Abstract Objective This was to elucidate the experiences and perceptions of people with severe mental illness (SMI) and their health care professionals with the SMILE (Severe Mental Illness Lifestyle Evaluation) group-based lifestyle intervention. SMILE focuses primarily on promoting healthy diet, physical activity and weight loss. Method A qualitative study with semi-structured interviews was conducted using purposive sampling. Interviews were conducted with 15 clients and 13 health care professionals (HCPs). Data were analysed according to a thematic analysis. Results Four overall themes were identified: interest in a lifestyle programme; group-based setting; changes in lifestyle behaviour; and preconditions for changing health behaviour. The results showed that clients valued the programme and were interested in the subject of lifestyle. The group-based setting was seen as a positive and important aspect of the intervention. Making lifestyle changes was acknowledged as difficult, especially in combination with the presence of psychiatric symptoms. Clients acquired an improved awareness of different aspects related to lifestyle behaviour. Irrespective of weight loss achieved, clients found their efforts successful with relatively ‘small’ changes. Some needed more support during the intervention than others. The practical activities in group sessions were regarded as most useful. HCPs were enthusiastic about the programme and their interactions with lifestyle improvements. Conclusions The results of this study shed light on different aspects that were considered important when delivering a lifestyle intervention to people with SMI. We recommend considering these aspects when implementing a lifestyle intervention in a mental health care setting for clients with SMI.
DOCUMENT
Abstract Background: Several interventions have been developed to improve physical health and lifestyle behaviour of people with a severe mental illness (SMI). Recently, we conducted a pragmatic cluster-randomised controlled trial which evaluated the efects of the one-year Severe Mental Illness Lifestyle Evaluation (SMILE) lifestyle intervention compared with usual care in clients with SMI. The SMILE intervention is a 12-month group-based lifestyle intervention with a focus on increased physical activity and healthy food intake. The aim of the current study was to explore the experiences of people with SMI and healthcare professionals (HCPs) regarding implementation feasibility of the SMILE intervention and the fdelity to the SMILE intervention. Methods: A process evaluation was conducted alongside the pragmatic randomized controlled trial. The experiences of clients and HCPs in the lifestyle intervention group were studied. First, descriptive data on the implementation of the intervention were collected. Next, semi-structured interviews with clients (n=15) and HCPs (n=13) were performed. Interviews were audiotaped and transcribed verbatim. A thematic analysis of the interview data was performed using MAXQDA software. In addition, observations of group sessions were performed to determine the fdelity to the SMILE intervention using a standardised form. Results: Ten out of 26 HCPs who conducted the group sessions discontinued their involvement with the intervention, primarily due to changing jobs. 98% of all planned group sessions were performed. Four main themes emerged from the interviews: 1) Positive appraisal of the SMILE intervention, 2) Suggestions for improvement of the SMILE intervention 3) Facilitators of implementation and 4) Barriers of implementation. Both clients and HCPs had positive experiences regarding the SMILE intervention. Clients found the intervention useful and informative. The intervention was found suitable and interesting for all people with SMI, though HCPs sometimes had to tailor the intervention to individual characteristics of patients (e.g., with respect to cognitive functioning). The handbook of the SMILE intervention was perceived as user-friendly and helpful by HCPs. Combining SMILE with daily tasks, no support from other team members, and lack of staf and time were experienced as barriers for the delivery of the intervention Conclusion: The SMILE intervention was feasible and well-perceived by clients and HCPs. However, we also identifed some aspects that may have hindered efective implementation and needs to be considered when implementing the SMILE intervention in daily practice
DOCUMENT
Abstract Background: Cardiovascular disease is the leading cause of the estimated 11–25 years reduced life expectancy for persons with serious mental illness (SMI). This excess cardiovascular mortality is primarily attributable to obesity, diabetes, hypertension, and dyslipidaemia. Obesity is associated with a sedentary lifestyle, limited physical activity and an unhealthy diet. Lifestyle interventions for persons with SMI seem promising in reducing weight and cardiovascular risk. The aim of this study is to evaluate the effectiveness and cost-effectiveness of a lifestyle intervention among persons with SMI in an outpatient treatment setting. Methods: The Serious Mental Illness Lifestyle Evaluation (SMILE) study is a cluster-randomized controlled trial including an economic evaluation in approximately 18 Flexible Assertive Community Treatment (FACT) teams in the Netherlands. The intervention aims at a healthy diet and increased physical activity. Randomisation takes place at the level of participating FACT-teams. We aim to include 260 outpatients with SMI and a body mass index of 27 or higher who will either receive the lifestyle intervention or usual care. The intervention will last 12 months and consists of weekly 2-h group meetings delivered over the first 6 months. The next 6 months will include monthly group meetings, supplemented with regular individual contacts. Primary outcome is weight loss. Secondary outcomes are metabolic parameters (waist circumference, lipids, blood pressure, glucose), quality of life and health related self-efficacy. Costs will be measured from a societal perspective and include costs of the lifestyle program, health care utilization, medication and lost productivity. Measurements will be performed at baseline and 3, 6 and 12 months. Discussion: The SMILE intervention for persons with SMI will provide important information on the effectiveness, cost-effectiveness, feasibility and delivery of a group-based lifestyle intervention in a Dutch outpatient treatment setting. Trial registration: Dutch Trial Registration NL6660, registration date: 16 November 2017.
DOCUMENT
IMPORTANCE People with a severe mental illness (SMI) have a life expectancy reduced by 10 to 20 years compared with the general population, primarily attributable to cardiometabolic disorders. Lifestyle interventions for people with SMI can improve health and reduce cardiometabolic risk. OBJECTIVE To evaluate the effectiveness of a group-based lifestyle intervention among people with SMI in outpatient treatment settings compared with treatment as usual (TAU). DESIGN, SETTING, AND PARTICIPANTS The Severe Mental Illness Lifestyle Evaluation (SMILE) study is a pragmatic cluster randomized clinical trial performed in 8 mental health care centers with 21 flexible assertive community treatment teams in the Netherlands. Inclusion criteria were SMI, age of 18 years or older, and body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or greater. Data were collected from January 2018 to February 2020, and data were analyzed from September 2020 to February 2023. INTERVENTIONS Weekly 2-hour group sessions for 6 months followed by monthly 2-hour group sessions for another 6 months, delivered by trained mental health care workers. The intervention targeted overall lifestyle changes, emphasizing establishing a healthy diet and promoting physical activity. TAU (control) did not include structured interventions or advice on lifestyle. MAIN OUTCOMES AND MEASURES Crude and adjusted linear mixed models and multivariable logistic regression analyses were performed. The main outcome was body weight change. Secondary outcomes included changes in body mass index, blood pressure, lipid profiles, fasting glucose level, quality of life, self-management ability, and lifestyle behaviors (physical activity and health, mental health, nutrition, and sleep). RESULTS The study population included 11 lifestyle intervention teams (126 participants) and 10 TAU teams (98 participants). Of 224 included patients, 137 (61.2%) were female, and the mean (SD) age was 47.6 (11.1) years. From baseline to 12 months, participants in the lifestyle intervention group lost 3.3 kg (95%CI, −6.2 to −0.4) more than those in the control group. In the lifestyle intervention group, people with high attendance rates lost more weight than participants with medium and low rates (mean [SD] weight loss: high, −4.9 [8.1] kg; medium, −0.2 [7.8] kg; low, 0.8 [8.3] kg). Only small or no changes were found for secondary outcomes. CONCLUSIONS AND RELEVANCE In this trial, the lifestyle intervention significantly reduced weight from baseline to 12 months in overweight and obese adults with SMI. Tailoring lifestyle interventions and increasing attendance rates might be beneficial for people with SMI. TRIAL REGISTRATION Netherlands Trial Register Identifier: NTR6837
DOCUMENT
DOCUMENT
Presentatie over online opvoedingsondersteuning mei 2014
DOCUMENT
Gisteren was het LEF-event van Fontys. Een bijeenkomst voor en door medewerkers van Fontys, om elkaar te inspireren, kennis en kennissen te delen. Ook aan mij is gevraagd of ik lef genoeg had om in 20 minuten de mensen te inspireren. Ik heb de stoute schoenen aangetrokken… Uiteraard ging het over talent. Alleen deze keer niet over de vraag ‘wat is jouw talent?’. Ik heb het over een andere boeg gegooid en gekeken naar ‘in welke omgeving komt jouw talent het beste tot zijn recht’
MULTIFILE
Uit de conclusie van het proefschrift : " De centrale vraag is opgedeeld in vier onderzoeksvragen. Aan de hand van deze onderzoeksvragen wordt een antwoord op de centrale vraag gegeven. 1 Wat zijn de principes van de Stichting Architecten Research (SAR) en gerelateerde concepten en welke aspecten zijn hieruit af te leiden om de toekomstbestendigheid van renovatieconcepten te beoordelen? 2 Welke overige factoren zijn van invloed op de toekomstbestendigheid van renovatieconcepten en welke aspecten zijn hieruit af te leiden om de toekomstbestendigheid van renovatieconcepten te beoordelen? 3 Welke renovatieconcepten worden er anno 2015 in Nederland aangeboden? 4 Op welke wijze voldoen de renovatieconcepten aan de aspecten die bepalend zijn voor de toekomstbestendigheid? Dit onderzoek is een evaluerend onderzoek naar 25 renovatieconcepten. Het doet geen aanbevelingen aan de conceptontwikkelaars. De 25 aangedragen concepten moeten verder onderzocht worden om de toepasbaarheid van elk van de aspecten nauwkeuriger te beschrijven en gerichter van aanbevelingen te kunnen voorzien. Zo is verder onderzoek naar de aanpasbaarheid van de installaties in combinatie met de verwachte klimatologische veranderingen een onderzoeksgebied. "
DOCUMENT
Digitization of activities in hospitals receives more attention, due to Covid-19 related regulations. The use of e-health to support patient care is increasing and efficient ways to implement digitization of processes and other technological equipment are needed. We constructed a protocol for implementation and in this study, we evaluate this protocol based on a case to implement a device in the OR. We used various data sources to evaluate this protocol: semi-structured interviews, questionnaires, and project documents. Based on these findings, this protocol, including identified implementation activities and implementation instructions can be used for implementations of other devices. Implementation activities include setting up a project plan, organizational and technological preparation, maintenance, and training. In future research, these activities and instructions need to be evaluated in more complex projects and a flexible tool needs to be developed to select relevant activities and instructions for implementations of information systems or devices.
LINK
