Healthy Team Healthy U: A Prospective Validation of an Evidence-Based Worksite Health Promotion and Wellness Platform

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

RATIONALE

Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. Thus, implementation should be evaluated to improve the effectiveness of WHWPs.

OBJECTIVE

We conducted a systematic review to identify critical success factors for WHWP implementation and gaps in the evidence. Doing so provides a platform for future theoretical development.

METHODS

We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (e.g., work redesign, 37 studies; and health behavior change, 8 studies), secondary (e.g., mindfulness training, 11 studies), tertiary (e.g., focused on rehabilitation, 9 studies), and multifocal (e.g., including components of primary and secondary, 9 studies).

RESULTS

Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance.

CONCLUSIONS

The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656].

An 8-week Stress Management Program in Information Technology Professionals and the Role of a New Cognitive Behavioral Method: a Pilot Randomized Controlled Trial

AIM

The aim of this study is to compare and evaluate the sort-term benefits of the effects of an 8-week stress management techniques in information technology professionals.

METHODS

In this parallel randomized controlled trial, participants were randomly assigned to either the stress management group (n=40; relaxation breathing, progressive muscle relaxation, guided imagery) or in the Pythagorean Self awareness group (n=41). Self-reported validated measures were used to evaluate perceived stress, health locus of control, anxiety and depression.

RESULTS

All groups were found with significantly better cognitive speed and verbal memory at the end of the follow-up. Taking into account the group by time interaction coefficients, PSAT was found significantly superior to standard SM with regards to depression, emotional intelligence, lifestyle and personal control and verbal memory suggesting that verbal memory improvement through time should be mostly attributed to PSAT. On the other hand, the cognitive speed improvement during follow-up should be attributed to both interventions.

CONCLUSIONS

These findings provide important insight into the role of stress management. Future studies should focus on randomized, controlled trials with larger samples and longer follow-up times.

Implementation of an interactive organ donation education program for Dutch lower-educated students: a process evaluation

BACKGROUND

As organ donation registration rates remain low, especially among lower-educated people, it is important to support this group in making their registration decision. To prepare lower-educated students in the Netherlands for making a well-informed decision, an interactive educational program was developed. We aim to understand both the (quality of) implementation as well as to contextualize the effects of this program in a lower-educated school setting.

METHODS

The process evaluation was part of a Cluster Randomized Controlled Trial, in which 11 schools for Intermediate Vocational Education throughout the Netherlands participated. Teachers who taught a course on Citizenship delivered three intervention elements (i.e. video fragments and discussion, quizzes with tailored feedback and an exercise filling out a registration form) to their students. Implementation was assessed by interviews with teachers, questionnaires from students, logbooks from teachers and user data from Google Analytics.

RESULTS

The program was well received and implemented, but on-the-spot adaptations were made by teachers to fit their students better. Within the lower-educated target group, differences between students are high in terms of active participation, reading abilities, knowledge and attention span. The program fit well within their regular teaching activities, but the topic of organ donation is not always prioritized by teachers.

CONCLUSIONS

We see opportunities to disseminate the program on a larger scale and reach a group that has been neglected in organ donation education before. Within the program, there are possibilities to increase the effectiveness of the program, such as alternative delivery methods for the elements with a lot of text, the addition of booster sessions and guidelines for teachers to adapt the program to students of different levels within Intermediate Vocational Education. Moreover, in order to have an impact on a national level, strategies need to be employed to reach high numbers of students and, therefore, support on a higher level is needed (both within schools and at policy level).

TRIAL REGISTRATION

Dutch Trial Register, NTR6771. Prospectively registered on 24 October 2017.

A Scoping Review of Digital Tools to Reduce Sedentary Behavior or Increase Physical Activity in Knowledge Workers

Background: There is increasing interest in the role that technology can play in improving the vitality of knowledge workers. A promising and widely adopted strategy to attain this goal is to reduce sedentary behavior (SB) and increase physical activity (PA). In this paper, we review the state-of-the-art SB and PA interventions using technology in the office environment. By scoping the existing landscape, we identified current gaps and underexplored possibilities. We discuss opportunities for future development and research on SB and PA interventions using technology. Methods: A systematic search was conducted in the Association for Computing Machinery digital library, the interdisciplinary library Scopus, and the Institute of Electrical and Electronics Engineers Xplore Digital Library to locate peer-reviewed scientific articles detailing SB and PA technology interventions in office environments between 2009 and 2019. Results: The initial search identified 1130 articles, of which 45 studies were included in the analysis. Our scoping review focused on the technologies supporting the interventions, which were coded using a grounded approach. Conclusion: Our findings showed that current SB and PA interventions using technology provide limited possibilities for physically active ways of working as opposed to the common strategy of prompting breaks. Interventions are also often offered as additional systems or services, rather than integrated into existing office infrastructures. With this work, we have mapped different types of interventions and provide an increased understanding of the opportunities for future multidisciplinary development and research of technologies to address sedentary behavior and physical activity in the office context.

The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments) Study: Mixed Methods Longitudinal Findings

The SHIELD (Safety & Health Improvement: Enhancing Law Enforcement Departments) Study is a worksite wellness team-based intervention among police and sheriff departments assessing the program's effectiveness to reduce occupational risks and unhealthy lifestyle behaviors. The SHIELD program focused on improving diet, physical activity, body weight and sleep, and reducing the effects of unhealthy stress and behaviors, such as tobacco and substance abuse. The SHIELD team-based health promotion program was found to be feasible and effective at 6 months in improving diet, sleep, stress, and overall quality of life of law enforcement department personnel. Both intervention and control groups were followed for 24 months, and we report those durability findings, along with qualitative group interview results that provide insight into the changes of the long-term outcomes. Long-term effects were observed for consumption of fruits and vegetables, and there was some evidence for effects on tobacco and alcohol use. Assessment of dietary habits, physical activity behaviors, weight loss maintenance, and substance use is rare more than 1 year following an intervention, and in general, initial positive changes do not persist in prior research. The SHIELD program was feasible, effective, and durable for improving dietary changes.

A Worksite Wellness Intervention: Improving Happiness, Life Satisfaction, and Gratitude in Health Care Workers

Objective

To assess the effect of a 12-week Stress Management and Resilience Training (SMART) program on happiness, life satisfaction, gratitude, mindfulness, spirituality, and stress in health care workers.

Participants and Methods

Participants were members of an employee wellness center at an academic health care center. Participants were enrolled as cohorts of 12 to 18 individuals and received the intervention at an employee wellness center from February 19, 2013, to February 27, 2017. The study was designed as a prospective, nonrandomized, single-arm clinical trial that included a 3-month in-person SMART program (defined as the intervention), with an additional 3-month postintervention follow-up period (6 months total). Outcomes were assessed at baseline (T0), end of intervention (T3), and after the postintervention follow-up period (T6) and included Subjective Happiness Survey, Satisfaction with Life Scale, Gratitude Scale, Mindful Attention Awareness Scale, Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being, and Perceived Stress Scale.

Results

Of the 110 participants who enrolled and provided consent, 98 participants (89%) completed the T0 and T3 assessments and 85 participants (77%) completed the T0, T3, and T6 assessments. On comparing the T0 and T6 responses, we observed statistically significant improvements (P<.001) in all the domains studied: subjective happiness (baseline average, 4.6; T6 average, 5.5; average difference, 0.9; 95% CI, 0.6-1.0), life satisfaction (baseline average, 22.8; T6 average, 27.5; average difference, 4.7; 95% CI, 3.6-5.9); gratitude (baseline average, 35.8; T6 average, 39.3; average difference, 3.5; 95% CI, 2.6-4.5), mindfulness (baseline average, 3.5; T6 average, 4.2; average difference, 0.7; 95% CI, 0.6-0.9), Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being (baseline average, 29.9; T6 average, 37.4; average difference, 7.5; 95% CI, 6.0-9.2), and percentage of people reporting high stress (baseline, 97.6%; T6, 67.1%). Similar results were observed when comparing the T0 and T3 responses.

Conclusion

In health care workers, training in the SMART program was associated with statistically significant improvements in happiness, satisfaction with life, gratitude, mindfulness, spirituality, and stress (P<.001). Given the importance of stress in the workplace, larger randomized trials and broader dissemination of the program in health care workers is warranted.