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Introduction: Sustainable employability is an important topic in all workplaces, including sheltered workplaces. Individual Development Plans (IDPs) have been introduced to increase the sustainable employability of sheltered workers. To date, how IDPs contribute to sustainable employability in this population of sheltered workers is ill understood. This is the first study to explore how IDPs contribute to sustainable employability practices in sheltered workplaces, from the perspective of sheltered workers. Methods: Eleven semi-structured interviews were conducted with sheltered workers about concepts relevant to IDP literature, sustainable employability, the Capability Approach (CA) and the Self-determination theory (SDT). Data were analyzed using thematic content analyses. Results: Findings show that many IDPs mainly focus on the productivity of the sheltered worker, while sheltered workers prefer to discuss aspects of valuable work, health and long-term perspective as well, to achieve sustainable employability. Discussion: A strength of this study is that it uses an interdisciplinairy approach by discussing the findings using the SDT and CA. Conclusion: The increased neoliberal values of the Dutch welfare state may negatively influence the contribution of IDPs to the sustainable employability practices of sheltered workplaces.

Introduction: Climate change is a societal problem, influenced by travel behaviors such as air travel and car use. Travel emissions can be reduced by changing consumer behavior. Social and personal norms influence behavior and may reduce travel behavior. Their influence on air travel and car use, and a possible mediation effect, are under-researched. This study aims to fill the gap and provide policy leads by examining the relationship between social norms and travel behavior, focusing on air travel and car use, and the mediation of personal norms. The Reasoned Action Approach (RAA), Value-Beliefs-Norms Theory (VBN), and a theory explaining internalization were used as a theoretical framework. Method: This quantitative, cross-sectional study used an online survey amongst a Dutch sample (n = 1039). Covariates included age, sex, education, and income. Simple linear regressions and mediation analyses using Hayes PROCESS Macro model 4 were conducted. Results: Results showed social norms were significantly positively related to air travel and car use. A partial mediation effect of personal norms for both behaviors was found. Discussion: The results showed (1) a positive relationship between car use and air travel in one’s social surroundings and one’s use and (2) this effect was partly mediated by how important one deems a reduction of car use and air travel in general. The findings of this research are in line with the hypotheses, previous findings in the literature, the RAA, the VBN, and the theory regarding internalization. It shows social norms can be targeted to achieve a travel reduction to reduce climate change impact. Based on these findings, future research should examine various norms, travel behaviors, and the mediation relationship in more detail, to improve knowledge as a base for interventions, to combat climate change. Keywords: social norms; personal norms; travel behavior; Reasoned Action Approach; Value-Belief-Norms theory

Background: The first 1000 days of a child’s life are crucial for healthy development and lifelong wellbeing. However, equal access to healthcare during this period remains a challenge, even in Western countries. Home-visiting programs are frequently implemented to support vulnerable individuals during this critical period, yet there is insufficient attention to the accessibility of these interventions. Objective: This rapid review synthesized existing knowledge, providing an overview of evidence regarding the accessibility of home-visiting interventions during the first 1000 days for individuals facing socioeconomic disparities. Methods: A rapid review was conducted, searching the PubMed and Scopus databases. Eligibility criteria were based on the PICOST Framework, including Western children and their parents in the first 1000 days of life (population), home-visiting interventions (intervention), studies with a control group (comparator), outcomes related to accessibility and effectiveness (outcomes), randomized and non-randomized controlled trials (study design), and English, peer-reviewed studies published between 2014 and 2024. Data were analyzed and coded using three theoretical lenses: accessibility framework, socioecological levels, and intersectionality, utilizing a data-extraction sheet and Atlas-TI. Results: 44 studies were included. Findings indicated that home-visiting interventions primarily address supply-side factors and challenges at the interpersonal and intrapersonal levels. However, there is a notable lack of attention to intersectionality and to institutional and structural challenges that influence the accessibility of healthcare during the first 1000 days. Discussion and conclusion: Home-visiting programs predominantly address challenges related to personal development and social interactions, focusing on supply-side factors of the intervention. Consequently, there is less focus on institutional and structural challenges, which often serve as n

Background Social connections serve as a protective factor for adolescent mental health. An increase in the use of online technology among adolescents has influenced their social connectedness and mental health in various ways. However, it remains unclear how the dynamic between adolescents' use of social media, their sense of connectedness, identity development, and mental health works. This study will provide a comprehensive understanding of current literature and identify key themes and gaps on this dynamic by answering the following question: How does social media use influence the mental health impact of social connectedness among adolescents, both positively and negatively? Methods This study employs a scoping review to synthesize current literature on how social media use influences the mental health impact of social connectedness among Western adolescents (ages 11-19). The review used Scopus, PubMed, and PsycInfo databases and applied the PICOST system to ensure eligibility criteria. 32 articles were analyzed; the selection process involved screening titles and abstracts, full-text analysis and quality assessment. Results Three main themes are identified in relation to social media use and mental health: social identity and expression, social connectedness and relations, Covid-19. Social media can both positively and negatively affect adolescent social connectedness and mental health, depending on the nature and extent of its use. Social media plays a crucial role in identity development, especially for marginalized groups, but also introduces risks such as stress and cyberbullying. The pandemic underscored the importance of social media in maintaining social connections during isolation. Conclusion Results highlight the complex relationship between social media use, social connectedness, and mental health among adolescents, revealing both positive and negative effects influenced by various factors. Key gaps include inconsistent definitions of social media u

Introduction. As health issues in society become more complex and change over time, the social domain is encountering challenges. This had led to higher expectations for municipalities and their residents to take ownership and accountability within the current healthcare system. Strengthening facilities and neighbourhoods is important to ensure no one is left behind. In this study, community centers are examined from the perspective of residents from rural and urban areas in the municipality of Zaltbommel, with the purpose of examining in what ways community centers can contribute to a person’s wellbeing, as these centers can strengthen and empower individuals and communities. Methods. Semi-structured individual face-to-face interviews (n = 15) in different community centers (n = 5) were conducted. Interviews were transcribed and coded using an inductive and deductive approach, followed by a thematic analysis. Results. Analysing through the healthy settings and the salutogenic theory as theoretical lens, the findings illustrate that community centers have the potential to positively impact individuals' personal wellbeing in three interrelated ways: 1) the friendly environment of the centers makes visitors feel comfortable and enjoy doing activities at these locations, 2) intrinsic personal needs are satisfied by visiting community centers, with urban centers playing an important role in personal learning experiences, 3) community centers contribute to social needs, such as promoting or strengthening social connections, with differences observed in rural and urban centers. Discussion. In summary, this research provides comprehension into community center participation and urban-rural differences. One of the limitations includes not achieving data saturation in the urban area. It is recommended to explore the needs of urban areas more extensively as their needs are diverse, and actively engage with residents for insights. This information can help policymakers make in

Item does not contain fulltext, Despite the potential health benefits of workplace health promotion for employees in sheltered workplaces, participation is often limited. The aim of this study was (i) to understand this limited participation, and (ii) to find opportunities for adapting workplace health promotion, such that it better meets the needs of the target population. A responsive process evaluation of an extensive multi-component workplace health promotion program targeting lifestyle behaviors, financial behaviors, literacy and citizenship, was performed in a large, sheltered workplace in the Netherlands (>3500 employees). To understand the limited participation, interviews with employees (n = 8), supervisors (n = 7) and managers (n = 2), and 10 participant observations were performed. To find opportunities for improving workplace health promotion in the sheltered workplace, 7 dialogs with employees were performed (n = 30). The interview data on the barriers for participation were evaluated through the lens of care ethics, as this allowed to understand the role of various stakeholders in the limited participation, as well as the indirect role of the institutional context. Findings showed that participation in workplace health promotion could increase if it is organized in a way that it encourages employees to work on health together, allow to tailor activities to different needs and capabilities of employees, and connects activities to employees' daily lives. A strength of this study is that the responsive process evaluation focused both on barriers for participation, as well as on opportunities to increase participation

Background: Technology, such as computers, laptops and tablets, negatively affects work-life balance due to work and non-work conflicts an individual experiences. This directly affects an individual’s well-being and quality of life, as they experience conflicts between roles within work and non-work domains and challenges in setting boundaries. This study aims to investigate whether the frequency of technology use of computers, laptops and tablets in work is associated with work-life balance. This study explores work-life balance and technology use further by using the Ideal Worker Norm, Role Conflict Theory and Boundary Theory and investigates whether there are differences in the association between workers of different ages, occupations and educational backgrounds. Methods: A quantitative analysis of secondary cross-sectional data was conducted. The data came from the OECD 2020 Risks that Matter Survey and was collected from over 25.000 respondents across 25 countries. The study focused on working Dutch respondents (N=951) and was analyzed using Pearson’s Partial Correlation and Hierarchical Regression Analyses via IBM SPSS Statistics v28. Results: The results were threefold. First, they revealed a positive association between work-life balance and frequency of technology use r(949)=.090,p<.05. Second, they revealed a positive correlation for moderator age for workers under the age of 45 and work-life balance (b=.319,p<.001). Third, the results showed no statistically significant correlation for moderator's occupation (b=.218,p=.520) and education (b= -.008,p=.945). Conclusion: This study confirms that work-life balance is associated with frequency of technology use of computers, laptops and tablets and that this is moderated by age. Future research is recommended to deepen the understanding of this relationship and assert causality.

Stigma has been identified as a significant barrier to the success of mental health promotions and programs. Therefore, understanding stigma towards individuals with mental illness is crucial for promoting inclusion and advancing the mental health systems. However, there is limited research focused on factors that contribute to stigma reduction. The Moldovan government in collaboration with the Swiss Agency for Development and Cooperation have been implementing a mental health reform (MENSANA) in Moldova, aimed to establish a community based mental health system. This study is aimed to examine the differences in stigma levels using the Community Attitudes towards the Mentally Ill (CAMI) scale across various socio-demographic characteristics. Additionally, the study explored the association of piloting districts with the mental health reform and the overall score of CAMI. In a cross-sectional study, the sample comprised 2973 adults. One-way ANOVA and T-test were used to assess the difference in CAMI scores across socio-demographic variables. Moderation analysis was conducted using PROCESS version 3.5. Results from the analysis of variances indicated slightly higher stigma levels among individuals with lower educational attainment (F=10.813, df1=3, df2=2969, p-value=<0.001). The independent t-test revealed that stigma levels were slightly higher among males who lacked social contact with individuals with mental illness (t=-4.257, df=2971, p<0.001; t=-5.322, df=2971, p<0.001). Although social contact was not found to be a moderator of piloting districts with mental health, a significant main effect was found, demonstrating that stigma was lower among those who have prior social contact experiences with individuals with mental illness (B=0.0855, SE=0.0167, t=5.1149, p<0.001). This study demonstrated that prior contact experiences with the mentally ill is a significant predictor of stigma level. To that end, follow-up research is needed to concretize the results into a s

There are persistent socioeconomic health inequalities in the Netherlands, with lower socioeconomic position (SEP) individuals living up to 25 years shorter in good health, compared to higher SEP individuals. Workplace health promotion interventions in the sheltered workplace are considered promising for addressing these health inequalities, particularly for low SEP individuals and those with disabilities. But differences in conceptualizations of health (and health promotion) between intervention developers/policymakers and those who are targeted, together with the lack of acknowledging diversity within the lower SEP group can possibly be the cause of the ineffectiveness of these interventions. This study takes an intersectional perspective to consider how SEP and able-bodiedness interact and thereby shape one’s conceptualization of health and health promotion by following the guidelines for secondary intersectional analysis as proposed by Muntinga et al (2020). For this analysis, transcripts of individual interviews and group dialogues with employees of a sheltered workplace were used. The findings of this study highlight the influence of capital (e.g. economic resources, knowledge, and social networks), responsibility, and the role of environmental contexts in shaping conceptualizations of health and health promotion among employees at the sheltered workplace. These conceptualizations have been shaped by internalized neoliberal thoughts focusing on self-reliance, accountability, and responsibility. By recognizing the complexities following intersections on these conceptualizations, policymakers can develop approaches for worksite health promotion that are more suitable for the specific needs and opportunities of this group regarding health. In the future, interventions aiming to tackle health inequalities should be accompanied by policies that aim to tackle the structural barriers for those working at a sheltered workplace.

Background: Since information technologies have been spreading in working environments, they have provided opportunities for the bettering of productivity, transparency and communication speeds. Techno-optimistic literature has explored the opportunities that this digitalization can provide. But when discussing digitalization, the human side of human-technology interaction that is intensified by digitalization should not be forgotten. This is where there is a knowledge gap that this thesis aims to fill. This study looks into these possible risks and side-effects of digitalization, of which technostress is an important part. Digital literacy is cemented as a way to cope with these side-effects. Further variables taken from literature are involved, such as age and education. Research questions: There are four research questions that help further the understanding of possible risks and side effects of digitalization. The first research question asks if there is a direct relationship between digitalization and technostress. After this the possible moderating roles of age, education and digital literacy are tested. Methods: A quantitative analysis of secondary data was executed. The dataset used is the ‘Risks that matter survey’ from the OECD. The data is analyzed using IBM SPSS 28 and the PROCESS macro. Results: It was found that individuals experience slightly but significantly less technostress in more digitalized working environments than in less digitalized working environments. Age and education moderated this relationship negatively. Digital literacy did not have a significantly moderating role. Conclusions: Although a negative relationship between digitalization and technostress was found, individuals would experience even less technostress if they have a low age or high education when encountering highly digitalized working environments. This thesis is limited by the cross-sectional nature of the dataset, and further research will substantiate the findings.

Contains fulltext : 247589.pdf (Publisher’s version ) (Open Access), Background: The aim of this study was to evaluate the perceived changes of an innovative workplace health promotion intervention and evaluation. In this study, a bottom-up approach was taken to define the central themes and relevant outcomes of an intervention. These central themes and relevant outcomes of the intervention were defined together with stakeholders, including employees with a low socioeconomic position. Methods: The intervention consisted of a series of structured stakeholder dialogues in which dilemmas around the - by employees defined - health themes were discussed. The intervention was implemented in a harbor service provider with approximately 400 employees. Over a two-year period, 57 participants engaged in eight dialogues of one hour. 15 interviews and six participant observations took place for the evaluation of the intervention. Results: Together with the stakeholders, high workload and mental health were defined as central themes for the dialogue intervention in the male-dominated workplace. The dialogue intervention contributed to changes, on different levels: individual, team, and organization. Overall, the stakeholder dialogues advanced the understanding of factors contributing to high workload and mental health. In reply to this, several actions were taken on a organizational level. Conclusions: Taking a bottom-up approach in WHP allows to understand the health issues that are important in the daily reality of employees with a low socioeconomic position. Through this understanding, workplace health promotion can become more suitable and relevant for employees with a low socioeconomic position. Trial registration: Netherlands Trial Register (NRT): NL8051. Registration date: 28/09/2019, Retrospectively registered https://www.trialregister.nl

Contains fulltext : 247594.pdf (Publisher’s version ) (Open Access)

Item does not contain fulltext, Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees' - and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.

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Contains fulltext : 232800.pdf (Publisher’s version ) (Open Access), The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (ß0.03 (95%CI: -0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.

Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Findings Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. Interpretation Post-exposure prophyl

Background: Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. Methods: The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Findings: Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174 782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. Interpretation: Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes with minimal additional efforts once contact tracing has been established; and is generally well accepted by index patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through the availability of a prophylactic intervention; therefore, we recommend rolling out SDR in all settings where contac

Contains fulltext : 222428.pdf (publisher's version ) (Open Access), Background: Large health inequalities exist in the Netherlands among individuals with a high compared to a low socioeconomic position. Worksite health promotion interventions are considered promising to reduce these inequalities, however, current interventions seem not to have the desired effects. This study proposes 'moral case deliberation', a form of stakeholder dialogue on moral dilemmas, as an integrated and inclusive intervention for worksite health promotion. This intervention takes into account three factors that are considered possible underlying causes of low effectiveness of current interventions, namely the lack of deliberate attention to: 1) the diverging values and interests of stakeholders in worksite health promotion, 2) the ethical issues of worksite health promotion, and 3) the connection with the lived experience (lifeworld) of lower SEP employees. Moral case deliberation will help to gain insight in the conflicting values in worksite health promotion, which contributes to the development of a vision for worksite health promotion that is supported by all parties. Methods: The intervention will be evaluated through Responsive Evaluation, a form of participatory research. Key to Responsive Evaluation is that stakeholders are consulted to determine relevant changes as a result of the intervention. The intervention will be evaluated yearly at both fixed moments (baseline and annual evaluation(s)) and continuously. Mixed methods will be used, including interviews, participatory observations, analyses of HRM-data and short questionnaires. In addition, the intervention will be evaluated economically, on both monetary and non-monetary outcomes. Discussion: This protocol proposes an innovative intervention and a novel participatory evaluation in the context of worksite health promotion. The study aims to gain understanding in how dialogue on moral dilemmas on health and health promotion can contribute to heightened personal and mutual understanding among s

_Objective:_ Leprosy post-exposure prophylaxis with single-dose rifampicin (SDRPEP) has proven effective and feasible, and is recommended by WHO since 2018. This SDR-PEP toolkit was developed through the experience of the leprosy postexposure prophylaxis (LPEP) programme. It has been designed to facilitate and standardise the implementation of contact tracing and SDR-PEP administration in regions and countries that start the intervention. _Results:_ Four tools were developed, incorporating the current evidence for SDRPEP and the methods and learnings from the LPEP project in eight countries. (1) the

BACKGROUND: The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patient- reported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts. METHODS: Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria. RESULTS: The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment ( P < .05).There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres ( P < .05), as well as smaller brain volumes ( P < .01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker. CONCLUSION: Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer self-reported health status. This may be due to the statistical advantage of using a multivariate approach.

Increasing incubation temperatures may threaten the viability of sea turtle populations. We explored opportunities for decreasing incubation temperatures at a Caribbean rookery with extreme female-biased hatchling production. To investigate the effect of artificial shading, temperatures were measured under simple materials (white sheet, white sand, palm leaves). To test natural drivers of incubation temperature, temperatures were measured at average nest depths with shading on two beaches. Results from a pilot experiment suggest the most effective material was palm leaves. Shading decreased temperatures by a mean of 0.60 °C (SE = 0.10 °C, N = 20). Variation between beaches averaged 1.88 °C (SE = 0.13 °C, N = 20). We used long-term rookery data combined with experimental data to estimate the effect on sex ratio: relocation and shading could shift ratios from current ranges (97–100% female) to 60–90% female. A conservation mitigation matrix summarises our evidence that artificial shading and nest relocation are effective, low-cost, low-technology conservation strategies to mitigate impacts of climate warming for sea turtles.