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Full text via link. Mensen met financiële problemen hebben vaak een ongezondere leefstijl en vaker lichamelijke en psychische klachten dan mensen zonder geldzorgen. Dat is zorgwekkend, want financiële problemen komen veel voor. Eén op de vijf Nederlandse huishoudens heeft risicovolle of problematische schulden. Huisartsen die alert zijn op de doorwerking van financiële problemen realiseren zich dat het oplossen van de schulden soms de belangrijkste stap is om (op de lange termijn) de klachten op te lossen of te verminderen. Meer aandacht voor problematische schulden in de spreekkamer begint met meer kennis bij huisartsen over de invloed van geldzorgen op gezondheid en bij een warm netwerk om patiënten over te dragen aan partijen die de financiële problemen kunnen helpen oplossen
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Collectie van voorbeelden van (data)fysicalisatie - fysieke, tastbare representaties van data. Onderdeel van KIEM project Zichtbaar slimmer.
The high prevalence and burden of cardiovascular diseases (CVD) is largely attributable to unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity and unhealthy food habits. Prevention of CVD, through the promotion of healthy lifestyles, appears to be a Sisyphean task for healthcare professionals, as the root causes of an unhealthy lifestyle lie largely outside their scope. Since most lifestyle choices are habitual and a response to environmental cues, rather than rational and deliberate choices, nationwide policies targeting the context in which lifestyle behaviours occur may be highly effective in the prevention of CVD. In this point-of-view article, we emphasise the need for government policies beyond those mentioned in the National Prevention Agreement in the Netherlands to effectively reduce the CVD risk, and we address the commonly raised concerns regarding ‘paternalism’.
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Gedragsveranderende gezondheidscommunicatie is voor veel communicatieprofessionals een uitdaging. Ontwikkelingen op het gebied van interactieve media kunnen hierbij een doorslaggevende rol spelen. De gezondheidsprofessional krijgt hierdoor nieuw gereedschap in handen. In dit artikel wordt uiteengezet hoe interactieve media strategisch kunnen worden ingezet ten einde de effectiviteit te vergroten van een drietal belangrijke ommunicatiestrategieën: inhaken op het kritieke moment, voelbaar maken van sociale druk en afstemming op het individu.
Background:Tobacco consumption is a leading cause of death and disease, killing >8 million people each year. Smoking cessation significantly reduces the risk of developing smoking-related diseases. Although combined treatment for addiction is promising, evidence of its effectiveness is still emerging. Currently, there is no published research comparing the effectiveness of blended smoking cessation treatments (BSCTs) with face-to-face (F2F) treatments, where web-based components replace 50% of the F2F components in blended treatment.Objective:The primary objective of this 2-arm noninferiority randomized controlled trial was to determine whether a BSCT is noninferior to an F2F treatment with identical ingredients in achieving abstinence rates.Methods:This study included 344 individuals who smoke (at least 1 cigarette per day) attending an outpatient smoking cessation clinic in the Netherlands. The participants received either a blended 50% F2F and 50% web-based BSCT or only F2F treatment with similar content and intensity. The primary outcome measure was cotinine-validated abstinence rates from all smoking products at 3 and 15 months after treatment initiation. Additional measures included carbon monoxide–validated point prevalence abstinence; self-reported point prevalence abstinence; and self-reported continuous abstinence rates at 3, 6, 9, and 15 months after treatment initiation.Results:None of the 13 outcomes showed statistically confirmed noninferiority of the BSCT, whereas 4 outcomes showed significantly (P<.001) inferior abstinence rates of the BSCT: cotinine-validated point prevalence abstinence rate at 3 months (difference 12.7, 95% CI 6.2-19.4), self-reported point prevalence abstinence rate at 6 months (difference 19.3, 95% CI 11.5-27.0) and at 15 months (difference 11.7, 95% CI 5.8-17.9), and self-reported continuous abstinence rate at 6 months (difference 13.8, 95% CI 6.8-20.8). The remaining 9 outcomes, including the cotinine-validated point prevalence abstinence rate at 15 months, were inconclusive.Conclusions:In this high-intensity outpatient smoking cessation trial, the blended mode was predominantly less effective than the traditional F2F mode. The results contradict the widely assumed potential benefits of blended treatment and suggest that further research is needed to identify the critical factors in the design of blended interventions.Trial Registration:Netherlands Trial Register 27150; https://onderzoekmetmensen.nl/nl/trial/27150
Background: Smoking is an avoidable risk factor for diseases, impacting socioeconomic and health care systems globally. The meaning, purposes, and values related to continued smoking after being diagnosed with COPD have not yet been sufficiently explored from an occupational perspective. Gaining an understanding of why people continue to engage in health-compromising or harmful occupations facilitates a more inclusive view on and discussion of occupation. The purpose of this study was to explore meaning construction regarding the occupation of tobacco smoking of people living with COPD in Germany. Methods: This study applied an interpretative phenomenology analysis (IPA) approach to explore the lived experience of people living with COPD who continue to smoke. Four participants were interviewed. Their accounts were then analysed following IPA guidelines. Findings: Three themes emerged from the data: Set in stone, Forbidden fruit, and To wear sackcloth and ashes. Smoking was experienced as a meaningful occupation, and it was especially valued for how it structured the day. Smoking was a familiar habit, and it supported emotional, physical, and cognitive well-being, and contributed to sense of identity. Conclusion: The findings illustrate the importance of understanding occupations that are not positively related to physical health and well-being because of their harmful nature. The findings of this study suggest that occupations do not need to be health-promoting, productive, or reasonable to be meaningful to individuals—meaning is constructed by subjective perceptions of enjoyment, pleasure, and well-being and by experiencing a sense of restoration and reward when engaging in them.
Smoking-behavior during pregnancy and the reliability of an interview were prospectively investigated. The tobacco-exposure was assessed a) by an intake interview b) by a smoking diary and c) by maternal thiocyanate and carboxy-hemoglobin concentrations. Of the 115 nulliparous women, 66 smoked (57.4%). Seventeen women (25.8%) quit and 39 women (59.1%) reduced smoking. Directly after intake, in the first week of the diary, significantly more cigarettes were smoked than stated during the intake interview. According to the diaries, the number of cigarettes increased during the first half of pregnancy. In the 24th week significantly more cigarettes were smoked than in the first week after intake. Also a significant increase of thiocyanate between the measurements at intake and in the 24th of amenorrhea was found. The maternal carboxy-hemoglobin levels did not significantly change during pregnancy. Investigators should be aware of changes in smoking behavior during pregnancy and the potential bias of self reported smoking behavior at the beginning of pregnancy. The tobacco-exposure should be assessed (anamnestic or biochemical) several times during pregnancy, anyway it should include the second half of pregnancy.
As in many other countries worldwide, the coronavirus pandemic prompted the implementation of an “intelligent lockdown” in the spring of 2020 in the Netherlands, including the closure of nightlife venues and cancellation of festivals. Such restrictions and social distancing could particularly affect people who use alcohol or other drugs in recreational settings and give rise to new challenges and additional needs in the field of addiction prevention and care. To monitor changes in substance use and provide services with practical directions for tailored prevention, an anonymous web survey was set up, targeting a convenience sample aged 16 years or older through various social media and other online channels. Between May and October 2020, a total of 6,070 participants completed the survey, mainly adolescents and young adults (16–24 years old). These data were used to explore and describe changing patterns in substance use. Overall results showed declined current use compared to “pre-corona,” but mask underlying variation in changing patterns, including discontinued (tobacco 10.4%, alcohol 11.3%, cannabis 16.3%, other drugs 30.4%), decreased (tobacco 23.0%, alcohol 29.1%, cannabis 17.4%, other drugs 20.7%), unchanged (tobacco 30.3%, alcohol 21.2%, cannabis 22.3%, other drugs 17.3%), increased (tobacco 29.6%, alcohol 32.1%, cannabis 32.9%, other drugs 25.3%), and (re)commenced use (tobacco 6.7%, alcohol 6.3%, cannabis 11.1%, other drugs 6.2%). Especially the use of drugs like ecstasy and nitrous oxide was discontinued or decreased due to the lack of social occasions for use. Increased use was associated with coping motives for all substance types. As measures combatting the coronavirus may need to be practiced for some time to come, possibly leading to prolonged changes in substance use with lingering “post-corona” consequences, timely and ongoing monitoring of changing patterns of substance use is vital for informing prevention services within this field.
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