Search results

(1 - 11 of 11)

Dubbeldeman, E.M.; Crone, M.R.; Jong, J.C.K.D.; Kleij, R.M.J.J. van der 2024

Optimizing implementation: elucidating the role of behavior change techniques and corresponding strategies on determinants and implementation performance: a cross-sectional study

Article / Letter to editor

open access

Introduction Behavior change techniques (BCTs) are considered as active components of implementation strate‑ gies, infuencing determinants and, ultimately, implementation performance. In our... Show moreIntroduction Behavior change techniques (BCTs) are considered as active components of implementation strate‑ gies, infuencing determinants and, ultimately, implementation performance. In our previous Delphi study, experts formulated ‘implementation hypotheses’, detailing how specifc combinations of BCTs and strategies (referred to as BCT-strategy combinations) might infuence determinants and guideline implementation within youth care. For example, educational meetings providing instructions on guideline use were hypothesized to enhance practition‑ ers’ knowledge and, consequently, guideline implementation. However, these hypotheses have not been verifed in practice yet. Method We conducted a cross-sectional study involving practitioners and management professionals from youth (health)care organizations. Using questionnaires, we obtained data on the presence of BCT-strategy combinations and their perceived infuence on determinants and implementation performance. Chi-squared tests and regres‑ sion analyses were employed to determine the infuence of specifc BCT-strategy combinations on determinants and implementation performance. Results Our analyses included data from 104 practitioners and 34 management professionals. Most of the manage‑ ment professionals indicated that the BCT-strategy combinations positively infuenced or had the potential to infu‑ ence their implementation performance. At the practitioner level, half of the combinations were perceived to have a positive infuence on determinants and implementation performance. Furthermore, practitioners who reported the absence of BCT-strategy combinations were more skeptical about their potential infuence on determinants and implementation performance. Conclusion Several BCT-strategy combinations were perceived to improve or potentially improve implementation performance of both practitioners and management professionals. In the development and evaluation of imple‑ mentation eforts, we advocate for clearly describing the implementation efort’s objective and using frameworks that detail the BCTs inducing behavior change, the strategy employed, and the processes driving the observed changes. Understanding these interconnected processes is important in designing targeted, evidence-based Show less

Gestel, L.C. van; Adriaanse, M.A.; Kanis, S.L.; Mensink-Bout, S.M.; Schoones, J.W.; Numans, M.E.; ... ; Brink, G. van den 2024

Determinants of and interventions for Proton Pump Inhibitor prescription behavior: a systematic scoping review

Article / Letter to editor

open access

Background Proton Pump Inhibitors (PPI) are frequently prescribed. Long-term use is associated with side-efects and patients often lack a valid indication. Inappropriate PPI prescribing thus needs... Show moreBackground Proton Pump Inhibitors (PPI) are frequently prescribed. Long-term use is associated with side-efects and patients often lack a valid indication. Inappropriate PPI prescribing thus needs to be addressed. This review aims to scope 1) what determinants are studied as reasons for PPI prescribing, 2) what strategies are used for changing PPI (de)prescribing, and 3) whether important determinants are addressed in these interventions. Methods We searched eight databases for papers on determinants of physician PPI prescribing. Studies were included if they were conducted in a Western country and focused on oral PPIs for an adult population. By follow‑ ing the Behaviour Change Wheel, we extracted information regarding PPI prescribing behavior, behavioral determi‑ nants and intervention strategies. Findings We included 74 papers. Most focused on the determinants knowledge and beliefs about consequences. The latter was consistently related to PPI prescribing. Results for knowledge were mixed. Most interventions used education or enablement (e.g., algorithms, quality check improvements, involvement of pharmacists) as strategies. Enablement consistently improved PPI prescribing, while results for education were mixed. Interpretation There is an overemphasis on refective processes in studies on PPI prescribing. Future research should comprehensively identify behavioral determinants, focusing on refective and impulsive processes, such that interven‑ tions can address the most important determinants. Show less

Uzan, L.M.; Brust, M.; Molenaar, J.M.; Leistra, E.; Boor, K.; Jong, J.C.K.D. 2024

A cross-sectional analysis of factors associated with the teachable moment concept and health behaviors during pregnancy

Article / Letter to editor

open access

Background Pregnancy is often associated with a change in health behaviors, leading some to suggest that pregnancy could be a teachable moment for lifestyle change. However, the prevalence and... Show moreBackground Pregnancy is often associated with a change in health behaviors, leading some to suggest that pregnancy could be a teachable moment for lifestyle change. However, the prevalence and underlying mechanism of this phenomenon is not well understood. The aim of this study is to explore the prevalence of a teachable moment during pregnancy, the psychosocial factors that are associated with experiencing such a moment, and its association with actual health behaviors. Methods In this cross-sectional study, 343 pregnant Dutch women completed an online questionnaire. Participants reported on their intentions to change lifestyle due to pregnancy, their current health behaviors, and several psychosocial factors that were assumed to be linked to perceiving a teachable moment during pregnancy: perceived risk, affective impact, changed self-concept, and social support. Multivariable linear and logistic regression were applied to the data analysis. Results Results demonstrate that 56% of the women experienced a teachable moment based on intentions to change their health behavior. Multivariate regression analyses revealed that changed self-concept (β=0.21; CI=0.11– 0.31), positive affect (positive β=0.28; CI=0.21–0.48), and negative affect (β=0.12; CI=0.00-0.15) were associated with higher intentions to change health behavior. Conversely, more perceived risk was associated with lower intentions to change health behavior (β=-0.29; CI=0.31−0.13). Multivariate regression analyses showed a positive association between intentions to change health behavior and diet quality (β=0.11; CI=0.82–1.64) and physical activity (OR=2.88; CI=1.66-5.00). Conclusions This study suggests that pregnancy may be experienced as a teachable moment, therefore providing an important window of opportunity for healthcare professionals to efficiently improve health behaviors and health in pregnant women and their children. Results suggest that healthcare professionals should link communication about pregnancy-related health behaviors to a pregnant women’s change in identity, affective impact (predominantly positive affective impact) and risk perception to stimulate the motivation to change healthy behavior positively. Show less

Brust, M.; Gebhardt, W.A.; Bruggen, S. van; Janssen, V.; Numans, M.E.; Jong, J.C.K.D. 2023

Making sense of a myocardial infarction in relation to changing lifestyle in the five months following the event: an interpretative phenomenological analysis

Article / Letter to editor

open access

ObjectivePrevious research has shown that experiencing an acute cardiac event, such as a myocardial infarction (MI), can lead to lifestyle changes. This study aimed to explore the potential of a MI as a ‘teachable moment’ (TM) for positive lifestyle changes and to identify psychosocial sensemaking processes that facilitate or hinder the presence of a TM.MethodWe conducted semi-structured interviews with 14 patients who suffered their first MI and were hospitalized in a larger Dutch city. Participants were interviewed twice, respectively one and five months after their hospitalization. They were encouraged to explain how they experienced their MI and how this had affected their lifestyle. We used an Interpretative Phenomenological Analysis approach to the data collection and analysis.FindingsThe participants varied in their willingness to adopt a healthy lifestyle due to their MI. Most participants experienced their event as a TM for changing specific health behaviors, for example facilitated by reflecting on self-concept or social roles and by constructing and comprehending a personal narrative of their MI. Some participants struggled to follow through on their intentions to change their behavior, for example because of a negative attitude towards a healthy behavior or because they perceived it as incongruent to their identity. Only three participants maintained most former health behaviors, for example because they failed to acknowledge their MI as severe or because of earlier life events that elicited more blunted cognitive responses.ConclusionCardiac patients may experience a TM, which is the consequence of interrelated processes of psychosocial sensemaking. As this does not occur at a singular time point, we suggest using the term ‘teachable window’ rather than ‘moment’. Given these findings, there is a window of opportunity to provide continuous psychosocial and lifestyle support during and after hospitalization for acute cardiac events.

Show less

Hysaj, M.; Crone, M.R.; Jong, J.C.K.D.; Vermeiren, R.R.J.M. 2023

Do parental attachment and prosocial behavior moderate the impairment from depression symptoms in adolescents who seek mental health care?

Article / Letter to editor

open access

We investigated parental attachment and prosocial behavior as social protective indicators in adolescents (age 11-17) with symptoms of depression in a clinical setting. Specifically, we tested the... Show moreWe investigated parental attachment and prosocial behavior as social protective indicators in adolescents (age 11-17) with symptoms of depression in a clinical setting. Specifically, we tested the moderating effect of these factors on the relation between symptoms of depression and their impairment on daily life. The Development and Well-Being Assessment, as completed by children, mothers, and fathers, was used, and hierarchical multiple regression analyses were conducted for these three perspectives. From the adolescents' reports we only found a significant effect of symptoms on impairment indicating that a higher number of symptoms were related to higher impairment. For the mothers and fathers, a higher score on the adolescents' prosocial behavior was related to a lower impairment from depression symptoms on the daily life of the adolescent and the family. Only for the mothers did a higher score on prosocial behavior buffered the effect of symptoms on impairment, while a higher parental attachment score was associated with a lower impairment. Further, when examining maternal and paternal attachment separately, we found that, only the mothers, reported less impairment from the symptoms when they perceived that the adolescent was attached to the father, and paternal attachment even buffered the effect of symptoms on impairment. To conclude, our results indicate that social protective factors, from the parent's perspective, are likely to have a beneficial effect in clinical practice and should be taken into account when examining impairment scores. Future studies should investigate whether additional protective indicators from the adolescents' perspective, such as quality of parental attachment or family climate, may have a positive impact on their daily functioning. Show less

Molenaar, J.M.; Meer, L. van der; Bertens, L.C.M.; Vries, E.F. de; Waelput, A.J.M.; Knight, M.; ... ; Struijs, J.N. 2022

Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis

Article / Letter to editor

open access

Background: Early detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children's development and health. We aimed to... Show moreBackground: Early detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children's development and health. We aimed to identify classes of vulnerability among pregnant women in the Netherlands using pre-pregnancy data on a wide range of social risk and protective factors, and validate these classes against the risk of adverse outcomes. Methods: We conducted a latent class analysis based on 42 variables derived from nationwide observational data sources and self-reported data. Variables included individual, socioeconomic, lifestyle, psychosocial and household characteristics, self-reported health, healthcare utilization, life-events and living conditions. We compared classes in relation to adverse outcomes using logistic regression analyses. Results: In the study population of 4172 women, we identified five latent classes. The largest 'healthy and socioeconomically stable'-class [n = 2040 (48.9%)] mostly shared protective factors, such as paid work and positively perceived health. The classes 'high care utilization' [n = 485 (11.6%)], 'socioeconomic vulnerability' [n = 395 (9.5%)] and 'psychosocial vulnerability' [n = 1005 (24.0%)] were characterized by risk factors limited to one specific domain and protective factors in others. Women classified into the 'multidimensional vulnerability'-class [n = 250 (6.0%)] shared multiple risk factors in different domains (psychosocial, medical and socioeconomic risk factors). Multidimensional vulnerability was associated with adverse outcomes, such as premature birth and caesarean section. Conclusions: Co-existence of multiple risk factors in various domains is associated with adverse outcomes for mother and child. Early detection of vulnerability and strategies to improve parental health and well-being might benefit from focussing on different domains and combining medical and social care and support. Show less

Molenaar, J.M.; Meer, L. van der; Bertens, L.C.M.; Vries, E.F. de; Waelput, A.J.M.; Knight, M.; ... ; Struijs, J.N. 2022

Defining vulnerability subgroups among pregnant women using pre-pregnancy information: a latent class analysis

Article / Letter to editor

open access

BackgroundEarly detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children’s development and health. We aimed to identify... Show moreBackgroundEarly detection of vulnerability during or before pregnancy can contribute to optimizing the first 1000 days, a crucial period for children’s development and health. We aimed to identify classes of vulnerability among pregnant women in the Netherlands using pre-pregnancy data on a wide range of social risk and protective factors, and validate these classes against the risk of adverse outcomes.MethodsWe conducted a latent class analysis based on 42 variables derived from nationwide observational data sources and self-reported data. Variables included individual, socioeconomic, lifestyle, psychosocial and household characteristics, self-reported health, healthcare utilization, life-events and living conditions. We compared classes in relation to adverse outcomes using logistic regression analyses.ResultsIn the study population of 4172 women, we identified five latent classes. The largest ‘healthy and socioeconomically stable’-class [n = 2040 (48.9%)] mostly shared protective factors, such as paid work and positively perceived health. The classes ‘high care utilization’ [n = 485 (11.6%)], ‘socioeconomic vulnerability’ [n = 395 (9.5%)] and ‘psychosocial vulnerability’ [n = 1005 (24.0%)] were characterized by risk factors limited to one specific domain and protective factors in others. Women classified into the ‘multidimensional vulnerability’-class [n = 250 (6.0%)] shared multiple risk factors in different domains (psychosocial, medical and socioeconomic risk factors). Multidimensional vulnerability was associated with adverse outcomes, such as premature birth and caesarean section.ConclusionsCo-existence of multiple risk factors in various domains is associated with adverse outcomes for mother and child. Early detection of vulnerability and strategies to improve parental health and well-being might benefit from focussing on different domains and combining medical and social care and support. Show less

Brust, M.; Gebhardt, W.A.; Voorde, N.A.E. van der; Numans, M.E.; Jong, J.C.K.D. 2022

The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event

Article / Letter to editor

open access

Better conceptually-driven research is necessary to learn more about 1) the characteristics of life events asteachable moments (TMs) and 2) the potential of life events to evoke lifestyle change... Show moreBetter conceptually-driven research is necessary to learn more about 1) the characteristics of life events asteachable moments (TMs) and 2) the potential of life events to evoke lifestyle change intention (LCI). This study aimed to develop and validate two scales for the purposes of TM research in the context of cardiovascular disease (CVD): the CardiacTM and CardiacLCI-scales. After the initial development of items based on a theoretical framework and literature search, six experts rated the content validity of both scales as sufficient. The item list was further adjusted after think-aloud sessions with two CVD patients. The resulting scales were presented online in a cross-sectional survey, which yielded 625 responses of Dutch CVD patients (June 2020). To test construct validity, we conducted Exploratory Factor Analysis (EFA) with Varimax rotation on a random split-half of the sample (n = 300) and evaluated the factor structure with Confirmatory Factor Analysis (CFA) on the holdout sample (n = 325). EFA and CFA on the CardiacTM-scale (α = 0.88) revealed a 28-item six-factor structure explaining 61.0% of the variance, with adequate goodness-of-fit statistics (CFI = 0.87; TLI = 0.85; SRMR = 0.07) and internally reliable factors (Affective impact, Risk CVD, Changed self-concept, CVD group identity, Risk noncommunicable disease, Anticipated regret). The CardiacLCI-scale (α = 0.81) revealed an 11-item two-factor structure explaining 51.5% of the variance, with adequate model fit (CFI = 0.92; TLI = 0.90; SRMR = 0.08) and internally reliable factors (Event-related lifestyle change and General healthy lifestyle). The scales may be used to expand knowledge around life events as TMs and to support conversation regarding lifestyle after cardiac and other life events. Show less

Regeer, H.; Nieuwenhuijse, E.A.; Vos, R.C.; Jong, J.C.K.D.; Empelen, P.; Koning, E.J.P.; ... ; Huisman, S.D. 2021

Psychological factors associated with changes in physical activity in Dutch people with type 2 diabetes under societal lockdown: a cross-sectional study

Article / Letter to editor

open access

Aims To investigate changes in physical activity (PA) and psychological factors during societal lockdown in people with type 2 diabetes.Methods A cross-sectional study among Dutch adults with type... Show moreAims To investigate changes in physical activity (PA) and psychological factors during societal lockdown in people with type 2 diabetes.Methods A cross-sectional study among Dutch adults with type 2 diabetes. Data were collected using online questionnaires. A multivariate multinomial logistic regression was performed with change in PA during societal lockdown as outcome and perceived change in stress, anxiety, perceived risk for COVID-19 infection, emotional well-being and former PA status as determinants.Results Five hundred and sixty seven respondents filled out the questionnaire, 536 were included in the final analysis: mean age of 65.9 +/- 7.9 years; mean diabetes duration 13.3 +/- 8 years; 54% men; 47% reported no change in PA, 27% became less active and 26% became more active during societal lockdown. Participants who were more likely to become less active were participants who experienced more stress (OR: 2.27; 95% CI 1.25-4.13) or less stress (OR: 2.20; 95% CI 1.03-4.71). Participants who were more likely to become more active were participants who experienced more stress (OR: 2.31; 95% CI 1.25, 4.26). Participants with higher emotional well-being (OR: 0.98; 95% CI 0.97, 0.99) were less likely to become less active than to report no change in PA.Conclusions Changes in PA in people with type 2 diabetes during societal lockdown are associated with changes in psychological factors such as perceived stress and emotional well-being. People with diabetes and their caregivers should be aware of these possible changes. Show less

Velde, L.A. van der; Dijk, W.W. van; Numans, M.E.; Jong, J.C.K.D. 2021

Extending the theory of planned behavior for explaining dietary quality: the role of financial scarcity and food insecurity status

Article / Letter to editor

open access

Objective: To examine whether an extended Theory of Planned Behavior (TPB) that included financerelated barriers better explained dietary quality. Design: Cross-sectional survey. Participants: One... Show moreObjective: To examine whether an extended Theory of Planned Behavior (TPB) that included financerelated barriers better explained dietary quality. Design: Cross-sectional survey. Participants: One-thousand and thirty-three participants were included from a Dutch independent adult panel. Main Outcome: Dietary quality. Analysis: Five TPB models were assessed: a traditional TPB, a TPB that included direct associations between attitude and subjective norm with dietary quality, a TPB that additionally included financial scarcity or food insecurity, and a TPB that additionally included financial scarcity and food insecurity simultaneously. Structural relationships among the constructs were tested to compare the explanatory power. Results: The traditional TPB showed poorest fit (x2 /degrees of freedom = 11; comparative fit index = 0.75; root mean square error of approximation [95% confidence interval], 0.10 [0.091−0.12]; standardized root mean square residual = 0.049), the most extended TPB (including both financial scarcity and food insecurity) showed best fit (x2 /degrees of freedom = 3.3; comparative fit index = 0.95; root mean square error of approximation [95% confidence interval], 0.050 [0.035−0.065]; standardized root mean square residual = 0.018). All 5 structure models explained »42% to 43% of the variance in intention; however, the variance in dietary quality was better explained by the extended TPB models, including food insecurity and/or financial scarcity (»22%) compared with the traditional TBP (»7%), indicating that these models better explained differences in dietary quality. Conclusions and Implications: These findings highlight the importance of accounting for financerelated barriers to healthy eating like financial scarcity or food insecurity to better understand individual dietary behaviors in lower socioeconomic groups. Show less

Felix, J.F.; Voortman, T.; Hooven, E.H. van den; Sajjad, A.; Leermakers, E.T.M.; Tharner, A.; ... ; Franco, O.H. 2014

Health in children: a conceptual framework for use in healthy ageing research

Article / Letter to editor

metadata only

Leiden University Scholarly Publications

Your Search

Enabled Filters

Sort Options

Refine Results

Resource Type

Availability

Creation Date

Faculty

Collection

Author

Language

Search results