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Papers by marielle jambroes
Children (Basel), Nov 14, 2022
The public health workforce is a key resource of population health. How many people work in publi... more The public health workforce is a key resource of population health. How many people work in public health in the Netherlands, what are their characteristics and who does what? Remarkably, such information about the size and composition of the public health workforce in the Netherlands is lacking. A standardized system to collect these data is also unavailable. This thesis introduces a new methodology to enumerate the public health workforce. By applying it to environmental public health and preventive youth health care, our insight in the quantity and quality of the current and future public health workforce in the Netherlands has increased. The studies described in this thesis are among the first scientific studies into public health workforce enumeration in the Netherlands and the results contribute to an empirical base for public health workforce planning and development.
Nederlands Tijdschrift voor Geneeskunde, 2016
International Journal of Environmental Research and Public Health, 2021
The COVID-19 pandemic and the associated measures have impacted the health of many. Not all popul... more The COVID-19 pandemic and the associated measures have impacted the health of many. Not all population groups are equally vulnerable to such health effects, possibly increasing health inequalities. We performed a group concept mapping procedure to define a common, context-specific understanding of what makes people vulnerable to health effects of the pandemic and the measures. We organized a two-step, blended brainstorming session with locally involved community members, using the brainstorm focus prompt ‘What I think makes people vulnerable for the COVID-19 pandemic and the measures is…’. We asked participants to generate as many statements as possible. Participants then individually structured (sorted and ranked) these statements. The structuring data was analysed using the groupwisdomTM software and then interpreted by the researchers to generate the concept map. Ninety-eight statements were generated by 19 participants. Sixteen participants completed both structuring tasks. The ...
PLOS ONE, 2021
Background Maternal body mass index (BMI) below or above the reference interval (18.5–24.9 kg/m2)... more Background Maternal body mass index (BMI) below or above the reference interval (18.5–24.9 kg/m2) is associated with adverse pregnancy outcomes. Whether BMI exerts an effect within the reference interval is unclear. Therefore, we assessed the association between adverse pregnancy outcomes and BMI, in particular within the reference interval, in a general unselected pregnant population. Methods Data was extracted from a prospective population-based multicentre cohort (Risk Estimation for PrEgnancy Complications to provide Tailored care (RESPECT) study) conducted between December 2012 to January 2014. BMI was studied in categories (I: <18.5, II: 18.5–19.9, III: 20.0–22.9, IV: 23.0–24.9, V: 25.0–27.4, VI: 27.5–29.9, VII: >30.0 kg/m2) and as a continuous variable within the reference interval. Adverse pregnancy outcomes were defined as composite endpoints for maternal, neonatal or any pregnancy complication, and for adverse pregnancy outcomes individually. Linear trends were asses...
European Journal of Public Health, 2019
Background Physicians play an important role in the control of emerging infections and antibiotic... more Background Physicians play an important role in the control of emerging infections and antibiotic resistance. Therefore, all physicians should have sufficient knowledge regarding infectious disease control. It is unknown what knowledge is considered as sufficient; the Dutch National Framework on learning outcomes for medical curricula only offers general terms for this topic. The aim of this study was to determine which learning items are considered as essential knowledge for junior doctors in the Netherlands. The results can support curriculum development regarding infectious disease control. Methods An online two-round Delphi study was performed, involving four expert groups: general practitioners; public health physicians; medical students; and educational coordinators of Dutch universities. Experts were asked to rate sixteen learning items, selected by a literature review. A learning item was considered as essential knowledge if at least 80% consensus was reached on a 5-point Li...
The European Journal of Public Health, 2003
International Journal of Environmental Research and Public Health, Nov 24, 2022
Nederlands tijdschrift voor geneeskunde, 2016
There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. T... more There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. These teenagers account for approximately 10% of the total population. Teenagers are relatively healthy and do not make much use of curative care. However, they are an important group in terms of public health, because a basis for good health in later life is created in the teenage years. Good health in teenagers is also important for education, relationships and employment, and their health has an influence on the health of the next generation. Child and adolescent healthcare plays an important part in preventive care for teenagers. Better cooperation and exchange of information between paediatricians, specialists in child and adolescent healthcare and general practitioners are important in order to optimise care for teenagers.
Nederlands Tijdschrift voor Geneeskunde, 2012
To gain insight into the size and composition of the various groups of professionals operating in... more To gain insight into the size and composition of the various groups of professionals operating in the Dutch public health sector in order to steer development within these groups and to improve quality and efficiency in public healthcare. Document analysis. Analysis of data from 7 reports published between 2003 and 2010, focussing on descriptions of working fields, (definitions of) professions and roles and total numbers. By combining the data from 7 reports, we were able to estimate that the total size of all professional groups operating in the public healthcare sector is 12,000 FTE. This is an imprecise estimation because delimitation of the workforce, the occupations and roles selected and data collection methods used during the analyses was not all the same. Per analysis, the delimitation of the working fields ranged, for example, from all municipal health services to a broad selection of facilities and organisations. The roles included varied from 1 to more than 15. The only p...
Nederlands Tijdschrift voor Geneeskunde, 2016
There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. T... more There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. These teenagers account for approximately 10% of the total population. Teenagers are relatively healthy and do not make much use of curative care. However, they are an important group in terms of public health, because a basis for good health in later life is created in the teenage years. Good health in teenagers is also important for education, relationships and employment, and their health has an influence on the health of the next generation. Child and adolescent healthcare plays an important part in preventive care for teenagers. Better cooperation and exchange of information between paediatricians, specialists in child and adolescent healthcare and general practitioners are important in order to optimise care for teenagers.
Nederlands Tijdschrift voor Geneeskunde, 2016
The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of... more The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had > 10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range: 688-1007). All essential public health operations were provided. Regional differences in the number of children per YHC professional were unrelated to the indicators of YHC need. The essentia...
European Journal of Public Health, 2015
European Journal of Public Health, 2015
European journal of public health, Jun 24, 2015
To explore the implications for public health policy of a new conceptualisation of health as '... more To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Secondary qualitative data analysis of 28 focus group interviews, with 277 participants involved in public health and healthcare, on the future of the Dutch healthcare system. WHO's essential public health operations (EPHOs) were used as a framework for analysis. Starting from the new concept of health, participants perceived health as an individual asset, requiring an active approach in the Dutch population towards health promotion and adaptation to a healthy lifestyle. Sectors outside healthcare and public health were considered as resources to support individual lifestyle improvement. Integrating prevention and health promotion in healthcare is also expected to stimulate individuals to comply with a healthy lifestyle. Attention should be paid to persons less skilled to self-man...
Health policy (Amsterdam, Netherlands), Jan 13, 2015
The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of... more The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had >10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range 688-1007). All essential public health operations were provided and could be clustered in an operational or policy profile. The operational profile prevailed in all regions. Regional difference...
Children (Basel), Nov 14, 2022
The public health workforce is a key resource of population health. How many people work in publi... more The public health workforce is a key resource of population health. How many people work in public health in the Netherlands, what are their characteristics and who does what? Remarkably, such information about the size and composition of the public health workforce in the Netherlands is lacking. A standardized system to collect these data is also unavailable. This thesis introduces a new methodology to enumerate the public health workforce. By applying it to environmental public health and preventive youth health care, our insight in the quantity and quality of the current and future public health workforce in the Netherlands has increased. The studies described in this thesis are among the first scientific studies into public health workforce enumeration in the Netherlands and the results contribute to an empirical base for public health workforce planning and development.
Nederlands Tijdschrift voor Geneeskunde, 2016
International Journal of Environmental Research and Public Health, 2021
The COVID-19 pandemic and the associated measures have impacted the health of many. Not all popul... more The COVID-19 pandemic and the associated measures have impacted the health of many. Not all population groups are equally vulnerable to such health effects, possibly increasing health inequalities. We performed a group concept mapping procedure to define a common, context-specific understanding of what makes people vulnerable to health effects of the pandemic and the measures. We organized a two-step, blended brainstorming session with locally involved community members, using the brainstorm focus prompt ‘What I think makes people vulnerable for the COVID-19 pandemic and the measures is…’. We asked participants to generate as many statements as possible. Participants then individually structured (sorted and ranked) these statements. The structuring data was analysed using the groupwisdomTM software and then interpreted by the researchers to generate the concept map. Ninety-eight statements were generated by 19 participants. Sixteen participants completed both structuring tasks. The ...
PLOS ONE, 2021
Background Maternal body mass index (BMI) below or above the reference interval (18.5–24.9 kg/m2)... more Background Maternal body mass index (BMI) below or above the reference interval (18.5–24.9 kg/m2) is associated with adverse pregnancy outcomes. Whether BMI exerts an effect within the reference interval is unclear. Therefore, we assessed the association between adverse pregnancy outcomes and BMI, in particular within the reference interval, in a general unselected pregnant population. Methods Data was extracted from a prospective population-based multicentre cohort (Risk Estimation for PrEgnancy Complications to provide Tailored care (RESPECT) study) conducted between December 2012 to January 2014. BMI was studied in categories (I: <18.5, II: 18.5–19.9, III: 20.0–22.9, IV: 23.0–24.9, V: 25.0–27.4, VI: 27.5–29.9, VII: >30.0 kg/m2) and as a continuous variable within the reference interval. Adverse pregnancy outcomes were defined as composite endpoints for maternal, neonatal or any pregnancy complication, and for adverse pregnancy outcomes individually. Linear trends were asses...
European Journal of Public Health, 2019
Background Physicians play an important role in the control of emerging infections and antibiotic... more Background Physicians play an important role in the control of emerging infections and antibiotic resistance. Therefore, all physicians should have sufficient knowledge regarding infectious disease control. It is unknown what knowledge is considered as sufficient; the Dutch National Framework on learning outcomes for medical curricula only offers general terms for this topic. The aim of this study was to determine which learning items are considered as essential knowledge for junior doctors in the Netherlands. The results can support curriculum development regarding infectious disease control. Methods An online two-round Delphi study was performed, involving four expert groups: general practitioners; public health physicians; medical students; and educational coordinators of Dutch universities. Experts were asked to rate sixteen learning items, selected by a literature review. A learning item was considered as essential knowledge if at least 80% consensus was reached on a 5-point Li...
The European Journal of Public Health, 2003
International Journal of Environmental Research and Public Health, Nov 24, 2022
Nederlands tijdschrift voor geneeskunde, 2016
There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. T... more There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. These teenagers account for approximately 10% of the total population. Teenagers are relatively healthy and do not make much use of curative care. However, they are an important group in terms of public health, because a basis for good health in later life is created in the teenage years. Good health in teenagers is also important for education, relationships and employment, and their health has an influence on the health of the next generation. Child and adolescent healthcare plays an important part in preventive care for teenagers. Better cooperation and exchange of information between paediatricians, specialists in child and adolescent healthcare and general practitioners are important in order to optimise care for teenagers.
Nederlands Tijdschrift voor Geneeskunde, 2012
To gain insight into the size and composition of the various groups of professionals operating in... more To gain insight into the size and composition of the various groups of professionals operating in the Dutch public health sector in order to steer development within these groups and to improve quality and efficiency in public healthcare. Document analysis. Analysis of data from 7 reports published between 2003 and 2010, focussing on descriptions of working fields, (definitions of) professions and roles and total numbers. By combining the data from 7 reports, we were able to estimate that the total size of all professional groups operating in the public healthcare sector is 12,000 FTE. This is an imprecise estimation because delimitation of the workforce, the occupations and roles selected and data collection methods used during the analyses was not all the same. Per analysis, the delimitation of the working fields ranged, for example, from all municipal health services to a broad selection of facilities and organisations. The roles included varied from 1 to more than 15. The only p...
Nederlands Tijdschrift voor Geneeskunde, 2016
There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. T... more There are about 1.8 million children between 10 and 18 years of age in the Netherlands in 2016. These teenagers account for approximately 10% of the total population. Teenagers are relatively healthy and do not make much use of curative care. However, they are an important group in terms of public health, because a basis for good health in later life is created in the teenage years. Good health in teenagers is also important for education, relationships and employment, and their health has an influence on the health of the next generation. Child and adolescent healthcare plays an important part in preventive care for teenagers. Better cooperation and exchange of information between paediatricians, specialists in child and adolescent healthcare and general practitioners are important in order to optimise care for teenagers.
Nederlands Tijdschrift voor Geneeskunde, 2016
The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of... more The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had > 10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range: 688-1007). All essential public health operations were provided. Regional differences in the number of children per YHC professional were unrelated to the indicators of YHC need. The essentia...
European Journal of Public Health, 2015
European Journal of Public Health, 2015
European journal of public health, Jun 24, 2015
To explore the implications for public health policy of a new conceptualisation of health as '... more To explore the implications for public health policy of a new conceptualisation of health as 'The ability to adapt and to self-manage, in the face of social, physical and emotional challenges'. Secondary qualitative data analysis of 28 focus group interviews, with 277 participants involved in public health and healthcare, on the future of the Dutch healthcare system. WHO's essential public health operations (EPHOs) were used as a framework for analysis. Starting from the new concept of health, participants perceived health as an individual asset, requiring an active approach in the Dutch population towards health promotion and adaptation to a healthy lifestyle. Sectors outside healthcare and public health were considered as resources to support individual lifestyle improvement. Integrating prevention and health promotion in healthcare is also expected to stimulate individuals to comply with a healthy lifestyle. Attention should be paid to persons less skilled to self-man...
Health policy (Amsterdam, Netherlands), Jan 13, 2015
The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of... more The progress in workforce planning in preventive youth health care (YHC) is hampered by a lack of data on the current workforce. This study aimed to enumerate the Dutch YHC workforce. To understand regional variations in workforce capacity we compared these with the workforce capacity and the number of children and indicators of YHC need per region. A national survey was conducted using online questionnaires based on WHO essential public health operations among all YHC workers. Respondents (n=3220) were recruited through organisations involved in YHC (participation: 88%). The YHC workforce is multi-disciplinary, 62% had >10 years working experience within YHC and only small regional variations in composition existed. The number of children per YHC professional varied between regions (range 688-1007). All essential public health operations were provided and could be clustered in an operational or policy profile. The operational profile prevailed in all regions. Regional difference...