Fragile, please handle with care:Understanding and supporting professionals' response to suspicions of child abuse and neglect

This research project focuses on: * Child healthcare professionals'​ adherence to national guidelines on child abuse and neglect and reasons for (non)adherence. * Child healthcare professional's adherence to consultation of an in-house expert on child abuse and neglect. * Professionals' preferences and experiences with regard to requesting information from other child-serving agencies in case of suspected child maltreatment. * The development and evaluation of a digital tool to support professionals responding according to the guidelines on child abuse and neglect in preventive child health care.

Survey of prevalence of protective and risk factors for SIDS in the Netherlands

BACKGROUND: From 1987 on, surveys have been conducted in the Netherlands to monitor babycare habits and target safe sleeping prevention campaigns. The last survey was conducted in 2011. In the Netherlands, the 2016 incidence of SIDS (R95) was 0.075/1000 live births (n=13); taking into account adjacent categories the SUDI incidence was 0.15/1000 (n=26). This low incidence, the lowest in the Western world, may result in decreased parental awareness of SIDS risks and complacency regarding preventive messages. Therefore, a new survey was conducted. OBJECTIVES: 1) To measure the prevalence of protective and risk factors for SIDS in the Netherlands in 2017 including new customs of babycare. 2) To compare 2011 prevalences with 2017. 3) To investigate why parents do not follow recommendations regarding safe sleep position and location. METHODS: A cross-sectional study was conducted using an online questionnaire (52 questions). The study population encompassed parents/caregivers of infants up to 1 year of age living in the Netherlands. Between February 12 – April 30, 2017, invitations with a link to the questionnaire were distributed to 9000 parents visiting 17 child healthcare organizations. In healthcare centers in socially more deprived neighborhoods research assistants helped parents fill out the online questionnaire. In May and June, invitations to participate were also communicated using social media. We used SPSS 24 to calculate prevalence rates and performed a content analysis of answers on open-ended questions on reasons for not following SIDS prevention advice. RESULTS: In total 1289 questionnaires were filled out, of which 80 were excluded, mostly because the child was too old. The study population was comparable to the Dutch population in terms of sex ratio, preterm infants, and parents with a lower education. First-born infants and parents with a higher education were overrepresented, families with a migration background were underrepresented. Sleeping prone increased from 3.1% of infants when 0-2 months old to 13.6% at 9-11 months. Infants aged 0-2 months slept in a separate room in 31.5%, roomshared with parents in 52.3%, slept in an attached bedside sleeper in 9.7% and with their parent(s) in bed in 6.3%. For age 7-8 months this was respectively 71.2%, 15.2%, 4.0% and 8%. Only 4.5% of infants used a duvet. The typical Dutch sleeping sack (wearable blanket) was used for 55.8% of infants. Only 50% of infants 0-2 months and 23.6% of infants 5-6 months were breastfed exclusively. Of all mothers, 4z had smoked during pregnancy; of all infants 21.3% were exposed to parents’ smoking. CONCLUSIONS: The number of infants that sleep prone is comparable to 2011, with still significant room for improvement. Roomsharing with infants 0-2 months has increased significantly since 2011, but so has bedsharing. These data are important for future preventive campaigns

A qualitative exploration of factors that facilitate and impede adherence to child abuse prevention guidelines in Dutch preventive child health care

Rationale, aims and objectives In the Netherlands, evidence-based child abuse prevention (CAP) guidelines have been developed to support child health care professionals (CHPs) in recognizing and responding to suspected child abuse. The aim of this study was to identify factors related to characteristics of the guidelines, the user, the organization and the socio-political context that facilitate or impede adherence to the CAP guidelines. Methods Three semi-structured focus groups including 14 CHPs working in one large Dutch child health care organization were conducted in January and February 2012. Participants were asked questions about the dissemination of the guidelines, adherence to their key recommendations and factors that impeded or facilitated desired working practices. The interviews were audiotaped and transcribed. Impeding and facilitating factors were identified and classified. An innovation framework was used to guide the research. Results CHPs mentioned 24 factors that facilitated or impeded adherence to the CAP guidelines. Most of these factors were related to characteristics of the user. Familiarity with the content of the guidelines, a supportive working environment and good inter-agency cooperation were identified as facilitating factors. Impeding factors included lack of willingness of caregivers to cooperate, low self-efficacy and poor inter-agency cooperation. Conclusions The results indicate that a broad variety of factors may influence CHPs' (non-)adherence to the CAP guidelines. Efforts to improve implementation of the guidelines should focus on improving familiarity with their contents, enhancing self-efficacy, promoting intra-agency cooperation, supporting professionals in dealing with uncooperative parents and improving inter-agency cooperation. Recommendations for future research are provide

In-house consultation to support professionals’ responses to child abuse and neglect:Determinants of professionals’ use and the association with guideline adherence

This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals’ performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study’s inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p = .001), who were more familiar with consultation (p = .002), who had more positive attitudes and beliefs about consultation (p = .011) and who reported being more susceptible to the behavior (p = .001) and expectations/opinions (p = .025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals’ responses to CAN are discussed

Patient participation in the development and application of eHealth:Willingness and preferences of people with diabetes mellitus type 2

AIM: The aim was to gain insight in the preferences of people with type 2 diabetes mellitus regarding the moments and methods of patient participation in the development and application of eHealth, and which factors influence this. METHODS: A digital questionnaire with both closed and open questions was distributed via various online platforms and the newsletter of the Diabetes Association in the Netherlands. Information was collected on: 1) willingness to participate; 2) preferences about the method of participation; 3) influencing factors on participation, including motivation, competence, resources, social influences, and outcome expectations; 4) background characteristics. RESULTS: 160 questionnaires were analysed. More than three quarter of the respondents intend to be involved in patient participation. Most respondents prefer solo participation methods over group participation, respectively 93% and 46%. Half of the respondents feel that they have sufficient knowledge to participate, and 40% feels that they can provide valuable input. As compensation for participation, participants prefer to use new technologies for free. CONCLUSION: As people with diabetes type 2 differ in their preferences for moments and methods of participation, it is recommended to offer different methods of participation and types of compensation in the process from development to application of eHealth

Can Integrated Care Help in Meeting the Challenges Posed on Our Health Care Systems by COVID-19? Some Preliminary Lessons Learned from the European VIGOUR Project

The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOU