title: Insights into the concept of vitality: associations with participation and societal costs.
abstract: BACKGROUND
  In healthcare, the focus is currently shifting from someone's disabilities to someone's abilities, which is also evident from the increasing focus on vitality. Vitality (here defined as energy, motivation and resilience) is an often used concept, which also aims at someone's capabilities. However, little is known about vitality yet; in particular about its association with participation and societal costs.
  
  
  METHODS
  Within a cross-sectional design, information regarding vitality, participation and societal costs was collected among 8015 Dutch adults aged 20 years and over. Vitality was measured using the validated Dutch Vitality Questionnaire (Vita-16). Information on economic (i.e. want/able to work, work absenteeism, work performance), societal (i.e. voluntary work, informal care giving) and social participation (i.e. quantity and quality of social contacts) and societal costs (i.e. healthcare and work-related costs) was collected using an internet survey.
  
  
  RESULTS
  Significant associations were found between vitality and various economic (i.e.sustainable employability:want to work: β = 1.21, 95% CI: 0.99-1.43,able to work:β = 2.09, 95% CI: 1.79-2.38;work absenteeism: OR = 0.75, 95% CI: 0.71-0.79;work performance:β = 0.49, 95% CI: 0.46-0.52), societal (i.e.voluntary work, informal care) and social (i.e.quantity and quality of social contacts) participation measures, as well as between vitality and societal costs (i.e.healthcare costs:β = -213.73, 95% CI: €-311.13 to €-107.08),absenteeism costs: β = -338.57, 95% CI: €-465.36 to €-214.14 and presenteeism costs:β = -1293.31, 95% CI: €-1492.69 to €-1088.95).
  
  
  CONCLUSIONS
  This study showed significant positive associations between vitality and economic, societal and social participation and negative associations between vitality and societal costs. This may stimulate research on interventions enhancing and maintaining vitality and thereby contributing to improved participation and reduced costs.
authors.affiliation: 1 Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: van Steenbergen
authors.affiliation: 2 Department of Health Sciences and EMGO + Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: van Dongen
authors.affiliation: 3 National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
authors.forename: G C W
authors.initials: GC
authors.lastname: Wendel-Vos
authors.affiliation: 1 Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, The Netherlands.
authors.forename: V H
authors.initials: VH
authors.lastname: Hildebrandt
authors.affiliation: 1 Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, The Netherlands jorien.strijk@tno.nl.
authors.forename: J E
authors.initials: JE
authors.lastname: Strijk
mesh_terms: D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009042:Motivation; D011788:Quality of Life; D055500:Resilience, Psychological; D012959:Socioeconomic Factors