1
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van de Ven D, Schuring M, Kouwenhoven-Pasmooij TA, Blom P, Burdorf A, Robroek SJW. Reach and effectiveness of a worksite health promotion program combining a preventive medical examination with motivational interviewing; a quasi-experimental study among workers in low socioeconomic position. BMC Public Health 2023; 23:2130. [PMID: 37904106 PMCID: PMC10617210 DOI: 10.1186/s12889-023-16908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND This study aimed to evaluate individual characteristics associated with participation and effectiveness of a worksite health promotion program with motivational interviewing targeting health and health behaviour among Dutch workers in low socioeconomic position. METHODS In a production company and a hospital, 838 workers were invited for a Preventive Medical Examination and subsequent coaching with motivational interviewing up to 7 sessions within 6 months. Follow-up information was collected after 6 months. Characteristics associated with participation in coaching were assessed with logistic regression models. The effectiveness of coaching on body mass index (BMI), bodyweight, self-rated health, vigorous physical activity, smoking, alcohol intake, fruit- and vegetable consumption, work ability, and sickness absence was evaluated with linear regression models and on participation in health promotion activities with logistic regression analysis. The analyses on effectiveness were performed without and with propensity score adjustment. RESULTS Of the 838 invited workers, 313 workers participated in the Preventive Medical Examination and follow-up data were available for 176 workers, of whom 100 workers with increased cardiovascular risk attended coaching. The majority of workers with obesity (73%), overweight (60%), and unhealthy behaviours (58%-69%) at baseline participated in motivational interviewing. Males, workers with overweight or obesity, workers at the production company, workers with insufficient vigorous physical activity, and workers with a low educational level were most likely to participate in coaching. Coaching with motivational interviewing after the Preventive Medical Examination was associated with a 4.74 times higher likelihood [95% confidence interval (CI): 1.99;11.32] to participate in health promotion activities and 10.9% (95%CI: 0.6;21.3) more persons who quit smoking compared to workers without coaching. No statistically significant effects were observed on BMI, bodyweight, health, health behaviour, work ability and sickness absence. CONCLUSIONS The program combining a Preventive Medical Examination with follow-up coaching reached - as intended - workers with obesity or overweight, those with a low education and with unhealthy behaviours. Adding coaching with motivational interviewing to a Preventive Medical Examination contributed to higher participation in health promotion activities and an increase in smoking cessation after 6 months among workers with a lower socioeconomic position, but was not effective on other outcomes. TRIAL REGISTRATION The study was registered retrospectively in the Netherlands Trial Register as NL8178 on 22/11/2019.
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Affiliation(s)
- David van de Ven
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | | | - Philip Blom
- Health Centre Zwolle, Zwolle, the Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
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2
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Nyhus Dhillon C, Ortenzi F. Assessing the Impact of Workforce Nutrition Programmes on Nutrition, Health and Business Outcomes: A Review of the Global Evidence and Future Research Agenda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095733. [PMID: 37174251 PMCID: PMC10178561 DOI: 10.3390/ijerph20095733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
One in three people globally suffers from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This narrative literature review aims to understand the impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We used PubMed as our primary research database, complemented by Google Scholar, to identify systematic reviews, meta-analyses, and randomised controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualised counselling and worksite environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on the impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.
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Affiliation(s)
| | - Flaminia Ortenzi
- The Global Alliance for Improved Nutrition (GAIN), 1202 Geneva, Switzerland
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3
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Jiménez-Mérida MR, Vaquero-Abellán M, Alcaide-Leyva JM, Cantón-Habas V, Raya-Cano E, Romero-Saldaña M. Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11081160. [PMID: 37107994 PMCID: PMC10137796 DOI: 10.3390/healthcare11081160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I2 = 59% for overall analysis). CONCLUSIONS The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.
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Affiliation(s)
- M Rocío Jiménez-Mérida
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Vaquero-Abellán
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - José M Alcaide-Leyva
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Vanesa Cantón-Habas
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Elena Raya-Cano
- Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
| | - Manuel Romero-Saldaña
- Grupo Asociado de Investigación GA16 Estilos de Vida, Tecnología y Salud, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Departamento de Enfermería, Farmacología y Fisioterapia, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14014 Córdoba, Spain
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4
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van Heijster H, van Berkel J, Boot CR, Abma T, de Vet E. Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions. BMJ Open 2022; 12:e062320. [PMID: 36549731 PMCID: PMC9791441 DOI: 10.1136/bmjopen-2022-062320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.
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Affiliation(s)
- Hanneke van Heijster
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
| | - Jantien van Berkel
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
- Department of Interdisciplinary Social Science: Public Health, Utrecht University, Utrecht, The Netherlands
| | - Cécile Rl Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Tineke Abma
- Department of Public Health, Leiden University Medical Center, Leiden, The Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
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van der Feltz S, van der Molen HF, Lelie L, Hulshof CTJ, van der Beek AJ, Proper KI. Changes in Fruit and Vegetable Consumption and Leisure Time Physical Exercise after a Citizen Science-Based Worksite Health Promotion Program for Blue-Collar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13652. [PMID: 36294231 PMCID: PMC9603698 DOI: 10.3390/ijerph192013652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers have, on average, poorer health than white-collar workers. Existing worksite health promotion programs (WHPPs) are often not successful among blue-collar workers. This study evaluates the effect of the Citizen Science-based WHPP on the targeted lifestyle behaviors among construction workers. The data of 114 participants were retrieved from questionnaires before (T0) and after (T1) the WHPP. Outcome measures were mean and categorical changes in daily fruit and vegetable intake and weekly leisure time physical exercise. Changes were tested using Wilcoxon signed rank tests and McNemar tests. No statistically significant changes were found between T0 and T1. In total, 73.7% of the participants felt involved in the WHPP. Changes in the outcome measures were not significantly different between subgroups based on age, nor in subgroups based on feelings of involvedness. The low intensity of the developed program could be an explanation for this lack of significant change. Future studies using the Citizen Science approach in an occupational setting should aim at developing a more intensified program and should test its effectiveness by comparing changes in a (randomized) controlled trial.
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Affiliation(s)
- Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Carel T. J. Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Karin I. Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
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6
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Sponselee HCS, Kroeze W, Robroek SJW, Renders CM, Steenhuis IHM. Perceptions of employees with a low and medium level of education towards workplace health promotion programmes: a mixed-methods study. BMC Public Health 2022; 22:1617. [PMID: 36008851 PMCID: PMC9404568 DOI: 10.1186/s12889-022-13976-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Understanding the perceptions of lower socioeconomic groups towards workplace health promotion is important because they are underrepresented in workplace health promotion activities and generally engage in unhealthier lifestyle behaviour than high SEP groups. This study aims to explore interest in workplace health promotion programmes (WHPPs) among employees with a low and medium level of education regarding participation and desired programme characteristics (i.e. the employer's role, the source, the channel, the involvement of the social environment and conditions of participation). METHODS A mixed-methods design was used, consisting of a questionnaire study (n = 475) and a sequential focus group study (n = 27) to enrich the questionnaire's results. Multiple logistic regression analysis was performed to analyse the associations between subgroups (i.e. demographics, weight status) and interest in a WHPP. The focus group data were analysed deductively through thematic analysis, using MAXQDA 2018 for qualitative data analysis. RESULTS The questionnaire study showed that 36.8% of respondents were interested in an employer-provided WHPP, while 45.1% expressed no interest. Regarding subgroup differences, respondents with a low level of education were less likely to express interest in a WHPP than those with a medium level of education (OR = .54, 95%, CI = .35-.85). No significant differences were found concerning gender, age and weight status. The overall themes discussed in the focus groups were similar to the questionnaires (i.e. the employer's role, the source, the channel, the involvement of the social environment and conditions of participation). The qualitative data showed that participants' perceptions were often related to their jobs and working conditions. CONCLUSIONS Employees with a medium level of education were more inclined to be interested in a WHPP than those with a low level of education. Focus groups suggested preferences varied depending on job type and related tasks. Recommendations are to allow WHPP design to adapt to this variation and facilitate flexible participation. Future research investigating employers' perceptions of WHPPs is needed to enable a mutual understanding of an effective programme design, possibly contributing to sustainable WHPP implementation.
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Affiliation(s)
- Hanne C S Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands.
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS, Ede, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
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7
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Smit DJM, van Oostrom SH, Engels JA, van der Beek AJ, Proper KI. A study protocol of the adaptation and evaluation by means of a cluster-RCT of an integrated workplace health promotion program based on a European good practice. BMC Public Health 2022; 22:1028. [PMID: 35597983 PMCID: PMC9123680 DOI: 10.1186/s12889-022-13352-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background An integrated workplace health promotion program (WHPP) which targets multiple lifestyle factors at different levels (individual and organizational) is potentially more effective than a single component WHPP. The aim of this study is to describe the protocol of a study to tailor a European good practice of such an integral approach to the Dutch context and to evaluate its effectiveness and implementation. Methods This study consists of two components. First, the five steps of the Map of Adaptation Process (MAP) will be followed to tailor the Lombardy WHP to the Dutch context. Both the employers and employees will be actively involved in this process. Second, the effectiveness of the integrated Dutch WHPP will be evaluated in a clustered randomized controlled trial (C-RCT) with measurements at baseline, 6 months and 12 months. Clusters will be composed based on working locations or units - dependent on the organization’s structure and randomization within each organization takes place after baseline measurements. Primary outcome will be a combined lifestyle score. Secondary outcomes will be the separate lifestyle behaviors targeted, stress, work-life balance, need for recovery, general health, and well-being. Simultaneously, a process evaluation will be conducted. The study population will consist of employees from multiple organizations in different industry sectors. Organizations in the intervention condition will receive the integrated Dutch WHPP during 12 months, consisting of an implementation plan and a catalogue with activities for multiple lifestyle themes on various domains: 1) screening and support; 2) information and education; 3) adjustments in the social, digital or physical environment; and 4) policy. Discussion The MAP approach provides an appropriate framework to systematically adapt an existing WHPP to the Dutch context, involving both employers and employees and retaining the core elements, i.e. the catalogue with evidence-based activities on multiple lifestyle themes and domains enabling an integrated approach. The following process and effect evaluation will contribute to further insight in the actual implementation and effectiveness of the integrated WHP approach. Trial registration NTR (trialregister.nl), NL9526. Registered on 3 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13352-0.
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Affiliation(s)
- Denise J M Smit
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands. .,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands.
| | - Sandra H van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands
| | - Josephine A Engels
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, 6525 EN, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
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8
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van Heijster H, van Berkel J, Boot CRL, Abma T, de Vet E. Stakeholder dialogue on dilemmas at work as a workplace health promotion intervention including employees with a low SEP: a Responsive Evaluation. BMC Public Health 2022; 22:407. [PMID: 35227228 PMCID: PMC8883621 DOI: 10.1186/s12889-022-12802-z] [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: 09/10/2021] [Accepted: 02/11/2022] [Indexed: 11/14/2022] Open
Abstract
Background The aim of this study was to evaluate the perceived changes of an innovative workplace health promotion intervention and evaluation. In this study, a bottom-up approach was taken to define the central themes and relevant outcomes of an intervention. These central themes and relevant outcomes of the intervention were defined together with stakeholders, including employees with a low socioeconomic position. Methods The intervention consisted of a series of structured stakeholder dialogues in which dilemmas around the – by employees defined —health themes were discussed. The intervention was implemented in a harbor service provider with approximately 400 employees. Over a two-year period, 57 participants engaged in eight dialogues of one hour. 15 interviews and six participant observations took place for the evaluation of the intervention. Results Together with the stakeholders, high workload and mental health were defined as central themes for the dialogue intervention in the male-dominated workplace. The dialogue intervention contributed to changes, on different levels: individual, team, and organization. Overall, the stakeholder dialogues advanced the understanding of factors contributing to high workload and mental health. In reply to this, several actions were taken on a organizational level. Conclusions Taking a bottom-up approach in WHP allows to understand the health issues that are important in the daily reality of employees with a low socioeconomic position. Through this understanding, workplace health promotion can become more suitable and relevant for employees with a low socioeconomic position. Trial registration Netherlands Trial Register (NRT): NL8051. Registration date: 28/09/2019, Retrospectively registered https://www.trialregister.nl Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12802-z.
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Affiliation(s)
- Hanneke van Heijster
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands.
| | - Jantien van Berkel
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Amsterdam, Netherlands
| | - Tineke Abma
- Department Public Health, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption & Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, Netherlands
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Peñalvo JL, Sagastume D, Mertens E, Uzhova I, Smith J, Wu JHY, Bishop E, Onopa J, Shi P, Micha R, Mozaffarian D. Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e648-e660. [PMID: 34454642 PMCID: PMC8627548 DOI: 10.1016/s2468-2667(21)00140-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/17/2022]
Abstract
Background The workplace offers a unique opportunity for effective health
promotion. We aimed to comprehensively study the effectiveness of
multicomponent worksite wellness programmes for improving diet and
cardiometabolic risk factors. Methods We did a systematic literature review and meta-analysis, following
PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library,
Web of Science, and Education Resources Information Center, from Jan 1,
1990, to June 30, 2020, for studies with controlled evaluation designs that
assessed multicomponent workplace wellness programmes. Investigators
independently appraised the evidence and extracted the data. Outcomes were
dietary factors, anthropometric measures, and cardiometabolic risk factors.
Pooled effects were calculated by inverse-variance random-effects
meta-analysis. Potential sources of heterogeneity and study biases were
evaluated. Findings From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised
controlled trials and 39 [32%] quasi-experimental interventions) met the
eligibility criteria. Most studies were done in North America (57 [47%]),
and Europe, Australia, or New Zealand (36 [30%]). The median number of
participants was 413·0 (IQR 124·0–904·0), and
median duration of intervention was 9·0 months
(4·5–18·0). Workplace wellness programmes improved
fruit and vegetable consumption (0·27 servings per day [95% CI
0·16 to 0·37]), fruit consumption (0·20 servings per
day [0·11 to 0·28]), body-mass index (−0·22
kg/m2 [−0·28 to −0·17]), waist
circumference (−1·47 cm [−1·96 to
−0·98]), systolic blood pressure (−2·03 mm Hg
[−3·16 to −0·89]), and LDL cholesterol
(−5·18 mg/dL [−7·83 to −2·53]),
and to a lesser extent improved total fat intake (−1·18% of
daily energy intake [−1·78 to −0·58]), saturated
fat intake (−0·70% of daily energy [−1·22 to
−0·18]), bodyweight (−0·92 kg
[−1·11 to −0·72]), diastolic blood pressure
(−1·11 mm Hg [−1·78 to −0·44]),
fasting blood glucose (−1·81 mg/dL [−3·33 to
−0·28]), HDL cholesterol (1·11 mg/dL [0·48 to
1·74]), and triglycerides (−5·38 mg/dL
[−9·18 to −1·59]). No significant benefits were
observed for intake of vegetables (0·03 servings per day [95% CI
−0·04 to 0·10]), fibre (0·26 g per day
[−0·15 to 0·67]), polyunsaturated fat
(−0·23% of daily energy [−0·59 to 0·13]),
or for body fat (−0·80% [−1·80 to 0·21]),
waist-to-hip ratio (−0·00 ratio [−0·01 to
0·00]), or lean mass (1·01 kg [−0·82 to
2·83]). Heterogeneity values ranged from 46·9% to
91·5%. Between-study differences in outcomes were not significantly
explained by study design, location, population, or similar factors in
heterogeneity analyses. Interpretation Workplace wellness programmes are associated with improvements in
specific dietary, anthropometric, and cardiometabolic risk indicators. The
heterogeneity identified in study designs and results should be considered
when using these programmes as strategies to improve cardiometabolic
health.
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Affiliation(s)
- José L Peñalvo
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | - Diana Sagastume
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Elly Mertens
- Non-Communicable Diseases Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irina Uzhova
- Department of Health and Nutritional Sciences, Institute of Technology Sligo, Sligo, Ireland
| | - Jessica Smith
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, USA
| | - Jason H Y Wu
- George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Eve Bishop
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jennifer Onopa
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA; Department of Food Science and Human Nutrition, University of Thessaly, Thessaly, Greece
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Park BM. Effects of Nurse-Led Intervention Programs Based on Goal Attainment Theory: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:699. [PMID: 34207799 PMCID: PMC8229705 DOI: 10.3390/healthcare9060699] [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] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to evaluate the effects of the goal attainment theory-based nurse-led intervention programs using a systematic review and meta-analysis. Randomized and non-randomized controlled trials, published from January 2001 to December 2020, were examined using four international databases and four domestic databases. The search, selection, and coding were performed independently by two researchers. R version 4.0.3 and Review Manager (version 5.3) were employed for meta-analysis and quality assessment, respectively. Of the 7529 articles retrieved, 18 were selected for analysis. The random overall effect size of the programs was 0.77 (95% CI = 0.61-0.94). Effect size by dependent variables were 2.36 (95% CI = 0.91-3.82), 1.25 (95% CI = 0.66-1.83), 0.83 (95% CI = 0.55-1.10), 0.64 (95% CI = 0.39-0.89), and 0.58 (95% CI = 0.30-0.85) for interpersonal, cognitive, health behavior, psychological, and indicators of physical health, respectively. Effect size by independent variables were 1.25 (95% CI = 0.86-1.64), 0.76 (95% CI = 0.48-1.03), 0.72 (95% CI = 0.37-1.06), 0.35 (95% CI = 0.21-0.49), and 1.35 (95% CI = -0.15-2.85) for prevention, health promotion, counseling and education, goal-setting and health contract, and parent participation programs, respectively. The effect size by control variables was 1.72 (95% CI = 0.88-2.56) at age ≤17, 0.85 (95% CI = 0.54-1.15) at time (min) 61-90, 1.04 (95% CI = 0.76-1.32) at sessions seven to eight, and 0.93 (95% CI = 0.66-1.19) at duration (weeks) five to eight. Thus, these programs were effective in improving various health aspects. Additionally, they can be recommended in various settings. Because efficacy is also influenced by control variables, considering treatment designs based on intervention characteristics and methodological approaches is warranted.
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Affiliation(s)
- Bom-Mi Park
- Department of Nursing, Konkuk University Glocal Campus, Chungju-si 27478, Korea
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11
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Czwikla G, Boen F, Cook DG, de Jong J, Harris T, Hilz LK, Iliffe S, Lechner L, Morris RW, Muellmann S, Peels DA, Pischke CR, Schüz B, Stevens M, Telkmann K, van Lenthe FJ, Vanderlinden J, Bolte G. Equity-specific effects of interventions to promote physical activity among middle-aged and older adults: results from applying a novel equity-specific re-analysis strategy. Int J Behav Nutr Phys Act 2021; 18:65. [PMID: 34001171 PMCID: PMC8130354 DOI: 10.1186/s12966-021-01131-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Reducing inequalities in physical activity (PA) and PA-associated health outcomes is a priority for public health. Interventions to promote PA may reduce inequalities, but may also unintentionally increase them. Thus, there is a need to analyze equity-specific intervention effects. However, the potential for analyzing equity-specific effects of PA interventions has not yet been sufficiently exploited. The aim of this study was to set out a novel equity-specific re-analysis strategy tried out in an international interdisciplinary collaboration. METHODS The re-analysis strategy comprised harmonizing choice and definition of outcomes, exposures, socio-demographic indicators, and statistical analysis strategies across studies, as well as synthesizing results. It was applied in a collaboration of a convenience sample of eight European PA intervention studies in adults aged ≥45 years. Weekly minutes of moderate-to-vigorous PA was harmonized as outcome. Any versus no intervention was harmonized as exposure. Gender, education, income, area deprivation, and marital status were harmonized as socio-demographic indicators. Interactions between the intervention and socio-demographic indicators on moderate-to-vigorous PA were analyzed using multivariable linear regression and random-effects meta-analysis. RESULTS The collaborative experience shows that the novel re-analysis strategy can be applied to investigate equity-specific effects of existing PA interventions. Across our convenience sample of studies, no consistent pattern of equity-specific intervention effects was found. Pooled estimates suggested that intervention effects did not differ by gender, education, income, area deprivation, and marital status. CONCLUSIONS To exploit the potential for equity-specific effect analysis, we encourage future studies to apply the strategy to representative samples of existing study data. Ensuring sufficient representation of 'hard to reach' groups such as the most disadvantaged in study samples is of particular importance. This will help to extend the limited evidence required for the design and prioritization of future interventions that are most likely to reduce health inequalities.
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Affiliation(s)
- Gesa Czwikla
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Filip Boen
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Derek G Cook
- Population Health Research Institute, St George's University of London, London, UK
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Tess Harris
- Population Health Research Institute, St George's University of London, London, UK
| | - Lisa K Hilz
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - Lilian Lechner
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Richard W Morris
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Denise A Peels
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine UniversityDuesseldorf, Duesseldorf, Germany
| | - Benjamin Schüz
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Prevention and Health Promotion, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus Telkmann
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Julie Vanderlinden
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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12
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The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis. SSM Popul Health 2021; 13:100743. [PMID: 33604445 PMCID: PMC7873680 DOI: 10.1016/j.ssmph.2021.100743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.
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Robroek SJ, Oude Hengel KM, van der Beek AJ, Boot CR, van Lenthe FJ, Burdorf A, Coenen P. Socio-economic inequalities in the effectiveness of workplace health promotion programmes on body mass index: An individual participant data meta-analysis. Obes Rev 2020; 21:e13101. [PMID: 32696580 PMCID: PMC7583467 DOI: 10.1111/obr.13101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/04/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022]
Abstract
This individual participant data meta-analysis assessed the effectiveness of workplace health promotion programmes on body mass index (BMI) across socio-economic groups and whether study and intervention characteristics explained inequalities in effectiveness. Studies were eligible if they assessed the effect of a workplace health promotion programme on BMI in the Netherlands, included workers of at least two different socio-economic positions (SEPs) and had a study design with premeasurement and postmeasurement and control condition. Data of 13 studies presenting 16 interventions (5183 participants) were harmonized. In a two-stage meta-analysis, the interaction between intervention and SEP on BMI was tested with linear mixed models for each study. Subsequently, the interaction terms were pooled. The influence of study and intervention characteristics on the effectiveness of workplace health promotion programmes was evaluated using meta-regression analyses. Compared with control conditions, workplace health promotion programmes overall showed a statistically non-significant 0.12 kg/m2 (95% CI: -0.01, 0.25) decrease in BMI, which did not differ across SEP. Interventions evaluated within randomized controlled trials, agentic interventions, those that focused on high-risk groups, included a counselling component, consisted of more than five sessions, or were offered at the individual level did statistically significantly reduce BMI. No evidence was found for intervention-generated SEP inequalities.
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Affiliation(s)
- Suzan J.W. Robroek
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Karen M. Oude Hengel
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
- Department of Work Health TechnologyNetherlands Organisation for Applied Scientific Research TNOLeidenThe Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Cécile R.L. Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Frank J. van Lenthe
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Alex Burdorf
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
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