Paul Gellert forscht am Einstein Center for Population Diversity zu den Folgen wachsender Bevölkerungsvielfalt für soziale Ungleichheit und Gesundheitsdisparitäten. Sein Schwerpunkt liegt darauf, wie sich verändernde Familienstrukturen und -konzepte auf die Entstehung und Weitergabe von Ungleichheiten zwischen und innerhalb von Generationen auswirken. Für Unternehmen und öffentliche Institutionen ist diese Forschung relevant, um evidenzbasierte Politiken und Programme zu entwickeln, die Ungleichheitseffekte von Diversität adressieren und Gesundheitsrisiken gezielt reduzieren. Die Arbeit verbindet Demografie, Soziologie, Politikwissenschaft und Datenwissenschaften in einem interdisziplinären Ansatz.
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Paul Gellert
HU-FIS-Profil ↗The Einstein Center for Population Diversity will bring together leading scholars in demography, sociology, political science, psychology / health sciences, and data science to study the consequences of growing population diversity for socioeconomic inequality and to examine how diversity and socioeconomic inequality relate to health disparities.
The Einstein Center for Population Diversity (ECPD) will study the consequences of increasing population diversity for social inequality and health disparities by focusing on the growing diversity of families, including changing conceptions and boundaries of the family itself. The family is a crucial, if not the primary, arena where inequalities are (re-)produced within and across generations, in and through the continuous interaction with social policy, the labor market, and educational institutions. Thus, changing family patterns and behavior are both a source of growing population diversity on the societal level and a driver of social inequality and wellbeing on the individual and household level. For example, when people get married, have children and divorce, they define the population structure. Union formation, marriage and union dissolution also have, however, immediate consequences for socialinequality, poverty, wellbeing and health of individuals and households. The strong relation between family patterns or family behavior and social inequality is maybe most obvious in the case of the large fraction of women who transit into poverty and welfare dependence after separation and divorce. It was also very evident during the COVID-19 pandemic, when families took over many tasks that are usually performed by the welfare state including care for children and care-dependent older adults. While this development was instrumental in maintaining key societal functions, it also put many families under intense pressure and strain, depending on the individual family constellation and its resources. The pandemic thus illustrates how families become the “place” where causes and consequences of population diversity and societal challenges play out. The ECPD will transcend disciplinary silos by linking biomedical sciences and social sciences to conduct collaborative research on the interrelations between family diversity, health, education, and social inequalities in aging societies. This will be done by a group of leading scholars in demography, sociology, medicine, psychology, and health sciences. The ECPD will be thus uniquely situated to investigate the biological, psychological, social, and environmental pathways and mechanisms as well as their interrelations operating at the family level. To unravel the longitudinal nature of the intra- and intergenerational effects of diversity in family trajectories and patterns, the ECPD will be committed to a holistic life course approach. Further, as a cross-cutting theme, the ECPD will investigate the role of global and regional crises and their multiple relations with population and family diversity. We will combine household panel data and register-based information with biomarker and genetic data to better understand biosocial pathways along the life course.
BMC Health Services Research · DOI
BACKGROUND: While the relation between care involvement of informal caregivers and caregiver burden is well-known, the additional psychosocial burden related to care involvement during the COVID-19 pandemic has not yet been investigated. METHODS: A total of 1000 informal caregivers, recruited offline, participated in a cross-sectional online survey from April 21 to May 2, 2020. Questionnaires were used to assess COVID-19-specific changes in the care situation, negative feelings in the care situation, problems with implementation of COVID-19 measures, concerns/excessive demands, loss of support, change in informal caregivers' own involvement in care and problems with provision, comprehension & practicability of COVID-19 information, and to relate these issues to five indicators of care involvement (i.e., being the main caregiver, high expenditure of time, high level of care, dementia, no professional help). Binomial and multiple regression analyses were applied. RESULTS: Across indicators of care involvement, 25.5-39.7% reported that the care situation rather or greatly worsened during the COVID-19 pandemic, especially for those caring for someone with dementia or those usually relying on professional help. In a multiple regression model, the mean number of involvement indicators met was associated with age (β = .18; CI .10-.25), excessive demands (β = .10, CI .00-.19), problems with implementation of COVID-19 measures (β = .11, CI .04-.19), an increase in caregiving by the informal caregivers themselves (β = .14, CI .03-.24) as well as with no change in the amount of caregiving (β = .18, CI .07-.29) and loss of support (β = -.08, CI -.16-.00). No significant associations with the mean number of involvement indicators met were found for gender, educational level, change in the care situation, negative feelings, and provision, comprehension & practicability of COVID-19 information. CONCLUSION: Those caregivers who perceived extensive care burden were those who suffered most during the pandemic, calling for structural support by the healthcare system now and in the future. TRIAL REGISTRATION: This article does not report the results of a health care intervention on human participants.
BMC Medical Research Methodology · DOI
BACKGROUND: Recruitment of general practitioners (GPs) and their patients is reported as one of the most challenging steps when undertaking primary care research. The present paper describes the recruitment process of a cluster randomised controlled trial (cRCT) aiming to improve dementia care in the primary care setting. METHODS: Recruitment data was analysed descriptively using frequency tables to investigate comparisons of recruitment rates and results of different recruitment strategies as well as reasons for participation and non-participation of GPs, patients with dementia (PwD) and their caregivers. RESULTS: Over a period of 23 months, N = 28 GPs were successfully included in the cRCT. This represents an overall recruitment rate of 4.6%. The most efficient strategy in terms of high response and low labour-intensity involved the dissemination of calls for participation in a GP research network. Most frequently reported reasons for GP's participation were Improvement of patient's well-being (n = 22, 79%) followed by Interest in dementia research (n = 18, 64%). The most common reasons for non-participation were Lack of time (n = 71, 34%) followed by Not interested in participation (n = 63, 30%). On a patient level, N = 102 PwD were successfully recruited. On average, each GP referred about n = 7 PwD (range: 1-17; mdn = 6; IQR = 3.5) and successfully recruited about n = 4 PwD (range: 1-11; mdn = 3; IQR = 3.5). CONCLUSION: First, our findings propose GP research networks as a promising strategy to promote recruitment and participation of GPs and their patients in research. Second, present findings highlight the importance of including GPs and their interests in specific research topics in early stages of research in order to ensure a successful recruitment. Finally, results do not support cold calls as a successful strategy in the recruitment of GPs. TRIAL REGISTRATION: The trial was prospectively registered with the ISRCTN registry (Trial registration number: ISRCTN15854413 ). Registered 01 April 2019.
BMC Health Services Research · DOI
BACKGROUND: Depression is the most common mental health burden worldwide. Primary care physicians (PCPs) play a key role in the care provision for people with depression. The first objective of the present study was to examine the health care situation of depression in primary care, focusing on the cooperation between PCPs and mental health specialists. Secondly, we aimed at examining the role of the German S3 Guideline for Unipolar Depression in the primary care provision. METHODS: Data of N = 75 PCPs were analysed from a cross-sectional online survey. Analysis of descriptive information on the current status of primary health care and depression was conducted. Further, to examine factors that are related to the usage of guidelines, multiple regression was performed. RESULTS: Only 22.1% of PCPs described the quality of cooperation with ambulatory mental health specialist as good. The most frequent problems in the cooperation were of structural nature (49.3%, long waiting list, few therapy units, as well as barriers in the communication and the information exchange). With regard to the role of the guideline, 65% of PCPs reported never or seldom using the guideline and 31.7% of PCPs perceived the guideline as not useful at all. In addition, perceived usefulness of the S3 guideline was positively associated with the usage of the guideline. Results of the logistic regression revealed a significant association between the usage of the German S3 Guideline for Unipolar Depression and rating of perceived usefulness of the guideline (OR: 4.771; 95% CI: 2.15-10.59; p < 0.001). CONCLUSION: This study highlights the central role of PCPs and demonstrates major barriers in the outpatient health care provision of depression. Present findings suggest a strong need for collaborative health care models to resolve obstacles resulting from fragmented mental health care systems. Finally, reported perceived barriers in the implementation of the German S3 Guideline for Unipolar Depression indicate the urge to involve PCPs in the development of evidence-based guidelines, in order to ensure a successful implementation and usage of guidelines in clinical practice.