Storytelling to communicate public health messages during the COVID-19 pandemic; A systematic review

Abstract Background Storytelling has been increasingly used in public health to disseminate health messages in a format that is more understandable and engaging. This project aims to summarize the findings from the studies that used storytelling approach for conveying health messages during the COVID-19 pandemic. Methods The protocol for this systematic review is registered in PROSPERO (CRD42021281957). Studies were identified via electronic databases; EMBASE, Ovid MEDLINE and EBSCO using variations of the search terms ‘COVID-19’ and ‘storytelling’. Studies that used storytelling interventions in COVID-19 and published in English after 2020 were eligible for inclusion. Data from eligible full text article was collated in a summary table. Quality of included studies were assessed using Joanna Briggs Institute Checklists. Results Of the 4562 studies identified in the electronic search, 11 were eligible for inclusion. Participant numbers in each study varied from 14 to 3746. Eight of the 11 studies included were set online, looking at virtual forms of storytelling. This included online surveys and social media campaigns within hospitals, and online meetings with patients at home. Overall, studies showed that storytelling intervention increased engagement in health communication and has the potential to be used as an effective public health communication tool, for changing health behaviours. Studies were small, six out of 11 were of poor quality. Conclusions Storytelling is a widely accepted intervention and has the potential to positively impact communication, empathy and health behaviour. As there is no standardized definition of storytelling, and studies into this area are new, it is important to continually re-evaluate data to enhance understanding and provide standardized guidelines for storytelling in the COVID-19 context. Key messages • Storytelling has been increasingly used in public health to disseminate health messages. • Storytelling has the potential to positively impact communication, empathy and health behaviour.

Climate change continues to be the biggest challenge of the 21st century, with profound and growing negative consequences on public health. While the public health and wider healthcare sector faces the health risks and consequences of climate change, it is also an important actor as producer of carbon footprint. There is therefore a need for public health and healthcare professionals to be prepared to address the climate emergency and its inequitable impacts across vulnerable populations. Climate resilience and climate-health-equity and political literacy should be built to enable public health and healthcare professionals to gain a deeper understanding of the needed changes and communicate the direct and indirect environmental impact of our health system, institutions and daily lives. This round table discussion will be framed by the joint statement ''Moving towards the right to 'health for all' by training the public health workforce on climate change and health'' issued by a network of public health stakeholders under the EU Health Policy Platform. Endorsed by more than 75 organisations from the global, European and national level, the statement calls actors in public health to bring climate change and health concerns to the forefront of the debates. During the round table, 4 panellists will touch on evidence, solutions and guidance to address the climate emergency from the different perspectives of ASPHER, EuroHealthNet, Ecorys and EHESP French School of Public Health. The added value of the round table is conveying the different views of the panellists, bringing together European CSOs and partnerships of public health authorities, academia and a research-based consultancy company, and laying out possible ways of how working together could steer the EU and national multidisciplinary policy and decision-making on the intersection of climate, health, social justice, and education. After setting the need for action, the round table will seek to produce recommendations from public health actors to address the climate emergency, bringing the dialogue parallel to COP27. This workshop will explore how different actors from inside and outside the public health domain can contribute to climate mitigation and adaptation actions. The discussion will cover: investing in climate-health training for public health and healthcare professionals; investing in public health research; designing and monitoring mitigation programmes (e.g., sustainable and resilience-enhancing healthcare policies); building climate-health-equity literacy; and providing space for dialogue for those communities who will be most harmed by an inadequate public health response. From a policy perspective, the workshop will help prepare recommendations for actions related to COP27 and will reflect on strategic processes taking place at the European level (including the Conference on the Future of Europe, the European Health Union, the Strategic Foresight, and the Recovery and Resilience Plans).

Key messages:
Climate change poses an immediate threat to planetary health, and the co-benefits of climate change mitigation and adaptation actions to health and social justice should be highlighted in policies.
The workshop provides public health actors the opportunity to produce recommended actions from public health actors to address the climate emergency at the European and national level.

Background:
Balancing electronic nicotine delivery systems (ENDS) health communication between limiting the harm for new users while offering current smokers the benefits of reduced-risk products is challenging. This umbrella review aims to summarize the evidence about ENDS risk and safety health profile to inform ENDS health communication strategies.

Methods:
Six databases were searched for systematic reviews presenting evidence on ENDS health effects. Ninety reviews divided into 5 categories were included: toxicity = 20, health effects = 40, smoking cessation = 24, transition to combustible cigarettes (CCs) = 13, and industry claims = 4. Findings were summarized narratively. Meta-analyses were conducted when appropriate. Quality assessment was conducted using the Measurement Tool to Assess Systematic Reviews. The Institute of Medicine's Levels of Evidence Framework was used to classify the evidence into high-level, moderate, limitedsuggestive, and limited-not-conclusive.

Results:
We found high-level evidence that ENDS exposes users to toxic substances; increases the risk of asthma; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases CCs initiation; and exposure to ENDS marketing increases its use/intention-touse. Evidence was moderate for ENDS association with mental health and substance use, and limited-not-conclusive for its association with cardiovascular, cancer, ear, ocular, and oral diseases, and pregnancy outcomes.

Conclusions:
Currently, ENDS communication can focus on high-level evidence related to ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning), and anti-ENDS industry sentiment. Further research is needed to assess the full spectrum of ENDS health profiles.

Key messages:
Further research is needed to establish the risk and safety health profile of ENDS with consideration of the wide variety of ENDS, their frequency of use, and different segments of the population. More prospective cohort studies that take place over longer time periods and with larger sample sizes are necessary to gauge accurately the short-and long-term health-related risks of ENDS.
15th European Public Health Conference 2022