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Volker D, Zijlstra-Vlasveld MC, Brouwers EPM, van der Feltz-Cornelis CM. Process Evaluation of a Blended Web-Based Intervention on Return to Work for Sick-Listed Employees with Common Mental Health Problems in the Occupational Health Setting. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:186-194. [PMID: 27150734 PMCID: PMC5405094 DOI: 10.1007/s10926-016-9643-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose A blended web-based intervention, "eHealth module embedded in collaborative occupational health care" (ECO), aimed at return to work, was developed and found effective in sick-listed employees with common mental disorders. In order to establish the feasibility of ECO, a process evaluation was conducted. Methods Seven process components were investigated: recruitment, reach, dose delivered, dose received, fidelity, satisfaction and context. Quantitative and qualitative methods were used to collect data: an online questionnaire for the employees, website data, telephonic interviews with occupational physicians (OPs) and observations of the researchers. Results Recruitment was uncomplicated for the employees, but required several steps for the OPs. Reach was 100 % at the OP level and 76.3 % at the employee level. Dose delivered and received for OPs: 91.6 % received minimally one email message. Dose delivered and received for the employees: finishing of the different modules of ECO varied between 13 and 90 %. Fidelity: the support of the OP to the employee in ECO was lower than anticipated. Satisfaction: both employees and OPs were satisfied with the intervention. However, employees reported a need for more support in ECO. The context showed that OPs had limited time to support the employees and it was impossible for the employee to contact the OP outside their regular contacts. Conclusion Feasibility of ECO and satisfaction of employees and OPs with ECO were good. Fidelity of OPs was limited. For further implementation in the occupational health setting, especially contextual barriers regarding time limitation and accessibility of OPs for employees should be addressed.
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Affiliation(s)
- D Volker
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands.
- Tranzo Department, Tilburg University, Tilburg, The Netherlands.
| | - M C Zijlstra-Vlasveld
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands
| | - E P M Brouwers
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
| | - C M van der Feltz-Cornelis
- Tranzo Department, Tilburg University, Tilburg, The Netherlands
- TopClinical Centre for Body, Mind and Health, GGZ Breburg, Tilburg, The Netherlands
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Adams EJ, Chalkley AE, Esliger DW, Sherar LB. Evaluation of the implementation of a whole-workplace walking programme using the RE-AIM framework. BMC Public Health 2017; 17:466. [PMID: 28521754 PMCID: PMC5437663 DOI: 10.1186/s12889-017-4376-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 05/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Promoting walking for the journey to/from work and during the working day is one potential approach to increase physical activity in adults. Walking Works was a practice-led, whole-workplace walking programme delivered by employees (walking champions). This study aimed to evaluate the implementation of Walking Works using the RE-AIM framework and provide recommendations for future delivery of whole-workplace walking programmes. METHODS Two cross sectional surveys were conducted; 1544 (28%) employees completed the baseline survey and 918 employees (21%) completed the follow-up survey. Effectiveness was assessed using baseline and follow-up data; reach, implementation and maintenance were assessed using follow-up data only. For categorical data, Chi square tests were conducted to assess differences between surveys or groups. Continuous data were analysed to test for significant differences using a Mann-Whitney U test. Telephone interviews were conducted with the lead organisation co-ordinator, eight walking champions and three business representatives at follow-up. Interviews were transcribed verbatim and analysed to identify key themes related to adoption, implementation and maintenance. RESULTS Adoption: Five workplaces participated in Walking Works. Reach: 480 (52.3%) employees were aware of activities and 221 (24.1%) participated. IMPLEMENTATION A variety of walking activities were delivered. Some programme components were not delivered as planned which was partly due to barriers in using walking champions to deliver activities. These included the walking champions' capacity, skills, support needs, ability to engage senior management, and the number and type of activities they could deliver. Other barriers included lack of management support, difficulties communicating information about activities and challenges embedding the programme into normal business activities. Effectiveness: No significant changes in walking to/from work or walking during the working day were observed. Maintenance: Plans to continue activities were mainly dependent on identifying continued funding. CONCLUSIONS RE-AIM provided a useful framework for evaluating Walking Works. No changes in walking behaviour were observed. This may have been due to barriers in using walking champions to deliver activities, programme components not being delivered as intended, the types of activities delivered, or lack of awareness and participation by employees. Recommendations are provided for researchers and practitioners implementing future whole-workplace walking programmes.
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Affiliation(s)
- Emma J Adams
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Anna E Chalkley
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Dale W Esliger
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Lauren B Sherar
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Weatherson KA, Gainforth HL, Jung ME. A theoretical analysis of the barriers and facilitators to the implementation of school-based physical activity policies in Canada: a mixed methods scoping review. Implement Sci 2017; 12:41. [PMID: 28347322 PMCID: PMC5369225 DOI: 10.1186/s13012-017-0570-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 03/13/2017] [Indexed: 11/10/2022] Open
Abstract
Background Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation. Methods A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student’s physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains. Results The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers’ perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student’s PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains. Conclusions With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future. Registration A protocol for this review was not registered. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0570-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katie A Weatherson
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 360-1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Heather L Gainforth
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 129-1147 Research Road, Kelowna, BC, V1V 1V7, Canada
| | - Mary E Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, Okanagan, RHS 119-3333 University Way, Kelowna, BC, V1V 1V7, Canada.
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104
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Brakenridge CL, Fjeldsoe BS, Young DC, Winkler EAH, Dunstan DW, Straker LM, Healy GN. Evaluating the effectiveness of organisational-level strategies with or without an activity tracker to reduce office workers' sitting time: a cluster-randomised trial. Int J Behav Nutr Phys Act 2016; 13:115. [PMID: 27814738 PMCID: PMC5097432 DOI: 10.1186/s12966-016-0441-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 10/26/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Office workers engage in high levels of sitting time. Effective, context-specific, and scalable strategies are needed to support widespread sitting reduction. This study aimed to evaluate organisational-support strategies alone or in combination with an activity tracker to reduce sitting in office workers. METHODS From one organisation, 153 desk-based office workers were cluster-randomised (by team) to organisational support only (e.g., manager support, emails; 'Group ORG', 9 teams, 87 participants), or organisational support plus LUMOback activity tracker ('Group ORG + Tracker', 9 teams, 66 participants). The waist-worn tracker provided real-time feedback and prompts on sitting and posture. ActivPAL3 monitors were used to ascertain primary outcomes (sitting time during work- and overall hours) and other activity outcomes: prolonged sitting time (≥30 min bouts), time between sitting bouts, standing time, stepping time, and number of steps. Health and work outcomes were assessed by questionnaire. Changes within each group (three- and 12 months) and differences between groups were analysed by linear mixed models. Missing data were multiply imputed. RESULTS At baseline, participants (46 % women, 23-58 years) spent (mean ± SD) 74.3 ± 9.7 % of their workday sitting, 17.5 ± 8.3 % standing and 8.1 ± 2.7 % stepping. Significant (p < 0.05) reductions in sitting time (both work and overall) were observed within both groups, but only at 12 months. For secondary activity outcomes, Group ORG significantly improved in work prolonged sitting, time between sitting bouts and standing time, and overall prolonged sitting time (12 months), and in overall standing time (three- and 12 months); while Group ORG + Tracker, significantly improved in work prolonged sitting, standing, stepping and overall standing time (12 months). Adjusted for confounders, the only significant between-group differences were a greater stepping time and step count for Group ORG + Tracker relative to Group ORG (+20.6 min/16 h day, 95 % CI: 3.1, 38.1, p = 0.021; +846.5steps/16 h day, 95 % CI: 67.8, 1625.2, p = 0.033) at 12 months. Observed changes in health and work outcomes were small and not statistically significant. CONCLUSIONS Organisational-support strategies with or without an activity tracker resulted in improvements in sitting, prolonged sitting and standing; adding a tracker enhanced stepping changes. Improvements were most evident at 12 months, suggesting the organisational-support strategies may have taken time to embed within the organisation. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry: ACTRN12614000252617 . Registered 10 March 2014.
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Affiliation(s)
- C. L. Brakenridge
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - B. S. Fjeldsoe
- School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - E. A. H. Winkler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - D. W. Dunstan
- School of Public Health, The University of Queensland, Brisbane, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
- Department of Medicine, Monash University, Melbourne, Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - L. M. Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - G. N. Healy
- School of Public Health, The University of Queensland, Brisbane, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
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105
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Hutcheson AK, Piazza AJ, Knowlden AP. Work Site-Based Environmental Interventions to Reduce Sedentary Behavior: A Systematic Review. Am J Health Promot 2016; 32:32-47. [PMID: 27780893 DOI: 10.1177/0890117116674681] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The purpose of this investigation was to systematically review work site-based, environmental interventions to reduce sedentary behavior following preferred reporting items for systematic reviews and meta-analyses guidelines. DATA SOURCE Data were extracted from Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, and Web of Science between January 2005 and December 2015. STUDY INCLUSION AND EXCLUSION CRITERIA Inclusion criteria were work site interventions, published in peer-reviewed journals, employing environmental modalities, targeting sedentary behavior, and using any quantitative design. Exclusion criteria were noninterventions and non-English publications. DATA EXTRACTION Data extracted included study design, population, intervention dosage, intervention activities, evaluation measures, and intervention effects. DATA SYNTHESIS Data were tabulated quantitatively and synthesized qualitatively. RESULTS A total of 15 articles were identified for review and 14 reported statistically significant decreases in sedentary behavior. The majority of studies employed a randomized controlled trial design (n = 7), used inclinometers to measure sedentary behavior (n = 9), recruited predominantly female samples (n = 15), and utilized sit-to-stand desks as the primary intervention modality (n = 10). The mean methodological quality score was 6.2 out of 10. CONCLUSION Environmental work site interventions to reduce sedentary behavior show promise because work sites often have more control over environmental factors. Limitations of this intervention stream include inconsistent measurement of sedentary behavior, absence of theoretical frameworks to guide program development, and absence of long-term evaluation. Future studies should include clear reporting of intervention strategies and explicit operationalization of theoretical constructs.
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Affiliation(s)
- Amanda K Hutcheson
- 1 Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Andrew J Piazza
- 1 Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Adam P Knowlden
- 1 Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
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106
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Abell CH, Main ME. Participants’ Perceptions of Worksite Health-Promotion Educational Activities. J Community Health Nurs 2016; 33:190-195. [DOI: 10.1080/07370016.2016.1227212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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107
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Chappell S, Pescud M, Waterworth P, Shilton T, Roche D, Ledger M, Slevin T, Rosenberg M. Exploring the Process of Implementing Healthy Workplace Initiatives. J Occup Environ Med 2016; 58:e341-e348. [DOI: 10.1097/jom.0000000000000854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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108
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van Egmond MP, Duijts SFA, Scholten APJ, van der Beek AJ, Anema JR. Offering a tailored return to work program to cancer survivors with job loss: a process evaluation. BMC Public Health 2016; 15:940. [PMID: 27600542 PMCID: PMC5013616 DOI: 10.1186/s12889-016-3592-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/25/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Europe, 1.7 million persons of working age are diagnosed with cancer each year. During or after treatment, cancer survivors (CSs) are vulnerable for job loss, and many CSs struggle with return to work (RTW). When offering RTW interventions to CSs, it is important to conduct a process evaluation to assess such factors as the population reached and implementation problems. Recently, we developed an innovative RTW program, tailored specifically to the needs of CSs with job loss in the Netherlands. The aim of this study was to evaluate the likelihood of theory and implementation failure, as well as to evaluate procedures for recruitment, execution and implementation of the tailored RTW program for CSs with job loss. METHODS Six components were evaluated in the RTW program: Recruitment, Reach, Dosage, Implementation, Satisfaction, and Experienced Barriers. Data were provided by logbooks and questionnaires from participating CSs, occupational health care (OHC) professionals, and re-integration coaches and job hunting officers who delivered the RTW program. SPSS and Excel were used to conduct the analyses. RESULTS 85 CSs received the tailored RTW program. Their mean age was 47.9 years (SD 8.5). The majority were female (72 %), married (52 %), and of Dutch nationality (91 %). The program reached 88.2 % of the target population and 52 % of participants who started the program received the adequate dosage. The program implementation score was 45.9 %. Participants' mean overall program duration remained within the protocol boundaries. Re-integration coaches were more satisfied with the program than job hunting officers or OHC professionals. Likewise, participants were more satisfied with the program delivery by the re-integration coaches than with the delivery by the job hunting officers. Reported barriers within the RTW program were a lack of communication, high program intensity and short program duration, and, with regard to the job hunting officers, a lack of experience with cancer-related RTW problems. CONCLUSIONS Participants, OHC professionals, re-integration coaches and job hunting officers generally had positive experiences with the innovative tailored RTW program. Facilitating communication between the delivering parties, and engaging usual care during program delivery, could be key elements to improved program implementation. TRIAL REGISTRATION Dutch Trial Register, registration number NTR3562 , registered 07-08-2012.
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Affiliation(s)
- M. P. van Egmond
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 – C581, 1081 BT Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - S. F. A. Duijts
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 – C581, 1081 BT Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A. P. J. Scholten
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 – C581, 1081 BT Amsterdam, The Netherlands
| | - A. J. van der Beek
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 – C581, 1081 BT Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - J. R. Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7 – C581, 1081 BT Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
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Barbosa A, Nolan M, Sousa L, Figueiredo D. Implementing a psycho-educational intervention for care assistants working with people with dementia in aged-care facilities: facilitators and barriers. Scand J Caring Sci 2016; 31:222-231. [PMID: 27440432 DOI: 10.1111/scs.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 12/29/2015] [Indexed: 11/26/2022]
Abstract
Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho-educational intervention for care assistants caring for people with dementia in aged-care facilities. A process evaluation was carried out alongside a pretest/post-test controlled study conducted in aged-care facilities. Seven focus-group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi-structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged-care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions.
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Affiliation(s)
- Ana Barbosa
- Department of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Mike Nolan
- School of Nursing and Midwifery, University of Sheffield, Northern General Hospital, Sheffield, UK
| | - Liliana Sousa
- Department of Health Sciences, University of Aveiro, Aveiro, Portugal.,Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal.,School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial. Scand J Public Health 2016; 44:560-70. [DOI: 10.1177/1403494816653668] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/15/2022]
Abstract
Aims: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. Methods: A stepped wedge cluster randomised, controlled trial with 594 nurses’ aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect. Results: Significant reduction in occupational lifting (–0.35 (95% confidence interval −0.61 to −0.08)), and improvement in two measures of fear avoidance ((–0.75 (95% confidence interval −1.05 to −0.45) and −0.45 (95% confidence interval −0.80 to −0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. Conclusions: The intervention was significantly effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence due to low back pain. To improve work ability or reduce sickness absence due to low back pain more specific interventions should probably be developed.
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Affiliation(s)
- Charlotte Diana Nørregaard Rasmussen
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | | | - Anders Ørberg
- National Research Centre for the Working Environment, Denmark
| | - Ole Steen Mortensen
- National Research Centre for the Working Environment, Denmark
- Department of Occupational Medicine, Holbæk Hospital, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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111
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Brakenridge CL, Fjeldsoe BS, Young DC, Winkler EAH, Dunstan DW, Straker LM, Brakenridge CJ, Healy GN. Organizational-Level Strategies With or Without an Activity Tracker to Reduce Office Workers' Sitting Time: Rationale and Study Design of a Pilot Cluster-Randomized Trial. JMIR Res Protoc 2016; 5:e73. [PMID: 27226457 PMCID: PMC4909392 DOI: 10.2196/resprot.5438] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background The office workplace is a key setting in which to address excessive sitting time and inadequate physical activity. One major influence on workplace sitting is the organizational environment. However, the impact of organizational-level strategies on individual level activity change is unknown. Further, the emergence of sophisticated, consumer-targeted wearable activity trackers that facilitate real-time self-monitoring of activity, may be a useful adjunct to support organizational-level strategies, but to date have received little evaluation in this workplace setting. Objective The aim of this study is to evaluate the feasibility, acceptability, and effectiveness of organizational-level strategies with or without an activity tracker on sitting, standing, and stepping in office workers in the short (3 months, primary aim) and long-term (12 months, secondary aim). Methods This study is a pilot, cluster-randomized trial (with work teams as the unit of clustering) of two interventions in office workers: organizational-level support strategies (eg, visible management support, emails) or organizational-level strategies plus the use of a waist-worn activity tracker (the LUMOback) that enables self-monitoring of sitting, standing, and stepping time and enables users to set sitting and posture alerts. The key intervention message is to ‘Stand Up, Sit Less, and Move More.’ Intervention elements will be implemented from within the organization by the Head of Workplace Wellbeing. Participants will be recruited via email and enrolled face-to-face. Assessments will occur at baseline, 3, and 12 months. Time spent sitting, sitting in prolonged (≥30 minute) bouts, standing, and stepping during work hours and across the day will be measured with activPAL3 activity monitors (7 days, 24 hours/day protocol), with total sitting time and sitting time during work hours the primary outcomes. Web-based questionnaires, LUMOback recorded data, telephone interviews, and focus groups will measure the feasibility and acceptability of both interventions and potential predictors of behavior change. Results Baseline and follow-up data collection has finished. Results are expected in 2016. Conclusions This pilot, cluster-randomized trial will evaluate the feasibility, acceptability, and effectiveness of two interventions targeting reductions in sitting and increases in standing and stepping in office workers. Few studies have evaluated these intervention strategies and this study has the potential to contribute both short and long-term findings.
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Fitzgerald S, Geaney F, Kelly C, McHugh S, Perry IJ. Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial. BMC Health Serv Res 2016; 16:139. [PMID: 27102407 PMCID: PMC4840486 DOI: 10.1186/s12913-016-1413-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 04/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees’ dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. Methods A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7–9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7–9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Results Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders’ perceptions of the benefits of participating, which facilitated implementation, included managers’ desire to improve company image and employees seeking health improvements. Other facilitators included stakeholder buy-in, organisational support and stakeholder cohesiveness with regards to the level of support provided to the intervention. Anticipation of employee resistance towards menu changes, workplace restructuring and target-driven workplace cultures impeded intervention implementation. Conclusions Contextual factors such as workplace structures and cultures need to be considered in the implementation of future workplace dietary interventions. Negotiation and flexibility of key workplace stakeholders plays an integral role in overcoming the barriers of workplace cultures, structures and resistance to change. Trial registration Current Controlled Trials: ISRCTN35108237. Date of registration: 02/07/2013 Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1413-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah Fitzgerald
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
| | - Fiona Geaney
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Clare Kelly
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Sheena McHugh
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
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113
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A 7-Step Strategy for the Implementation of Worksite Lifestyle Interventions: Helpful or Not? J Occup Environ Med 2016; 58:e159-65. [PMID: 27035104 DOI: 10.1097/jom.0000000000000690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the use of and adherence to a 7-step strategy for the development, implementation, and continuation of a comprehensive, multicomponent lifestyle program. METHODS Strategy use and adherence was assessed with 12 performance indicators. Data were collected by combining onsite monitoring with semi-structured interviews at baseline and follow-up (6, 12, and 18 months). RESULTS Not all performance indicators were met so partial strategy adherence was obtained. The strategy could be improved on the following aspects: support among management, project structure, adaptation to needs of employees, planning, and maintenance. CONCLUSION The results of this evaluation indicate that strategy adherence facilitated structured development and implementation. On the basis of the qualitative data, this study suggests that when improvements will be made on both the content and performance, the 7-step strategy could be an effective tool to successfully implement a multicomponent WHPP.
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114
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Lucini D, Zanuso S, Solaro N, Vigo C, Malacarne M, Pagani M. Reducing the risk of metabolic syndrome at the worksite: preliminary experience with an ecological approach. Acta Diabetol 2016; 53:63-71. [PMID: 25863782 DOI: 10.1007/s00592-015-0744-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/14/2015] [Indexed: 12/11/2022]
Abstract
AIM Given the time spent at work, the workplace represents an ideal setting to implement preventive programs for non-communicable diseases, the major cause of mortality and morbidity in Western and developing countries. We sought to verify if an ecological approach based on corporate culture, employees' education and concrete modifications of workplace environment, offering easy opportunity to assume healthy lifestyle, could be associated with reduced cardiometabolic risk. METHODS The study involved 1089 workers in two multinational companies following different workplace health promotion policies. Company A offered to all employees the opportunity to access a web platform dedicated to general information on health and diseases. Company B implemented an ecological model encompassing company culture, employees' education and concrete modifications of workplace environment, giving to all employees the opportunity to adopt healthy solutions throughout daily living at workplace. Participants volunteered self-reported clinical information using an IT tool. Numbers of Metabolic Syndrome components (MetS) were taken as proxy of cardiometabolic risk. RESULTS MetS probability obtained via statistical modeling was lower in company B as compared to company A, and absenteeism was also lower in company B. Our study shows that a work environment favoring assumption of healthy lifestyle, as in company B, is associated with a lower percentage of employees with MetS components and lower absenteeism. Moreover, statistical modeling shows that individual probabilities of being without MetS elements, controlling for age and gender, is remarkably higher in company B. CONCLUSIONS Our data suggest that ecological approaches might be useful in worksite prevention policies.
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Affiliation(s)
- Daniela Lucini
- BIOMETRA, University of Milano, Milan, Italy.
- Sezione Medicina dell'Esercizio e Patologie Funzionali, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, Rozzano, 20089, Milan, Italy.
| | - Silvano Zanuso
- University of Greenwich, Chatham Maritime, London, UK
- Technogym Scientific Department, Cesena, Italy
| | - Nadia Solaro
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Chiara Vigo
- BIOMETRA, University of Milano, Milan, Italy
- Sezione Medicina dell'Esercizio e Patologie Funzionali, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, Rozzano, 20089, Milan, Italy
| | - Mara Malacarne
- BIOMETRA, University of Milano, Milan, Italy
- Sezione Medicina dell'Esercizio e Patologie Funzionali, Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, Rozzano, 20089, Milan, Italy
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115
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Process evaluation of an intervention program to reduce occupational quartz exposure among Dutch construction workers. J Occup Environ Med 2015; 57:428-35. [PMID: 25695930 DOI: 10.1097/jom.0000000000000382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Evaluate the process of an intervention in the construction industry to reduce quartz exposure. METHODS In a cluster randomized controlled trial, data on seven process aspects (ie, recruitment, reach, dose delivered, dose received, fidelity, satisfaction, and context) were quantitatively collected on manager and worker levels. RESULTS Dose delivered was 95% for the plenary sessions and 20% for the worksite visit. Although the protocol was mostly implemented as intended, dose received was lower than expected. Both managers and workers appreciated the intervention and recommended the intervention for future implementation. Workers attending all intervention sessions were most satisfied about the intervention. CONCLUSIONS High rates for dose delivered and fidelity for the plenary sessions and relatively high satisfaction rates were achieved. Furthermore, continuous monitoring of contextual factors beforehand and alongside the implementation of interventions is recommended.
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Horodyska K, Luszczynska A, Hayes CB, O'Shea MP, Langøien LJ, Roos G, van den Berg M, Hendriksen M, De Bourdeaudhuij I, Brug J. Implementation conditions for diet and physical activity interventions and policies: an umbrella review. BMC Public Health 2015; 15:1250. [PMID: 26678996 PMCID: PMC4683715 DOI: 10.1186/s12889-015-2585-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This umbrella review aimed at identifying evidence-based conditions important for successful implementation of interventions and policies promoting a healthy diet, physical activity (PA), and a reduction in sedentary behaviors (SB). In particular, we examined if the implementation conditions identified were intervention-specific or policy-specific. This study was undertaken as part of the DEterminants of DIet and Physical Activity (DEDIPAC) Knowledge Hub, a joint action as part of the European Joint Programming Initiative a Healthy Diet for a Healthy Life. METHODS A systematic review of reviews and stakeholder documents was conducted. Data from nine scientific literature databases were analyzed (95 documents met the inclusion criteria). Additionally, published documentation of eight major stakeholders (e.g., World Health Organization) were systematically searched (17 documents met the inclusion criteria). The RE-AIM framework was used to categorize elicited conditions. Across the implementation conditions 25 % were identified in at least four documents and were subsequently classified as having obtained sufficient support. RESULTS We identified 312 potential conditions relevant for successful implementation; 83 of these received sufficient support. Using the RE-AIM framework eight implementation conditions that obtained support referred to the reach in the target population; five addressed efficacy of implementation processes; 24 concerned adoption by the target staff, setting, or institutions; 43 referred to consistency, costs, and adaptations made in the implementation process; three addressed maintenance of effects over time. The vast majority of implementation conditions (87.9 %; 73 of 83) were supported by documents referring to both interventions and policies. There were seven policy-specific implementation conditions, which focused on increasing complexities of coexisting policies/legal instruments and their consequences for implementation, as well as politicians' collaboration in implementation. CONCLUSIONS The use of the proposed list of 83 conditions for successful implementation may enhance the implementation of interventions and policies which pursue identification of the most successful actions aimed at improving diet, PA and reducing SB.
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Affiliation(s)
- Karolina Horodyska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, 30b Ostrowskiego St, 53238, Wroclaw, Poland.
- Trauma, Health, & Hazards Center, University of Colorado, 1861 Austin Bluffs Pkwy, Colorado Springs, CO, 80933-7150, USA.
| | - Catherine B Hayes
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Miriam P O'Shea
- Department of Public Health and Primary Care, Trinity College Dublin, Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland.
| | - Lars J Langøien
- Department for Physical Education, Norwegian School of Sport Sciences, P.O. BOX 4014, Ullevål Stadion, N-0806, Oslo, Norway.
| | - Gun Roos
- SIFO - National Institute for Consumer Research, P.O. BOX 4682, Nydalen, N-0405, Oslo, Norway.
| | - Matthijs van den Berg
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Marieke Hendriksen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721, Bilthoven, The Netherlands.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
| | - Johannes Brug
- VU University Medical Center, Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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117
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The implementation of multiple lifestyle interventions in two organizations: a process evaluation. J Occup Environ Med 2015; 56:1195-206. [PMID: 25376415 PMCID: PMC4219515 DOI: 10.1097/jom.0000000000000241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To evaluate the implementation of a multicomponent lifestyle intervention at two different worksites. Methods: Data on eight process components were collected by means of questionnaires and interviews. Data on the effectiveness were collected using questionnaires. Results: The program was implemented partly as planned, and 84.0% (max 25) and 85.7% (max 14) of all planned interventions were delivered at the university and hospital, respectively. Employees showed high reach (96.6%) and overall participation (75.1%) but moderate overall satisfaction rates (6.8 ± 1.1). Significant intervention effects were found for days of fruit consumption (β = 0.44 days/week, 95% CI: 0.02 to 0.85) in favor of the intervention group. Conclusions: The study showed successful reach, dose, and maintenance but moderate fidelity and satisfaction. Mainly relatively simple and easily implemented interventions were chosen, which were effective only in improving employees’ days of fruit consumption.
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118
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Verloigne M, Ahrens W, De Henauw S, Verbestel V, Mårild S, Pigeot I, De Bourdeaudhuij I. Process evaluation of the IDEFICS school intervention: putting the evaluation of the effect on children's objectively measured physical activity and sedentary time in context. Obes Rev 2015; 16 Suppl 2:89-102. [PMID: 26707019 DOI: 10.1111/obr.12353] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 10/09/2015] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The first aim was to describe the intervention implementation and reception with specific regard to physical activity (PA) within Belgian schools participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention. Second, we examined if a higher intervention process score in schools showed more favourable effects on children's objectively measured PA and sedentary time (ST). METHODS The IDEFICS intervention focused on improving children's health behaviour (including PA) at the community, school/kindergarten and family level. Five process evaluation questionnaires completed by school working groups, and (physical education) teachers were used for the process evaluation of four intervention modules (school working groups, healthy weeks, school environment, health-related physical education and PA). Items were summed to calculate a total intervention process score per school. Schools were subdivided into three groups (low, medium and high score). Multilevel models were used to examine if changes in PA or ST differed between schools with a low, medium or high score. In total, 333 children (54.1% girls, mean age 6.0 ± 1.5 years) from 34 intervention schools (18 pre-schools and 16 primary schools) in the town of Geraardsbergen, Belgium, provided valid accelerometer data for two weekdays and one weekend day. RESULTS Mean intervention process score (maximum value = 44) was 20.9 ± 5.8 for schools. The breakdown per module showed which components were implemented and received well and which components could have been improved. After the intervention, the decrease in light PA and increase in ST was much higher in children from primary schools with a low intervention process score, whereas the behaviours remained relatively stable in children from primary schools with a medium or high score. The change in moderate to vigorous PA did not differ significantly between schools with a low, medium or high score. CONCLUSION The IDEFICS intervention was relatively able to prevent unfavourable changes in ST and light PA in schools with a medium and high intervention process score. Further process evaluation research is needed to obtain a more profound picture of the IDEFICS intervention process.
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Affiliation(s)
- M Verloigne
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Research Foundation - Flanders (FWO), Brussel, Belgium
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - S De Henauw
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium
| | - V Verbestel
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - S Mårild
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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119
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Sutcliffe K, Thomas J, Stokes G, Hinds K, Bangpan M. Intervention Component Analysis (ICA): a pragmatic approach for identifying the critical features of complex interventions. Syst Rev 2015; 4:140. [PMID: 26514644 PMCID: PMC4627414 DOI: 10.1186/s13643-015-0126-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/30/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In order to enable replication of effective complex interventions, systematic reviews need to provide evidence about their critical features and clear procedural details for their implementation. Currently, few systematic reviews provide sufficient guidance of this sort. METHODS Through a worked example, this paper reports on a methodological approach, Intervention Component Analysis (ICA), specifically developed to bridge the gap between evidence of effectiveness and practical implementation of interventions. By (a) using an inductive approach to explore the nature of intervention features and (b) making use of trialists' informally reported experience-based evidence, the approach is designed to overcome the deficiencies of poor reporting which often hinders knowledge translation work whilst also avoiding the need to invest significant amounts of time and resources in following up details with authors. RESULTS A key strength of the approach is its ability to reveal hidden or overlooked intervention features and barriers and facilitators only identified in practical application of interventions. It is thus especially useful where hypothesised mechanisms in an existing programme theory have failed. A further benefit of the approach is its ability to identify potentially new configurations of components that have not yet been evaluated. CONCLUSIONS ICA is a formal and rigorous yet relatively streamlined approach to identify key intervention content and implementation processes. ICA addresses a critical need for knowledge translation around complex interventions to support policy decisions and evidence implementation.
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Affiliation(s)
- Katy Sutcliffe
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London (UCL), 18 Woburn Square, London, WC1H 0NS, UK.
| | - James Thomas
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London (UCL), 18 Woburn Square, London, WC1H 0NS, UK.
| | - Gillian Stokes
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London (UCL), 18 Woburn Square, London, WC1H 0NS, UK.
| | - Kate Hinds
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London (UCL), 18 Woburn Square, London, WC1H 0NS, UK.
| | - Mukdarut Bangpan
- EPPI-Centre, Social Science Research Unit, Institute of Education, University College London (UCL), 18 Woburn Square, London, WC1H 0NS, UK.
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120
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Organizing workplace health literacy to reduce musculoskeletal pain and consequences. BMC Nurs 2015; 14:46. [PMID: 26388697 PMCID: PMC4574516 DOI: 10.1186/s12912-015-0096-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/04/2015] [Indexed: 11/21/2022] Open
Abstract
Background Despite numerous initiatives to improve the working environment for nursing aides, musculoskeletal disorders (pain) is still a considerable problem because of the prevalence, and pervasive consequences on the individual, the workplace and the society. Discrepancies between effort and effect of workplace health initiatives might be due to the fact that pain and the consequences of pain are affected by various individual, interpersonal and organizational factors in a complex interaction. Recent health literacy models pursue an integrated approach to understanding health behavior and have been suggested as a suitable framework for addressing individual, organizational and interpersonal factors concomitantly. Therefore, the aim of the trial is to examine the effectiveness of an intervention to improve health literacy (building knowledge, competences and structures for communication and action) at both the organizational and individual level and reduce pain among nursing aides. Methods/design The intervention consists of 2 steps: 1) Courses at the workplace for employees and management in order to organize a joint fundament of knowledge and understanding, and a platform for communication and action about pain prevention in the organization. 2) Organizing a fixed 3-weekly structured dialogue between each employee and her/his supervisor, with particular focus on developing specific plans to prevent and reduce pain and its consequences. This enables the workplace to generate knowledge about employee resources and health challenges and to act and convey this knowledge into initiatives at the workplace. Discussion Previous studies to improve health literacy have primarily targeted patients or specific deprived groups in health care or community settings. Recently the idea of the workplace as an arena for improving health literacy has developed emphasizing the organizational responsibility in facilitating and supporting that employees obtain basic knowledge and information needed to understand and take action on individual and occupational health concerns. The literature about workplace health literacy is very limited but points at the importance of educating employees to be able to access, appraise and apply health information and of organizing the infrastructure and communication in the organization. This study suggests a concrete operationalization of health literacy in a workplace setting. Results are expected published in 2016.
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121
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Hoekstra F, Hettinga FJ, Alingh RA, Duijf M, Dekker R, van der Woude LHV, van der Schans CP. The current implementation status of the integration of sports and physical activity into Dutch rehabilitation care. Disabil Rehabil 2015; 39:181-186. [DOI: 10.3109/09638288.2015.1073371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Femke Hoekstra
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
- Centre for Rehabilitation, Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
| | - Florentina J. Hettinga
- Centre of Sport and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK,
| | - Rolinde A. Alingh
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
- Centre for Rehabilitation, Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
| | - Marjo Duijf
- Stichting Onbeperkt Sportief, Bunnik, The Netherlands,
| | - Rienk Dekker
- Centre for Rehabilitation, Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
- Centre for Sports Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands, and
| | - Lucas H. V. van der Woude
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
- Centre for Rehabilitation, Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
| | - Cees P. van der Schans
- Centre for Rehabilitation, Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands,
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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Pescud M, Teal R, Shilton T, Slevin T, Ledger M, Waterworth P, Rosenberg M. Employers' views on the promotion of workplace health and wellbeing: a qualitative study. BMC Public Health 2015; 15:642. [PMID: 26162910 PMCID: PMC4499225 DOI: 10.1186/s12889-015-2029-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/06/2015] [Indexed: 11/24/2022] Open
Abstract
Background The evidence surrounding the value of workplace health promotion in positively influencing employees’ health and wellbeing via changes to their health behaviours is growing. The aim of the study was to explore employers’ views on the promotion of workplace health and wellbeing and the factors affecting these views. Methods Using a qualitative phenomenological approach, 10 focus groups were conducted with employers selected from a range of industries and geographical locations within Western Australia. The total sample size was 79. Results Three factors were identified: employers’ conceptualization of workplace health and wellbeing; employers’ descriptions of (un)healthy workers and perceptions surrounding the importance of healthy workers; and employers’ beliefs around the role the workplace should play in influencing health. Conclusions Progress may be viable in promoting health and wellbeing if a multifaceted approach is employed taking into account the complex factors influencing employers’ views. This could include an education campaign providing information about what constitutes health and wellbeing beyond the scope of occupational health and safety paradigms along with information on the benefits of workplace health and wellbeing aligned with perceptions relating to healthy and unhealthy workers.
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Affiliation(s)
- Melanie Pescud
- Health Promotion Evaluation Unit, 35 Stirling Highway, Crawley, 6009, Australia. .,Regulatory Institutions Network (RegNet), The Australian National University, Acton, Australia.
| | - Renee Teal
- Health Promotion Evaluation Unit, 35 Stirling Highway, Crawley, 6009, Australia.
| | | | | | | | - Pippa Waterworth
- Health Promotion Evaluation Unit, 35 Stirling Highway, Crawley, 6009, Australia.
| | - Michael Rosenberg
- Health Promotion Evaluation Unit, 35 Stirling Highway, Crawley, 6009, Australia.
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van der Kleij R, Coster N, Verbiest M, van Assema P, Paulussen T, Reis R, Crone M. Implementation of intersectoral community approaches targeting childhood obesity: a systematic review. Obes Rev 2015; 16:454-72. [PMID: 25824957 DOI: 10.1111/obr.12273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/19/2015] [Accepted: 02/05/2015] [Indexed: 10/23/2022]
Abstract
The implementation of intersectoral community approaches targeting childhood obesity (IACO) is considered challenging. To help overcome these challenges, an overview of the evidence to date is needed. We searched four databases to identify papers that reported on the determinants of successful implementation of IACOs, resulting in the inclusion of 25 studies. We appraised study quality with the Crowe Critical Appraisal Tool and the Quality Framework; reported implementation outcome indicators were reviewed via narrative synthesis. Quality of included studies varied. The most frequently reported indicators of implementation success were fidelity and coverage. Determinants related to the social-political context and the organization were most often cited as influencing implementation, in particular, 'collaboration between community partners', 'the availability of (human) resources' and 'time available for implementation'. The association between determinants and implementation variability was never explicated. We conclude that although some insights into the effective implementation of IACOs are present, more research is needed. Emphasis should be placed on elucidating the relationship between determinants and implementation success. Research should further focus on developing a 'golden standard' for evaluating and reporting on implementation research. These actions will improve the comparison of study outcomes and may constitute the cumulative development of knowledge about the conditions for designing evidence-based implementation strategies.
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Affiliation(s)
- R van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands
| | - N Coster
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - M Verbiest
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - P van Assema
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - T Paulussen
- Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,TNO Leiden, Leiden, The Netherlands
| | - R Reis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,Amsterdam Institute for Social Science Research, University of Amsterdam, The Netherlands
| | - M Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands
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Nigenda G, Wirtz VJ, González-Robledo LM, Reich MR. Evaluating the Implementation of Mexico's Health Reform: The Case of Seguro Popular. Health Syst Reform 2015; 1:217-228. [PMID: 31519075 DOI: 10.1080/23288604.2015.1031336] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Abstract-In 2012, the Mexican government declared that Seguro Popular had reached the goal of providing health insurance to nearly 53 million individuals previously not enrolled with social security. This major achievement was reached in only nine years of operation of the new system. However, enormous challenges remain to guarantee that Seguro Popular will provide adequate services to the newly enrolled population. This article uses information collected by four external evaluations of Seguro Popular carried out between 2007 and 2012 to analyze how financial resources are transferred from the federal level to the states and how these resources are used to purchase services on behalf of the affiliated population. We focus on three topics: the financial transfer mechanisms, the purchasing of medicines, and the contracting of health workers. The analysis shows that the implementation of Seguro Popular has confronted major challenges due to limited institutional capacity at the federal and state levels, tension in federal-state relations, limited information systems, the influence of political interests, and the use of financial resources for unauthorized expenditures at the state level. Various legal, normative, and technical changes have been introduced during implementation of Seguro Popular to improve performance, with mixed results. Mexico's experiences with the implementation of health reform may offer important lessons for other countries seeking to expand health coverage.
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Affiliation(s)
- Gustavo Nigenda
- Center for Health Systems Research, National Institute of Public Health , Cuernavaca , Mexico
| | - Veronika J Wirtz
- Center for Global Health and Development, Boston University , Boston , MA , USA
| | | | - Michael R Reich
- Department of Global Health and Population; Harvard T. H. Chan School of Public Health ; Boston , MA USA
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Naylor PJ, Nettlefold L, Race D, Hoy C, Ashe MC, Wharf Higgins J, McKay HA. Implementation of school based physical activity interventions: a systematic review. Prev Med 2015; 72:95-115. [PMID: 25575800 DOI: 10.1016/j.ypmed.2014.12.034] [Citation(s) in RCA: 248] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 12/01/2014] [Accepted: 12/26/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation. METHODS We searched 7 electronic databases (1995-2014) and included controlled studies of school-based PA programmes for healthy youth (6-18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation. RESULTS There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n=15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate. CONCLUSIONS Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation.
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Affiliation(s)
- Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015 STN CSC, Victoria BC V8W 3P1, Canada.
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada.
| | - Douglas Race
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada.
| | - Christa Hoy
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada.
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada; Department of Family Practice, University of British Columbia, 5950 University Boulevard, Vancouver BC V6T 1Z3, Canada.
| | - Joan Wharf Higgins
- School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015 STN CSC, Victoria BC V8W 3P1, Canada.
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada; Department of Family Practice, University of British Columbia, 5950 University Boulevard, Vancouver BC V6T 1Z3, Canada; Department of Orthopaedics, University of British Columbia, 910 West 10th Avenue, Vancouver BC V5Z 1M9, Canada.
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Zentrale Einflussfaktoren der betrieblichen Gesundheitsförderung. PRAVENTION UND GESUNDHEITSFORDERUNG 2015. [DOI: 10.1007/s11553-015-0488-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Process evaluation of workplace interventions with physical exercise to reduce musculoskeletal disorders. Int J Rheumatol 2014; 2014:761363. [PMID: 25574172 PMCID: PMC4276703 DOI: 10.1155/2014/761363] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/19/2014] [Indexed: 11/23/2022] Open
Abstract
Process evaluation is important to explain success or failure of workplace interventions. This study performs a summative process evaluation of workplace interventions with physical exercise. As part of a randomized controlled trial 132 office workers with neck and shoulder pain were to participate in 10 weeks of elastic resistance training five times a week at the workplace; the 2 min group performed a single set of lateral raise to failure, and the 12 min group performed 5-6 sets with 8–12 repetitions. Participants received a single instructional session together with a training diary and manual at baseline (100% dose delivered and 100% dose received), and 59 and 57 participants, respectively, replied to the process evaluation questionnaire at 10-week follow-up. Results showed that in the 2 and 12 min groups, respectively, 82% and 81% of the participants completed more than 30 training sessions. However, two-thirds of the participants would have preferred more than a single exercise to vary between. In the 12 versus 2 min group more participants experienced the training sessions as too long (30% versus 5%). Most participants (67–92%) found the training diary and manual helpful, adequacy in a single instructional session, and satisfaction with the type of training. Among those with low adherence, lack of time (51%) and difficulties in starting exercising after illness (26%) were common barriers for regular training. Among those with low adherence, 52% felt that five training sessions per week were too much, and 29% would rather have trained a completely different kind of exercise. In conclusion, resistance training at the workplace is generally well received among office workers with neck-shoulder pain, but a one-size-fits-all approach is not feasible for all employees.
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Compernolle S, De Cocker K, Lakerveld J, Mackenbach JD, Nijpels G, Oppert JM, Rutter H, Teixeira PJ, Cardon G, De Bourdeaudhuij I. A RE-AIM evaluation of evidence-based multi-level interventions to improve obesity-related behaviours in adults: a systematic review (the SPOTLIGHT project). Int J Behav Nutr Phys Act 2014; 11:147. [PMID: 25480391 PMCID: PMC4266878 DOI: 10.1186/s12966-014-0147-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 11/17/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This systematic literature review describes the potential public health impact of evidence-based multi-level interventions to improve obesity-related behaviours in adults, using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. METHODS Electronic databases (PubMed, Embase, and The Cochrane Library) were searched to identify intervention studies published between January 2000 and October 2013. The following inclusion criteria were used: (1) the study included at least one outcome measure assessing obesity-related behaviours (i.e. diet, physical activity or sedentary behaviour), (2) the study collected data over at least one year and (3) the study's intervention targeted adults, was conducted in a specified geographical area or worksite, and was multi-level (i.e. targeting both individual and environmental level). Evidence of RE-AIM of the selected interventions was assessed. Potential public health impact of an intervention was evaluated if information was provided on at least four of the five RE-AIM dimensions. RESULTS Thirty-five multi-level interventions met the inclusion criteria. RE-AIM evaluation revealed that the included interventions generally had the potential to: reach a large number of people (on average 58% of the target population was aware of the intervention); achieve the assumed goals (89% found positive outcomes); be broadly adopted (the proportion of intervention deliverers varied from 9% to 92%) and be sustained (sixteen interventions were maintained). The highest potential public health impact was found in multi-level interventions that: 1) focused on all levels at the beginning of the planning process, 2) guided the implementation process using diffusion theory, and 3) used a website to disseminate the intervention. CONCLUSIONS Although most studies underreported results within the RE-AIM dimensions, the reported Reach, Effectiveness, Adoption, Implementation and Maintenance were positively evaluated. However, more information on external validity and sustainability is needed in order to take informed decisions on the choice of interventions that should be implemented in real-world settings to accomplish long-term changes in obesity-related behaviours.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders (FWO), B-1000, Ghent, Belgium.
| | - Jeroen Lakerveld
- The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - Joreintje D Mackenbach
- The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - Giel Nijpels
- The EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Jean-Michel Oppert
- Université Paris 13, Sorbonne Paris Cité - UREN (Unité de Recherche en Epidémiologie Nutritionnelle), U557 Inserm; U1125 Inra; Cnam, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Bobigny, France. .,Université Pierre et Marie Curie-Paris 6, Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
| | - Harry Rutter
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Design of a process evaluation of the implementation of a physical activity and sports stimulation programme in Dutch rehabilitation setting: ReSpAct. Implement Sci 2014; 9:127. [PMID: 25241188 PMCID: PMC4177248 DOI: 10.1186/s13012-014-0127-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background There is a growing interest to study the transfer of evidence-based information into daily practice. The evidence-based programme Rehabilitation, Sports and Exercise (RSE) that aims to stimulate an active lifestyle during and after a rehabilitation period in people with a disability and/or chronic disease is prepared for nationwide dissemination. So far, however, little is known about the implementation of a new programme to stimulate physical activity in people with a disability in a rehabilitation setting. Therefore, a process evaluation of the implementation of the RSE programme within 18 Dutch rehabilitation centres and hospitals is performed in order to gain more insight into the implementation process itself and factors that facilitate or hamper the implementation process. This paper describes the study design of this process evaluation. Methods During a three-year period, the adoption, implementation and continuation of the RSE programme is monitored and evaluated in 12 rehabilitation centres and 6 hospitals with a rehabilitation department in The Netherlands. The main process outcomes are: recruitment, reach, dose delivered, dose received, fidelity, satisfaction, maintenance and context. The process outcomes are evaluated at different levels (organisational and patient) and different time points. Data collection includes both quantitative (online registration system and questionnaires) and qualitative (focus groups and semi-structured interviews) methods. Discussion The nationwide dissemination of an evidence-based programme to stimulate physical activity and sports during and after a rehabilitation period is extensively monitored and evaluated on different levels (organization and patients) using mixed methods. The study will contribute to the science of translating evidence-based programmes into daily practice of the rehabilitation care. The results of the study can be used to further optimize the content of the RSE programme and to facilitate the implementation in other health facilities. Furthermore, the results of the study can help future implementation processes in the rehabilitation setting. Trial registration The study is registered by The Netherlands National Trial Register: NTR3961. Electronic supplementary material The online version of this article (doi:10.1186/s13012-014-0127-7) contains supplementary material, which is available to authorized users.
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Rongen A, Robroek SJW, van Ginkel W, Lindeboom D, Altink B, Burdorf A. Barriers and facilitators for participation in health promotion programs among employees: a six-month follow-up study. BMC Public Health 2014; 14:573. [PMID: 24909151 PMCID: PMC4066706 DOI: 10.1186/1471-2458-14-573] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 05/23/2014] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Health promotion programs (HPPs) are thought to improve health behavior and health, and their effectiveness is increasingly being studied. However, participation in HPPs is usually modest and effect sizes are often small. This study aims to (1) gain insight into the degree of participation of employees in HPPs, and (2) identify factors among employees that are associated with both their intention to participate and actual participation in HPPs. METHODS Employees of two organizations were invited to participate in a six-month follow-up study (n = 744). Using questionnaires, information on participation in HPPs was collected in two categories: employees' intention at baseline to participate and their actual participation in a HPP during the follow-up period. The following potential determinants were assessed at baseline: social-cognitive factors, perceived barriers and facilitators, beliefs about health at work, health behaviors, and self-perceived health. Logistic regression analyses, adjusted for demographics and organization, were used to examine associations between potential determinants and intention to participate, and to examine the effect of these determinants on actual participation during follow-up. RESULTS At baseline, 195 employees (26%) expressed a positive intention towards participation in a HPP. During six months of follow-up, 83 employees (11%) actually participated. Participants positively inclined at baseline to participate in a HPP were more likely to actually participate (OR = 3.02, 95% CI: 1.88-4.83). Privacy-related barriers, facilitators, beliefs about health at work, social-cognitive factors, and poor self-perceived health status were significantly associated with intention to participate. The odds of employees actually participating in a HPP were higher among participants who at baseline perceived participation to be expected by their colleagues and supervisor (OR = 2.87, 95% CI: 1.17-7.02) and among those who said they found participation important (OR = 2.81, 95% CI: 1.76-4.49). CONCLUSIONS Participation in HPPs among employees is limited. Intention to participate predicted actual participation in a HPP after six months of follow-up. However, only 21% of employees with a positive intention actually participated during follow-up. Barriers, facilitators, beliefs about health at work, social-cognitive factors, and a poor self-perceived health status were associated with intention to participate, but hardly influenced actual participation during follow-up.
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Affiliation(s)
| | - Suzan J W Robroek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
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