Background: Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older adults. Previous research indicates that current models of technology acceptance are missing essential predictors specific to community-dwelling older adults. Furthermore, in situ research within the specific context of aging in place is scarce, while this type of research is needed to better understand how and why community-dwelling older adults are using technology. Objective: To explore which factors influence the level of use of various types of technology by older adults who are aging in place and to describe these factors in a comprehensive model. Methods: A qualitative explorative field study was set up, involving home visits to 53 community-dwelling older adults, aged 68-95, living in the Netherlands. Purposive sampling was used to include participants with different health statuses, living arrangements, and levels of technology experience. During each home visit: (1) background information on the participants' chronic conditions, major life events, frailty, cognitive functioning, subjective health, ownership and use of technology was gathered, and (2) a semistructured interview was conducted regarding reasons for the level of use of technology. The study was designed to include various types of technology that could support activities of daily living, personal health or safety, mobility, communication, physical activity, personal development, and leisure activities. Thematic analysis was employed to analyze interview transcripts. Results: The level of technology use in the context of aging in place is influenced by six major themes: challenges in the domain of independent living; behavioral options; personal thoughts on technology use; influence of the social network; influence of organizations, and the role of the physical environment. Conclusion: Older adults' perceptions and use of technology are embedded in their personal, social, and physical context. Awareness of these psychological and contextual factors is needed in order to facilitate aging in place through the use of technology. A conceptual model covering these factors is presented.
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The booklet describes the renewed Healthy Active Ageing programme, a neighbourhood-oriented health-promoting group programme for and by older people living independently at home. Participants in the programme exchange experiences and knowledge and actively explore topics they consider important, now and with a view to the future. The aim of the programme is to improve participants' perceived health and quality of life by strengthening resilience and increasing opportunities to do activities that have personal meaning.
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An emerging body of research indicates that active arts engagement can enhance older adults’ health and experienced well‐being, but scientific evidence is still fragmented. There is a research gap in understanding arts engagement grounded in a multidimensional conceptualization of the value of health and well‐being from older participants’ perspectives. This Dutch nation‐wide study aimed to explore the broader value of arts engagement on older people’s perceived health and well‐being in 18 participatory arts‐based projects (dance, music, singing, theater, visual arts, video, and spoken word) for community‐dwelling older adults and those living in long term care facilities. In this study, we followed a participatory design with narrative‐ and arts‐based inquiry. We gathered micro‐narratives from older people and their (in)formal caregivers (n = 470). The findings demonstrate that arts engagement, according to participants, resulted in (1) positive feelings, (2) personal and artistic growth, and (3) increased meaningful social interactions. This study concludes that art‐based practices promote older people’s experienced well‐being and increase the quality of life of older people. This study emphasizes the intrinsic value of arts engagement and has implications for research and evaluation of arts engagement.
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Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change “arguing oneself into change” and “increasing self-efficacy/confidence.”
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Active transport to school is associated with higher levels of physical activity in children. Promotion of active transport has therefore gained attention as a potential target to increase children’s physical activity levels. Recent studies have recognized that the distance between home and school is an important predictor for active travel among children. These studies did not yet use the promising global positioning system (GPS) methods to objectively assess active transport. This study aims to explore active transport to school in relation to the distance between home and school among a sample of Dutch elementary school children, using GPS. Seventy-nine children, aged 6-11 years, were recruited in six schools that were located in five cities in the Netherlands. All children were asked to wear a GPS receiver for one week. All measurements were conducted between December 2008 and April 2009. Based on GPS recordings, the distance of the trips between home and school were calculated. In addition, the mode of transport (i.e., walking, cycling, motorized transport) was determined using the average and maximum speed of the GPS tracks. Then, proportion of walking and cycling trips to school was determined in relation to the distance between home and school. Out of all school trips that were recorded (n = 812), 79.2% were classified as active transport. On average, active commuting trips were of a distance of 422 meters with an average speed of 5.2 km/hour. The proportion of walking trips declined significantly at increased school trip distance, whereas the proportion of cycling trips (β = 1.23, p < 0.01) and motorized transport (β = 3.61, p < 0.01) increased. Almost all GPS tracks less than 300 meters were actively commuted, while of the tracks above 900 meters, more than half was passively commuted. In the current research setting, active transport between home and school was the most frequently used mode of travel. Increasing distance seems to be associated with higher levels of passive transport. These results are relevant for those involved in decisions on where to site schools and residences, as it may affect healthy behavior among children. https://doi.org/10.1186/1471-2458-14-227 LinkedIn: https://www.linkedin.com/in/sanned/
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Although critical differences exist between large companies and small- and medium-sized enterprises (SMEs), limited empirical research has been done on human resource (HR)-related corporate social responsibility (CSR). In this paper we study aging workforce management (AWM) as a component of CSR. Our study was conducted in the Netherlands through a randomly distributed online questionnaire. Managers and team leaders of 201 SMEs responded. The data were analyzed using multiple hierarchical regression analysis. Our results are twofold: first, findings suggest that CSR policies in micro organizations with fewer than five employees seem to be strongly associated with AWM; and second, that companies with a focus on integration of older workers in daily activities do not perceive their actions as HR-related. Using AWM as part of CSR helps to give insight into the role of the owner, company size and the nature of implicit CSR practices. Our study demonstrates that the use of AWM in CSR research can lead to valuable insights and therefore, our overarching research question is answered that AWM can be used when studying CSR. © 2012 Blackwell Publishing Ltd.
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BACKGROUND: There is a growing interest in empowering older adults to age in place by deploying various types of technology (ie, eHealth, ambient assisted living technology, smart home technology, and gerontechnology). However, initiatives aimed at implementing these technologies are complicated by the fact that multiple stakeholder groups are involved. Goals and motives of stakeholders may not always be transparent or aligned, yet research on convergent and divergent positions of stakeholders is scarce. OBJECTIVE: To provide insight into the positions of stakeholder groups involved in the implementation of technology for aging in place by answering the following questions: What kind of technology do stakeholders see as relevant? What do stakeholders aim to achieve by implementing technology? What is needed to achieve successful implementations? METHODS: Mono-disciplinary focus groups were conducted with participants (n=29) representing five groups of stakeholders: older adults (6/29, 21%), care professionals (7/29, 24%), managers within home care or social work organizations (5/29, 17%), technology designers and suppliers (6/29, 21%), and policy makers (5/29, 17%). Transcripts were analyzed using thematic analysis. RESULTS: Stakeholders considered 26 different types of technologies to be relevant for enabling independent living. Only 6 out of 26 (23%) types of technology were mentioned by all stakeholder groups. Care professionals mentioned fewer different types of technology than other groups. All stakeholder groups felt that the implementation of technology for aging in place can be considered a success when (1) older adults' needs and wishes are prioritized during development and deployment of the technology, (2) the technology is accepted by older adults, (3) the technology provides benefits to older adults, and (4) favorable prerequisites for the use of technology by older adults exist. While stakeholders seemed to have identical aims, several underlying differences emerged, for example, with regard to who should pay for the technology. Additionally, each stakeholder group mentioned specific steps that need to be taken to achieve successful implementation. Collectively, stakeholders felt that they need to take the leap (ie, change attitudes, change policies, and collaborate with other organizations); bridge the gap (ie, match technology with individuals and stimulate interdisciplinary education); facilitate technology for the masses (ie, work on products and research that support large-scale rollouts and train target groups on how to use technology); and take time to reflect (ie, evaluate use and outcomes). CONCLUSIONS: Stakeholders largely agree on the direction in which they should be heading; however, they have different perspectives with regard to the technologies that can be employed and the work that is needed to implement them. Central to these issues seems to be the tailoring of technology or technologies to the specific needs of each community-dwelling older adult and the work that is needed by stakeholders to support this type of service delivery on a large scale. KEYWORDS: aged; eHealth; focus groups; health services for the elderly; implementation management; independent living; project and people management; qualitative research; technology
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Feedback is one of the most powerful tools teachers can use to enhance student learning. In 2006, the Dutch Inspectorate of Education concluded from classroom observations that it is difficult for Dutch teachers to give their students good feedback in order to stimulate students' learning process and developmental progress. Similar problems were revealed in other school levels and countries, for example in secondary education and in Finland. Giving feedback during active learning may be even more troublesome for teachers. During active learning, students are working in small groups on different learning goals and undertake different learning activities at the same time. They need to achieve task-related goals as well as to develop the meta-cognitive knowledge and skills that are needed for active learning. Yet, teachers often seem unable to provide the feedback that is needed and they do not know how to support the development of meta-cognitive knowledge and skills.Therefore, this research project focused on ways to improve primary school teachers' feedback giving practices during active learning. The central research question is: How can primary school teachers learn to give optimal feedback to pupils during active learning? To answer this question, five studies have been conducted. In the first study, knowledge regarding teachers' feedback practices was gathered. A category system was developed based on the literature and empirical data. A total of 1465 teacher-student interactions of 32 teachers who practiced active learning in the domain of environmental studies in the sixth, seventh or eighth grade of 13 Dutch primary schools were videotaped and assessed using this system. Results showed that about half of the teacher-student interactions contained feedback. This feedback was usually focused on the tasks that were being performed by the students and on the ways in which these tasks were processed. Only 5% of the feedback was explicitly related to a learning goal. In their feedback, the teachers were directing (rather than facilitating) the learning processes. During active learning, however, feedback on meta-cognition and social learning is important. Feedback should be explicitly related to learning goals. In practice, these kinds of feedback appear to be scarce. In the second study, the problems these 32 primary school teachers perceive and the beliefs they hold regarding the provision of feedback were investigated. A writing task and an interview were conducted. It appeared that teachers believed that conditional teacher skills, especially time management, hindered them most from giving good feedback. The most widely held belief was that 'feedback should be positive'. Teachers also believed that it is important to adopt a facilitative way of giving feedback, but they found this difficult to implement. Only some teachers believed goal-directedness and a focus on student meta-cognition were important during active learning and teachers did not perceive problems regarding these aspects. In the third study, a professional development program (PDP) was developed, implemented and evaluated. The goals and content of the PDP were based on a review of the literature regarding feedback and active learning and on the results of the preceding studies. The design of the PDP was based on the extant literature regarding the features which are considered to be important for PDPs, including structural features, goal setting and characteristics of the professional development activities that are part of the program. Effects of this PDP on 16 primary schoolteachers' knowledge, beliefs, perceived problems and classroom behavior were examined via observations, a writing task and a questionnaire prior and twice after the program was implemented. Results showed that several aspects of feedback during active learning were improved, both in the short and in the long term. For example, teachers learned to believe that feedback must be goal-directed and that learning goals need to be communicated to students. In the classrooms, teachers related their feedback more often explicitly to the learning goals. In the fourth study, the extent to which teachers attributed the success of the PDP to each of the purposefully implemented features of the PDP was examined. The 16 teachers that participated in the PDP completed a questionnaire and four focus group interviews were conducted. Results indicated that teachers value most features quite highly; all features contributed to teachers' professional development according to the teachers themselves. The qualitative data was used to illustrate and specify the theoretical knowledge regarding the features that appeared to be effective in PDP's. Finally, in the fifth study, the learning process of two of the participating teachers was described in detail. Written reflections, as well as videotaped reflections during the video interaction training meetings were analyzed and related to the effects of the PDP on both teachers' knowledge, beliefs, perceived problems and classroom behavior during te course of the PDP. By relating the learning processes of these two teachers to the literature regarding professional development, we aimed for a rich understanding of the impact of the PDP on teachers' professional development.
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The aim of the current study was to examine the effectiveness of a school-centered multicomponent PA intervention, called ‘Active Living’, on children's daily PA levels. A quasi-experimental design was used including 9 intervention schools and 9 matched control schools located in the Netherlands. The baseline measurement took place between March–June 2013, and follow-up measurements were conducted 12 months afterwards. Accelerometer (ActiGraph, GT3X +) data of 520 children aged 8–11 years were collected and supplemented with demographics and weather conditions data. Implementation magnitude of the interventions was measured by keeping logbooks on the number of implemented physical environmental interventions (PEIs) and social environmental interventions (SEIs). Multilevel multivariate linear regression analyses were used to study changes in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) between baseline and follow-up. Finally, effect sizes (ESs) were calculated using Cohen's d. No pooled effects on PA and SB were found between children exposed and not exposed to Active Living after 12 months. However, children attending Active Living schools that implemented larger numbers of both PEIs and SEIs engaged in 15 more minutes of LPA per weekday at follow-up than children in the control condition (ES = 0.41; p < .05). Moreover, children attending these schools spent less time in SB at follow-up (ES = 0.33), although this effect was non-significant. No significant effects were found on MVPA. A school-centered multicomponent PA intervention holds the potential to activate children, but a comprehensive set of intervention elements with a sufficient magnitude is necessary to achieve at least moderate effect sizes.
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Background: The built environment is increasingly recognized as a determinant for health and health behaviors. Existing evidence regarding the relationship between environment and health (behaviors) is varying in significance and magnitude, and more high-quality longitudinal studies are needed. The aim of this study was to evaluate the effects of a major urban redesign project on physical activity (PA), sedentary behavior (SB), active transport (AT), health-related quality of life (HRQOL), social activities (SA) and meaningfulness, at 29–39 months after opening of the reconstructed area. Methods: PA and AT were measured using accelerometers and GPS loggers. HRQOL and sociodemographic characteristics were assessed using questionnaires. In total, 241 participants provided valid data at baseline and follow-up. We distinguished three groups, based on proximity to the intervention area: maximal exposure group, minimal exposure group and no exposure group. Results: Both the maximal and minimal exposure groups showed significantly different trends regarding transportbased PA levels compared to the no exposure group. In the exposure groups SB decreased, while it increased in the no exposure group. Also, transport-based light intensity PA remained stable in the exposure groups, while it significantly decreased in the no exposure group. No intervention effects were found for total daily PA levels. Scores on SA and meaningfulness increased in the maximal exposure group and decreased in the minimal and no exposure group, but changes were not statistically significant. Conclusion: The results of this study emphasize the potential of the built environment in changing SB and highlights the relevance of longer-term follow-up measurements to explore the full potential of urban redesign projects.
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