Projects

Supporting the development of self-regulation in infants: a promising strategy in preventive mental health care.

A major challenge of the newborn child is to learn to regulate internal states (physiological, emotional, and cognitive) and behavior. The child's self-regulation stems from successful co-regulation between the baby and its caregiver(s) and constitutes the basis of mental health. Regulation problems (RP) in early childhood are the seeds for emergent developmental psychopathology and for persistent mental health problems later in life. Given the increasing pressure on our mental health care system, targeting RP at an early age is a cost-effective prevention strategy. Based on growing empirical and clinical evidence, we hypothesize that child RP largely result from/persist through co-regulation difficulties within the child-parent dyad, which itself is largely impacted by stress and regulation difficulties in the parent. Hence, reducing stress and enhancing parents' regulation abilities may be the most optimal gateway for improving self-regulation in the child, thereby preventing future mental health problems. To date, however, there is a dearth of scientific research on this topic, both with respect to the (1) characterization, detection and understanding of regulation (problems) (WP1&2), and (2) the organization of preventive care around early regulation in young children (WP3&4). The current proposal will address these gaps in 4 work packages aimed at: (1) quantifying micro self- and co-regulation dynamics within a 'biobehavioral synchrony framework'; (2) understanding the prevalence and contextual risk and protective factors of RP; (3) pinpointing the missed opportunities in the preventive care for young children with RP and translating 3rd line clinical expertise to fill these gaps and (4) developing and testing a 0th/1st line health care program empowering parents in the co-regulation process with their child. Together with our committed stakeholders, this multidisciplinary project aims to be a game changer in the early prevention of mental health care.

The quality of formal childcare has been cited as an important determinant of young children’s mental health, as it has been demonstrated that children’s self-regulation abilities – resulting from repeated cycles of co-regulation in caregiving – hold extreme importance for their mental health, now and later in life. Given the high uptake of formal childcare in Flanders and the high enrollment rates of the youngest children, childcare teachers thus play an very important role in these co- and self-regulation processes. High job strains within the sector, however, put these services at risk of inducing stress and mental well-being problems among childcare teachers, possibly impacting the co-regulation processes. Fundamental research is scarce in measuring, disentangling and optimizing these relationships. In the current proposal, we will address these gaps using a mixed-method design focusing on 3 research objectives (ROs): (RO1) map the job characteristics that explain job strain in childcare teachers (structural quality), and investigate its association with childcare teachers’ ensuing mental well-being, (RO2) examine the impact of childcare teachers’ strain and ensuing mental well-being on their co-regulation attitudes and practices (process quality), and (RO3) explore effective strategies to structurally optimize both the structural and process quality of formal childcare.

​More information about this project 

Coolschools is a European transdisciplinary applied research project. The objective of Coolschools is to assess the multiple co-benefits of implementing nature-based climate shelters in school environments. Coolschools uses an inter- and transdisciplinary approach that combines natural, bio-medical, social and education sciences, to assess how nature-based climate shelters can act as drivers of transformation at larger urban scales. The project builds on pioneering pilot nature-based climate shelter projects of school transformation in Barcelona, Brussels, Paris and Rotterdam.

Researchers from SEHPO are co-responsible for work package 3, together with researchers from the Centre for Environmental Sciences (UHasselt). In work package 3 the aim is to unravel health transformation capacities of nature-based climate school shelters by analyzing the associations between exposure to nature-based climate school shelters and children’s cognitive development, emotional well-being and behavior. The pilots’ best practices and key learnings will be disseminated among city governments, urban planners, companies, school communities and other relevant stakeholders.

More information about the COOLSCHOOLS project

Equity in breast cancer screening in Flanders: the necessity of tailored reminders for women with low socioeconomic status

ENTER stands for ‘Equity iN breasT cancEr scReening: the necessity of tailored reminders for women with low socioeconomic status’. In this project, funded by Stichting tegen Kanker, we develop and test a reminder letter to attend the breast cancer screening program (BCSP) in Flanders, tailored for women with low socioeconomic status.  

While the BCSP has been implemented in Flanders since 2001, only 50% of eligible women on average are screened every year. Moreover, participation inequity was observed, with women with low socioeconomic status (SES) being 40% less likely to participate in the BCSP than high-SES women. Studies have shown that misconceptions about BCSP are one of the most prominent reasons for non-participation, for example, the idea that screening is only necessary for old women, or women with a family history of BC, and that screening is dangerous. Therefore, tailored interventions based on a systematic understanding of the misconceptions towards BCSP are needed especially for low-SES non- participants in order to improve the equity of the BCSP.

The primary objective of ENTER is to improve the participation of low-SES women in the BCSP by developing a tailored reminder to address the misconceptions about the BCSP. Then, the cost- effectiveness of the tailored reminder will be evaluated in order to implement it in the BCSP. SEHPO-UAntwerpen, CvKO and Thomas More are the main institutions involved, in cooperation with Solidaris, Logo, FMDO, AZ Damian, Saamo and Community Health Workers.

Urban green spaces as a potential climate change adaptation strategy for climate sensitive health outcomes: 

This is a one-year (2023-2024) collaborative research project between the University of Antwerp (Belgium), Makerere University (Uganda), and the South African Medical Research Council (South Africa). The aims of this research project are twofold. Firstly, we will investigate the association between urban green spaces and climate-sensitive health outcomes (hypertension, depression, and anxiety) among residents of Kampala, Uganda and secondly, we will examine the underlying mechanisms in the association between urban green spaces and the aforementioned health outcomes. This project is funded by the National Institute for Health Research, United Kingdom.

In 2021 this chair started as a collaboration between Reinier de Graaf Gasthuis in Delft, the Netherlands, and the University of Antwerp. 

The goal of the chair is to better map and further reduce problematic alcohol use in adolescents in Flanders. 

This is done by focusing on three pillars: 

1) Registration of alcohol intoxications among adolescents in Flanders 

2) Developing, setting up, and evaluating an outpatient clinic for youth and alcohol in Antwerp 

3) Raising awareness in society about the risks of problematic alcohol use for adolescents 

 More information about the Chair Reinier de Graaf Youth and Alcohol

The ORIENT (tOwaRds Informed dEcisions iN colorecTal cancer screening) Prevention Project is a collaborative effort between SEHPO-UAntwerpen and Thomas More, supported by Domus Medica and funded by Kom op Tegen Kanker. This project runs from August 2022 to August 2024 under the supervision of Prof. dr. Guido Van Hal (Principal investigator), Postdoc Wessel van de Veerdonk, and Dr. Timon Vandamme.

The project's central aim is to develop and pilot-test a risk-stratified shared decision-making (SDM) tool tailored specifically for vulnerable populations in the context of colorectal cancer (CRC) screening. Vulnerable population in this project includes those who have low literacy skills, low socio-economic status and migrant backgrounds in Flanders.

The project is structured around four work packages, aiming to systematically develop and test the SDM tool while ensuring its adaptation to the needs and preferences of vulnerable populations and general practitioners in Flanders. Work Package (WP) 1 focuses on synthesizing evidence regarding SDM tools for cancer screening and risk prediction models for CRC. WP 2 is dedicated to developing the alpha version of the risk-stratified SDM tool tailored for vulnerable populations considering CRC screening. WP 3 aims to test the beta version of the SDM tool, specifically assessing its impact on the informed choices of vulnerable populations. Finally, WP 4 involves disseminating and communicating results among relevant stakeholders to raise awareness and promote the SDM tool among end-users.

To address the primary goal of this project, the ORIENT prevention project outlines five main objectives:

1. Systematically reviewing shared decision-making tools for cancer screening and individualized risk prediction models for colorectal cancer.
2. Developing the content, layout, and framework of the risk-stratified SDM tool catered to vulnerable populations.
3. Incorporating the CRC Machine Learning (AI) model into the SDM tool.
4. Conducting pilot tests to gauge the SDM tool's impact on informed decision-making concerning CRC screening among patients.
5. Exploring the acceptability and satisfaction levels of patients and general practitioners with the innovative SDM tool, with a focus on formulating an implementation strategy.

​More information about ORIENT​

Evaluation of the process and impact of the ‘Smakelijke’ School project: 

‘Smakelijke School’ is set up by the city authorities of Antwerp with the aim of providing children in Antwerp kindergartens and elementary schools with healthy meals at schools. The city aims with this project to improve the health of the children and to boost their energy levels.

Researchers from SEHPO are, together with researchers from ELIZA and CAPRI, responsible for the evaluation of the process and the impact of the ‘Smakelijke School’ program. More specifically, one of the aims is to assess the impact of ‘Smakelijke School’ on knowledge, attitude and habits (regarding diet and health), well-being of children and on children’s cognitive performance, blood pressure, anthropometry and behavior.

More information about Smakelijke School​

The PIPO study is a research project from the University of Antwerp, which follows participants from before birth until they reach young adulthood. This allows us to investigate the influence of environmental factors during the early years of life on health outcomes.

The PIPO study was initiated in 1997 in collaboration with the Antwerp University Hospital. Its original aim was to examine factors that play a significant role in the development of allergies. Later on, several other health outcomes were added, such as mental health, BMI, and cardiovascular diseases.

More information about the PIPO study

The European Community Respiratory Health Survey (ECRHS) is a large ongoing multi-center prospective cohort that was initiated in the 1990s. Its primary objective was to provide comprehensive estimates of the prevalence and incidence of respiratory diseases, symptoms and allergies, while also investigating their associated risk factors and treatment options. At baseline, 59 centers in 25 predominantly European countries recruited participants aged 20 to 44 years. To date, participants from nearly all centers included at baseline have been followed-up every 10 years. Each follow-up includes a clinical examination and administration of questionnaires. The clinical examination includes, among others, lung function tests, anthropometrics, and blood sampling. The questionnaires gather detailed information on health (mainly respiratory), lifestyles, occupation and other socio-economic information, and environmental exposures. SEHPO is coordinator of the two Belgian ECRHS centers: Antwerp center and Antwerp south. Both centers have been involved since the early 1990’s in ECRHS and in all ECRHS follow-ups conducted up to now.

More information about ECRHS

IRNOVIS stands for International Research Network on Violence and Integrity in Sport

Violence against children and adults in sport can be regarded as a wicked problem, as it involves many actors with different interests and responsibilities as well as a diversity of emotions ranging from anger to fear and anxiety (Stevens, 2019). The complexity of this problem, which appears to be prevalent in up to 44% of children participating in sport, necessitates a coordinated, interdisciplinary approach in order to fully understand how violence is perpetuated and dealt with in sport, both within individual countries and on the international level. To date, the knowledge base on the issue is limited, as the scientific community addressing these issues is relatively small, and the research field is in its infancy. The few researchers addressing this topic have predominantly been working in silos, and, consequently, initial studies have examined this issue with a singular discipline approach. Violence in sport is a multifaceted issue that has physical, psychological, social and organizational consequences. The fragmentation of the research efforts in this space thus far has limited the possibility of formulating a clear, collaborative and international agenda for future research. By bringing together the most active researchers from multiple disciplines in this field of study, the first International Research Network on Violence and Integrity in Sport (IRNOVIS) was established. IRNOVIS aims to maximize the scientific impact of research in order to better inform policy development and implementation as well as ethical governance. Specifically, this research network aims to develop an international research agenda to study violence and integrity in sport. By producing Position Statements, disseminating research findings and actively engaging in the international public debate about sport integrity and athlete protection, IRNOVIS aims to bring the field forward. IRNOVIS future activities, coordinated by the University of Antwerp, include yearly network meetings, guest lectures, an international conference, a Delphi study on expert opinion and joint research project applications.

​More information about IRNOVIS​

Colorectal cancer (CRC) and breast cancer are amongst the most common and deadliest cancers worldwide. Early detection through current screening programs for both cancers have reduced mortality, but important limitations of these methods, such as limited sensitivity, limited specificity and invasiveness, remain. There is a need for a new, minimally-invasive, cost-effective and very sensitive diagnostic test for screening and early cancer detection. Methylated circulating tumor DNA (metctDNA) biomarkers have shown great potential to discriminate between normal tissue and tumors. MetctDNA can be detected in a minimally-invasive manner using liquid biopsies, such as plasma. Currently, DNA methylation is studied using bisulfite conversion followed by next-generation sequencing or droplet digital PCR. However, disadvantages including DNA degradation, non-optimal sensitivity and specificity of subsequent techniques and limited multiplex capacities still need to be overcome. At this moment, there exists no efficient technique for the simultaneous analysis of several methylated regions in ctDNA in one assay. In our research group, we aim to develop a new, sensitive multi-region metctDNA based bisulfite-free detection technique. The technique will be used in this project to detect differential methylation signatures between normal tissue, pre-cancerous lesions and tumors. With this approach, we aim to develop a new and better assay for screening and detection of CRC and breast cancer.

​More information about this project​

MultiMorbidity (MM), the concurrence of two or more chronic conditions, is a growing phenomenon in all countries, and more prevalent among vulnerable groups in society. Yet, research to understand and address the phenomenon has only recently taken off. In the Belgium context, the burden of multimorbidity, measured by disability, is highest for cardiovascular diseases with or without diabetes; chronic respiratory diseases and depression; neurological diseases and cancers. The prevalence of MM has risen from 8,9% in 1997 to 15,2% in 2018. How patients use health care for their different conditions is not well known, while this has implications for quality of care and cost. Best practices in health care organizations to manage multimorbidity are being documented, but implementation research on feasibility, cost and effectiveness is still patchy. The PhD aims to improve understanding the burden, management and cost of multimorbidity in the Belgium health system, from the patient and health system perspective. Two Research Questions will be examined: 1) What are patterns of health care utilisation and health care cost for people with multiple chronic conditions? 2) Which innovations to manage multimorbidity are implemented, and what is the feasibility acceptability and effectiveness and cost of implementation? Year 1 and 2 will be used to develop the research protocol, explore existing data and to do the analysis of RQ1. Year 2 and 3 will be used for RQ. At least drie peer reviewed articles will be written with the following topics: 1) health care utilization and cost for Belgium patients with multiple chronic conditions; 2) implementation analysis of pilots for integrated care for multimorbidity; and 3) cost-effectiveness of multimorbidity pilots in the Belgium health system.