SAMENVATTING Mensen met een ernstige psychiatrische aandoening (EPA) hebben een sterk verminderde levensverwachting in vergelijking met de algemene populatie, vooral veroorzaakt door fysieke aandoeningen. Een ongezonde leefstijl speelt een belangrijke rol in de verminderde levensverwachting bij mensen met EPA. Ter bevordering van de fysieke gezondheid van deze doelgroep is de nurse-led e-health-interventie GILL (Gezondheid in Lichaam en Leefstijl) ontwikkeld voor somatische screening en het stimuleren van een gezonde(re) leefstijl. Door het uitvoeren van een cluster-gerandomiseerde studie (RCT) wordt onderzocht of de GILL e-health-interventie effectiever is dan de standaardzorg in het verbeteren van de fysieke gezondheid en leefstijl van mensen met EPA. De primaire uitkomstmaat van deze studie is de score voor de ernst van het metabool syndroom. Naast de RCT wordt een procesevaluatie uitgevoerd om de implementatie en de ervaringen van zowel de deelnemende cliënten als de hulpverleners met de GILLinterventie systematisch te evalueren.
DOCUMENT
Verslag van twee bijeenkomsten: Symposium 'Kwalitatief onderzoek als bewijs voor wat werkt' en oratie Saskia Keuzenkamp als bijzonder hoogleraar Participatie en Armoede bij VU in Amsterdam en Masterclass Onderzoek 'RCT, ja of nee?' georganiseerd door Kenniscentrum Phrenos.
LINK
Background: Blended face-to-face and web-based treatment is a promising mode to deliver smoking cessation treatment. In an outpatient clinic in a Dutch Hospital effectiveness of a blended treatment (BSCT) was compared to usual face-to-face treatment (F2F). The results from 6 months post-treatment follow-up are presented here.Methods: In this open-label two-arm non-inferiority RCT patients (N=344) of a Dutch outpatient smoking cessation clinic were assigned either to the blended smoking cessation treatment (BSCT, N=167) or a face-to-face treatment with identical ingredients and duration (F2F, N=177). CO-validated point prevalence abstinence at 6 months follow-up, taken shortly after end of treatment was analyzed. Intention-to-treat analyses were performed, retaining missing participants as continuing smokers. Non-inferiority was assessed based on a one-sided margin of five percentage points difference between arms. Additionally, a Bayes Factor was estimated (with a BF>3 supporting non-inferiority, and a <.3 rejecting non-inferiority).Method: At 6 months follow up, 23 BSCT participants (13.8%) and 31 F2F participants (17.5%) were abstinent, with a difference of 3.7% (95%CI: 11.4;-4.0) in favor of F2F. Furthermore, a BF=1.28 was found.Discussion: Based on observed biochemically validated abstinence rates, this RCT suggests that delivering outpatient smoking cessation treatment in a blended mode yields comparable quit rates as full face-to-face treatment mode. However, non-inferiority could not be supported conclusively. Ignoring patient preferences for either of the delivery modes may explain these inconclusive findings.
DOCUMENT
DOCUMENT
This paper evaluates the impact of an online game-based financial education tool on students' financial literacy levels. By conducting a Randomized Controlled Trial (RCT) involving 2,220 students across four countries in a multi-country experimental setting, we demonstrate that the intervention significantly enhances students' financial literacy levels by 0.313 SD. This study contributes to the emerging academic literature concerning the evaluation of financial education interventions that incorporate learning-by-playing. The participation of students from four countries adds relevance by facilitating cross-comparison of outcomes and stimulating discussions about country-specific factors and peculiarities influencing youth financial literacy.
DOCUMENT
BACKGROUND. In order to prevent sarcopenia in community dwelling older adults a higher daily protein intake is needed. A new m-health strategy for dietary counseling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/d, optimal 1.5 g/kg/d) through use of regular food products. METHODS. The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. Dietary intake was measured by a 3d dietary record at baseline and after 6 months intervention. In total 173 subjects were eligible for analysis. A two-way mixed ANOVA with time, group, and time*group interaction was performed. Post-hoc Bonferroni was performed with significance level at p<0.05. RESULTS. Mean age of the subjects was 72.1±6.3y, with a BMI of 25.7±4.2 of which 68% were females. ANOVA revealed significant effect of time, group and time*group (p<0.001). Table 1 shows higher protein intake over time in the dietary counseling group than either control (p=0.038) or exercise (p=0.008) group. Additional analyses revealed no change in vegetable protein intake. The higher protein intake was fully accounted for by animal protein intake. In the dietary counseling group 72% of subjects increased protein intake above the minimum intake level.
DOCUMENT
Background/purpose: For prevention of sarcopenia and functionaldecline in community-dwelling older adults, a higher daily proteinintake is needed. A new e-health strategy for dietary counselling wasused with the aim to increase total daily protein intake to optimallevels (minimal 1.2 g/kg/day, optimal 1.5 g/kg/day) through use ofregular food products.Methods: The VITAMIN (VITal Amsterdam older adults IN the city)RCT included 245 community-dwelling older adults (age ≥ 55y):control, exercise, and exercise plus dietary counselling (protein)group. The dietary counselling intervention was based on behaviourchange and personalization. Dietary intake was measured by a 3ddietary record at baseline, after 6-month intervention and 12-monthfollow-up. The primary outcome was average daily protein intake(g/kg/day). Sub-group analysis and secondary outcomes includeddaily protein distribution, sources, product groups. A Linear MixedModels (LMM) of repeated measures was performed with STATAv13.Results: Mean age of the 224 subjects was 72.0(6.5) years, a BMI of26.0(4.2). The LMM showed a significant effect of time and time*group(p<0.001). The dietary counselling group showed higher protein intakethan either control (1.41 vs 1.13 g/kg/day; β +0.32; p<0.001) or exercisegroup (1.41 vs 1.11 g/kg/day; β +0.33; p<0.001) after 6-month interventionand 12-month follow-up.Conclusions and implications: This study shows digitally supporteddietary counselling improves protein intake sufficiently in communitydwellingolder adults with use of regular food products. Protein intakeincrease by personalised counselling with e-health is a promising strategyfor dieticians.
DOCUMENT
Rationale In order to prevent sarcopenia in community dwelling older adults a higher daily protein intake is needed. A new m-health strategy for dietary counseling was used with the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/d, optimal 1.5 g/kg/d) through use of regular food products.Methods The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. Dietary intake was measured by a 3d dietary record at baseline and after 6 months intervention. In total 173 subjects were eligible for analysis. A two-way mixed ANOVA with time, group, and time*group interaction was performed. Post-hoc Bonferroni was performed with significance level at p<0.05.Results Mean age of the subjects was 72.1±6.3, with a BMI of 25.7±4.2 of which 68% were females. ANOVA revealed significant effect of time, group and time*group (p<0.001). Table 1 shows higher protein intake over time in the dietary counseling group than either control (p=0.038) or exercise (p=0.008) group. Additional analyses revealed no change in vegetable protein intake. The higher protein intake was fully accounted for by animal protein intake. In the dietary counseling group 72% of subjects increased protein intake above the minimum intake level.Conclusions This study shows digitally supported dietary counseling improves protein intake sufficiently in community dwelling older adults. Protein intake increase by counseling with m-health is a promising strategy for dieticians with the upcoming rising ageing population.Keywords: Aging, Sarcopenia, Functioning, Nutrition, Technology
DOCUMENT
Purpose: For prevention of sarcopenia and functional decline in community dwelling older adults, a higher daily protein intake is needed in addition to increased exercise. A new e-health strategy for dietary counseling was usedwith the aim to increase total daily protein intake to optimal levels (minimal 1.2 g/kg/day, optimal 1.5 g/kg/day) through use of regular food products.Methods: The VITAMIN (VITal AMsterdam older adults IN the city) RCT included 245 community dwelling older adults (age ≥ 55y): control, exercise, and exercise plus dietary counseling (protein) group. The dietary counselingintervention was based on behavior change and personalization was offered by a dietitian coach, by use of face-to-face contacts and videoconferencing during a 6-month intervention. Dietary intake was measured by a 3d dietaryrecord at baseline, after 6-month intervention and 12-month follow-up. The primary outcome was average daily protein intake (g/kg/day). Sub-group analysis and secondary outcomes included daily protein distribution, sources,product groups. A Linear Mixed Models (LMM) of repeated measures was performed with STATA v13.Results: Mean age of the 224 subjects was 72.0(6.5) years, a BMI of 26.0(4.2) and 71% were female. The LMM showed a significant effect of time and time*group (p<0.001). The dietary counseling group showed higher protein intakethan either control (1.41 vs 1.13 g/kg/day; β +0.32; p<0.001) or exercise group (1.41 vs 1.11 g/kg/day; β +0.33; p<0.001) after 6-month intervention and 12-month follow-up (1.24 vs 1.05; β +0.23; p<0.001 | 1.24 vs 1.07 β +0.19;p<0.001). Additional analysis revealed the higher protein intake was fully accounted for by animal protein intake.Conclusions: This study shows digitally supported dietary counseling improves protein intake sufficiently incommunity dwelling older adults with use of regular food products. Protein intake increase by personalizedcounseling with e-health is a promising strategy for dietitians with the upcoming rising ageing population.Keywords: Ageing, Behavior change, Nutrition, Physical Functioning, Sarcopenia
DOCUMENT
