Biomedical subjects

Mariël Droomers

Publications and source records attributed to Mariël Droomers.

8 recordsLinked to original sources

PubMed2006

Moderators of environmental intervention effects on diet and activity in youth.

BACKGROUND: The complexity of the relationship between environmental factors on the one hand and dietary behavior and physical activity on the other necessitates the search for moderators of environmental influences. The current evidence base is reviewed regarding potential moderating factors in the effectiveness of environmental interventions aimed at diet and/or physical activity of children and adolescents. METHODS: The following databases were used: (1) Medline, (2) PubMed, (3) PsychInfo, (4) Web of Science, and (5) ERIC. Additionally, all potentially relevant references in recent reviews were checked. RESULTS: Of the 41 studies included in the review, only seven studies (17%) were identified that reported tests of potential moderators of intervention effects. Gender proved to be the most frequently studied potential moderator. Additionally, race, age, and site have been studied regarding their potential role in modifying the effect of environmental interventions. DISCUSSION: The small number of studies identified in this review prohibited us from attempting to formulate a conclusion on differential environment-behavior relationships in distinct subgroups. Rather than being an exception, it is argued that tests of effect modifiers should become common practice in behavioral nutrition and physical activity research to increase our understanding of mechanisms of behavior change and to optimize interventions.

Adolescent↗

PubMed2006

Exceptions to the rule: healthy deprived areas and unhealthy wealthy areas.

In general, inhabitants of low socio-economic areas are unhealthier than inhabitants of high socio-economic areas, but some areas are an exception to this rule. These exceptions imply that other factors besides the socio-economic level of an area contribute to the health of the inhabitants of an area, e.g. environmental factors. In our study we concentrate on areas within the Netherlands that are healthier or unhealthier than could be expected based on their socio-economic level. This study first identifies these areas and secondly determines which area characteristics distinguish these areas from those areas where the level of health is in agreement with their socio-economic level. We used nation-wide data on neighbourhood differences in population composition (gender, age, marital status and ethnicity), urbanisation and two health indicators: mortality and hospitalisation rates. In the Netherlands, many areas are healthier or unhealthier than could be expected based on their income level alone. Areas with higher mortality rates than expected are mainly urban areas with high percentages of elderly people and persons living alone. Similar but opposite associations are observed for areas with lower mortality rates than expected, which are further characterised by a low percentage of non-western immigrants. Areas with lower hospitalisation rates than expected are mainly rural areas with few non-western immigrants. From these results, we conclude that urbanisation and residential segregation based on age, ethnicity and marital status might be important contributors to geographical health inequalities.

Adolescent↗

PubMed2006

Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: The Amsterdam Health Monitor Survey.

OBJECTIVE: To assess ethnic differences in the prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands. DESIGN: A cross-sectional survey. PARTICIPANTS: A random sample of 1304 adults aged 18 years and over. Of these, 39.2% were Dutch, 33.2% were Turkish and 27.6% were Moroccan. RESULTS: The prevalence of hypertension was lower in Turkish (men 25.8% and women 22.2%) and Moroccan (men 26.1% and women 19.6%) than in Dutch individuals (men 48.8% and women 35.0%). Except for Turkish women, these differences persisted after adjustment for age and body mass index: the odds ratios (95% confidence interval) for being hypertensive were 0.47 (0.30-0.74; P < 0.001) for Turkish men, 0.48 (0.30-0.76; P < 0.001) for Moroccan men and 0.51 (0.28-0.94; P = 0.03) for Moroccan women. Only Moroccan hypertensive women were less likely than Dutch women to be aware of their condition 0.31 (0.11-0.81; P < 0.01) and to be treated 0.32 (0.12-0.88; P < 0.01) for hypertension. There were no differences in hypertension control between the ethnic groups in both men and women. CONCLUSION: The lower prevalence of hypertension among Moroccan men may contribute to the low cardiovascular disease (CVD) mortality reported among this group in the Netherlands. The differential risks in CVD mortality between Moroccan men and women may partly result from the lower hypertension awareness and treatment rates in Moroccan women. Strategies aimed at improving the detection and treatment of hypertension among Moroccan women may improve the sex disparity in cardiovascular mortality between Moroccan men and women in the Netherlands.

Adolescent↗

PubMed2005

Father's occupational group and daily smoking during adolescence: patterns and predictors.

OBJECTIVES: We investigated the relationship among father's occupational group, daily smoking, and smoking determinants in a cohort of New Zealand adolescents. METHODS: The longitudinal Multidisciplinary Health and Development Study provided information on adolescents' self-reported smoking behavior and potential predictors of smoking, such as social and material factors, personality characteristics, educational achievement, and individual attitudes and beliefs regarding smoking. Longitudinal logistic generalized estimating equation analyses were used. RESULTS: Adolescents whose fathers were classified in the lowest-status occupational group were twice as likely as those whose fathers occupied the highest-status occupational group to be daily smokers. This high risk of daily smoking among the adolescents from the lowest occupational group was largely predicted by their lower intelligence scores and by the higher prevalence of smoking among fathers and friends. CONCLUSIONS: To prevent socioeconomic differences in smoking, school-based interventions should seek to prevent smoking uptake among adolescents, particularly those of lower socioeconomic status. Programs need to provide positive, nonsmoking role models consonant with the culture and norms of lower-socioeconomic-status groups. Adolescents need to acquire resistance skills and protective behaviors against social pressure and influences.

Adolescent↗

PubMed2004

Educational differences in starting excessive alcohol consumption: explanations from the longitudinal GLOBE study.

This paper describes educational differences in starting excessive alcohol consumption during 6 1/2 years of follow-up among 1648 initially alcohol-consuming Dutch adults. The longitudinal GLOBE study provides the unique possibility to study explanations for educational differences due to the collection of extensive baseline information on educational level, alcohol consumption, stressors (tension reduction theory) and vulnerability indicators (differential vulnerability theory) in 1991. Alcohol consumption was again assessed in 1997. We report that lower educated people were almost three times more likely to start excessive alcohol consumption during follow-up compared to the highest educated persons. Both educational differences in exposure to stressors (financial problems) and vulnerability (low social support) contributed to the educational differences in starting excessive alcohol consumption and explained 23% of the educational variation in starting excessive alcohol consumption. Remaining educational differences were however still statistically significant. These results are discussed with regard to implications for interventions and possible additional explanatory mechanisms.

Adaptation, Psychological↗

PubMed2004

Educational differences in the intention to stop smoking: explanations based on the Theory of Planned Behaviour.

BACKGROUND: At this time, the mechanisms by which socioeconomic differences in smoking develop are not completely understood. In this paper the Theory of Planned Behaviour as a potential explanatory framework for socioeconomic differences in smoking is tested. It was hypothesized that components of the Theory of Planned Behaviour may be unequally distributed over educational groups and therefore contribute to the explanation of socioeconomic differences in smoking. Educational differences in the intention to quit smoking are described and attempts are made to understand these in the light of educational patterns in attitude towards smoking cessation, perceived subjective norm concerning quitting smoking, and self-efficacy. METHODS: This cross-sectional study was part of the longitudinal GLOBE study on socioeconomic differences in The Netherlands. Components of the Theory of Planned Behaviour were measured in 1997 among 602 Dutch daily smokers. RESULTS: No educational differences in the intention to quit smoking were found. Persons with a more positive attitude towards smoking cessation and a high subjective norm significantly more often intended to quit smoking. But, positive attitude and high subjective norm were not related to education, which explains the lack of educational differences in intention to quit smoking. Higher educated respondents reported significantly higher self-efficacy to refrain from smoking, which, however, was not related to the intention to quit smoking. CONCLUSION: It is anticipated that, from all components of the Theory of Planned Behaviour, only the direct effect of self-efficacy on behaviour may contribute to educational differences in smoking cessation.

Adolescent↗

PubMed2004

Do lower socioeconomic groups use more health services, because they suffer from more illnesses?

BACKGROUND: The more diseases one suffers from, the higher the number of health care services attended. This study aims to examine the role this association plays in socio-economic differences in multiple health care utilization. METHODS: The study population derived from the Netherlands Health Interview Surveys (1990-1998) and was 25 years or older (N=53,339). Socio-economic position was indicated by educational level. Comorbidity was defined as the concurrence of multiple health conditions in the same person. Multiple health care utilization was measured by the number of different health care services contacted in the preceding year. Logistic multiple regression was used, adjusted for age, gender and year of interview. RESULTS: The lower the socioeconomic status, the more often people used multiple health care services (OR 1.46) and the higher the prevalence of comorbidity (OR 2.47). CONCLUSIONS: Lower socioeconomic groups use more health care services, partly because they suffer from more illnesses.

Adult↗

PubMed2002

Why do lower educated people continue smoking? Explanations from the longitudinal GLOBE study.

This article describes the effect of educational level on the decision to continue smoking among 1,354 initially smoking participants (age > or = 20 years) in the Dutch GLOBE study. The effect of education on continued smoking was explained from baseline information (1991) on smoking characteristics, individual characteristics, and environmental factors. Smoking status was reassessed after 6.5 years. Lower educated smokers more often continued smoking (odds ratio 2.09). Poor perceived health and earlier smoking initiation in lower educated groups were main predictors of educational differences in smoking maintenance. Educational differences in chronic illness, perceived control, neuroticism, and emotional support also contributed to the explanation of educational differences in continued smoking. These results have important implications for intervention programs and policy.

Adult↗