Use of Intervention Mapping for Occupational Risk Prevention and Health Promotion: A Systematic Review of Literature

Development and usability testing of an integrated geriatric care model (SMART system) to promote integrated home-based geriatric care

BACKGROUND

Although integrated care has been proposed as a promising approach to the challenges of fragmented geriatric care, a universally accepted implementation framework for integrated care for older adults living at home remains elusive. This study aimed to address the gap by developing an integrated geriatric care model (SMART system) using a knowledge-based clinical decision support system (CDSS) architecture inspired by the principle of neural reflex and evaluate the usability of the SMART system.

METHODS

The development of our SMART system was guided by the knowledge-based Clinical Decision Support System architecture and the principle of neural reflexes, which included 5 phases: (1) functional design; (2) architecture and database design; (3) security measures design; (4) user interface and visualization design; (5) prototypes development and iteratively testing. Subsequently, a cross-sectional study was conducted from December 2020 to February 2021, collecting older Chinese adults aged 60 years old and above consecutively to evaluate their usability perception of the Care Receiver App within the SMART system via the Health Information Technology Usability Evaluation Scale (Health-ITUES) version designed for older adults.

RESULTS

The SMART system consisted of a Care Receiver App, a Professional Care Provider App, and a Cloud Platform. According to the assessment results and daily monitoring data, the SMART system can diagnose care problems and tailor interventions and implementation approaches to address the multifaceted care needs of older individuals. The personalized interventions and implementation approaches generated by the SMART system, after being reviewed and adjusted by professional geriatric nurses, will be sent to the corresponding care providers to facilitate coordinated care services. A total of 110 eligible older individuals were included in the usability testing. The Care Receiver App was perceived as useful and acceptable among older individuals with the mean scores for each item of the Health-ITUES version designed for older adults exceeding 3.00.

CONCLUSIONS

This study successfully developed an integrated geriatric care model using a knowledge-based CDSS architecture inspired by the principle of neural reflex. Furthermore, the study indicated acceptable usability perception of the SMART system among older population.

TRIAL REGISTRATION

The study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR-IOR-17010368) on 12/01/2017.

Assisting Employers of Small and Medium-Sized Enterprises (SMEs) to Support Employees on Long-Term Sick-Leave: Development of a Web-Based SME Tool Using Intervention Mapping

PURPOSE

Employers of small and medium-sized enterprises (SMEs) face challenges in supporting employees on long-term sick-leave, due to limited resources and expertise available. This study aimed to develop an intervention assisting employers of SMEs in supporting long-term sick-listed employees during sick-leave and return to work (RTW).

METHODS

Intervention mapping (IM) steps 1-4 were employed to develop the intervention. For the needs assessment, 20 employers, 8 employees, 8 occupational physicians, and 9 other stakeholders were interviewed (step 1). A logic model of change was developed (step 2), followed by the identification of theoretical methods for achieving the changes required (step 3). The intervention was composed (step 4), incorporating the results of a pilot test with 4 employers, 4 employees, 4 occupational physicians, and 3 other stakeholders.

RESULTS

Identified needs (step 1) span knowledge on legislation, communication skills, stakeholder engagement, practical support, actions regarding RTW, relapse prevention, and organizational policy. Using the self-determination theory as the theoretical basis for improving employer intention and ability to support sick-listed employees (steps 2 and 3), a web-based intervention was developed (step 4) (hereafter: SME tool). The SME tool includes succinct tips, communication videos, and practical checklists. Minor adjustments were made following the pilot test, such as adding supplementary information on privacy regulations and preventive strategies.

CONCLUSION

By focusing on enhancing SME employers' intention and ability to support their long-term sick-listed employee(s), the developed SME tool has the potential to improve the satisfaction of employees with the sick-leave and RTW support of their employer during long-term sick-leave.

Trauma-Informed Professional Development: An Intervention Mapping Study

BACKGROUND AND SIGNIFICANCE

Nurses are disproportionately affected by mental and physical health problems that are a result of exposure to traumatic events in the workplace.

PURPOSE

The purpose of this study was to use intervention mapping strategies to construct interventions to address traumatic stress in nurses through trauma-informed professional development (TIPD) in a rehabilitation hospital.

DESIGN

This study used a community-based participatory research design with an intervention mapping approach. Logic models were created through input from theory, evidence from the literature, and feedback from 12 focus groups with leaders, nursing professional development practitioners, and direct-care nurses.

FINDINGS

Major themes in the logic models included safety, empowerment, peer support, and awareness. These findings were used to create specific TIPD interventions to be used with nurses in a rehabilitation hospital.

Effects of a participatory work stress prevention approach for employees in primary education: results of a quasi-experimental study

OBJECTIVE

Work stress is a serious problem for employees in primary education. This study evaluates the effects of a work stress prevention approach on emotional exhaustion and work stress determinants (job crafting behavior, quantitative and emotional demands, leadership, support, autonomy, team culture and feelings of competence), and the impact of implementation success (management commitment, employee involvement, communication during implementation) on these outcomes.

METHODS

A quasi-experimental study was conducted with an intervention group (4 schools, N=102 employees) and a control group (26 schools, N=656 employees) using questionnaires at baseline (T0), one-year (T1) and two-year (T2) follow-up. Multilevel mixed model analyses were performed to test effects of condition and implementation success on changes in emotional exhaustion and work stress determinants between T0 and T2 in the intervention and control group.

RESULTS

No effect were found for emotional exhaustion. Improvement of quality of leadership between T0 and T2 was significantly larger in the intervention compared to the control group. Additionally, implementation success was associated with a decrease in unnecessary demands and an increase in quality of leadership, team culture and job crafting behavior.

CONCLUSIONS

This study shows no direct effect of the approach on emotional exhaustion, but it does show beneficial effects on quality of leadership. Additionally, results suggest that, when successfully implemented, the approach also has beneficial effects on other work stress determinants (ie, job crafting behavior, unnecessary demands and team culture). Results indicate that - if implemented successfully - the organizational-level intervention has the potential to improve the psychosocial work context.

Planning Individual and Population-Based Interventions in Global Health: Applying the DEA-A Framework to Promote Behavioral, Emotional, and/or Cognitive Change among Stakeholders

Addressing health challenges that impact human well-being requires a comprehensive, interdisciplinary approach that would be at the crossroad of population-based prevention and individual-level clinical care, which is in line with a Global Health perspective. In the absence of a unifying theoretical framework to guide such interventions, a Dynamic Ecosystem Adaptation through the Allostasis (DEA-A) framework has been proposed, emphasizing the functional adaptation of individuals and organizations in symbiosis with their living ecosystem. While a conceptual model has been presented, this methodological contribution aims at illustrating the practical application of the DEA-A framework for planning Global Health interventions. The methodology combines Intervention Mapping and Cognitive and Behavioral Theory, extended to the ecosystem. Practical guidelines and supporting tools are provided to help public health providers and clinicians in establishing a functional ecosystem diagnosis of the issue; defining not only behavioral, but also emotional and cognitive change objectives (allostasis targets) expected for each stakeholder; and designing intervention plans targeting determinants of these allostasis. The discussion addresses implementation and evaluation perspectives of interventions based on the DEA-A framework, emphasizing the importance of considering change in its processual and ecosystem complexity. Lastly, encouragements for a deeper understanding of individual and ecosystem homeostasis/allostasis processes are made in order to promote more functional interventions.

Development of an Implementation Strategy Tailored to Deliver Evidence-Based and Person-Centred Nursing Care for Patients with Community-Acquired Pneumonia: An Intervention Mapping Approach

Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting. The implementation strategy was developed by completing the six steps of the Intervention Mapping framework: (1) developing a logic model of the problem and (2) a logic model of change by defining performance and change objectives, (3) designing implementation strategy interventions by selecting theory-based change methods, (4) planning the interventions and producing materials through a co-design approach, (5) developing a structured plan for adoption, maintenance and implementation and (6) developing an evaluation plan. This method can serve as a guide to (1) target behavioural and environmental barriers hindering the delivery of nursing care in local clinical practice, (2) support evidence uptake, (3) support RNs in the delivery of nursing care according to individual patient needs and thereby (4) optimise health-related patient outcomes.

General practitioners' stay-at-work practices in patients with musculoskeletal disorders: using Intervention Mapping to develop a training program

OBJECTIVES

To describe current stay-at-work practices among Danish general practitioners (GPs) in relation to patients with musculoskeletal disorders, to identify potential avenues for improvement, and to suggest a training program for the GPs.

DESIGN AND SETTING

We followed the principles of Intervention Mapping. Data were collected by means of literature searches, focus group interviews with GPs, and interaction with stakeholder representatives from the Danish labour market.

RESULTS

GPs' current stay-at-work practices were influenced by systemic, organisational, and legislative factors, and by personal determinants, including knowledge and skills relating to stay-at-work principles and musculoskeletal disorders, recognition of the patient's risk of long-term work disability, their role as a GP, and expectations of interactions with other stay-at-work stakeholders. GPs described themselves as important partners and responsible for the diagnostic and holistic assessments of the patient but placed themselves on the side line relying on the patient or workplace stakeholders to act. Their practices are influenced both by patients, employers, and by other stakeholders. We propose a training course for GPs that incorporate both concrete tools and behaviour change techniques.

CONCLUSIONS

We have identified varied perspectives on the roles and responsibilities of GPs, as well as legislative and organisational barriers, and proposed a training program. Not all barriers identified can be addressed by a training course, and some questions are left unanswered, among others - who are best suited to help patients staying at work?

Experiences in the application of logic models in the context of workplace health promotion - A focus group discussion

Gathering evidence on complex workplace health promotion interventions faces methodological challenges. Therefore, the application of logic models as a theory of change is recommended to support outcome and process evaluations. The present study explores challenges and opportunities of applying logic models in application-oriented intervention research on workplace health promotion. A focus group (n = 6), consisting of scientists and workplace health promotion practitioners, was conducted using a semi-structured interview guide. The recorded qualitative data were transcribed and analysed using the structuring content analysis method. According to the focus group, logic models provide several opportunities for planning and evaluating complex workplace health promotion interventions. Logic models support the communication between science and practice, and have benefits for the provider of workplace health promotion interventions. The main challenges in working with logic models were dealing with the complex and constantly developing intervention and with the derivation and implementation of reasonable evaluation methods. The focus group exposed repeated application and a shared understanding between stakeholders as facilitators for working with logic models. In conclusion, at the science-practice interface, logic models could enhance the integrative understanding and the further development of evidence-based workplace health promotion.

Scientometric evaluation of trends and global characteristics of published research on occupational public health

The objective of this scientometric study was to assess the global trends and characteristics of published occupational health research from 2016 to 2020. The SciVal tool (Elsevier) was used to perform the corresponding bibliometric analyses such as the Field-Weighted Citation Impact (FWCI), Source Normalized Impact per Paper (SNIP), CiteScore, and SCImago Journal Rank (SJR). Most of the manuscripts (46.5%) had national collaboration, with an average of 6.1 citations per paper. However, only 71 manuscripts (5.4%) presented single authorship (without collaboration). It was found that 486 manuscripts related to occupational health were published in Q2 journals (top 26-50%). Scientific publications on occupational health have increased remarkably worldwide, especially in Europe, and have mainly been published in Q1 and Q2 journals with a total of 292 and 289 scientific manuscripts in 2019 and 2020, respectively.

Strengthening supervisor support for employees with common mental health problems: developing a workplace intervention using intervention mapping

Background

This study presents the development of a workplace intervention to strengthen supervisor’s support for employees with common mental health problems (CMHP). CMHP have been increasing over the last years, resulting into negative work outcomes, such as absenteeism or reduced work performance. To date, organisational interventions have been promising in preventing these negative work outcomes, however it is yet unknown in what way the role of workplace stakeholders, in particular supervisors, can be strengthened. This study contributes to the literature of interventions on an organizational level which uses a preventative approach by promoting stay at work among employees with CMHP through supervisor support.

Methods

we applied the intervention mapping (IM) approach, by actively involving workplace stakeholders (employees with CMHP, supervisors and occupational health professionals) through the development process and the use of Integrated model of behaviour prediction for employers. All six steps of IM are followed and thematic analysis was used to analyse interviews and focus groups.

Results

Based on a comprehensive needs assessment, the intervention resulted in an online guideline, with five step-wise themes on how to support employees with CMHP to stay at work (SAW). The guideline addressed the most important and changeable actions using the Integrated model of behaviour prediction. The guideline presents how to signal and address problems in the workplace and find solutions by stimulating autonomy of employees, explore job accommodations and ask for occupational support. In addition, basic conditions on how to create mentally healthy workplaces were presented. Coaching sessions by occupational health professionals, that include practical strategies using the best available evidence, were identified by the stakeholders.

Conclusions

This SAW-Supervisor Guideline-intervention responds to the need of supervisors to be supported in their role, responsibility and ways to support employees with mental health issues, through a behaviour-oriented, preventative approach. Intervention mapping provided a systematic process to identify, structure and prioritize factors of supervisor support, resulting in a novel workplace intervention. The active involvement of workplace stakeholders throughout the process resulted into a well-received intervention. The theoretical framework provided practical ways to induce supportive behaviour of supervisors, bridging theory with practice.

An Intervention Mapping Study: Developing the Choosing Health digital weight loss and maintenance intervention (Preprint)

Background

Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are widely accessible, personalized, and theory- and evidence-based are still limited.

Objective

This study aimed to develop a digital behavior change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and use these to provide tailored support.

Methods

We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of a logic model of the problem, a model of change, intervention design and intervention production, the implementation plan, and the evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research—including 4 focus groups (n=40), expert consultations (n=12), and interviews (n=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from a variety of relevant backgrounds (including nutrition, physical activity, and the health care sector).

Results

Following a structured process, we developed a tailored intervention that has the potential to reduce excess body weight and support behavior changes in people with overweight and obesity. The Choosing Health intervention consists of tailored, personalized text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. The intervention content includes behavior change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support, and addressing physical and psychological resources.

Conclusions

The use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of the general public, we were able to map out program facilitators and barriers while increasing the ecological validity of the program to ensure that we build an intervention that is useful, user-friendly, and informative. We also summarized the lessons learned for the Choosing Health intervention development and for other health promotion programs.

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2020-040183