A social care programme’s impact on quit-smoking intention in multi-problem households: exploring the scarcity theory 273 8 words; often used parts of sentences were “opening incoming post” and “keeping up with post”. This might indicate that prior to the coaching trajectory participants had no mental capacity left to deal with even more problems, thus not opening incoming post. It shows the importance of breaking down large issues (no overview of debts), into smaller pieces (opening incoming post). Clearly, if one loses control over such important elements as paying bills, health promotion activities are deemed ineffective. Yet, health appeared to be very important to clients as well. Interestingly, the topic of health consisted of both practical issues such as general practitioner and dentist, but also more abstract such as stress and healthy. The combination of health and money related issues suggests that a better alignment of efforts to tackle financial problems and health promotion is important. What the optimal order is, and whether synergy can be created requires further research. The survey data could neither support nor refute the second part of the hypothesis. Increased and decreased intention to change behaviour were observed as well as no change at all. Changes in intention to eat more fruit seemed positive and could indicate a start in changing unhealthy behaviour. For future research it would be recommended to assess change at multiple moments and over a longer period of time. In their review of the theory of scarcity de Bruijn and Antonides16 concluded there was no unambiguous evidence for the reduction in mental bandwidth due to poverty, which is partly due to methodologically challenges. The reverse effect of increasing mental bandwidth with decreasing poverty might also be subject to such challenges. Conclusion Social care clients experience money-related issues as most pressing, quickly followed by health-related issues. A stronger focus on money-related issues may ultimately benefit interventions to improve health and health behaviour of groups facing problems in multiple domains in life. Acknowledgements We would like to thank Edwin Huijskens and Suzan Daamen for their indispensable contributions. Furthermore, many thanks to all involved at De Uitvoeringsbrigade and Bureau Frontlijn. More information on both social care organizations can be found here: https://www.uitvoeringsbrigade.nl/ and https://www.rotterdam.nl/ wonen-leven/frontlijn/
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