The diverse European landscape of climate consciousness is shaped by political values, financial constraints, and country-specific point of view. The aim of the study was to unravel age-specific ecological awareness, forms of engagement, and perceptions, contributing to a nuanced understanding of climate dynamics.Selected regions: Germany (Rheinisches Revier), the Netherlands (Amsterdam Metropolitan Area), and Poland (Upper Silesia/Metropolis GZM) present different states regarding recycling/Circular Economy principles, and different environments.The research design incorporates an inductive qualitative approach to investigate environmental awareness and attitudes toward ecologically friendly behaviors. Six FGIs (Focus Group Interviews) were conducted across three European regions, involving participants from diverse age groups (20–39 years and 40–60 years) in each region.The study shows that ecological awareness varies between countries and generations, reflecting distinctive environmental strategies shaped by cultural and developmental factors. Participants in each region and age group exhibit diverse levels of engagement in sustainable activities, and highlight issues such as the need for tailored strategies, concerns related to eco-labelling, greenwashing, and inadequate waste treatment, as well as information gaps.These variations in pro-environmental attitudes and behaviors across age groups and regions underscore the need for tailored strategies and regional policies. Transparency in waste management, eco-labelling, and sustainable transportation alternatives should be prioritized. Educational initiatives addressing information gaps, especially regarding lifestyle choices, are crucial. Collaboration and interdisciplinary approaches are essential for fostering positive change and a sustainable future across the European Union. Transparent communication, regulatory measures, and accessible eco-friendly options encourage widespread adoption of pro-environmental behaviors.
BACKGROUND: The performance of activities of daily living (ADL) at home is important for the recovery of older individuals after hip fracture. However, 20-90% of these individuals lose ADL function and never fully recover. It is currently unknown to what extent occupational therapy (OT) with coaching based on cognitive behavioral treatment (CBT) improves recovery. The same holds for sensor monitoring-based coaching in addition to OT. Here, we describe the design of a study investigating the effect of sensor monitoring embedded in an OT rehabilitation program on the recovery of ADL among older individuals after hip fracture.METHODS/ DESIGN: Six nursing homes will be randomized in a three-arm stepped wedge cluster randomized trial. All nursing homes will initially provide standard care. At designated time points, nursing homes, successively and in random order, will cross over to the provision of OT and at the next time point, to sensor monitoring-enhanced OT. A total of 288 older individuals, previously living alone in the community, who after a hip fracture were admitted to a geriatric rehabilitation ward for a short-term rehabilitation, will be enrolled. Individuals in the first intervention group (OTc) will participate in an OT rehabilitation program with coaching based on cognitive behavioral therapy (CBT) principles. In the sensor monitoring group, sensor monitoring is added to the OT intervention (OTcsm). Participants will receive a sensor monitoring system consisting of (i) an activity monitor during nursing home stay, (ii) a sensor monitoring system at home and a (iii) a web-based feedback application. These components will be embedded in the OT. The OT consists of a weekly session with an occupational therapist during the nursing home stay followed by four home visits and four telephone consultations. The primary outcome is patient-perceived daily functioning at 6 months, assessed using the Canadian Occupational Performance Measure (COPM).DISCUSSION: As far as we know, this study is the first large-scale stepped wedge trial, studying the effect of sensor monitoring embedded in an OT coaching program. The study will provide new knowledge on the combined intervention of sensor monitoring and coaching in OT as a part of a rehabilitation program to enable older individuals to perform everyday activities and to remain living independently after hip fracture.TRIAL REGISTRATION NUMBER: Netherlands National Trial Register, NTR 5716 Date registered: April 1 2016.
