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Sign in for a healthy life. Effect evaluation of an integrated e-Health approach in disadvantaged groups.

Projectomschrijving

Vraagstuk

Vrijwel iedereen in Nederland is digitaal. Ook in achterstandsgroepen is het gebruik van een pc en smartphone volop aanwezig. Men gebruikt deze middelen met succes om deel te nemen aan de maatschappij. Als het om gezondheid gaat, blijft het gebruik echter achter. Dat komt enerzijds doordat tools onvoldoende zijn afgestemd op de doelgroep, anderzijds doordat de tools onvoldoende zijn ingebed in de lokale zorg- en preventiestructuren. De digitale Persoonlijke Gezondheidscheck (PGC) geeft inzicht in risicofactoren voor gezondheid en deze is inmiddels met en aan de doelgroep aangepast.

Onderzoek

In dit project onderzoeken we hoe we de PGC het beste kunnen implementeren in de lokale context en deze als startpunt te gebruiken voor interventies in lokale zorg- en preventiestructuren. In een actief consortium, en met oog voor de duurzaamheid van de interventie, evalueren we de effectiviteit van deze integrale eHealth aanpak om het gezondheidspotentieel in Nederland ten volste te benutten.

Verwachte uitkomst

Een evaluatie van de effectiviteit van de integrale eHealth aanpak.

Producten

Titel: Online symposium over e-Health en kwetsbare groepen
Auteur: CEPHIR, Erasmus MC, RIVM, NIVEL
Link: https://vimeo.com/755604259
Titel: Informatiefilm voor deelnemers aan de PIE-studie
Auteur: Adriana Israël, Mariëlle Beenackers, Frank van Lenthe
Link: http://www.pie-studie.nl/voor-deelnemers
Titel: Website over de PIE-studie
Auteur: Israël, A.M.C. & Beenackers M.A. Website door BrandNewFresh
Link: https://pie-studie.nl/

Verslagen


Samenvatting van de aanvraag

PROBLEM DEFINITION & RELEVANCE In a recent briefing to the parliament, the Dutch government prioritized four societal ambitions, among which the goal ‘living five years longer in good health by 2040’. Specific targets of this goal are the reduction of socioeconomic inequalities in health by 30% in 2040 and that 50% of health care should be organized in the own living environment. The first ambition can only be realized by successfully targeting disadvantaged groups. The second target requires a drastic change in content and delivery of health care towards outpatient activities with new delivery models for health care with new technologies, such as e-Health/m-Health. The Netherlands is frontrunner in internet access and 98% of Dutch households has access to internet. Also among people with lower socioeconomic position (SEP) the use of personal computers and smartphones is ubiquitous. People use these tools to successfully participate in society but the use of digital aids for health purposes lacks behind in these groups. To unlock the potential of e-health to lower SEP people, e-health tools need to be inclusive, accessible, usable, understandable to all and developed in co-creation with the target group so it aligns with their needs and preferences. Furthermore, e-health tools should be integrated in the local care and preventative infrastructure and be part of a blended care setting (combination of online and face-to-face care). In this project, we will evaluate an integrated e-health approach that follows the guidelines above; the Personal Health Check, a scientifically founded e-health tool that provides insight into a person’s health and health behaviors has been adapted in co-creation with the target population to be inclusive. This inclusive e-health tool will be applied in a blended care setting that will be integrated with the local care infrastructure, including the “Gezond in…” approach (GIDS) – which is specifically targeted towards low SEP. The approach is integrated in its form (blended care), function (impact at individual and community level) and content (guidance towards interventions at all domains). The integrated e-health approach will be implemented and evaluated in a stepwise method in a total of 10 local pilots across the Netherlands using different strategies (e.g. via general practitioner or health coach) that are embedded in and adapted to the local context. The integrated e-health approach has the potential to reach people with lower SEP and improve their health determinants, health behaviors, and overall health. It may therefore help to improve health in populations with the largest health potential. OBJECTIVE The overall objective of this project is to systematically evaluate the effectiveness of the integrated e-health approach. We will evaluate whether the approach is able to reach lower SEP people and improve their health determinants, behaviors and overall health; what works, for whom, why and under what circumstances? STRATEGY In Phase 1, we will strengthen the underlying theory of change and provide insight into barriers and facilitators for participation in the integrated e-health approach. This will inform the most promising implementation strategies that fit the needs, resources and capabilities of all stakeholders. In Phase 2 we will answer what works, for whom, why and under what circumstances. Therefore, we will adapt a realist evaluation approach with mixed methods. A quasi-experimental approach with propensity score matching will be used to assess the health and behavioral outcomes of the integrated e-health approach (what). Qualitative and quantitative implementation monitoring and (focus group) interviews will provide more insight into the underlying mechanisms that underlie the effectiveness (why). Comparative effectiveness assessment will demonstrate whether the what and the why differ between population subgroups (for whom) and between implementation strategies (under what circumstances). STAKEHOLDER INVOLVEMENT & KNOWLEDGE TRANSFER A participative research approach, a user council with end-users from all 10 pilots, an advisory board with implementation professionals, and an active learning community will ensure active involvement of all stakeholders of the integrated e-health approach. Throughout the project, learning community events will be organized to disseminate results and stimulate learning across pilots and stakeholders. Also, knowledge will be disseminated through presentations, publications, factsheets with infographics, and vlogs. The embedding of this project within an active larger consortium of the Health Deal ‘Stimulering gezondheid door persoonlijke preventie via e-health’, the active learning community, accompanying social return of investment analysis, and the considerate integration of the approach in the local context will instigate sustainable implementation of this promising approach and the potential for prompt scaling-up when effective.

Kenmerken

Projectnummer:
555002013
Looptijd: 91%
Looptijd: 91 %
2020
2024
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. M.A. Beenackers
Verantwoordelijke organisatie:
Erasmus Medisch Centrum