TSG : tijdschrift voor gezondheidswetenschappen最新文献

Smoking remains a major issue in the Netherlands. Municipal public health departments (GGDen) and municipalities are playing an increasingly important role in tobacco control policies. However, it is unclear to what extent municipalities actively contribute to tobacco prevention. In recent years, we studied the role of municipal health departments and municipalities in local tobacco control. At the local level, there is a lack of conditions and incentives to prioritize tobacco prevention. To enable municipalities to contribute to national tobacco control goals and prevention, structural funding, clear responsibilities, and measurable targets are needed.

Funding bodies are increasingly valuing youth participation in research and want to further encourage this development. Until now, researchers have mainly been motivated to work with young people in conducting research. An innovative ZonMw programme goes a step further and gives young people the opportunity to select a researcher themselves and jointly apply for funding for a theme chosen by the young people themselves. Using a responsive process evaluation, we investigated what lessons this innovative programme offers for young people, researchers, policymakers and funding bodies. Young people were in the lead in 13 research projects. The topics ranged from breaking taboos to strengthening resilience. The collaboration was successful, though it raised practical and ethical dilemmas, such as how young people in vulnerable positions can participate fully alongside their studies, work, therapy and social life. The power of youth participation does not lie in perfection, but in learning together by doing and genuinely giving space to young people. In this way, participation becomes more than just a tick in a box-it becomes a practice that brings about change, also in the distribution of societal research funds.

Introduction: By evaluating the Dutch national program All about Health (AiG) for facilitating cross-domain societal health networks, we investigate the question 'How can societal health transformation be conceptualized and evaluated?' Using literature, progress in these networks has been interpreted as a chain of small wins resulting from situational, action-oriented, and transformational change mechanisms of contextual preconditions.

Methods: Between 2014 and 2022, a multiple case study was conducted with four different initiative networks affiliated with AiG, involving a total of 53 semi-structured stakeholder interviews, fifteen observations of network meetings, training sessions, and local workshops, and validating insights in three dialogue workshops with pioneers and AiG staff.

Results: Observations led to the formulation of five small wins and five change mechanisms that mutually reinforce each other in a non-linear way, driven by a national platform facilitated by the AiG program office. Conflict escalation and management are of essential importance for the adaptation or revision of norms, practices and underlying rules and responsibilities. These gains and mechanisms have been brought together in a heuristic Transformative Health Governance Model.

Conclusion: Societal health transformation calls for a transition within policy systems towards demand-driven policy and a transformation towards shared responsibilities between policy systems as well as between the state, the market, and society. The THG model offers an evaluative framework and an action perspective to health transformation initiatives in society. More research is required to understand and achieve a translation of normative transformation into institutional transformation.

Introduction: This article aims at an exploratory validation of a Transformative Health Governance (THG) model. This model stems from a literature review and observations in four diverse case studies, consisting of cross-domain health networks affiliated with the program Alles is Gezondheid (AiG; see the article 'De ontwikkeling van een heuristisch Maatschappelijk GezondheidsTransformatie-model op basis van een evaluatie van het programma Alles is Gezondheid' in this special). In this article, we test the model among a broader representation of partners and users of AiG.

Methods: In April 2022, an online survey was conducted among partners and users of the AiG platform and services. A total of 103 questionnaires were analysed to explore the relevance of this model for follow-up research and for practice.

Results: We find strong associations between mechanisms and small wins, indicating mutual reinforcement of building conditions for health transformation. Support from a facilitating platform such as the AiG program office appears to promote awareness of a broader health concept and the adoption of innovations in daily working routines.

Conclusion: The THG model offers a cautious indication of actual transformative processes in the context of AiG. The THG model requires validation in other contexts to test generalizability and its suitability for evaluative research. For practice, the THG model provides direction for the coordination and evaluation of initiative networks for transformative health governance.

Communities and individual citizens play a crucial role in pandemic preparedness, not only in developing and implementing plans but also in increasing their own resilience. Citizen science can contribute to this by, for example, identifying disease outbreaks, collecting and analyzing data, and supporting policymaking and risk communication. The recent COVID-19 pandemic showed that enabling conditions for using citizen science for pandemic preparedness are not in place. Therefore, this research focuses on the enabling conditions needed to effectively engage citizens in knowledge development for pandemic preparedness. We conducted an exploratory qualitative study consisting of fourteen interviews and four workshops and identified two overarching enabling conditions: public and professional recognition of citizen science and an accessible infrastructure for knowledge sharing and collaboration. Investing in a solid social, material, and technological infrastructure before a crisis strikes is necessary for fostering citizen engagement in knowledge development for pandemic preparedness. By strengthening these enabling conditions and taking the role of citizens in research seriously, citizen science can contribute not only to more effective pandemic preparedness but also to broader societal resilience in future crises.

In this article, we situate the growing attention for transitions in public health within broader scientific literature on transitions. We discuss these insights in the context of nicotine, alcohol, and overweight. We describe how the TransMission model typifies system-defining factors and transition phases, and are mindful of the misconception that transitions naturally move in a positive direction or that they can be easily managed. We conclude that by embracing the conflicts, uncertainties, and power asymmetries inherent to transitions, transition theory can serve as a critical framework for public health.

The Context-Sensitive Positive Health Questionnaire (CPHQ_2.0) was developed to measure broad health from both the Capability Approach and the Positive Health perspective. Whereas traditional instruments, such as the EQ-5D-5L and IPH-17, primarily focus on health status, the CPHQ_2.0 explicitly integrates personal and contextual factors that influence an individual's opportunities to live healthily. The further development from the original CPHQ_1.0 to CPHQ_2.0 involved ten focus groups, expert validation, a member check, and a longitudinal panel study for psychometric analysis (n = 1001). The results demonstrate a robust factor structure with eight domains: mental relaxation, social acceptance, well-being, vitality, social support, financial resources, health literacy, and mobility. It also had a good internal consistency (CR > 0.77) and test-retest reliability (ICC > 0.70). The CPHQ_2.0 can be applied in healthcare practice, the social domain, and health policy. Correlations with the IPH-17 and EQ-5D-5L confirm discriminant validity, with the CPHQ_2.0 distinguishing itself by not only providing insight into broad health, but also incorporating the opportunities individuals have to live healthily. As such, it offers valuable information for health promotion.

Forensic medicine in primary care setting is dealing with a structural shortage of forensic physicians. Due to an increasing demand, as well as a low inflow and a high expected outflow of the profession, increasing shortages are to be expected. By distributing forensic tasks differently, capacity of forensic physicians could be unlocked and re-allocated. Nivel, in collaboration with Panaxea, and in consultation with the professional field, identified three scenarios for task shifting. In this article, we describe how these scenarios were investigated and to what extent they can contribute to a future-proof organization of forensic medicine in the Netherlands.

While pregnancy is recognized as a "teachable moment" for lifestyle changes, many pregnant women struggle to meet dietary guidelines due to multiple barriers including limited nutritional support in antenatal care and challenges such as physical discomfort, food aversions, and conflicting information. Power 4 a Healthy Pregnancy (P4HP), a program that flexibly integrates four consultations into routine antenatal care, has demonstrated significant improvements in the quality of pregnant women's diets. This article reflects on the program's participatory development process, and examines how stakeholder engagement and empowerment principles shaped an effective program. We claim that the program's success is rooted in its cocreation with midwives, dietitians, and pregnant women. The P4HP program offers valuable insights for developing other sustainable health promotion initiatives in antenatal care.

Supplementary information: The online version of this article (10.1007/s12508-025-00473-1) contains supplementary material, which is available to authorized users.

Recognizing and addressing gambling-related problems, and referring to appropriate care, is complex for social professionals. Having a wide range of responsibilities, problem gambling is not always their priority concern. Based on design research, we developed a resource guide that includes knowledge, advice, and tools to detect and tackle problem gambling. In four iterative phases of exploring, defining, developing, and delivering, we co-created the guide together with professionals in education, community and youth work, and debt counselling, as well as with prevention and gambling experts, and individuals with lived experience. In this article, we reflect on the lessons learned, opportunities and challenges of this approach.