The roles of health culture and physical environment in workplace health promotion: a two-year prospective intervention study in China

Examining the impact of a restorative breath-based intervention "Sudarshan Kriya Yoga" at work: a field experiment

Background

Human capital plays a crucial role in the success of an organization and further contributes to the broader goals of growth and development of society. In this regard, it is essential to ensure the well-being of employees at the workplace. Given the positive impact of yoga on psycho-physiological aspects of health, this study aims to examine the impact of a breath-based yogic intervention, Sudarshan Kriya Yoga (SKY), on stress, anxiety, thriving, general health, emotional well-being, social well-being, and psychological well-being among employees of a leading manufacturing firm in India.

Methods

Undertaking a randomized-control experiment design (n = 64), we examined the impact of SKY on stress, anxiety, thriving, general health, and emotional, social, and psychological well-being. Two certified instructors conducted the SKY intervention in a retreat format over 3 days.

Results

The analysis demonstrated positive outcomes across various aspects of participants' well-being, i.e., it significantly reduced their stress and anxiety and increased the levels of thriving, general health, and emotional, social, and psychological well-being. These findings are valuable for understanding the potential benefits of the SKY intervention.

Discussion

The findings provide support for considering SKY as a potential well-being intervention for employers at the workplace and society at large. Further exploration, implementation, and research in diverse contexts will be crucial to fully understand the long-term impact and scalability of the SKY intervention in promoting holistic well-being.

Exploring the determinants of health-promoting behaviors among miners: A text mining and meta-analysis

The health-promoting behaviors of miners are of great significance to their physical and mental well-being. With a focus on enhancing their overall health, this study aimed to explore the determinants and influencing mechanisms of health-promoting behaviors in miners. Initially, the latent Dirichlet allocation (LDA) model was utilized to extract topical keywords from literature over the last 23 years and to categorize the determinants based on integrating the health promotion model and the health belief model. Subsequently, a meta-analysis was performed based on 51 related empirical research to explore the mechanisms between determinants and health-promoting behaviors. The results indicated that (1) the factors influencing miners' health-promoting behaviors can be divided into four dimensions: physical environment, psychosocial environment, individual characteristics, and health beliefs. (2) Noise was negatively related to health-promoting behaviors, while protective equipment, health culture, interpersonal relationships, health literacy, health attitudes, and income were positively related to health-promoting behaviors. (3) Protective equipment and health literacy were positively related to perceived threat, whereas interpersonal relationships were positively related to perceived benefits. This study sheds light on the mechanisms influencing miners' health-promoting behaviors and could inform behavioral interventions in occupational health.

Insufficient Workplace Infection Control and Unhealthy Lifestyle Behaviors Are Related to Poor Self-Rated Health During the COVID-19 Pandemic

OBJECTIVE

This study investigated whether workers who practiced unhealthy lifestyles but worked under organizations with insufficient control against coronavirus disease 2019 (COVID-19) would pose a synergistic risk of poor self-rated health (SRH).

METHODS

A total of 22,637 workers (men, 48.5%) were extracted from an online survey during the COVID-19 pandemic in Japan (December 2020). Multiple logistic regression analyses were performed to estimate adjusted odds ratio (AOR) against poor (poor, fair) SRH.

RESULTS

Accumulation of unhealthy lifestyle behaviors (AOR, 1.49 to 4.40; P < 0.05) and insufficient infection control (AOR, 1.80; P < 0.05) were independently related to poor SRH; however, when these factors were combined, SRH was additively worsened (AOR, 2.14 to 7.72; P < 0.05).

CONCLUSIONS

This study highlights that not only unhealthy lifestyle practices but also poor organizational management against infection would worsen workers' SRH during the COVID-19 pandemic.

Automated Digital Interventions and Smoking Cessation: Systematic Review and Meta-analysis Relating Efficiency to a Psychological Theory of Intervention Perspective

BACKGROUND

Smoking remains a highly significant preventable global public health problem. In this context, digital interventions offer great advantages in terms of a lack of biological side effects, possibility of automatic delivery, and consequent human resource savings relative to traditional interventions. Such interventions have been studied in randomized controlled trials (RCTs) but have not been systematically reviewed with the inclusion of text-based and multiplatform-based interventions. In addition, this area has not been evaluated from the perspective of the psychological theoretical basis of intervention.

OBJECTIVE

The aim of this paper is to assess the efficiency of digital interventions in RCT studies of smoking cessation and to evaluate the effectiveness of the strategies used for digital interventions.

METHODS

An electronic search of RCTs was conducted using PubMed, Embase, and the Cochrane Library by June 30, 2021. Eligible studies had to compare automated digital intervention (ADI) to the use of a self-help guideline or no intervention. Participants were current smokers (aged 16 years or older). As the main outcome, abstinence after endpoint was extracted from the studies. Systematic review and meta-analysis were conducted to assess the efficiency of ADIs. Metaregressions were conducted to assess the relationship between intervention theory and effectiveness.

RESULTS

A total of 19 trials (15,472 participants) were included in the analysis. The overall abstinence rate (95% CI) at the endpoint was 17.8% (17.0-18.7). The overall risk ratio of the intervention group compared to the controls at the endpoint was 17.8% (17.0-18.7). Cochrane risk-of-bias tool for randomized trials (ROB 2) suggested that most of the studies had a low risk of bias (56.3%). Psychological theory-related constructs or predictors, which refer to other theory-based concepts (rather than only behavioral theory) such as craving or anxiety, are associated with effectiveness.

CONCLUSIONS

This study found that ADI had a clear positive effect compared to self-help guidelines or to no intervention, and effectiveness was associated with theory-related constructs or predictors. ADIs should be promoted by policy makers and clinical practitioners to address the huge gap between the need for smoking cessation and availability of traditional treatment resources. Possible increases in ADI efficiency may be achieved by optimally integrating psychotherapeutic theories and techniques.

TRIAL REGISTRATION

PROSPERO CRD42021256593; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256593.

Development of occupational health culture scale: A study based on miners and construction workers

Culture is an essential influence on effectiveness of workplace health promotion, which can promote occupational health protection behavior. The aim of this research was to develop and validate an occupational health culture scale available to Chinese workers. Occupational health culture scale (OHCS) was developed based on elements of health culture and safety culture in workplace. Nine techniques steps of scale development were used, including a 15-member expert group, 10 workers for cognitive interview, and 1,119 questionnaires (from 710 miners and 409 construction workers) for formal investigation. Welch's variance analysis, independent samples t-test, Kruskal-Wallis test, Spearman correlation analysis was employed, respectively, to verified nine hypotheses about impact relationship on OHCS score. After the analysis reliability and validity, the final scale consisted of 21 items in five domains: leadership support, co-workers support, values, policy and norms, employee involvement, physical environment. Moreover, respirable dust concentration from individual sampler had the largest negative correlation coefficient on OHCS score, -0.469 (p < 0.01). The development of an occupational health culture among Chinese workers is necessary for the sustainability of human resources and the implementation of corporate responsibility.

Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: a qualitative study

Background

There is an immense difference between large companies and small and medium-sized enterprises (SMEs) in implementation of evidence-based interventions (EBIs). Previous literature reveals various barriers that SMEs face during implementation, such as a lack of time, accessibility, and resources. However, few studies have comprehensively examined those influential factors at multi-levels. This study aims to identify the factors influencing the implementation of non-communicable disease prevention activities (tobacco, alcohol, diet, physical activity, and health check-up) in SMEs using Consolidated Framework for Implementation Research (CFIR).

Methods

We conducted 15 semi-structured interviews with health managers and/or employers in 15 enterprises with less than 300 employees, and four focus groups among public health nurses/nutritionists of health insurers who support SMEs in four prefectures across Japan. A qualitative content analysis by a deductive directed approach was performed. After coding the interview transcript text into the CFIR framework constructs by two independent researchers, the coding results were compared and revised in each enterprise until an agreement was reached.

Results

Of the 39 CFIR constructs, 25 were facilitative and 7 were inhibitory for workplace health promotion implementation in SMEs, which were across individual, internal, and external levels. In particular, the leadership engagement of employers in implementing the workplace health promotion activities was identified as a fundamental factor which may influence other facilitators, including “access to knowledge and information,” “relative priority,” “learning climate,” at organizational level, and “self-efficacy” at the health manager level. The main barrier was the beliefs held by the employer/manager that “health management is one’s own responsibility.”

Conclusions

Multi-level factors influencing the implementation of non-communicable diseases prevention activities in SMEs were identified. In resource-poor settings, strong endorsement and support, and positive feedback from employers would be important for health managers and employees to be highly motivated and promote or participate in health promotion. Future studies are needed to develop context-specific strategies based on identified barriers and facilitative factors, and empirically evaluate them, which would contribute to narrowing the differences in worksite health promotion implementation by company size.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00268-4.

Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review

Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.

Categorizing Foods by Relative Healthfulness: A Scoping Review of Front of Pack Labelling

Worksites are a suitable platform for employees to engage in behavioral change towards a healthy lifestyle by the modification of the food environment. Grading canteen foods at worksites into categories of relative healthfulness is an important indicator in the planning of food environmental interventions. However, in the absence of mandatory front of pack (FOP) labelling in South Africa, categorizing packaged and cooked food at worksite canteens is challenging. A scoping review was conducted on FOP labelling schemes to inform the selection of a FOP labelling scheme best suited for canteen foods at worksites in South Africa. The results of the scoping study, tabulated into a narrative summary, showed that there are several well-developed approaches to classifying foods by relative healthfulness through nutrient profiling and different forms of expression. It is recommended that because worksite canteen food sales in South Africa include both packaged and cooked food, and that a general test of various labelling schemes should be conducted to determine if a directional change is made towards purchasing healthier foods. Grading foods using interpretational aides such as an adapted FOP nutrition label to the South African context into categories of relative healthfulness can be a practical tool to inform food environmental interventions at worksite canteens and beyond.

Do Multicomponent Workplace Health and Wellbeing Programs Predict Changes in Health and Wellbeing?

Organizations typically deploy multiple health and wellbeing practices in an overall program. We explore whether practices in workplace health and wellbeing programs cohere around a small number of archetypal categories or whether differences between organizations are better explained by a continuum. We also examine whether adopting multiple practices predicts subsequent changes in health and wellbeing. Using survey data from 146 organizations, we found differences between organizations were best characterized by a continuum ranging from less to more extensive adoption of practices. Using two-wave multilevel survey data at both individual and organizational levels (N = 6968 individuals, N = 58 organizations), we found that, in organizations that adopt a wider range of health and wellbeing practices, workers with poor baseline psychological wellbeing were more likely to report subsequent improvements in wellbeing and workers who reported good physical health at baseline were less likely to report experiencing poor health at follow-up. We found no evidence that adopting multiple health and wellbeing practices buffered the impact of individuals’ workplace psychosocial hazards on physical health or psychological wellbeing.

Workplace health promotion interventions for Australian workers with intellectual disability

Workplace health promotion (WHP) and the general wellbeing of workers in the Australian workforce should be a priority for all management. Our study argues that management support for workers with an intellectual disability (WWID) can make a difference to their health promotion and ultimately their participation in the workforce. We adopt a qualitative approach, through semi-structured interviews with 22 managers, across various organizations, to examine their perspectives around the WHP of WWID. We integrate the key values of WHP; rights for health, empowerment for health and participation for health (Spencer, Corbin and Miedema, Sustainable development goals for health promotion: a critical frame analysis, Health Promot Int 2019;34:847-58) into the four phases of WHP interventions; needs assessment, planning, implementation and evaluation (Bortz and Döring, Research Methods and Evaluation for Human and Social Scientists, Heidelberg: Springer, 2006) and examine management perspectives (setting-based approach) on WHP of WWID. Where this integration had taken place, we found some evidence of managers adopting more flexible, innovative and creative approaches to supporting the health promotion of WWID. This integration seemed to drive continuous improvement for WWID health promotion at the workplace. We also found evidence that some organizations, such an exemplar film company, even over deliver in terms of supporting WWID needs by encouraging their capabilities in film making interventions, whilst others are more direct in their support by matching skills to routine jobs. Our approach demonstrates that incorporating key WHP values into the four-phase WHP framework is critical for the effective health promotion of WWID.

Implementing practices focused on workplace health and psychological wellbeing: A systematic review

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].

Family members' perceptions of older person discharge from emergency departments

BACKGROUND

People aged over 64 years account for approximately 20% of adult emergency presentations, with up to 60% of people discharged home from emergency departments (EDs). Many older people discharged home are supported by family.

OBJECTIVES

The objective of this study was to explore the family members' perspectives of older people's discharge from ED to inform new alternative or innovative models of care.

METHODS

The design was a descriptive exploratory study. A convenience sample of family members was recruited from three EDs across Sydney, New South Wales. Telephone interviews were conducted over a six-month period and data were analysed using statistics or thematic analysis.

RESULTS

Interviews were conducted with 133 family members of whom the majority were female (n = 80, 60%) with a median age of 70 years (IQR 91-35). Over 87% of family members were satisfied with ED care and discharge processes that were provided to the older person. The majority (n = 129, 97%) of family members reported that they understood the treatment and perceived that the older person's condition was well managed (n = 119, 86%). The majority (n = 114, 86%) of family members reported being informed of the medical diagnosis and were confident (87%, n = 115) to continue care of the older person at home. Three themes emerged from qualitative data: (a) a sense of time-moving through ED; (b) giving voice to the impact of clinician communication; and (c) the delivery of comfort and basic care.

DISCUSSION

Family members reported that they were engaged in and satisfied with the older person's ED treatment and discharge. However, family members suggested that there was opportunity to improve communication consistency for ED discharge and managing the wait.

CONCLUSION

Clinicians need to engage with family members to optimise quality and safety. Clinicians need to understand that family members considered comfort and fundamentals of care to be an important dimension of the older person's ED management plan.

Measuring nurses' perceptions of their work environment and linking with behaviour change theories and implementation strategies to support evidence based practice change

PURPOSE

Survey tools, such as the Alberta Context Tool, reliably measure context but researchers have no process to map context to clinician behaviour and develop strategies to support practice change. Therefore, we aimed to map the Alberta Context Tool to the Theoretical Domains Framework and the Behaviour Change Wheel.

METHOD

The multi-centre study used the Alberta Context Tool to collect data from a convenience sample of nurses working in two emergency departments. These findings were categorised as barriers and enablers, and then mapped to the Theoretical Domains Framework to examine for behavioural domains. Using the Behaviour Change Wheel functions, strategies were developed to target clinician behaviour change.

RESULTS

Survey response rate was 42% (n = 68). Nurses perceived a positive work environment in the dimensions of Social Capital (median 4.00, IQR 0.33), Culture (median 3.83, IQR 1.16) and Leadership (median 3.60, IQR 1.1). Low scoring dimensions included Formal Interactions (median 2.75, IQR 1.00); Time (median 2.60, IQR 1.00) Staffing (median 3.0, IQR 2.00) and Space (median 3.0, IQR 2.00). Enablers (n = 77) and barriers (n = 25) were identified in both sites. The Theoretical Domains Framework was mapped to Alberta Context Tool barriers and enablers. The behaviour change strengths included: social and professional role; beliefs about capability; goals; and emotions. Using the Behaviour Change Wheel functions, 67 strategies were developed to address barriers and enablers.

CONCLUSIONS

The Alberta Context Tool successfully measured two emergency environments identifying barriers and enablers. This approach enabled environment dimensions to be targeted with practical solutions to support evidence-based practice implementation.

Development and initial validation of a questionnaire to assess facilitators and barriers to physical activity for patients with rheumatoid arthritis, axial spondyloarthritis and/or psoriatic arthritis

To develop and validate a self-administered questionnaire to identify in people with Inflammatory arthritis (IA) Facilitators And Barriers to Physical activity (PA): the IFAB questionnaire. The development of the questionnaire included a systematic review of barriers and facilitators to PA to identify key themes, face validity assessment by 11 experts, and cognitive debriefing with 14 patients. The psychometric properties of the questionnaire were assessed by convergent validity (Spearman correlation) against the modified Health Assessment Questionnaire (mHAQ), the Fear-Avoidance Beliefs Questionnaire subscale for PA and the Tampa Scale for Kinesiophobia, internal consistency (Cronbach α) in 63 IA patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA). Reliability and feasibility were assessed in 32 IA patients. The questionnaire comprises 10 items: 4 assessing either barriers or facilitators, 3 assessing barriers, and 3 assessing facilitators. The items are related to psychological status (N = 6), social support (N = 2), disease (N = 1), environmental factors (N = 1). The validation study included 63 patients: 26 RA, 24 axSpA, 13 PsA; with mean age 52.8 (standard deviation 16.5) years, mean disease duration 12.5 (12.3) years, and 53% of women. The questionnaire was correlated (rho = 0.24) with mHAQ. Internal consistency (Cronbach α 0.69) and reliability (interclass coefficient 0.79 [95% confidence interval 0.59; 0.88]) were satisfactory, as was feasibility (missing data 12%, mean completion time < 5 min). The questionnaire allows the assessment of barriers and facilitators to PA in patients with IA. This questionnaire may guide targeted interventions to increase levels of PA in these patients.