Adults In Flanders Research Articles

From bliss to burden: An ethnographic inquiry into how social, material and individual obstacles to digital well-being shape everyday life

Drawing from a two-year ethnography with sixteen adults in Flanders and Brussels, Belgium, this study disentangles the social, material, and individual obstacles experienced in day-to-day life that hinder and foster digital well-being. Findings show how these obstacles are interrelated, laying bare the tensions that cut across social relations, digital devices, and spaces. Moreover, (gendered) responsibilities and social relations impact whether someone can, or even desires, to overcome obstacles to digital well-being. We thus observed a “constrained agency” that limited individual efforts in feeling digitally well. Emphasizing the relational characteristics of connected everyday life, the study argues that identifying where agency is constrained can make visible the layers and tensions in people’s experiences with digital media use. To put this into practice, we echo the call for a re-imagination of digitized everyday life that questions underlying inequalities and privileges, seeing a need for individual and collective strategies that can foster sustainable digital well-being.

A lifestyle program for socially vulnerable community-dwelling elderly

Abstract Problem Socially vulnerable older adults often face lower health literacy and limited access to health care. Description of the problem Current lifestyle programs are often insufficiently adapted to this socially vulnerable target group. As a result, these older adults are underrepresented in lifestyle programs. From a public health perspective, lifestyle programs that improve the poorer physical and mental health of these older adults, should be made more accessible by involving the expertise, participation and needs of this group. The aim of this study was to develop and implement a lifestyle program adapted to the expectations and needs of socially vulnerable older adults. Results Both the target group and the local community (health) centers were involved during the co-creative phase of development. A neighborhood analysis was used to identify and reach out to the target group. Motivators and barriers for a healthy lifestyle were identified through focus groups. The developed program consisted of 10 weekly group sessions. Various health aspects were integrated, including exercise, nutrition, stress, sleep, positive psychology, meaningful living, and motivation. Nine centers for community dwelling older adults in Flanders and Brussels were included. In total, 93 older adults were recruited out of which 76 completed the full program. In the final phase, the program was evaluated by means of objective and subjective measuring methods. Finally, the local community (health) centers are currently involved in the program’s sustainability through a trainers’ program. Lessons The belongingness, the catering, the empowering attitude of the trainer and the ‘fun’ factor turned out to be success factors for the adherence to the program. The participating centres experienced an increase in numbers of older adults that were attracted to their activities that are focused on healthy lifestyle behaviors. The continuity of the program is currently being examined. Key messages • A neighbourhood analysis in collaboration with local partners helped to reach the target group. • The program was made attractive by the involvement of the older adults, the fun-factor and the small groups.

Individual and food environment factors associated with the diet of disadvantaged adults in Flanders

Abstract Background Health inequalities partially remain due to differences in diet between socioeconomic groups. Examining the association between socio-ecological factors and the diet of socioeconomically disadvantaged (SED) individuals can enhance the development of interventions to decrease health inequalities. Methods In total, 278 SED adults residing in two Flemish municipalities completed a survey addressing sociodemographics, diet, health and their perceptions of the food environment. The objective food environment was examined by assessing food retailer information in street network-based buffers of 500m and 1000m around participants’ addresses. Linear regression was used to test assumptions. Results Individual factors such as poor subjective health (OR0.58;CI 0.34-0.97), food insecurity (OR0.60;CI 0.38-0.94) and living alone (OR0.86;CI 0.75-0.98) were negatively associated with healthy dietary habits such as daily fruit and vegetable (FV) consumption. Positive perceptions on the availability of FV were positively associated (OR1.09;CI 1.02-1.17) with daily FV consumption. Objective food environmental factors showed a stronger association with unhealthy dietary habits. A greater amount of retailers within 1000m walking distance was negatively associated with fast-food (OR0.96;CI 0.94-0.99) and sugar-sweetened beverages (SSB) consumption (OR0.93; CI 0.88-0.98). More supermarkets within 500m distance was negatively associated (OR0.77;CI 0.58-0.97) with SSB consumption, while more convenience stores within a 1000m distance was positively associated (OR1.48;CI 1.17-1.88) with SSB consumption. Conclusions Our findings suggest that factors associated with the diet of SED adults differ according to food and drink items. Interventions focused on this population should take these differences into account. Key messages

Using a Factorial Survey to Estimate the Relative Importance of Well-Being Dimensions According to Older People: Insights From a Repeated Survey Experiment in Flanders.

Background and ObjectivesAlthough it has become standard to include the views of older people when assessing their well-being, most existing methods are ill-suited to estimate the relative importance of well-being dimensions. This article investigates the potential of the factorial survey method to estimate the relative importance of six well-being dimensions (health, income, social relations, leisure, engaging activities, and religion) based on the views of older people themselves.Research Design and MethodsWe implemented a factorial survey in a repeated survey experiment among 800 older adults in Flanders (the Dutch-speaking northern part of Belgium). We performed several within-sample test–retests to investigate the consistency of the estimated coefficients over time (i.e., temporal reliability). In addition, we tested the feasibility of the factorial survey by studying two indicators of cognitive load: response time and response consistency.ResultsWe estimated the relative importance of increases in six well-being dimensions. Increases from the lowest level to the highest level in the dimensions of health, income, and social relations had the highest effect on well-being—followed by leisure, engaging activities, and religion. The results proved to be consistent in most of the test–retest analyses. Furthermore, we found that respondents produced a high level of response consistency within an acceptable amount of response time.Discussion and ImplicationsThe findings suggest that the factorial survey method offers a promising way forward to elicit older people’s views on well-being and, hence, in developing tailored policies that matter to them.

Epidemiology of native kidney disease in Flanders: results from the FCGG kidney biopsy registry.

ABSTRACTBackgroundThe Flemish Collaborative Glomerulonephritis Group (FCGG) registry is the first population-based native kidney biopsy registry in Flanders, Belgium. In this first analysis, we report on patient demographics, frequency distribution and incidence rate of biopsied kidney disease in adults in Flanders.MethodsFrom January 2017 to December 2019, a total of 2054 adult first native kidney biopsies were included. A ‘double diagnostic coding’ strategy was used, in which every biopsy sample received a histopathological and final clinical diagnosis. Frequency distribution and incidence rate of both diagnoses were reported and compared with other European registries.ResultsThe median age at biopsy was 61.1 years (interquartile range, 46.1–71.7); male patients were more prevalent (62.1%) and biopsy incidence rate was 129.3 per million persons per year. Immunoglobulin A nephropathy was the most frequently diagnosed kidney disease (355 biopsies, 17.3% of total) with a similar frequency as in previously published European registries. The frequency of tubulointerstitial nephritis (220 biopsies, 10.7%) and diabetic kidney disease (154 biopsies, 7.5%) was remarkably higher, which may be attributed to changes in disease incidence as well as biopsy practices. Discordances between histopathological and final clinical diagnoses were noted and indicate areas for improvement in diagnostic coding systems.ConclusionsThe FCGG registry, with its ‘double diagnostic coding’ strategy, provides useful population-based epidemiological data on a large Western European population and allows subgroup selection for future research.

Examining Care Assessment Scores of Community-Dwelling Adults in Flanders, Belgium: The Role of Socio-Psychological and Assessor-Related Factors.

One of the primary objectives of health systems is to provide a fair system by providing a comprehensive and holistic approach to caregiving rather than focusing on a single aspect of a person’s care needs. This approach is often embodied by using standardized care assessments across health and social care settings. These assessments are completed by professional assessors and yield vital information regarding a person’s health or contextual characteristics (e.g., civic engagement, psychosocial wellbeing, environmental characteristics, informal care). However, these scores may be subject to bias that endangers the fairness of the health system. In this study, we investigate to what extent socio-economic and psychological indicators and assessor-related indicators are associated with BelRAI Screener care assessment scores amongst 743 community-dwelling adults nested within 92 assessors in Flanders, Belgium. Findings indicate that there is significant variance in scores at the assessor-level. Socio-psychological characteristics of clients are associated with scores: being fluent in Dutch and providing informal care are associated with low care dependency, while living with children, feelings of depression, and the presence of an informal caregiver during assessment are associated with high care dependency. We discuss the importance of rigorous assessor training and the potential for socio-psychological factors to contribute to the allocation of welfare benefits in light of the Flemish home care system’s potential (lack of) fairness.

Negative old-age life events and well-being in later life: the moderating and mediating role of loneliness

Although older adults often experience negative life events or loss experiences, they rarely experience large decreases in their quality of life or well-being. Emotionally satisfying relationships in older adults may serve as a protective factor that reduces the impact of negative events in decreasing well-being. The availability of these close social contacts is essential, and their potential for alleviating feelings of loneliness after negative events could have an important role in promoting well-being. The aim of this study was to test the hypothetical moderation and mediation effects of social and emotional loneliness on the occurrence of negative old-age life events and well-being in later life. This was a cross-sectional survey conducted as part of the Detection, Support and Care for older people - Prevention and Empowerment research project (2015-2018). Participants were community-dwelling older adults in Flanders (Belgium). The sample composed of 770 participants aged 60 years and over. Participant demographics, social and emotional loneliness, and subjective well-being were measured. Moderation and mediation analyses were performed using the regression-based approach as conducted by Hayes and Rockwood (2017). Results indicated that a low degree of (social) loneliness is a protective, moderating factor and (emotional) loneliness is a mediating factor on the effects of negative life events on well-being in later life. Findings highlight the importance of emotionally and socially satisfying social contacts in order to maintain positive subjective well-being in later life when negative life events may occur.

The Alzheimer case: perceptions, knowledge and the acquisition of information about Alzheimer's disease by middle-aged and older adults in Flanders

AbstractAlzheimer's disease (AD) is a major health concern as the world population ages. Yet, few studies have examined what the public over the age of 50 knows about AD. This qualitative study, based on 40 in-depth interviews, examines the knowledge of AD by Flemish people between 50 and 80 years old and their cross-source engagement with information sources. Building on AD media representations and theories on media complementarity and health information behaviour, we find that respondents mostly encounter AD information non-purposively via traditional mass media and interpersonal communication, while the internet is occasionally used to purposefully seek information. Novels, personal experiences/social proximity, public figures and particularly film stand out as channels and sources of AD information, suggesting that fictional narratives, personal experiences and being able to identify with others leave lasting impressions and help to communicate and disperse AD information. However, common misconceptions and gaps in knowledge persist, including AD being considered part of the normal ageing process and old age as well as confusing AD with Parkinson's disease. The biomedical perspective and the tragedy discourse prevail among the majority of respondents, who describe AD in terms of decline, loss and death and as ‘the beginning of the end’. Only a few, typically female respondents, appear aware of the role of individual health behaviour and lifestyle choices to prevent dementia or delay its onset. The misconceptions of AD and gaps in knowledge, as well as the fact that a third of all cases of dementia might be delayed or prevented by managing lifestyle and other risk factors, stress the importance of public educational programmes and the need to emphasise and raise awareness of preventative behaviour. Overall, the findings from this study can be of help to public health communicators and dementia-awareness campaigns, as well as AD training programmes for health-care professionals and family care-givers.

Perceptions and opinions on the COVID-19 pandemic in flanders, belgium: Data from a three-wave longitudinal study

During the COVID-19 pandemic, people have become increasingly fearful of the disease as death tolls rise, while governments attempt to combat it by installing restrictive measures. News media play a vital role as they are the main sources from which people gather information regarding the disease and the public health measures. The present longitudinal data reflect a bird's eye view of people's fears towards getting ill, their news media consumption, and their attitudes regarding the (Belgian) government's handling of the COVID-19 crisis. Data were collected at three key moments in the pandemic among adults in Flanders, Belgium: in the middle of March (when the first restrictive measures went into effect; N = 1,000), early April (as hospital admissions and death toll peaked; N = 870), and at the end of May and beginning of June (as several measures were lifted or relaxed; N = 768). With only 23.2% drop-out across the three waves, these data may be of interest to researchers who wish to explore dynamics of fear and attitudes towards public health measures during this particularly challenging time.

Features of Flemish Emerging Adults and their Association with Demographic Markers.

As the Inventory of Dimensions of Emerging Adulthood (IDEA) was developed to assess features of emerging adulthood, international differences have been observed between emerging adults over the world. To assess the IDEA’s applicability to emerging adults in Flanders, a Dutch translation was administered to 489 participants between 17 and 26 years old, and exploratory and confirmatory factor analyses were performed. Important latent factors in the version used in the United States of America, such as focus on others, were not observed. Four subscales were created to reflect psychological features of our sample, combining elements of both Arnett’s theory of emerging adulthood and neo-Eriksonian theories of identity development. A new subscale, reflecting commitment and responsibility, was more present in older participants and employed participants, and associated with well-being. Finally, results suggested that employment, as well as place of residency, and romantic relationships significantly influence psychological development during young adulthood.

The Ethics of Socially Assistive Robots in Aged Care. A Focus Group Study With Older Adults in Flanders, Belgium

Socially assistive robots (SARs) need to be studied from older adults' perspective, given their predicted future ubiquity in aged-care settings. Current ethical discourses on SARs in aged care are uninformed by primary stakeholders' ethical perceptions. This study reports on what community-dwelling older adults in Flanders, Belgium, perceive as ethical issues of SARs in aged care. Constructivist grounded theory guided the study of 9 focus groups of 59 community-dwelling older adults (70+ years) in Flanders, Belgium. An open-ended topic guide and a modified Alice Cares documentary focused discussions. The Qualitative Analysis Guide of Leuven (QUAGOL) guided data analysis. Data revealed older adults' multidimensional perceptions on the ethics of SARs which were structured along three sections: (a) SARs as components of a techno-societal evolution, (b) SARs' embeddedness in aged-care dynamics, (c) SARs as embodiments of ethical considerations. Perceptions sociohistorically contextualize the ethics of SAR use by older adults' views on societal, organizational, and relational contexts in which aged care takes place. These contexts need to inform the ethical criteria for the design, development, and use of SARs. Focusing on older adults' ethical perceptions creates "normativity in place," viewing participants as moral subjects.

Acting One's Age in Physical Exercise: Do Perceived Age Norms Explain Autonomous Motivation Among Older Adults?

The social identity approach proposes that the more older adults identify with the social group of "older adults," the more they will conform to what they perceive as being normative exercising for their group. However, so far, it remains unclear why older adults adhere to these norms. This study evaluated whether perceived exercise norms are associated with higher levels of autonomous motivation according to the self-determination theory and actual exercise participation. A cross-sectional survey, either by regular mail or online, was conducted among 409 older adults in Flanders (Belgium). Our analyses revealed that older adults who perceived more positive older adult norms for exercising were more autonomously motivated to exercise. In explaining 24% of their exercise motivation, older adults' perceptions of the exercise norms for older adults predicted 6% of their exercise participation. Our findings suggest that social identity approach and self-determination theory can be meaningfully integrated.

Environmental influences on older adults’ transportation cycling experiences: A study using bike-along interviews

Cycling for transport offers an opportunity to promote active and sustainable mobility among the growing population of older adults. However, only a few studies examined how environmental factors may promote cycling for transport among older adults. Purposeful convenience sampling was used to recruit 40 older adults in Flanders, Belgium. Researchers and participants made a cycle trip, during which bike-along interviews were used to obtain in-depth and context-sensitive information about the environmental factors influencing their perceptions and experiences, which were analysed using inductive content analysis.A model including seven environmental themes emerged; traffic safety, cycling infrastructure, road design & maintenance, connectivity, aesthetics, hilliness and weather. Traffic safety appeared to be the most important concern. Participants felt safer where cycling tracks were well-separated from motorized traffic and where clearly demarcated crossings were present. They expressed preferences for cycling tracks being wide, obstacle-free, even and well-separated from the sidewalk; and, for a well-connected street network that provided alternative routes to reach destinations.Our findings suggest that traffic safety may have a major influence on older adults’ transportation cycling experiences and that the provision of a well-separated cycling space may be crucial in that context. Further research studies with larger, more-representative, samples and using quantitative methods are needed to examine the mechanisms proposed in our inductively-derived model.

Perceived Group Threat, Perceived Injustice, and Self-Reported Right-Wing Violence: An Integrative Approach to the Explanation Right-Wing Violence.

The present study aims at explaining individual differences in self-reported political violence. We integrate key concepts from the field of criminology that are conceptually related to social identity theory (Flemish identity, feelings of group superiority, and ethnocentrism) and the dual process model on prejudice (perceived injustice, perception of threat, and right-wing authoritarianism). In our model, social identity concepts are hypothesized to play a mediating role between mechanisms derived from the dual process model and political violence. To test the integrated model, a model was run for testing the strength of direct and indirect effects of perceived injustice, authoritarianism thrill-seeking behavior, feelings of superiority, Flemish nationalism, ethnocentrism, right-wing extremist beliefs, and exposure to racist peers on political violence. The analyses are based on a web survey (N = 723) among adolescents and young adults in Flanders, Belgium. Results indicate that social identity variables play an important mediation role between perceptions and ideological attitudes related to injustice, and political violence. The main path revealed by our study is that perceived injustice may result in heightened perceptions of threat, which in turn positively influence levels of right-wing authoritarianism. Mediated by ethnocentrism, this variable has a significant and positive effect on right-wing beliefs, which in turn has a positive effect on political violence.

Not for People Like Us? A Six-Year Panel Study of the Mutual Relationship Between Feelings of Relative Deprivation and Occupational Status Among Young Adults in Flanders

In this paper we analysed the mutual relationship between occupational status and feelings of relative deprivation, at the start of young adults’ labour market careers. For our analysis we used panel data from young adults for the birth cohort of 1976 who were surveyed three times between the ages of 23 and 29, between 1999 and 2005. These panel data not only provided information about the associations between the occupational status and feelings of relative deprivation, but also allowed us to gain better insight into the causal ordering of the relationship between both. We find effects in both directions, from occupational status to feelings of relative deprivation, and the reverse, although these differ both in strength and timing. The effect of feelings of relative deprivation for the occupational status is significant but rather weak, and only tangible between the age of 23 and 26. The effect of the occupational status on relative deprivation on the other hand is substantially stronger, but manifests itself only between the age of 26 and 29.

The Relationship of Dispositional and Situational Fear of Crime with Television Viewing and Direct Experience with Crime

Considerable differences exist in the size and direction of the relationship between television viewing and fear of crime found by previous studies. This article argues that different types of fear exist and that fear should not be confused with perception of risk. A distinction was introduced between dispositional fear of crime and situational fear of crime. The relationship between television viewing and the two types of fear was examined and a distinction was made between direct, indirect, and mediated experience with crime. Hawkins and Pingree (1990) hypothesized that direct experience would interact negatively with television viewing, whereas cultivation's resonance hypothesis assumed a positive interaction. Face-to-face interviews were conducted with 1,394 adults in Flanders, Belgium. Television viewing was positively related to dispositional fear of crime, whereas direct experience with crime was not. Direct experience predicted situational fear of crime, whereas television did not. There were no interaction effects. This study suggests that the relationship between television viewing and fear of crime depends upon the operationalization of the concept of fear of crime. More research is needed to establish which types of fear exist and how they are related to television viewing and direct experience with crime.

Expenditures on Sport Apparel: Creating Consumer Profiles through Interval Regression Modelling

Using a heterodox theoretical approach, this article presents sport consumer profiles based on socio-demographic and sport-related lifestyle characteristics. Sport apparel is operationalized as a categorical, hierarchical variable. Given the censored nature of the dependent variable, a two step Heckman-type approach with an interval regression model was used. Data were obtained from a cross-sectional sample of adults in Flanders, Belgium (N=1355). The results indicate that the decision to spend money on sport clothing and shoes is mainly determined by sport-related lifestyle characteristics, confirming the emerging importance of lifestyle in understanding the decision to consume material goods. However, the variability in the amount of money spent on sport apparel is explained by both socio-demographic variables and sport-related lifestyle characteristics. Consequently, both socio-demographic and lifestyle variables are used in the interval regression models, which is introduced as a novel technique to create consumer profiles. These profiles assist sporting goods marketers in refining their strategies to reach specific target markets.

Transcriptome Analysis in Peripheral Blood of Humans Exposed to Environmental Carcinogens: A Promising New Biomarker in Environmental Health Studies

BackgroundHuman carcinogenesis is known to be initiated and/or promoted by exposure to chemicals that occur in the environment. Molecular cancer epidemiology is used to identify human environmental cancer risks by applying a range of effect biomarkers, which tend to be nonspecific and do not generate insights into underlying modes of action. Toxicogenomic technologies may improve on this by providing the opportunity to identify molecular biomarkers consisting of altered gene expression profiles.ObjectivesThe aim of the present study was to monitor the expression of selected genes in a random sample of adults in Flanders selected from specific regions with (presumably) different environmental burdens. Furthermore, associations of gene expression with blood and urinary measures of biomarkers of exposure, early phenotypic effects, and tumor markers were investigated.ResultsIndividual gene expression of cytochrome p450 1B1, activating transcription factor 4, mitogen-activated protein kinase 14, superoxide dismutase 2 (Mn), chemokine (C-X-C motif) lig-and 1 (melanoma growth stimulating activity, alpha), diacylglycerol O-acyltransferase homolog 2 (mouse), tigger transposable element derived 3, and PTEN-induced putative kinase1 were measured by means of quantitative polymerase chain reaction in peripheral blood cells of 398 individuals. After correction for the confounding effect of tobacco smoking, inhabitants of the Olen region showed the highest differences in gene expression levels compared with inhabitants from the Gent and fruit cultivation regions. Importantly, we observed multiple significant correlations of particular gene expressions with blood and urinary measures of various environmental carcinogens.ConclusionsConsidering the observed significant differences between gene expression levels in inhabitants of various regions in Flanders and the associations of gene expression with blood or urinary measures of environmental carcinogens, we conclude that gene expression profiling appears promising as a tool for biological monitoring in relation to environmental exposures in humans.

The influence of social indices on oral health and oral health behaviour in a group of Flemish socially deprived adolescents.

To investigate the impact of social indices on oral health and oral health behaviour in socially deprived adolescents and young adults in Flanders. The study design was cross-sectional and included 68 subjects aged 12 to 26, who called for help by "Habbekrats", a non-profit organisation rendering assistance to adolescents and young adults living on the fringes of our society. The clinical oral examination was performed using criteria based on the diagnostic criteria for caries prevalence surveys published by BASCD. Information on parental occupational level, educational level, living condition and oral health behaviour was gained using questionnaires completed by the participants themselves and their social workers. The mean age was 16.2 years. Within the sample 92% and 90.8% respectively had a father or mother belonging to a low social level. For 68% of the sample the educational level was low. Concerning oral health behaviour 67% reported nutritional habits conducive to poor oral health whereas 64% reported good oral hygiene habits. The mean DMFS was 11.42 (SD = 14.33) and the mean care-index equalled 0.60 (SD = 0.39). Statistical analysis by means of a logistic regression model revealed that only the 'living condition' had a statistically significant influence on oral health behaviour (p < or = 0.05) and care-index (p < or = 0.05). There was no significant correlation between the parents occupation and subjects' educational level and the oral health behaviour and oral health status of the study group. From this analysis it is clear that 'living condition' had a significant influence on the oral health behaviour and care indices of the studied population of socially deprived adolescents.

Social Sports Stratification in Flanders 1969-1999

This article provides substantial empirical evidence that significant social differences exist in sports involvement in Flanders. A 30-year follow-up study of social stratification in sports was carried out to find out (i) if sports participation in Flanders is still socially stratified, and (ii) if social changes occurred in the status sports pyramid over the years of investigation. Based upon the educational status, the professional status and the geographical status of male and female adults in Flanders, social stratification pyramids in sport were set up for 1969, 1979, 1989 and 1999. Although the amount of sports participation from 1969 until 1999 has increased for each socioprofessional status, a significant difference persists between the high and the low professional levels ( X² test for trend = 85.90; p&lt;0.0001; df=1). The 1999 social sports pyramid continues to be socially stratified, and therefore confirms that sports participation still depends on socioprofessional status.