Design and development of a digital intervention for workplace stress and mental health (EMPOWER)

Purpose

We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress.

Results

A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants.

Conclusion

The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.

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

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.

Strategies for Implementing Occupational eMental Health Interventions: Scoping Review

BACKGROUND

The implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers.

OBJECTIVE

The objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures.

METHODS

A scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research.

RESULTS

A total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions.

CONCLUSIONS

This scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review's findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.

[The state of mental health in people with a diagnosis of neuroborreliosis]

BACKGROUND

In recent years, the number of recorded cases of Borrelia burgdorferi infections causing Lyme borreliosis has been on a steady rise in Poland. A wide spectrum of disorders in the peripheral and central nervous system is observed in the course of such infections. Symptoms which are not clear-cut are reported by approx. 10-25% of all people infected with B. burgdorferi. They may concern both the somatic and mental spheres, which in turn significantly impedes the daily functioning of the patients. The main purpose of the research was to compare the mental health status of people with neuroborreliosis with that of healthy people. An answer was also obtained to the question of whether people with neuroborreliosis experience difficulties in functioning in the following areas: family, social, professional and educational.

MATERIAL AND METHODS

The study included 60 people: 30 people with the diagnosis of neuroborreliosis and 30 healthy people aged 18-47. The mean age in the study group was 28.6 years. As a research tool, the General Health Questionnaire 28 (GHQ-28) by Goldberg was used along with a socio-demographic questionnaire.

RESULTS

The subjects diagnosed with neuroborreliosis obtained higher results in GHQ-28, both on individual scales: Somatic Symptoms, Anxiety, Insomnia, Social Dysfunction, Severe Depression, as well as the overall result, which is an indicator of the mental health status. As much as 70% of the patients experienced difficulties in functioning in the social area, 66% in the professional area, and 60% in the educational area. No impact of the disease on functioning in the family area has been demonstrated.

CONCLUSIONS

The results of the study indicate some significant differences in the mental health status of people diagnosed with neuroborreliosis and that of healthy people. The patients obtained significantly higher results in GHQ-28 than the healthy subjects, which proves the poor mental health of the former. It was also confirmed that people diagnosed with neuroborreliosis experience difficulties in functioning in the social, professional and educational areas. Therefore, it becomes crucial to deepen research into mental health in tick-borne diseases, including neuroborreliosis, and to adapt and implement appropriate preventive and therapeutic measures. Med. Pr. 2021;72(3):259-66.