An analysis of health promotion materials for Dutch truck drivers: Off target and too complex?

What moves truck drivers? A person-centered perspective on workplace physical activity promotion

Objectives. In developing physical activity (PA) promotion measures in the workplace, individual needs of the target groups must be considered. For this reason, this study aimed to qualitatively identify the individual needs for an increase of PA in truck drivers, representing a neglected working group in terms of PA promotion. Methods. Semi-structured interviews were conducted (N = 19; mean age 50.5 years, SD 11.4 years; 10.5% female). The interview guide was based on the COM-B model to identify needs related to PA behavior in terms of capabilities, opportunities and motivation. The interviews were transcribed and coded by two independent investigators. Results. Altogether, the codes encompassed 395 statements, and the code system contained 14 codes. Three additional codes described further individual needs related to other health behaviors (nutrition, recreation) or external incentives for health interventions. Conclusion. The results reveal a variety of needs that are fundamental to the development of PA-promoting interventions for truck drivers. These needs appear to be closely linked, so a combination of capabilities, opportunities and/or motivation should be considered when developing holistic interventions. An example would be linking automatic motivation and psychological capabilities that encompass motivational techniques combined with information for psychoeducation of truck drivers.

Exploration of the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare-The Shift-Diabetes Study: A qualitative study using the theoretical domains framework

AIM

To identify factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings.

METHODS

Semi-structured qualitative interviews based on the theoretical domains framework (TDF) were conducted with a convenience sample (n = 15) of shift workers (32-59 years) diagnosed with T2D who worked night shifts as part of a mixed shift schedule. The TDF was applied to analyse transcripts using a combined deductive framework and inductive thematic analysis approach. Identified influences were mapped to the behaviour change technique taxonomy to identify potential strategies to change dietary behaviour in this context.

RESULTS

Key barriers to healthy dietary behaviours were access and cost of food available during night work (TDF domain: Environment Context and Resources). Factors identified as both enablers and barriers included: availability of staff facilities and time to take a break, (Environment Context and Resources), the physical impact of night work (Beliefs About Consequences), eating in response to stress or tiredness (Emotion), advance planning of meals/food and taking own food to work (Behavioural Regulation). Potential techniques to address these influences and improve dietary behaviour in this context include: meal planning templates, self-monitoring and biofeedback, and increasing accessibility and availability of healthier food choices during night shifts.

CONCLUSIONS

The dietary behaviour of shift workers with T2D is influenced by interacting individual, socio-cultural and environmental factors. Intervention should focus on environmental restructuring and strategies that enable monitoring and meal planning.

Effects of working conditions and safety awareness on job satisfaction of truck drivers in Korea

BACKGROUND: Truck driving is one of the occupations with high injury rates. OBJECTIVE: This study investigates the relationships between age, work experience, workdays, monthly income, perceived job risk, satisfaction of working conditions, safety awareness, and job satisfaction of truck drivers. Also, this study analyzes the effects of satisfaction of working conditions and safety awareness on the job satisfaction of truck drivers. METHODS: This study interviewed 278 truck drivers and surveyed age, work experience, workdays, monthly income, perceived job risk, satisfaction of working conditions, safety awareness, and job satisfaction. A regression analysis was performed to determine leading factors affecting safety and satisfaction and the relationships. RESULTS: The results showed that the number of workdays was related to monthly income, perceived job risk, and job satisfaction. The monthly income of truck drivers was increased according to workdays and age. Perceived job risk increased with number of days worked. Safety awareness decreased with the monthly income, and job satisfaction decreased with perceived job risk level, workdays, and work experience. Finally, job satisfaction was directly affected by satisfaction with working conditions and indirectly affected by safety awareness. CONCLUSIONS: The results suggest that an increase in satisfaction of working conditions can enhance safety awareness and job satisfaction.

Facts Tell, Stories Sell? Assessing the Availability Heuristic and Resistance as Cognitive Mechanisms Underlying the Persuasive Effects of Vaccination Narratives

Online vaccine-critical sentiments are often expressed in appealing personal narratives, whereas vaccine-supporting information is often presented in a non-narrative, expository mode describing scientific facts. In two experiments, we empirically test whether and how these different formats impact the way in which readers process and retrieve information about childhood vaccination, and how this may impact their perceptions regarding vaccination. We assess two psychological mechanisms that are hypothesized to underlie the persuasive nature of vaccination narratives: the availability heuristic (experiment 1, N = 418) and cognitive resistance (experiment 2, N = 403). The results of experiment 1 showed no empirical evidence for the availability heuristic, but exploratory analyses did indicate that an anti-vaccination narrative (vs. expository) might reduce cognitive resistance, decrease vaccination attitudes and reduce attitude certainty in a generally pro-vaccination sample, especially for those who were more vaccine hesitant. Preregistered experiment 2 formally tested this and showed that not narrative format, but prior vaccine hesitancy predicts cognitive resistance and post-reading attitudes. Hesitant participants showed less resistance toward an anti-vaccine text than vaccine-supporting participants, as well as less positive post-reading attitudes and attitude certainty. These findings demonstrate belief consistency effects rather than narrative persuasion, which has implications for scientific research as well as public health policy.

Towards targeted dietary support for shift workers with type 2 diabetes (Shift-Diabetes study): A mixed-methods case study protocol

BACKGROUND

Blood glucose is higher in people working night shifts compared to day workers. Changes to eating behaviour, activity and sleep patterns in addition to circadian disruption are likely to impact glucose management in night-shift workers with type 2 diabetes.

AIM

To investigate current dietary intake and glucose variability during night work, including barriers and facilitators to dietary behaviour in this context.

METHODS

A mixed-methods case study will be conducted. Shift workers with type 2 diabetes working in a hospital setting will be recruited to this two-part study. Part 1: 70 participants will complete a 10-day observational study collecting data on continuous glucose, diet (self-report diary), sleep and physical activity during a period covering night work, rest days and non-night workdays. Mean glucose concentration and variability, and the mean healthy diet index score, will be compared between days of night work, non-night work and rest, after adjusting for other individual factors (sleep/physical activity/demographics). Part 2: A sample (n~13) will complete semi-structured interviews based on behavioural science frameworks to explore barriers/enablers to dietary behaviour when working night shifts. This will inform a quantitative survey to explore the generalisability of interview findings.

DISCUSSION

Findings from Part 1 and 2 will be triangulated to identify potential intervention strategies to address key barriers and enablers to healthier eating, and in turn improved glucose control, in shift workers with type 2 diabetes. This will be facilitated through stakeholder consultation and application of behavioural science frameworks. Shift-Diabetes study registration: ISRCTN11764942.

Corporate Application of Health Literacy

BACKGROUND

The growing concern of low health literacy in populations combined with the interest of companies to develop cultures of health and the emerging interest in the workplace as an arena for improving health literacy is increasingly acknowledged. This study aimed to explore how companies currently apply the concept of health literacy as part of their health efforts in the work sphere.

METHODS

A systematic literature review was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. The search was performed in the databases PubMed, Science Direct, and Directory of Open Access Journals from July 2019 to August 2019 and included the search terms "health literacy," "health literate," and "health competence" combined with the search terms "company/companies," "corporation/corporates," "workplace," "business," and "organization." Studies were eligible for inclusion if they (1) were written in English or German, (2) were concerned with employers/employees, companies, corporations, or organizations, (3) dealt with health literacy in particular, and (4) were formatted as journal articles, systematic literature reviews, or book chapters.

KEY RESULTS

The search identified 20 articles. A thematic analysis resulted in 5 clusters with 2 to 3 sub-themes illustrating the characteristics of how corporations apply health literacy. The clusters entailed the conceptualization of health literacy, its measurement, and the application of health literacy in strategies, interventions, and training.

DISCUSSION

The literature review reveals that the application of health literacy by companies is in its infancy. More research and practical experience are warranted on how companies can mobilize and facilitate a health literate workforce. [HLRP: Health Literacy Research and Practice. 2021;5(3):e218-e225.] Plain Language Summary: This literature study explored the role of advancing health literacy in companies. Five aspects were identified as important, including the understanding of the concept, its measurement, and its integration into strategies, interventions, and training. The involvement of management and the staff was crucial for success.

Australian bus drivers' modifiable and contextual risk factors for chronic disease: A workplace study

INTRODUCTION

Little is known about workplace health promotion for bus drivers. Bus drivers are at-risk of chronic disease because they are exposed to the risk factor combination of poor nutrition, low levels of physical activity, high levels of sedentary time and are often overweight or obese. The purpose of this paper is to situate the quantitative baseline data collected from bus drivers within qualitative findings about the socio-cultural context of the workplace.

MATERIALS AND METHODS

Baseline data about physical activity, dietary intake and sedentary hours was collected from 58 drivers employed by a large bus company in southeast Queensland. Ten drivers and seven key workplace informants participated in interviews and discussion groups about driver health behaviours, workplace structure, culture, and resources.

RESULTS

The quantitative results of our study reveal bus drivers have a cluster of poor health behaviours-limited physical activity, lower than recommended consumption of fruit and vegetables and high levels of sitting time during working-hours-which contribute to a high prevalence of overweight and obesity and a heightened risk of chronic disease. The qualitative findings suggest there are individual and structural barriers to improving drivers' modifiable health behaviours. Individual barriers include ingrained poor habits and more pressing life concerns, while structural barriers in the context of the workplace include time constraints, shift work, long days, a lack of work amenities and a general disconnect of drivers with their workplace.

CONCLUSION

In this workplace, health promotion strategies for bus drivers should be prioritised as a means of improving drivers' health. To maximise uptake and effectiveness, these strategies should make use of existing workplace resources and consider the context of workplace health behaviour change. Further research is warranted in a broader sample of Australian bus companies to explore the context of workplace health behavior change so targeted strategies to improve bus drivers' health can be developed.

Truckies and the Australian transport industry: Managers' perspectives about enablers and inhibitors to workplace health promotion

BACKGROUND

There is little published research about managers' views about implementing and embedding workplace health promotion interventions.

OBJECTIVE

To shed light on research-to-practice challenges in implementing workplace health promotion interventions in the Australian road transport industry.

METHODS

In this Participatory Action Research project, managers from small-to-midsized companies in the Australian road transport industry were asked their views about enablers and barriers to implementing nutrition and physical activity interventions in their workplace.

RESULTS

Managers identified practical assistance with resources, ideas, and staffing as being key enablers to implementation. Barriers included time restraints, worker age and lack of interest, and workplace issues relating to costs and resources.

CONCLUSION

Manager perspectives add new insights about successful implementation of workplace health promotion. A Participatory Action Research approach allows managers to develop their own ideas for adapting interventions to suit their workplace. These findings add to a small body of knowledge about managers' views regarding implementing workplace health promotion in small-to-midsized road transport companies - a relatively unexplored group. Managers highlight the importance of time constraints and worker availability when designing interventions for the road transport industry. Managers require a good understanding of the workplaces' socio-cultural context for successful health promotion and health behaviour change.

Improving the health of workers with a low socioeconomic position: Intervention Mapping as a useful method for adaptation of the Participatory Approach

Background

Workers with a low socioeconomic position (SEP) have a higher risk for health problems and premature dropout from the workforce. Unfavorable working conditions and unhealthy behaviors are more prevalent among this group of workers. The Participatory Approach (PA), is an evidence-based method to identify and solve problems at the workplace related to health issues of the worker. Health problems among workers with a low SEP are usually caused by an interplay of problems in and outside the workplace. To solve health problems on multiple life domains for workers with a low SEP we aim to adapt this approach to a broader perspective.

Methods

An Intervention Mapping (IM) protocol was used to adapt the PA. First, a needs assessment was conducted combining literature with data from interviews and focus groups with workers with a low SEP, employers and occupational health professionals (OHPs). Based on the needs assessment a program goal and performance and change objectives were defined, which resulted in methods and practical strategies to solve problems on multiple life domains. Based on the results of these steps, the PA was adapted and an implementation and evaluation plan were developed.

Results

The needs assessment confirmed that an interplay of problems on multiple life domains affect work functioning and health of workers with a low SEP. Moreover, they perceived difficulties with solving problems or used passive or avoidant coping styles towards these problems. The program goal is to identify and solve problems on multiple life domains that affect healthy functioning at work. To achieve this workers need support from OHPs to solve problems. The PA protocol and materials were adapted using theoretical concepts of the Self-Determination Theory (SDT), which resulted in the Grip on Health intervention. For OHPs a training was developed on how to implement this intervention in practice. The intervention will be evaluated in a pilot implementation study among workers with a low SEP and other relevant stakeholders.

Conclusions

IM was a valuable tool for the adaptation of the PA to better support workers with a low SEP to improve their work functioning and health from a broader perspective.

Using Facebook for Health Promotion in "Hard-to-Reach" Truck Drivers: Qualitative Analysis

BACKGROUND

Workers in the road transport industry, and particularly truck drivers, are at increased risk of chronic diseases. Innovative health promotion strategies involving technologies such as social media may engage this "hard-to-reach" group. There is a paucity of evidence for the efficacy of social media technologies for health promotion in the Australian transport industry.

OBJECTIVE

This study analyzed qualitative data from interviews and focus group discussions to evaluate a social media health promotion intervention, the Truckin' Healthy Facebook webpage, in selected Australian transport industry workplaces.

METHODS

We engaged 5 workplace managers and 30 truck drivers from 6 transport industry organizations in developing workplace health promotion strategies, including a social media intervention, within a Participatory Action Research approach. Mixed methods, including a pre- and postintervention manager survey, truck driver survey, key informant semistructured interviews, truck driver focus groups, and focused observation, were used to evaluate the social media intervention. We asked questions about workplace managers' and truck drivers' opinions, engagement, and satisfaction with the intervention. This paper focuses on qualitative data.

RESULTS

Of the workplace managers who reported implementing the social media intervention at their workplace, all (3/3, 100%) reported satisfaction with the intervention and expressed a keen interest in learning more about social media and how it may be used for workplace health promotion and other purposes. Truck drivers were poorly engaged with the intervention because (1) many believed they were the "wrong age" and lacked the necessary skills; (2) the cost of smartphone technology was prohibitive; (3) they confined their use of social media to nonwork-related purposes; and (4) many workplaces had "no Facebook" policies.

CONCLUSIONS

The use of social media as a health promotion intervention in transport industry workplaces has potential. Workplace interventions using social media can benefit from a Participatory Action Research approach. Involving managers and workers in the design of social media health promotion interventions and developing strategies to support and deliver the interventions helps to facilitate their success. The workers' profile, including their age and familiarity with social media, and work, workplace, and family context is important to consider in this process. Much more research needs to be undertaken to better understand the effective use of social media to engage "hard-to-reach" groups.

Storybridging: Four steps for constructing effective health narratives

OBJECTIVE

To develop a practical step-by-step approach to constructing narrative health interventions in response to the mixed results and wide diversity of narratives used in health-related narrative persuasion research.

METHOD

Development work was guided by essential narrative characteristics as well as principles enshrined in the Health Action Process Approach.

RESULTS

The 'storybridging' method for constructing health narratives is described as consisting of four concrete steps: (a) identifying the stage of change, (b) identifying the key elements, (c) building the story, and (d) pre-testing the story. These steps are illustrated by means of a case study in which an effective narrative health intervention was developed for Dutch truck drivers: a high-risk, underprivileged occupational group.

CONCLUSION

Although time and labour intensive, the Storybridging approach suggests integrating the target audience as an important stakeholder throughout the development process. Implications and recommendations are provided for health promotion targeting truck drivers specifically and for constructing narrative health interventions in general.