Aim: There is often a gap between the ideal of involving older persons iteratively throughout the design process of digital technology, and actual practice. Until now, the lens of ageism has not been applied to address this gap. The goals of this study were: to voice the perspectives and experiences of older persons who participated in co-designing regarding the design process; their perceived role in co-designing and intergenerational interaction with the designers; and apparent manifestations of ageism that potentially influence the design of digital technology. Methods: Twenty-one older persons participated in three focus groups. Five themes were identified using thematic analysis which combined a critical ageism ‘lens’ deductive approach and an inductive approach. Results: Ageism was experienced by participants in their daily lives and interactions with the designers during the design process. Negative images of ageing were pointed out as a potential influencing factor on design decisions. Nevertheless, positive experiences of inclusive design pointed out the importance of “partnership” in the design process. Participants defined the “ultimate partnership” in co-designing as processes in which they were involved from the beginning, iteratively, in a participatory approach. Such processes were perceived as leading to successful design outcomes, which they would like to use, and reduced intergenerational tension. Conclusions: This study highlights the potential role of ageism as a detrimental factor in how digital technologies are designed. Viewing older persons as partners in co-designing and aspiring to more inclusive design processes may promote designing technologies that are needed, wanted and used.
DOCUMENT
Since the introduction of Family Group Conferences (FGCs) in the Netherlands, there has been a steady growth in conferences being organised each year. Government policy emphasises the importance of empowering families to strengthen their ability to take responsibility for their own well-being. A recently adopted amendment in the Dutch Civil Code reflects this commitment and designates FGC as good practice. However, there is little knowledge on the application of FGCs in mental health care, let alone in a setting even more specific, such as public mental health care (PMHC). Clients in PMHC often have a limited network. The starting point of this study is the assumption that conferences promote involvement, expand and restore relationships and generate support. Over the next two years, we will research the applicability of FGCs in PMHC by evaluating forty case studies. The aim of our study is to provide an answer to the question of whether Family Group Conferencing is an effective tool to generate social support, to prevent coercion and to promote social integration in PMHC. Although making contact and gaining trust is a goal of PMHC, it is an aim to study whether FGCs can elevate or replace the work of professionals.
LINK
As the population ages, more people will have comorbid disorders and polypharmacy. Medication should be reviewed regularly in order to avoid adverse drug reactions and medication-related hospital visits, but this is often not done. As part of our student-run clinic project, we investigated whether an interprofessional student-run medication review program (ISP) added to standard care at a geriatric outpatient clinic leads to better prescribing. In this controlled clinical trial, patients visiting a memory outpatient clinic were allocated to standard care (control group) or standard care plus the ISP team (intervention group). The medications of all patients were reviewed by a review panel (“gold standard”), resident, and in the intervention arm also by an ISP team consisting of a group of students from the medicine and pharmacy faculties and students from the higher education school of nursing for advanced nursing practice. For both groups, the number of STOPP/START-based medication changes mentioned in general practitioner (GP) correspondence and the implementation of these changes about 6 weeks after the outpatient visit were investigated. The data of 216 patients were analyzed (control group = 100, intervention group = 116). More recommendations for STOPP/STARTbased medication changes were made in the GP correspondence in the intervention group than in the control group (43% vs. 24%, P = < 0.001). After 6 weeks, a significantly higher proportion of these changes were implemented in the intervention group (19% vs. 9%, P = 0.001). The ISP team, in addition to standard care, is an effective intervention for optimizing pharmacotherapy and medication safety in a geriatric outpatient clinic.
MULTIFILE
"The booklet presents curated real-world good practice examples that help translate our strategy into concrete actions, and in turn, into the design of education and training programmes that will contribute to skill, upskill, or reskill individuals into high demand professional software roles."
LINK
Dit is het eindrapport van de Global mOralHealth bijeenkomst georganiseerd door de Wereldgezondheidsorganisatie (WHO) en de universiteit van Montpellier. Docent Mondzorgkunde - Janneke Scheerman en lid van het lectoraat GGZ verpleegkunde - woonde deze bijeenkomst in oktober 2018 bij en droeg bij aan het rapport: https://www.inholland.nl/nieuws/be-helthy-be-mobile/ Als vervolg op de Global mOralHealth bijeenkomst wordt het mOralHealth handboek ontwikkeld, waaraan Janneke meeschrijft. In het handboek worden de procedures voor het ontwikkelen van mOralHealth interventies beschreven.
LINK
Background: Patients with chronic obstructive pulmonary disease (COPD) demonstrate reduced levels of daily physical activity (DPA) compared to healthy controls. This results in a higher risk of hospital admission and shorter survival. Performing regular DPA reduces these risks. Objective: To develop an eHealth intervention that will support patients with COPD to improve or maintain their DPA after pulmonary rehabilitation. Methods: The design process consisted of literature research and the iterative developing and piloting phases of the Medical Research Council (MRC) model for complex clinical interventions and the involvement of end users. Participants were healthy adults and persons with COPD. Results: The mobile phone interface met all the set requirements. Participants found that the app was stimulating and that reaching their DPA goals was rewarding. The mean (SD) scores on a 7-point scale for usability, ease of use, ease of learning, and contentment were 3.8 (1.8), 5.1 (1.1), 6.0 (1.6), and 4.8 (1.3), respectively. The mean (SD) correlation between the mobile phone and a validated accelerometer was 0.88 (0.12) in the final test. The idea of providing their health care professional with their DPA data caused no privacy issues in the participants. Battery life lasted for an entire day with the final version, and readability and comprehensibility of text and colors were favorable. Conclusions: By employing a user-centered design approach, a mobile phone was found to be an adequate and feasible interface for an eHealth intervention. The mobile phone and app are easy to learn and use by patients with COPD. In the final test, the accuracy of the DPA measurement was good. The final version of the eHealth intervention is presently being tested by our group for efficacy in a randomized controlled trial in COPD patients.
LINK
What does this paper add to existing knowledge? • This study provides insight into the severity of the problem. It demonstrates the differences in risk factors and OHRQoL between patients diagnosed with a psychotic disorder (first-episode) and the general population. • A negative impact on OHRQoL is more prevalent in patients diagnosed with a psychotic disorder (first-episode) (14.8%) compared to the general population (1.8%). • Patients diagnosed with a psychotic disorder (first-episode) have a considerable increase in odds for low OHRQoL compared to the general population, as demonstrated by the odds ratio of 9.45, which supports the importance of preventive oral health interventions in this group. What are the implications for practice? • The findings highlight the need for oral health interventions in patients diagnosed with a psychotic disorder (first-episode). Mental health nurses, as one of the main health professionals supporting the health of patients diagnosed with a mental health disorder, can support oral health (e.g. assess oral health in somatic screening, motivate patients, provide oral health education to increase awareness of risk factors, integration of oral healthcare services) all in order to improve the OHRQoL.
MULTIFILE
Over the last decade, sport and physical activity have become increasingly recognised and implemented as tools to foster social cohesion in neighbourhoods, cities and communities around Europe. As a result, numerous programmes have emerged that attempt to enhance social cohesion through a variety of sport-based approaches (Moustakas, Sanders, Schlenker, & Robrade, 2021; Svensson & Woods, 2017). However, despite this boom in sport and social cohesion, current definitions and understandings of social cohesion rarely take into account the needs, expectations or views of practitioners, stakeholders and, especially, participants on the ground (Raw, Sherry, & Rowe, 2021). Yet, to truly foster broad social outcomes like social cohesion, there is increasing recognition that programmes must move beyond interventions that only focus on the individual level, and instead find ways to work with and engage a wide array of stakeholders and organisations (Hartmann & Kwauk, 2011; Moustakas, 2022). In turn, this allows programmes to respond to community needs, foster engagement, deliver more sustainable outcomes, and work at both the individual and institutional levels. The Living Lab concept - which is distinguished by multi-stakeholder involvement, user engagement, innovation and co-creation within a real-life setting - provides an innovative approach to help achieve these goals. More formally, Living Labs have been defined as “user-centred, open innovation ecosystems based on a systematic user co-creation approach, integrating research and innovation processes in real-life communities and settings” (European Network of Living Labs, 2021). Thus, this can be a powerful approach to engage a wide array of stakeholders, and create interventions that are responsive to community needs. As such, the Sport for Social Cohesion Lab (SSCL) project was conceived to implement a Living Lab approach within five sport for social cohesion programmes in four different European countries. This approach was chosen to help programmes directly engage programme participants, generate understanding of the elements that promote social cohesion in a sport setting and to co-create activities and tools to explore, support and understand social cohesion within these communities. The following toolkit reflects our multi-national experiences designing and implementing Living Labs across these various contexts. Our partners represent a variety of settings, from schools to community-based organisations, and together these experiences can provide valuable insights to other sport (and non-sport) organisations wishing to implement a Living Lab approach within their contexts and programmes. Thus, practitioners and implementers of community-based programmes should be understood as the immediate target group of this toolkit, though the insights and reflections included here can be of relevance for any individual or organisation seeking to use more participatory approaches within their work. In particular, in the coming sections, this toolkit will define the Living Lab concept more precisely, suggest some steps to launch a Living Lab, and offer insights on how to implement the different components of a Living Lab.
DOCUMENT
Background: In the past years, a mobile health (mHealth) app called the Dutch Talking Touch Screen Questionnaire (DTTSQ) was developed in The Netherlands. The aim of development was to enable Dutch physical therapy patients to autonomously complete a health-related questionnaire regardless of their level of literacy and digital skills. Objective: The aim of this study was to evaluate the usability (defined as the effectiveness, efficiency, and satisfaction) of the prototype of the DTTSQ for Dutch physical therapy patients with diverse levels of experience in using mobile technology. Methods: The qualitative Three-Step Test-Interview method, including both think-aloud and retrospective probing techniques, was used to gain insight into the usability of the DTTSQ. A total of 24 physical therapy patients were included. The interview data were analyzed using a thematic content analysis approach aimed at analyzing the accuracy and completeness with which participants completed the questionnaire (effectiveness), the time it took the participants to complete the questionnaire (efficiency), and the extent to which the participants were satisfied with the ease of use of the questionnaire (satisfaction). The problems encountered by the participants in this study were given a severity rating that was used to provide a rough estimate of the need for additional usability efforts. Results: All participants within this study were very satisfied with the ease of use of the DTTSQ. Overall, 9 participants stated that the usability of the app exceeded their expectations. The group of 4 average-/high-experienced participants encountered only 1 problem in total, whereas the 11 little-experienced participants encountered an average of 2 problems per person and the 9 inexperienced participants an average of 3 problems per person. A total of 13 different kind of problems were found during this study. Of these problems, 4 need to be addressed before the DTTSQ will be released because they have the potential to negatively influence future usage of the tool. The other 9 problems were less likely to influence future usage of the tool substantially. Conclusions: The usability of the DTTSQ needs to be improved before it can be released. No problems were found with satisfaction or efficiency during the usability test. The effectiveness needs to be improved by (1) making it easier to navigate through screens without the possibility of accidentally skipping one, (2) enabling the possibility to insert an answer by tapping on the text underneath a photograph instead of just touching the photograph itself, and (3) making it easier to correct wrong answers. This study shows the importance of including less skilled participants in a usability study when striving for inclusive design and the importance of measuring not just satisfaction but also efficiency and effectiveness during such studies.
LINK
Even in a less eventful year, it’s no easy feat: working to make our food supply healthy and sustainable. But 2020 brought a spate of new challenges. It was the year of Brexit, Black Lives Matter, and the COVID-19 pandemic. A year of hope and loss and solidarity, of masks and worries and Zoom calls. Of infection sweeping through the meatpacking industry and sometimes, of empty supermarket shelves. It was also the year that brought us the glimmering realisation that everything could be different. When so much has changed – how we work, who we spend time with, how far we venture from home – what all might be possible for food and for farming? In Flevo Campus’s latest collection of essays, thirteen journalists, scholars, and thought leaders from the US, the Netherlands, and the UK share insight into the question: How can we build resilience into our food supply – and grow more resilient ourselves? Every year, Flevo Campus publishes the best work on feeding the cities of today and tomorrow. This year’s edition includes essays by Stephen Satterfield, Charles C. Mann, Herman Lelieveldt, Hester Dibbits, Kelly Streekstra, Sigrid Wertheim-Heck, Anke Brons, Joris Lohman, Sebastiaan Aalst, Marian Stuiver, Frank Verhoeven, Emily Whyman, and Lenno Munnikes.
DOCUMENT
