Edwin Wouters
Biographic Data
| ID | 171331 |
|---|---|
| NAME | Edwin Wouters |
| GIVEN NAMES | Edwin |
| FAMILY NAME | Wouters |
| SIGNATURE | WOUTERS E |
| AFFILIATIONS | University of Antwerp |
| ORCID | 0000-0003-2268-3829 |
| VERIFIED | Yes |
| TOTAL WORKS | 104 |
| TOTAL CITATIONS | 63 |
| AUTHOR COUNT | 104 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2007 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
In pursuit of intimacy
The COVID-19 crisis gave rise to measures such as physical distancing, sheltering in place, and social bubbles that impacted sexual lives profoundly. One group particularly badly impacted by COVID-19 containment, and at risk of sexual and mental health consequences as a result, comprised gay, bisexual and other men who have sex with men -- many of whom were more likely to live alone, to have had multiple partners before the epidemic, and some of …
Choosing to care
The childcare sector is experiencing major staff shortages, putting pressure on the quality provided within childcare centers and consequently on the children. One cause of these shortages is the insufficient supply of new childcare professionals. This study examines pre-service childcare professionals’ intentions to enter the field in relation to the following three aspects: study choice motivation, practicum experiences and perceptions of worki…
The Impact of a Household Intervention on ART Adherence and Household HIV Competency for People Living with HIV
Beyond the Diagnosis
This study utilizes the illness identity framework to investigate the incorporation of HIV into a sense of self and how varying degrees of integration influence key patient-reported outcomes. Using baseline data from the SINAKO Cluster Randomised Controlled Trial, we analysed responses from 316 adults living with HIV (PLHIV) attending 12 healthcare facilities in the Cape metropole, South Africa. Respondents completed assessments on four illness i…
Household-level factors and ART adherence among people living with HIV in Cape Town, South Africa
South Africa has the largest ART programme in the world. ART is provided within the context of the universal test and treat strategy. Sustained high levels of ART adherence are required to ensure viral suppression and prevent ART-drug resistance. However, poor ART adherence remains a challenge in South Africa. While much research has focused on individual - and community-level factors influencing adherence, household-level factors remain under-re…
Exploring the role of household and individual-level factors in depressive symptoms among people initiating ART in Cape Town, South Africa
Depression is the most prevalent mental health comorbidity among people living with HIV (PLWH) in sub-Saharan Africa, impairing treatment adherence and quality of life. While existing research has predominantly focused on individual and community-level determinants of mental health, the household-level has received little empirical attention. This study investigates the explanatory value of household-level factors, alongside established individua…
Reasons for HIV testing and testing experiences among men testing for HIV in Cape Town, South Africa
6) (5-7 participants per group). Participants were purposively selected. Thematic analysis, guided by the conceptual framework of access to healthcare, was applied. Testing was influenced by (a) healthcare workers initiating HIV testing, which men generally accepted, (b) the availability of male-friendly and men's clinics, which were limited, but approachable and preferred over general facilities, and (c) men's engagement in sexual behaviours tha…
Understanding the role of family social support in the medication adherence to hypertension treatment in Cambodia
The role of social support from family members was very positive in enhancing medication adherence among patients with HTN in Cambodia. Potential strategic interventions should include focus on establishing an intervention involving family members to provide support for HTN treatment
A situation analysis methodology to support integrated care pathway projects through the Joint Action on Cardiovascular Diseases and Diabetes (Jacardi)
Background: Cardiovascular diseases (CVD) and diabetes (DM) are major burdens on European health systems, magnified by ageing populations and staff shortages. To face these challenges, partners from 21 countries joined forces to launch the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), an EU-sponsored effort aiming to facilitate the strengthening of services in the context of these diseases. As part of this initiative, between 20…
Scaling up integrated care for chronic diseases in belgium
INTRODUCTION: Few integrated care studies elaborate how interventions are brought to wider scale. The SCUBY project developed interventions for scale-up of an Integrated Care Package (ICP) for two common diseases - type 2 diabetes and hypertension-, comprising evidence-based roadmaps and policy dialogues. This paper's aim is to report on the process evaluation of the ICP scale-up in Belgium. Specific objectives are: to describe the development of…
Navigating diabetes care inequities
Our pioneering findings support the social capital pathway, as CCM implementation is associated with a reduction in the healthcare inequity gap in the T2D care process. This suggests that promoting CCM implementation may improve healthcare equity, particularly in regions with significant socioeconomic disparities or high concentrations of deprived individuals
Evaluating the effectiveness of lifestyle education for individuals at increased risk of type 2 diabetes and cardiovascular diseases (Halt2Diabetes)
This study is registered with the ISRCTN registry, identifier: ISRCTN62149214 ( https://www.isrctn.com/ISRCTN62149214 ). The date of registration is March 13, 2025
Hypertension Cascade Across Three Healthcare Systems and in Relation to the Level of Implementation of the Integrated Care Package
Despite contextual differences between the countries and difficulties in comparability of the cascades, lessons can be learnt from each country's strengths and weaknesses to improve quality of integrated hypertension care
Study Protocol Medimig
Background: European society is becoming increasingly diverse due to high levels of migration. Persons with a migration background, especially those from non-western countries, may experience significant challenges when they seek medical care. Some of the main issues arise in the context of medical decision-making (MDM), where cultural preferences for close family involvement may be difficult to reconcile with the western model of medicine, as en…
Country-Specific Roadmaps for Scaling Up Integrated Care in Belgium, Slovenia, and Cambodia – Lessons Learned from the SCUBY Project
Introduction: The SCUBY project aimed to provide knowledge on the scaling-up of an Integrated Care Package (ICP) for type 2 diabetes and hypertension across three distinct health systems (Cambodia, Slovenia, and Belgium). Here, we analyse the different elements of the country-specific scale-up roadmaps to identify similarities and differences, and share lessons learned. Methods: Thematic analysis was used to derive crucial roadmap elements from k…
Scale-Up of Integrated Care Interventions for Chronic Diseases in Diverse Settings
The global burden of chronic conditions such as Type 2 Diabetes (T2DM) and hypertension (HTN) is increasing exponentially, not only in high-income countries (HIC) but also, and more rapidly, in low- and middle-income countries (LMIC). Health systems worldwide struggle to manage this growing burden. Integrated interventions for prevention, detection, treatment, and control of T2DM and HTN have been previously demonstrated to be effective in contro…
Unravelling the Belgian cascade of hypertension care and its determinants
Our results show that undiagnosed hypertension is the most significant barrier to BP control in Belgium. Health interventions are thus needed to improve the accurate and timely diagnosis of hypertension. Once diagnosed, the Belgian health system retains patients fairly well along the continuum of hypertension care, yet targeted health interventions to improve hypertension management for high-risk groups remain necessary, especially with regard to…
Including the Household
Antiretroviral therapy (ART) adherence is crucial for health outcomes of people living with HIV (PLHIV), influenced by a complex interplay of individual, community, and household factors. This article focuses on the influence of household factors, as well as individual and community factors, on ART adherence among PLHIV in Cape Town who have recently initiated ART. Baseline data for a cluster-randomized controlled trial were collected from 316 PL…
Strengthening policy engagement when scaling up interventions targeting non-communicable diseases
Policy engagement is an essential component of implementation research for scaling up interventions targeting non-communicable diseases (NCDs). It refers to the many ways that research team members, implementers and policymakers, who represent government decision-making, connect and interact to explore common interests. Well-conducted engagement activities foster co-production, local contextualization and assist in the successful translation of r…
An in-depth Analysis of the Degree of Implementation of Integrated Care for Diabetes in Primary Health Care in Cambodia
The evidence suggests that while each care initiative has its potential contributions towards integrated care for T2D, the three care initiatives should be effectively implemented in an integrated manner in order to potentially produce the desired outcomes
Examining Macro-Level Barriers and Facilitators to Scaling Up Integrated Care from a Complexity Perspective
Examining differences and similarities between barriers in each health system stimulated reciprocal learning. Interactions between health system barriers in specific contexts require further attention to move complex health systems forward
Cost of “Ideal Minimum Integrated Care” for Type 2 Diabetes and Hypertension Patients in Cambodia Context
The projected costs of IMIC for T2D and HTN in Cambodia provides evidence to informed decision-making of relevant actors in implementing scale-up of IMIC for T2D and HTN. The model can be used in countries with similar context to calculate costs of integrated care
Evaluation of the Implementation of Integrated Primary Care for Patients with Type 2 Diabetes and Hypertension in Belgium, Cambodia, and Slovenia
Countries can enhance integrated care for chronic diseases by implementing central policies, standardized protocols, and local adaptation, addressing resource constraints, promoting systematic screening and health education, and providing training for healthcare workers, tailored to community needs, to improve patient outcomes and healthcare delivery
Journey Through Healthcare of People With Complications of Type 2 Diabetes
Non-medical costs are not reimbursed, presenting a high burden to people. Self-management is tedious and hampered by other worries that people may have, such as financial constraints and coping with important life events. To conclude this study highlighted the need to improve diabetes screening. We suggest to enhance the role of paramedical professionals, integrate a social care worker, reduce financial constraints, and increase health literacy t…
Scaling-up integrated type-2 diabetes and hypertension care in Cambodia
Background: Non-communicable diseases (NCDs) such as type-2 diabetes (T2D) and hypertension (HTN) pose a massive burden on health systems, especially in low- and middle-income countries. In Cambodia, to tackle this issue, the government and partners have introduced several limited interventions to ensure service availability. However, scaling-up these health system interventions is needed to ensure universal supply and access to NCDs care for Cam…
Family Financial Stress, Parenting and Problem Behavior in Adolescents
In this study, we examine how financial stress is associated with problem behavior in adolescents through the lives of their parents. Using an actor-partner interdependence model, we explore pathways within (actor) and between (partner) parents. Our data included 340 families, with both parents rating their financial stress, depressive symptoms, and interparental conflict, and with parents and adolescents rating parenting and problem behavior in …
Family Functioning and Socioeconomic Status in South African Families
Public-sector ART in the Free State Province, South Africa
Women's experience of HIV as a chronic illness in South Africa
This article presents findings from a longitudinal qualitative study (48 in-depth interviews with 12 women on antiretroviral treatment (ART)) exploring the experience of living with HIV as a chronic illness in South Africa by applying the structural and interactionist perspectives on chronic illness. The structural perspective indicates that the illness experience needs to be contextualised within the wider framework of the women's hard-earned li…
A Family System Approach to Investigate Family‐Based Pathways Between Financial Stress and Adolescent Problem Behavior
This article proposes a family system approach to improve our understanding on family stress processes. Examining effects within (actor) and between (partner) parents, we explored family‐based pathways through which financial stress is associated with adolescent externalizing problem behavior. Data from 340 families were analyzed, with both parents rating their financial stress and parenting stress, and parents as well as adolescents rating the p…
A peer adherence support intervention to improve the antiretroviral treatment outcomes of HIV patients in South Africa
What Makes Integration of Chronic Care so Difficult? A Macro-Level Analysis of Barriers and Facilitators in Belgium
This paper highlights the importance of homogenization of responsibilities of governments regarding integrated care and the interdependency of policy and health care system factors. A whole system change is needed instead of the current Belgian model of prolonged search for common ground between conflicting opinions. Political commitment and citizen participation will be crucial
Life with HIV as a chronic illness
The National Strategic Plan of South Africa
Hitherto, the story of HIV/AIDS in South Africa is, to a large extent, one of lost opportunities. Whereas the country has one of the worst epidemics in the world, consecutive national AIDS strategies have been repeatedly marked by failure over almost three decades. Understandably, South Africa's most recent HIV/AIDS policy, the HIV & AIDS and STI Strategic Plan for South Africa, 2007-2011 (NSP), has been greeted with general acclaim. However, wha…
Examining mediating pathways between financial stress of mothers and fathers and problem behaviour in adolescents
In this study, we examined the association between income, financial stress, parenting stress, positive parenting, negative control and problem behaviour in adolescents to improve our understanding of how income and financial stress are associated with adolescents’ behaviour. Using the actor–partner interdependence approach, we explored the pathways within (actor) and between (partner) parents and examined whether the strength of these pathways d…
Evaluation of the Implementation of Integrated Primary Care for Patients with Type 2 Diabetes and Hypertension in Belgium, Cambodia, and Slovenia
Countries can enhance integrated care for chronic diseases by implementing central policies, standardized protocols, and local adaptation, addressing resource constraints, promoting systematic screening and health education, and providing training for healthcare workers, tailored to community needs, to improve patient outcomes and healthcare delivery
Journey Through Healthcare of People With Complications of Type 2 Diabetes
Non-medical costs are not reimbursed, presenting a high burden to people. Self-management is tedious and hampered by other worries that people may have, such as financial constraints and coping with important life events. To conclude this study highlighted the need to improve diabetes screening. We suggest to enhance the role of paramedical professionals, integrate a social care worker, reduce financial constraints, and increase health literacy t…
Understanding Mental Wellbeing amongst Potentially Vulnerable Higher Education Students during the Covid-19 Pandemic
During the COVID-19 pandemic, higher education students were reported as one of the most affected in terms of wellbeing. In the current study, we explored higher education students’ self-perceptions on why and how their mental wellbeing was affected by the COVID-19 pandemic and its related measures. Focus group discussions with potentially vulnerable university student groups, as well as university staff, revealed that the students described the …
Collaborative mental health care in the bureaucratic field of post-apartheid South Africa
South Africa's long and arduous journey from colonial and apartheid-era care for people with mental illness to more comprehensive, equitable mental health care is well-described. Deeper engagement with the structural power dynamics involved in providing collaborative mental health services are less-well described, especially in its post-apartheid era. This conceptual article positions state and non-state mental health service providers – along wi…
Short-term physical and emotional health outcomes of public sector ART in the Free State province of South Africa
State of the ART
The South African public-sector antiretroviral treatment (ART) program has yielded promising early results. To extend and reinforce these preliminary findings, we undertook a detailed assessment of the clinical efficacy and outcomes over two years of ART. The primary objective was to assess the clinical outcomes and adverse effects of two years of ART, while identifying the possible effects of baseline health and patient characteristics. A second…
Slow to share
HIV serostatus disclosure to community members has been shown to have potential public and personal health benefits. This study examined the impact of bonding and bridging social capital (i.e. close and distant ties) on public disclosure and described the complex relationship between bonding and bridging social capital in the context of serostatus disclosure among AIDS patients enrolled in South Africa's public sector antiretroviral treatment (AR…
Physical and emotional health outcomes after 12 months of public-sector antiretroviral treatment in the Free State Province of South Africa
This study provides evidence that the South African public-sector ART programme is effective in delivering sustained improvement in patient well-being. However, the results should encourage clinicians and lay health workers to be vigilant regarding the adverse effects of treatment, because they can seriously affect physical and emotional QoL
Public-sector ART in the Free State Province, South Africa
Who is accessing public-sector anti-retroviral treatment in the Free State, South Africa? An exploratory study of the first three years of programme implementation
Our analysis showed significant changes in the demographic, socio-economic, geographic, and medical characteristics of the patients during the first three years of the programme. Knowledge of the characteristics of these patients can assist policy makers in developing measures to retain them in care. The information reported here can also be usefully applied to target patient groups that are currently not reached in the implementation of the ART …
The National Strategic Plan of South Africa
Hitherto, the story of HIV/AIDS in South Africa is, to a large extent, one of lost opportunities. Whereas the country has one of the worst epidemics in the world, consecutive national AIDS strategies have been repeatedly marked by failure over almost three decades. Understandably, South Africa's most recent HIV/AIDS policy, the HIV & AIDS and STI Strategic Plan for South Africa, 2007-2011 (NSP), has been greeted with general acclaim. However, wha…
The evolving socio-political context of community health worker programmes in South Africa
Anxiety and depression amongst patients enrolled in a public sector antiretroviral treatment programme in South Africa
The findings from the study provide valuable insights into the psychosocial aspects of the Free State public-sector ART programme. Combined with the literature on the intricate link between mental health problems and treatment outcomes our results emphasise firstly, the necessity that resources be allocated for both screening and treating mental health problems and, secondly, the need for interventions that will encourage support-group participat…
Life with HIV as a chronic illness
“If I have nothing to eat, I get angry and push the pills bottle away from me”
The global response to the HIV/AIDS epidemic has improved access to antiretroviral therapy (ART) and has contributed to decreased HIV/AIDS morbidity and mortality in sub-Saharan Africa. Patient adherence to ART is crucial to the success of HIV/AIDS treatment. However, little is known about the determinants of adherence to ART among people living with HIV/AIDS (PLWHA) in the Democratic Republic of Congo (DRC). This qualitative study used in-depth …
Parenting stress and marital relationship as determinants of mothers' and fathers' parenting
Using the actor–partner interdependence model, we explore how various sources of stress and support experienced by fathers and mothers influence their own parenting styles and the parenting styles of the partner. Data from 227 couples were analyzed, with mothers and fathers rating their parenting stress and marital relationship and children rating the parenting styles of both mothers and fathers. Structural equation models revealed actor effects …
TB/HIV-related training, knowledge and attitudes of community health workers in the Free State province, South Africa
With its emphasis on task shifting and multi-trained and skilled outreach teams the primary healthcare (PHC) re-engineering strategy in South Africa depends on the training, knowledge and attitudes of community health workers (CHWs) to provide a variety of TB/HIV services. The aim of this exploratory research was to assess TB/ HIV-related training, knowledge and attitudes of CHWs. Interviews were conducted with 206 CHWs at 28 clinics in 1 urban a…
Financiële stress van ouders en het probleemgedrag van adolescenten - De mediërende bijdrage van depressieve symptomen, relatieconflicten en opvoedingsgedragingen
The association between financial stress experienced by mothers and fathers and problem behavior in adolescents: the mediating role of depressive symptoms, interparental conflicts and parenting In this study, we examine how financial stress is associated with problem behaviour in adolescents through the lives of their parents. Using an actor-partner interdependence model, we explore pathways within (actor) and between (partner) parents. Our data …
Scaling up antiretroviral treatment and improving patient retention in care
BACKGROUND: Antiretroviral treatment (ART) was provided to more than nine million people by the end of 2012. Although ART programs in resource-limited settings have expanded treatment, inadequate retention in care has been a challenge. Ethiopia has been scaling up ART and improving retention (defined as continuous engagement of patients in care) in care. We aimed to analyze the ART program in Ethiopia. METHODS: A mix of quantitative and qualitati…
The Impact of Community Support Initiatives on the Stigma Experienced by People Living with HIV/Aids in South Africa
Poverty and Substance Use in South African Tuberculosis Patients
Poverty alleviation and social support-based interventions may benefit male TB patients with substance use
Examining mediating pathways between financial stress of mothers and fathers and problem behaviour in adolescents
In this study, we examined the association between income, financial stress, parenting stress, positive parenting, negative control and problem behaviour in adolescents to improve our understanding of how income and financial stress are associated with adolescents’ behaviour. Using the actor–partner interdependence approach, we explored the pathways within (actor) and between (partner) parents and examined whether the strength of these pathways d…
Examining mediating pathways between financial stress of mothers and fathers and problem behaviour in adolescents
A Family System Approach to Investigate Family‐Based Pathways Between Financial Stress and Adolescent Problem Behavior
This article proposes a family system approach to improve our understanding on family stress processes. Examining effects within (actor) and between (partner) parents, we explored family‐based pathways through which financial stress is associated with adolescent externalizing problem behavior. Data from 340 families were analyzed, with both parents rating their financial stress and parenting stress, and parents as well as adolescents rating the p…
A peer adherence support intervention to improve the antiretroviral treatment outcomes of HIV patients in South Africa
Public sector antiretroviral treatment programme in South Africa
Although there is a high prevalence of anxiety and depression amongst people receiving antiretroviral treatment (ART), many patients are not screened, diagnosed or referred for mental health problems. This study aims to determine whether public sector health care workers in South Africa observe, screen, diagnose and refer ART patients that show symptoms of common mental disorders. It also aims to ascertain the extent of mental health training rec…
Workplace interventions to reduce HIV and TB stigma among health care workers – Where do we go from here
Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the …
On the Road to HIV/Aids Competence in the Household
When aiming to provide chronic disease care within the context of human resource shortages, we should not only consider the responsibility of the individual person living with HIV/AIDS (PLWHA) but also the capacity of the social environment to actively encourage a lifestyle that fosters health. In this social environment, extensive efforts are thus required to increase HIV/AIDS knowledge, reduce stigma, stimulate HIV testing, improve health care-…
The Importance of the Family
Medicine (77 works) · Political science (42 works) · Nursing (41 works) · Psychology (40 works) · Sociology (38 works) · Health care (36 works) · HIV/AIDS Research and Interventions (34 works) · Public health (33 works) · Family medicine (30 works) · Environmental health (29 works)