Woerden

This research evaluates the effectiveness of the RISE blended behavior change intervention in people who have experienced their first stroke. The study aims to prevent major adverse cardiovascular events such as recurrent stroke, transient ischemic attacks, acute coronary events, and cardiovascular death over a one-year follow-up period compared to standard care. It also investigates the intervention's impact on reducing sedentary behavior after hospital discharge in community-dwelling stroke survivors with sedentary movement patterns. Approximately 950 to 1000 participants are expected to be enrolled to account for loss to follow-up. Participants are randomly assigned to an experimental group receiving the 15-week RISE intervention alongside usual care or to a control group receiving only usual care. The RISE intervention involves coaching by a primary care physiotherapist who supports participants in balancing their 24-hour activity pattern, focusing on reducing and interrupting sedentary time to increase physical activity. This coaching includes the use of an activity monitor, a smartphone application with real-time feedback and e-learning modules, and a dashboard for the physiotherapist. Support from someone in the participant's social network is also included. Control group participants receive hospital-specific standard care. Participants will undergo assessments at baseline, immediately post-treatment (four months), and at six, nine, and twelve months after randomization. These assessments include wearing activity monitors, completing questionnaires, and performing physical tests, all of which are non-invasive and conducted either online or at home. Researchers monitor the occurrence of major adverse cardiovascular events as the primary outcome. The study's burden and risks are considered low, with physiotherapist visits conducted at home or online, and participants are physically capable of completing the required activities.

Researchers are evaluating the effectiveness of a group course called Hold Me Tight/Let Me Go (HmT/LmG) designed to improve relationships between parents and adolescents aged 12 to 18. The course targets families experiencing stressful parent-adolescent relationships that may worsen adolescent problems. This study uses a within-subject design with three phases: a waiting period averaging five weeks, a six-week treatment phase, and an eight-week follow-up to measure changes in relationship satisfaction and negative interaction patterns over time. The intervention includes four group sessions for parents, focusing on psycho-education and skills training such as recognizing negative interaction patterns, emotional validation, and supportive limit-setting. Additionally, there are three individual sessions involving adolescents and parents: one with the adolescent alone, one with the parents, and one with both together. These sessions include interviews, role plays, and exercises to restore secure bonds and improve communication. The program is delivered in groups of 4 to 6 families and incorporates emotion-focused therapy principles. Participants will attend intake and group sessions, complete questionnaires before, during, and after the treatment, and participate in interviews and recordings to assess relationship dynamics. Researchers will monitor changes in relationship satisfaction and negative patterns from baseline through follow-up. The study includes detailed assessments using paper questionnaires and online surveys, along with audio recordings of sessions, to evaluate the course's impact and understand the mechanisms behind its effects.