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Background. The development of school-based programs for preventing adolescent sexual harassment often lacks an evidence-based approach and use of proper theories. Appropriate stakeholders are often not involved in the development process. To help improve this process, we used the Intervention Mapping framework to retrospectively evaluate the development of two school-based programs, Benzies & Batchies and Boys, each of which was intended to prevent sexual harassment among adolescent students of a lower educational level in the Netherlands. The two interventions were among the first school-based programs targeting sexual harassment, and were implemented in Dutch secondary schools. Methods. As well as doing desk research into the context and content of the interventions, we used semi-structured focused interviews with the initial developers to gather their opinions on and experiences with the development process, whereby the topics were based on the six steps of the IM framework. To better suit the needs of the respondents, we had adapted the language of our topics and had used open-ended questions The data we had gathered from the desk research and face-to-face consultations were checked against a planning tool that was based on 19 tasks within the six steps of IM. Results. Although both programs had been developed in practice and lacked a thorough theoretical foundation, the methods and materials used represented aspects of behavior-change theories. The developers of Benzies & Batchies completed slightly more planning criteria within the six steps of the planning process, and used more change methods than the developers of Boys did. Conclusions. We recommend that parents should also be involved in the development of sex and relationship education programs, and should be allowed to participate in the program itself. To meet the needs of intervention developers, greater insight is needed into the importance of the individual steps in the Intervention Mapping framework. In our view, the development of practice-based interventions will improve if future intervention developers combine evidence-based theories with their practice-based experience. This will increase the success and effectiveness of their interventions.

BACKGROUND: The goal of the current study was to evaluate the effects of the Social Emotional Learning program Skills 4 Life on mental health and its risk factors self-esteem, self-efficacy, and social interaction skills in students of secondary schools. METHODS: A cluster randomized controlled study was conducted, including 38 schools (66 classes; grades 7 to 9) for secondary education, with a 1 year and 20 months follow-up (teachers and students reports). RESULTS: The intervention was effective in improving self-efficacy, depressive symptoms, and teacher-reported psychological problem behavior, all after 20 months. Stratified analyses showed effects in mainly lower educational level students. CONCLUSION: The Skills 4 Life curriculum is effective in improving the mental health and self-efficacy among adolescents, especially for adolescents from lower educational level, a group that is most prone to ill mental health. © 2019, American School Health Association

EUSUHM-congres: kennisdelen voor en samenwerken aan een gezonde jeugd! Changing contexts—influencing youth and their surroundings. Het thema van het congres was ‘Changing contexts – influencing youth and their surroundings’. Met dit thema komt tot uiting dat gezondheid meer is dan lichaam en geest en dat lichaam en geest worden beïnvloed door de context waarin zij zich bevinden. Dit is waar publieke gezondheid over gaat.

Background: The aim of this study is to understand the determinants of adherence to wrap-around care (WAC) by professional care providers working in child and family services. WAC is a care coordination method targeting families with complex needs. The core components of WAC involve activating family members and the social network, integrating the care provider network, and assessing, planning and evaluating the care process. WAC was introduced in the Netherlands using two approaches: the network approach (NA) and the team approach (TA). Methods: A cross-sectional study was conducted using a digital questionnaire targeted at care providers. After imputation of missing data, univariate and multilevel regression analyses were conducted to study the associations between adherence to the core components of WAC, the determinants of adherence and background characteristics. Results: In total 145 out of 275 care providers (52.7%) responded to the questionnaire. Multilevel regression analysis showed that self-efficacy of the care providers and the way WAC is organised (NA versus TA region) were significantly associated with adherence to core components of WAC. Self-efficacy was significantly associated with all WAC core components (activating family members and the social network: β (95% confidence interval, CI) =.27(.04-.50), integrating the network of care providers: β (95% CI) =.27(.05-.50) and assessing, planning and evaluating the care process: β (95% CI) =.30(.08-.52)). The way WAC is organised was significantly associated to two core components (activating family members and the social network: β (95% CI) =.18(0.1-.37) and integrating the network of care providers: β (95% CI) =.25(.09-.42)). Conclusion: The way WAC is organised and the self-efficacy of care providers who use WAC are factors that are relevant for the redesign of the strategy for introducing WAC. Longitudinal research into the predictive value of determinants of adherence to WAC is advised. © 2019 The Author(s).

Objective. As part of the Models of Child Health Appraised (MOCHA) project, this study aimed to answer the following research questions: 1) How do European citizens perceive the quality of primary health care provided for children? And 2) What are their priorities with respect to quality assessment of primary health care aimed at satisfying children’s needs? Methods. Nine potential attributes of quality of primary care were operationalized in 40 quality aspects. An online survey was used to elicit opinions in a representative sample of citizens of Germany, the Netherlands, Poland, Spain, and the United Kingdom. Data collection comprised: background characteristics; perceived quality of primary health care for children; and priority setting of quality aspects. Descriptive analysis was performed and differences between groups were tested using Chi-Square test and ANOVA. Results. Valid results were obtained from 2403 respondents. Mean satisfaction with quality of primary care ranged from 5.5 (Poland) to 7.2 (Spain). On average, between 56% (Poland) and 70% (Netherlands) of respondents had a positive perception of the primary health care system for children in their country. The ability of a child to limit their parents’ access to the child’s medical records was judged most negatively in all countries (average agreement score 28%, range 12–36%). The right of a child to a confidential consultation was judged most differently between countries (average agreement score 61%, range 40–75%). Overall top-10 priorities in ensuring high quality primary care were: timeliness (accessibility); skills/competences, management, facilities (appropriateness); no costs (affordability); information, dignity/respect (continuity); and swift referrals, collaboration (coordination). Discussion. Between countries, significant differences exist in the perceived quality of primary care and priorities with regard to quality assessment. Taking into account the citizens’ perspective in decision-making means that aspects with low perceived quality that are highly prioritizedwarrant further action.

Background The Models of Child Health Appraised (MOCHA) project – www.childhealthservicemodels.eu – is a Horizon 2020 Research Project which aims to describe and appraise various models of primary child health care in Europe – including well child clinics and school and adolescent health services - and make recommendations as to optimal features of provision of child health care. Aims To provide insight in the structure, process and outcomes of systems of primary child health care in EU countries To review the primary child health care systems from the perspective of children, adults (parents) and expert stakeholders. Program Four short presentation (about 40 minutes) Young people: children’s experiences with primary child health care collected through narrative in-depth interviews (Manna Alma). Communication and relationships with health care professionals play a pivotal role for children in terms of what is good about primary care and what they felt needs to be improved. Adults: a survey of public experiences and priorities with regard to primary care for children (Magda Boere-Boonekamp/Janine van Til/Karin Groothuis-Oudshoorn). Between countries, significant differences exist in the citizens’ perceived quality of primary care and priorities. Country experts: data provided by country agents on school and adolescent health services (Danielle Jansen). This presentation will address the challenges experienced by the country experts in answering questions about national policies regarding primary care. Stakeholders: views of policy makers, health care professionals, scientist and end-users (Eline Vlasblom/Paul Kocken/Menno Reijneveld). Improvements to the child primary healthcare system can be made, but perceived barriers are the current healthcare system and service provision in the EU countries. Plenary discussion (about 50 minutes) Statements that exemplify the conditions for good system components of child primary care will be the center of the plenary discussion. The audience will be asked to form an opinion on the following questions: What is your opinion on changing the primary child healthcare system in your country? What has to be changed in order to optimize the primary child healthcare system? What are quick wins? We will conclude with recommendations for future models of primary child health care.

Report on implementation conditions of good practices for MOCHA WP 9.

Theoretical Framework, objectives and research questions School programs have been developed to promote psychosocial health (e.g. emotional and behaviour disorders and pro-social behaviour) of youth and to prevent them from problems, e.g. violence, depression and anxiety that can increase or emerge during adolescence (Steinberg, 2005). Those programs often focus on social and emotional skills or life skills (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011; Sklad, Diekstra, De Ritter, Ben, Gravesteijn, 2012). These SEL skills are also related to success in school, life and work (Ananiadou & Claro, 2009). Future jobs on all levels of the labour market in Europe assume employees to have social and emotional skills, e.g. cooperation, problem solving, decision taking and constructive management of feelings (EU, 2010).Social and emotional skills are supposed to become more important in VET jobs, as a result of the rapidly changing labour market. Continually changing jobs is the reality in working life in the present and future for all professionals. These professionals are expected to be flexible and able to adapt to new and different types of work and costumers all over the world. This puts emphasis on social and emotional skills, e.g. cooperation, communication, and searching for reliable information in an increasingly complex world (Ananiadou & Claro, 2009). Youth have to learn those skills in school and during internships.Social and emotional skills are defined in various ways (Denham, 2015). We used the multivariate construct of the five social and emotional learning (SEL) skills of the CASEL group (Zins and Elias, 2007) 1. Self-awareness: the identification and recognition of emotions and strengths and a sense of self-efficacy and self-confidence; 2. Social-awareness: showing empathy, and respect for others, and be able to take different perspectives; 3. Self-management: being able to control impulse, manage stress, stay motivated and show persistence in goal setting and achieving; 4. Relationship skills, being able to cooperate and communicate with others and to seek and provide help when needed; 5. (Responsible) decision-making: the evaluation, reflection, and taking personal and ethical responsibility for personal behaviour and social interactions. The construct of the SEL skills is often referred to in the last decade as being essential for the development of psychosocial health in youth.Until now limited insight exists in the interrelations between SEL skills and the relationships between SEL skills and psychosocial health. There is also limited knowledge with regard to the mediating role of SEL skills in relation to psychosocial problems (Durlak et al., 2011). Knowledge about the relationships between SEL skills and between SEL skills and psychosocial health is useful for tailoring school programs to those SEL skills that are the most relevant with regard to psychosocial health.The following two research questions were formulated:To what extent are the SEL skills (self-awareness, social awareness, self-management, relationship skills and decision-making) interrelated?To what extent are the SEL skills related to psychosocial health?To what extent do one or more SEL skills mediate the relationship between other SEL skills and psychosocial problems?

Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents’ future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.

Inleiding: Het doel van dit onderzoek is het verbeteren van de praktijk van signalering van gezondheidsproblemen bij 5-6 en 10-11 jarige kinderen in de Jeugdgezondheidszorg (JGZ). Een standaard signaleringslijst is ontwikkeld en getoetst op de bruikbaarheid voor het Preventief Gezondheidsonderzoek (PGO), waarbij wel of geen triage wordt gebruikt. Methode: De standaard signaleringlijst werd op een systematische wijze ontwikkeld op basis van een beoordelingskader en met betrokkenheid van een expertgroep. Vervolgens is de ontwikkelde signaleringslijst op bruikbaarheid getoetst bij ouders en JGZ-medewerkers. De antwoorden van 793 ouders op de signaleringslijsten zijn kwantitatief geanalyseerd. Ook zijn er interviews gehouden met 50 ouders en negen JGZ-medewerkers over de bruikbaarheid van de lijst. Resultaten: Resultaten van het bruikbaarheidsonderzoek tonen aan dat het merendeel van de ouders van de 5-6 en 10-11 jarigen alle vragen invult, respectievelijk 68% en 71%. Ouders van allochtone herkomst vulden de signaleringlijst minder volledig in dan ouders van Nederlandse herkomst. Zowel ouders als JGZ-medewerkers beoordelen de bruikbaarheid van de standaard signaleringslijsten positief. Conclusie: Het onderzoek toont aan dat de standaard signaleringslijst goed bruikbaar is binnen de JGZ-praktijk. Aanbevolen wordt om aandacht te geven aan implementatie van de standaard signaleringslijst in de JGZ en verder onderzoek te doen naar normaalwaarden en validiteit.

Sinds september 2011 wordt in de gemeente Den Haag op twee basisscholen gewerkt met de functie ‘schoolcoach’. Het betreft de uitwerking van het Amerikaanse concept 'family coach'. De gemeente formuleerde het doel van de schoolcoach als ‘een preventieve relatie onderhouden met ouders die bijdraagt aan het tijdig signaleren en wegnemen van belemmeringen die de ‘onderwijsontwikkeling’ van het kind in de weg kunnen staan, in samenwerking met daartoe aangewezen instanties’. De uitvoering van de functie schoolcoach is in handen van Stichting Zebra Welzijn. Op verzoek van de gemeente Den Haag voerde TNO in samenwerking met de Academische Werkplaats Publieke Gezondheid - jeugd Noordelijk Zuid-Holland (AWP-j) een procesevaluatie uit voor de Pilot Schoolcoach. Doel was om de Pilot Schoolcoach te professionaliseren met een theoretisch basis en praktische handvatten te geven voor het inpassen ervan in de huidige ontwikkelingen in het onderwijs en beleid rond zorg voor jeugd. Allereerst is een quick scan uitgevoerd van relevante literatuur naar achterliggende modellen en concepten. De functie schoolcoach sluit aan bij het theoretische kader van het bio-ecologisch model, waarin de opvoeding van kinderen wordt gezien als een gezamenlijke verantwoordelijkheid van thuis, school en bredere gemeenschap. De schoolcoach past in dit model doordat zij de verbinding tussen leerkracht, klas / school, ouders en ouders onderling faciliteert en bevordert. Als tweede sluit de schoolcoach aan bij het concept ouderbetrokkenheid; de mate waarin ouders betrokken zijn bij hun kind, de school en bredere omgeving is van invloed op de schoolprestaties van hun kind. Op de derde plaats blijkt de manier van werken van de schoolcoach gestoeld op een oplossingsgerichte benadering. Ten slotte kenmerkt het werk van de schoolcoach zich door het outreachende karakter en een hoge mate van eigen beheer en controle. Vervolgens zijn de eerste praktijkervaringen met de inzet van schoolcoaches op de twee basisscholen in Den Haag in kaart gebracht. De gegevens zijn verzameld via zeventien semigestructureerde interviews, analyse van de registraties in week- en maandstaten, en overleg met de adviesgroep. De waardering voor de schoolcoach is in het algemeen groot. De schoolcoach blijkt op de pilot scholen in een belangrijke behoefte te voorzien. De meerwaarde is de combinatie van: meer tijd beschikbaar, laagdrempelig aanspreekpunt, los van school maar toch ín de school, er zijn vóór de ouders, preventief/proactief werken, ontlasten van leerkrachten en intern begeleider, het helpen van de ouders bij het vinden en organiseren van hulpverlening voor kleine én grotere problemen. Als aandachtspunten worden gesignaleerd: de overlap van de taken van de schoolcoach met die van bijvoorbeeld de schoolmaatschappelijk werker en de oudercoördinator en met het overig aanbod in de wijk; het aantal ouders dat wordt bereikt; het beperkte aantal huisbezoeken dat wordt gebracht; de verschillende registratiesystemen en de beperkingen van deze systemen; de omgang met privacy van leerlingen en ouders. Aan het einde van het rapport worden dertien aanbevelingen gegeven (paragraaf 4.3). Deze aanbevelingen concentreren zich op: het beter omschrijven van de doelen en taken van de functies schoolcoach, schoolmaatschappelijk werker en oudercoördinator; het overwegen om functies te combineren; het uitwerken van het concept ouderbetrokkenheid; het versterken van het proactieve, outreachende karakter van de functie; en het verbeteren van het registratiesysteem. Bij voortzetting en eventuele uitbreiding van het project schoolcoach kan de meerwaarde worden uitgebouwd wanneer rekening wordt gehouden met deze aanbevelingen.

s Nederlands Congres Volksgezondheid 2012. Op 11 en 12 april jl. vond het Nederlands Congres Volksgezondheid plaats.

Op middelbare scholen werd een experiment uitgevoerd om het aanbod van snacks- en frisdrankautomaten gezonder te maken. Niet alleen het assortiment in de automaten werd veranderd, ook werd geëxperimenteerd met het bieden van productinformatie en verlaging van de prijzen van minder calorierijke producten. Scholieren kregen les over snacks en frisdrank. In dit artikel wordt het proces van verandering in de schoolautomaten beschreven. In welke mate is het gewenste automatenaanbod gerealiseerd en hoe is het gewaardeerd door leerlingen en betrokken partijen?

Minisymposium van het Nederlands Congres Volksgezondheid 2011, Duurzaam Gezond gehouden 6 en 7 april De Meervaart Amsterdam

Objective: : The effectiveness of use of migrant health educators in the general practitioners' care for female migrants with psychosomatic problems was evaluated to contribute to the improvement of the care for these patients. Methods: : A randomised controlled trial (RCT) design was used. A total of 104 patients (75%) agreed to take part in the intervention study. The patients were from Turkish and Moroccan immigrant groups living in The Netherlands. The intervention group received counselling and education from the migrant health educators as adjuncts to the GPs' care. Special attention was given to the patient's cultural background, supporting the communication between GP and patient. The control group received regular treatment from their GPs. Results: : A significant improvement of perceived general health, psychological health and reported ability to cope with pain was observed among the intervention group. No effects were found for social support and the perceived burden of stressful life-events. Conclusion: : The patients' perceived health and coping abilities improved through the intervention as a whole. Not all outcome measures had been affected due to among others the diversity of physical and psychological complaints the patients suffered from, non-compliance and a perceived decrease of disability over time. Practice implications: : The intervention methods should be integrated in the patient care delivery for migrants in general practice. Further development of intervention methods to address the patients' social support is recommended. © 2007 Elsevier Ireland Ltd. All rights reserved.

Een inventarisarend onderzoek naar interventies die in Nederland beschikbaar zijn op het gebied van seksuele gezondheidsbevordering gericht op jongeren en kinderen. De inventarisatie betreft voorlichtingspakketten lesmethoden en internetsites waarin de seksualiteitsbeleving en relaties van jeugdigen centraal staan. De inventarisatie is verricht ten behoeve van het ZonMw-programma "Seksuele gezondheid van de jeugd". Inventraistie geeft inzicht geven in de beschikbaarheid, de bruikbaarheid en het gebruik van bestaande interventies op het gebied van de seksuele gezondheidsbevordering voor jeugdigen. Tevens wordt inzicht gegeven in eventuele hiaten, mogelijkheden voor verbetering van het aanbod, en randvoorwaarden voor implementatie. In het onderzoek is de volgende werkwijze gevolgd. Aan de hand van bestudering van de literatuur is een beschrijving gemaakt van doelstellingen, doelgroepen, thema's, didactische werkvormen, effectiviteit en implementatie van de aangetroffen interventies. Voor aanvullende informatie over de interventies zijn sleutelinformanten geraadpleegd. In focus groepsinterviews en individuele interviews is aan intermediaire gebruikers van de interventies gevraagd naar hun opvattingen over het voorlichtingsaanbod. Concepten van de rapportage zijn voor commentaar voorgelegd aan Nederlandse experts op het gebied van seksuele gezondheidsbevordering.

JGZ

verzekeringsgeneeskunde, arbeidsongeschiktheid, protocollen, medische keuringen, implementatie.

The aim of this dissertation is to enhance understanding of care use by children known to have or be at risk of complex problems (CP). Children with CP have a greater need for health services than the average child because their chronic physical, behavioral or emotional conditions interact and enhance their vulnerability. Worldwide, around 5% of children suffer from complex problems. They typically have high levels of care consumption, especially psychosocial care.In our studies we address factors impacting care use of children with CP, its intensity, and barriers to care. We found several risk factors for identification of these children: child’s age, adverse life events, child’s psychosocial problems, and parenting concerns. We also look at care use of multiproblem families, involving a subgroup of these children with the highest level of CP. Finally, we studied professionals to understand the challenges they meet in organizing care for these children when using Wraparound Care. This care-coordination method is used in the Netherlands as the backbone of treatment for children with CP. Further development of Wraparound Care and greater understanding of the factors impacting care use by children with CP will help to make their pathway to care more efficient and effective.

An increasing number of young people are confronted with sexually transgressive behavior, such as sexting (sending and receiving sexual images or messages against someone's will), sexual remarks and dating violence. Two existing Dutch teaching programs on sex and relationships, and in particular on the occurrence of sexually transgressive behavior of young people, were evaluated for this PhD research: Benzies & Batchies and Jongens. Based on the positive results found, the thesis concludes that such curriculum can be used to prevent young people's unacceptable behavior; the programs must take account of differences between the sexes and the level of development of the pupils. This dissertation offers support to professionals who develop preventive interventions, and to professionals who work with young people in schools, such as teachers and school staff.