On October 31st 2019 the 4th Annual Meeting of the Amsterdam Public Health research institute (APH) took place. About 400 researchers visited the conference held in the cozy De Meervaart theater in Amsterdam. During the plenary and parallel theme sessions, researchers were challenged to discuss relevant questions concerning the theme of the day ‘Urban Health’.
The morning program was hosted by science journalist Geert Maarse. First, it was up to city councilor Simone Kukenheim to take the stage. During the interview it became clear how the city of Amsterdam takes care of its citizens’ health. After the interview, APH director Prof. Martine de Bruijne presented the first PechaKucha of the day. In 6 minutes and 40 seconds, she gave a clear overview of the contribution of APH to public health. Next, keynote speaker Steve Appleton was invited to share his point of view. He stressed that cities all over the world increasingly realize that an integrated approach is needed to tackle mental health problems and to realize change. After a short coffee break, Dr Wilma Waterlander presented the results from the LIKE project, in which combined system dynamics and participatory action research are crucial ingredients to achieve a sustainable shift towards healthy habits in young adolescents. In the morning break, the green room offered for our external guests a peaceful environment to discuss the urban health theme with each other and with our APH program leaders, and to start new collaborations.
The morning program ended with a PechaKucha competition as Mandy Hu, Arjen Mol and Eva van den Ende presented their research projects using 20 pictures. The audience decided by voting that Dr Mandy Hu was the well-deserved winner of the competition!
Winner: Mandy Hu (MH) Title: Physical activity interventions for the prevention of depression: a systematic review of meta-analyses
During the lunch break, junior and mid-career APH researchers presented their research by means of a poster. APH vice-director Prof. Carlo Schuengel awarded the top 3 on stage during the award ceremony at the end of the day. The winner of the APH Poster Award 2019 was Anke Hammerschlag, from the Mental Health research program!
Winner: Anke Hammerschlag (MH) Title: Genetic variation associated with ADHD and ASD partly exerts their effects via gene regulation
1st runner-up: Bo Schouten & Eva van den Ende (QoC) Title: Understanding what matters most to patients in acute care; an international Flash Mob study in 1840 patients
2nd runner-up: Michiel Luijten (Meth) Title: From statistician to clinician: The feedback of PROMIS® CATs within KLIK
Afternoon theme sessions
In the afternoon a broad range of themes with an overall focus on ‘urban health’ were discussed in parallel theme sessions. An overview of these sessions can be found below.
After the theme sessions, het Acteursgenootschap performed the theater piece ‘The ConScience App’ to start the debate on scientific integrity. With the help of propositions showed by the online tool MentiMeter, Dr Anja ‘t Hoog, member of the APH Scientific Quality Committee, pleasantly moderated the discussion. The day offered many opportunities for researchers, politicians, as well as community stakeholders to forge new collaborations. Due to the great number of visitors, the possibility for networking, and the inspiring atmosphere, the 4th Annual Meeting of APH was a great success!
We look forward to meeting you again next year!
© Laura Ponchel photography
Overview theme sessions
Our world is experiencing a remarkable shift towards urbanization, with 60% of the world population expected to live in urban centers in the next 10 years. Although urbanization can improve individuals wellbeing it can have a profound negative impact on health particularly among the vulnerable groups due to factors such as poverty, unhealthy lifestyle, and environment hazards. Therefore, addressing the health of the urban populations remains one of the most important challenges in our time. During this theme session, Global Health addressed this important issue head-on by bringing together two leading scholars to discuss the health impact of urbanization and migration on vulnerable populations. Prof. van den Muijsenbergh (Radboud University Nijmegen) presented a paper on migration and its consequences for health using the Netherlands as case study while Prof. de-Graft Aikins (University College London) presented a paper on urbanization and its consequences for health using Ghana as case study. Interestingly, the two very inspiring presentations highlighted important similarities in the effect of urbanization on health among vulnerable migrants in high-income countries and vulnerable populations in low-and middle income countries such as unhealthy lifestyle due to poverty, poor access to health care and growing inequalities in health between the rich and the poor.
The theme session ‘Aging society and the rising pensionable age’ was organized Societal Participation & Health. In the first part of the session, prof. Allard van der Beek gave an introduction on the current evidence, interventions, as well as the recommendations of the Health Council. What followed was a plenary brainstorm about ideas and solutions with regard to working longer in good health, and the role of research in this. In the second part of the session, organized and moderated by Edwin Boezemans, Heleen Beckerman and Femmy Bijsndorp, we talked about informal care givers. Informal caregiving currently plays a role in the lives of many people in the Netherlands and affects the participation of these individuals in society. Current SP&H-projects were discussed and avenues for future research were explored with the audience.
This theme session organized by Personalized Medicine was allocated to explore possibilities for personalized health interventions in the Amsterdam area. Dr Matty de Wit and Daan Uitenbroek (GGD Amsterdam) kicked-off the session with a presentation on tailoring public health, showing results of the Amsterdam health monitor. Second, Karin Kauw (Stichting Eigenwijks) gave an inspiring insight in the bottom-up approach in the area of ‘Nieuw-West’, where they help inhabitants to become a health ambassador. The last speaker was Jan Jacob Sikkema (European Grants Amsterdam), who highlighted a project to develop an ‘Urban family school’. Collaboration with research institutes is deemed extremely relevant to build a business case, in order to make such initiatives sustainable. The session was ended with a fun board game (‘Krachtig naar de tachtig’) underlining the impact of diversity on peoples’ life course. Gaining and losing ‘vitality’ depended on chance, but even more on background, gender and social economic class.
Living environments influences people as they age, especially persons who are more dependent and spent more time in their homes. At the same time there are not enough homes, and older persons often live isolated form friends/neighbours and (informal) care. Housing, design and architecture should however not be aimed at older persons but at all ages: ‘What is good for babies is good for older persons as well’. On the other hand there is a call for clustered living for older persons. The social environment might also be improved by making use of people’s existing network. In our panel discussion we found that many ‘healthy living’ initiatives are being set-up but the various stakeholders may not be aware of each other’s projects. Also, bottom- up approaches work best and should be prioritized by the municipality. Research should prioritize sharing their results with municipalities and should allocate time to implementation. The theme session was organized by Aging & Later Life
Urban mental health
This year the theme session ‘Urban Mental Health’ was organized by Mental Health, and was well-attended. Prof. Aartjan Beekman opened by presenting data on mental health in Amsterdam (from the GGD report ‘Gezondheid in Beeld’), demonstrating the value of an urban focus. This was followed by a short quiz: ‘How well do you know Amsterdam?’ Which surprisingly was won by a researcher from France! Prof. Reinout Wiers introduced the new UvA/AMC Urban Mental Health Research priority area, which sparked a discussion on how our institutes may further collaborate as they clearly share interests. Dr Eveline de Zeeuw presented findings on the relationship between population density and genetic risk for schizophrenia, showing that vulnerable people are more inclined to move or remain in a city, and that the city living itself also is a risk-factor. This inspired a discussion on the usefulness of genetic risk profiling in clinical practice. After the break, Prof. Arnoud Verhoeff provided an overview of available mental health cohorts from the Amsterdam area. Prof. Arne Popma closed the session with an interactive presentation on multidisciplinary collaboration within APH mental health and how to apply this to care.
Evaluation of interventions
Randomized controlled trials (RCTs) and quasi experimental designs, although frequently used, can be problematic for evaluating complex interventions that aim to tackle so-called wicked problems, such as unhealthy diets or self-management of chronic diseases. The complexity arises from, amongst others, interconnections between levels of influences (individual, social network, neighbourhood etc.) and the difficulty in predicting outcomes in such complex settings. Therefore, new evaluation designs have been developed to deal with this complexity trying not to compartmentalise the problems. During this joint-organized Health Behaviors & Chronic Diseases and Methodology session, these designs and the underlying notion of what counts as evidence for causality in this type of research have been introduced by Prof. Jacqueline Broerse. Characteristic for these study designs is that they monitor changes along the way, they incorporate histories and narratives, employ mixed methods, and research and implementation go hand in hand. Her presentation was followed by examples of research based on relevant methodologies such as complexity science and realist evaluation, presented by three APH researchers: Angie Luna Pinzon, Michael Schreuders, and Dr Jeroen Lakerveld. The discussion focused on the value of these designs versus the RCT, and the appropriateness of each of these designs for different research questions. Finally, the participants were challenged to think about strategies to promote the use of these novel evaluation designs, resulting in, amongst others, the suggestion to develop a ’wickedpedia’ specifying the value and practicalities of these methodologies for APH researchers.
The session was organized by Quality of Care and was led by Prof. Sophia Kramer and started with an interactive Menti quiz which showed the experience of the attendees’ with community participation/stakeholder involvement (this appeared to vary widely). Dr Lilian Peeters discussed how she involved pregnant women with poor lifestyle behavior during her ZonMw project ‘Together we’ll quit smoking!’. This was followed by an interactive session in which 2 DO’s and DON’Ts were formulated in small groups. During a lively panel discussion, these DO’s and DON’Ts were further discussed. For example: ‘DO’: really know your target population (their beliefs, needs, sources). After that, Roos de Jonge (Advisor patient participation in education) & Simone Louissa (Eurordis) shared their experiences from the patient perspective. The session ended with the presentation of Jolanda Huizer & Astrid van den Broek (ZonMW) who told about community participation from the funders’ perspective. Altogether, it was a very inspiring and informative session!