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Cillekens B, Coenen P, Huysmans MA, Holtermann A, Troiano RP, Mork PJ, Krokstad S, Clays E, De Bacquer D, Aadahl M, Kårhus LL, Sjøl A, Bo Andersen L, Kauhanen J, Voutilainen A, Pulsford R, Stamatakis E, Goldbourt U, Peters A, Thorand B, Rosengren A, Björck L, Sprow K, Franzon K, Rodriguez-Barranco M, Luján-Barroso L, Alfredsson L, Bahls M, Ittermann T, Wanner M, Bopp M, Marott JL, Schnohr P, Nordestgaard BG, Dalene KE, Ekelund U, Clausen J, Jensen MT, Petersen CB, Krause N, Twisk J, van Mechelen W, van der Beek AJ. Should workers be physically active after work? Associations of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels-An individual participant data meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100987. [PMID: 39277081 DOI: 10.1016/j.jshs.2024.100987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
BACKGROUND There is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels. This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels. METHODS This study utilized individual participant data from 21 cohort studies, comprising both published and unpublished data. Eligibility criteria included individual-level data on leisure-time and occupational physical activity (categorized as sedentary, low, moderate, and high) along with data on all-cause and/or cardiovascular mortality. A 2-stage individual participant data meta-analysis was conducted, with separate analysis of each study using Cox proportional hazards models (Stage 1). These results were combined using random-effects models (Stage 2). RESULTS Higher leisure-time physical activity levels were associated with lower all-cause and cardiovascular mortality risk across most occupational physical activity levels, for both males and females. Among males with sedentary work, high compared to sedentary leisure-time physical activity was associated with lower all-cause (hazard ratios (HR) = 0.77, 95% Confidence interval(95%CI): 0.70-0.85) and cardiovascular mortality (HR = 0.76, 95%CI: 0.66-0.87) risk. Among males with high levels of occupational physical activity, high compared to sedentary leisure-time physical activity was associated with lower all-cause (HR = 0.84, 95%CI: 0.74-0.97) and cardiovascular mortality (HR = 0.79, 95%CI: 0.60-1.04) risk, while HRs for low and moderate levels of leisure-time physical activity ranged between 0.87 and 0.97 and were not statistically significant. Among females, most effects were similar but more imprecise, especially in the higher occupational physical activity levels. CONCLUSION Higher levels of leisure-time physical activity were generally associated with lower mortality risks. However, results for workers with moderate and high occupational physical activity levels, especially women, were more imprecise. Our findings suggests that workers may benefit from engaging in high levels of leisure-time physical activity, irrespective of their level of occupational physical activity.
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Affiliation(s)
- Bart Cillekens
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, the Netherlands
| | - Pieter Coenen
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, the Netherlands.
| | - Maaike A Huysmans
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, the Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark
| | | | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, 8905 Trondheim, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, 8905 Trondheim, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger 7601, Norway
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Ghent 9000, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent 9000, Belgium
| | - Mette Aadahl
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg 2000, Denmark
| | - Line Lund Kårhus
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg 2000, Denmark
| | - Anette Sjøl
- The Capital Region of Denmark, Copenhagen 1172, Denmark
| | - Lars Bo Andersen
- Western Norway University of Applied Sciences, Faculty of Education, Arts and Sports, Sogndal 5414, Norway
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio 1627, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio 1627, Finland
| | - Richard Pulsford
- Faculty of Health and Life Sciences, University of Exeter, EX1 2LU Exeter, UK
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, NSW 2050, Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, NSW 2050, Australia
| | - Uri Goldbourt
- Sackler Medical faculty in Tel Aviv University, Tel Aviv 6997801, Israel
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; German Centre for Cardiovascular Research (DZHK e.V.), partner site Munich Heart Alliance, Munich 80636, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine, Ludwig-Maximilians-Universität, 80636 Munich, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg 85764, Germany; German Centre for Cardiovascular Research (DZHK e.V.), partner site Munich Heart Alliance, Munich 80636, Germany
| | - Annika Rosengren
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 40530, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg 41345, Sweden
| | - Lena Björck
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 40530, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine Geriatrics and Emergency Medicine/Östra, Gothenburg 41345, Sweden
| | - Kyle Sprow
- Administration for Strategic Preparedness and Response, U.S. Department of Health and Human Services, 20002 Washington D.C., USA
| | - Kristin Franzon
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala 75237, Sweden
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada 18011, Spain; Instituto de Investigación Biosanitaria ibs, Granada 18012, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid 28029, Spain
| | - Leila Luján-Barroso
- Catalan Institute of Oncology, Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, L'Hospitalet de Llobregat, Barcelona 08908, Spain; Bellvitge Biomedical Research Institute, Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, 08908 L'Hospitalet de Llobregat, Spain
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden and Centre for Occupational and Environmental Medicine, Stockholm 17177, Sweden
| | - Martin Bahls
- Department of Internal Medicine B (Cardiology), University Medicine Greifswald, Greifswal 17489d, Germany; German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald 17489, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald 17489, Germany; Institute for Community Medicine; University Medicine Greifswald, Greifswald 17489, Germany
| | - Miriam Wanner
- Biostatistics and Prevention Institute, University of Zürich, Epidemiology, Zürich 8001, Switzerland; Institute of Pathology and Molecular Pathology, Cancer Registry Zürich, University Hospital Zürich, Zürich 8091, Switzerland
| | - Matthias Bopp
- Biostatistics and Prevention Institute, University of Zürich, Epidemiology, Zürich 8001, Switzerland
| | - Jacob Louis Marott
- Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Frederiksberg 2000, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark
| | - Peter Schnohr
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev 2730, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Knut Eirik Dalene
- Department of Sport Sciences, Norwegian School of Sport Sciences, 0863 Oslo, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Ulf Ekelund
- Department of Sport Sciences, Norwegian School of Sport Sciences, 0863 Oslo, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Johan Clausen
- Epidemiological Research Unit, Departments of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen 2400, Denmark
| | - Magnus T Jensen
- Steno Diabetes Center Copenhagen, Herlev 2730, Denmark; The Copenhagen City Heart Study, Copenhagen 2000, Denmark
| | | | - Niklas Krause
- Departments of Epidemiology and Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Jos Twisk
- Amsterdam UMC, Department of Epidemiology and Data Science, Amsterdam 1081HV, the Netherlands
| | - Willem van Mechelen
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, the Netherlands
| | - Allard J van der Beek
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam 1081 HV, the Netherlands
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van Elk F, Lammers-van der Holst HM, Robroek SJW, Burdorf A, Oude Hengel KM. Effects and implementation of an intervention to improve sleep, fatigue and recovery among healthcare workers with night shifts: A pre- and post-test study. Int J Nurs Stud 2024; 160:104881. [PMID: 39255526 DOI: 10.1016/j.ijnurstu.2024.104881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 08/02/2024] [Accepted: 08/19/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Previous intervention studies among night workers mainly focused on single interventions and found inconclusive evidence for effectiveness. A comprehensive intervention approach that includes individual and environmental components has been argued as important. Gaining insight into contributing factors for the implementation of interventions for night workers and effectiveness is important to distinguish between theory and programme failure. OBJECTIVES To evaluate the effects and implementation of the PerfectFit@Night intervention to improve sleep, fatigue and recovery of night workers in healthcare, using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation and maintenance of interventions. DESIGN A prospective pre-post study design, with two measurements before and three and six months after the intervention. SETTING Twelve different departments of a university hospital in the Netherlands. PARTICIPANTS Healthcare workers working night shifts (n = 210). METHODS PerfectFit@Night consisted of environmental (provision of a powernap bed and healthy food, and workshop healthy rostering) and individual elements (e-learning and sleep coaching) and was implemented for three months in a phased manner. Questionnaires, logbooks and interview data were used. Effects of the intervention on sleep, fatigue and recovery were evaluated with mixed-effects models, and implementation factors of reach, adoption, implementation and maintenance were evaluated. RESULTS Night shift-related insomnia (-11 %-points, 95 % CI: -19 %, -4 % at three months), need for recovery (β: -2.45, 95 % CI: -4.86, -0.03 at six months) and fatigue (OR: 0.46, 95 % CI: 0.25, 0.86 at six months) decreased significantly after the intervention. No changes were found for subjective sleep quality and sleep duration. Barriers and facilitators for implementation were identified for each intervention element at individual (e.g., dietary preferences), organisational (e.g., responsibilities at work) and workplace levels (e.g., location of power nap bed), and for the intervention itself (e.g., useful information in e-learning). Although satisfaction was high and continuation was preferred, embedding of the intervention in the daily routine was limited. Facilitators for future implementation include a positive attitude towards the intervention, clear guidelines regarding intervention elements, appointment of night workers as ambassadors, and suitable conditions in terms of work demands and for the intervention elements. CONCLUSIONS The multi-faceted PerfectFit@Night intervention reduced insomnia, fatigue and need for recovery in night workers in healthcare. The most important facilitators to improve the implementation of PerfectFit@Night exist at the organisational level (e.g., positive attitude within the culture and suitable work demands). Combining effect and implementation evaluation is crucial to identify barriers and facilitators that hamper or enhance intervention effects. TRIAL REGISTRATION The study was registered in the Netherlands Trial Register on 17 January 2021 (trial number NL9224).
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, the Netherlands.
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Turon H, Bezzina A, Lamont H, Barnes C, Lum M, Hodder RK, Leung GKW, Peeters A, Wolfenden L, Yoong S. Interventions in the workplace to reduce risk factors for noncommunicable diseases: an umbrella review of systematic reviews of effectiveness. J Occup Health 2024; 66:uiae044. [PMID: 39096275 DOI: 10.1093/joccuh/uiae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/23/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Workplaces are an important setting to deliver programs to reduce risk factors for noncommunicable diseases (NCDs). To help decision makers understand the most current and relevant evidence regarding effectiveness of workplace programs, we conducted an umbrella review to present a comprehensive synthesis of the large volume of literature. METHODS Systematic reviews of workplace interventions targeting primary risk factors for NCDs-unhealthy diet, insufficient physical activity, overweight/obesity, tobacco use, and/or excessive alcohol use-published since 2010 were sourced. For each risk factor, reviews were categorized by intervention type and quality. The most recent, high-quality review was included for each intervention type. Evidence for the effectiveness of each intervention type was then broadly classified based on the review summary findings. RESULTS Twenty-one reviews were included. Most reviews focused on diet (n = 5), physical activity (n = 7), or obesity (n = 9) interventions, with fewer targeting alcohol (n = 2) or tobacco (n = 2) use. Reviews of interventions focusing on individual behavior (such as education or counseling) were most common. Across diet, obesity, physical activity, and tobacco use, multicomponent interventions were consistently likely to be classified as "likely effective." Motivational interviewing and broad health promotion interventions were identified as "promising" for alcohol use. CONCLUSION This umbrella review identified that multicomponent workplace interventions were effective to reduce NCD risk factors. There is a gap around interventions targeting alcohol use as most syntheses lacked enough studies to draw conclusions about effectiveness. Exploring the impact of interventions that utilize policy and/or environmental strategies is a critical gap for future research.
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Affiliation(s)
- Heidi Turon
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Aaron Bezzina
- Centre for Resources Health and Safety, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan 2308, NSW, Australia
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan 2308, NSW, Australia
| | - Hannah Lamont
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Courtney Barnes
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Melanie Lum
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Rebecca K Hodder
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Gloria K W Leung
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Anna Peeters
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
| | - Serene Yoong
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
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4
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Bleier H, Lützerath J, Schaller A. Organizational facilitators and barriers for participation in workplace health promotion in healthcare: A qualitative interview study among nurses. Front Psychol 2023; 14:1101235. [PMID: 36936007 PMCID: PMC10017985 DOI: 10.3389/fpsyg.2023.1101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/01/2023] [Indexed: 03/06/2023] Open
Abstract
Background There is evidence for the positive effects of workplace health promotion (WHP) for nurses. Although this highly stressed target group also actively desires WHP, the number of participants is low. Individual reasons play a role in the decision to engage in WHP activities, yet it is interesting to consider which organizational factors a company could address to improve participation. In this regard, the question arises of what organizational factors facilitate participation in WHP activities from the perspective of nurses in inpatient care facility (ICF), outpatient care service (OCS), and acute care hospitals (ACH). Method Sixteen semi-structured interviews were conducted in different care settings between May and September 2021. Questions about everyday working life, WHP activities, and organizational framework conditions were asked. Result The results show that there is a wide range of influencing factors at the organizational level, some overall settings, and others setting-specific. High workload and the fit of WHP activities with shift times were particularly inhibiting overall settings. A negative association with the employer worked as a barrier in ICF and ACH. Conclusion When implementing WHP activities, it can be useful to consider organizational facilitators and barriers to promote sustainable and attractive WHP activities and higher participation rates in the different settings of nursing.
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Affiliation(s)
- Hannah Bleier
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Jasmin Lützerath
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
- Institute for Workplace Health Promotion, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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van Heijster H, van Berkel J, Boot CR, Abma T, de Vet E. Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions. BMJ Open 2022; 12:e062320. [PMID: 36549731 PMCID: PMC9791441 DOI: 10.1136/bmjopen-2022-062320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.
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Affiliation(s)
- Hanneke van Heijster
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
| | - Jantien van Berkel
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
- Department of Interdisciplinary Social Science: Public Health, Utrecht University, Utrecht, The Netherlands
| | - Cécile Rl Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Tineke Abma
- Department of Public Health, Leiden University Medical Center, Leiden, The Netherlands
| | - Emely de Vet
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, The Netherlands
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Morse AK, Askovic M, Sercombe J, Dean K, Fisher A, Marel C, Chatterton ML, Kay-Lambkin F, Barrett E, Sunderland M, Harvey L, Peach N, Teesson M, Mills KL. A systematic review of the efficacy, effectiveness and cost-effectiveness of workplace-based interventions for the prevention and treatment of problematic substance use. Front Public Health 2022; 10:1051119. [PMID: 36419993 PMCID: PMC9676969 DOI: 10.3389/fpubh.2022.1051119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
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Affiliation(s)
- Ashleigh K. Morse
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Mina Askovic
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jayden Sercombe
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Kate Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Alana Fisher
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
- eCentre Clinic, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | | | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Logan Harvey
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Natalie Peach
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Katherine L. Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
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van der Feltz S, van der Molen HF, Lelie L, Hulshof CTJ, van der Beek AJ, Proper KI. Changes in Fruit and Vegetable Consumption and Leisure Time Physical Exercise after a Citizen Science-Based Worksite Health Promotion Program for Blue-Collar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13652. [PMID: 36294231 PMCID: PMC9603698 DOI: 10.3390/ijerph192013652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers have, on average, poorer health than white-collar workers. Existing worksite health promotion programs (WHPPs) are often not successful among blue-collar workers. This study evaluates the effect of the Citizen Science-based WHPP on the targeted lifestyle behaviors among construction workers. The data of 114 participants were retrieved from questionnaires before (T0) and after (T1) the WHPP. Outcome measures were mean and categorical changes in daily fruit and vegetable intake and weekly leisure time physical exercise. Changes were tested using Wilcoxon signed rank tests and McNemar tests. No statistically significant changes were found between T0 and T1. In total, 73.7% of the participants felt involved in the WHPP. Changes in the outcome measures were not significantly different between subgroups based on age, nor in subgroups based on feelings of involvedness. The low intensity of the developed program could be an explanation for this lack of significant change. Future studies using the Citizen Science approach in an occupational setting should aim at developing a more intensified program and should test its effectiveness by comparing changes in a (randomized) controlled trial.
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Affiliation(s)
- Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Carel T. J. Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Karin I. Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
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8
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Sponselee HCS, ter Beek L, Renders CM, Robroek SJW, Steenhuis IHM, Kroeze W. Stakeholders' Perceptions Regarding Adaptation and Implementation of Existing Individual and Environmental Workplace Health Promotion Interventions in Blue-Collar Work Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13545. [PMID: 36294131 PMCID: PMC9603088 DOI: 10.3390/ijerph192013545] [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: 09/09/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers often have disadvantageous health statuses and might therefore benefit from a combination of individual and environmental workplace health promotion interventions. Exploring stakeholders' perceived facilitators and barriers regarding the combined implementation of these interventions in blue-collar work settings is important for effective implementation. A qualitative study consisting of 20 stakeholder interviews within six types of organisations in The Netherlands was conducted. The potential implementation of the evidence-based individual intervention SMARTsize and the environmental intervention company cafeteria 2.0 was discussed. Data were analysed using thematic analysis with a deductive approach. Five main themes emerged: (1) the availability of resources, (2) professional obligation, (3) expected employee cooperation, (4) the compatibility of the proposed health interventions, and (5) the content of implementation tools and procedures. Generally, stakeholders expressed a sense of professional obligation toward workplace health promotion, mentioning that the current societal focus on health and lifestyle provided the perfect opportunity to implement interventions to promote healthy eating and physical activity. However, they often perceived the high doses of employees' occupational physical activity as a barrier. We recommend co-creating interventions, implementation tools, and processes by involving stakeholders with different professional backgrounds and by adapting communication strategies at diverse organisational levels.
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Affiliation(s)
- Hanne C. S. Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Lies ter Beek
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Suzan J. W. Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3015 GD Rotterdam, The Netherlands
| | - Ingrid H. M. Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS Ede, The Netherlands
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9
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Sponselee HCS, Kroeze W, Robroek SJW, Renders CM, Steenhuis IHM. Perceptions of employees with a low and medium level of education towards workplace health promotion programmes: a mixed-methods study. BMC Public Health 2022; 22:1617. [PMID: 36008851 PMCID: PMC9404568 DOI: 10.1186/s12889-022-13976-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Understanding the perceptions of lower socioeconomic groups towards workplace health promotion is important because they are underrepresented in workplace health promotion activities and generally engage in unhealthier lifestyle behaviour than high SEP groups. This study aims to explore interest in workplace health promotion programmes (WHPPs) among employees with a low and medium level of education regarding participation and desired programme characteristics (i.e. the employer's role, the source, the channel, the involvement of the social environment and conditions of participation). METHODS A mixed-methods design was used, consisting of a questionnaire study (n = 475) and a sequential focus group study (n = 27) to enrich the questionnaire's results. Multiple logistic regression analysis was performed to analyse the associations between subgroups (i.e. demographics, weight status) and interest in a WHPP. The focus group data were analysed deductively through thematic analysis, using MAXQDA 2018 for qualitative data analysis. RESULTS The questionnaire study showed that 36.8% of respondents were interested in an employer-provided WHPP, while 45.1% expressed no interest. Regarding subgroup differences, respondents with a low level of education were less likely to express interest in a WHPP than those with a medium level of education (OR = .54, 95%, CI = .35-.85). No significant differences were found concerning gender, age and weight status. The overall themes discussed in the focus groups were similar to the questionnaires (i.e. the employer's role, the source, the channel, the involvement of the social environment and conditions of participation). The qualitative data showed that participants' perceptions were often related to their jobs and working conditions. CONCLUSIONS Employees with a medium level of education were more inclined to be interested in a WHPP than those with a low level of education. Focus groups suggested preferences varied depending on job type and related tasks. Recommendations are to allow WHPP design to adapt to this variation and facilitate flexible participation. Future research investigating employers' perceptions of WHPPs is needed to enable a mutual understanding of an effective programme design, possibly contributing to sustainable WHPP implementation.
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Affiliation(s)
- Hanne C S Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands.
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS, Ede, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, The Netherlands
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10
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Tabak R, Colvin R, Strickland JR, Dale AM, Kepper M, Ruggeri T, Evanoff B. Impacts of a Workplace-Based Weight-Control Intervention on Objective and Perceived Physical Activity among a Subgroup of Workers. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2022; 2:73-87. [PMID: 36381293 PMCID: PMC9648423 DOI: 10.51250/jheal.v2i2.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Physical activity (PA) has many benefits; however, groups facing barriers to health-promoting behaviors are less likely to be physically active. This may be addressed through workplace interventions. The current study employs objective (accelerometry) and perceived (International Physical Activity Questionnaire [IPAQ]) measures of PA among a subset of participants from the "Working for You" study, which tests a multi-level (work group and individual) workplace intervention targeted at workers with low-incomes. Linear mixed and hierarchical logistic regression models are used to determine the intervention's impact on moderate- to vigorous-PA (MVPA) and achieving the PA Guideline for Americans (≥150 minutes MVPA/week), respectively from baseline to 6- and 24-months, relative to a control group. Correlations (Spearman Rho) between perceived and objective PA are assessed. Of the 140 workers (69 control, 71 intervention) in the sub-study, 131 (94%) have valid data at baseline, 88 (63%) at 6-months, and 77 (55%) at 24-months. Changes in MVPA are not significantly different among intervention relative to control participants assessed by accelerometer or IPAQ at 6- or 24-months follow-up. The percent achieving the PA Guideline for Americans does not vary by treatment group by any measure at any time point (e.g., baseline accelerometry: [control: n=37 (57%); intervention: n=35 (53%)]). This study identifies limited agreement (correlation range: 0.04 to 0.42, all p>.05) between perceived and objective measures. Results suggest the intervention did not improve PA among the sub-study participants. Though agreement between objective and perceived MVPA is low, similar conclusions regarding intervention effectiveness are drawn.
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Affiliation(s)
- Rachel Tabak
- Brown School at Washington University in St. Louis, St. Louis, MO
| | - Ryan Colvin
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | - Ann Marie Dale
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Maura Kepper
- Brown School at Washington University in St. Louis, St. Louis, MO
| | - Tara Ruggeri
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Bradley Evanoff
- Washington University School of Medicine in St. Louis, St. Louis, MO
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11
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Smit DJM, van Oostrom SH, Engels JA, van der Beek AJ, Proper KI. A study protocol of the adaptation and evaluation by means of a cluster-RCT of an integrated workplace health promotion program based on a European good practice. BMC Public Health 2022; 22:1028. [PMID: 35597983 PMCID: PMC9123680 DOI: 10.1186/s12889-022-13352-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background An integrated workplace health promotion program (WHPP) which targets multiple lifestyle factors at different levels (individual and organizational) is potentially more effective than a single component WHPP. The aim of this study is to describe the protocol of a study to tailor a European good practice of such an integral approach to the Dutch context and to evaluate its effectiveness and implementation. Methods This study consists of two components. First, the five steps of the Map of Adaptation Process (MAP) will be followed to tailor the Lombardy WHP to the Dutch context. Both the employers and employees will be actively involved in this process. Second, the effectiveness of the integrated Dutch WHPP will be evaluated in a clustered randomized controlled trial (C-RCT) with measurements at baseline, 6 months and 12 months. Clusters will be composed based on working locations or units - dependent on the organization’s structure and randomization within each organization takes place after baseline measurements. Primary outcome will be a combined lifestyle score. Secondary outcomes will be the separate lifestyle behaviors targeted, stress, work-life balance, need for recovery, general health, and well-being. Simultaneously, a process evaluation will be conducted. The study population will consist of employees from multiple organizations in different industry sectors. Organizations in the intervention condition will receive the integrated Dutch WHPP during 12 months, consisting of an implementation plan and a catalogue with activities for multiple lifestyle themes on various domains: 1) screening and support; 2) information and education; 3) adjustments in the social, digital or physical environment; and 4) policy. Discussion The MAP approach provides an appropriate framework to systematically adapt an existing WHPP to the Dutch context, involving both employers and employees and retaining the core elements, i.e. the catalogue with evidence-based activities on multiple lifestyle themes and domains enabling an integrated approach. The following process and effect evaluation will contribute to further insight in the actual implementation and effectiveness of the integrated WHP approach. Trial registration NTR (trialregister.nl), NL9526. Registered on 3 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13352-0.
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Affiliation(s)
- Denise J M Smit
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands. .,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands.
| | - Sandra H van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands
| | - Josephine A Engels
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, 6525 EN, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
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12
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Gurugubelli VS, Fang H, Shikany JM, Balkus SV, Rumbut J, Ngo H, Wang H, Allison JJ, Steffen LM. A review of harmonization methods for studying dietary patterns. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 23:100263. [PMID: 35252528 PMCID: PMC8896407 DOI: 10.1016/j.smhl.2021.100263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Data harmonization is the process by which each of the variables from different research studies are standardized to similar units resulting in comparable datasets. These data may be integrated for more powerful and accurate examination and prediction of outcomes for use in the intelligent and smart electronic health software programs and systems. Prospective harmonization is performed when researchers create guidelines for gathering and managing the data before data collection begins. In contrast, retrospective harmonization is performed by pooling previously collected data from various studies using expert domain knowledge to identify and translate variables. In nutritional epidemiology, dietary data harmonization is often necessary to construct the nutrient and food databases necessary to answer complex research questions and develop effective public health policy. In this paper, we review methods for effective data harmonization, including developing a harmonization plan, which common standards already exist for harmonization, and defining variables needed to harmonize datasets. Currently, several large-scale studies maintain harmonized nutrient databases, especially in Europe, and steps have been proposed to inform the retrospective harmonization process. As an example, data harmonization methods are applied to several U.S longitudinal diet datasets. Based on our review, considerations for future dietary data harmonization include user agreements for sharing private data among participating studies, defining variables and data dictionaries that accurately map variables among studies, and the use of secure data storage servers to maintain privacy. These considerations establish necessary components of harmonized data for smart health applications which can promote healthier eating and provide greater insights into the effect of dietary patterns on health.
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Affiliation(s)
| | - Hua Fang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
- Corresponding author. Tel.: +0-508-910-6411;
| | - James M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, 1720 University Blvd, Birmingham, 35294, Alabama, USA
| | - Salvador V Balkus
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Joshua Rumbut
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Hieu Ngo
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Honggang Wang
- University of Massachusetts Dartmouth, 285 Old Westport Rd, North Dartmouth, 02747, Massachusetts, USA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 N Lake Ave, Worcester, 01655, Massachusetts, USA
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, 55455, Minnesota, USA
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13
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Sidossis A, Gaviola GC, Sotos-Prieto M, Kales S. Healthy lifestyle interventions across diverse workplaces: a summary of the current evidence. Curr Opin Clin Nutr Metab Care 2021; 24:490-503. [PMID: 34622825 DOI: 10.1097/mco.0000000000000794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Workplaces provide a unique opportunity to deliver health promotion interventions to their workers. This review summarizes evidence from the most recent studies (September 2019 to April 2021) of workplace healthy lifestyle interventions and identifies gaps in the literature and key aspects for successful future workplace lifestyle interventions. RECENT FINDINGS Recent intervention studies have focused on four health domains: (1) multicomponent wellness programs, (2) healthy diet interventions, (3) physical activity interventions, and (4) mental health/sleep interventions. Within each group of studies, there was significant heterogeneity in study length, intervention components, and worker populations. Nonetheless, most studies across all categories showed positive associations between healthy lifestyle interventions and improved worker health. SUMMARY Although recent literature has shown an overall positive trend between healthy lifestyle interventions implemented at the workplace and improvements in markers of health and wellbeing, further research should include longer follow-up periods, more objective measures of wellbeing, evaluation of worker performance, and analogous interventions between studies to identify the most effective interventions to improve worker health and wellness.
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Affiliation(s)
- Amalia Sidossis
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gabriel C Gaviola
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz)
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Stefanos Kales
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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14
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Zhou N, Wong HM, McGrath CP. Parental Compliance towards Oral Health Education among Preschoolers with Special Healthcare Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147323. [PMID: 34299771 PMCID: PMC8307991 DOI: 10.3390/ijerph18147323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/25/2022]
Abstract
Background: Young children with special needs greatly rely on their parents to support their daily living activities; parental compliance may have great impact on the implementation of health promotion activities among those children. This study aimed to investigate the parental compliance towards oral health education (OHE) among children with special healthcare needs (SHCN). Method: The participants were 306 parents whose children had participated in a 24-month OHE program for preschool children with SHCN. The primary outcome of this cross-sectional study was parental compliance towards the OHE program. Parents’ oral health literacy (OHL) was assessed by a validated tool. Parents’ socioeconomic status, attitudes towards OHE topics, perceptions of children’s oral hygiene status, and usefulness of OHE materials were collected via questionnaires. Results: A higher dropout rate was observed among parents who perceived that their children had unfavorable oral hygiene status (p = 0.038), or parents who had poor OHL skills (p = 0.015). Parental noncompliance was more likely to be observed among parents who perceived that the OHE materials were not useful for their children (OR = 3.63, 95% CI 1.56 to 8.47, p = 0.003), or parents whose children had been diagnosed with developmental delays (OR = 5.45, 95% CI 1.59 to18.74, p = 0.007). Conclusion: Non-compliance existed among parents whose children had received OHE intervention. Parental compliance towards OHE intervention might be associated with parents’ OHL skills, usefulness of OHE materials, and children’s developmental conditions. OHE programs should be individually tailored to support children whose parents are at a higher risk of noncompliant behaviors.
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Affiliation(s)
- Ni Zhou
- School of Stomatology, Kunming Medical University, Kunming 650000, China;
| | - Hai Ming Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China;
- Correspondence:
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15
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Czwikla G, Boen F, Cook DG, de Jong J, Harris T, Hilz LK, Iliffe S, Lechner L, Morris RW, Muellmann S, Peels DA, Pischke CR, Schüz B, Stevens M, Telkmann K, van Lenthe FJ, Vanderlinden J, Bolte G. Equity-specific effects of interventions to promote physical activity among middle-aged and older adults: results from applying a novel equity-specific re-analysis strategy. Int J Behav Nutr Phys Act 2021; 18:65. [PMID: 34001171 PMCID: PMC8130354 DOI: 10.1186/s12966-021-01131-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Reducing inequalities in physical activity (PA) and PA-associated health outcomes is a priority for public health. Interventions to promote PA may reduce inequalities, but may also unintentionally increase them. Thus, there is a need to analyze equity-specific intervention effects. However, the potential for analyzing equity-specific effects of PA interventions has not yet been sufficiently exploited. The aim of this study was to set out a novel equity-specific re-analysis strategy tried out in an international interdisciplinary collaboration. METHODS The re-analysis strategy comprised harmonizing choice and definition of outcomes, exposures, socio-demographic indicators, and statistical analysis strategies across studies, as well as synthesizing results. It was applied in a collaboration of a convenience sample of eight European PA intervention studies in adults aged ≥45 years. Weekly minutes of moderate-to-vigorous PA was harmonized as outcome. Any versus no intervention was harmonized as exposure. Gender, education, income, area deprivation, and marital status were harmonized as socio-demographic indicators. Interactions between the intervention and socio-demographic indicators on moderate-to-vigorous PA were analyzed using multivariable linear regression and random-effects meta-analysis. RESULTS The collaborative experience shows that the novel re-analysis strategy can be applied to investigate equity-specific effects of existing PA interventions. Across our convenience sample of studies, no consistent pattern of equity-specific intervention effects was found. Pooled estimates suggested that intervention effects did not differ by gender, education, income, area deprivation, and marital status. CONCLUSIONS To exploit the potential for equity-specific effect analysis, we encourage future studies to apply the strategy to representative samples of existing study data. Ensuring sufficient representation of 'hard to reach' groups such as the most disadvantaged in study samples is of particular importance. This will help to extend the limited evidence required for the design and prioritization of future interventions that are most likely to reduce health inequalities.
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Affiliation(s)
- Gesa Czwikla
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
| | - Filip Boen
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Derek G Cook
- Population Health Research Institute, St George's University of London, London, UK
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Tess Harris
- Population Health Research Institute, St George's University of London, London, UK
| | - Lisa K Hilz
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK
| | - Lilian Lechner
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Richard W Morris
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Denise A Peels
- Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine UniversityDuesseldorf, Duesseldorf, Germany
| | - Benjamin Schüz
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Prevention and Health Promotion, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Klaus Telkmann
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Julie Vanderlinden
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
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16
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The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis. SSM Popul Health 2021; 13:100743. [PMID: 33604445 PMCID: PMC7873680 DOI: 10.1016/j.ssmph.2021.100743] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.
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