ARPH 2021

University Medical Center Groningen

Welcome to the virtual poster session of the ARPH 2021!

Below you can find all posters, sorted into six tracks. You can view all posters at this home page, or per track. Specific topics or abstracts can be found using the search box on the right.

Instructions:

By clicking on the poster, an online PDF version is shown and there is an option to download the poster.
Via the button "Watch Presentation", you can watch a 3-minute pitch about the poster.
Via the button "Join the Discussion", you can join the discussion and post questions. The first time you want to leave a comment, you will be asked to confirm your e-mail address. When you leave a comment, the presenter will receive an e-mail to inform him/her about your message.
Vote for your favourite poster(s) by giving it a star!

In case of any issues or questions, please email us: arphconference2021@gmail.com

We hope you enjoy this poster session!

Please note: In order to increase visibility of the posters, this session will be open from January 27th till February 14th

More info: https://arphconference.nl

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Show or hide this track Adjustment to illness Back to top ↑

ShareHeart: a qualitative study in patients with Ischemia with No Obstructive Coronary Arteries (INOCA) and health care providers

Dinah van Schalkwijk MSc , Jos Widdershoven, MD PhD, Suzette Elias Smale MD PhD, Mariëlle Hartzema Meije , Paula Mommersteeg PhD

Abstract: Introduction: Ischemia with No Obstructive Coronary Arteries (INOCA) is a condition caused by vascular dysfunctions and more prevalent in women. INOCA poses a diagnostic and treatment challenge for patients and health care providers (HCP). The Dutch ‘Zorginstituut’ argues the need for a shared decision making tool in this patient group. In this qualitative study, experiences and health care needs were investigated in order to be able to develop and implement a shared decision making product. Methods: Participants were recruited from two Dutch hospitals: Elisabeth-Tweesteden Hospital and Radboud University Medical Center. Patients (N= 36 women) and HCP (cardiologists N = 15, general practitioners N= 11, other specialist N = 4) participated in online semi-structured focus group interviews. Preliminary Results: Both HCP and patients reported a lack of familiarity with the disease and its symptoms. Early in the health care trajectory, patients reported not being taken seriously, repeated hospital admission without a clear diagnosis as important barriers. Later in the trajectory, the need for better information regarding diagnostic testing, medication use, and other treatment options were important. Participants expressed a lack of a multidisciplinary approach as a barrier to symptom management. Conclusion: Our first findings illustrate the need for familiarity and knowledge regarding INOCA, which should be supported by an adequate referral system in both an early and a later stage of the healthcare trajectory. Diagnostic referral tools applicable and understandable by patients and HCP may facilitate the diagnostic/treatment process and/or improve communication between patients and HCP.
Presented by: Dinah van Schalkwijk (poster 2)
Institution: Dept of medical and clinical psychology, Tilburg University

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Negative Illness Perceptions Are Related to More Fatigue Among Haematological Cancer Survivors: A Profiles Study

Dounya Schoormans (TiU), Mandy Jansen (TiU), Floortje Mols (TiU), Simone Oerlemans (IKNL)

Abstract: The common sense model provides a theoretical framework for understanding substantial fatigue among (haematological) cancer survivors based on their illness perceptions. We therefore examined the associations between modifiable illness perceptions and substantial fatigue while controlling for sociodemographic, clinical, and psychological factors (symptoms of depression and anxiety) among haematological cancer survivors.Data from the population-based PROFILES registry were used. Survivors diagnosed between 1999 and 2013 with Hodgkin lymphoma (N=164), non-Hodgkin lymphoma (N=655) and chronic lymphocytic leukaemia (N=174) were included. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), the Fatigue Assessment Scale (FAS), and Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regressions analyses were performed for the total group and three haematological cancers separately relating illness perceptions to substantial fatigue (>21 FAS).Haematological cancer survivors with illness perceptions that represent more negative consequences (consequences, OR=1.27; 95%CI=1.13-1.42); attribute more symptoms to their illness (identity, OR=1.29; 95%CI=1.17-1.43); and have a poorer illness understanding (coherence, 1.13; 1.04-1.22) were more often substantially fatigued. Non-Hodgkin lymphoma survivors who reported a poor illness understanding (coherence, OR=1.35; 95%CI=1.06-1.72) and chronic lymphocytic leukaemia survivors who reported that treatment can control (OR=1.25; 95%CI=1.01-1.55) the illness experienced more often substantial fatigue.Our cross-sectional study shows that those survivors who experience more consequences of their disease and attribute more symptoms to their illness have a higher risk to experience substantial levels of fatigue even years after diagnosis, although causality is unclear. Psychological interventions, like cognitive behavioral therapy changing these illness perceptions may be beneficial in reducing substantial fatigue among haematological cancer survivors.
Presented by: Dounya Schoormans
Institution: Tilburg University

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What patients want to know, and what we actually tell them: the ABIDE project

Agnetha D. Fruijtier, Leonie N.C. Visser, Femke H. Bouwman, Rogier Lutz, Niki Schoonenboom, Kees Kalisvaart, Liesbeth Hempenius, Gerwin Roks, Leo Boelaarts, Jules Claus, Mariska Kleijer, Marlijn de Beer, Wiesje M. van der Flier, Ellen M.A. Smets

Abstract: BACKGROUND: We formerly identified 17 informational topics on which health care professionals, patients and care-partners agree that these should be discussed during diagnostic consultations in memory-clinics. In addition, 8 topics were identified as highly relevant by at least one, but not all three groups. Here, we studied to what degree these 25 informational topics are actually discussed during diagnostic consultations and at whose initiative, i.e., the clinician, the patient or the care-partner.

METHODS: Audio-recordings of pre- and post-test clinician-patient consultations of 71 patients (age 70±10 (M±SD), range 43-90, female 32/71(45%)), seen by 32 clinicians (age 43±12 (M±SD), range 25-66, female 11/32(34%)), were collected in eight memory-clinics and independently content-coded by two coders. The coding scheme encompassed the 25 informational topics, grouped into 4 categories; (i) diagnostic testing, (ii) test results, (iii) diagnosis and prognosis, and (iv) practical implications.

FINDINGS: Many topics were discussed frequently, though individual topics ranged from being discussed with 2/71 (3%) to 70/71 (99%) of the patients. On average, 12 (SD=4) of the 25 topics were discussed per patient, during the diagnostic process. Topics in the category ‘diagnosis and prognosis’ were discussed least frequently. Patients and/or care-partners rarely initiated discussion of a topic (topic initiated by clinician: 90%), but when they did, the topic was most often one of the least frequently addressed topics.

DISCUSSION: We found most topics to be addressed quite frequently by clinicians in memory-clinics. Nevertheless, we observed considerable variation when looking at individual topics. Discussion of diagnostic or prognostic information was relatively limited, while patients and care-partners consider this topic highly relevant, as substantiated by initiating discussion on these topics. Hence, this information should receive more attention in clinical practice. In addition, providing the topic list to patients prior to their visit could allow them to better prepare and stimulate active participation.
Presented by: Agnetha Fruijtier
Institution: Amsterdam UMC, department of Medical Psychology
Other Affiliations: Amsterdam UMC, Alzheimer Center Amsterdam

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Poster: Clinical and psychological characteristics of patients with ischemia and non-obstructive coronary arteries (INOCA) and obstructive coronary artery disease.

Clinical and psychological characteristics of patients with ischemia and non-obstructive coronary arteries (INOCA) and obstructive coronary artery disease.

Dinah L. van Schalkwijk MSc, Jos W. Widdershoven MD PhD, Michael Magro MD PhD, Ilse Vermeltfoort MD PhD, Paula M.C. Mommersteeg PhD

Abstract: Introduction: The majority of patients with symptoms suspect of myocardial ischemia show normal or non-obstructive coronary arteries during diagnostic testing. This is a condition termed ‘Ischemia with no obstructive Coronary Arteries’ (INOCA) and is predominantly seen in women. The aim of this study was to investigate the psychosocial functioning and quality of life in patients with INOCA compared to patients with non-cardiac symptoms and patients with obstructive coronary artery disease (CAD). Methods: Participants (N= 373, mean age 65.2 ± 9.3, 57% women) were included from two studies, which examined, respectively, (1) women with (recurrent cardiac) complaints without obstructive coronary artery disease and (2) patients referred for myocardial perfusion imaging. Participants completed questionnaires assessing psychological distress, quality of life and well-being. Medical information was obtained from hospital records. Presence of ischemia and obstructive CAD was used to categorize patients into INOCA or obstructive CAD. Results: INOCA was significantly more prevalent in women (71%) and younger patients compared to patients with obstructive CAD (26%). Patients with INOCA tended to report a better health related quality of life, but this was not significantly different. Accept for anxiety no significant differences were psychological characteristics. Conclusion: Common psychological symptoms (anxiety, depression, stress and fatigue) are prevalent in patients with both obstructive and non-obstructive CAD, but do not differ between patients with INOCA and obstructive CAD accept for anxiety. Differences in timing of measurement between the studies may have affected the outcomes.
Presented by: Dinah van Schalkwijk
Institution: Dept of medical and clinical psychology, Tilburg University

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Show or hide this track COVID-19 Back to top ↑

Fear of COVID-19: Differences between North America and Europe

Stefanie Duijndam, Gaetan Mertens

Abstract: Background. Since the outbreak of COVID-19 several reports have shown that fear relating to COVID-19 has sharply increased. Given that the restrictions and rules for lockdowns were different for Europe and North America, the aim of this study was to examine the differences in fear of COVID-19 between these continents. Methods. Participants filled out an online survey (N=2000) via Prolific every month for six months (March through August 2020). Fear of COVID-19 was assessed with the eight-item Fear of Coronavirus Questionnaire (range 8-40). Repeated measures ANOVA was used to compare fear of COVID-19 between continents (Europe vs. North America) over time. Results. Our results showed that fear of COVID-19 decreases over time (F (3.27, 3266.42) = 68.20, p<.001), and that this decrease in fear differs between continents (time*continent F (3.27, 3266.42) = 16.88, p<.001; see Figure 1a). Lastly, a between-subjects effect of continent was observed (F (1, 1000) = 69.00, p<.001) indicating that fear levels are overall higher in North America compared to Europe. Conclusion. Levels of fear of COVID-19 seem to sharply increase at the start of the pandemic (March to April), but then slowly decrease over time (see Figure 1a). The pattern of decrease differs between North America and Europe, which could be explained by the different patterns of infections between continents (see Figure 1b). Additionally, the larger number of infections in North America may also explain why our results showed that levels of fear are significantly higher in North America compared to Europe.
Presented by: Stefanie Duijndam
Institution: Tilburg University, Department of Medical and Clinical Psychology

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Who experiences post-traumatic growth from the COVID-19 pandemic?

Denise M. Blom, Esther Sulkers, Wendy J. Post, Maya J. Schroevers, and Adelita V. Ranchor

Abstract: COVID-19 has various consequences for people, such as uncertainty regarding infection or infecting others, and may therefore be experienced as a traumatic event. After experiencing a traumatic event, people may perceive positive changes, defined as post-traumatic growth (PTG). To gain more insight into the concept of PTG, the present study aims to examine who perceived PTG during the COVID-19 pandemic, by exploring subgroups based on age, primary and secondary appraisal, stressfulness, rumination, positive reappraisal, and coping flexibility. Only participants who experienced higher levels of PTG were included in the analysis, defined by experiencing at least 2 of the 10 presented positive changes of the post-traumatic growth inventory (PTGI) to a moderate degree. Based on this criterium, 438 individuals of the total 975 participants experienced higher levels of PTG and were included in the analysis. Results of Latent Profile Analysis (LPA), showed two distinct groups reporting PTG: 1) a group reporting higher levels of secondary appraisal, positive reappraisal, and coping flexibility and 2) a group reporting higher levels of primary appraisal, stressfulness, and rumination. Thus, among people experiencing PTG, there seems to be a group who is less impacted by COVID-19 and better able to cope with COVID-19, and a group who perceives a greater impact of COVID-19 and less able to cope with the pandemic.
Presented by: Denise Blom <d.m.blom@umcg.nl>
Institution: University Medical Center Groningen

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The COVID-19 crisis as a teachable moment for lifestyle change in Dutch cardiovascular disease patients

Michelle Brust, Winifred A. Gebhardt, Mattijs E. Numans, Jessica C. Kiefte-de Jong

Abstract: Introduction: Life events or crises such as COVID-19 may function as ‘teachable moments’. The aim of this study was to explore whether the pandemic can provoke a teachable moment regarding lifestyle change in cardiovascular disease (CVD) patients.

Method: In this cross-sectional study, 830 CVD patients completed an online survey on their intentions to change lifestyle, instigated by the COVID-19 outbreak, and their risk perception, affective response and a change in self-concept on the basis of a ‘teachable moments’ framework. Multivariate regression analyses were conducted to examine the role of these factors on intention to optimize lifestyle.

Results: Between 8-30% of the sample reported increased intentions to optimize health behaviors, in particular related to general lifestyle (28%), physical activity (25%) and dietary behavior (21%) and to a lesser extent to limiting alcohol consumption (13%) and smoking (8%). The multivariate regression analyses revealed changed self-concept as a significant predictor of improving general lifestyle (β = .28), physical activity (β = .25) and smoking (β = .29). Both changed in self-concept and affective response were significant predictors of the intention to improve dietary behavior (resp. β = .29 and β = .12) and limiting alcohol consumption (resp. β = .24 and β = .11).

Conclusion: Our results demonstrate that the COVID-19 crisis may pose a teachable moment towards changing lifestyle for CVD patients, possibly driven by a change in self-concept. The results suggest a window of opportunity for healthcare professionals to utilize the COVID-19 crisis to promote a healthy lifestyle among their patients.
Presented by: Michelle Brust
Institution: LUMC Campus The Hague/Leiden University Medical Centre

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Show or hide this track E-Health Back to top ↑

Determinants of Implementation of eHealth Solutions to support Informal Dementia Care: an Umbrella Review

Bastoni S., Wrede C., Da Silva M.C., Sanderman R., Gaggioli A., van Gemert-Pijnen J.E.W.C.

Abstract: Introduction: Providing unpaid care for a loved one or a family member with dementia can have tremendous impact on caregivers’ lives. eHealth technologies aim at relieving the burden of care, but often end up in unsuccessful implementation. Although literature is abundant with review studies about eHealth technologies in the dementia context and generic frameworks of the implementation process, a further synthesis and practical guidelines tailored to the context of informal dementia care are needed. The aims of this umbrella review are to (i) synthesize determinants of eHealth technology implementation aimed at supporting informal dementia care, and (ii) identify gaps between theory and practice. Methods: Medline, Cochrane, PyscInfo, PubmMed, and Scopus were searched and 23 reviews were included. Studies were included if they were review studies about eHealth technologies to support informal care of people with dementia. Results: The NASSS framework was used as analysis framework to interpret this review’s findings. Main determinants of implementation identified in the analysis centered around the physical appearance of devices, the challenge of early-stage involvement of people with dementia and timing of technology introduction, the mismatch of perceived and expected benefits and ethical and privacy concerns. Surprisingly, determinants related to the wider context and embedding and adaptation over time were rarely found. Conclusions: This review identified a greater focus on development and adoption in the short term, thereby highlighting the lack of long term-oriented sustainable implementation strategies of eHealth technologies in the context of informal dementia care.
Presented by: Sofia Bastoni <s.bastoni@utwente.nl>
Institution: Centre for eHealth & Wellbeing Research, University of Twente, Enschede, The Netherlands
Other Affiliations: Department of Psychology, Universitá Cattolica del Sacro Cuore di Milano

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How are Ehealth Technologies Personalized? Protocol for a Systematic Review

I. ten Klooster, H. Kip, R. Crutzen, S.M. Kelders, J.E.W.C. van Gemert-Pijnen

Abstract: Introduction: Personalizing eHealth interventions can increase the added value of eHealth, as a counterpart to the commonly used one-size-fits-all approach. Yet, there is no unambiguous agreement on how personalization is defined, and how personalization is applied to eHealth interventions. Therefore, our literature study, we aim to describe in detail (1) how personalization is defined in the literature (2) how eHealth users are segmented by investigating which variables are used to describe the groups of users on a more individual level, (3) how the described eHealth intervention is customized to the characteristics or context of the end user, and (4) whether personalized eHealth interventions have larger effect sizes than the same intervention without personalization.

Methods: We aim to review literature describing personalized eHealth intervention(s) that aim to change users’ (determinants of) health-related behaviours. This systematic review consists of three steps, aligned with the aims of the current study with increasingly specific inclusion criteria.

Results: We will search the literature by means of a search string in which terms regarding personalization, tailoring, technology, intervention and eHealth were included. Titles, abstracts, and full texts will be screened by two researchers. The full texts will be further included for each step of the literature search.

Conclusion: Our elaborate systematic review will contribute to gaining insight into if and how personalization increases the effectiveness of eHealth interventions. During the poster presentation we aim to present our protocol, and share our preliminary results. Moreover, we would like to discuss the definition of personalization with participants of the conference.
Presented by: Iris ten Klooster
Institution: Centre for eHealth and Wellbeing Research, University of Twente
Other Affiliations: Saxion University of Applied Sciences, Optentia Research Focus Area, North-West University, Department of Health Promotion, Care and Public Health Research Institute, University Medical Centre Groningen

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Show or hide this track Etiology of illness Back to top ↑

Cancer comorbidity in patients with non-obstructive coronary artery disease: Depressive symptoms related to C-reactive protein

Dounya Schoormans (TiU), Mandy Jansen (TiU), Floortje Mols (TiU), Simone Oerlemans (IKNL)

Abstract: Background: Depression and anxiety are risk factors for CVD, on top of cardiotoxic cancer treatment and traditional CVD risk factors among cancer survivors. Increased inflammation can be a shared potential pathophysiological mechanism, as higher levels of inflammation (like C-reactive protein, CRP) are known associates of depression and anxiety and increased inflammation is involved in CVD. Cancer(treatment) can lead to elevated levels of inflammation. We willtherefore examine whether the relation between depression and anxiety with inflammatory markers among patients with either CVD or cancer is different from those with both conditions Method: The TweeSteden Mild Stenosis (TWIST) study among patients with non-obstructive coronary artery disease (NOCAD, luminal narrowing <60%), a type of ischemic heart disease, previously reported a significant association between depressive symptoms and increased inflammation (high sensitive (hs)CRP). The TWIST sample was therefore used to explore whether the association between depression and elevated inflammation (hsCRP) was similar for NOCAD-patients with and without a history of cancer. Results: The association between depressive symptoms and increased hsCRP levels is stronger among NOCAD-patients with a history of cancer than among NOCAD-patients without a history of cancer. Furthermore, whereas this relation is mediated by lifestyle factors among NOCAD-patients without cancer, the association remained significant after adjusting for lifestyle factors among NOCAD-patients with a history of cancer.Conclusion: The stronger association between depression and hsCRP among NOCAD-patients with a history of cancer indicates that there may be an additive or synergistic effect of having NOCAD and cancer for general inflammation and possibly depression.
Presented by: Dounya Schoormans (poster 2)
Institution: Tilburg University

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Impact of psychological stress and personality traits on an inherited heart muscle disease: preliminary insights

E. van Drie, MD1; S.E.L. Taal, BsC1; D. Schoormans, PhD2; P.M.C. Mommersteeg, PhD2; T.E. Verstraelen, MD3; A.A. Wilde, MD, PhD3; R. de Brouwer, MD; R.A. de Boer, MD, PhD4; A.F. Baas, MD, PhD1; J.P. van Tintelen, MD, PhD1; L.M. van den Heuvel, MsC1

Abstract: Background: Carriers of the PLN p.Arg14del mutation are at increased risk of developing arrhythmias and end-stage heart failure. Clinical features are highly variable, even within families. Several risk factors may be linked to this variability. We aim to examine psychological stress and personality in PLN mutation carriers, as this has been proven to affect cardiovascular disease progression like coronary artery disease. Methods: PLN mutation carriers diagnosed in three University Medical Centers in the Netherlands were asked to fill out a survey assessing psychological stress (e.g. experienced stress and the occurrence of multiple life-events) and personality traits (e.g. Type D-personality). Clinical outcomes (heart failure and arrhythmias) were retrospectively collected from the PLN registry. Preliminary results: Preliminary results in 351 persons indicated no significant association of perceived stress and Type D personality with more severe clinical outcomes at younger age based on log-rank tests. We observed that carriers who experienced more life events earlier in life seem to get major cardiac events at younger age (25-45 year), compared to carriers with less life events. However, this association was not statistically significant (p = 0.287) Discussion: Preliminary findings show no significant associations of stress and personality with the severity of cardiac phenotype in PLN carriers, but there may be a trend in number of life events at young age and risk of more severe clinical outcomes, Increased awareness among cardiologists and adequate referral for psychosocial support may help mutation carriers lower the risk of psychological stress. Data collection will finish in 2021.
Presented by: Esmée van Drie
Institution: 1 Department of Genetics, University Medical Center Utrecht, the Netherlands
Other Affiliations: 2 Department of Medical and Clinical Psychology, Tilburg University, the Netherlands, 3. Department of Cardiology, Amsterdam University Medical Center, location AMC, the Netherlands, 4. Department of Cardiology, University Medical Center Groningen, the Netherlands

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Psychological Distress Trajectories in Medical Students and their Predictive Value for Burnout.

Sagmeister, V., van Tuijl, L.A. & Fleer, J.

Abstract: Background. More than half of the medical student population experience burnout and it impacts their private lives as well as their professional development. To prevent burnout, we need to understand how those who do (not) burn out differ. Experiencing psychological distress (PD) has predictive value for burnout but there is a lack of research that investigates which longitudinal patterns of distress are linked to burnout. Particularly when transitioning from theoretical to practical medical education (i.e., bachelor to master), the burnout risk increases given the sharp increase in demands. The aim of this study is to examine how trajectories of PD in medical students during their bachelor can predict burnout in the master phase.

Methods. We will use data from the Juggle Study, a cohort study (2015-) that follows medical students (n=374) over six years. Students completed yearly measures, including a measure of PD (GHQ-12) and burnout (MBI). This study uses data-driven clustering to investigate PD trajectories of medical students during the bachelor with latent class growth modelling. Subsequently, these trajectories are entered into a multiple linear regression to predict burnout at the beginning of the master.

Results. Preliminary analyses suggest four distinct PD trajectories (group 1= low PD, g2 = decreasing PD, g3 =increasing PD, and g4= peak during the second year). There were no differences between group 1 (reference) and group 3; group 2 had higher levels of cynicism (one dimension of the MBI). However, group 4 had higher levels of burnout on all dimensions.

Discussion. The results suggest that there is a difference in burnout experience in the PD trajectory groups. In future work, we will investigate the effect of engagement within the trajectory groups and their effect on burnout.
Presented by: Valentina Sagmeister
Institution: University of Groningen & Universitair Medisch Centrum Groningen, Department of Health Psychology

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Show or hide this track Health behavior Back to top ↑

My Future Self (Has Not) Quit Smoking: An Experimental Study into ihe Effect of a Future-Self Intervention on Smoking-Related Identity

Kristell Penfornis, MSc; Eline Meijer, PhD; Winifred Gebhardt, PhD

Abstract: Background: Identity refers to self-perceptions of who we are. Identity theories posit that next to current self-perceptions, individuals have self-perceptions of who they (do not) want to become in the future (feared and desired self). While studies on identity and smoking have shown that sustainable cessation is more likely in smokers seeing themselves as quitter and/or nonsmoker, few studies have attempted to experimentally strengthen either identity as a means to facilitate SC. We tested the effect of a future-self task on identity (primary outcome) and a number of behavioral and psychological smoking-related variables including intention to quit and quit attempts (secondary outcomes). Methods: For this longitudinal online experimental study, 233 smokers with an intention to quit were randomized to the experimental (i.e., participants were asked to imagine their desired future-self as a successful quitter and feared future-self as a continued smoker and referred to a SC website) or the control condition (i.e., participants were solely referred to the SC website). Outcomes were measured at baseline, post-test and after one- and three-months. Preliminary results: There was a significant post-test increase in intention to quit (p= 0.03) and in quitter self-identity (p = 0.03) within the experimental group. Quitter identity was especially strengthened in women (p < .001) and those reporting more past quit attempts (p = 0.04). There were no differences in primary and secondary outcomes between conditions (all ps > .05) at follow-up measurements. Conclusions: Future-self tasks show promise in strengthening quitter identity and intention to quit but should be improved for more consistent and generalizable results.
Presented by: Kristell Penfornis
Institution: Leiden University
Other Affiliations: Leiden University Medical Center

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Poster: Perceived severity of HIV infection in the biomedical era and its association with sexual risk behavior among HIV-negative men who have sex with men

Perceived severity of HIV infection in the biomedical era and its association with sexual risk behavior among HIV-negative men who have sex with men

Hanne M.L. Zimmermann, Ward P.H. van Bilsen, , Anders Boyd, Udi Davidovich, on behalf of HIV Transmission Elimination Team Amsterdam

Abstract: Background Health-related behaviors are closely linked to the perceived severity and potential consequences of a disease. With increasingly tolerable HIV-treatment, HIV may be seen more than ever as an easily manageable condition, which might negatively affect HIV-prevention uptake. We investigated current perceptions of HIV-infection and its association with sexual risk behavior among HIV-negative MSM living in the Netherlands.

Methods In-depth interviews with recently-diagnosed MSM were used to develop a questionnaire measuring the severity and anticipated consequences of HIV-infection. The questionnaire was distributed online using gay dating sites/apps and social media between April-July 2019. A structural equation model was constructed to explore which anticipated consequences contributed most to the general perceived severity of HIV-infection and to assess the association between perceived severity and sexual risk behavior.

Results We analyzed 1,072 HIV-negative MSM completing the survey, of whom 28% reported sexual risk behavior in the preceding 6 months. 77% perceived HIV as a severe illness. Anticipated negative consequences of HIV on sex/relationships were strongly related to the general perceived severity of HIV (β=0.32, 95%CI 0.23-0.42, p<0.001). Moreover, anticipated psychological (p<0.001), disclosure-related (p<0.001) and health-related negative consequences of HIV-infection (p=0.04) were also related to general severity perceptions. Finally, a higher general perceived severity of HIV was correlated with lower sexual risk taking (β=-0.06; 95%CI=-0.11,-0.01; p=0.02).

Conclusion One-quarter of HIV-negative MSM did not perceive HIV as a serious illness, which was associated with more prevalent sexual risk taking. These data imply that prevention strategies are challenged by the perceptions of low HIV-infection severity among some HIV-negative MSM.
Presented by: Hanne Zimmermann
Institution: Public Health Service Amsterdam

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Show or hide this track Interventions Back to top ↑

The Effect of Agency on Interactive Narrative Fear Appeals

Hendrik Engelbrecht, Dr. Ir. Nynke van der Laan, Dr. Renske van Enschot and Prof. Dr. Emiel Krahmer

Abstract: College students are often confronted with social facilitation of alcohol abuse and this can be linked to a greater likelihood of alcohol dependence, further abuse and drunk driving later in life. Prevention focused approaches need to receive more attention to educate and train young adults to moderate their drinking and thereby reduce the risk of dependence. Fostering the execution of health- and preventative behaviours to create long-lasting change demands the development of interventions that are personally relevant, engaging and effective to avoid adverse short-term and long-term health outcomes. The current study investigates the potential of applying fear appeal theory, as rooted in the assumptions of the extended parallel processing model, in an interactive digital narrative. The study therefore specifically focuses on the effect of interactivity (low/high agency) on fear appeal effectiveness and the difference between short- and long-term outcomes integrated into an interactive digital narrative about a risk situation appropriate for the target population. Effectiveness of the fear appeal, as measured by severity, susceptibility, self-efficacy and response-efficacy, will be assessed as well as the behavioural intention to abstain from alcohol abuse. We expect higher agency to result in a more effective fear appeal through increased self-efficacy by executing the behaviour in the narrative. We expect this effect to be strengthened by the framing of the narrative in terms of short-term threat outcomes as opposed to long-term threat outcomes.
Presented by: Hendrik Engelbrecht
Institution: Tilburg University

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A tailored approach towards informing relatives at risk of inherited cardiac diseases: results of a randomised controlled trial

Lieke Van den Heuvel, Yvonne Hoedemaekers, Annette Baas, Marieke Baars, Ellen Smets, Peter van Tintelen, Imke Christiaans

Abstract: Introduction: If undetected, inherited cardiac diseases can lead to sudden cardiac death, while preventive and treatment options are available. Genetic counselling is deemed important for relatives (who have a 50% risk of disease) to make a well-informed decision regarding predictive DNA testing. Currently, patients are asked to inform relatives. However, less than half of relatives attends genetic counselling. Research suggests that informing relatives directly by the healthcare professional may enhance the uptake, although there are legal, ethical and psychological concerns using such an approach. Methods: Current practice was compared to a tailored approach, in which patients were asked to decide to (initially) inform relatives themselves or by the counsellor, and family letters were sent directly by the healthcare professional 1 month after disclosure of the patients’ test result. Outcomes were uptake of counselling in the first year, impact on psychological and family functioning, and evaluation of the approach (measured with surveys at 3 (T1) and 9 (T2) months after disclosure). Results: 96 patients were included and 482 relatives were eligible for counselling and genetic testing. We observed no significant difference in uptake of genetic counselling between the current (38%) and the tailored (37%) approach. No differences in worry, anxiety and impact on family communication about the disease was observed between the tailored and the current approach. Significantly more patients in the tailored group were satisfied with the used approach, while they also felt more pressure to inform at-risk relatives and perceived room for improvement of the used approach. Conclusions: No differences in uptake and impact on family and psychological functioning between the current and the tailored approach were observed, but patients randomised to the tailored approach more often felt satisfied about the used approach. Further research is needed to identify the most optimal approach to support informing at-risk relatives.
Presented by: Lieke van den Heuvel
Institution: Department of Clinical Genetics, Amsterdam UMC (location AMC)
Other Affiliations: 1. Department of Clinical Genetics, Amsterdam UMC (location AMC), Amsterdam, the Netherlands; 2. Netherlands Heart Institute, Utrecht, the Netherlands; 3. Department of Genetics, University Medical Centre Utrecht, Utrecht, the Netherlands ; 4. Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, the Netherlands; 5. Department of Medical Psychology, Amsterdam UMC (location AMC), Amsterdam, the Netherlands; 6. Department of Clinical Genetics, University Medical Centre Groningen, Groningen, the Netherlands

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Let’s not reinvent the wheel – adapting the Adherence Improving self-Management Strategy (AIMS) to Chronic Heart Failure

J. Dam, A. M. Janssen, T. M. H. Eijsvogels, G.P. Westert, M. de Bruin

Abstract: Background: The theory-based Adherence Improvement self-Management Strategy (AIMS) is feasible, effective and cost-effective in supporting medication adherence for patients with HIV. AIMS-HIV is comprised of 1-to-1 nurse-patient conversation during routine clinical visits, with electronic medication monitoring and feedback as core components. No (cost)effective interventions have been identified for supporting treatment adherence amongst CHF. The aim of this study was to adapt AIMS to Chronic Heart Failure (AIMS-CHF) and explore its acceptability. Methods: AIMS was adapted using Intervention Mapping, by systematically identifying elements that require adaptation, with the preservation of core programme components. A literature review was conducted and advisory boards with patients and nurses were organized to inform the adaptation process. Results: AIMS-CHF had to become a multiple behaviour intervention, including medication adherence, adherence to physical activity and symptom monitoring. The key determinants of these behaviours were largely similar to those already targeted in AIMS-HIV (e.g., illness perceptions, attitude, self-efficacy, habits, and self-regulatory skills), so intervention methods and strategies could be retained. Findings from the literature review and advisory boards allowed making informed decisions about the modification and translation of the AIMS-materials to CHF (e.g., modifying specific beliefs, barriers/solutions, images, and monitoring devices). Conclusion: The building blocks of AIMS were generally appropriate for supporting the self-management of CHF, although additional behaviours and content modifications were required. The Intervention Mapping approach, complemented with the literature (in particular review and qualitative studies) and advisory boards, allowed systematic adaptation of AIMS to CHF and assess its acceptability to patients and healthcare providers.
Presented by: Joëlle Dam
Institution: Radboud Institute for Health Sciences, Departments of IQ Healthcare and Physiology, Radboud University Medical Center.

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Emotional and cognitive processes in psychological interventions for children with chronic diseases

Mareike Kaemmerer, Olivier Luminet, Magali Lahaye, Georgia Panayiotou

Abstract: Introduction: Pediatric chronic diseases have been associated with emotional and cognitive difficulties. Yet, most studies investigate general psychological outcomes (e.g. quality of life, anxiety; Beale, 2006; Sansom-Daly et al., 2012). At present, no systematic review has specifically analyzed the effectiveness of interventions on processes underlying the effects on these variables. Therefore, we will conduct a systematic review of empirical studies testing the effectiveness of psychological interventions for children with chronic diseases in which we will examine the mediating role of emotional and cognitive processes.

Methods: The systematic review will be conducted according to the PRISMA statement. The search will be conducted on different electronic databases and include a grey literature search. Search terms are defined in five categories referring to the age group (children, 8-12 years), disease types (e.g. diabetes, cystic fibrosis), types of intervention (e.g. CBT, mindfulness, family therapy), outcomes of interest (e.g. emotion regulation, cognition) and study type/design (e.g. intervention study, RCT). The main inclusion criterion for articles concerns the presence of at least one measure of effectiveness on emotional (emotion regulation or coping) or cognitive (executive functions) processes.

Results: The results will allow to better determine the emotional and cognitive processes that underlie beneficial effects on physical and psychological health.

Conclusions: The systematic review is a first step towards the development and implementation of an evidence-based psychological intervention for children with chronic diseases. This intervention will be co-constructed by families, health care professionals and researchers and based on the acquired scientific evidence concerning the implied, targeted processes.
Presented by: Mareike Kaemmerer <mareike.kaemmerer@uclouvain.be>
Institution: UCLouvain
Other Affiliations: University of Cyprus

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