QUESTIONS: What are the perceived reasons for people with chronic obstructive pulmonary disease (COPD) to be physically active or sedentary? Are those reasons related to the actual measured level of physical activity?DESIGN: A mixed-methods study combining qualitative and quantitative approaches.PARTICIPANTS: People with mild to very severe COPD.OUTCOME MEASURES: Participants underwent a semi-structured interview and physical activity was measured by a triaxial accelerometer worn for one week.RESULTS: Of 118 enrolled, 115 participants (68% male, mean age 65 years, mean FEV1 57% predicted, mean modified Medical Research Council dyspnoea score 1.4) completed the study. The most frequently reported reason to be physically active was health benefits, followed by enjoyment, continuation of an active lifestyle from the past, and functional reasons. The most frequently reported reason to be sedentary was the weather, followed by health problems, and lack of intrinsic motivation. Mean steps per day ranged between 236 and 18 433 steps. A high physical activity level was related to enjoyment and self-efficacy for physical activity. A low physical activity level was related to the weather influencing health, financial constraints, health and shame.CONCLUSION: We identified important facilitators to being physically active and barriers that could be amenable to change. Furthermore, we distinguished three important potential strategies for increasing physical activity in sedentary people with COPD, namely reducing barriers and increasing insight into health benefits, tailoring type of activity, and improvement of self-efficacy.
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Introduction: Midwifery education that strengthens self-efficacy can support student midwives in their role as advocates for a physiological approach to childbirth. Methods: To assess the effect of an educational intervention on self-efficacy, a pre- and post-intervention survey was administered to a control group and an intervention group of third year student midwives. The General Self-Efficacy Scale (GSES) was supplemented with midwifery-related self-efficacy questions related to behaviour in home and hospital settings, the communication of evidence, and ability to challenge practice. Results: Student midwives exposed to midwifery education designed to strengthen self-efficacy demonstrated significantly higher levels of general self-efficacy (p = .001) when contrasted to a control cohort. These students also showed significantly higher levels of self-efficacy in advocating for physiological childbirth (p = .029). There was a non-significant increase in self-efficacy in the hospital setting in the intervention group, a finding that suggests that education may ameliorate the effect of hospital settings on midwifery practice. Discussion: In spite of the small size of the study population, education that focuses on strengthening student midwife self-efficacy shows promise.
Financially vulnerable consumers are often associated with suboptimal financial behaviors. Evaluated financial education programs so far show difficulties to effectively reach this target population. In our attempt to solve this problem, we built a behaviorally informed financial education program incorporating insights from both motivational and behavioral change theories. In a quasi-experimental field study among Dutch financially vulnerable people, we compared this program with both a control group and a traditional program group. In comparison with the control group, we found robust positive effects of the behaviorally informed program on financial skills and knowledge and self-reported financial behavior, but not on other outcomes. Additionally, we did not find evidence that the behaviorally informed program performed better than the traditional program. Finally, we discuss the findings and limitations of this study in light of the financial education literature and provide implications for policymaking and directions for future research.
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Social enterprises (SEs) can play an important role in addressing societal problems. SEs are businesses whose primary objective is to generate social impact (e.g. well-being, social wealth and cohesion, and ecology) through a market-based model. SEs achieve this through a hybrid business model, trading-off financial and social value creation objectives. SEs typically face higher costs, for example because of ethical sourcing principles and/or production processes centering around the needs of workers who are vulnerable or hard-to-employ. This results in SEs’ struggling to scale-up due to their relatively costly operating model. Traditional management techniques are not always appropriate, as they do not take into account the tensions between financial and social value creation objectives of SEs. Our project examines how continuous improvement, and in particular the philosophy and tools of Lean can be harnessed to improve SEs competitiveness. Lean organizations share many values with SEs, such as respect for people, suggesting a good fit between the values and principles of Lean and those of SEs. The consortium for this project is a cooperation between the research groups Improving Business and New Marketing of the Center of Expertise Well-Being Economy and New Entrepreneurship and the minor Continuous Improvement of AVANS Hogeschool, and the SME companies Elliz in Company and Ons Label. The project consists of two phases, an exploratory phase during which the question “in what ways can the philosophy and tools of Lean be used by Social Enterprises?” will be addressed. Interviews and focus groups will be conducted with multiple SEs (not only partners). Participant observation will be conducted by the students of the minor Continuous Improvement at the partner SEs. During the second phase, the implementation of the identified principles and tools will be operationalized through a roadmap. Action research will be conducted in cooperation with the partner SEs.
