Veranstaltungsprogramm

Introduction: Globally, health workforce shortages are more severe in rural areas. Achieving the kinds of support and job satisfaction that will recruit and retain health workers in rural areas is critical. Yet, the complexity of retaining health workers in rural areas is evident. There is variation in uptake, applicability, and effectiveness of retention schemes across rural areas because of variability in the communities served and health workers addressed. This is complicated by the fact that rural health systems range substantially in the design and composition of staff roles, as well as resources available. In 2021, the World Health Organization released Guidelines that include a suite of recommendations around education, regulation, incentives, and personal and professional support. Understanding how these guidelines are implemented is urgently needed.

Methods: In 2025, we searched the peer-reviewed literature (PubMed, Scopus and Web of Science) for articles on the implementation of rural and remote health workforce retention, attraction, development and recruitment strategies, focusing implementation. A total of 1.992 articles were identified,1.009 articles were screened, and 77 considered eligible.

Results: Using country examples, we present the extent to which countries are implementing the WHO-recommended strategies and to which key implementation factors, such as availability, affordability, acceptability, relevance, feasibility are used to decide what to implement. We highlight what we know about what works in the 4 domains of the WHO guidelines: Education, Regulation, Incentives, and Support using country examples.

Conclusions: The most effective interventions are tailored to the local context and implemented as bundled strategies. Feasibility, acceptability, and affordability are not holistically assessed prior to implementation. Rigorous and holistic evaluation, including systematic monitoring are needed. Unintended consequences and continuous learning are under explored (e.g. spillover effects, community resistance). Sharing across high-income and low-income settings is important.

Background:

Arts and cultural activities are discussed as resources for health and well-being. However, there remains a need for low-threshold and voluntary formats that can be integrated into everyday hospital life without disrupting existing routines. In response, PAUSE was developed as an artistic pause format for healthcare settings.

Methods:

PAUSE is a pilot project offering short live musical moments for staff, patients and relatives in a hospital setting. An exploratory pilot phase took place from 18 to 21 March 2026 in the chapel of the Hospital of the Elisabethinen in Graz, Austria. The format consisted of short vocal pieces of no more than three minutes, presented in 15-minute programmes that were repeated over the course of one hour and performed daily at a fixed time after midday. The musical programme was inspired by basic emotions and historical concepts of human affects. Participation was voluntary, and participants could arrive and leave at any time.

Results:

The pilot phase indicated that the format was accepted by healthcare staff from different professional groups and by patients. The possibility to come and go was actively used. Staff tended to participate for shorter periods, often leaving after two or three songs, whereas patients frequently remained in the room for the entire 15-minute musical pause. Both staff and patients often left the room with a brief “thank you”, a gentle smile or quiet applause. Informal feedback from staff particularly highlighted the voluntary and self-determined nature of participation, without any time commitment, as an important reason for attending the musical pause.

Conclusions:

The pilot phase suggests that PAUSE may represent a feasible and acceptable artistic pause format for everyday hospital life and provides a starting point for future implementation and evaluation research on arts-based health promotion in healthcare settings, particularly regarding low-threshold and self-determined forms of participation.

Background

Since 2015, occupational health management (OHM) measures have been implemented in the German Federal Armed Forces (GFAF) to promote the health of military and civilian employees. Here, the aim was to evaluate differences in the use of prescribed medication between employees participating (OHM: yes) and not participating (OHM: no) in OHM measures, applying a gender and diversity perspective.

Methods

An employee survey was conducted online and paper based from 06-09/2022. All about 220,000 employees of the GFAF were invited to participate. Employees were asked about any prescribed medication intake in the past four weeks (regularly/as required/none).

Results

In total 23.568 employees participated (11%; OHM: yes: 6772/12406 (54,6%), age 42 ± 11.37, 29% women). Among OHM participants, a smaller proportion reported a regular intake of cardiovascular medication (4.8% (288/6026) vs 5.5% (279/5088)), antihypertensive medication (16.8% (1031/6143) vs 17.5% (908/5179)) and antidepressants (2.5% (152/5995) vs 3.2% (160/5073)) compared to employees not participating. A smaller proportion of women reported a regular intake of cardiovascular medication (3.6% (214/5893); men: 5.7% (834/14,729)) and antihypertensive medication (13.1% (786/6,014); men: 17.4% (2,616/15,013)). Regarding antidepressants, a higher proportion of women reported a regular intake (4.3% (254/5886); men: 2.4% (359/14654)). Employees aged ≥40 years, employees caring for relatives, and employees of the lower and middle educational groups reported higher overall use of these medications.

Conclusion

OHM-participants reported lower levels of regular use of cardiovascular and antihypertensive medication, as well as antidepressants, and thus appear to be healthier or be prescribed fewer medicines than non-participants. With the exception of antidepressants, a smaller proportion of women reported regular medication use. A higher proportion of older employees, as well as those with care responsibilities or of lower and middle educational groups, reported taking medication regularly. When designing OHM measures a diversity-sensitive approach should be applied to improve participation.

*shared last authorship