PhD research

Elena Agachi
Evaluating and improving the effectiveness of health programs.

As a recent development, an increasing number of health promotion organizations start implementing mobile software apps promoting preventive health behaviors, targeted at improving the lifestyle of their participants. In this project we evaluate an online preventive health program, delivered in the Netherlands, via a website and a mobile app. Firstly, we examine the adoption of the program, focusing on differences between population segments of different socio-economic conditions. Secondly, we measure the ability of email prompts to increase the participants' engagement with the mobile app of the health program. Lastly, we estimate the effect of actively using the mobile app on actual healthcare utilization costs.

The aim of this project is to assess the effectiveness of the online health program by analyzing the impact of health program engagement on the healthcare consumption of the participants. This project is a collaboration between the University of Groningen and the insurance agency Menzis.

Claudio Annibali
topic: human capital, health and labor market participation

In this project we use panel data to address whether individuals with undiagnosed diabetes type 2 suffer from lower labor market outcomes over time. We do so with panel data methods but also investigate on possible endogeneity, through instrumental variable analysis and mendelian randomization.

Marleen Fluit
Creating healthy cities - governing relationships between local government and local initiatives

Health is considered the driving force for implementing urban regeneration programs where local government collaborates with several stakeholders across domains. In this context, there is a growing interest in the roles of local initiatives initiated by citizens. This project focuses on the governance relationships between local government and local initiatives in light of creating healthy cities. First, our multiple case study based on secondary data shows a classification of local initiatives and illustrates several governance strategies implemented by local government and their barriers. Second, our longitudinal case study examines the role of local government in managing a network of formal organizations and local initiatives in implementing a healthy ageing district approach. Finally, by conducting a segmentation study, we identified groups of citizens with different self-sufficiency profiles. These profiles can be used to offer more demand-driven services at the district level.

This PhD project is funded by ZonMw and is conducted in cooperation with the municipality of Groningen. The Healthy Ageing district approach developed by the municipality of Groningen consists of six key aspects related to the social and physical environment which include: Active Residentship, Healthy Housing, Accessible Green, Healthy Transfer and Movement, Healthy Food and Active Relaxation.

Selwerd has been selected as a case study in this research as it is one of the pilot districts in which the healthy ageing approach is implemented. One of the objectives of this research is to examine how informal structures within the district can contribute to the accessibility of formal structures in the district such as social care teams and housing associations etc. In addition, this research will analyse how initiatives within the district such as the Wijkbedrijf can have an influence on the social networks between residents in the district and social participation. Finally, this research will look into ways to develop modular arrangements which include multiple interventions aimed at delivering health care in a cost-efficient way, taking into account the heterogeneity in the demands of residents. In this way, the modular arrangements could provide more integrated and personalised care and better access to health services. The implementation of the Healthy Ageing district approach, the development of an informal structure in the district and modular arrangements could lead to more social cohesion, self-efficacy, better health and reducing health inequalities within the city of Groningen.

Michael Fröhlke
Simultaneous cooperation and competition in healthcare supply networks. How ‘coopetition’ influences performance in Dutch regional oncology networks.

Healthcare expenses increase continuously on a global scale creating an unsustainable burden for our society. Reducing costs without forfeiting treatment quality has become a major societal challenge. Value-based healthcare aims to increase treatment efficiency by facilitating shared use of resources through cooperation between healthcare providers and simultaneously limiting treatments to procedures that actively contribute to patients’ health outcomes. In Dutch oncological care, hospitals formed regional networks that cooperate to provide high-quality care at reduced costs. At the same time, care providers compete with each other over prices and volumes in their negotiation with health insurers. How this simultaneous cooperation and competition – coopetition – and the resulting tensions affect care quality and costs is not exactly understood. In my research, I assess the challenges and conditions to high-value healthcare provision in Dutch regional oncology networks impacted by coopetition and integrated treatment pathways.

In multiple case studies and social network analyses with data from Dutch oncology networks and the Netherlands Cancer Registry, I study treatment pathways and resources utilization (e.g., capacities, equipment, expertise) with the aim to stimulate more efficient and effective oncological care. Therefore, this research strives to counter the unsustainable cost development of healthcare provision while optimizing oncological networks.

Jana Holthöwer
Social robots are increasingly used in frontline service settings. These robots distinguish themselves from previous generations of automation because they engage users on a social level. Driven by the ever-increasing shortage of personnel, and recently also the corona crisis, the healthcare sector greatly invests in social robots. However, research into the acceptance of social robots is still in its infancy, and a theory of robot-to-human social interaction in services is lacking. Accordingly, this research aims to deliver insights on what drives and hinders the acceptance of service robots performing social tasks in health and elderly care.

Y. Kang
Newcomer learning and assimilation

This PhD project examines how to get newcomers better socialized in a dynamic world through their networks and relationships.

Aukje Nieuwenhuis
Topic: Gender in the labor market, cross-generational analysis

In her master's thesis (also completed at the Faculty of Economics and Business, University of Groningen) Nieuwenhuis looked at genderstereotypical attitudes of parents (as derived from their job choices) and how those affect the employment choices of their children. In her PhD project, she expands on this topic, with an alternative estimation technique to check the sensitivity of her earlier results and with data from another country (before she focused on Germany). She poses the following question: If a parent displays employment behavior that is typical for their gender, is their child then more or less likely to make career choices in line with stereotypes for their gender?

The second part of her PhD project focuses on gender gaps in working hours, specifically in the Netherlands. Here, the roots of the gender income gap appear to lie in part-time employment. The fact that Dutch women are part-time “champions” among all OECD countries makes the Netherlands an interesting population to study female labor force participation

David Olk
Green means go healthy: how transparent and actionable food labeling helps customers make healthier purchases

Status: In progress

Noncommunicable diseases pose a major health risk as they accounted for 71% of deaths worldwide in 2015. Among various environmental, behavioral, and metabolic factors, obesity and overweight were the third-highest cause of disease globally after high blood pressure and smoking. These consumption-related health-risks related to unhealthy food intake are largely influenced by consumers’ choices in the supermarket.

In the supermarket environment, choosing healthy food items is often challenging due to nutritional information that is hard to evaluate, misleading health claims by producers, and an often-overwhelming number of product options and amount of information. To solve these issues, so-called front-of-package labels have been developed. The goal of these labels is to provide consumers a scientifically-based, transparent, and actionable indication of the health of a product. A popular front-of-package label is the Nutri-Score, a colored scale from A (healthiest) to E (unhealthiest) that is printed on the front of a products packaging.

Together with all major retailers active in the Netherlands, this project analyzes the consumers’ reactions to the introductions of front-of-package labels like the Nutri-Score. Furthermore, we research additional tools based on the Nutri-Score to help consumers make healthy choices.

Supervisors: prof. dr. ir. Koert van Ittersum & prof. dr. Tammo H.A. Bijmolt

Herman Paryono
Moving back and forth between work and nonwork roles: Examining the impact of micro role transitions on well-being in boundaryless work-nonwork interface conditions

We are extending the micro role transitions theory by adding specific dimensions (i.e., experience, sequence, configuration, pattern) in a boundaryless condition (i.e., for knowledge workers with flexible/alternative working arrangements).

Tamool Muhamed
prenatal, maternal and child health outcomes in targeted socioeconomic status groups

The project, an interfaculty project between the Faculty of Economics and Business (FEB) and the University Medical Centre Groningen (UMCG), aims to investigate which modifiable factors are related and most influential to prenatal, maternal and child health outcomes in targeted socioeconomic status groups. Socioeconomic health inequalities exist and are affecting clinical and psychological outcomes of maternal and neonatal health. The project aims to tackle the intertwined individual, societal, and health system-related trajectories that build social gradients, providing a reliable and reproducible approach. Providing a healthier future for the next generations is the passion that drives this project.

The project requires epidemiological and econometrical approaches; it requires advanced epidemiological study designs, health system analysis, and health econometrics considerations.

A. Shui
Early-life conditions, socioeconomic status and the health effects of Groningen earthquakes

Martian Slagter
Social Community Teams’ Creation of Service Integration Through Boundary Work and Play with their Stakeholders

For an 18 month-period, this research project followed three social community teams (SCTs) from the same, larger social care organisation in the Netherlands, in their efforts towards service integration. In this research project, the SCTs developed new collaboration practices with one or more stakeholders. The researchers use the Boundary Work lens to explore how SCTs shape their collaboration in a multi-stakeholder context. Keywords: Team Boundary Work, Team Identity Work, Team Legitimacy.

Jeroen van der Vaart
Health inequalities, saving motives and the generosity of public insurance programs for the elderly

Jeroen van der Vaart studies the interplay between health risks at old-age, social insurances, and individual decisions to self-insure these risks and leave bequests to heirs. First, he measures socioeconomic inequalities in mortality and long-term care use. Second, he studies whether social insurances redistribute welfare across socioeconomic groups due to these health inequalities. Third, he quantifies the importance of different saving motives in old-age for saving behavior. He exploits quasi-experimental variation from two reforms to disentangle precautionary from bequest saving motives. Lastly, he analyzes the implications of long-term care risk for strategic bequest saving, inducing help from relatives by leaving them larger bequests.

Wieteke de Vries
How healthy is your basket? The effect of real-time nutritional feedback on the healthiness of food purchase decisions.

Obesity is a global health concern with severe negative consequences for personal and societal well-being. In response to the obesity epidemic, the call is growing to develop strategies for improving population-wide consumption by making food environments more conducive to healthy purchases. In particular, grocery stores — the main source of food purchases — hold critical opportunities for improving consumption patterns and personal well-being. Most in-store interventions currently promote healthy within-product category purchases, thereby implicitly and erroneously assuming that a healthy choice triggered by the intervention does not affect subsequent purchases. However, consumers show a tendency to balance (un)healthy choices between-product categories, off-setting the benefits of healthy purchases triggered by within-product category interventions. Therefore, we propose and test interventions for improving the healthiness of the entire shopping basket, which also allows us to better understand the dynamic and complex decision-making environment of grocery stores. In particular, we examine the effects of real-time nutritional feedback on the healthiness of shopping baskets.

Arlinde Vrooman
The effect of colonial rule on health and health care in Ghana and Côte d’Ivoire, 1900-1960.

Despite a clear effect of changes during the colonial period on health suggested by qualitative sources, the literature on the (long-term) effects of colonial rule largely overlooks this relationship. My PhD project aims to enhance our understanding of the effect of colonial rule on health and health care in a specific place and setting: Ghana and Côte d’Ivoire from ca. 1900 to 1960. Using qualitative and quantitative primary sources, new data sets will be built to capture (the results of) regional colonial government investments in health care provision and regional health outcomes during this time period. These data sets will be employed to show and analyze patterns and trends. In addition, they will be paired with data on relevant control variables in a comparative empirical analysis.

Amber Werkman
Waist versus waste: Understanding the interface between health and sustainability in consumer food consumption

People make more than 200 food-related decisions each day. We are not always fully aware of these decisions and make a lot of them automatically. This seems harmless but two potential negative consequences loom large in the domain of food decisions and purchases: overconsumption and waste. Overconsumption is a fundamental cause of the growing obesity epidemic, which has become one of the biggest health concerns in communities across the world. Worldwide obesity has nearly tripled since 1975. Equally concerning is food waste. One-third of all edible food destined for human consumption is lost or wasted each year within the food supply chain. In developed countries, consumers can be held responsible for up to 65 percent of the waste.

At first glance, overconsumption and food waste are two separate issues that need to be addressed. In fact, they are more related than previously recognized. People waste more food as they try to eat healthier and people start consuming more food in order to reduce waste. Especially when portions are large, people are confronted with a trade-off between consuming or wasting. This research aims to investigate the tension on the interface between health and sustainability in consumer food decision making and food consumption. By combining insights from the portion and unit size effect, we intend to study in more detail how this mechanism works and how we can use it to it to create win-win solutions that reduce both food intake and food waste.