Improving population health and reducing inequalities through better integrated health and social care services is high up on the agenda of policymakers internationally. In recent years, regional cross-domain partnerships have emerged in several countries, which aim to achieve better population health, quality of care and a reduction in the per capita costs. These cross-domain partnerships aim to have a strong data foundation and are committed to continuous learning in which data plays an essential role. This paper describes our approach towards the development of the regional integrative population-based data infrastructure Extramural LUMC (Leiden University Medical Center) Academic Network (ELAN), in which we linked routinely collected medical, social and public health data at the patient level from the greater The Hague and Leiden area. Furthermore, we discuss the methodological issues of routine care data and the lessons learned about privacy, legislation and reciprocities. The initiative presented in this paper is relevant for international researchers and policy-makers because a unique data infrastructure has been set up that contains data across different domains, providing insights into societal issues and scientific questions that are important for data driven population health management approaches.

Background: The use of social media by adolescents has increased considerably in the past decade. With this increase in social media use in our daily lives, there has been a rapidly expanding awareness of the potential unhealthy lifestyle-related health effects arising from excessive, maladaptive, or addictive social media use. Objective: This study aims to assess the association between adolescents’ social media use and health-related behaviors. Methods: We used a cross-sectional research approach and analyzed data from 96,919 adolescents at high schools throughout the Netherlands. A structured 43-item questionnaire was used to gather data on sociodemographics, dietary and lifestyle factors, and the degree of social media use based on the Compulsive Internet Use Scale. Logistic regression analyses were performed to assess the association between problematic social media use (PSMU) and lifestyle behaviors while adjusting for sociodemographic factors. Results: Of the 96,919 included adolescents, 7.4% (n=7022) were identified as at risk for PSMU. Furthermore, logistic regression results showed that adolescents who are at risk for PSMU were more likely to report alcohol consumption and smoking while simultaneously having significantly lower levels of health-promoting behavior such as healthy eating habits (eating fruits, vegetables, and breakfast regularly) and physical activity. Conclusions: This study confirms that adolescents at risk of PSMU were more likely to exhibit an unhealthy lifestyle. Being at risk for PSMU was a determinant of soft drug use, alcohol consumption, smoking, poor eating habits, and lower physical activity independent of the additional adjusted covariates including demographic variables and remaining lifestyle variables. Future research is needed to confirm this observation in an experimental setting.

Introduction. Social prescribing (SP) is an integrated care program aimed to improve individuals’ health and wellbeing. Understanding the influence of SP and determining best practices and processes are challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method. A comprehensive search was conducted in twelve databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. We utilized ASReview, an open‐source machine learning tool, to conduct title and abstract screening. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool, and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS‐I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Quantitative data were visually presented using Harvest Plots, and qualitative data were narratively summarized. Results and Discussion. In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. The findings highlight the importance of social‐related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP.

This study aims to analyze prescription patterns of new diabetes medication and assess socioeconomic disparities in their initiation among individuals with T2DM with very high cardiovascular risk. Individuals diagnosed with T2DM and very high cardiovascular risk were identified (N = 10,768) based on general practitioner's electronic health record data. SGLT-2is and GLP-1RAs prescription patterns were examined. Furthermore, the association between SES and the prescription of SGLT-2is and GLP-1RAs in 2022 was investigated. Despite the increase in prescription rates of SGLT-2is and GLP-1RAs between 2019 and 2022, approximately 85 % and 93 % of eligible individuals did not receive SGLT-2is and GLP-1RAs in 2022, respectively. We found a positive association between SGLT-2is prescription and SES in only the 4th quintile compared to 1st quintile (referent) in the fully adjusted model (OR 1.29 95 % CI:1.08-1.54). The prescription rates among eligible individuals highlight significant room for improvement in aligning prescribing practices with guidelines. We found no profound socioeconomic gradient in initiation of SGLT-2is and GLP-1RAs. The latter may be due to guidelines' clear indication of the eligible population and GP education. Future development and potential disparities in initiation and maintenance should be monitored to ensure equitable prescribing.

Background: There is a concern regarding socioeconomic disparities in prescription of new medications such as SGLT-2is or GLP-1RAs in type 2 diabetes mellitus (T2DM). This study aims to analyze prescription patterns of these medications and assess socioeconomic disparities in their initiation among individuals with T2DM with very high cardiovascular risk. Methods: Individuals diagnosed with T2DM and very high cardiovascular risk were identified (N = 10,768) based on general practitioner’ electronic health record data. Socioeconomic status (SES) was based on standardized disposable household income in quintiles. The association between SES and the prescription of SGLT-2is and GLP-1RAs in 2022 was investigated by logistic regression analyses, adjusting for potential confounding factors. SGLT-2is and GLP-1RAs prescription patterns were examined over 2019-2022, stratified for age-groups and sex. Results: We found a positive association between SES quintile 1 (referent) and quintile 4 in SGLT-2is prescription in all models (OR 1.29 95%CI:1.08-1.54 in the fully adjusted model). For prescriptions of GLP-1RAs, we found no significant differences in SES. Proportionally, men are more frequently prescribed SGLT-2is, while there are no sex disparities in GLP-1RAs prescription. Older individuals consistently receive fewer SGLT-2is and GLP-1RAs prescriptions compared to other age categories. Conclusions: We observed sex and age disparities but no profound socioeconomic differences in initiation of SGLT-2is and GLP-1RAs in the Netherlands. The latter may be due to guidelines’ clear indication of the eligible population (T2DM and very high cardiovascular risk) and GP education. Future development and potential disparities in initiation and maintenance should be monitored. Key messages: • We found no disparities in prescribing new Type 2 diabetes medication based on socioeconomic status. • The adoption of prescribing new medication for Type 2 diabetes patients takes time.

Introduction: Social Prescribing (SP) is an integrated care program aimed to improve individuals’ health and wellbeing. Understanding the influence of SP and determining best practices and processes is challenging due to variability in its delivery, implementation, and intervention characteristics between different studies and countries. This study aimed to identify the intervention characteristics, mechanisms, and outcomes associated with SP research, and explore how these factors relate to the influence of SP on health and wellbeing, healthcare utilization, and care experiences. Method: A comprehensive search was conducted in 12 databases, Google Scholar, and reference lists of relevant studies published from January 2010 up to April 2023. Searches were limited to literature written in English or Dutch. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool and the risk of bias was evaluated using the Cochrane RoB2 and the ROBINS-I. We coded all intervention characteristics, mechanisms, and relevant outcomes. Qualitative data were visually presented using Harvest Plots and qualitative data were narratively summarized. Results and discussion: In total, 49 papers were included, of which seven qualitative, seventeen quantitative, and 25 mixed method studies. Moreover, the findings highlights the importance of social-related mechanisms, including loneliness and social connectedness, in contributing to the observed positive influence of SP on mental health and wellbeing. The observed outcomes seem to be influenced by various characteristics, including gender, age, the presence of a link worker, and the use of behavior change techniques. However, we should be cautious when interpreting these results due to limitations in study designs, such as the lack of controlled trials and statistical considerations. Further rigorous research is needed to comprehensively understand the impact and potential benefits of SP.