and health staff, the mother-child relationship as well as organisational patterns. If the mother is unable to provide her infant with breast milk (at first), human donor milk should be the preferred alternative. However, due to structural, legal and financial challenges, this is currently only possible within a few German neonatal intensive care units (NICUs). Therefore, the aim of this study is to develop an evidence-based concept for breastfeeding for neonatal intensive care units as well as a structured concept for the implementation of human donor milk banks that cover the NICU’s own demands for donor milk. The target group are preterm infants with a birth weight of less than 1,500 grams.
Study design: The second project phase will include the implementation of the breastfeeding promotion concept and a related app as well as the setup of human donor milk banks in 12 NICUs which will be evaluated through a Stepped Wedge Cluster-randomised study. The primary outcome is an increased number of preterm infants with a birth weight of less than 1,500 grams who are fed with mother’s milk at the time of NICU discharge. The secondary outcomes include the complication rate (e.g., NEC), the length of hospitalisation as well as the implementation and intervention expenditures among others. Furthermore, the evaluation includes formative elements.
Scientific and operative project management
Project execution (IMVR)
Scientific collaboration partners
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Project description
Every year, almost 10,500 very small premature babies with a birth weight of less than 1,500 g are born in Germany. These prematurely born children with a critical weight are usually cared for over in the so-called perinatal centres over a long period of time.
It is not always possible for mothers and fathers to be permanently with their child in the hospital. This separation could lead to a strain on the parents and the parent-child relationship or the parental bond. Therefore, some facilities provide a webcam to see the child. However, this service is currently only available in a few neonatal intensive care units (NICUs) in Germany. Nevertheless, the use of such webcams can also bring psychological challenges and burdens. Often, there is no systematic information or education provided for the parents.
The aim of the project Neo-CamCare is to analyse the current distribution and to capture the attitude towards using webcams in German NICUs and to evaluate their use. At the same time, the demand, possible barriers and parents’ concerns should be examined. Subsequently, a practical guide for parents and clinic employees will be developed. This guidance will include recommendations for the usage and handling of webcams.
The cameras will initially be implemented and evaluated at four clinics. The evaluation and analyses are carried out at the Institute of Sociology, Health Services Research and Rehabilitation (IMVR), University of Cologne in cooperation with the University Hospital Bonn, the Goethe-University Frankfurt and the Data Protection Research Centre, as well as the Techniker Krankenkasse and DAK-Gesundheit. Further assistance is provided by the federal association “Das frühgeborene Kind” e. V. (“The premature child”) and the European Foundation for the Care of Newborn infants (EFCNI). In the long run, the outcomes enable a structured, scientifically sound use of webcams in NICUs in Germany and address the needs of both parents and clinical staff.