This dissertation describes a research project about the communication between communication vulnerable people and health care professionals in long-term care settings. Communication vulnerable people experience functional communication difficulties in particular situations, due to medical conditions. They experience difficulties expressing themselves or understanding professionals, and/or professionals experience difficulties understanding these clients. Dialogue conversations between clients and professionals in healthcare, which for example concern health-related goals, activity and participation choices, diagnostics, treatment options, and treatment evaluation, are, however, crucial for successful client-centred care and shared decision making. Dialogue conversations facilitate essential exchanges between clients and healthcare professionals, and both clients and professionals should play a significant role in the conversation. It is unknown how communication vulnerable people and their healthcare professionals experience dialogue conversations and what can be done to support successful communication in these conversations. The aim of this research is to explore how communication vulnerable clients and professionals experience their communication in dialogue conversations in long-term care and how they can best be supported in improving their communication in these conversations.
The central question in this study is how, for whom, and under which conditions professional youth work contributes to the personal development of socially vulnerable youngsters, the reinforcement of their social network, the enhancement of their social participation, and the timely finding of appropriate specialized care services in relation to contextual factors such as life events and the influence of significant others. This research used a multiple case study with a comparative design. During a 12-month period, youth workers (N = 20) participated in group intervision meetings and kept diaries reporting on their actions and the development of the youngsters (N = 23). An analysis of this data revealed four patterns of development of socially vulnerable youngsters in youth work settings. Each pattern consisted of a specific form of multi-methodic action that resulted in a specific outcome. The study also revealed how these processes of development are influenced by important life events and significant others. The findings suggest that youth work contributes to personal development and social participation and thereby may lessen the need for formal social care services.
BackgroundPeople from lower and middle socioeconomic classes and vulnerable populations are among the worst affected by the COVID-19 pandemic, thus exacerbating disparities and the digital divide.ObjectiveTo draw a portrait of e-services as a digital approach to support digital health literacy in vulnerable populations amid the COVID-19 infodemic, and identify the barriers and facilitators for their implementation.MethodsA scoping review was performed to gather published literature with a broad range of study designs and grey literature without exclusions based on country of publication. A search was created in Medline (Ovid) in March 2021 and translated to Medline, PsycINFO, Scopus and CINAHL with Full Text (EBSCOhost). The combined literature search generated 819 manuscripts. To be included, manuscripts had to be written in English, and present information on digital intervention(s) (e.g. social media) used to enable or increase digital health literacy among vulnerable populations during the COVID-19 pandemic (e.g. older adults, Indigenous people living on reserve).ResultsFive articles were included in the study. Various digital health literacy-enabling e-services have been implemented in different vulnerable populations. Identified e-services aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, increase digital knowledge and skills, decrease health literacy barriers and increase technology acceptance in specific groups. Many facilitators of digital health literacy-enabling e-services implementation were identified in expectant mothers and their families, older adults and people with low-income. Barriers such as low literacy limited to no knowledge about the viruses, medium of contamination, treatment options played an important role in distracting and believing in misinformation and disinformation. Poor health literacy was the only barrier found, which may hinder the understanding of individual health needs, illness processes and treatments for people with HIV/AIDS.ConclusionsThe literature on the topic is scarce, sparse and immature. We did not find any literature on digital health literacy in Indigenous people, though we targeted this vulnerable population. Although only a few papers were included, two types of health conditions were covered by the literature on digital health literacy-enabling e-services, namely chronic conditions and conditions that are new to the patients. Digital health literacy can help improve prevention and adherence to a healthy lifestyle, improve capacity building and enable users to take the best advantage of the options available, thus strengthening the patient’s involvement in health decisions and empowerment, and finally improving health outcomes. Therefore, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.
Dutch society faces major future challenges putting populations’ health and wellbeing at risk. An ageing population, increase of chronic diseases, multimorbidity and loneliness lead to more complex healthcare demands and needs and costs are increasing rapidly. Urban areas like Amsterdam have to meet specific challenges of a growing and super divers population often with a migration background. The bachelor programs and the relating research groups of social work and occupational therapy at the Amsterdam University of Applied Sciences innovate their curricula and practice-oriented research by multidisciplinary and cross-domain approaches. Their Centres of Expertise foster interprofessional research and educational innovation on the topics of healthy ageing, participation, daily occupations, positive health, proximity, community connectedness and urban innovation in a social context. By focusing on senior citizens’ lives and by organizing care in peoples own living environment. Together with their networks, this project aims to develop an innovative health promotion program and contribute to the government missions to promote a healthy and inclusive society. Collaboration with stakeholders in practice based on their urgent needs has priority in the context of increasing responsibilities of local governments and communities. Moreover, the government has recently defined social base as being the combination of citizen initiatives, volunteer organizations , caregivers support, professional organizations and support of vulnerable groups. Kraktie Foundations is a community based ethno-cultural organization in south east Amsterdam that seeks to research and expand their informal services to connect with and build with professional care organizations. Their aim coincides with this project proposal: promoting health and wellbeing of senior citizens by combining intervention, participatory research and educational perspectives from social work, occupational therapy and hidden voluntary social work. With a boundary crossing innovation of participatory health research, education and Kraktie’s work in the community we co-create, change and innovate towards sustainable interventions with impact.
The projectThe overarching goal of DIGNITY, DIGital traNsport In and for socieTY, is to foster a sustainable, integrated and user-friendly digital travel eco-system that improves accessibility and social inclusion, along with the travel experience and daily life of all citizens. The project delves into the digital transport eco-system to grasp the full range of factors that might lead to disparities in the uptake of digitalised mobility solutions by different user groups in Europe. Analysing the digital transition from both a user and provider’s perspective, DIGNITY looks at the challenges brought about by digitalisation, to then design, test and validate the DIGNITY approach, a novel concept that seeks to become the ‘ABCs for a digital inclusive travel system’. The approach combines proven inclusive design methodologies with the principles of foresight analysis to examine how a structured involvement of all actors – local institutions, market players, interest groups and end users – can help bridge the digital gap by co-creating more inclusive mobility solutions and by formulating user-centred policy frameworks.The objectivesThe idea is to support public and private mobility providers in conceiving mainstream digital products or services that are accessible to and usable by as many people as possible, regardless of their income, social situation or age; and to help policy makers formulate long-term strategies that promote innovation in transport while responding to global social, demographic and economic changes, including the challenges of poverty and migration.The missionBy focusing on and involving end-users throughout the process of designing policies, products, or services, it is possible to reduce social exclusion while boosting new business models and social innovation. The end result that DIGNITY is aiming for is an innovative decision support tool that can help local and regional decision-makers formulate digitally inclusive policies and strategies, and digital providers design more inclusive products and services.The approachThe DIGNITY approach combines analysis with concrete actions to make digital mobility services inclusive over the long term. The approach connects users’ needs and requirements with the provision of mobility services, and at the same time connects those services to the institutional framework. It is a multi-phase process that first seeks to understand and bridge the digital gap, and then to test, evaluate and fine-tune the approach, so that it can be applied in other contexts even after the project’s end.Partners: ISINNOVA (Italy), Mobiel 21 (Belgium), Universitat Politechnica deCatalunya Spain), IZT (Germany), University of Cambridge (UK), Factualconsulting (Spain), Barcelona Regional Agencia (Spain), City of Tilburg(Netherlands), Nextbike (Germany), City of Ancona (Italy), MyCicero (Italy),Conerobus (Italy), Vlaams Gewest (Belgium)
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.
