1
|
Röben T, van Oostrom S, Benning F, Smit D, Proper K. Preventive health measures in small and medium-sized enterprises: A scoping review on implementation strategies. APPLIED ERGONOMICS 2024; 119:104303. [PMID: 38714103 DOI: 10.1016/j.apergo.2024.104303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE To describe implementation strategies for preventive health measures in SMEs and the effectiveness of the strategies on implementation outcomes. METHODS A literature search was performed in multiple electronic databases. Studies published between 2000 and 2021 that evaluated the implementation of preventive health measures in SMEs were included. Classification of implementation strategies was based on two complementary classification systems. RESULTS Nineteen studies, of which 5 RCTs were included. Eighteen distinct implementation strategies were reported. All studies applied a combination of implementation strategies, and nearly all reported a positive effect on one or more implementation outcomes: sustainability, acceptability, feasibility, penetration, fidelity, adoption, and appropriateness. CONCLUSIONS Overall, a positive effect of combined implementation strategies on the implementation outcome(s) was found. The 'distribution of educational materials' and 'provide ongoing consultation' combined show positive effects on sustainability.
Collapse
Affiliation(s)
- Thomas Röben
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sandra van Oostrom
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Friederike Benning
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Denise Smit
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Karin Proper
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| |
Collapse
|
2
|
Bensa K, Širok K. Is It Time to Re-Shift the Research Agenda? A Scoping Review of Participation Rates in Workplace Health Promotion Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032757. [PMID: 36768121 PMCID: PMC9916376 DOI: 10.3390/ijerph20032757] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 06/12/2023]
Abstract
Workplace health promotion programmes (WHPPs) are among the most important measures to improve the health and motivation of the ageing workforce. However, they are accompanied with certain challenges, such as low participation rates and higher participation levels of the more health-conscious workers, often failing to engage those who need such interventions the most. Following the PRISMA guidelines, this scoping review examined participation rates reported in articles on WHPPs to identify potential knowledge gaps. The results are worrying: participation rates are not only infrequently reported, but also low. Of the 58 articles, 37 report participation rates, with the majority (20) reporting an average participation rate of less than 50%. Reported participation rates refer either to different target groups, the type of intervention, or to single points in time, which makes it difficult to establish consistent criteria for comparison. We argue that despite the importance of WHPP efficacy, research focus should shift to the determinants of participation, as well as the issue of standardising the reporting of participation rates, alongside the potential problem of reporting bias.
Collapse
Affiliation(s)
- Katarina Bensa
- Faculty of Management, University of Primorska, 6000 Koper, Slovenia
| | - Klemen Širok
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia
| |
Collapse
|
3
|
Odawara M, Saito J, Yaguchi-Saito A, Fujimori M, Uchitomi Y, Shimazu T. Using implementation mapping to develop strategies for preventing non-communicable diseases in Japanese small- and medium-sized enterprises. Front Public Health 2022; 10:873769. [PMID: 36276371 PMCID: PMC9582744 DOI: 10.3389/fpubh.2022.873769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Workplace programs to prevent non-communicable diseases (NCDs) in the workplace can help prevent the incidence of chronic diseases among employees, provide health benefits, and reduce the risk of financial loss. Nevertheless, these programs are not fully implemented, particularly in small- and medium-sized enterprises (SMEs). The purpose of this study was to develop implementation strategies for health promotion activities to prevent NCDs in Japanese SMEs using Implementation Mapping (IM) to present the process in a systematic, transparent, and replicable manner. Methods Qualitative methods using interviews and focus group discussions with 15 SMEs and 20 public health nurses were conducted in a previous study. This study applied the Consolidated Framework for Implementation Research and IM to analyze this dataset to develop implementation strategies suitable for SMEs in Japan. Results In task 2 of the IM, we identified performance objectives, determinants, and change objectives for each implementation stage: adoption, implementation, and maintenance; to identify the required actors and actions necessary to enhance implementation effectiveness. Twenty-two performance objectives were identified in each implementation stage. In task 3 of the IM, the planning group matched behavioral change methods (e.g., modeling and setting of graded tasks, framing, self-re-evaluation, and environmental re-evaluation) with determinants to address the performance objectives. We used a consolidated framework for implementation research to select the optimal behavioral change technique for performance objectives and determinants and designed a practical application. The planning team agreed on the inclusion of sixteen strategies from the final strategies list compiled and presented to it for consensus, for the overall implementation plan design. Discussion This paper provides the implementation strategies for NCDs prevention for SMEs in Japan following an IM protocol. Although the identified implementation strategies might not be generalizable to all SMEs planning implementation of health promotion activities, because they were tailored to contextual factors identified in a formative research. However, identified performance objectives and implementation strategies can help direct the next steps in launching preventive programs against NCDs in SMEs.
Collapse
Affiliation(s)
- Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,*Correspondence: Taichi Shimazu
| |
Collapse
|
4
|
Hente L, Schlesinger T. Factors influencing the implementation of workplace health promotion in companies in rural areas. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-04-2020-0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeWorkplace health promotion (WHP) is becoming increasingly important due to the ageing workforce and a shortage of skilled workers. Nevertheless, too few companies have reacted to the demographic change and introduced health-promoting measures. This paper aims to identify which factors influence the implementation of WHP, especially in small and medium-sized enterprises (SMEs) in rural areas.Design/methodology/approach253 companies in a rural area in the federal state of Saxony (Germany) were surveyed using a standardised questionnaire via a computer-assisted telephone interview. Bivariate analyses and logistic regression models were carried out. The focus was on the relationship between the status of WHP and the size of the company, pressure of demographic change, health-related attitude and organisational capacity factors.FindingsIt was shown that, in addition to the control variables company size and pressure of the shortage of skilled workers, a company's attitude regarding health promotion, financial capacity and planning and development capacity has a relevant influence on the status of WHP.Practical implicationsBased on the results, targeted measures can be developed and converted to implement WHP, particularly in SMEs in rural regions. The focus should be on sensitisation, knowledge transfer and capacity development.Originality/valueThe present paper reveals the relationship between company size, pressure of demographic change, health-related attitude and organisational capacities regarding the status of health-promoting measures in SMEs in a rural region.
Collapse
|
5
|
International Total Worker Health: Applicability to Agribusiness in Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052252. [PMID: 33668716 PMCID: PMC7956694 DOI: 10.3390/ijerph18052252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022]
Abstract
Total Worker Health® (TWH) is a framework for integrating worker and workplace safety, health, and well-being, which has achieved success in European and US settings. However, the framework has not been implemented in Latin America or in agricultural sectors, leaving large and vulnerable populations underrepresented in the implementation and evaluation of these strategies to improve safety and promote health and well-being. This study presents a case study of how a TWH approach can be applied to a multinational Latin American agribusiness. We describe the process and adaptation strategy for conducting a TWH assessment at multiple organizational levels and in multiple countries. We follow this with a description of a TWH leadership training that was conducted based on the results of the assessment. Finally, we describe our methods to make corporate recommendations for TWH policies and programs that were informed by the TWH assessment and leadership trainings. With this case study we aim to demonstrate the importance and feasibility of conducting TWH in Latin America.
Collapse
|
6
|
Cleveland LP, Seward MW, Simon D, Rifas-Shiman SL, Lewis KH, Bennett-Rizzo C, Halperin F, McManus KD, Block JP. BWHealthy Weight Pilot Study: A randomized controlled trial to improve weight-loss maintenance using deposit contracts in the workplace. Prev Med Rep 2020; 17:101061. [PMID: 32071848 PMCID: PMC7011078 DOI: 10.1016/j.pmedr.2020.101061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/26/2019] [Accepted: 01/23/2020] [Indexed: 12/26/2022] Open
Abstract
Objective Deposit contracts, where participants “bet” on achieving a goal and get their money back only if successful, have been shown to be effective for short-term weight-loss. This pilot study examined their effect on weight-loss maintenance. Methods From 2016 to 2018, we conducted a pilot, 50-week randomized controlled trial among 42 hospital employees (19 intervention and 23 control), in Boston, Massachusetts, who lost ≥10 lb (4.5 kg) in the two years prior to enrollment. Participants were recruited primarily in-person. Both control and intervention participants were asked to attend a weigh in weekly and received weekly email communication. Intervention participants also entered into a deposit contract to maintain baseline weight within ≤2 lb (0.9 kg). We examined weight change from baseline to 50 weeks (primary outcome) and maintenance of baseline weight at 50 weeks (secondary outcome; binary – yes v. no). Participants completed baseline and follow-up surveys and received incentives for completion. Results At baseline, mean (SD) weight was 83.2 (15.5 kg) among intervention and 80.7 (14.5 kg) among control participants. After 50 weeks, intervention participants had slightly less but non-significant weight gain (adjusted β −1.12 kg; 95% CI −5.28, 3.05) than control participants; 73.7% of intervention v. 39.1% of control participants met their weight-loss maintenance goal by study end (adjusted OR 4.78; 95% CI 1.01, 22.71). Conclusions A deposit contract was not associated with differences in weight but led to more participants meeting their weight-loss maintenance goals; a deposit contract for weight-loss maintenance should be tested in a full-scale intervention. Most intervention participants viewed the deposit contract as acceptable.
Collapse
Affiliation(s)
- Lauren P Cleveland
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| | - Michael W Seward
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| | - Denise Simon
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| | - Kristina H Lewis
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Carin Bennett-Rizzo
- Occupational Health Department, Brigham and Women's Hospital, Boston, MA, United States
| | - Florencia Halperin
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Katherine D McManus
- Department of Nutrition, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Jason P Block
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
7
|
Reynolds GS, Bennett JB. A Brief Measure of Organizational Wellness Climate: Initial Validation and Focus on Small Businesses and Substance Misuse. J Occup Environ Med 2019; 61:1052-1064. [PMID: 31626071 PMCID: PMC7691977 DOI: 10.1097/jom.0000000000001739] [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] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Organizations with fewer than 100 employees comprise most businesses in the United States. Since small businesses lack comparable resources, they may benefit from a simple valid tool for broadly assessing positive wellness climate, especially because climate contributes to employee wellbeing. METHODS Using an ethnically and occupationally diverse sample of 45 businesses (n = 1512), the current study developed and tested a brief self-report measure of organizational wellness climate. RESULTS Confirmatory factor analysis shows that a 9-item measure has good model fit (RMSEA = 0.06, CFI = 0.91), inter-item consistency of 0.74, and mean Rwg(j) of 0.87. The new measure is significantly positively correlated with physical health and wellbeing, and negatively correlated with substance use behavior. CONCLUSIONS Findings indicate that a 9-item measure has good reliability, construct, and criterion validity. Implications for practical use of the measure are discussed.
Collapse
|
8
|
Wolfenden L, Goldman S, Stacey FG, Grady A, Kingsland M, Williams CM, Wiggers J, Milat A, Rissel C, Bauman A, Farrell MM, Légaré F, Ben Charif A, Zomahoun HTV, Hodder RK, Jones J, Booth D, Parmenter B, Regan T, Yoong SL. Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database Syst Rev 2018; 11:CD012439. [PMID: 30480770 PMCID: PMC6362433 DOI: 10.1002/14651858.cd012439.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.
Collapse
Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Sharni Goldman
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanNSWAustralia2287
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Andrew Milat
- NSW Ministry of HealthCentre for Epidemiology and EvidenceNorth SydneyNSWAustralia2060
- The University of SydneySchool of Public HealthSydneyAustralia
| | - Chris Rissel
- Sydney South West Local Health DistrictOffice of Preventive HealthLiverpoolNSWAustralia2170
| | - Adrian Bauman
- The University of SydneySchool of Public HealthSydneyAustralia
- Sax InstituteThe Australian Prevention Partnership CentreSydneyAustralia
| | - Margaret M Farrell
- US National Cancer InstituteDivision of Cancer Control and Population Sciences/Implementation Sciences Team9609 Medical Center DriveBethesdaMarylandUSA20892
| | - France Légaré
- Université LavalCentre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)2525, Chemin de la CanardièreQuebecQuébecCanadaG1J 0A4
| | - Ali Ben Charif
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)Université Laval2525, Chemin de la CanardièreQuebecQuebecCanadaG1J 0A4
| | - Hervé Tchala Vignon Zomahoun
- Centre de recherche sur les soins et les services de première ligne ‐ Université LavalHealth and Social Services Systems, Knowledge Translation and Implementation Component of the SPOR‐SUPPORT Unit of Québec2525, Chemin de la CanardièreQuebecQCCanadaG1J 0A4
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Benjamin Parmenter
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Tim Regan
- University of NewcastleThe School of PsychologyCallaghanAustralia
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | | |
Collapse
|
9
|
Herrera-Sánchez IM, León-Pérez JM, León-Rubio JM. Steps to Ensure a Successful Implementation of Occupational Health and Safety Interventions at an Organizational Level. Front Psychol 2017; 8:2135. [PMID: 29375413 PMCID: PMC5770633 DOI: 10.3389/fpsyg.2017.02135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
There is increasing meta-analytic evidence that addresses the positive impact of evidence-based occupational health and safety interventions on employee health and well-being. However, such evidence is less clear when interventions are approached at an organizational level and are aimed at changing organizational policies and processes. Given that occupational health and safety interventions are usually tailored to specific organizational contexts, generalizing and transferring such interventions to other organizations is a complex endeavor. In response, several authors have argued that an evaluation of the implementation process is crucial for assessing the intervention's effectiveness and for understanding how and why the intervention has been (un)successful. Thus, this paper focuses on the implementation process and attempts to move this field forward by identifying the main factors that contribute toward ensuring a greater success of occupational health and safety interventions conducted at the organizational level. In doing so, we propose some steps that can guide a successful implementation. These implementation steps are illustrated using examples of evidence-based best practices reported in the literature that have described and systematically evaluated the implementation process behind their interventions during the last decade.
Collapse
Affiliation(s)
| | - José M León-Pérez
- Department of Social Psychology, Universidad de Sevilla, Seville, Spain
| | - José M León-Rubio
- Department of Social Psychology, Universidad de Sevilla, Seville, Spain
| |
Collapse
|
10
|
Nobrega S, Kernan L, Plaku-Alakbarova B, Robertson M, Warren N, Henning R. Field tests of a participatory ergonomics toolkit for Total Worker Health. APPLIED ERGONOMICS 2017; 60:366-379. [PMID: 28166897 PMCID: PMC5860810 DOI: 10.1016/j.apergo.2016.12.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 11/12/2016] [Accepted: 12/13/2016] [Indexed: 05/16/2023]
Abstract
Growing interest in Total Worker Health® (TWH) programs to advance worker safety, health and well-being motivated development of a toolkit to guide their implementation. Iterative design of a program toolkit occurred in which participatory ergonomics (PE) served as the primary basis to plan integrated TWH interventions in four diverse organizations. The toolkit provided start-up guides for committee formation and training, and a structured PE process for generating integrated TWH interventions. Process data from program facilitators and participants throughout program implementation were used for iterative toolkit design. Program success depended on organizational commitment to regular design team meetings with a trained facilitator, the availability of subject matter experts on ergonomics and health to support the design process, and retraining whenever committee turnover occurred. A two committee structure (employee Design Team, management Steering Committee) provided advantages over a single, multilevel committee structure, and enhanced the planning, communication, and teamwork skills of participants.
Collapse
Affiliation(s)
- Suzanne Nobrega
- University of Massachusetts Lowell, One University Ave, Kitson 200, Lowell, MA, 01854, United States.
| | - Laura Kernan
- University of Massachusetts Lowell, One University Ave, Kitson 200, Lowell, MA, 01854, United States.
| | - Bora Plaku-Alakbarova
- University of Massachusetts Lowell, One University Ave, Kitson 200, Lowell, MA, 01854, United States.
| | - Michelle Robertson
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd, Hopkinton, MA, 01748, United States.
| | - Nicholas Warren
- University of Connecticut Health Center, Farmington, CT, United States.
| | - Robert Henning
- University of Connecticut Storrs, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, United States.
| |
Collapse
|
11
|
Employer and Employee Opinions About Workplace Health Promotion (Wellness) Programs. J Occup Environ Med 2017; 59:256-263. [DOI: 10.1097/jom.0000000000000946] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Taylor AW, Pilkington R, Montgomerie A, Feist H. The role of business size in assessing the uptake of health promoting workplace initiatives in Australia. BMC Public Health 2016; 16:353. [PMID: 27097738 PMCID: PMC4839116 DOI: 10.1186/s12889-016-3011-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 04/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worksite health promotion (WHP) initiatives are increasingly seen as having potential for large-scale health gains. While health insurance premiums are directly linked to workplaces in the USA, other countries with universal health coverage, have less incentive to implement WHP programs. Size of the business is an important consideration with small worksites less likely to implement WHP programs. The aim of this study was to identify key intervention points and to provide policy makers with evidence for targeted interventions. METHODS The worksites (n = 218) of randomly selected, working participants, aged between 30 and 65 years, in two South Australian cohort studies were surveyed to assess the practices, beliefs, and attitudes regarding WHP. A survey was sent electronically or by mail to management within each business. RESULTS Smaller businesses (<20 employees) had less current health promotion activies (mean 1.0) compared to medium size businesses (20-200 employees - mean 2.4) and large businesses (200+ employees - mean 2.9). Management in small businesses were less likely (31.0 %) to believe that health promotion belonged in the workplace (compared to 55.7 % of medium businesses and 73.9 % of large businesses) although half of small businesses did not know or were undecided (compared to 36.4 and 21.6 % of medium and large businesses). In total, 85.0 % of smaller businesses believed the health promotion activities currently employed in the worksite were effective (compared to 89.2 % of medium businesses and 83.1 % of large businesses). Time and funding were the most cited responses to the challenges to implementing health promoting strategies regardless of business size. Small businesses ranked morale and work/life balance the highest among a range of health promotion activities that were important for their workplace while work-related injury was the highest ranked consideration for large businesses. CONCLUSION This study found that smaller workplaces had many barriers, beliefs and challenges regarding WHP. Often small businesses find health promotion activities a luxury and not a serious focus of their activities although this study found that once a health promoting strategy was employed, the perceived effectiveness of the activities were high for all business regardless of size. Tailored low-cost programs, tax incentives, re-orientation of work practices and management support are required so that the proportion of small businesses that have WHP initiatives is increased.
Collapse
Affiliation(s)
- A W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia.
| | - R Pilkington
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - A Montgomerie
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia
| | - H Feist
- Australian Population & Migration Research Centre, The University of Adelaide, Adelaide, South Australia
| |
Collapse
|
13
|
Pawar PS, Nagler EM, Gupta PC, Stoddard AM, Lando HA, Shulman L, Pednekar MS, Kasisomayajula V, Aghi MB, Sinha DN, Sorensen GS. Tracking intervention delivery in the ‘Tobacco-Free Teachers/Tobacco-Free Society’ program, Bihar, India. HEALTH EDUCATION RESEARCH 2015; 30:731-41. [PMID: 26342136 PMCID: PMC4626741 DOI: 10.1093/her/cyv039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 08/06/2015] [Indexed: 05/09/2023]
Abstract
In health education and behavior change interventions, process tracking monitors the delivery of an intervention and its receipt to the intended audience. A randomized controlled trial in the state of Bihar, India was conducted to help school teachers become tobacco free through appropriately designed intervention program and delivery system. We describe the results from process tracking of this intervention delivery. The intervention program was centred on six topics delivered in each school through 12 sessions over 6 successive months. The program deliverers recorded the process measures as total number of sessions and program-components implemented (fidelity); time spent conducting sessions (dose) and proportion of teachers attending at least one session (reach). The outcome measures (teachers’ exposure to intervention messages and tobacco policy adoption) were assessed post-intervention. All 12 sessions were delivered in 33 out of 36 schools. Thirty-one schools implemented all six program components. In 18 schools, ≥95% of the teachers participated in one or more sessions. Thirty-three schools received 12 or more hours of dose. In 29 schools, 100% teachers reported exposure to all program messages. Tobacco policy was adopted by all schools. Thus, the intervention was generally delivered as planned and it had a positive impact on teachers and schools.
Collapse
Affiliation(s)
- P. S. Pawar
- Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India
- *Correspondence to: P. S. Pawar. E-mail: or
| | - E. M. Nagler
- Center for Community-Based Research, Dana Farber Cancer Institute; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts 02115, USA
| | - P. C. Gupta
- Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India
| | - A. M. Stoddard
- Biostatistical Consultant, Pelham, Massachusetts 01002, USA
| | - H. A. Lando
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis 55455, USA and
| | - L. Shulman
- Center for Community-Based Research, Dana Farber Cancer Institute; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts 02115, USA
| | - M. S. Pednekar
- Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India
| | - V. Kasisomayajula
- Center for Community-Based Research, Dana Farber Cancer Institute; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts 02115, USA
| | - M. B. Aghi
- Healis Sekhsaria Institute for Public Health, Navi Mumbai 400701, India
| | - D. N. Sinha
- School of Preventive Oncology, Patna 800001, India
| | - G. S. Sorensen
- Center for Community-Based Research, Dana Farber Cancer Institute; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts 02115, USA
| |
Collapse
|
14
|
Health promotion in small business: a systematic review of factors influencing adoption and effectiveness of worksite wellness programs. J Occup Environ Med 2015; 56:579-87. [PMID: 24905421 DOI: 10.1097/jom.0000000000000171] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the evidence regarding the adoption and efficacy of worksite health promotion programs (WHPPs) in small businesses. METHODS Peer-reviewed research articles were identified from a database search. Included articles were published before July 2013, described a study that used an experimental or quasiexperimental design and either assessed adoption of WHPPs or conducted interventions in businesses with fewer than 500 employees. A review team scored the study's rigor using the WHO-adapted GRADEprofiler "quality of evidence" criteria. RESULTS Of the 84 retrieved articles, 19 met study inclusion criteria. Of these, only two met criteria for high rigor. CONCLUSIONS Fewer small businesses adopt WHPPs compared with large businesses. Two high-rigor studies found that employees were healthier postintervention. Higher quality research is needed to better understand why small businesses rarely adopt wellness programs and to demonstrate the value of such programs.
Collapse
|
15
|
Harris JR, Hannon PA, Beresford SAA, Linnan LA, McLellan DL. Health promotion in smaller workplaces in the United States. Annu Rev Public Health 2014; 35:327-42. [PMID: 24387086 PMCID: PMC10378509 DOI: 10.1146/annurev-publhealth-032013-182416] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Most American workplaces are smaller, with fewer than 1,000 employees. Many of these employees are low-wage earners and at increased risk for chronic diseases. Owing to the challenges smaller workplaces face to offering health-promotion programs, their employees often lack access to health-promotion opportunities available at larger workplaces. Many smaller employers do not offer health insurance, which is currently the major funding vehicle for health-promotion services. They also have few health-promotion vendors to serve them and low internal capacity for, and commitment to, delivery of on-site programs. The programs they offer, whether aimed at health promotion alone or integrated with health protection, are rarely comprehensive and are understudied. Research priorities for health promotion in smaller workplaces include developing programs feasible for the smallest workplaces with fewer than 20 employees. Policy priorities include incentives for smaller workplaces to implement comprehensive programs and an ongoing system for monitoring and evaluation.
Collapse
Affiliation(s)
- Jeffrey R Harris
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington 98105; , ,
| | | | | | | | | |
Collapse
|
16
|
Wierenga D, Engbers LH, Van Empelen P, Duijts S, Hildebrandt VH, Van Mechelen W. What is actually measured in process evaluations for worksite health promotion programs: a systematic review. BMC Public Health 2013; 13:1190. [PMID: 24341605 PMCID: PMC3890539 DOI: 10.1186/1471-2458-13-1190] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/03/2013] [Indexed: 12/02/2022] Open
Abstract
Background Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. Methods Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. Results Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. Conclusions Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components.
Collapse
Affiliation(s)
- Debbie Wierenga
- Body@Work, Research Centre on Physical Activity, Work and Health, TNO-VUmc, Amsterdam, Netherlands.
| | | | | | | | | | | |
Collapse
|
17
|
Carroll C, Rick J, Leaviss J, Fishwick D, Booth A. A qualitative evidence synthesis of employees' views of workplace smoking reduction or cessation interventions. BMC Public Health 2013; 13:1095. [PMID: 24274158 PMCID: PMC4222886 DOI: 10.1186/1471-2458-13-1095] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 11/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The need to reduce smoking rates is a recognised public health policy issue in many countries. The workplace offers a potential context for offering smokers' programmes and interventions to assist smoking cessation or reduction. A qualitative evidence synthesis of employees' views about such programmes might explain why some interventions appear effective and others not, and can be used to develop evidence-based interventions for this population and setting. METHODS A qualitative evidence synthesis of primary research exploring employees' views about workplace interventions to encourage smoking cessation, including both voluntary programmes and passive interventions, such as restrictions or bans. The method used was theory-based "best fit" framework synthesis. RESULTS Five relevant theories on workplace smoking cessation were identified and used as the basis for an a priori framework. A comprehensive literature search, including interrogation of eight databases, retrieved 747 unique citations for the review. Fifteen primary research studies of qualitative evidence were found to satisfy the inclusion criteria. The synthesis produced an evidence-based conceptual model explaining employees' experiences of, and preferences regarding, workplace smoking interventions. CONCLUSION The synthesis suggests that workplace interventions should employ a range of different elements if they are to prove effective in reducing smoking among employees. This is because an employee who feels ready and able to change their behaviour has different needs and preferences from an employee who is not at that stage. Only a multi-faceted intervention can satisfy the requirements of all employees.
Collapse
Affiliation(s)
- Christopher Carroll
- Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), University of Sheffield Regent Court, Regent Street, Sheffield S1 4DA, UK.
| | | | | | | | | |
Collapse
|
18
|
Hannon PA, Hammerback K, Garson G, Harris JR, Sopher CJ. Stakeholder perspectives on workplace health promotion: a qualitative study of midsized employers in low-wage industries. Am J Health Promot 2013; 27:103-10. [PMID: 23113780 DOI: 10.4278/ajhp.110204-qual-51] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Study goals were to (1) describe stakeholder perceptions of workplace health promotion (WHP) appropriateness, (2) describe barriers and facilitators to implementing WHP, (3) learn the extent to which WHP programs are offered to workers' spouses and partners and assess attitudes toward including partners in WHP programs, and (4) describe willingness to collaborate with nonprofit agencies to offer WHP. DESIGN Five 1.5-hour focus groups. SETTING The focus groups were conducted with representatives of midsized (100-999 workers) workplaces in the Seattle metropolitan area, Washington state. SUBJECTS Thirty-four human resources professionals in charge of WHP programs and policies from five low-wage industries: accommodation/food services, manufacturing, health care/social assistance, education, and retail trade. MEASURES A semistructured discussion guide. ANALYSIS Qualitative analysis of focus group transcripts using grounded theory to identify themes. RESULTS Most participants viewed WHP as appropriate, but many expressed reservations about intruding in workers' personal lives. Barriers to implementing WHP included cost, time, logistical challenges, and unsupportive culture. Participants saw value in extending WHP programs to workers' partners, but were unsure how to do so. Most were willing to work with nonprofit agencies to offer WHP. CONCLUSION Midsized, low-wage employers face significant barriers to implementing WHP; to reach these employers and their workers, nonprofit agencies and WHP vendors need to offer WHP programs that are inexpensive, turnkey, and easy to adapt.
Collapse
Affiliation(s)
- Peggy A Hannon
- Health Promotion Research Center, Department of Health Services, School of Public Health, University of Washington, Seattle, 98105, USA.
| | | | | | | | | |
Collapse
|
19
|
Workplace health promotion implementation, readiness, and capacity among midsize employers in low-wage industries: a national survey. J Occup Environ Med 2013; 54:1337-43. [PMID: 23090160 DOI: 10.1097/jom.0b013e3182717cf2] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To describe workplace health promotion (WHP) implementation, readiness, and capacity among midsize employers in low-wage industries in the United States. METHODS A cross-sectional survey of a national sample of midsize employers (100 to 4999 employees) representing five low-wage industries. RESULTS Employers' WHP implementation for both employees and employees' spouses and partners was low. Readiness scales showed that employers believe WHP would benefit their employees and their companies, but they were less likely to believe that WHP was feasible for their companies. Employers' capacity to implement WHP was very low; nearly half the sample reported no capacity. CONCLUSION Midsize employers in low-wage industries implement few WHP programs; their responses to readiness and capacity measures indicate that low capacity may be one of the principal barriers to WHP implementation.
Collapse
|
20
|
"Best fit" framework synthesis: refining the method. BMC Med Res Methodol 2013; 13:37. [PMID: 23497061 PMCID: PMC3618126 DOI: 10.1186/1471-2288-13-37] [Citation(s) in RCA: 265] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 03/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Following publication of the first worked example of the "best fit" method of evidence synthesis for the systematic review of qualitative evidence in this journal, the originators of the method identified a need to specify more fully some aspects of this particular derivative of framework synthesis. METHODS AND RESULTS We therefore present a second such worked example in which all techniques are defined and explained, and their appropriateness is assessed. Specified features of the method include the development of new techniques to identify theories in a systematic manner; the creation of an a priori framework for the synthesis; and the "testing" of the synthesis. An innovative combination of existing methods of quality assessment, analysis and synthesis is used to complete the process. This second worked example was a qualitative evidence synthesis of employees' views of workplace smoking cessation interventions, in which the "best fit" method was found to be practical and fit for purpose. CONCLUSIONS The method is suited to producing context-specific conceptual models for describing or explaining the decision-making and health behaviours of patients and other groups. It offers a pragmatic means of conducting rapid qualitative evidence synthesis and generating programme theories relating to intervention effectiveness, which might be of relevance both to researchers and policy-makers.
Collapse
|
21
|
Nagler EM, Pednekar MS, Viswanath K, Sinha DN, Aghi MB, Pischke CR, Ebbeling CB, Lando HA, Gupta PC, Sorensen GC. Designing in the social context: using the social contextual model of health behavior change to develop a tobacco control intervention for teachers in India. HEALTH EDUCATION RESEARCH 2013; 28:113-29. [PMID: 22669010 PMCID: PMC3549584 DOI: 10.1093/her/cys060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 04/03/2012] [Indexed: 05/24/2023]
Abstract
This article provides a theory-based, step-by-step approach to intervention development and illustrates its application in India to design an intervention to promote tobacco-use cessation among school personnel in Bihar. We employed a five-step approach to develop the intervention using the Social Contextual Model of Health Behavior Change (SCM) in Bihar, which involved conducting formative research, classifying factors in the social environment as mediating mechanisms and modifying conditions, developing a creative brief, designing an intervention and refining the intervention based on pilot test results. The intervention engages users and non-users of tobacco, involves teachers in implementing and monitoring school tobacco control policies and maximizes teachers' role as change agents in schools and communities. Intervention components include health educator visits, discussions led by lead teachers, cessation assistance, posters and other educational materials and is implemented over the entire academic year. The intervention is being tested in Bihar government schools as part of a randomized-controlled trial. SCM was a useful framework for developing a tobacco control intervention that responded to teachers' lives in Bihar.
Collapse
Affiliation(s)
- Eve M Nagler
- Center for Community Based-Research, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
DeJoy DM, Wilson MG, Padilla HM, Goetzel RZ, Parker KB, Della LJ, Roemer EC. Process evaluation results from an environmentally focused worksite weight management study. HEALTH EDUCATION & BEHAVIOR 2012; 39:405-18. [PMID: 22002249 PMCID: PMC11034935 DOI: 10.1177/1090198111418109] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2024]
Abstract
There is currently much interest in exploring environmental approaches to combat weight gain and obesity. This study presents process evaluation results from a workplace-based study that tested two levels of environmentally focused weight management interventions in a manufacturing setting. The moderate treatment featured a set of relatively simple, low-cost environmental modifications designed to facilitate healthy eating and physical activity; the intense treatment added elements intended to actively involve and engage management in program efforts. Fidelity varied across the 11 interventions comprising the two treatment conditions but did not vary systematically by treatment condition (moderate vs. intense). Environmental assessments showed improvements in workplace supports for weight management and significant differences by treatment level. Positive shifts in health climate perceptions also occurred, but sites receiving the intense treatment were not perceived as more supportive by employees. Challenges and limitations associated with environmental interventions are discussed with specific reference to activating management support.
Collapse
|
23
|
Hannon PA, Vu T, Ogdon S, Fleury EM, Yette E, Wittenberg R, Celedonia M, Bowen DJ. Implementation and process evaluation of a workplace colorectal cancer screening program in eastern Washington. Health Promot Pract 2012; 14:220-7. [PMID: 22796739 DOI: 10.1177/1524839912443240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Colorectal cancer screening is a life-saving intervention, but screening rates are low. The authors implemented and evaluated the Spokane Colorectal Cancer Screening Program-a novel worksite intervention to promote colorectal cancer screening that used a combination of evidence-based strategies recommended by the Guide to Community Preventive Services, as well as additional strategies. Over a period of approximately 3 months, participating worksites held one or more physician-led seminars about colorectal cancer screening for employees. They also distributed free fecal immunochemical tests at the worksite to employees 50 years and older, and they provided test results to employees and their primary care physician. The authors measured attendance at seminars, test kits taken and returned, employee awareness of the program, and colorectal cancer screening rates in participating and comparison worksites. It is estimated that 9% of eligible employees received kits at the worksite, and 4% were screened with these kits. The Spokane Colorectal Cancer Screening Program was a promising pilot test of an innovative worksite screening program that successfully translated evidence-based strategies into practical use in a brief period of time, and it merits a larger study to be able to test its effects more rigorously.
Collapse
Affiliation(s)
- Peggy A Hannon
- University of Washington School of Public Health, Seattle, WA 98105, USA.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Devine CM, Maley M, Farrell TJ, Warren B, Sadigov S, Carroll J. Process evaluation of an environmental walking and healthy eating pilot in small rural worksites. EVALUATION AND PROGRAM PLANNING 2012; 35:88-96. [PMID: 22054528 DOI: 10.1016/j.evalprogplan.2011.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 08/08/2011] [Accepted: 08/10/2011] [Indexed: 05/31/2023]
Abstract
Small Steps are Easier Together (SS) was a pilot environmental intervention in small rural worksites in Upstate New York in collaboration with Extension educators. Worksite leaders teamed with co-workers to select and implement environmental changes to increase walking steps over individual baseline and to choose healthy eating options over 10 weeks. Participants were 226 primarily white, women employees in 5 sites. A mixed methods process evaluation, conducted to identify determinants of intervention effectiveness and to explain differences in outcomes across worksites, included surveys, self-reports of walking and eating, interviews, focus groups, and an intervention log. The evaluation assessed reach, characteristics of recruited participants, dose delivered, dose received, and context and compared sites on walking and eating outcomes. Emergent elements of participant-reported dose received included: active leadership, visible environmental changes, critical mass of participants, public display of accomplishments, accountability to co-workers, and group decision making. Participants at sites with high reach and dose were significantly more likely than sites with low reach and dose to achieve intervention goals. Although this small pilot needs replication, these findings describe how these evaluation methods can be applied and analyzed in an environmental intervention and provide information on trends in the data.
Collapse
Affiliation(s)
- Carol M Devine
- Division of Nutritional Sciences, MVR Hall, Cornell University, Ithaca, NY 14853-4401, USA.
| | | | | | | | | | | |
Collapse
|
25
|
Wilson MG, Basta TB, Bynum BH, DeJoy DM, Vandenberg RJ, Dishman RK. Do intervention fidelity and dose influence outcomes? Results from the move to improve worksite physical activity program. HEALTH EDUCATION RESEARCH 2010; 25:294-305. [PMID: 19168573 DOI: 10.1093/her/cyn065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this paper is to evaluate the implementation of the Move to Improve worksite physical activity program using a four step framework that includes the following: (i) defining the active ingredients, (ii) using good methods to measure implementation, (iii) monitoring implementation and (iv) relating implementation to outcomes. The intervention active ingredients consisted of a goal setting behavior change program, a team competition and environmental supports. Intervention fidelity and dose were measured by surveys administered to site co-ordinators, team captains and employees. Implementation was monitored by the use of biweekly assessments that tracked individual physical activity levels and through weekly reports of the project director and site co-ordinators. Latent growth modeling was conducted to determine whether intervention outcomes were affected by site implementation (i.e. fidelity) and/or participation by employees (i.e. dose). Results showed high levels of intervention fidelity, moderate to high levels of intervention dose delivered and moderate levels of the intervention dose received. Level of implementation affected the degree of change in vigorous physical activity (Mean = 5.4 versus 2.2; chi(2) = 4.9, df = 1), otherwise outcome measures were unaffected by fidelity and dose. These findings suggest that practitioners should focus more energy assuring that the core components are fully implemented and be less concerned about the level of participation.
Collapse
Affiliation(s)
- Mark G Wilson
- Department of Health Promotion.ehavior, University of Georgia, Athens, GA 30602, USA.
| | | | | | | | | | | |
Collapse
|
26
|
McPeck W, Ryan M, Chapman LS. Bringing Wellness to the Small Employer. Am J Health Promot 2009; 23:1-10, iii. [DOI: 10.4278/ajhp.23.5.tahp] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
27
|
Sorensen G, Stoddard AM, Dubowitz T, Barbeau EM, Bigby J, Emmons KM, Berkman LF, Peterson KE. The influence of social context on changes in fruit and vegetable consumption: results of the healthy directions studies. Am J Public Health 2007; 97:1216-27. [PMID: 17538059 PMCID: PMC1913084 DOI: 10.2105/ajph.2006.088120] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
As part of the Harvard Cancer Prevention Program Project, we used a social contextual model of health behavior change to test an intervention targeting multiple risk-related behaviors in working-class, multiethnic populations. We examined the relationships between the social contextual factors in our conceptual model and changes in fruit and vegetable consumption from baseline to completion of intervention in health centers and small business studies. We analyzed change in fruit and vegetable consumption, measured at baseline and final assessments by self-report, in 2 randomized controlled prevention trials: 1 in small businesses (n = 974) and 1 in health centers (n = 1954). Stronger social networks, social norms that were more supportive, food sufficiency, and less household crowding were associated with greater change in fruit and vegetable intake. We also observed differences between our intervention sites. Social context can play an important role in promoting changes in fruit and vegetable consumption.
Collapse
Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Mass 02115, USA.
| | | | | | | | | | | | | | | |
Collapse
|