Nienke Boderie

Chapter 8 272 program and the scientists, allowed us to conduct the study as part of the care program. The combination of using app and questionnaire data allowed for both in debt information through questionnaires, as well as more general information of a larger sample. Furthermore, this study applied a unique approach by evaluating behaviour change without an intervention focusing on behaviour. The use of text analysis appeared to enrich the information obtained from the quantitative data. Nevertheless, the study also suffered from limitations. Most importantly, the small sample of participants with repeated data from the questionnaires does not allow to draw firm conclusions. Whereas recruitment of the app-sample was relatively easy as this was used as standard care, the questionnaires was an additional element. Coaches either judged obtaining this information on top of the regular care was too demanding for the participants, or participants mentioned to have no interest in participation. It cannot be excluded that families with the most severe problems were excluded from the questionnaire study; the direction of the bias is difficult to estimate. Furthermore, the time between the baseline and follow-up might have been too short. The link between stress and health is well established and it is well known that those in multi-problematic situations endure high levels of stress. The effect a of reduction in stress (caused by factors outside the health domain) on changes in health behaviour has not been investigated much, but receives increasing attention. Interestingly, they take different approaches. In the BeHealthyR study,14 participants received a multicomponent intervention including a stress reduction course, and effects will be evaluated on stress, smoking behaviour, financial health and health perceptions. Van Rongen et al.15 tried to manipulate scarcity in an experimental study, but found no significant difference between the group experiencing scarcity and the group who did not experience scarcity. Despite the face validity of the scarcity-theory, more evidence is needed to support the theory in the context of health promotion in lower socioeconomic groups. The hypothesis presented in this paper was twofold; 1) we expected health behaviour to be low in the list of priorities and 2) expected an increase in the intention to change unhealthy behaviour when other problems would be solved. The app data revealed a high perceived importance for the field ‘Money’. The words used within the field Money reveal that gaining insight in one’s financial situation is perceived as urgent. The word ‘post’ was in the top of most used

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