Background: Many community-dwelling older adults experience limitations in (instrumental) activities of daily living, resulting in the need for homecare services. Whereas services should ideally aim at maintaining independence, homecare staff often take over activities, thereby undermining older adults’ self-care skills and jeopardizing their ability to continue living at home. Reablement is an innovative care approach aimed at optimizing independence. The reablement training program ‘Stay Active at Home’ for homecare staff was designed to support the implementation of reablement in the delivery of homecare services. This study evaluated the implementation, mechanisms of impact and context of the program. Methods: We conducted a process evaluation alongside a 12-month cluster randomized controlled trial, using an embedded mixed-methods design. One hundred fifty-four homecare staff members (23 nurses, 34 nurse assistants, 8 nurse aides and 89 domestic workers) from five working areas received the program. Data on the implementation (reach, dose, fidelity, adaptations and acceptability), possible mechanisms of impact (homecare staff's knowledge, attitude, skills and support) and context were collected using logbooks, registration forms, checklists, log data and focus group interviews with homecare staff (n = 23) and program trainers (n=4). Results: The program was largely implemented as intended. Homecare staff's average compliance to the program meetings was 73.4%; staff members accepted the program, and particularly valued its practical elements and team approach. They experienced positive changes in their knowledge, attitude and skills about reablement, and perceived social and organizational support from colleagues and team managers to implement reablement. However, the extent to which homecare staff implemented reablement in practice, varied. Perceived facilitators included digital care plans, the organization’s lump sum funding and newly referred clients. Perceived barriers included resistance to change from clients or their social network, complex care situations, time pressure and staff shortages. Conclusions: The program was feasible to implement in the Dutch homecare setting, and was perceived as useful in daily practice. Nevertheless, integrating reablement into homecare staff's working practices remained challenging due to various personal and contextual factors. Future implementation of the program may benefit from minor program adaptations and a more stimulating work environment.
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Older people today are more likely to age in their own private living environment. However, many face declining health and/or other issues that affect their ability to live independently and necessitate additional support. Such support can be provided by formal networks, but a considerable part can also be offered by informal networks of older people themselves. Going beyond these networks, older people can additionally and perhaps even more substantially benefit from vital communities. Nevertheless, even though this term is increasingly common in the literature, its meaning remains indistinct. A more thorough understanding of this concept might provide valuable knowledge that health care professionals, researchers and community workers can use to offer meaningful and effective support. The purpose of this paper is to draw on existing empirical research on vital communities to build knowledge of the different descriptions and dimensions of the concept. Arksey and O’Malley’s scoping review methodology was adopted. Our search, conducted on 23 March 2020 and updated on 06 January 2021, yielded 4433 articles, of which six articles were included in the scoping review. We deduced that the conceptualisation of a vital community is based on three dimensions: the aim of a vital community, the processes behind a vital community and the typical characteristics of a vital community. None of the selected studies have mapped all three dimensions. Nevertheless, we assume that understanding all three matters when vital communities aim to contribute to the quality of life of people ageing in place.
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In this paper we discuss the design process that took place while creating social software for Amsterdam University of Professional Education (AUPE) and the interactive knowledge platform, called ‘Theme-sites’. Themesites are used collaboratively by nine universities bound by a consortium, Digital University (DU). The DU is experimenting using communities of practice (CoPs) as a way to to stimulate the use of ICT in Higher Education. We describe the redesign, for which we used principles of design research (Col-lins et al., 2004). However in both described cases user experiences revealed that users have difficulties in getting actively involved in the knowledge portal. We propose how we might redesign the knowledge platform to support learning processes better, using theories like Wenger’s (1998) related to learning ar-chitectures. This paper aims at expanding design knowledge about knowledge portals and CoPs and dis-cusses the yet overseen critical design elements, like the brokering competences that facilitators need.
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Het grote publiek heeft steeds meer moeite om zijn weg te vinden in een steeds groter wordende hoeveelheid digitale bronnen. Het onderscheiden van feit van nep en het identificeren van relevante feiten over gebeurtenissen in een continue stroom van heterogene gegevens is niet alleen moeilijk geworden voor burgers, maar ook voor professionele informatiemakelaars zoals journalisten. Om deze uitdaging aan te gaan, co-creëert en onderzoekt HAICu samen met de belangrijkste stakeholders in het veld nieuwe vormen van AI-gestuurde toegang tot multimodale data die zijn opgeslagen in Nederlandse cultureel erfgoed (CH) instellingen. Met name de huidige ontoegankelijkheid belemmert burgers, journalisten, burgerorganisaties en andere maatschappelijke belanghebbenden bij het ontwikkelen en verifiëren van geïnformeerde standpunten over onderwerpen van hun interesse.
