Anne-Marie Depoorter

Vaccination coverage in 14-year-old adolescents: documentation, timeliness, and sociodemographic determinants.

OBJECTIVE. The objective of this study was to measure the coverage and influencing determinants of hepatitis B virus, measles-mumps-rubella, and Meningococcus serogroup C vaccination in 14-year-old adolescents in Flanders, Belgium, in 2005. METHODS. A total of 1500 adolescents who were born in 1991 and were living in Flanders were selected with a 2-stage cluster sampling technique. Home visits to copy vaccination documents and complete a questionnaire on sociodemographic and other related factors were conducted by trained interviewers. Only documented vaccination dates were accepted. Missing data were, when possible, retrieved through medical charts of the School Health System. RESULTS. For 1344 (89.6%) adolescents, a home visit was performed. Vaccination coverage was 75.7% for the third dose of hepatitis B virus, 80.6% for the first dose and 83.6% for the second dose of measles-mumps-rubella, and 79.8% for Meningococcus serogroup C. Only 74.6% of the adolescents had proof of 2 measles-mumps-rubella vaccines. Although 1006 (74.8%) adolescents had vaccination data available at home at the time of the interview, only 427 (31.8%) were able to show written proof of all studied vaccines. The probably underestimated coverage rates are well below World Health Organization recommendations, but timeliness of vaccinations was respected. Univariate logistic regression showed that unemployment of the father as proxy measure of socioeconomic status was detrimental for vaccination status, in contrast to partial employment of the mother, which was a favorable factor. Previously unreported determinants of lower coverage rates inferred from this study are single divorced parents, larger families (≥4 children), lower adolescent educational level, enrollment in special education, and repeating a grade. CONCLUSIONS. Insufficient documentation is a major barrier in this vaccination coverage study. More attention should go to those with the lowest coverage rates, such as adolescents from large families, with separated parents, and with a lower socioeconomic background.

Coverage of recommended vaccines in children at 7–8 years of age in Flanders, Belgium

Aim:  Evaluation of the coverage of primary diphtheria‐tetanus‐pertussis (DTP), poliomyelitis, hepatitis B (HBV) and measles‐mumps‐rubella (MMR) vaccine doses recommended before the age of 18 months in 7‐year‐old school children in Flanders, Belgium. Meningococcal serogroup C and DT‐polio vaccines offered respectively as catch‐up and booster vaccinations were also evaluated.

Pilot Health Promoting Hospital in rural South Africa: Evidence-based approach to systematic hospital transformation

This project aimed at transforming a rural District Hospital in the Limpopo Province of South Africa into a Health Promoting Hospital according to standards developed by WHO-Europe. The intervention used a diagnostic approach and baseline needs assessment of hospital staff, patients, and their relatives to identify health education and promotion needs. Activities included empowerment training and skills development, implementation of health education and promotion activities, and the integration of health-promoting standards and values in the hospital structure and culture. The project indicated applicability of the model in a resource-limited setting, based on staff empowerment, local leadership, and stakeholder engagement.

Introducing a Primary Health Care nurse training course at the University of Limpopo: Experiences and views of trainees

Abstract Background A new post-basic Primary Health Care (PHC) nurse training was piloted at the University of Limpopo in rural South Africa in order to reinforce PHC services and to address the backlog of trained PHC nurses. The training comprised residential and decentralised training modules based on the principles of problem based learning and community based education, and a patient-centred care approach developed in the field of family medicine was applied for acquiring consultation skills. Clinical reasoning was improved through on-site supervision by individual preceptors. Objective The aim of the study was to describe the satisfaction, experiences and views of trainees in the first year of implementing the new PHC nurse training programme. Method The study had a descriptive, exploratory and cross-sectional design, and used quantitative and qualitative methods for data collection that included a semi-structured survey questionnaire and focus group discussion. A purposive sample of trainees enrolled in the pilot programme (n = 15) was recruited for this study. Results were analysed quantitatively for the survey questionnaire and content analysis was used for qualitative data. Results Results revealed trainee satisfaction with the quality of community based visits and classroom lectures and dissatisfaction with on-site supervision and training material. Qualitative findings indicated a need to improve information and communication of supervisors and preceptors, and to provide more training material. Factors related to the work environment were identified as barriers to implement learning, but the use of tools developed in family medicine curricula was perceived as beneficial. Lessons learnt included the need for strong programme coordination and stakeholder commitment, as well as the need to develop a competence framework for PHC nursing. Conclusion The implementation of a pilot programme for PHC nurse training had the outcomes of trainee satisfaction with the mixed method of teaching, and valuable lessons were learned with regard to programme implementation and organisation. Integration of tools and concepts developed in the field of family medicine proved beneficial, and several recommendations were formulated to inform similar projects.

Association between feeling threatened by a terrorist attack and subjective health: a web survey a week after the attacks of 22 March 2016 in Belgium

ABSTRACT Background: The wave of terrorist attacks over the past years in Europe and other regions may cause problems such as anxiety and depressive symptoms. Some studies suggest that perceived threat might also trigger physical health problems. Objective: To investigate the association between feeling threatened and subjective health during the week following a terrorist attack. Method: Online survey with a self-selected sample in the Belgian population one week after the terrorist attacks in 2016. Participants were invited through the Belgian media to fill in a questionnaire in Dutch, French or English on a website. The main outcomes were the association between ‘feeling threatened’ and subjective health problems. Perceived threat was measured with the question ‘During the week after the attacks … Did you feel threatened?’ Subjective health was measured by using standardized scales (ACSA, PHQ-4, PHQ-15). Results: A total of 2620 respondents completed the questionnaire, of whom 69.8% were female, 27.7% lived and 43.1% worked in Brussels. Gender, age, place of living and working, media exposure, religiousness and religious affiliation were associated significantly with higher perceived threat. A total of 21% of the respondents felt much or very much threatened during the week after the attacks. They reported significantly higher levels of mental and physical health problems. The most frequently reported problems were anxiety and depressive symptoms. The health problems that differentiated most markedly between those with low and high levels of perceived threat were fainting spells, chest pain and shortness of breath. Conclusion: In a self-selected sample of respondents, ‘feeling threatened’ was strongly associated with lower level of wellbeing and higher levels of mental and physical health problems. The most prevalent health problems were mental health problems but the most pronounced differences between people with low versus high levels of perceived threat were physical health problems.

Linking numbers to perceptions and experiences: Why we need transdisciplinary mixed-methods combining neurophysiological and qualitative data

Today, more and more problems that scientists need to tackle are complex problems. Many examples of these can be found in the health sciences, medicine and ecology. Typical features of complex problems are that they cannot be studied by one discipline and that they need to take into account subjective data as well as objective data. Two promising responses to deal with complex problems are Transdisciplinary and Mixed Method approaches. However, there is still a lacuna to fill, with transdisciplinary studies bridging the social sciences and biomedical sciences. More specifically, we need more and better studies that combine qualitative data about subjective experiences, perception and so on with objective, quantitative, neurophysiological data. We believe that the combination of qualitative and neurophysiological data is a good example of what we would like to call transdisciplinary mixed methods. In this article, we aim to explore the opportunities of transdisciplinary mixed-methods studies in which qualitative and neurophysiological data are used. We give a brief overview of what is characteristic for this kind of studies and illustrate this with examples; we point out strengths and limitations and propose an agenda for the future. We conclude that transdisciplinary mixed-methods studies in which qualitative and neurophysiological data are used have the potential to improve our knowledge about complex problems. A main obstacle seems to be that most scientists from the biomedical sciences are not familiar with the (qualitative) methods from the social sciences and vice versa. To end this ‘clash of paradigms’™, we urgently need to cultivate transdisciplinary thinking.