To investigate the digital aspect of travel among vulnerable-to-exclusion groups, Customer Journey Mapping [CJM] was used to gain qualitative and quantitative in-depth knowledge of the experiences of elderly people, low-income citizens, wheelchair users, blind people and women. Due to COVID-19 the developed CJM method questioned participants about past trips over the phone or MS teams. This generated 36 interviews. Main outcomes: the elderly do not struggle with operating ticket machines or transport cards but are insecure about operating apps, finding information and rely on social ties. Low-income participants have good digital capabilities but suffer financial stress and prefer to pay cash. People in wheelchairs plan extensively in advance but receive limited support. Screen readers are crucial for blind people, and 69% of the women felt limited by safety; none of the men did.
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Digital mobility services have great potential to increase passengers' transportation options, improve their experiences and reduce exclusion. For example, they can facilitate access to information and support, and join transport modes together more seamlessly. However, these advantages will only be available to those who can access and use these services effectively. To facilitate the development of usable and inclusive services, information on the range of potential users' digital interface capabilities, attitudes and current use of digital services is needed. A population-representative survey examining these issues was carried out with 1010 participants in Germany in 2020. As well as self-report questions, it examined basic digital interface competence using simplified paper prototyping. The results are examined in terms of the characteristics of groups that are particularly vulnerable to either digital or transport exclusion. Older people (aged 65+), people with disabilities and people with low levels of education were found to have particularly low levels of digital technology access, use, attitudes and competence. Caution is thus required when rolling out digital mobility services. Non-digital alternatives are needed to ensure an inclusive service. When digital interfaces are used, they need to be designed carefully to be usable by and reassuring to digital novices.
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This feasibility report aims to create a solid background for Savings Groups programming in Italy, Spain, Germany, Poland and the Netherlands where partner organisations of the LETS SAVEE1 project are based. This Erasmus+ funded project aims at exploring the potential of saving groups in the European countries’ context, by improving entrepreneurial skills and access to financial services and social networks of diverse target groups. This particular report provides the partner organisation as well as other interested implementing organisations with a better understanding of how the different contexts influences the setting up and/or scale up of saving groups. This report is set up as follows: The market potential is based on literature of societal developments and how they can be linked to the emergence of saving groups in the respective countries and what kind of target groups have potential for benefitting the services offered by savings groups. By mapping partner organisations, the feasibility study identifies present and potential partners and stakeholders which could play an essential role reaching out to target groups. Then, the study will inform partner organisations and other implementers about the legal framework in each country that allows them to set up Savings Groups accordingly and identify issues that might need advocacy actions. Finally, this report provides a mapping of risk factors and ways to mitigate risks for savings groups members that were applicable for all partner organizations.
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The theoretical framework of this dissertation is based on Amartya Sen’s capability approach (Chapter 2). In the early 1980s, development economist Amartya Sen developed the capability framework as a broad normative framework for the evaluation and assessment of individual well-being and social arrangements mainly in countries in the Global South (Sen, 1999, 2009). I chose the capability approach was chosen because of its strong focus on the notion of freedom as the capability to live the life each individual is aiming for. The freedom to choose a particular lifestyle is an intrinsic part of Sen’s notions of agency and well-being (Sen, 1999). After elaborating on notions of agency and well-being in detail, I turn to the role of financial self-help groups and how their members are influenced by social structures. This chapter concludes by operationalizing the theoretical framework into three capabilities (C1–C3) that serve as sensitizing concepts throughout the dissertation. These capabilities focus on the potential impact CAF groups have on members’ abilities to develop social networks (C1), to control their financial household management (C2), and to adopt an enterprising attitude (C3). Chapter 3 discusses my research methodology. I describe how the three capabilities (C1–C3) were applied as sensitizing concepts in the set-up of this particular action research (Blumer, 1954). I also explain in more detail how, by using sensitizing concepts, I combined an inductive research approach with a deductive angle. Then, I elaborate on the fundamental elements of this action research project: the implementation of the CAF groups as well as the collection and analysis of the empirical data. Finally, I reflect on how I designed and carried out this action research, with a special focus on the interaction between researcher and CAF members as research participants. A more detailed background description of the Dutch financial landscape is provided in Chapter 4. The chapter focuses on two particular financial self-help groups: ROSCAs among Ethiopians and Ghanaians living in the Netherlands. Compared to the formal banking system dominating the current financial landscape, these financial self-help groups claim effectivity instead of efficiency in the operation and management of their respective groups. By exploring developments in the current financial landscape, this chapter argues that distinguishing different kinds of resilience creates possibilities for analysing the different roles of financial arrangements and institutions for the financial landscape. Thus, this explorative study on ROSCAs questions the dominance of the financial side of the coin that has resulted from the efficiency-driven institutions of the financial sector. Chapter 5 presents each CAF group in more detail. The reader gets to know the different members of each CAF group and their motivations to join. Financial performance is assessed according to members’ savings and loan behaviour during the period of their participation. The quantitative data is analysed on how much the members of a respective CAF group saved and how much they borrowed from the group’s fund during the entire period of the research. These insights help the reader to better understand the differences and similarities between the five CAF groups. Chapter 6 discusses the empirical findings from the first three CAF groups. This chapter explores whether and how participation in a CAF group improves individuals’ well-being with regard to expanding their social networks, improving their financial household management, and strengthening their entrepreneurial positions. It also shows how participating in CAF groups at the grassroots level contributes to the well- Balancing the social and financial sides of the coin26being of vulnerable people in the Netherlands. Finally, the chapter reconsiders Sen’s notion of freedom for the particular context of overconsumption, inequality, and overindebtedness. In applying Sen’s capability approach, I realized that the approach has a “blind spot” regarding individuals’ possible impacts on the structures within and around them. By adding notions of Giddens’s structuration theory to the core concepts of the capability approach, I rendered the capability approach more sensitive to how CAF-group members may interact with their surrounding structures (Chapter 7). The relation between individuals and surrounding societal structures is extensively discussed in what is often referred to as the agency-structure debate (Ritzer, 2003). This debate is based on differing views about whether and to what extent individuals have a free will and can act according to their preferences, values, and personal feelings, or to what extent they are the “product” of their surrounding social structures. By expanding the capability approach with the notions of internal structures, on the one hand, and more proximate and more distant societal structures, on the other (Stones, 2008), I detail not only how individual agents are influenced by their surrounding structures, but how they might also have – however small and modest – an impact on those structures themselves. As a result, this chapter not only provides answers to how CAF-group participation affects individual members’ access to social networks, their financial household management, and their entrepreneurial positioning, but it also enabled me to investigate how and why individuals join a CAF group to take part in a so-called countermovement. Thus, I also consider how CAF members could possibly play a role in their surrounding social structures, like the existing financial landscape and the emerging participation society in the Netherlands.One way in which a CAF group can play a role in the surrounding structures is to become a community of practice. Wenger (1998) describes a community of practice as a group of people who share a certain domain of interest that distinguishes them from others. In a community of practice, it is crucial to learn from each other by engaging in joint activities and discussions. To discuss whether and how some of the CAF groups studied here turned into a community of practice, I apply the criteria of a common goal, trust, democratic leadership, and accumulation of knowledge in Chapter 8. The application of these criteria to the functioning of the CAF groups also provides more insight into how members interacted which each other in the different CAF groups. I will show how two of the five CAF groups indeed turned into communities of practice. Chapter 9 concludes this dissertation by linking the empirical findings on the individual level (Chapters 6 and 7) with those on the group level (Chapter 8). I follow this with a general discussion of the main contribution to theory development made by the Balancing the social and financial sides of the coin27expansion of Sen’s capability approach with Giddens’s structuration theory. Then, I discuss the role of CAF groups in enabling individual participants to balance the social and financial sides of the coin. Finally, I conclude this dissertation by showing how CAF groups have the potential to empower their members to meet the expectations of the participation society and the challenges of the contemporary financial landscape. I also provide recommendations for how engaged scholars doing action research can be reflective about the way they interact with their research participants and for how practitioners can set up CAF groups in the field. In the Epilogue, I tell the story of Cash2Grow. Based on the experiences and findings of my research, I co-founded the Cash2Grow foundation to promote savings groups in the Netherlands as a tool for financial and social empowerment. By developing improved savings-group methodologies and financial education tools, the foundation aims to train staff and volunteers from different types of (welfare) organizations to establish savings groups among their target populations. At the moment, we are also collaborating with similar organizations in Spain, Italy, Germany, and Poland to learn more from each other in a project subsidized by the EU.
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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.
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This is the report on the situation in the Netherlands in the field of youth, young homeless people and unaccompanied minor aliens. The report describes risk factors for children and young people in relation to social exclusion and homelessness. This report forms the first part of the international comparative study ‘CSEYHP’. MOVISIE carries out this three-year study by order of the European Union. The cooperative partners are three universities in: England, the Czech Republic and Portugal. The objectives of ‘Combating Youth Homelessness’ are as follows: 1. to understand the life trajectories of different homeless youth populations in different national contexts; 2. to develop the concepts of risk and social exclusion in relation to the experience of young homeless people and to the reinsertion process; 3. to test how different methods of working contribute to the reinsertion process for young people; 4. to investigate the roles of and relationships between the young person, trusted adults, lead professionals, peer mentors and family members in the delivery of these programmes across all four countries. When preparing the national reports, the three partner countries the Czech Republic, England and Portugal use the same format as used in the Dutch report. Based on the four national reports, England will prepare a comparative report, in which the four national situations will be compared.
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Thirty to sixty per cent of older patients experience functional decline after hospitalisation, associated with an increase in dependence, readmission, nursing home placement and mortality. First step in prevention is the identification of patients at risk. The objective of this study is to develop and validate a prediction model to assess the risk of functional decline in older hospitalised patients.
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Background: The integrated uptake of patient-reported experience measures, using outcomes for the micro, meso and macro level, calls for a successful implementation process which depends on how stakeholders are involved in this process. Currently, the impact of stakeholders on strategies to improve the integrated use is rarely reported, and information about how stakeholders can be engaged, including care-users who are communication vulnerable, is limited. This study illustrates the impact of all stakeholders on developing tailored implementation strategies and provides insights into supportive conditions to involve care-users who are communication vulnerable. Methods: With the use of participatory action research, implementation strategies were co-created by care-users who are communication vulnerable (n = 8), professionals (n = 12), management (n = 6) and researchers (n = 5) over 9 months. Data collection consisted of audiotapes, reports, and researchers’ notes. Conventional content analysis was performed. Results: The impact of care-users concerned the strategies’ look and feel, understandability and relevance. Professionals influenced impact on how to use strategies and terminology. The impact of management was on showing the gap between policy and practice, and learning from previous improvement failures. Researchers showed impact on analysis, direction of strategy changes and translating academic and development experience into practice. The engagement of care-users who are communication vulnerable was supported, taking into account organisational issues and the presentation of information. Conclusions: The impact of all engaged stakeholders was identified over the different levels strategies focused on. Care-users who are communication vulnerable were valuable engaged in co-creation implementation strategies by equipping them to their needs and routines, which requires adaptation in communication, delimited meetings and a safe group environment. Trial registration: Reviewed by the Medical Ethics Committee of Zuyderland-Zuyd (METCZ20190006). NL7594 registred at https://www.trialregister.nl/. Plain English summary Exploring care-users experiences is important for decisions to improve quality of care. This applies to care-users in the disability care in particular, as these care-users are highly dependent on their care professional. Instruments that facilitate a dialogue between care-users and care professionals about experiences with care are not always used correctly. Furthermore, it is difficult to translate outcomes into decisions about improving quality of care for the individual care-user and the organisation. In our study, care-users, care professionals, management and researchers developed strategies together to improve the use of care-user experience measures. This study aims to show the impact of all participants, including care-users, professionals, management and researchers, on developing implementation strategies. Additionally, the study aims to show how care-users can participate in developing strategies whilst having problems with communication due to intellectual, developmental and acquired disabilities. We found that care-users gave crucial input to the look and feel, and understandability and relevance of the strategies. The contribution of the professionals had impact on how to use strategies and terminology used in instructions and visuals. Management shared lessons learned and represented the needs on the policy level. Researchers used their analytical skills and facilitated the group process. Care-users were able to collaborate by taking into account their needs and because information was presented to them clearly and attractively.
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Introduction: In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation. Theory and Method: The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods. Discussion: The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.
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Titel: The Exodus from the Netherlands or Brain Circulation: Push and Pull Factors of Remigration among Highly Educated Turkish Dutch Auteurs: Gürkan Çelik and Ton Notten In: European Review, 22 (3), 2014, pp. 403-413 The exodus from the Netherlands or brain circulation: Push and pull factors of remigration among highly educated Turkish-Dutch An increasing number of Turks, the Netherlands’ largest ethnic minority, are beginning to return to their country of origin, taking with them the education and skills they have acquired abroad, as the Netherlands faces challenges from economic difficulties, social tension and increasingly powerful right wing parties. At the same time Turkey’s political, social and economic conditions have been improving, making returning home even more appealing for Turkish migrants at large. This article gives explanations about the push and pull factors of return migration. The factors influencing return to one’s country of origin are “pulls”. It is assumed that remigration is more affected by positive developments in the country of origin than by negative developments in the country of residence. Civil society, business world and the Dutch government can develop policies to bind these capable people to the Netherlands, at least in the form of “brain circulation” so that they can serve as “bridge builders” between the two countries. Keywords Return migration, integration, Turkish-Dutch, Turkish migrants, brain circulation =============================================================================== SAMENVATTING De uittocht uit Nederland of breincirculatie: Push- en pull-factoren van remigratie onder hoogopgeleide Turkse Nederlanders. In Nederland zien we een lichte toename van het aantal Turken, de grootste etnische minderheidsgroep in Nederland, die terugkeren naar hun land van herkomst. Ze exporteren daarmee goede opleidingen en vaardigheden die ze in Nederland verwierven. De oorzaken: de economische neergang, sociale spanningen en de groeiende invloed van extreemrechtse partijen. Tegelijkertijd verbeteren in Turkije de politieke, sociale en economische omstandigheden die steeds meer aantrekkingskracht uitoefenen op immigranten in dat land. Dit artikel gaat in op de push- and pull-factoren voor remigranten. Pull-factoren beinvloeden iemands terugkeer naar zijn land van herkomst. Aangenomen wordt dat zo’n remigratie sterker wordt bevorderd door positieve ontwikkelingen in het land van herkomst dan door negatieve (push-factoren) in het land waar men op dat moment woont. De civil society, het bedrijfsleven en de Nederlandse overhead kunnen een beleid ontwikkelen dat verdienstelijke inwoners weet te behouden, hen op z’n minst kan inschakelen als bruggenbouwers en aldus kenniscirculatie mogelijk maakt tussen beide landen. Trefwoorden Retourmigratie, integratie, Turkse Nederlanders, Turkse migranten, kenniscirculatie, breincirculatie
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