'Value-based methodology for person-centred, integrated care supported by Information and Communication Technologies' (ValueCare) for older people in Europe: study protocol for a pre-post controlled trial.

BACKGROUND: Older people receive care from multiple providers which often results in a lack of coordination. The Information and Communication Technology (ICT) enabled value-based methodology for integrated care (ValueCare) project aims to develop and implement efficient outcome-based, integrated health and social care for older people with multimorbidity, and/or frailty, and/or mild to moderate cognitive impairment in seven sites (Athens, Greece; Coimbra, Portugal; Cork/Kerry, Ireland; Rijeka, Croatia; Rotterdam, the Netherlands; Treviso, Italy; and Valencia, Spain). We will evaluate the implementation and the outcomes of the ValueCare approach. This paper presents the study protocol of the ValueCare project; a protocol for a pre-post controlled study in seven large-scale sites in Europe over the period between 2021 and 2023. METHODS: A pre-post controlled study design including three time points (baseline, post-intervention after 12 months, and follow-up after 18 months) and two groups (intervention and control group) will be utilised. In each site, (net) 240 older people (120 in the intervention group and 120 in the control group), 50-70 informal caregivers (e.g. relatives, friends), and 30-40 health and social care practitioners will be invited to participate and provide informed consent. Self-reported outcomes will be measured in multiple domains; for older people: health, wellbeing, quality of life, lifestyle behaviour, and health and social care use; for informal caregivers and health and social care practitioners: wellbeing, perceived burden and (job) satisfaction. In addition, implementation outcomes will be measured in terms of acceptability, appropriateness, feasibility, fidelity, and costs. To evaluate differences in outcomes between the intervention and control group (multilevel) logistic and linear regression analyses will be used. Qualitative analysis will be performed on the focus group data. DISCUSSION: This study will provide new insights into the feasibility and effectiveness of a value-based methodology for integrated care supported by ICT for older people, their informal caregivers, and health and social care practitioners in seven different European settings. TRIAL REGISTRATION: ISRCTN registry number is 25089186 . Date of trial registration is 16/11/2021.

Children's sugar-sweetened beverages consumption: associations with family and home-related factors, differences within ethnic groups explored.

BACKGROUND: The consumption of sugar-sweetened beverages (SSB) may contribute to the development of overweight among children. The present study aimed to evaluate associations between family and home-related factors and children's SSB consumption. We explored associations within ethnic background of the child. METHODS: Cross-sectional data from the population-based 'Water Campaign' study were used. Parents (n = 644) of primary school children (6-13 years) completed a questionnaire on socio-demographic characteristics, family and home-related factors and child's SSB intake. The family and home-related factors under study were: cognitive variables (e.g. parental attitude, subjective norm), environmental variables (e.g. availability of SSB, parenting practices), and habitual variables (e.g. habit strength, taste preference). Regression analyses were used to evaluate the associations between family and home-related factors and child's SSB intake (p < 0.05). RESULTS: Mean age of the children was 9.4 years (SD: 1.8) and 54.1% were girls. The child's average SSB intake was 0.9 litres (SD: 0.6) per day. Child's age, parents' subjective norm, parenting practices, and parental modelling were positively associated with the child's SSB intake. The availability of SSB at home and school and parental attitude were negatively associated with the child's SSB intake. The associations under study differed according to the child's ethnic background, with the explained variance of the full models ranging from 8.7% for children from Moroccan or Turkish ethnic background to 44.4% for children with Dutch ethnic background. CONCLUSIONS: Our results provide support for interventions targeting children's SSB intake focussing on the identified family and home-related factors, with active participation of parents. Also, the relationships between these factors and the child's SSB intake differed for children with distinct ethnic backgrounds. Therefore, we would recommend to tailor interventions taking into account the ethnic background of the family. TRIAL REGISTRATION: Number NTR3400 ; date April 4th 2012; retrospectively registered.

Associations between the home environment and children's sweet beverage consumption at 2-year follow-up: the 'Be active, eat right' study.

BACKGROUND: This study evaluates the association between home environmental characteristics and sweet beverage consumption (i.e. beverages that contain sugar) of 7-year-old children. METHODS: The population for analysis consisted of n = 2047 parents and their children from the population-based 'Be active, eat right' study. Data on sociodemographic characteristics, parental beliefs, parenting practices and child's sweet beverage consumption were obtained by parental report with questionnaires. We performed linear and multinomial regression analyses evaluating associations between characteristics at age 5 years and (i) consumption at 7 years and (ii) consumption patterns between age 5 and 7 years with reference category 'low consumption'. RESULTS: Based on the report from their parents, 5-year-old children drank on average 3.0 (SD:1.4) sweet beverage per day. Children consumed less sweet beverages at age 7 years (beta -0.16, 95% confidence interval [CI] -0.24 to -0.09) when there were less sweet beverages available at home. The multinomial regression model showed that children with parents who discouraged sweet beverage consumption were more likely to decrease their sweet beverage consumption over the study period (odds ratio: 1.24, 95% CI 1.07 to 1.43). Moreover, when there were less sweet beverages available at home, children were less likely to increase their consumption or have a high consumption over the study period (odds ratio: 0.70, 95% CI 0.59 to 0.83 and 0.61, 95% CI 0.54 to 0.70, respectively). CONCLUSIONS: The results showed that characteristics of the home environment are associated with the consumption of sweet beverages among children. Specifically, the availability of sweet beverages at home is associated with the child's sweet beverage consumption.

Design of a controlled trial to evaluate the effectiveness of Supportive Parenting ('Stevig Ouderschap'): an intervention to empower parents at increased risk of parenting problems by providing early home visits.

BACKGROUND: In the Netherlands, 15% of all families with children under the age of 13 years deal with significant parenting problems. Severe parenting problems may lead to adverse physical, cognitive, and psychosocial outcomes for children, both in the short and long run. The intervention Supportive Parenting (in Dutch: "Stevig Ouderschap") is a preventive program, which aims to reduce the risk of (developing) parenting problems among parents at risk of these problems. The intervention consists of six additional home visits by a Youth Health Care nurse during the first 18 months after childbirth and is focusing on the following elements of parental empowerment: activating social networks, increasing parenting skills and supporting parent(s)/caregiver(s) in getting grip on their own life. METHODS AND DESIGN: A controlled trial is performed in two regions in the Netherlands. An intervention group receives the intervention Supportive Parenting, and a control group receives 'care-as-usual'. Parents in both the intervention and control group fill out three questionnaires focusing on various elements of empowerment (social support, parenting skills, self-sufficiency and resilience), behavioral and emotional problems of the child. The effects of the intervention will be evaluated at child age 1-3 months (baseline) and child age 18 months by comparing the outcomes between the intervention group and the control group on the primary outcomes. Additionally, interviews and focus group interviews will be held to identify factors, which hinder or stimulate a wider implementation of the intervention Supportive Parenting. DISCUSSION: It is hypothesized that parents at increased risk of parenting problems who receive the intervention Supportive Parenting during the first 18 months after childbirth, will have enhanced their social support networks and parenting skills, increased their self-sufficiency and strengthened resilience compared to at risk parents receiving care-as-usual. Additionally children of parents from the intervention group will display less parent-reported behavioral and emotional problems. TRIAL REGISTRATION: Netherlands Trial Register NTR5307. Registered 16 July 2015.