Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 18:2:100028.
doi: 10.1016/j.hctj.2023.100028. eCollection 2024.

Enhancing self-care and access - The Dutch stepped care model to strategically organize public sexual health for young people

Filippo Zimbile  1   2   3 , Silke David  1 , Elmari Briedenhann  4 , Lisette Schutte  2 , Rik Crutzen  3
Affiliations

Enhancing self-care and access - The Dutch stepped care model to strategically organize public sexual health for young people

Filippo Zimbile et al. Health Care Transit. .

Abstract

Public Sexual and Reproductive Health (SRH) services are traditionally provided face-to-face by Dutch Sexual Healthcare Clinics. High demand for these services led to the exploration of digital health to increase access and support self-care. However, the implementation was fragmented and uncoordinated. Therefore, the Stepped Care Model (SCM) was introduced to (1) organize coordination and cooperation between regional and national providers of public SRH-services for young people; (2) link digital services to clinical services and identify opportunities for new digital services; (3) increase the accessibility of SRH-services; and (4) stimulate self-care. This article describes the Dutch SCM and how digital health is integrated The process started by identifying key stakeholders and promoting collaboration followed by development and implementation of an unified national online platform to access comprehensive SRH services. The different levels of care of the existing services were categorized and overlap between services were inventoried. Based on 'ideal client journeys' for different sexual health themes, relevant services on different care levels were linked to each other and new opportunities for digital or combined digital-professional supported services were identified. It is explained how young people can gain easy access to increasingly specific and specialist services at the higher steps of the model via the online central portal with general information as a first step. The lessons learned highlight the importance of partnerships, coordination and a shared strategy leading to reduced fragmentation and increased accessibility of services and more self-care. The constraints of the Dutch SCM are related to restricted evaluation possibilities due to anonymized client data, limited target group involvement, complexity of digital service development along with possible resistance from health professionals. The SCM shows how efficiency in health systems can be achieved following the principle of economies of scale: more coordination and less fragmentation, leading to lower costs for development and implementation of digital services, availability and bundling of specialized technical and regulatory expertise and financial resources, ultimately leading to reduced waiting times and more self-care for young people.

Keywords: Accessibility of SRH-information and services; Cooperation in health care; Digital health; EHealth; Public health system; Public sexual health for young people; Self-care; Stepped Care; Web-based interventions.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Self-care in the context of interventions linked to health systems .
Fig. 2
Fig. 2
Dutch SCM for public sexual health.
Fig. 3
Fig. 3
Flowchart Dutch SCM for public sexual health for young people (12–25 years) in 2022.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Koster, L. ea Evaluatie ASG-Regeling. Ministerie van Volksgezondheid, Welzijn en Sport (VWS); 2018.
    1. Sørensen K., Van den Broucke S., Fullam J., et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12(1) doi: 10.1186/1471-2458-12-80. - DOI - PMC - PubMed
    1. Berglas N.F., Hucles K., Constantine N.A., Jerman P., Rohrbach L.A. Predisposing, enabling and need-for-care predictors of adolescents’ intention to use sexual health services. Sex Health. 2016;13(6):540. doi: 10.1071/SH16061. - DOI - PubMed
    1. Slater C., Robinson A.J. Sexual health in adolescents. Clin Dermatol. 2014;32(2):189–195. doi: 10.1016/j.clindermatol.2013.08.002. - DOI - PubMed
    1. Wasserman J., Palmer R.C., Gomez M.M., Berzon R., Ibrahim S.A., Ayanian J.Z. Advancing health services research to eliminate health care disparities. Am J Public Health. 2019;109(S1):S64–S69. doi: 10.2105/AJPH.2018.304922. - DOI - PMC - PubMed

LinkOut - more resources