Hans van Oers | Tilburg University (original) (raw)

Papers by Hans van Oers

Research paper thumbnail of Preventie en gezondheidszorg: waarom eigenlijk?

Tijdschrift voor gezondheidswetenschappen, 2013

Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het d... more Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het doel van het gezondheidszorgsysteem is de gezondheid te beschermen of te bevorderen, ziekten te voorkomen of te genezen, en de kwaliteit van leven van chronisch zieken te verbeteren. Gezondheid als kernwaarde lijkt logisch en dat is het ook. Maar als je een krant openslaat, of met mensen praat blijkt al snel dat er veel meer doelen gediend worden met preventie en zorg. Ook in beleidsstukken, of deze nou van de rijksoverheid zijn, van patiëntenorganisaties of van beroepsgroepen, kom je veel meer doelen tegen. Zo moet preventie helpen de kosten te reduceren en is de zorg soms vooral bedoeld om mensen de regie over het eigen leven terug te geven.

Research paper thumbnail of ‘Are we there yet?’ – Operationalizing the concept of Integrated Public Health Policies

Health Policy, 2014

Objectives: Although 'integrated' public health policies are assumed to be the ideal way to optim... more Objectives: Although 'integrated' public health policies are assumed to be the ideal way to optimize public health, it remains hard to determine how far removed we are from this ideal, since clear operational criteria and defining characteristics are lacking. Methods: A literature review identified gaps in previous operationalizations of integrated public health policies. We searched for an approach that could fill these gaps. Results: We propose the following defining characteristics of an integrated policy: (1) the combination of policies includes an appropriate mix of interventions that optimizes the functioning of the behavioral system, thus ensuring that motivation, capability and opportunity interact in such a way that they promote the preferred (health-promoting) behavior of the target population, and (2) the policies are implemented by the relevant policy sectors from different policy domains. Conclusion: Our criteria should offer added value since they describe pathways in the process towards formulating integrated policy. The aim of introducing our operationalization is to assist policy makers and researchers in identifying truly integrated cases. The Behavior Change Wheel proved to be a useful framework to develop operational criteria to assess the current state of integrated public health policies in practice.

Research paper thumbnail of Qualitative health research and health promotion at the local level

International quarterly of community health education, 1996

The Municipal Health Service for Rotterdam area in the Netherlands has developed a health researc... more The Municipal Health Service for Rotterdam area in the Netherlands has developed a health research strategy with special focus on qualitative methods. This article describes one of the first and most instructive cases in which this strategy has been applied: a local health study in "Feijenoord." The research in Feijenoord was carried out between 1989 and 1990 making it possible to look both at the short-term and long-term effects. Quantitative data were used to describe the neighborhood health situation. Qualitative data were used to expand on this description. The qualitative information was obtained from residents and workers in health care and welfare using focused interviews and nominal group interviews. The results and effects of the research presented were influential. The research started a train of activity that could not have been predicted, and of which the Municipal Health Service had little control at first. An important effect in the short-term was that, as br...

Research paper thumbnail of Preventie en gezondheidszorg: waarom eigenlijk?

Tijdschrift voor gezondheidswetenschappen, 2013

Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het d... more Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het doel van het gezondheidszorgsysteem is de gezondheid te beschermen of te bevorderen, ziekten te voorkomen of te genezen, en de kwaliteit van leven van chronisch zieken te verbeteren. Gezondheid als kernwaarde lijkt logisch en dat is het ook. Maar als je een krant openslaat, of met mensen praat blijkt al snel dat er veel meer doelen gediend worden met preventie en zorg. Ook in beleidsstukken, of deze nou van de rijksoverheid zijn, van patiëntenorganisaties of van beroepsgroepen, kom je veel meer doelen tegen. Zo moet preventie helpen de kosten te reduceren en is de zorg soms vooral bedoeld om mensen de regie over het eigen leven terug te geven.

Research paper thumbnail of Public health: disconnections between policy, practice and research

Background: Public health includes policy, practice and research but to sufficiently connect acad... more Background: Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed.

Research paper thumbnail of An evaluation of the development of a marketing strategy in mental healthcare delivery

International Journal of Healthcare Management, 2014

ABSTRACT

Research paper thumbnail of The Specificity of the CDT Assay in General Practice

Alcoholism: Clinical & Experimental Research, 1998

Early recognition of alcohol problems by general practitioners might be enhanced by the use of be... more Early recognition of alcohol problems by general practitioners might be enhanced by the use of better alcohol markers. Several studies have revealed promising results for the carbohydrate-deficient transferrin (CDT) assay in certain populations. The aim of our study was to examine the specificity of the CDT assay in a general practice population. The main research question was whether common chronic diseases andlor the accompanying prescribed drugs have a negative influence on the specificity of the CDT assay. The 524 men who participated were selected from seven general practices and were suffering from one or more of the following diseases: hypertension, asthmahronchitis, diabetes mellitus, adipositidlipid metabolism disorder, angina pectoris, depression, and disorders of the digestive tract. None of the studied diseases or of the accompanying prescribed drugs had an influence on the specificity of the CDT assay. The overall specificity in this general practitioner population was 0.92. It can be concluded that the studied diseases do not bear an influence on the serum CDT concentration, and that, therefore, the CDT assay isa highly specific instrument for use in assessing alcohol consumption in general practice patients.

Research paper thumbnail of Comparing the Diagnostic Accuracy of Carbohydrate-Deficient Transferrin, gamma-Glutamyltransferase, and Mean Cell Volume in a General Practice Population

Alcoholism: Clinical and Experimental Research, 1999

In certain populations, the biological alcohol marker carbohydrate-deficient transferrin (CDT) is... more In certain populations, the biological alcohol marker carbohydrate-deficient transferrin (CDT) is known to have a high diagnostic accuracy. The aim of this study was to compare the diagnostic accuracy of CDT, y-glutamyltransferase (y-GT), and mean cell volume (MCV) in a general practice population; more specifically, to ascertain whether CDT is a better tool than y-GT and MCV for (early) recognition of excessive alcohol use. To represent the general practice situation as realistically as possible, three different drinking patterns are defined: irregular excessive, regular excessive, and very excessive. From a sample of 524 men from seven general practices, sensitivity, specificity, and predictive values of the three markers for the three drinking patterns were compared, and receiver-operating characteristic analysis was used to compare differences between the markers. The results indicate that drinking patterns do influence the (difference in) diagnostic accuracy. CDT has a higher diagnostic accuracy for all three drinking patterns than y-GT and higher predictive values for hazardous [@)regular excessive] drinking patterns than MCV. However, receiver-operating characteristic analyses failed to demonstrate a significant difference between these patterns. It is concluded that the performance of all tests is too low to be useful for screening procedures in a general population; however, some tests may be useful for case finding. CDT seems to be the best alcohol marker available, although the difference between CDT and MCV is small.

Research paper thumbnail of Conditions for sustainability of Academic Collaborative Centres for Public Health in the Netherlands: a mixed methods design

Health research policy and systems / BioMed Central, 2015

Contemporary research should increasingly be carried out in the context of application. Nowotny c... more Contemporary research should increasingly be carried out in the context of application. Nowotny called this new form of knowledge production Mode-2. In line with Mode-2 knowledge production, the Dutch government in 2006 initiated the so-called Academic Collaborative Centres (ACC) for Public Health. The aim of these ACCs is to build a regional, sustainable knowledge-sharing network to deliver socially robust knowledge. The present study aims to highlight the enabling and constraining push and pull factors of these ACCs in order to assess whether the ACCs are able to build and strengthen a sustainable integrated organizational network between public health policy, practice, and research. Our empirical analysis builds on a mixed methods design. Quantitative data was derived from records of a survey sent to all 11 ACCs about personnel investments, number and nature of projects, and earning power. Qualitative data was derived from 21 in-depth interviews with stakeholders involved. The in...

Research paper thumbnail of Quality aspects of Dutch general practice-based data: a conceptual approach

Family Practice, 2013

Background. General practice-based data, collected within general practice registration networks ... more Background. General practice-based data, collected within general practice registration networks (GPRNs), are widely used in research. The quality of the data is important but the recording criteria about what type of information is collected and how this information should be recorded differ between GPRNs.

Research paper thumbnail of Health status and the challenges for prevention in The Netherlands

Public Health, 2005

In 2002, the third Public Health Status and Forecasts report was published, containing up-to-date... more In 2002, the third Public Health Status and Forecasts report was published, containing up-to-date information about Dutch public health and health care. A striking finding was that although life expectancy (LE) in The Netherlands increased between 1980 and 2000, the LE of men is rising less rapidly than the European Union (EU) average. The LE of Dutch women is stagnating and has now fallen below the EU average. These and many other unfavourable trends in the health status of the Dutch population were found to be largely due to unhealthy behaviour. One of the policy recommendations therefore was to strengthen the investments in prevention in order to reverse the stagnation in health status.

Research paper thumbnail of Do practice characteristics explain differences in morbidity estimates between electronic health record based general practice registration networks?

BMC Family Practice, 2014

Background: General practice based registration networks (GPRNs) provide information on populatio... more Background: General practice based registration networks (GPRNs) provide information on population health derived from electronic health records (EHR). Morbidity estimates from different GPRNs reveal considerable, unexplained differences. Previous research showed that population characteristics could not explain this variation. In this study we investigate the influence of practice characteristics on the variation in incidence and prevalence figures between general practices and between GPRNs.

Research paper thumbnail of Tien jaar professionals opleiden voor de publieke gezondheid

Tijdschrift voor gezondheidswetenschappen, 2013

De publieke gezondheidszorg heeft zich de laatste tien jaar sterk ontwikkeld. Professionals moete... more De publieke gezondheidszorg heeft zich de laatste tien jaar sterk ontwikkeld. Professionals moeten steeds meer leren te opereren in de driehoek beleid-onderzoek-praktijk, samenwerken in netwerken wordt steeds belangrijker, de structuur van opleiden van artsen in de sector is veranderd, de relatie tussen arbeid en gezondheid wordt steeds belangrijker gevonden, en dat alles in een snel veranderende samenleving die een deel van deze tien jaar economische voorspoed kende, maar daarna in een financiële crisis geraakte.

Research paper thumbnail of Uitdagingen in de volksgezondheid: vier perspectieven

Tijdschrift voor gezondheidswetenschappen, 2014

Het thema van het Nederlands Congres Volksgezondheid 2014 is 'perspectieven op de volksgezondheid... more Het thema van het Nederlands Congres Volksgezondheid 2014 is 'perspectieven op de volksgezondheid'. Dit congres vindt elk jaar plaats, en elk jaar is er veel ruimte voor de hele breedte van de volksgezondheid. Niet iedereen verstaat immers hetzelfde onder volksgezondheid. Voor de een is het lang leven in goede gezondheid, voor de ander is het een gezonde leefstijl, het verkleinen van gezondheidsachterstanden of de participatie van chronisch zieken. Op het congres van 2014 staat juist deze diversiteit centraal. De diversiteit in visies op de volksgezondheid vangen we in het begrip 'perspectieven'.

Research paper thumbnail of Aspecten van kwaliteit van data uit de huisartsenpraktijk

Inleiding: Routinematig vastgelegde gegevens uit de huisartsenpraktijk worden veel gebruikt voor ... more Inleiding: Routinematig vastgelegde gegevens uit de huisartsenpraktijk worden veel gebruikt voor onderzoek naar bijvoorbeeld de morbiditeit in Nederlands of efficiëntie van zorg. Er wordt veel energie gestopt in de kwaliteit van de gegevens, (scholing huisartsen, schonen van data, terugkoppelen van de informatie aan huisartsenpraktijken), maar in Nederland zijn er verschillende huisartsenregistraties, die anders, van opzet zijn. Onderzoeksvraag: Wat verstaan experts van verschillende registraties onder goede kwaliteit van data uit de huisartsenpraktijk? Methode: In dit onderzoek hebben we gebruik gemaakt van 'concept mapping'. In een brainstorm werden door tien experts van negen registraties uitspraken gedaan over goede kwaliteit van data uit de huisartsenpraktijk. Zestien experts beoordeelden deze uitspraken op belang (5-punts Likert schaal, 1= minst, 5= meest belangrijk) en groepeerden de uitspraken op basis van inhoud. Deze informatie is geanalyseerd in Ariadne, een softw...

Research paper thumbnail of Kosten en baten van preventie, een lastige analyse

Tijdschrift voor gezondheidswetenschappen, 2012

ABSTRACT ‘Investeren in preventie van ziektes loont’kopte het Financiële Dagblad in februari 2012... more ABSTRACT ‘Investeren in preventie van ziektes loont’kopte het Financiële Dagblad in februari 2012 naar aanleiding van Pomp’s scenarioanalyse van de maatschappelijke baten van healthy ageing onderzoek. En in het kielzog van die publicatie ontstonden op diverse plekken discussies over de betekenis van dit onderzoek: onder andere op Twitter, in de dagbladen, en in de Tweede Kamer. Maar ook op de werkvloer van verschillende organisaties die zich bezig houden met preventie deed het rapport van Marc Pomp stof opwaaien. En in die discussies liepen de meningen soms aanzienlijk uiteen.Voldoende aanleiding dus om verschillende partijen aan het woord te laten over de betekenis van het rapport. Als eerste komen Marc Pomp en Erik Buskens zelf aan het woord, om kort de hoofdlijnen van het rapport toe te lichten. Vervolgens wordt vanuit verschillende kanten een reactie geleverd. Jaap Koot doet dat vanuit het NIGZ (daar was hij al twitterend mee begonnen op de dag van verschijnen van het rapport). Matthijs van ...

Research paper thumbnail of URBAN40, een natuurlijk experiment met integraal wijkgericht gezondheidsbeleid

Tijdschrift voor gezondheidswetenschappen, 2014

ABSTRACT Spectrum biedt ruimte voor beschouwingen, discussies en opiniërende artikelen over onder... more ABSTRACT Spectrum biedt ruimte voor beschouwingen, discussies en opiniërende artikelen over onderwerpen op het terrein van de volksgezondheid en de gezondheidszorg. Bijdragen dienen te worden aangeboden conform de aanwijzingen voor de auteurs. Voor overleg over het thema kan contact worden opgenomen met de rubrieksredacteuren van Spectrum: prof. dr. J.A.M. van Oers (e-mail: Hans.van.Oers@rivm.nl) en dr. N. Hoeymans (e-mail: Nancy.Hoeymans@rivm.nl)

Research paper thumbnail of Knowledge in process? Exploring barriers between epidemiological research and local health policy development

Background: In the Netherlands municipalities are legally required to draw up a Local Health Poli... more Background: In the Netherlands municipalities are legally required to draw up a Local Health Policy Memorandum every four years. This policy memorandum should be based on (local) epidemiological research as performed by the Regional Health Services. However, it is largely unknown if and in what way epidemiological research is used during local policy development. As part of a larger study on knowledge utilization at the local level in The Netherlands, an analytical framework on the use of epidemiological research in local health policy development in the Netherlands is presented here. Method: Based on a literature search and a short inventory on experiences from Regional Health Services, we made a description of existing research utilization models and concepts about research utilization. Subsequently we mapped different barriers in research transmission.

Research paper thumbnail of Lokaal gezondheidsbeleid: making the evidence-based choice the easy choice

TSG, 2008

ABSTRACT Gemeentelijk gezondheidsbeleid dient (mede) gebaseerd te zijn op epidemiologisch inzicht... more ABSTRACT Gemeentelijk gezondheidsbeleid dient (mede) gebaseerd te zijn op epidemiologisch inzicht in de lokale gezondheidssituatie. Doel hiervan is het stimuleren van evidence-based gezondheidsbeleid. De implementatie van evidence-based werken in de openbare gezondheidszorg verloopt echter moeizaam. Huidige epidemiologische rapportages laten al zien waar problemen en kansen op gezondheidswinst liggen, maar geven nog onvoldoende aanknopingspunten voor concrete maatregelen en actieplannen. Hiervoor is informatie nodig over de effectiviteit van interventies en lokale beleidsmaatregelen. De GGD Hart voor Brabant wil het voor zijn gemeenten zo makkelijk mogelijk maken om de hierin de beste keuze te maken: ‘making the evidence-based choice the easy choice’. Het artikel beschrijft de ontwikkeling van het Regionaal Kompas Volksgezondheid (www.regionaalkompas.nl), een website die hiervoor specifiek is bedoeld. Geconcludeerd wordt dat het mogelijk is een website te maken met informatie die gemeentelijke beleidsmakers relevant vinden voor de vertaling van gezondheidsproblemen naar een concreet plan van aanpak. De implementatie in de regio West-Brabant laat zien dat het goed mogelijk is deze website grotendeels te delen met andere GGD’en. De discussie spitst zich toe op de kwaliteit en het gebruik van de website. Daarbij worden ook aanbevelingen gegeven om deze te verbeteren. Local public health policy: making the evidence-based choice the easy choice. The development and possibilities of the Regional Health Compass By law, local public health policy in the Netherlands has to be based on the epidemiological analysis of the local health situation, in order to stimulate evidence-based public health. However, the implementation of evidence-based acting in public health is laborious. Current epidemiological reports already show where problems and opportunities for health gain lie, but they do not provide sufficient handles for concrete policy arrangements and action plans. For this, information is needed on the effectiveness of interventions and local policy arrangements. Therefore, the Regional Public Health Service (GGD) ‘Hart voor Brabant’ wants to make the best choices on these matters as easy as possible for their municipalities: ‘making the evidence-based choice the easy choice’. This article describes the development of the Regional Health Compass (www.regionaalkompas.nl), a website specifically designed for this purpose. It is concluded that it is possible to build a website with information that is particular relevant for public health officers as to the translation of local health problems into a concrete plan of action. The implementation in the region West-Brabant shows that it is also possible to share this website with other Regional Public Health Services. The discussion focusses on the quality and the use of the website. Also recommendations for their improvement are given. Keywords: epidemiology, local health policy, evidence-based policy, public health, public health report epidemiologie-lokaal gezondheidsbeleid-evidence-based beleid-volksgezondheid-VTV

Research paper thumbnail of How can collaboration be strengthened between public health and primary care? A Dutch multiple case study in seven neighbourhoods

BMC public health, 2015

Although public health and primary care share the goal of promoting the health and wellbeing of t... more Although public health and primary care share the goal of promoting the health and wellbeing of the public, the two health sectors find it difficult to develop mutually integrated plans and to collaborate with each other. The aim of this multiple case study was to compare seven neighbourhoods in which a stepwise approach based on two central tools (district health profile and policy dialogue) was used to develop integrated district plans and promote collaboration. The stepwise approach involved the following steps: 1 Getting to know the neighbourhood, 2 Assembling the workgroup, 3 Analysing the neighbourhood, 4 Developing a district health profile, 5 Preparing policy dialogue, 6 Holding local dialogues, 7 Embedding integrated district plans and collaboration. To supervise this process, a core team was assembled for each neighbourhood, consisting of people drawn from both public health and primary care. Both the use of the two tools and the collaboration were studied by means of docu...

Research paper thumbnail of Preventie en gezondheidszorg: waarom eigenlijk?

Tijdschrift voor gezondheidswetenschappen, 2013

Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het d... more Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het doel van het gezondheidszorgsysteem is de gezondheid te beschermen of te bevorderen, ziekten te voorkomen of te genezen, en de kwaliteit van leven van chronisch zieken te verbeteren. Gezondheid als kernwaarde lijkt logisch en dat is het ook. Maar als je een krant openslaat, of met mensen praat blijkt al snel dat er veel meer doelen gediend worden met preventie en zorg. Ook in beleidsstukken, of deze nou van de rijksoverheid zijn, van patiëntenorganisaties of van beroepsgroepen, kom je veel meer doelen tegen. Zo moet preventie helpen de kosten te reduceren en is de zorg soms vooral bedoeld om mensen de regie over het eigen leven terug te geven.

Research paper thumbnail of ‘Are we there yet?’ – Operationalizing the concept of Integrated Public Health Policies

Health Policy, 2014

Objectives: Although 'integrated' public health policies are assumed to be the ideal way to optim... more Objectives: Although 'integrated' public health policies are assumed to be the ideal way to optimize public health, it remains hard to determine how far removed we are from this ideal, since clear operational criteria and defining characteristics are lacking. Methods: A literature review identified gaps in previous operationalizations of integrated public health policies. We searched for an approach that could fill these gaps. Results: We propose the following defining characteristics of an integrated policy: (1) the combination of policies includes an appropriate mix of interventions that optimizes the functioning of the behavioral system, thus ensuring that motivation, capability and opportunity interact in such a way that they promote the preferred (health-promoting) behavior of the target population, and (2) the policies are implemented by the relevant policy sectors from different policy domains. Conclusion: Our criteria should offer added value since they describe pathways in the process towards formulating integrated policy. The aim of introducing our operationalization is to assist policy makers and researchers in identifying truly integrated cases. The Behavior Change Wheel proved to be a useful framework to develop operational criteria to assess the current state of integrated public health policies in practice.

Research paper thumbnail of Qualitative health research and health promotion at the local level

International quarterly of community health education, 1996

The Municipal Health Service for Rotterdam area in the Netherlands has developed a health researc... more The Municipal Health Service for Rotterdam area in the Netherlands has developed a health research strategy with special focus on qualitative methods. This article describes one of the first and most instructive cases in which this strategy has been applied: a local health study in "Feijenoord." The research in Feijenoord was carried out between 1989 and 1990 making it possible to look both at the short-term and long-term effects. Quantitative data were used to describe the neighborhood health situation. Qualitative data were used to expand on this description. The qualitative information was obtained from residents and workers in health care and welfare using focused interviews and nominal group interviews. The results and effects of the research presented were influential. The research started a train of activity that could not have been predicted, and of which the Municipal Health Service had little control at first. An important effect in the short-term was that, as br...

Research paper thumbnail of Preventie en gezondheidszorg: waarom eigenlijk?

Tijdschrift voor gezondheidswetenschappen, 2013

Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het d... more Het doel van preventie en zorg is het verbeteren van de gezondheid. Of anders geformuleerd: het doel van het gezondheidszorgsysteem is de gezondheid te beschermen of te bevorderen, ziekten te voorkomen of te genezen, en de kwaliteit van leven van chronisch zieken te verbeteren. Gezondheid als kernwaarde lijkt logisch en dat is het ook. Maar als je een krant openslaat, of met mensen praat blijkt al snel dat er veel meer doelen gediend worden met preventie en zorg. Ook in beleidsstukken, of deze nou van de rijksoverheid zijn, van patiëntenorganisaties of van beroepsgroepen, kom je veel meer doelen tegen. Zo moet preventie helpen de kosten te reduceren en is de zorg soms vooral bedoeld om mensen de regie over het eigen leven terug te geven.

Research paper thumbnail of Public health: disconnections between policy, practice and research

Background: Public health includes policy, practice and research but to sufficiently connect acad... more Background: Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed.

Research paper thumbnail of An evaluation of the development of a marketing strategy in mental healthcare delivery

International Journal of Healthcare Management, 2014

ABSTRACT

Research paper thumbnail of The Specificity of the CDT Assay in General Practice

Alcoholism: Clinical & Experimental Research, 1998

Early recognition of alcohol problems by general practitioners might be enhanced by the use of be... more Early recognition of alcohol problems by general practitioners might be enhanced by the use of better alcohol markers. Several studies have revealed promising results for the carbohydrate-deficient transferrin (CDT) assay in certain populations. The aim of our study was to examine the specificity of the CDT assay in a general practice population. The main research question was whether common chronic diseases andlor the accompanying prescribed drugs have a negative influence on the specificity of the CDT assay. The 524 men who participated were selected from seven general practices and were suffering from one or more of the following diseases: hypertension, asthmahronchitis, diabetes mellitus, adipositidlipid metabolism disorder, angina pectoris, depression, and disorders of the digestive tract. None of the studied diseases or of the accompanying prescribed drugs had an influence on the specificity of the CDT assay. The overall specificity in this general practitioner population was 0.92. It can be concluded that the studied diseases do not bear an influence on the serum CDT concentration, and that, therefore, the CDT assay isa highly specific instrument for use in assessing alcohol consumption in general practice patients.

Research paper thumbnail of Comparing the Diagnostic Accuracy of Carbohydrate-Deficient Transferrin, gamma-Glutamyltransferase, and Mean Cell Volume in a General Practice Population

Alcoholism: Clinical and Experimental Research, 1999

In certain populations, the biological alcohol marker carbohydrate-deficient transferrin (CDT) is... more In certain populations, the biological alcohol marker carbohydrate-deficient transferrin (CDT) is known to have a high diagnostic accuracy. The aim of this study was to compare the diagnostic accuracy of CDT, y-glutamyltransferase (y-GT), and mean cell volume (MCV) in a general practice population; more specifically, to ascertain whether CDT is a better tool than y-GT and MCV for (early) recognition of excessive alcohol use. To represent the general practice situation as realistically as possible, three different drinking patterns are defined: irregular excessive, regular excessive, and very excessive. From a sample of 524 men from seven general practices, sensitivity, specificity, and predictive values of the three markers for the three drinking patterns were compared, and receiver-operating characteristic analysis was used to compare differences between the markers. The results indicate that drinking patterns do influence the (difference in) diagnostic accuracy. CDT has a higher diagnostic accuracy for all three drinking patterns than y-GT and higher predictive values for hazardous [@)regular excessive] drinking patterns than MCV. However, receiver-operating characteristic analyses failed to demonstrate a significant difference between these patterns. It is concluded that the performance of all tests is too low to be useful for screening procedures in a general population; however, some tests may be useful for case finding. CDT seems to be the best alcohol marker available, although the difference between CDT and MCV is small.

Research paper thumbnail of Conditions for sustainability of Academic Collaborative Centres for Public Health in the Netherlands: a mixed methods design

Health research policy and systems / BioMed Central, 2015

Contemporary research should increasingly be carried out in the context of application. Nowotny c... more Contemporary research should increasingly be carried out in the context of application. Nowotny called this new form of knowledge production Mode-2. In line with Mode-2 knowledge production, the Dutch government in 2006 initiated the so-called Academic Collaborative Centres (ACC) for Public Health. The aim of these ACCs is to build a regional, sustainable knowledge-sharing network to deliver socially robust knowledge. The present study aims to highlight the enabling and constraining push and pull factors of these ACCs in order to assess whether the ACCs are able to build and strengthen a sustainable integrated organizational network between public health policy, practice, and research. Our empirical analysis builds on a mixed methods design. Quantitative data was derived from records of a survey sent to all 11 ACCs about personnel investments, number and nature of projects, and earning power. Qualitative data was derived from 21 in-depth interviews with stakeholders involved. The in...

Research paper thumbnail of Quality aspects of Dutch general practice-based data: a conceptual approach

Family Practice, 2013

Background. General practice-based data, collected within general practice registration networks ... more Background. General practice-based data, collected within general practice registration networks (GPRNs), are widely used in research. The quality of the data is important but the recording criteria about what type of information is collected and how this information should be recorded differ between GPRNs.

Research paper thumbnail of Health status and the challenges for prevention in The Netherlands

Public Health, 2005

In 2002, the third Public Health Status and Forecasts report was published, containing up-to-date... more In 2002, the third Public Health Status and Forecasts report was published, containing up-to-date information about Dutch public health and health care. A striking finding was that although life expectancy (LE) in The Netherlands increased between 1980 and 2000, the LE of men is rising less rapidly than the European Union (EU) average. The LE of Dutch women is stagnating and has now fallen below the EU average. These and many other unfavourable trends in the health status of the Dutch population were found to be largely due to unhealthy behaviour. One of the policy recommendations therefore was to strengthen the investments in prevention in order to reverse the stagnation in health status.

Research paper thumbnail of Do practice characteristics explain differences in morbidity estimates between electronic health record based general practice registration networks?

BMC Family Practice, 2014

Background: General practice based registration networks (GPRNs) provide information on populatio... more Background: General practice based registration networks (GPRNs) provide information on population health derived from electronic health records (EHR). Morbidity estimates from different GPRNs reveal considerable, unexplained differences. Previous research showed that population characteristics could not explain this variation. In this study we investigate the influence of practice characteristics on the variation in incidence and prevalence figures between general practices and between GPRNs.

Research paper thumbnail of Tien jaar professionals opleiden voor de publieke gezondheid

Tijdschrift voor gezondheidswetenschappen, 2013

De publieke gezondheidszorg heeft zich de laatste tien jaar sterk ontwikkeld. Professionals moete... more De publieke gezondheidszorg heeft zich de laatste tien jaar sterk ontwikkeld. Professionals moeten steeds meer leren te opereren in de driehoek beleid-onderzoek-praktijk, samenwerken in netwerken wordt steeds belangrijker, de structuur van opleiden van artsen in de sector is veranderd, de relatie tussen arbeid en gezondheid wordt steeds belangrijker gevonden, en dat alles in een snel veranderende samenleving die een deel van deze tien jaar economische voorspoed kende, maar daarna in een financiële crisis geraakte.

Research paper thumbnail of Uitdagingen in de volksgezondheid: vier perspectieven

Tijdschrift voor gezondheidswetenschappen, 2014

Het thema van het Nederlands Congres Volksgezondheid 2014 is 'perspectieven op de volksgezondheid... more Het thema van het Nederlands Congres Volksgezondheid 2014 is 'perspectieven op de volksgezondheid'. Dit congres vindt elk jaar plaats, en elk jaar is er veel ruimte voor de hele breedte van de volksgezondheid. Niet iedereen verstaat immers hetzelfde onder volksgezondheid. Voor de een is het lang leven in goede gezondheid, voor de ander is het een gezonde leefstijl, het verkleinen van gezondheidsachterstanden of de participatie van chronisch zieken. Op het congres van 2014 staat juist deze diversiteit centraal. De diversiteit in visies op de volksgezondheid vangen we in het begrip 'perspectieven'.

Research paper thumbnail of Aspecten van kwaliteit van data uit de huisartsenpraktijk

Inleiding: Routinematig vastgelegde gegevens uit de huisartsenpraktijk worden veel gebruikt voor ... more Inleiding: Routinematig vastgelegde gegevens uit de huisartsenpraktijk worden veel gebruikt voor onderzoek naar bijvoorbeeld de morbiditeit in Nederlands of efficiëntie van zorg. Er wordt veel energie gestopt in de kwaliteit van de gegevens, (scholing huisartsen, schonen van data, terugkoppelen van de informatie aan huisartsenpraktijken), maar in Nederland zijn er verschillende huisartsenregistraties, die anders, van opzet zijn. Onderzoeksvraag: Wat verstaan experts van verschillende registraties onder goede kwaliteit van data uit de huisartsenpraktijk? Methode: In dit onderzoek hebben we gebruik gemaakt van 'concept mapping'. In een brainstorm werden door tien experts van negen registraties uitspraken gedaan over goede kwaliteit van data uit de huisartsenpraktijk. Zestien experts beoordeelden deze uitspraken op belang (5-punts Likert schaal, 1= minst, 5= meest belangrijk) en groepeerden de uitspraken op basis van inhoud. Deze informatie is geanalyseerd in Ariadne, een softw...

Research paper thumbnail of Kosten en baten van preventie, een lastige analyse

Tijdschrift voor gezondheidswetenschappen, 2012

ABSTRACT ‘Investeren in preventie van ziektes loont’kopte het Financiële Dagblad in februari 2012... more ABSTRACT ‘Investeren in preventie van ziektes loont’kopte het Financiële Dagblad in februari 2012 naar aanleiding van Pomp’s scenarioanalyse van de maatschappelijke baten van healthy ageing onderzoek. En in het kielzog van die publicatie ontstonden op diverse plekken discussies over de betekenis van dit onderzoek: onder andere op Twitter, in de dagbladen, en in de Tweede Kamer. Maar ook op de werkvloer van verschillende organisaties die zich bezig houden met preventie deed het rapport van Marc Pomp stof opwaaien. En in die discussies liepen de meningen soms aanzienlijk uiteen.Voldoende aanleiding dus om verschillende partijen aan het woord te laten over de betekenis van het rapport. Als eerste komen Marc Pomp en Erik Buskens zelf aan het woord, om kort de hoofdlijnen van het rapport toe te lichten. Vervolgens wordt vanuit verschillende kanten een reactie geleverd. Jaap Koot doet dat vanuit het NIGZ (daar was hij al twitterend mee begonnen op de dag van verschijnen van het rapport). Matthijs van ...

Research paper thumbnail of URBAN40, een natuurlijk experiment met integraal wijkgericht gezondheidsbeleid

Tijdschrift voor gezondheidswetenschappen, 2014

ABSTRACT Spectrum biedt ruimte voor beschouwingen, discussies en opiniërende artikelen over onder... more ABSTRACT Spectrum biedt ruimte voor beschouwingen, discussies en opiniërende artikelen over onderwerpen op het terrein van de volksgezondheid en de gezondheidszorg. Bijdragen dienen te worden aangeboden conform de aanwijzingen voor de auteurs. Voor overleg over het thema kan contact worden opgenomen met de rubrieksredacteuren van Spectrum: prof. dr. J.A.M. van Oers (e-mail: Hans.van.Oers@rivm.nl) en dr. N. Hoeymans (e-mail: Nancy.Hoeymans@rivm.nl)

Research paper thumbnail of Knowledge in process? Exploring barriers between epidemiological research and local health policy development

Background: In the Netherlands municipalities are legally required to draw up a Local Health Poli... more Background: In the Netherlands municipalities are legally required to draw up a Local Health Policy Memorandum every four years. This policy memorandum should be based on (local) epidemiological research as performed by the Regional Health Services. However, it is largely unknown if and in what way epidemiological research is used during local policy development. As part of a larger study on knowledge utilization at the local level in The Netherlands, an analytical framework on the use of epidemiological research in local health policy development in the Netherlands is presented here. Method: Based on a literature search and a short inventory on experiences from Regional Health Services, we made a description of existing research utilization models and concepts about research utilization. Subsequently we mapped different barriers in research transmission.

Research paper thumbnail of Lokaal gezondheidsbeleid: making the evidence-based choice the easy choice

TSG, 2008

ABSTRACT Gemeentelijk gezondheidsbeleid dient (mede) gebaseerd te zijn op epidemiologisch inzicht... more ABSTRACT Gemeentelijk gezondheidsbeleid dient (mede) gebaseerd te zijn op epidemiologisch inzicht in de lokale gezondheidssituatie. Doel hiervan is het stimuleren van evidence-based gezondheidsbeleid. De implementatie van evidence-based werken in de openbare gezondheidszorg verloopt echter moeizaam. Huidige epidemiologische rapportages laten al zien waar problemen en kansen op gezondheidswinst liggen, maar geven nog onvoldoende aanknopingspunten voor concrete maatregelen en actieplannen. Hiervoor is informatie nodig over de effectiviteit van interventies en lokale beleidsmaatregelen. De GGD Hart voor Brabant wil het voor zijn gemeenten zo makkelijk mogelijk maken om de hierin de beste keuze te maken: ‘making the evidence-based choice the easy choice’. Het artikel beschrijft de ontwikkeling van het Regionaal Kompas Volksgezondheid (www.regionaalkompas.nl), een website die hiervoor specifiek is bedoeld. Geconcludeerd wordt dat het mogelijk is een website te maken met informatie die gemeentelijke beleidsmakers relevant vinden voor de vertaling van gezondheidsproblemen naar een concreet plan van aanpak. De implementatie in de regio West-Brabant laat zien dat het goed mogelijk is deze website grotendeels te delen met andere GGD’en. De discussie spitst zich toe op de kwaliteit en het gebruik van de website. Daarbij worden ook aanbevelingen gegeven om deze te verbeteren. Local public health policy: making the evidence-based choice the easy choice. The development and possibilities of the Regional Health Compass By law, local public health policy in the Netherlands has to be based on the epidemiological analysis of the local health situation, in order to stimulate evidence-based public health. However, the implementation of evidence-based acting in public health is laborious. Current epidemiological reports already show where problems and opportunities for health gain lie, but they do not provide sufficient handles for concrete policy arrangements and action plans. For this, information is needed on the effectiveness of interventions and local policy arrangements. Therefore, the Regional Public Health Service (GGD) ‘Hart voor Brabant’ wants to make the best choices on these matters as easy as possible for their municipalities: ‘making the evidence-based choice the easy choice’. This article describes the development of the Regional Health Compass (www.regionaalkompas.nl), a website specifically designed for this purpose. It is concluded that it is possible to build a website with information that is particular relevant for public health officers as to the translation of local health problems into a concrete plan of action. The implementation in the region West-Brabant shows that it is also possible to share this website with other Regional Public Health Services. The discussion focusses on the quality and the use of the website. Also recommendations for their improvement are given. Keywords: epidemiology, local health policy, evidence-based policy, public health, public health report epidemiologie-lokaal gezondheidsbeleid-evidence-based beleid-volksgezondheid-VTV

Research paper thumbnail of How can collaboration be strengthened between public health and primary care? A Dutch multiple case study in seven neighbourhoods

BMC public health, 2015

Although public health and primary care share the goal of promoting the health and wellbeing of t... more Although public health and primary care share the goal of promoting the health and wellbeing of the public, the two health sectors find it difficult to develop mutually integrated plans and to collaborate with each other. The aim of this multiple case study was to compare seven neighbourhoods in which a stepwise approach based on two central tools (district health profile and policy dialogue) was used to develop integrated district plans and promote collaboration. The stepwise approach involved the following steps: 1 Getting to know the neighbourhood, 2 Assembling the workgroup, 3 Analysing the neighbourhood, 4 Developing a district health profile, 5 Preparing policy dialogue, 6 Holding local dialogues, 7 Embedding integrated district plans and collaboration. To supervise this process, a core team was assembled for each neighbourhood, consisting of people drawn from both public health and primary care. Both the use of the two tools and the collaboration were studied by means of docu...