Developing an Intervention and Evaluation Model of Outdoor Therapy for Employee Burnout: Unraveling the Interplay Between Context, Processes, and Outcomes

BACKGROUND Burnout is a major societal issue adversely affecting employees' health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research. AIM The study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout. METHODOLOGICAL APPROACH We build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts. RESULTS We identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature). CONCLUSION The intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation

Strategies for public health adaptation to climate change in practice: social learning in the processionary Moth Knowledge Platform

Social learning theory can support understanding of how a group of diverse actors addresses complex challenges related to public health adaptation. This study focuses on one specific issue of public health adaptation: oak processionary moth (OPM) adaptation. With a social learning framework, we examined how public health adaption strategies gradually develop and are adjusted on the basis of new knowledge and experiences. For this qualitative case study, data were collected through 27 meetings of the Processionary Moth Knowledge Platform in the Netherlands and six additional interviews. Results indicate that relations between stakeholders, including experts played a major role in the learning process, facilitating the development and implementation of OPM adaptation and connecting local challenges to national adaptation strategies. Uncertainties regarding knowledge and organization were recurrent topics of discussion, highlighting the iterative and adaptive nature of public health adaptation. The study emphasizes the importance of building relationships among stakeholders and small steps in the learning process that can lead to the creation of new strategies and, if successful, the prevention of negative health impacts

Unravelling adolescent girls’ aspirations in Nepal:Status and associations with individual-, household-, and community-level characteristics

Background Adolescents’ aspirations have potential to influence their present and future well-being. Limited knowledge exists on adolescent girls’ aspirations and their determinants, particularly in low-income contexts. Methods and findings Using cross-sectional data, collected in 2018 in Nepal, within the Suaahara II Adolescent Panel Survey, (n = 840), adolescent girls’ aspirations in several domains—education, occupation, marriage, fertility, health, and nutrition–were described. Regression models were estimated to explore associations between individual, household and community characteristics and these aspirations for all adolescents and separately for younger (10–14 years) and older (15–19 years) girls. Age, school attendance, and self-efficacy, as well as household wealth, caste/ethnicity, size, and agro-ecological zone of residence were significantly associated with aspirations, although effect sizes and significance varied by aspiration domain and age group. Conclusions Findings underscore the curtailing effect of poverty on aspirations and the dynamic nature of aspirations. Initiatives to foster girls’ aspirations must address both individual and contextual factors

Salutogenesis for thriving societies

Settings are defined by the World Health Organization (1998) as “the place or social context in which people engage in daily activities in which environmental, organizational, and personal factors interact to affect health and well-being.” Such settings range from small-scale home/family to (international) organizations and large cities and thus differ in size, in their degree of formalized organization and their relationships to society. The chapters in Part V review how salutogenesis has been applied to health promotion research and practice in a broad range of settings: organizations in general, schools, higher education, workplace, military settings, neighborhood/communities, cities, and restorative environments. The following synthesis demonstrates that applying salutogenesis to various settings and linking salutogenesis with other models established in these settings has the great potential to generate ideas on how to advance the general salutogenic model

Bidirectional and passive optical field to microwave field quantum converter with high bandwidth

The conversion between microwave photons and optical photons with quantum coherence is important for quantum communication and computation. In this paper, we report a proposal using an ensemble of atoms coupled to microwave and optical resonators. Input photons to one resonator are converted into output photons in the other resonator without active operation. Usually the conversion is only optimized at certain frequency. In our proposal, we find that the efficiency is almost a constant and can be close to 100% in a large interval of frequency, i.e. a high-bandwidth conversion can be realized with our proposal.Comment: 6 pages, 4 figure

The Application of Salutogenesis in Communities and Neighborhoods

Communities and neighborhoods have reemerged as important settings for health promotion; they are particularly effective for encouraging social processes which may shape our life-chances and lead to improved health and well-being; consequently, as Scriven and Hodgins, (2012) note, of all the settings (cities, schools, workplaces, universities, etc.), communities are the least well defined. Indeed, within the health literature, they are frequently referred to in terms of place, identity, social entity, or collective action.This chapter on communities and neighborhoods distinguishes between settings as a place (natural and built environment), identity (sense of community), social entity (cohesion, social capital), and collective action (reactive-resilience; proactive-community action) – all meaningful categories of generalized resistance resources (GRRs). Such clearly defined GRR categories would allow the study of their relative importance for developing the sense of coherence (SOC) and a newer concept – setting-specific SOC

Culture in salutogenesis: the scholarship of Aaron Antonovsky

Aaron Antonovsky wrote extensively, although disjointedly, about the roles of culture in salutogenesis. This paper provides a synopsis of his work in this arena. A literature review identified those of his English language writings in which culture was a subject, and relevant text segments were analysed using an inductive followed by a deductive method. Using thematic network analysis, text segments were sorted inductively by open coding and then analysed. This was followed by deductive text segment coding guided by the constructs of the salutogenic model of health. The analysis revealed that Antonovsky had an expansive interest in the roles of culture in salutogenesis. His writings included attention to the role of culture in: (a) shaping life situations; (b) giving rise to stressors and resources; (c) contributing to life experiences of predictability, load balance and meaningful roles; (d) facilitating the development of the sense of coherence and (e) shaping perceptions of health and well-being. Antonovsky’s writings about culture were sometimes conjectural, as well as being obviously influenced by his life experience in the USA and then in Israel, and by the spirit of the times in which he lived. However, he also drew extensively on his own and others’ empiricism, leading him to view culture as an integral aspect of the salutogenic model of health. The present analysis provides salutogenesis scholars with a roadmap of Antonovsky’s reflections, ponderings and conclusions about culture in the context of salutogenesis. It provides assistance in the form of an overview of Antonovsky’s treatment of culture in the context of salutogenesis

Visions de les Xarxes

Discussió sobre diferents visions de la promoció de la salut a la xarx

Evaluating the Healthy Futures Nearby Program: Protocol for Unraveling Mechanisms in Health-Related Behavior Change and Improving Perceived Health Among Socially Vulnerable Families in the Netherlands

Background: The persistence of health inequalities within high-income societies such as the Netherlands indicates the importance of researching effective ways to reduce those inequalities. Multiple strategies for reducing health inequalities have been identified. Specifically targeting health-related behaviors among lower socioeconomic status groups is one of those strategies. All in all, it seems relatively clear what types of approaches in general lead to health-related behavior change. However, it is still unclear how these approaches, in interaction with context, trigger a specific desired change. In the Netherlands, the private funding organization, Fonds NutsOhra, funded 46 small-scale projects under the umbrella of the Healthy Futures Nearby program. The projects aim to reduce vulnerable families’ health deprivation by triggering lifestyle changes.Objective: This study aimed to outline and justify the protocol for the overall evaluation of the program. The evaluation aimed to find out to what extent and how the small-scale projects and approaches within the program affect (or not) health-related behaviors and improve perceived health.Methods: The approach to the overall evaluation of the 46 projects builds on a combination of 3 frequently used evaluation models; it is theory-based, realist informed, and uses a mixed methodology design. Methods include analysis of quantitative project data, document analysis, focus groups, and interviews. A study design has been drawn up that values and uses the multifaceted development of the projects and the influence this might have on implementation and project outcomes. Also, it respects the complex nature of the projects and is suited to studying health promotion mechanisms in depth. Finally, it optimizes the usage of all—quantitative and qualitative—project evaluation data available.Results: This study protocol included the design of at least 4 different studies. The results will hence provide information on (1) building and defining theories of change in health promotion practice, (2) mechanisms at work in promotion of healthy behavior among vulnerable families, (3) what works and what does not in professionals’ practices in health promotion among those vulnerable groups, and (4) what works and what does not in health promotion projects with a participatory approach. In addition, data will be collected on the overall effectiveness of the 46 initiatives. Data collection started in 2016. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019.Conclusions: This overall evaluation provides a unique opportunity. The diversity of projects allows for a study protocol that answers in greater depth questions of how specific health promotion approaches work while also elucidating their effectiveness in a more traditional way. Using a theory-based complexity-sensitive approach that is mainly realist informed, this study also provides an opportunity to see whether combining assumptions from different evaluation perspectives yields relevant information