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  • 1
    Language: English
    In: BMC health services research, 2018, Vol.18 (1), p.285-285
    Description: Background Community engagement is increasingly seen as crucial to achieving high quality, efficient and collaborative care. However, organisations are still searching for the best and most effective ways to engage citizens in the shaping of health and care services. This review highlights the barriers and enablers for engaging communities in the planning, designing, governing, and/or delivering of health and care services on the macro or meso level. It provides policymakers and professionals with evidence-based guiding principles to implement their own effective community engagement (CE) strategies. Methods A Rapid Realist Review was conducted to investigate how interventions interact with contexts and mechanisms to influence the effectiveness of CE. A local reference panel, consisting of health and care professionals and experts, assisted in the development of the research questions and search strategy. The panel’s input helped to refine the review’s findings. A systematic search of the peer-reviewed literature was conducted. Results: Eight action-oriented guiding principles were identified: Ensure staff provide supportive and facilitative leadership to citizens based on transparency; foster a safe and trusting environment enabling citizens to provide input; ensure citizens’ early involvement; share decision-making and governance control with citizens; acknowledge and address citizens’ experiences of power imbalances between citizens and professionals; invest in citizens who feel they lack the skills and confidence to engage; create quick and tangible wins; take into account both citizens’ and organisations’ motivations. Conclusions An especially important thread throughout the CE literature is the influence of power imbalances and organisations’ willingness, or not, to address such imbalances. The literature suggests that ‘meaningful participation’ of citizens can only be achieved if organisational processes are adapted to ensure that they are inclusive, accessible and supportive of citizens.
    Subject(s): Citizen engagement ; Community engagement ; Community Participation ; Decision Making ; Delivery of Health Care ; Evidence-based medicine ; Healthcare ; Humans ; Motivation ; Quality of Health Care ; Rapid realist review ; Realist evaluation
    ISSN: 1472-6963
    E-ISSN: 1472-6963
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 2
    Language: English
    In: BMC health services research, 2021, Vol.21 (1), p.1-611
    Description: Background The causes and consequences of childhood obesity are complex and multifaceted. Therefore, an integrated care approach is required to address weight-related issues and improve children’s health, societal participation and quality of life. Conducting a psychosocial and lifestyle assessment is an essential part of an integrated care approach. The aim of this study was to explore the experiences, needs and wishes of healthcare professionals with respect to carrying out a psychosocial and lifestyle assessment of childhood obesity. Methods Fourteen semi-structured interviews were conducted with Dutch healthcare professionals, who are responsible for coordinating the support and care for children with obesity (coordinating professionals, ‘CPs’). The following topics were addressed in our interviews with these professionals: CPs’ experiences of both using childhood obesity assessment tools and their content, and CPs’ needs and wishes related to content, circumstances and required competences. The interviews comprised open-ended questions and were recorded and transcribed verbatim. The data was analysed using template analyses and complemented with open coding in MAXQDA. Results Most CPs experienced both developing a trusting relationship with the children and their parents, as well as establishing the right tone when engaging in weight-related conversations as important. CPs indicated that visual materials were helpful in such conversations. All CPs used a supporting assessment tool to conduct the psychosocial and lifestyle assessment but they also indicated that a more optimal tool was desirable. They recognized the need for specific attributes that helped them to carry out these assessments, namely: sufficient knowledge about the complexity of obesity; having an affinity with obesity-related issues; their experience as a CP; using conversational techniques, such as solution-focused counselling and motivational interviewing; peer-to-peer coaching; and finally, maintaining an open-minded, non-stigmatizing stance and harmonizing their attitude with that of the child and their parents. Conclusions Alongside the need for a suitable tool for conducting a psychosocial and lifestyle assessment, CPs expressed the need for requisite knowledge, skills and attitudes. Further developing a supporting assessment tool is necessary in order to facilitate CPs and thereby improve the support and care for children with obesity and their families.
    Subject(s): Beliefs, opinions and attitudes ; Care and treatment ; CHILDHOOD OBESITY assessment ; Children & youth ; Diagnosis ; Families & family life ; Healthcare professionals ; Integrated care approach ; Integrated delivery networks ; Integrated delivery systems ; Interviews ; Lifestyles ; Management ; Medical personnel ; Obesity ; Obesity in children ; Overweight ; Participation ; QUALITATIVE RESEARCH ; Research ; Risk factors ; The Netherlands
    ISSN: 1472-6963
    E-ISSN: 1472-6963
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 3
    Language: English
    In: Obesity reviews, 2012-01, Vol.13 (1), p.2-16
    Description: Migrants from Turkey and Morocco are among the largest ethnic minority groups in several European countries. In this review, we aimed to systematically search, assess and describe the available literature on cardiovascular disease (CVD), obesity and other endogenous cardiovascular risk factors among these groups. Although the number of publications covering this topic among Turkish and Moroccan migrants has increased in the past decades, studies among these groups, especially the Moroccan, are still limited. There is a particular lack of information on CVD mortality and morbidity rates. Furthermore, studies are often hampered by low participation rates, small sample sizes and self-reported data. This further complicates drawing sound conclusions on CVD and risk factors among these migrant groups. The results with regard to CVD morbidity and mortality rates are inconclusive. With regard to CVD risk factors, we tentatively conclude that obesity and diabetes are more common among Turkish and Moroccan migrant groups in Europe than the western European population. In the Turkish population there is also a fair amount of evidence for unfavourable high-density lipoprotein cholesterol levels. However, more research on this topic among these major ethnic minorities is of high importance. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.
    Subject(s): Cardiorespiratory ; Cardiovascular Diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - ethnology ; Cardiovascular Diseases - etiology ; Cholesterol ; Death ; Diabetes ; Diabetes mellitus ; Diseases ; Europe ; Europe - epidemiology ; Humans ; Hypertension ; Journal Article ; Lipids ; Migrants ; Minorities ; Minority Groups ; Minority Health ; Morbidity ; Morocco ; Morocco - ethnology ; Mortality ; Obesity ; Obesity - complications ; Obesity - epidemiology ; Obesity - ethnology ; Participation ; Prevalence ; Public health ; Review ; Reviews ; Risk Factors ; systemic inflammation ; Transients and Migrants ; Transients and Migrants - statistics & numerical data ; Turkey ; Turkey - ethnology ; Universities and colleges
    ISSN: 1467-7881
    E-ISSN: 1467-789X
    Source: Hellenic Academic Libraries Link
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  • 4
    Language: English
    In: Diabetic medicine, 2012-08, Vol.29 (8), p.e223-e231
    Description: Diabet. Med. 29, e223-e231 (2012) ABSTRACT: Aims To determine the effectiveness of a 2.5-year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care. Methods A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC-score 〉/= 13) in 14 general practices in the Netherlands. Intervention consisted of lifestyle counselling from the nurse practitioner and the general practitioner. Usual care consisted of oral and written information at the start of the study. Study groups were compared over 2.5 years regarding changes in clinical and lifestyle measures. Results Both groups showed modest changes in body weight, glucose concentrations, physical activity and dietary intake [weight: intervention group, -0.8 (5.1) kg, usual care group, -0.4 (4.7) kg, (P = 0.69); fasting plasma glucose: intervention group, -0.17 (0.4) mmol/l, usual care group, -0.10 (0.5) mmol/l, (P = 0.10)]. Differences between groups were significant only for total physical activity and fibre intake. In the intervention group, self-efficacy was significantly higher in individuals successful at losing weight compared with unsuccessful individuals. No significant differences in participant weight loss were found between general practitioners and nurse practitioners with different levels of motivation or self-efficacy. Conclusions Diabetes risk factors could significantly be reduced by lifestyle counselling in Dutch primary care. However, intervention effects above the effects attributable to usual care were modest. Higher participant self-efficacy seemed to facilitate weight loss. Lack of motivation or self-efficacy of professionals did not negatively influence participant guidance.
    Subject(s): Adult ; Aged ; Attitude to Health ; Blood Glucose - metabolism ; Clinical trials ; Counseling - methods ; Dextrose ; Diabetes ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - prevention & control ; Energy Intake ; Family medicine ; follow-up ; General Practice ; Glucose ; Health Promotion - methods ; health-care ; Humans ; impaired glucose-tolerance ; implementation ; Life Style ; lifestyle intervention ; Middle Aged ; Netherlands ; Nurse practitioners ; Physician-Patient Relations ; Physicians (General practice) ; Practice Patterns, Nurses ; prevention ; primary care ; program ; Public health ; questionnaire ; real-world ; Risk factors ; Surveys and Questionnaires ; Treatment Outcome ; Type 2 diabetes ; validity ; Weight Loss - physiology ; weight-loss
    ISSN: 0742-3071
    E-ISSN: 1464-5491
    Source: Hellenic Academic Libraries Link
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  • 5
    Language: English
    In: International journal of integrated care, 2013-10-23, Vol.13 (5)
    Subject(s): framework ; Payment Systems and Incentives ; population health management
    ISSN: 1568-4156
    E-ISSN: 1568-4156
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 6
    Language: English
    In: Quality of life research, 2016-01-01, Vol.25 (1), p.175-182
    Description: Objective To study the prevalence, impact and dose-response relationship of comorbid chronic conditions on quality of life of type 2 diabetes patients. Research design and methods Cross-sectional data of 1676 type 2 diabetes patients, aged 31-96 years, and treated in primary care, were analyzed. Quality of life (QoL) was measured using the mental component summary (MCS) and the physical component summary (PCS) scores of the Short Form-12. Diagnosis of type 2 diabetes was obtained from medical records and comorbidities from self-reports. Results Only 361 (21.5 %) of the patients reported no comorbidities. Diabetes patients with comorbidities showed significantly lower mean difference in PCS [-8.5; 95 % confidence interval (CI) -9.8 to -7.3] and MCS scores (-1.9; 95 % CI -3.0 to -0.9), compared to diabetes patients without. Additional adjustments did not substantially change these associations. Both MCS and PCS scores decrease significantly with the number of comorbid conditions, yet most pronounced regarding physical QoL. Comorbidities that reduced physical QoL most significantly were retinopathy, heart diseases, atherosclerosis in abdomen or legs, lung diseases, incontinence, back, neck and shoulder disorder, osteoarthritis and chronic rheumatoid arthritis, using the backwards stepwise regression procedure. Conclusion Comorbidities are highly prevalent among type 2 diabetes patients and have a negative impact on the patient's QoL. A strong dose-response relationship between comorbidities and physical QoL was found. Reduced physical QoL is mainly determined by musculoskeletal and cardiovascular disorders.
    Subject(s): Adult ; Aged ; Aged, 80 and over ; Analysis ; Angina pectoris ; Article ; Atherosclerosis ; Chronic Disease - epidemiology ; Chronic Disease - psychology ; Chronic diseases ; Chronic illnesses ; Chronic obstructive pulmonary disease ; CLINICAL AND POLICY APPLICATIONS ; Comorbidities ; Comorbidity ; Cross-Sectional Studies ; Diabetes ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - psychology ; Diabetic retinopathy ; Disease management ; Disorders ; Education ; Female ; general ; Heart diseases ; Heart Diseases - epidemiology ; Heart Diseases - psychology ; Humans ; Lung diseases ; Male ; Medical records ; Medicine ; Medicine & Public Health ; Metacarpophalangeal joint ; Middle Aged ; Osteoarthritis ; Osteoarthritis - epidemiology ; Osteoarthritis - psychology ; Patients ; Population ; Prevalence ; Primary care ; Public Health ; Quality of life ; Quality of Life - psychology ; Quality of Life Research ; Questionnaires ; Respiratory tract diseases ; Rheumatoid arthritis ; Rheumatoid factor ; Self Report ; Sociology ; Surveys and Questionnaires ; Type 1 diabetes mellitus ; Type 2 diabetes ; Type 2 diabetes mellitus
    ISSN: 0962-9343
    E-ISSN: 1573-2649
    Source: Academic Search Ultimate
    Source: JSTOR Arts & Sciences VII
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: BMC family practice, 2014, Vol.15 (1), p.61-61
    Description: Background Multimorbidity is common among ageing populations and it affects the demand for health services. The objective of this study was to examine the relationship between multimorbidity (i.e. the number of diseases and specific combinations of diseases) and the use of general practice services in the Dutch population of 55 years and older. Methods Data on diagnosed chronic diseases, contacts (including face-to-face consultations, phone contacts, and home visits), drug prescription rates, and referral rates to specialised care were derived from the Netherlands Information Network of General Practice (LINH), limited to patients whose data were available from 2006 to 2008 (N = 32,583). Multimorbidity was defined as having two or more out of 28 chronic diseases. Multilevel analyses adjusted for age, gender, and clustering of patients in general practices were used to assess the association between multimorbidity and service utilization in 2008. Results Patients diagnosed with multiple chronic diseases had on average 18.3 contacts (95% CI 16.8 19.9) per year. This was significantly higher than patients with one chronic disease (11.7 contacts (10.8 12.6)) or without any (6.1 contacts (5.6 6.6)). A higher number of chronic diseases was associated with more contacts, more prescriptions, and more referrals to specialized care. However, the number of contacts per disease decreased with an increasing number of diseases; patients with a single disease had between 9 to 17 contacts a year and patients with five or more diseases had 5 or 6 contacts per disease per year. Contact rates for specific combinations of diseases were lower than what would be expected on the basis of contact rates of the separate diseases. Conclusion Multimorbidity is associated with increased health care utilization in general practice, yet the increase declines per additional disease. Still, with the expected rise in multimorbidity in the coming decades more extensive health resources are required.
    Subject(s): Aged ; Aged, 80 and over ; Cardiovascular disease ; Chronic Disease ; Chronic illnesses ; Chronic obstructive pulmonary disease ; Classification ; Comorbidity ; Epidemiology ; Female ; General Practice ; Health care ; Health care utilisation ; Health services ; Health Services Research ; Heart failure ; Humans ; Male ; Medical records ; Middle Aged ; Multimorbidity ; Netherlands - epidemiology ; Older people ; Patient Acceptance of Health Care ; Problems ; Public health
    ISSN: 1471-2296
    E-ISSN: 1471-2296
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 8
    Language: English
    In: International journal of integrated care, 2010-12-01, Vol.10 (6)
    Subject(s): quality of care, thrombosis, chronic care management, disease management, effectiveness
    ISSN: 1568-4156
    E-ISSN: 1568-4156
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 9
    Language: English
    In: BMC public health, 2020-04-16, Vol.20 (1), p.508-508
    Description: Community engagement is increasingly seen as key to improving healthcare systems and to increasing communities' involvement in the shaping of their own communities. This paper describes how 'community engagement' (CE) is understood and being operationalised in the Dutch healthcare system by investigating the CE approaches being implemented in six different regions and by examining engaged citizens' and professionals' experiences of those CE approaches. For this realist study, interviews and focus groups were held with citizens (16) and professionals (42) involved in CE approaches in the six regions. Additionally, CE-related activities were observed to supplement interview data. This study shows that citizens and professionals defined and experienced CE differently and that they differed in who they felt had ownership of CE. The CE approaches implemented in community-led initiatives and organisationally-led initiatives varied accordingly. Furthermore, both citizens and professionals were searching for meaningful ways for citizens to have more control over healthcare in their own communities. CE can be improved by, first of all, developing a shared and overarching vision of what CE should look like, establishing clear roles and remits for organisations and communities, and taking active measures to ensure CE is more inclusive and representative of harder-to-reach groups. At the same time, to help ensure such shared visions do not further entrench power imbalances between citizens and professionals, professionals require training in successful CE approaches.
    Subject(s): Citizen engagement ; Citizens ; Community ; Community engagement ; Community involvement ; Community participation ; Data analysis ; Decentralisation ; Decision making ; Health care ; Healthcare ; Interviews ; Principles ; Qualitative research ; Realist evaluation ; Searching ; Studies
    ISSN: 1471-2458
    E-ISSN: 1471-2458
    Source: BioMedCentral Open Access
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 10
    Language: English
    In: Journal of health communication, 2014-10-14, Vol.19 (Suppl 2), p.115-131
    Description: Various studies have examined the association between health literacy and self-management behavior, but few have explored ways through which this occurs. The present study examines to what extent health literacy is associated with diabetes self-management behavior and to what extent diabetes knowledge is a mechanism in this association. The study was based on cross-sectional data retrieved from patient registrations and questionnaires completed in 2010. The sample included 1,714 predominantly type 2 diabetes patients, with a mean age of 67 years. Diabetes self-management was indicated by HbA1c level, glucose self-control and self-reported monitoring of glucose levels, physical activity, and smoking. Multilevel analyses were applied based on multiple imputed data. Lower health literacy was significantly associated with less diabetes knowledge, higher HbA1c level, less self-control of glucose level, and less physical activity. Participants with more diabetes knowledge were less likely to smoke and more likely to control glucose levels. Diabetes knowledge was a mediator in the association between health literacy and glucose self-control and between health literacy and smoking. This study indicates that higher health literacy may contribute to participation in certain self-management activities, in some cases through diabetes knowledge. Diabetes knowledge and health literacy skills may be important targets for interventions promoting diabetes self-management.
    Subject(s): Adult ; Adult literacy ; Adults ; Aged ; Blood Glucose ; Blood Glucose - analysis ; Blood Glucose Self-Monitoring ; Blood Glucose Self-Monitoring - statistics & numerical data ; Cross-Sectional Studies ; Diabetes ; Diabetes Mellitus ; Diabetes Mellitus - therapy ; Diabetes Mellitus, Type 2 ; Diabetes Mellitus, Type 2 - therapy ; Female ; Glycated Hemoglobin A - analysis ; Health behavior ; Health education ; Health Knowledge, Attitudes, Practice ; Health Literacy ; Health Literacy - statistics & numerical data ; Health technology assessment ; Hemoglobin A, Glycosylated ; Humans ; Journal Article ; Knowledge ; Literacy ; Male ; Middle Aged ; Motor Activity ; Multilevel Analysis ; Netherlands ; Patients ; Personal health ; Physical activity ; Questionnaires ; Research Support, Non-U.S. Gov't ; Self Care ; Self Care - psychology ; Self Report ; Smoking ; Smoking - psychology ; Young Adult
    ISSN: 1081-0730
    E-ISSN: 1087-0415
    Source: Communication & Mass Media Complete
    Source: International Bibliography of the Social Sciences (IBSS)
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