City based interventions to stimulate active movement for health (CITY-MOVE). 01/01/2024 - 31/12/2027

Abstract

CITY-MOVE adapts and implements the WHO Global Action Plan on Physical Activity (GAPPA) in six cities across three continents and develops a cross-contextual evaluation framework for transferability and scalability. Physical activity is a key behavior to reduce the NCD burden, including protecting against cancers and type 2 diabetes. There are many evidence-based interventions for cities to promote physical activity, yet they remain under-implemented, with a whole-of-system approach particularly lacking, and often fail to target the least active or vulnerable groups. Knowledge gaps are: a) how to adapt, b) successfully implement, and c) evaluate interventions, and d) how to transfer lessons to other interventions, target groups and contexts. In partnership with the cities, we identified interventions targeting individuals across the life course, particularly vulnerable and least active groups, aligned with the GAPPA domains of active people, societies, environments and systems. CITY-MOVE will: 1) Develop a city-GAPPA Theory of Change and operationalise assessment measures; 2) Adapt city-GAPPA to six cities, engaging stakeholders in each context; 3) Support cities in successful implementation through action research in living labs; 4) Assess reach, adoption, feasibility, fidelity, and sustainability of selected interventions in each city; 5) Improve the development and utilisation of routinely collected data to support successful implementation; 6) Generate cross-contextual evidence on implementation, evaluation and scalability through multi-criteria decision assessment for 12 interventions in six cities; and 7) Generate global capacity through regional Communities of Practice. CITY-MOVE results lead to increased physical activity by target populations, contributing to reduced premature NCD mortality, and to adaptable solutions ready for take-up by implementers.

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  • Research Project

SEvere MAlaria treatment with Rectal artesunate and Artemisinin-based Combination Therapy [in remote settings] (SEMA ReACT). 01/04/2023 - 31/03/2027

Abstract

Annually, almost 500,000 children under 5 years die from malaria in Africa. Timely access to effective antimalarial therapies is life saving as treatment with pre-referral rectal artesunate (RAS), followed by injectable artesunate and 3 days treatment with ACTs leads to an observed 96% reduction in mortality. Though recommended by the WHO for years, RAS deployment is very limited. The full treatment paradigm is not always feasible when access to primary healthcare facilities is limited due to lack of transport, non-availability of services, and cost. Rollout has recently been paused as outcomes data is incomplete in these contexts making the development of best practice recommendations challenging. Hence the relevance of the proposed study. The proposed project is an observational, non inferiority study in Zambia and DRC. Community Health Care Workers will identify/diagnose, treat and follow up patients with (severe) malaria as part of integrated community case management. We will compare the efficacy of a treatment regimen consisting of pre-referral RAS, then post-referral injectable artesunate, followed by three days of ACT versus a regimen consisting of RAS alone followed by three days of ACT in remote areas. We will compare recurrence rate between the two regimens at Day 28, the number of lives saved, the risk of generating drug resistance. We will assess and mitigate operational and institutional facilitators and barriers in all stakeholders (patients, caregivers, health care providers, regulators, malaria experts) and recommend sustainable policies for this remote context. This generated evidence will support policy development and implementation. The proposed consortium brings together vital experience in the rollout and deployment of rectal artesunate, study design and execution, social science, data collection and management, stakeholder engagement and translation of research results into clinical practice.

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  • Research Project

Scientific research on the impact of the 'Smakelijke School' project. 01/02/2023 - 31/01/2026

Abstract

Background: Providing children with healthy meals at schools can benefit the health of children and can positively influence health behavior. However, most studies on this topic are cross-sectional and focus on the short-term effects. Recently, the city authorities of Antwerp invested 40 million euros in the project 'Smakelijke School'. The aim of the project is to provide children with healthy meals at school and consequently to improve the health of children. In Belgium, no studies are conducted yet to evaluate the process and impact of such interventions. The specific aims are: 1. To describe the intervention and implementation process in detail using the 'Template for Intervention Description and Replication' checklist and guideline (TIDieR). 2. Explore the attitudes and experiences of the schools, teachers, parents and children, focusing on feasibility, acceptability and perceived impact on eating behavior. 3. Explore the impact of the intervention on knowledge, attitude and habits (regarding diet and health) and well-being of children. 4. To measure the impact of the intervention on children's cognitive performance, blood pressure, anthropometry and behavior. Methods: • Intervention: In total, 4 schools (participating in the Smakelijke School project) will be included: two high-intensity intervened schools (defined as schools offering a healthy meal/snack every day) and two low-intensity intervened schools (defined as schools that offer a healthy meal/snack no more than twice a week). Low-intensity schools will be compared with high-intensity schools and within the schools children not taking the meals (intervention) will be compared with children taking the meals. • Participants and setting: We will invite schools starting in September 2023. The school management (principals), teachers, children of the 4th grade and their parents will be invited to participate. Work package 1: quantitative assessments • Measurements: o Cognitive function tests: Stroop Test (selective attention), Continuous Performance Test (attention and concentration), Memory Span Test (short-term memory), Digit Symbol Test (information processing), Signal Detection Test (visual information processing). o Anthropometrics (height, weight and fat percentage) and blood pressure measurement o SDQ, KIDSCREEN-27 questionnaire and KAH-questionnaire (knowledge, attitude and habits) regarding food. o Questionnaire for the parents to gather information on individual socio-economic status and child general health and physical activity. Work package 2: qualitative assessments In the first phase of the qualitative aspect, we will describe the intervention and the implementation process and conduct interviews with the school management, teachers, children and parents. Based on the results from the quantitative part (WP 1) of this study, we will select the participants needed to continue the qualitative part of this study. We will organize observations in the schools, focus groups and a class conversation.

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  • Research Project

Leaving no one behind: bridging the gap between vulnerable populations and the primary healthcare system through reverse innovation. 01/10/2022 - 30/09/2026

Abstract

Sustainable Development Goal 3 underlines the right of everyone to have timely access to primary healthcare (PHC). Despite the fact that Belgium has put various reforms in place to make PHC more affordable and accessible, inequalities in access to care are even getting bigger – creating the need for innovative measures. A new health care model should thus be designed and tested to link people who have difficulties accessing PHC (PDAP) to the existing PHC system. Such a new model requires new fundamental knowledge, as former solutions have repeatedly failed. Since the country is also confronted with increasing health demands and limited budgets, there is impetus to tap into the potential of reverse innovations from low and middleincome countries (LMICs). A review of health innovations in LMICs and a theoretical analysis on the required characteristics of such a new model resulted in a community health worker (CHW) intervention – inspired by the Family Health System in Brazil and Re-engineering PHC in South Africa. We hypothesise that an outreaching PHC model with a CHW intervention will address the access-to-care challenges in Flanders, Belgium. We will first study the interplay over time between the different barriers PDAP experience throughout the access-to-care continuum in Flanders (WP 1). Secondly, we will investigate the innovative PHC models in South Africa and Brazil to develop the CHW intervention (WP2). In WP3, we will design a new outreaching PHC model which uses CHWs to improve access to care for PDAP in Flanders. In WPs 4 and 5, we will implement and evaluate the CHW intervention in a cluster randomised controlled trial. Finally, we will also assess the cost-effectiveness of the intervention (WP6). Throughout this work, academic experts from sociology, family medicine, and economics closely collaborate with committed societal stakeholders to join scientific insights and implementation knowhow, to optimise fit to practice and societal impact.

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  • Research Project

Health promotion and disease prevention in primary care training: a Belgian framework from European guidelines (PROPELLER) 09/12/2021 - 09/12/2022

Abstract

Given the crucial role of health promotion and disease prevention in primary care and the limited attention paid to it in current training programmes in Belgium, there is a need for capacity building for disease prevention and health promotion for primary care professionals. With this project, we formulate strategies for a better embedding of health promotion and disease prevention in primary care training, based on international standards and using a European network. The project is carried out by a multidisciplinary consortium of two academic partners from both language areas -University of Antwerp (UA) and Université Catolique de Louvain (UCL) - and the expertise centre on health promotion - Vlaams Instituut Gezond Leven (GL). The multidisciplinary research team consists of general practitioners, psychologists, educational experts and communication scientists. The research group can call upon an extensive steering committee of stakeholders with representatives of care users, educational institutes, professional organisations and policy makers from both parts of the country, both during the inventory phase and for the development of the strategy and dissemination. The inclusion of representatives of vulnerable target groups in the steering committee guarantees specific attention to the needs and input of these groups. The development of strategies is done in 3 phases, organised in 3 work packages. In WP1 we will elaborate a Belgian frame of reference for the provision and quality of education in health promotion and disease prevention through desk research. Existing international frameworks such as the core skills set for health promotion workers by the International Union for Health Promotion and Education (IUHPE) are the starting point for a cross-professional frame of reference adapted to the Belgian context. In WP2, we will make an inventory of the existing provision and of the quality of health promotion and disease prevention in primary health care training in Belgium through a survey starting from the stakeholder network. This also includes a comparative analysis with training courses in other European countries, through the research group's connections to European networks. The trainings will be analysed based on the frame of reference developed in WP1 and Clement's didactic model. WP3 will focus on the development of strategies for the envisaged embedding of health promotion and disease prevention in primary care training based on the results of WP1 and WP2. By means of co-creation work sessions, the research group together with stakeholders will develop a draft strategy in the form of an educational package, which will be tested in a Delphi procedure. The dissemination to training institutes, professional and scientific organisations, target groups and policy makers and the creation of a support base for concrete strategies will take place together with the steering committee. A final symposium and publications in professional journals will contribute to this.

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  • Research Project

Mapping study of instruments, frameworks, and perspectives on elder abuse. 01/12/2021 - 30/11/2023

Abstract

This project aims to perform a first mapping of the instruments, frameworks, and perspectives that are relevant in preventing, detecting, and addressing elder abuse in Belgium. The results of this research will provide the foundations for future research aimed at establishing and implementing an interprofessional protocol that is able to adequately respond to elder abuse.

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  • Research Project

Effective information exchange and care orientation in Covid-19-related contact tracing phone calls. An applied sociolinguistic and conversation analytic enquiry into optimizing interactional dynamics and pragmatic awareness. 01/11/2020 - 31/10/2021

Abstract

Responding to a number of urgent problems noted in the area of Covid-19 contact tracing (reluctance to give information, lack of care orientation, script-dominated talk), this project analyses and seeks to optimize the interactional functioning of the contact tracing phone call services coordinated by the Flemish Agency for Health & Care. It combines 4 objectives: (i) diagnosis of interactional practice in 3 cycles of data collection and analysis (incl. 1 cycle on encounters in other languages than Dutch); (ii) recommendations for practice, the development of training materials and a recruitment package; (iii) a pilot implementation followed by an efficacy measurement; and (iv) societal impact on the general public's support for contact tracing. The project inserts itself in an applied, interactional sociolinguistic and conversation analytic research tradition on medical encounters and institutional interviewing on sensitive topics. It addresses a current gap in (i) fundamental knowledge about the linguistic interactional dynamics of contact tracing calls as a specific type of institutional encounter and (ii) applied knowledge on how to improve task-oriented efficiency and enhance pragmatic awareness of practitioners as a dimension of professional reflexivity in a currently, important domain of combatting and containing the Covid-19 pandemic. The project benefits from close collaboration between relevant linguistic, medical and ethical expertise.

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  • Research Project

Being prepared for COVID-19: more to consider than face masks and social distancing. 17/08/2020 - 16/08/2021

Abstract

This project will support the GPs, who play a crucial role in local flare-ups of COVID-19, in structured referral of vulnerable people and groups to local welfare work. The local network of health workers and welfare workers will in this way play its role more optimally in scientifically detect, monitor and evaluate the psychosocial impact of COVID-19 and the associated measures. This project ensures that local flare-ups of the virus are detected and, in addition to the medical ones, will also detect, monitor and tackle the psychosocial impact of the disease. iCAREdata is already operational with detection and follow-up from COVID-19. This database is easily enriched with the social determinants in order to better deal with the pandemic and its impact traces and combat local flare-ups with a focus on vulnerable groups in the local context. This innovative platform supports GPs in correctly referring psychosocial needs to welfare work. The target audience includes the care actors and care providers in primary care zones (ELZ) who want to coordinate care through partnerships on the needs of the citizen, in accordance with GDPR. Secondary target groups are primary care patients, in particular vulnerable groups as well as the policy bodies that want to gain insight into medical and psychosocial care needs with a targeted and local approach.

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  • Research Project

Nature impact on Mental health distribution (NAMED - second phase). 01/04/2018 - 30/11/2021

Abstract

Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

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  • Research Project

Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research (SPICES) 01/01/2017 - 30/06/2022

Abstract

The overall research objective of the SPICES project is to implement and evaluate a comprehensive CVD prevention and control program in five settings: a rural & semi-urban community in a low-income country (Uganda), middle income (South Africa) and vulnerable groups in three high-income countries (Belgium, France and United Kingdom) as well as to identify and compare the barriers and facilitators across study contexts. The project will be evaluated using a mix of qualitative and quantitative methods. At the beginning of the project, we will conduct baseline assessments including literature reviews, formative studies, household surveys (where feasible) and learn lessons from other projects to understand healthcare and lifestyle practices, barriers, and facilitators. A costeffectiveness and cost benefit analysis will be included. In addition, the teams will conduct site exchanges visits to learn from each other and organise policy dialogues to ensure sustainability and maximise impact of the interventions.

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  • Research Project

NAture impact on MEntal health Distribution (NAMED). 01/01/2017 - 15/04/2020

Abstract

Mental illnesses are a growing problem in modern societies. The interaction with the urbanised environment is little understood. The BELSPO funded NAMED-project (July 2017 – July 2021) investigates the impact of the (non-)built environment on mental health in the Brussels Capital Region. Methods will combine quantitative and qualitative research. From ELIZA Hans Keune, Hilde Bastiaens & Roy Remmen are involved.

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  • Research Project

Green light. To design a research protocol to study the effects of nature on health, with a focus on frail populations in the Province of Antwerp 01/01/2016 - 31/12/2017

Abstract

Green light. To design a research protocol to study the effects of nature on health, with a focus on frail populations in the Province of Antwerp. We will perform qualitative methods to study priority areas among key stakeholders and analyse the possible use of available quantitative data in future research. Principal researcher Dr Hans Keune Co-researchers professor Hilde Bastiaens and Roy Remmen

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  • Research Project

Phase II partner programme (2015-2019) for the Institutional University Cooperation between the University of Limpopo and the Flemish universities. 01/04/2015 - 31/12/2019

Abstract

This project represents a formal research agreement between UA and on the other hand VLIR. UA provides VLIR research results mentioned in the title of the project under the conditions as stipulated in this contract.

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  • Research Project