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The value of a family-centered approach in preventive child healthcare

This thesis focuses on the effectiveness of a family-centered approach (in Dutch “DMOprotocol”, further referred to as the family-centered approach), designed for monitoring and enhancing children’s social-emotional development in Preventive Child Healthcare (PCH). The effectiveness study took place at a Dutch PCH organization (Icare JGZ). In a quasi-experimental design, regions in which the family-centered approach had already been implemented (northern and southeastern part of Drenthe) were compared to regions in which care-as-usual had been maintained (northern part of Overijssel). The aim was to assess the added value of the family-centered approach from different perspectives. Therefore several research questions were answered in analyses that arereported in different chapters of this thesis.

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The value of a family-centered approach in preventive child healthcare

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Changes in youth care use after the implementation of community-based support teams:

Nieuwe wetgeving voor jeugdzorg in Nederland heeft geleid tot de implementatie van teams, die geïntegreerde eerstelijns jeugdzorg bieden. Belangrijke doelen van de nieuwe Jeugdwet waren meer geïntegreerde, tijdige zorg en minder gebruik van intensieve vormen van zorg. Het doel van dit onderzoek was het bestuderen van veranderingen in het gebruik van jeugdzorg in de tijd en de rol van nieuw ingevoerde wijkgerichte ondersteuningsteams hierin. Patronen van jeugdzorggebruik veranderden naar meer lokaal geleverde primaire jeugdzorg, iets minder gespecialiseerde en iets meer residentiële jeugdzorg. Bovendien nam het jeugdzorggebruik onder jongere kinderen toe in de tijd. Deze trends komen deels overeen met de trends die de Jeugdwet beoogt. Er is weinig bewijs gevonden voor de rol van specifieke teamkenmerken op veranderingen in jeugdzorggebruik in de tijd.

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Changes in youth care use after the implementation of community-based support teams:

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Growth opportunities in professional youth work.

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6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair

Objective: Despite the common occurrence of lower levels of physical activity and physical fitness in youth with spina bifida (SB) who use a wheelchair, there are very few tests available to measure and assess these levels. The purpose of this study was to determine reliability and the physiologic response of the 6-minute push test (6MPT) in youth with SB who self-propel a wheelchair. Methods: In this reliability and observational study, a sample of 53 youth with SB (5-19 years old; mean age = 13 years 7 months; 32 boys and 21 girls) who used a wheelchair performed 2 exercise tests: the 6MPT and shuttle ride test. Heart rate, minute ventilation, respiratory exchange ratio, and oxygen consumption were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, intraclass correlation coefficients (ICCs), SE of measurement, smallest detectable change for total covered distance, minute work, and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentage of maximal values achieved during the shuttle ride test. Results: The ICCs for total distance and minute work were excellent (0.95 and 0.97, respectively), and the ICC for heart rate was good (0.81). The physiologic response during the 6MPT was 85% to 89% of maximal values, except for minute ventilation (70.6%). Conclusions: For most youth with SB who use a wheelchair for mobility or sports participation, the 6MPT is a reliable, functional performance test on a vigorous level of exercise. Impact: This is the first study to investigate physiologic response during the 6MPT in youth (with SB) who are wheelchair using. Clinicians can use the 6MPT to evaluate functional performance and help design effective exercise programs for youth with SB who are wheelchair using. Keywords: 6-minute push test; adolescent; disabled children; spinal diseases; wheelchairs.

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6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair

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Physical fitness and physical behavior in (wheelchair-using) youth with spina bifida

In this thesis we analyzed clinimetric measurement properties of physical fitness tests in wheelchair-using youth with SB. Furthermore, the amount of physical behavior in wheelchair-using youth with SB was quantified and associations with age, gender, VO2peak and Hoffer classification were evaluated. Finally, we described the factors associated with physical behavior in youth with SB and youth with physical disabilities, after which the evidence of interventions to improve physical behavior in youth with physical disabilities was analyzed. This last chapter presents the theoretical and clinical implications. At the end, methodological considerations and directions for further research will be discussed after which the overall conclusion is presented.

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Physical fitness and physical behavior in (wheelchair-using) youth with spina bifida

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Professional youth work as a preventive service: towards an integrated conceptual framework

Knowledge of how professional youth work might prevent individual and social problems in socially vulnerable youngsters is poorly developed. This article presents a conceptual framework that clarifies the implicit methodical process used by professional youth workers and focuses on what stakeholders regard as the potential of professional youth work as a preventive service. A qualitative research synthesis approach was used to combine the findings of six practice-based studies conducted in six European countries. This synthesis revealed that professional youth workers employ a multi-methodic approach in their prevention efforts, strengthening the social skills and self-mastery of youngsters, reinforcing their social network, enhancing their civic participation and helping them find additional social or health services. Twelve methodic principles were identified as contributing to achieving these prevention efforts, shedding light on the process taking place between youngsters and youth workers. This conceptual framework provides essential information for future evaluation research.

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Professional youth work as a preventive service: towards an integrated conceptual framework

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The impact of laws and regulations on the administrative burdens within healthcare

Despite all improvement initiatives such as the national action plan [De-]Regulate Healthcare by the Dutch Ministry of Health, Welfare and Sport in 2018 to create more time for care within the Netherlands, the administrative burden for care workers is still increasing. Managers of healthcare institutes struggle with efficiently implementing government legislations in day-to-day operations. They indicate that the time spent on administrative tasks demanded by municipalities and national authorities is too much. In addition, they also indicate that there is a lack of consistency and uniformity when it comes to the way care workers handle administrative tasks. This way of working causes additional, and often ad hoc, work in the run-up to an audit. It seems that before laws and regulations are effectively implemented, new laws or regulations again demand attention. This looks like a vicious circle, but research to confirm this is not found yet. Therefore, the following research question is formulated: "What is the impact of laws and regulations on the administrative burden with regard to the primary and supportive processes of Dutch long-term care?" An explanatory multiple case study was conducted to answer the research question. Three case studies were carried out during September 2019 to January 2020. Based on these studies, we have concluded that between 29% and 62% of the total perceived administrative burden by long-term care professionals can be related to legislation.

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The impact of laws and regulations on the administrative burdens within healthcare

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Youth Quarter: Success and Failure Factors of a Digital Platform for Youth

The digital platform Youth Quarter is built by youth care organizations with the intention to facilitate youth care professionals to share knowledge. The adoption of Youth Quarter is investigated using the USE IT-adoption-model. Interviews with 27 youth care professionals demonstrated that the main problem they experience is high working pressure. Youth Quarter does not relieve the working pressure nor solves other relevant problems. Youth Quarter is regarded as having little relevance and not meeting users’ requirements, because of the little content and low number of users. Youth care professionals prefer to consult colleagues, and professionals they know. To increase the adoption, Youth Quarter should reward users by providing up-to-date relevant information and knowledge, and support efficient and effective working processes. Management should share clear goals for Youth Quarter and encourage the use of Youth Quarter, in order to increase the adoption.

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Youth Quarter: Success and Failure Factors of a Digital Platform for Youth

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Using an activity tracker in healthcare

Despite the increased use of activity trackers, little is known about how they can be used in healthcare settings. This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center and gaining knowledge about the implementation process. An action research design was used to let healthcare professionals and patients learn about how and when they can use an activity tracker. Data collection was performed in the specialized center with audio recordings of conversations during therapy, reflection sessions with the therapists, and semi-structured interviews with the patients. Analyses were performed by directed content analyses. Twenty-eight conversations during therapy, four reflection sessions, and eleven interviews were recorded. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value. Therapists formulated exclusion criteria for patients, a flowchart on when to use the activity tracker, defined goals, and guidance on how to discuss (the data of) the activity tracker. The action research approach was helpful to allow therapists to learn and reflect with each other and embed the activity trackers into their clinical practice at a specialized mental healthcare center.

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Producten 305

The value of a family-centered approach in preventive child healthcare

Changes in youth care use after the implementation of community-based support teams:

Growth opportunities in professional youth work.

6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair

Physical fitness and physical behavior in (wheelchair-using) youth with spina bifida

Professional youth work as a preventive service: towards an integrated conceptual framework

The impact of laws and regulations on the administrative burdens within healthcare

Youth Quarter: Success and Failure Factors of a Digital Platform for Youth

Using an activity tracker in healthcare

Personen 1

Margo van Hartingsveldt

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Producten 305

The value of a family-centered approach in preventive child healthcare

Changes in youth care use after the implementation of community-based support teams:

Growth opportunities in professional youth work.

6-Minute Push Test in Youth Who Have Spina Bifida and Who Self-Propel a Wheelchair

Physical fitness and physical behavior in (wheelchair-using) youth with spina bifida

Professional youth work as a preventive service: towards an integrated conceptual framework

The impact of laws and regulations on the administrative burdens within healthcare

Youth Quarter: Success and Failure Factors of a Digital Platform for Youth

Using an activity tracker in healthcare

Personen 1

Margo van Hartingsveldt