Long before the COVID-19 pandemic swept the globe, Nienke Beerlage-De Jong was conducting research into infectious diseases and zoonoses (infections and diseases that can be transmitted between humans and animals). She is fascinated by human behaviour and decision-making processes in this area, and by how technology can be used to promote certain types of behaviour. The UT researcher affiliated with the TechMed Centre takes us into the world of infectious diseases, behaviour, decision-making and technology.
What reasons do people have for not following hand hygiene guidelines? What makes a person decide to wear a face mask or not? These are questions that UT researcher Nienke Beerlage-De Jong is only too happy to tackle. The same goes for the question of when a General Practitioner (GP) should or should not prescribe antibiotics. ‘It’s all about behaviour and making a decision. I am curious to know what psychological, social and cultural factors play a role in these processes.’ To illustrate her point, she picks up on the example of the GP prescribing antibiotics. ‘Using interviews, our aim is to identify the tipping point. Does the GP feel pressured by the patient? Is the GP uncertain due to lack of experience? Being able to pinpoint underlying drivers can help us think about interventions, such as a technological tool to help someone make the best decision possible.’
Zoonosis map
Another area GPs tend not to think about when diagnosing patients is zoonoses. Beerlage-De Jong hopes to change this by developing an interactive map in collaboration with the Faculty of Geo-Information Science and Earth Observation (ITC) and Labmicta. ‘ITC is good at designing maps and visual representations, while Labmicta has a wealth of data on infectious diseases at its fingertips. Combining that knowledge and expertise can give us a far better visual understanding of what is going on regionally and of developments due to processes such as climate change. Then, there’s the matter of how to design and implement such a map so that it actually helps healthcare providers. Which brings us back to the technological challenge.’ This project is funded by the University of Twente’s Climate Centre’s seed fund.
Serious gaming
The interrelationships between human behaviour, decision-making and technical support form the common thread in Beerlage-De Jong’s research. A readiness to look beyond borders and combine disciplines is another hallmark of her approach. ‘As a way of working, it is so instructive. For example, we used serious gaming to simulate an outbreak of bird flu. Each stakeholder was presented with dilemmas. They were only permitted to give yes or no answers, but they were allowed to ask stakeholders for advice. The result? Many of these stakeholders stuck to the paths they were familiar with, yet far more knowledge is available if you look beyond the barriers between various disciplines. A game simulation can bring such behaviour into sharp focus and create an awareness of the differences in interests and perspectives, showing just how crucial cooperation can be.’
Germany
Beerlage-De Jong also looks beyond national borders, working extensively with fellow researchers from Germany, more specifically the Carl von Ossietzky Universität Oldenburg and the University of Münster. ‘We are examining the ways in which healthcare is organised in Germany and the Netherlands. Every aspect of our respective systems is set up differently. In Germany, for example, if an employee calls in sick, they are obliged to obtain a certificate from their GP; in the Netherlands, there is no such requirement. Comparable differences can be found across the board. Fascinating stuff, especially when you consider that we practically live next door to each other.’
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The future
Now that the shock of the COVID-19 outbreak is steadily ebbing away, Beerlage-De Jong is looking to issues that will affect our future. ‘Climate change in relation to infectious diseases and zoonoses is certainly one of them. But citizen science and social media are also themes that clearly lend themselves for future research. Involving ‘ordinary citizens’ in studies offers all kinds of opportunities as regards human behaviour and the chance to make a real societal impact through our research.’
