Background: The prescription of physical activity (PA) in clinical care has been advocated worldwide. This “exercise is medicine” (E=M) concept can be used to prevent, manage, and cure various lifestyle-related chronic diseases. Due to severalchallenges, E=M is not yet routinely implemented in clinical care. Objective: This paper describes the rationale and design of the Physicians Implement Exercise = Medicine (PIE=M) study, which aims to facilitate the implementation of E=M in hospital care.Methods: PIE=M consists of 3 interrelated work packages. First, levels and determinants of PA in different patient and healthy populations will be investigated using existing cohort data. The current implementation status, facilitators, and barriers of E=M will also be investigated using a mixed-methods approach among clinicians of participating departments from 2 diverse university medical centers (both located in a city, but one serving an urban population and one serving a more rural population). Implementation strategies will be connected to these barriers and facilitators using a systematic implementation mapping approach. Second, ageneric E=M tool will be developed that will provide tailored PA prescription and referral. Requirements for this tool will be investigated among clinicians and department managers. The tool will be developed using an iterative design process in which all stakeholders reflect on the design of the E=M tool. Third, we will pilot-implement the set of implementation strategies, including the E=M tool, to test its feasibility in routine care of clinicians in these 2 university medical centers. An extensive learning process evaluation will be performed among clinicians, department managers, lifestyle coaches, and patients using a mixed-methods design based on the RE-AIM framework. Results: This project was approved and funded by the Dutch grant provider ZonMW in April 2018. The project started in September 2018 and continues until December 2020 (depending on the course of the COVID-19 crisis). All data from the first work package have been collected and analyzed and are expected to be published in 2021. Results of the second work package are described. The manuscript is expected to be published in 2021. The third work package is currently being conducted in clinical practice in 4 departments of 2 university medical hospitals among clinicians, lifestyle coaches, hospital managers, and patients. Results are expected to be published in 2021. Conclusions: The PIE=M project addresses the potential of providing patients with PA advice to prevent and manage chronicdisease, improve recovery, and enable healthy ageing by developing E=M implementation strategies, including an E=M tool, in routine clinical care. The PIE=M project will result in a blueprint of implementation strategies, including an E=M screening and referral tool, which aims to improve E=M referral by clinicians to improve patients’ health, while minimizing the burden on clinicians.
Objective: To evaluate the preliminary effectiveness of a goal-directed movement intervention using a movement sensor on physical activity of hospitalized patients. Design: Prospective, pre-post study. Setting: A university medical center. Participants: Patients admitted to the pulmonology and nephrology/gastro-enterology wards. Intervention: The movement intervention consisted of (1) self-monitoring of patients' physical activity, (2) setting daily movement goals and (3) posters with exercises and walking routes. Physical activity was measured with a movement sensor (PAM AM400) which measures active minutes per day. Main measures: Primary outcome was the mean difference in active minutes per day pre- and post-implementation. Secondary outcomes were length of stay, discharge destination, immobility-related complications, physical functioning, perceived difficulty to move, 30-day readmission, 30-day mortality and the adoption of the intervention. Results: A total of 61 patients was included pre-implementation, and a total of 56 patients was included post-implementation. Pre-implementation, patients were active 38 ± 21 minutes (mean ± SD) per day, and post-implementation 50 ± 31 minutes per day (Δ12, P = 0.031). Perceived difficulty to move decreased from 3.4 to 1.7 (0-10) (Δ1.7, P = 0.008). No significant differences were found in other secondary outcomes. Conclusions: The goal-directed movement intervention seems to increase physical activity levels during hospitalization. Therefore, this intervention might be useful for other hospitals to stimulate inpatient physical activity.
OBJECTIVE: To describe professionals' perceptions of factors that facilitate or hamper the implementation and continuation of a physical activity promotion programme in rehabilitation.DESIGN: This study used a qualitative design.METHODS: Semi-structured interviews (n = 22) were conducted with rehabilitation professionals (n = 28) involved in the implementation of a physical activity promotion programme. Two additional interviews were conducted with the programme coordinators (n = 2). The study involved 18 rehabilitation organizations implementing the programme that targets people with disabilities or chronic diseases. Organizations were supported in the implementation process by the programme coordinators.RESULTS: Commonly perceived facilitating factors were: involvement of committed and enthusiastic professionals; agreement with their organizations' vision/wishes; the perceived additional value of the programme; and opportunities to share knowledge and experience with professionals from other organizations. Commonly perceived hampering factors were: uncertainty about continuing the programme; limited flexibility; and lack of support from physicians and therapists to implement the programme.CONCLUSION: Professionals perceived a heterogeneous set of factors that facilitate and/or hamper the implementation and continuation of a physical activity promotion programme in rehabilitation. Based on these findings, recommendations were formulated to enhance embedding of physical activity promotion during and after rehabilitation.
Horse riding falls under the “Sport for Life” disciplines, where a long-term equestrian development can provide a clear pathway of developmental stages to help individuals, inclusive of those with a disability, to pursue their goals in sport and physical activity, providing long-term health benefits. However, the biomechanical interaction between horse and (disabled) rider is not wholly understood, leaving challenges and opportunities for the horse riding sport. Therefore, the purpose of this KIEM project is to start an interdisciplinary collaboration between parties interested in integrating existing knowledge on horse and (disabled) rider interaction with any novel insights to be gained from analysing recently collected sensor data using the EquiMoves™ system. EquiMoves is based on the state-of-the-art inertial- and orientational-sensor system ProMove-mini from Inertia Technology B.V., a partner in this proposal. On the basis of analysing previously collected data, machine learning algorithms will be selected for implementation in existing or modified EquiMoves sensor hardware and software solutions. Target applications and follow-ups include: - Improving horse and (disabled) rider interaction for riders of all skill levels; - Objective evidence-based classification system for competitive grading of disabled riders in Para Dressage events; - Identifying biomechanical irregularities for detecting and/or preventing injuries of horses. Topic-wise, the project is connected to “Smart Technologies and Materials”, “High Tech Systems & Materials” and “Digital key technologies”. The core consortium of Saxion University of Applied Sciences, Rosmark Consultancy and Inertia Technology will receive feedback to project progress and outcomes from a panel of international experts (Utrecht University, Sport Horse Health Plan, University of Central Lancashire, Swedish University of Agricultural Sciences), combining a strong mix of expertise on horse and rider biomechanics, veterinary medicine, sensor hardware, data analysis and AI/machine learning algorithm development and implementation, all together presenting a solid collaborative base for derived RAAK-mkb, -publiek and/or -PRO follow-up projects.
Cross-Re-Tour supports European tourism SME while implementing digital and circular economy innovations. The three year project promotes uptake and replication by tourism SMEs of tools and solutions developed in other sectors, to mainstream green and circular tourism business operations.At the start of the project existing knowledge-gaps of tourism SMEs will be researched through online dialogues. This will be followed by a market scan, an overview of existing state of the art solutions to digital and green constraints in other economic sectors, which may be applied to tourism SME business operations: water, energy, food, plastic, transport and furniture /equipment. The scan identifies best practices from other sectors related to nudging of clients towards sustainable behaviour and nudging of staff on how to best engage with new tourism market segments.The next stage of the project relates to two design processes: an online diagnostic tool that allows for measuring and assessing (160) SME’s potential to adapt existing solutions in digital and green challenges, developed in other economic sectors. Next to this, a knowledge hub, addresses knowledge constraints and proposes solutions, business advisory services, training activities to SMEs participating. The hub acts as a matchmaker, bringing together 160 tourism SMEs searching for solutions, with suppliers of existing solutions developed in other sectors. The next key activity is a cross-domain open innovation programme, that will provide 80 tourism SMEs with financial support (up to EUR 30K). Examples of partnerships could be: a hotel and a supplier of refurbished matrasses for hospitals; a restaurant and a supplier of food rejected by supermarkets, a dance event organiser and a supplier of refurbished water bottles operating in the cruise industry, etc.The 80 cross-domain partnerships will be supported through the knowledge hub and their business innovation advisors. The goal is to develop a variety of innovative partnerships to assure that examples in all operational levels of tourism SMEs.The innovation projects shall be presented during a show-and-share event, combined with an investors’ pitch. The diagnostic tool, market scan, knowledge hub, as well as the show and share offer excellent opportunities to communicate results and possible impact of open innovation processes to a wider international audience of destination stakeholders and non-tourism partners. Societal issueSupporting the implementation of digital and circular economy solutions in tourism SMEs is key for its transition towards sustainable low-impact industry and society. Benefit for societySolutions are already developed in other sectors but the cross-over towards tourism is not happening. The project bridges this gap.
De afgelopen twee decennia is er veel meer aandacht ontstaan bij onderzoekers en beleidsmakers voor het begrip co-creatie. Bijna altijd wordt de rol van co-creatie als positief en essentieel gezien in een proces waarin maatschappelijke of publieke uitdagingen worden onderzocht en opgelost (zogenaamde sociale innovatie). Het meeste onderzoek naar deze twee begrippen is kwalitatief van aard en gebaseerd op ‘case studies’.In zijn promotieonderzoek kijkt Peter Broekema naar de rol van co-creatie binnen sociale innovatie in Europese samenwerkingsprojecten. In zijn eerste artikel heeft hij de begrippen co-creatie en sociale innovatie tussen 1995 en 2018 binnen de EU geanalyseerd en geconcludeerd dat beide begrippen steeds breder gebruikt worden en samen met het begrip impact zijn getransformeerd tot een beleidsparadigma.In het tweede artikel keek Peter Broekema hoe beide begrippen doorwerken in specifieke subsidieoproepen en hoe consortia deze begrippen toepassen en samenwerken. Hierbij bleek dat er weliswaar verschillende typen consortia bestaan, maar dat zij geen specifieke co-creatiestrategie hadden.In zijn laatste twee artikelen zal hij gedetailleerd kijken naar een aantal EU projecten en vaststellen hoe de samenwerking is verlopen en hoe tevreden de verschillende partners zijn met het resultaat. Peter Broekema maakt hiervoor gebruik van projecten waarin hij zelf participeert (ACCOMPLISSH, INEDIT en SHIINE).EU beleidsparadigma van sociale innovatie in combinatie met co-creatie en impact. Co-creatie vindt vaak binnen eigen type stakehodlers plaatsAbstractSocial innovation and co-creation are both relatively new concepts, that have been studied by scholars for roughly twenty years and are still heavily contested. The former emerged as a response to the more technologically focused concept of innovation and the latter originally solely described the collaboration of end-users in the development of new products, processes or services. Between 2010-2015, both concepts have been adapted and started to be used more widely by for example EU policymakers in their effort to tackle so called ‘grand societal challenges’. Within this narrative – which could be called co-creation for social innovation, it is almost a prerequisite that partners – especially citizens - from different backgrounds and sectors actively work together towards specific societal challenges. Relevance and aimHowever, the exact contribution of co-creation to social innovation projects is still unclear. Most research on co-creation has been focussing on the involvement of end-users in the development of products, processes and services. In general, scholars conclude that the involvement of end-users is effective and leads to a higher level of customer satisfaction. Only recently, research into the involvement of citizens in social innovation projects has started to emerge. However, the majority of research on co-creation for social innovation has been focusing on collaborations between two types of partners in the quadruple helix (citizens, governments, enterprises and universities). Because of this, it is still unclear what co-creation in social innovation projects with more different type of partners entails exactly. More importantly however, is that most research has been based on national case studies in which partners from different sectors collaborate in a familiar ‘national’ setting. Normally institutional and/or cultural contexts influence co-creation (for example the ‘poldermodel’in the Netherlands or the more confrontational model in France), so by looking at projects in a central EU and different local contexts it becomes clear how context effects co-creation for social innovation.Therefore this project will analyse a number of international co-creation projects that aim for social innovation with different types of stakeholders in a European and multi-stakeholder setting.With this research we will find out what people in different contexts believe is co-creation and social innovation, how this process works in different contexts and how co-creation contributes to social innovation.Research question and - sub questionsThe project will answer the following question: “What is the added value of co-creation in European funded collaboration projects that aim for social innovation?” To answer the main question, the research has been subdivided into four sub questions:1) What is the assumed added value of co-creation for social innovation?2) How is the added value of co-creation for social innovation being expressed ex ante and ex post in EU projects that aim specifically for social innovation by co-creation?3) How do partners and stakeholders envision the co-creation process beforehand and continuously shape this process in EU projects to maximise social innovation?4) How do partners and stakeholders regard the added value of co-creation for social innovation in EU projects that that aim for social innovation?Key conceptsThe research will focus on the interplay between the two main concepts a) co-creation and b) social innovation. For now, we are using the following working definitions:a) co-creation is a non-linear process that involves multiple actors and stakeholders in the ideation, implementation and assessment of products, services, policies and systems with the aim of improving their efficiency and effectiveness, and the satisfaction of those who take part in the process.b) social innovation is the invention, development and implementation of new ideas with the purpose to (immediately) relieve and (eventually) solve social problems, which are in the long run directed at the social inclusion of individuals, groups or communities.It is clear that both definitions are quite opaque, but also distinguish roughly the same phases (ideation/invention, development, implementation and assessment) and also distinguish different levels (products/services, policies and systems). Both concepts will be studied within the policy framework of the EU, in which a specific value to both concepts has been attributed, mostly because policymakers regard co-creation with universities and end-users almost as a prerequisite for social innovation. Based on preliminary research, EU policies seem to define social innovation in close reation with ‘societal impact’, which could defined as: “the long lasting effect of an activity on society, because it is aimed at solving social problems”, and therefore in this specific context social innovation seems to encompasses societal impact. For now, I will use this working definition of social innovation and will closely look at the entanglement with impact in the first outlined paper.MethodologyIn general, I will use a qualitative mixed method approach and grounded theory to answer the main research question (mRQ). In order to better understand the added value of co-creation for social innovation in an EU policy setting, the research will:SubRQ1) start with an analysis of academic literature on co-creation and social impact. This analysis will be followed by and confronted with an analysis of EU policy documents. SubRQ2) use a qualitative data analysis at nineteen EU funded projects to understand how co-creation is envisoned within social innovation projects by using the quintuple helix approach (knowledge flows between partners and stakeholders in an EU setting) and the proposed social innovation journey model. By contrasting the findings from the QDA phase of the project with other research on social innovation we will be able to find arachetypes of social innovation in relation with the (perceived) added value of co-creation within social innovation. SubRQ3) These archetypes will be used to understand the process of co-creation for social innovation by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.SubRQ4) The archetypes will also be used to understand the perceived added value by looking closely at behavioural interactions within two social innovation projects. This close examination will be carried out by carrying out interviews with key stakeholders and partners and participant observation.ImpactThe project will contribute to a better understanding of the relationship between co-creation and social innovation on different levels:a) Theoretical: the research will analyse the concepts of co-creation and social innovation in relation to each other by looking at the origins of the concepts, the adaptation in different fields and the uptake within EU policies;b) Methodological: a model will be developed to study and understand the non-lineair process of co-creation within social innovation, by focusing on social innovation pathways and social innovation strategies within a quintuple helix setting (i) academia, ii) enterprises and iii) governments that work together to improve iv) society in an v) EU setting);c) Empirical: the project will (for the first time) collect data on behavioural interactions and the satisfaction levels of these interactions between stakeholders and partners in an EU project.d) Societal: the results of the research could be used to optimize the support for social innovation projects and also for the development of specific funding calls.
