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Paterson C, Leduc C, Maxwell M, Aust B, Strachan H, O'Connor A, Tsantila F, Cresswell-Smith J, Purebl G, Winter L, Fanaj N, Doukani A, Hogg B, Corcoran P, D'Alessandro L, Mathieu S, Hegerl U, Arensman E, Greiner BA. Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis. Syst Rev 2024; 13:152. [PMID: 38849924 PMCID: PMC11157821 DOI: 10.1186/s13643-024-02569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors. METHODS A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models. RESULTS We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible. CONCLUSIONS There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
- Charlotte Paterson
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | - Caleb Leduc
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | | | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Louvain, 3000, Belgium
| | - Johanna Cresswell-Smith
- Finnish Institute for Health and Welfare (THL) Equality Unit-Mental Health Team, Helsinki, Finland
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Lars Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | - Naim Fanaj
- Mental Health Center Prizren, Prizren, Kosovo
- Almae Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Asmae Doukani
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, SpainHospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Paul Corcoran
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), 5221 Wisconsin Avenue NW, Washington, DC, 20015, USA
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Brisbane, Australia
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, QLD, 4122, Australia
| | - Ulrich Hegerl
- European Alliance Against Depression E.V., Leipzig, 04109, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, 60528, Germany
| | - Ella Arensman
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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Taylor WC, Das BM, Paxton RJ, Shegog R, Suminski RR, Johnson SR, Akintola OA, Hammad A, Guidry MK. Development and implementation of a logic model: Occupational stress, physical activity, and sedentary behavior in the workplace. Work 2021; 67:203-213. [PMID: 32986642 DOI: 10.3233/wor-203266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND An increasing level of occupational stress is a major problem in the workplace that requires innovative approaches and strategies. An understudied research area pertains to the effects that physical activity performed during the workday have on occupational stress. OBJECTIVE To determine if and how an intervention that increases physical activity and reduces sedentary behavior affects workplace stress. The population of interest are employees at a large university medical center including supportive staff, healthcare professionals, physicians, and faculty members; the study design is longitudinal; the approach is the implementation of an innovative workplace program (i.e., the Booster Break). METHODS We present a logic model promoting physical activity and reducing sitting time during the workday as a feasible and practical strategy to cope with occupational stress. RESULTS The logic model approach emphasizes that funding, partnerships, and incentives are inputs to implementing program activities such as Booster Break sessions, weekly meetings, social support, and personal self-monitoring. Short-term outcomes were categorized as psychosocial, goal setting, organizational, and social; intermediate outcomes were behavioral and psychosocial; and long-term outcomes were health status and physiological status. CONCLUSIONS This study is the first known effort to outline a comprehensive intervention based on changing physical activity and sedentary behavior during the workday and the concomitant effects on occupational stress. The findings of this study can be used to develop and implement interventions at workplaces to target increases in physical activity, decreases in sedentary time, and improvements in overall employee health.
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Affiliation(s)
- Wendell C Taylor
- The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | | | | | - Ross Shegog
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Omotola A Akintola
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Asmaa Hammad
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Monica K Guidry
- The University of Texas Health Science Center at Houston, Houston, TX, USA
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Abstract
Over the past few decades, there has been a narrative wave that has advanced and subsided but consistently moved toward acceptance in health care circles. Despite the importance of narrative to nursing practice and research, the discipline has been slow to claim the narrative wave as its own. The purpose of this article is to claim the narrative wave for the discipline of nursing with story theory-guided research and practice and to describe dimensions of the narrative movement in health-related literature. Practical application of story theory is described for both nursing practice and nursing research.
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Taylor WC, Bui C, Paxton RJ, Maity S, Walker TJ, Robertson MC, Sadruddin SM, Hare-Everline N, Craig DW. A Systematic Evaluation of Six Different Physical Activity Routines: A Strategic Science Approach. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Garne-Dalgaard A, Mann S, Bredahl TVG, Stochkendahl MJ. Implementation strategies, and barriers and facilitators for implementation of physical activity at work: a scoping review. Chiropr Man Therap 2019; 27:48. [PMID: 31624537 PMCID: PMC6784342 DOI: 10.1186/s12998-019-0268-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 07/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background Inactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplace-based physical activity (PA) initiatives. Previous studies on workplace-based PA have only shown moderate and short-term effects. This has been attributed to the lack of clear implementation strategies and understanding of factors that may hinder or enable uptake of PA. To ensure long-term, sustainable outcomes, there is a need for a better understanding of implementation strategies, and barriers and facilitators to workplace-based PA. Method A scoping review of studies investigating implementation approaches and factors affecting uptake of workplace-based PA was conducted. Qualitative and quantitative articles published in MEDLINE, Embase, Scopus, or PsycINFO between 2008 and 2018 evaluating the implementation of PA were included. Data on study characteristics, evaluation, and implementation methods applied were systematically extracted. Two reviewers extracted, coded, and organised factors affecting uptake using the Theoretical Domains Framework (TDF). Results After dual, blinded screening of titles and abstracts, 16 articles reporting on eight studies were included in the review. Several different methods of implementation were applied, including information meeting, kick-off events, and "change agents" as the most common. A total of 109 factors influencing implementation were identified, consisting of 57 barriers and 52 facilitators. Barriers most often related to the TDF domains Environmental Context and Resources (n = 34, 36.2%), Social influences (n = 13, 13.8%), and Social/Professional Role and Identity (n = 8, 8.5%). Likewise, facilitators most often related to the TDF domains Social influences (n = 17, 19.5%), Environmental Context and Resources (n = 16, 18.4%), and Social/Professional Role and Identity (n = 9, 10.3%). Conclusion Our review has highlighted the multilevel factors affecting the uptake of workplace-based PA and underpins the complexities in implementation of such initiatives. The published literature predominantly provides details from the employees' perspectives on factors that need to be addressed and a lack of attention to these factors will cause them to hamper uptake of PA. The analysis of barriers and facilitators provides a theoretical foundation to guide future intervention design. However, further research is needed to fully understand the success or failure of implementation processes.
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Affiliation(s)
- Anne Garne-Dalgaard
- 1Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,2Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Stephanie Mann
- 1Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Mette Jensen Stochkendahl
- 1Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,2Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
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Taylor WC, Suminski RR, Das BM, Paxton RJ, Craig DW. Organizational Culture and Implications for Workplace Interventions to Reduce Sitting Time Among Office-Based Workers: A Systematic Review. Front Public Health 2018; 6:263. [PMID: 30320051 PMCID: PMC6165892 DOI: 10.3389/fpubh.2018.00263] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/24/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Time spent in sedentary behaviors is an independent risk factor for several chronic diseases (e.g., cardiometabolic diseases, obesity, type 2 diabetes, and hypertension). Recently, interventions to reduce sitting time at work (a prominent sedentary behavior) have been developed and tested. Organizational culture plays a critical role in the success of workplace interventions. However, there are a limited number of studies that have examined the role of organizational culture in reducing sitting time in the workplace. Objectives: Therefore, in this systematic review, we summarized the empirical literature investigating organizational culture and sedentary behavior in the workplace and identify gaps in the knowledge base. Methods: We described the procedures of our systematic review and included two study flow diagrams that detailed the step by step process. Combinations of several search terms were used; the databases searched were PubMed, Medline, Academic Search Complete, and Google Scholar. We started with thousands of citations. After applying the inclusion and exclusion criteria, eight relevant articles were identified. Results: For each identified article, the data extracted included citation, sample, objective, intervention, assessment of organizational culture and workplace sitting, findings, and implications. Each article was rated for risk of bias by population, intervention, comparator, outcomes, and study design (PICOS) analysis. The classification for each study was either: high-, moderate-, or low-quality evidence. Given the paucity of data, no definitive conclusions were presented; however, positive trends were highlighted. Conclusions: Work place interventions to reduce sitting time at work may benefit from considering elements of organizational culture; however, the evidence to date is sparse and more high-quality studies in this area are needed. To advance the field of workplace health promotion, organizational culture, and interventions to reduce sitting at work, we present 11 recommendations.
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Affiliation(s)
- Wendell C Taylor
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Richard R Suminski
- Department of Behavioral Health and Nutrition, Center for Innovative Health Research, University of Delaware, Newark, DE, United States
| | - Bhibha M Das
- Department of Kinesiology, East Carolina University, Greenville, NC, United States
| | - Raheem J Paxton
- Department of Community Medicine and Population Health, University of Alabama, Tuscaloosa, AL, United States
| | - Derek W Craig
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Largo-Wight E, Wlyudka PS, Merten JW, Cuvelier EA. Effectiveness and feasibility of a 10-minute employee stress intervention: Outdoor Booster Break. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2017. [DOI: 10.1080/15555240.2017.1335211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Erin Largo-Wight
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Peter S. Wlyudka
- Department of Mathematics and Statistics, University of North Florida, Jacksonville, Florida, USA
| | - Julie W. Merten
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Elizabeth A. Cuvelier
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
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Taylor WC, Paxton RJ, Shegog R, Coan SP, Dubin A, Page TF, Rempel DM. Impact of Booster Breaks and Computer Prompts on Physical Activity and Sedentary Behavior Among Desk-Based Workers: A Cluster-Randomized Controlled Trial. Prev Chronic Dis 2016; 13:E155. [PMID: 27854422 PMCID: PMC5127177 DOI: 10.5888/pcd13.160231] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction The 15-minute work break provides an opportunity to promote health, yet few studies have examined this part of the workday. We studied physical activity and sedentary behavior among office workers and compared the results of the Booster Break program with those of a second intervention and a control group to determine whether the Booster Break program improved physical and behavioral health outcomes. Methods We conducted a 3-arm, cluster-randomized controlled trial at 4 worksites in Texas from 2010 through 2013 to compare a group-based, structured Booster Break program to an individual-based computer-prompt intervention and a usual-break control group; we analyzed physiologic, behavioral, and employee measures such as work social support, quality of life, and perceived stress. We also identified consistent and inconsistent attendees of the Booster Break sessions. Results We obtained data from 175 participants (mean age, 43 y; 67% racial/ethnic minority). Compared with the other groups, the consistent Booster Break attendees had greater weekly pedometer counts (P < .001), significant decreases in sedentary behavior and self-reported leisure-time physical activity (P < .001), and a significant increase in triglyceride concentrations (P = .02) (levels remained within the normal range). Usual-break participants significantly increased their body mass index, whereas Booster Break participants maintained body mass index status during the 6 months. Overall, Booster Break participants were 6.8 and 4.3 times more likely to have decreases in BMI and weekend sedentary time, respectively, than usual-break participants. Conclusion Findings varied among the 3 study groups; however, results indicate the potential for consistent attendees of the Booster Break intervention to achieve significant, positive changes related to physical activity, sedentary behavior, and body mass index.
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Affiliation(s)
- Wendell C Taylor
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, 7000 Fannin St, Suite 2670, Houston, TX 77030.
| | - Raheem J Paxton
- School of Public Health and Institute of Healthy Aging, University of North Texas Health Science Center, Fort Worth, Texas
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Sharon P Coan
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Allison Dubin
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Timothy F Page
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - David M Rempel
- School of Medicine, University of California, San Francisco, California
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