Effects of a PRECEDE-PROCEED model based ergonomic risk management programme to reduce musculoskeletal symptoms of ICU nurses

Health status and ergonomics education: A comparison between student nurses and first-year nursing staff

AIMS

To (a) compare student nurses' health status and levels of ergonomics knowledge and awareness to those of first-year nursing staff and (b) investigate the association between nurses' ergonomic compliance and health status with their educational preparedness.

DESIGN

This cohort study compared ergonomics awareness and knowledge, and health status of nurses when they were students and after their first-year working in medical facilities.

METHODS

In total, 133 4th-year student nurses completed a survey; 45 of them completed a second survey after working 1 year in a medical facility. Their health status was compared over time using repeated-measures ANOVA. Correlation tests were used to analyse associations between ergonomics knowledge and awareness, health status, demographic variables and educational preparedness.

RESULTS

Respondents in both surveys displayed weak knowledge of ergonomic principles significantly associated with increased pain intensity and educational preparedness.

PATIENT CONTRIBUTION

Ergonomics training should be expanded during nursing studies and first-year training to prevent long-term health disorders.

Investigating the effect of education based on PRECEDE-PROCEED model on the preventive behaviors of musculoskeletal disorders in a group of nurses

Background

One of the most important occupational complications that could occur in nurses is musculoskeletal disorders. In this study, we designed an educational intervention based on the PRECEDE-PROCEED model to investigate its effects on a group of nurses on preventive behaviors of musculoskeletal disorders.

Methods

A total of 120 nurses working in Izeh City, Iran, participated in this semi-experimental study. The sampling was performed through a convenient sampling method, and the participants were randomly assigned to the experimental and control groups (60 participants for each group). Both groups filled out a questionnaire based on the PRECEDE-PROCEED model before and 2 months after the educational program as part of the data collection process. The data were examined using a paired t-test, an independent t-test, and a chi-square test after being entered into SPSS version 24.

Results

According to the findings, prior to the intervention, there was no difference between the two groups in terms of their knowledge (p = 0.221), attitude (p = 0.136), enabling factors (p = 0.325), reinforcing factors (p = 0.548), self-efficacy (0.421), and behavior (0.257) levels. However, following the intervention, a substantial rise was witnessed in the experimental group in each of the mentioned variables (p = 0.001).

Conclusion

In the current study, education based on the PRECEDE-PROCEED model led to the improvement of knowledge, attitude, enabling and reinforcing factors, self-efficacy, and finally preventive behaviors with musculoskeletal disorders in the participants. Considering the importance of the role of health education in promoting behaviors related to musculoskeletal disorders in nurses and the importance of observing related behaviors in preventing long-term complications, the necessity of education in a wider dimension and with different tools is felt more and more in society. Therefore, longer interventions with this aim could be carried out on nurses and other healthcare personnel.

Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population.

METHODS

Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results.

RESULTS

A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention.

CONCLUSION

The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.

Potential Factors of Primary Hospital Healthcare Professionals in Hindering the Abolition of Routine Skin Test for Cephalosporin: A Cross-Sectional Study

Background

In 2021, National Health Commission of the People's Republic of Chinese issued a document that no longer recommended the routine skin test for cephalosporin (RSTC). However, there is still resistance to the cancellation of RSTC in a primary hospital. The study aimed to explore the potential factors for hindering the abolition of the RSTC in a county-level hospital based on the PRECEDE model.

Methods

The cross-sectional study was conducted on healthcare workers in the Pidu District People's Hospital, Chengdu, by online questionnaire from September 10 to September 25 in the 2021.The PRECEDE model was used to divide the potential factors of healthcare professionals in hindering the abolition of the RSTC into predisposing factors, enabling factors and reinforcing factors. Data were analyzed by ANOVA, Chi-square test, multiple linear and multiple logistic regression analysis.

Results

We collected 605 respondents' valid questionnaires. 254 healthcare professionals were against cancellation of the RSTC, accounting for 41.98%. Multiple linear regression analysis showed that working for 6~10 years (β = 1.953, P = 0.024), medium (β = 1.995, P = 0.030) or senior (β = 4.003, P = 0.007) professional qualification, pharmacists (β = 3.830, P = 0.013) and working in surgical department (β= 4.462, P < 0.001) were significantly associated with higher score of predisposing factors, enabling factors, and reinforcing factors on abolition of RSTC. Furthermore, multiple logistic regression analysis showed that pharmacists (OR=3.113, 95% CI: 1.341-7.223, P=0.030), medium professional qualification (OR=1.272, 95% CI: 0.702-2.302, P=0.008), scores of predisposing factors (OR=1.335, 95% CI: 1.033-1.726, P=0.009), and scores of enabling factors (OR=1.208, 95% CI: 1.109-1.315, P<0.001) were independently associated with the positive anticipated behavior on the abolition of RSTC. While nurses (OR=0.516, 95% CI: 0.284-0.938, P<0.001) were independently associated with anticipated negative behavior.

Conclusion

Pharmacists, medium professional qualification, and healthcare professionals with higher scores of predisposing and enabling factors were more likely to have a positive anticipated behavior on the abolition of RSTC, while nurses did not.

A PRECEDE-PROCEED model-based educational intervention to promote healthy eating habits in middle school girls

The present study was designed to develop Nutrition Education Program (NEP) based on PRECEDE-PROCEED model (PPM) to address healthy eating behavior among middle school girls aged between 4 and 12 years. For this, middle school girls from grade 1 to 8 (n = 900) were consulted for their eating behaviors, followed by the analysis of their health problems. From 15 different schools of three large cities (Faisalabad, Lahore, and Rawalpindi) of Pakistan, students were divided into two groups: control group (n = 30) and intervention group (n = 30) from each school. The data were collected through interview-based questionnaires according to the phases of PRECEDE Model and evaluated based on PROCEED model. Implementation of NEP was carried out through lectures. Lessons were prepared to enhance student's awareness about nutritious food and healthy lifestyle through educational pamphlets and influenced their attitude towards selection of food choices from My-Plate. Results showed that NEP was quite successful for long-term results. A significant increase in total caloric intake was observed after 8 weeks of NEP intervention (1694 ± 217 Kcal) as compared to before intervention (1329 ± 318 Kcal). Similarly, carbohydrate, protein, and fat content was also increased in daily diet. Conclusively, NEP based on PPM has great impact on healthy lifestyle of middle school girls. Significant difference was observed in score of health variables before and after NEP intervention.

Mothers' breastfeeding six weeks postpartum and factors influencing exclusive breastfeeding during the first six months

We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.

A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: a scoping review

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are a key topic in occupational health. In the primary prevention of these disorders, interventions to minimize exposure to work-related physical risk factors are widely advocated. Besides interventions aimed at the work organisation and the workplace, interventions are also aimed at the behaviour of workers, the so-called individual working practice (IWP). At the moment, no conceptual framework for interventions for IWP exists. This study is a first step towards such a framework.

METHODS

A scoping review was carried out starting with a systematic search in Ovid Medline, Ovid Embase, Ovid APA PsycInfo, and Web of Science. Intervention studies aimed at reducing exposure to physical ergonomic risk factors involving the worker were included. The content of these interventions for IWP was extracted and coded in order to arrive at distinguishing and overarching categories of these interventions for IWP.

RESULTS

More than 12.000 papers were found and 110 intervention studies were included, describing 810 topics for IWP. Eventually eight overarching categories of interventions for IWP were distinguished: (1) Workplace adjustment, (2) Variation, (3) Exercising, (4) Use of aids, (5) Professional skills, (6) Professional manners, (7) Task content & task organisation and (8) Motoric skills.

CONCLUSION

Eight categories of interventions for IWP are described in the literature. These categories are a starting point for developing and evaluating effective interventions performed by workers to prevent WMSDs. In order to reach consensus on these categories, an international expert consultation is a necessary next step.

Clinical Application of Rapid Upper Limb Assessment and Nordic Musculoskeletal Questionnaire in Work-Related Musculoskeletal Disorders: A Bibliometric Study

Assessment of work-related musculoskeletal disorders (WMSDs) using the Rapid Upper Limb Assessment (RULA) and the Nordic Musculoskeletal Questionnaire (NMQ) has become widely accepted and reported in the literature. The objectives of this study are to (1) recognize and describe the topmost 50 cited scientific articles in WMSDs using the RULA and NMQ and (2) explore the factors that contribute to making an article influential. In this bibliometric study, we used the Web of Science and MEDLINE databases to identify the top 50 cited articles published from 1993 to 2022. The data collected were the title of the journal, number of citations, year of publication, type of the study, institution where the work was conducted, level of evidence, contribution of primary authors, and country of origin of the work. Our results showed that the top 50 cited articles were published between 1980 and 2010. The 2000s was the most valuable decade. Regarding journals, the Work journal had the highest number of articles concerning the use of RULA and NMQ in healthcare professionals. The maximum number of citations regarding RULA occurred in the Journal of Robotic Surgery (n = 50) and the maximum for NMQ occurred in the Journal of Safety Research (n = 106). Most articles originated from the United States, followed by England and the Netherlands. Eight authors had two publications published in the top 50 list. The majority of the topmost cited research articles were cross-sectional studies. Most of these studies were level III evidence. The bibliometric analysis from this study provides insights to researchers to choose the most appropriate and influential journal for submitting work on WMSDs.

Effect of the PRECEDE-PROCEED model on health programs: a systematic review and meta-analysis

BACKGROUND

The predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation policy, regulatory, and organizational constructs in educational and environmental development (PRECEDE-PROCEED) model has been used as a theoretical framework to guide health promotion strategies to prevent chronic diseases and improve the quality of life. However, there is a lack of evidence as to whether applying the PRECEDE-PROCEED model effectively improves health outcomes. This study aimed to systematically review intervention studies that applied the PRECEDE-PROCEED model and examine its effectiveness.  METHODS: In December 2020, seven databases were systematically searched. The quality of studies was assessed using the Mixed Methods Appraisal Tool. The outcome of interest for the meta-analysis was knowledge.

RESULTS

In total, 26 studies were systematically reviewed. Most studies provided educational programs as the main intervention for various population groups. Symptom or disease management and health-related behavior promotion were the most common topics, and education was the most frequently used intervention method. The PRECEDE-PROCEED model was applied in the planning, implementation, and evaluation of the intervention programs. Eleven studies were included in the meta-analysis, which showed that interventions using the PRECEDE-PROCEED model significantly improved knowledge.

CONCLUSIONS

This study indicated that individuals are more likely to engage in health-related behaviors with better knowledge. Thus, the PRECEDE-PROCEED model can be used as the theoretical framework for health promotion interventions across population groups, and these interventions are particularly effective with regard to knowledge improvement.

Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature

INTRODUCTION

Work-related musculoskeletal disorders (WMSDs) are among the main causes of injury and pain in healthcare professionals. Previous reviews provided a fragmented view of the interventions available for WMSDs. This review aims to provide a comprehensive description of interventions for preventing and reducing work-related musculoskeletal injuries and/or pain among healthcare professionals, and to assess the methodological quality of studies.

METHODS

A systematic literature review was performed, based on the Effective Public Health Practice Project process. A comprehensive search was conducted on six peer-reviewed databases and manually. The methodological quality of the studies included was rated as weak, moderate, or strong. The studies were organized based on the 2019 classification of the interventions by Oakman and colleagues.

RESULTS

Twenty-seven articles were included reporting individual (n = 4), task-specific (n = 4), work organization and job design (n = 2), work environment (n = 1), and multifactorial (n = 16) interventions. Overall quality rating was strong for 6 studies, moderate for 16, and weak for 5. Individual interventions such as neuromuscular and physical exercise were effective in reducing pain. Task-specific and work organization interventions could prevent certain injuries. Significant reduction of both injuries and pain resulted from multifactorial interventions, which were reported by the majority of strong (n = 5) and moderate (n = 10) quality articles.

CONCLUSIONS

This review provides healthcare professionals with evidence-based information to plan interventions targeted towards reducing WMSDs. In particular, more efforts are needed to implement and extend effective multifactorial interventions. Moreover, studies about each professional healthcare target group are needed.

PRACTICAL APPLICATION

Our results can guide policy-makers, healthcare managers and professionals to choose the best strategies to prevent and reduce WMSDs and to shape continuous education programs. This study prompts clinicians to develop inter-professional collaborations and to practice physical activities in order to reduce WMSDs.

Effectiveness of the PRECEDE-PROCEED model for improving the care knowledge, skill, and sense of competence in mothers of preterm infants

Objective

This quasi-randomized controlled trial was performed to evaluate the effects of the PRECEDE-PROCEED model (PPM) in enabling mothers of preterm infants to develop care knowledge, skill, and a sense of competence.

Methods

Among 116 mothers of preterm infants, 60 received traditional discharge education (control group) and 56 received PPM discharge education (PPM group). Improvement in knowledge and skills was transformed into the mothers’ routine daily care of infants. The primary outcome was knowledge of preterm infant care. The secondary outcomes were preterm infant care skills and a sense of competence, routine intervention compliance among mothers, and the readmission rate of infants 6 months after discharge.

Results

Six months after discharge, the mean knowledge score and mean skills score were significantly higher in the PPM group than in the control group. The mothers’ sense of competence with respect to both self-efficacy and satisfaction was also significantly better in the PPM group than in the control group. Moreover, intervention behavior compliance and the readmission rate were significantly better in the PPM group than in the control group.

Conclusion

Care knowledge, skills, and sense of competence in mothers of preterm infants improved after implementation of the PPM.

The Nursing Effect of PRECEDE Management on Occupational Exposure to Surgical Smoke: Based on a Randomized Controlled Study

Background

Occupational exposure seriously threatens the physical and mental health of professionals and has become an important public health problem. In clinical medical and nursing work, medical staff, especially nursing staff, are faced with the status quo of occupational exposure with high risk, serious harm, and severe situation. Therefore, a sound management system must be established to control the occupational exposure of nurses.

Aims

According to the PRECEDE management model, evaluate the operating room nurses' knowledge, belief, and behavior scores on the protection of surgical smoke, understand their awareness of surgical smoke and the current status of protection, improve the mastery rate and protection compliance of surgical smoke-related knowledge in the operating room, reduce the harm of surgical smoke to the human body, and provide a basis for smoke protection.Materials and methods. 125 doctors working in the operating room of our hospital were selected as the control group of this study, and 112 nonsmoke-exposed nurses working in the operating room of our hospital were selected as the observation group. The nurses' knowledge-belief behavior scores and self-evaluation scores of smoke influence were counted before and after the intervention in the operating room. SPSS25.0 was used to process the data. Tests and repeated measures analysis of variance were used to compare the effects before and after intervention.

Results

After one month of intervention, the knowledge scores of nurses in the operating room on the protection of surgical smoke increased significantly, and the difference was significant (P < 0.05); the scores of related concepts, physical properties, chemical properties, and authoritative protection standards increased significantly (P < 0.05). There was no significant increase in the scores of smoke hazards (P > 0.05); the attitude of smoke protection increased significantly, which was statistically significant (P < 0.05); and the behavior compliance of smoke protection was significantly increased, which was statistically significant (P < 0.05). After one month of intervention, the self-evaluation score of smoke effect of operating room nurses decreased significantly, and the difference was statistically significant (P < 0.05). The data was analyzed by repeated measure analysis of variance. The knowledge of surgical smoke (F = 65.570, P < 0.001), attitude (F = 78.307, P < 0.001), and behavior (F = 403.015, P < 0.001) scores gradually increased. The observation group's total cholesterol, low-density lipoprotein cholesterol, and the proportion of low-density lipoprotein cholesterol were higher than that of the control group, and the proportion of high-density lipoprotein cholesterol was lower than that of the control group. The difference was statistically significant P < 0.05.

Conclusion

After the intervention of operating room nurses under the guidance of PRECEDE management mode, the theoretical knowledge of operating room nurses is effectively improved, the operations are standardized, the self-evaluation scores of smoke influence are reduced, and the safety level of operating room is improved. More importantly, the health of nursing staff is fully guaranteed.

Application of the rapid upper limb assessment tool to assess the level of ergonomic risk among health care professionals: A systematic review

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) and ergonomic risk factors are widespread problems in the healthcare sector. OBJECTIVE: The primary objective of this review is to evaluate the application of the Rapid Upper Limb Assessment (RULA) tool in various healthcare professionals and to assess the level of ergonomic risk among them. METHODS: The databases MEDLINE, EMBASE, CINAHL, LILACS, SCIELO, DOAJ, PubMed, and PEDro were searched with terms associated with ergonomics, assessment, health care providers, risk factors, workplace, and RULA. We reviewed the literature from 2000 to 2020, including studies assessing RULA’s effectiveness for evaluating the WMSD’s and ergonomic risk in health care practitioners. We excluded the studies which were not open access and freely available. RESULTS: Overall, 757 records were screened; of these 40 potential studies, 13 different healthcare professionals were identified as eligible for inclusion. In most studies, the RULA tool was established as an effective tool in application and evaluating the level of the ergonomic risk among them. CONCLUSIONS: The RULA tool assessed the high ergonomic risk levels in dental professionals and low ergonomic risk levels in professionals working in the pharmacy department, clearly suggesting potential changes in work postures were necessary to prevent or reduce these risk factors.

Effects of an ergonomic intervention program based on the PRECEDE-PROCEED model for reducing work-related health problems and exposure risks among emergency medical dispatchers

OBJECTIVE

To evaluate the effectiveness of an ergonomic intervention program based on the PRECEDE-PROCEED model in terms of improving exposure risks and work-related health problems in emergency medical dispatchers.

METHODS

This quasi-experimental study used an interrupted time series design. Participants were 55 employees working in an Emergency Medical Communications Center in Iran. The intervention program was based on the PRECEDE-PROCEED model and included five face-to-face training sessions and installing auxiliary equipment according to best ergonomic principles. Direct observations of the emergency medical dispatchers' working postures using the Rapid Office Strain Assessment and a survey which included a modified Nordic Questionnaire, Work Ability Score, Visual Fatigue Questionnaire, and a Behavioral Factors Questionnaire were used at three time points: baseline, 1 month post-intervention, and 3 months post-intervention.

RESULTS

The modified Nordic Questionnaire showed significant reductions in pain intensity scores for neck, lower back, knee and ankle after the ergonomic intervention program. In addition, there were considerable post-training improvements in behavioral factors (knowledge and enabling factors) and working postures. No significant changes were observed in Work Ability Scores, or visual symptoms.

CONCLUSIONS

An ergonomic intervention program based on a systematic framework such as the PRECEDE-PROCEED model and on-site interventions can be effective in improving and enhancing the working conditions of emergency medical dispatchers. Therefore, it is suggested that ergonomic interventions be implemented based on standard and valid behavioral change models such as PRECEDE-PROCEED model in other work environments in which musculoskeletal pain and digital eye strain are common.

Effects of School-Based Educational Program on Backpack Carrying Behavior in Teenage Students

One of the most serious issues is the growing prevalence of backaches among adolescent students as a result of carrying backpacks. The purpose of this study was to examine the impact of an education program (remedial information) on the school backpack carrying habits of adolescent students. The study sample consisted of 138 adolescent students aged 12 to 16 from 4 schools who were randomly assigned to either the experimental (N = 69) or control (N = 69) groups. The experimental group was subjected to a 6-week education program consisting of 6 sessions, whereas the control group received no educational intervention. During the pre-test and 3 months after the intervention, participants completed a questionnaire. The results (healthy items) were as follows: (1) carry as little as possible, (2) carry a school backpack on both shoulders, and (3) use lockers or something similar. After a 3-month follow-up, healthy items in the experimental group improved, but no significant changes were observed in the control group. When compared to the baseline, the experimental group’s healthy backpack usage habits improved significantly at the post-test (P = .001). The current study’s findings show that school-based education interventions on backpack behaviors improve the school-bag carrying habits of adolescent students.

A systematic review of work interventions to promote safe patient handling and movement in the healthcare sector

PURPUSE

The aim of this systematic review was to describe interventions which promote safe patient handling and movement (PHM) among workers in healthcare by reviewing the literature of their effectiveness for work and health-related outcomes.

METHODS

Data bases were searched for studies published 1997‒2018. Measures was operationalised broadly, capturing outcomes of work and health. Only Randomized controlled trials (RCTs) and cohort studies with control group were included. Quality was assessed using evidence-based checklists by Swedish Agency for Health Technology Assessment and Assessment of Social Services.

RESULTS

The systematic review included 10 RCTs and 19 cohort. Providing work equipment and training workers is effective: it can increase usage. Training workers to be peer coaches is associated with fewer injuries. Other effective strategies are participatory ergonomics and management engagement in collaboration with workers, facilitating safe PHM.

CONCLUSIONS

This systematic review suggests interventions for safe PHM with an impact of health-related outcomes should include access to work equipment, training as well as employer and employee engagement. The additional impact of multifaceted interventions is inconclusive.

PRACTITIONER SUMMARY

In clinical practice, there is a need for employers in healthcare to; 1) provide healthcare workers access to suitable work equipment. 2) provide training on how to use work equipment to prevent work-related injuries. Furthermore, the study also indicates that 3) training and appointing peer coaches can facilitate safe manual handling and movement (PHM) and, 4) It can be beneficial to involve workers in a participatory approach.

Application of the PRECEDE-PROCEED model in the development of evidence-informed interventions for drowning prevention: a mixed-methods study protocol

INTRODUCTION

Drowning is a global public health threat, disproportionately impacting low-income and middle-income countries. In the Philippines, it is estimated that more than 5200 people die from drowning per annum. This number is likely to be higher than currently estimated with the inclusion of disaster-related and transportation-related drowning. Drowning is preventable if appropriate preventive interventions are put in place which redress known risk factors.

METHODS AND ANALYSIS

This study uses the PRECEDE-PROCEED model (PPM), an eight-step health promotion planning and evaluation model for building and improving intervention programmes. This mixed-methods study, which can be used in any location, will be implemented in Los Baňos, Laguna, Philippines, identified as an area of concern for drowning. Using the PPM, data on drowning will be collected from death records, community observation, key informant interviews, focus group discussions and community survey. A range of analytical methods will be used to explore drowning data including univariate and χ² analyses, analysis of variance, relative risk and calculating rates using population data. The quantitative data and themes drawn from qualitative data will be used to populate the first four phases of the PPM. Following the data collection, the remaining stages of the PPM will be designed and implemented in the barangay (village) with the highest drowning rate.

ETHICS AND DISSEMINATION

This study has obtained ethical clearance from the University of the Philippines Manila Research Ethics Board (UPMREB 2017-425-01). Study findings will be disseminated through workshops and presentations to the local community as well as through peer-reviewed literature and conference presentations. The PPM has rarely been applied to drowning prevention and it is the aim that the study described in this protocol is expanded across other areas of the Philippines and to other countries with a high drowning burden to inform prevention efforts.

Identification of factors related to behaviors associated with musculoskeletal pain among elementary students

BACKGROUND

Musculoskeletal pains are among evident health problems in children and adolescents. Backpack carrying behaviors and the sitting postures are among behavioral factors associated with musculoskeletal pain in schoolchildren. Therefore, this study aims to identify the factors related to these important musculoskeletal behaviors, using Health Promotion Models.

METHODS

In this cross-sectional study, a questionnaire was created based on PRECEDE Model and Health Belief Model and was administered to 673 Iranian students, whom were selected randomly from elementary schools of Hamadan, Iran, in 2018.

RESULTS

The findings of the study revealed that proper sitting postures and backpack carrying were 42 and 33%, respectively. The findings also showed that predisposing factors including perceived susceptibility (p < 0.05, β = 0.219), perceived severity (p < 0.05, β = 0.166), perceived barriers (p < 0.05, β = - 0.191), perceived self-efficacy (p < 0.05, β = 0.188) and also enabling factors (p < 0.05, β = 0.329) were significantly related to sitting behaviors. Moreover, backpack carrying behaviors had significant relationships with predisposing factors of perceived susceptibility (p < 0.05, β = 0.198), perceived barriers (p < 0.05, β = - 0.258), perceived self-efficacy (p < 0.05, β = 0.185) and reinforcing factors (p < 0.05, β = 0.208).

CONCLUSIONS

It seems necessary for future preventive programs to take factors of musculoskeletal pains among children and adolescents into account.

The effectiveness of social media and in-person interventions for low back pain conditions in nursing personnel (SMILE)

AIM

To compare two educational approaches to reduce low back pain in nurses.

DESIGN

A community randomized controlled clinical trial.

METHODS

Data were collected with two interventions and a control arm between August 2018 and January 2019. Participants were recruited from three hospitals. Hospital 1 received an in-person educational programme, Hospital 2 received via the website and Hospital 3 received nothing. Statistical analysis was carried out with a follow-up of 3 and 6 months.

RESULTS

A total of 180 female nurses with low back pain participated in the study. Dimensions of the quality of life improved over 3 and 6 months, pain and disability decreased over 3 months in both intervention groups and over 6 months in the social media group.

CONCLUSION

Two educational approaches can be effective in decreasing pain, disability and improving quality of life. However, the findings suggest that the social media approach was more successful over the long-term and might be a better way to present the programme.

A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work

Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752 ).

Effects of educational program based on Precede-Proceed model in promoting low back pain behaviors (EPPLBP) in health care workers Shahid Beheshti University of medical sciences: randomized trial

The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors “group” and “test time” (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system.

Physician and Nurse Research in Multidisciplinary Intensive Care Units

BACKGROUND

Although clinical care is multidisciplinary, intensive care unit research commonly focuses on single-discipline themes. We sought to characterize intensive care unit research conducted by physicians and nurses.

METHODS

One hundred randomly selected reports of clinical studies published in critical care medical and nursing journals were reviewed.

RESULTS

Of the 100 articles reviewed, 50 were published in medical journals and 50 were published in nursing journals. Only 1 medical study (2%) used qualitative methods, compared with 9 nursing studies (18%) (P = .02). The distribution of quantitative study designs differed between medical and nursing journals (P < .001), with medical journals having a predominance of cohort studies (29 articles [58%]). Compared with medical journal articles, nursing journal articles had significantly fewer authors (median [interquartile range], 5 [3-6] vs 8 [6-10]; P < .001) and study participants (94 [51-237] vs 375 [86-4183]; P < .001) and a significantly lower proportion of male study participants (55% [26%-65%] vs 60% [51%-65%]; P = .02). Studies published in medical journals were much more likely than those published in nursing journals to exclusively involve patients as participants (47 [94%] vs 25 [50%]; P < .001). Coauthorship between physicians and nurses was evident in 14 articles (14%), with infrequent inclusion of authors from other health care disciplines.

CONCLUSIONS

Physician research and nurse research differ in several important aspects and tend to occur within silos. Increased interprofessional collaboration is possible and worthwhile.

Musculoskeletal Risks: RULA Bibliometric Review

The objective of this study was to reveal RULA method applications in terms of the knowledge, country, year and journal categories. The search was performed using the "Web of Science Core Collection". The period from 1993 to April 2019 was selected. Eight hundred nine results were obtained, of which 226 were used. The largest number of publications was determined to be in the fields of industry and health and social assistance, which coincides with the OWAS and Standardized Nordic Questionnaire methods. By country, the USA stands out for its greater number of research studies and categories that are encompassed. By date, 2016 was the year when more studies were carried out, again coinciding with the Standardized Nordic Questionnaire. By journal, "Work-A Journal of Prevention Assessment and Rehabilitation" is highlighted, as it is for the REBA method as well. It was concluded that RULA can be applied to workers in different fields, usually in combination with other methods, while technological advancement provides benefits for its application.

A management program for preventing occupational blood-borne infectious exposure among operating room nurses: an application of the PRECEDE-PROCEED model

Objectives

The study aim was to determine the effect of an occupational blood-borne pathogen exposure (OBE) management program based on the PRECEDE-PROCEED model on knowledge, attitude and behaviour regarding OBE prevention among operating room nurses.

Methods

This was a one-group pre-test post-test experimental study. The PRECEDE-PROCEED model was used to design and evaluate the effect of an OBE management program on 87 operating room nurses from February to July 2018. The study included pre-intervention assessment; risk factor analysis; interventions targeted to predisposing, reinforcing and enabling factors and focusing on areas of low scoring; and a post-intervention assessment. Attitudes, knowledge and behaviour compliance regarding OBE were measured before and after the 6-month program using a self-developed questionnaire. Descriptive epidemiological analysis and t-tests were used for data analysis.

Results

Low-scoring items for OBE knowledge, attitudes and behaviour were identified in the baseline assessment. Six months post-intervention, there were significant improvements in attitudes toward OBE prevention, in knowledge about OBE safety precautions and in behaviour compliance with standard precautions.

Conclusions

The findings indicate the effectiveness of an OBE management program based on the PRECEDE-PROCEED model for improving knowledge, attitudes and behaviour adherence to OBE prevention among operating room nurses.