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Neuhaus CA, Metzler YA, Taibi Y, Müller A, Bellingrath S. The burdens and benefits of managing and engaging: a diary study approach to person-centred risk assessment of top executives and works council members. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024:1-9. [PMID: 39108135 DOI: 10.1080/10803548.2024.2383058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
The present diary study investigates the impact of daily effort-reward imbalance (ERI), subjective stress and the cortisol awakening response (CAR) as an objective measure on work engagement of top managers and high-level works council members (N = 45) on three consecutive working days. In the scope of psychosocial risk assessment, we argue that focusing on ERI as a generalized work characteristic might be more suitable for work re-design of higher leadership positions because of their highly dynamic and unpredictable psychosocial work characteristics, while at the same time having more access to job resources. The analyses reveal that both baseline and daily ERI, as well as subjective stress, influence work engagement. Our results suggest that interventions to reduce daily levels of ERI may improve the work environment of top managers and works councils by promoting work engagement and related positive health outcomes in the scope of person-centred risk assessment.
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Affiliation(s)
- Ciel A Neuhaus
- Department of Work and Organizational Psychology, University of Duisburg-Essen, Germany
| | - Yannick A Metzler
- Department of Work and Organizational Psychology, University of Duisburg-Essen, Germany
- Department of Ergonomics, IfADo - Leibniz Research Centre for Working Environment and Human Factors, Germany
| | - Yacine Taibi
- Department of Work and Organizational Psychology, University of Duisburg-Essen, Germany
| | - Andreas Müller
- Department of Work and Organizational Psychology, University of Duisburg-Essen, Germany
| | - Silja Bellingrath
- Department of Work and Organizational Psychology, University of Duisburg-Essen, Germany
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Aust B, Leduc C, Cresswell-Smith J, O'Brien C, Rugulies R, Leduc M, Dhalaigh DN, Dushaj A, Fanaj N, Guinart D, Maxwell M, Reich H, Ross V, Sadath A, Schnitzspahn K, Tóth MD, van Audenhove C, van Weeghel J, Wahlbeck K, Arensman E, Greiner BA. The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review. Int Arch Occup Environ Health 2024; 97:485-522. [PMID: 38695906 PMCID: PMC11130054 DOI: 10.1007/s00420-024-02065-z] [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: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. METHODS Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. RESULTS We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. CONCLUSION Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Clíodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Arilda Dushaj
- Community Centre for Health and Wellbeing, Tirana, Albania
| | - Naim Fanaj
- Per Mendje Te Shendoshe (PMSH), Prizren, Kosovo
- Alma Mater Europaea Campus Rezonanca, Pristina, Kosovo
| | - Daniel Guinart
- CIBERSAM, Hospital del Mar Research Institute, Barcelona, Spain
- Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Hanna Reich
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Anvar Sadath
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Chantal van Audenhove
- KU Leuven, Louvain, Belgium
- Center for Care Research and Consultancy, LUCAS, Louvain, Belgium
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Anger WK, Dimoff JK, Alley L. Addressing Health Care Workers' Mental Health: A Systematic Review of Evidence-Based Interventions and Current Resources. Am J Public Health 2024; 114:213-226. [PMID: 38354343 PMCID: PMC10916736 DOI: 10.2105/ajph.2023.307556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 02/16/2024]
Abstract
Background. Mental health is declining in health care workers. Objectives. To provide a comprehensive assessment of intervention literature focused on the support and treatment of mental health within the health care workforce. Search Methods. We searched online databases (e.g., Medline, PsycINFO). Selection Criteria. We selected manuscripts published before March 2022 that evaluated the target population (e.g., nurses), mental health outcomes (e.g., burnout, depression), and intervention category (e.g., mindfulness). Data Collection and Analysis. Of 5158 publications screened, 118 interventions were included. We extracted relevant statistics and information. Main Results. Twenty (17%) earned study quality ratings indicating design, analysis, and implementation strengths. Randomized controlled trials were used by 52 studies (44%). Thirty-eight percent were conducted in the United States (n = 45). Ninety (76%) reported significant changes, and 46 (39%) reported measurable effect sizes. Multiple interventions significantly reduced stress (n = 29; 24%), anxiety (n = 20; 17%), emotional exhaustion or compassion fatigue (n = 16; 14%), burnout (n = 15; 13%), and depression (n = 15; 13%). Authors' Conclusions. Targeted, well-designed mental health interventions can improve outcomes among health care workers. Public Health Implications. Targeted health care‒focused interventions to address workers' mental health could improve outcomes within this important and vulnerable workforce. (Am J Public Health. 2024;114(S2):S213-S226. https://doi.org/10.2105/AJPH.2023.307556).
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Affiliation(s)
- W Kent Anger
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
| | - Jennifer K Dimoff
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
| | - Lindsey Alley
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
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Thomson L, Hassard J, Frost A, Bartle C, Yarker J, Munir F, Kneller R, Marwaha S, Daly G, Russell S, Meyer C, Vaughan B, Newman K, Blake H. Digital Training Program for Line Managers (Managing Minds at Work): Protocol for a Feasibility Pilot Cluster Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48758. [PMID: 37874612 PMCID: PMC10630869 DOI: 10.2196/48758] [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: 05/05/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Mental health problems affect 1 in 6 workers annually and are one of the leading causes of sickness absence, with stress, anxiety, and depression being responsible for half of all working days lost in the United Kingdom. Primary interventions with a preventative focus are widely acknowledged as the priority for workplace mental health interventions. Line managers hold a primary role in preventing poor mental health within the workplace and, therefore, need to be equipped with the skills and knowledge to effectively carry out this role. However, most previous intervention studies have directly focused on increasing line managers' understanding and awareness of mental health rather than giving them the skills and competencies to take a proactive preventative approach in how they manage and design work. The Managing Minds at Work (MMW) digital training intervention was collaboratively designed to address this gap. The intervention aims to increase line managers' knowledge and confidence in preventing work-related stress and promoting mental health at work. It consists of 5 modules providing evidence-based interactive content on looking after your mental health, designing and managing work to promote mental well-being, management competencies that prevent work-related stress, developing a psychologically safe workplace, and having conversations about mental health at work. OBJECTIVE The primary aim of this study is to pilot and feasibility test MMW, a digital training intervention for line managers. METHODS We use a cluster randomized controlled trial design consisting of 2 arms, the intervention arm and a 3-month waitlist control, in this multicenter feasibility pilot study. Line managers in the intervention arm will complete a baseline questionnaire at screening, immediately post intervention (approximately 6 weeks after baseline), and at 3- and 6-month follow-ups. Line managers in the control arm will complete an initial baseline questionnaire, repeated after 3 months on the waitlist. They will then be granted access to the MMW intervention, following which they will complete the questionnaire post intervention. The direct reports of the line managers in both arms of the trial will also be invited to take part by completing questionnaires at baseline and follow-up. As a feasibility pilot study, a formal sample size is not required. A minimum of 8 clusters (randomized into 2 groups of 4) will be sought to inform a future trial from work organizations of different types and sectors. RESULTS Recruitment for the study closed in January 2022. Overall, 24 organizations and 224 line managers have been recruited. Data analysis was finished in August 2023. CONCLUSIONS The results from this feasibility study will provide insight into the usability and acceptability of the MMW intervention and its potential for improving line manager outcomes and those of their direct reports. These results will inform the development of subsequent trials. TRIAL REGISTRATION ClinicalTrials.gov NCT05154019; https://clinicaltrials.gov/study/NCT05154019. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48758.
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Affiliation(s)
- Louise Thomson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Alexandra Frost
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Craig Bartle
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Joanna Yarker
- Department of Organisational Psychology, Birkbeck College, University of London, London, United Kingdom
- Affinity Health at Work, London, United Kingdom
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Richard Kneller
- School of Economics, University of Nottingham, Nottingham, United Kingdom
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Specialist Mood Disorders Clinic, The Zinnia Centre, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom
| | - Guy Daly
- Office of the Provost, British University in Egypt, Cairo, Egypt
| | - Sean Russell
- Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | | | - Benjamin Vaughan
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Kristina Newman
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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Claes S, Vandepitte S, Clays E, Annemans L. How job demands and job resources contribute to our overall subjective well-being. Front Psychol 2023; 14:1220263. [PMID: 37539001 PMCID: PMC10394838 DOI: 10.3389/fpsyg.2023.1220263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/02/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives How the work environment contributes to employees' overall subjective well-being remains inadequately explored. Building upon the seminal Job Demands-Resources model, this study aims to test a complex model that combines leadership, job demands, and job resources, as factors contributing either indirectly (via job satisfaction) or directly to employees' subjective well-being (SWB). Methods The cross-sectional data (N = 1,859) of the Belgian National happiness study (2020) were used. Leadership (satisfaction with leadership; perceived supervisor support), job demands (role conflict; job insecurity; work-private conflict; perceived working conditions), job resources (autonomy; relatedness; competence; skill utilization; personal growth), job satisfaction and subjective well-being (life evaluation; positive affect; negative affect) were assessed via self-report questionnaires. The proposed model investigates the direct impact of job demands and resources on SWB, as well as the indirect impact with job satisfaction as mediating factor, and was tested using the Structural Equation Modeling technique. Results Findings supported the proposed model. Both job demands and job resources have a direct relationship with SWB. Job resources are positively related to overall SWB, whereas job demands negatively affected SWB. Moreover, job resources are more strongly related to SWB compared to job demands. The demands and resources also indirectly contribute to employee's SWB via job satisfaction as job satisfaction appeared to mediate these relationships. Conclusion The current study shows that both job demands and resources directly and indirectly contribute to employees' SWB. Creating a supportive and healthy work environment is thus of paramount importance in order to foster employees' SWB. In particular, investing in improving job resources may be a fruitful approach to promote employees' overall subjective well-being.
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Sakuraya A, Imamura K, Watanabe K, Asai Y, Ando E, Eguchi H, Nishida N, Kobayashi Y, Arima H, Iwanaga M, Otsuka Y, Sasaki N, Inoue A, Inoue R, Tsuno K, Hino A, Shimazu A, Tsutsumi A, Kawakami N. Corrigendum: What kind of intervention is effective for improving subjective well-being among workers? A systematic review and meta-analysis of randomized controlled trials. Front Psychol 2023; 14:1236746. [PMID: 37469895 PMCID: PMC10353613 DOI: 10.3389/fpsyg.2023.1236746] [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: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2020.528656.].
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Affiliation(s)
- Asuka Sakuraya
- Department of Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumi Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emiko Ando
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Hisashi Eguchi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | | | - Yuka Kobayashi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mai Iwanaga
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health Japan, Fukuoka, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, Kanagawa, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Blodgett JM, Birch JM, Musella M, Harkness F, Kaushal A. What Works to Improve Wellbeing? A Rapid Systematic Review of 223 Interventions Evaluated with the Warwick-Edinburgh Mental Well-Being Scales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15845. [PMID: 36497919 PMCID: PMC9737992 DOI: 10.3390/ijerph192315845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) is a commonly used scale of mental wellbeing focusing entirely on the positive aspect of mental health. It has been widely used in a broad range of clinical and research settings, including to evaluate if interventions, programmes or pilots improve wellbeing. We aimed to systematically review all interventions that used WEMWBS and evaluate which interventions are the most effective at improving wellbeing. METHODS Eligible populations included children and adults, with no health or age restrictions. Any intervention study was eligible if the wellbeing outcome was measured using the 7 or 14-item WEMWBS scale assessed both pre- and post-intervention. We identified eligible intervention studies using three approaches: a database search (Medline, EMBASE, CINAHL, PyschInfo and Web of Science from January 2007 to present), grey literature search, and by issuing a call for evidence. Narrative synthesis and random-effects meta-analysis of standardised mean differences in the intervention group were used to summarise intervention effects on WEMWBS score. RESULTS We identified 223 interventions across 209 studies, with a total of 53,834 participants across all studies. Five main themes of interventions were synthesised: psychological (n = 80); social (n = 54); arts, culture and environment (n = 29); physical health promotion (n = 18); and other (n = 28). Psychological interventions based on resilience, wellbeing or self-management techniques had the strongest effect on wellbeing. A broad range of other interventions were effective at improving mental wellbeing, including other psychological interventions such as cognitive behavioural therapy, psychoeducation and mindfulness. Medium to strong effects were also seen for person-centred support/advice (social), arts-based, parenting (social) and social prescribing interventions. However, a major limitation of the evidence was that only 75 (36%) of studies included a control group. CONCLUSIONS WEMWBS has been widely used to assess wellbeing across a diverse range of interventions, settings and samples. Despite substantial heterogeneity in individual intervention design, delivery and groups targeted, results indicate that a broad range of intervention types can successfully improve wellbeing. Methodological changes, such as greater use of control groups in intervention evaluation, can help future researchers and policy makers further understand what works for mental wellbeing.
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Affiliation(s)
- Joanna M. Blodgett
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Institute of Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London W1T 7HA, UK
| | - Jack M. Birch
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Homerton College, University of Cambridge, Cambridge CB2 8PH, UK
| | | | | | - Aradhna Kaushal
- Kohlrabi Consulting, Manchester SK4 3HJ, UK
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
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Blake H, Vaughan B, Bartle C, Yarker J, Munir F, Marwaha S, Daly G, Russell S, Meyer C, Hassard J, Thomson L. Managing Minds at Work: Development of a Digital Line Manager Training Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8006. [PMID: 35805665 PMCID: PMC9266047 DOI: 10.3390/ijerph19138006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
Mental ill-health is the leading cause of sickness absence, creating a high economic burden. Workplace interventions aimed at supporting employers in the prevention of mental ill-health in the workforce are urgently required. Managing Minds at Work is a digital intervention aimed at supporting line managers in promoting better mental health at work through a preventative approach. This intervention was developed as part of the Mental Health and Productivity Pilot, a wider initiative aimed at supporting employers across the Midlands region of the United Kingdom to improve the future of workplace mental health and wellbeing. The aim of the study is to describe the design and development of the Managing Minds at Work digital training program, prior to feasibility testing. We adopted a collaborative participatory design involving co-design (users as partners) and principles of user-centred design (pilot and usability testing). An agile methodology was used to co-create intervention content with a stakeholder virtual community of practice. Development processes were mapped to core elements of the Medical Research Council (MRC) framework for developing and evaluating complex interventions. The program covers five broad areas: (i) promoting self-care techniques among line managers; (ii) designing work to prevent work-related stress; (iii) management competencies to prevent and reduce stress; (iv) having conversations with employees about mental health; (v) building a psychologically safe work environment. It was considered by stakeholders to be appropriate for any type of organization, irrespective of their size or resources. Pilot and usability testing (n = 37 surveys) aligned with the Technology Acceptance Model (TAM) demonstrated that the program was perceived to be useful, relevant, and easy to use by managers across sectors, organization types, and sizes. We identified positive impacts on manager attitudes and behavioral intentions related to preventing mental ill-health and promoting good mental wellbeing at work. The next step is to explore the feasibility and acceptability of Managing Minds at Work with line managers in diverse employment settings.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Benjamin Vaughan
- Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham NG3 6AA, UK; (B.V.); (C.B.); (L.T.)
| | - Craig Bartle
- Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham NG3 6AA, UK; (B.V.); (C.B.); (L.T.)
| | - Jo Yarker
- Birkbeck, University of London, London WC1H 0PD, UK;
| | - Fehmidah Munir
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough LE11 3TU, UK;
| | - Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK;
| | - Guy Daly
- Office of the Provost, The British University in Egypt, El Sherouk City 11837, Cairo, Egypt;
- Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Sean Russell
- Thrive at Work, West Midlands Combined Authority, Birmingham B19 3SD, UK;
| | - Caroline Meyer
- Executive Office, Warwick University, Coventry CV4 7AL, UK;
| | - Juliet Hassard
- School of Medicine, University of Nottingham Jubilee Campus, Nottingham NG8 1BB, UK;
| | - Louise Thomson
- Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham NG3 6AA, UK; (B.V.); (C.B.); (L.T.)
- School of Medicine, University of Nottingham Jubilee Campus, Nottingham NG8 1BB, UK;
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Stratton E, Lampit A, Choi I, Malmberg Gavelin H, Aji M, Taylor J, Calvo RA, Harvey SB, Glozier N. Are Organizational EHealth Interventions Becoming More Effective at Addressing Employee Mental Health; A Systematic Review and Meta-Analysis (Preprint). J Med Internet Res 2022; 24:e37776. [PMID: 36166285 PMCID: PMC9555335 DOI: 10.2196/37776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/26/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mental health conditions are considered the leading cause of disability, sickness absence, and long-term work incapacity. eHealth interventions provide employees with access to psychological assistance. There has been widespread implementation and provision of eHealth interventions in the workplace as an inexpensive and anonymous way of addressing common mental disorders. Objective This updated review aimed to synthesize the literature on the efficacy of eHealth interventions for anxiety, depression, and stress outcomes in employee samples in organizational settings and evaluate whether their effectiveness has improved over time. Methods Systematic searches of relevant articles published from 2004 to July 2020 of eHealth intervention trials (app- or web-based) focusing on the mental health of employees were conducted. The quality and bias of all studies were assessed. We extracted means and SDs from publications by comparing the differences in effect sizes (Hedge g) in standardized mental health outcomes. We meta-analyzed these data using a random-effects model. Results We identified a tripling of the body of evidence, with 75 trials available for meta-analysis from a combined sample of 14,747 articles. eHealth interventions showed small positive effects for anxiety (Hedges g=0.26, 95% CI 0.13-0.39; P<.001), depression (Hedges g=0.26, 95% CI 0.19-0.34; P<.001), and stress (Hedges g=0.25, 95% CI 0.17-0.34; P<.001) in employees’ after intervention, with similar effects seen at the medium-term follow-up. However, there was evidence of no increase in the effectiveness of these interventions over the past decade. Conclusions This review and meta-analysis confirmed that eHealth interventions have a small positive impact on reducing mental health symptoms in employees. Disappointingly, we found no evidence that, despite the advances in technology and the enormous resources in time, research, and finance devoted to this area for over a decade, better interventions are being produced. Hopefully, these small effect sizes do not represent optimum outcomes in organizational settings. Trial Registration PROSPERO CRD42020185859; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=185859
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Affiliation(s)
- Elizabeth Stratton
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
| | - Isabella Choi
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
| | - Hanna Malmberg Gavelin
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Parkville, Australia
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Melissa Aji
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
| | - Jennifer Taylor
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
| | - Rafael A Calvo
- Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nick Glozier
- Central Clinical School, Faculty of Health and Medicine, University of Sydney, Camperdown, Australia
- ARC Centre of Excellence for Children and Families over the Life Course, Sydney, Australia
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10
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Stuber F, Seifried-Dübon T, Tsarouha E, Rahmani Azad Z, Erschens R, Armbruster I, Schnalzer S, Mulfinger N, Müller A, Angerer P, Helaß M, Maatouk I, Nikendei C, Ruhle S, Puschner B, Gündel H, Rieger MA, Zipfel S, Junne F. Feasibility, psychological outcomes and practical use of a stress-preventive leadership intervention in the workplace hospital: the results of a mixed-method phase-II study. BMJ Open 2022; 12:e049951. [PMID: 35197332 PMCID: PMC8867373 DOI: 10.1136/bmjopen-2021-049951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Hospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility and outcomes, including work-related stress, well-being and transformational leadership. DESIGN This is a mixed-methods study with three measure points (T0: baseline, T1: after the last training session, T2: 3-month follow-up). Additionally, focus groups were conducted to assess participants' change in everyday work. SETTING A tertiary hospital in Germany. PARTICIPANTS N=93 leaders of different professions. INTERVENTION An interactive group setting intervention divided in five separate sessions ((1) self-care as a leader, (2) leadership attitudes and behaviour, (3) motives, needs and stressors of employees, (4) strengthen the resource 'team', (5) reflection and focus groups). The intervention was conducted between June 2018 and March 2020 in k=5 runs of the intervention. OUTCOME MEASURES Feasibility and acceptance were measured with a self-developed intervention specific questionnaire. Psychological outcomes were assessed with the following scales: work-related strain with the Irritation Scale, well-being with the WHO-5 Well-being Index and transformational leadership with the Questionnaire of Integrative Leadership. RESULTS After the intervention at T2, over 90% of participants reported that they would recommend the intervention to another coworker (92.1%, n=59) and all participants (n=64) were satisfied with the intervention and rated the intervention as practical relevant for their everyday work. Participants' self-rated cognitive irritation was reduced, whereas their well-being and transformational leadership behaviour were improved over time. Focus group discussions revealed that participants implemented intervention contents successfully in their everyday work. CONCLUSIONS This intervention was feasible and showed first promising intraindividual changes in psychological outcomes. Participants confirmed its practical relevance. As a next step, the intervention will be evaluated as part of a multicentre-randomised controlled trial within the project SEEGEN (SEElische GEsundheit am Arbeitsplatz KrankeNhaus).
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Affiliation(s)
- Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Elena Tsarouha
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Zahra Rahmani Azad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Ines Armbruster
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Nadine Mulfinger
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Andreas Müller
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Essen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - Madeleine Helaß
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sascha Ruhle
- Chair of Business Administration, Human Resource Management and Organisation Studies, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Bernd Puschner
- Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
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11
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Tsarouha E, Stuber F, Seifried-Dübon T, Radionova N, Schnalzer S, Nikendei C, Genrich M, Worringer B, Stiawa M, Mulfinger N, Gündel H, Junne F, Rieger MA. Reflection on leadership behavior: potentials and limits in the implementation of stress-preventive leadership of middle management in hospitals - a qualitative evaluation of a participatory developed intervention. J Occup Med Toxicol 2021; 16:51. [PMID: 34844608 PMCID: PMC8628435 DOI: 10.1186/s12995-021-00339-7] [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: 04/14/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mental health and stress prevention aspects related to workplace in hospitals are gaining increasingly more attention in research. The workplace hospital is characterized by high work intensity, high emotional demands, and high levels of stress. These conditions can be a risk for the development of mental disorders. Leadership styles can hinder or foster work-related stress and influence the well-being of employees. Through leadership interventions, leaders may be encouraged to develop a stress-preventive leadership style that addresses both, the well-being of the leaders and of the subordinates. A comprehensive qualitative description of leaders’ experiences with interventions on the topic of stress-preventive leadership is yet missing in the literature. Therefore, we address leaders of middle management regarding the development of stress-preventive leadership styles through supporting interventions. The research questions are: How do leaders of middle management perceive their leadership role in terms of effectiveness in stress prevention? Which potentials and limits in the implementation of stress-preventive leadership are experienced? Methods The study follows a qualitative research design and content analysis. We conducted individual interviews with leaders of middle management (n = 30) of a tertiary hospital in Germany for the participatory development of an intervention. This intervention, consisting of five consecutive modules, addressed leaders of middle management in all work areas within one hospital. After participation in the intervention, the leaders were asked to reflect on and evaluate the implementation of the contents learned within focus group discussions. Overall 10 focus group discussions with leaders (n = 60) were conducted. Results The results demonstrate that leaders of middle management perceived potentials for a stress-preventive leadership style (e.g., reflection on leadership role and leadership behavior, awareness/mindfulness, and conveying appreciation). However, limits were also mentioned. These can be differentiated into self-referential, subordinate-related, and above all organizational barriers for the implementation of stress-preventive leadership. Conclusions Some of the organizational barriers can be addressed by mid-level leadership interventions (e.g., lack of peer-exchange) or possibly by adapted leadership interventions for top management (e.g., lack of stress-preventive leadership styles in top level management). Other organizational limits are working conditions (e.g., staff shortage) that can only be influenced by health policy decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00339-7.
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Affiliation(s)
- Elena Tsarouha
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Natalia Radionova
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Guenzburg, Germany
| | - Nadine Mulfinger
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Harald Gündel
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
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12
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Dannheim I, Ludwig-Walz H, Buyken AE, Grimm V, Kroke A. Effectiveness of health-oriented leadership interventions for improving health and wellbeing of employees: a systematic review. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01664-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
Aim
To identify and summarize the evidence for the effect of health-oriented leadership interventions on health and well-being outcomes at the employee level following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Moher et al. 2009).
Subject and Methods
A systematic search of relevant studies was conducted in multiple databases. Randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs) and controlled before–after studies (CBAs) were included based on the following criteria: interventions that addressed supervisors, to raise awareness for the importance of health issues, teach mindfulness practices for conscious awareness, reduce stress and promote resources at the level of individual behavior, and evaluated the effect on at least one outcome of psychomental stress, absenteeism and well-being on the employee level.
Results
Of 6126 publications retrieved, ten studies were identified for analysis. Significant effects of leadership training were reported on exhaustion tendency, self-reported sickness absence, work-related sickness absence and job satisfaction in studies comparing health-oriented training programs to no intervention. Studies comparing health-oriented leadership training to other training did not report significant effects. Risk of bias was judged to be high in seven studies and unclear in three studies.
Conclusion
Evidence for the effectiveness of health-oriented leadership interventions on employees’ stress, absenteeism or well-being is judged to be low, clearly indicating the need for more and higher-quality research.
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13
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Ryan JC, Williams G, Wiggins BW, Flitton AJ, McIntosh JT, Carmen MJ, Cox DN. Exploring the active ingredients of workplace physical and psychological wellbeing programs: a systematic review. Transl Behav Med 2021; 11:1127-1141. [PMID: 33677571 DOI: 10.1093/tbm/ibab003] [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: 12/30/2022] Open
Abstract
Previous reviews have established that workplace wellbeing initiatives are effective at promoting wellbeing, but less is known about which intervention characteristics or "active ingredients" underpin this effectiveness (i.e., behavior change techniques [BCTs]). This review aims to illuminate the connections between the types of BCTs and the level of intervention intensity with intervention effectiveness. A systematic search for peer-reviewed studies evaluating a workplace wellbeing initiative was undertaken across five databases: Medline, Scopus, PsycInfo, and CINAHL (Ovid Emcare). Eligible studies included those that evaluated the effect of a workplace wellbeing initiative on participants' physical wellbeing (e.g., physical activity and quality of life) and psychological wellbeing (e.g., mental health and stress), were published between 2009 and September 2019, and utilized a comparator (e.g., control group or prepost change). Studies were screened in independent duplicate to minimize bias. Effect sizes were calculated. Following removal of duplicates, 1,541 studies were identified and screened for eligibility. Of these, 23 studies reporting 28 comparisons were deemed to meet eligibility criteria. Just over 50% of these studies reported evidence of either a strong or moderate effect across a physical and a psychological outcome, providing a positive indication that workplace wellbeing programs can promote physical and psychological wellbeing in workers. Interventions tended to employ multiple BCTs (mean range 8.1-9.4), however, no discernible patterns between the types or numbers of BCTs employed and intervention effectiveness was found. Further experimental work is required that compares and contrasts workplace wellbeing initiatives to enable a better understanding of how to develop and implement highly effective programs.
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Affiliation(s)
- J C Ryan
- Precision Health Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia.,Public Health and Wellbeing Research Group, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia
| | - G Williams
- Public Health and Wellbeing Research Group, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia
| | - B W Wiggins
- Precision Health Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia.,Public Health and Wellbeing Research Group, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia
| | - A J Flitton
- Physiotherapy Discipline, Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia
| | - J T McIntosh
- Physiotherapy Discipline, Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia
| | - M J Carmen
- Physiotherapy Discipline, Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia
| | - D N Cox
- Precision Health Future Science Platform, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia.,Public Health and Wellbeing Research Group, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia
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14
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Stratton E, Jones N, Peters SE, Torous J, Glozier N. Digital mHealth Interventions for Employees: Systematic Review and Meta-Analysis of Their Effects on Workplace Outcomes. J Occup Environ Med 2021; 63:e512-e525. [PMID: 34050095 DOI: 10.1097/jom.0000000000002267] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To justify the capital investment, employers require proof of benefit of digital mHealth beyond symptomatic improvement. METHODS A systematic review and meta-analysis were conducted to identify studies investigating digital mHealth interventions for employees and their effects on workplace outcomes. RESULTS We identified 28 eligible studies, (8023 employees) comparing digital mHealth interventions to controls. Small significant effects at postintervention in engagement (g = 0.19), and productivity (g = 0.16) were found. Sustained effects were observed, engagement (g = 0.24) and productivity (g = 0.20). There was a wide range of study heterogeneity (I2 = 16% to 94%). CONCLUSION In RCTs digital mHealth interventions demonstrate small, potentially sustained efficacy on employee's engagement and productivity. Similar small yet non-significant effect sizes were seen for absenteeism and presenteeism. This supports the need to find ways of enabling employers to deliver these low-cost digital mHealth interventions that can help improve employee's mental health.
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Affiliation(s)
- Elizabeth Stratton
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia (Dr Stratton and Prof Glozier), Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts (Dr Jones and Dr Peters), Beth Israel Deaconness Medical Center, Harvard Medical School, Harvard University Boston, Massachusetts (Dr Torous)
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15
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Daniels K, Watson D, Nayani R, Tregaskis O, Hogg M, Etuknwa A, Semkina A. Implementing practices focused on workplace health and psychological wellbeing: A systematic review. Soc Sci Med 2021; 277:113888. [PMID: 33865095 DOI: 10.1016/j.socscimed.2021.113888] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/21/2021] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Abstract
RATIONALE Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. Thus, implementation should be evaluated to improve the effectiveness of WHWPs. OBJECTIVE We conducted a systematic review to identify critical success factors for WHWP implementation and gaps in the evidence. Doing so provides a platform for future theoretical development. METHODS We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (e.g., work redesign, 37 studies; and health behavior change, 8 studies), secondary (e.g., mindfulness training, 11 studies), tertiary (e.g., focused on rehabilitation, 9 studies), and multifocal (e.g., including components of primary and secondary, 9 studies). RESULTS Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance. CONCLUSIONS The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656].
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Affiliation(s)
- Kevin Daniels
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom.
| | - David Watson
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Rachel Nayani
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Olga Tregaskis
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Martin Hogg
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Abasiama Etuknwa
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Antonina Semkina
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
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16
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Meinert E, Eerens J, Banks C, Maloney S, Rivers G, Ilic D, Walsh K, Majeed A, Car J. Exploring the Cost of eLearning in Health Professions Education: Scoping Review. JMIR MEDICAL EDUCATION 2021; 7:e13681. [PMID: 33704073 PMCID: PMC8081275 DOI: 10.2196/13681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/25/2019] [Accepted: 12/18/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Existing research on the costs associated with the design and deployment of eLearning in health professions education is limited. The relative costs of these learning platforms to those of face-to-face learning are also not well understood. The lack of predefined costing models used for eLearning cost data capture has made it difficult to complete cost evaluation. OBJECTIVE The key aim of this scoping review was to explore the state of evidence concerning cost capture within eLearning in health professions education. The review explores the available data to define cost calculations related to eLearning. METHODS The scoping review was performed using a search strategy with Medical Subject Heading terms and related keywords centered on eLearning and cost calculation with a population scope of health professionals in all countries. The search was limited to articles published in English. No restriction was placed on literature publication date. RESULTS In total, 7344 articles were returned from the original search of the literature. Of these, 232 were relevant to associated keywords or abstract references following screening. Full-text review resulted in 168 studies being excluded. Of these, 61 studies were excluded because they were unrelated to eLearning and focused on general education. In addition, 103 studies were excluded because of lack of detailed information regarding costs; these studies referred to cost in ways either indicating cost favorability or unfavorability, but without data to support findings. Finally, 4 studies were excluded because of limited cost data that were insufficient for analysis. In total, 42 studies provided data and analysis of the impact of cost and value in health professions education. The most common data source was total cost of training (n=29). Other sources included cost per learner, referring to the cost for individual students (n=13). The population most frequently cited was medical students (n=15), although 12 articles focused on multiple populations. A further 22 studies provide details of costing approaches for the production and delivery of eLearning. These studies offer insight into the ways eLearning has been budgeted and project-managed through implementation. CONCLUSIONS Although cost is a recognized factor in studies detailing eLearning design and implementation, the way cost is captured is inconsistent. Despite a perception that eLearning is more cost-effective than face-to-face instruction, there is not yet sufficient evidence to assert this conclusively. A rigorous, repeatable data capture method is needed, in addition to a means to leverage existing economic evaluation methods that can then test eLearning cost-effectiveness and how to implement eLearning with cost benefits and advantages over traditional instruction.
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Affiliation(s)
- Edward Meinert
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Jessie Eerens
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Christina Banks
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Stephen Maloney
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - George Rivers
- Faculty of Business and Economics, Monash University, Melbourne, Australia
| | - Dragan Ilic
- Medical Education Research and Quality, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kieran Walsh
- BMJ Knowledge Centre, BMJ Learning, London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Josip Car
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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17
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Stuber F, Seifried-Dübon T, Rieger MA, Gündel H, Ruhle S, Zipfel S, Junne F. The effectiveness of health-oriented leadership interventions for the improvement of mental health of employees in the health care sector: a systematic review. Int Arch Occup Environ Health 2021; 94:203-220. [PMID: 33011902 PMCID: PMC7532985 DOI: 10.1007/s00420-020-01583-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE An increasing prevalence of work-related stress and employees' mental health impairments in the health care sector calls for preventive actions. A significant factor in the workplace that is thought to influence employees' mental health is leadership behavior. Hence, effective leadership interventions to foster employees' (leaders' and staff members') mental health might be an important measure to address this pressing issue. METHODS We conducted a systematic review according to the PRISMA statement (Liberati et al. 2009) and systematically searched the following databases: PubMed (PMC), Web of Science, PsycINFO (EBSCOhost), EconLit (EBSCOhost), and Business Source Premier (EBSCOhost). In addition, we performed a hand search of the reference lists of relevant articles. We included studies investigating leadership interventions in the health care sector that aimed to maintain/foster employees' mental health. RESULTS The systematic search produced 11,221 initial search hits in relevant databases. After the screening process and additional literature search, seven studies were deemed eligible according to the inclusion criteria. All studies showed at least a moderate global validity and four of the included studies showed statistically significant improvements of mental health as a result of the leadership interventions. CONCLUSIONS Based on the findings, leadership interventions with reflective and interactive parts in group settings at several seminar days seem to be the most promising strategy to address mental health in health care employees. As the available evidence is limited, efforts to design and scientifically evaluate such interventions should be extended.
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Affiliation(s)
- Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Monika A Rieger
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Sascha Ruhle
- Department of Business Administration, in particular, Work Human Resource Management and Organization Studies, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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18
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Sakuraya A, Imamura K, Watanabe K, Asai Y, Ando E, Eguchi H, Nishida N, Kobayashi Y, Arima H, Iwanaga M, Otsuka Y, Sasaki N, Inoue A, Inoue R, Tsuno K, Hino A, Shimazu A, Tsutsumi A, Kawakami N. What Kind of Intervention Is Effective for Improving Subjective Well-Being Among Workers? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychol 2020; 11:528656. [PMID: 33281653 PMCID: PMC7691289 DOI: 10.3389/fpsyg.2020.528656] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB.
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Affiliation(s)
- Asuka Sakuraya
- Department of Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumi Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emiko Ando
- Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Hisashi Eguchi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | | | - Yuka Kobayashi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mai Iwanaga
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health Japan, Fukuoka, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, Kanagawa, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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de Oliveira C, Cho E, Kavelaars R, Jamieson M, Bao B, Rehm J. Economic analyses of mental health and substance use interventions in the workplace: a systematic literature review and narrative synthesis. Lancet Psychiatry 2020; 7:893-910. [PMID: 32949521 DOI: 10.1016/s2215-0366(20)30145-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
Mental illness and substance use disorders in the workplace have been increasingly recognised as a problem in most countries; however, evidence is scarce on which solutions provide the highest return on investment. We searched academic and grey literature databases and additional sources for studies that included a workplace intervention for mental health or substance abuse, or both, and that did an economic analysis. We analysed the papers we found to identify the highest yielding and most cost-effective interventions by disorder. On the basis of 56 studies, we found moderate strength of evidence that cognitive behavioural therapy is cost-saving (and in some cases cost-effective) to address depression. We observed strong evidence that regular and active involvement of occupational health professionals is cost-saving and cost-effective in reducing sick leave related to mental health and in encouraging return to work. We identified moderate evidence that coverage for pharmacotherapy and brief counselling for smoking cessation are both cost-saving and cost-effective. Addressing mental health and substance misuse in the workplace improves workers' wellbeing and productivity, and benefits employers' bottom line (ie, profit). Future economic analyses would benefit from the consideration of subgroup analyses, examination of longer follow-ups, inclusion of statistical and sensitivity analyses and discussion around uncertainty, and consideration of potential for bias.
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Affiliation(s)
- Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Centre for Health Economics and Hull York Medical School, University of York, York, UK; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
| | - Edward Cho
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - RuthAnne Kavelaars
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Margaret Jamieson
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Buddy Bao
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Epidemiological Research Unit, Technische Universität Dresden, Dresden, Germany; Department of International Health Projects, Institute for Leadership and Health Management, IM Sechenov First Moscow State Medical University, Moscow, Russia
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Kovess-Masfety V, Saunder L, Mellor N. Améliorer la santé mentale et le bien-être des salariés : quelles sont les interventions qui marchent ? ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Saint-Marc P, Ratiney R, Schlatter J. Challenges in Implementing an E-Learning Education Program for Syringe Pump Use. Int J Nurs Educ Scholarsh 2019; 16:ijnes-2017-0079. [PMID: 30673627 DOI: 10.1515/ijnes-2017-0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 09/04/2018] [Indexed: 11/15/2022]
Abstract
To prevent the incidence of risks imputable to human error during the process of preparing the infusion pump, clarity in teaching and learning are required. Because traditional classroom training is difficult and time-consuming, the aim of the present study was to challenge the implementation of an e-learning education program for syringe pump use. The impact of the e-learning program was evaluated with 100 nurses between March and June 2016. The e-learning program significantly increased general baseline knowledge in syringe pump use; however, aspects of the program confused participants. The feedback from 98 % of nurses on the e-learning program was that it was effective in helping them with this skill. However, only 54 % opted for the e-learning program versus traditional training. The present study showed nurses preferred a blended learning format. Based on our hospital incident and error reports, this study shows local training requires a specific approach strategy for syringe pump education.
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Affiliation(s)
| | | | - Joël Schlatter
- Hopital universitaire Necker-Enfants Malades, Pharmacie, 75743Paris, France
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Gayed A, LaMontagne AD, Milner A, Deady M, Calvo RA, Christensen H, Mykletun A, Glozier N, Harvey SB. A New Online Mental Health Training Program for Workplace Managers: Pre-Post Pilot Study Assessing Feasibility, Usability, and Possible Effectiveness. JMIR Ment Health 2018; 5:e10517. [PMID: 29970359 PMCID: PMC6053610 DOI: 10.2196/10517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental health has become the leading cause of sickness absence in high-income countries. Managers can play an important role in establishing mentally healthy workplaces and coordinating their organization's response to a mentally ill worker. OBJECTIVE This pilot study aims to evaluate the feasibility, usability, and likely effectiveness of a newly developed online training program for managers called HeadCoach. HeadCoach aims to build managers' confidence in supporting the mental health needs of staff and promote managerial behavior most likely to result in a more mentally healthy workplace. METHODS In total, 66 managers from two organizations were invited to participate in this pre-post pilot study of HeadCoach, which was made available to managers to complete at their own pace over a 4-week period. Data were collected at baseline and post intervention via an online research platform. The difference in mean scores for each outcome between these two time points was calculated using paired samples t tests. RESULTS Of all the invited managers, 59.1% (39/66) participated in the trial, with complete pre-post data available for 56.4% (22/39) of the participants. The majority of respondents reported positive engagement with the program. During the study period, managers' knowledge regarding their role in managing mental health issues (P=.01) and their confidence in communicating with employees regarding mental illness (P<.001) significantly increased. In addition, a significant increase was observed from the baseline in managers' self-reported actions to use strategies to prevent and decrease stress among their team members (P=.02). CONCLUSIONS Although caution is needed due to the absence of a control group, preliminary results of this study suggest that HeadCoach could be a feasible, acceptable, and efficient method of training managers in best workplace practices to help support the mental health needs of their staff.
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Affiliation(s)
- Aimée Gayed
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia
| | - Anthony D LaMontagne
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Centre for Population Health Research, Deakin University, Geelong, Australia
| | - Allison Milner
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Mark Deady
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Rafael A Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Arnstein Mykletun
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, Australia.,Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine,, University of Tromsø, Tromsø, Norway.,Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway.,Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway
| | - Nick Glozier
- Brain and Mind Centre and Central Clinical School, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Watson D, Tregaskis O, Gedikli C, Vaughn O, Semkina A. Well-being through learning: a systematic review of learning interventions in the workplace and their impact on well-being. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2018. [DOI: 10.1080/1359432x.2018.1435529] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- David Watson
- Norwich Business School, University of East Anglia, Norwich, UK
| | - Olga Tregaskis
- Norwich Business School, University of East Anglia, Norwich, UK
| | - Cigdem Gedikli
- Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
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Gayed A, Bryan BT, Petrie K, Deady M, Milner A, LaMontagne AD, Calvo RA, Mackinnon A, Christensen H, Mykletun A, Glozier N, Harvey SB. A protocol for the HeadCoach trial: the development and evaluation of an online mental health training program for workplace managers. BMC Psychiatry 2018; 18:25. [PMID: 29378536 PMCID: PMC5789544 DOI: 10.1186/s12888-018-1603-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Within high income countries, mental health is now the leading cause of long term sickness absence in the workplace. Managers are in a position to make changes and decisions that have a positive effect on the wellbeing of staff, the recovery of employees with mental ill health, and potentially prevent future mental health problems. However, managers report addressing workplace mental health issues as challenging. The aim of the HeadCoach trial is to evaluate the effectiveness of a newly developed online training intervention to determine whether it is able to build managers' confidence to better support individuals within their teams who are experiencing mental ill health, and the confidence to promote manager behaviour likely to result in a more mentally healthy workplace. METHODS/DESIGN We will conduct a cluster randomised control trial (RCT) to evaluate the effect of HeadCoach, an online training intervention for managers with a focus on the mental health of their employees, compared to a waitlist control. The target sample is 168 managers, and their direct employees. Managers and employees will be assessed at baseline and at 4-month follow up. Managers will have an additional, intermediate assessment 6-weeks post-baseline. The primary outcome is change from baseline in managers' self-reported confidence when dealing with mental health issues within their team and promoting a mentally healthy workplace. The difference between the intervention and waitlist control groups will be assessed using linear mixed effects repeated measures (MMRM) analysis of variance (ANOVA). Secondary managerial outcomes include mental health literacy, attitudes towards mental health issues in the workplace and managerial behaviour in dealing with mental health matters with their staff. Employee outcomes will be perceived level of manager support, engagement, psychological distress, and rates of sickness absence and presenteeism. DISCUSSION To our knowledge this will be the first RCT of a purely online training intervention developed specifically for managers that promotes confidence to both support staff experiencing mental ill health and create a mentally healthy work environment. If successful, this intervention has the potential to provide an effective and efficient method of training managers in workplace mental health and to enhance employee wellbeing. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12617000279325.
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Affiliation(s)
- Aimée Gayed
- School of Psychiatry, University of New South Wales, Randwick, Australia
| | - Bridget T. Bryan
- School of Psychiatry, University of New South Wales, Randwick, Australia
- Black Dog Institute, Randwick, NSW Australia
| | - Katherine Petrie
- School of Psychiatry, University of New South Wales, Randwick, Australia
- Black Dog Institute, Randwick, NSW Australia
| | - Mark Deady
- School of Psychiatry, University of New South Wales, Randwick, Australia
- Black Dog Institute, Randwick, NSW Australia
| | - Allison Milner
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Anthony D. LaMontagne
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Centre for Population Health Research, Deakin University, Geelong, VIC Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Andrew Mackinnon
- Black Dog Institute, Randwick, NSW Australia
- Centre for Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Arnstein Mykletun
- School of Psychiatry, University of New South Wales, Randwick, Australia
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital Trust, Bodø, Norway
- Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway
| | - Nicholas Glozier
- Brain and Mind Centre, Sydney Medical School , University of Sydney, Australia
| | - Samuel B. Harvey
- School of Psychiatry, University of New South Wales, Randwick, Australia
- Black Dog Institute, Randwick, NSW Australia
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Stratton E, Lampit A, Choi I, Calvo RA, Harvey SB, Glozier N. Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis. PLoS One 2017; 12:e0189904. [PMID: 29267334 PMCID: PMC5739441 DOI: 10.1371/journal.pone.0189904] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/04/2017] [Indexed: 02/03/2023] Open
Abstract
Background Many organisations promote eHealth applications as a feasible, low-cost method of addressing mental ill-health and stress amongst their employees. However, there are good reasons why the efficacy identified in clinical or other samples may not generalize to employees, and many Apps are being developed specifically for this group. The aim of this paper is to conduct the first comprehensive systematic review and meta-analysis evaluating the evidence for the effectiveness and examine the relative efficacy of different types of eHealth interventions for employees. Methods Systematic searches were conducted for relevant articles published from 1975 until November 17, 2016, of trials of eHealth mental health interventions (App or web-based) focused on the mental health of employees. The quality and bias of all identified studies was assessed. We extracted means and standard deviations from published reports, comparing the difference in effect sizes (Hedge’s g) in standardized mental health outcomes. We meta-analysed these using a random effects model, stratified by length of follow up, intervention type, and whether the intervention was universal (unselected) or targeted to selected groups e.g. “stressed”. Results 23 controlled trials of eHealth interventions were identified which overall suggested a small positive effect at both post intervention (g = 0.24, 95% CI 0.13 to 0.35) and follow up (g = 0.23, 95% CI 0.03 to 0.42). There were differential short term effects seen between the intervention types whereby Mindfulness based interventions (g = 0.60, 95% CI 0.34 to 0.85, n = 6) showed larger effects than the Cognitive Behaviour Therapy (CBT) based (g = 0.15, 95% CI 0.02 to 0.29, n = 11) and Stress Management based (g = 0.17, 95%CI -0.01 to 0.34, n = 6) interventions. The Stress Management interventions however differed by whether delivered to universal or targeted groups with a moderately large effect size at both post-intervention (g = 0.64, 95% CI 0.54 to 0.85) and follow-up (g = 0.69, 95% CI 0.06 to 1.33) in targeted groups, but no effect in unselected groups. Interpretation There is reasonable evidence that eHealth interventions delivered to employees may reduce mental health and stress symptoms post intervention and still have a benefit, although reduced at follow-up. Despite the enthusiasm in the corporate world for such approaches, employers and other organisations should be aware not all such interventions are equal, many lack evidence, and achieving the best outcomes depends upon providing the right type of intervention to the correct population.
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Affiliation(s)
- Elizabeth Stratton
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
- * E-mail:
| | - Amit Lampit
- School of Psychiatry, University of Sydney, Sydney, Australia
| | - Isabella Choi
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Rafael A. Calvo
- School of Electrical and Information Engineering, University of Sydney, Sydney, Australia
| | - Samuel B. Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St George Hospital, Sydney, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia
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Milligan-Saville JS, Tan L, Gayed A, Barnes C, Madan I, Dobson M, Bryant RA, Christensen H, Mykletun A, Harvey SB. Workplace mental health training for managers and its effect on sick leave in employees: a cluster randomised controlled trial. Lancet Psychiatry 2017; 4:850-858. [PMID: 29031935 DOI: 10.1016/s2215-0366(17)30372-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/20/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Mental illness is one of the most rapidly increasing causes of long-term sickness absence, despite improved rates of detection and development of more effective interventions. However, mental health training for managers might help improve occupational outcomes for people with mental health problems. We aimed to investigate the effect of mental health training on managers' knowledge, attitudes, confidence, and behaviour towards employees with mental health problems, and its effect on employee sickness absence. METHODS We did a cluster randomised controlled trial of manager mental health training within a large Australian fire and rescue service, with a 6-month follow-up. Managers (clusters) at the level of duty commander or equivalent were randomly assigned (1:1) using an online random sequence generator to either a 4-h face-to-face RESPECT mental health training programme or a deferred training control group. Researchers, managers, and employees were not masked to the outcome of randomisation. Firefighters and station officers supervised by each manager were included in the study via their anonymised sickness absence records. The primary outcome measure was change in sickness absence among those supervised by each of the managers. We analysed rates of work-related sick leave and standard sick leave seperately, with rate being defined as sickness absence hours divided by the sum of hours of sickness absence and hours of attendance. This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613001156774). FINDINGS 128 managers were recruited between Feb 18, 2014, and May 17, 2014. 46 (71%) of 65 managers allocated to the intervention group received the intervention, and 42 (67%) of 63 managers allocated to the control group were entered in the deferred training group. Managers and their employees were followed up and reassessed at 6 months after randomisation. 25 managers (1233 employees) in the intervention group and 19 managers (733 employees) in the control group provided data for the primary analysis. During the 6-month follow-up, the mean rate of work-related sick leave decreased by 0·28 percentage points (pp) from a pre-training mean of 1·56% (SE 0·23) in the intervention group and increased by 0·28 pp from 0·95% (0·20) in the control group (p=0·049), corresponding to a reduction of 6·45 h per employee per 6 months. The mean percentage of standard sick leave increased by 0·48 pp from 4·97% (0·22) in the intervention group and by 0·31 pp from 5·27% (0·21) in the control group (p=0·169). INTERPRETATION A 4-h manager mental health training programme could lead to a significant reduction in work-related sickness absence, with an associated return on investment of £9.98 for each pound spent on such training. Further research is needed to confirm these findings and test their applicability in other work settings. FUNDING NSW Health and Employers Mutual Ltd.
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Affiliation(s)
| | - Leona Tan
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | - Aimée Gayed
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | | | - Ira Madan
- Occupational Health Department, The Education Centre, Guy's and St Thomas' NHS Trust, London, UK; Division of Health and Social Care Research, King's College London, London, UK
| | - Mark Dobson
- Fire and Rescue NSW, Public Safety Office, Sydney, NSW, Australia
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Black Dog Institute, Randwick, NSW, Australia; School of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Arnstein Mykletun
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Norwegian Institute of Public Health, Bergen, Norway; Centre for Research and Education in Forensic Psychiatry and Psychology, Haukeland University Hospital, Bergen, Norway; Department of Community Medicine, University of Tromsø, Tromsø, Norway; Nordland Hospital Trust, Bodø, Norway
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Randwick, NSW, Australia.
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Abstract
PURPOSE OF REVIEW The current review aims to provide an update on the recent work in mental health promotion with a special emphasis on emerging evidence and innovations in the field. RECENT FINDINGS Studies reviewed across settings like the home, school, workplace, communities, and internet-based platforms, have indicated a growing evidence base for effective mental health promotion strategies that are holistic, multicomponent, and targeted at both, specific vulnerable groups and whole populations. Innovative approaches involving online delivery platforms, sports and exercise, positive psychology and lifestyle interventions, mobilizing community networks, and mental health first aid, are some exciting and upcoming areas for future research. SUMMARY Mental health promotion interventions are applicable to individuals, groups, and whole populations and can be delivered in many ways, including media and communication technology. They can be applied in low-resource settings by mobilizing existing community resources like opinion leaders, health workers, and peer educators, thereby increasing cost-efficiency, cultural acceptability, and local capacity. There needs to be a greater focus on study designs and variable measures that examine process-factors affecting well being outcomes. Early interventions through intersectorial collaborations may result in improved long-term positive mental health outcomes for individuals, families, and communities.
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Kuster AT, Dalsbø TK, Luong Thanh BY, Agarwal A, Durand‐Moreau QV, Kirkehei I. Computer-based versus in-person interventions for preventing and reducing stress in workers. Cochrane Database Syst Rev 2017; 8:CD011899. [PMID: 28853146 PMCID: PMC6483691 DOI: 10.1002/14651858.cd011899.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic exposure to stress has been linked to several negative physiological and psychological health outcomes. Among employees, stress and its associated effects can also result in productivity losses and higher healthcare costs. In-person (face-to-face) and computer-based (web- and mobile-based) stress management interventions have been shown to be effective in reducing stress in employees compared to no intervention. However, it is unclear if one form of intervention delivery is more effective than the other. It is conceivable that computer-based interventions are more accessible, convenient, and cost-effective. OBJECTIVES To compare the effects of computer-based interventions versus in-person interventions for preventing and reducing stress in workers. SEARCH METHODS We searched CENTRAL, MEDLINE, PubMed, Embase, PsycINFO, NIOSHTIC, NIOSHTIC-2, HSELINE, CISDOC, and two trials registers up to February 2017. SELECTION CRITERIA We included randomised controlled studies that compared the effectiveness of a computer-based stress management intervention (using any technique) with a face-to-face intervention that had the same content. We included studies that measured stress or burnout as an outcome, and used workers from any occupation as participants. DATA COLLECTION AND ANALYSIS Three authors independently screened and selected 75 unique studies for full-text review from 3431 unique reports identified from the search. We excluded 73 studies based on full-text assessment. We included two studies. Two review authors independently extracted stress outcome data from the two included studies. We contacted study authors to gather additional data. We used standardised mean differences (SMDs) with 95% confidence intervals (CIs) to report study results. We did not perform meta-analyses due to variability in the primary outcome and considerable statistical heterogeneity. We used the GRADE approach to rate the quality of the evidence. MAIN RESULTS Two studies met the inclusion criteria, including a total of 159 participants in the included arms of the studies (67 participants completed computer-based interventions; 92 participants completed in-person interventions). Workers were primarily white, Caucasian, middle-aged, and college-educated. Both studies delivered education about stress, its causes, and strategies to reduce stress (e.g. relaxation or mindfulness) via a computer in the computer-based arm, and via small group sessions in the in-person arm. Both studies measured stress using different scales at short-term follow-up only (less than one month). Due to considerable heterogeneity in the results, we could not pool the data, and we analysed the results of the studies separately. The SMD of stress levels in the computer-based intervention group was 0.81 standard deviations higher (95% CI 0.21 to 1.41) than the in-person group in one study, and 0.35 standard deviations lower (95% CI -0.76 to 0.05) than the in-person group in another study. We judged both studies as having a high risk of bias. AUTHORS' CONCLUSIONS We found very low-quality evidence with conflicting results, when comparing the effectiveness of computer-based stress management interventions with in-person stress management interventions in employees. We could include only two studies with small sample sizes. We have very little confidence in the effect estimates. It is very likely that future studies will change these conclusions.
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Affiliation(s)
- Anootnara Talkul Kuster
- Faculty of Public Health, Khon Kaen UniversityDepartment of Environmental Health Science, Occupational Health and Safety123 Moo 16 Mittapap Rd.Khon KaenThailand40002
| | - Therese K Dalsbø
- Norwegian Institute of Public HealthDepartment for Health ServicesPO Box 4404, NydalenOsloOslo, NorwayNorwayN‐0403
| | - Bao Yen Luong Thanh
- Faculty of Public Health, Hue University of Medicine and PharmacyDepartment of Biostatistics ‐ Demography ‐ Reproductive Health06 Ngo QuyenHueThua Thien HueVietnam47000
| | - Arnav Agarwal
- University of TorontoFaculty of Medicine1 King's College CircleTorontoONCanadaM5S 1A8
| | - Quentin V Durand‐Moreau
- University Hospital of BrestOccupational and Environmental Diseases Center5 avenue FochBrestFrance29609
| | - Ingvild Kirkehei
- Norwegian Institute of Public HealthDivision for health servicesPO Box 4404 NydalenOsloNorwayN‐0403
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Ryan C, Bergin M, Chalder T, Wells JS. Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy. J Occup Health 2017; 59:215-236. [PMID: 28320977 PMCID: PMC5478505 DOI: 10.1539/joh.16-0227-ra] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This review sought to determine what is currently known about the focus, form, and efficacy of web-based interventions that aim to support the well-being of workers and enable them to manage their work-related stress. METHOD A scoping review of the literature as this relates to web-based interventions for the management of work-related stress and supporting the psychological well-being of workers was conducted. RESULTS Forty-eight web-based interventions were identified and reviewed, the majority of which (n = 37) were "individual" -focused and utilized cognitive-behavioral techniques, relaxation exercises, mindfulness, or cognitive behavior therapy. Most interventions identified were provided via a website (n = 34) and were atheoretical in nature. CONCLUSIONS There is some low-to-moderate quality evidence that "individual" -focused interventions are effective for supporting employee well-being and managing their work-related stress. There are few web-based interventions that target "organizational" or "individual/organization" interface factors, and there is limited support for their efficacy. A clear gap appears to exist between work-stress theory and its application in the design and development of web-based interventions for the management of work-related stress.
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Affiliation(s)
- Cathal Ryan
- Department of Nursing and Health Care, School of Health Sciences, Waterford Institute of Technology
| | - Michael Bergin
- Department of Nursing and Health Care, School of Health Sciences, Waterford Institute of Technology
| | | | - John Sg Wells
- School of Health Sciences, Waterford Institute of Technology
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Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ 2016; 355:i5239. [PMID: 27777223 PMCID: PMC5076380 DOI: 10.1136/bmj.i5239] [Citation(s) in RCA: 1416] [Impact Index Per Article: 177.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Sandra M Eldridge
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Claire L Chan
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Michael J Campbell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christine M Bond
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, Scotland, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Lehana Thabane
- Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Gillian A Lancaster
- Department of Mathematics and Statistics, Lancaster University, Lancaster, UK
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Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot Feasibility Stud 2016; 2:64. [PMID: 27965879 PMCID: PMC5154046 DOI: 10.1186/s40814-016-0105-8] [Citation(s) in RCA: 668] [Impact Index Per Article: 83.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/10/2016] [Indexed: 01/10/2023] Open
Abstract
The Consolidated Standards of Reporting Trials (CONSORT) statement is a guideline designed to improve the transparency and quality of the reporting of randomised controlled trials (RCTs). In this article we present an extension to that statement for randomised pilot and feasibility trials conducted in advance of a future definitive RCT. The checklist applies to any randomised study in which a future definitive RCT, or part of it, is conducted on a smaller scale, regardless of its design (eg, cluster, factorial, crossover) or the terms used by authors to describe the study (eg, pilot, feasibility, trial, study). The extension does not directly apply to internal pilot studies built into the design of a main trial, non-randomised pilot and feasibility studies, or phase II studies, but these studies all have some similarities to randomised pilot and feasibility studies and so many of the principles might also apply. The development of the extension was motivated by the growing number of studies described as feasibility or pilot studies and by research that has identified weaknesses in their reporting and conduct. We followed recommended good practice to develop the extension, including carrying out a Delphi survey, holding a consensus meeting and research team meetings, and piloting the checklist. The aims and objectives of pilot and feasibility randomised studies differ from those of other randomised trials. Consequently, although much of the information to be reported in these trials is similar to those in randomised controlled trials (RCTs) assessing effectiveness and efficacy, there are some key differences in the type of information and in the appropriate interpretation of standard CONSORT reporting items. We have retained some of the original CONSORT statement items, but most have been adapted, some removed, and new items added. The new items cover how participants were identified and consent obtained; if applicable, the prespecified criteria used to judge whether or how to proceed with a future definitive RCT; if relevant, other important unintended consequences; implications for progression from pilot to future definitive RCT, including any proposed amendments; and ethical approval or approval by a research review committee confirmed with a reference number. This article includes the 26 item checklist, a separate checklist for the abstract, a template for a CONSORT flowchart for these studies, and an explanation of the changes made and supporting examples. We believe that routine use of this proposed extension to the CONSORT statement will result in improvements in the reporting of pilot trials. Editor's note: In order to encourage its wide dissemination this article is freely accessible on the BMJ and Pilot and Feasibility Studies journal websites.
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Affiliation(s)
- Sandra M. Eldridge
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Claire L. Chan
- Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
| | - Michael J. Campbell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Christine M. Bond
- Centre of Academic Primary Care, University of Aberdeen, Aberdeen, Scotland, UK
| | - Sally Hopewell
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Lehana Thabane
- Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada
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Fontaine G, Cossette S, Heppell S, Boyer L, Mailhot T, Simard MJ, Tanguay JF. Evaluation of a Web-Based E-Learning Platform for Brief Motivational Interviewing by Nurses in Cardiovascular Care: A Pilot Study. J Med Internet Res 2016; 18:e224. [PMID: 27539960 PMCID: PMC5010651 DOI: 10.2196/jmir.6298] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Brief motivational interviewing (MI) can contribute to reductions in morbidity and mortality related to coronary artery disease, through health behavior change. Brief MI, unlike more intensive interventions, was proposed to meet the needs of clinicians with little spare time. While the provision of face-to-face brief MI training on a large scale is complicated, Web-based e-learning is promising because of the flexibility it offers. OBJECTIVE The primary objective of this pilot study was to examine the feasibility and acceptability of a Web-based e-learning platform for brief MI (MOTIV@CŒUR), which was evaluated by nurses in cardiovascular care. The secondary objective was to assess the preliminary effect of the training on nurses' perceived brief MI skills and self-reported clinical use of brief MI. METHODS We conducted a single-group, pre-post pilot study involving nurses working in a coronary care unit to evaluate MOTIV@CŒUR, which is a Web-based e-learning platform for brief MI, consisting of two sessions lasting 30 and 20 minutes. MOTIV@CŒUR covers 4 real-life clinical situations through role-modeling videos showing nurse-client interactions. A brief introduction to MI is followed by role playing, during which a nurse practitioner evaluates clients' motivation to change and intervenes according to the principles of brief MI. The clinical situations target smoking, medication adherence, physical activity, and diet. Nurses were asked to complete both Web-based training sessions asynchronously within 20 days, which allowed assessment of the feasibility of the intervention. Data regarding acceptability and preliminary effects (perceived skills in brief MI, and self-reported clinical use of conviction and confidence interventions) were self-assessed through Web-based questionnaires 30 days (±5 days) after the first session. RESULTS We enrolled 27 women and 4 men (mean age 37, SD 9 years) in March 2016. Of the 31 participants, 24 (77%, 95% CI 63%-91%) completed both sessions in ≤20 days. At 30 days, 28 of the 31 participants (90%) had completed at least one session. The training was rated as highly acceptable, with the highest scores observed for information quality (mean 6.26, SD 0.60; scale 0-7), perceived ease of use (mean 6.16, SD 0.78; scale 0-7), and system quality (mean 6.15, SD 0.58; scale 0-7). Posttraining scores for self-reported clinical use of confidence interventions were higher than pretraining scores (mean 34.72, SD 6.29 vs mean 31.48, SD 6.75, respectively; P=.03; scale 10-50). Other results were nonsignificant. CONCLUSIONS Brief MI training using a Web-based e-learning platform including role-modeling videos is both feasible and acceptable according to cardiovascular care nurses. Further research is required to evaluate the e-learning platform in a randomized controlled trial. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 16510888; http://www.isrctn.com/ISRCTN16510888 (Archived by WebCite at http://www.webcitation.org/6jf7dr7bx).
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Russell J, Berney L, Stansfeld S, Lanz D, Kerry S, Chandola T, Bhui K. The role of qualitative research in adding value to a randomised controlled trial: lessons from a pilot study of a guided e-learning intervention for managers to improve employee wellbeing and reduce sickness absence. Trials 2016; 17:396. [PMID: 27507134 PMCID: PMC4977834 DOI: 10.1186/s13063-016-1497-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 05/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the growing popularity of mixed-methods studies and considerable emphasis on the potential value of qualitative research to the trial endeavour, there remains a dearth of published studies reporting on actual contribution. This paper presents a critically reflective account of our experience of the actual value of undertaking qualitative research alongside a pilot cluster randomised controlled trial of a guided e-learning intervention for managers in an NHS Mental Health Trust to improve employee wellbeing and reduce sickness absence. For the qualitative study we undertook 36 in-depth interviews with key informants, managers and employees. We observed and took in-depth field notes of 10 meetings involving managers and employees at the Trust, and the two qualitative researchers acted as participant observers at steering committee and monthly research team meetings. We adopted a narrative methodological orientation alongside a thematic approach to data analysis, eliciting a rich account of the complexities of managing stress at work. RESULTS We identified two key overarching roles played by the qualitative research: 'problematising' and 'contextualising'. Specifically, the qualitative data revealed and challenged assumptions embedded in the trial about the nature of the learning process, and exposed the slippery and contested nature of abstracted variables, on which a trial depends. The qualitative data challenged the trial's logic model, and provided a rich understanding of the context within which the trial and intervention took place. CONCLUSIONS While acknowledging the ever-present tension in mixed-methods research between the requirements of quantitative research to represent the social world as abstracted variables, and the goal of qualitative research to explore and document the complexity of social phenomena, we adopted a pragmatic position that enabled us to engage with this tension in a productive and partially integrative way. Our critically reflective account of the praxis of integration illuminated opportunities and challenges for maximising the value of qualitative research to a trial. This paper sets out tangible illustrative lessons for other mixed-methods researchers endeavouring to get the most from qualitative research. TRIAL REGISTRATION This study is registered as ISRCTN58661009 . Registration was submitted on 22 April 2013 and completed on 17 June 2013.
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Affiliation(s)
- Jill Russell
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Lee Berney
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Doris Lanz
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sally Kerry
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tarani Chandola
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Dorling H, Cook A, Ollerhead L, Westmore M. The NIHR Public Health Research Programme: responding to local authority research needs in the United Kingdom. Health Res Policy Syst 2015; 13:77. [PMID: 26652743 PMCID: PMC4676828 DOI: 10.1186/s12961-015-0068-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 11/30/2015] [Indexed: 11/29/2022] Open
Abstract
The remit of the National Institute for Health Research Public Health Research (PHR) Programme is to evaluate public health interventions, providing new knowledge on the benefits, costs, acceptability and wider impacts of interventions, set outside of the National Health Service, intended to improve the health of the public and reduce inequalities. This paper illustrates how the PHR Programme is providing new knowledge for public health decision makers, based on the nine key areas for local authority public health action, described by the King's Fund. Many funded PHR projects are evaluating interventions, applied in a range of settings, across the identified key areas for local authority influence. For example, research has been funded on children and young people, and for some of the wider determinants of health, such as housing and travel. Other factors, such as spatial planning, or open and green spaces and leisure, are less represented in the PHR Programme. Further opportunities in research include interventions to improve the health of adolescents, adults in workplaces, and communities. Building evidence for public health interventions at local authority level is important to prioritise and implement effective changes to improve population health.
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Affiliation(s)
- Hannah Dorling
- NIHR Evaluation Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK.
| | - Andrew Cook
- Wessex Institute, University of Southampton, Southampton, UK.
- University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Liz Ollerhead
- NIHR Evaluation Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK.
| | - Matt Westmore
- NIHR Evaluation Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Alpha House, Enterprise Road, Southampton, SO16 7NS, UK.
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