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Nielsen SG, Pedersen M, Toftager-Oster JU, Saervoll CA, Fischer TK, Lindegaard B, Molsted S. Feasibility and Effects of Exercise During Working Hours in Acute Hospital Staff - A Non-Randomized Controlled Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2025:10.1007/s10926-025-10275-6. [PMID: 39966325 DOI: 10.1007/s10926-025-10275-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2025] [Indexed: 02/20/2025]
Abstract
PURPOSE Workplace health interventions with exercise have positive effects on musculoskeletal pain and well-being at work, however, effectiveness is questioned due to low adherence. In hospitals participation is challenged by shiftwork and unpredictable workload. Our aim was to investigate the feasibility of exercise during working hours in an acute hospital, herein to estimate the health impact to guide management decisions on implementation. METHODS A clinical trial in a public hospital, offering staff supervised group-based individualized exercise with combined aerobic and strength training during working hours twice weekly for 20 weeks. Delivery, acceptance, and adherence were investigated. Subjective outcomes were social capital, well-being, quality of life, and musculoskeletal pain were assessed. Objective outcomes were blood pressure, body composition, and cardiorespiratory fitness. RESULTS Twenty-three percent of the employees (n = 617) accepted participation (92% female, median age was 50 years, 38% nurses). Adherence was 29% with no difference between employees with clinical versus non-clinical functions. Non-clinicians participated during working hours, while clinicians participated outside of working hours in 50% (IQR 5-87) of the sessions. Positive changes were seen in systolic and diastolic blood pressure (decreased 2.0 [0.9; 2.2] and 0.9 [0.1; 1.7] mmHG, respectively), aerobic capacity 2.3 ml/O2/min/kg [1.7; 2.9], and in waist-hip ratio, social capital, well-being, quality of life, and musculoskeletal pain. CONCLUSION Exercise during working hours in an acute hospital staff was feasible, but strategies to increase acceptance and adherence are necessary for a successful implementation. Despite low adherence, the intervention was associated with improvements of physical and mental health. REGISTRATION The study protocol has been uploaded on www. CLINICALTRIALS gov (NCT04988724).
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Affiliation(s)
- S G Nielsen
- Department of Clinical Research, Copenhagen University Hospital- North Zealand, Hillerød, Denmark.
| | - M Pedersen
- Department of Clinical Research, Copenhagen University Hospital- North Zealand, Hillerød, Denmark
| | - J U Toftager-Oster
- Department of Clinical Research, Copenhagen University Hospital- North Zealand, Hillerød, Denmark
| | | | - T K Fischer
- Department of Clinical Research, Copenhagen University Hospital- North Zealand, Hillerød, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Lindegaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Pulmonary- and Infectious Disease, Copenhagen University Hospital -North Zealand, Hillerød, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - S Molsted
- Department of Clinical Research, Copenhagen University Hospital- North Zealand, Hillerød, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Schutte M, van Mansfeld R, de Vries R, Dekker M. Determinants of compliance with infection prevention measures by physicians: a scoping review. J Hosp Infect 2024; 153:30-38. [PMID: 39214255 DOI: 10.1016/j.jhin.2024.08.011] [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] [Received: 05/31/2024] [Revised: 08/05/2024] [Accepted: 08/17/2024] [Indexed: 09/04/2024]
Abstract
Despite evidence that application of infection prevention measures can reduce healthcare-associated infections, compliance with these measures is low, especially among physicians. Intervention effects often do not sustain. An overview of determinants for physicians' infection prevention behaviour and successful behaviour change strategies is lacking. The aim of this review was to identify what determinants influence physicians' infection prevention behaviour, what strategies to improve compliance have been explored, and whether theories, models, and frameworks from implementation science have been used in these studies. A literature search was performed in PubMed, Embase, APA PsycInfo and Web of Science up to June 2nd, 2023, in collaboration with a medical information specialist. All study types focusing on infection prevention behaviour of physicians in high-income countries were included. Data on determinants and strategies was extracted; determinants were categorized into the Theoretical Domains Framework (TDF). Fifty-six articles were included. The TDF domains 'environmental context and resources', 'social influences', 'beliefs about consequences', 'memory, attention and decision-making', 'knowledge', and 'skills' were found most relevant. The prevailing determinant covers a theme outside the TDF: socio-demographic factors. Sustainable interventions are multimodal approaches that at least include feedback, education, and a champion. Theories, models, and frameworks have rarely been used to guide implementation strategy development. In conclusion, it was found that intervention studies rarely specify the determinants that they aim to address and they lack theoretical underpinning. Future initiatives should combine knowledge about determinants with implementation science to develop theory-based interventions tailored to determinants.
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Affiliation(s)
- M Schutte
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - R van Mansfeld
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - M Dekker
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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3
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Roos M, Lamontagne ME, Desmeules F, Dionne C, Savard I, Pinard AM, Lafrance S, Tanguay M, Roy JS. Workplace Injury Prevention and Wellness Program for Orchestra Musicians: A Randomized Controlled Trial. J Orthop Sports Phys Ther 2024; 54:584-593. [PMID: 39180194 DOI: 10.2519/jospt.2024.12277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
OBJECTIVE: To evaluate the effect of a workplace injury prevention and wellness program compared to no intervention (control) on musicians' playing-related musculoskeletal pain intensity. The hypothesis was that musicians who completed the program would have a greater reduction in pain intensity than the control group. DESIGN: Pragmatic parallel randomized controlled trial. METHODS: Sixty-five orchestra musicians were recruited and completed patient-reported outcome measures (primary outcome: pain intensity over 11 months, using the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians; range: 0-40; lower is better) at baseline, 14 weeks (T1), and 11 months (T2). Following baseline assessment, participants were randomly assigned to the intervention (n = 33) or control (n = 32) groups, stratified by instrument and pain prevalence. The intervention group received a 14-week injury prevention and wellness program including education and exercise; the control group received no intervention. RESULTS: Pain intensity means (standard deviation) were 7.8 (6.2), 8.0 (7.5), and 8.6 (5.7) in the control group, and 9.0 (6.6), 5.0 (4.2), and 6.7 (6.6) in the intervention group at T0, T1, and T2, respectively. Using intention-to-treat analyses (3 dropouts, n = 65 analyzed), between-group differences in pain intensity (95% confidence interval) were T1-T0: -4.2 (-7.5, -0.9); T2-T0: -3.7 (-7.1, -0.3), type III (overall) P = .03, favoring the intervention group. No adverse events were reported. CONCLUSION: A workplace injury prevention and wellness program may have a clinically meaningful effect on reducing orchestra musicians' pain intensity. J Orthop Sports Phys Ther 2024;54(9):1-10. Epub 11 June 2024. doi:10.2519/jospt.2024.12277.
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Röben T, van Oostrom S, Benning F, Smit D, Proper K. Preventive health measures in small and medium-sized enterprises: A scoping review on implementation strategies. APPLIED ERGONOMICS 2024; 119:104303. [PMID: 38714103 DOI: 10.1016/j.apergo.2024.104303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE To describe implementation strategies for preventive health measures in SMEs and the effectiveness of the strategies on implementation outcomes. METHODS A literature search was performed in multiple electronic databases. Studies published between 2000 and 2021 that evaluated the implementation of preventive health measures in SMEs were included. Classification of implementation strategies was based on two complementary classification systems. RESULTS Nineteen studies, of which 5 RCTs were included. Eighteen distinct implementation strategies were reported. All studies applied a combination of implementation strategies, and nearly all reported a positive effect on one or more implementation outcomes: sustainability, acceptability, feasibility, penetration, fidelity, adoption, and appropriateness. CONCLUSIONS Overall, a positive effect of combined implementation strategies on the implementation outcome(s) was found. The 'distribution of educational materials' and 'provide ongoing consultation' combined show positive effects on sustainability.
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Affiliation(s)
- Thomas Röben
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Sandra van Oostrom
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Friederike Benning
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Denise Smit
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Karin Proper
- Center for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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5
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Paterson C, Leduc C, Maxwell M, Aust B, Strachan H, O'Connor A, Tsantila F, Cresswell-Smith J, Purebl G, Winter L, Fanaj N, Doukani A, Hogg B, Corcoran P, D'Alessandro L, Mathieu S, Hegerl U, Arensman E, Greiner BA. Barriers and facilitators to implementing workplace interventions to promote mental health: qualitative evidence synthesis. Syst Rev 2024; 13:152. [PMID: 38849924 PMCID: PMC11157821 DOI: 10.1186/s13643-024-02569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Despite growing interest in workplace mental health interventions, evidence of their effectiveness is mixed. Implementation science offers a valuable lens to investigate the factors influencing successful implementation. However, evidence synthesis is lacking, especially for small-to-medium-sized enterprises (SMEs) and for specific work sectors. The objectives of this review are to establish the scope of research with explicit analysis of implementation aspects of workplace mental health interventions and to identify barriers and facilitators to implementation in general and within SMEs and selected sectors. METHODS A systematic scoping review and meta-synthesis of mixed methods process evaluation research from 11 databases, with the evaluation of methodological quality (MMAT) and confidence in findings (CERQual), was conducted. We selected information-rich studies and synthesised them using domains within the Nielsen and Randall implementation framework: context, intervention activities, implementation; and mental models. RESULTS We included 43 studies published between 2009 and 2022, of which 22 were rated as information-rich to be analysed for barriers and facilitators. Most studies were conducted in healthcare. Facilitators reflecting 'high confidence' included: relevant and tailored content, continuous and pro-active leadership buy-in and support, internal or external change agents/champions, assistance from managers and peers, resources, and senior-level experience and awareness of mental health issues. Healthcare sector-specific facilitators included: easy accessibility with time provided, fostering relationships, clear communication, and perceptions of the intervention. Stigma and confidentiality issues were reported as barriers overall. Due to the small number of studies within SMEs reported findings did not reach 'high confidence'. A lack of studies in construction and Information and Communication Technology meant separate analyses were not possible. CONCLUSIONS There is dependable evidence of key factors for the implementation of workplace mental health interventions which should be used to improve implementation. However, there is a lack of studies in SMEs and in a larger variety of sectors. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
- Charlotte Paterson
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | - Caleb Leduc
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK.
| | - Birgit Aust
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, 2100, Denmark
| | - Heather Strachan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Pathfoot Building, Stirling, FK9 4LA, Scotland, UK
| | | | - Fotini Tsantila
- LUCAS, Centre for Care Research and Consultancy, KU Leuven, Louvain, 3000, Belgium
| | - Johanna Cresswell-Smith
- Finnish Institute for Health and Welfare (THL) Equality Unit-Mental Health Team, Helsinki, Finland
| | - Gyorgy Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Lars Winter
- Phrenos Center of Expertise for Severe Mental Illnesses, Utrecht, the Netherlands
| | - Naim Fanaj
- Mental Health Center Prizren, Prizren, Kosovo
- Almae Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Asmae Doukani
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Bridget Hogg
- Centre Fòrum Research Unit, Institute of Mental Health, Hospital del Mar Barcelona, Barcelona, SpainHospital del Mar Research Institute, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Paul Corcoran
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
| | - Luigia D'Alessandro
- International Association for Suicide Prevention (IASP), 5221 Wisconsin Avenue NW, Washington, DC, 20015, USA
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, Brisbane, Australia
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus, Brisbane, QLD, 4122, Australia
| | - Ulrich Hegerl
- European Alliance Against Depression E.V., Leipzig, 04109, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, 60528, Germany
| | - Ella Arensman
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, Western Gateway Building, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Birgit A Greiner
- School of Public Health, University College Cork, Western Gateway Building, Cork, Ireland
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Yin M, Li H, Bai M, Liu H, Chen Z, Deng J, Deng S, Meng C, Vollaard NBJ, Little JP, Li Y. Is low-volume high-intensity interval training a time-efficient strategy to improve cardiometabolic health and body composition? A meta-analysis. Appl Physiol Nutr Metab 2024; 49:273-292. [PMID: 37939367 DOI: 10.1139/apnm-2023-0329] [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: 11/10/2023]
Abstract
The present meta-analysis aimed to assess the effects of low-volume high-intensity interval training (LV-HIIT; i.e., ≤5 min high-intensity exercise within a ≤15 min session) on cardiometabolic health and body composition. A systematic search was performed in accordance with PRISMA guidelines to assess the effect of LV-HIIT on cardiometabolic health and body composition. Twenty-one studies (moderate to high quality) with a total of 849 participants were included in this meta-analysis. LV-HIIT increased cardiorespiratory fitness (CRF, SMD = 1.19 [0.87, 1.50]) while lowering systolic blood pressure (SMD = -1.44 [-1.68, -1.20]), diastolic blood pressure (SMD = -1.51 [-1.75, -1.27]), mean arterial pressure (SMD = -1.55 [-1.80, -1.30]), MetS z-score (SMD = -0.76 [-1.02, -0.49]), fat mass (kg) (SMD = -0.22 [-0.44, 0.00]), fat mass (%) (SMD = -0.22 [-0.41, -0.02]), and waist circumference (SMD = -0.53 [-0.75, -0.31]) compared to untrained control (CONTROL). Despite a total time-commitment of LV-HIIT of only 14%-47% and 45%-94% compared to moderate-intensity continuous training and HV-HIIT, respectively, there were no statistically significant differences observed for any outcomes in comparisons between LV-HIIT and moderate-intensity continuous training (MICT) or high-volume HIIT. Significant inverse dose-responses were observed between the change in CRF with LV-HIIT and sprint repetitions (β = -0.52 [-0.76, -0.28]), high-intensity duration (β = -0.21 [-0.39, -0.02]), and total duration (β = -0.19 [-0.36, -0.02]), while higher intensity significantly improved CRF gains. LV-HIIT can improve cardiometabolic health and body composition and represent a time-efficient alternative to MICT and HV-HIIT. Performing LV-HIIT at a higher intensity drives higher CRF gains. More repetitions, longer time at high intensity, and total session duration did not augment gains in CRF.
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Affiliation(s)
- Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Hansen Li
- Department of Physical Education, Southwest University, Chongqing, China
| | - Mingyang Bai
- School of Physical Education, Sichuan Agriculture University, Yaan, China
| | - Hengxian Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Zhili Chen
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Jianfeng Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Shengji Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Chuan Meng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Yongming Li
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- China Institute of Sport Science, Beijing, China
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7
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Brown CEB, Richardson K, Halil-Pizzirani B, Atkins L, Yücel M, Segrave RA. Key influences on university students' physical activity: a systematic review using the Theoretical Domains Framework and the COM-B model of human behaviour. BMC Public Health 2024; 24:418. [PMID: 38336748 PMCID: PMC10854129 DOI: 10.1186/s12889-023-17621-4] [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: 08/26/2023] [Accepted: 12/30/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Physical activity is important for all aspects of health, yet most university students are not active enough to reap these benefits. Understanding the factors that influence physical activity in the context of behaviour change theory is valuable to inform the development of effective evidence-based interventions to increase university students' physical activity. The current systematic review a) identified barriers and facilitators to university students' physical activity, b) mapped these factors to the Theoretical Domains Framework (TDF) and COM-B model, and c) ranked the relative importance of TDF domains. METHODS Data synthesis included qualitative, quantitative, and mixed-methods research published between 01.01.2010-15.03.2023. Four databases (MEDLINE, PsycINFO, SPORTDiscus, and Scopus) were searched to identify publications on the barriers/facilitators to university students' physical activity. Data regarding study design and key findings (i.e., participant quotes, qualitative theme descriptions, and survey results) were extracted. Framework analysis was used to code barriers/facilitators to the TDF and COM-B model. Within each TDF domain, thematic analysis was used to group similar barriers/facilitators into descriptive theme labels. TDF domains were ranked by relative importance based on frequency, elaboration, and evidence of mixed barriers/facilitators. RESULTS Thirty-nine studies involving 17,771 participants met the inclusion criteria. Fifty-six barriers and facilitators mapping to twelve TDF domains and the COM-B model were identified as relevant to students' physical activity. Three TDF domains, environmental context and resources (e.g., time constraints), social influences (e.g., exercising with others), and goals (e.g., prioritisation of physical activity) were judged to be of greatest relative importance (identified in > 50% of studies). TDF domains of lower relative importance were intentions, reinforcement, emotion, beliefs about consequences, knowledge, physical skills, beliefs about capabilities, cognitive and interpersonal skills, social/professional role and identity, and behavioural regulation. No barriers/facilitators relating to the TDF domains of memory, attention and decision process, or optimism were identified. CONCLUSIONS The current findings provide a foundation to enhance the development of theory and evidence informed interventions to support university students' engagement in physical activity. Interventions that include a focus on the TDF domains 'environmental context and resources,' 'social influences,' and 'goals,' hold particular promise for promoting active student lifestyles. TRIAL REGISTRATION Prospero ID-CRD42021242170.
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Affiliation(s)
- Catherine E B Brown
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.
| | - Karyn Richardson
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | | | - Lou Atkins
- Centre for Behaviour Change, University College London, London, UK
| | - Murat Yücel
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, QLD, Australia
| | - Rebecca A Segrave
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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8
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Dabkowski E, Porter JE, Barbagallo M, Prokopiv V, Snell C, Missen K. A systematic literature review of workplace physical activity programs: an exploration of barriers and enabling factors. COGENT PSYCHOLOGY 2023. [DOI: 10.1080/23311908.2023.2186327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Affiliation(s)
- Elissa Dabkowski
- Research Fellow Collaborative Evaluation & Research Group (CERG) Federation University Australia, Churchill, Victoria, Australia
| | - Joanne E Porter
- Director of the Collaborative Evaluation & Research Group (CERG) Federation University Australia, Churchill, Victoria, Australia
| | - Michael Barbagallo
- Scholarly Teaching Fellow Institute of Health and Wellbeing Federation University Australia, Churchill, Victoria, Australia
| | - Val Prokopiv
- Research Fellow Collaborative Evaluation & Research Group (CERG) Federation University Australia, Churchill, Victoria, Australia
| | - Christopher Snell
- Program Co-ordinator Physiotherapy Institute of Health and Wellbeing Federation University Australia, Churchill, Victoria, Australia
| | - Karen Missen
- Institute of Health and Wellbeing Federation University Australia, Churchill, Victoria, Australia
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9
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Pultz CJ, Lohse TM, Justesen JB, Særvoll CA, Møller SF, Lindegaard B, Fischer TK, Dalager T, Molsted S. Implementation of Intelligent Physical Exercise Training at a Danish Hospital-A Qualitative Study of Employees' Barriers and Facilitators for Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7085. [PMID: 37998316 PMCID: PMC10671440 DOI: 10.3390/ijerph20227085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Exercise training at work has the potential to improve employees' productivity, health, and well-being. However, exercise interventions for healthcare workers in hospitals may be challenged by time pressure and the ongoing workflow with patient care. OBJECTIVE The aim was to identify barriers and facilitators for participation in exercise training during work in a hospital department. METHODS Eight semi-structured interviews of 13 individuals were conducted with hospital employees from different staff groups who participated in 12 weeks of exercise twice weekly. The data analysis was a thematic approach based on the Theoretical Domains Framework and the COM-B factors in the Behavior Change Wheel. RESULTS Barriers and facilitators varied between different groups. Barriers included limited structure, busyness, and a discouraging culture. Facilitators included gaining a feeling of community and psychological and physical well-being. Seven contextual subthemes were vital for successful implementation of exercise in a hospital setting: sharing of knowledge and information; involvement; administration and structure; culture; individualization; purpose and objective; and incentives. CONCLUSIONS The informants appreciated exercise training during work. Inpatient departments' informants found it difficult to participate in the intervention, whilst those with more administrative tasks found it easier. This study identified barriers and facilitators vital for a successful implementation of an exercise training intervention in a hospital department. The study explains how future interventions can improve reach, adoption, and implementation of exercise training interventions to hospital staffs.
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Affiliation(s)
- Christina Juul Pultz
- Department of Sports Science and Clinical Biomechanics, The Faculty of Health Science, University of Southern Denmark, 5000 Odense, Denmark; (C.J.P.); (T.M.L.); (T.D.)
| | - Thea Mundt Lohse
- Department of Sports Science and Clinical Biomechanics, The Faculty of Health Science, University of Southern Denmark, 5000 Odense, Denmark; (C.J.P.); (T.M.L.); (T.D.)
| | - Just Bendix Justesen
- Department of Sports Science and Clinical Biomechanics, Research Unit of Physical Activity and Health in Working Life, University of Southern Denmark, 5000 Odense, Denmark;
| | - Charlotte Ahlgren Særvoll
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark; (C.A.S.); (S.F.M.)
| | - Sofie Fønsskov Møller
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark; (C.A.S.); (S.F.M.)
| | - Birgitte Lindegaard
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark;
- Centre for Physical Activity Research, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark
| | - Thea K. Fischer
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark; (C.A.S.); (S.F.M.)
- Department of Public Health, University of Copenhagen, 1172 København, Denmark
| | - Tina Dalager
- Department of Sports Science and Clinical Biomechanics, The Faculty of Health Science, University of Southern Denmark, 5000 Odense, Denmark; (C.J.P.); (T.M.L.); (T.D.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark; (C.A.S.); (S.F.M.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1172 København, Denmark
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10
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Weber MB, Rhodes EC, Ranjani H, Jeemon P, Ali MK, Hennink MM, Anjana RM, Mohan V, Narayan KMV, Prabhakaran D. Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial. Implement Sci Commun 2023; 4:134. [PMID: 37957783 PMCID: PMC10642065 DOI: 10.1186/s43058-023-00516-1] [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: 07/05/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Structured lifestyle change education reduces the burden of cardiometabolic diseases such as diabetes. Delivery of these programs at worksites could overcome barriers to program adoption and improve program sustainability and reach; however, tailoring to the worksite setting is essential. METHODS The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at 11 large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, and peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. RESULTS Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add a wider variety of exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. CONCLUSION This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. TRIAL REGISTRATION Clinicaltrials.gov NCT02813668. Registered June 27, 2016.
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Affiliation(s)
- Mary Beth Weber
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Elizabeth C Rhodes
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Harish Ranjani
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Panniyammakal Jeemon
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Mohammed K Ali
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Monique M Hennink
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ranjit M Anjana
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation/Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, New Delhi, India
- Centre for Chronic Disease Control, New Delhi, India
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Weber MB, Rhodes EC, Ranjani H, Jeemon P, Ali MK, Hennink MM, Anjana RM, Mohan V, Narayan KV, Prabhakaran D. Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial. RESEARCH SQUARE 2023:rs.3.rs-3143470. [PMID: 37577514 PMCID: PMC10418536 DOI: 10.21203/rs.3.rs-3143470/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background Delivery of proven structured lifestyle change education for reducing the burden of cardiometabolic diseases such as diabetes at worksites could overcome barriers to program adoption and improve sustainability and reach of these programs; however, tailoring to the worksite setting is essential. Methods The Integrating Diabetes Prevention in Workplaces (INDIA-WORKS) study tested the implementation and effectiveness of a multi-level program for reducing cardiometabolic disease risk factors at eleven large and diverse worksites across India. Herein, we describe and classify program adaptations reported during in-depth interviews and focus group discussions with worksite managers, program staff, peer educators involved in program delivery, and program participants and drop-outs. We used thematic analysis to identify key themes in the data and classified reported program adaptations using the FRAME classification system. Results Adaptations were led by worksite managers, peer educators, and program staff members. They occurred both pre- and during program implementation and were both planned (proactive) and unplanned (proactive and reactive). The most frequently reported adaptations to the individual-level intervention were curriculum changes to tailor lessons to the local context, make the program more appealing to the workers at the site, or add exercise options. Other content adaptations included improvements to the screening protocol, intervention scheduling, and outreach plans to tailor participant recruitment and retention to the sites. Environment-level content adaptations included expanding or leveraging healthy food and exercise options at the worksites. Challenges to adaptation included scheduling and worksite-level challenges. Participants discussed the need to continue adapting the program in the future to continue making it relevant for worksite settings and engaging for employees. Conclusion This study describes and classifies site-specific modifications to a structured lifestyle change education program with worksite-wide health improvements in India. This adds to the literature on implementation adaptation in general and worksite wellness in India, a country with a large and growing workforce with, or at risk of, serious cardiometabolic diseases. This information is key for program scale-up, dissemination, and implementation in other settings. Trial Registration Clinicaltrial.gov NCT02813668, registered June 27, 2016.
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Amatori S, Ferri Marini C, Gobbi E, Sisti D, Giombini G, Rombaldoni R, Rocchi MBL, Lucertini F, Federici A, Perroni F, Calcagnini G. Short High-Intensity Interval Exercise for Workplace-Based Physical Activity Interventions: A Systematic Review on Feasibility and Effectiveness. Sports Med 2023; 53:887-901. [PMID: 36840913 PMCID: PMC10036456 DOI: 10.1007/s40279-023-01821-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Workplace exercise interventions showed good results, but lack of time was often reported as a barrier to participation. To overcome this problem, several studies attempted to implement short high-intensity interval training (HIT) within the workplace. OBJECTIVES The aim of this systematic review is to explore the feasibility and effectiveness of HIT interventions within the workplace setting. DATA SOURCES A systematic literature search was conducted in PubMed and SPORTDiscus to identify articles related to HIT within the workplace. STUDY ELIGIBILITY CRITERIA Only interventions that consisted of HIT programmes within the workplace and tested at least one physiological, psychological, or work-related outcome were included. RESULTS Seven studies (317 participants) met the inclusion criteria. HIT interventions lasted 6-12 weeks, with a frequency of 2-4 sessions/week and a duration of 8-30 min per session. Feasibility was qualitatively investigated in four studies, with key positive aspects reported for HIT time-appeal, the sense of competence driven by individual intensity, and improved intention to exercise; five studies reported adherence rates > 80%. Small-to-large effect sizes were reported for improvements in cardiorespiratory and muscular fitness. Small-to-medium effect sizes were reported for blood parameters and health-related quality of life. CONCLUSIONS HIT interventions in the workplace showed limited effectiveness in improving health-related outcomes, while promising results regarding feasibility were reported, mainly due to the time-efficiency and the positive post-exercise psychosocial responses. However, further high-quality studies involving more participants are still needed to make firm conclusions on HIT effectiveness and feasibility compared to other types of exercise in this context.
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Affiliation(s)
- Stefano Amatori
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Erica Gobbi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy.
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Germana Giombini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Rosalba Rombaldoni
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco B L Rocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Ario Federici
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Fabrizio Perroni
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Via Dell'Annunziata 4, 61029, Urbino, Italy
| | - Giorgio Calcagnini
- Department of Economics, Social Science, and Politics, University of Urbino Carlo Bo, Urbino, Italy
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Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Maintenance effect of corrective exercises on neck-shoulder pain and workability among office workers: A 1-year follow-up. Work 2023; 75:1403-1411. [PMID: 36776092 DOI: 10.3233/wor-220493] [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: 02/12/2023] Open
Abstract
BACKGROUND While positive short-term effects from corrective exercise on neck-shoulder pain (NSP) are evident, maintenance effects after cessation of the exercise remain unknown. OBJECTIVE The objective of the present study was to assess the lasting effects of corrective exercise in NSP and workability after a year of detraining. METHODS A cohort study with 1-year follow-up was carried out in two previous training groups (n = 24) using a self-reported paper-based questionnaire, which was completed three times (baseline, 8-week exercise, and 1-year detraining). The subjects (mean±SD age: 39.0±6.4, 38.1±8.0) responded to the Visual Analogue Scale (VAS) for NSP as the primary outcome. A single validated item from the Workability Index determined workability as the secondary outcome. Between and within-group differences of the two groups were investigated using non-parametric tests, including 12 subjects in each group. RESULTS The results indicated that 8-week exercise improvements in NSP and mental and physical workability were largely maintained after one year of detraining. The lasting effects of NSP and physical and mental workability were statistically identified in 8-week and 1-year follow-ups. Nevertheless, it is noticeably warranted to adhere to the exercise program. CONCLUSION The current study indicates that a brief 8-week exercise period once per year is sufficient to reduce pain and improve workability among workers. This knowledge can make exercise interventions more feasible and cost-effective for companies aiming to improve employee health.
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Affiliation(s)
- Zohreh Yaghoubitajani
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Mehdi Gheitasi
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Bayattork
- Department of Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Oestergaard AS, Sandal LF, Smidt TF, Søgaard K. Intelligent Physical Exercise Training (IPET) in the offshore wind industry: a feasibility study with an adjusted conceptual model. Pilot Feasibility Stud 2022; 8:152. [PMID: 35870979 PMCID: PMC9308937 DOI: 10.1186/s40814-022-01106-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Good physical health and capacity is a requirement for offshore wind service technicians (WTs) who have substantial physical work demands and are exposed to numerous health hazards. Workplace physical exercise has shown promise for improving physical health and work ability among various occupational groups. Therefore, we aimed to assess the feasibility and preliminary efficacy of Intelligent Physical Exercise Training (IPET) among WTs in the offshore wind industry.
Methods
A within-subject design was used to assess the feasibility and preliminary efficacy of IPET (one hour/week individualized exercise during working hours). The intervention period was 12 weeks, with the first eight weeks performed on site as supervised or partly supervised exercise during work hours and the last four weeks planned as home-administered exercise after the seasonal offshore service period. Three assessments, T1 (six months prior to intervention start), T2 (start of intervention) and T3 (end of intervention), of physical health and capacity (self-reported and objective measurements) were conducted and the period between T1 and T2 served as a within-subject control period. Primary outcome was feasibility measured as compliance, adherence, adverse events, and participant acceptability. Descriptive statistics were used to present feasibility outcomes. Preliminary efficacy was reported as mean differences with 95% confidence intervals for health and physical capacity outcomes between T1 and T2, between T2 and T3 and between T1 and T3.
Results
All WTs at the included wind farm (n=24, age: 40 years (SD±8)) participated in the study. No serious adverse events were reported. Compliance and adherence of 95 and 80% respectively, were reached in the eight-week supervised part, but were lower when exercise was home-administered (<20%). Acceptability was high for the supervised part, with 83% indicating that the exercise program worked well and 100% that exercise should be implemented as an integrated part of the working structure. Changes in physical capacity and health indicators, such as VO2max (ml O2/kg/min) at T1 (38.6 (SD±7.2)), T2 (44.1 (SD±9)) and T3 (45.8 (SD±6.5)), may indicate seasonal fluctuations as well as improvements from the intervention.
Conclusion
On-site Intelligent Physical Exercise Training during working hours was feasible and well received among WTs in the offshore wind industry. The proceeding of larger-scale evaluation and implementation is therefore recommended.
Trial registration
ClinicalTrials.gov
(Identifier: NCT04995718). Retrospectively registered on August 6, 2021,
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Valenzuela R, Saadiq S, Cobos S, Salinas JJ. Engagement in Physical Activity Improves after Participation in Pasos Para Prevenir Cancer-An Obesity-Related Cancer Prevention Program in El Paso, Texas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11607. [PMID: 36141878 PMCID: PMC9517185 DOI: 10.3390/ijerph191811607] [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: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND This present study experimentally evaluated the Pasos Para Prevenir Cancer (PPPC) program to determine whether participation was associated with improved physical activity engagement. Evidence suggests that obesity prevention programs improve physical activity (PA) engagement and lead to healthier weights, which substantially impacts cancer and cardiometabolic disease risk. There is a shortage of knowledge on the effectiveness of programs tailored to populations along the U.S.-Mexico border. METHODS We collected demographic, nutrition, and physical activity data at baseline, 6 months, and 12 months using the Research Electronic Data Capture (REDCap) for 209 participants. We analyzed the average metabolic equivalents (METS) per week for all physical activity levels and types and the achievement of the recommended METS per week to determine the demographic characteristics most associated with a change between baseline, 6 months, and 12 months. RESULTS Light activity was the most common activity at all three points, and it slightly increased at 6 months in work settings. Subjects conducted moderate physical activity primarily at home and work, and moderate physical activity increased more compared to vigorous physical activity. CONCLUSIONS Intervention tailoring might improve PA engagement in Mexican Americans residing on the U.S.-Mexico border; however, larger studies that are more diverse are required.
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Affiliation(s)
- Roy Valenzuela
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Stefan Saadiq
- Francis Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Sandra Cobos
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Jennifer J. Salinas
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
- Francis Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
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16
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Calvo-Schimmel A, Newman SD, Sterba KR, Miaskowski C, Qanungo S. Barriers and Facilitators to Supportive Care Implementation in Advanced Disease Prostate Cancer Survivors: A Theory-Informed Scoping Review. Cancer Nurs 2022; 45:E782-E800. [PMID: 35025769 DOI: 10.1097/ncc.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individualized supportive care is recommended to manage the debilitating effects of advanced prostate cancer and its treatments. Yet, the implementation of supportive care in practice remains inconsistent. OBJECTIVE The aim of this study was to synthesize the barriers and facilitators to implementing supportive care interventions after identifying supportive care interventions for advanced prostate cancer survivors. METHODS PubMed, SCOPUS, CINAHL Complete, ProQuest, and PsycINFO were searched for relevant studies published between 2011 and 2020. Studies were included if they reported on a supportive care intervention and included a description of implementation barriers and/or facilitators. The Theoretical Domains Framework was used to characterize implementation barriers and facilitators. RESULTS Of the 620 articles identified, 13 met all prespecified inclusion criteria. Primary barriers were related to the domains of environmental context and resources (eg, limited resources), knowledge (eg, insufficient knowledge on efficacy of supportive care), and beliefs about capabilities (eg, lack of confidence in materials). Facilitators fell under environmental context and resources (partnerships with local services), reinforcement (eg, partners inclusion), and skills (eg, delivery by professionals). CONCLUSIONS This scoping review highlights barriers and facilitators that affect supportive care implementation. Future research that focuses on overcoming barriers and maximizing facilitators is needed to improve, modify, or supplement existing supportive care implementation practices. IMPLICATIONS FOR PRACTICE As the number of advanced prostate cancer survivors continues to increase, supportive care must become the standard of care. Future interventions must incorporate increased knowledge and funding, alternative delivery models, and consistent use of specialty nurses.
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Affiliation(s)
- Alejandra Calvo-Schimmel
- Author Affiliations: College of Nursing (Dr Calvo-Schimmel), Department of Nursing Operating (Drs Qanungo and Newman); and Department of Public Health Sciences (Dr Sterba), Medical University of South Carolina, Charleston; and Department of Physiological Nursing, School of Nursing, University of California, San Francisco (Dr Miaskowski)
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17
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Väänänen I, Mas-Alòs S, Vandaele F, Codina-Nadal A, Matas S, Aumatell E, De Clerk I, Puig-Ribera A. Workplace physical activity practices in real life: a scoping review of grey literature for small- and medium-sized enterprises. Eur J Public Health 2022; 32:i22-i27. [PMID: 36031820 PMCID: PMC9421405 DOI: 10.1093/eurpub/ckac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is a need to scale-up effective physical activity (PA) programmes for small- and medium-sized enterprises (SMEs), where the uptake of PA interventions is low. Identifying real-life workplace practices in PA could contribute to a better understanding of what PA programmes might be most grounded in the 'real world'. However, there is a scarcity of evidence showing what gets done. This study aimed to identify, describe and comprehensively summarize the real-life implementations of workplace PA initiatives, particularly in Europe, as a prior step to disseminating future feasible PA practices for SMEs. METHODS A scoping review of grey literature included a systematic search in the Google advanced search platform that permuted a combination of key concepts (PA, workplace, interventions/programmes), internet domains, and search operators in six different languages (Catalan, Finnish, French, Dutch, English and Spanish) between 2015 and November 2020. The analysis process was iterative, and multiple methods were used to sort, group and categorize the initiatives. RESULTS There were a total of 713 real-life workplace PA initiatives from different-sized organizations identified. These were categorized into five themes: active work and living, exercise and fitness programs, management and leadership, communication and dissemination, and facilities. Finally, feature trees showing a menu for real-life workplace PA practices were implemented. CONCLUSIONS Identifying real-life practice providing a state-of-the-art snapshot of current PA practices in workplaces, which is a starting point to better understand feasible practices in the context of small- and medium-sized workplaces.
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Affiliation(s)
- Ilkka Väänänen
- LAB University of Applied Sciences, Health Care Unit, Physical Activity and Functional Capacity Research Group, Lahti Campus, Finland
| | - Sebastià Mas-Alòs
- National Institute of Physical Education of Catalonia (INEFC), Lleida Campus, Catalonia, Spain
- University of Lleida (UdL), Human Movement Research Group, Catalonia, Spain
| | | | - Anna Codina-Nadal
- University of Vic-Central University of Catalonia, Centre for Health and Social Care Research, Sport and Physical Activity Research Group, Vic, Spain
| | - Sergi Matas
- National Institute of Physical Education of Catalonia (INEFC), Lleida Campus, Catalonia, Spain
- University of Lleida (UdL), Human Movement Research Group, Catalonia, Spain
| | - Eva Aumatell
- Open University of Catalonia, eHealth Center, Barcelona, Spain
| | - Ine De Clerk
- Artevelde University of Applied Sciences, Gent, Belgium
| | - Anna Puig-Ribera
- University of Vic-Central University of Catalonia, Centre for Health and Social Care Research, Sport and Physical Activity Research Group, Vic, Spain
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18
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Hill B, Savaglio M, Blewitt C, Ahuja K, Kandel P, Madden S, Hills AP, Skouteris H. Preconception Health in the Workplace: An Opportunity to Support Equitable Access to Education. Semin Reprod Med 2022; 40:199-204. [PMID: 35760313 DOI: 10.1055/s-0042-1750132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Preconception health is a key determinant of pregnancy and offspring outcomes, but challenges reaching people during preconception are frequently cited by health professionals. This article highlights the workplace as an important setting for promoting equitable access to preconception health-related information and education to support optimal well-being before pregnancy. Workplaces can support equitable access to education and knowledge for preconception health: (1) due to the high engagement of reproductive-age women in the workforce and (2) by reaching vulnerable or high-risk population groups who may otherwise face barriers to accessing preconception health information. Literature that explicitly investigates workplace delivery of preconception health promotion programs is scarce. However, workplace health promotion more broadly is associated with improved corporate competitiveness, productivity, and strengthened employee-employer relationships. Workplace health promotion activities may also address social determinants of health and improve employee well-being outcomes. The opportunity for workplaces to benefit from an increase in the bottom line makes workplace health promotion programs more attractive, but organizational support and stakeholder engagement are needed to facilitate the design and delivery of successful workplace preconception health education programs. Such programs have the potential to facilitate health gains for women and their families.
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Affiliation(s)
- Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Claire Blewitt
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kiran Ahuja
- School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Pragya Kandel
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Seonad Madden
- School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, University of Tasmania, Tasmania, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Mastenbroek VJEZ, Jelsma JGM, van der Ploeg HP, Stijnman DPM, Huysmans MA, van der Beek AJ, van Nassau F. Barriers and facilitators influencing the implementation of the occupational health intervention 'Dynamic Work': a qualitative study. BMC Public Health 2022; 22:947. [PMID: 35546228 PMCID: PMC9097120 DOI: 10.1186/s12889-022-13230-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sedentary behavior is associated with an increased risk of morbidity and mortality. To reduce occupational sitting time of office workers, the multi-component intervention 'Dynamic Work' was implemented in a Dutch insurance company. Although the results showed no significant reductions in sitting time, associations were found between higher levels of implementation and reductions in sitting time. Building upon these findings, this qualitative study aimed to identify barriers and facilitators from an organizational perspective for the implementation of Dynamic Work. In addition, we explored differences in barriers and facilitators between departments with a low, middle and high level of implementation. METHODS In total, eighteen semi-structured interviews were conducted with two Dynamic Work coordinators, three occupational physiotherapists who delivered the intervention, and thirteen department managers. All participants were purposively sampled. The data was coded in Atlas.ti and a thematic analysis was performed guided by The Integrated Checklist of Determinants (TICD). RESULTS Implementation factors were related to the organization; working culture and financial support facilitated implementation. Factors related to the implementing department mainly hindered implementation, i.e. lack of information at start of the project, late delivery of Dynamic Work equipment, large group sizes, employee's workload and work tasks, and an ongoing reorganization. The facilitating role of managers was experienced as both enabling and hindering. The pre-existing familiarity of the occupational physiotherapists with the departments and alignment amongst the three implementers facilitated implementation. Yet, the non-obligatory nature of the intervention as well as limited availability and technical problems of equipment did not support implementation. CONCLUSIONS Various barriers and facilitators influenced the implementation of the Dynamic Work intervention, where the key role of the department manager, late delivery of dynamic work equipment and groups sizes varied between low and high implementing departments. These results can contribute to developing and improving implementation strategies in order to increase the effectiveness of future occupational health interventions. TRIAL REGISTRATION The study protocol was registered on April 14, 2017 in the ClinicalTrials.gov Protocol Registration and Results System under registration number NCT03115645 .
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Affiliation(s)
- Victoria J E Z Mastenbroek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Dominique P M Stijnman
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.
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20
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van Dijk - Huisman HC, Raeven-Eijkenboom PH, Magdelijns FJH, Sieben JM, de Bie RA, Lenssen AF. Barriers and enablers to physical activity behaviour in older adults during hospital stay: a qualitative study guided by the theoretical domains framework. BMC Geriatr 2022; 22:314. [PMID: 35399054 PMCID: PMC8994876 DOI: 10.1186/s12877-022-02887-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Older adults admitted with an acute medical illness spent little time active during hospitalisation and this has been associated with negative health outcomes. Understanding which barriers and enablers influence the physical activity behaviour of hospitalised older adults is a first step towards identifying potentially modifiable factors and developing, evaluating and implementing targeted interventions aimed at increasing their physical activity behaviour. Using a theoretical framework has been found to be more successful in changing behaviour than using a non-theory driven approach. This study aimed to explore barriers and enablers to physical activity behaviour in older adults admitted to a hospital with an acute medical illness, as perceived by patients and healthcare professionals, and to categorise them using the Theoretical Domains Framework (TDF).
Methods
A qualitative study was conducted at a combined university and regional hospital in the Netherlands between January 2019 and February 2020. Older adults (≥70 years) admitted with an acute medical illness, and healthcare professionals (nurses, physicians, physiotherapists) were recruited using purposive sampling. Semi-structured interviews were audiotaped, transcribed and analysed using directed qualitative content analysis. Barriers and enablers to physical activity behaviour during hospitalisation were identified and coded using the TDF.
Results
Meaning saturation was determined after interviews with 12 patients and 16 healthcare professionals. A large number of barriers and enablers were identified and each categorised to 11 of the 14 domains of the TDF. The ‘Environmental Context and Resources’ domain in particular yielded many examples, and revealed that the hospital environment exerts an inactivating influence on patients.
Conclusions
The large number of identified barriers and enablers highlights the complexity of influencing older adults’ physical activity behaviour during hospitalisation. This overview of barriers and enablers to physical activity behaviour in older adults admitted to a hospital with an acute medical illness represents an initial step towards developing, evaluating and implementing theory-informed behaviour change interventions to improve hospitalised older adults’ physical activity levels. It can assist clinicians and researchers in selecting modifiable factors that can be targeted in future interventions.
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21
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Di Sebastiano KM, Lau EY, Yun L, Faulkner G. An Evaluation of a Commercialized mHealth Intervention to Promote Physical Activity in the Workplace. Front Public Health 2022; 10:740350. [PMID: 35372253 PMCID: PMC8964520 DOI: 10.3389/fpubh.2022.740350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/14/2022] [Indexed: 01/04/2023] Open
Abstract
Background UPnGO with ParticipACTION (UPnGO) was a commercialized 12-month workplace physical activity intervention, aimed at encouraging employees to sit less and move more at work. Its design took advantage of the ubiquitous nature of mobile fitness trackers and aimed to be implemented in any office-based workplace in Canada. The program was available at cost from June 2017 to April 2020. The objectives of this study are to evaluate the program and identify key lessons from the commercialization of UPnGO. Methods Using a quasi-experimental design over 3 time points: baseline, 6 months, 12 months, five evaluation indicators were measured as guided by the RE-AIM framework. Reach was defined as the number and percentage of employees who registered for UPnGO and the number and percentage of sedentary participants registered. Effectiveness was assessed through average daily step count. Adoption was determined by workplace champion and senior leadership responses to the off-platform survey. Implementation was assessed as the percentage of participants who engaged with specific program elements at the 3-evaluation time points. Maintenance was assessed by the number of companies who renewed their contracts for UPnGO. Results Reach across 17 organizations, 1980 employees participated in UPnGO, with 27% of participants identified as sedentary at baseline. Effectiveness Daily step count declined from 7,116 ± 3,558 steps at baseline to 6,969 ± 6,702 (p = <0.001) at 12 months. Adoption Workplace champion and senior leadership engagement declined from 189 to 21 and 106 to 5 from baseline to 12 months, respectively. Maintenance Two companies renewed their contracts beyond the first year. Conclusions The commercialization of UPnGO was an ambitious initiative that met with limited success; however, some key lessons can be generated from the attempt. The workplace remains an important environment for PA interventions but effective mHealth PA programs may be difficult to implement and sustain long-term.
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Affiliation(s)
- Katie M Di Sebastiano
- Department of Sport and Exercise Sciences, Durham University, Durham, United Kingdom.,Population and Physical Activity Laboratory, School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Erica Y Lau
- Vancouver Costal Health Research Centre, Centre for Clinical Epidemiology and Evaluation, Vancouver, BC, Canada.,Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lira Yun
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Guy Faulkner
- Population and Physical Activity Laboratory, School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
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22
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Andersen LL, Skovlund SV, Vinstrup J, Geisle N, Sørensen SI, Thorsen SV, Sundstrup E. Potential of micro-exercise to prevent long-term sickness absence in the general working population: prospective cohort study with register follow-up. Sci Rep 2022; 12:2280. [PMID: 35145176 PMCID: PMC8831624 DOI: 10.1038/s41598-022-06283-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 01/27/2022] [Indexed: 12/27/2022] Open
Abstract
This study assesses the potential of workplace-based micro-exercise (brief and simple exercise bouts) to prevent long-term sickness absence (LTSA) at the population level. In the Work Environment and Health in Denmark Study (2012–2018), we followed 70,130 workers from the general working population, without prior LTSA, for two years in the Danish Register for Evaluation of Marginalisation. We used Cox regression with model-assisted weights and controlled for various confounders. From 2012 to 2018, the percentage of workers in Denmark using workplace-based micro-exercise during and outside of working hours increased from 7.1 to 10.9% and from 0.8 to 1.4%, respectively. The incidence of long-term sickness absence (at least 30 days) was 8.4% during follow-up. The fully adjusted model showed reduced risk of long-term sickness absence from using micro-exercise during working hours, (HR 0.86, 95% CI 0.77–0.96), but not when used outside of working hours. If used by all workers, micro-exercise during working hours could potentially prevent 12.8% of incident long-term sickness absence cases (population attributable fraction). In conclusion, micro-exercise performed during working hours holds certain potential to prevent incident long-term sickness absence in the general working population. Large-scale implementation of workplace-based micro-exercise may represent an unexploited opportunity for public health promotion.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark. .,Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | - Sebastian V Skovlund
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Research Unit for Muscle Physiology and Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jonas Vinstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Niels Geisle
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Stig I Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,The Danish Sector Working Environment Council - Welfare & Public Administration, Copenhagen, Denmark
| | - Sannie V Thorsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
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23
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Bouma SE, van Beek JFE, Diercks RL, van der Woude LHV, Stevens M, van den Akker-Scheek I. Barriers and facilitators perceived by healthcare professionals for implementing lifestyle interventions in patients with osteoarthritis: a scoping review. BMJ Open 2022; 12:e056831. [PMID: 35105598 PMCID: PMC8808449 DOI: 10.1136/bmjopen-2021-056831] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/07/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To provide an overview of barriers and facilitators that healthcare professionals (HCPs) perceive regarding the implementation of lifestyle interventions (LIs) in patients with hip and/or knee osteoarthritis (OA). DESIGN Scoping review. DATA SOURCES The databases PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were searched from inception up to January 2021. ELIGIBILITY CRITERIA Primary research articles with a quantitative, qualitative or mixed-methods design were eligible for inclusion if they reported: (1) perceptions of primary and/or secondary HCPs (population); (2) on implementing LIs with physical activity and/or weight management as key components (concept) and (3) on conservative management of hip and/or knee OA (context). Articles not published in English, German or Dutch were excluded. DATA EXTRACTION AND SYNTHESIS Barriers and facilitators were extracted by two researchers independently. Subsequently, the extracted factors were linked to a framework based on the Tailored Implementation for Chronic Diseases checklist. RESULTS Thirty-six articles were included. In total, 809 factors were extracted and subdivided into nine domains. The extracted barriers were mostly related to non-optimal interdisciplinary collaboration, patients' negative attitude towards LIs, patients' low health literacy and HCPs' lack of knowledge and skills around LIs or promoting behavioural change. The extracted facilitators were mostly related to good interdisciplinary collaboration, a positive perception of HCPs' own role in implementing LIs, the content or structure of LIs and HCPs' positive attitude towards LIs. CONCLUSIONS Multiple individual and environmental factors influence the implementation of LIs by HCPs in patients with hip and/or knee OA. The resulting overview of barriers and facilitators can guide future research on the implementation of LIs within OA care. To investigate whether factor frequency is related to the relevance of each domain, further research should assess the relative importance of the identified factors involving all relevant disciplines of primary and secondary HCPs. PROSPERO REGISTRATION NUMBER CRD42019129348.
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Affiliation(s)
- Sjoukje E Bouma
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Juliette F E van Beek
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ron L Diercks
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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24
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Walking Engagement in Mexican Americans Who Participated in a Community-Wide Step Challenge in El Paso, TX. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312738. [PMID: 34886463 PMCID: PMC8657117 DOI: 10.3390/ijerph182312738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
In the United States, the Latinx population has the highest prevalence of physical inactivity compared with other ethnicities. Research shows that work-based physical activity interventions have been widely implemented in the non-Latinx population and effectively increase physical activity in the non-Latinx population. In an effort to improve physical activity and reduce obesity among the Latinx population, we conducted 10,000 Steps for 100 Days, an employer-based walking challenge campaign, to increase walking engagement among Latinx employees located in El Paso, Texas. Participants reported their number of steps using a pedometer or smartphone. Step counts were collected at baseline, 2 weeks post challenge, and 6 months post challenge. Screenshots of the tracking device were uploaded to an online tracker. Regression analysis was conducted to identify covariates associated with baseline and 2-week and 6-month average daily steps. Generalized estimating equations (GEE) were performed to predict steps over time by demographic characteristics. Participation in the 10,000 Steps for 100 Days walking challenge was associated with a sustained increase in average daily steps. Participants with less than 7000 steps per day demonstrated the greatest increase in average daily steps (921 steps at 2 weeks; 1002.4 steps at 6 months). Demographic characteristics were not significant predictors of average steps, except that married participants had higher average steps. Participants with 10,000 or more daily steps had a 51% (p = 0.031) higher chance of having a professional occupation than a non-professional one compared to those with 7000 or fewer daily steps. We provided initial evidence that the walking challenge is an effective approach for improving physical activity in the Latinx population.
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25
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Geelen SJG, van Dijk-Huisman HC, de Bie RA, Veenhof C, Engelbert R, van der Schaaf M, Lenssen AF. Barriers and enablers to physical activity in patients during hospital stay: a scoping review. Syst Rev 2021; 10:293. [PMID: 34736531 PMCID: PMC8569983 DOI: 10.1186/s13643-021-01843-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low levels of physical activity are common during the hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during a hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during a hospital stay for acute care, using the Theoretical Domains Framework (TDF). METHODS We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO, and Cochrane Library (inception to September 2020), which included quantitative, qualitative, and mixed-methods studies reporting barriers and enablers to physical activity during a hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded, and categorized all barriers and enablers into TDF domains. RESULTS Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54). CONCLUSIONS Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during a hospital stay and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients' physical activity behavior. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation. SCOPING REVIEW REGISTRATION No protocol was registered for this review.
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Affiliation(s)
- Sven Jacobus Gertruda Geelen
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands.
| | - Hanneke Corine van Dijk-Huisman
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands.
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
| | - Robert Adriaan de Bie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Cindy Veenhof
- Physical Therapy Research, Department of Rehabilitation, Physical Therapy Sciences & Sports, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Expertise Centre Healthy Urban Living, Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Raoul Engelbert
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Marike van der Schaaf
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Antoine François Lenssen
- Department of Physical Therapy, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, 6229HX, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
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26
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Arkkukangas M, Bååthe KS, Ekholm A, Tonkonogi M. A 10-week judo-based exercise programme improves physical functions such as balance, strength and falling techniques in working age adults. BMC Public Health 2021; 21:744. [PMID: 33865349 PMCID: PMC8052647 DOI: 10.1186/s12889-021-10775-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 04/06/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Falls and fall-related injuries are major threats not only for older adults but also for younger age groups such as working-age adults. It has been shown that it is possible to reduce the risk of falls and fall-related injuries, to some extent. However, interventions aiming at reducing both the risk of falls and mitigating fall-related injuries through teaching safe falling techniques are still sparsely investigated. The aim with this study was to investigate the effect of a 10-week workplace-based judo inspired exercise programme (Judo4Balance). The measures in the study include physical functions, fall-related self-efficacy and safe falling techniques. METHODS A total of 142 working-age adults participated in this non-randomised controlled study. The participants were allocated to the Judo4Balance group (n = 79), or to a waiting list control group (n = 63). The mean age was 47 years (18-68). The recruitment period was from May 2018 to October 2019. A total of 128 participants were included in the analysis. Logistic Regression models were used to analyse the outcomes: physical function, balance and fall-related self-efficacy as well as falling techniques (backwards and forwards). RESULTS At the 10-week follow-up, the results displayed significant differences between the two groups in all measurements, except for the fall-related self-efficacy with OR = 1.8. Techniques for falling forwards and backwards displayed the highest OR = 124.1 and OR = 98.9. Physical function and balance showed OR = 3.3 and OR = 6.4. CONCLUSIONS This exercise programme under study displayed significant differences in strength, balance and safe falling techniques between the groups. It is suggested that these functions, which were studied here, can effectively be trained in working-age adults by using the Judo4Balace exercise programme. Thus, it may be beneficial to further investigate and include training in proper falling techniques when designing fall prevention exercise programmes. Furthermore, it may be a novel way of addressing fall-related injuries, which are of utmost importance to prevent in near future. TRIAL REGISTRATION NCT04294342 . Registered 4 March 2020 - The Impact of Specifically Adapted Judo-based Training Program on Risk Factors for Falls Among Adults - Full Text View - ClinicalTrials.gov.
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Affiliation(s)
- Marina Arkkukangas
- Research and Development in Sörmland, Eskilstuna, Sweden. .,Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
| | - Karin Strömqvist Bååthe
- Department of Medicine, Sport and Fitness Science, School of Education, Health and Social Studies, Högskolan Dalarna, Falun, Sweden
| | - Anna Ekholm
- Research and Development in Sörmland, Eskilstuna, Sweden
| | - Michail Tonkonogi
- Department of Medicine, Sport and Fitness Science, School of Education, Health and Social Studies, Högskolan Dalarna, Falun, Sweden
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27
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Roos M, Roy JS, Lamontagne ME. A qualitative study exploring the implementation determinants of rehabilitation and global wellness programs for orchestral musicians. Clin Rehabil 2021; 35:1488-1499. [PMID: 33853373 DOI: 10.1177/02692155211010254] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the facilitators and barriers to implementation of a pilot workplace rehabilitation and global wellness program for orchestral musicians. DESIGN Qualitative study comprising focus groups and interviews.Setting: Workplace of conservatory and orchestral musicians and administrators. PARTICIPANTS Musicians, administrators and a conductor from two professional orchestras; tertiary-level orchestral students and an administrator from a conservatory of music. INTERVENTIONS We held four focus groups and two interviews to document the perspectives of the participants concerning the implementation determinants of a pilot workplace rehabilitation and wellness program (exercises and health-related education). Meetings consisted of questions based on the Consolidated Framework for Implementation Research. Thematic content analysis was conducted using this same framework, with subcoding according to the Theoretical Domains Framework. RESULTS Fourteen musicians and five administrators participated. Results suggest that the implementation determinants for the pilot and future programs rely mainly on the Inner Setting, that is, what musicians refer to as 'the music world', specifically cultural elements such as pain beliefs (e.g. no pain no gain) and lack of resources and time (barriers). Characteristics of Individuals such as social influences amongst colleagues and beliefs about the consequences of self-care or lack thereof, and Intervention Characteristics such as complexity can be facilitators or barriers. All emerging themes have an undercurrent that lies in the Inner Setting. CONCLUSION Musicians' culture, currently a barrier, is a crucial determinant of rehabilitation and wellness program implementation in the orchestral musicians' workplace. A focus on musicians' workplace environment is necessary to optimise implementation and intervention impacts.
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Affiliation(s)
- Marianne Roos
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, QC, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, QC, Canada
| | - Marie-Eve Lamontagne
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, QC, Canada
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28
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Paterson C, Leduc C, Maxwell M, Aust B, Amann BL, Cerga-Pashoja A, Coppens E, Couwenbergh C, O’Connor C, Arensman E, Greiner BA. Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol. Syst Rev 2021; 10:41. [PMID: 33509258 PMCID: PMC7844910 DOI: 10.1186/s13643-020-01570-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. METHODS AND ANALYSIS A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall's model of organisational-level interventions and Moore's sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. DISCUSSION This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | | | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Benedikt L. Amann
- Centro Forum Research Unit, Institut de Neuropsiquiatria i Addicions (INAD), Parc de Salut Mar, Hospital del Mar Medical Research Institute (IMIM), Autonomous University Barcelona, CIBERSAM, Barcelona, Spain
| | | | - Evelien Coppens
- Centre for Health Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Cliodhna O’Connor
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Research, Griffith University, Mount Gravatt, Australia
- International Association for Suicide Prevention (IASP), Washington, DC USA
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29
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Salinas JJ, Valenzuela R, Sheen J, Carlyle M, Gay J, Morales A. An ORBIT Phase 1: Design study of a citywide employer-based walking challenges in a predominantly Mexican American metropolitan area. J Health Psychol 2020; 27:961-973. [PMID: 33345634 DOI: 10.1177/1359105320977650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Most Mexican-Americans do not meet current physical activity recommendations. This paper uses the ORBIT model of obesity intervention development as a framework to outline the process of establishing three employer-based walking challenges in El Paso, Texas, a predominantly Mexican American community. The walking challenges were planned and implemented through the Border Coalition for Fitness and participating partnering organizations. Over 2000 participants and several employers took part in the walking challenges. Results from this ORBIT Phase 1 design intervention suggest that walking challenges are a feasible approach to increase physical activity in Mexican-Americans.
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Affiliation(s)
| | - Roy Valenzuela
- Texas Tech University Health Sciences Center El Paso, TX, USA
| | - Jon Sheen
- Texas Tech University Health Sciences Center El Paso, TX, USA
| | - Malcolm Carlyle
- Texas Tech University Health Sciences Center El Paso, TX, USA
| | | | - Alma Morales
- Texas Tech University Health Sciences Center El Paso, TX, USA
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30
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Holtermann A, Straker L, Lee IM, Stamatakis E, van der Beek AJ. Workplace physical activity promotion: why so many failures and few successes? The need for new thinking. Br J Sports Med 2020; 55:650-651. [PMID: 33262108 DOI: 10.1136/bjsports-2020-103067] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Andreas Holtermann
- National Research Centre for the Working Environment, Kobenhavn, Denmark .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Leon Straker
- Curtin University, Perth, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - I-Min Lee
- Harvard Medical School, Boston, Massachusetts, USA
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC - VUMC Campus, Amsterdam, The Netherlands
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Christensen J, Larsen C, Kolind M. Managers attitude towards implementing workplace health promotion programmes to employees in eldercare: a cross-sectional study. PUBLIC HEALTH IN PRACTICE 2020; 1:100049. [PMID: 36101701 PMCID: PMC9461371 DOI: 10.1016/j.puhip.2020.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 11/08/2022] Open
Abstract
Objectives To determine the attitudes of eldercare services managers to the potential health benefits of workplace health promotion programmes (WHPPs), including physical exercise during working hours and the feasibility of implementing a WHPP at the workplace. Study design A cross-sectional study. Methods Respondents filled out a 14-item questionnaire on attitudes towards the potential health benefits of WHPPs and the feasibility of implementing WHPPs. Differences between groups were analysed using the Kruskal-Wallis test. The significance level was set to p = 0.05. Bonferroni’s correction was used in the setting of multiple comparisons. A content analysis was performed exploring answers provided in the optional comment section in the questionnaire. Results 695 eldercare services managers in Denmark were contacted by email, 393 replied, and 382 respondents were included in the analysis (54.7%). The survey revealed that 89.8% of the respondents believed that WHPPs would increase health, 89.6% believed that it would increase well-being and 87.6% believed that WHPPs would increase workability among workers. 87.7% expressed a willingness towards implementing WHPPs and believed ‘it to be a good idea’. Respondents with a negative attitude to the feasibility of implementing WHPPs, were more likely to hold negative attitudes to the potential health benefits of WHPPs (p < 0.001). Organisational issues were the most frequently stated barrier to implementation. Conclusions The majority of eldercare managers expressed a positive attitude to the benefits of WHPPs and their implementation. Addressing organisational issues and ensuring management support in the planning stage of a WHPP is highly important. Managers in eldercare are willing to implement workplace health promotion programmes (WHPPs). Managers in eldercare express that WHPPs can benefit the health of their employees. Managers in eldercare are not barriers for implementing WHPPs. Lack of knowledge on how to implement WHPPs is the prime reason for non-implementation.
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Arkkukangas M, Bååthe KS, Hamilton J, Ekholm A, Tonkonogi M. Feasibility of a novel Judo4Balance - fall preventive exercise programme targeting community-dwelling older adults. J Frailty Sarcopenia Falls 2020; 5:47-52. [PMID: 32885100 PMCID: PMC7461350 DOI: 10.22540/jfsf-05-047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 11/05/2022] Open
Abstract
Objectives: It is of utmost importance to investigate risk factors for falls and learning techniques for falling safely. Therefore, the aim of this study was to assess the feasibility of a novel judo-inspired exercise intervention for community-dwelling older adults. Methods: We included 28 participants, 60–88 years of age, in this study. In three different settings, the feasibility of carrying out a full-scale study was evaluated by the following: the study process, resource management and scientific aspects. The outcome measures evaluated were physical performance, fall related self-efficacy and fall techniques (backwards and forwards) among the older adults. Results: The intervention was judged to be feasible in the different settings used in this study. Some changes regarding duration of the intervention were suggested as being important. Significant improvements were seen in the selected outcome measures, physical performance (p=.030) and fall techniques (p=<.001). A corresponding difference was not found for fall related self- efficacy (p=.113). Conclusions: This study confirms the judo inspired exercise programme, Judo4Balance, to be a feasible intervention for active older adults. This study will provide a safe and thoroughly planned protocol for the planned study and provides indication of appropriate setting depending on the target group.
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Affiliation(s)
- Marina Arkkukangas
- Research and Development in Sörmland, Sweden.,Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Karin Strömqvist Bååthe
- School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Science, Högskolan Dalarna, Falun, Sweden
| | - Julia Hamilton
- Sabbatsbergs Department of Geriatric Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Ekholm
- Research and Development in Sörmland, Sweden
| | - Michail Tonkonogi
- School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Science, Högskolan Dalarna, Falun, Sweden
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Arkkukangas M, Strömqvist Bååthe K, Ekholm A, Tonkonogi M. Health promotion and prevention: The impact of specifically adapted judo-inspired training program on risk factors for falls among adults. Prev Med Rep 2020; 19:101126. [PMID: 32489772 PMCID: PMC7256641 DOI: 10.1016/j.pmedr.2020.101126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/24/2022] Open
Abstract
Judo-inspired exercises may be effective for learning techniques for falling safely among adults. Physical and psychological functions increase after 10 sessions of judo-inspired exercises. Judo-inspired exercises may serve as an additional measure to address risk factors for falls.
Globally, falls and fall-related injuries constitute a severe threat to public health at all ages. New approaches are warranted since existing knowledge and actions have failed to reduce the incidence of falls and fall-related injuries, both at work and during leisure time. The purpose of this quasi-experimental study was to investigate the impact of a 10-week supervised judo-inspired exercise program, Judo4Balance, provided in a workplace setting among men and women targeting: physical functions, activity level, fall-related self-efficacy, and techniques for safe landing when falling. A total of 79 adults from seven different workplaces in Sweden, mean age 45 years (18–68), participated in the program. The study was conducted from May 2018 to June 2019. The 10-week exercise program performed in a workplace setting improved physical and psychological functions, as well as techniques for falling safely, factors of great importance to prevent falls and fall-related injuries among men and women. Therefore, it is suggested that the judo-inspired exercise program may be an effective tool in the quest to promote health and prevention of risk factors for falls and fall-related injuries among those of working age.
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Affiliation(s)
- Marina Arkkukangas
- Research and Development in Sörmland, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
- Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
- Corresponding author at: Research and Development in Sörmland, Sweden.
| | - Karin Strömqvist Bååthe
- School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Science, Högskolan Dalarna, Falun, Sweden
| | - Anna Ekholm
- Research and Development in Sörmland, Sweden
| | - Michail Tonkonogi
- School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Science, Högskolan Dalarna, Falun, Sweden
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