Ethnic minorities and prescription medication; concordance between self-reports and medical records

BACKGROUND: Ethnic differences in health care utilisation are frequently reported in research. Little is known about the concordance between different methods of data collection among ethnic minorities. The aim of this study was to examine to which extent ethnic differences between self-reported data and data based on electronic medical records (EMR) from general practitioners (GPs) might be a validity issue or reflect a lower compliance among minority groups. METHODS: A cross-sectional, national representative general practice study, using EMR data from 195 GPs. The study population consisted of Dutch, Turks, Surinamese, Antilleans and Morrocans. Self-reported data were collected through face-to-face interviews and could be linked to the EMR of GPs. The main outcome measures were the level of agreement between annual prescribing rate based on the EMRs of GPs and the self-reported receipt and use of prescriptions during the preceding 14 days. RESULTS: The pattern of ethnic differences in receipt and use of prescription medication depended on whether self-reported data or EMR data were used. Ethnic differences based on self-reports were not consistently reflected in EMR data. The percentage of agreement above chance between EMR data and self-reported receipt was in general relative low. CONCLUSION: Ethnic differences between self-reported data and EMR data might not be fully perceived as a cross-cultural validity issue. At least for Moroccans and Turks, compliance with the prescribed medication by the GP is suggested not to be optimal

Increasing physical activity: opinion on the role of child and youth health services

Het RIVM heeft in kaart gebracht welke mogelijkheden de jeugdgezondheidszorg (JGZ) heeft om jongeren meer te laten bewegen. In het standpunt 'Beweegstimulering door de jeugdgezondheidszorg' is uiteengezet hoe de JGZ het beweeggedrag kan volgen, hoe zij een gebrek aan beweging kan signaleren en hoe zij kinderen (en hun ouders) kan motiveren om meer te gaan bewegen. Ook kan de JGZ kinderen zo nodig gericht doorverwijzen naar passende beweegactiviteiten. Het standpunt is in opdracht van het ministerie van VWS geformuleerd. Een groot deel van de Nederlandse jeugd beweegt te weinig, wat de lichamelijke en psychosociale gezondheid negatief kan beinvloeden. De jeugdgezondheidszorg (JGZ) ziet (bijna) alle kinderen vanaf hun geboorte regelmatig en kan daardoor een belangrijke bijdrage leveren om ze meer te laten bewegen. Onderzoek wijst uit dat mensen die op jonge leeftijd actief zijn, dat vaker ook op latere leeftijd zijn. Behalve activiteiten op individueel niveau kan de JGZ aanhaken aan bestaande collectieve activiteiten. Daar bestaan veel kansen en mogelijkheden voor aangezien het stimuleren van sport en bewegen een belangrijk speerpunt is van de overheid. Veel gemeenten hebben bijvoorbeeld beweegstimuleringsprojecten ontwikkeld in het kader van het Nationaal Actieplan Sport en Bewegen, of van het Beleidskader Sport, Bewegen en Onderwijs. JGZ-organisaties kunnen hierbij aansluiten en de gemeenten adviseren over activiteiten die aansluiten bij lokale aandachtspunten, zoals het voorkomen van obesitas of bewegingsarmoede bij jongeren. Ook kunnen zij meer samenwerken met het onderwijs, sportverenigingen en gezondheidsbevorderende instanties om de jeugd in beweging te krijgen.This report provides insight into the possible contribution of child and youth health services to increasing physical activity levels of young people in The Netherlands. It highlights how professionals can monitor levels and patterns of physical activity, how they can identify insufficient activity levels, and what they can do to motivate young people -and their parents- in adopting a more physically active lifestyle. The child and youth health professional may also provide advice about the kind of physical exercise that may be helpful and appropriate. This opinion has been drafted at the request of the Ministry of Health, Welfare and Sports. Overall, levels of physical activity are too low among Dutch youth. This may impact negatively on their physical as well as their mental health. Providing preventative services to 0-19 year-olds, the child and youth health sector is in regular contact with -almost- all children and young people in the country. Consequently, they can play a substantial role in efforts to increase physical activity levels in this population. Research suggests activity levels in childhood may have a long-lasting impact: people who are active as a young age are more likely to be active in adulthood. The contribution of the child and youth health sector may go beyond individual consultation, advice and support. Forging partnerships with other sectors -such as education or leisure-, and building on ongoing community initiatives offer additional opportunities. Encouraging sport and physical activity is a policy priority of national and local government. Many local Councils have developed specific projects in response to the National Action Plan on Sports and Physical Activity or within the Policy Framework on Sports, Physical Activity and Education. Child and youth health services may advise local government to choose activities according to local needs, focusing on -for instance- reducing obesity or increasing activity levels. They can also build alliances with health promotion specialists, educational institutes and sport facilities.VW