The Health Impact of Social Community Enterprises in Vulnerable Neighborhoods: Protocol for a Mixed Methods Study.

BACKGROUND: This 4-year research project focuses on 6 social community enterprises (SCEs) that operate in 5 neighborhoods in a Dutch city. Residents of these neighborhoods face problems such as poor average levels of physical and mental health, high unemployment rates, and weak social cohesion. SCEs offer residents social, cultural, and work-related activities and are therefore believed to help these persons develop themselves and strengthen the social ties in the community. Because of a lack of empirical evidence; however, it is unclear whether and how SCEs benefit the health and well-being of participants. OBJECTIVE: This paper outlines a protocol for an evaluation study on the impact of SCEs, aiming to determine (1) to what extent SCEs affect health and well-being of participating residents, (2) what underlying processes and mechanisms can explain such impact, and (3) what assets are available to SCEs and how they can successfully mobilize these assets. METHODS: A mixed methods multiple-case study design including repeated measurements will be conducted. Six SCEs form the cases. An integrated model of SCE health intervention will be used as the theoretical basis. First, the impact of SCEs is measured on the individual and community level, using questionnaires and in-depth interviews conducted with participants. Second, the research focuses on the underlying processes and mechanisms and the organizational and sociopolitical factors that influence the success or failure of these enterprises in affecting the health and well-being of residents. At this organizational level, in-depth interviews are completed with SCE initiators and stakeholders, such as municipal district managers. Finally, structurally documented observations are made on the organizational and sociopolitical context of the SCEs. RESULTS: This research project received funding from the Netherlands Organization for Health Research and Development in 2018. Data collection takes place from 2018 until 2022. Data analysis starts after the last round of data collection in 2022 and finalizes in 2024. Expected results will be published in 2023 and 2024. CONCLUSIONS: Despite the societal relevance of SCEs, little empirical research has been performed on their functioning and impact. This research applies a variety of methods and includes the perspectives of multiple stakeholders aiming to generate new empirical evidence. The results will enable us to describe how SCE activities influence intermediate and long-term health outcomes and how the organizational and sociopolitical context of SCEs may shape opportunities or barriers for health promotion. As the number of these initiatives in the Netherlands is increasing rapidly, this research can benefit many SCEs attempting to become more effective and increase their impact. The findings of this research will be shared directly with relevant stakeholders through local and national meetings and annual reports and disseminated among other researchers through scientific publications. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37966.

Care Farming for People with Dementia; What Can Healthcare Leaders Learn from This Innovative Care Concept?

There is growing recognition that traditional dementia care models fall short for people with dementia and their family caregivers. This has led to a call for new dementia care approaches. In response to this call, innovations in long-term dementia care are taking place both in the community and in residential care. One of these innovations is the care concept called "care farming." Care farms are farms that combine agricultural activities with care and support services for a variety of client groups, including people with dementia. Although the concept is being implemented in an increasing number of countries, the Netherlands and Norway are still front-runners in providing and researching this innovative dementia care approach. Over the last couple of years, several research projects have been carried out in these countries addressing a wide range of issues related to dementia care provision at care farms and using a wide range of research methods. This paper synthesizes the knowledge that has been generated in these research projects. By sharing the knowledge obtained in the Netherlands and Norway, we hope to inspire leaders in healthcare undertaking similar efforts to innovate care for the increasing number of people with dementia. By providing starting-points for future research, we additionally hope to contribute to a research agenda to further advance the field.

Characteristics and Challenges for the Development of Nature-Based Adult Day Services in Urban Areas for People with Dementia and Their Family Caregivers.

Nature-based adult day services (ADSs) for people with dementia (PwD) are well-known in rural areas. In recent years, a number of providers have started offering these services in urban contexts, e.g., in city farms and community gardens, where people with dementia participate in outdoor activities, such as gardening and caring for animals. At the moment, little is known about these services within an urban context, and the aim of this study is to characterize different types of nature-based ADSs in urban areas for PwD living at home, as well as to identify general and specific challenges with regard to the development of different types of ADSs. An inventory was carried out and 17 ADS providers in urban areas were interviewed about their initiatives, settings, client groups, motivations for starting their nature-based ADS, and their experiences with, competences for, and funding of urban nature-based ADS. The interviews were recorded, transcribed verbatim and thematically analyzed. Five types of nature-based ADSs were identified: (1) services offered by social entrepreneurs, (2) nursing homes opening their garden to people with dementia, (3) social care organization setting up nature-based, (4) community garden set up by citizens, and (5) hybrid initiatives. Common activities were gardening, preparing meals, and taking care of farm animals. The main activities organized by nursing homes included sitting and walking in the garden and attending presentations and excursions. General challenges included the availability of green urban spaces and acquiring funding for the nature-based services. Initiatives of social entrepreneurs depended strongly on their commitment. Challenges for nursing homes included a lack of commitment among nursing staff, involvement of PwD living at home and a lack of interaction with the neighborhood. Volunteers played a key role in the initiatives organized by social care organizations and in community gardens. However, it was a major challenge to find volunteers who know enough about care and gardening. Specific challenges for the hybrid types were related to differences in work culture between social entrepreneurs and care organizations. Different types of care-oriented and community-oriented nature-based adult day services in urban areas for people with dementia have been developed, facing different types of challenges. Care oriented initiatives like nursing homes opening their garden focus on risk prevention and their nature-based services tended to be less diverse and stimulating for people with dementia living at home. Collaboration between such care-oriented initiatives with initiatives of other types of organizations or social entrepreneurs can lead to more appealing community-oriented nature-based services.

Exploring the role of social capital in urban citizens' initiatives in the Netherlands / Papel del capital social en las iniciativas de los ciudadanos de zonas urbanas en los Países Bajos

Objective: This research explores the role of social capital in urban citizens’ initiatives in the Netherlands, by using in-depth interviews. Method: Social capital was operationalized as shared norms and values, connectedness, trust and reciprocity. Results: The findings show that initiatives form around a shared idea or ambition (shared norms and values). An existing network of relationships (connectedness) is needed for an idea to emerge and take form. Connectedness can also increase as a result of an initiative. Some level of trust between people needs to be present from the start of the initiative. For the initiative to persist, strong in-group connections seem important, as well as a good balance between investments and returns. This reciprocity is mainly about intangible assets, such as energy and friendship. Conclusion: This study concludes that social capital within citizens’ initiatives is both a prerequisite for the formation of initiatives and a result of the existence of initiatives

Objetivo: Explorar, mediante la realización de entrevistas en profundidad, el papel del capital social en las iniciativas de los ciudadanos de zonas urbanas de los Países Bajos. Método: Se conceptualizó el capital social como normas y valores compartidos, conectividad, confianza y reciprocidad. Resultados: Las iniciativas se forman alrededor de una idea o ambición compartida (normas y valores compartidos). Es necesaria la existencia de una red de relaciones previa (conectividad) para que una idea surja y tome forma. La conectividad también puede incrementarse como resultado de la iniciativa. Desde el inicio de la iniciativa debe estar presente un nivel mínimo de confianza entre las personas. Para que la iniciativa persista, parecen importantes las conexiones fuertes dentro del grupo, así como un buen equilibrio entre los esfuerzos y los beneficios obtenidos. Esta reciprocidad se refiere principalmente a bienes inmateriales, como la energía y la amistad. Conclusión: Este estudio concluye que el papel del capital social en las iniciativas de los ciudadanos de zonas urbanas es tanto un requisito para la aparición de iniciativas como el resultado de la existencia de algunas iniciativas

Exploring the role of social capital in urban citizens' initiatives in the Netherlands.

OBJECTIVE: This research explores the role of social capital in urban citizens' initiatives in the Netherlands, by using in-depth interviews. METHOD: Social capital was operationalized as shared norms and values, connectedness, trust and reciprocity. RESULTS: The findings show that initiatives form around a shared idea or ambition (shared norms and values). An existing network of relationships (connectedness) is needed for an idea to emerge and take form. Connectedness can also increase as a result of an initiative. Some level of trust between people needs to be present from the start of the initiative. For the initiative to persist, strong in-group connections seem important, as well as a good balance between investments and returns. This reciprocity is mainly about intangible assets, such as energy and friendship. CONCLUSION: This study concludes that social capital within citizens' initiatives is both a prerequisite for the formation of initiatives and a result of the existence of initiatives.

Exploring the Role of Farm Animals in Providing Care at Care Farms.

We explore the role of farm animals in providing care to different types of participants at care farms (e.g., youngsters with behavioural problems, people with severe mental problems and people with dementia). Care farms provide alternative and promising settings where people can interact with animals compared to a therapeutic healthcare setting. We performed a literature review, conducted focus group meetings and carried out secondary data-analysis of qualitative studies involving care farmers and different types of participants. We found that farm animals are important to many participants and have a large number of potential benefits. They can (i) provide meaningful day occupation; (ii) generate valued relationships; (iii) help people master tasks; (iv) provide opportunities for reciprocity; (v) can distract people from them problems; (vi) provide relaxation; (vii) facilitate customized care; (viii) facilitate relationships with other people; (ix) stimulate healthy behavior; (x) contribute to a welcoming environment; (xi) make it possible to experience basic elements of life; and (xii) provide opportunities for reflection and feedback. This shows the multi-facetted importance of interacting with animals on care farms. In this study the types of activities with animals and their value to different types of participants varied. Farm animals are an important element of the care farm environment that can address the care needs of different types of participants.

Exploring salutogenic mechanisms of an outdoor experiential learning programme on youth care farms in the Netherlands: untapped potential?

This study explored how (learning) experiences offered through outdoor experiential programmes, particularly the youth care farm approach, may (or may not) enhance young peoples' ability to recognise and then utilise available resources for personal growth, protection and health promotion. A total of 11 youngsters were asked to look back on their half-year stay on a care farm in the Netherlands, by using semi-structured interviews to elicit their experiences from a salutogenic perspective. Analysis revealed that several resources (and the interaction of these resources) on the youth care farm worked well for the youngsters; contributed to their personal development and to their sense of coherence: the feeling that the world is or can be meaningful, comprehensible and manageable, associated with positive outcome in endeavours linked to improving health and well-being. In general, the attitude of the farmer, working with animals, the informal atmosphere and being temporarily cut-off from the former environment were elements most positively highlighted by the youngsters. The farm environment was mentioned as calming, however, as structuring as well. The strength of the programme as an experiential learning opportunity appears to be the diversity and richness of resources (and stressors!) available to the participants. This creates various opportunities for learning: making sense, interpreting and giving meaning to resources and stressors. Further research into the impact of this kind of programmes, compared to more 'traditional' programmes, especially on the ability of youngsters to use resources to finish school, find employment and develop better relationships with their parents is recommended.

The development of green care in western European countries.

This article represents a review of green care across Western European countries. The following questions are addressed: What is green care, and what are its basic goals? What are the most commonly known types of green care interventions, and how are they connected to each other? There are different sectors of green care intervention that vary from each other regarding their structure, specific goals, and purpose. These traits will be investigated in this review. And lastly, how these interventions are designed and their approach to promote and provide health will be examined.

Care farms in the Netherlands: attractive empowerment-oriented and strengths-based practices in the community.

Empowerment-oriented and strengths-based practices focusing on community integration have gained recognition for various client groups in recent decades. This paper discusses whether care farms in the Netherlands are relevant examples of such practices. We identify characteristics associated with care farms that are relevant for three different client groups: clients with severe mental health problems, clients from youth care backgrounds, and frail elderly clients. We interviewed 41 clients, 33 care farmers, and 27 health professionals. The study shows that care farms are experienced as unique services because of a combination of different types of characteristic qualities: the personal and involved attitude of the farmer, a safe community, useful and diverse activities, and a green environment. This leads to an informal context that is close to normal life. We found no essential differences in the assessment of characteristics between different client groups and between clients, farmers, and health professionals. Care farms can be considered as an innovative example of community-based services that can improve the quality of life of clients.

Comparison of wind tunnel and field experiments to measure potential deposition of fenpropimorph following volatilisation from treated crops.

The potential for short-range transport via air, i.e. volatilisation from the area of application and subsequent deposition on adjacent non-target areas, was investigated for the fungicide fenpropimorph in a wind tunnel system and under outdoor conditions in a higher-tier field study. Fenpropimorph 750 g L(-1) EC was applied post-emergence to cereal along with a reference standard lindane EC. Stainless steel containers of water were placed at different distances downwind of the application area to trap volatile residues during a study period of 24 h following application. Meteorological conditions in the wind tunnel as well as on the field were constantly monitored during the study period. The wind tunnel system was a partly standardised system on a semi-field scale, i.e. wind direction and wind speed (2 m s(-1)) were constant, but temperature and humidity varied according to the conditions outside. In the field experiment, the average wind speed over the 24 h study period was 3 m s(-1) and no rainfall occurred. Three different measuring lines were installed on the non-target area beside the treated field to cover potential variations in the wind direction. However, no significant differences were observed since the wind direction was generally constant. Fenpropimorph was detected in minor amounts of 0.01-0.05% of the applied material in the wind tunnel experiment. Even at a distance of 1 m beside the treated field, no significant deposition occurred (0.04% of applied material after 24 h). In the field, less than 0.1% of the applied fenpropimorph was detected at 0 m directly beside the treated field. At 5 m distance the deposition values were below 0.04%, and at 20 m distance about 0.01%. In general, the amounts of deposited fenpropimorph detected in the partly standardised wind tunnel system and the higher-tier field study were in good agreement.