H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces

A Scoping Review of Prevention Classification in Mental Health: Examining the Application of Caplan's and Gordon's Prevention Frameworks (2018-2024)

Mental health prevention is a global priority owing to the increasing burden of mental disorders exacerbated by global crises such as the COVID-19 pandemic, climate change, economic instability, and armed conflicts. These crises have heightened the need for effective preventive strategies addressing mental health across different life stages and populations. To structure and classify such strategies, Caplan's and Gordon's frameworks have been widely used, with one focusing on disease progression and the other on population risk. Although both frameworks are frequently used in mental health prevention, their application in clinical trials remains unexplored. This review addresses this gap by examining how Caplan's and Gordon's frameworks have been applied in mental health prevention, identifying research gaps, and exploring their potential for their combined application to enhance prevention strategies. A scoping review was conducted following PRISMA-ScR guidelines. Studies were selected based on predefined criteria and the data were synthesized. The search spanned PubMed, Scopus, APA PsycArticles, and PubPsych, covering peer-reviewed clinical trials, including randomized controlled trials, published between 2018 and 2024 in English or German. Eligible studies classified interventions based on Caplan's framework, which focuses on disease stage (primary, secondary, tertiary), or Gordon's framework, which categorizes prevention by population risk (universal, selective, indicated). Studies had to focus on mental health prevention, include populations relevant to mental health and well-being, and report mental health or well-being outcomes. Of the 40 included studies, six applied Caplan's framework, 30 applied Gordon's framework and three used a modified classification based on Gordon's approach. One study applied both frameworks, highlighting that their complementary use is rare. Studies were conducted in 19 countries, with the highest number from Germany (n = 8), the USA (n = 8), and the Netherlands (n = 6), across four continents (Asia, n = 5; Australia, n = 5; Europe, n = 22; North America, n = 8). Gordon's framework was applied more frequently, particularly in universal (n = 15) and indicated prevention (n = 12), while Caplan's framework was used mainly in primary prevention (n = 4). Depression (n = 25), anxiety (n = 21), stress (n = 8), and general mental health (n = 8) were the most frequently assessed outcomes. The studies targeted diverse populations, including children (n = 7), adolescents (n = 8), children and adolescents (n = 1) parents and their children or adolescents (n = 2), university students (n = 6), working adults (n = 7), older adults (n = 1), and adults without specifying (n = 8). This review highlights the underutilized potential of integrating Caplan's and Gordon's frameworks in mental health interventions. Two application examples illustrate how these frameworks can be combined to structure prevention strategies more effectively. Future research should explore combining these frameworks to enhance prevention strategies and address the emerging global health challenges.

A systematic realist synthesis of digital interventions for enhancing mental health at work: contexts, mechanisms, and outcomes

BACKGROUND

Digital interventions (DIs) have emerged as promising tools for promoting mental health in the workplace. However, evidence on if, how, and under what circumstances they affect positive outcomes requires elucidation. This systematic realist review aimed to synthesize current knowledge on contexts, mechanisms, and outcomes of workplace DIs to enhance mental health at work.

METHODS

The review integrates elements of both systematic and realist review methodologies. Forty-four workplace mental health DIs studies were gathered through a systematic electronic search using PsycNet, Scopus, Web of Science, and PubPsych.

RESULTS

Results showed that demographics, previous mental health, and personal skills were the main individual context factors influencing the success of DIs. Key mechanisms were DIs usage, frequency, adherence, and relevance of content triggering positive perceptual shifts. Results showed improvements in psychological resources, wellbeing, and affect. Reduced ill-health symptoms were also evidenced. Five propositions were developed on the contexts and mechanisms under which digital interventions yield positive outcomes for mental health at work.

CONCLUSIONS

This study highlights several areas where future research can expand our understanding of DIs in the workplace by examining interactions between mechanisms and cultural aspects influencing implementation.

An exploratory examination of the symptoms of moral injury and posttraumatic growth in veterinary professionals following exposure to potentially morally injurious events

Through their occupational role, veterinary professionals are regularly exposed to potentially morally injurious events (PMIEs). These events can elicit negative (pathogenic) psychological outcomes of moral distress. However, PMIEs can also result in positive (salutogenic) outcomes of posttraumatic growth. Both outcomes are characterised by specific symptomology that is suggestive of a pathogenic or salutogenic trajectory. This study employed data from 194 veterinary professionals from Australia and New Zealand and sought to examine symptoms experienced by professionals following exposure to PMIEs. Respondents reported more symptoms of moral distress than posttraumatic growth following PMIE exposure. Negative symptoms included both affective and work-related factors including consideration of leaving the profession, while positive factors included increased confidence, personal growth, and staff cohesion. Potential factors contributing to the disparity in salutogenic and pathogenic outcomes are discussed. An integrated approach comprising both individual- and organisation-level factors is recommended to facilitate more salutogenic outcomes for veterinary professionals following PMIE exposure.

Workplace mental health promotion in a large state organization: Perceived needs, expected effects, neglected side effects

Background

Work ability and mental health in the workplace is increasingly promoted in terms of workplace health management. In order to select suitable interventions at work in a concrete context, employees and managers of a large state organization (science and development sector) were asked about perceived needs, desired effects and possible side effects of health promotion interventions.

Methods

13 semi-structured interviews with managers and three focus group interviews with employees ( N = 20) were conducted in autumn 2020 by a behavior therapist in training. The evaluation was carried out by a qualitative content analysis of the interview transcripts according to a deductive procedure and was checked by two independent raters.

Results

Most frequently, need was expressed for individual case counselling by a health expert due to the diversity of work-related problems. Managers would like to see more health-related leadership training, and a review of the various communication channels of their organization. Expected positive effects are increased self-efficacy, higher person-job-fits and reduced absenteeism. Side effects were mentioned, such as confusion of health management activities with therapy, or sensitization effects when speaking too much about mental health in mentally healthy teams. Lack of competence with the topic of mental health was mentioned as a reason for non-participation in mental health promotion activities.

Conclusions

The role of managers in relation to mental health needs to be more defined. Side effects related to mental health activities should be considered in evaluations. Selection of health interventions should depend on the concrete needs of the organization.

Effectiveness of an online text-based stress management program for employees who work in micro- and small-sized enterprises: A randomized controlled trial

Background

Internet psychoeducational interventions improve employees' mental health. However, implementing them for employees in micro- and small-sized enterprises (MSEs) is challenging.

Objectives

This randomized controlled trial examined the effectiveness of a fully automated text-based stress management program, "WellBe-LINE," in improving mental health and job-related outcomes for employees in workplaces with fewer than 50 employees.

Methods

The program was developed based on stakeholder interviews and surveys of 1000 employees at MSEs. Adult full-time employees at an enterprise with fewer than 50 employees were recruited from registered members of a web survey company in Japan. Participants were randomly allocated to the intervention or control group (1:1). Participants in the intervention group were invited to register for the program using the LINE app. Psychological distress measured by Kessler 6 (K6) was a primary outcome, with self-administrated questionnaires at baseline, 2-month (post), and 6-month follow-ups. A mixed model for repeated measures conditional growth model analysis was conducted using a group ∗ time interaction as an intervention effect. Implementation outcomes were measured through implementation outcome scales for digital mental health (iOSDMH).

Results

1021 employees were included in this study. No significant effects were shown in any outcome. The reported implementation outcomes were positively evaluated, with 80 % acceptability, 86 % appropriateness, and feasibility (ease of understanding the contents [88 %], frequency [86 %], and length of content [86 %]).

Conclusions

A simple text-message program for employees at MESs was acceptable, appropriate, and feasible; however, it did not result in improved mental health or job-related outcomes.

Trial registration

UMIN clinical trial registration: UMIN000050624 (registration date: March 18, 2023).

The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review

OBJECTIVE

To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing.

METHODS

Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible.

RESULTS

We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed.

CONCLUSION

Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.

Effects and Side Effects in a Short Work Coaching for Participants with and without Mental Illness

Employees with mental illness are often the first to be unable to cope with increasingly complex psychosocial work demands. But people without mental illness can also suffer from, for example, high workload. This study compares a short coaching to stabilize work ability for employees with and without mental illness regarding coaching topics, effects on work-related resources, goal attainment, and unwanted events. Individual coaching of three sessions (problem exploration by behavior analysis, practice of new behavior, reflection) was conducted with employees from different professional fields. A medical history was taken to determine whether participants are affected by a mental disorder. All coaching was conducted by the same behavior therapist in training (L.P.W.) under the supervision of an experienced behavior therapist (B.M.). Two hundred and three coachings with three sessions were completed. In total, 103 participants did not have a mental illness (51%), and 100 participants reported a mental disorder (49%). The coaching participants with mental illness had lower initial levels of work-related capacities (more severe impairments) and coping behavior as compared to the participants without mental illness. In the pre-post comparisons, both groups achieved significant improvements in work-related coping after the coaching. There were no differences in goal attainment between both groups. While participants without mental illness reported more unwanted events in parallel to the coaching (30% reported negative developments in life), participants with mental illness reported coaching-related unwanted events (20% felt to be dependent on the coach). Coaching with an individual focus on one topic can improve work-related resources in participants with and without mental disorders. Since participants with and without mental illness experience different unwanted events in coaching, psychotherapeutic expertise is needed in order to set the right focus.

A joint training of healthcare line managers and health and safety representatives in facilitating occupational health interventions: a feasibility study protocol for the Co-pilot project

Healthcare employees are experiencing poor wellbeing at an increasing rate. The healthcare workforce is exposed to challenging tasks and a high work pace, a situation that worsened during and after the COVID-19 pandemic. In turn, exposure to these high demands contributes to poor health, increased turnover, reduced job satisfaction, reduced efficacy, and reduced patient satisfaction and safety. Therefore, it is imperative that we identify measures to mitigate this crisis. One piece of this puzzle is how to implement sustainable tools and processes to improve the work environment of healthcare organizations. In this paper, we present the study protocol for the outlining and piloting of a joint training for pairs of healthcare line managers and their associated health and safety representatives in a Swedish healthcare organization. The objective of the training is to aid and advance the implementation of interventions to improve the work environment at the unit level. Following recommendations in the literature, the training is based on a stepwise approach that considers the specific context and focuses on the involvement of employees in creating interventions based on their needs. A central component of the training is the development of the pairs' collaboration in prioritizing, developing, implementing, and evaluating the interventions. The training is based on an on-the-job train-the-trainer approach in which participants are progressively trained during four workshops in the steps of a participatory intervention process. Between these workshops, the pairs follow the same progressive steps together with their employees to develop and implement interventions at their unit. The pilot will involve four pairs (i.e., eight participants) representing different parts and functions of the organization and will be conducted over a period of three months. We will use a mixed method design to evaluate preconditions, the process, and proximal transfer and implementation outcome factors of the training. The overall aim of the pilot is to appraise its feasibility and be able to adjust the training before a potential scale-up.

Implementing a complex mental health intervention in occupational settings: process evaluation of the MENTUPP pilot study

BACKGROUND

According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices.

OBJECTIVES

This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace.

METHOD

The Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance.

RESULTS

Factors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19.

CONCLUSIONS

The results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity.

TRIAL REGISTRATION NUMBER

ISRCTN14582090.

The influence of meaningful work on the mental health of SME employees in the COVID-19 era: can coping strategies mediate the relationship?

BACKGROUND

Stress, depression, and anxiety are prevalent issues among SME employees during the COVID-19 pandemic. Even while having meaningful work that expressively contributes to individual growth has been related to improving mental health, employees' work may also need to adopt coping strategies to increase outcomes. The purpose of this study was to examine the relationship between meaningful work (positive meaning, meaning-making, and greater good motivations) and mental health, as well as coping strategies (problem-focused and emotion-focused) as a mediator of this relationship.

METHODS

Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.

RESULTS

The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.

CONCLUSION

This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.

Does Organizational Commitment to Mental Health Affect Team Processes? A Longitudinal Study

Purpose

Team processes, such as reflexivity and participation, are critical for organizational sustainability, especially in high-reliability professions such as healthcare. However, little is known about health-related predictors of team processes. Basing our hypotheses on the Input-Process-Output (IPO) model, this study investigates the influence of perceived organizational commitment to mental health (OCMH) on healthcare workers' team reflexivity and participation via mental health-specific leadership (MHsL) and team autonomy.

Patients and Methods

The study involved 82 participants (ie, physicians, nurses, healthcare assistants, healthcare technicians, and physiotherapists) working in the Medicine, Emergency, and Neurological Departments at a large public healthcare organization in Italy. Data was gathered at 2-time points, 14 months apart.

Results

The results suggest that healthcare workers' perception of their organization's support for mental health at T1 significantly impacts team participation at T2 through MHsL and team autonomy. Likewise, the indirect effect of OCMH through MHsL and team autonomy was also significant in the model predicting team reflexivity. However, in both models, no direct relationship of OCMH on the dependent variables was found.

Conclusion

The findings highlight the importance of a mental health-supportive environment and leadership to foster team autonomy and, subsequentially, team processes, which are fundamental for performance and patient care.

Work-related causes of mental health conditions and interventions for their improvement in workplaces

Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.

Outcome assessment of a complex mental health intervention in the workplace. Results from the MENTUPP pilot study

OBJECTIVE

Multicomponent interventions are recommendable to achieve the greatest mental health benefits, but are difficult to evaluate due to their complexity. Defining long-term outcomes, arising from a Theory of Change (ToC) and testing them in a pilot phase, is a useful approach to plan a comprehensive and meaningful evaluation later on. This article reports on the pilot results of an outcome evaluation of a complex mental health intervention and examines whether appropriate evaluation measures and indicators have been selected ahead of a clustered randomised control trial (cRCT).

METHODS

The MENTUPP pilot is an evidence-based intervention for Small and Medium Enterprises (SMEs) active in three work sectors and nine countries. Based on our ToC, we selected the MENTUPP long-term outcomes, which are reported in this article, are measured with seven validated scales assessing mental wellbeing, burnout, depression, anxiety, stigma towards depression and anxiety, absenteeism and presenteeism. The pilot MENTUPP intervention assessment took place at baseline and at 6 months follow-up.

RESULTS

In total, 25 SMEs were recruited in the MENTUPP pilot and 346 participants completed the validated scales at baseline and 96 at follow-up. Three long-term outcomes significantly improved at follow-up (p < 0.05): mental wellbeing, symptoms of anxiety, and personal stigmatising attitudes towards depression and anxiety.

CONCLUSIONS

The results of this outcome evaluation suggest that MENTUPP has the potential to strengthen employees' wellbeing and decrease anxiety symptoms and stigmatising attitudes. Additionally, this study demonstrates the utility of conducting pilot workplace interventions to assess whether appropriate measures and indicators have been selected. Based on the results, the intervention and the evaluation strategy have been optimised.

Does meaningful work mediate the relationship between empowering leadership and mental health? Evidence from Malaysian SME employees

Introduction

In Malaysia, small and medium enterprises (SMEs) account for more than half of all employment and 98.7% of all businesses. There is little research on empowering behaviors in SMEs, despite leadership empowerment being often practiced. Therefore, the study aims to investigate how empowering leadership affects employees' mental health. The study also reveals meaningful work's role in mediating the relationship between empowering leadership and employees' mental health.

Methods

A stratified random sample approach was used to collect data from 516 employees of Malaysian SMEs. The data was analyzed, and the hypothesis was tested using structural equation modeling (AMOS 21.0) with bootstrap confidence intervals computed to evaluate the mediating effect.

Results

The results demonstrate that empowering leadership significantly improves employees' mental health. Furthermore, the association between empowering leadership and mental health is partially mediated by meaningful work.

Discussion

This study contributes to the present empowering leadership-meaningful work-mental health model for SME employees, which reduces stress and anxiety at the workplace and positively impacts psychological empowerment and their capacity to control their overall emotions in instances of success.

Developing a framework for evaluation: a Theory of Change for complex workplace mental health interventions

BACKGROUND

There is a gap between the necessity of effective mental health interventions in the workplace and the availability of evidence-based information on how to evaluate them. The available evidence outlines that mental health interventions should follow integrated approaches combining multiple components related to different levels of change. However, there is a lack of robust studies on how to evaluate multicomponent workplace interventions which target a variety of outcomes at different levels taking into account the influence of different implementation contexts.

METHOD

We use the MENTUPP project as a research context to develop a theory-driven approach to facilitate the evaluation of complex mental health interventions in occupational settings and to provide a comprehensive rationale of how these types of interventions are expected to achieve change. We used a participatory approach to develop a ToC involving a large number of the project team representing multiple academic backgrounds exploiting in tandem the knowledge from six systematic reviews and results from a survey among practitioners and academic experts in the field of mental health in SMEs.

RESULTS

The ToC revealed four long-term outcomes that we assume MENTUPP can achieve in the workplace: 1) improved mental wellbeing and reduced burnout, 2) reduced mental illness, 3) reduced mental illness-related stigma, and 4) reduced productivity losses. They are assumed to be reached through six proximate and four intermediate outcomes according to a specific chronological order. The intervention consists of 23 components that were chosen based on specific rationales to achieve change on four levels (employee, team, leader, and organization).

CONCLUSIONS

The ToC map provides a theory of how MENTUPP is expected to achieve its anticipated long-term outcomes through intermediate and proximate outcomes assessing alongside contextual factors which will facilitate the testing of hypotheses. Moreover, it allows for a structured approach to informing the future selection of outcomes and related evaluation measures in either subsequent iterations of complex interventions or other similarly structured programs. Hence, the resulting ToC can be employed by future research as an example for the development of a theoretical framework to evaluate complex mental health interventions in the workplace.

Sustainable Leadership, Environmental Turbulence, Resilience, and Employees' Wellbeing in SMEs

Drawing on the conservation of resources theory and contingency theories of leadership, this study aims to investigate how sustainable leadership (SL) influences employees' wellbeing (WB) through employee resilience (ER) and to examine the moderating effect of environmental turbulence (ET) on the “sustainable leadership-employees' wellbeing” relationship. Data were collected from 593 employees and 373 supervisors adopting two-wave design among small and medium-sized enterprises (SMEs) in China. The authors used structural equation modeling to empirically test the hypothesized model in this study. The research shows that SL is significantly related to the employees' WB in SMEs. Regarding mediating effect, SL also indirectly influences employees' WB through ER. Moreover, the impact of SL on employees' WB becomes more prominent in the presence of lower ET. To the best of the authors' knowledge, no prior study is available about the integrated relationship of SL, ER, ET, and employee WB.

Added value of motion capture technology for occupational health and safety innovations

Ergonomic principles in production assembly and manufacturing operations have become an essential part of comprehensive health and safety innovations. We aim to provide new insights into occupational health and safety innovations and how they utilise biomechanical methods and cutting-edge motion capture technology by assessing movements at a workplace. The practical goal is to quantify a connection between work exposure and ergonomic risk measures to determine biomechanical risk factors of diseases or health-related disorders objectively. The target group consisted of 62 factory employees working in manufacturing (26 participants on 12 devices) or assembly areas (36 participants on 9 devices). Body posture, body parts position, movements, energy cost and workloads were assessed using an inertial motion capture (MC) system. MC technology accurately assesses the operator’s movements. The proposed methodology could complement ergonomic procedures in the design of workstations, which is the added value of the motion capture technology for occupational health and safety innovations.

Understanding Polarizing Community Perspectives on Harm Reduction Strategies: Challenges to Addressing the Opioid Crisis in Appalachian Pennsylvania

Introduction

Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose

The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods

A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide and analyzed the qualitative data using an inductive grounded theory approach.

Results

Our findings illustrate how conflicting perspectives about opioid dependence lay the foundation for the polarizing community perspectives on addressing opioid use and overdose and general disagreement regarding the legitimacy of harm reduction approaches versus abstinence-based recovery plans. Community members shared varying perspectives on multiple aspects of the opioid epidemic, including appropriate strategies, treatment, and overdose prevention methods and how community leaders and organizations should respond.

Implications

Opinions, coupled with a general lack of education regarding opioid use and harm reduction options, make it challenging for small communities with limited resources to create comprehensive plans to address the opioid crisis.

New Technologies in the Workplace: Can Personal and Organizational Variables Affect the Employees' Intention to Use a Work-Stress Management App?

Organizations are interested in finding new and more effective ways to promote the well-being of their workers, to help their workers manage work-related stress. New technologies (e.g., smartphones) are cheaper, allow more workers to be reached, and guarantee their anonymity. However, not all employees agree on the use of new technological interventions for the promotion of well-being. Consequently, organizations need to investigate technological acceptance before introducing these tools. By considering the technology acceptance model (TAM) framework, we investigate both the influence of workers’ perceived usefulness and ease of use on their intentions to use apps that help them managing work stress. Moreover, we contribute to the extension of this model by considering both personal (i.e., self-efficacy, personal innovativeness) and organizational (i.e., organizational support for innovation) variables. Our research involved 251 participants who completed an online self-report questionnaire. The results confirm the central hypothesis of the TAM and the influence of other variables that could influence acceptance of new technologies, such as apps that help manage work stress, and the intentions to use them. These results could help organizations ensure technological acceptance and usage by their workers, increasing the effectiveness of new technologies and interventions to promote well-being.

Cross-Cultural Comparison of Mental Health Between German and South African Employees: Shame, Self-Compassion, Work Engagement, and Work Motivation

The negative impact of the coronavirus disease outbreak 2019 (COVID-19) on work mental health is reported in many countries including Germany and South Africa: two culturally distinct countries. This study aims to compare mental health between the two workforces to appraise how cultural characteristics may impact their mental health status. A cross-sectional study was used with self-report measures regarding (i) mental health problems, (ii) mental health shame, (iii) self-compassion, (iv) work engagement and (v) work motivation. 257 German employees and 225 South African employees have completed those scales. This study reports results following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. T-tests, correlation and regression analyses were performed. German employees had lower mental health problems and mental health shame, and higher self-compassion than South Africans. Mental health problems were positively associated with mental health shame and amotivation, and negatively associated with work engagement and intrinsic motivation in both groups. Lastly, self-compassion, a PP 2.0 construct, was the strongest predictor for mental health problems in both countries. Our results suggest (i) that German culture's long-term orientation, uncertainty avoidance and restraint may help explain these differences, and (ii) that self-compassion was important to mental health in both countries. While the levels of mental health differed between the two countries, cultivating self-compassion may be an effective way to protect mental health of employees in those countries. Findings can help inform managers and HR staff to refine their wellbeing strategies to reduce the negative impact of the pandemic, especially in German-South African organizations.