Aligning health interventions to vulnerable groups

People who are in a vulnerable position due to stress, poverty, a chronic condition, or limited digital or language skills for example, run a greater risk of mental health issues and an unhealthy lifestyle, and are more often located in an unhealthy living environment.

However, it is these very groups that are harder to reach for existing behavioural change programmes. Prevention and a customised and inclusive approach are essential to ensure that vulnerable target groups can also participate.

Personalised inclusive prevention and care

Behavioural change is a complex challenge that often involves trial and error. TNO has years of experience in behavioural change research. Based on our behavioural expertise, we offer support in various health domains.

Through personalised, inclusive prevention and care, we aim to give children, adolescents, young adults, and their environment – for example parents, healthcare and other professionals, and policymakers – a more active role in promoting healthy behaviour (e.g. exercise, nutrition, mental and sexual resilience, oral health), preventing risky behaviour (alcohol and substance use), and making informed choices about health (vaccinations, population screening, healthy pregnancy, timely recognition of conditions).

We are committed to maintaining behavioural change and promoting healthy habits over the long term. We do this by developing interventions that support self-regulation and self-management, and that are aligned with the dynamic process of behavioural change. On the other hand, we create stimulating social and physical environments (healthy school, healthy living environment), because many people are insufficiently committed to personal control.

Practical implementation

We translate fundamental knowledge about behavioural change and behavioural maintenance into practical and evidence-based programmes. We deliver more effective and inclusive behavioural change programmes that are useful in practice. For these programmes, we use various qualitative, quantitative, and co-creation research methods.

We always work with stakeholders who are relevant for the adoption, implementation, and safeguarding of the programmes. This could include theme-based institutes (7 Dutch knowledge institutes, each with a specific area of expertise in relation to a healthy lifestyle and a healthy living environment), professional associations, but also, for example, schools.

Examples of what we are working on

'What Do You Drink?' is an example of an intervention we developed, in collaboration with the Trimbos Institute, Radboud University, and Senior Secondary Vocational Education (MBO) students. This personalised e-coaching app offers adolescents and young adults personal advice on their alcohol consumption. Young people set a goal to reduce the number of glasses per week and they are asked daily about their alcohol consumption, mood, motivation, and self-confidence to drink less. Monitoring the achievement of the set target or understanding barriers that prevent achievement enables targeted feedback and advice to be provided.

We have also described how we can better reach and involve people with limited health literacy and functional illiteracy in researching and designing health information. These groups are more likely to live in unhealthy conditions and to have more difficulty finding, understanding, and applying information and intervention materials. Since it is precisely in these people that the greatest health gains can be made, it is important for information and interventions to be accessible and comprehensible.

From healthcare to health

Our ambition for the coming years is to contribute to the health transition from illness and healthcare to health by reducing inequalities in health and other matters, giving better support to vulnerable target groups, and contributing to a healthier living environment.

In addition to our research into methodologies and data-driven techniques aimed at participation, empowerment, and behavioural maintenance, as well as increasing the inclusiveness of research and interventions, the development of more integrated and systemic solutions also contributes to these aims. This also means that we are increasingly focusing on cross-domain solutions that impact multiple transitions outside the health domain, such as energy, climate, and mobility.