Aim: To evaluate healthcare professionals' performance and treatment fidelity in the Cardiac Care Bridge (CCB) nurse-coordinated transitional care intervention in older cardiac patients to understand and interpret the study results. Design: A mixed-methods process evaluation based on the Medical Research Council Process Evaluation framework. Methods: Quantitative data on intervention key elements were collected from 153 logbooks of all intervention patients. Qualitative data were collected using semi-structured interviews with 19 CCB professionals (cardiac nurses, community nurses and primary care physical therapists), from June 2017 until October 2018. Qualitative data-analysis is based on thematic analysis and integrated with quantitative key element outcomes. The analysis was blinded to trial outcomes. Fidelity was defined as the level of intervention adherence. Results: The overall intervention fidelity was 67%, ranging from severely low fidelity in the consultation of in-hospital geriatric teams (17%) to maximum fidelity in the comprehensive geriatric assessment (100%). Main themes of influence in the intervention performance that emerged from the interviews are interdisciplinary collaboration, organizational preconditions, confidence in the programme, time management and patient characteristics. In addition to practical issues, the patient's frailty status and limited motivation were barriers to the intervention. Conclusion: Although involved healthcare professionals expressed their confidence in the intervention, the fidelity rate was suboptimal. This could have influenced the non-significant effect of the CCB intervention on the primary composite outcome of readmission and mortality 6 months after randomization. Feasibility of intervention key elements should be reconsidered in relation to experienced barriers and the population. Impact: In addition to insight in effectiveness, insight in intervention fidelity and performance is necessary to understand the mechanism of impact. This study demonstrates that the suboptimal fidelity was subject to a complex interplay of organizational, professionals' and patients' issues. The results support intervention redesign and inform future development of transitional care interventions in older cardiac patients.
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In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. This second article addresses FAQs about context, research questions and designs. Qualitative research takes into account the natural contexts in which individuals or groups function to provide an in-depth understanding of real-world problems. The research questions are generally broad and open to unexpected findings. The choice of a qualitative design primarily depends on the nature of the research problem, the research question(s) and the scientific knowledge one seeks. Ethnography, phenomenology and grounded theory are considered to represent the ‘big three’ qualitative approaches. Theory guides the researcher through the research process by providing a ‘lens’ to look at the phenomenon under study. Since qualitative researchers and the participants of their studies interact in a social process, researchers influence the research process. The first article described the key features of qualitative research, the third article will focus on sampling, data collection and analysis, while the last article focuses on trustworthiness and publishing.
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In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research.
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Due to societal developments, like the introduction of the ‘civil society’, policy stimulating longer living at home and the separation of housing and care, the housing situation of older citizens is a relevant and pressing issue for housing-, governance- and care organizations. The current situation of living with care already benefits from technological advancement. The wide application of technology especially in care homes brings the emergence of a new source of information that becomes invaluable in order to understand how the smart urban environment affects the health of older people. The goal of this proposal is to develop an approach for designing smart neighborhoods, in order to assist and engage older adults living there. This approach will be applied to a neighborhood in Aalst-Waalre which will be developed into a living lab. The research will involve: (1) Insight into social-spatial factors underlying a smart neighborhood; (2) Identifying governance and organizational context; (3) Identifying needs and preferences of the (future) inhabitant; (4) Matching needs & preferences to potential socio-techno-spatial solutions. A mixed methods approach fusing quantitative and qualitative methods towards understanding the impacts of smart environment will be investigated. After 12 months, employing several concepts of urban computing, such as pattern recognition and predictive modelling , using the focus groups from the different organizations as well as primary end-users, and exploring how physiological data can be embedded in data-driven strategies for the enhancement of active ageing in this neighborhood will result in design solutions and strategies for a more care-friendly neighborhood.
This project establishes a collaborative network centered around the Amsterdam Museum, comprising key stakeholders from prominent cultural institutions, including the Centraal Museum Utrecht and the Rotterdam Museum. The consortium is designed to explore the transformative potential of co-creation in museums, focusing on enhancing visitor engagement, fostering inclusivity, and integrating digital technologies into cultural practices. Key personnel will provide interdisciplinary expertise in communication and cultural heritage, facilitating a robust understanding of stakeholder dynamics and collaborative processes. The research aims to analyze how co-creation can bridge the gap between museums and their diverse audiences, creating a sense of ownership and connection. Initial observational findings suggest that co-creation practices significantly enhance visitor experiences while revealing stakeholders' desires for deeper collaborative opportunities. To achieve these objectives, qualitative methods such as semi-structured interviews, focus groups, and ethnographic observations will be employed, delivering rich insights into the impact of co-created programming. An essential output of this project will be an academic publication aimed at foundational research on effective co-creation practices within the cultural sector. Furthermore, the consortium will pursue a larger grant application to secure sustainable funding for ongoing research initiatives, ensuring the long-term viability and impact of this collaborative network. This will not only advance academic discourse but also facilitate knowledge transfer between academia and museums, enriching cultural engagement strategies. Ultimately, the project aspires to enhance the visibility and societal relevance of cultural institutions, fostering innovative solutions to contemporary challenges through collaborative research and community involvement.
Effectiveness of Supported Education for students with mental health problems, an experimental study.The onset of mental health problems generally occurs between the ages of 16 and 23 – the years in which young people follow postsecondary education, which is a major channel in ourso ciety to prepare for a career and enhance life goals. Several studies have shown that students with mental health problems have a higher chance of early school leaving. Supported Education services have been developed to support students with mental health to remain at school. The current project aims to study the effect of an individually tailored Supported Education intervention on educational and mental health outcomes of students with mental health problems at a university of applied sciences and a community college. To that end, a mixed methods design will be used. This design combines quantitative research (Randomized Controlled Trial) with qualitative research (focus groups, monitoring, interviews). 100 students recruited from the two educational institutes will be randomly allocated to either the intervention or control group.
