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Engels M, Scheepers L, Engels J, Boß L, Kuhlmann R, Kuske J, Lesener L, Pavlista V, Schmidt-Stiedenroth K, Diebig M, Ruhle SA, Zapkau FB, Angerer P, Hoewner J, Lehr D, Schwens C, Süß S, Wulf IC, Dragano N. Web-based occupational stress prevention in German micro- and small-sized enterprises - process evaluation results of an implementation study. BMC Public Health 2024; 24:1618. [PMID: 38886711 PMCID: PMC11184923 DOI: 10.1186/s12889-024-19102-8] [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: 11/20/2023] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE. OBJECTIVE The aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention ("System P") and to identify potential barriers for its uptake and use in MSE in Germany. METHODS This study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders. RESULTS Part I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8. COSTS The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed. CONCLUSIONS Although System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution. ⁺ FULL PROJECT NAME: "PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben" (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). TRIAL REGISTRATION German Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.
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Affiliation(s)
- Miriam Engels
- Department of Work and Organisational Psychology, Faculty of Psychology, Open University of the Netherlands, Valkenburgerweg 177, Heerlen, 6419 AT, The Netherlands
| | - Louisa Scheepers
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Judith Engels
- Department of Work and Organisational Psychology, Faculty of Psychology, Open University of the Netherlands, Valkenburgerweg 177, Heerlen, 6419 AT, The Netherlands
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Dusseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Luneburg, Universitätsallee 1, 21335, Lüneburg, Germany
| | - Rebekka Kuhlmann
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Dusseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Johanna Kuske
- Chair for Entrepreneurship and Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus‑Magnus‑Platz, 50923, Köln, Germany
| | - Lutz Lesener
- K12 Agentur für Kommunikation und Innovation GmbH, Schirmerstr. 76, 40211, Düsseldorf, Germany
| | - Valeria Pavlista
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Kira Schmidt-Stiedenroth
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Mathias Diebig
- Department of Work and Organisational Psychology, Faculty I - Psychology, Trier University, Universitätsring 15, 54296, Trier, Germany
| | - Sascha A Ruhle
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Luneburg, Universitätsallee 1, 21335, Lüneburg, Germany
- Department of Human Resource Studies, Tilburg University, Prof. Cobbenhagenlaan 225, Tilburg, 5037 DB, The Netherlands
| | - Florian B Zapkau
- Institute for International Business, Department of Global Business and Trade, Vienna University of Economics and Business, Welthandelsplatz 1, Wien, 1020, Austria
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Jörg Hoewner
- K12 Agentur für Kommunikation und Innovation GmbH, Schirmerstr. 76, 40211, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Luneburg, Universitätsallee 1, 21335, Lüneburg, Germany
| | - Christian Schwens
- Chair for Entrepreneurship and Management, Faculty of Management, Economics and Social Sciences, University of Cologne, Albertus‑Magnus‑Platz, 50923, Köln, Germany
| | - Stefan Süß
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Dusseldorf, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Ines C Wulf
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
- German Social Accident Insurance Institution for the Administrative Sector, Markgrafenstraße 18, 10969, Berlin, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Dusseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Geboers L, de Vet E, Rongen FC, Poelman MP. More than the worksite cafeteria: the workplace food environment of small and medium-sized enterprises in the Netherlands. Public Health Nutr 2024; 27:e137. [PMID: 38679460 DOI: 10.1017/s1368980024000946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To characterise the food environment of Dutch small and medium-sized enterprises (SMEs), encompassing physical, sociocultural, economic and policy features and to explore variations within SMEs according to company characteristics (number of employees, location of work and presence of worksite cafeteria). DESIGN Online cross-sectional survey study of a representative Dutch SME sample by a panel agency. SETTING Dutch SMEs. PARTICIPANTS Three hundred and fifteen employees of Dutch SMEs responsible for food and drink in their company. RESULTS Most SMEs did not have a worksite cafeteria, no provision of fruits or vegetables, and did not offer discounts on food or drinks. The food environment of these SMEs varied significantly based on company characteristics. For example, SMEs with a worksite cafeteria were significantly more likely to have fruits (OR = 8·76, 95 % CI (4·50, 17·06)), vegetables (OR = 10·29, 95 % CI (5·49, 19·31)) and company food policies (OR = 5·04, 95 % CI (2·08, 12·20)) than SMEs without. Additionally, SMEs with ≥ 50 employees were more likely to have fruits (OR = 2·39, 95 % CI (1·42, 4·03)), vegetables (OR = 1·89, 95 % CI (1·04, 3·46)) and company food policies (OR = 2·82, 95 % CI (1·09, 7·29) than SMEs with < 50 employees. Moreover, having a worksite cafeteria (B = 0·23, 95 % CI (0·08, 0·38)) and employees working mostly on-site (B = 0·14, 95 % CI (0·01, 0·28)) were associated with stronger social norms of healthy and sustainable eating at work compared to SMEs without a worksite cafeteria and working mostly off-site. CONCLUSIONS In SMEs, an overall comprehensive picture of the food environment points to its limited active encouragement of healthy food choices, particularly so in small SMEs without a worksite cafeteria. Company characteristics strongly influence SME food environments and should be considered when developing interventions improving SME workplace food environments.
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Affiliation(s)
- Lisanne Geboers
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Emely de Vet
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Frédérique C Rongen
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Department of Social Sciences, Wageningen University & Research, Wageningen, the Netherlands
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Sasaki N, Shimazu T, Takeno H, Ogawa S, Sawada U, Tsutsumi A, Imamura K. Implementation of an internet-based stress management program in micro- and small-sized enterprises: a study protocol for a pre-post feasibility study of the effectiveness-implementation hybrid type 2 trial. Pilot Feasibility Stud 2024; 10:56. [PMID: 38581058 PMCID: PMC10996202 DOI: 10.1186/s40814-024-01481-9] [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: 11/22/2022] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Although internet-based stress management programs are proven effective in improving mental health among workers, micro- and small-sized enterprises (MSEs), lacking in occupational healthcare services, face challenges implementing them. To address this gap, this study will develop the program with stakeholders at MSEs to aim for real-world implementation. OBJECTIVES This paper describes a study protocol for a pre-post feasibility study of an effectiveness-implementation hybrid type 2 trial of text-based internet-based programs ("WellBe-LINE") in MSEs with less than 50 employees. This feasibility study primarily aims to evaluate trial methods for future effectiveness-implementation hybrid type 2 trials. METHODS For this study protocol, an internet- and text-based self-care intervention program using the LINE app (a popular message tool in Japan) will be prepared according to evidence-based psychoeducational topics. Based on our online survey findings, personalized algorithms will be implemented according to employees' gender, age, and psychological distress levels. A personalized program using a popular pre-existing text app is expected to reduce employees' burdens and be attractive to them, resulting in successful implementation outcomes and mental health benefits. A pre-post design feasibility study will be conducted on ten companies to evaluate trial methods (e.g., recruitment and procedures). The primary outcome will involve individual-level penetration, defined as the proportion of the number of employees who register for the program divided by the total number of invited employees at the company. The progression criterion to go next trial specifies that more than 50% of the recruited companies obtain 60% individual penetration, which is set based on the findings of the prior survey of employees at MSEs and of interviews of stakeholders involved in this study, and will be measured by LINE system. Finally, acceptability, appropriateness, and feasibility will be measured using internet-based questionnaires and interviews. DISCUSSION This pre-post feasibility study for future effectiveness-implementation hybrid type 2 trials will provide in-depth knowledge about the successful implementation of text-based, semi-personalized, self-care mental health interventions in real-world settings using both quantitative and qualitative data. CONCLUSIONS This feasibility study will help validate the effectiveness of text-based interventions using a widely used social networking service (SNS) tool for employees in MSEs. TRIAL REGISTRATION UMIN clinical trial registration, UMIN000046960. Registered on February 21, 2022. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000053570.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hajime Takeno
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sayaka Ogawa
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Utako Sawada
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
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Gómez-García AR, Chang AH, Valenzuela-Mendieta RO, García-Arroyo JA. Leaving no-one behind in the workplace health promotion: towards regulatory equity in the Ecuadorian micro-enterprises. J Public Health Policy 2024; 45:152-163. [PMID: 38233505 DOI: 10.1057/s41271-023-00466-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/19/2024]
Abstract
The purpose of workplace public health programmes and regulations is to promote safety and health for the entire working population nationwide. Some countries limit the scope of such programmes to medium or big-sized companies, leaving out small and micro-enterprises, thus discriminating against many workers exposed to risks. This Viewpoint aims to identify inequalities in occupational health generated by the new Regulation for Workplace Health Promotion (WHP) in Ecuador. We showed how the regulation excludes all micro-enterprises and displayed the essential role of micro-enterprises in the business fabric and the Ecuadorian labour market. More than 93% of the registered companies are micro-enterprises and these include more than 25% of the employees in the formal economy. Integrating occupational health into the public health system will require deep analysis to improve protection for the working population.
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Affiliation(s)
| | - Alywin Hacay Chang
- Universidad Espíritu Santo UEES, Samborondón Avenue 5, Samborondón, 092301, Ecuador
- Universidad Politécnica de Valencia, Valencia, Spain
| | | | - José A García-Arroyo
- Universidad Espíritu Santo UEES, Samborondón Avenue 5, Samborondón, 092301, Ecuador.
- Universidad Internacional de la Rioja (UNIR), La Rioja, Spain.
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Nagasawa T, Saito J, Odawara M, Kaji Y, Yuwaki K, Imamura H, Nogi K, Nakamura M, Shimazu T. Smoking cessation interventions and implementations across multiple settings in Japan: a scoping review and supplemental survey. Implement Sci Commun 2023; 4:146. [PMID: 37993908 PMCID: PMC10666296 DOI: 10.1186/s43058-023-00517-0] [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: 08/07/2023] [Accepted: 10/28/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Smoking is the leading risk factor for death worldwide. In Japan, although several evidence-based interventions (EBIs) for smoking cessation have been disseminated or adopted, there is a gap between scientific evidence and the actual implementation. This scoping review aimed to describe the knowledge gaps in local-level smoking cessation interventions in Japan, their implementation outcomes, implementation barriers and facilitators, and the use of implementation strategies. METHODS This study comprised two approaches: (1) a comprehensive scoping review of primary and grey literature, and (2) a supplemental survey of organizations in the grey literature. For the scoping review, we included original studies or reports on smoking cessation interventions targeting adults aged 18 years and older, or providers of cessation support at various settings (community, workplace, school, and clinical settings) in Japan. The extracted data included basic characteristics, intervention categories, implementation outcomes, factors influencing implementation, and implementation strategies for each intervention. Responses to the supplemental survey were extracted same used for the scoping review. To gain a deeper understanding, semi-structured interviews were conducted with some of the organizations in the survey. RESULTS A total of 600 interventions with 691 intervention components, based on EBIs in the 2020 US Surgeon General Report, from 498 articles were included in the data extraction; 32 of the 88 organizations responded to the survey. Regarding the overall knowledge about smoking cessation intervention components, behavioral counseling, and cessation medication in clinical settings were mostly reported (34.7%). Implementation outcomes were measured in 18 articles (3.0%) and penetration was mostly reported. Regarding influential factors, "available resources," and "knowledge and beliefs about the intervention" for barriers, and "relative priority" for facilitators were mostly reported. Implementation strategies were measured in 29 articles (4.8%), and "Train and educate stakeholders" was mostly reported. CONCLUSIONS Most EBIs reported in the Japanese literature included smoking cessation treatments in clinical settings. While a few articles focused on the implementation indicators in Japan, significant knowledge and experience were extracted from the grey literature, especially in the workplace and community settings. Future research should focus more on implementation to reduce the knowledge gap regarding smoking cessation interventions.
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Affiliation(s)
- Tomomi Nagasawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Yuki Kaji
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Keiichi Yuwaki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan
- Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Haruhiko Imamura
- Graduate School of Health and Nutrition Sciences, The University of Nagano, Nagano City, Nagano, Japan
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Ota-Ku, Tokyo, Japan
| | - Kazuya Nogi
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, Ota-Ku, Tokyo, Japan
| | - Masakazu Nakamura
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Chiyoda-Ku, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan.
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Meshkovska B, Gebremariam MK, Atukunda P, Iversen PO, Wandel M, Lien N. Barriers and facilitators to implementation of nutrition-related actions in school settings in low- and middle-income countries (LMICs): a qualitative systematic review using the Consolidated Framework for Implementation Research (CFIR). Implement Sci Commun 2023; 4:73. [PMID: 37370179 DOI: 10.1186/s43058-023-00454-y] [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: 09/30/2022] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Low- and middle-income countries (LMICs) are particularly vulnerable to the double burden of malnutrition: co-existence of underweight, overweight, obesity, and/or diet-related non-communicable diseases. Nutrition-related double-duty actions in school settings have been identified as one of the ways to address this challenge. However, to be able to take full advantage of the potential impact, it is important to understand their implementation as well. The aim of this paper is to systematically review qualitative research on barriers and facilitators to the implementation of nutrition-related actions in the school settings in LMICs. METHODS The following databases were searched: EMBASE, ERIC, MEDLINE, Global Health and PsycInfo (all on Ovid), Scopus (Elsevier), the Web of Science Social Sciences Citation Index, and Global Index Medicus from the World Health Organization. Of the 4253 identified records, 4030 were excluded after the abstract and title screen, leaving 223 for the full-text screen. A final 36 papers were included in this review. The consolidated framework for implementation research (CFIR) was used in the analysis. RESULTS We identified barriers and facilitators to implementation linked to the following CFIR constructs/sub-constructs: design quality and packaging, cost (intervention characteristics); target group needs and resources, cosmopolitanism, external policy and incentives (outer setting); structural characteristics, readiness for implementation (inner setting); knowledge and beliefs (characteristics of individuals) and engaging, executing (process). All identified constructs apart from target group needs and resources, knowledge and beliefs, and engaging were predominantly barriers. Available resources were the most prevalent barriers across studies. CONCLUSION This review identified barriers and facilitators to the implementation of nutrition-related actions based on qualitative articles in the school setting in LMICs, using the CFIR. Schools face continuous challenges in regard to funding and the government sector may have a role to play not only by offering financial assistance, but also through policy-making that would support healthy eating practices on school grounds. REGISTRATION PROSPERO ID: CRD42022296159.
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Affiliation(s)
- Biljana Meshkovska
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, P.O. Box 1046, 0316, Oslo, Norway.
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Kirkeveien 166, Fredrik Holsts hus, 0450, Oslo, Norway
| | - Prudence Atukunda
- Center for Crisis Psychology, University of Bergen, Møllendalsbakken 9, 5009, Bergen, Norway
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, P.O. Box 1046, 0316, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Sognsvannsveien 20, 0372, Oslo, Norway
- Division of Human Nutrition, Stellenbosch University, Francie Van Zijl Drive, Tygerberg, Cape Town, South Africa
| | - Margareta Wandel
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, P.O. Box 1046, 0316, Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Blindern, P.O. Box 1046, 0316, Oslo, Norway
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Saito J, Odawara M, Fujimori M, Kuchiba A, Oyamada S, Swe KT, Saito E, Fukai K, Tatemichi M, Nakamura M, Uchitomi Y, Shimazu T. Interactive assistance via eHealth for small- and medium-sized enterprises' employer and health care manager teams on tobacco control (eSMART-TC): protocol for a cluster randomized hybrid type II trial (N-EQUITY2101/J-SUPPORT2102). Implement Sci Commun 2023; 4:61. [PMID: 37287041 DOI: 10.1186/s43058-023-00444-0] [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: 04/24/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Tobacco control should be a higher public health priority in Japan. Some workplaces provide smoking cessation support and connect employees to effective smoking cessation treatments such as outpatient clinics. However, tobacco control measures have not been sufficiently implemented in Japan, especially in small- and medium-sized enterprises (SMEs), where resources are limited. Organizational commitment and consistent leadership are crucial to facilitate implementation, but research on whether supporting organizational leaders leads to health behavior changes among employees is limited. METHODS This hybrid type II cluster randomized effectiveness implementation trial (eSMART-TC) aims to examine the effects of interactive assistance for SME management on health and implementation outcomes. We will provide interactive assistance to employers and health managers for 6 months, aiming to promote the utilization of reimbursed smoking cessation treatments by public health insurance and to implement smoke-free workplaces. The intervention will consist of three strategies: supporting employees through campaigns, tailored ongoing facilitation, and ensuring executive engagement and support. The primary health and implementation outcomes will be salivary cotinine-validated 7-day point-prevalence abstinence rate, and the adoption of two recommended measures (promoting utilization of smoking cessation treatment and implementing smoke-free workplaces) 6 months after the initial session, respectively. Other outcomes for implementation (e.g., penetration of smoking cessation clinic visits), health (e.g., salivary cotinine-validated 7-day point-prevalence abstinence rate at 12 months), and process (e.g., adherence and potential moderating factors) will be collected via questionnaires, interviews, logbooks, and interventionists' notes at 6 and 12 months. An economic analysis will be undertaken to assess the cost-effectiveness of the implementation interventions at 12 months. DISCUSSION This will be the first cluster randomized controlled trial to evaluate the effectiveness of an implementation intervention with interactive assistance for employers and health managers in SMEs on smoking cessation and implementation of evidence-based tobacco control measures in SMEs. The findings of this trial targeting management in SMEs have the potential to accelerate the implementation of evidence-based smoking cessation methods as well as abstinence rates among employees in SMEs across Japan. TRIAL REGISTRATION The study protocol has been registered in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000044526). Registered on 06/14/2021.
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Affiliation(s)
- Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Institute for Cancer Control/Biostatistics Division, CRAS, National Cancer Center, Tokyo, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | | | - Khin Thet Swe
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Masakazu Nakamura
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
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Reynolds GS, Bennett JB. The Role of Wellness Climate in Small Business Health Promotion and Employee Wellbeing. OCCUPATIONAL HEALTH SCIENCE 2023:1-36. [PMID: 37359456 PMCID: PMC10131546 DOI: 10.1007/s41542-023-00148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/28/2023]
Abstract
Wellness involves physical, emotional, behavioral, social, and spiritual dimensions. A climate for wellness exists at both the psychological and organizational levels, consisting of individual and shared perceptions of policies, structures, and managerial behavior that support or promote employee wellbeing. This study explored the associations between psychological and organizational wellness climate and the effectiveness of a team health promotion training on employees' perceived physical and mental wellbeing and substance use. Employees from 45 small businesses completed self-report measures of wellness climate, wellbeing, positive unwinding behavior, work-family conflict, job stress, drug use, and alcohol use, assessed before, and one and six months after, attending either of two types of onsite health promotion training. Team Awareness training targeted improvements in the social climate at work. Healthy Choices training targeted individual health behavior. A control group did not receive training until after the study. Businesses were randomly assigned to conditions and data were analyzed using multi-level modeling. Models that included wellness climate as a mediator fit the data significantly better than models without climate as a mediator. Team Awareness participants showed greater improvements in wellness climate and wellbeing compared to the control group. Healthy Choices participants showed no changes in climate and no mediation effects of climate. Health promotion efforts may be enhanced by including wellness climate as a target in program design at multiple levels.
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Affiliation(s)
- G. Shawn Reynolds
- Organizational Wellness & Learning Systems, 2221 Justin Rd. #119485, Flower Mound, TX 75028 USA
| | - Joel B. Bennett
- Organizational Wellness & Learning Systems, 2221 Justin Rd. #119485, Flower Mound, TX 75028 USA
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Hoffmann C, Schaller A. Evaluation of the communication strategy for promoting physical activity in a cross-company network in Germany: A mixed-methods analysis. Front Public Health 2022; 10:905451. [PMID: 36589998 PMCID: PMC9799332 DOI: 10.3389/fpubh.2022.905451] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The workplace is considered a promising setting for reaching physically inactive adults, but participation quotes in workplace health promotion (WHP) remain low. Regarding the low participation in WHP, the question emerges concerning the importance of health communication strategies. This paper presents the results from the evaluation of the communication strategy of a cross-company network for promoting physical activity and derives findings for the successful communication of measures. Materials and methods Quantitative and qualitative data sources were used to evaluate the communication strategy. The methods applied included individual semi-structured interviews (n = 14) and the monitoring of the usage of digital communication channels. Results The analysis revealed that the usage of the digital communication channels within this study was subjected to major fluctuations and a variety of factors must be considered when communicating physical activity measures in a cross-company network. It is important to engage in appropriate communication management that explicitly takes the interpersonal communication and the organizational circumstances into account. Conclusion This study revealed which factors may have an influence on the successful communication of physical activity measures in the context of WHP in cross-company networks. Thus, it makes an important contribution to the transfer of science and practice as it captured relevant questions from the field of WHP. Trial registration German Clinical Trials Register (DRKS)-ID: DRKS00020956; Date of registration: 18 June 2020, https://drks.de/search/de/trial/DRKS00020956.
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Affiliation(s)
- Carina Hoffmann
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
- Department Research and Development, Institute for Occupational 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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Olaya B, Van der Feltz-Cornelis CM, Hakkaart-van Roijen L, Merecz-Kot D, Sinokki M, Naumanen P, Shepherd J, van Krugten F, de Mul M, Staszewska K, Vorstenbosch E, de Miquel C, Lima RA, Ayuso-Mateos JL, Salvador-Carulla L, Borrega O, Sabariego C, Bernard RM, Vanroelen C, Gevaert J, Van Aerden K, Raggi A, Seghezzi F, Haro JM. Study protocol of EMPOWER: A cluster randomized trial of a multimodal eHealth intervention for promoting mental health in the workplace following a stepped wedge trial design. Digit Health 2022; 8:20552076221131145. [PMID: 36276189 PMCID: PMC9583218 DOI: 10.1177/20552076221131145] [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: 09/12/2021] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022] Open
Abstract
Objective: This article describes the EMPOWER study, a controlled trial aiming to determine the effectiveness and cost-effectiveness of an eHealth intervention to prevent common health problems and reduce presenteeism and absenteeism in the workplace. Intervention: The EMPOWER intervention spans universal, secondary and tertiary prevention and consists of an eHealth platform delivered via a website and a smartphone app designed to guide employees throughout different modules according to their specific profiles. Design: A stepped-wedge cluster randomized trial will be implemented in four countries (Finland, Poland, Spain and UK) with employees from small and medium enterprises (SMEs) and public agencies. Companies will be randomly allocated in one of three groups with different times at which the intervention is implemented. The intervention will last 7 weeks. Employees will answer several questionnaires at baseline, pre- and post-intervention and follow-up. Outcome measures: The main outcome is presenteeism. Secondary outcomes include depression, anxiety, insomnia, stress levels, wellbeing and absenteeism. Analyses will be conducted at the individual level using the intention-to-treat approach and mixed models. Additional analyses will evaluate the intervention effects according to gender, country or type of company. Cost-effectiveness and cost-utility analyses [based on the use of quality-adjusted life-years (QALYS)] will consider a societal, employers' and employees' perspective.
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Affiliation(s)
- Beatriz Olaya
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de
Déu, Sant Boi de Llobregat, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain,Beatriz Olaya, Research, Innovation and
Teaching Unit, Parc Sanitari Sant Joan de Déu, Carrer Doctor Pujadas 42, 08830
Sant Boi de Llobregat, Spain.
| | - Christina M. Van der Feltz-Cornelis
- MHARG, Department of Health Sciences, Hull York Medical School, University of York, York, UK,Institute of Health Informatics, University College London, London,
UK
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management (ESHPM), Erasmus
University Rotterdam, Rotterdam, The Netherlands
| | | | - Marjo Sinokki
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Päivi Naumanen
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Jessie Shepherd
- MHARG, Department of Health Sciences, Hull York Medical School, University of York, York, UK
| | - Frédérique van Krugten
- Erasmus School of Health Policy and Management (ESHPM), Erasmus
University Rotterdam, Rotterdam, The Netherlands
| | - Marleen de Mul
- Erasmus School of Health Policy and Management (ESHPM), Erasmus
University Rotterdam, Rotterdam, The Netherlands
| | | | - Ellen Vorstenbosch
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de
Déu, Sant Boi de Llobregat, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain
| | - Carlota de Miquel
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de
Déu, Sant Boi de Llobregat, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de
Déu, Sant Boi de Llobregat, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain
| | - José Luis Ayuso-Mateos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain,Department of Psychiatry, Faculty of Medicine, Universidad Autónoma
de Madrid, Madrid, Spain
| | - Luis Salvador-Carulla
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia,National Centres for Epidemiology and Population Health, College of
Health and Medicine, Australian National University, Canberra, Australia
| | | | - Carla Sabariego
- Swiss Paraplegic Research
(SPF), Nottwil, Switzerland,Department of Health Sciences and Medicine, University of Lucerne,
Lucerne, Switzerland; Center for Rehabilitation in Global Health Systems, World
Health Organization Collaborating Center, University of Lucerne, Lucerne,
Switzerland
| | | | - Christophe Vanroelen
- Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
| | - Jessie Gevaert
- Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
| | - Karen Van Aerden
- Interface Demography, Department of Sociology, Vrije
Universiteit Brussel, Brussels, Belgium
| | - Alberto Raggi
- Fondazione IRCCS Istituto Neurologico Carlo Besta, UO Neurologia
Salute Pubblica e Disabilità, Milano, Italy
| | | | | | - Josep Maria Haro
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de
Déu, Sant Boi de Llobregat, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM),
Madrid, Spain
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Odawara M, Saito J, Yaguchi-Saito A, Fujimori M, Uchitomi Y, Shimazu T. Using implementation mapping to develop strategies for preventing non-communicable diseases in Japanese small- and medium-sized enterprises. Front Public Health 2022; 10:873769. [PMID: 36276371 PMCID: PMC9582744 DOI: 10.3389/fpubh.2022.873769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Workplace programs to prevent non-communicable diseases (NCDs) in the workplace can help prevent the incidence of chronic diseases among employees, provide health benefits, and reduce the risk of financial loss. Nevertheless, these programs are not fully implemented, particularly in small- and medium-sized enterprises (SMEs). The purpose of this study was to develop implementation strategies for health promotion activities to prevent NCDs in Japanese SMEs using Implementation Mapping (IM) to present the process in a systematic, transparent, and replicable manner. Methods Qualitative methods using interviews and focus group discussions with 15 SMEs and 20 public health nurses were conducted in a previous study. This study applied the Consolidated Framework for Implementation Research and IM to analyze this dataset to develop implementation strategies suitable for SMEs in Japan. Results In task 2 of the IM, we identified performance objectives, determinants, and change objectives for each implementation stage: adoption, implementation, and maintenance; to identify the required actors and actions necessary to enhance implementation effectiveness. Twenty-two performance objectives were identified in each implementation stage. In task 3 of the IM, the planning group matched behavioral change methods (e.g., modeling and setting of graded tasks, framing, self-re-evaluation, and environmental re-evaluation) with determinants to address the performance objectives. We used a consolidated framework for implementation research to select the optimal behavioral change technique for performance objectives and determinants and designed a practical application. The planning team agreed on the inclusion of sixteen strategies from the final strategies list compiled and presented to it for consensus, for the overall implementation plan design. Discussion This paper provides the implementation strategies for NCDs prevention for SMEs in Japan following an IM protocol. Although the identified implementation strategies might not be generalizable to all SMEs planning implementation of health promotion activities, because they were tailored to contextual factors identified in a formative research. However, identified performance objectives and implementation strategies can help direct the next steps in launching preventive programs against NCDs in SMEs.
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Affiliation(s)
- Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan,*Correspondence: Taichi Shimazu
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Minamitani M, Tatemichi M, Mukai T, Katano A, Nakagawa K. Effect of employers' concerns about cancer countermeasures on the implementation of cancer screening and support for balancing cancer treatment and work in small and medium-sized Japanese enterprises. J Occup Health 2022; 64:e12352. [PMID: 35989472 PMCID: PMC9393347 DOI: 10.1002/1348-9585.12352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/04/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Japan has recently implemented screening and support to balance cancer treatment and work. The present study evaluated whether the interest of employers in small and medium-sized enterprises (SMEs) affects cancer control in the workplace. METHODS Cancer preparedness at work was examined by a Japanese life insurance company contracting 370 000 SMEs. The analysis targeted SMEs hiring ≤50 employees whose employer was aged ≥40 years. The endpoints were performing one or more screening for stomach, colon, or lung cancer recommended for both sexes in Japan and implementing three or more supportive measures from the nine systems listed in a questionnaire. Logistic regression analysis was performed to predict these endpoints using other factors. RESULTS The survey was completed from January 5 to 28, 2022 and included 5268 eligible companies. Around half were small enterprises with up to five employees. Screenings were performed for stomach (32%), colorectal (27%), and lung (26%) cancers. Sick leave (36%) was the most common support for balancing cancer treatment and work. Logistic regression analysis revealed that employer's concern was a significant predictor of screening (odds ratio [OR] = 3.59, P < .001) and support (OR = 2.55, P < .01) compared with "not concerned at all," along with industry type, annual sales, experience of employees with cancer, and employer's participation in screening. CONCLUSION Our findings suggested that employers' interest was a powerful predictor of implementing cancer control in SMEs. Educational intervention targeted toward the employer could play a critical role in improving SMEs.
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Affiliation(s)
- Masanari Minamitani
- Department of Comprehensive Radiation OncologyThe University of TokyoTokyoJapan
| | - Masayuki Tatemichi
- Department of Preventive MedicineTokai University School of MedicineIsehara‐ShiJapan
| | - Tomoya Mukai
- Graduate Schools for Law and PoliticsThe University of TokyoTokyoJapan
| | - Atsuto Katano
- Department of RadiologyThe University of Tokyo HospitalTokyoJapan
| | - Keiichi Nakagawa
- Department of Comprehensive Radiation OncologyThe University of TokyoTokyoJapan
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