Papers by marielle jambroes
Children (Basel), Nov 14, 2022
Despite the many benefits of club-organized sports participation for children, studies have shown... more Despite the many benefits of club-organized sports participation for children, studies have shown that sports participation is lower among children from low-income families than among children from middle-or high-income families. Adopting a socioecological perspective, the main aim of our study was to identify and describe experiences of person-environment (PE) misfits in relation to parental facilitation of children's sports participation. We conducted 24 interviews with parents from low-income families. PE misfits were found in multiple behaviors related to the facilitation of children's sports participation: financing sports participation; planning and investing time; transporting children; acquiring, processing, and providing information; and arranging support. Across these PE misfits, influential attributes were found on the individual level (e.g., skills) as well as within the social, policy, physical, and information environment. In response to PE misfits experienced, parents deployed multiple strategies to reduce these PE misfits, aimed at enhancing either themselves (e.g., increasing financial capacities) or their environments (e.g., arranging social support). These results provide an insight into experienced PE misfits that took the form of multiple specific behaviors which parents found difficult while facilitating their children's sports participation. Furthermore, the results provide insight into the environmental and individual attributes that were involved in these PE misfits, and into how parents modified themselves or their environments in order to make their environments more supportive. The study contributes to future research on individual and environmental influences on parental facilitation of their children's sports participation, as well as on the development of multilevel interventions aimed at increasing sports participation among children from low-income families.
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
were excluded due to their lack of information regarding the outcome (67%) or because they were d... more were excluded due to their lack of information regarding the outcome (67%) or because they were done in combination with other cardiac or extra-cardiac procedures. The first analysis on the remaining 10,127 interventions of "isolated CABG", carried in 45 centers, showed a 30 day mortality of about 3%. Using indirect standardization, 4 Centers had adjusted mortality rates significantly better than the national rate; 4 others had rates that were significantly worse. Using direct standardization, 9 Centers appear to have a significantly lower and 2 a significantly greater risk when compared with the reference standard; the general order of the centers was similar using both methods. Our preliminary analysis has confirmed a good general applicability of the predictive models, although substantial differences in the case-mix of patients between different structures underlines the importance of risk adjustment when making comparisons between centers. The relative performance of the centers was similar regardless of the standardization methods used.
International Journal of Environmental Research and Public Health, Nov 24, 2022
It is increasingly recognized that community-based interventions for active ageing are more lasti... more It is increasingly recognized that community-based interventions for active ageing are more lasting and effective, yet the tools and methods for developing these interventions are lacking. This study investigates how to co-design community-based active ageing with older adults via the development of a toolkit to support this goal. Rapid reviews were conducted to understand (i) the effective behavioural change techniques for older adults, (ii) how to co-design with older adults for community-based interventions, and (iii) how to design tools for behaviour change that are easy to use. These reviews served as the foundation for developing a toolkit to support the co-design of community-based active ageing, which was evaluated during an interdisciplinary hackathon with older adults. Quantitative data from the surveys suggested that the confidence levels of students in developing interventions for health behaviour change and in co-designing with older adults increased after the hackathon, and the enjoyment of participating in the hackathon and of using the toolkit were statistically significant factors influencing this increase. Qualitative data from interviews and observations revealed how the toolkit was (un)used by the participants and what aspects of the toolkit can be improved. We encourage future researchers and practitioners to apply and adapt our research findings to the communities of older adults that they are working with.
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.
November 2015 De NPHF projectgroep Beroepen & Opleidingen is in de periode december 2014 t/m apri... more November 2015 De NPHF projectgroep Beroepen & Opleidingen is in de periode december 2014 t/m april 2015 actief geweest om de transitie van nazorg naar voorzorg op het beleidsterrein van Beroepen en opleidingen uit te werken. Als resultaat hiervan heeft zij de slotnotitie "Actieagenda Projectgroep Beroepen en Opleidingen" in mei 2015 gepubliceerd. De NPHF Federatie voor Gezondheid heeft positieve reacties op de slotnotitie ontvangen. Naar aanleiding van de reacties en de geplaatste opmerkingen wil de NPHF de slotnotitie op twee punten herzien:
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...
BMC Public Health, 2015
Background: Public health workforce planning and policy development require adequate data on the ... more Background: Public health workforce planning and policy development require adequate data on the public health workforce and the services provided. If existing data sources do not contain the necessary information, or apply to part of the workforce only, primary data collection is required. The aim of this study was to develop a strategy to enumerate and characterize the public health workforce and the provision of essential public health operations (EPHOs), and apply this to the environmental public health workforce in the Netherlands as an example. Methods: We specified WHO's EPHOs for environmental public health and developed an online questionnaire to assess individual involvement in these. Recruitment was a two-layered process. Through organisations with potential involvement in environmental public health, we invited environmental public health workers (n = 472) to participate in a national survey. Existing benchmark data and a group of national environmental public health experts provided opportunities for partial validity checks. Results: The questionnaire was well accepted and available benchmark data on physicians supported the results of this study regarding the medical part of the workforce. Experts on environmental public health recognized the present results on the provision of EPHOs as a reasonable reflection of the actual situation in practice. All EPHOs were provided by an experienced, highly educated and multidisciplinary workforce. 27 % of the total full-time equivalents (FTEs) was spent on EPHO 'assuring governance for health'. Only 4 % was spent on 'health protection'. The total FTEs were estimated as 0.66 /100,000 inhabitants. Conclusions: Characterisation of the public health workforce is feasible by identification of relevant organisations and individual workers on the basis of EPHOs, and obtaining information from those individuals by questionnaire. Critical factors include the operationalization of the EPHOS into the field of study, the selection and recruitment of eligible organisations and the response rate within organisations.. When existing professional registries are incomplete or do not exist, this strategy may provide a start to enumerate the quantity and quality of the public health within or across countries.
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...
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Papers by marielle jambroes