31 results on '"E. Vlasblom"'
Search Results
2. De richtlijn lengtegroei voor de jeugdgezondheidszorg
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namens de leden van de werkgroep, T. de Jong, K. Bisschoff, M. Beltman, M. Gianotten, J.M. Wit, E. A. Lindhout-Hoogendoorn, J.A. de Wilde, T. Steenbergen, J. van de Laar, Wilma Oostdijk, Anita C. S. Hokken-Koelega, P. van Dommelen, M. Oostdijk-van den Berg, R. van Zoonen, E. Vlasblom, I. van Zon, and F K Grote
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Maternal and child health ,business.industry ,Medicine ,business ,Humanities - Abstract
Inleiding: Het doel van dit onderzoek was het ontwikkelen van een richtlijn voor Jeugdgezondheidszorg (JGZ)-professionals om aandoeningen die samenhangen met een kleine lengte (en/of trage groei) of een grote lengte (en/of snelle groei) vroegtijdig op te sporen. Methode: Op basis van literatuur en advies van een expertcommissie werd de vorige JGZ-richtlijn Signalering van en verwijscriteria bij kleine lichaamslengte voor kinderen van 0 tot 10 jaar geactualiseerd en uitgebreid naar adolescenten (10 tot 18 jaar). Verder werden verwijscriteria voor grote lengte toegevoegd. De specificiteit van nieuwe verwijscriteria werd berekend in een cohort van gezonde Nederlandse kinderen van 0 tot 10 jaar (n = 970). Daarnaast werd de invloed van een late puberteit op de standaarddeviatiescore (SDS) voor lengte op basis van de Nederlandse groeidiagrammen onderzocht. Resultaten: Groeiparameters van de richtlijn zijn: (1) lengte, (2) de afstand tussen lengte en de streeflengte (target height) en (3) een groeiafbuiging of -toename in SDS. Andere parameters zijn aanwijzingen uit de anamnese en het lichamelijk onderzoek, bijvoorbeeld gedragsproblemen, vroege of vertraagde puberteit, lichaamsdisproportie en dysmorfe kenmerken. Conclusie: JGZ-professionals hebben nu een geactualiseerde richtlijn voor het verwijzen van kinderen met een kleine of grote lengte naar specialistische zorg. Verder onderzoek naar de diagnostische opbrengst na verwijzing en de specificiteit in de dagelijkse praktijk is wenselijk.
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- 2021
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3. Verband tussen slaap en BMI : Een longitudinaal onderzoek bij kinderen van 6–36 maanden
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Wilma Jansen, E. Vlasblom, M. Beltman, Hein Raat, A. van Grieken, Monique P. L'Hoir, Lu Wang, and Magdalena M. Boere-Boonekamp
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Gynecology ,Global Nutrition ,medicine.medical_specialty ,Wereldvoeding ,Maternal and child health ,business.industry ,medicine ,Life Science ,business - Abstract
Inleiding: Er zijn relatief weinig longitudinale onderzoeken gedaan naar de relatie tussen slaap en body mass index (BMI) bij jonge kinderen. We hebben bij kinderen (6–36 maanden) onderzocht wat de verbanden zijn tussen slaapduur en slaapproblemen enerzijds, en BMI z‑scores anderzijds. Methode: Er is gebruikgemaakt van data van het BeeBOFT-onderzoek (n = 2.308). Slaapduur en slaapproblemen zijn door ouders gerapporteerd. BMI is gemeten volgens het standaard meetprotocol door een jeugdgezondheidszorgmedewerker bij de contactmomenten van 6, 14 en 36 maanden. Lineaire mixed-modellen en lineaire regressiemodellen werden gebruikt voor de analyse van de cross-sectionele en longitudinale verbanden. Resultaten: De cross-sectionele analyses lieten zien dat een kortere slaapduur samenhing met een hogere BMI z‑score op de leeftijd van 14 maanden (β = −0,034; p < 0,05) en 36 maanden (β = −0,045; p < 0,05). Uit de longitudinale analyses bleek dat slaapduur op 6 of 14 maanden niet samenhing met de BMI z‑score op 36 maanden. Andersom was er wel een samenhang tussen een hogere BMI z‑score op 6 maanden en een kortere slaapduur op 14 maanden (β = −0,129; p < 0,001). Conclusie: Dit onderzoek laat cross-sectionele verbanden zien tussen een kortere slaapduur en een hogere BMI z‑score op 14 en 36 maanden. Uit longitudinale analyses blijkt dat een hogere BMI z‑score voorafgaat aan een kortere slaapduur en niet andersom.
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- 2020
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4. Factors associated with early introduction of complementary feeding and consumption of non-recommended foods among Dutch infants: the BeeBOFT study
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M. Beltman, Lu Wang, Magda M. Boere-Boonekamp, Monique P. L'Hoir, Laura A. van der Velde, E. Vlasblom, Amy van Grieken, Hein Raat, Health Technology & Services Research, and Public Health
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Male ,Parents ,Dietary Sugars ,Breastfeeding ,Logistic regression ,Eating ,0302 clinical medicine ,Pregnancy ,030212 general & internal medicine ,Infant Nutritional Physiological Phenomena ,Netherlands ,lcsh:Public aspects of medicine ,Breast Feeding ,Educational Status ,Female ,Infant Food ,medicine.symptom ,Nutritive Value ,Psychosocial ,Maternal Age ,Research Article ,Adult ,medicine.medical_specialty ,Introduction of complementary feeding ,Mothers ,030209 endocrinology & metabolism ,Affect (psychology) ,03 medical and health sciences ,Environmental health ,Intervention (counseling) ,medicine ,Humans ,Retrospective Studies ,Consumption (economics) ,Global Nutrition ,Wereldvoeding ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Infant ,Sweet beverage ,lcsh:RA1-1270 ,Child Day Care Centers ,Feeding Behavior ,Snack foods ,Diet ,Cross-Sectional Studies ,Risk factors ,Snacks ,business ,Weight gain - Abstract
Background Timing and types of complementary feeding in infancy affect nutritional status and health later in life. The present study aimed to investigate the factors associated with early introduction of complementary feeding (i.e., before age 4 months), and factors associated with infants consumption of non-recommended foods, including sweet beverages and snack foods. Methods This study used cross-sectional data from the BeeBOFT study (n = 2157). Data on complementary feeding practices and potential determinants were obtained by questionnaire at infant’s age of 6 months. Logistic regression models were used to investigate factors associated with early introduction of complementary feeding and infants’ consumption of non-recommended foods. Results 21.4% of infants had received complementary feeding before 4 months of age. At the age of 6 months, 20.2% of all infants were consuming sweet beverages daily and 16.5% were consuming snack foods daily. Younger maternal age, lower maternal educational level, absence or shorter duration of breastfeeding, parental conviction that “my child always wants to eat when he/she sees someone eating” and not attending day-care were independently associated with both early introduction of complementary feeding and the consumption of non-recommended foods. Higher maternal pre-pregnancy BMI and infant postnatal weight gain were associated only with early introduction of complementary feeding. Conclusions We identified several demographical, biological, behavioral, psychosocial, and social factors associated with inappropriate complementary feeding practices. These findings are relevant for designing intervention programs aimed at educating parents. Trial registration The trail is registered at Netherlands Trial Register, trail registration number: NTR1831. Retrospectively registered on May 29, 2009. Electronic supplementary material The online version of this article (10.1186/s12889-019-6722-4) contains supplementary material, which is available to authorized users.
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- 2019
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5. Tailored communication methods as key to implementation of evidence-based solutions in primary child health care
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Michael Rigby, Denise Alexander, Paul Kocken, E. Vlasblom, Mitch Blair, Peter Schröder-Bäck, Kinga Zdunek, European Commission Directorate-General for Research and Innovation, RS: FHML Studio Europa Maastricht, RS: CAPHRI - R2 - Creating Value-Based Health Care, International Health, and Behavioural Change
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Evidence-based practice ,Process (engineering) ,media_common.quotation_subject ,Child Health Services ,MEDLINE ,Information Dissemination ,Target audience ,1117 Public Health and Health Services ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Child and Adolescent Health ,Humans ,AcademicSubjects/MED00860 ,AcademicSubjects/SOC01210 ,Family ,Quality (business) ,030212 general & internal medicine ,Child ,Dissemination ,media_common ,Public, Environmental & Occupational Health ,Science & Technology ,business.industry ,Communication ,030503 health policy & services ,Child Health ,Public Health, Environmental and Occupational Health ,Stakeholder ,Public relations ,Attitude ,Business ,Public Health ,0305 other medical science ,AcademicSubjects/SOC02610 ,RA ,Life Sciences & Biomedicine - Abstract
Background Evidence-based policies should underpin successful implementation of innovations within child health care. The EU-funded Models of Child Health Appraised project enabled research into effective methods to communicate research evidence. The objective of this study was to identify and categorize methods to communicate evidence-based research recommendations and means to tailor this to stakeholder audiences. Methods We conducted an online survey among national stakeholders in child health. Analysis of the most effective strategies to communicate research evidence and reach the target audience was carried out in order to ensure implementation of optimal child health care models at a national level. Results Representatives of stakeholders from 21 of the then 30 EU MS and EEA countries responded to the questionnaire. Three main approaches in defining the strategies for effective communication of research recommendations were observed, namely: dissemination of information, involvement of stakeholders and active attitude towards change expressed in actions. The target audience for communicating recommendations was divided into two layers: proximal, which includes those who are remaining in close contact with the child, and distal, which contains those who are institutionally responsible for high quality of child health services. They should be recipients of evidence-based results communicated by different formats, such as scientific, administrative, popular and personal. Conclusions Influential stakeholders impact the process of effective research dissemination and guide necessary actions to strengthen the process of effective communication of recommendations. Communication of evidence-based results should be targeted to each audience’s profile, both professional and non-professionals, by adjusting appropriate communication formats.
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- 2020
6. Het oogonderzoek in de jeugdgezondheidszorg op de leeftijd van 3 jaar: ruimte voor verbetering
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V. Iyer, S. van der Harst, E. Vlasblom, H. M. van Minderhout, and A. van Samkar
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Maternal and child health ,media_common.quotation_subject ,Art ,Humanities ,media_common - Abstract
Achtergrond Nederlandse kinderen krijgen op de leeftijd van 36 maanden op het consultatiebureau een visustest aangeboden met behulp van de Amsterdamse Plaatjes Kaart (APK). Bij een afwijkende APK-uitslag is het mogelijk om een Vroegtijdige Opsporing van Visuele Stoornissen (VOV) onderzoek aan te bieden. Na verwijzing wordt in het ziekenhuis een uitgebreid oogonderzoek gedaan. Een alternatief voor de VOV zou de Bruckner Test Variant (BTV) kunnen zijn. In dit onderzoek wordt nagegaan hoeveel kinderen onterecht verwezen worden naar aanleiding van de APK-testuitslag, of de VOV- en BTV-uitslagen onterechte verwijzingen kunnen voorkomen, en hoe de APK-test wordt uitgevoerd. Methode Tussen oktober 2013 en januari 2014 werden kinderen met een afwijkende uitslag van de APK-test geselecteerd en werd hen een VOV- en BTV-onderzoek aangeboden. Deze resultaten werden vergeleken met het uitgebreide oogonderzoek in het ziekenhuis. Resultaten Van de 1950 driejarigen had 21 % een afwijkende score op de APK-test. Bij 1 op de 4 verwijzingen was een uitslag van het oogonderzoek in het ziekenhuis beschikbaar. Amblyopie, de aandoening waarop het onderzoek in de jeugdgezondheidszorg op de leeftijd van 3 jaar (primair) is gericht, werd bij 9 kinderen van de 101 verwezen kinderen gevonden. Bij 57 % van deze 101 kinderen werd ‘een of andere oogafwijking’ gevonden, maar meestal betrof dat een mogelijke risicofactor voor het ontstaan van amblyopie. De huidige APK-kaart wordt volgens professionals niet geheel gebruikt zoals bedoeld. De APK leidt tot een relatief groot aantal onterechte verwijzingen. Het VOV-onderzoek en de BTV hebben volgens dit onderzoek geen ondersteunende of aanvullende waarde bij het visusonderzoek met de APK. Conclusie De APK-test wordt niet altijd volgens de richtlijn uitgevoerd en resulteert in een groot aantal afwijkende uitslagen en onnodige verwijzingen. Bij de groep kinderen met een afwijkende APK was de VOV evenals de BTV niet voorspellend voor een of andere oogafwijking.
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- 2017
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7. Identifying patterns of lifestyle behaviours among children of 3 years old
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Lu Wang, Monique P. L'Hoir, Magda M. Boere-Boonekamp, Amy van Grieken, Hein Raat, E. Vlasblom, Wilma Jansen, Health Technology & Services Research, and Public Health
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Male ,030309 nutrition & dietetics ,Physical activity ,Child Behavior ,030209 endocrinology & metabolism ,03 medical and health sciences ,Screen time ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Child and Adolescent Health ,Medicine ,Humans ,Life Science ,AcademicSubjects/MED00860 ,AcademicSubjects/SOC01210 ,Permissive ,Child ,Weight status ,Life Style ,Male gender ,Global Nutrition ,0303 health sciences ,Wereldvoeding ,Snacking ,Parenting ,business.industry ,Life style ,Body Weight ,Public Health, Environmental and Occupational Health ,Feeding Behavior ,Latent class model ,Diet ,Cross-Sectional Studies ,Child, Preschool ,business ,AcademicSubjects/SOC02610 ,Demography - Abstract
Background To identify the patterns of lifestyle behaviours in children aged 3 years, to investigate the parental and child characteristics associated with the lifestyle patterns, and to examine whether the identified lifestyle patterns are associated with child BMI and weight status. Methods Cross-sectional data of 2090 children 3 years old participating in the Dutch BeeBOFT study were used. Child dietary intakes, screen times and physical activity were assessed by parental questionnaire, and child weight and height were measured by trained professionals according to a standardized protocol. Latent class analysis was applied to identify patterns of lifestyle behaviours among children. Results Three subgroups of children with distinct patterns of lifestyle behaviours were identified: the ‘unhealthy lifestyle’ pattern (36%), the ‘low snacking and low screen time’ pattern (48%) and the ‘active, high fruit and vegetable, high snacking and high screen time’ pattern (16%). Children with low maternal educational level, those raised with permissive parenting style (compared those with authoritative parents), and boys were more likely be allocated to the ‘unhealthy lifestyle’ pattern and the ‘active, high fruit and vegetable, high snacking and high screen time’ pattern (P Conclusions Three different lifestyle patterns were observed among children aged 3 years. Low maternal educational level, permissive parenting style and male gender of the child were associated with having unhealthy lifestyle patterns for the child.
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- 2020
8. Parenting support to prevent overweight during regular well-child visits in 0-3 year old children (BBOFT+ program), a cluster randomized trial on the effectiveness on child BMI and health behaviors and parenting
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M. Beltman, Monique P. L’Hoir, Magda M. Boere-Boonekamp, Hein Raat, E. Vlasblom, Amy van Grieken, Public Health, and Health Technology & Services Research
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Male ,European People ,Pediatric Obesity ,Multivariate analysis ,Physiology ,Office Visits ,Child Health Services ,Health Behavior ,Psychological intervention ,Breastfeeding ,Social Sciences ,Overweight ,Pediatrics ,Education, Nonprofessional ,Body Mass Index ,law.invention ,Families ,Child Development ,0302 clinical medicine ,Sociology ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Medicine and Health Sciences ,Psychology ,Ethnicities ,Cluster Analysis ,Public and Occupational Health ,030212 general & internal medicine ,Cluster randomised controlled trial ,Early childhood ,Parent-Child Relations ,Children ,Netherlands ,Multidisciplinary ,Parenting ,Child Health ,Primary Prevention ,Physiological Parameters ,Child, Preschool ,Medicine ,Female ,medicine.symptom ,Behavioral and Social Aspects of Health ,Research Article ,Adult ,Childhood Obesity ,Science ,Parenting Behavior ,030209 endocrinology & metabolism ,Education ,03 medical and health sciences ,medicine ,Humans ,Life Science ,Obesity ,Life Style ,Educational Attainment ,Dutch People ,Global Nutrition ,Wereldvoeding ,Behavior ,business.industry ,Body Weight ,Infant, Newborn ,Biology and Life Sciences ,Infant ,Age Groups ,People and Places ,Population Groupings ,business ,Body mass index ,Program Evaluation ,Demography - Abstract
BACKGROUND: Prevention of overweight during early childhood seems promising. OBJECTIVE: To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+). METHODS: A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI. RESULTS: No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses. CONCLUSION: The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight.
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- 2020
9. Primary care in five European countries
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Paul Kocken, Catharina G.M. Groothuis-Oudshoorn, Janine Astrid van Til, E. Vlasblom, Magda M. Boere-Boonekamp, Behavioural Change, and Health Technology & Services Research
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Health Care Providers ,Pediatrics ,Geographical locations ,Families ,0302 clinical medicine ,Germany ,Medicine and Health Sciences ,Public and Occupational Health ,030212 general & internal medicine ,Child ,10. No inequality ,Children ,Netherlands ,media_common ,Multidisciplinary ,Medical record ,Child Health ,3. Good health ,Test (assessment) ,Europe ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Medicine ,Psychology ,Research Article ,Health care quality ,medicine.medical_specialty ,Science ,media_common.quotation_subject ,03 medical and health sciences ,Patient satisfaction ,medicine ,Humans ,Quality (business) ,European Union ,Primary Care ,Quality of Health Care ,Data collection ,Primary Health Care ,Descriptive statistics ,Health Care ,Age Groups ,Spain ,Health Care Surveys ,Family medicine ,People and Places ,Managed care ,Population Groupings ,Poland - Abstract
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 prioritized warrant further action.
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- 2019
10. Predictive validity of developmental milestones for detecting limited intellectual functioning
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Paula van Dommelen, Elise Dusseldorp, Paul H. Verkerk, Magda M. Boere-Boonekamp, E. Vlasblom, Esther Hafkamp-de Groen, and Health Technology & Services Research
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Male ,European People ,Intelligence ,Social Sciences ,Pediatrics ,Families ,0302 clinical medicine ,Borderline intellectual functioning ,Child Development ,Sociology ,Life ,CH - Child Health ,Intellectual disability ,Prevalence ,Medicine and Health Sciences ,Ethnicities ,Psychology ,Public and Occupational Health ,Child ,Children ,Intelligence Tests ,Intellectual ,Multidisciplinary ,Schools ,Intelligence quotient ,05 social sciences ,Child Health ,Health ,Child, Preschool ,Developmental Milestone ,Medicine ,Female ,Growth and Development ,050104 developmental & child psychology ,Clinical psychology ,Research Article ,Predictive validity ,Adolescent ,Psychometrics ,Science ,Disabilities ,Development ,Sitting ,Education ,03 medical and health sciences ,030225 pediatrics ,medicine ,Humans ,0501 psychology and cognitive sciences ,Dutch People ,business.industry ,Infant, Newborn ,Infant ,Reproducibility of Results ,Biology and Life Sciences ,Odds ratio ,medicine.disease ,Child development ,Age Groups ,People and Places ,Population Groupings ,business - Abstract
Developmental milestones are commonly used in child health care, although from many milestones the predictive validity has not been adequately assessed. We aimed to determine the predictive validity of 75 developmental milestones for detecting limited intellectual functioning that can be obtained before the age of 4 years. We performed a case-control study with 148 children aged 5–10 years with limited intellectual functioning (IQ 50–69), who were in special education (cases) and a random sample of 300 children aged 5–10 years who were in regular elementary education (controls). Developmental milestones scores were retrieved from Child Healthcare files. We calculated sensitivity, specificity, positive likelihood ratios (LR+) and diagnostic odds ratios (DOR) for limited intellectual functioning. The LR+ determines whether a test result changes the probability that a condition exists. Given the prevalence of intellectual disability (1–3%), we considered that an LR+ > 10 would be clinically useful, as it increases the a priori probability of limited intellectual functioning from 2% to a posteriori probability of at least 17%. Out of 75 assessed milestones, 50 were included in the analysis. We found nine milestones to have a significant adjusted (for socio-economic status and prematurity) DOR > 1 and a significant LR+ > 10 (assessment age in months between brackets): ‘says "dada-baba‴ (9), ‘balances head well while sitting’ (9), ‘sits on buttocks while legs stretched’ (9), ‘babbles while playing’ (12), ‘sits in stable position without support’ (12), ‘walks well alone’ (24), ‘says "sentences" of 3 or more words’ (36), ‘places 3 forms in form-box’ (36) and ‘copies circle’ (48). Sensitivities of these 9 milestones varied from 8–54%, specificities of these 9 milestones varied from 95–100%. Combining these milestones at 9, 12, and 36 months respectively resulted in sensitivities of 27–60% and specificities of 94–99%. These nine developmental milestones have substantial predictive validity for limited intellectual functioning.
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- 2019
11. Determinants of adherence to wrap-around care in child and family services
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Paul Kocken, Sijmen A. Reijneveld, Margot Fleuren, E. Vlasblom, Noortje M. Pannebakker, Mattijs E. Numans, Behavioural Change, and Public Health Research (PHR)
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Male ,medicine.medical_specialty ,Wrap-around care ,Cross-sectional study ,Child Health Services ,Self-concept ,Health informatics ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Surveys and Questionnaires ,medicine ,Humans ,Family ,030212 general & internal medicine ,Imputation (statistics) ,Innovation strategy ,Child ,Netherlands ,Social network ,business.industry ,030503 health policy & services ,Health Policy ,Nursing research ,Public health ,lcsh:Public aspects of medicine ,lcsh:RA1-1270 ,Self Efficacy ,Cross-Sectional Studies ,Adherence ,Family medicine ,Patient Compliance ,Regression Analysis ,Female ,0305 other medical science ,business ,Delivery of Health Care ,Research Article - Abstract
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. Electronic supplementary material The online version of this article (10.1186/s12913-018-3774-6) contains supplementary material, which is available to authorized users.
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- 2019
12. Sleep and body mass index in infancy and early childhood (6-36 mo): a longitudinal study
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Lu Wang, Amy van Grieken, M. Beltman, Monique P. L'Hoir, Magda M. Boere-Boonekamp, E. Vlasblom, Wilma Jansen, Hein Raat, Public Health, and Health Technology & Services Research
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0301 basic medicine ,Male ,Pediatrics ,medicine.medical_specialty ,Longitudinal study ,Time Factors ,UT-Hybrid-D ,030209 endocrinology & metabolism ,Standard score ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Life ,CH - Child Health ,Linear regression ,medicine ,Humans ,Early childhood ,Longitudinal Studies ,child BMI ,Original Research ,Human Nutrition & Health ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Health professionals ,business.industry ,Health Policy ,Humane Voeding & Gezondheid ,Public Health, Environmental and Occupational Health ,longitudinal study ,Infant ,bidirectional association ,Sleep in non-human animals ,Cross-Sectional Studies ,Health ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Linear Models ,sleep duration ,Female ,ELSS - Earth, Life and Social Sciences ,Healthy for Life ,business ,Sleep ,Body mass index ,Healthy Living ,Human Resource Management ,Sleep duration - Abstract
Summary Background Relatively, few longitudinal studies have evaluated the association between sleep and body mass index (BMI) among younger children. In addition, few studies have evaluated the bidirectional longitudinal association between sleep duration and child BMI. Objective The objective of the study is to determine in children aged 6 to 36 months (1) the cross‐sectional association of sleep duration and sleep problems with child BMI z score, (2) whether sleep duration predicts changes in child BMI z score, and (3) and whether BMI z score can predict changes in child sleep duration. Methods This study used longitudinal data from the BeeBOFT study (N = 2308). Child sleep duration and sleep problems (indicated by night awakenings and sleep‐onset latency) were parent reported, and child BMI was measured using a standardized protocol by trained healthcare professionals at approximately 6, 14, and 36 months of age. Linear mixed models and linear regression models were applied to assess the cross‐sectional and bidirectional longitudinal associations between sleep and BMI z scores. Results Cross sectionally, shorter sleep duration was associated with higher BMI z scores at 14 (β = −0.034, P
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- 2019
13. Stakeholders’ views on scenarios on EU child healthcare systems and how changes might be achieved
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G.P.A. de Lijster, Paul Kocken, MM Boere Boonekamp, and E. Vlasblom
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business.industry ,Public Health, Environmental and Occupational Health ,Public relations ,business ,Healthcare system - Published
- 2018
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14. Relationship between socioeconomic status and weight gain during infancy: The BeeBOFT study
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Hein Raat, Magda M. Boere-Boonekamp, Lu Wang, Monique P. L'Hoir, Junwen Yang-Huang, Amy van Grieken, E. Vlasblom, Public Health, and Health Technology & Services Research
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Male ,Parents ,Physiology ,Maternal Health ,Breastfeeding ,lcsh:Medicine ,Social Sciences ,Weight Gain ,Pediatrics ,Families ,0302 clinical medicine ,Endocrinology ,Life ,Sociology ,CH - Child Health ,Weight for Age ,Medicine and Health Sciences ,Birth Weight ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,Children ,Human Nutrition & Health ,Multidisciplinary ,Humane Voeding & Gezondheid ,Gestational age ,Socioeconomic Aspects of Health ,Breast Feeding ,Physiological Parameters ,Health ,Educational Status ,Female ,medicine.symptom ,Healthy Living ,Infants ,Research Article ,Endocrine Disorders ,Birth weight ,Education ,03 medical and health sciences ,030225 pediatrics ,medicine ,Diabetes Mellitus ,Life Science ,Humans ,Gestational Diabetes ,Socioeconomic status ,Educational Attainment ,business.industry ,lcsh:R ,Body Weight ,Infant, Newborn ,Infant ,Biology and Life Sciences ,medicine.disease ,Obesity ,Health Care ,Social Class ,Age Groups ,Metabolic Disorders ,Multivariate Analysis ,People and Places ,Linear Models ,Women's Health ,lcsh:Q ,Population Groupings ,ELSS - Earth, Life and Social Sciences ,Healthy for Life ,Neonatology ,business ,Breast feeding ,Weight gain ,Demography - Abstract
BACKGROUND: Increased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain. METHODS: Subjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0-3, 0-6, and 6-12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain. RESULTS: On average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0-6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27-0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0-6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain. CONCLUSION: Infants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices.
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- 2017
15. JGZ-richtlijn Gezonde slaap en slaapgedrag
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M. Beltman and E. Vlasblom
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Onezonde slaap ,05 social sciences ,Richtlijnen ,Kinderen ,03 medical and health sciences ,0302 clinical medicine ,Life ,Health ,CH - Child Health ,Signalering ,0501 psychology and cognitive sciences ,ELSS - Earth, Life and Social Sciences ,Jeugdgezondheidszorg ,Preventie ,Healthy for Life ,Healthy Living ,030217 neurology & neurosurgery ,Interventie ,050104 developmental & child psychology - Abstract
In februari 2017 is de JGZ-richtlijn Gezonde slaap en slaapproblemen bij kinderen gepubliceerd. Belangrijk doel van de richtlijn is JGZ-professionals te ondersteunen bij het bevorderen van gezond slaapgedrag en het verminderen van slaapproblemen bij kinderen van 0 tot 18 jaar.
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- 2017
16. Primary prevention of overweight in preschool children, the BeeBOFT study (breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing): design of a cluster randomized controlled trial
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M. Beltman, Teun Remmers, Amy van Grieken, Saskia J. te Velde, Mirjam K Struijk, E. Vlasblom, Hein Raat, Suzanne Broeren, Monique P. L'Hoir, Magda M. Boere-Boonekamp, Epidemiology and Data Science, EMGO - Lifestyle, overweight and diabetes, Faculty of Behavioural, Management and Social Sciences, and Public Health
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Male ,Parents ,Gerontology ,Health Behavior ,Psychological intervention ,Breastfeeding ,Overweight ,LS - Life Style ,Body Mass Index ,Study Protocol ,Parenting styles ,Cluster Analysis ,Parenting ,IR-88053 ,Primary Prevention ,Breast Feeding ,Research Design ,Health ,Child, Preschool ,Female ,Television ,Health education ,medicine.symptom ,Healthy Living ,Birth cohort ,Human ,medicine.medical_specialty ,Beverages ,Quality of life (healthcare) ,SDG 3 - Good Health and Well-being ,medicine ,Humans ,METIS-299259 ,Toddler ,Exercise ,Life Style ,Breakfast ,Child rearing ,business.industry ,Physical activity ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Infant ,Feeding Behavior ,Lifestyle ,BSS - Behavioural and Societal Sciences ,Play and Playthings ,Accelerometer ,Quality of Life ,Physical therapy ,Healthy for Life ,business ,Constipation ,Program Evaluation - Abstract
Background Two overweight prevention interventions were developed to be offered by preventive Youth Health Care (YHC) in addition to the currently applied overweight prevention protocol to parents of 0-3 year old children. The two interventions aim to support parents of preschool children to realize healthy child nutrition and activity behaviors of their young child. The aim of this study is to assess the effects of the two overweight prevention interventions with regard to child health behaviors and child Body Mass Index. Methods/Design A cluster randomized controlled trial was conducted among parents and their preschool children who attend one of 51 participating YHC teams. The teams were randomly allocated to one of the two intervention groups, or to the control group (care as usual). The ‘BBOFT+’ intervention focuses on effective child rearing by parents from birth onwards by enlarging parental skills concerning healthy behavioural life-style habits. Parents who are allocated to the ‘E-health4Uth Healthy toddler’ intervention group, at the child age of circa 18 and 24 months old, are invited to complete an online E-health module providing tailored health education regarding healthy child nutrition and activity behaviors. The E-health messages are discussed and reinforced during the subsequent regularly scheduled visits by YHC professionals, and were repeated after 4 weeks. The primary outcome measures at child age 3 years are: overweight inducing/reducing behaviors, (for ‘BBOFT+’ only) healthy sleep, Body Mass Index and prevalence of overweight and obesity. Secondary outcome measures are attitudes and other cognitive characteristics of the parents regarding the overweight-related behaviors of their child, parenting styles and practices, and health-related quality of life of the children. Discussion We hypothesize that the use of the additional interventions will result in a healthier lifestyle of preschool children and an improved BMI and less development of overweight and obesity compared to usual care. Trial registration Nederlands Trial Register NTR1831.
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- 2013
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17. Slaap en overgewicht in Europees onderzoek. Gezonde kinderen in een Gezonde Kindomgeving (GKGK)
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M.P. L'Hoir, E. Vlasblom, Dorothee Schmelt, P. van Dommelen, Roland Naul, Dennis Dreiskämper, and Magdalena M. Boere-Boonekamp
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kinderen ,Maternal and child health ,Health ,Political science ,CH - Child Health LS - Life Style ,slaap ,overgewicht ,Healthy for Life ,Humanities ,Healthy Living ,BSS - Behavioural and Societal Sciences ,Human - Abstract
Er blijkt een relatie te bestaan tussen de nachtrust van kinderen in het weekend en overgewicht. Dit blijkt uit de eerste resultaten van een longitudinaal onderzoek bij kinderen in de leeftijd van 7 à 8 jaar in 6 Nederlandse (n = 474) en 6 Duitse steden (n = 393) naar de relatie tussen slaap en overgewicht. Met dat de nachtrust in het weekend met 1 uur daalt, stijgt de prevalentie van overgewicht met een factor 1,42 (95%-BI 1,09-1,86; p=o,010). Door de week is dit verband niet significant, hoewel de relatie in dezelfde richting wijst (p=0,2. Deze resultaten bevestigen het belang van het stimuleren van voldoende slaap, naast het bevorderen van bewegen en gezonde voeding bij de preventie van overgewicht.
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- 2012
18. Preventie van overgewicht en het verbeteren van slaap vanaf de geboorte tot de leeftijd van 13 maanden; voorlopige resultaten van de BBOFT+-interventie
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Hein Raat, E. Vlasblom, Magdalena M. Boere-Boonekamp, M. Beltman, and M.P. L'Hoir
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Overgewicht ,Health ,CH - Child Health ,Maternal and child health ,Jeugdgezondheidszorg ,Healthy for Life ,Healthy Living ,BSS - Behavioural and Societal Sciences ,Human - Published
- 2013
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19. Transgenic mouse--an in vivo system for detection of aneugens
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A T, Natarajan, S E, Vlasblom, A, Manca, P H, Lohman, J A, Gossen, J, Vijg, F, Beermann, E, Hummler, and I, Hansmann
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Male ,Mice, Inbred C57BL ,Mice ,Lac Operon ,Nondisjunction, Genetic ,Mutagenicity Tests ,Organ Specificity ,Genes, Synthetic ,Animals ,Female ,Mice, Transgenic ,Oncogenes ,Aneuploidy - Published
- 1990
20. European capacity to implement evidence-based child health policy
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Paul Kocken, G. Lijster-van Kampen, Peter Schröder-Bäck, Kinga Zdunek, M Rigby, Mitch Blair, E. Vlasblom, International Health, and RS: CAPHRI - R2 - Creating Value-Based Health Care
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03 medical and health sciences ,0302 clinical medicine ,Evidence-based practice ,Public economics ,030503 health policy & services ,Political science ,Public Health, Environmental and Occupational Health ,030212 general & internal medicine ,0305 other medical science ,Child health - Full Text
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21. Guideline for referring short or tall children in preventive child health care.
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van Dommelen P, van Zoonen R, Vlasblom E, Wit JM, and Beltman M
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- Adolescent, Body Height, Child, Child, Preschool, Growth Charts, Humans, Infant, Infant, Newborn, Physical Examination, Child Health, Growth Disorders diagnosis, Growth Disorders prevention & control
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Aim: To develop a guideline for preventive child healthcare professionals in order to improve early detection of pathological disorders associated with short stature (or growth faltering) or tall stature (or accelerated growth)., Methods: We updated the previous Dutch guideline for short stature in children aged 0-9 years and extended it to adolescents (10-17 years), and added a guideline for tall stature, based on literature and input from an expert committee. Specificities were calculated in a cohort of healthy Dutch children aged 0-9 years (n = 970). We investigated the impact of a late onset of puberty on height standard deviation score based on the Dutch growth charts., Results: Growth parameters of the guideline include height, the distance between height and target height and change of height over time. Other parameters include diagnostic clues from medical history and physical examination, for example behavioural problems, precocious or delayed puberty, body disproportion and dysmorphic features., Conclusion: Preventive child healthcare professionals now have an updated guideline for referring short or tall children to specialist care. Further research is needed on the diagnostic yield after referral and specificity at field level., (©2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
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- 2021
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22. Costs and effects of conventional vision screening and photoscreening in the Dutch preventive child health care system.
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Van der Ploeg CPB, Grevinga M, Eekhout I, Vlasblom E, Lanting CI, van Minderhout HME, van Dijk-van der Poel J, van den Akker-van Marle ME, and Verkerk PH
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- Child, Child Health, Cross-Sectional Studies, Delivery of Health Care, Humans, Infant, Reproducibility of Results, Sensitivity and Specificity, Amblyopia diagnosis, Vision Screening
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Background: Little is known about costs and effects of vision screening strategies to detect amblyopia. Aim of this study was to compare costs and effects of conventional (optotype) vision screening, photoscreening or a combination in children aged 3-6 years., Methods: Population-based, cross-sectional study in preventive child health care in The Hague. Children aged 3 years (3y), 3 years and 9 months (3y9m) or 5-6 years (5/6y) received the conventional chart vision screening and a test with a photoscreener (Plusoptix S12C). Costs were based on test duration and additional costs for devices and diagnostic work-up., Results: Two thousand, one hundred and forty-four children were included. The estimated costs per child screened were €17.44, €20.37 and €6.90 for conventional vision screening at 3y, 3y9m and 5/6y, respectively. For photoscreening, these estimates were €6.61, €7.52 and €9.40 and for photoscreening followed by vision screening if the result was unclear (combination) €9.32 (3y) and €9.33 (3y9m). The number of children detected with amblyopia by age were 9, 14 and 5 (conventional screening), 6, 13 and 3 (photoscreening) and 10 (3y) and 15 (3y9m) (combination), respectively. The estimated costs per child diagnosed with amblyopia were €1500, €1050 and €860 for conventional vision screening, €860, €420 and €1940 for photoscreening and €730 (3y) and €450 (3y9m) for the combination., Conclusions: Combining photoscreening with vision screening seems promising to detect amblyopia in children aged 3y/3y9m, whereas conventional screening seems preferable at 5/6y. As the number of study children with amblyopia is small, further research on the effects of these screening alternatives in detecting children with amblyopia is recommended., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.)
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- 2021
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23. Tailored communication methods as key to implementation of evidence-based solutions in primary child health care.
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Zdunek K, Schröder-Bäck P, Alexander D, Vlasblom E, Kocken P, Rigby M, and Blair M
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- Attitude, Child, Communication, Family, Humans, Child Health, Child Health Services
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Background: Evidence-based policies should underpin successful implementation of innovations within child health care. The EU-funded Models of Child Health Appraised project enabled research into effective methods to communicate research evidence. The objective of this study was to identify and categorize methods to communicate evidence-based research recommendations and means to tailor this to stakeholder audiences., Methods: We conducted an online survey among national stakeholders in child health. Analysis of the most effective strategies to communicate research evidence and reach the target audience was carried out in order to ensure implementation of optimal child health care models at a national level., Results: Representatives of stakeholders from 21 of the then 30 EU MS and EEA countries responded to the questionnaire. Three main approaches in defining the strategies for effective communication of research recommendations were observed, namely: dissemination of information, involvement of stakeholders and active attitude towards change expressed in actions. The target audience for communicating recommendations was divided into two layers: proximal, which includes those who are remaining in close contact with the child, and distal, which contains those who are institutionally responsible for high quality of child health services. They should be recipients of evidence-based results communicated by different formats, such as scientific, administrative, popular and personal., Conclusions: Influential stakeholders impact the process of effective research dissemination and guide necessary actions to strengthen the process of effective communication of recommendations. Communication of evidence-based results should be targeted to each audience's profile, both professional and non-professionals, by adjusting appropriate communication formats., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.)
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- 2021
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24. Identifying patterns of lifestyle behaviours among children of 3 years old.
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Wang L, Jansen W, van Grieken A, Vlasblom E, Boere-Boonekamp MM, L'Hoir MP, and Raat H
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- Body Weight, Child, Child, Preschool, Cross-Sectional Studies, Diet, Feeding Behavior, Humans, Male, Parenting, Child Behavior, Life Style
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Background: To identify the patterns of lifestyle behaviours in children aged 3 years, to investigate the parental and child characteristics associated with the lifestyle patterns, and to examine whether the identified lifestyle patterns are associated with child BMI and weight status., Methods: Cross-sectional data of 2090 children 3 years old participating in the Dutch BeeBOFT study were used. Child dietary intakes, screen times and physical activity were assessed by parental questionnaire, and child weight and height were measured by trained professionals according to a standardized protocol. Latent class analysis was applied to identify patterns of lifestyle behaviours among children., Results: Three subgroups of children with distinct patterns of lifestyle behaviours were identified: the 'unhealthy lifestyle' pattern (36%), the 'low snacking and low screen time' pattern (48%) and the 'active, high fruit and vegetable, high snacking and high screen time' pattern (16%). Children with low maternal educational level, those raised with permissive parenting style (compared those with authoritative parents), and boys were more likely be allocated to the 'unhealthy lifestyle' pattern and the 'active, high fruit and vegetable, high snacking and high screen time' pattern (P < 0.05). No association was found between the identified lifestyle patterns and child BMI z-score at age 3 years., Conclusions: Three different lifestyle patterns were observed among children aged 3 years. Low maternal educational level, permissive parenting style and male gender of the child were associated with having unhealthy lifestyle patterns for the child., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.)
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- 2020
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25. Parenting support to prevent overweight during regular well-child visits in 0-3 year old children (BBOFT+ program), a cluster randomized trial on the effectiveness on child BMI and health behaviors and parenting.
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Vlasblom E, van Grieken A, Beltman M, L'Hoir MP, Raat H, and Boere-Boonekamp MM
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- Adult, Child Development physiology, Child Health Services, Child, Preschool, Cluster Analysis, Female, Humans, Infant, Infant, Newborn, Life Style, Male, Netherlands, Office Visits, Parent-Child Relations, Pediatric Obesity prevention & control, Primary Prevention methods, Program Evaluation, Surveys and Questionnaires, Body Mass Index, Education, Nonprofessional methods, Health Behavior physiology, Overweight prevention & control, Parenting
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Background: Prevention of overweight during early childhood seems promising., Objective: To evaluate the effectiveness of the parenting-based BBOFT+ overweight prevention program on child BMI, child health behavior and parenting behavior among 0-36 month old children. BBOFT+ is an acronym for the key healthy lifestyle behaviors that are targeted in the BBOFT+ intervention: breastfeeding (B), daily breakfast (B), daily going outdoors (O), limiting sweet beverages (in Dutch, F) and minimal TV or computer time (T), complemented with healthy sleep behavior and improvement of parenting skills (+)., Methods: A cluster randomized controlled trial in newborn children visiting well-baby clinics, comparing the BBOFT+ intervention (N = 901) with care as usual (CAU) (N = 1094). In both groups, parents received regular well-child visits (±11 visits in the first 3 years). In the intervention group, care was supplemented with the BBOFT+ program, which focuses on improving parenting skills from birth onwards to increase healthy behavior. Questionnaires were filled in at child's age 2-4 weeks, 6, 14 and 36 months. In multivariate analyses we corrected for child's birthweight, age, ethnic background, mother's educational level and BMI., Results: No differences were found in weight status at 36 months between intervention and control group children. At 6 months, BBOFT+ parents reported their child drinking less sweet beverages than control parents (48% vs 54%;p = .027), and going outdoors daily with their child less often (57% vs 62%;p = .03). At 14 months, more BBOFT+ parents than control parents reported to have breastfed for six months or longer (32% vs 29%;p = .022). At 36 months, more BBOFT+ parents than control parents reported their child going outside daily (78% vs 72%;p = .011) and having less TV/computer time on week- (38% vs 46%;p = .001) and weekend days (48% vs 56%;p = .002). Also, BBOFT+ parents reported having more parental control than control parents (3.92 vs 3.89;p = .02). No significant differences were found for daily breakfast, sleep duration and parenting practices in adjusted analyses., Conclusion: The BBOFT+ overweight prevention program showed small improvements in parent-reported child health behaviors, compared to care as usual; no effect was observed on child BMI. The identified modifiable elements are potentially relevant for interventions that aim to prevent overweight., Competing Interests: We have read the journal's policy and the authors of this manuscript have the following competing interests: We have a potential conflict of interest with PLOS ONE editor Jacobus P. van Wouwe, because the first (EV), third (MB), and fourth (MLH) authors have worked together in the same department at TNO. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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- 2020
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26. Primary care in five European countries: A citizens' perspective on the quality of care for children.
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van Til JA, Groothuis-Oudshoorn CGM, Vlasblom E, Kocken PL, and Boere-Boonekamp MM
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- Child, Europe, Health Care Surveys, Humans, Patient Satisfaction, Primary Health Care standards, Quality of Health Care standards
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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 prioritized warrant further action., Competing Interests: The authors have declared that no competing interest exist.
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- 2019
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27. Sleep and body mass index in infancy and early childhood (6-36 mo): a longitudinal study.
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Wang L, Jansen W, Boere-Boonekamp MM, Vlasblom E, L'Hoir MP, Beltman M, van Grieken A, and Raat H
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- Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Linear Models, Longitudinal Studies, Male, Time Factors, Body Mass Index, Sleep
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Background: Relatively, few longitudinal studies have evaluated the association between sleep and body mass index (BMI) among younger children. In addition, few studies have evaluated the bidirectional longitudinal association between sleep duration and child BMI., Objective: The objective of the study is to determine in children aged 6 to 36 months (1) the cross-sectional association of sleep duration and sleep problems with child BMI z score, (2) whether sleep duration predicts changes in child BMI z score, and (3) and whether BMI z score can predict changes in child sleep duration., Methods: This study used longitudinal data from the BeeBOFT study (N = 2308). Child sleep duration and sleep problems (indicated by night awakenings and sleep-onset latency) were parent reported, and child BMI was measured using a standardized protocol by trained healthcare professionals at approximately 6, 14, and 36 months of age. Linear mixed models and linear regression models were applied to assess the cross-sectional and bidirectional longitudinal associations between sleep and BMI z scores., Results: Cross sectionally, shorter sleep duration was associated with higher BMI z scores at 14 (β = -0.034, P < 0.05) and 36 months (β = -0.045, P < 0.05). Sleep duration at 6 or 14 months did not predict BMI z score at either 14 or 36 months. Higher BMI z scores at 6 months predicted shorter sleep duration (hours) at 14 months (β = -0.129, P < 0.001). No association was found between sleep problems and child BMI z scores., Conclusions: Cross-sectional associations between shorter sleep duration and higher BMI z score emerged in early childhood (age 14 and 36 mo). Higher BMI z scores may precede shorter sleep duration but not vice versa., (© 2019 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)
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- 2019
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28. Predictive validity of developmental milestones for detecting limited intellectual functioning.
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Vlasblom E, Boere-Boonekamp MM, Hafkamp-de Groen E, Dusseldorp E, van Dommelen P, and Verkerk PH
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- Adolescent, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Male, Prevalence, Reproducibility of Results, Growth and Development, Intelligence
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Developmental milestones are commonly used in child health care, although from many milestones the predictive validity has not been adequately assessed. We aimed to determine the predictive validity of 75 developmental milestones for detecting limited intellectual functioning that can be obtained before the age of 4 years. We performed a case-control study with 148 children aged 5-10 years with limited intellectual functioning (IQ 50-69), who were in special education (cases) and a random sample of 300 children aged 5-10 years who were in regular elementary education (controls). Developmental milestones scores were retrieved from Child Healthcare files. We calculated sensitivity, specificity, positive likelihood ratios (LR+) and diagnostic odds ratios (DOR) for limited intellectual functioning. The LR+ determines whether a test result changes the probability that a condition exists. Given the prevalence of intellectual disability (1-3%), we considered that an LR+ > 10 would be clinically useful, as it increases the a priori probability of limited intellectual functioning from 2% to a posteriori probability of at least 17%. Out of 75 assessed milestones, 50 were included in the analysis. We found nine milestones to have a significant adjusted (for socio-economic status and prematurity) DOR > 1 and a significant LR+ > 10 (assessment age in months between brackets): 'says "dada-baba‴ (9), 'balances head well while sitting' (9), 'sits on buttocks while legs stretched' (9), 'babbles while playing' (12), 'sits in stable position without support' (12), 'walks well alone' (24), 'says "sentences" of 3 or more words' (36), 'places 3 forms in form-box' (36) and 'copies circle' (48). Sensitivities of these 9 milestones varied from 8-54%, specificities of these 9 milestones varied from 95-100%. Combining these milestones at 9, 12, and 36 months respectively resulted in sensitivities of 27-60% and specificities of 94-99%. These nine developmental milestones have substantial predictive validity for limited intellectual functioning., Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: We have a potential conflict of interest with the PlosOne editor Jacobus P. van Wouwe, because the first (EV), fifth (PvD) and sixth (PV) authors have worked closely with him. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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- 2019
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29. Determinants of adherence to wrap-around care in child and family services.
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Pannebakker NM, Fleuren MAH, Vlasblom E, Numans ME, Reijneveld SA, and Kocken PL
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- Child, Cross-Sectional Studies, Family, Female, Humans, Male, Netherlands, Regression Analysis, Self Efficacy, Surveys and Questionnaires, Child Health Services, Delivery of Health Care organization & administration, Patient Compliance
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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.
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- 2019
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30. Relationship between socioeconomic status and weight gain during infancy: The BeeBOFT study.
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Wang L, van Grieken A, Yang-Huang J, Vlasblom E, L'Hoir MP, Boere-Boonekamp MM, and Raat H
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- Educational Status, Female, Humans, Infant, Infant, Newborn, Linear Models, Male, Multivariate Analysis, Parents, Social Class, Weight Gain
- Abstract
Background: Increased weight gain during infancy is a risk factor for obesity and related diseases in later life. The aim of the present study was to investigate the association between socioeconomic status (SES) and weight gain during infancy, and to identify the factors mediating the association between SES and infant weight gain., Methods: Subjects were 2513 parent-child dyads participating in a cluster randomized controlled intervention study. Family SES was indexed by maternal education level. Weight gain in different time windows (infant age 0-3, 0-6, and 6-12 months) was calculated by subtracting the weight for age z-score (WAZ) between the two time-points. Path analysis was performed to examine the mediating pathways linking SES and infant weight gain., Results: On average, infants of low-educated mothers had a lower birth weight and caught-up at approximately 6 months. In the period of 0-6 months, infants with low-educated mothers had an 0.42 (95% CI 0.27-0.57) higher gain in weight for age z-score compared to children with high-educated mothers. The association between maternal education level and increased infant weight gain in the period of 0-6 months can be explained by infant birth weight, gestational age at child birth, duration of breastfeeding, and age at introduction of complementary foods. After adjusting all the mediating factors, there was no association between maternal education level and infant weight gain., Conclusion: Infants with lower SES had an increased weight gain during the first 6 months of infancy, and the effect can be explained by infant birth weight, gestational age at child birth, and infant feeding practices., Competing Interests: The authors have declared that no competing interests exist.
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- 2018
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31. Personalized Web-Based Advice in Combination With Well-Child Visits to Prevent Overweight in Young Children: Cluster Randomized Controlled Trial.
- Author
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van Grieken A, Vlasblom E, Wang L, Beltman M, Boere-Boonekamp MM, L'Hoir MP, and Raat H
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Parents psychology, Surveys and Questionnaires, Young Adult, Child Welfare trends, Overweight prevention & control, Telemedicine methods
- Abstract
Background: Overweight is a major health issue, and parent-targeted interventions to promote healthy development in children are needed., Objective: The study aimed to evaluate E-health4Uth Healthy Toddler, an intervention that educates parents of children aged 18 to 24 months regarding health-related behaviors, as compared with usual care. The effect of this intervention on the following primary outcomes was evaluated when the children were 36 months of age: health-related behaviors (breakfast daily, activity and outside play, sweetened beverage consumption, television (TV) viewing and computer time), body mass index (BMI), and the prevalence of overweight and obesity., Methods: The BeeBOFT (acronym for breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing) study is a cluster randomized controlled trial involving 51 Youth Health Care (YHC) teams. In total, 1094 parents participated in the control group, and 1008 parents participated in the E-health4Uth Healthy Toddler intervention group. The intervention consisted of Web-based personalized advice given to parents who completed an eHealth module and discussion of the advice during a regular well-child visit. In this study the eHealth module was offered to parents before two regular well-child visits at 18 and 24 months of age. During the well-child visits, the parents' personalized advice was combined with face-to-face counseling provided by the YHC professional. Parents in the control group received usual care, consisting of the regular well-child visits during which general information on child health-related behavior was provided to parents. Parents completed questionnaires regarding family characteristics and health-related behaviors when the child was 1 month (inclusion), 6 months, 14 months, and 36 months (follow-up) of age. The child's height and weight were measured by trained health care professionals from birth through 36 months of age at fixed time points. Multilevel linear and logistic regression models were used to evaluate the primary outcomes at 36 months of age., Results: At 36 months, we observed no differences between health-related behaviors of children, BMI or the percentage of children having overweight or obesity in the control and intervention group (P>.05). An analysis of the intervention effect revealed that boys benefited from eating breakfast daily, non-Dutch children spent more time being active or playing outdoors, children of low-educated parents and of overweight and obese mothers spent less time watching TV or using the computer, and children of normal weight mothers drank less sweetened beverages (P<.05) compared with the control group., Conclusions: The E-health4Uth Healthy Toddler intervention resulted in small improvements in health-related behaviors among subgroups but had no significant effects with respect to the children's BMI. We conclude that the E-health4Uth Healthy Toddler intervention may be useful for pediatric health care professionals in terms of providing parents with personalized information regarding their child's health-related behaviors., Trial Registration: Netherlands Trial Register: NTR1831; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1831 (Archived by WebCite at http://www.webcitation.org/6mm5YFOB0)., (©Amy van Grieken, Eline Vlasblom, Lu Wang, Maaike Beltman, Magda M Boere-Boonekamp, Monique P L'Hoir, Hein Raat. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 27.07.2017.)
- Published
- 2017
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