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Bendig E, Meißner D, Erb B, Weger L, Küchler AM, Bauereiss N, Ebert D, Baumeister H. Study protocol of a randomised controlled trial on SISU, a software agent providing a brief self-help intervention for adults with low psychological well-being. BMJ Open 2021; 11:e041573. [PMID: 33558351 PMCID: PMC7871683 DOI: 10.1136/bmjopen-2020-041573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Only a minority of people living with mental health problems are getting professional help. As digitalisation moves on, the possibility of providing internet/mobile-based interventions (IMIs) arises. One type of IMIs are fully automated conversational software agents (chatbots). Software agents are computer programs that can hold conversations with a human by mimicking a human conversational style. Software agents could deliver low-threshold and cost-effective interventions aiming at promoting psychological well-being in a large number of individuals. The aim of this trial is to evaluate the clinical effectiveness and acceptance of the brief software agent-based IMI SISU in comparison with a waitlist control group. METHODS AND ANALYSIS Within a two-group randomised controlled trial, a total of 120 adult participants living with low well-being (Well-being Scale/WHO-5) will be recruited in Germany, Austria and Switzerland. SISU is based on therapeutic writing and acceptance and commitment therapy-based principles. The brief intervention consists of three modules. Participants work through the intervention on 3 consecutive days. Assessment takes place before (t1), during (t2) and after (t3) the interaction with SISU, as well as 4 weeks after randomisation (t4). Primary outcome is psychological well-being (WHO-5). Secondary outcomes are emotional well-being (Flourishing Scale), psychological flexibility (Acceptance and Action Questionnaire-II), quality of life (Assessment of Quality of Life -8D), satisfaction with the intervention (Client Satisfaction Questionnaire-8) and side effects (Inventory for the assessment of negative effectsof psychotherapy). Examined mediators and moderators are sociodemographic variables, personality (Big Five Inventory-10), emotion regulation (Emotion Regulation Questionnaire), alexithymia (Toronto Alexithymia Scale-20), centrality of events (Centrality of Events Scale), treatment expectancies (Credibility Expectancy Questionnaire) and technology alliance (Inventory of Technology Alliance-Online Therapy). Data analysis will be based on intention-to-treat principles. SISU guides participants through a 3-day intervention. ETHICS AND DISSEMINATION This trial has been approved by the ethics committee of the Ulm University (No. 448/18, 18.02.2019). Results will be submitted for publication in a peer-reviewed journal and presented at conferences. TRIAL REGISTRATION The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS): DRKS00016799 (date of registration: 25 April 2019). In case of important protocol modifications, trial registration will be updated. This is protocol version number 1.
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Affiliation(s)
- Eileen Bendig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Dominik Meißner
- Department of Computer Science, Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Benjamin Erb
- Department of Computer Science, Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Lena Weger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Natalie Bauereiss
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David Ebert
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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102
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Tosta Maciel RRB, Chiavegato LD, Camelier FW, Portella DD, De Souza MC, Padula RS. Does tutors' support contribute to a telehealth program that aims to promote the quality of life of office workers? A cluster randomized controlled trial. Contemp Clin Trials Commun 2021; 21:100722. [PMID: 33604486 PMCID: PMC7875823 DOI: 10.1016/j.conctc.2021.100722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/23/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
The quality of life in the workplace can be achieved by creating a place more humanized and strategies that provide wellness to workers. The aim of this study was to investigate the effectiveness of telehealth education program to promote quality of life of office workers. This is a cluster randomized controlled trial (RCT). The participants were office workers computer users (n = 326). All received 9 audiovisual content (grouped into topics: musculoskeletal health, healthy diet, and mental health) that addresses the real needs identified by them in the focus groups. The intervention group (n = 178) was instructed to seek the tutor support about topics addressed by the audiovisual content. The primary outcome measure was quality of life by WHOQOL-BREF. The secondary outcome measure was level of physical activity of the participants. Data analysis was performed by General Linear Mixed Model. After six months of telehealth education program a general improvement in health and environmental domain, was observed in the intervention group. During that period, a within-group analysis showed that there was a significant improvement in the intervention group, with respect to quality of life in general health (p < 0.05) and in the environmental domain (p < 0.01). In the baseline to the eighth month, there were statistically significant changes within-group for the general health (p < 0.05) and for the physical domain (p < 0.01) in both groups (p < 0.01). Telehealth education program promoted an improvement in the participants' quality of life. There was no benefit in favor of the telehealth education program, with tutor support in relation to the conventional program. Trial registration The trial was prospectively registered at ClinicalTrial.gov (NCT02980237). The date of registration was August 23, 2016.
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Affiliation(s)
- Roberto Rodrigues Bandeira Tosta Maciel
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.,Department of Life Sciences, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Luciana Dias Chiavegato
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.,Pulmonology Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Marcio Costa De Souza
- Department of Life Sciences, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Rosimeire Simprini Padula
- Masters and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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103
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Griep Y, Bankins S, Vander Elst T, De Witte H. How psychological contract breach affects long-term mental and physical health: the longitudinal role of effort-reward imbalance. Appl Psychol Health Well Being 2021; 13:263-281. [PMID: 33492770 PMCID: PMC8248376 DOI: 10.1111/aphw.12246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022]
Abstract
This study contributes to the research of employee health and well‐being by examining the longitudinal effects of psychological contract (PC) breach on employees’ health. We integrate Social Exchange and Conservation of Resources theories to position effort–reward imbalance (ERI) as the mediating mechanism. We also assessed the moderating role of perceived job control as a boundary condition through which employees could prevent PC breach and ERI from adversely affecting their health. Using three‐wave longitudinal survey data from 389 employees, we estimated a path model using each variable’s growth parameters (intercept and slope). We found support for our hypotheses regarding stable effects; we found positive associations between PC breach and physical and mental health complaints and a need for recovery through ERI perceptions. We further tested employees’ perceived control over the work environment as a boundary condition and found support for its role in attenuating the positive relationship between PC breach and ERI perceptions, but not for its moderating role in the ERI–health outcomes relationship. Our findings indicate that exposure to PC breach has a detrimental impact on employee health/well‐being via perceptions of ERI and allow us to unravel one of the cognitive mechanisms leading to potential employee ill‐health. We conclude with theoretical and practical implications.
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Affiliation(s)
- Yannick Griep
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Sarah Bankins
- Macquarie Business School, Macquarie University, North Ryde Campus, NSW, Australia
| | - Tinne Vander Elst
- Research Group Work, Organizational and Personnel Psychology (WOPP/O2L), Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Hans De Witte
- Research Group Work, Organizational and Personnel Psychology (WOPP/O2L), Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Optentia Research Focus Area, Vanderbijlpark Campus, North-West University, Vanderbijlpark, South Africa
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104
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Smoktunowicz E, Lesnierowska M, Carlbring P, Andersson G, Cieslak R. Resource-Based Internet Intervention (Med-Stress) to Improve Well-Being Among Medical Professionals: Randomized Controlled Trial. J Med Internet Res 2021; 23:e21445. [PMID: 33427674 PMCID: PMC7834939 DOI: 10.2196/21445] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background Medical professionals are exposed to multiple and often excessive demands in their work environment. Low-intensity internet interventions allow them to benefit from psychological support even when institutional help is not available. Focusing on enhancing psychological resources—self-efficacy and perceived social support—makes an intervention relevant for various occupations within the medical profession. Previously, these resources were found to operate both individually or sequentially with self-efficacy either preceding social support (cultivation process) or following it (enabling process). Objective The objective of this randomized controlled trial is to compare the efficacy of 4 variants of Med-Stress, a self-guided internet intervention that aims to improve the multifaceted well-being of medical professionals. Methods This study was conducted before the COVID-19 pandemic. Participants (N=1240) were recruited mainly via media campaigns and social media targeted ads. They were assigned to 1 of the following 4 groups: experimental condition reflecting the cultivation process, experimental condition reflecting the enabling process, active comparator enhancing only self-efficacy, and active comparator enhancing only perceived social support. Outcomes included 5 facets of well-being: job stress, job burnout, work engagement, depression, and job-related traumatic stress. Measurements were taken on the web at baseline (time 1), immediately after intervention (time 2), and at a 6-month follow-up (time 3). To analyze the data, linear mixed effects models were used on the intention-to-treat sample. The trial was partially blinded as the information about the duration of the trial, which was different for experimental and control conditions, was public. Results At time 2, job stress was lower in the condition reflecting the cultivation process than in the one enhancing social support only (d=−0.21), and at time 3, participants in that experimental condition reported the lowest job stress when compared with all 3 remaining study groups (ds between −0.24 and −0.41). For job-related traumatic stress, we found a significant difference between study groups only at time 3: stress was lower in the experimental condition in which self-efficacy was enhanced first than in the active comparator enhancing solely social support (d=−0.24). The same result was found for work engagement (d=−0.20), which means that it was lower in exactly the same condition that was found beneficial for stress relief. There were no differences between study conditions for burnout and depression neither at time 2 nor at time 3. There was a high dropout in the study (1023/1240, 82.50% at posttest), reflecting the pragmatic nature of this trial. Conclusions The Med-Stress internet intervention improves some components of well-being—most notably job stress—when activities are completed in a specific sequence. The decrease in work engagement could support the notion of dark side of this phenomenon, but further research is needed. Trial Registration ClinicalTrials.gov NCT03475290; https://clinicaltrials.gov/ct2/show/NCT03475290 International Registered Report Identifier (IRRID) RR2-10.1186/s13063-019-3401-9
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Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Magdalena Lesnierowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Roman Cieslak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Trauma, Health, and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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105
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Russo D, Hanel PHP, Altnickel S, van Berkel N. Predictors of well-being and productivity among software professionals during the COVID-19 pandemic - a longitudinal study. EMPIRICAL SOFTWARE ENGINEERING 2021; 26:62. [PMID: 33942010 PMCID: PMC8080489 DOI: 10.1007/s10664-021-09945-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2021] [Indexed: 05/04/2023]
Abstract
The COVID-19 pandemic has forced governments worldwide to impose movement restrictions on their citizens. Although critical to reducing the virus' reproduction rate, these restrictions come with far-reaching social and economic consequences. In this paper, we investigate the impact of these restrictions on an individual level among software engineers who were working from home. Although software professionals are accustomed to working with digital tools, but not all of them remotely, in their day-to-day work, the abrupt and enforced work-from-home context has resulted in an unprecedented scenario for the software engineering community. In a two-wave longitudinal study (N = 192), we covered over 50 psychological, social, situational, and physiological factors that have previously been associated with well-being or productivity. Examples include anxiety, distractions, coping strategies, psychological and physical needs, office set-up, stress, and work motivation. This design allowed us to identify the variables that explained unique variance in well-being and productivity. Results include (1) the quality of social contacts predicted positively, and stress predicted an individual's well-being negatively when controlling for other variables consistently across both waves; (2) boredom and distractions predicted productivity negatively; (3) productivity was less strongly associated with all predictor variables at time two compared to time one, suggesting that software engineers adapted to the lockdown situation over time; and (4) longitudinal analyses did not provide evidence that any predictor variable causal explained variance in well-being and productivity. Overall, we conclude that working from home was per se not a significant challenge for software engineers. Finally, our study can assess the effectiveness of current work-from-home and general well-being and productivity support guidelines and provides tailored insights for software professionals.
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Affiliation(s)
- Daniel Russo
- Department of Computer Science, Aalborg University, Aalborg, Denmark
| | | | | | - Niels van Berkel
- Department of Computer Science, Aalborg University, Aalborg, Denmark
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106
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Schaafsma FG, Hulsegge G, de Jong MA, Overvliet J, van Rossum EFC, Nieuwenhuijsen K. The potential of using hair cortisol to measure chronic stress in occupational healthcare; a scoping review. J Occup Health 2021; 63:e12189. [PMID: 33426766 PMCID: PMC7797775 DOI: 10.1002/1348-9585.12189] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Workplace-based selective prevention of mental health problems currently relies on subjective evaluation of stress complaints. Hair cortisol captures chronic stress responses and could be a promising biomarker for the early identification of mental health problems. The objective was to provide an overview of the state-of-the-art knowledge on the practical value of hair cortisol in the occupational setting. METHODS We performed a scoping review of cross-sectional and longitudinal studies in PubMed, Embase, and PsycINFO up to November 2019 assessing the relations of hair cortisol with work-related stressors, perceived stress, and mental health outcomes in healthy workers. RESULTS We found five longitudinal studies, of which two observed an increase in work-related stressors to be associated with higher hair cortisol, one found a relation with lower hair cortisol and one did not find a relationship. Findings of cross-sectional studies were also mixed. The one available longitudinal study regarding mental health showed that hair cortisol was not related to depressive symptoms. CONCLUSIONS Hair cortisol measurement within occupational health research is still in its early stage and more longitudinal studies are urgently needed to clarify its relationship with work-related stressors and perceived stress before hair cortisol can be used to identify workers at risk for mental health problems.
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Affiliation(s)
- Frederieke G. Schaafsma
- Department of Public and Occupational HealthAmsterdam Public Health research instituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Gerben Hulsegge
- Department of Public and Occupational HealthAmsterdam Public Health research instituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Present address:
Sustainable Productivity and EmployabilityThe Netherlands Organization for Applied Scientific Research, TNOLeiden2316 ZLThe Netherlands
| | - Merel A. de Jong
- Department of Public and Occupational HealthCoronel Institute of Occupational HealthAmsterdam Public Health research instituteAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Present address:
Reinier van ArkelDen BoschThe Netherlands
| | - Joyce Overvliet
- Department of Public and Occupational HealthAmsterdam Public Health research instituteAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Karen Nieuwenhuijsen
- Department of Public and Occupational HealthCoronel Institute of Occupational HealthAmsterdam Public Health research instituteAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
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107
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Shashar S, Ellen M, Codish S, Davidson E, Novack V. Medical Practice Variation Among Primary Care Physicians: 1 Decade, 14 Health Services, and 3,238,498 Patient-Years. Ann Fam Med 2021; 19:30-37. [PMID: 33431388 PMCID: PMC7800753 DOI: 10.1370/afm.2627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/14/2020] [Accepted: 07/24/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Variation in medical practice is associated with poorer health outcomes, increased costs, disparities in care, and increased burden on the public health system. In the present study, we sought to describe and assess inter- and intra-primary care physician variation, adjusted for patient and clinic characteristics, over a decade of practice and across a broad range of health services. METHODS We assessed practice patterns of 251 primary care physicians in southern Israel. For each of 14 health services (imaging tests, cardiac tests, laboratory tests, and specialist visits) we described interphysician and intraphysician variation, adjusted for patient case mix and clinic characteristics, using the coefficient of variation. The adjusted rates were assessed by generalized linear negative-binomial mixed models. RESULTS The variation between physicians was on average 3-fold greater than the variation of individual physician practice over the years. Services with low utilization were associated with greater inter- and intraphysician variation: rs = (-0.58), P = .03 and rs = (-0.39), P = .17, respectively. In addition, physician utilization ranks averaged over all health services were consistent across the 14 health services (intraclass correlation coefficient, 0.94; 95% CI, 0.93-0.95). CONCLUSIONS Our results show greater variation in practice patterns between physicians than for individual physicians over the years. It appears that the variation remains high even after adjustment for patient and clinic characteristics and that the individual physician utilization patterns are stable across health services. We propose that personal behavioral characteristics of medical practitioners might explain this variation.
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Affiliation(s)
- Sagi Shashar
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Moriah Ellen
- Department of Health Services Management, Guilford Glazer Faculty of Business and Management, Ben Gurion University of the Negev, Be'er-Sheva, Israel.,Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada
| | - Shlomi Codish
- Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Ehud Davidson
- General Management, Clalit Health Services, Tel-Aviv, Israel
| | - Victor Novack
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
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108
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Michaelis M, Burgess S, Junne F, Rothermund E, Gündel H, Zipfel S, Wolf M, Rieger MA. Mental Health Applications for Primary and Secondary Prevention of Common Mental Disorders: Attitudes of German Employees. Front Psychiatry 2021; 12:508622. [PMID: 34017269 PMCID: PMC8130826 DOI: 10.3389/fpsyt.2021.508622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/29/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Web-based and mobile mental health applications for the prevention and treatment of common mental disorders (CMDs) are on the rise. Under certain circumstances they have proved to be effective for a range of conditions (e.g., depression). Objective: There is not sufficient evidence regarding the benefits and barriers especially for mobile phone apps and for programs in the field of primary prevention. Studies on the acceptance of potential users of mental health apps yielded mixed outcomes. In a large survey we investigated the attitudes of employees toward mental health apps and various traditional mental health services. Our main research question in this contribution focuses on the acceptance of apps compared to other measures and the moderating influence of individual characteristics. Methods: The standardized survey was completed by members of an online access panel with different job types. A set of 33 self-developed items, including three questions on e-health, captured the perceived relevance of prevention at the (A) occupational, (B) individual, and (C) societal level. On the basis of an exploratory factor analysis, mean scores for mapping seven (sub-)dimensions were constructed and compared using the Wilcoxon test. The influence of potential predictors was analyzed in linear regression models. Results: The data of 610 respondents were analyzed (response rate 75%). Support from mental health applications was rated significantly less important compared to all other dimensions at the levels (A) to (C). Respondents were more likely to use mental health apps if they felt literate with electronic devices, perceived a high relevance of work-related demands as causal factors for CMDs, stated they would be ashamed of having a CMD, and would be willing to begin psychotherapy if recommended. Discussion and Conclusions: The results confirm the critical attitudes of potential mental health app users found in other studies. Since users with a negative attitude toward e-health might have a higher risk for dropout and non-adherence as well as lower intervention effects, well-designed educational strategies should be carried out beforehand.
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Affiliation(s)
- Martina Michaelis
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany.,Research Centre for Occupational and Social Medicine (FFAS), Freiburg, Germany
| | - Stephanie Burgess
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Department for Psychosomatic Medicine and Psychotherapy, University Hospital, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center/Leadership Personality Centre, Ulm University, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center/Leadership Personality Centre, Ulm University, Ulm, Germany
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Markus Wolf
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
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109
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Doty B, Grzenda A, Hwang S, Godar S, Gruttadaro D, Hauge KA, Sherman B, Clarke DE. An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: "Right Direction". Front Psychiatry 2021; 12:581876. [PMID: 34489743 PMCID: PMC8417939 DOI: 10.3389/fpsyt.2021.581876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/27/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: Right Direction (RD) was a component of a universal employee wellness program implemented in 2014 at Kent State University (KSU) to increase employees' awareness of depression, reduce mental health stigma, and encourage help-seeking behaviors to promote mental health. We explored changes in mental health care utilization before and after implementation of RD. Methods: KSU Human Resources census and service use data were used to identify the study cohort and examine the study objectives. A pre-post design was used to explore changes in mental health utilization among KSU employees before and after RD. Three post-intervention periods were examined. A generalized linear mixed model approach was used for logistic regression analysis between each outcome of interest and intervention period, adjusted by age and sex. Logit differences were calculated for post-intervention periods compared to the pre-intervention period. Results: Compared to the pre-intervention period, the predicted proportion of employees seeking treatment for depression and anxiety increased in the first post-intervention period (OR = 2.14, 95% Confidence Interval [CI] = 1.37-3.34), then declined. Outpatient psychiatric treatment utilization increased significantly in the first two post-intervention periods (OR =1.89, 95% CI = 1.23-2.89; OR = 1.75, 95% CI = 1.11-2.76). No difference was noted in inpatient psychiatric treatment utilization across post-intervention periods. Unlike prescription for anxiolytic prescriptions, receipt of antidepressant prescriptions increased in the second (OR = 2.25, 95% CI = 1.56-3.27) and third (OR = 2.16, 95% CI = 1.46-3.20) post-intervention periods. Conclusions: Effects of RD may be realized over the long-term with follow-up enhancements such as workshops/informational sessions on mindfulness, stress management, resiliency training, and self-acceptance.
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Affiliation(s)
- Benjamin Doty
- American Psychiatric Association, Washington, DC, United States
| | - Adrienne Grzenda
- American Psychiatric Association, Washington, DC, United States.,Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA-Olive View Medical Center, Los Angeles, CA, United States
| | - Seungyoung Hwang
- American Psychiatric Association, Washington, DC, United States.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sean Godar
- Employers Health, Dublin, OH, United States
| | | | | | - Bruce Sherman
- School of Medicine, Case Western University, Cleveland, OH, United States
| | - Diana E Clarke
- American Psychiatric Association, Washington, DC, United States.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Grimm LA, Bauer GF, Jenny GJ. A Digital Tool to Build the Capacity of Leaders to Improve Working Conditions Related to Psychological Health and Well-Being in Teams: Intervention Approach, Prototype, and Evaluation Design of the Web-Application "wecoach". Front Public Health 2020; 8:521355. [PMID: 33425825 PMCID: PMC7793658 DOI: 10.3389/fpubh.2020.521355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
The “wecoach” is a web-application that builds the capacities of team leaders to improve working conditions that are positively related to the psychological health and well-being of their team members. The web-application works through an automated, rule-based chat enhanced by machine learning. This so-called conversational agent guides the team leader through a systematic project cycle, providing a mind map of work and health, training materials, self-assessments, and online tools to conduct team surveys and workshops, as well as self-evaluation of progress and effectiveness. In this paper, we present the development process of this web-application, which resulted in (1) a comprehensive intervention approach, (2) the prototype, and (3) the implementation of an evaluation design for a multi-level, randomized controlled trial.
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Affiliation(s)
- Luisa A Grimm
- Center of Salutogenesis, University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - Georg F Bauer
- Center of Salutogenesis, University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - Gregor J Jenny
- Center of Salutogenesis, University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
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Svendsen MJ, Wood KW, Kyle J, Cooper K, Rasmussen CDN, Sandal LF, Stochkendahl MJ, Mair FS, Nicholl BI. Barriers and facilitators to patient uptake and utilisation of digital interventions for the self-management of low back pain: a systematic review of qualitative studies. BMJ Open 2020; 10:e038800. [PMID: 33310794 PMCID: PMC7735096 DOI: 10.1136/bmjopen-2020-038800] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Low back pain (LBP) is a leading contributor to disability globally. Self-management is a core component of LBP management. We aimed to synthesise published qualitative literature concerning digital health interventions (DHIs) to support LBP self-management to: (1) determine engagement strategies, (2) identify barriers and facilitators affecting patient uptake/utilisation and (3) develop a preliminary conceptual model of barriers and facilitators to uptake/utilisation. DESIGN Systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. DATA SOURCES MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, DoPHER, TRoPHI, Web of Science and OT Seeker, from January 2000 to December 2018, using the concepts: LBP, DHI and self-management. ELIGIBILITY CRITERIA Peer-reviewed qualitative study (or component) examining engagement with, or barriers and/or facilitators to the uptake/utilisation of an interactive DHI for self-management of LBP in adults (community, primary or secondary care settings). DATA EXTRACTION AND SYNTHESIS Standardised data extraction form was completed. COREQ (Consolidated criteria for Reporting Qualitative research) checklist was used to assess methodology. Data was synthesised narratively for engagement strategies, thematically for barriers/facilitators to uptake/utilisation and normalisation process theory was applied to produce a conceptual model. RESULTS We identified 14 191 citations, of which 105 full-text articles were screened, and five full-text articles from four studies included. These were from community and primary care contexts in Europe and the USA, and involved 56 adults with LBP and 19 healthcare professionals. There was a lack of consideration on how to sustain engagement with DHIs. Examination of barriers and facilitators for uptake/utilisation identified four major themes: IT (information technology) usability-accessibility; quality-quantity of content; tailoring-personalisation; and motivation-support. These themes informed the development of a preliminary conceptual model for uptake/utilisation of a DHI for LBP self-management. CONCLUSIONS We highlight key barriers and facilitators that should be considered when designing DHIs for LBP self-management. Our findings are in keeping with reviews of DHIs for other long-term conditions, implying these findings may not be condition specific. SYSTEMATIC REVIEW REGISTRATION A protocol for this systematic review was registered with https://www.crd.york.ac.uk/PROSPERO/ (CRD42016051182) on 10 November 2016. https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016051182.
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Affiliation(s)
- Malene Jagd Svendsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Musculoskeletal disorders and physical work demands, National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - Karen Wood Wood
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Kyle
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | | | - Louise Fleng Sandal
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mette Jensen Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Frances S Mair
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Barbara I Nicholl
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Determinants of Managerial Preventive Actions in Relation to Common Mental Disorders at Work: A Cross-Sectional Study Among Swedish Managers. J Occup Environ Med 2020; 61:854-862. [PMID: 31090675 DOI: 10.1097/jom.0000000000001629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Manager characteristics (personal, work-, and competence-related) were investigated as determinants of managerial preventive actions (MPAs) in relation to common mental disorders (CMDs) among employees. METHODS A web survey (n = 2921) among Swedish managers measured diverse managerial characteristics and two types of MPAs: reviewing assignments and work situation (MPA-review); talking about CMDs at the work place (MPA-talk). RESULTS MPA-review was reported by 50% and MPA-talk by 57% of managers. Characteristics that related to more MPAs were female gender, workplace offering lectures on CMDs, workplace offering stress counseling, being responsible for the work environment, management training on CMDs, and more than 10 years of managerial experience (MPA-talk only). CONCLUSION Managers who are female, have had training on CMDs, and work for organizations paying attention to CMD prevention initiate MPAs more often.
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De Angelis M, Giusino D, Nielsen K, Aboagye E, Christensen M, Innstrand ST, Mazzetti G, van den Heuvel M, Sijbom RB, Pelzer V, Chiesa R, Pietrantoni L. H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8035. [PMID: 33142745 PMCID: PMC7662282 DOI: 10.3390/ijerph17218035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022]
Abstract
The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.
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Affiliation(s)
- Marco De Angelis
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Davide Giusino
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Karina Nielsen
- Institute of Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 FL, UK;
| | - Emmanuel Aboagye
- Institute of Environmental Medicine, Karolinska Institute, 171 65 Stockholm, Sweden;
| | - Marit Christensen
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Siw Tone Innstrand
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Greta Mazzetti
- Department of Education Studies, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy;
| | - Machteld van den Heuvel
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Roy B.L. Sijbom
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Vince Pelzer
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Rita Chiesa
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Luca Pietrantoni
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
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Effect of a brief cognitive behavioral program on depressive symptoms among newly licensed registered nurses: An observational study. PLoS One 2020; 15:e0240466. [PMID: 33045002 PMCID: PMC7549829 DOI: 10.1371/journal.pone.0240466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 09/26/2020] [Indexed: 12/27/2022] Open
Abstract
Depressive symptoms are a serious problem in workplaces. Hospital staff members, such as newly licensed registered nurses (NLRNs), are at particularly increased risk of these symptoms owing to their limited experience. Previous studies have shown that a brief program-based cognitive behavioral therapy program (CBP) can offer effective treatment. Here, we conducted a longitudinal observational study of 683 NLRNs (CBP group, n = 522; no-CBP group, n = 181) over a period of 1 year (six times surveys were done during this period). Outcomes were assessed on the basis of surveys that covered the Beck Depression Inventory-I (BDI). The independent variables were CBP attendance (CBP was conducted 3 months after starting work), personality traits, personal stressful life events, workplace adversity, and pre-CBP change in BDI in the 3 months before CBP (ΔBDIpre-CBP). All factors were included in Cox proportional hazards models with time-dependent covariates for depressive symptoms (BDI ≥10), and we reported hazard ratios (HRs). Based on this analysis, we detected that CBP was significantly associated with benefit for depressive symptoms in all NLRNs (Puncorrected = 0.0137, HR = 0.902). To identify who benefitted most from CBP, we conducted a subgroup analysis based on the change in BDI before CBP (ΔBDIpre-CBP). The strongest association was when BDI scores were low after starting work and increased before CBP (Puncorrected = 0.00627, HR = 0.616). These results are consistent with previous findings, and indicate that CBP may benefit the mental health of NLRNs. Furthermore, selective prevention based on the pattern of BDI change over time may be important in identifying who should be offered CBP first. Although CBP is generally effective for all nurses, such a selective approach may be most appropriate where cost-effectiveness is a prominent concern.
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Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176401. [PMID: 32887475 PMCID: PMC7504457 DOI: 10.3390/ijerph17176401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
The aim of this systematic review and meta-analysis was to identify and evaluate the impact of interventions to improve or reduce insomnia in the workforce through randomized clinical trials. Following the recommendations of the PRISMA and MARS statement, a systematic literature search was carried out on the PubMed, Web of Science, CINHAL, and PsycINFO databases, with no restrictions on the language or publication date. For the meta-analysis, a random-effects model and the Insomnia Severity Index were used as outcome measures. To assess the risk of bias and the quality of evidence, the Cochrane Collaboration tool and the GRADE method were used, respectively. Twenty-two studies were included in the systematic review and 12 studies in the meta-analysis, making a total of 14 intervention groups with a sample of 827 workers. Cognitive behavioral therapy was the most widely used intervention. According to the estimated difference between the means, a moderate effect for the reduction of insomnia symptoms after the intervention (MD -2.08, CI 95%: [-2.68, -1.47]) and a non-significant degree of heterogeneity were obtained (p = 0.64; I2 = 0%). The quality of the evidence and the risk of bias were moderate. The results suggest that interventions on insomnia in the workplace are effective for improving workers' health, and that improvements in the quality of sleep and a decrease in the symptoms of insomnia are produced, thanks to an increase in weekly sleeping hours and a reduction in latency at sleep onset. As regards work, they also led to improvements in productivity, presenteeism, and job burnout.
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116
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Venkatesan A, Rahimi L, Kaur M, Mosunic C. Digital Cognitive Behavior Therapy Intervention for Depression and Anxiety: Retrospective Study. JMIR Ment Health 2020; 7:e21304. [PMID: 32845246 PMCID: PMC7481876 DOI: 10.2196/21304] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Digital mental health interventions offer a scalable solution that reduces barriers to seeking care for clinical depression and anxiety. OBJECTIVE We aimed to examine the effectiveness of a 12-week therapist supported, app-based cognitive behavioral therapy program in improving symptoms of depression and anxiety within 9 months. METHODS A total of 323 participants with mild to moderately severe depression or anxiety were enrolled in a 12-week digital cognitive behavior therapy program. The analysis was restricted to participants who provided at least one follow-up assessment after baseline. As a result, 146 participants (45.2%) were included in the analysis-74 (50.7%) participants completed assessments at 3 months, 31 participants (21.2%) completed assessments at 6 months, and 21 participants (14.4%) completed assessments at 9 months. The program included structured lessons and tools (ie, exercises and practices) as well as one-on-one weekly video counseling sessions with a licensed therapist for 12 weeks and monthly check-in sessions for 1 year. The clinically validated Patient Health Questionnaire (PHQ-8) and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. Linear mixed-effects modeling was employed to examine changes in depression and anxiety over time. RESULTS We observed a significant positive effect of program time on improvement in depression (β=-0.12, P<.001) and anxiety scores (β=-0.10, P<.001). At the end of the 12-week intervention, we observed an average reduction of 3.76 points (95% CI -4.76 to -2.76) in PHQ-8 scores. Further reductions in depression were seen at program month 6 (4.75-point reduction, 95% CI -6.61 to -2.88) and program month 9 (6.42-point reduction, 95% CI -8.66 to -6.55, P<.001). A similar pattern of improvement emerged for anxiety, with a 3.17-point reduction at the end of the 12-week intervention (95% CI -4.21 to -2.13). These improvements were maintained at program month 6 (4.87-point reduction, 95% CI -6.85 to -2.87) and program month 9 (5.19-point, 95% -6.85 to 4.81). In addition, greater program engagement during the first 12 weeks predicted a greater reduction in depression (β=-0.29, P<.001). CONCLUSIONS The results suggest that digital interventions can support sustained and clinically meaningful improvements in depression and anxiety. Furthermore, it appears that strong initial digital mental health intervention engagement may facilitate this effect. However, the study was limited by postintervention participant attrition as well as the retrospective observational study design.
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Affiliation(s)
| | - Lily Rahimi
- Vida Health, San Francisco, CA, United States
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Pilot Testing of a Nudge-Based Digital Intervention (Welbot) to Improve Sedentary Behaviour and Wellbeing in the Workplace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165763. [PMID: 32784956 PMCID: PMC7459464 DOI: 10.3390/ijerph17165763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022]
Abstract
Welbot is a nudge-based digital intervention that aims to reduce sedentary behaviour and improve physical and mental wellbeing at work. The purpose of this study was to pilot test the Welbot intervention. Forty-one (6M/35F) University staff (M age = 43-years) participated in this study, which was a single arm repeated measures trial conducted over three weeks of intervention. The primary outcome was sedentary behaviour (measured subjectively and objectively) and secondary outcomes included: mental wellbeing, procrastination, depression, anxiety and stress, and work engagement. A subset of participants (n = 6) wore an ActivPAL to objectively measure activity data, while another subset of participants (n = 6) completed a qualitative semi-structured interview to ascertain experiences of using Welbot. Following the intervention, a Friedman non-parametric test revealed that participants self-reported significantly less time sitting and more time standing and objectively recorded more steps at the week-1 follow-up. A series of paired t-tests exhibited that changes in all secondary outcomes were in the expected direction. However, only improvements in depression, anxiety, and stress were significant. After using Welbot, thematic analysis demonstrated that participants perceived they had a positive behaviour change, increased awareness of unhealthy behaviours at work, and provided suggestions for intervention improvement. Overall, findings provided indications of the potential positive impact Welbot may have on employees' wellbeing, however, limitations are noted. Recommendations for intervention improvement including personalisation (e.g., individual preferences for nudges and the option to sync Welbot with online calendars) and further research into how users engage with Welbot are provided.
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118
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Tchir DR, Szafron ML. Occupational Health Needs and Predicted Well-Being in Office Workers Undergoing Web-Based Health Promotion Training: Cross-Sectional Study. J Med Internet Res 2020; 22:e14093. [PMID: 32452806 PMCID: PMC7284409 DOI: 10.2196/14093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 11/28/2019] [Accepted: 02/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Office workers face workplace-related health issues, including stress and back pain, resulting in considerable cost to businesses and health care systems. Workplace health promotion attempts to prevent these health issues, and the internet can be used to deliver workplace health promotion interventions to office workers. Data were provided by Fitbase GmbH, a German company, which specializes in workplace health promotion via the internet (Web-based health). The Web-based health intervention allowed workers to focus on different health categories by using information modules (reading health information) and/or completing practical exercises (guided, interactive health tutorials). OBJECTIVE This study aimed to identify the extent to which office workers have workplace-related health issues, assess whether office workers who differ in their health focus also differ in their improved well-being, and assess whether completing practical exercises is associated with improved well-being compared with reading information modules. METHODS Fitbase GmbH collected data for the period of February 2016 to May 2017 from health insurance employees undergoing Web-based health training in Hamburg, Germany. The data consisted of a needs assessment examining health issues faced by office workers, a wellness questionnaire regarding one's perception of the Web-based health intervention, and activity logs of information modules and practical exercises completed. Through logistic regression, we determined associations between improved well-being from Web-based health training and differences in a worker's health focus and a worker's preferred intervention method. RESULTS Nearly half of the office workers had chronic back pain (1532/3354) and felt tense or irritated (1680/3348). Over four-fifth (645/766) of the office workers indicated that the Web-based health training improved their well-being (P<.001). Office workers who preferred practical exercises compared with information modules had 2.22 times greater odds of reporting improved well-being from the Web-based health intervention (P=.01; 95% CI 1.20-4.11). Office workers with a focus on practical exercises for back health had higher odds of improved well-being compared with other health foci. Office workers focused on practical exercises for back pain had at least two times the odds of having their well-being improved from the Web-based health intervention compared with those focused on stress management (P<.001), mindfulness (P=.02), stress management/mindfulness (P=.005), and eye health (P=.003). No particular health focus was associated with improved well-being for the information modules. CONCLUSIONS Office workers frequently report having back pain and stress. A focus on Web-based health training via practical exercises and practical exercises for back health predict an improvement in office workers' reported well-being.
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Manning JB, Blandford A, Edbrooke-Childs J, Marshall P. How Contextual Constraints Shape Midcareer High School Teachers' Stress Management and Use of Digital Support Tools: Qualitative Study. JMIR Ment Health 2020; 7:e15416. [PMID: 32338623 PMCID: PMC7215497 DOI: 10.2196/15416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/10/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Persistent psychosocial stress is endemic in the modern workplace, including among midcareer high school (secondary comprehensive) teachers in England. Understanding contextual influences on teachers' self-management of stress along with their use of digital health technologies could provide important insights into creating more usable and accessible stress support interventions. OBJECTIVE The aim of this study was to investigate the constraints on stress management and prevention among teachers in the school environment and how this shapes the use of digitally enabled stress management tools. METHODS Semistructured interviews were conducted with 14 teachers from southern England. The interviews were analyzed using thematic analysis. RESULTS Teachers were unanimous in their recognition of workplace stress, describing physical (such as isolation and scheduling) and cultural (such as stigma and individualism) aspects in the workplace context, which influence their ability to manage stress. A total of 12 participants engaged with technology to self-manage their physical or psychological well-being, with more than half of the participants using consumer wearables, but Web-based or smartphone apps were rarely accessed in school. However, digital well-being interventions recommended by school leaders could potentially be trusted and adopted. CONCLUSIONS The findings from this study bring together both the important cultural and physical contextual constraints on the ability of midcareer high school teachers to manage workplace stress. This study highlights correlates of stress and offers initial insight into how digital health interventions are currently being used to help with stress, both within and outside high schools. The findings add another step toward designing tailored digital stress support for teachers.
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Affiliation(s)
- Julia B Manning
- University College London Interaction Centre, London, United Kingdom
| | - Ann Blandford
- Institute of Healthcare Engineering, University College London, London, United Kingdom
| | - Julian Edbrooke-Childs
- Evidence-based Practice Unit, Anna Freud Centre and University College London, London, United Kingdom
| | - Paul Marshall
- Department of Computer Science, University of Bristol, London, United Kingdom
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Laitinen J, Korkiakangas E, Mäkiniemi JP, Tiitinen S, Tikka P, Oinas-Kukkonen H, Simunaniemi AM, Ahola S, Jaako J, Kekkonen M, Muhos M, Heikkilä-Tammi K, Hannonen H, Lusa S, Punakallio A, Oksa J, Mänttäri S, Ilomäki S, Logren A, Verbeek J, Ruotsalainen J, Remes J, Ruusuvuori J, Oksanen T. The effects of counseling via a smartphone application on microentrepreneurs' work ability and work recovery: a study protocol. BMC Public Health 2020; 20:438. [PMID: 32245379 PMCID: PMC7118938 DOI: 10.1186/s12889-020-8449-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/03/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- J Laitinen
- Finnish Institute of Occupational Health, Helsinki, Finland.
| | - E Korkiakangas
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J P Mäkiniemi
- Faculty of Management and Business, Tampere University, Tampere, Finland
| | - S Tiitinen
- Faculty of Sciences, Tampere University, Tampere, Finland
| | - P Tikka
- Faculty of Information Technology and Electrical Engineering, Oulu Advanced Research on Service and Information Systems (OASIS), University of Oulu, Oulu, Finland
| | - H Oinas-Kukkonen
- Faculty of Information Technology and Electrical Engineering, Oulu Advanced Research on Service and Information Systems (OASIS), University of Oulu, Oulu, Finland
| | - A M Simunaniemi
- Kerttu Saalasti Institute, University of Oulu, Oulu, Finland
| | - S Ahola
- Faculty of Management and Business, Tampere University, Tampere, Finland
| | - J Jaako
- Faculty of Information Technology and Electrical Engineering, Oulu Advanced Research on Service and Information Systems (OASIS), University of Oulu, Oulu, Finland
| | - M Kekkonen
- Faculty of Information Technology and Electrical Engineering, Oulu Advanced Research on Service and Information Systems (OASIS), University of Oulu, Oulu, Finland
| | - M Muhos
- Kerttu Saalasti Institute, University of Oulu, Oulu, Finland
| | - K Heikkilä-Tammi
- Faculty of Management and Business, Tampere University, Tampere, Finland
| | - H Hannonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Lusa
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A Punakallio
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Oksa
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Mänttäri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - S Ilomäki
- Faculty of Sciences, Tampere University, Tampere, Finland
| | - A Logren
- Faculty of Sciences, Tampere University, Tampere, Finland
| | - J Verbeek
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Ruotsalainen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Remes
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - J Ruusuvuori
- Faculty of Sciences, Tampere University, Tampere, Finland
| | - T Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Atkins S, Reho T, Talola N, Sumanen M, Viljamaa M, Uitti J. Improved recording of work relatedness during patient consultations in occupational primary health care: a cluster randomized controlled trial using routine data. Trials 2020; 21:256. [PMID: 32164777 PMCID: PMC7068938 DOI: 10.1186/s13063-020-4168-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prolonging working careers is a key policy goal in ageing populations in Europe, but reaching this goal is complex. Occupational health services are in the best position to contribute towards prolonging working careers through preventing illnesses that cause work disability and early retirement. However, impacting on the trajectory between illness and work disability requires continuity of care and follow up, enabled through identifying patients at risk. We aimed to determine whether a combined educational and electronic reminder system in occupational health care could improve the recording and follow up of primary care visits made by patients at risk of work disability, and whether the system could impact on sickness absence rates. METHODS This study is a pragmatic, cluster-randomized controlled trial using medical record data. Twenty-two Pihlajalinna Työterveys units were randomized into an intervention group receiving education and electronic reminders or a group receiving usual care through minimization methods. Patient consultation data were extracted from routine Pihlajalinna Työterveys patient registers from 2015 to 2017. In addition, process indicators were collected from the electronic system. Data were cleaned and analysed on an intention-to-treat basis using analysis of covariance. RESULTS There was no significant difference between intervention and control units in terms of sickness absences of different duration. Process indicators suggested that there was a change in physicians' practice of recording patients' risk of work disability and work-relatedness of visits following the educational intervention. CONCLUSION Education with an electronic reminder can change physicians' practice, but long-term follow up is needed to determine whether this impacts on patients' sickness absences. TRIAL REGISTRATION ISRCTN Registry: ISRCTN45728263. Registered on 12 April 2016.
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Affiliation(s)
- Salla Atkins
- New Social Research and Faculty of Social Sciences, Tampere University, Tampere, Finland. .,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Tiia Reho
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Pihlajalinna Työterveys, Tampere, Finland
| | - Nina Talola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Church of Finland, Tampere, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Jukka Uitti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Finnish Institute of Occupational Health, Tampere, Finland.,Occupational medicine clinic, Tampere University Hospital, Tampere, Finland
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Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment-A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1742123. [PMID: 32083124 PMCID: PMC7011340 DOI: 10.1155/2020/1742123] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 01/07/2020] [Indexed: 12/29/2022]
Abstract
Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted.
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Hulls PM, Richmond RC, Martin RM, de Vocht F. A systematic review protocol examining workplace interventions that aim to improve employee health and wellbeing in male-dominated industries. Syst Rev 2020; 9:10. [PMID: 31918756 PMCID: PMC6953289 DOI: 10.1186/s13643-019-1260-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 12/18/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The workplace environment potentially provides access to a large population who are employed, and it is an employer's responsibility to provide appropriate conditions for its employees. Whilst the aetiology of cardiovascular disease is multifactorial, it is generally acknowledged that working conditions, gender and age are involved in its development. Male-dominated industries (comprising > 70% male workers, e.g., agriculture, construction, manufacturing, mining, transport and technology) have a higher prevalence of health risk behaviours than other population subgroups. Working in a gender-dominated industry can impact an employee's health and wellbeing, particularly for the opposite sex. This systematic review examines workplace interventions that address the health and wellbeing of employees in male-dominated industries. METHODS We will include randomised controlled trials and studies with non-randomised intervention groups. The interventions must aim to improve employee physical and/or mental health and wellbeing implemented in the workplace in male-dominated industries. There will be no limits on date. The following electronic databases will be searched for published studies: Web of Science, Embed, MedLine, PsycInfo and the Cochrane Database. The search strategy will include free-text terms and MeSH vocabulary, including 'male-dominated industries', 'workplace interventions', 'occupational stress', 'mental health', 'cardiovascular disease', 'blood pressure', 'body mass index' and 'exercise'. Two authors will independently select, review and extract data from studies that meet the inclusion criteria. The Cochrane's Risk of Bias tool will be used to assess risk of bias. We will perform structured summaries of the included studies and, if possible, conduct meta-analyses or construct an Albatross plot. DISCUSSION There are an increasing number of interventions designed to improve employee health and wellbeing in the workplace, but no prior review that systematically evaluates their effectiveness. A systematic review is required to prioritise the future implementation of those interventions found to be most effective. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019161283.
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Affiliation(s)
- Paige M. Hulls
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rebecca C. Richmond
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Richard M. Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR School for Public Health Research, University of Bristol, Bristol, UK
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Behrendt D, Ebert DD, Spiegelhalder K, Lehr D. Efficacy of a Self-Help Web-Based Recovery Training in Improving Sleep in Workers: Randomized Controlled Trial in the General Working Population. J Med Internet Res 2020; 22:e13346. [PMID: 31909725 PMCID: PMC6996739 DOI: 10.2196/13346] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 09/22/2019] [Accepted: 09/26/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sleep complaints are among the most prevalent health concerns, especially among workers, which may lead to adverse effects on health and work. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-I) offers the opportunity to deliver effective solutions on a large scale. The efficacy of iCBT-I for clinical samples has been demonstrated in recent meta-analyses, and there is evidence that iCBT-I is effective in the working population with severe sleep complaints. However, to date, there is limited evidence from randomized controlled trials that iCBT-I could also be an effective tool for universal prevention among the general working population regardless of symptom severity. Although increasing evidence suggests that negatively toned cognitive activity may be a key factor for the development and maintenance of insomnia, little is known about how iCBT-I improves sleep by reducing presleep cognitive activity. OBJECTIVE This study aimed to examine the efficacy of a self-help internet-delivered recovery training, based on principles of iCBT-I tailored to the work-life domain, among the general working population. General and work-related cognitive activities were investigated as potential mediators of the intervention's effect. METHODS A sample of 177 workers were randomized to receive either the iCBT-I (n=88) or controls (n=89). The intervention is a Web-based training consisting of six 1-week modules. As the training was self-help, participants received nothing but technical support via email. Web-based self-report assessments were scheduled at baseline, at 8 weeks, and at 6 months following randomization. The primary outcome was insomnia severity. Secondary outcomes included measures of mental health and work-related health and cognitive activity. In an exploratory analysis, general and work-related cognitive activities, measured as worry and work-related rumination, were investigated as mediators. RESULTS Analysis of the linear mixed effects model showed that, relative to controls, participants who received iCBT-I reported significantly lower insomnia severity scores at postintervention (between-group mean difference -4.36; 95% CI -5.59 to - 3.03; Cohen d=0.97) and at 6-month follow-up (between-group difference: -3.64; 95% CI -4.89 to -2.39; Cohen d=0.86). The overall test of group-by-time interaction was significant (P<.001). Significant differences, with small-to-large effect sizes, were also detected for cognitive activity and for mental and work-related health, but not for absenteeism. Mediation analysis demonstrated that work-related rumination (indirect effect: a1b1=-0.80; SE=0.34; 95% boot CI -1.59 to -0.25) and worry (indirect effect: a2b2=-0.37; SE=0.19; 95% boot CI -0.85 to -0.09) mediate the intervention's effect on sleep. CONCLUSIONS A self-help Web-based recovery training, grounded in the principles of iCBT-I, can be effective in the general working population, both short and long term. Work-related rumination may be a particularly crucial mediator of the intervention's effect, suggesting that tailoring interventions to the workplace, including components to reduce the work-related cognitive activity, might be important when designing recovery interventions for workers. TRIAL REGISTRATION German Clinical Trials Register DRKS00007142; https://www.drks.de/DRKS00007142.
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Affiliation(s)
- Doerte Behrendt
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
| | - David Daniel Ebert
- Faculty of Behavioural and Movement Sciences, Clinical, Neuro- & Developmental Psychology, Free University Amsterdam, Amsterdam, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
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Development and Fidelity Testing of the Test@Work Digital Toolkit for Employers on Workplace Health Checks and Opt-In HIV Testing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010379. [PMID: 31935985 PMCID: PMC6982120 DOI: 10.3390/ijerph17010379] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/19/2019] [Accepted: 12/29/2019] [Indexed: 12/20/2022]
Abstract
Background: In the UK, few employers offer general health checks for employees, and opt-in HIV testing is rarely included. There is a need to provide evidence-based guidance and support for employers around health checks and HIV testing in the workplace. An Agile approach was used to develop and evaluate a digital toolkit to facilitate employers’ understanding about workplace health screening. Methods: The Test@Work toolkit development included an online survey (STAGE 1: n = 201), stakeholder consultation (STAGE 2: n = 19), expert peer review (STAGE 3: n = 24), and pilot testing (STAGE 4: n = 20). The toolkit includes employer guidance on workplace health promotion, workplace health screening, and confidential opt-in HIV testing with signposting to resources. Pilot testing included assessment of fidelity (delivery and engagement) and implementation qualities (attitudes, resources, practicality, acceptability, usability and cost). Results: STAGE 1: The vast majority of respondents would consider offering general health checks in the workplace that included confidential opt-in HIV testing, and this view was broadly comparable across organisation types (n = 201; public: 87.8%; private: 89.7%; third: 87.1%). STAGES 2 and 3: Stakeholders highlighted essential content considerations: (1) inclusion of the business case for workplace health initiatives, (2) clear pathways to employer responsibilities, and (3) presenting HIV-related information alongside other areas of health. With regards presentation, stakeholders proposed that the toolkit should be concise, with clear signposting and be hosted on a trusted portal. STAGE 4: Employers were satisfied with the toolkit content, usability and utility. The toolkit had high fidelity with regards to delivery and employer engagement. Assessment of implementation qualities showed high usability and practicality, with low perceived burden for completion and acceptable cost implications. Very few resource challenges were reported, and the toolkit was considered to be appropriate for any type of organisation, irrespective of size or resources. Conclusions: Employers perceived the Test@Work toolkit to be useful, meaningful and appropriate for their needs. This digital resource could be used to support employers to engage with health screening and opt-in HIV testing within the context of workplace health promotion.
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Kuribayashi K, Imamura K, Tokita M, Shimazu A, Kawakami N. Effects of internet-based cognitive behavioral therapy on depressive symptoms among new graduate nurses: a pilot study. ENVIRONMENTAL AND OCCUPATIONAL HEALTH PRACTICE 2020. [DOI: 10.1539/eohp.2019-0020-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kazuto Kuribayashi
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo
- Department of Mental Health and Psychiatric Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo
| | - Masahito Tokita
- Department of Keio Research Institute at SFC (Shonan Fujisawa Campus), Keio University
| | - Akihito Shimazu
- Department of Keio Research Institute at SFC (Shonan Fujisawa Campus), Keio University
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo
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Armaou M, Konstantinidis S, Blake H. The Effectiveness of Digital Interventions for Psychological Well-Being in the Workplace: A Systematic Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E255. [PMID: 31905882 PMCID: PMC6981473 DOI: 10.3390/ijerph17010255] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 12/23/2019] [Accepted: 12/25/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Psychological well-being has been associated with desirable individual and organisational outcomes. This systematic review aims to assess the effectiveness of digital interventions for the improvement of psychological well-being and/or the prevention/management of poor mental well-being in the workplace. METHODS This review protocol is registered in PROSPERO (CRD42019142428). Scientific databases including MEDLINE, Web of Science, CINAHL, PsycINFO, Cochrane Register of Controlled Trials (CENTRAL) and EMBASE will be searched for relevant studies published between January 1990 and July 2019. Studies will be included if they report specific primary and secondary outcomes of digital interventions delivered to adults in the workplace for the improvement of their psychological wellbeing and/or the prevention/management of poor mental well-being and were published in English. Following screening of titles and abstracts, full texts of potentially eligible papers will be screened in duplicate to identify studies that assess the effectiveness of those digital interventions. Discrepancies will be resolved through consensus or by consulting a third reviewer. An integrated narrative synthesis will assess included studies' findings, and a meta-analysis will be performed if included studies appear to be homogeneous. The "Cochrane Collaboration's Risk of Bias" tool and the JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Quasi-Experimental Studies will be used to appraise included studies. CONCLUSION The results of this work will provide recommendations on the use of digital interventions for the promotion of psychological well-being at work. It will also guide the development of future workplace digital interventions and subsequent primary research in this field.
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Affiliation(s)
- Maria Armaou
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.K.); (H.B.)
| | - Stathis Konstantinidis
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.K.); (H.B.)
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK; (S.K.); (H.B.)
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG7 2UH, UK
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Ryan J, Curtis R, Olds T, Edney S, Vandelanotte C, Plotnikoff R, Maher C. Psychometric properties of the PERMA Profiler for measuring wellbeing in Australian adults. PLoS One 2019; 14:e0225932. [PMID: 31869336 PMCID: PMC6927648 DOI: 10.1371/journal.pone.0225932] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/15/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This study evaluated the psychometric properties of the PERMA Profiler, a 15-item self-report measurement tool designed to measure Seligman's five pillars of wellbeing: Positive emotions, Relationships, Engagement, Meaning, and Accomplishment. METHODS Australian adults (N = 439) completed the PERMA Profiler and measures of physical and mental health (SF-12), depression, anxiety, stress (DASS 21), subjective physical activity (Active Australia Survey), and objective activity and sleep (GENEActiv accelerometer). Internal consistency was examined using Cronbach's alpha and associations between theoretically related constructs examined using Pearson's correlation. Model fit in comparison with theorised models was examined via Confirmatory Factor Analysis. RESULTS Results indicated acceptable internal consistency for overall PERMA Profiler scores and all subscales (α range = 0.80-0.93) except Engagement (α = 0.66). Moderate associations were found between PERMA Profiler wellbeing scores with subjective constructs (e.g. depression, anxiety, stress; r = -0.374 - -0.645, p = <0.001) but not objective physical activity or sleep. Data failed to meet model fit criteria for neither the theorised five-factor nor an alternative single-factor structure. CONCLUSIONS Findings were mixed, providing strong support for the scale's internal consistency and moderate support for congervent and divergent validity, albeit not in comparison to objectively captured activity outcomes. We could not replicate the theorised data structure nor an alternative, single factor structure. Results indicate insufficient psychometric properties of the PERMA Profiler.
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Affiliation(s)
- Jillian Ryan
- Precision Health Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Rachel Curtis
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah Edney
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School of Health Medical and Applied Sciences, Central Queensland University, Norman Gardens, Queensland, Australia
| | - Ronald Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition, and Activity, University of South Australia, Adelaide, South Australia, Australia
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Kouvonen A, Mänty M, Harkko J, Sumanen H, Konttinen H, Lahti J, Pietilainen O, Blomgren J, Tuovinen E, Ketonen EL, Stenberg JH, Donnelly M, Sivertsen B, Mittendorfer-Rutz E, Pirkola S, Rahkonen O, Lallukka T. Effectiveness of internet-delivered cognitive behavioural therapy in reducing sickness absence among young employees with depressive symptoms: study protocol for a large-scale pragmatic randomised controlled trial. BMJ Open 2019; 9:e032119. [PMID: 31690647 PMCID: PMC6858165 DOI: 10.1136/bmjopen-2019-032119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Depression is a highly prevalent condition with typical onset in early adulthood. Internet-delivered cognitive behavioural therapy (iCBT) is a promising cost-effective and more widely available alternative to face-to-face CBT. However, it is not known whether it can reduce sickness absence in employees showing depressive symptoms. The randomised controlled trial component of the DAQI (Depression and sickness absence in young adults: a quasi-experimental trial and web-based treatment intervention) project aims to investigate if iCBT is effective in reducing sickness absence compared with care as usual (CAU) among young employees with depressive symptoms in primary care provided in an occupational health setting. METHODS AND ANALYSIS This study will use a randomised controlled single-centre service-based trial of an existing iCBT programme (Mental Hub iCBT for Depression) to evaluate whether or not this treatment can reduce the number of sickness absence days in public sector employees aged 18-34 years who present at the occupational health service with mild depressive symptoms (score ≥9 on the Beck Depression Inventory-IA). Control participants will be offered CAU, with no constraints regarding the range of treatments. The active condition will consist of seven weekly modules of iCBT, with support from a web therapist. Primary outcome will be participants' all-cause sickness absence as indicated in employer's and national administrative records up to 6 months from study entry. Secondary outcomes relating to long-term sickness absence (over 11 calendar days) for mental and musculoskeletal disorders and psychotropic medication use will be obtained from the Finnish Social Insurance Institution's administrative records; and short sickness absence spells (up to 11 calendar days) will be extracted from employer's records. Analyses will be conducted on an intention-to-treat basis. ETHICS AND DISSEMINATION The Coordinating Ethics Committee of the Hospital District of Helsinki and Uusimaa has approved the study (HUS/974/2019). The results will be published in peer-reviewed scientific journals and in publications for lay audience. TRIAL REGISTRATION NUMBER ISRCTN10877837.
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Affiliation(s)
- Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Minna Mänty
- Unit of Statistics and Research, City of Vantaa, Vantaa, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hilla Sumanen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Unit of Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
| | - Hanna Konttinen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Jouni Lahti
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Olli Pietilainen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jenni Blomgren
- Research Unit, The Social Insurance Institution of Finland, Helsinki, Finland
| | | | | | - Jan-Henry Stenberg
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Børge Sivertsen
- Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sami Pirkola
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Pieper C, Schröer S, Eilerts AL. Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3553. [PMID: 31547516 PMCID: PMC6801553 DOI: 10.3390/ijerph16193553] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 12/25/2022]
Abstract
Work environment factors are highly correlated with employees' health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.
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Affiliation(s)
- Claudia Pieper
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, 45147 Essen, Germany.
| | - Sarah Schröer
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, 45147 Essen, Germany.
| | - Anna-Lisa Eilerts
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, 45147 Essen, Germany.
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Kuribayashi K, Imamura K, Watanabe K, Miyamoto Y, Takano A, Sawada U, Sasaki N, Suga M, Sugino A, Hidaka Y, Iida M, Sudo M, Tokita M, Kawakami N. Effects of an internet-based cognitive behavioral therapy (iCBT) intervention on improving depressive symptoms and work-related outcomes among nurses in Japan: a protocol for a randomized controlled trial. BMC Psychiatry 2019; 19:245. [PMID: 31391029 PMCID: PMC6686442 DOI: 10.1186/s12888-019-2221-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 07/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is a major problem among nurses; hence, it is important to develop a primary prevention strategy to manage depression among nurses. This randomized controlled trial (RCT) study aims to investigate the effects of a newly developed internet-based cognitive behavioral therapy (iCBT) program on depressive symptoms, measured at baseline and three- and six-month follow-ups, among nurses in Japan. METHODS Nurses working at three university hospitals, one public hospital, and twelve private hospitals who meet inclusion criteria will be recruited and randomized either to the intervention group or the control group (planned N = 525 for each group). The newly developed iCBT program for nurses consists of six modules, which cover different components of cognitive behavioral therapy (CBT); transactional stress model (in module 1), self-monitoring skills (in module 2), behavioral activation skills (in module 3), cognitive restructuring skills (in modules 4 and 5), relaxation skills (in module 5), and problem-solving skills (in module 6). Participants in the intervention group will be asked to read these modules within 9 weeks. The primary outcome will be depressive symptoms as assessed by the Beck Depression Inventory-II (BDI-II) at baseline, three-, and six-month follow-ups. DISCUSSION The greatest strength of this study is that it is the first RCT to test the effectiveness of the iCBT program in improving depressive symptoms among nurses. A major limitation is that all measurements, including major depressive episodes, are self-reported and may be affected by situational factors at work and participants' perceptions. TRIAL REGISTRATION This trial was registered at the University Hospital Medical Information Network clinical trials registry (UMIN-CTR; ID = UMIN000033521 ) (Date of registration: August 1, 2018).
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Affiliation(s)
- Kazuto Kuribayashi
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Ayumi Takano
- Department of Mental Health and Psychiatric Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Utako Sawada
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Mariko Suga
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Atsushi Sugino
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Yui Hidaka
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Mako Iida
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Mie Sudo
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Masahito Tokita
- Department of Keio Research Institute at SFC (Shonan Fujisawa Campus), Keio University SFC, 5322 Endo, Fujisawa-shi, Kanagawa, 252-0882 Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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Hunter RF, Gough A, Murray JM, Tang J, Brennan SF, Chrzanowski-Smith OJ, Carlin A, Patterson C, Longo A, Hutchinson G, Prior L, Tully MA, French DP, Adams J, McIntosh E, Xin Y, Kee F. A loyalty scheme to encourage physical activity in office workers: a cluster RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Increasing physical activity in the workplace can provide physical and mental health benefits for employees and economic benefits for the employer through reduced absenteeism and increased productivity. However, there is limited evidence on effective behaviour change interventions in workplace settings that led to maintained physical activity. This study aimed to address this gap and contribute to the evidence base for effective and cost-effective workplace interventions.
Objectives
To determine the effectiveness and cost-effectiveness of the Physical Activity Loyalty scheme, a multicomponent intervention based on concepts similar to those that underpin a high-street loyalty card, which was aimed at encouraging habitual physical activity behaviour and maintaining increases in mean number of steps per day.
Design
A cluster randomised controlled trial with an embedded economic evaluation, behavioural economic experiments, mediation analyses and process evaluation.
Setting
Office-based employees from public sector organisations in Belfast and Lisburn city centres in Northern Ireland.
Participants
A total of 853 participants [mean age 43.6 years (standard deviation 9.6 years); 71% of participants were female] were randomly allocated by cluster to either the intervention group or the (waiting list) control group.
Intervention
The 6-month intervention consisted of financial incentives (retail vouchers), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of the workplaces allowed participants to monitor their accumulated minutes of physical activity.
Main outcome measures
The primary outcome was mean number of steps per day recorded using a sealed pedometer (Yamax Digiwalker CW-701; Yamax, Tasley, UK) worn on the waist for 7 consecutive days and at 6 and 12 months post intervention. Secondary outcomes included health, mental well-being, quality of life, work absenteeism and presenteeism, and the use of health-care resources.
Results
The mean number of steps per day were significantly lower for the intervention group than the control group [6990 mean number of steps per day (standard deviation 3078) vs. 7576 mean number of steps per day (standard deviation 3345), respectively], with an adjusted mean difference of –336 steps (95% confidence interval –612 to –60 steps; p = 0.02) at 6 months post baseline, but not significantly lower at 12 months post baseline. There was a small but significant enhancement of mental well-being in the intervention group (difference between groups for the Warwick–Edinburgh Mental Wellbeing Scale of 1.34 points, 95% confidence interval 0.48 to 2.20 points), but not for the other secondary outcomes. An economic evaluation suggested that, overall, the scheme was not cost-effective compared with no intervention. The intervention was £25.85 (95% confidence interval –£29.89 to £81.60) more costly per participant than no intervention and had no effect on quality-adjusted life-years (incremental quality-adjusted life-years –0.0000891, 95% confidence interval –0.008 to 0.008).
Limitations
Significant restructuring of participating organisations during the study resulted in lower than anticipated recruitment and retention rates. Technical issues affected intervention fidelity.
Conclusions
Overall, assignment to the intervention group resulted in a small but significant decline in the mean pedometer-measured steps per day at 6 months relative to baseline, compared with the waiting list control group. The Physical Activity Loyalty scheme was deemed not to be cost-effective compared with no intervention, primarily because no additional quality-adjusted life-years were gained through the intervention. Research to better understand the mechanisms of physical activity behaviour change maintenance will help the design of future interventions.
Trial registration
Current Controlled Trials ISRCTN17975376.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ruth F Hunter
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Aisling Gough
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jennifer M Murray
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Jianjun Tang
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Sarah F Brennan
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | | | | | - Chris Patterson
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Alberto Longo
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - George Hutchinson
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
- School of Biological Sciences, Queen’s University Belfast, Belfast, UK
| | - Lindsay Prior
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - David P French
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frank Kee
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- UKCRC Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
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133
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Kerr DC, Ornelas IJ, Lilly MM, Calhoun R, Meischke H. Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study. J Med Internet Res 2019; 21:e13449. [PMID: 31219045 PMCID: PMC6607772 DOI: 10.2196/13449] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/09/2019] [Accepted: 05/05/2019] [Indexed: 11/21/2022] Open
Abstract
Background Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention. Objective The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging. Methods We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI. Results We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content. Conclusions The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work. Trial Registration ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621
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Affiliation(s)
- Darragh C Kerr
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - India J Ornelas
- Department of Health Services, University of Washington, Seattle, WA, United States
| | - Michelle M Lilly
- Department of Psychology, Northern Illinois University, DeKalb, IL, United States
| | - Rebecca Calhoun
- Northwest Center for Public Health Practice, University of Washington, Seattle, WA, United States
| | - Hendrika Meischke
- Department of Health Services, University of Washington, Seattle, WA, United States.,Northwest Center for Public Health Practice, University of Washington, Seattle, WA, United States
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134
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Smoktunowicz E, Lesnierowska M, Cieslak R, Carlbring P, Andersson G. Efficacy of an Internet-based intervention for job stress and burnout among medical professionals: study protocol for a randomized controlled trial. Trials 2019; 20:338. [PMID: 31182128 PMCID: PMC6558742 DOI: 10.1186/s13063-019-3401-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/06/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Medical professionals are at high risk of job stress and burnout. Research shows that work-related stress can be reduced through enhancing psychological resources, in particular, self-efficacy and perceived social support. These psychological resources can operate either individually or sequentially: in line with the cultivation hypothesis, self-efficacy precedes and cultivates perceived social support, whereas according to the enabling hypothesis it is perceived social support that comes first and enables self-efficacy. Based on this theoretical framework we developed an internet-based intervention, Med-Stress, dedicated to healthcare providers and aimed at reducing job stress and burnout. Med-Stress contains two modules that enhance self-efficacy and perceived social support, which are tested in four variants reflected in four study conditions. We expect that sequential enhancement of resources: self-efficacy and social support or social support and self-efficacy will yield larger posttest results than individual enhancement. METHODS In this four-arm randomized controlled trial we will test four variants of the Med-Stress intervention. The trial is open for professionally active medical providers aged at least 18 years (N = 1200) with access to an Internet-connected device. We will compare the effects of two experimental conditions reflecting cultivation and enabling effects of self-efficacy and perceived social support (sequential enhancement of resources), and two active controls strengthening self-efficacy or perceived social support. Job stress and job burnout will be the primary outcomes, whereas depression, job-related traumatic stress, and work engagement will be secondary ones. Additionally, we will measure perceived social support, self-efficacy to manage job stress and burnout, and the ability to obtain social support, exposure to traumatic events, and users' expectancy and credibility of the intervention. All assessments will be applied before the intervention, at posttest (at 3 or 6 weeks depending on the study condition), and at 6-month and 12-month follow up. In the case of experimental groups, additional measurements will be taken after enhancing each resource. DISCUSSION Resource-based interventions are relatively context-free and could potentially benefit medical professionals across the field. If Med-Stress is successful, its most effective variant could be implemented in the healthcare system as a standalone, supportive tool for employees. TRIAL REGISTRATION ClinicalTrials.gov, NCT03475290 Registered on 23 March 2018.
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Affiliation(s)
- Ewelina Smoktunowicz
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
| | - Magdalena Lesnierowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
| | - Roman Cieslak
- Department of Psychology, SWPS University of Social Sciences and Humanities, Chodakowska 19/31, 03–815 Warsaw, Poland
- Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO USA
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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135
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Jarden RJ, Narayanan A, Sandham M, Siegert RJ, Koziol-McLain J. Bibliometric mapping of intensive care nurses' wellbeing: development and application of the new iAnalysis model. BMC Nurs 2019; 18:21. [PMID: 31171915 PMCID: PMC6547532 DOI: 10.1186/s12912-019-0343-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/24/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Intensive care nurse wellbeing is essential to a healthy healthcare workforce. Enhanced wellbeing has widespread benefits for workers. Bibliometrics enables quantitative analysis of bourgeoning online data. Here, a new model is developed and applied to explore empirical knowledge underpinning wellbeing and intensive care nurse wellbeing in terms of size and impact, disciplinary reach, and semantics. METHODS Mixed methods bibliometric study. Firstly, a new model coined 'iAnalysis' was developed for the analysis of published data. Secondly, iAnalysis was applied in two studies to examine wellbeing and ICU nurse wellbeing. Study one explored data from a title search with search terms [wellbeing OR well-being], identifying 17,543 records with bibliographic data. This dataset included 20,526 keywords. Of the identified records, 10,715 full-text manuscripts were retrieved. Study two explored data from a topic search with search terms [(intensive OR critical) AND (nurs*) AND (wellbeing OR well-being)], identifying 383 records with bibliographic data. This dataset included 1223 author keywords. Of the identified records, 328 full-text manuscripts were retrieved. RESULTS Once data were collected, for size and impact, WoS Clarivate Analytics™ and RStudio™ were used to explore publication dates, frequencies, and citation performance. For disciplinary reach, RStudio™ (with the Bibliometrics™ package & Vosviewer™ plugin) was used to explore the records in terms of country of publication, journal presence, and mapping of authors. For semantics, once the bibliographic data was imported to RStudio™ (with the Bibliometrics™ package & Vosviewer™ plugin) keyword co-occurrences were identified and visualised. Full-text manuscripts were imported to NVivo™ to explore word frequencies of both the keywords and full-text manuscripts using the word frequency search. For both studies, records were predominantly published in the past 5 years, in English language, and from USA. The highest keyword co-occurrence for study one was "health and well-being", and for study two, "family and model". CONCLUSIONS Terms commonly associated with 'illbeing', as opposed to 'wellbeing', were highly prevalent in both study datasets, but more so in intensive care nurse wellbeing data. Intensive care nurse wellbeing was virtually absent in this literature. The iAnalysis model provided a practice-friendly tool to explore a large source of online published literature.
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Affiliation(s)
- Rebecca J. Jarden
- Present Address: Department of Nursing, Melbourne School of Health Sciences, 161 Barry St, Carlton, Victoria 3053 Australia
- School of Clinical Sciences, Auckland University of Technology (AUT), North Shore Campus, 90 Akoranga Drive, Northcote, Auckland, 0627 New Zealand
| | - Ajit Narayanan
- School of Engineering, Computing and Mathematical Sciences (D-75), Auckland University of Technology, AUT Tower, 2-14 Wakefield Street, Auckland, 1010 New Zealand
| | - Margaret Sandham
- School of Clinical Sciences, Auckland University of Technology (AUT), North Shore Campus, 90 Akoranga Drive, Northcote, Auckland, 0627 New Zealand
| | - Richard J. Siegert
- School of Clinical Sciences and School of Public Health and Psychosocial Studies, Auckland University of Technology (AUT), North Shore Campus, 90 Akoranga Drive, Northcote, Auckland, 0627 New Zealand
| | - Jane Koziol-McLain
- School of Clinical Sciences, Auckland University of Technology (AUT), North Shore Campus, 90 Akoranga Drive, Northcote, Auckland, 0627 New Zealand
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136
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Murray JM, French DP, Patterson CC, Kee F, Gough A, Tang J, Hunter RF. Predicting Outcomes from Engagement With Specific Components of an Internet-Based Physical Activity Intervention With Financial Incentives: Process Analysis of a Cluster Randomized Controlled Trial. J Med Internet Res 2019; 21:e11394. [PMID: 31002304 PMCID: PMC6498305 DOI: 10.2196/11394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/28/2018] [Accepted: 01/06/2019] [Indexed: 01/12/2023] Open
Abstract
Background Investigating participant engagement and nonusage attrition can help identify the likely active ingredients of electronic health interventions. Research on engagement can identify which intervention components predict health outcomes. Research on nonusage attrition is important to make recommendations for retaining participants in future studies. Objective This study aimed to investigate engagement and nonusage attrition in the Physical Activity Loyalty (PAL) scheme, a 6-month complex physical activity intervention in workplaces in Northern Ireland. The intervention included financial incentives with reward redemption and self-regulation techniques. Specific objectives were (1) to determine whether engagement in specific intervention components predicted physical activity at 6 months, (2) to determine whether engagement in specific intervention components predicted targeted mediators at 6 months, and (3) to investigate predictors of nonusage attrition for participants recording daily activity via the PAL scheme physical activity monitoring system and logging onto the website. Methods Physical activity was assessed at baseline and 6 months using pedometers (Yamax Digiwalker CW-701, Japan). Markers of engagement and website use, monitoring system use, and reward redemption were collected throughout the scheme. Random-effects generalized least-squares regressions determined whether engagement with specific intervention components predicted 6-month physical activity and mediators. Cox proportional hazards regressions were used to investigate predictors of nonusage attrition (days until first 2-week lapse). Results A multivariable generalized least-squares regression model (n=230) showed that the frequency of hits on the website’s monitoring and feedback component (regression coefficient [b]=50.2; SE=24.5; P=.04) and the percentage of earned points redeemed for financial incentives (b=9.1; SE=3.3; P=.005) were positively related to 6-month pedometer steps per day. The frequency of hits on the discussion forum (b=−69.3; SE=26.6; P=.009) was negatively related to 6-month pedometer steps per day. Reward redemption was not related to levels of more internal forms of motivation. Multivariable Cox proportional hazards regression models identified several baseline predictors associated with nonusage attrition. These included identified regulation (hazard ratio [HR] 0.88, 95% CI 0.81-0.97), recovery self-efficacy (HR 0.88, 95% CI 0.80-0.98), and perceived workplace environment safety (HR 1.07, 95% CI 1.02-1.11) for using the physical activity monitoring system. The EuroQoL health index (HR 0.33, 95% CI 0.12-0.91), financial motivation (HR 0.93, 95% CI 0.87-0.99), and perceived availability of physical activity opportunities in the workplace environment (HR 0.96, 95% CI 0.93-0.99) were associated with website nonusage attrition. Conclusions Our results provide evidence opposing one of the main hypotheses of self-determination theory by showing that financial rewards are not necessarily associated with decreases in more internal forms of motivation when offered as part of a complex multicomponent intervention. Identifying baseline predictors of nonusage attrition can help researchers to develop strategies to ensure maximum intervention adherence. Trial Registration ISRCTN Registry ISRCTN17975376; http://www.isrctn.com/ISRCTN17975376 (Archived by WebCite at http://www.webcitation.org/76VGZsZug)
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Affiliation(s)
- Jennifer M Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - David P French
- Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Christopher C Patterson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Aisling Gough
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Jianjun Tang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
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137
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Imamura K, Tran TTT, Nguyen HT, Kuribayashi K, Sakuraya A, Nguyen AQ, Bui TM, Nguyen QT, Nguyen KT, Nguyen GTH, Tran XTN, Truong TQ, Zhang MWB, Minas H, Sekiya Y, Sasaki N, Tsutsumi A, Kawakami N. Effects of two types of smartphone-based stress management programmes on depressive and anxiety symptoms among hospital nurses in Vietnam: a protocol for three-arm randomised controlled trial. BMJ Open 2019; 9:e025138. [PMID: 30962230 PMCID: PMC6500319 DOI: 10.1136/bmjopen-2018-025138] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 01/07/2019] [Accepted: 02/26/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Due to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam. METHODS AND ANALYSIS The target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixed-order stress management (intervention group B, n=360), or a treatment as usual control group (n=360). Two types (free-choice and fixed sequential order) of smartphone-based six-module stress management programmes will be developed. Participants in the intervention groups will be required to complete one of the programmes within 10 weeks after the baseline survey. The primary outcomes are depressive and anxiety symptoms, measured by using the Depression Anxiety and Stress Scales (DASS) at 3-month and 7 month follow-ups. ETHICS AND DISSEMINATION The study procedures have been approved by the Research Ethics Review Board of Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (no 11991) and the Ethical Review Board for Biomedical Research of Hanoi University of Public Health (no 346/2018/YTCC-HD3). If a significant effect of the intervention programmes will be found in the RCT, the programmes will be made available to all nurses in the hospital including the control group. If the positive effects are found in this RCT, the e-stress management programmes will be disseminated to all nurses in Vietnam. TRIAL REGISTRATION NUMBER UMIN000033139; Pre-results.
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Affiliation(s)
- Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Thuy Thi Thu Tran
- Department of Occupational Health and Safety, Hanoi University of Public Health, Hanoi, Vietnam
| | - Huong Thanh Nguyen
- Faculty of Social Sciences - Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kazuto Kuribayashi
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asuka Sakuraya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Thu Minh Bui
- Nursing Office, Bach Mai Hospital, Hanoi, Vietnam
| | - Quynh Thuy Nguyen
- Department of Occupational Health and Safety, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kien Trung Nguyen
- Faculty of Social Sciences - Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | | | | | - Tien Quang Truong
- Faculty of Social Sciences - Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Melvyn W B Zhang
- Family Medicine & Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Harry Minas
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuki Sekiya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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138
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Joyce S, Shand F, Lal TJ, Mott B, Bryant RA, Harvey SB. Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders. J Med Internet Res 2019; 21:e12894. [PMID: 30777846 PMCID: PMC6399574 DOI: 10.2196/12894] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/13/2019] [Accepted: 01/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time. Objective This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers. Methods We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills. Results Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002). Conclusions The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615000574549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368296 (Archived by WebCite at http://www.webcitation.org/75w4xtrpw).
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Affiliation(s)
- Sadhbh Joyce
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,The Black Dog Institute, Hospital Road, Randwick, Australia
| | - Fiona Shand
- The Black Dog Institute, Hospital Road, Randwick, Australia
| | - Tara J Lal
- Fire and Rescue New South Wales, Sydney, Australia
| | - Brendan Mott
- Fire and Rescue New South Wales, Sydney, Australia
| | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, Australia
| | - Samuel B Harvey
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,The Black Dog Institute, Hospital Road, Randwick, Australia
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139
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Deady M, Johnston D, Milne D, Glozier N, Peters D, Calvo R, Harvey S. Preliminary Effectiveness of a Smartphone App to Reduce Depressive Symptoms in the Workplace: Feasibility and Acceptability Study. JMIR Mhealth Uhealth 2018; 6:e11661. [PMID: 30514694 PMCID: PMC6299234 DOI: 10.2196/11661] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/14/2018] [Accepted: 09/14/2018] [Indexed: 12/18/2022] Open
Abstract
Background The workplace represents a unique setting for mental health interventions. Due to range of job-related factors, employees in male-dominated industries are at an elevated risk. However, these at-risk groups are often overlooked. HeadGear is a smartphone app–based intervention designed to reduce depressive symptoms and increase well-being in these populations. Objective This paper presents the development and pilot testing of the app’s usability, acceptability, feasibility, and preliminary effectiveness. Methods The development process took place from January 2016 to August 2017. Participants for prototype testing (n=21; stage 1) were recruited from industry partner organizations to assess acceptability and utility. A 5-week effectiveness and feasibility pilot study (n=84; stage 2) was then undertaken, utilizing social media recruitment. Demographic data, acceptability and utility questionnaires, depression (Patient Health Questionnaire-9), and other mental health measures were collected. Results The majority of respondents felt HeadGear was easy to use (92%), easily understood (92%), were satisfied with the app (67%), and would recommend it to a friend (75%; stage 1). Stage 2 found that compared with baseline, depression and anxiety symptoms were significantly lower at follow-up (t30=2.53; P=.02 and t30=2.18; P=.04, respectively), days of sick leave in past month (t28=2.38; P=.02), and higher self-reported job performance (t28=−2.09; P=.046; stage 2). Over 90% of respondents claimed it helped improve their mental fitness, and user feedback was again positive. Attrition was high across the stages. Conclusions Overall, HeadGear was well received, and preliminary findings indicate it may provide an innovative new platform for improving mental health outcomes. Unfortunately, attrition was a significant issue, and findings should be interpreted with caution. The next stage of evaluation will be a randomized controlled trial. If found to be efficacious, the app has the potential to reduce disease burden and improve health in this at-risk group.
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Affiliation(s)
- Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David Johnston
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Milne
- School of Systems, Management and Leadership, Faculty of Engineering and IT, University of Technology, Sydney, Australia
| | - Nick Glozier
- Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Dorian Peters
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Rafael Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
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140
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Abhulimen S, Hirsch A. Quantifying the economic impact of a digital self-care behavioral health platform on Missouri Medicaid expenditures. J Med Econ 2018; 21:1084-1090. [PMID: 30095023 DOI: 10.1080/13696998.2018.1510834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM The primary objective of this study is to estimate the economic benefits relative to return on investment (ROI) of a state-wide initiative to integrate digital behavioral health (BH) self-care into the community BH system. METHODS The observational study reviewed claims data of 799 people who registered with the digital tool (myStrength) and 715 matched control study participants. The control group was formed via coarsened exact match with blocking variables, including presence on the claims file, volume of health care utilization, participation in a medical health home, BH diagnosis and volume of psychotherapy claims. The primary study analysis of cost differences for the BH self-care tool group versus the control group were calculated by cost setting and the ROI of the BH self-care tool was estimated. Cost settings assessed include inpatient, emergency services, general and psychiatric outpatient, and outpatient psychotherapy. RESULTS An incremental annual difference in difference reduction of $382 per user was observed over the 11 month study period in the self-care tool group. Sensitivity analysis indicated an ROI of between 142% and 695%. CONCLUSIONS Augmenting BH offerings to include digital BH self-care tools appears to generate positive ROI via reduced total cost of care.
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141
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Kim JI, Yun JY, Park H, Park SY, Ahn Y, Lee H, Kim TK, Yoon S, Lee YJ, Oh S, Denninger JW, Kim BN, Kim JH. A Mobile Videoconference-Based Intervention on Stress Reduction and Resilience Enhancement in Employees: Randomized Controlled Trial. J Med Internet Res 2018; 20:e10760. [PMID: 30348630 PMCID: PMC6234345 DOI: 10.2196/10760] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Videoconferencing-based treatments have shown great potential in increasing engagement and compliance by decreasing the barriers of time and distance. In general, employees tend to experience a lot of stress, but find it difficult to visit a clinic during office hours. OBJECTIVE The purpose of this study was to investigate the effectiveness of a mobile videoconference-based intervention for stress reduction and resilience enhancement in employees. METHODS In total, 81 participants were randomly allocated to one of the three conditions: mobile videoconferencing, in-person, and self-care; of these, 72 completed the study. All participants underwent assessment via self-reported questionnaires before, immediately after, and 1 month after the intervention. Intervention lasted for 4 weeks and consisted of elements of cognitive behavioral therapy, positive psychology, and meditation. Changes in clinical variables regarding stress and resilience across time were compared between treatment conditions. RESULTS There were significant condition × time effects on variables measuring perceived stress, resilience, emotional labor, and sleep, demonstrating significantly differential effects across time according to treatment condition. Moreover, there were significant effects of condition on perceived stress and occupational stress. There were no significant differences in any variable between the mobile videoconferencing and in-person conditions at 1 month after the intervention. CONCLUSIONS Results indicate that both mobile videoconferencing and in-person interventions were comparably effective in decreasing stress and enhancing resilience. Further studies with a larger sample size and a longer follow-up period are warranted to investigate the long-term effect of mobile videoconferencing interventions. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03256682; https://clinicaltrials.gov/ct2/show/NCT03256682 (Archived by WebCite at http://www.webcitation.org/71W77bwnR).
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Affiliation(s)
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic Of Korea.,Seoul National University College of Medicine, Seoul, Republic Of Korea
| | - Heyeon Park
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | - Suk-Young Park
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
| | | | - Hansol Lee
- Korean Academy of Gifted Education, Seoul, Republic Of Korea
| | | | - Sooran Yoon
- Aimmed Company Ltd, Seoul, Republic Of Korea
| | | | - Sohee Oh
- Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic Of Korea
| | - John W Denninger
- Benson-Henry Institue for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Bung-Nyun Kim
- Seoul National University Hospital, Seoul, Republic Of Korea.,Seoul National University College of Medicine, Seoul, Republic Of Korea.,Human Behavioral Medical Institute, Seoul National University Medical Research Center, Seoul, Republic Of Korea
| | - Jeong-Hyun Kim
- Seoul National University Bundang Hospital, Seongnam, Republic Of Korea
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142
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Joyce S, Shand F, Bryant RA, Lal TJ, Harvey SB. Mindfulness-Based Resilience Training in the Workplace: Pilot Study of the Internet-Based Resilience@Work (RAW) Mindfulness Program. J Med Internet Res 2018; 20:e10326. [PMID: 30206055 PMCID: PMC6231729 DOI: 10.2196/10326] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/22/2018] [Accepted: 06/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background The impact of mental illness on society is far reaching and has been identified as the leading cause of sickness absence and work disability in most developed countries. By developing evidence-based solutions that are practical, affordable, and accessible, there is potential to deliver substantial economic benefits while improving the lives of individual workers. Academic and industry groups are now responding to this public health issue. A key focus is on developing practical solutions that enhance the mental health and psychological resilience of workers. A growing body of research suggests resilience training may play a pivotal role in the realm of public health and prevention, particularly with regards to protecting the long-term well-being of workers. Objective Our aim is to examine whether a mindfulness-based resilience-training program delivered via the internet is feasible and engaging to a group of high-risk workers. Additionally, we aim to measure the effect of the Resilience@Work Resilience@Work Mindfulness program on measures of resilience and related skills. Methods The current pilot study recruited 29 full-time firefighters. Participants were enrolled in the 6-session internet-based resilience-training program and were administered questionnaires prior to training and directly after the program ended. Measurements examined program feasibility, psychological resilience, experiential avoidance, and thought entanglement. Results Participants reported greater levels of resilience after Resilience@Work training compared to baseline, with a mean increase in their overall resilience score of 1.5 (95% CI -0.25 to 3.18, t14=1.84, P=.09). Compared to baseline, participants also reported lower levels of psychological inflexibility and experiential avoidance following training, with a mean decrease of -1.8 (95% CI -3.78 to 0.20, t13=-1.94, P=.07). With regards to cognitive fusion (thought entanglement), paired-samples t tests revealed a trend towards reduction in mean scores post training (P=.12). Conclusions This pilot study of the Resilience@Work program suggests that a mindfulness-based resilience program delivered via the Internet is feasible in a high-risk workplace setting. In addition, the firefighters using the program showed a trend toward increased resilience and psychological flexibility. Despite a number of limitations, the results of this pilot study provide some valuable insights into what form of resilience training may be viable in occupational settings particularly among those considered high risk, such as emergency workers. To the best of our knowledge, this is the first time a mindfulness-based resilience-training program delivered wholly via the internet has been tested in the workplace.
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Affiliation(s)
- Sadhbh Joyce
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia
| | | | - Richard A Bryant
- School of Psychology, Faculty of Science, University of New South Wales, Randwick, Australia
| | - Tara J Lal
- Fire and Rescue New South Wales, Alexandria, Australia
| | - Samuel B Harvey
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,Black Dog Institute, Randwick, Australia
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143
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Bennett JB, Neeper M, Linde BD, Lucas GM, Simone L. Team Resilience Training in the Workplace: E-Learning Adaptation, Measurement Model, and Two Pilot Studies. JMIR Ment Health 2018; 5:e35. [PMID: 29720362 PMCID: PMC5956157 DOI: 10.2196/mental.8955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/25/2018] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The majority of resilience interventions focus on the individual. Workplace resilience is a growing field of research. Given the ever-increasing interconnectedness in businesses, teamwork is a guarantee. There is also growing recognition that resilience functions at the team level. OBJECTIVE The objective of our work was to address three shortcomings in the study of workplace resilience interventions: lack of interventions focusing on group-level or team resilience, the need for brief interventions, and the need for more theoretical precision in intervention studies. METHODS The authors took an established evidence-based program (Team Resilience) and modified it based on these needs. A working model for brief intervention evaluation distinguishes outcomes that are proximal (perceptions that the program improved resilience) and distal (dispositional resilience). A total of 7 hypotheses tested the model and program efficacy. RESULTS Two samples (n=118 and n=181) of engineering firms received the Web-based training and provided immediate reactions in a posttest-only design. The second sample also included a control condition (n=201). The findings support the model and program efficacy. For example, workplace resilience was greater in the intervention group than in the control group. Other findings suggest social dissemination effects, equal outcomes for employees at different stress levels, and greater benefit for females. CONCLUSIONS This preliminary research provides evidence for the capabilities of e-learning modules to effectively promote workplace resilience and a working model of team resilience.
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Affiliation(s)
- Joel B Bennett
- Organizational Wellness & Learning Systems, Fort Worth, TX, United States
| | - Michael Neeper
- Organizational Wellness & Learning Systems, Fort Worth, TX, United States
| | - Brittany D Linde
- Organizational Wellness & Learning Systems, Fort Worth, TX, United States
| | - Gale M Lucas
- Organizational Wellness & Learning Systems, Fort Worth, TX, United States
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144
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Myers ND, Dietz S, Prilleltensky I, Prilleltensky O, McMahon A, Rubenstein CL, Lee S. Efficacy of the Fun For Wellness Online Intervention to Promote Well-Being Actions: A Secondary Data Analysis. Games Health J 2018; 7:225-239. [PMID: 29708773 DOI: 10.1089/g4h.2017.0132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Fun For Wellness (FFW) is a new online intervention designed to promote growth in well-being by providing capability-enhancing learning opportunities (e.g., play an interactive game) to participants. The purpose of this study was to provide an initial evaluation of the efficacy of the FFW intervention to increase well-being actions. MATERIALS AND METHODS The study design was a secondary data analysis of a large-scale prospective, double-blind, parallel-group randomized controlled trial. Data were collected at baseline and 30 and 60 days postbaseline. A total of 479 adult employees at a major university in the southeast of the United States of America were enrolled. Participants who were randomly assigned to the FFW group were provided with 30 days of 24-hour access to the intervention. A two-class linear regression model with complier average causal effect estimation was fitted to well-being actions scores at 30 and 60 days. RESULTS Intent-to-treat analysis provided evidence that the effect of being assigned to the FFW intervention, without considering actual participation in the FFW intervention, had a null effect on each dimension of well-being actions at 30 and 60 days. Participants who complied with the FFW intervention, however, had significantly higher well-being actions scores, compared to potential compliers in the Usual Care group, in the interpersonal dimension at 60 days, and the physical dimension at 30 days. CONCLUSIONS Results from this secondary data analysis provide some supportive evidence for both the efficacy of and possible revisions to the FFW intervention in regard to promoting well-being actions.
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Affiliation(s)
- Nicholas D Myers
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
| | - Samantha Dietz
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Isaac Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Ora Prilleltensky
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Adam McMahon
- 2 School of Education and Human Development , University of Miami, Coral Gables, Florida
| | - Carolyn L Rubenstein
- 3 Department of Educational and Psychological Studies, University of Miami , Coral Gables, Florida
| | - Seungmin Lee
- 1 Department of Kinesiology, Michigan State University , East Lansing, Michigan
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145
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Jimenez P, Bregenzer A. Integration of eHealth Tools in the Process of Workplace Health Promotion: Proposal for Design and Implementation. J Med Internet Res 2018; 20:e65. [PMID: 29475828 PMCID: PMC5845105 DOI: 10.2196/jmir.8769] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/12/2017] [Accepted: 12/18/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Electronic health (eHealth) and mobile health (mHealth) tools can support and improve the whole process of workplace health promotion (WHP) projects. However, several challenges and opportunities have to be considered while integrating these tools in WHP projects. Currently, a large number of eHealth tools are developed for changing health behavior, but these tools can support the whole WHP process, including group administration, information flow, assessment, intervention development process, or evaluation. OBJECTIVE To support a successful implementation of eHealth tools in the whole WHP processes, we introduce a concept of WHP (life cycle model of WHP) with 7 steps and present critical and success factors for the implementation of eHealth tools in each step. METHODS We developed a life cycle model of WHP based on the World Health Organization (WHO) model of healthy workplace continual improvement process. We suggest adaptations to the WHO model to demonstrate the large number of possibilities to implement eHealth tools in WHP as well as possible critical points in the implementation process. RESULTS eHealth tools can enhance the efficiency of WHP in each of the 7 steps of the presented life cycle model of WHP. Specifically, eHealth tools can support by offering easier administration, providing an information and communication platform, supporting assessments, presenting and discussing assessment results in a dashboard, and offering interventions to change individual health behavior. Important success factors include the possibility to give automatic feedback about health parameters, create incentive systems, or bring together a large number of health experts in one place. Critical factors such as data security, anonymity, or lack of management involvement have to be addressed carefully to prevent nonparticipation and dropouts. CONCLUSIONS Using eHealth tools can support WHP, but clear regulations for the usage and implementation of these tools at the workplace are needed to secure quality and reach sustainable results.
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146
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Nicholson J, Wright SM, Carlisle AM. Pre-post, mixed-methods feasibility study of the WorkingWell mobile support tool for individuals with serious mental illness in the USA: a pilot study protocol. BMJ Open 2018; 8:e019936. [PMID: 29437756 PMCID: PMC5829935 DOI: 10.1136/bmjopen-2017-019936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Successful competitive employment has been found to be related to enhanced self-esteem, higher quality of life and reduced mental health service use for individuals living with serious mental illnesses (SMIs) including schizophrenia, bipolar disorder and major depression. The effectiveness of the individual placement and support model has been demonstrated in multiple randomised controlled trials in many countries. The management of stress, depression and anxiety in the workplace may be effectively enhanced through digital mental health interventions. The WorkingWell mobile support tool ('app') is specifically designed to meet the need for illness management support for individuals with SMI in the workplace, as an adjunct to professional treatment. METHODS AND ANALYSIS The WorkingWell app, grounded in evidence-based supported employment, is informed by user experience design. It will be tested in a pre-post design, mixed-methods pilot study to explore issues of feasibility, acceptability and usefulness, and to provide preliminary data on the impact of use. Putative mediators of improved job tenure and psychological well-being, including postintervention changes in social support, self-efficacy and work-related motivation, will be investigated. Forty individuals at least 18 years of age, meeting the eligibility requirements for supported employment services (ie, diagnosed with a mental illness meeting the criteria for severity, duration and treatment), working a minimum of 10 hours per week at study enrolment, and speaking, reading and writing in English will be recruited for the pilot study. Research staff will recruit individuals at community-based mental health agencies; provide orientation to the study, the study smartphones and the WorkingWell app; conduct research interviews including standardised measures as well as semistructured items; and provide technical assistance in telephone calls and inperson meetings. A sample of 10 agency staff will be recruited to obtain further information on the feasibility, acceptability and usefulness of WorkingWell. ETHICS AND DISSEMINATION The study design and procedures are approved by the Dartmouth-Hitchcock Medical Center Committee for the Protection of Human Subjects, the Massachusetts Department of Mental Health Central Office Research Review Committee and the Vermont Agency of Human Services Institutional Review Board. Study findings will be disseminated to agency partners, state agencies and funders, and to the research and technology development communities. Findings from the study will inform the design, data collection procedures and protocol for future full-scale randomised controlled trial testing of the effectiveness of the WorkingWell app, as well as investigations of work-related variables as mediators of psychological well-being and quality of life for individuals with SMI.
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Affiliation(s)
- Joanne Nicholson
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Spenser M Wright
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Alyssa M Carlisle
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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147
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Carolan S, de Visser RO. Employees' Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study. JMIR Ment Health 2018; 5:e8. [PMID: 29351900 PMCID: PMC5797290 DOI: 10.2196/mental.9146] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. OBJECTIVE The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. METHODS Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. RESULTS Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and reminders to log in. The main barrier to engagement was the lack of time. The perfect digital mental health intervention was described as a website that combined a short interactive course that was accessed alongside time-unlimited information and advice that was regularly updated and could be dipped in and out of. Participants also wanted access to e-coaching support. CONCLUSIONS Occupational digital mental health interventions may have an important role in delivering health care support to employees. Although the advantages of digital mental health interventions are clear, they do not always fully translate to interventions delivered in an occupational setting and further work is required to identify ways of minimizing potential barriers to access and engagement. TRIAL REGISTRATION ClinicalTrials.gov: NCT02729987; https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987& rank=1 (Archived at WebCite at http://www.webcitation.org/6wZJge9rt).
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Affiliation(s)
- Stephany Carolan
- School of Psychology, University of Sussex, Brighton, United Kingdom
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148
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Mantani A, Kato T, Furukawa TA, Horikoshi M, Imai H, Hiroe T, Chino B, Funayama T, Yonemoto N, Zhou Q, Kawanishi N. Smartphone Cognitive Behavioral Therapy as an Adjunct to Pharmacotherapy for Refractory Depression: Randomized Controlled Trial. J Med Internet Res 2017; 19:e373. [PMID: 29101095 PMCID: PMC5695656 DOI: 10.2196/jmir.8602] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 09/02/2017] [Accepted: 09/23/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. OBJECTIVE The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. METHODS A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan. Participants were eligible if they had a primary diagnosis of major depression and were antidepressant-refractory after taking one or more antidepressants at an adequate dosage for four or more weeks. After a 1-week run-in in which participants started the medication switch and had access to the welcome session of the app, patients were randomized to medication switch alone or to medication switch plus smartphone CBT app via the centralized Web system. The smartphone app, called Kokoro-app ("kokoro" means "mind" in Japanese), included sessions on self-monitoring, behavioral activation, and cognitive restructuring presented by cartoon characters. The primary outcome was depression severity as assessed by masked telephone assessors with the Patient Health Questionnaire-9 (PHQ-9) at week 9. The secondary outcomes included the Beck Depression Inventory-II (BDI-II) and Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER). RESULTS In the total sample (N=164), 81 participants were allocated to the smartphone CBT in addition to medication change and 83 to medication change alone. In the former group, all but one participant (80/81, 99%) completed at least half, and 71 (88%) completed at least six of eight sessions. In the intention-to-treat analysis, patients allocated the CBT app scored 2.48 points (95% CI 1.23-3.72, P<.001; standardized mean difference 0.40) lower on PHQ-9 than the control at week 9. The former group also scored 4.1 points (95% CI 1.5-6.6, P=.002) lower on BDI-II and 0.76 points (95% CI -0.05 to 1.58, P=.07) lower on FIBSER. In the per-protocol sample (comfortable with the smartphone app, still symptomatic, and adherent to medication with mild or less side effects after run-in), the intervention group (n=60) scored 1.72 points (95% CI 0.25-3.18, P=.02) lower on PHQ-9, 3.2 points (95% CI -0.01 to 6.3, P=.05) lower on BDI-II, and 0.75 points (95% CI 0.03-1.47, P=.04) lower on FIBSER than the control (n=57). The treatment benefits were maintained up to week 17. CONCLUSIONS This is the first study to demonstrate the effectiveness of a smartphone CBT in the treatment of clinically diagnosed depression. Given the merits of the mobile mental health intervention, including accessibility, affordability, quality control, and effectiveness, it is clinically worthwhile to consider adjunctive use of a smartphone CBT app when treating patients with antidepressant-resistant depression. Research into its effectiveness in wider clinical contexts is warranted. TRIAL REGISTRATION Japanese Clinical Trials Registry UMIN CTR 000013693; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ ctr_view.cgi?recptno=R000015984 (Archived by WebCite at http://www.webcitation.org/6u6pxVwik).
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Affiliation(s)
| | | | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Hissei Imai
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | | | - Naohiro Yonemoto
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Qi Zhou
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Nao Kawanishi
- Advanced Telecommunications Research Institute International, Kyoto, Japan
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149
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Mayer-Hirshfeld I, Brannan D, Murphy LA, Hecht EM, Caban-Martinez AJ. Association between positive and negative affect and musculoskeletal pain among US home health aides. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 73:355-359. [PMID: 28876189 DOI: 10.1080/19338244.2017.1373056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 08/25/2017] [Indexed: 06/07/2023]
Abstract
As the US population ages, there is an expected increase in demand for home health aides (HHAs); therefore, it is important to ensure their occupational well-being. Previous studies have demonstrated associations between negative emotions and musculoskeletal pain. Using survey data collected from 285 HHAs, we characterize the association between affect and musculoskeletal pain. Affect was measured using the Positive and Negative Affect Schedule, while musculoskeletal pain was measured using the Brief Pain Inventory. We found that as positive affect composite score increased, musculoskeletal pain decreased [β = -0.57, t(124) = -7.01, p < .001]. There was no significant association between the negative affect composite score and musculoskeletal pain. However, several individual moods were associated with decreased or increased pain. These data suggest that some moods may buffer against musculoskeletal pain, while others may predispose HHAs to musculoskeletal pain.
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Affiliation(s)
- Ilana Mayer-Hirshfeld
- a Division of Environment and Public Health, Department of Public Health Sciences , University of Miami, Miller School of Medicine , Miami , Florida , USA
- b Department of Medical Education , University of Miami, Miller School of Medicine , Miami , Florida , USA
| | - Debi Brannan
- c Behavioral Sciences Division , Western Oregon University , Monmouth , Oregon , USA
| | - Lauren A Murphy
- d Bouvé College of Health Sciences, Department of Physical Therapy, Movement and Rehabilitation Sciences , Northeastern University , Boston , Massachusetts , USA
| | - Eric M Hecht
- e Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences , University of Miami, Miller School of Medicine , Miami , Florida, USA
| | - Alberto J Caban-Martinez
- a Division of Environment and Public Health, Department of Public Health Sciences , University of Miami, Miller School of Medicine , Miami , Florida , USA
- b Department of Medical Education , University of Miami, Miller School of Medicine , Miami , Florida , USA
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Carolan S, Harris PR, Greenwood K, Cavanagh K. Increasing engagement with an occupational digital stress management program through the use of an online facilitated discussion group: Results of a pilot randomised controlled trial. Internet Interv 2017; 10:1-11. [PMID: 30135747 PMCID: PMC6084816 DOI: 10.1016/j.invent.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Rates of work-related stress, depression and anxiety are high, resulting in reduced work performance and absenteeism. There is evidence that digital mental health interventions delivered in the workplace are an effective way of treating these conditions, but intervention engagement and adherence remain a challenge. Providing guidance can lead to greater engagement and adherence; an online facilitated discussion group may be one way of providing that guidance in a time efficient way. This study compares engagement with a minimally guided digital mental health program (WorkGuru) delivered in the workplace with a discussion group (DG) and without a discussion group (MSG), and with a wait list control (WLC); it was conducted as a pilot phase of a definitive trial. METHODS Eighty four individuals with elevated levels of stress from six organisations were recruited to the study and randomised to one of two active conditions (DG or MSG) or a WLC. The program WorkGuru is a CBT based, eight-week stress management intervention that is delivered with minimal guidance from a coach. Data was collected at baseline, post-intervention and at 16-week follow-up via online questionnaires. The primary outcome measure was number of logins. Secondary measures included further engagement measures, and measures of depression, anxiety, stress, comfort and enthusiasm. Quality measures including satisfaction and system usability were also collected. RESULTS A greater number of logins was observed for the DG compared with the MSG; this was a medium between group effect size (d = 0.51; 95% CI: - 0.04, 1.05). Small to medium effect size differences were found at T2 in favour of the active conditions compared with the control on the DASS subscales depression, anxiety and stress, and the IWP subscales enthusiasm and comfort. This was largely maintained at T3. Satisfaction with the intervention was high with individuals in the MSG reporting greater satisfaction than individuals in the DG. CONCLUSIONS This study shows that access to an online facilitated discussion group increases engagement with a minimally supported occupational digital mental health intervention (as defined by the number of logins), but that this doesn't necessarily result in improved psychological outcomes or increased satisfaction when compared to access to the intervention without the group. Access to the web-based program was associated with lower levels of depression, anxiety and stress and an increase in comfort and enthusiasm post intervention; these changes were largely maintained at follow-up. TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov on March the 18th 2016 NCT02729987 (website link https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987&rank=1).
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Affiliation(s)
- Stephany Carolan
- School of Psychology, University of Sussex, Falmer BN1 9QH, United Kingdom,Corresponding author.
| | - Peter R. Harris
- School of Psychology, University of Sussex, Falmer BN1 9QH, United Kingdom
| | - Kathryn Greenwood
- School of Psychology, University of Sussex, Falmer BN1 9QH, United Kingdom,Research and Development Department, Sussex Partnership NHS Foundation Trust, United Kingdom
| | - Kate Cavanagh
- School of Psychology, University of Sussex, Falmer BN1 9QH, United Kingdom
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