This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.
SamenvattingDe afgelopen decennia is sterk ingezet op het terugdringen van tabaks- en alcoholgebruik onder jongeren. Monitoring is belangrijk om te toetsen of uitgezet beleid gepaard gaat met het gewenste resultaat. Met gegevens van het Peilstationsonderzoek Scholieren wordt onderzocht hoe het tabaks- en alcoholgebruik onder scholieren van twaalf tot en met zestien jaar tussen 1999 en 2019 veranderd is, met specifieke aandacht voor (1) verschillen naar geslacht en leeftijd, en (2) veranderingen in de populatiesamenstelling over tijd. Roken en alcoholgebruik zijn in deze periode sterk gedaald (lifetime-prevalentie roken van 53,9% in 1999 naar 17,0% in 2019; lifetime-prevalentie alcoholgebruik van 71,9% naar 46,6%). De daling heeft zich vooral tot 2015 voorgedaan en lijkt sindsdien tot stilstand gekomen. De trends zijn voor jongens en meisjes vrijwel hetzelfde, maar de daling is voor jongere leeftijdsgroepen groter dan voor oudere leeftijdsgroepen. Ook na controle voor sociaal-demografische kenmerken bleef de daling in roken en alcoholgebruik bestaan. Daarnaast is het drinken van vijf glazen of meer bij één gelegenheid (bingedrinken) onder degenen die de afgelopen maand dronken van 64,1% in 2003 gestegen naar 70,6% in 2019. Een nieuwe impuls lijkt nodig om het gebruik van tabak en alcohol onder scholieren verder terug te dringen.
Background Depression is one of the leading causes of illness and disability among young people. In the Netherlands, one in twelve Dutch adolescents has experienced depression in the last 12 months. Pre-vocational students are at higher risk for elevated depressive symptoms. Effective interventions, especially for this risk group, are therefore needed to prevent the onset of depression or mitigate the adverse long-term effects of depression. The aim of this study is to examine the effectiveness and implementation of a school-based program Happy Lessons (HL), that aims to prevent depression and promote well-being among pre-vocational students. Methods A cluster randomized controlled trial (RCT) with students randomized to HL or to care as usual will be conducted. Pre-vocational students in their first or second year (aged 12 to 14) will participate in the study. Subjects in both conditions will complete assessments at baseline and at 3- and 6-months follow-up. The primary outcome will be depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) at 6-months follow-up. Secondary outcomes are well-being using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and life satisfaction (Cantril Ladder) measured at 6-months follow-up. Alongside the trial, an implementation study will be conducted to evaluate the implementation of HL, using both quantitative and qualitative methods (interviews, survey, and classroom observations). Discussion The results from both the RCT and implementation study will contribute to the limited evidence base on effective school-based interventions for the prevention of depression and promotion of well-being among pre-vocational adolescents. In addition, insights from the implementation study will aid identifying factors relevant for optimizing the future implementation and scale-up of HL to other schools and contexts. Trial registration This study was registered on 20 September 2021 in the Dutch Trial Register (NL9732).
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