Viola Voncken on doing a PhD partially abroad

My PhD journey

I started my PhD journey in the Netherlands at Maastricht University. A few years into the project I decided to follow my heart and married an American who had to move back to the US. We ended up in Oklahoma City. Fortunately, I did not have to give up on a PhD degree, as I was given the opportunity to collaborate with researchers at the University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine. Completing the project overseas was not always easy, but looking back it was well worth it.

The project

My project focused on self-management of people with or at risk for chronic obstructive pulmonary disease (COPD). Self-management is important for people with COPD. However, many patients experience difficulties carrying out self-management behaviors, such as smoking cessation and physical activity. My dissertation describes the development and evaluation of a computer-tailored self-management program for people with or at risk for COPD. The program was developed to help patients quit smoking and become more physically active. The usability of the program and the program’s usefulness in primary care were evaluated positively. However, the results of a randomized controlled trial suggested that the intervention was not effective in it’s current form. Application use was insufficient, and although some trends suggesting potential effectiveness were found when only analyzing data of participants who used the application, we suspect that the effects were not significant due to power problems. The findings can, nonetheless, aid the search for effective self-management interventions for COPD patients or people at risk for COPD.

New department, new ideas

While I was working in Oklahoma I learned a few things about their approach in primary care research projects. One of the things that stood out was their use of practice facilitators. Practice facilitators are trained health care professionals working with academic researchers and community clinicians. They aim to close the gap between researchers and clinicians. It was interesting to see how valuable practice facilitators were to the research projects in Oklahoma. Since I think that using practice facilitators could be of value for other projects as well, I included the following proposition in my dissertation: Hiring practice facilitators, after the example of the Oklahoma Physicians Resource Network (OKPRN), is recommended in order to improve implementation of eHealth interventions in primary care.


Looking back at my time as a PhD candidate I have had many good experiences. The most fun times were with co-workers. Talking and laughing about what happened in our projects or life was always a great stress reliever. There were also bigger events, such as moving to another country and becoming part of a new department. Also, of course, the defense of my dissertation. I didn’t consider these experiences fun at the time, but very exciting and memorable nevertheless.

Viola Voncken