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INTRODUCTION Randomized controlled trials have demonstrated the effectiveness of workplace smoking cessation programs. However, with low participation rates reported, it is important to understand the barriers and facilitators for the reach and participation of employees in workplace smoking cessation programs. The objective of the present study is to uncover the needs of employees regarding reach and participation when implementing a workplace program to address smoking cessation. METHODS We carried out 19 semi-structured qualitative interviews in 2019 based on the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) Framework with current and former smoking employees of organizations with ≥100 employees in the Netherlands. Some of the interviewees had experience with a cessation program. Data were analyzed using the Framework method. RESULTS The main barriers according to employees were insufficient promotion of the cessation program, completing the program in the employee’s own time and working night shifts and peak hours. Facilitators included being actively approached to participate by a colleague, positive reactions from colleagues about employee’s participation in the program, providing the program on location and integrating the program as part of the organization’s vitality policy. CONCLUSIONS Effective workplace programs for smoking cessation can stimulate cessation but implementers often experience low participation rates. Our study presents recommendations to improve the recruitment and participation of employees in a workplace smoking cessation program, such as using active communication strategies, training managers to stimulate smoking employees to participate and making the program as accessible as possible by reimbursing time spent and offering the program at the workplace or nearby. Integrating the smoking cessation program into wider company vitality policy will also aid

Introduction: Little is known about smoking cessation among gender minority populations compared to cisgender individuals (whose gender matches their sex assigned at birth). We examined differences between smokers from gender minority populations, cis-women, and cis-men in the heaviness of smoking, quit intentions, use of cessation assistance, quit attempts (ever tried and number), and triggers for thinking about quitting. Aims and Methods: We used cross-sectional data from the 2020 International Tobacco Control Netherlands Survey. Among smoking respondents, we distinguished (1) cis-women (female sex, identified as women, and having feminine gender roles; n = 670), (2) cis-men (male sex, identified as men, and having masculine gender roles; n = 897), and (3) gender minorities (individuals who were intersex, who identified as nonbinary, genderqueer, had a sex/gender identity not listed, whose gender roles were not feminine or masculine, or whose gender identity and/or roles were not congruent with sex assigned at birth; n = 220). Results: Although gender minorities did not differ from cis-women and cis-men in the heaviness of smoking, plans to quit smoking, and quit attempts, they were significantly more likely to use cessation assistance (20% in the past 6 months) than cis-women (12%) and cis-men (9%). Gender minorities were also significantly more likely to report several triggers for thinking about quitting smoking, for example, quit advice from a doctor, an anti-smoking message/campaign, and the availability of a telephone helpline. Conclusion: Despite equal levels of quit attempts and heaviness of smoking, gender minority smokers make more use of smoking assistance, and respond stronger to triggers for thinking about quitting smoking. Implications: Smoking cessation counselors should be sensitive to the stressors that individuals from any minority population face, such as stigmatizat

The COVID-19 vaccination rate is not evenly distributed across the Netherlands. In some neighborhoods, the vaccination rate is relatively low, causing individual health risks and a burden to the health care system. An explanation is the use of a national, general information campaign, while using a similar approach (equality approach) does not always lead to similar results. Therefore, we advocate the use of an equity approach instead, as defined by the WHO, which aims at achieving equal results by taking the specific needs of certain vulnerable groups into account. As an example, we describe an intervention that took place in Rotterdam, in which medical doctors, among which GPs, took the initiative to offer information about vaccinations and vaccination on the popular weekly markets of Rotterdam. Using interviews with medical volunteers who contributed to these market vaccinations, we outline the preconditions for successfully implementing such an outreach-based approach, and we make a number of practical recommendations.

Sex and gender are determinants of health outcomes across an individual’s life course. However, often in health research and practice, sex and gender considerations are either overlooked or confounded. Recent developments in health research and practice ask for the inclusion of sex and gender considerations within health research and practice. This article is a reaction to these calls. It explores the ways in which an international team of health researchers created a comic book that highlighted the impact of gender in many areas of health across an individual’s life course. The creative processes are critically explored, as well as selected images. Through this work, it is proposed that comic art knowledge mobilization projects can be viewed as means to transform health research and practice by critiquing and disrupting dominant cis-heteronormative sex and gender discourses. This article is Open Access under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International licence (CC BY-NC-ND), which allows users to copy, distribute and transmit the article as long as the author is attributed, the article is not used for commercial purposes, and the work is not modified or adapted in any way. To view a copy of the licence, visit https://crea-tivecommons.org/licenses/by-nc-nd/4.0/.

Het doel van dit promotieonderzoek was het monitoren van de zorg voor mensen met psychische problemen in Nederlandse huisartsenpraktijken in de periode 2011-2015. In 2014 werd in Nederland de geestelijke gezondheidszorg (GGZ) hervormd. Huisartsen mogen alleen nog patiënten verwijzen met een (vermoedelijke) psychiatrische stoornis of een hoog risico op bijvoorbeeld ernstige zelfverwaarlozing of suïcide. Alle andere patiënten met psychische problemen moeten binnen de huisartsenpraktijk behandeld worden. Huisartsenzorg is namelijk laagdrempelig en goedkoper dan gespecialiseerde zorg. Om de toenemende vraag het hoofd te kunnen bieden werken bijna alle huisartsen inmiddels samen met een praktijkondersteuner GGZ (POH-GGZ). De POH-GGZ zoekt samen met patiënten uit wat er aan de hand is, en helpt hen tijdens een aantal gesprekken weer op weg. Zo kunnen steeds meer patiënten met psychische problemen binnen de huisartsenpraktijk behandeld worden. De POH-GGZ neemt tot nu toe geen taken over van de huisarts, maar biedt vooral aanvullende zorg aan mensen die voorheen waarschijnlijk geen hulp zouden hebben ontvangen of die direct verwezen zouden zijn. Huisartsen zijn de laatste jaren niet minder antidepressiva gaan voorschrijven aan patiënten met angst of depressie, ondanks dat zij sinds de komst van de POH-GGZ meer behandelopties hebben. Zowel huisartsen als POH’s-GGZ zien steeds meer mensen met psychische problematiek. Naar verwachting neemt dit de komende jaren verder toe. Het is daarom belangrijk om de zorg voor mensen met psychische problemen in de huisartsenpraktijk te blijven monitoren., The aim of this thesis was to monitor mental health care in Dutch general practices in recent years. In 2014, a reform of the Dutch mental health care system was introduced. Since this reform, general practitioners (GPs) are expected to only refer patients with a (suspected) psychiatric disorder or at high risk for (self) harm. All other patients with mental health problems should be treated within general practice. Treatment in general practice is highly accessible for patients, and less expensive than specialized care. To be able to treat more patients with mental health problems, the majority of the GPs now collaborate with a mental health nurse. The main tasks of mental health nurses are to clarify the problems of patients, and to support them during a small number of consultations. Since the introduction of mental health nurses, increasing numbers of patients with mental health problems receive treatment within general practice. So far, no task shifting from GPs to mental health nurses has been observed. Mental health nurses provide additional care to patients who previously probably would not have received any treatment or who would have been referred immediately. GPs’ antidepressants prescriptions did not decrease in recent years, despite the fact that mental health nurse support can be an alternative to medication for some patients. The care for patients with mental health problems seems to place a large burden on general practitioners and mental health nurses. Therefore, mental health care in general practice should be continuously monitored.