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Background Previous studies have advocated the benefits of resilience-based interventions for creating a healthy and sustainable workforce. However, resilience is defined and measured in diverse ways. Therefore, the aim of this systematic review is (1) to identify how resilience is defined within different workplace interventions, translated into intervention content, and measured in these interventions; and (2) to synthesize the effectiveness of these interventions. Methods A systematic literature search was conducted and included articles from 2013 – 2023. Twenty-four studies met the inclusion criteria, covering a total of 26 unique interventions. Definitions were categorized as: resilience as a trait, process, or outcome. Cohen’s D was calculated to depict the effect sizes within the intervention groups from pre-test to post-test and, when possible, from pre-test to 3-month follow-up. Results Included studies applied a wide range of definitions; most definitions fitted within the trait-orientation, conceptualizing resilience as an individual characteristic or ability, or the process-orientation, conceptualizing resilience as a dynamic process. No studies solely used the outcome-orientation, but some did combine elements of all three orientations. Various definitions, measures and intervention strategies were applied, however, almost half of the studies (46%) showed inconsistencies within these choices. Furthermore, findings show that most resilience-based interventions in the workplace have a positive impact. While educational workshops with a higher frequency and duration had medium to large effects, solely digital interventions had small effects, changing to small to medium when combined with non-digital elements. Conclusions Findings suggest that resilience-based can benefit employees by enhancing their psychological well-being. This, in turn, can lead to improved work-related outcomes such as productivity, thereby offering advantages to employers as well. This underscores the growing recognition that resilience should be viewed as a shared responsibility between the individual and the organization. Further advancement in the field of resilience-based interventions in the workplace calls for future research to focus on maintaining consistency when choosing a definition of resilience, developing intervention content, and choosing an outcome measure. Preregistration The search protocol was preregistered in the Open Science Framework, see Hollaar et al. (2023). https://doi.org/10.17605/OSF.IO/UKYF7 .

Worldwide the Covid-19 pandemic resulted in drastic behavioral measures and lockdowns. Vaccination is widely regarded as the true and only global exit strategy; however, a high vaccination coverage is needed to contain the spread of the virus. Vaccination rates among young people are currently lacking. We therefore studied the experienced motivations and barriers regarding vaccination in young people with the use of the health belief model. We conducted a correlational study, based on a convenience sample. At the vaccination location, directly after vaccination, 194participants(16-30 years) who decided to get vaccinated at a pop-up location several weeks after receiving a formal invitation, filled out a questionnaire regarding their attitudes towards vaccination based on concepts defined in the health belief model. We used these concepts to predict vaccination hesitancy. Younger participants and participants with lower educational levels report higher levels of hesitancy regarding vaccination (low education level = 38.9%, high education level = 25.4%). Perceived severity (Mhesitancy = .23, Mno hesitancy = .37) and susceptibility (Mhesitancy = .38, Mno hesitancy = .69) were not associated with hesitancy. Health related and idealistic benefits of vaccination were negatively associated with experienced hesitancy (Mhesitancy = .68, Mno hesitancy = -.37), while individualistic and practical benefits were not associated with hesitancy (Mhesitancy = -.09, Mno hesitancy = .05). Practical barriers were not associated with hesitancy (Mhesitancy = .05, Mno hesitancy = -.01), while fear related barriers were strongly associated with hesitancy (Mhesitancy = -.60, Mno hesitancy = .29). Health related, and idealistic beliefs are negatively associated with experienced hesitancy about vaccination, while fear related barriers is positively associated with experienced hesitancy. Future interventions should focus on these considerations, since they can facilitate or stand in the way of vaccination in young people who are doubting vaccination, while not principally opposed to it.

Background Examining the correlates of adolescent’s physical activity (PA) and how they may differ according to the intersection of gender and family socioeconomic status (SES) can support the development of tailored interventions to more effectively promote adolescents’ PA. This study explored how the associations between psychosocial, behavioural and environmental factors and adolescent’s PA differed according to gender and family SES. Methods This study used data from the Dutch Youth Health Survey 2015. Adolescents ( n  = 9068) aged 12–19 were included in the study. The associations between psychosocial, behavioural, and environmental factors and PA (days per week engaging in at least one hour of PA) were examined with multilevel linear regression analysis. Potential interactions between these correlates, gender and family SES were explored. Results On average, adolescents engaged in at least one hour of PA for 4,2 days per week. Poor self-perceived health, low peer social support, and a weak connection with the environment were all associated with lower PA in adolescents. Daily smoking, cannabis use, risk of problematic gaming and social media use, as well as lack of daily consumption of fruit, vegetables, water and breakfast were associated with lower PA, whereas binge drinking was not. Interactions revealed that poor self-perceived health was associated with lower PA in adolescents from moderate- and high-SES families, but not in low-SES adolescents, whereas cannabis use was only associated with lower PA amongst low-SES adolescents. Low peer social support was associated with lower PA across all groups, but it was most strongly associated with lower PA amongst male adolescents from low-SES families than in other subgroups. Amongst low-SES males, low peer social support was associated with a 1.47 reduction in days engaging in sufficient PA, compared with a 0.69 reduction for high-SES males. Conclusions This study identified several psychosocial, behavioural and environmental factors that can be targeted to potentially increase adolescent’s PA. We also found that correlates of PA differed according to the intersection of gender and family SES. Our findings suggest that PA interventions should be tailored according to gender and SES to address the specific needs, barriers and facilitators of different subgroups.

Low-educated native Dutch and non-western minority women have inadequate access to obstetric care. Moreover, the care they receive lacks responsiveness to their needs and cultural competences. Gaining a deeper understanding of their experiences and satisfaction with antenatal, birthing and maternity care will help to adjust healthcare responsiveness to meet their needs during pregnancy, childbirth and the postpartum period. We combined the World Health Organization conceptual framework of healthcare responsiveness with focus group research to measure satisfaction with antenatal, birthing and maternity care of women with a low-educated native Dutch and non-western ethnic background. From September 2011 until December 2013, 106 women were recruited for 20 focus group sessions. Eighty-five percent of the women had a non-western immigrant background and 89% a low or intermediate educational attainment. The study population was mostly positive about the provided care during the antenatal phase. They were less positive about the other two phases of care. Moreover, the obstetric healthcare systems' responsiveness in all phases of care (antenatal, birthing and maternity) did not meet these women's needs. The 'respect for persons' domains 'autonomy', 'communication' and 'dignity' and the 'client orientation' domain 'prompt attention' were judged most negatively. The study findings give contextual meaning and starting points for improvement of responsiveness in the provision of obstetric care within a multi-ethnic women's population.

Background Compared to higher socioeconomic status (SES) groups, those in lower SES groups are financially strained, experience higher rates of smoking-related morbidity, are in poorer health and have reduced life expectancy. This is especially true for the city of Rotterdam, where a large inequality in health is observed between low and high SES groups. The BeHealthyR study (Dutch: Grip en Gezondheid) is a randomized controlled trial (RCT) which will evaluate the impact of a theory-based multicomponent behavior intervention aiming to reduce stress, smoking, and improve financial health by means of a group-based stress management program combining cognitive and behavioral techniques, and nudges in low-SES residents living in Rotterdam. Methods The BeHealthyR study is a three-arm RCT. Between February 2018 and July 2019, low-SES participants who perceive stress, smoke, are financially strained and reside in Rotterdam (one of the four largest cities in The Netherlands) are recruited. Subsequently, participants are randomly assigned to either a stress management condition (SM), stress management with a buddy condition (SM-B) or a control condition (CC). Participants in the SM and SM-B conditions will attend four weekly group sessions (1.5 h/session) and a follow-up session eight weeks later. The SM condition includes psychoeducation and exercises, and cognitive and behavioral intervention techniques. Demographic data and objective measures will be collected at baseline (T0), four weeks post-baseline (T1), and twelve weeks post-baseline (T2). Primary outcome measures are to reduce stress, smoking and improve financial health. We hypothesize that low-SES participants in the intervention conditions, compared with those in the control condition, will experience less stress, smoke less and have improved financial health. Discussion This study is a group-based intervention which aims to investigate the effects of a theory-based behavioral change intervention employing several components on reducing stress, smoking, and improving financial health in low-SES residents living in Rotterdam. If effective, the findings from the present study will serve to inform future directions of research and clinical practice with regard to behavioral change interventions for low-SES groups. Trial registration ClinicalTrials.gov (ID: NCT03553979 ). Registered on January 1 2018.

Introduction Promotion of healthy pregnancies has gained high priority in the Netherlands because of the relative unfavourable perinatal outcomes. In response, a nationwide study Healthy Pregnancy 4 All (HP4ALL) has been initiated. One of the substudies within HP4ALL focuses on preconception care (PCC). PCC is an opportunity to detect and eliminate risk factors before conception to optimise health before organogenesis and placentation. The main objectives of the PCC substudy are (1) to assess the effectiveness of a recruitment strategy for the PCC health services and (2) to assess the effectiveness of individual PCC consultations. Methods/analysis Prospective cohort study in neighbourhoods of 14 municipalities with perinatal mortality and morbidity rates exceeding the nation's average. The theoretical framework of the PCC substudy is based on Andersen's model of healthcare utilisation (a model that evaluates the utilisation of healthcare services from a sociological perspective). Women aged 18 up to and including 41 years are targeted for utilisation of the PCC health service by a four armed recruitment strategy. The PCC health service consists of an individual PCC consultation consisting of (1) initial risk assessment and risk management and (2) a follow-up consultation to assess adherence to the management plan. The primary outcomes regarding the effectiveness of consultations is behavioural change regarding folic acid supplementation, smoking cessation, cessation of alcohol consumption and illicit substance use. The primary outcome regarding the effectiveness of the recruitment strategy is the number of women successfully recruited and the outreach in terms of which population is reached in comparison to the approached population. Data collection consists of registration in the database of women that enrol for a visit to the individual PCC consultations (women successfully recruited), and preconsultation and postconsultation measurements among the included study population (by questionnaires, anthropometric measurements and biomarkers). Sample size calculation resulted in a sample size of n=839 women. Ethics and dissemination Approval for this study has been obtained from the Medical Ethical Committee of the Erasmus Medical Center of Rotterdam (MEC 2012-425). Results will be published and presented at international conferences.

To explore how patients and general practice professionals in low-income neighborhoods experienced the increase of remote care during COVID-19. As the GP (general practitioner) is the first point of contact in Dutch health care, there are concerns about access to remote care for patients from low-income neighborhoods. Now that general practice professionals have returned to the pre-pandemic ways of healthcare delivery, this paper looks back at experiences with remote care during COVID-19. It investigates experiences of both patients and general practice professionals with the approachability and appropriateness of remote care and their satisfaction. In this qualitative study, 78 patients and 18 GPs, 7 nurse practitioners and 6 mental health professionals were interviewed. Interviews were held on the phone and face-to-face in the native language of the participants. Remote care, especially telephone consultation, was generally well-approachable for patients from low-income neighborhoods. Contrarily, video calling was rarely used. This was partly because patients did not know how to use it. The majority of patients thought remote care was possible for minor ailments but would also still like to see the doctor face-to-face regularly. Patients were generally satisfied with remote care at the time, but this did not necessarily reflect their willingness to continue using it in the future. Moreover, there was lack in consensus among general practice professionals on the appropriateness of remote care for certain physical and mental complaints. Nurse practitioners and mental health professionals had a negative attitude toward remote care. In conclusion, it is important to take the opinions and barriers of patients and care providers into account and to increase patient-centered care elements and care provider satisfaction in remote care. Integrating remote care is not only important in times of crisis but also for future care that is becoming increasingly digitalized.

IntroductionEmployees in sheltered workplaces face greater challenges in maintaining a healthy and vitality-enhancing lifestyle due to physical, mental and psychosocial disabilities. While workplace health and vitality programmes are particularly relevant for this group, evaluation of programmes in this setting remains limited. This paper presents a protocol for a realist evaluation of a sheltered workplace’s vitality programme aimed at physical, mental and social sources of vitality.Methods and analysisUsing a multimethod design with adaptive qualitative methods, we developed an initial programme theory that describes how context and mechanisms of the sheltered workplace’s vitality programme influence the outcomes related to physical activity, healthy eating and social interaction. The protocol explains how we will collect and synthesise qualitative data, interviews, observations and focus group discussions, to refine and validate this initial programme theory and further evaluate the vitality programme. We aim to conduct at least 15 interviews, 15 observations, 3 focus group discussions and 1 final validating focus group. The study includes recipients of the intervention, namely individuals with varying work abilities, as well as other key stakeholders involved in the vitality programme. In this way, we will get insights into how to promote vitality-enhancing behaviours. Our context-sensitive methodology offers both scientific and practical value for future research in similar settings.Ethics and disseminationEthical approval was granted through the Ethics Review Committee of Erasmus University Rotterdam (application number: ETH2324-0939). Findings will be disseminated through presentations, conferences, social media and peer-reviewed publications.

Age-friendly neighbourhoods seem to promote physical activity among older individuals. Physical activity is especially important for chronically ill individuals. In the Netherlands, older Surinamese individuals are more likely to have chronic diseases than are their native Dutch counterparts. This study examined relationships of neighbourhood characteristics with physical activity among older Surinamese individuals in Rotterdam, the Netherlands. Of 2749 potential participants, 697 (25%) community-dwelling older (age ≥ 70 years) Surinamese individuals living in Rotterdam, the Netherlands, completed a questionnaire on personal and neighbourhood characteristics between March and June 2020. Correlation and multilevel regression analyses were performed to identify associations between missing neighbourhood characteristics for ageing in place and physical activity. Scores for the neighbourhood domains communication and information (r = -0.099, p ≤ 0.05), community support and health services (r = -0.139, p ≤ 0.001), and respect and social inclusion (r = -0.141, p ≤ 0.001), correlated negatively with participants' PA. In the multilevel analysis, overall missing neighbourhood characteristics to age in place scores were associated negatively with physical activity (p ≤ 0.05). This study showed the importance of age-friendly neighbourhoods for physical activity among older Surinamese individuals in Rotterdam, the Netherlands. Our findings suggest that the neighbourhood plays an important role in supporting older individuals' leading of physically active lifestyles. Further research is needed to support the development of interventions to create age-friendly neighbourhoods.

Whether behaviour change interventions are effective for the maintenance of older migrants' health and well-being is uncertain. A systematic review was conducted to assess evidence for the capacity of behaviour change techniques (BCTs) to promote the health and well-being of older migrants. Electronic databases (Cochrane CENTRAL, Embase, Ovid MEDLINE and Web of Science) were searched systematically to identify relevant randomised controlled trials, pre-post studies and quasi-experimental studies published before March 2021. Additional articles were identified through citation tracking. Studies examining BCTs used to promote the health and/or well-being of older migrants were eligible. Two independent reviewers used the Behaviour Change Technique Taxonomy version 1 to extract data on BCTs. Data on intervention functions (IFs) and cultural adaption strategies were also extracted. Intervention contents (BCTs, IFs, culture adaption strategies) were compared across effective and ineffective interventions according to health and well-being outcome clusters (anthropometrics, health behaviour, physical functioning, mental health and cognitive functioning, social functioning and generic health and well-being). Forty-three studies (23 randomised controlled trials, 13 pre-post studies and 7 quasi-experimental studies) reporting on 39 interventions met the inclusion criteria. Thirteen BCTs were identified as promising for at least one outcome cluster: goal-setting (behaviour), problem-solving, behavioural contract, self-monitoring of behaviour, social support (unspecified), instruction on how to perform the behaviour, information about health consequences, information about social and environmental consequences, demonstration of the behaviour, social comparison, behavioural practice/rehearsal, generalisation of a target behaviour and addition of objects to the environment. Three BCTs (instruction on how to perform the behaviour, demonstration of the behaviour, and social comparison) and two IFs (modelling and training) were identified as promising for all outcome clusters. Thirteen distinct BCTs are promising for use in future interventions to optimise health and well-being among older migrants. Future research should focus on the effectiveness of these BCTs (combinations) in various contexts and among different subgroups of older migrants, as well as the mechanisms through which they act. Given the scarcity of interventions in which cultural adaption has been taken into account, future behavioural change interventions should consider cultural appropriateness for various older migrant (sub)groups. PROSPERO CRD42018112859.