Background/Objectives: Homecare staff often take over activities instead of “doing activities with” clients, thereby hampering clients from remaining active in daily life. Training and supporting staff to integrate reablement into their working practices may reduce clients' sedentary behavior and improve their independence. This study evaluated the effectiveness of the “Stay Active at Home” (SAaH) reablement training program for homecare staff on older homecare clients' sedentary behavior. Design: Cluster randomized controlled trial (c-RCT). Setting: Dutch homecare (10 nursing teams comprising a total of 313 staff members). Participants: 264 clients (aged ≥65 years). Intervention: SAaH seeks to equip staff with knowledge, attitude, and skills on reablement, and to provide social and organizational support to implement reablement in homecare practice. SAaH consists of program meetings, practical assignments, and weekly newsletters over a 9-month period. The control group received no additional training and delivered care as usual. Measurements: Sedentary behavior (primary outcome) was measured using tri-axial wrist-worn accelerometers. Secondary outcomes included daily functioning (GARS), physical functioning (SPPB), psychological functioning (PHQ-9), and falls. Data were collected at baseline and at 12 months; data on falls were also collected at 6 months. Intention-to-treat analyses using mixed-effects linear and logistic regression were performed. Results: We found no statistically significant differences between the study groups for sedentary time expressed as daily minutes (adjusted mean difference: β 18.5 (95% confidence interval [CI] 22.4, 59.3), p = 0.374) and as proportion of wake/wear time (β 0.6 [95% CI 1.5, 2.6], p = 0.589) or for most secondary outcomes. Conclusion: Our c-RCT showed no evidence for the effectiveness of SAaH for all client outcomes. Refining SAaH, by adding components that intervene directly on homecare clients, may optimize the program and require further research. Additional research should explore the effectiveness of SAaH on behavioral determinants of clients and staff and cost-effectiveness.
Background: Existing studies have yet to investigate the perspectives of patients and professionals concerning relapse prevention programs for patients with remitted anxiety or depressive disorders in primary care. User opinions should be considered when optimizing the use and implementation of interventions. Objective: This study aimed to evaluate the GET READY relapse prevention programs for patients with remitted anxiety or depressive disorders in general practice. Methods: Semistructured interviews (N=26) and focus group interviews (N=2) with patients and mental health professionals (MHPs) in the Netherlands were performed. Patients with remitted anxiety or depressive disorders and their MHPs who participated in the GET READY study were interviewed individually. Findings from the interviews were tested in focus group interviews with patients and MHPs. Data were analyzed using thematic analysis. Results: Participants were positive about the program because it created awareness of relapse risks. Lack of motivation, lack of recognizability, lack of support from the MHP, and symptom severity (too low or too high) appeared to be limiting factors in the use of the program. MHPs play a crucial role in motivating and supporting patients in relapse prevention. The perspectives of patients and MHPs were largely in accordance, although they had different perspectives concerning responsibilities for taking initiative. Conclusions: The implementation of the GET READY program was challenging. Guidance from MHPs should be offered for relapse prevention programs based on eHealth. Both MHPs and patients should align their expectations concerning responsibilities in advance to ensure optimal usage. Usage of blended relapse prevention programs may be further enhanced by diagnosis-specific programs and easily accessible support from MHPs.
MULTIFILE
Financially vulnerable consumers are often associated with suboptimal financial behaviors. Evaluated financial education programs so far show difficulties to effectively reach this target population. In our attempt to solve this problem, we built a behaviorally informed financial education program incorporating insights from both motivational and behavioral change theories. In a quasi-experimental field study among Dutch financially vulnerable people, we compared this program with both a control group and a traditional program group. In comparison with the control group, we found robust positive effects of the behaviorally informed program on financial skills and knowledge and self-reported financial behavior, but not on other outcomes. Additionally, we did not find evidence that the behaviorally informed program performed better than the traditional program. Finally, we discuss the findings and limitations of this study in light of the financial education literature and provide implications for policymaking and directions for future research.
MULTIFILE
Een vraagarticulatieproces met projectmanagers en -leiders uit private en Triple-Helix organisaties laat zien dat zij behoefte hebben aan tools voor: 1. Het bepalen van de juiste incentives om stakeholders actief te betrekken in multi-sector collaboratieve innovatieprojecten (verder verwezen als innovatieprojecten), en 2. Het concreet, transparant en op één lijn te krijgen van de belangen van de partners. Vandaar dat dit project betreft het doorontwikkelen van het Degrees of Engagement diagram (DoE-diagram), een tool voor het managen van stakeholder engagement in innovatieprojecten voor het behalen van de maatschappelijke opgaven. Hiermee sluit het project aan bij de programmalijn ‘rollen, belangen en coördinatie’ van de Kennis en Innovatieagenda van de missie Maatschappelijke Verdienvermogen- thema’s Klimaat & Energie en Circulaire economie. Het consortium bestaat uit de Hogeschool van Amsterdam (HvA), KplusV en Amsterdam Smart City (ASC). De HvA ontwikkelde het DoE-diagram. Voor het identificeren van stakeholders bevat het DoE-diagram attributen op project- en organisatieniveau. In dit project wordt het DoE doorontwikkeld door onderzoek te doen naar: 1. De attributen op individuniveau en potentiele nieuwe attributen op project- en organisatieniveau, 2. De mate waarin deze attributen invloed hebben op het bepalen van de passende incentives, de concretisering van de partnerbelangen en al dan niet succesvolle verloop van innovatieprojecten, 3. Een verkenning van een digitale versie van het DoE voor het managen van in- en uitstappen van partners. Hiermee beoogt het project twee doelen: 1. Inzicht verkrijgen in stakeholderconfiguraties voor het ondersteunen van beslissingen met betrekking tot stakeholder-engagement, 2. Bouwen van een consortium van partijen die vervolg aan het project gaan geven door longitudinaal onderzoek te doen naar de inzet van de uitbreiding van het DoE-diagram en het maken van een werkend prototype en testen van de digitale versie ervan.
E-cycling intelligence is a research project directly connected to the PhD-research of Joost de Kruijf at the Utrecht University. Within the program the effects of the introduction of e-bikes in daily commuting are being investigated. Using a large-scale incentive program targeting on behavioral change among car-oriented commuters the next four specific components are being :- Modal shift to e-cycling- Well-being and travel satisfaction of e-bikes vs. car- Weather circumstances and e-cycling- Behavioral intention to e-bike vs. actual behavior Using a combination of three surveys (baseline, one month and half a year) and continuous GPS-measurement on the behavior of more than 800 participants makes this research unique. In collaboration with the TU/e the GPS-dataset is being translated into relevant information on modal shift on different trip purposes offering a new range of possibilities to analyses behavioral change. Knowledge on every of the four topics in the project is translated scientific paper. The expected end of the project is July 2021.With the research not new insights are being gained, the Breda University of Applied Sciences also develops a scientific network of cycling related researchers together with a network of cycling engaged road authorities.
