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Damen MAW, Detaille SI, Engels JA, De Lange AH. Perceived Factors Influencing Blue-Collar Workers' Participation in Worksite Health Promotion Programs in Freight Transport: A Qualitative Investigation Using the TDF and COM-B. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:116. [PMID: 38276810 PMCID: PMC10815228 DOI: 10.3390/ijerph21010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
Blue-collar workers in the freight transport industry report a high risk of developing chronic diseases, partly due to an unhealthy lifestyle. Worksite health promotion programs (WHPPs) may be able to promote a healthier lifestyle, but participation among blue-collar workers in these programs is generally lower than among other workers. The current study aimed to further examine factors that can explain participation of blue-collar workers in these programs. A pragmatic, qualitative study was conducted, and semi-structured interviews were held with 32 blue-collar workers in freight transport in the Netherlands (94% men, 81% driver, mean age 48 (SD = 11)). The interview guide was based on the Theoretical Domains Framework (TDF) and Capability-Opportunity-Motivation-Behavior (COM-B) model, and was used to assess perceived determinants that influence participation. A combination of framework analysis and thematic analysis was conducted, which yielded the following nine main themes: (i) not being aware of WHPPs on offer, (ii) no clear picture of what to expect, (iii) (not) giving priority to health, (iv) expecting feedback and practical support, (v) being open and ready to change, (vi) preferring to be self-dependent, (vii) being offered a practical, fun and joint WHPP, (viii) having an employer who cares, thinks along and facilitates participation, and (ix) working and living in an environment in which a healthy lifestyle is not the norm. With these insights we were able to formulate recommendations to enhance the participation of blue-collar workers in WHPPs.
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Affiliation(s)
- Marc A. W. Damen
- Faculty of Psychology, Open Universiteit, P.O. Box 2960, 6401 DL Heerlen, The Netherlands
- School of Organization and Development, Han University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, The Netherlands
| | - Sarah I. Detaille
- School of Organization and Development, Han University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, The Netherlands
| | - Josephine A. Engels
- School of Organization and Development, Han University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, The Netherlands
| | - Annet H. De Lange
- Faculty of Psychology, Open Universiteit, P.O. Box 2960, 6401 DL Heerlen, The Netherlands
- Faculty of Social Sciences, Hotel School of Management, University of Stavanger, P.O. Box 8600, 4036 Stavanger, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
- Department of Psychology, Campus de A Coruña, Universidade da Coruña, 15701 A Coruña, Spain
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ElSayed NA, Bannuru RR, Bakris G, Bardsley J, de Boer IH, Gabbay RA, Gockerman J, McCoy RG, McCracken E, Neumiller JJ, Pilla SJ, Rhee CM. Diabetic Kidney Disease Prevention Care Model Development. Clin Diabetes 2023; 42:274-294. [PMID: 38694240 PMCID: PMC11060626 DOI: 10.2337/cd23-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
More than one-third of people with diabetes develop diabetic kidney disease (DKD), which substantially increases risks of kidney failure, cardiovascular disease (CVD), hypoglycemia, death, and other adverse health outcomes. A multifaceted approach incorporating self-management education, lifestyle optimization, pharmacological intervention, CVD prevention, and psychosocial support is crucial to mitigate the onset and progression of DKD. The American Diabetes Association convened an expert panel to develop the DKD Prevention Model presented herein. This model addresses prevention and treatment, including screening guidelines, diagnostic tools, and management approaches; comprehensive, holistic interventions; well-defined roles for interdisciplinary health care professionals; community engagement; and future directions for research and policy.
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Affiliation(s)
- Nuha A. ElSayed
- American Diabetes Association, Alexandria, VA
- Harvard Medical School, Boston, MA
| | | | - George Bakris
- Department of Medicine, American Heart Association Comprehensive Hypertension Center, University of Chicago School of Medicine, Chicago, IL
| | - Joan Bardsley
- MedStar Health Research Institute and MedStar System Nursing, Columbia, MD
| | - Ian H. de Boer
- Division of Nephrology, University of Washington School of Medicine, Seattle, WA
| | | | | | - Rozalina G. McCoy
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, University of Maryland Institute for Health Computing, Rockville, MD
| | | | - Joshua J. Neumiller
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA
- Providence Medical Research Center, Providence Health Care, Spokane, WA
| | - Scott J. Pilla
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Connie M. Rhee
- Division of Nephrology, Hypertension, and Kidney Transplantation, University of California Irvine School of Medicine, Irvine, CA
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Hassen HY, Sisay BG, Van Geertruyden JP, Le Goff D, Ndejjo R, Musinguzi G, Abrams S, Bastiaens H. Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis. Public Health Nutr 2023; 26:2480-2491. [PMID: 37191001 DOI: 10.1017/s1368980023000976] [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: 05/17/2023]
Abstract
OBJECTIVE We aimed to synthesise available evidence on the effects of community-based interventions in improving various dietary outcome measures. DESIGN Systematic review and meta-analysis. SETTING We searched databases including Medline, EMBASE, PSYCINFO, CINAHL and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis. PARTICIPANTS A total of fifty-one studies, thirty-three randomised and eighteen non-randomised, involving 100 746 participants were included. RESULTS Overall, thirty-seven studies found a statistically significant difference in at least one dietary outcome measure favouring the intervention group, whereas fourteen studies found no statistically significant difference. Our meta-analyses indicated that, compared with controls, interventions were effective in decreasing daily energy intake (MJ/d) (mean difference (MD): -0·25; 95 % CI: -0·37, -0·14), fat % of energy (MD: -1·01; 95 % CI: -1·76, -0·25) and saturated fat % of energy (MD: -1·54; 95 % CI: -2·01, -1·07). Furthermore, the interventions were effective in improving fibre intake (g/d) (MD: 1·08; 95 % CI: 0·39, 1·77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes. CONCLUSION This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimise dietary risk factors, which in turn decrease morbidity and mortality due to CVD and other non-communicable diseases.
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Affiliation(s)
- Hamid Y Hassen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
| | - Binyam G Sisay
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jean-Pierre Van Geertruyden
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
| | - Delphine Le Goff
- Department of General Practice, University of Western Brittany, Brest, France
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda
| | - Steven Abrams
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Hilde Bastiaens
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp2610, Belgium
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van de Ven D, Schuring M, Kouwenhoven-Pasmooij TA, Blom P, Burdorf A, Robroek SJW. Reach and effectiveness of a worksite health promotion program combining a preventive medical examination with motivational interviewing; a quasi-experimental study among workers in low socioeconomic position. BMC Public Health 2023; 23:2130. [PMID: 37904106 PMCID: PMC10617210 DOI: 10.1186/s12889-023-16908-w] [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: 07/25/2022] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND This study aimed to evaluate individual characteristics associated with participation and effectiveness of a worksite health promotion program with motivational interviewing targeting health and health behaviour among Dutch workers in low socioeconomic position. METHODS In a production company and a hospital, 838 workers were invited for a Preventive Medical Examination and subsequent coaching with motivational interviewing up to 7 sessions within 6 months. Follow-up information was collected after 6 months. Characteristics associated with participation in coaching were assessed with logistic regression models. The effectiveness of coaching on body mass index (BMI), bodyweight, self-rated health, vigorous physical activity, smoking, alcohol intake, fruit- and vegetable consumption, work ability, and sickness absence was evaluated with linear regression models and on participation in health promotion activities with logistic regression analysis. The analyses on effectiveness were performed without and with propensity score adjustment. RESULTS Of the 838 invited workers, 313 workers participated in the Preventive Medical Examination and follow-up data were available for 176 workers, of whom 100 workers with increased cardiovascular risk attended coaching. The majority of workers with obesity (73%), overweight (60%), and unhealthy behaviours (58%-69%) at baseline participated in motivational interviewing. Males, workers with overweight or obesity, workers at the production company, workers with insufficient vigorous physical activity, and workers with a low educational level were most likely to participate in coaching. Coaching with motivational interviewing after the Preventive Medical Examination was associated with a 4.74 times higher likelihood [95% confidence interval (CI): 1.99;11.32] to participate in health promotion activities and 10.9% (95%CI: 0.6;21.3) more persons who quit smoking compared to workers without coaching. No statistically significant effects were observed on BMI, bodyweight, health, health behaviour, work ability and sickness absence. CONCLUSIONS The program combining a Preventive Medical Examination with follow-up coaching reached - as intended - workers with obesity or overweight, those with a low education and with unhealthy behaviours. Adding coaching with motivational interviewing to a Preventive Medical Examination contributed to higher participation in health promotion activities and an increase in smoking cessation after 6 months among workers with a lower socioeconomic position, but was not effective on other outcomes. TRIAL REGISTRATION The study was registered retrospectively in the Netherlands Trial Register as NL8178 on 22/11/2019.
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Affiliation(s)
- David van de Ven
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | | | - Philip Blom
- Health Centre Zwolle, Zwolle, the Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
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Damen MAW, Detaille SI, Robroek SJW, Engels JA, de Lange AH. Factors associated with blue-collar workers' participation in Worksite Health Promotion Programs: a scoping literature review. Health Promot Int 2023; 38:daad052. [PMID: 37379570 DOI: 10.1093/heapro/daad052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
A growing number of employers implement worksite health promotion programs (WHPPs). In particular, blue-collar workers may benefit from these WHPPs. However, they are less likely than other workers to participate and little is known about which factors affect their participation. The aim of this scoping literature review is to produce an overview of studies on factors associated with blue-collar workers' participation in WHPPs. Five databases were searched: BSU, PsycINFO, Medline, Web of Science and CINAHL. The review included peer-reviewed empirical studies on determinants associated with blue-collar workers' participation in WHPPs. Factors were extracted and categorized. Similar determinants were clustered and the direction of the associations was further examined. Nineteen papers describing 11 qualitative and 4 quantitative studies met the eligibility criteria. Seventy-seven determinants were analyzed (in quantitative studies) or reported (in qualitative studies). In most studies, only participant characteristics were investigated. Participation may be enhanced by addressing needs, tailoring from a broad range of activities, offering group activities, requiring little effort and commitment at the start, using incentives, leading by example and combining WHPPs with occupational safety interventions. WHPPs seem to be able to reach blue-collar workers, but it remains particularly challenging to reach shift workers and those who do not yet experience health complaints.
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Affiliation(s)
- Marc A W Damen
- School of Organisation and Development, Han University of Applied Sciences, PO Box 6960, 6503 GL Nijmegen, the Netherlands
- Faculty of Psychology, Open Universiteit, PO Box 2960, 6401 DL, Heerlen, the Netherlands
| | - Sarah I Detaille
- School of Organisation and Development, Han University of Applied Sciences, PO Box 6960, 6503 GL Nijmegen, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Josephine A Engels
- School of Organisation and Development, Han University of Applied Sciences, PO Box 6960, 6503 GL Nijmegen, the Netherlands
| | - Annet H de Lange
- Faculty of Psychology, Open Universiteit, PO Box 2960, 6401 DL, Heerlen, the Netherlands
- Faculty of Social Sciences, Hotel School of Management, University of Stavanger, PO Box 8600, 4036, Stavanger, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), NO-7491, Trondheim, Norway
- Department of Psychology, University of Coruña, 15701, A Coruña, Spain
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Poznańska A, Lewtak K, Wojtyniak B, Stokwiszewski J, Moskalewicz B. Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4402. [PMID: 36901412 PMCID: PMC10002111 DOI: 10.3390/ijerph20054402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Effective lifestyle health promotion interventions require the identification of groups sharing similar behavioural risk factors (BRF) and socio-demographic characteristics. This study aimed to identify these subgroups in the Polish population and check whether local authorities' health programmes meet their needs. Population data came from a 2018 question survey on a random representative sample of 3000 inhabitants. Four groups were identified with the TwoStep cluster analysis method. One of them ("Multi-risk") differed from the others and the general population by a high prevalence of numerous BRF: 59% [95% confidence interval: 56-63%] of its members smoke, 35% [32-38%] have alcohol problems, 79% [76-82%] indulge in unhealthy food, 64% [60-67%] do not practice recreational physical activity, and 73% [70-76%] are overweight. This group, with an average age of 50, was characterised by an excess of males (81% [79-84%]) and people with basic vocational education (53% [50-57%]). In 2018, only 40 out of all 228 health programmes in Poland addressed BRF in adults; only 20 referred to more than one habit. Moreover, access to these programmes was limited by formal criteria. There were no programmes dedicated to the reduction of BRF exclusively. The local governments focused on improving access to health services rather than on a pro-health change in individual behaviours.
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Affiliation(s)
- Anna Poznańska
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland
- Department of Health Promotion and Chronic Diseases Prevention, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland
| | - Bogdan Wojtyniak
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
| | - Jakub Stokwiszewski
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
| | - Bożena Moskalewicz
- Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
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Crane MM, Newman K, Hebert-Beirne J, Abril EP, Powell LH, Appelhans BM. Weight Loss Program Preferences of Men Working in Blue-Collar Occupations: A Qualitative Inquiry. Am J Mens Health 2022; 16:15579883221117932. [PMID: 36154524 PMCID: PMC9515537 DOI: 10.1177/15579883221117932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Men who work in blue-collar occupations (skilled and unskilled trades) experience high rates of obesity and comorbid conditions. This group is underrepresented in behavioral interventions for weight management, which may stem from a mismatch between the features of available programs and these men's preferences. This qualitative study explored the views of these men, their experiences with weight loss, their preferences for weight loss programs, and messaging related to these programs. We conducted remote interviews with 20 men (age: 43 ± 13 years, M ± SD) currently working in blue-collar occupations (50% construction, 25% transportation, and 25% manufacturing) who had body mass indices (BMIs) in the overweight/obese categories (BMI: 33 ± 6 kg/m2). Deductive codes and summary themes were developed and discussed by the first two authors. A selection of transcripts was reviewed following theme development to confirm accuracy of the themes. Most participants (n = 16, 80%) reported a prior weight loss attempt. The most common approaches to weight loss reported were increased exercise and following their own approach to changing diet (e.g., "eating less junk food"). For program and message preferences, two major themes emerged: participants wanted accurate and trustworthy information and wanted programs that fit their lifestyle. Results suggest that weight loss programs targeting men working in blue-collar occupations should emphasize the accuracy of information related to the program and the ease of incorporating it into participants' lifestyles. There is an urgent need to incorporate these preferences into effective programs.
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Affiliation(s)
- Melissa M. Crane
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA,Melissa M. Crane, Assistant Professor,
Department of Family and Preventive Medicine, Rush University Medical Center,
1700 W. Van Buren St., Ste 470, Chicago, IL 60612, USA.
| | - Katerina Newman
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Sciences,
School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Eulàlia P. Abril
- Department of Communication, University
of Illinois Chicago, Chicago, IL, USA
| | - Lynda H. Powell
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Bradley M. Appelhans
- Department of Family and Preventive
Medicine, Rush University Medical Center, Chicago, IL, USA
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