Background: The environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention. Methods: A quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data. Discussion: Two important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used.
From the article : "Based on a review of recent literature, this paper addresses the question of how urban planners can steer urban environmental quality, given the fact that it ismultidimensional in character, is assessed largely in subjective terms and varies across time. A novel perspective of urban environmental quality is proposed, simultaneously exploring three questions that are at the core of planning and designing cities: ‘quality of what?’, ‘quality for whom?’ and ‘quality at what time?’. The dilemmas that urban planners face in answering these questions are illustrated using secondary material. This approach provides perspectives for action. Rather than further detailing the exact nature of urban quality, it calls for sustainable urban environmental quality planning that is integrated, participative and adaptive" ( wileyonlinelibrary.com ) DOI: 10.1002/eet.1759 - Preprint available for free download.
Objective: To describe the development of a goal-directed movement intervention in two medical wards, including recommendations for implementation and evaluation. Design: Implementation Research. Setting: Pulmonology and nephrology/gastroenterology wards of the University Medical Centre Utrecht, The Netherlands. Participants: Seven focus groups were executed including 28 nurses, 7 physical therapists and 15 medical specialists. Patients' perceptions were repeatedly assessed during the iterative steps of the intervention development. Intervention: Interventions were targeted to each ward's specific character, following an Intervention Mapping approach using literature and research meetings. Main measures: Intervention components were linked to Behavior Change Techniques and implementation strategies will be selected using the Expert Recommendation Implementing Change tool. Evaluation outcomes like number of patients using the movement intervention will be measured, based on the taxonomy of Proctor. Results: The developed intervention consists of: insight in patients movement behavior (monitoring & feedback), goal setting (goals & planning) and adjustments to the environment (associations & antecedents). The following implementation strategies are recommended: to conduct educational meetings, prepare & identify champions and audit & provide feedback. To measure service and client outcomes, the mean level of physical activity per ward can be evaluated and the Net Promoter Score can be used. Conclusion(s): This study shows the development of a goal-directed movement intervention aligned with the needs of healthcare professionals. This resulted in an intervention consisting of feedback & monitoring of movement behavior, goal setting and adjustments in the environment. Using a step-by-step iterative implementation model to guide development and implementation is recommended.
Het probleem dat deze projectaanvraag adresseert is de hoge werkdruk van zorgprofessionals in de dementiezorg. Door een stijging in het aantal ouderen met dementie, stijgt de zorgvraag, terwijl het tekort aan zorgprofessionals groeit. Door de inzet van slimme technologische innovaties zoals een Intelligente Zorgomgeving kan deze werkdruk sterk verminderd worden. Een Intelligente Zorgomgeving maakt gebruik van sensortechnieken en gebruikt Artificiële Intelligentie (AI) om gepersonaliseerde zorg te leveren door de zorgbehoefte in kaart te brengen en daarop te reageren. De Intelligente Zorgomgeving werkt daarbij samen met de zorgprofessional. Deze oplossingsrichting wordt in dit project verder uitgewerkt samen met vier zorgpartijen en drie innovatieve MKB. Aan de hand van de casus “Ondersteuning bij eten en drinken” worden Just-in-time adaptive interventions (JITAI) ontwikkeld zodat de zorgprofessional de zorgprofessional ondersteund wordt in het uitvoeren van bepaalde zorgtaken. Een voorbeeld van een interventie is het op het juiste moment geven van op de persoon aangepaste zintuigelijke prikkels (geluiden, lichten en projecties) die senioren stimuleren om te eten. Door dergelijke interventies wordt de druk op de zorgprofessional verminderd en neemt de kwaliteit van de zorg toe. Niet alleen de integratie van de AI-modules is van belang maar ook hoe de AI ‘getoond’ wordt aan de zorgprofessional. Daarom wordt er in dit project ook extra aandacht besteed aan de interactie tussen zorgprofessional en de Intelligente Zorgomgeving waardoor het gebruiksgemak wordt verhoogd en zowel cliënt als zorgprofessional een hogere mate van autonomie kunnen ervaren. Door het prototype van de Intelligente Zorgomgeving verder te ontwikkelen in zorginstellingen in samenwerking met verschillende zorgprofessionals en aandacht te besteden aan het ontwikkelen van AI en Interactie met het systeem kunnen de wensen en behoeften van de zorgprofessionals worden geïntegreerd in de Intelligente Zorgomgeving. Dit gebeurt in drie iteraties waarbij de drie opeenvolgende beschikbare living labs in toenemende mate complex en realistisch zijn.
