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BackgroundThe Internet has become a popular medium for the delivery of tailored healthy lifestyle promoting interventions. The actual reach of Internet-delivered interventions seems, however, lower than expected, and attrition from interventions is generally high. Characteristics of an intervention, such as personally tailored feedback and goal setting, are thought to be among the important factors related to of use of and exposure to interventions. However, there is no systematic overview of which characteristics of Internet-delivered interventions may be related to more exposure. ObjectiveThe present study aims to identify (1) which potentially exposure-promoting methods and strategies are used in existing Internet interventions, (2) which objective outcome measures are used to measure exposure to Internet interventions, and (3) which potentially exposure-promoting methods and strategies are associated with better exposure. MethodsA systematic review of the literature was conducted based on the Cochrane guidelines. Papers published between 1995 and 2009 were searched in the PubMed, PsycINFO, and Web of Science databases. In total, 64 studies were included that reported objective exposure measures such as completion of an initial visit, number of log-ins, and time spent on the website. Information about intervention-related characteristics (ie, interactive behavior change strategies, interactive elements for fun, peer or counsel support, email/phone contact, and regular updates of the website) that could potentially contribute to better exposure and objective exposure outcomes were abstracted from the studies and qualitative systematic descriptive analyses were performed. ResultsThe results showed that a large variety of behavior change techniques and other exposure-promoting elements were used in the interventions and that these methods and strategies varied for the various lifestyle behaviors. Feedback, interactive elements, and email/phone contact were used most often. In addition, there was much variety and a lack of consistency in the exposure measures that were reported. Of all the categories of intervention characteristics that may be associated with better exposure, there were indications that peer and counselor support result in a longer website visit and that email/phone contact and updates of the website result in more log-ins. ConclusionsResults of this qualitative systematic review indicate that of all intervention characteristics that could potentially enhance exposure, only peer support, counselor support, email/phone contact with visitors, and updates of the intervention website were related to better exposure. The diversity of intervention methods used and the inconsistency in the report of exposure measures prevented us from drawing firmer conclusions. More research is needed to identify whether other characteristics of Internet interventions are associated with greater exposure.

Background The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure. Objective The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention. Methods A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD ≤ 1 were considered to be important. Results Of the 62 experts invited for the first round, 30 completed the questionnaire (48% response rate); 93/233 experts completed the second-round questionnaire (40% response rate), and 59/88 completed the third round (67% response rate). Being motivated to visit an Internet intervention and perceiving the intervention as personally relevant appeared to be important factors related to a first visit. The provision of tailored feedback, relevant and reliable information, and an easy navigation structure were related to an extended visit. Provision of regular new content and the possibility to monitor personal progress toward behavior change were identified as important factors to encourage a revisit. Primarily traditional promotion strategies, like word-of-mouth by family and friends, a publicity campaign with simultaneous use of various mass media, and recommendation by health professionals, were indicated as effective ways to encourage adults to visit an Internet intervention. Conclusions This systematic study identified important factors related to the dissemination of and exposure to Internet interventions aimed at adults. In order to improve optimal use of and exposure to Internet interventions, potential users may need to be motivated to visit such an intervention and the information provided needs to be personally relevant. Furthermore, several (technical) aspects of the intervention itself need to be taken into account when developing Internet interventions.

The COVID-19 pandemic has been forcing people to work remotely in virtual teams around the globe. Global virtual teamwork will continue, and people are not sufficiently prepared for this, resulting in reduced team commitment and lower performance. Higher education institutions need to equip their graduates with International Online Collaboration Competencies (IOCCs), but research into these is fragmented, lacking even a definition of these competencies. This study was systematically reviewing empirical studies on IOCCs. 516 studies were reviewed, and data from 14 full texts were analyzed. Six competence domains emerged from the literature. Most studies focused on single domains of IOCCs, and none of the studies covered all domains. Results indicate that this preliminary framework for higher education students provides a first overview of the fragmented literature on IOCCs. Methods to teach and evaluate IOCCs acquisition are underdeveloped but urgently needed to equip professionals for global virtual teamwork.

Health professionals often need to work together to provide team-based care. With increasing healthcare complexities and manpower shortages, more health professionals are working in multiple, fluid teams instead of one stable team, to provide care to patients. However, there is currently no validated instrument to measure the quality of interprofessional collaboration in fluid teams. One approach is to assess team members' perceived level of teamness (qualities that make clinical teams effective). This study aimed to examine the validity evidence of using the Assessment for Collaborative Environment (ACE-15) in fluid teams and investigate if teamness varies among health professions and clinical settings. Content and response process validity were gathered through consulting experts and cognitive interviews, resulting in revisions to 11 of 15 items in ACE-15. Through exploratory factor analysis of 194 responses on the revised ACE-15, a 13-item instrument, ACE-13F, with strong validity evidence for use in fluid teams was developed. A two-factor fixed effect ANOVA model revealed that the clinical setting that health professionals work in has a significant impact on the level of teamness (F[3,170] = 6.15, p <.001, η2 = 0.09). ACE-13F can be used as a rapid instrument to measure interprofessional collaboration in fluid healthcare teams. [ABSTRACT FROM AUTHOR]

International Online Collaboration Competencies (IOCCs) are considered essential for global virtual teams, yet no consensus exists on what experts consider as IOCCs and which competencies are involved. To develop a framework to support higher education in designing learning tasks and evaluation instruments for the acquisition of IOCCs, a three-round consensus study was conducted among a purposive sample of academic and field experts in international online collaboration. The final IOCCs framework includes a definition of IOC and 34 IOCCs within six competency domains: (1) information and communication technology, (2) international and intercultural, (3) communication and language, (4) collaboration, (5) management and organization, and (6) domain-specific. The framework may be a benchmark for program development for Internationalization of the Curriculum (IoC), evaluation, and continuous professional development. Further research is needed to evaluate how this IOCCs framework can be integrated into higher education settings to teach and evaluate IOCCs. [ABSTRACT FROM AUTHOR]

The Internet is considered to be a promising delivery channel of interventions aimed at promoting healthful behaviors, especially for adolescents and young adults. Exposure to these interventions, however, is generally low. A more extensive exploration of methods, strategies, and their effectiveness with regard to facilitating exposure is therefore timely, because this knowledge is crucial to improve the use of such interventions and, subsequently, to increase behavioral change. Therefore, a systematic review of the literature was conducted, resulting in 838 studies based on title selection, of which 26 studies met the eligibility criteria. The systematic review resulted in an overview of methods and strategies that have been used to facilitate exposure. Patterns of effective strategies could be observed, such as the combination of tailored communication and the use of reminders and incentives. Nevertheless, exposure-specific theories need to be developed and objective exposure measures should be tracked and reported in future studies. (Contains 2 tables and 1 figure.)

Purpose: The purpose of this paper is to examine the needs and views of adolescents regarding the development of online support for mental health problems. Design/methodology/approach: Semi-structured qualitative focus group interviews were conducted with ten groups of Dutch adolescents (n=106), aged 12-19 years, from four urban secondary schools offering different levels of education in the Southeastern part of The Netherlands. Interviews were verbally transcribed and analysed with Nvivo, using a classification based on the research questions. Findings: The participants reported that they searched on the internet to get information or help for some mental health problems. They also expressed the need for a youth healthcare website offering information, self-tests and anonymous help. They had different ideas about the layout of such a website, which were related to their educational level. Reliability of such a website was an important issue. Practical implications: Adolescents reported a distinct need for online information and help for mental health problems. Youth healthcare organisations could meet this need by creating an innovative additional assistance method. These organisations should cooperate with website developers, taking into account that adolescents with different levels of education have different preferences regarding the interventions for online information and help. Originality/value: This paper provides a conclusive examination of the needs and views of adolescents regarding development of online support for mental health problems. (Contains 2 tables.)

Purpose: The purpose of this paper is to gain first insight into factors which might be associated with exposure to internet-delivered interventions. Design/methodology/approach: Semi-structured focus group interviews were conducted with five groups of Dutch adolescents (n = 54), aged 12-17 years. Several aspects of exposure: a first visit; staying long enough actually to use and process the information; and revisiting the intervention, were explored. Findings: Several factors that are likely to improve exposure to internet-delivered interventions were identified, such as the use of "word of mouth" marketing, comparison of own behaviour with friends and the use of reminders. Research limitations/implications: Focus group interviews are only a first step in the generation of ideas and opinions. A next step would be to conduct observational, experimental and longitudinal studies to test "if" and "how" these factors improve exposure to internet-delivered interventions. Practical implications: This paper is a useful source for those developing internet-delivered interventions who want to improve exposure rates to their interventions. Originality/value: The results of this exploration serve as an important first step to gain more insight into factors that improve exposure to internet-delivered interventions. (Contains 1 table.)

Background: Two primary school-based interventions were implemented, aimed at increasing fruit and vegetable (F&V) consumption by children, both with proven effectiveness: (1) a free daily F&V distribution scheme for all primary school children and (2) a multicomponent, age-specific program consisting of a classroom curriculum, parental involvement, and an environmental component. This article describes and compares the implementation, evaluation, and potential for adoption of the 2 interventions. Methods: A total of 48 teachers who worked with either of these programs filled out a questionnaire at the end of the intervention period. Additionally, 24 of the teachers who worked with the multicomponent program filled out periodic monitoring reports during the intervention. Results: Compared to the F&V distribution, the multicomponent program was less fully implemented and that implementation of activities decreased over time. Both programs were evaluated favorably, and about half of the teachers indicated that they were willing to use the program again in the following school year. Teachers who used the multicomponent program experienced more social pressure to implement the program. They rated the program they had used as more complex and risky than the other group rated the distribution program. Conclusions: The free distribution program has the greatest potential for being adopted by schoolteachers, but that efforts must be made to acquire funding for it. Until these resources are available, the multicomponent program seems to be a good alternative if improved as suggested. (Contains 4 tables.)

Purpose: The aim of this paper is to explore the beliefs of 15-17 year-old Dutch adolescents about starting or quitting smoking and to explore their preferences regarding education concerning this topic. Design/methodology/approach: The paper shows that a total of 12 group interviews were held with 101 students in the highest classes in secondary school (lower and higher secondary school and first class of intermediate vocational education). Findings: The findings in this paper indicate that most adolescents started smoking to be cool and because they were curious about the taste of a cigarette. Smokers felt that smoking is sociable and relaxing, while non-smokers emphasized the negative consequences of smoking. Smokers expected to quit smoking when the price of cigarettes further increased, or when they fell ill as a result of smoking. They did not expect to receive social support from their friends and parents during a quit attempt. The hardest times during their quit attempts would be in the presence of smoking friends, when feeling stressed or during a night out. Adolescents preferred to receive future education through the internet. A web site should consist of much colour and animated images, but should also be serious. Originality/value: The paper shows that computer tailoring could be an effective method of educating adolescents about (quitting) smoking through the internet, since it links up with their personal situation and therefore relevant advice can be given. (Contains 2 tables.)

Purpose: The purpose of this research is to explore individual and social factors that are associated with children's F&V (fruit and vegetable) intake in order to develop a school-based intervention to increase their F&V consumption. Design/methodology/approach: Group interviews were conducted with ten groups of Dutch children (n=104), aged 4-12 years, and two groups of parents (n=28). Additionally, a total of ten parents participated in an interview by telephone. Opinions about the actual F&V consumption, awareness of consumption patterns, attitudes towards F&V, promotion of F&V consumption by parents and F&V intake at school were explored. Transcripts were analysed using Nvivo 2.0. Findings: Several factors that are likely to increase F&V consumption of the participants were identified, such as preferences, modeling of F&V consumption by teachers and parents and availability of F&V in ready-to-eat form at home and school. Although both children and parents favoured activities to promote F&V at school, most parents were not willing to participate in these activities. Research limitations/implications: The present study obtains information from a broad perspective, and not from a representative sample. Practical implications: This article is a useful source for health promotion planners that are developing food-related interventions for children. Originality/value: Information on factors that influence children's F&V consumption is usually acquired through parents. It is questionable whether parents are aware of the factors that influence their children's food choice. Therefore this study combined information gathered among parents with information gathered directly among children. (Contains 3 tables.)

Increasing prevalence of chronic disease leads to an increased need for person-centered care. To prepare future health professionals for this need, educational institutions provide interprofessional education in which they actively involve patients (hereafter called experts by experience). The organization of inter-institutional, interprofessional education with the active involvement of experts by experience poses challenges. To overcome these challenges, a joint student- and expert by experience-led organization was established, named Patient as a Person Foundation. This organization functions as the linking pin between three educational institutions. Jointly, they enabled the involvement of 181 experts by experience in interprofessional education and 1313 students from nine study programs over the course of two curriculum years. To facilitate joint education involving patients, Patient as a Person Foundation realizes three main activities: (a) recruitment and instruction of experts by experience, (b) enabling the inter-institutional organization of education and facilitating its logistics and financing, and (c) universal training of teaching staff. This interprofessional Education and Practice Guide aims to provide lessons on how to sustainably organize interprofessional education involving experts by experience across multiple educational institutions. The key lessons provided in this guide, underpinned by research and key literature, aim to inspire and enable similar initiatives elsewhere. [ABSTRACT FROM AUTHOR]

Objective: To study predictors of fruit intake in a sample of 627 adults. Design: Potential predictors of fruit intake were assessed at baseline, and fruit intake was assessed at two-week follow-up with self-administered questionnaires distributed by e-mail. Setting: The study was conducted among Dutch adult members of an Internet research panel Participants: A random sample of 627 adults aged 18-78. Variables Measured: Attitudes, subjective norms, self-efficacy, expected pros and cons, habit strength, intention, and fruit intake. Fruit intake was assessed with a validated food-frequency questionnaire. Analysis: Hierarchical linear and logistic regression analyses. Alpha Results: Sex, attitudes, subjective norms, perceived pros, different self-efficacy expectations, and habit strength were significantly associated with the intention to eat two or more servings of fruit per day. Age, intentions, and habit strength were significant predictors of consumption of two or more servings of fruit per day. Conclusions and Implications: The results confirm that Theory of Planned Behavior constructs predict fruit intake, and that habit strength and different self-efficacy expectations may be additional determinants relevant to fruit intake. Because habitual behavior is considered to be triggered by environmental cues, fruit promotion interventions should further explore environmental change strategies.

Objective: The present study examined (1) whether respondents who were encouraged to make implementation intentions to eat more fruit increased their fruit intakes, as measured by three measures of fruit intake; (2) whether the effects of implementation intentions on fruit intake were dependent on positive goal intentions at baseline; and (3) the respondents' commitment to perform their implementation intentions. Design: Dutch adults (n = 535) were randomly assigned to either receive implementation intention instructions or not. Two questionnaires were completed with a 1.5-week time interval. Respondents in the implementation intention condition were asked to form implementation intentions to eat an extra serving of fruit per day during one week. Results: Respondents in the implementation intention group reported a high frequency of eating an extra serving of fruit per day. The implementation intention effect on frequency of extra fruit did not depend on goal intention at baseline. The more committed respondents were to carrying out their implementation intention, the more likely they were to increase their fruit intake. Conclusion: These results provide some indications that implementation intentions could be a useful strategy to induce a short-term increase in fruit intake. Key Words: fruit consumption, implementation intention, goal intention, commitment

Social psychological correlates of two main aspects of the process of cancer detection, viz. passive detection (i.e., paying attention to cancer symptoms) and help-seeking intention, were studied among a-symptomatic Dutch adults. Two written questionnaires, with a six-week interval, identified correlates of both variables, using a determinant model based on the theory of planned behavior. Knowledge, advantages, self-efficacy, being female and being more highly educated were associated with passive detection. Knowledge, advantages, moral obligation, anticipated regret, social norm, and self-efficacy were correlated with the intention to seek help. We suggest that educational programs need to address the two variables separately and also need to tailor their content to the various social psychological correlates of these two aspects. Keywords: The Netherlands; Cancer, Cancer detection; Theory of planned behavior

Although interprofessional education (IPE) is acknowledged as a way to prepare health professions students for future interprofessional collaboration (IPC), there is a need to better ground IPE-design in learning theory. Landscapes of practice and its concepts of knowledgeability and identification are suggested as a framework that may help optimize IPE. This Observation paper provides an explanation of how these concepts might be used in IPE-design. We propose using three modes of identification, i.e., engagement, imagination, and alignment, described in this framework, for an IPE-design that fosters IPC skills, professional identity formation, and knowledgeability about a field and its actors. Identification and knowledgeability are through to enable successful collaboration across professional and practice boundaries. Focusing on identification implies that students develop a sense of relevance to one another in solving complex problems (engagement), they become aware of their own roles and responsibilities in relation to others (imagination), and they gain awareness of the context in which the different professions align and collaborate (alignment). Altogether, this enables students to become knowledgeable in the landscape, which prepares them for successful interprofessional collaboration in practice. [ABSTRACT FROM AUTHOR]