Het doel heiligt de middelen?

Rede, uitgesproken ter gelegenheid van de aanvaarding van het ambt van bijzonder hoogleraar aan het Erasmus MC - faculteit van de Erasmus Universiteit - vanwege de Stichting Volksbond Rotterdam, gevestigd bij het IVO, met de leeropdracht Verslavingsonderzoek, op 28 maart 200

How to assist probationers with debt problems during supervision?:A qualitative study into the experiences of both probation officers and clients

Little research exists on what works in the supervision of offenders with debt problems. This qualitative study aims to provide insight into the barriers probation officers and clients experience during supervision regarding debt and the support that clients need. Interviews were conducted with 33 Dutch probation officers and 16 clients. The results show that debt often negatively influences clients’ lives and hinders their resocialization. Probation officers lack effective methods to support clients with debt problems. To adequately help clients with debt problems, probation officers should obtain more knowledge about effective interventions and collaborate more closely with debt specialists from the probation supervision outset

Ethical considerations for alcohol researchers in their relation towards policy makers

Alcohol policy research all over the world is often funded by national or local governments. Researchers involved may be confronted with several ethical questions. These questions can have quite a different character. Ethical questions may have a severe character that can be quite “clear” for the researchers involved. Miller et al. [1] for instance recently studied interference of funders, like governments or industrial and charitable organizations, in addiction research. Results show that activities occur such as censorship of research outputs, interference with the wording in reports and articles and interventions in when and how findings are released. Governments funding policy research may interfere in a way as described by Miller et al. [1]. but also less obvious ethical issues may occur: What if the research question is formulated in a “questionable” or “suggestive” way? What if policy makers deliberately ignore results of scientific research? The purpose of this contribution is to elaborate on these less obvious ethical issues, not primarily to give clear-cut answers but to raise consciousness and stimulate reflection and debate among researchers and policy makers

Inequalities in Health, to Be Continued? A life-course perspective on socio-economic inequalities in health

People in lower socia-economic positions are generally worse off with respect to their health than people in higher positions. The

What do we not know (yet) about recovery colleges?:A study protocol on their (cost-)effectiveness, mechanisms of action, fidelity and positioning

BackgroundRecovery Colleges (RCs) have spread across the globe as a new way of supporting people with mental vulnerabilities in their recovery journey. RCs focus on ‘learning’ rather than ‘curing’ and in that line facilitate a transition from being a passive, dependent patient/client to an active, empowered student learning to live life, despite vulnerabilities. Peer support and co-creation are central in RCs, as peers learn from each other by sharing personal experiences with mental vulnerabilities in an accessible, inspiring and stimulating atmosphere. The implementation of RCs is highly encouraged internationally, and as a result RCs and related self-help initiatives increasingly emerge. However, high-quality research on RCs is scarce and there is a call for thorough investigation of (cost-)effectiveness, mechanisms of action, cross-border fidelity and positioning of RCs. In response, this research project aims to fill these gaps.MethodsThis research project entails (1) a prospective quasi-experimental effectiveness study and economic evaluation, (2) a multifaceted qualitative study to elaborate on the mechanisms of action of RCs for those involved (3) a study to develop a (Dutch) Fidelity Measure of Recovery Colleges, and (4) an organisational case study to describe the positioning of RCs in relation to other mental health care services and community-based initiatives. Following the ideals of co-creation and empowerment in RCs we conduct this research project in co-creation with RC students from Enik Recovery College in Utrecht, the Netherlands.DiscussionThis research project will lead to one of the first longitudinal controlled quantitative evaluations of both cost-effectiveness and effectiveness of RC attendance in a broad sense (beyond attending courses alone). Moreover, we will gather data on a micro level (i.e., impact on RC students), meso level (i.e., organisational fidelity) and macro level (i.e., positioning in the care and support domain), capturing all important perspectives when scrutinizing the impact of complex systems. Finally, we will demonstrate the validity and value of embracing experiential knowledge in science as a complementary source of information, leading to a more profound understanding of what is researched.<br/

Impeding and facilitating factors for the implementation of alcohol interventions in hospitals:A qualitative and exploratory study among Dutch healthcare professionals

BACKGROUND: Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. METHODS: Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. RESULTS: Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. CONCLUSIONS: Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital

Maternal educational level and children's healthy eating behaviour: Role of the home food environment (cross-sectional results from the INPACT study)

Background: The aims of this study are 1) to investigate the association between maternal educational level and healthy eating behaviour of 11-year-old children (fruit, vegetables and breakfast consumption), and 2) to examine whether factors in the home food environment (parental intake of fruit, vegetables and breakfast; rules about fruit and vegetables and home availability of fruit and vegetables) mediate these associations.Methods: Data were obtained from the Dutch INPACT study. In total, 1318 parent-child dyads were included in this study. Multilevel regression models were used to investigate whether factors of the home food environment mediated the association between maternal educational level and children's healthy eating behaviour.Results: Children of mothers with a high educational level consumed more pieces of fruit per day (B = 0.13, 95% CI: 0.04-0.22), more grams of vegetables per day (B = 23.81, 95% CI = 14.93-32.69) and were more likely to have breakfast on a daily basis (OR = 2.97, 95% CI: 1.38-6.39) than children of mothers with a low educational level. Home availability, food consumption rules and parental consumption mediated the association between maternal education level and children's fruit and vegetable consumption. Parental breakfast consumption mediated the association between maternal education level and children's breakfast consumption.Conclusions: Factors in the home food environment play an important role in the explanation of socio-economic disparities in children's healthy eating behaviour and may be promising targets for interventions

Parental and child fruit consumption in the context of general parenting, parental education and ethnic background

This study examines the association between parental and child fruit consumption in the context of general parenting, parental education and ethnic background. A cross-sectional study was performed among 1762 parent-child dyads. Mean age of the children was 8. years. One parent completed a questionnaire to measure their own and their child's fruit consumption, parenting style, education level and ethnicity. In mediation and moderation analyses, child fruit consumption was regressed on parental fruit consumption, parenting style, parental education and ethnicity. Participating children consumed on average 7.5 pieces of fruit per week. Fourteen percent met the recommended Dutch norm of two pieces of fruit per day. Parental and child fruit consumption were positively associated. The association was more pronounced under higher levels of psychological control and behavioural control, and among ethnic groups. Additionally, parental education and child fruit consumption were positively associated. Parental fruit consumption partially mediated this association. Interventions are needed to increase child fruit consumption. Interventions should focus on increasing parental fruit consumption and positive parental modelling, with particular focus on low-SES families. Additionally, interventions that combine positive modelling with positive general parenting skills (e.g. increasing behavioural control) may be more effective than interventions that focus on parental modelling alone

Associations of Children's Appetitive Traits with Weight and Dietary Behaviours in the Context of General Parenting

Background: Individual variations in child weight can be explained by genetic and behavioural susceptibility to obesity. Behavioural susceptibility can be expressed in appetite-related traits, e.g. food responsiveness. Research into such behavioural factors is important, as it can provide starting points for (preventive) interventions. Objectives: To examine associations of children's appetitive traits with weight and with fruit, snack and sugar-sweetened beverage intake, and to examine whether parenting style interacts with appetite in determining child weight/intake. Methods: Data were used from 1275 children participating in the INPACT study in 2009-2010, with a mean age of 9 years in 2009. Their height and weight were measured to calculate body mass index (BMI). Parents completed a questionnaire to measure children's appetitive traits, children's dietary intake and parenting style. Child BMI z-scores, fruit, snack and sugar-sweetened beverage intake were regressed on appetitive traits. Moderation by parenting style was tested by adding interaction terms to the regression analyses. Results: Food-approaching appetitive traits were positively, and food-avoidant appetitive traits were negatively related to child BMI z-scores and to child fruit intake. There were no or less consistent associations for snack and sugar-sweetened beverage intake. Authoritative parenting voided the negative association between food fussiness and fruit intake, while neglecting parenting strengthened the positive association between food-approaching appetitive traits and weight. Conclusions: Early assessment of appetitive traits could be used to identify children at risk for overweight. As parenting style can moderate the associations between appetitive traits and weight/intake in a favourable way, parents are a promising target group for preventive interventions aimed at influencing the effect of appetitive traits on children