Zoekresultaten

Should social programs target finances, health, or well-being

In recent years, both scientists and the general population gained awareness of the deep entanglement between finances, health, and well-being. People cannot be reduced to a set of problems to be tackled independently, thinking that somehow these solutions add up to solve the problem as a whole.4 Researchers pay increasing attention to how problems are related, and many lessons have been learned over time. Policy-makers and practitioners who understand the complex relationship between financial, physical, and mental well-being find themselves in the unique position to use these insights in how they design their programs. This paper provides an overview of academic and grey literature and the lessons we can learn from these studies.

Bullying and mental health: the effects of Prima anti-bullying program in The Netherlands

Background:Victimization among children is associated with adverse effects on their physical and psychological health. Many health complaints follow as a result of bullying and anxiety and depression also precede bullying. The Dutch school-wide antibullying program ‘Prima’ was developed based on techniques and scientific insights that are known to be effective. In this randomized trial we investigate the effects of school-wide antibullying program on bullying behavior and self-esteem and depression.Methods:A total of 4,229 students of grade 3 to 6 of 31 primary schoolsparticipated in this study. The schools were randomly assigned to three conditions. Condition A was offered a teachertraining, an online screening tool for bullying behavior, and a set of practice- and evidence-based guidelines to deal with difficult bullying situations. Condition B included all of condition A plus a series of eight lessons for the students. Condition C was the control group. A questionnaire was filled out by the students before and after the intervention.Results:Results from the pretest showed that 16% of the students was bullied regularly. There was a significant difference between bullied and non-bullied children in their reported mental health. Bullied students indicated much more depressive symptoms compared to non-bullied students (3,67 vs 1,67, p= .000). Bullied children also indicated lower self-esteem (16,74 vs 19,84, p = .000). The effects of the intervention program are currently analyzed and will be presented at the conference in the fall of 2018.Conclusions:Bullying is strongly related to mental health issues among children. To address mental health issues among youth, schools should focus on evidence-based anti-bullying programs as a vital part of a wider school policy.Key messages:-Bullying has a strong impact on the wellbeing and mental health of children.-School programs focused on preventing bullying can therefore reduce health complaints among children.

Professional competence in a health promotion program in the Netherlands

Health promotion for senior citizens ('seniors') is an increasingly important factor in health and welfare policy, having important implications for occupational therapy. The health promotion program 'Healthy and Active Aging' originated in the US, has been modified and adapted to the Dutch context and has been implemented in community contexts. This study aimed to generate an in-depth understanding of the Healthy and Active Aging program and to use this knowledge to inform professional practice. A naturalistic case study methodology was followed, using document analysis, observations, interviews and a group interview as data gathering methods. Data were analyzed and interpreted using narrative analyses. In this specific case, a small group of women joined the program. During 10 sessions, the participants explored the meaning of everyday activities for their self-perceived health and well-being. The key experience reported by the participants and professionals related to the positive ambience within the group, the emotional recognition among the participants and the responsive guidance of the professionals. This case showed how the framework of the program can be modified and tailored to the wishes and needs of the participating seniors. The group facilitators chose a subtle, responsive manner to support and motivate the participants.

Implementation fidelity trajectories of a health promotion program in multidisciplinary settings

BACKGROUND: Although the importance of evaluating implementation fidelity is acknowledged, little is known about heterogeneity in fidelity over time. This study aims to generate insight into the heterogeneity in implementation fidelity trajectories of a health promotion program in multidisciplinary settings and the relationship with changes in patients' health behavior.METHODS: This study used longitudinal data from the nationwide implementation of an evidence-informed physical activity promotion program in Dutch rehabilitation care. Fidelity scores were calculated based on annual surveys filled in by involved professionals (n = ± 70). Higher fidelity scores indicate a more complete implementation of the program's core components. A hierarchical cluster analysis was conducted on the implementation fidelity scores of 17 organizations at three different time points. Quantitative and qualitative data were used to explore organizational and professional differences between identified trajectories. Regression analyses were conducted to determine differences in patient outcomes.RESULTS: Three trajectories were identified as the following: 'stable high fidelity' (n = 9), 'moderate and improving fidelity' (n = 6), and 'unstable fidelity' (n = 2). The stable high fidelity organizations were generally smaller, started earlier, and implemented the program in a more structured way compared to moderate and improving fidelity organizations. At the implementation period's start and end, support from physicians and physiotherapists, professionals' appreciation, and program compatibility were rated more positively by professionals working in stable high fidelity organizations as compared to the moderate and improving fidelity organizations (p < .05). Qualitative data showed that the stable high fidelity organizations had often an explicit vision and strategy about the implementation of the program. Intriguingly, the trajectories were not associated with patients' self-reported physical activity outcomes (adjusted model β = - 651.6, t(613) = - 1032, p = .303).CONCLUSIONS: Differences in organizational-level implementation fidelity trajectories did not result in outcome differences at patient-level. This suggests that an effective implementation fidelity trajectory is contingent on the local organization's conditions. More specifically, achieving stable high implementation fidelity required the management of tensions: realizing a localized change vision, while safeguarding the program's standardized core components and engaging the scarce physicians throughout the process. When scaling up evidence-informed health promotion programs, we propose to tailor the management of implementation tensions to local organizations' starting position, size, and circumstances.TRIAL REGISTRATION: The Netherlands National Trial Register NTR3961 . Registered 18 April 2013.

Setting Overweight adults in motion: the role of health beliefs.

Objective: Health beliefs of overweight adults who did and did not enter an exercise program were compared to identify possible factors that hamper people to increase physical exercise. Method: Participants (n = 116, 78 women and 38 men) were overweight adults without comorbidities. Self-report instruments examined the burden of suffering, beliefs related to physical exercise and obesity, somatic complaints, and obesity-related quality of life of new participants of exercise programs versus sedentary non-exercisers. Results: Mean BMI of exercisers was and of non-exercisers was 34.6 (7.0) and 32.8 (5.8) respectively. The exercisers were more often female, had fathers with less overweight, and considered overweight a more serious health problem. Fear of injury was higher and perceived health benefits were lower in the non-exercisers, who also more often attributed their overweight to physical causes and believed overweight to be irreversible. Body weight, age, education level, somatic complaints, and quality of life of the groups were comparable. Conclusion: With respect to health beliefs, overweight non-exercisers reported more fear of injury and perceived their overweight as more irreversible than exercisers. Considering these factors in intervention and public health promotion may help overweight sedentary people to start physical exercise.

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