Introduction: Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) are expected to increase rapidly, due to the aging population worldwide. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing fall rates among older adults. However, these FPPs have not reached their full potential as most programs are under-enrolled. Therefore, this study aims to identify promising strategies that promote participation in FPPs among community-dwelling older adults. Methods: This is an exploratory qualitative study. Previously, barriers and facilitators for participation in FPPs by older adults had been identified. Next, six strategies had been designed using the Intervention Mapping approach: (1) reframing; (2) informing about benefits; (3) raising awareness of risks; (4) involving social environment; (5) offering tailored intervention; (6) arranging practicalities. Strategies were validated during semi-structured interviews with communitydwelling older adults (n = 12) at risk of falling. Interviews were audio-recorded, transcribed, and analyzed following a qualitative thematic methodology, with a hybrid approach. Results: All strategies were considered important by at least some of the respondents. However, two strategies stood out: (1) reframing ‘aging’ and ‘fall prevention’: respondents preferred to be approached differently, taking a ‘life course’ perspective about falls, and avoiding confronting words; and (2) ‘informing about benefits’ (e.g., ‘living independently for longer’); which was mentioned to improve the understanding of the relevance of participating in FPPs. Other strategies were considered important to take into account too, but opinions varied more strongly. Discussion: This study provides insight into potential strategies to stimulate older adults to participate in FPPs. Results suggest that reframing ‘aging’ and ‘fall prevention’ may facilitate the dialogue about fall prevention, by communicating differently about the topic, for example ‘staying fit and healthy’, while focusing on the benefits of participating in FPPs. Gaining insight into the strategies’ effectiveness and working mechanisms is an area for future research. This could lead to practical recommendations and help professionals to enhance older adults’ participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht).
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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ObjectiveThe Joint Effort Initiative was endorsed by Osteoarthritis Research Society International (OARSI) in 2018 as a collaboration between international researchers and clinicians with an interest in the implementation of osteoarthritis management programs (OAMPs). This study aimed to identify and prioritise activities for future work of the Joint Effort Initiative.DesignA survey was emailed to delegates of the 2018 OARSI World Congress attending a pre-conference workshop or with a known interest in OAMPs (n = 115). Delegates were asked about the most important issues regarding OAMP implementation. The top 20 issues were synthesised into 17 action statements, and respondents were invited to participate in a priority ranking exercise to determine the order of importance of the statements.ResultsSurvey respondents (n = 51, 44%) were most commonly female (71%), with an allied health background (57%), affiliated with universities (73%) from Oceania (37%), and Europe/UK (45%). The five highest ranked action statements were:i)Establish guidelines for the implementation of different OAMP models to ensure consistency of delivery and adherence to international best practice.ii)Develop and assess training and education programs for health care professionals (HCPs) delivering OAMPs.iii)Develop and evaluate the implementation and outcomes of novel models of OAMPs.iv)Develop and assess core skill sets and resources for HCPs delivering OA care.v)Develop a framework for enhancing the quality of care provided by OAMPs.ConclusionPrioritising statements will bring focus to the future work of the Joint Effort Initiative in the future and provide a basis for longer-term actions.
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Zand en andere grove grondstoffen worden steeds schaarser door intensief gebruik in infrastructuur en industrie, terwijl miljarden kubieke meters slib wereldwijd worden uitgebaggerd om vaargeulen en havens operationeel te houden. Vanwege dit groeiende tekort aan traditionele grondstoffen is er behoefte aan het ontwikkelen van nieuwe methodieken voor hergebruik van slib en lokaal sediment, onder andere voor dijkversterking en ophoging van landbouwgronden. Echter wordt gebaggerd slib volgens de regelgeving nog als een van de grootste potentiële afvalstromen gezien. Ook is slib complexer in het gebruik omdat het bestaat uit een heterogeen mengsel van onder meer water, zand, organisch materiaal, fijnstof en gas. Vanwege schaarste in bouwmaterialen lopen er steeds meer initiatieven voor het nuttig hergebruiken van gebaggerd slib, maar de optimale laagdikte en aanlegtechnieken moeten nog worden onderzocht. Met dit project zoeken lectoraat Sustainable River Management samen met Hogeschool Van Hall Larenstein en de praktijkpartners Klaei B.V., Waterschap Noorderzijlvest en EcoShape naar de best practices voor het produceren van waardevol klei uit havenslib. Via laboratoriumexperimenten en veldproeven binnen grootschalige pilots worden mechanische eigenschappen van havenslib uit de Lauwersoog haven in beeld gebracht. Er wordt gezocht naar de optimale dikte van havenslib om bruikbare klei te produceren. Daarbij wordt onderzocht of de mechanische eigenschappen van de geproduceerde klei afhankelijk zijn van de laagdikte van de initiële laag of havenslib. De resultaten verbinden de laagdikte in rijpingscompartimenten met materiaaleigenschappen en monitoren de initiële verouderingsprocessen na de aanleg van de klei in een proefdijk. Het eindresultaat biedt inzicht in de best practices voor toepassing van havenslib en de daarbij horende materiaaleigenschappen. Dit project draagt daarmee direct bij aan de ontwikkeling van een nieuw, duurzaam materiaal voor gebruik in dijkversterkingen en landbouw en een circulaire economie in Nederland in 2050.
