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Introduction Physical activity levels of children with disabilities are low, as these children and their parents face a wide variety of both personal and environmental barriers. Behavior change techniques support pediatric physical therapists to address these barriers together with parents and children. We developed the What Moves You?! intervention Toolkit (WMY Toolkit) filled with behavioral change tools for use in pediatric physical therapy practice. Objective To evaluate the feasibility of using the WMY Toolkit in daily pediatric physical therapy practice. Methods We conducted a feasibility study with a qualitative approach using semi-structured interviews with pediatric physical therapists (n = 11). After one day of training, the pediatric physical therapists used the WMY Toolkit for a period of 9 weeks, when facilitating physical activity in children with disabilities. We analyzed the transcripts using an inductive thematic analysis followed by a deductive analysis using a feasibility framework. Results For acceptability, pediatric physical therapists found that the toolkit facilitated conversation about physical activity in a creative and playful manner. The working mechanisms identified were in line with the intended working mechanisms during development of the WMY Toolkit, such as focusing on problem solving, self-efficacy and independence. For demand, the pediatric physical therapists mentioned that they were able to use the WMY Toolkit in children with and without disabilities with a broad range of physical activity goals. For implementation, education is important as pediatric physical therapists expressed the need to have sufficient knowledge and to feel confident using the toolkit. For practicality, pediatric physical therapists were positive about the ease of which tools could be adapted for individual children. Some of the design and materials of the toolkit needed attention due to fragility and hygiene. Conclusion The WMY Toolkit is a promising and innovative way to integrate behavior change techniques into pediatric physical therapy practice.
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Background and purpose The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients. Methods A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories. Results In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found. Conclusion Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.
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The Hospitality, Tourism, Innovation & Technology Experts Network (HTIT-EN) is a pivotal initiative aimed at unlocking societal impact potential. The Dutch hospitality and tourism sector, which employs over half a million individuals and annually hosts more than 40 million guests, ranks as the Netherlands’ 8th largest economic sector. However, this sector faces numerous challenges, including the uncertain impact of emerging technologies and issues such as unethical behavior, workforce attrition, and staff shortages, which have been exacerbated by the COVID-19 pandemic. The advent of emerging technologies like service robots, immersive experiences, and artificial intelligence has brought the sector to a critical juncture. These innovations pose significant disruptions, challenging the traditional concept of hospitality and questioning the positive societal impact in terms of ethical considerations, inclusivity, affordability, and data privacy.Strategically positioned to address these challenges, HTIT-EN focuses on leveraging emerging technologies to create impactful scenarios and shape the future of hospitality and tourism. Our motivation stems from the sector’s societal importance and its continuous influence on our daily lives. By harnessing technology and innovation, we aim to tackle industry-specific issues and extend the positive societal impact to related human-centered service industries.The overarching mission of HTIT-EN is to empower the Dutch Hospitality and Tourism sector to serve as a driving force for technology-enabled societal impact. The primary objective is to align research activities and promote collaboration. Key objectives include bringing together leading professors specializing in technology-driven impact within the hospitality and tourism sector, initiating research projects in line with a shared research agenda and in collaboration with local and international industry partners, and collaboratively developing expertise in emerging technologies that empower the role of hospitality and tourism as catalysts for societal impact. This endeavor contributes to the development and acceleration of the Knowledge and Innovation Agenda (KIA) ‘Key technologies’ & ‘Digitalization’. The aim is to foster an excellent reputation for Dutch hospitality and tourism as a global leader in technology-driven societal impact.We have strong support from CELTH, the Centre of Expertise within the domain of leisure, tourism and hospitality for the overall ambitions of the research project.Societal issueThe HTIT-EN project bridges societal importance and cross-cutting issues in the tourism and hospitality sectors. It’s fueled by the ambition to leverage emerging technologies to tackle industry-specific challenges, including knowledge and skills gaps, labor shortages and replacements, and evolving consumer expectations.Benefit to societyThe platform brings together professors and researchers from MBO, HBO and WO knowledge institutes as well as diverse set of professional partners to stimulate collaboration, align research lines and establish joint a joint research agenda on how technology-driven impact may become a catalyst within hospitality and tourism.
Regular physical activity is considered to be an important component of a healthy lifestyle that decreases the risk of coronary heart disease, diabetes mellitus type 2, hypertension, colon and breast cancer, obesity and other debilitating conditions. Physical activity can also improve functional capacity and therefore also the quality of life in older adults. Despite all these favorable aspects, a substantial part of the Dutch older adult population is still underactive or even sedentary. To change this for the better, the Groningen Active Living Model (GALM) was developed.Aim of GALM is to stimulate recreational sports activities in sedentary and underactive older adults in the 55-65 age band. After a door-to-door visit as part of an intensive recruitment phase, a fitness test was conducted followed by the GALM recreational sports program. This program was based on principles from evolutionary-biological play theory and insights fromsocial cognitive theory. The program was versatile in nature (e.g. softball, dance, self-defense, swimming, athletics, etc.) in two main ways: a) to improve compliance with the program different sports were offered, which was reported to be more appealing for older adults; b) by aiming at more components of motor fitness (e.g. strength, flexibility, speed, endurance and coordination). Between 1997 and 2005 more than 552,000 persons were visited door-to-door, over 55,700 were tested, and 41,310 participated in the GALM recreational sports program. The aim of the present thesis is to determine the effects of participation in the GALM recreational sports program on physical activity, health and fitness outcomes.Chapter 2 describes the effectiveness of the GALM recruitment in selecting and recruiting sedentary and underactive older adults. Three municipalities in the Netherlands were selected, and in every municipality four neighborhoods were included. Two of each of the four neighborhoods were randomly assigned as intervention and the others as control neighborhoods. In total, 8,504 persons were mailed and received a home visit. During this home visit the GALM recruitment questionnaire was collected on which the selection between sedentary/underactive and physically active older adults was based. Ultimately we succeeded inincluding 12.3% (315 of the 2,551 qualifying) of the older adults, 79.4% of whom could be indeed considered sedentary or underactive. The cost of successfully recruiting an older adult was estimated at $84.To assess the effects of a physical activity intervention on health and fitness and explain the results, it is necessary to know program characteristics regarding frequency, intensity, time and content of the activities. With respect to the GALM recreational sports activity program, the only unknown characteristic was intensity. Chapter 3 describes the intensity of this program systematically. Using heart rate monitors, data of 97 persons (mean age 60.1 yr) were collected in three municipalities. The mean intensity of all 15 GALM sessions was 73.7% of the predicted maximal heart rate. Six percent of the monitored heart rate time could be classified as light, 33% as moderate and 61% as hard. In summary, the GALM recreational sports program meets the 1998 ACSM recommendations for intensity necessary to improve cardiorespiratory fitness.Chapters 4 and 5 describe the effects of 6 and 12 months of participation in the GALM recreational sports program, and 181 persons were followed over time. Results after 6 months revealed only few significant between-group differences favoring the intervention group (i.e. sleep, diastolic blood pressure, perceived fitness score and grip strength). Changes in energyexpenditure for leisure-time physical activities (EELTPA) showed an increase in both study groups. From 6 to 12 months a decrease in EELTPA occurred in the intervention group and an increase in the control group. The significant positive time effects for the health outcomes (diastolic blood pressure, BMI, percentage of body fat) that were found after 6 months were diminishedfrom 6 to 12 months. However, the energy expenditure for recreational sports activities (EERECSPORT) demonstrated a continuous increase over 12 months. Parallel to this, significant main effects for time were found in performance-based fitness outcomes (i.e. simple reaction time, leg strength, flexibility of hamstrings and lower back, and aerobic endurance). After 12 months only a significant between-group difference for flexibility of the hamstrings andlower back was found, favoring the control group. In conclusion, a short-term increase in EELTPA was found with accompanying improvements in health outcomes that more or less disappeared in 6 to 12 months. In the long term, results showed a continuous increase in EERECSPORT and performance-based fitness. This latter increase is probably a reflection of the significantimprovement over time in EERECSPORT and the fact that recreational sports activities are of a higher intensity.Aerobic endurance is regarded as the most important component of motor fitness that is relevant for older adults to function independently. In Chapter 6, the development in aerobic endurance after 18 months of participation in the GALM recreational sports program was assessed by means of changes in heart rate during fixed submaximal exercise. Since both groups were comparable regarding changes in energy expenditure for physical activity after 6 months and testing confirmed this, both groups were combined and considered as one group. Multilevel analyses were conducted and models for change were developed. A significant decrease in heart rate over time was found at all walking speeds (4, 5, 6 and 7 km/h). The average decrease in heart rate was 5.5, 6.0, 10.0 and 9.0 beats/min for the 4, 5, 6 and 7 km/h walking speeds, respectively. The relative decrease varied from 5.1 to 7.4% relative to average heart rates at baseline. These results illustrate that participation in the GALM recreational sports program has a positive significant effect on aerobic endurance, and that the participants are able to perform at submaximal intensity more easily.Based on the overall results it can be concluded that this study contributes to the field in how to effectively recruit sedentary and underactive older adults and stimulate them to become and stay active in recreational sports activities. As far as we know, this recruitment in combination with the recreational sport program is not only unique but also effective toward increasing performance-based fitness in the long term. Short-term effects were found in other leisure-time activities and health outcomes. To further stimulate other leisure-time and probably health outcomes besides the favorable effects that were already seen, additional interventions that pay more attention to behavioral change in terms of how to integrate other activities besides sports activities are recommended.
In the small village of Nuenen in the Netherlands, Vincent van Gogh, the legendary artist, resided with his parents for two years in the late 19th century. Today, visitors can literally walk in Vincent’s footsteps and hear stories about that period of his life. There is also a renovated indoor museum in the village showcasing many beautiful and inspiring objects.We carefully studied the visitor experience over two rounds of data collection: one in 2018 and another in 2023 after the museum's renovation. In the second round, 40 students from Breda University of Applied Sciences were invited to spend a day in Nuenen. The participants, aged mostly between 20 and 30 years, came from the Netherlands and 16 other countries. None of them had visited the previous museum setup in Nuenen, although two-thirds had visited at least one other Vincent-centered attraction or had researched Vincent and his life prior to the visit.During their visit, research participants were tracked using Bluetooth beacons (indoors) and GPS tracking (outdoors), while wearing wristbands that measured their level of emotional engagement in real time. They toured the museum and the village and provided feedback on their experience through questionnaires administered before and after the visit.The results of the research showed that visitors were emotionally touched at certain stops of the tour more than others, enjoyed interacting with specific elements in the museum, and spent more time in particular areas of the museum. Most participants could vividly imagine themselves back in the days (narrative transportation), felt closer to Nuenen residents as a result of the visit, and generally found the visit to be quite meaningful. Learning and self-expansion were high, with some visitors even finding the visit transformative, leading to changes in attitude, behavior, and identities. We also found a strong correlation between these measures and the Net Promoter Score (NPS). Recommendations and emotion maps were presented to the museum as they continue to refine their visitor experiences.Research carried out for Van Gogh Village Museum Nunen.
