Dutch Citizens Research Articles

Predictors to Use Mobile Apps for Monitoring COVID-19 Symptoms and Contact Tracing: Survey Among Dutch Citizens.

BackgroundeHealth apps have been recognized as a valuable tool to reduce COVID-19’s effective reproduction number. The factors that determine the acceptance of COVID-19 apps remain unknown. The exception here is privacy.ObjectiveThe aim of this article was to identify antecedents of acceptance of (1) a mobile app for COVID-19 symptom recognition and monitoring and (2) a mobile app for contact tracing, both by means of an online survey among Dutch citizens.MethodsNext to the demographics, the online survey contained questions focusing on perceived health, fear of COVID-19, and intention to use. We used snowball sampling via posts on social media and personal connections. To identify antecedents of the model for acceptance of the 2 mobile apps, we conducted multiple linear regression analyses.ResultsIn total, 238 Dutch adults completed the survey; 59.2% (n=141) of the responders were female and the average age was 45.6 years (SD 17.4 years). For the symptom app, the final model included the predictors age, attitude toward technology, and fear of COVID-19. The model had an r2 of 0.141. The final model for the tracing app included the same predictors and had an r2 of 0.156. The main reason to use both mobile apps was to control the spread of the COVID-19 virus. Concerns about privacy was mentioned as the main reason to not use the mobile apps.ConclusionsAge, attitude toward technology, and fear of COVID-19 are important predictors of the acceptance of COVID-19 mobile apps for symptom recognition and monitoring and for contact tracing. These predictors should be taken into account during the development and implementation of these mobile apps to secure acceptance.

Does supplementary health insurance play a role in the switching behaviour of citizens in the Netherlands?

ABSTRACT Background: Several healthcare systems have elements of managed competition in which citizens can choose between multiple insurers. In order for this principle to function properly, all citizens should have equal opportunities to switch insurer. Studies, conducted around 2015, have shown that the supplementary insurance policy is perceived by citizens as a barrier to switching, which could have negative consequences for the intended goals of the system. We aim to explore whether a supplementary insurance policy still has a restraining role on the opportunity to switch among citizens in the Netherlands from 2015 to 2020. Furthermore, we will examine if the extensiveness of the supplementary insurance policy relates to the switching behaviour of citizens. This element has not been addressed in previous studies. Methods: We obtained information on the role of the supplementary health insurance policy in the switching behaviour of citizens by sending questionnaires, yearly in February from 2015–2020, to 1,500 members of the Dutch Health Care Consumer Panel (DHCCP) each year. As such, we were able to examine whether having a supplementary insurance policy plays a role in the decision of Dutch citizens to switch insurer. The response rates were consecutively from 2015 to 2020: 60% (n = 896), 47% (n = 703), 44% (n = 659), 50% (n = 751), 48% (n = 715), and 54% (n = 806). Results: Citizens with a supplementary insurance policy switch less often than citizens without one. The extensiveness of the supplementary insurance policy is significantly associated with the decision of citizens to switch insurer; the more extensive citizens are insured, the less often they switch. Additionally, our results show that every year a small group of citizens does not switch insurer because they are concerned that they will not be accepted for a supplementary insurance policy. Conclusions: Our results indicate that having a supplementary insurance policy holds citizens back from using their opportunity to switch. This contributes to the idea that having a supplementary insurance policy could be experienced by citizens as a barrier to switch. This raises questions about the extent to which the principle of managed competition in the Dutch healthcare system works as intended.

Ragebol en Sabel

Duster and Sabre. Civilian Armament, Revolution, and Terror during the Patriot Revolt in Holland, 1786-7 Historians have interpreted the armament of Dutch citizens during the Dutch Patriot Revolt of the 1780s either as a revival of traditional urban militias, or as an essentially symbolic action echoing the classical-republican ideal of the active citizen. This article argues that these interpretations have overlooked the fact that the patriots innovated traditional forms of armament by setting up National or Provincial Assemblies of Civilian Corps (Vergadering van Burgercorpsen), and that popular armament was essential in order for the patriot movement to become an organized political force of national importance. In the summer of 1787 patriots in Holland deployed the so-called Flying Army to enforce the revolution on a local level, crush opposition, and instill fear and terror into their enemies.

Functional and Facilitating: A Look into the Promotion and Standardization of Dutch as the Official Language in the Netherlands

Dutch society is open and international-oriented. A long standing tradition of world trade has contributed to the English proficiency of Dutch citizens. This, however, brings challenges to the status of Dutch as the national official language in the Netherlands. This paper takes the framework of national language capacity building proposed by Wen Qiufang and inspects the Dutch language policy in official language promotion and standardization. Results of the research show that coming from other languages that undermines the position of Dutch as national official language is gradually increasing. The Dutch solution is to put facilitating measures in place and to develop functional tools to support language users and learners. This solution can be valuable for the building of European multilingual landscape with its facilitating feature.

Extraterritorial Privacy Zone?

The Protestant Reformation led to a radical redrawing of the map of Europe, severely affecting international relations. An important consequence of Protestantism was the emphasis on the private dimension of religious practices, as it did away with clerical intermediaries and instead put the focus on the direct relationship between God and the believer. In this context, to facilitate diplomatic traffic between Catholic and Protestant countries, ambassadors came to enjoy the so-called Right of Chapel, allowing them to create a private place of worship and have a private chaplain at their ambassadorial residences. This right was explicitly included in two treaties that the Kingdom of Portugal and the Dutch Republic concluded with each other in the mid-seventeenth century. However, the two parties to the treaties had starkly different understandings of what was meant by ‘private’. Both of these treaties granted Dutch citizens in Portugal freedom of conscience in their own houses, but the contrasting interpretations of what ‘private’ actually meant for the Dutch and for the Portuguese resulted in serious disagreement about the exact scope of these religious rights.

The Effect of Gain-versus-Loss Framing of Economic and Health Prospects of Different COVID-19 Interventions: An Experiment Integrating Equivalence and Emphasis Framing

AbstractA survey experiment was conducted that exposed Dutch citizens to different scenarios that either emphasized the gains or the losses regarding the number of victims or the economic damage caused by SARS-CoV-2. Replicating prospect theory in an ecologically valid crisis context, we found that gain frames promoted risk-aversive preferences, whereas loss frames increased support for risk-seeking alternatives. We further demonstrate the effect’s conditionality: Framing effects are strongest for health compared to economic scenarios and most pronounced when the type of intervention entails the highest risk associated with the respective domain. Theoretically, we show that the strongest media effects occur as an interplay between emphasis and equivalence framing effects, which underlines the need for media effects research to integrate both framing elements rather than studying them separately.

Public engagement in the management of the COVID-19 pandemic: Views & expectations of the publics

IntroductionDuring an epidemic, like COVID-19, trade-offs have to be made between measures to reduce mortality and morbidity and associated social, economic and political consequences. Traditionally, epidemic management (EM) has been guided by experts and policymakers, and is executed most attentively. It can however still be controversial in the public sphere. The question arises if public engagement (PE) could be a means to improve the quality and effectiveness of EM, as it has proven to be for other domains of healthcare policy.MethodsFrom June to October 2020, seven Deliberative Discussion Focus Groups were executed with 35 Dutch citizens between 19 and 84 years old, to discuss their views on PE in COVID-19 management. Timeline Interviews were conducted to elucidate meaningful experiences during the epidemic. Next, benefits, barriers, timing and possible forms of PE in EM were discussed.ResultsAlmost all participants supported PE in EM, as the integration of experiences and ideas of the public would benefit the quality of EM, and PE would increase awareness and acceptance of measures. Also, participants emphasized the importance of receiving information on the process of EM, to overcome the perceived lack of transparency herein. Consultation was seen as a fitting form for PE since the public could share ideas and feedback on EM, particularly on communication campaigns and control measures, however final authority stayed with experts. PE could be executed after the first acute phase of the epidemic, but also during evaluations. Moreover, barriers for PE were identified such as time constraints and the lack of knowledge of the public.ConclusionsA foundation of values and conditions for PE in EM from the perspective of the public was laid. Support for PE was identified and considered valuable for quality and effectiveness of EM. Next, the results should be confirmed within a broader audience and the views of experts and policymakers on PE in EM should be elucidated.Key messages According to participants, public engagement can increase quality and effectiveness of outbreak management, by sharing knowledge, experiences and ideas between the public, experts and policymakers.The focus groups in this study were executed whilst the COVID-19 pandemic unfolded, which yielded very relevant outcomes of current interest.

Chronic disease prevalence and patterns of comorbidities in people with intellectual disabilities

Abstract This study aims to examine chronic chronic disease prevalence in people with ID compared to those without ID in primary care settings and comorbidity patterns accompanying chronic diseases, by focusing on age and sex differences. With a focus on the four highest-impact chronic diseases worldwide and individually, ischemic heart disease, cerebrovascular disease, diabetes mellitus, and chronic obstructive pulmonary disease (COPD), it is assessed to what extent these diseases affect people with ID. Two databases are linked, that of Nivel Primary Care Database, a large representative sample of Dutch citizens registered in general practices, and non-public microdata from Statistics Netherlands, containing information on indication of long-term care or supportive services for people with ID. With prevalence rates and odds ratios chronic disease prevalence and comorbidity patterns were established by total groups of people with and without ID and by sex and age groups. Results displayed differences in chronic disease prevalence in people with and without ID: cardiovascular diseases were less prevalent, and diabetes mellitus more prevalent in people with ID. At relatively young age (<50 years), people with ID not only had more chronic diseases, but also more often had multiple comorbidities compared to those without ID. The most common comorbidity in all chronic diseases was hypertension, while diabetes mellitus as comorbidity also occurred often. This study is the first to present chronic disease prevalence and comorbidity patterns across the groups of people with and without ID and by sex and age groups. It can therefore be used as source of accurate information on the health prevalence and patterns of people with ID compared to the general populations, and provides a novel insight into differences in the group of people with ID.

Understanding the adoption, use, and effects of ecological footprint calculators among Dutch citizens

Ecological footprint calculators allow users to estimate their individual environmental impact, with the goal of raising awareness and changing behaviour. Prior to this study, little was known about users’ reasons for adopting a footprint calculator, their evaluation of these tools, and the effects of calculator use. With this paper, we aim to provide a deep understanding of these factors. Based on a thematic analysis of interviews with 11 Dutch ecological footprint calculator users, centred around their experiences with existing calculators, we draw several conclusions. Calculator users can be divided into two groups with different motivations and needs: Explorers and Environmentalists. For both user groups, calculators increase awareness. In some cases, this results in behaviour change. Other effects are more difficult to measure, but no less important — for example, calculators facilitate discussions around sustainability between users and non-users. Despite the promising effects of calculators, achieving widespread adoption and stimulating continuous engagement is difficult. Based on our findings, we formulate a set of design recommendations to help calculators overcome these and other challenges.

Capitalizing on the “Public Turn”: New Possibilities for Citizens and Civil Servants in Smart City-Making

ABSTRACT There is a sharp contrast between the public value discourse that typifies smart city-making on the one hand and its democratic deficit on the other. In this article we explore this contrast in more detail and assess that the paradigm and practices of networked government, which dominates smart city making, positions citizens as “audiences” of smart city makers and civil servants as “shepherds” of their public values. In these positions, both citizens and civil servants participate in a wide array of smart city experiments and engagements. However, an active, autonomous agenda setting role by citizens or democratically legitimated advocacy of civil servants is rare and does not easily fit within the paradigm of networked government. We draw on the work of Dewey and Marres to envision such different roles and make them concrete by highlighting experiences of Dutch citizens and civil servants with urban data and technology. These show, first, that the desires and goals of citizens may differ markedly from those of the smart city, and—second—that civil servants struggle with legitimate ways to advocate for socially and economically balanced smart city solutions. We conclude, in the final section, that the smart city can only be developed further through representative democratic means of engagement, among which local elections that express the collective desires of citizens and frame the mandate of civil servants.

Participatory value evaluation for the evaluation of flood protection schemes

Participatory Value Evaluation (PVE) is a new survey method which elicits citizens' preferences over the allocation of public budgets as well as their private income. In a PVE, citizens are asked to choose the best portfolio of projects given a governmental and a private budget constraint. First, this paper aligns PVE with the traditional Kaldor-Hicks welfare economics framework underlying many Cost-Benefit Analyses. Second, this paper positions PVE against other valuation methods. Third, this paper applies the PVE method to evaluate the impacts of projects mitigating flood risks in the Netherlands. This empirical application reveals that Dutch citizens indicate a preference for projects that combine strengthening dikes and give space to the river to flood safely, particularly when such projects positively influence biodiversity and recreational opportunities.

Examining the Dutch Resistance Movement During World War II

This paper is an analysis of the Dutch resistance movement during World War II. During the German occupation of the Netherlands, 102,000 Dutch Jews were deported and killed, which amounted to approximately 75 percent of the pre-war Jewish population in the Netherlands. Additionally, hundreds of thousands of Dutch civilians were forced to work in German work camps to fuel the German war machine. Despite this, only 4% of Dutch citizens participated in the resistance movement. This paper will examine the roles of these resistance fighters, as well as several primary sources that demonstrate their importance and significance. It will explain that resistance work was incredibly dangerous work done by many local organizations that when combined formed a national movement. The resistance movement was recognized and encouraged by the Dutch government in exile and was viewed as a threat by the German occupiers. Ultimately, members of the resistance movement should be viewed as heroes who were willing to stand up to the evil of the Nazi regime and risk their lives for freedom.

Fiscal Integration in an Experimental Union: How Path-Breaking Was the EU's Response to the COVID-19 Pandemic?

Fiscal Integration in an Experimental Union: How Path-Breaking Was the EU's Response to the COVID-19 Pandemic?

O-096 The ethics of stem cell-based embryo-like structures: a focus group study on the attitudes of Dutch professionals and lay citizens

Abstract Study question What are main themes guiding the attitudes of Dutch professionals and lay citizens with regard to the creation and research use of embryo-like structures? Summary answer The attitudes of Dutch citizens indicate feelings of trust and distrust, distinct ‘embryo’ conceptualizations, competing moral values and beliefs, and criteria for adequate regulatory safeguards. What is known already Researchers are hopeful that the creation and research use of so-called embryo-like structures (ELS), i.e., stem cell-based models that can mimic (parts of) early (human) embryogenesis, may provide a morally less controversial way of studying the period during which most human etiologies rise while also reducing and replacing the use of animals and/or human embryos in research. Scholars in the humanities and social sciences underline that public engagement and support will be essential in harvesting this presumed moral advantage. Studies on the public endorsement of and attitudes towards synthetic embryology remain nevertheless significantly scarce. Study design, size, duration For this qualitative study with a cross-sectional design, data were collected through four semi-structured focus group discussions (N = 33) between August and September 2020. Participants/materials, setting, methods The focus group interviews consisted of one pilot interview (n = 5), two interviews with lay citizens (n = 21), and one interview with professionals (n = 7). The pilot participants and lay citizens were invited based on sociodemographic characteristics of the Dutch public. Professionals were selected from the networks of the authors based on their experience and affinity with ethical and legal debates on emerging biotechnologies. The transcriptions were analyzed using inductive thematic analysis. Main results and the role of chance From our analysis emerged four themes: (1) trust, distrust and ambivalence in synthetic embryology, mainly due to concerns about scientific compliance with societal norms, also in view of a projected future ability of using ELS for reproductive ends; (2) diversity of ELS-conceptualizations, also in terms of their (non-)distinction from ‘natural’ human embryos; (3) grounds for moral value and moral standing, in which a possible potential to grow into a human being and perceived tinkering with nature were considered key issues of moral concern; and (4) conditions for responsible embryo-like research, with an emphasis on legally binding the use of ELS to non-reproductive research purposes. Interestingly, whereas questions on the developmental potential of ELS were critical for both the attitudes of professionals and those of lay citizens, lay citizens were much more concerned that synthetic embryology could fundamentally change human existence for the worse. In particular, lay citizens worried that synthetic embryology could lead to dystopian futures, for instance, because it stimulates a ‘makeable human existence’ or because of a presumed inability to monitor and control scientific progress. These findings may imply a correlation between fear of research and degrees of (un)familiarity with the governance systems of science. Limitations, reasons for caution Qualitative research methods provide rich and in-depth data for an ethical analysis of motivations and intuitions, but do not allow generalizations of the findings to broader publics. Wider implications of the findings The results may provide a useful starting point for further discussion and analysis of adequate regulatory parameters for the creation and research use of ELS. The findings also show that societal dialogue and public consultation can play a significant role in addressing concerns about emerging (bio)technologies. Trial registration number not applicable

How to understand diversity in citizens’ care attitudes: an exploratory study in the Netherlands

AbstractThe aim of this study is to investigate Dutch citizens’ care attitudes by looking at care-giving norms and citizens’ welfare state orientation and to explore to what extent these attitudes can be explained by combinations of diversity characteristics. We combined two datasets (2016 and 2018, N = 5,293) containing citizens’ opinions regarding society and conducted multivariate linear and ordered probit regression analyses. An intersectional perspective was adopted to explore the influence of combinations of diversity characteristics. Results show that citizens’ care-giving norms are relatively strong, meaning they believe persons in need of care should receive help from their families or social networks. However, citizens consider the government responsible for care as well. Men, younger people, people in good health and people of non-Western origin have stronger care-giving norms than others, and younger people assign relatively more responsibility to the family than the government. Level of education and religiosity are also associated with care attitudes. Primary diversity dimensions are more related to care attitudes than secondary, circumstantial dimensions. Some of the secondary dimensions interact with primary dimensions. These insights offer policy makers, social workers and (allied) health professionals the opportunity to align with citizens’ care attitudes, as results show that people vary to a large extent in their care-giving norms and welfare state orientation.

A Focus Group Study Among Inactive Adults Regarding the Perceptions of a Theory-Based Physical Activity App.

Background: Despite the increasing attention for the positive effects of physical activity (PA), nearly half of the Dutch citizens do not meet the national PA guidelines. A promising method for increasing PA are mobile exercise applications (apps), especially if they are embedded with theoretically supported persuasive strategies (e.g., goal setting and feedback) that align with the needs and wishes of the user. In addition, it is argued that the operationalization of the persuasive strategies could increase the effectiveness of the app, such as the actual content or visualization of feedback. Although much research has been done to examine the preferences for persuasive strategies, little is known about the needs, wishes, and preferences for the design and operationalization of persuasive strategies.Objective: The purpose of this study was to get insight in the needs, wishes, and preferences regarding the practical operationalization of persuasive strategies in a mobile application aimed at promoting PA in healthy inactive adults.Methods: Five semistructured focus groups were performed. During the focus groups, the participants were led into a discussion about the design and operationalization of six predefined theory-based persuasive strategies (e.g., self-monitoring, feedback, goal setting, reminders, rewards, and social support) directed by two moderators. The audio-recorded focus groups were transcribed verbatim and analyzed following the framework approach.Results: Eight men and 17 women between 35 and 55 years (mean age, 49.2) participated in the study. Outcomes demonstrated diverse preferences for implementation types and design characteristics of persuasive strategies in mobile applications. Basic statistics (such as distance, time and calories), positive feedback based on easy-to-achieve goals that relate to health guidelines, and motivating reminders on a relevant moment were preferred. Participants had mixed preferences regarding rewards and a social platform to invite other users to join PA.Conclusions: Findings indicated that in mHealth applications for healthy but inactive adults, persuasive strategies should be designed and implemented in a way that they relate to health guidelines. Moreover, there is a need for an app that can be adapted or can learn based on personal preferences as, for example, preferences with regard to timing of feedback and reminders differed between people.

The Need for an Alternative to Culling Day-Old Male Layer Chicks: A Survey on Awareness, Alternatives, and the Willingness to Pay for Alternatives in a Selected Population of Dutch Citizens.

A concerning by-product of producing laying hen chicks are the hatched male layer chicks. As a consequence of their inability to lay eggs, these male chicks are culled as day-old chicks in the hatchery. To find an alternative for this ethical dilemma (generally), three alternatives are under study, namely, in ovo sex determination, using dual-purpose breeds, and the rearing of layer cockerels. In order to assess the awareness of this practice and preference for one of the alternatives, we conducted an online survey of the Dutch public. Most of the 259 respondents completing the survey were highly educated woman (HEW, n = 143) versus others (REST, n = 86). The questionnaire was divided into six topics: (1) general knowledge of the poultry industry, (2) awareness of culling male layer chicks (CMC), and (3) its acceptability, (4) alternatives to CMC, (5) willingness to pay (WTP) for eggs without CMC, and (6) WTP for cockerel meat. Awareness about CMC was 52%, and its acceptability was rejected by 78% (HEW) and 67% (REST). The level of acceptability increased when more salient facts were given, and almost all respondents agreed that an alternative was needed (90% HEW, 84% REST). For both groups of respondents, more than 50% preferred in ovo sex determination over keeping the current practice or using dual-purpose breeds or male layers. Furthermore, the majority of respondents were willing to pay more than double the price for eggs without CMC being involved. Roughly 40% would not buy processed cockerel meat burgers, most likely due to their vegan or vegetarian diet. Of the remaining respondents, half were willing to pay the current price or 1 euro more for processed cockerel meat burgers. The most important factors when buying poultry meat or eggs without CMC were food safety, animal friendliness (welfare), and the environment; price was the least important factor. Despite the skewed respondents' background, the results of our survey show that consumers are willing to pay more for poultry products that do not require culling day-old male chicks.

Facilitators and barriers to contact between asylum seekers and their Dutch neighbors

AbstractCurrently, Europe is dealing with a large number of asylum seekers. A recent report show that attitudes toward asylum seekers are not that negative in the Netherlands, and yet Dutch citizens living close to asylum seeker centers barely have contact with them. Because contact is vital for a multicultural society, we investigated the facilitators and barriers for Dutch citizens to establish and maintain contact with asylum seekers where they live close together. We conducted semistructured interviews with Dutch people and analyzed them using thematic analysis. We found four themes: Physical possibilities for Contact, Goals for Contact, Social Identities, and Positivity and Openness, and proposed a grounded theory model based on how the themes are related. The findings are discussed in relation to debates on multiculturalism and intergroup tolerance, and can be used to improve the integration policies by local governments, because they present clear conditions and practical information as to how contact can be established and maintained.

From “Far Away” to “Shock” to “Fatigue” to “Back to Normal”: How Young People Experienced News During the First Wave of the COVID-19 Pandemic

ABSTRACT This paper explores how young people used and experienced news during the first wave of the COVID-19 pandemic. Drawing from 22 in-depth interviews with Dutch young people (19-36), we found four successive phases in which participants used and made sense of news in distinct ways. First, before the virus reached the Netherlands, they saw it as “a problem far away” and felt indifferent toward the news. During the second phase of “shock”, as COVID-19 reached the Netherlands, news use increased as participants frantically tried to make sense of the situation. Third, participants experienced “Corona-fatigue” due to informational and emotional overload and began “dosing” their intake of news. Finally, they became used to “the new normal” and returned to (perceived) regular levels of news consumption. Two new rituals stood out during the first wave: press conferences seemingly “interpellated” participants as Dutch citizens who should take their responsibility, and daily updates of COVID-19 cases were used as a gauge for how “we” were doing. Overall, participants’ position could best be described as critical-but-pragmatic: even if they questioned the veracity of some news, they chose to follow measures to curtail the virus.

Environmental stress and the quality of life connected with COVID-19 among people in Poland and the Netherlands.

In addition to physical damage, COVID-19 also has a serious impact on the mental health of society. For many people, this involves the necessity of adapting to new conditions, uncertainty about the future and a tremendous mental burden. It was investigated whether there were any differences between the 2 measures (before and during the COVID-19 pandemic) in the levels of perceived stress, anxiety, life satisfaction and experienced emotions. The study, conducted in Poland and the Netherlands, involved 168 people. The metric, the Positive and Negative Experience Scale, the Perceived Stress Scale, the and the Satisfaction With Life Scale were used. The subjects were divided into 3 groups: non-immigrants living in Poland (N = 50), Dutch citizens (N = 56), and Polish immigrants living in the Netherlands (N = 62). The level of stress and negative emotions was higher in the groups of Poles living in Poland and Poles living in the Netherlands than in the group of Dutch citizens. Therefore, access to psychological care should be improved during the pandemic, especially for immigrants, due to the increased risk of developing stress-induced mental disorders. In the groups of Poles, there was an increase in perceived stress and trait anxiety during the COVID-19 pandemic. The group of Dutch citizens experienced a reduction in the anxiety level during the COVID-19 pandemic. In the group of Polish immigrants, there was an increase in life satisfaction during the COVID-19 pandemic. Int J Occup Med Environ Health. 2021;34(2):177-88.