L.A.M. van de Goor

Concept mapping as a promising method to bring practice into science.

OBJECTIVE Concept mapping is a method for developing a conceptual framework of a complex topic for use as a guide to evaluation or planning. In concept mapping, thoughts and ideas are represented in the form of a picture or map, the content of which is determined by a group of stakeholders. This study aimed to explore the suitability of this method as a tool to integrate practical knowledge with scientific knowledge in order to improve theory development as a sound basis for practical decision-making. METHOD Following a short introduction to the method of concept mapping, five Dutch studies, serving different purposes and fields in public health, will be described. The aim of these studies was: to construct a theoretical framework for good regional public health reporting; to design an implementation strategy for a guideline for integral local health policy; to guide the evaluation of a local integral approach of overweight and obesity in youth; to guide the construction of a questionnaire to measure the quality of postdisaster psychosocial care; and to conceptualize an integral base for formulation of ambitions and targets for the new youth healthcare programme of a regional health service. RESULTS The studies showed that concept mapping is a way to integrate practical and scientific knowledge with careful selection of participants that represent the different perspectives. Theory development can be improved through concept mapping; not by formulating new theories, but by highlighting the key issues and defining perceived relationships between topics. In four of the five studies, the resulting concept map was received as a sound basis for practical decision-making. CONCLUSIONS Concept mapping is a valuable method for evidence-based public health policy, and a powerful instrument for facilitating dialogue, coherence and collaboration between researchers, practitioners, policy makers and the public. Development of public health theory was realized by a step-by-step approach, considering both scientific and practical knowledge. However, the external validity of the concept maps in place and time is of importance.

The opinion on Dutch cannabis policy measures: A cross-sectional survey

Aim: The aim of this study was to examine the opinion on Dutch cannabis policy measures and to explore whether the popularity of these policy measures depends on the extent to which lay people are affected by these measures. The extent to which people are affected has been made operational by: (1) own cannabis use and (2) cannabis use in social network. Methods: A panel survey was carried out among a representative probability of households with 8280 members of above 16 years. Peoples opinions were examined on four restrictive availability measures and two educational measures. Descriptives, one-way ANOVA and regression analysis were used to obtain the opinion on cannabis policy measures. Findings: The educational measures were popular among more than 90% of all respondents. The measures that restrict the availability of cannabis were more popular among non-users than among users. Having cannabis users within a social network made a significant difference to the opinion on cannabis policy measures. Own cannabis use seems to be the strongest predictor for the opinion of restrictive availability measures. Conclusions: The opinion of a cannabis policy measure depends on whether one is affected by that policy measure.

Dutch and Norwegian support of alcohol policy measures to prevent young people from problematic drinking: a cross-national comparison.

AIMS To examine whether Dutch and Norwegian adults differ in their opinion on policy measures that may prevent young people from problematic drinking. METHODS Data were derived from a web-based cross-sectional study. In this study, only Dutch and Norwegian adults (aged ≥24 years) were included (n(NL) = 5023, n(NO) = 1916). Opinions on policy items concerning restrictive and educational measures were examined together with alcohol consumption. RESULTS Differences between the opinions of the Dutch and Norwegians concerning the restrictive and educational measures were small. In both countries, the support for restrictive measures was predicted by female gender, higher age and less own alcohol consumption. For the educational measures, the explained variance in the Norwegian and Dutch sample was relatively low; this indicates that opinion was more strongly predicted by other factors. CONCLUSION This study indicates that, despite the differences between the Dutch and Norwegian alcohol policy, differences in opinion are small between Dutch and Norwegian respondents, especially regarding restrictive measures that may prevent young people from drinking.

Characterizing intensive community-based care : Use, reliability and factor structure of a generic measure

Background: There is a need for a reliable measurement instrument to characterize intensive community-based care across different types of programs. Aims: The aim of the current study was to use and test the previously developed Intensive Community-Based Care Program Components (ICPC) Questionnaire. Method: This questionnaire was used in a census of programs throughout the Netherlands. Reliability of the a priori scales was assessed, and exploratory factor analysis was used to reduce the number of scales and to re-evaluate the structure of the questionnaire. Descriptive data were calculated to characterize Dutch programs. Of the programs, 58% responded to the questionnaire. Results: Of the a priori scales, 70% were internally consistent. With factor analysis the number of scales was considerably reduced (73%), but still explaining 58% of the total variance. Conclusions: This study shows that the ICPC can be used to improve future effect studies and for international comparisons of programs.

Acceptance of illicit drug use in the Netherlands and Norway: A cross-national survey

Aim: This study aims to explore differences between Dutch and Norwegian adults in the acceptance of illicit drug use in relation to the normalization thesis. Methods: Data were collected in November 2008. In total, 2150 Norwegian and 5616 Dutch respondents were included and the samples were weighted. The level of acceptance was assessed by measuring beliefs and opinions among Dutch and Norwegian people of 16 years and older and among different user groups in the Netherlands and Norway. t-Tests, χ2-tests and multiple regression analyses were conducted to examine the differences between both countries. Findings: Norwegian and Dutch respondents were somewhat reserved concerning the acceptance of illicit drug use. However, the acceptance of illicit drugs among Dutch respondents was significantly higher compared to Norwegian respondents. Regarding different user groups, even non-users in both countries showed a significant difference, with Dutch non-users accepting illicit drug use to a larger extent than Norwegians. Conclusions: According to the findings of this study, the acceptance of illicit drug use seems to be larger in the Dutch society than in the Norwegian one.

Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries

BackgroundOne of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy game ‘In2Action’ within a real-life setting of public health policymaking networks in the Netherlands, Denmark and Romania.MethodsThe development of the policy game intervention consisted of three phases, pre intervention, designing the game intervention and tailoring the intervention.ResultsIn2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy.ConclusionsThis study introduced an innovative intervention for public health policymaking. It described the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected to be generalizable for other European countries to stimulate interaction and collaboration in the policy process.

Ketencoördinatie door de jeugdgezondheidszorg: sleutel voor effectievere samenwerking?

Ketencoördinatie is effectief samenwerken met professionals en ouders. Door een gecoördineerde aanpak van diverse problemen kan een gezin, na een bepaalde tijd, de regie weer zelfstandig oppakken en worden de kinderen niet meer bedreigd in hun ontwikkeling. Ketencoördinatie kan uitgevoerd worden door de afdeling jeugdgezondheidszorg van de GGD West-Brabant of Bureau Jeugdzorg. Dit artikel beschrijft de eerste bevindingen met de methodiek ketencoördinatie uitgevoerd door een jeugdarts werkzaam bij de GGD. Gegevens zijn verzameld over de deelnemende gezinnen woonachtig in de gemeente Oosterhout, de participerende professionals, de zorgsignalen en de resultaten van de ketencoördinatie. Tevens is een deel van de betrokken professionals gevraagd hun mening te geven over de methodiek ketencoördinatie. De ketencoördinatie betrof 72 gezinnen met meerdere problemen. Na inzet van hulpverlening en ketencoördinatie bleek de situatie voor iets meer dan de helft van de gezinnen (38) verbeterd. Achttien gezinnen zijn verwezen naar Bureau Jeugdzorg omdat in de eerste lijn geen passend aanbod beschikbaar was. Voor drie gezinnen is een zorgmelding gedaan. Bij vier gezinnen is de ketencoördinatie niet gestart omdat na advisering van de signaleerder coördinatie niet nodig was. Twee gezinnen zijn verhuisd gedurende het traject. Voor zeven gezinnen is ketencoördinatie gecontinueerd in 2011. De professionals beoordelen de ketencoördinatie voldoende tot goed en adviseren om door te gaan met deze methodiek, bij voorkeur in aanwezigheid van ouders. Professionals en ouders ervaren deelname aan de gezamenlijke overleggen als positief. Bij vergelijking met een kwaliteitsmodel van de inspecties voor jeugdzorg blijkt dat de ketencoördinatie deels al voldoet aan verschillende kwaliteitscriteria. Voor de toekomst is het belangrijk om ook de overige kwaliteitscriteria mee te nemen in de evaluatie van ketencoördinatie.Case management achieved by the primary health care: a key to effective cooperation? Case management is an effective key in the youth care chain for professionals and parents. After a certain period of coordinated approach and care for several problems, the family take up the control and the childern are no longer threatened in their development. This article describes the first results of case management realized by a doctor specialized in primary health care. Data are collected about the participating families and professionals, the care signals and the results of the case management. 46 professionals are asked to express their opinion about the process of case management achieved by the primary health care. Within the intervention 72 families participated with multiple problems. After deployment of care assistance and coordination the situation for more than half of the families (38) improved. Eighteen families are referred to the youth care agency because of insufficië;nt facilities in de primary care services. For three families there was a care message. Two families moved out en four families didn’t need case management. For seven families case management wasn’t finished at the end of the scientific research. Generally the professionals evaluated the case management postive and advised to continue with the intervention, preferably in the presence of parents. Both professionals and parents experience parental participation as positive. Comparison with a set of quality assessment tools, edited by the dutch inspection youth care shows that the intervention already meets some various quality criteria. For the future it is important to include the other quality criteria in the evaluation of case management.

De patiënt aan zet: hoe kan de chronisch zieke zijn eigen zorg verbeteren?

Het thema van de Tranzo Zorgsalon van 14 juni was: ‘De patiënt aan zet: hoe kan de chronisch zieke zijn eigen zorg verbeteren?’, met als aandachtspunten de regierol en het zelfmanagement van de chronische patiënt. Deze vraag werd vanuit drie invalshoeken bekeken. Vanuit de zorgverzekeraar, door drs. Lynn Rulkens, programmamanager Zorginnovatie bij CZ. Vanuit onderzoek door dr. Wilma Otten, research scientist bij TNO. En ten slotte vanuit het patiëntenperspectief door Kitty van Gorp, trainster via Diabetesvereniging Nederland.