Background Syrians have been the largest group of refugees in Germany since 2014. Little is known about Syrian refugees` perspectives on substance use. The aim of this study is to investigate the perspective of male refugees from Syria and to foster specific knowledge and understanding of substance use. Methods We applied a qualitative study design. Five semi-structured focus group discussions with a total of 19 refugees were conducted in 2019 among the difficult to reach population of Syrian refugees. Audio recordings were translated and transcribed. We used a hybrid approach by integrating inductive and deductive thematic frameworks. Results We identified common themes. Firstly, refugees perceived that substances are widely available and accepted in Germany. Secondly, refugees perceived that rules and norms in Germany differ from rules and norms in the home country and favor availability of substances. Thirdly, substance use is related to the intention to escape the past. Fourthly, substance use is related to living in the present through connecting with others and being part of the community. Finally, mental health professional treatment for substance use is associated with shame. Conclusions Findings support Syrian refugees` perspectives of substance use as a way of both escaping the past and coping with psychosocial difficulties in the present in a socio-ecological understanding. Understanding the explanatory model of Syrian refugees can inform future interventions to prevent substance abuse and design tailored interventions. Further studies with Syrian refugees in more countries are needed to better understand resettled refugees` perspectives on substance use.

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Background The ongoing community-based participatory research (CBPR) project is based on a representative cross-sectional study on health and well-being in a rural region of Germany (n = 655). Methods We use a wide array of participatory methods to involve the general public, politicians and experts such as conferences open to the public including the use of the Mentimeter app, e-participation via an online-forum, working groups on topics identified by the public, a Delphi survey elicit expert opinions and focus groups to get deeper knowledge on key aspects. Results The results confirm the interest the public has in understanding better scientific research in the field of public health. The diversity of people (most notably age, social background) is a challenge in reaching out to people. Presenting statistical data to non-experts requires the researchers to re-think ways of presenting data, therefore basic knowledge on data research has to be taught. Usage of the tools such as the Mentimeter app offers a low-threshold for empowering people to take part in participatory conferences. Conclusions Sustainability is of utmost importance for participatory research. The population not only has the need but deserves timely information on results. Key challenges are communication, building trust and implementing sustainable CBPR projects. CBPR helps in building mutual trust, knowledge and science - public co-operations. Conferences open to the public that are tailored to the public`s needs and competences show the great interest people have in scientific knowledge generated through population-based surveys. By participatory research, Public Health Science can contribute to society, empower the general public. Key messages There is an existing interest in CBPR by the general public. It can be assumed that promoting CBPR in a sustainable manner will increase that interest. The diversity of participants is a challenge as well as communicating scientific data to non-experts.

Background Relationship of wellbeing of adolescent and community determinants in rural areas are mainly unknown. The aims of this study is 1) to provide data on wellbeing of adolescents in a rural area, 2) to analyses the association of sociodemographic variables and satisfaction with their community with adolescents` wellbeing. Methods We conducted a representative cross-sectional study (June 2018 - May 2019) in a rural catchment area including adolescents aged 14-18 years. We included socio-demographics (age, gender, education status), and time spent with parents in our study. Additionally, we measured wellbeing with the Ryff wellbeing scale (42 Items) and satisfaction with the community with a self-developed scale (21 Items). Data were analysed with uni- and multivariate linear regression models. Results A total of n = 157 adolescents (n = 82 girls/n=73 boys, age mean=16.7 years) participated in this families health study. The majority (97%/n=152) lived with their parents, and 70% (n = 110) had siblings. Among them were n = 146 adolescents (93%) who are in school-based education, and n = 11 (7%) are under work training education. Overall, adolescents reported high well-being scores (mean=166.78, SD = 32.8, 95%CI=161.24-172.19) and high satisfaction with their community (mean=13.67, SD = 1.63, 95%CI=13.45-14.03). Surprisingly, adolescents loved to spend time with their parents. Multivariate analyses suggest no significant associations of age (p-value=0,565), gender (p-value=0.961), education status (p-value=0.271) with well-being. However, community satisfaction is associated with well-being (p-value=0,006). Conclusions Sociodemographic variables were not associated with adolescents' satisfaction but with well-being in this rural community. A potential explanation might be that adolescents rely on their families rather than the wider community. Further studies are necessary to investigate the role of family relations in explaining the high well-being of this population.

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