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3The purpose of the research was the development of a questionnaire that can measure the behaviour of groups of students (for instance departments' cohorts) in Personal Information Management (PIM). Variables for the questionnaire were derived from the international literature on PIM. The questionnaire has been tested out on 79 students (last year before graduation) from four different departments of the Academy of ICT&Media at The Hague University of Applied Sciences. The students' responses were checked on consistency, item non response, desirability bias and information value of the results. All these criteria indicated that the questionnaire is an adequate tool for the assessment of PIM at an institutional level. The results that have been found for the four departments have not yet been discussed with the managers of the Academy and those of the individual departments. [De hier gepubliceerde versie is het 'accepted paper' van het origineel dat is gepubliceerd op www.springerlink.com . De officiële publicatie kan worden gedownload op http://www.springerlink.com/content/n0h3k71u85024xnt/]
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Background Literature on self-management innovations has studied their characteristics and position in healthcare systems. However, less attention has been paid to factors that contribute to successful implementation. This paper aims to answer the question: which factors play a role in a successful implementation of self-management health innovations? Methods We conducted a narrative review of academic literature to explore factors related to successful implementation of self-management health innovations. We further investigated the factors in a qualitative multiple case study to analyse their role in implementation success. Data were collected from nine self-management health projects in the Netherlands. Results Nine factors were found in the literature that foster the implementation of self-management health innovations: 1) involvement of end-users, 2) involvement of local and business partners, 3) involvement of stakeholders within the larger system, 4) tailoring of the innovation, 5) utilisation of multiple disciplines, 6) feedback on effectiveness, 7) availability of a feasible business model, 8) adaption to organisational changes, and 9) anticipation of changes required in the healthcare system. In the case studies, on average six of these factors could be identified. Three projects achieved a successful implementation of a self-management health innovation, but only in one case were all factors present. Conclusions For successful implementation of self-management health innovation projects, the factors identified in the literature are neither necessary nor sufficient. Therefore, it might be insightful to study how successful implementation works instead of solely focusing on the factors that could be helpful in this process.
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This study provides an in-depth understanding of the perceptions of patients with T2DM before use (acceptability) and after use (acceptance) regarding 4 different mobile health apps for diabetes control and self-management. This study was part of the TOPFIT Citizenlab project. TOPFIT Citizenlab is a 3-year research and innovation program in the eastern part of the Netherlands. Citizens, health care professionals (HCPs), and companies have joined forces with researchers to develop and implement technology for health and well-being.
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Background: Changes in reimbursement have been compelling for Dutch primary care practices to apply a disease management approach for patients with chronic obstructive pulmonary disease (COPD). This approach includes individual patient consultations with a practice nurse, who coaches patients in COPD management. The aim of this study was to gauge the feasibility of adding a web-based patient self-management support application, by assessing patients’ self-management, patients’ health status, the impact on the organization of care, and the level of application use and appreciation. Methods: The study employed a mixed methods design. Six practice nurses recruited COPD patients during a consultation. The e-Health application included a questionnaire that captured information on demographics, self-management related behaviors (smoking cessation, physical activity and medication adherence) and their determinants, and nurse recommendations. The application provided tailored feedback messages to patients and provided the nurse with reports. Data were collected through questionnaires and medical record abstractions at baseline and one year later. Semi-structured interviews with patients and nurses were conducted. Descriptive statistics were calculated for quantitative data and content analysis was used to analyze the qualitative data. Results: Eleven patients, recruited by three nurses, used the application 1 to 7 times (median 4). Most patients thought that the application supported self-management, but their interest diminished after multiple uses. Impact on patients’ health could not be determined due to the small sample size. Nurses reported benefits for the organization of care and made suggestions to optimize the use of the reports. Conclusion: Results suggest that it is possible to integrate a web-based COPD self-management application into the current primary care disease management process. The pilot study also revealed opportunities to improve the application and reports, in order to increase technology use and appreciation.
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Europe’s aging population is leading to a growing number of people affected by chronic disease, which will continue over the coming decades. Healthcare systems are under pressure to deliver appropriate care, partly due to the burden imposed on their limited financial and human resources by the growing number of people with (multiple) chronic diseases. Therefore, there is a strong call for patient self-management to meet these patients’ healthcare needs. While many patients experience medication self-management as difficult, it poses additional challenges for people with limited health literacy. This thesis aims to explore the needs of patients with a chronic disease and limited health literacy regarding medication self-management and how support for medication self-management can be tailored to those needs.
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Objective This cross-sectional questionnaire study investigates if there a difference in the extent to which health care providers in prenatal Shared Medical Appointments (CenteringPregnancy©) and in prenatal individual appointments support self-management in patient education. It also investigates if there is a difference in the extent to which health care providers in CenteringPregnancy@ and in individual appointments pay attention to the factors of the Integrated Model for Behavioral Change (I-Change) in supporting self-management. Methods Dutch health care providers in prenatal care were invited to fill out a questionnaire. Respondents who provided care in CenteringPregnancy© formed the CenteringPregnancy© group, the others were categorized in the individual appointments’ group. After a definition of self-management and an introduction of the I-Change model, respondents were asked if they supported self-management and if they paid attention to the I-Change model for each of 17 themes of prenatal patient education. Pearson’s chi-squared tests and Fisher’s Exact tests were performed to compare both groups. Results We included 133 respondents. Health care providers in the CenteringPregnancy@ group supported self-management to a higher extent compared to the individual appointments group. This difference was statistically significant for eight themes (body position and exercises, oral health, domestic violence, birth mechanism and premature birth, postnatal period, transition from pregnancy to parenthood, taking care of the baby and newborn’s safety). In both groups, health care providers paid most attention to information or to awareness factors instead of motivation factors. Conclusion We found a first prove that health care providers in CenteringPregnancy@ support self-management to a higher extent than health care providers in individual appointments. This could be explained by factors as time, feelings of safety and bonding, continuity of care and emphasis on future health behaviour changes. For effective self-management support, attention to motivation factors is important. However, we found that health care providers in both groups paid more attention to information or to awareness factors than to motivation. Practice implications Health care providers in prenatal individual appointments should be aware of the fact that they possibly support self-management less than health care providers in CenteringPregnancy@ . Health care providers in both types of prenatal care should be aware of the fact that they pay little attention to motivation factors. They might need some skills to change their role from teaching professional to supportive leader.
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In November 2021, the Lecturer Position at Institutes (L.INT) professorship was established by Saxion and Medical Spectrum Twente and as partners physiotherapy practice Pro-F and the Thoracic Centre Twente, with Sandra van Hogen-Koster as a professor. With this, the first Dutch professorship that focuses on the ideas of Positive Health has been launched.
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This study explores the evaluation of research pathways of self-management health innovations from discovery to implementation in the context of practice-based research. The aim is to understand how a new process model for evaluating practice-based research provides insights into the implementation success of innovations. Data were collected from nine research projects in the Netherlands. Through document analysis and semi-structured interviews, we analysed how the projects start, evolve, and contribute to the healthcare practice. Building on previous research evaluation approaches to monitor knowledge utilization, we developed a Research Pathway Model. The model’s process character enables us to include and evaluate the incremental work required throughout the lifespan of an innovation project and it helps to foreground that innovation continues during implementation in real-life settings. We found that in each research project, pathways are followed that include activities to explore a new solution, deliver a prototype and contribute to theory. Only three projects explored the solution in real life and included activities to create the necessary changes for the solutions to be adopted. These three projects were associated with successful implementation. The exploration of the solution in a real-life environment in which users test a prototype in their own context seems to be a necessary research activity for the successful implementation of self-management health innovations.
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Background/Objectives: Digital technologies and data-driven approaches are rapidly transforming healthcare practice and enabling more personalized and preventive care. As personal health data becomes increasingly embedded in healthcare systems, understanding how future healthcare professionals interpret these developments is essential for shaping responsive health education. This study aims to identify the factors that students in health-related programs consider important regarding the increasing use of personal health data in healthcare. Methods: An exploratory qualitative focus group study was conducted between March 2024 and July 2025 across five higher education institutions in Australia, Canada, and the Netherlands. Seven focus groups were conducted with forty students from health-related programs, including nursing, public health, occupational therapy, and social work. Participants discussed the use of personal health data in healthcare and reflected on short fictional future scenarios designed to stimulate discussion about possible developments in data-driven healthcare. Data were analyzed using reflexive thematic analysis using ATLAS.ti. Results: Three overarching domains were identified: (1) personalization and prevention, (2) data quality and ethical considerations, and (3) organizational implications and conditions. Students described personal health data as a powerful tool for personalization, prevention, and informed decision-making. At the same time, they raised concerns about data reliability, overreliance on automated systems, patient anxiety, potential dehumanization of care, privacy risks, and emerging inequalities related to access to and representation within data systems. Overall, students appeared neither purely techno-optimistic nor technophobic, but articulated nuanced ethical, cultural, and professional tensions surrounding data-driven care. Conclusions: Preparing future healthcare professionals for data-driven healthcare requires integrating critical data literacy, ethical reflection, interdisciplinary collaboration and opportunities to critically engage with the societal and professional implications of data-driven technologies into health professional education, while ensuring that organizational conditions support the responsible use of personal health data.
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Background: Self-management of exacerbations in COPD patients is important to reduce exacerbation impact. There is a need for more comprehensive and individualized interventions to improve exacerbation-related selfmanagement behavior. The use of mobile health (mHealth) could help to achieve a wide variety of behavioral goals. Understanding of patients and health care providers perspectives towards using mHealth in promoting selfmanagement will greatly enhance the development of solutions with optimal usability and feasibility. Therefore, the aim of this study was to explore perceptions of COPD patients and their health care providers towards using mHealth for self-management of exacerbations. Methods: A qualitative study using focus group interviews with COPD patients (n = 13) and health care providers (HCPs) (n = 6) was performed to explore perceptions towards using mHealth to support exacerbation-related selfmanagement. Data were analyzed by a thematic analysis. Results: COPD patients and HCPs perceived mostly similar benefits and barriers of using mHealth for exacerbationrelated self-management. These perceived benefits and barriers seem to be important drivers in the willingness to use mHealth. Both patients and HCPs strengthen the need for a multi-component and tailored mHealth intervention that improves patients’ exacerbation-related self-management by determining their health status and providing adequate information, decision support and feedback on self-management behavior. Most importantly, patients and HCPs considered an mHealth intervention as support to improve self-management and emphasized that it should never replace patients’ own feelings nor undermine their own decisions. In addition, the intervention should be complementary to regular contact with HCPs, as personal contact with a HCP was considered to be very important. To optimize engagement with mHealth, patients should have a positive attitude toward using mHealth and an mHealth intervention should be attractive, rewarding and safe. Conclusions: This study provided insight into perceptions of COPD patients and their HCPs towards using mHealth for self-management of exacerbations. This study points out that future mHealth interventions should focus on developing self-management skills over time by providing adequate information, decision support and feedback on self-management behavior and that mHealth should complement regular care. To optimize engagement, mHealth interventions should be attractive, rewarding, safe and tailored to the patient needs.
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