Towards guideline implementation for integrated local health policies:Evaluation of an experimental implementation strategy in regional health services

To enhance implementation of a Guideline for integrated local health policy, a draft implementation strategy (DIS) was developed. It was hypothesized that the DIS would be feasible and effective to enhance the use of a Guideline for integrated local health policy. To examine its feasibility and effectiveness, the DIS was pilot tested simultaneously in two Regional Health Services (RHSs) and compared with the 'care as usual' in two other RHSs that did not receive a predefined strategy for Guideline implementation. The DIS was evaluated in a qualitative way by means of semi-structured individual-and group interviews. We applied the Nutbeam framework for evaluation on: i) program integrity, ii) program reach, iii) program acceptability, and iv) observed change. Comparison of pilot results with the two other RHSs included semi-structured group interviews. Both RHSs conducted implementation largely as planned. The purpose of the Guideline for RHS policy objectives was not discussed at all desired levels. Increased Guideline use was mainly found among health promoters. Comparison with Guideline implementation in the other RHSs revealed information for further evaluation of the DIS. The feasibility and effectiveness of the DIS applied to building blocks which aimed at alignment of goals and ambitions between RHS management and executive disciplines. Possible implications for future application of the DIS are dealt with in the discussion section of this pape

De wetenschap draait door

Onderzoekers, beleidsmakers, professionals en burgers moeten elkaar in een automatisme gaan vinden. Dat was de inzet van de track De Wetenschap Draait Door, georganiseerd door Tranzo/Tilburg University samen met de NSPOH en het RIVM. Cocreatie moet de norm worden. Onderzoeksresultaten moeten in de praktijk landen en onderzoekers moeten gevoed worden door ontwikkelingen vanuit die praktijk. Vragen die in de track centraal stonden waren onder andere: ‘Moeten er nieuwe samenwerkingsvormen komen tussen beleid, onderzoek en praktijk?’; ‘Welke rol kunnen het (academisch) onderzoek en onderwijs hierin vervullen?'; ‘Welke rol kunnen burgers spelen bij het agenderen, uitvoeren en interpreteren van onderzoek?’; ‘Moeten we toegroeien naar een universiteit die naar buiten reikt in duurzame partnerships tussen universiteit en praktijk?

Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown

Background: The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. Aim: To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. Methods: The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. Results: Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. Conclusions: The results emphasize the strain of the pandemic on young fathers’ and mothers' mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation