Public participation in genomics research in the Netherlands: validating a measurement scale.

Nowadays, new technologies, like genomics, cannot be developed without the support of the public. However, although interested, the public does not always actively participate in science issues when offered the opportunity via public participation activities. In a study aimed at validating a measurement scale, first, we investigated if public participation existed, and, secondly, we investigated how levels of public participation in genomics research varied among groups.

The role of cognition in cost-effectiveness analyses of behavioral interventions.

Background: Behavioral interventions typically focus on objective behavioral endpoints like weight loss and smoking cessation. In reality, though, achieving full behavior change is a complex process in which several steps towards success are taken. Any progress in this process may also be considered as a beneficial outcome of the intervention, assuming that this increases the likelihood to achieve successful behavior change eventually.

Online usability and patients with long-term conditions: a mixed-methods approach.

Background: To improve the information position of health care consumers and to facilitate decision-making behavior in health the Dutch ministry of Health commissioned the National Institute for Public Health and the Environment to develop, host and manage a public national health and care portal (www.kiesbeter.nl) on the Internet.

Moving beyond a limited follow-up in cost-effectiveness analyses of behavioral interventions.

Background: Cost-effectiveness analyses of behavioral interventions typically use a dichotomous outcome criterion. However, achieving behavioral change is a complex process involving several steps towards a change in behavior. Delayed effects may occur after an intervention period ends, which can lead to underestimation of these interventions.

Why business modeling is crucial in the development of eHealth technologies.

The impact and uptake of information and communication technologies that support health care are rather low. Current frameworks for eHealth development suffer from a lack of fitting infrastructures, inability to find funding, complications with scalability, and uncertainties regarding effectiveness and sustainability. These issues can be addressed by defining a better implementation strategy early in the development of eHealth technologies.

Cost-effectiveness of an intensive smoking cessation intervention for COPD outpatients.

Introduction: To determine the cost-effectiveness of a high-intensity smoking cessation program (SmokeStop Therapy; SST) versus a medium-intensity treatment (Minimal Intervention Strategy for Lung patients [LMIS]) for chronic obstructive pulmonary disease outpatients.

Methods: The cost-effectiveness analysis was based on a randomized controlled trial investigating the effectiveness of the SST compared with the LMIS with 12-month follow-up. The primary outcome measure was the cotinine-validated continuous abstinence rate based on intention to treat.

A holistic framework to improve the uptake and impact of eHealth technologies.

Background: Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders.

Factors influencing the use of a Web-based application for supporting the self-care of patients with type 2 diabetes: a longitudinal study.

Background: The take-up of eHealth applications in general is still rather low and user attrition is often high. Only limited information is available about the use of eHealth technologies among specific patient groups.

Objective: The aim of this study was to explore the factors that influence the initial and long-term use of a Web-based application (DiabetesCoach) for supporting the self-care of patients with type 2 diabetes.

Correlates of sexual faithfulness among low-literate rural males in the Amhara Region of Ethiopia.

HIV is a major threat to the people of the rural Amhara Region, northwest Ethiopia. To date, numerous studies have focused on condom use for HIV prevention. Using the theory of planned behaviour, this study investigates the psychosocial determinants of intended sexual faithfulness among rural males in the Amhara Region.

Effectiveness of a Web-based intervention aimed at healthy dietary and physical activity behavior: a randomized controlled trial about users and usage.

Background: Recent studies have shown the potential of Web-based interventions for changing dietary and physical activity (PA) behavior. However, the pathways of these changes are not clear. In addition, nonusage poses a threat to these interventions.

Reaching the hearts and minds of illiterate women in the Amhara highland of Ethiopia: Development and pre-testing of oral HIV/AIDS prevention messages.

In the style of radio programmes, we developed three episodes of audio HIV prevention education for illiterate women in Ethiopia. We used social-oriented presentation formats, such as discussion between women on HIV prevention, and expert-oriented presentation formats, such as an interview with a male doctor. The aim of this study was to assess the relation between evaluation of presentation formats and overall liking of episodes, which is important for persuasive effects.

Effects of a theory-based audio HIV/AIDS intervention for illiterate rural females in Amhara, Ethiopia.

In Ethiopia the level of illiteracy in rural areas is very high. In this study, we investigated the effects of an audio HIV/AIDS prevention intervention targeted at rural illiterate females. In the intervention we used social-oriented presentation formats, such as discussion between similar females and role-play.

Usage and effect of a web-based intervention for the prevention of overweight; a RCT.

Web-based interventions can be effective in changing behaviour of people faced with health problems. However, it is unclear whether they are effective in preventing health problems like overweight. The aim of this study was to investigate usage and effectiveness of the Healthy Weight Assistant (HWA), a web-based application to increase healthy behaviour in adults with a healthy weight or slight overweight, by means of a Randomised Controlled Trial (RCT).

Experiences and attitudes of Dutch rheumatologists and oncologists with regard to their patients' health-related Internet use.

The objective of this study is to explore the experiences and attitudes of rheumatologists and oncologists with regard to their patients' health-related Internet use. In addition, we explored how often physicians referred their patients to health-related Internet sites. We sent a questionnaire to all the rheumatologists and oncologists in the Netherlands.

Patient-initiated online support groups: motives for initiation, extent of success and success factors.

We studied the success and success factors of online support groups (OSGs) for patients, and the motives and goals of people who start such groups. We interviewed 23 webmasters of OSGs for patients with breast cancer, fibromyalgia and arthritis. The majority were women (n = 20) and most were patients (n = 21).

A study of a Dutch online decision aid for parents of children with ADHD.

During a three-month study period, visitors to an online decision aid (DA) for attention deficit hyperactivity disorder (ADHD) were invited to complete an online questionnaire before and after working through the DA. Some 75,000 unique visitors found their way to the page on DAs, although fewer than 1 in 10 visited the DA for ADHD, staying there for about six minutes on average and using 8-9 clicks to navigate. A total of 195 people completed the first questionnaire (a response rate of about 3%).

Patient use and compliance with medical advice delivered by a web-based triage system in primary care.

We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based triage system and 3812 patients went right through the triage process to the end.

Evaluation of a web-based lifestyle coach designed to maintain a healthy bodyweight.

We evaluated a web-based intervention, the Healthy Weight Assistant (HWA), which was designed to help people with a healthy bodyweight, or those who are slightly overweight, to achieve and maintain a healthy weight. Four evaluation methods were used: (1) pre- and post-test questionnaires; (2) real time usability-tests; (3) log-file analysis; (4) qualitative analysis of forum posts, email messages and free-text responses in the questionnaires. A total of 703 respondents received access to the HWA.

HIV-prevention knowledge among illiterate and low-literate women in rural Amhara, Ethiopia.

More than 85% of Ethiopia's population lives in rural areas and literacy levels in the country are relatively low. Despite this, little is known about levels of knowledge in regard to HIV/AIDS and condom use among illiterate and low-literate rural individuals. We conducted a cross-sectional study among 200 illiterate to semi-literate women, ages 13 to 24, from two rural communities in the Amhara region of northwestern Ethiopia.

Increasing the use of e-consultation in primary care: results of an online survey among non-users of e-consultation.

Objective: To identify factors that can enhance the use of e-consultation in primary care. We investigated the barriers, demands and motivations regarding e-consultation among patients with no e-consultation experience (non-users).

Methods: We used an online survey to gather data.

Health-related Internet use by patients with somatic diseases: frequency of use and characteristics of users.

The aim of this study was to explore the percentage of Dutch patients using the Internet to search for information about their illness. In addition, we studied patients' usage of health-related Internet applications, such as online patient support groups. The final objective of this study was to explore which demographic, health and psychological characteristics are related to patients' health-related Internet use.

Self-reported differences in empowerment between lurkers and posters in online patient support groups.

Background: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants' feelings of "being empowered." However, most studies of online patient support groups have focused on the members of these groups who actively contribute by sending postings (posters).

Evaluation of internet-based technology for supporting self-care: problems encountered by patients and caregivers when using self-care applications.

Background: Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care.

Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia.

Ever since the rise of online support groups it has been presumed that there is an empowering effect from patients' participating in these groups, despite a lack of evidence to back up this assumption. In this study we explored if, and in which ways, patients feel empowered by participation. Additionally, we studied which empowering and disempowering processes occur as a result of taking part in these groups.

Comparison of three carbon monoxide monitors for determination of smoking status in smokers and nonsmokers with and without COPD.

In this (CAMOXI) study, three carbon monoxide (CO) monitors and salivary cotinine are assessed regarding their ability to distinguish smokers from nonsmokers, both in chronic obstructive pulmonary disease (COPD) and healthy people. Twenty-six healthy smokers, 25 healthy nonsmokers, 25 smoking, and 25 former smoking stable COPD patients (age 40-72 years) were included based on self-report (N = 101). All volunteers were measured following a 12-h abstinence period.