Vogel, I.

Parental Decisional Strategies Regarding HPV Vaccination Before Media Debates: A Focus Group Study (Article)

2013-04-08T00:00:00Z

Before the introduction of the human papillomavirus (HPV) vaccine, decisional strategies and factors that could guide HPV vaccination intentions were explored. The authors conducted 4 focus group discussions with 36 parents of children 8-15 years of age. Three groups consisted primarily of Dutch parents and 1 group of only Turkish parents. Discussions followed a semi-structured question route. Results showed that some parents used an approach of systematically seeking information as a way to prepare a decision, whereas others merely relied on trust in the message source. In general, parents believed that it was important to protect their child against negative outcomes that could result from vaccinating or not, and they felt that it is their responsibility to decide about uptake. Perceived susceptibility, vaccine effectiveness, and possibility of serious side effects were most important in the HPV vaccination decision-making process. In conclusion, parents perceived a lack of information and felt insecure about the vaccine's safety and effectiveness. This may result in ambivalent feelings toward HPV vaccination, which, in turn, may lead to postponing decisions about uptake. To facilitate informed decision making, which requires central processing, personally relevant messages about the knowns and unknowns regarding the effects of HPV vaccination should be provided.

An observational study on socio-economic and ethnic differences in indicators of sedentary behavior and physical activity in preschool children (Article)

2012-01-01T00:00:00Z

Objective: We studied associations between social disadvantage and indicators of sedentary behavior and physical activity at preschool age. Methods: Data from 4688 children enrolled in a birth cohort in Rotterdam, the Netherlands, between 2002 and 2006 were analyzed. Indicators of sedentary behavior (watching television ≥ 2 h/day and sitting in a buggy ≥ 0.5 h/day) and physical inactivity (playing outside < 3 h/day) were measured by a parent-reported questionnaire at age 3. Adjustments were made for social circumstances and indicators of health behaviors. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CI). Results: Children with low-educated mothers (OR: 3.27, 95% CI 2.12-5.05) and non-Dutch children (ORnonWestern: 2.67, 95% CI 2.04-3.49, ORWestern: 2.09, 95% CI 1.42-3.0) were more likely to watch television for at least 2h/day. Similar results were seen for sitting in a buggy for at least 0.5h/day. Non western children were more likely to play outside for less than 3h/day (OR: 1.95, 95% CI: 1.39-2.73) than native Dutch children, while no differences were seen for other western children or children from mothers with a low educational level. Conclusions: Socio-economic status and ethnicity are already associated with indicators of sedentary lifestyles at preschool age.

Postpartum fepression after mild and severe preeclampsia (Article)

2011-10-01T00:00:00Z

Objective: To describe the prevalence of postpartum depressive symptoms after preeclampsia, to assess the extent to which the prevalence of postpartum depressive symptoms differs after mild and severe preeclampsia, and to investigate which factors contribute to such differences. Methods: Women diagnosed with preeclampsia (n=161) completed the Edinburgh Postnatal Depression Scale (EPDS) at 6, 12, or 26 weeks postpartum. Multiple logistic regression analysis was used to investigate the association between severity of preeclampsia, contributing factors and postpartum depression (PPD) (1) at any time during the first 26 weeks postpartum and (2) accounting for longitudinal observations at three time points. Results: After mild preeclampsia, 23% reported postpartum depressive symptoms at any time up to 26 weeks postpartum compared to 44% after severe preeclampsia (unadjusted odds ratio [OR] 2.65, 95% confidence interval [CI] 1.16-6.05) for depression at any time up to 26 weeks postpartum (unadjusted OR 2.57, 95% CI, 1.14-5.76) while accounting for longitudinal observations. Admission to the neonatal intensive care unit (NICU) (adjusted OR 3.19, 95% CI 1.15-8.89) and perinatal death (adjusted OR 2.96, 95% CI 1.09-8.03) contributed to this difference. Conclusions: It appears that not the severity of preeclampsia itself but rather the consequences of the severity of the disease (especially admission to the NICU and perinatal death) cause postpartum depressive symptoms. Obstetricians should be aware of the high risk of postpartum depressive symptoms after severe preeclampsia, particularly among women whose infant has been admitted to the NICU or has died.

Poor Health-related Quality of Life After Severe Preeclampsia (Article)

2011-09-01T00:00:00Z

Background: Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality, and adverse birth outcomes. The objective of this study was to describe changes in all domains of health-related quality of life between 6 and 12weeks postpartum after mild and severe preeclampsia; to assess the extent to which it differs after mild and severe preeclampsia; and to assess which factors contribute to such differences. Methods: We conducted a prospective multicenter cohort study of 174 postpartum women who experienced preeclampsia, and who gave birth between February 2007 and June 2009. Health-related quality of life was measured at 6 and 12weeks postpartum by the RAND 36-item Short-Form Health Survey (SF-36). The population for analysis comprised women (74%) who obtained scores on the questionnaire at both time points. Results: Women who experienced severe preeclampsia had a lower postpartum health-related quality of life than those who had mild preeclampsia (all p<0.05 at 6wk postpartum). Quality of life improved on almost all SF-36 scales from 6 to 12weeks postpartum (p<0.05). Compared with women who had mild preeclampsia, those who experienced severe preeclampsia had a poorer mental quality of life at 12weeks postpartum (p<0.05). Neonatal intensive care unit admission and perinatal death were contributing factors to this poorer mental quality of life. Conclusions: Obstetric caregivers should be aware of poor health-related quality of life, particularly mental health quality of life in women who have experienced severe preeclampsia (especially those confronted with perinatal death or their child's admission to a neonatal intensive care unit), and should consider referral for postpartum psychological care. (BIRTH 38:3 September 2011) © 2011, the Authors. Journal compilation

Adolescents risky MP3-player listening and its psychosocial correlates (Article)

2011-04-01T00:00:00Z

Analogue to occupational noise-induced hearing loss, MP3-induced hearing loss may be evolving into a significant social and public health problem. To inform prevention strategies and interventions, this study investigated correlates of adolescents' risky MP3-player listening behavior primarily informed by protection motivation theory. We invited 1687 adolescents (12- to 19-year old) of Dutch secondary schools to complete questionnaires about their MP3-player listening, sociodemographic characteristics and presumed psychosocial determinants of MP3-player listening. Of all participants, 90% reported listening to music through earphones on MP3 players; 28.6% were categorized as listeners at risk for hearing loss due to estimated exposure of 89 dBA for ≥1 hour per day. Compared with listeners not at risk for hearing loss, listeners at risk were more likely not to live with both parents, to experience rewards of listening to high-volume levels, to report a high habit strength related to risky MP3 listening, and were less likely to be motivated to protect their hearing. Habit strength was the strongest correlate of risky listening behavior, suggesting that voluntary behavior change among adolescents might be difficult to achieve and that a multiple strategy approach may be needed to prevent MP3-induced hearing loss.

Preferences for postpartum lifestyle counseling among women sharing an increased cardiovascular and metabolic risk: A focus group study (Article)

2011-02-01T00:00:00Z

Objective. To describe women's preferences for postpartum lifestyle counseling after a pregnancy complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes. Methods. Thirty-six women who had experienced these pregnancy complications participated in six focus group interviews. Results. All women expressed a need for participation in postpartum lifestyle counseling. They preferred participation to be tailored to individual preferences. A combination of face-to-face counseling supported by computer-tailored lifestyle advice appealed to them. Conclusion. Postpartum lifestyle counseling aimed at these women should be tailored to individual needs and preferences.

Breastfeeding patterns among ethnic minorities: The Generation R Study (Article)

2010-12-01T00:00:00Z

Background Because breastfeeding is the best method of infant feeding, groups at risk of low breastfeeding rates should be identified. Therefore, this study compared breastfeeding patterns of ethnic minority groups in The Netherlands with those of native mothers and established how they were influenced by generational status and socio-demographic determinants of breastfeeding. Methods We used data on 2914 Dutch, 366 Mediterranean first-generation, 143 Mediterranean second-generation, 285 Caribbean first-generation and 140 Caribbean second-generation mothers. Information on starting breastfeeding and breastfeeding at 2 and 6 months after birth were obtained from questionnaires during the first year after birth. Results Overall, 90.6% of women started breastfeeding after delivery. This percentage was lowest among the native Dutch (89.1%) and highest among the Mediterranean second-generation women (98.6%; p≤0.001). At 6 months postpartum, 30.6% of mothers were still breastfeeding, ranging from 19.3% in the Caribbean second-generation mothers to 42.6% in first-generation Mediterranean mothers. After adjustment for covariates, more non-native mothers started breastfeeding than native Dutch mothers. While Mediterranean first-generation mothers had higher breastfeeding rates at 6 months (OR: 2.71, 95% CI: 2.09 to 3.51), there were no differences in Mediterranean second-generation and Caribbean mothers compared to native Dutch mothers. Conclusion More non-native mothers started breastfeeding than native mothers, but relative fewer continued. Although both native Dutch and non-native mothers had low continuation rates, ethnic minorities may face other difficulties in continuing breastfeeding than native women.

Effect of postpartum lifestyle interventions on weight loss, smoking cessation, and prevention of smoking relapse: A systematic review (Article)

2010-10-01T00:00:00Z

Postpartum lifestyle interventions are recommended for women after pregnancies complicated by preeclampsia, intrauterine growth restriction, and/or gestational diabetes, since they are at increased cardiovascular risk. To identify potential intervention strategies to reduce this risk, a systematic review of the literature is presented on the effectiveness of postpartum lifestyle interventions aimed at weight loss, smoking cessation, and smoking relapse prevention. The main characteristics of these postpartum lifestyle interventions are briefly described. The PubMed, Embase, Web of Science, PsychInfo, and Cinahl databases were searched for studies on the effects of postpartum lifestyle interventions on weight loss, and smoking cessation or prevention of smoking relapse, initiated for up to 1 year postpartum. No studies on the effectiveness of postpartum lifestyle interventions after the aforementioned specific pregnancy complications were found. However, 21 studies are included that describe existing postpartum lifestyle interventions, which were applied to unselected (on the basis of pregnancy complications) postpartum women. Copyright

Young People: Taking Few Precautions Against Hearing Loss in Discotheques (Article)

2010-05-01T00:00:00Z

This study evaluated adolescents' music-listening risk and protective behaviors in discotheques. While frequently standing close to the loudspeakers, taking few breaks, and hardly using hearing-protection devices, many are at risk of developing permanent hearing loss. Assessing visiting mode may be a first and quick screener to identify adolescents at risk.

Ethnic differences in informed decision-making about prenatal screening for Down's syndrome (Article)

2010-03-01T00:00:00Z

Background: The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables. Methods: Pregnant women of Dutch, Turkish and Surinamese origin were recruited between 2006 and 2008 from community midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed 3 weeks (mean) after booking for prenatal care. Knowledge, attitude and participation in prenatal screening were assessed following the 'Multidimensional Measure of Informed Choice' that has been developed and applied in the UK. Results: In total, 71% of the Dutch women were classified as informed decision-makers, compared with 5% of the Turkish and 26% of the Surinamese women. Differences between Surinamese and Dutch women could largely be attributed to differences in educational level and age. Differences between Dutch and Turkish women could mainly be attributed to differences in language skills and gender emancipation. Conclusion: Women from ethnic minority groups less often made an informed decision whether or not to participate in prenatal screening. Interventions to decrease these ethnic differences should first of all be aimed at overcoming language barriers and increasing comprehension among women with a low education level. To further develop diversity-sensitive strategies for counselling, it should be investigated how women from different ethnic backgrounds value informed decisionmaking in prenatal screening, what decision-relevant knowledge they need and what they take into account when considering participation in prenatal screening.

Ethnic differences in considerations whether or not to participate in prenatal screening for Down syndrome (Article)

2009-12-01T00:00:00Z

Objective: To evaluate ethnic differences in considerations whether or not to participate in prenatal screening for Down syndrome and to relate these to differences in participation. Method: The study population consisted of 270 pregnant women from Dutch, Turkish and Surinamese (African and South Asian) ethnic origin, attending midwifery or obstetrical practices in the Netherlands. Women were interviewed after booking for prenatal care. Considerations were assessed by one open-ended question and 18 statements that were derived from focus group interviews. Actual participation was assessed several months later. Results: Women from ethnic minorities were less likely to participate in prenatal screening, which could be attributed to differences in age and religious identity. They more often reported acceptance of 'what God gives', low risk of having a child with Down syndrome and costs of screening as considerations not to participate in prenatal screening. They also reported many considerations in favour of participation, which did not differ from those of Dutch women but were less often consistent with actual participation in screening. Conclusions: Women from ethnic minorities should not be stereotyped as being uninterested in prenatal screening, but should be better informed about the consequences of prenatal screening and Down syndrome. Copyright

Music venues and hearing loss: Opportunities for and barriers to improving environmental conditions (Article)

2009-11-04T00:00:00Z

This study explores the opportunities for and barriers to improving environmental conditions in order to reduce the risk for music-induced hearing loss in people who attend music venues. Individual semi-structured interviews were held with 20 representatives of music venues and of governmental organizations, according to a semi-structured interview guide. The interviews were audiotaped, transcribed, and systematically coded using a content-analysis technique. Reported opportunities to reduce music volume included improving the acoustics and installing advanced speaker systems. The most important barrier reported was the lack of clear definitions of what levels of high-volume music are hazardous. Other barriers mentioned included economic considerations, and the beliefs that visitors demand high-volume music in music venues and are personally responsible for their own hearing. Before measures to improve environmental conditions are implemented, the exact dangers of exposure to high-volume music have to be established. Evidence-based guidelines and safety standards for leisure-time noise exposure should therefore be developed.

Music-Listening Behavior of Adolescents and Hearing Conservation: many risks, few precautions (Doctoral Thesis)

2009-09-09T00:00:00Z

Noise-induced hearing loss (NIHL) is a significant social and public-health problem. Long-term exposure to high-volume levels will cause permanent hearing loss after 5-10 years. With the massive spread in the popularity of portable MP3 players, exposure to high sound levels has increased dramatically, and millions of adolescents and young adults are potentially at risk of permanent hearing loss by listening to their favorite music. In order to prevent hearing loss or to prevent any mild hearing loss to progress to more severe hearing loss, it is necessary to reduce exposure to high-volume sounds, including music. This may be induced through health education aimed at promotion of protective behaviors among the children and young people themselves, or through health protection measures. It is important that this is done step by step through careful theory-based intervention planning. The research as presented in this thesis reports on studies on adolescents music-related risk and protective behaviors, important and modifiable determinants of such behaviors, and ideas and opinions of experts, key persons and decision-makers on the possibilities for potentially effective strategies and interventions for the prevention of music-induced hearing loss in adolescents. In the project that this thesis reports upon a mix of qualitative and quantitative approaches has been applied such as a summary of the literature, focus group as well as individual interviews, a Delphi study, and a school-based survey.

Strategies for the prevention of MP3-induced hearing loss among adolescents: Expert opinions from a Delphi study (Article)

2009-05-01T00:00:00Z

OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions. METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth work, music entertainment, and enforcement authorities participated in a qualitative, electronic, 3-round, Web-based Delphi study. RESULTS. Multiple parties involved in the prevention of MP3-induced hearing loss among adolescents were identified; the most relevant are the adolescents themselves, their parents, manufacturers of MP3 players and earphones, and the authorities. The experts did not expect that adolescents in general would perform the necessary protective behaviors to prevent MP3-induced hearing loss. Two environmental health protection measures were identified as both relevant and feasible to be implemented (ie, authorities encourage manufacturers to produce safer products, and public health campaigns will be held to improve knowledge of the risks of high-volume music, possible protective measures, and consequences of hearing loss). CONCLUSIONS. Authorities, the music industry in general, and especially manufacturers of MP3 players and earphones should recognize their responsibility and create a safer MP3-listening environment by taking measures to protect today's youth from the dangers of listening to high-volume music on MP3 players. Copyright

Information about prenatal screening for Down syndrome Ethnic differences in knowledge. (Article)

2009-04-01T00:00:00Z

OBJECTIVE: To evaluate the provision of information about prenatal screening for Down syndrome to women of Dutch, Turkish and Surinamese origins, and to examine the effects of this provision on ethnic differences in knowledge about Down syndrome and prenatal screening. METHODS: The study population consisted of 105 Dutch, 100 Turkish and 65 Surinamese pregnant women attending midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed for 3 weeks (mean) after booking for prenatal care. RESULTS: Most women reported to have received oral and/or written information about prenatal screening by their midwife or obstetrician at booking for prenatal care. Turkish and Surinamese women less often read the information than Dutch women, more often reported difficulties in understanding the information, and had less knowledge about Down syndrome, prenatal screening and amniocentesis. Language skills and educational level contributed most to the explanation of these ethnic variations. CONCLUSION: Although most Dutch, Turkish and Surinamese women reported to have received information from their midwife or obstetrician, ethnic differences in knowledge about Down syndrome and prenatal screening are substantial. PRACTICE IMPLICATIONS: Interventions to improve the provision of information to women from ethnic minority groups should especially be aimed at overcoming language barriers, and targeting information to the women's abilities to comprehend the information about prenatal screening for Down syndrome.

Ethnic differences in outcomes of diabetes care and the role of self-management behavior (Article)

2008-07-01T00:00:00Z

Objective: Ethnic differences in outcomes of outpatient diabetic care and the role of self-management behavior and its determinants in explaining observed differences. Methods: Face-to-face interviews were held with 102 Turkish or Moroccan, and 102 native Dutch diabetic patients to measure self-management behavior and determinants of self-management (as derived from the Attitudes-Social support self-Efficacy model, and Personal Models and Barriers). A medical record review was conducted to measure ethnic differences in outcomes of diabetes care. Data were analyzed using multiple linear regression. Results: Outcomes differed significantly with ethnic minorities having higher levels of lipids (risk difference = RD = 0.7%; CI: 0.3-1.2) and HbA1c (RD = 0.9%; CI: 0.4-1.4) than native Dutch patients. Differences in self-management could not explain the ethnic differences in outcomes. Self-efficacy explained 18% of the ethnic differences in HbA1c. Beliefs about seriousness of diabetes and social support regarding diabetes management together explained 47% of the ethnic differences in lipids. Conclusion: This study provides evidence for ethnic differences in outcomes of diabetes care. Self-efficacy is the most important determinant in explaining the differences in HbA1c. Practice implications: For diabetes practice this suggests that strengthening patients' self-efficacy may improve the control of HbA1c and may result in a decrease of ethnic differences. The relationship between behavioral determinants like seriousness and social support and outcomes of diabetes care was differential by ethnic group, implying that caution is required when applying behavioral models to different ethnic groups.

MP3 Players and Hearing Loss: Adolescents' Perceptions of Loud Music and Hearing Conservation (Article)

2008-03-01T00:00:00Z

Objective: To explore adolescents' behaviors and opinions about exposure to loud music from MP3 players. Study design: We conducted a qualitative analysis of focus-group discussions with adolescents aged 12 to 18 years from 2 large secondary schools (1 urban and 1 rural) for pre-vocational and pre-university education. The semi-structured question route was theoretically framed within the protection motivation theory. Results: Most adolescents-especially male students and students from pre-vocational schools-indicated that they often played their MP3 players at maximum volume. Although they appeared to be generally aware of the risks of exposure to loud music, they expressed low personal vulnerability to music-induced hearing loss. Most adolescents said that they would not accept any interference with their music-exposure habits. Conclusions: Interventions should target students from pre-vocational schools and should focus on increasing adolescents' knowledge of the risks of loud music and how to protect themselves. Besides hearing education for adolescents and technical modifications of MP3 players, volume-level regulations for MP3 players may be warranted.

Young people's exposure to loud music: a summary of the literature (Article)

2007-08-01T00:00:00Z

OBJECTIVES: This descriptive summary of the literature provides an overview of the available studies (published before October 2006) on sociodemographic, psychosocial, and other correlates of risk and protective behaviors for hearing loss in young people aged 12 to 25 years. METHODS: Publications were identified by a structured search in PubMed, PsycINFO, and Web of Science, and by scrutinizing the reference lists of relevant articles. The protection motivation theory was used as the theoretical framework for categorizing the psychosocial correlates. RESULTS: Thirty-three papers were included that identified several sociodemographic and psychosocial correlates, such as age, gender, school level, ethnicity, music preference, physical activity, social influence, and free supply of hearing protection. CONCLUSIONS: For the development of effective interventions we recommend theory-based longitudinal studies among those frequently exposed to loud music to assess these correlates in greater depth.