Health and Health Care Use of Elderly Immigrants in the Netherlands: a comparative study

History shows an ongoing voluntary or involuntary migration flow of people from their birthplaces to other societies. Many Western countries have become multi-ethnic societies. The number of elderly immigrants in those countries is rapidly rising. Contrary to the situation in the United States, little information is yet available on the health status and health care use of elderly immigrants in Europe, including the Netherlands. In Europe, elderly are often included as part of the study population whereas in the United States separate studies on elderly have been conducted indicating more health prob

The BeHealthyR Study: A randomized trial of a multicomponent intervention to reduce stress, smoking and improve financial health of low-income residents in Rotterdam

Background: Compared to higher socioeconomic status (SES) groups, those in lower SES groups are financially strained, experience higher rates of smoking-related morbidity, are in poorer health and have reduced life expectancy. This is especially true for the city of Rotterdam, where a large inequality in health is observed between low and high SES groups. The BeHealthyR study (Dutch: Grip en Gezondheid) is a randomized controlled trial (RCT) which will evaluate the impact of a theory-based multicomponent behavior intervention aiming to reduce stress, smoking, and improve financial health by means of a group-based stress management program combining cognitive and behavioral techniques, and nudges in low-SES residents living in Rotterdam. Methods: The BeHealthyR study is a three-arm RCT. Between February 2018 and July 2019, low-SES participants who perceive stress, smoke, are financially strained and reside in Rotterdam (one of the four largest cities in The Netherlands) are recruited. Subsequently, participants are randomly assigned to either a stress management condition (SM), stress management with a buddy condition (SM-B) or a control condition (CC). Participants in the SM and SM-B conditions will attend four weekly group sessions (1.5 h/session) and a follow-up session eight weeks later. The SM condition includes psychoeducation and exercises, and cognitive and behavioral intervention techniques. Demographic data and objective measures will be collected at baseline (T0), four weeks post-baseline (T1), and twelve weeks post-baseline (T2). Primary outcome measures are to reduce stress, smoking and improve financial health. We hypothesize that low-SES participants in the intervention conditions, compared with those in the control condition, will experience less stress, smoke less and have improved financial health. Discussion: This study is a group-based intervention which aims to investigate the effects of a theory-based behavioral change intervention employing several components on reducing stress, smoking, and improving financial health in low-SES residents living in Rotterdam. If effective, the findings from the present study will serve to inform future directions of research and clinical practice with regard to behavioral change interventions for low-SES groups. Trial registration: ClinicalTrials.gov (ID: NCT03553979). Registered on January 1 2018

Perinatale gezondheid in Rotterdam; nulmeting periode 2000-2007

Inleiding Rotterdam heeft binnen Nederland een relatief hoog perinataal sterftecijfer. Onder perinatale sterfte verstaan we sterfte vanaf 22 weken zwangerschapsduur tot en met de eerste 7 dagen na de geboorte. Dit bleek reeds in 2008 toen De Graaf et al. beschreven dat vrouwen in de vier grote steden een sterk verhoogde kans hebben op perinatale sterfte en daarmee samenhangende perinatale ziekte. De belangrijkste vier perinatale ziekten, die vaak voorlopers zijn van perinatale sterfte, zijn aangeboren afwijkingen, vroeggeboorte, laag geboortegewicht gelet op de zwangerschapsduur, en een lage Apgar score (een slechte start bij de geboorte). In vervolg op de bevindingen voor Rotterdam is in 2008 het Aanvalsplan Perinatale Sterfte Rotterdam van start gegaan. Dit is een meerjarig programma waarin de Gemeente Rotterdam in samenwerking met het Erasmus MC en de GGD Rotterdam Rijnmond tot doel heeft de perinatale sterfte en perinatale ziekte binnen Rotterdam te verminderen. Een eerste stap hierbij is het nauwkeurig in kaart brengen van perinatale ziekten en sterfte, en de factoren die mogelijk hiervoor verantwoordelijk zijn. Deze factoren kunnen gebonden zijn aan zwangeren zelf, met hun omgeving te maken hebben of met de zorg te maken hebben

Identifying barriers to vaccination intention at walk-in vaccination facilities in deprived neighbourhoods:A cross-sectional survey

Objectives: Low COVID-19 vaccination adherence in deprived neighbourhoods is problematic since the prevalence of chronic diseases associated with mortality rates due to COVID-19 is higher in these populations. The aim of this study is to provide an insight about beliefs and considerations relating to vaccination intention among inhabitants of deprived neighbourhoods in the Netherlands. Design: Cross-sectional survey. Setting: Easily accessible vaccination facilities at markets in deprived neighbourhoods in the Netherlands. Participants: Participants were recruited at three vaccination facilities that were set up at markets in deprived neighbourhoods in Rotterdam. A total of 124 surveys were retained for analysis. Main outcome measure: Intention to get vaccinated against COVID-19. Results: The survey was filled out by 124 respondents; 62 % had - prior to visiting the easily accessible locations - intended to get a COVID-19 vaccine and 38 % were hesitant (22.3 % had doubts and 15.7 % did not plan to get vaccinated). Many people mentioned the convenience of an easily accessible location nearby. At the bivariate level, the influence of information from the family was associated with vaccination intention (p &lt; 0.01). In a logistic regression model, both fear of vaccination and fear of side-effects were significantly associated with vaccination intention (ORs 0.56 (CI 0.35–0.89) and 0.47 (CI 0.30–0.73)). Conclusion: The accessibility of a vaccination facility, family influence and fear are relevant factors for the intention to get vaccinated against COVID-19 in people living in deprived neighbourhoods. Interventions should address these factors in order to increase vaccination uptake.</p

Current practice of preconception care by primary caregivers in the Netherlands

Objectives: Over the past decade the value of preconception care (PCC) consultations has been acknowledged. Investments have been made to promote delivery and uptake of PCC consultations in the Dutch primary care setting. We assessed current activities, perceptions and prerequisites for delivery of PCC in primary care. Methods: A questionnaire was compiled and distributed by mail or e-mail among 1682 general practitioners (GPs) and 746 midwives in the Netherlands between 2013 and 2014. Results: The questionnaire was completed by 449 GPs and 250 midwives. While GPs and midwives were frequently asked about preconception risks, explicit requests by patients for a PCC consultation were less frequent. Although caregivers gave information on preconception risk factors, only a minority recommended PCC in the form of a dedicated consultation. Such consultations occurred infrequently. Risk factor assessment varied between GPs

Planned home compared with planned hospital births: Mode of delivery and Perinatal mortality rates, an observational study

Background: To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted a

Knowledge on preconceptional folic acid supplementation and intention to seek for preconception care among men and women in an urban city: A population-based cross-sectional study

Background: To study the knowledge of a large city population on preconception folic acid supplementation and intention to seek for preconception care within an urban perinatal health program. Methods: Cross-sectional surveys run in Rotterdam, the Netherlands, in 2007 and annually from 2009 to 2014. A random sample of residents aged between 16 and 85 years was taken each year from the municipal population register. Bivariate analysis, interaction analysis, trend analysis and logistic regression were performed. Results: Knowledge on preconceptional folic acid supplementation significantly improved (+20 %) between 2007 and 2009, and the intention to consult a GP or midwife in the preconception period significantly increased (+53 %) from 2007 to 2012. Logistic regression analyses showed that low socio-economic status was significantly associated with low preconceptional folic acid knowledge, but with higher intention to seek out preconception care. An interaction effect was found between educational level and ethnicity, showing that the higher the educational level the lower the gap of level of knowledge between the different ethnic groups. Conclusion: Despite campaigns about folic acid supplementation knowledge on this supplement remains low. The intention amongst men and women to seek out preconception care is still insufficient. Structural interventions to increase and maintain awareness on folic acid supplementation, especially among high-risk groups, are needed

Differences in perinatal morbidity and mortality on the neighbourhood level in Dutch municipalities: A population based cohort study

Background: In a national perinatal health programme, we observed striking heterogeneity in the explanation of the most prominen