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Evaluation of pediatric dentists’ approaches to oral health literacy : Nevra Karamüftüoğlu

Abstract Aim In the study;it is aimed to determine the knowledge,attitudes,behaviors and educational needs of pediatric dentists about oral health literacy(OHL). Methods The study was carried out with 100 pediatric dentists across Turkey between 20/06/2021-20/07/2021 on the online platform.In the questionnaire form;there are 14 descriptive,25 approaches to OHL in a 5-point Likert format and 8 questions about communication barriers in individuals with insufficient OHL. Results The mean age of the participants was 34.4±7.9 years.92.0%(n = 92) of the participants did not receive OHL training.63%(n = 63) of the participants stated that it is necessary to carry out studies to improve OHL and to develop programs.The mean OHL approach scores of the participants were 3.81±0.61;the mean score of evaluating communication barriers in individuals with insufficient OHL level was 4.06±0.62.60%(n = 54) of the participants think that the health information in the media is very effective in misleading patients.As the age of the participants increased,the OHL approach score increased(r = 0.204;p=0.042).As the number of daily outpatient clinics of the individuals participating in the research increases,the evaluation scores of communication barriers decrease(r=-0.304;p=0.004).Among the participants,those who work in private institutions,those who know their rights while providing oral health services and those who are satisfied with the profession have higher scores for evaluating the OHL approach,the difference is statistically significant(p < 0.05). Conclusions As a result,positive benefits will be provided to the professional satisfaction of pediatric dentists and the quality of oral health services with in-service trainings to be organized before and after graduation on the evaluation of communication barriers in individuals with inadequate OHL approach and level. Key messages • Oral health literacy is a new concept and is becoming increasingly important in dentistry. • The importance of oral health literacy in pediatric dentistry is that both children and parents are affected.

Karamüftüoğlu N, Atabek D, Uğraş Dikmen A et al.

O3-3 Active commuting and healthy behavior among adolescents in neighborhoods with varying socioeconomic status

Abstract The World Health Organization recommends active commuting to and from school as a source of physical activity. Worldwide, active commuting, i.e. walking or biking, is determined by various factors including gender, socioeconomic status of families and neighborhoods, the built envormnet, distance to schools, perceived neighborhood safety, life styles, and availability of walkways, biking paths and parks. Previous studies from Swedish indicate that the proportion of youth being active commuters descres with age, but has also decresed over time. This study aimed at assessing health and environmental factors associated with modes of transportation to and from school among 333 adolescents aged 16-19 living in a middle-sized city in Sweden. The present city has 380 kilometer of walking and biking paths that cover the whole city, of which parts are heated in the winter to avoid snow and ice. Still, only 32% of the adolescents were active commuters to and from school. Active commuting was linked to other healthy behaviours including more frequenct daily consumption of fruits and vegetables and less frequent consumption of junk food. Morover, the presence of well illuminated walking and biking paths was strongly associated with active commuting, as compared to not having access to less illuminated paths. However, the relation between active commuting and socioeconomic status of the neighborhood was complex and needs to be explored in future larger studies. The results will be used to increase awareness of the health and enviromental benfits of active commuting among adolencnets, schools, and local policy makers.

Buli B, Tillander A, Fell T et al.

P66 Adalimumab originator versus biosimilar in children and young people with JIA

Abstract Introduction/Background Biosimilar therapies are considered to have comparable efficacy to their originators and prescribing is encouraged in the UK for significant cost-savings to the NHS. However, real-world evidence comparing originators and biosimilars is limited, particularly in children and young people. The objective of this analysis was to compare the effectiveness of the anti-TNF adalimumab originator and a biosimilar in the treatment of JIA in children and young people, by comparing change in disease activity after six months. Description/Method This analysis included children and young people with JIA from the Biologics for Children with Rheumatic Diseases (BCRD) study. Data are collected at the point of starting biologic therapy, and after 6 months, including patient demographics, biologic therapy, and disease activity. Patients were included if they were starting adalimumab (originator or biosimilar) as their first biologic. Patients with follow-up data at 6 months were assessed for outcomes at 6 months. Change in Juvenile Arthritis Disease Activity Score (JADAS-71) from baseline to 6 months was calculated and compared between therapies using linear regression. Multivariable logistical regression was used to compare remission (JADAS-71 ≤1) at 6 months between therapies. Both regression models were adjusted for baseline characteristics at the start of biologic therapy: age, gender, disease duration, ILAR category, history of uveitis, number of comorbidities (0/1/2+), and JADAS-71. Multiple imputation was used to account for missing data. Discussion/Results A total of 457 patients were registered starting adalimumab as their first biologic: 413 on originator, 44 on biosimilar (Table). Of these, 63% were female, median age at start of therapy was 11 years old (IQR 6, 14), and median disease duration was 2 years (IQR 1, 5). The majority of patients had RF-negative polyarticular JIA (29%), persistent oligoarticular (20%) or extended oligoarticular JIA (18%). There were 47% of patients who had a history of uveitits when starting biologic therapy, and 68% reported at least one comorbidity. Baseline characters were similar between both therapies. There were 429 patients with follow-up data after six months of treatment: 393 on originator and 36 on biosimliar. The median JADAS-71 improved by -4.4 (IQR -9.9, -0.2) with no difference seen between the originator and the biosimilar patients (adjusted b-coefficient: -0.4; 95% CI -2.6, 1.8; p = 734). There were 36% of patients in remission, with no difference between the two therapies (odds ratio 1.2; 95% CI 0.5, 2.9; p = 0.543).P66 Table: Baseline characteristics and 6-month outcomes All patientsOriginatorBiosimilarBaseline Characteristics Patients45741344Gender290 (63%)257 (62%)33 (75%)Age11 (6, 14)11 (6, 14)11 (6, 13)Disease duration2 (1, 5)2 (1, 5)3 (1, 6)N = 446N = 403N = 43ILAR Category Persistent Oligoarticular20%19%27%Extended Oligoarticular 18%17%20%RF- Polyarticular 29%29%30%RF+ Polyarticular7%7%5%Systemic<1%<1%2%Psoriatic6%6%7%Enthesitis-related15%16%7%Undifferentiated / missing4%5%2%History of Uveitis47%48%35%N = 448N = 405N = 43Comorbidities 032%31%41%144%45%41%2+24%25%18% 6-month outcomes Patients42939336JADAS-71 (0-101) Baseline, median (IQR)7.8 (4.1, 14)7.8 (4.0, 14)8.3 (4.5, 11)6 months, median (IQR)2.5 (0.4, 5.6)2.4 (0.4, 5.5)3.7 (0.8, 5.7)Change, median (IQR)−4.4 (-9.9, -0.2)−4.5 (-10, -0.2)−3.9 (-6.9, -1.2)Coef. (95% CI)–−1.8 (-5.5, 2.0)Reference. Adjusted* coef. (95% CI)–−0.4 (-2.6, 1.8)Reference. JADAS-71 Remission 6 months, %36%36%32%Odds ratio (95% CI)–1.2 (0.5, 2.9)Reference.Adjusted* odds ratio (95% CI)–1.3 (0.5, 3.4)Reference. Key learning points/Conclusion There was no significant difference in disease activity response between children and young people with JIA treated with adalimumab originator versus biosimilar. These results support that the adalimumab biosimilar is similar in effectiveness to the originator in treating JIA, although more research is needed regarding safety and tolerability.

IMPLEMENTATION RESEARCH: INTERGENERATIONAL PROGRAMS ACROSS UNIVERSITY SETTINGS

Abstract Implementing intergenerational programs within university settings has been associated with benefits for all generations involved, which often includes young children, university students, and older adults. However, from conceptualization to pilot testing to evaluation, challenges and opportunities present themselves. This symposium will highlight implementation realities for intergenerational programs within higher education settings. This symposium will specifically address dimensions of: geography (rural versus urban), modality (such as in-person, virtual, or a mix), community/university partnerships, and scholarship for faculty balancing instruction and research demands. Addressing stages of implementation, the papers reflect a continuum from pre-planning to pilot to more advanced stages of implementation. First, Lisa Borrero will highlight challenges and opportunities of conceptualizing fully online intergenerational programming, including the pre-implementation planning, execution, and evaluation stages.The second paper from Ladan Ghazi Saidi will describe pre-implementation tasks completed to establish interest in intergenerational programming in a rural setting, as well as challenges stemming from the pandemic. Third, Jill Juris and colleagues will highlight an online intergenerational technology program offered from a rural Western North Carolina university that began implementation during the pandemic.Fourth, Rachel Scrivano and colleagues will describe a community-based participatory research method that bridged the gap between expectations and reality of implementing a 5-year intergenerational program focused on healthy food access. The fifth paper from Skye Leedahl and colleagues will discuss the implementation experiences of an intergenerational, reverse mentoring, technology program that has evolved for seven years at a Rhode Island public university and utilizes community partners from across the state.

Urban places and Mental Health challenges (lessons learned from Covid-19 crisis) : Marija Jevtic

Abstract Nature deprivation under COVID-19 lead to reduced well-being. Urban design interventions were also identified as an important contributor to the restoration of community confidence, choice, and safety. Factors related to sociodemographic, housing and lockdown were linked to changes in exposure to nature during the pandemic lockdown. Changes in exposure to nature and mental health outcomes during the COVID-19 lockdown were strongly linked. Especially young people had an increased number of mental health problems. Children and youth were more bored and worried in comparison with the pre-pandemic period. The educational institutions worldwide were closed or changed to online education during the pandemic, leading to great disturbance in students’ education and outdoor events. All “green infrastructure” (GI) resources (including parks, gardens etc.) received great attention as “essential infrastructure” supporting well-being. But, the quality, functionality and position of GI in urban areas showed inequality in distribution. Frequently, societies with greater ethnic diversity, lower income and larger health inequality suffered from unsatisfactory or lack of access. GI is important in decision-making to address inequality. This work will also present an open-air activity for all generations: A reflective walk through the oldest part of Novi Sad (EU Capital of Culture 2022), as a part of Project Reflective citizens in Novi Sad. This walking tour was led by pupils from primary school - where all generations spend useful time in open space and a safe atmosphere walking tour, learning and listening about the cultural history of the oldest part of the city. It is vital to enhance urban planning and design practices in making healthier and more resilient communities. It is necessary to underline the importance of planning green spaces that need time to form in urban areas, and which have proven to be very important for mental health in the midst of the pandemic crisis.

Jevtic M, Matkovic V, Kusturica M et al.

MINNESOTA’S 2021 LGBTQ AGING NEEDS ASSESSMENT

Abstract Every decade Minnesota embarked on a needs assessment of lesbian, gay, bisexual, transgender and queer (LGBTQ) older adults which has provided important insights into aging within these communities. In 2021, a research team replicated these past monumental studies into this Minnesota 2021 LGBTQ Aging Needs Assessment. 485 individuals responded to the survey, either online or by paper. Of those, 354 met the inclusion criteria and are included in the results. Like the 2012 study, LGBTQ older adults who participated in the study were more likely to be a caregiver than compared to the general population. At the same time they were less likely to have a caregiver and less likely to have children. Half of the participants experienced some form of discrimination and the vast majority more knew someone who experienced discrimination due to their sexual orientation or gender identity. Positively, study participants were more likely to have completed a health care directive and more likely to volunteer than the general population. Possibly one of the most striking changes over the last two decades is that 85% of respondents were confident they would receive sensitive services. In 2012 only 18% and 2002 only 9% expressed the same confidence. In congruence with the past studies, the majority of respondents continue to desire LGBTQ welcoming senior services rather than LGBTQ segregated services.

P64 Accurate incidence and prevalence estimates are important for families of children with juvenile idiopathic arthritis

Abstract Introduction/Background Juvenile Idiopathic Arthritis (JIA) is a heterogenous group of autoimmune disorders characterised by chronic joint inflammation, affecting children and young people (CYP) under the age of 16. Recent analysis in the UK [1] has provided an update to the estimated incidence and prevalence of JIA. Whilst the policy and health-care benefits of accurate incidence and prevalence rates are understood, this patient- and parent-led qualitative project sought views from parents of CYP with JIA to understand whether knowing accurate estimates of incidence and prevalence are important to them. Description/Method Parents of CYP with JIA, all members of a small online group on social media, were asked whether knowing accurate rates of JIA were important to them, and why. Responses were collated and summarized. Discussion/Results Whilst a few respondents felt it did not matter to them what the overall rates of JIA were, focusing instead on their own personal experience with the condition, the majority did want to know and gave consistent reasoning. They advised that, when your child is diagnosed with JIA, it is a very isolating experience. Most people have never heard of the condition before, and being told your child has arthritis is a frightening time (especially if you then become aware of some of the significant long-term effects, such as potential continuation of disease into adulthood and possible joint damage, and the side effects of treatment, and social impacts of the disease [2, 3]. Whilst direct support is available to families affected by JIA (www.jarproject.org/hope), understanding prevalence rates can help reduce mental health burdens on patients and parents and reduce feelings of isolation. Families also advised that they want to know numbers of children with JIA so we collectively can get a better understanding of the cause, the trends, and the possible reasons behind changes. Knowing accurately the numbers of children with JIA can help to raise awareness; current lack of awareness in society and primary care contributes to delays in diagnosis and potentially worse clinical outcomes [4]. In addition they reported the need for appropriate resourcing of paediatric rheumatology and support services, and the political and financial discussions that must take place to enable that to happen need to be supported by evidence. Key learning points/Conclusion Overall, parents do want to know how many other children have JIA. It takes some of the isolation and anxiety away to know you are not alone. It matters because knowing there are other parents in the same situation as you can help reduce anxiety and loneliness. It matters, because knowing there are researchers focussing on JIA helps remind you that work is underway to better understand JIA, its causes, and improved treatments which will eventually lead to improved care for children with the condition. It matters, because it can help target resources appropriately. It matters, because raising awareness is more effective if we know how many people are affected by a chronic condition. And it matters, because as improved treatments are developed we want to be able to see the number of children categorised as having active JIA to reduce and health outcomes for each child to improve. References:  1. Costello R, McDonagh J, Hyrich K, Humphreys J. Incidence and prevalence of Juvenile Idiopathic Arthritis in the United Kingdom 2000-2018: results from the Clinical Practice Research Datalink, Rheumatology, 2021; keab714, https://doi.org/10.1093/rheumatology/keab714 2. Minden K, Niewerth M, Listing J, Biedermann T, Bollow M, Schöntube M, et al. Long-term outcome in patients with juvenile idiopathic arthritis. Arthritis & Rheumatism. 2002;46(9):2392-401. 3. Moorthy LN, Peterson MG, Hassett AL, Lehman TJ. Burden of childhood-onset arthritis. Pediatric Rheumatology. 2010;8(1):20. 4. Rapley T, May C, Smith N, Foster HE. ‘Snakes & Ladders': factors influencing access to appropriate care for children and young people with suspected juvenile idiopathic arthritis - a qualitative study. Pediatr Rheumatol Online J. 2021;19(1):43.

The Success of Headucate: The Student-Led Mental Health Society

Introduction Headucate: University of East Anglia, a university student-led society, was founded almost 10 years ago by medical students to promote mental health education and raise awareness and funds for mental health causes. Objectives Headucate aims to spread mental health awareness and reduce stigma by working with schools, universities, other societies and charities internationally. Methods Headucate delivers workshops for children aged 4-18 in primary and secondary schools, community and youth groups and university students. These sessions were delivered in-person pre-COVID and online as interactive webinars since 2020, to spark discussion around mental health, and provide information about the variety of supports available for young people. Results In the past decade, Headucate UEA has grown to become one of UEA’s largest student-led groups boasting over 175 members in 2020-2021 from all courses. Within the online world, Headucate’s events have reached worldwide. The initiative has received national recognition, won national student awards and has expanded to set up three further Headucate branches nationwide. Outreach has accelerated and the school workshops reached over 1,000 students in the past year. Conclusions Headucate has grown from strength to strength and has plans to continue to develop, with passionate student drivers behind the project. Expansion of the project could include a national mental health university directory, bringing together like-minded mental health advocate students around the country and creating new Headucate branches across the country. To further develop, Headucate could expand outreach to the elderly community as discussed by previous committee. Disclosure No significant relationships.

Selwyn V, Beezhold J, Gilmore R et al.