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Rasmussen SKB, Lidegaard LP, Pisinger C, Johnsen NF, Kristiansen M. Corrigendum: Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation. Tob Prev Cessat 2023; 9:31. [PMID: 37794857 PMCID: PMC10546946 DOI: 10.18332/tpc/173032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 10/06/2023]
Abstract
[This corrects the article DOI: 10.18332/tpc/162878.].
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Affiliation(s)
- Sofie K. B. Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark
| | | | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nina F. Johnsen
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark
| | - Maria Kristiansen
- Department of Public Health and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rasmussen SKB, Lidegaard LP, Pisinger C, Johnsen NF, Kristiansen M. Implementation fidelity of a smoke-free workplace intervention in a private medical company: A mixed-methods process evaluation. Tob Prev Cessat 2023; 9:17. [PMID: 37251694 PMCID: PMC10214475 DOI: 10.18332/tpc/162878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Smoke-free workplaces are considered an important part of tobacco control strategies. The purpose of this study was to evaluate implementation fidelity and explore the significance of social and contextual factors for the implementation of a strict smoke-free workplace intervention in a large Danish medical company. METHODS The UK Medical Research Council's guidance for process evaluation was used as a framework. Data were collected from approximately six months before the implementation until ten months after (2019-2020). A mixed method study design was used (a survey of 398 employees, a focus group of four employees and field visits on two days). Data were analyzed separately and later integrated through triangulation. We used the Fisher's exact test in the analysis of the questionnaire. RESULTS We assessed the implementation fidelity through four key factors: reach, dose and delivery, mechanisms of change, and context for the intervention components. Despite compliance issues, the policy component had high implementation fidelity. However, the implementation fidelity of the smoking cessation support component was low. We identified three social mechanisms influencing the employees' responsiveness towards the policy: expectation, the social aspect of the smoking facilities, and management leadership. COVID-19 was identified as the main contextual factor affecting the implementation. CONCLUSIONS Although not all elements of the intervention components were implemented as planned, the strict smoke-free workplace intervention is considered implemented. Further strategies can be initiated to raise implementation fidelity through better communication concerning the cessation support component, compliance, and enforcement of the policy.
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Affiliation(s)
- Sofie K. B. Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark
| | | | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Frederiksberg, Denmark
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nina F. Johnsen
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark
| | - Maria Kristiansen
- Department of Public Health and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Lidegaard LP, Kristiansen M, Pisinger C. Readiness for implementation of smoke-free work hours in private companies: A qualitative study of perceptions among middle managers. Tob Prev Cessat 2021; 7:38. [PMID: 34056145 PMCID: PMC8145195 DOI: 10.18332/tpc/134800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Workplaces are important settings for implementation of smoke-free environments. In this study, we follow a medical production company with 677 employees that implemented one of the most stringent tobacco policies legally possible in Denmark – smoke-free work hours – which means that employees are not allowed to smoke during work time. This study explores tobacco use restrictions during work hours regarding readiness of implementation, focusing specifically on middle managers’ perceptions and considerations, as well as their perceived responsibility in enforcing these. METHODS A case study is presented. Two focus groups of 10 middle managers were conducted, seven months before smoke-free work hours were implemented. The facilitators used open-ended questions, which consisted of a structured section with specific themes related to the implementation of smoke-free work hours. Focus groups were recorded, transcribed, and analyzed thematically. RESULTS We identified five main themes: 1) Benefits of the new policy due to better health, lower sickness-related absences, increased productivity, and improved branding value; 2) Social interactions across smoking status; 3) Smoking is a private matter with ethical dimensions; 4) The role of middle managers and concerns about enforcement; and 5) Limited experience with resistance from the smoking employees. CONCLUSIONS The findings suggest that workplaces in the preparation phase should ensure that: 1) The middle managers gain training on how to talk with employees about smoking cessation; 2) The middle managers are equipped to handle the new policy and have a joint vision and understanding of why and how they should enforce it; and 3) Room is made for discussions on resistance and enforcement-related challenges as well as ethical issues.
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Affiliation(s)
- Lærke P Lidegaard
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark
| | - Maria Kristiansen
- Center for Healthy Aging, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Charlotta Pisinger
- Department of Research, Danish Heart Foundation, Copenhagen, Denmark.,Center for Healthy Aging, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, University of Copenhagen, Copenhagen, Denmark
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Lidegaard LP, Schwennesen N, Willaing I, Faerch K. Barriers to and motivators for physical activity among people with Type 2 diabetes: patients' perspectives. Diabet Med 2016; 33:1677-1685. [PMID: 27279343 DOI: 10.1111/dme.13167] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/30/2022]
Abstract
AIM To explore barriers to and motivators for physical activity in a group of overweight and obese individuals with dysregulated Type 2 diabetes. METHODS Data were collected from the Steno Diabetes Center's outpatient clinic in Denmark. Four focus groups were conducted including 28 individuals with Type 2 diabetes aged 39-71 years. The facilitators used open-ended questions and probes such as images, statements and quotations about physical activity to foster active participation and interaction among participants. Focus groups were recorded on video and the discussions were transcribed and analysed thematically. RESULTS We identified four main themes: 1) the body as a barrier to physical activity because of functional limitations; 2) logistical challenges, including lack of time and awareness of where to exercise in the local area; 3) being physically active with others, providing a sense of mutual commitment and enjoyment; and 4) goal-setting and self-tracking, which was seen as an opportunity to track physical improvement over time. CONCLUSIONS The findings suggest that, once people are active, a high level of social interaction may help maintain their activity levels. Further research is needed to investigate the effect of combining individually tailored exercise plans with the establishment of customized and locally based exercise communities that offer enjoyment and support. Additionally, it is relevant to explore experiences of using self-tracking technologies to review short- and long-term goals.
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Affiliation(s)
| | - N Schwennesen
- Steno Diabetes Center, Gentofte, Denmark
- Centre for Healthy Ageing, Department of Anthropology and Public Health, University of Copenhagen, Copenhagen, Denmark
| | - I Willaing
- Steno Diabetes Center, Gentofte, Denmark
| | - K Faerch
- Steno Diabetes Center, Gentofte, Denmark
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Lidegaard LP, Hansen ALS, Johansen NB, Witte DR, Brage S, Lauritzen T, Jørgensen ME, Christensen DL, Færch K. Physical activity energy expenditure vs cardiorespiratory fitness level in impaired glucose metabolism. Diabetologia 2015; 58:2709-17. [PMID: 26342596 DOI: 10.1007/s00125-015-3738-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/05/2015] [Indexed: 12/17/2022]
Abstract
AIM/HYPOTHESIS Little is known about the relative roles of physical activity energy expenditure (PAEE) and cardiorespiratory fitness (CRF) as determinants of glucose regulation. The aim of this study was to examine the associations of PAEE and CRF with markers of glucose metabolism, and to test the hypothesis that CRF modifies the association between PAEE and glucose metabolism. METHODS We analysed cross-sectional data from 755 adults from the Danish ADDITION-PRO study. On the basis of OGTT results, participants without known diabetes were classified as having normal glucose tolerance, isolated impaired fasting glycaemia (i-IFG), isolated impaired glucose tolerance (i-IGT), combined IFG + IGT or screen-detected diabetes mellitus. Markers of insulin sensitivity and beta cell function were determined. PAEE was measured using a combined heart rate and movement sensor. CRF (maximal oxygen uptake) was estimated using a submaximal 8 min step test. The associations were examined by linear regression analysis. Results were adjusted for relevant confounders. RESULTS PAEE and CRF were reduced in individuals with i-IGT, combined IFG + IGT and screen-detected diabetes mellitus, but were not significantly different in individuals with i-IFG compared with those with normal glucose tolerance. When adjusting CRF for PAEE and vice versa, PAEE and CRF were both associated with lower fasting and 2 h insulin and higher peripheral insulin sensitivity. CRF was additionally associated with lower fasting and 2 h glucose and higher insulin sensitivity and beta cell function. There was no interaction between CRF and PAEE for any markers of glucose metabolism. CONCLUSIONS/INTERPRETATION Only CRF, not PAEE, appears to be independently associated with plasma glucose levels and beta cell function, suggesting that CRF may be particularly important for glycaemic control.
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Affiliation(s)
- Lærke P Lidegaard
- Steno Diabetes Center A/S, Niels Steensens Vej 6, DK-2820, Gentofte, Denmark.
| | - Anne-Louise S Hansen
- Department of Public Health - Institute of General Medical Practice, Aarhus University, Aarhus, Denmark
| | - Nanna B Johansen
- Steno Diabetes Center A/S, Niels Steensens Vej 6, DK-2820, Gentofte, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Daniel R Witte
- Department of Public Health - Institute of General Medical Practice, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Torsten Lauritzen
- Department of Public Health - Institute of General Medical Practice, Aarhus University, Aarhus, Denmark
| | - Marit E Jørgensen
- Steno Diabetes Center A/S, Niels Steensens Vej 6, DK-2820, Gentofte, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Dirk L Christensen
- Steno Diabetes Center A/S, Niels Steensens Vej 6, DK-2820, Gentofte, Denmark
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Section of Global Health, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Færch
- Steno Diabetes Center A/S, Niels Steensens Vej 6, DK-2820, Gentofte, Denmark
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Færch K, Lidegaard LP, Hansen ALS, Johansen NB, Witte DR, Brage S, Lauritzen T, Jørgensen ME, Christensen DL. Role of Physical Activity Energy Expenditure versus Estimated Fitness Level in Impaired Glucose Regulation. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478565.90196.c5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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