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Klaver KM, Duijts SFA, Geusgens CAV, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Neuropsychological test performance and self-reported cognitive functioning associated with work-related outcomes in occupationally active cancer survivors with cognitive complaints. J Cancer Surviv 2024; 18:412-424. [PMID: 35776235 DOI: 10.1007/s11764-022-01223-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To assess cognitive functioning in occupationally active non-central nervous system cancer survivors with cognitive complaints using neuropsychological tests, and to investigate the association between (1) formally assessed cognitive functioning and self-reported work-related outcomes and (2) self-reported cognitive functioning at work and self-reported work-related outcomes. METHODS Baseline data of a multicenter, randomized controlled trial (n = 279) were used. Associations between neuropsychological test performance (Amsterdam Cognition Scan) and self-reported cognitive functioning (Cognitive Symptom Checklist-work) with work ability (Work Ability Index) and work functioning (Work Role Functioning Questionnaire) were examined using multivariate linear regression. RESULTS Thirty percent of cancer survivors had lower than expected performance on neuropsychological tests. Higher overall neuropsychological test performance was associated with better work ability (Cohen's f2 = 0.014) and physical functioning at work (Cohen's f2 = 0.13). Furthermore, higher motor performance was associated with better work ability (Cohen's f2 = 0.018). In addition, self-reported work-related cognitive complaints were associated with self-reported work-related outcomes (Cohen's f2 = 0.13-0.35). CONCLUSIONS The percentage of cancer survivors with lower than expected performance on neuropsychological tests exceeded the percentage expected in a normal population. This neuropsychological test performance was weakly associated with various aspects of work ability and work functioning. Stronger associations were found between self-reported cognitive functioning at work with self-reported work-related outcomes. IMPLICATIONS FOR CANCER SURVIVORS A cognitive rehabilitation approach that specifically aims at reducing cognitive symptoms at work could be a valuable part of interventions that aim to improve work-related outcomes. Trial registration The study is registered at ClinicalTrials.gov (NCT03900806) at 03 April 2019 (current status: ongoing), https://clinicaltrials.gov/ct2/show/NCT03900806?term=NCT03900806&draw=2&rank=1.
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Affiliation(s)
- Kete M Klaver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University, MC, Maastricht, The Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Brain and Cognition Group, University of Amsterdam, Amsterdam, The Netherlands.
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Klaver KM, Duijts SFA, Geusgens CAV, Kieffer JM, Agelink van Rentergem J, Hendriks MP, Nuver J, Marsman HA, Poppema BJ, Oostergo T, Doeksen A, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Internet-based cognitive rehabilitation for working cancer survivors: results of a multicenter randomized controlled trial. JNCI Cancer Spectr 2024; 8:pkad110. [PMID: 38273712 PMCID: PMC10868395 DOI: 10.1093/jncics/pkad110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Cognitive problems contribute to decline in work performance. We evaluated (1) the effectiveness of basic self-management and extensive therapist-guided online cognitive rehabilitation on attainment of individually predetermined work-related goals among occupationally active cancer survivors, and (2) whether effectiveness of the programs differed for survivors with and without formal cognitive impairment. METHODS In a 3-arm randomized controlled trial (NCT03900806), 279 non-central nervous system cancer survivors with cognitive complaints were assigned to the basic program (n = 93), the extensive program (n = 93), or a waiting-list control group (n = 93). Participants completed measurements pre-randomization (T0), 12 weeks post-randomization upon program completion (T1), and 26 weeks post-randomization (T2). Mixed-effects modeling was used to compare intervention groups with the control group on goal attainment, and on self-perceived cognitive problems, work ability, and health-related quality of life. RESULTS Participants in the extensive program achieved their predetermined goals better than those in the control group, at short- and long-term follow-up (effect size [ES] = .49; P < .001; ES = .34; P = .014). They also had fewer recovery needs after work (ES = -.21; P = .011), more vitality (ES = .20; P = .018), and better physical role functioning (ES = .0.43 P = .015) than controls. At long-term follow-up, this finding persisted for physical role functioning (ES = .42; P = .034). The basic program elicited a small positive nonsignificant short-term (not long-term) effect on goal attainment for those with adequate adherence (ES = .28, P = .053). Effectiveness of the programs did not differ for patients with or without cognitive impairment. CONCLUSIONS Internet-based therapist-guided extensive cognitive rehabilitation improves work-related goal attainment. Considering the prevalence of cognitive problems in survivors, it is desirable to implement this program.
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Affiliation(s)
- Kete M Klaver
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, Amsterdam, the Netherlands
| | - Chantal A V Geusgens
- Department of Medical Psychology, Zuyderland Medical Center, Sittard, the Netherlands
| | - Jacobien M Kieffer
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Joost Agelink van Rentergem
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, the Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Boelo J Poppema
- Department of Medical Oncology, Ommelander Hospital Group, Groningen, the Netherlands
| | - Tanja Oostergo
- Department of Medical Oncology, Diakonessenhuis Utrecht, Utrecht, the Netherlands
| | - Annemiek Doeksen
- Department of Surgery, St Antonius Hospital, Utrecht, the Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Sanne B Schagen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Re: Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health. 2022;48(2):86-98. doi:10.5271/sjweh.3993. Scand J Work Environ Health 2023; 49:231-244. [PMID: 37000459 PMCID: PMC10621902 DOI: 10.5271/sjweh.4090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 04/01/2023] Open
Abstract
Objectives Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. Methods A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. Results We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.84–1.12] and females (HR 0.97, 95% CI 0.82–1.15). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 9% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.09, 95% CI 0.82–1.43). Conclusions While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
| | | | | | | | | | | | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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4
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van Veen M, Oude Hengel KM, Schelvis RMC, Bongers PM, Ket JCF, van der Beek AJ, Boot CRL. Psychosocial work factors affecting mental health of young workers: a systematic review. Int Arch Occup Environ Health 2023; 96:57-75. [PMID: 35976432 PMCID: PMC9823059 DOI: 10.1007/s00420-022-01907-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/30/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE For the general working population, robust evidence exists for associations between psychosocial work exposures and mental health. As this relationship is less clear for young workers, this systematic review aims at providing an overview of the evidence concerning psychosocial work factors affecting mental health of young workers. METHODS The electronic databases used were PubMed, Web of Science, and PsycINFO and were last searched in October 2021. The eligible outcomes included depression-, stress-, burnout- and anxiety-related complaints, and fatigue, excluding clinical diagnoses and suicide-related outcomes. Only studies with workers aged 35 years or younger were included, which reported at least one association between a psychosocial work factor as exposure and a mental health complaint as outcome. Studies had to be in English, German or Dutch. Risk of bias was assessed using an instrument from the National Heart, Lung, and Blood Institute. Data synthesis was conducted using GRADE. RESULTS In total 17 studies were included in this systematic review, including data from 35,600 young workers in total. Across these studies 86 exposure-outcome associations were reported. Nine exposure-outcome associations could be synthesised. The application of the GRADE framework led to one "low" assessment for the association between psychosocial job quality and mental health. The certainty of evidence for the other eight associations in the synthesis was very low. CONCLUSIONS The current systematic review disclosed a high degree of uncertainty of the evidence due to conceptually fuzzy outcomes and exposures as well as large heterogeneity between studies.
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Affiliation(s)
- Malte van Veen
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands. .,Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands. .,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands. .,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands.
| | - Karen M. Oude Hengel
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands
| | - Roosmarijn M. C. Schelvis
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam UMC, location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
| | - Paulien M. Bongers
- Netherlands Organisation for Applied Scientific Research TNO, Unit Healthy Living, Leiden, The Netherlands ,Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands
| | - Johannes C. F. Ket
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
| | - Cécile R. L. Boot
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Boelelaan 1117, Amsterdam, The Netherlands ,Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, The Netherlands ,Amsterdam Public Health, Societal Participation & Health, Amsterdam, The Netherlands
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5
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Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Immediate Effect of Working From Home During the COVID-19 Pandemic on the Incidence of Non-Specific Neck and Low Back Pain: A Prospective Cohort Study. Asia Pac J Public Health 2022; 34:849-852. [PMID: 36114708 PMCID: PMC9483132 DOI: 10.1177/10105395221126012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Pooriput Waongenngarm
- Faculty of Health Science Technology,
HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy,
Bangkok, Thailand
| | - Allard J. van der Beek
- Department of Public and Occupational
Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije
Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nipaporn Akkarakittichoke
- Inter-Department Program of Biomedical
Sciences, Faculty of Graduate School, Chulalongkorn University, Bangkok,
Thailand
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty
of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand,Prawit Janwantanakul, Department of
Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University,
Phyathai Road, Bangkok 10330, Thailand.
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6
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van der Feltz S, van der Molen HF, Lelie L, Hulshof CTJ, van der Beek AJ, Proper KI. Changes in Fruit and Vegetable Consumption and Leisure Time Physical Exercise after a Citizen Science-Based Worksite Health Promotion Program for Blue-Collar Workers. Int J Environ Res Public Health 2022; 19:13652. [PMID: 36294231 PMCID: PMC9603698 DOI: 10.3390/ijerph192013652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Blue-collar workers have, on average, poorer health than white-collar workers. Existing worksite health promotion programs (WHPPs) are often not successful among blue-collar workers. This study evaluates the effect of the Citizen Science-based WHPP on the targeted lifestyle behaviors among construction workers. The data of 114 participants were retrieved from questionnaires before (T0) and after (T1) the WHPP. Outcome measures were mean and categorical changes in daily fruit and vegetable intake and weekly leisure time physical exercise. Changes were tested using Wilcoxon signed rank tests and McNemar tests. No statistically significant changes were found between T0 and T1. In total, 73.7% of the participants felt involved in the WHPP. Changes in the outcome measures were not significantly different between subgroups based on age, nor in subgroups based on feelings of involvedness. The low intensity of the developed program could be an explanation for this lack of significant change. Future studies using the Citizen Science approach in an occupational setting should aim at developing a more intensified program and should test its effectiveness by comparing changes in a (randomized) controlled trial.
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Affiliation(s)
- Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Carel T. J. Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC, University of Amsterdam, 1100 DD Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
| | - Karin I. Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands
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Jelsma JGM, van der Ploeg HP, Renaud LR, Stijnman DPM, Loyen A, Huysmans MA, van der Beek AJ, van Nassau F. Mixed-methods process evaluation of the Dynamic Work study: A multicomponent intervention for office workers to reduce sitting time. Appl Ergon 2022; 104:103823. [PMID: 35724470 DOI: 10.1016/j.apergo.2022.103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Previously, we observed no significant reductions in sitting time of the multicomponent Dynamic Work (DW) intervention among office workers. In this study we used mixed-method data to understand context, implementation (i.e. recruitment and delivery) and mechanism of impact (i.e. experiences) of the DW intervention and to explore whether an higher implementation index score led to larger changes in participants' outcomes. We found considerable variation across departments regarding context (i.e. different size and work tasks) and implementation (i.e. delivery varied). Satisfaction with the DW intervention was high. An higher implementation index score was associated with lower overall sitting time, lower occupational sitting time, higher number of steps/day and steps/day at work at 4-months, which was maintained at 8-month for occupational sitting time. These findings provide an understanding that implementation was affected by a lack of availability of intervention components, department policy, work tasks, positioning and work location. TRIAL REGISTRATION: Clinicaltrials.gov, registration number:NCT03115645. Registered February 17, 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03115645.
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Affiliation(s)
- Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Hidde P van der Ploeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Lidewij R Renaud
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Dominique P M Stijnman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Anne Loyen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Maaike A Huysmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
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8
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Lelie L, van der Molen HF, van den Berge M, van der Feltz S, van der Beek AJ, Hulshof CTJ, Proper KI. The process evaluation of a citizen science approach to design and implement workplace health promotion programs. BMC Public Health 2022; 22:1610. [PMID: 36002884 PMCID: PMC9399973 DOI: 10.1186/s12889-022-14009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many workplace health promotion programs (WHPPs) do not reach blue-collar workers. To enhance the fit and reach, a Citizen Science (CS) approach was applied to co-create and implement WHPPs. This study aims to evaluate i) the process of this CS approach and ii) the resulting WHPPs. METHODS The study was performed in two companies: a construction company and a container terminal company. Data were collected by questionnaires, interviews and logbooks. Using the framework of Nielsen and Randall, process measures were categorized in the intervention, context and mental models. Interviews were transcribed and thematically coded using MaxQDA software. RESULTS The involvement in the CS approach and co-creating the WHPPs was positively experienced. Information provision, sustained engagement over time and alignment with the workplace's culture resulted in barriers in the CS process. As to the resulting WHPPs, involvement and interaction during the intervention sessions were particularly experienced in small groups. The reach was affected by the unfavorable planning off the WHPPs and external events of re-originations and the covid-19 pandemic. DISCUSSION Continuous information provision and engagement over time, better alignment with the workplace's culture and favorable planning are considered to be important factors for facilitating involvement, reach and satisfaction of the workers in a Citizen science approach to design and implement a WHPP. Further studies continuously monitoring the process of WHPPs using the CS approach could be helpful to anticipate on external factors and increase the adaptability. CONCLUSIONS Workers were satisfied with the involvement in WHPPs. Organizational and social cultural factors were barriers for the CS approach and its reach. Involvement and interaction in WHPPs were particularly experienced in small grouped sessions. Consequently, contextual and personal factors need be considered in the design and implementation of WHPPs with CS approach among blue-collar workers.
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Affiliation(s)
- Lisa Lelie
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands.
| | - Henk F van der Molen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC location AMC, University of Amsterdam, 1100, DD, Amsterdam, The Netherlands
| | - Mandy van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Sophie van der Feltz
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam UMC location AMC, University of Amsterdam, 1100, DD, Amsterdam, The Netherlands
| | - Karin I Proper
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1007, MB, Amsterdam, The Netherlands. .,Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, 3721, MA, Bilthoven, The Netherlands.
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9
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Bijnsdorp FM, Onwuteaka-Philipsen BD, Boot CRL, van der Beek AJ, Pasman HRW. Caregiver's burden at the end of life of their loved one: insights from a longitudinal qualitative study among working family caregivers. Palliat Care 2022; 21:142. [PMID: 35945558 PMCID: PMC9364551 DOI: 10.1186/s12904-022-01031-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Growing numbers of people with advanced illnesses who wish to die at home, a concurrent decline in the accessibility of professional home care, and policies aiming at prolonging work participation are increasing the reliance on family caregivers. This study aimed to describe trajectories in burden of working family caregivers who care for patients with a life-threatening illness, and identify factors in work and care that are related to changes in burden over time. Methods Semi-structured interviews were held in one to four rounds between July 2018 and November 2020 with 17 working family caregivers of patients with a life-threatening illness living at home. Transcripts were analysed as a single unit to create timelines per participant. Next, individual burden trajectories were created and grouped based on the course of burden over time. Factors related to changes in burden were analysed, as well as similarities and differences between the groups. Results It was common for family caregivers who combine work and end-of-life care to experience a burden. Two trajectories of caregiver burden were identified; caregivers with a persistent level of burden and caregivers with an increasing burden over time. Family caregivers with a persistent level of burden seemed to be at risk for burnout throughout the illness trajectory, but were often able to cope with the situation by making arrangements in care or work. Caregivers with an increasing burden were unable to make sufficient adjustments, which often resulted in burnout symptoms and sick leave. In both groups, burden was mostly related to aspects of the care situation. The emotional burden, a decreasing burden after death and a different view on the trajectory in hindsight proved to be important overarching themes. Conclusions Providing care to a loved one nearing the end of life is often emotionally burdensome and intensive. To facilitate the combination of paid work and family care, and reduce the risk of burnout, more support is needed from employers and healthcare professionals during the illness trajectory and after death. Bereaved family caregivers also warrant more attention from their supervisors and occupational physicians in order to facilitate their return to work. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01031-1.
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Affiliation(s)
- Femmy M Bijnsdorp
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam, Netherlands.
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam, Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam, Netherlands
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10
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Garcia-Lunar I, van der Ploeg HP, Fernández Alvira JM, van Nassau F, Castellano Vázquez JM, van der Beek AJ, Rossello X, Fernández-Ortiz A, Coffeng J, van Dongen JM, Mendiguren JM, Ibáñez B, van Mechelen W, Fuster V. Effects of a comprehensive lifestyle intervention on cardiovascular health: the TANSNIP-PESA trial. Eur Heart J 2022; 43:3732-3745. [PMID: 35869885 PMCID: PMC9553098 DOI: 10.1093/eurheartj/ehac378] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/29/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Aims To investigate the effectiveness of a 3-year worksite lifestyle intervention on cardiovascular metrics and to study whether outcomes are influenced by baseline subclinical atherosclerosis (SA) by non-invasive imaging. Methods and results A randomized controlled trial was performed to compare a lifestyle intervention with standard of care in asymptomatic middle-aged subjects, stratified by SA. The intervention consisted of nine motivational interviews during the first year, followed by three further sessions between Years 1 and 3. The primary outcome was the change in a pre-specified adaptation of the Fuster-BEWAT score (Blood pressure, Exercise, Weight, Alimentation, and Tobacco) between baseline and follow-up Years 1–3. A total of 1020 participants (mean age 50 ± 4 years) were enrolled, of whom 510 were randomly assigned to the intervention and 510 to the control group. The baseline adapted Fuster-BEWAT score was 16.2 ± 3.7 points in the intervention group and 16.5 ± 3.5 points in the control group. At Year 1, the score improved significantly in intervention participants compared with controls [estimate 0.83 (95% CI 0.52–1.15) points]. However, intervention effectiveness decreased to non-significant levels at Year 3 [0.24 (95% CI –0.10 to 0.59) points]. Over the 3-year period, the intervention was effective in participants having low baseline SA [0.61 (95% CI 0.30–0.93) points] but not in those with high baseline SA [0.19 (95% CI –0.26 to 0.64) points]. Conclusion In middle-aged asymptomatic adults, a lifestyle intervention was associated with a significant improvement in cardiovascular health and behavioural metrics. The effect attenuated after 1 year as the intensity of the intervention was reduced. Trial registration ClinicalTrials.gov (NCT02561065).
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Affiliation(s)
- Ines Garcia-Lunar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, University Hospital La Moraleja , Madrid , Spain
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | | | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Jose Maria Castellano Vázquez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Monteprincipe, Grupo HM Hospitales , Madrid , Spain
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Xavier Rossello
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases , Palma , Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC , Madrid , Spain
| | - Jennifer Coffeng
- Dutch Institute of Employee Benefits Schemes (UWV) , Amsterdam , The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute , Amsterdam , The Netherlands
| | | | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- CIBER Enfermedades Cardiovasculares (CIBERCV) , Madrid , Spain
- Cardiology Department, IIS-Hospital Universitario Fundación Jiménez Díaz , Madrid , Spain
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit , Amsterdam , The Netherlands
| | - Valentin Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC) , Madrid , Spain
- Cardiovascular Institute, Mount Sinai Heart at Icahn School of Medicine , New York, NY , USA
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11
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Gupta N, van Dongen JM, Holtermann A, van der Beek AJ, Stevens ML, Nørregaard Rasmussen CD. Cost-Effectiveness and Return-on-Investment of a Participatory Ergonomics Intervention Among Childcare Workers: An Economic Evaluation in a Randomized Controlled Trial. J Occup Environ Med 2022; 64:533-539. [PMID: 35143453 PMCID: PMC9275851 DOI: 10.1097/jom.0000000000002510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the cost-effectiveness and return-on-investment (ROI) of 20-week ergonomic intervention to reduce physical exertion at work compared with usual-practice among childcare workers. METHODS One hundred ninety workers from 16 institutions were cluster-(institute)-randomized to intervention (n = 96) and usual-practice (n = 94) group. The intervention group participated in three workshops to develop/implement action plans improving ergonomic conditions. The rating of physical exertion (RPE) was measured at baseline and 20-weeks. Employer-perspective-based costs of intervention, absenteeism, and presenteeism were estimated. RESULTS Although statistically non-significant, one-unit reduction in RPE was associated with saving of 592 EUR/worker. Per-EUR invested by the employer was associated with 1.6 EUR (95% CI: -3.1; 6.5) return in the intervention compared with usual practice. CONCLUSION The intervention tended to gain monetary benefit for the employer. The results should be replicated in larger populations for improved precision of economic evaluation estimates.Trial registration: ISRCTN10928313.
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Affiliation(s)
- Nidhi Gupta
- From the Department of Musculoskeletal Disorders and PhysicalWork Demands, The National Research Centre for the Working Environment, Copenhagen, Denmark (Dr Gupta, Dr Holtermann, Dr Stevens, Dr Rasmussen); Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute (Dr van Dongen); Department of Public and Occupational Health, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (Dr van der Beek)
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12
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Waongenngarm P, van der Beek AJ, Janwantanakul P, Akkarakittichoke N, Coenen P. Can the Borg CR-10 scale for neck and low back discomfort predict future neck and low back pain among high-risk office workers? Int Arch Occup Environ Health 2022; 95:1881-1889. [PMID: 35650349 PMCID: PMC9630392 DOI: 10.1007/s00420-022-01883-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Purpose Perceived discomfort could indicate an early sign of pain, for example, as a result of a biomechanical load on the musculoskeletal system. Assessing discomfort can, therefore, help to identify workers at increased risk of musculoskeletal disorders for targeted intervention development. We aimed: (1) to identify the optimal cut-off value of neck and low back discomfort among office workers and (2) to evaluate its predictive validity with future neck and low back pain, respectively. Methods At baseline healthy participants (n = 100) completed questionnaires, including the Borg CR-10 discomfort scale (on a 0–10 scale), and were followed for six months, during which musculoskeletal pain was assessed monthly. Logistic regression analyses were performed to assess the associations of baseline discomfort with the onset of future neck or low back pain. Sensitivity, specificity, and the area under the receiver operating characteristics curve were estimated to identify the optimal discomfort cut-off value predicting future pain. Results Borg CR-10 scores ≥ 3.5 for perceived neck and low back discomfort had acceptable sensitivity and specificity to predict future neck and low back pain, respectively. Perceived discomfort at baseline as a dichotomous measure (using the ≥ 3.5 cut-off) was a statistically significant predictor of future neck pain (OR = 10.33) and low back pain (OR = 11.81). Conclusion We identified the optimal cut-off value of the Borg CR-10 discomfort scale to identify office workers at increased risk of developing neck and low back pain. These findings might benefit ergonomists, primary health care providers, and occupational health researchers in developing targeted interventions.
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Affiliation(s)
- Pooriput Waongenngarm
- Faculty of Health Science Technology, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Nipaporn Akkarakittichoke
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
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13
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Coenen P, Zegers AD, de Vreeze N, van der Beek AJ, Duijts SFA. 'Nobody can take the stress away from me': a qualitative study on experiences of partners of patients with cancer regarding their work and health. Disabil Rehabil 2022; 45:1696-1704. [PMID: 35604402 DOI: 10.1080/09638288.2022.2074547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To explore experienced health- and work-related problems of partners of patients with cancer, and their needs for support. MATERIALS AND METHODS Semi-structured interviews were conducted with Dutch partners of patients with cancer. Interviews were transcribed verbatim. Data were analysed thematically, following the six steps of Braun & Clarke. RESULTS Of 20 included partners (mean age: 50 years [31-63]), 60% was female. Five themes consistently emerged from the data: 1) overwhelming chaos calls for taking control; 2) impact of prolonged stress; 3) flexibility and support of the employer are crucial; 4) coping with family and friends is a delicate matter; and 5) support from healthcare professionals is needed, but not a given. CONCLUSIONS Findings from this study show that the burden on partners of patients with cancer is substantial and cannot be overlooked. The state of survival mode that partners get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation. Given this high burden and as legislation for care leave from work and (health care) support for partners appear to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer. Implications for RehabilitationThe survival mode that partners of patients with cancer get into during the diagnosis, treatment and follow-up of their loved ones can have various implications on their physical and mental health, and work situation.This study showed that the burden on partners of patients with cancer is substantial and cannot be overlooked.Given this high burden and because legislation for care leave from work and (health care) support for partners appears to be insufficiently in place in the Dutch context, there is a need for better-targeted support for partners of patients with cancer.
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Affiliation(s)
- Pieter Coenen
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Nadia de Vreeze
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam UMC location Vrije Universiteit, Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands.,The Netherlands Comprehensive Cancer Organization (IKNL), Research & Development, Utrecht, the Netherlands
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14
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Smit DJM, van Oostrom SH, Engels JA, van der Beek AJ, Proper KI. A study protocol of the adaptation and evaluation by means of a cluster-RCT of an integrated workplace health promotion program based on a European good practice. BMC Public Health 2022; 22:1028. [PMID: 35597983 PMCID: PMC9123680 DOI: 10.1186/s12889-022-13352-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background An integrated workplace health promotion program (WHPP) which targets multiple lifestyle factors at different levels (individual and organizational) is potentially more effective than a single component WHPP. The aim of this study is to describe the protocol of a study to tailor a European good practice of such an integral approach to the Dutch context and to evaluate its effectiveness and implementation. Methods This study consists of two components. First, the five steps of the Map of Adaptation Process (MAP) will be followed to tailor the Lombardy WHP to the Dutch context. Both the employers and employees will be actively involved in this process. Second, the effectiveness of the integrated Dutch WHPP will be evaluated in a clustered randomized controlled trial (C-RCT) with measurements at baseline, 6 months and 12 months. Clusters will be composed based on working locations or units - dependent on the organization’s structure and randomization within each organization takes place after baseline measurements. Primary outcome will be a combined lifestyle score. Secondary outcomes will be the separate lifestyle behaviors targeted, stress, work-life balance, need for recovery, general health, and well-being. Simultaneously, a process evaluation will be conducted. The study population will consist of employees from multiple organizations in different industry sectors. Organizations in the intervention condition will receive the integrated Dutch WHPP during 12 months, consisting of an implementation plan and a catalogue with activities for multiple lifestyle themes on various domains: 1) screening and support; 2) information and education; 3) adjustments in the social, digital or physical environment; and 4) policy. Discussion The MAP approach provides an appropriate framework to systematically adapt an existing WHPP to the Dutch context, involving both employers and employees and retaining the core elements, i.e. the catalogue with evidence-based activities on multiple lifestyle themes and domains enabling an integrated approach. The following process and effect evaluation will contribute to further insight in the actual implementation and effectiveness of the integrated WHP approach. Trial registration NTR (trialregister.nl), NL9526. Registered on 3 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13352-0.
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Affiliation(s)
- Denise J M Smit
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands. .,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands.
| | - Sandra H van Oostrom
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands
| | - Josephine A Engels
- Occupation & Health Research Group, HAN University of Applied Sciences, Nijmegen, 6525 EN, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
| | - Karin I Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, 3721 MA, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, 1081 BT, The Netherlands
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15
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13230-9.
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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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van Dongen JM, van der Beek AJ. Economic evaluations in occupational health: what brings the best bang for the buck? Scand J Work Environ Health 2022; 48:249-252. [PMID: 35380166 PMCID: PMC9524160 DOI: 10.5271/sjweh.4026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Johanna M van Dongen
- Correspondence to Dr Allard van der Beek Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, The Netherlands.
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17
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health 2022; 48:86-98. [PMID: 34656067 PMCID: PMC9045238 DOI: 10.5271/sjweh.3993 10.5271/sjweh.4090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. METHODS A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. RESULTS We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.87-1.15] and females (HR 0.95, 95% CI 0.82-1.09). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 15% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.15, 95% CI 0.88-1.49). CONCLUSIONS While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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18
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Bijnsdorp FM, van der Beek AJ, Broese van Groenou MI, Proper KI, van den Heuvel SG, Boot CRL. Associations of combining paid work and family care with gender-specific differences in depressive symptoms among older workers and the role of work characteristics. Scand J Work Environ Health 2022; 48:190-199. [PMID: 35128561 PMCID: PMC9523461 DOI: 10.5271/sjweh.4014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives This study aims to provide insight into (i) how the combination of paid work and family care is longitudinally associated with gender-related differences in depressive symptoms and (ii) the role of work characteristics in this association. Methods Data were derived from STREAM, a Dutch prospective cohort study of older workers aged 45–64 years. Respondents were included if they were employed in at least one measurement between 2015 and 2017 (N=12 447). Mixed-models were applied to disentangle between-person (BP) and within-person (WP) effects of family caregiving on depressive symptoms. Analyses were stratified by gender. Work characteristics (social support, autonomy, emotional and mental workload) were separately added to the multivariable models. Results For older employees, family caregiving was positively associated with depressive symptoms between and within persons for both women [BP B=0.80, 95% confidence interval (CI) 0.52–1.08; WP B=0.32, 95% CI 0.08–0.56] and men (BP B=0.75, 95% CI 0.45–1.05; WP B=0.25, 95% CI 0.01–0.48). Social support at work reduced the adverse effect of family care on depressive symptoms for women (BP) and men (BP and WP). Emotional workload partly explained the effect of family care for both women and men (BP). Conclusions The longitudinal association between family care and mental health was similar for male and female employees. Resources at work (ie, social support) could protect caregiving employees against depressive symptoms. More research is needed regarding the relative impact of the care context compared to the work context of working family caregivers.
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Affiliation(s)
- Femmy M Bijnsdorp
- Department of Public and Occupational Health, Amsterdam UMC, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
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Vos E, de Bruin SR, van der Beek AJ, Proper KI. “It’s like juggling, constantly trying to keep all balls in the air”: A qualitative study of the support needs of working caregivers taking care of an older adult. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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20
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Boot C, Sewdas R, Hoogendijk E, Deeg D, van der Beek AJ, de Wind A. Disability free life expectancy and working conditions. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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21
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van Zaanen Y, Kievit AJ, van Geenen RC, Pahlplatz TM, Hoozemans MJ, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TM, Das DH, Scholtes VA, van der Beek AJ, Kuijer PF. Is consulting an occupational physician associated with earlier return to work among total knee arthroplasty patients? A prospective cohort study in the Netherlands. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants. Scand J Work Environ Health 2021; 48:86-98. [PMID: 34656067 PMCID: PMC9045238 DOI: 10.5271/sjweh.3993] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. Methods A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. Results We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.87–1.15] and females (HR 0.95, 95% CI 0.82–1.09). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 15% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.15, 95% CI 0.88–1.49). Conclusions While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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23
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Zegers AD, Coenen P, Bültmann U, Retèl V, Kieffer JM, van der Beek AJ, Duijts SFA. Supporting participation in paid work of cancer survivors and their partners in the Netherlands: protocol of the SusTained Employability in cancer Patients and their partnerS (STEPS) multi-centre randomized controlled trial and cohort study. BMC Public Health 2021; 21:1844. [PMID: 34641839 PMCID: PMC8506084 DOI: 10.1186/s12889-021-11865-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Many cancer survivors experience physical and/or psychosocial problems affecting return to work (RTW) and work retention. Current interventions on RTW lack evidence regarding effectiveness, while interventions for work retention are missing. Partners of cancer survivors may also experience work- and health-related outcomes; yet, these consequences are not well understood. Here, the protocol of the STEPS study is described. The study aims are to: 1) evaluate the (cost-)effectiveness of a rehabilitation program for RTW and work retention in cancer survivors, and 2) assess health- and work-related outcomes among cancer survivors' partners. METHODS In a multicentre Randomized Controlled Trial (RCT), 236 working-age cancer survivors with an employment contract will be randomly allocated to a usual care group or an intervention group receiving a multidisciplinary rehabilitation program, combining occupational therapy facilitating work retention (e.g., energy management and self-efficacy training) and reintegration consultation addressing work-related issues (e.g., RTW planning and discussing workplace or task modifications with the supervisor). Alongside the RCT, a prospective cohort study will be conducted among cancer survivors' partners (n = 267). Participants in the RCT and cohort study will be asked to complete questionnaires at baseline, and after six and 12 months, assessing work- and health-related outcomes. Generalized estimating equations will be used to assess intervention's effectiveness, compared to usual care, regarding primary (i.e., working hours per week) and secondary outcomes. Also economic and process evaluations will be performed. For the cohort study, logistic or linear regression modelling will be applied assessing work- and health-related outcomes (primary outcome: working hours) of cancer survivors' partners, and what factors predict these outcomes. RESULTS The study is planned to start in September 2021; results are expected in 2023. CONCLUSION Compared to usual care, the STEPS intervention is hypothesized to be (cost-)effective and the intervention could be a valuable addition to standard care helping cancer survivors to sustain employment. Further, it is expected that living with a cancer survivor has a substantial impact on work and health of partners, while specific groups of partners that are at particular risk for this impact are likely to be identified. TRIAL REGISTRATION Dutch Trial Register ( NTR;NL9094 ; 15-12-2020).
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Affiliation(s)
- Amber D Zegers
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, location VUmc, van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, location VUmc, van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, the Netherlands
| | - Valesca Retèl
- The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, the Netherlands
| | - Jacobien M Kieffer
- The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, the Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, location VUmc, van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, location VUmc, van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.,The Netherlands Comprehensive Cancer Organization (IKNL), Research & Development, Utrecht, the Netherlands
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24
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Bijnsdorp FM, Onwuteaka-Philipsen BD, Boot CR, van der Beek AJ, Klop HT, Pasman HRW. Combining paid work and family care for a patient at the end of life at home: insights from a qualitative study among caregivers in the Netherlands. BMC Palliat Care 2021; 20:93. [PMID: 34167518 PMCID: PMC8228921 DOI: 10.1186/s12904-021-00780-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/25/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Population ageing, an emphasis on home-based care of palliative patients and policies aimed at prolonging participation in the labour market are placing a growing demand on working family caregivers. This study aimed to provide insight into experiences with combining paid work and family care for patients at the end of life, factors facilitating and hindering this combination, and support needs. METHOD Semi-structured interviews were held between July 2018 and July 2019 with 18 working family caregivers of patients with a life-threatening illness who were living at home. Transcripts were analysed following the principles of thematic analysis. RESULTS Some family caregivers could combine paid work and family care successfully, while this combination was burdensome for others. Family caregivers generally experienced a similar process in which four domains - caregiver characteristics, the care situation, the work situation and the context - influenced their experiences, feelings and needs regarding either the combination of paid work and care or the care situation in itself. In turn, experiences, feelings and needs sometimes affected health and wellbeing, or prompted caregivers to take actions or strategies to improve the situation. Changes in health and wellbeing could affect the situation in the four domains. Good health, flexibility and support at work, support from healthcare professionals and sharing care tasks were important in helping balance work and care responsibilities. Some caregivers felt 'sandwiched' between work and care and reported physical or mental health complaints. CONCLUSIONS Experiences with combining paid work and family care at the end of life are diverse and depend on several factors. If too many factors are out of balance, family caregivers experience stress and this impacts their health and wellbeing. Family caregivers could be better supported in this by healthcare professionals, employers and local authorities.
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Affiliation(s)
- Femmy M. Bijnsdorp
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Expertise Center for Palliative Care, Amsterdam, the Netherlands
| | - Bregje D. Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Expertise Center for Palliative Care, Amsterdam, the Netherlands
| | - Cécile R.L. Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Hanna T. Klop
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Expertise Center for Palliative Care, Amsterdam, the Netherlands
| | - H. Roeline W. Pasman
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Expertise Center for Palliative Care, Amsterdam, the Netherlands
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25
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Bakker EJM, Roelofs PDDM, Kox JHAM, Miedema HS, Francke AL, van der Beek AJ, Boot CRL. Psychosocial work characteristics associated with distress and intention to leave nursing education among students; A one-year follow-up study. Nurse Educ Today 2021; 101:104853. [PMID: 33866076 DOI: 10.1016/j.nedt.2021.104853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/03/2021] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Dropout in later years of the nursing degree programme involves lost investment and is a particular problem for both students and educators. Reasons for late dropout seem to be related to the work and learning environment of the clinical placement. OBJECTIVES The aim of this study was to investigate associations between psychosocial work characteristics and distress and intention to leave nursing education among third-year nursing students. DESIGN A prospective cohort study. SETTING A Bachelor of Nursing programme of a University of Applied Sciences in the Netherlands. PARTICIPANTS 363 third-year nursing students. METHODS Baseline and one-year follow-up measurements were used from a prospective cohort study. Third-year nursing students were invited annually in May between 2016 and 2018. Psychosocial work characteristics were psychological demands, supervisor and co-worker support, and acts of offensive behaviour. Logistic regression analyses were used to build multivariate models. RESULTS Frequent exposure to violence (OR = 2.52, 95% CI: 1.29-4.92) was univariately associated with distress. In the multivariate model for distress, psychological demands (OR = 1.63, 95% CI: 1.05-2.52) and frequent exposure to violence (OR = 3.02, 95% CI: 1.48-6.19) were associated with distress. Supervisor support (OR = 0.54, 95% CI: 0.36-0.80) and co-worker support (OR = 0.41, 95% CI: 0.24-0.72) were negatively associated with intention to leave (i.e. were protective) in the univariate model. In the adjusted multivariate model, only co-worker support (OR = 0.50, 95% CI: 0.25-0.97) was a protective factor for an intention to leave. CONCLUSION Psychological demands and frequent exposure to violence are risk factors for distress, and co-worker support is a protective factor reducing the intention to leave nursing education in the last stage of the programme. Improving the psychosocial working climate of nursing students may reduce the intention to leave at a late stage in nursing education, and hence actual late dropout.
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Affiliation(s)
- Ellen J M Bakker
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Department of Health Sciences, Community and Occupational Medicine, A. Deusinglaan 1, 9713 AV Groningen, the Netherlands
| | - Jos H A M Kox
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Erasmus University Medical Centre, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - Anneke L Francke
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; NIVEL Netherlands institute for health services research, P.O. Box 1568, 3500 BN Utrecht, the Netherlands
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands
| | - Cécile R L Boot
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands
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26
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Vos EE, de Bruin SR, van der Beek AJ, Proper KI. " It's Like Juggling, Constantly Trying to Keep All Balls in the Air": A Qualitative Study of the Support Needs of Working Caregivers Taking Care of Older Adults. Int J Environ Res Public Health 2021; 18:5701. [PMID: 34073386 PMCID: PMC8198548 DOI: 10.3390/ijerph18115701] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 12/30/2022]
Abstract
Many informal caregivers of older adults combine their caregiving tasks with a paid job. Adequate support is important to enable them to combine paid work with caregiving, while maintaining their health and wellbeing. To date, however, knowledge about working caregivers' support needs is fragmented. This study, therefore, aimed to obtain more insight into the support needs of working caregivers of older adults. We conducted six online semi-structured focus group interviews with in total 25 working caregivers of older adults living at home. Data were complemented with information from seven working caregivers participating in the study's advisory board. Data were analyzed using inductive and deductive thematic analysis. Six themes related to working caregivers' needs were identified: (1) Recognition of caregivers, including the challenges they face; (2) Attention for caregivers' health, wellbeing and ability to cope; (3) Opportunities to share care responsibilities; (4) Help with finding and arranging care and support; (5) Understanding and support from the work environment; (6) Technological support tailored to the needs and capacities of caregivers and older adults. To address these needs, working caregivers suggested several options in multiple domains of life (i.e., work, home and social life, care environment, personal health and wellbeing). To successfully support them, a multi-faceted effort, involving actors from multiple settings, is needed.
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Affiliation(s)
- Eline E. Vos
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands;
| | - Simone R. de Bruin
- Research Group Living Well with Dementia, Department of Health and Wellbeing, Windesheim University of Applied Sciences, Campus 2, P.O. Box 10090, 8000 GB Zwolle, The Netherlands;
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
| | - Karin I. Proper
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands;
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
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27
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Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Effects of an active break and postural shift intervention on preventing neck and low-back pain among high-risk office workers: a 3-arm cluster-randomized controlled trial. Scand J Work Environ Health 2021; 47:306-317. [PMID: 33906239 PMCID: PMC8091075 DOI: 10.5271/sjweh.3949] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study evaluated the effects of the promotion of active breaks and postural shifts on new onset of neck and low-back pain during a 6-month follow-up among high-risk office workers. METHODS A 3-arm cluster-randomized controlled trial with 6-month follow-up was conducted among healthy but high-risk office workers. Participants were recruited from six organizations in Bangkok, Thailand (N=193) and randomly assigned at cluster level into active break intervention (N=47), postural shift intervention (N=46), and control (N=100) groups. Participants in the intervention groups received a custom-designed apparatus to facilitate designated active breaks and postural shifts during work. Participants in the control group received a placebo seat pad. The primary outcome measure was new onset of neck and low-back pain during 6-month follow-up. Analyses were performed using Cox proportional hazard models. RESULTS One-hundred and eighty-six (96%) predominantly female participants were successfully followed up over six months. New onset of neck pain during the 6-month follow-up occurred in 17%, 17%, and 44% of the participants in the active break, postural shift, and control groups, respectively. For new onset of low-back pain, these percentages were 9%, 7%, and 33%, respectively. Hazard rate (HR) ratios after adjusting for biopsychosocial factors indicated a protective effect of the active break and postural shift interventions for neck pain [HRadj 0.45, 95% confidence interval (CI) 0.20-0.98 for active break and HRadj 0.41, 95% CI 0.18-0.94 for postural shift] and low-back pain (HRadj 0.34, 95% CI 0.12-0.98 for active break and HRadj 0.19, 95% CI 0.06-0.66 for postural shift). CONCLUSION Interventions to increase either active breaks or postural shifts reduced new onset of neck and low-back pain among high-risk office workers.
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Affiliation(s)
- Pooriput Waongenngarm
- Prawit Janwantanakul, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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28
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Cillekens B, Lang M, van Mechelen W, Verhagen E, Huysmans MA, Holtermann A, van der Beek AJ, Coenen P. How does occupational physical activity influence health? An umbrella review of 23 health outcomes across 158 observational studies. Br J Sports Med 2021; 54:1474-1481. [PMID: 33239353 DOI: 10.1136/bjsports-2020-102587] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Physical activity (PA) has substantial benefits across a range of health outcomes. There is uncertainty about the PA-specific health effects, and in particular, the occupational domain. In this umbrella review, we synthesised available evidence on the associations between occupational PA (OPA) and health-related outcomes (including cancer, all-cause mortality and cardiovascular disease). This work informed the development of WHO's guidelines on PA and sedentary behaviour (2020). DESIGN Umbrella review of systematic reviews. DATA SOURCE We performed a literature search in PubMed, Web of Science, Embase, CINAHL and Sportdiscuss from database inception to 2 December 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included systematic reviews if they contained a quantitative assessment of OPA and its relationship with at least one health-related outcome. RESULTS We summarised the evidence of 17 reviews covering 23 unique health-related outcomes. We graded most evidence as low or very low, or moderate quality. We found health benefits for those engaging in high versus low OPA for multiple cancer outcomes (including colon and prostate), ischaemic stroke, coronary heart disease and mental health (ie, mental well-being and life satisfaction). High OPA was associated with unfavourable health outcomes for all-cause mortality in men, mental ill health (ie, depression and anxiety), osteoarthritis, and sleep quality and duration. CONCLUSIONS We found favourable associations for most health-related outcomes with high OPA levels, but we also found some evidence for unfavourable associations due to high OPA levels. At this point, there is a need for better quality evidence to provide a unequivocal statement on the health effects of OPA.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Matthias Lang
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Evert Verhagen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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van den Berge M, van der Beek AJ, Türkeli R, van Kalken M, Hulsegge G. Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity. Int Arch Occup Environ Health 2021; 94:741-750. [PMID: 33409697 PMCID: PMC8068657 DOI: 10.1007/s00420-020-01627-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/01/2020] [Indexed: 01/08/2023]
Abstract
Objective This study investigated associations between the co-existence of multiple types of work-related psychosocial and physical risk factors, and (1) obesity; (2) smoking; and (3) leisure-time physical inactivity. It also aimed to identify sociodemographic characteristics related to clustering of work-related risk factors and lifestyle factors. Methods Cross-sectional data on work-related risk factors (e.g., decision authority and repetitive movements) and lifestyle was measured using a standardized questionnaire among 52,563 Dutch workers in health care, services, manufacturing and public sector. Multiple-adjusted logistic regression models assessed associations between the co-existence of multiple types of psychosocial and physical risk factors and lifestyle factors. Additionally, logistic regression models related age, gender and educational level to clustering of risk factors and lifestyle factors. Results The co-existence of multiple types of work-related psychosocial risk factors was associated with higher odds of smoking and being physically inactive. For example, workers exposed to three psychosocial risk factors had a 1.55 times higher odds of being physically inactive (95%CI: 1.42–1.70) compared to unexposed workers. A higher number of physical risk factors was also significantly associated with higher odds of smoking and obesity. The co-existence of multiple types of physical risk factors was not associated with higher odds of physical inactivity. Clustering of work-related risk factors and at least one unhealthy lifestyle factor occurred in particular among workers with low educational level. Conclusions Results imply that interventions are needed that focus on workers with a low educational level and address work-related physical and psychosocial risk factors as well as lifestyle. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-020-01627-1.
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Affiliation(s)
- Mandy van den Berge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | - Rukiye Türkeli
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands
| | | | - Gerben Hulsegge
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.,The Netherlands Organization for Applied Scientific Research, TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
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30
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Oude Hengel KM, Riumallo-Herl C, Schram JL, Nieboer D, van der Beek AJ, Burdorf A. Effects of changes in early retirement policies on labor force participation: the differential effects for vulnerable groups. Scand J Work Environ Health 2021; 47:224-232. [PMID: 33399213 PMCID: PMC8126444 DOI: 10.5271/sjweh.3946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study investigated the effects of a national early retirement reform, which was implemented in 2006 and penalized early retirement, on paid employment and different exit pathways and examined whether these effects differ by gender, income level and health status. Methods: This study included all Dutch individuals in paid employment born six months before (control group) and six months after (intervention group) the cut-off date of the reform (1 January 1950) that fiscally penalized early retirement. A regression discontinuity design combined with restricted mean survival time analysis was applied to evaluate the effect of penalizing early retirement on labor force participation from age 60 until workers reached the retirement age of 65 years, while accounting for secular trends around the threshold. Results: The intervention group postponed early retirement by 7.41 months [95% confidence interval (CI) 6.11–8.72], and partly replaced this by remaining 4.87 months (95% CI 3.60–6.24) longer in paid employment. Workers born after the threshold, annually earning €25 000–40 000, spent 1.24 months (95% CI 0.31–2.18) more in economic inactivity than those born before. The working months lost to unemployment increased by 1.50 months (95% CI 0.30–2.71) for female workers and 1.99 months (95% CI 0.06–3.92) for workers reporting multiple chronic diseases. Conclusions: The national reform successfully prolonged working lives of older workers. However, workers with a middle income, female workers, and workers with chronic diseases were more vulnerable to premature exit from the labor market through unemployment or being without any income or benefit.
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Affiliation(s)
- Karen M Oude Hengel
- Erasmus University Medical Center, Department of Public Health, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
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Coenen P, Zegers AD, Stapelfeldt CM, de Maaker-Berkhof M, Abma F, van der Beek AJ, Bültmann U, Duijts SFA. Cross-cultural translation and adaptation of the Readiness for Return To Work questionnaire for Dutch cancer survivors. Eur J Cancer Care (Engl) 2020; 30:e13383. [PMID: 33277767 DOI: 10.1111/ecc.13383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/25/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Effective interventions supporting cancer survivors in work participation are lacking, possibly due to the poor fit between interventions and cancer survivors' needs. The 'Readiness for Return To Work' (RRTW) questionnaire could facilitate intervention development tailored to cancer survivors' needs. We performed a cross-cultural translation and adaptation of this questionnaire into Dutch and pre-tested its psychometric properties among cancer survivors. METHODS Questionnaire translation and adaptation were conducted using a systematic approach of: forward translation, synthesis, backward translation, consolidation of translations with an expert committee, and pre-testing. Pre-testing consisted of interviewing 40 cancer survivors, who completed the questionnaire. RESULTS The translated and adapted RRTW questionnaire showed reasonable psychometric properties, that is high item-to-stage correlations and internal consistency for all RRTW stages, except for the prepared for action - self-evaluative stage. CONCLUSIONS The translated and adapted RRTW questionnaire may be useful for tailoring interventions to support cancer survivors in returning to and maintaining at work. However, some items showed poor psychometric properties and several factors, important for work participation, are not captured, for example personal, disease-, treatment- and/or work-related characteristics. We recommend to further test the RRTW questionnaire and to use it in combination with additional measurement instruments when developing tailored work participation interventions.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Amber D Zegers
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Christina Malmose Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus C, Denmark.,DEFACTUM Social & Health Services and Labour Market, Aarhus C, Denmark
| | - Marianne de Maaker-Berkhof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke Abma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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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: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Robroek SJW, Oude Hengel KM, van der Beek AJ, Boot CRL, van Lenthe FJ, Burdorf A, Coenen P. Socio-economic inequalities in the effectiveness of workplace health promotion programmes on body mass index: An individual participant data meta-analysis. Obes Rev 2020; 21:e13101. [PMID: 32696580 PMCID: PMC7583467 DOI: 10.1111/obr.13101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/04/2020] [Accepted: 06/26/2020] [Indexed: 12/30/2022]
Abstract
This individual participant data meta-analysis assessed the effectiveness of workplace health promotion programmes on body mass index (BMI) across socio-economic groups and whether study and intervention characteristics explained inequalities in effectiveness. Studies were eligible if they assessed the effect of a workplace health promotion programme on BMI in the Netherlands, included workers of at least two different socio-economic positions (SEPs) and had a study design with premeasurement and postmeasurement and control condition. Data of 13 studies presenting 16 interventions (5183 participants) were harmonized. In a two-stage meta-analysis, the interaction between intervention and SEP on BMI was tested with linear mixed models for each study. Subsequently, the interaction terms were pooled. The influence of study and intervention characteristics on the effectiveness of workplace health promotion programmes was evaluated using meta-regression analyses. Compared with control conditions, workplace health promotion programmes overall showed a statistically non-significant 0.12 kg/m2 (95% CI: -0.01, 0.25) decrease in BMI, which did not differ across SEP. Interventions evaluated within randomized controlled trials, agentic interventions, those that focused on high-risk groups, included a counselling component, consisted of more than five sessions, or were offered at the individual level did statistically significantly reduce BMI. No evidence was found for intervention-generated SEP inequalities.
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Affiliation(s)
- Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Perceived musculoskeletal discomfort and its association with postural shifts during 4-h prolonged sitting in office workers. Appl Ergon 2020; 89:103225. [PMID: 32755740 DOI: 10.1016/j.apergo.2020.103225] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/09/2020] [Accepted: 07/18/2020] [Indexed: 06/11/2023]
Abstract
This study examined the characteristics of perceived discomfort and postural shifts at different magnitudes during a 4-h sitting period and the association between perceived discomfort and number of postural shifts. Forty healthy participants continuously typed a standardized text passage at a computer work station for 4 h. Subjects rated perceived body discomfort using Borg's CR-10 scale in 10 body regions (i.e. neck, shoulder, elbow, wrist/hand, upper back, lower back, buttock, thigh, knee, and ankle/foot). A seat pressure mat device was used to gather seat pressure data during sitting. Postural shifts were determined by analysis of the dispersion index of both ischial tuberosities from seat pressure data. The threshold for a postural shift was set at ±10% and ±20%. Perceived discomfort in all body regions increased continuously during a 4-h sitting period. The body regions with the highest perceived discomfort were the low back, buttocks, upper back, thigh, and neck. The average (±SD) numbers of postural shifts during the 1st, 2nd, 3rd, and 4th hour of sitting were 14.8 ± 9.5, 17.8 ± 9.4, 18.2 ± 11.1, and 18.1 ± 9.8 shifts per hour for the 10% threshold, and were 4.8 ± 4.4, 6.0 ± 5.6, 7.4 ± 6.7, and 7.7 ± 6.6 shifts per hour for the 20% threshold, respectively. Prolonged sitting led to an increase in perceived musculoskeletal discomfort over time. The number of postural shifts at both magnitudes increased in the first 2 h of sitting and, in the second 2-h period of sitting, only the number of larger postural shifts (with 20% threshold) increased. The findings extend our understanding of sitting behaviors.
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Affiliation(s)
- Pooriput Waongenngarm
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands.
| | - Nipaporn Akkarakittichoke
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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35
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Zegers AD, Coenen P, van Belzen M, Engelen V, Richel C, Dona DJS, van der Beek AJ, Duijts SFA. Cancer survivors' experiences with conversations about work-related issues in the hospital setting. Psychooncology 2020; 30:27-34. [PMID: 33037828 PMCID: PMC7894286 DOI: 10.1002/pon.5529] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/11/2020] [Accepted: 08/16/2020] [Indexed: 01/22/2023]
Abstract
Objective Early access to work‐related psychosocial cancer care can contribute to return to work of cancer survivors. We aimed to explore: (a) the extent to which hospital healthcare professionals conduct conversations about work‐related issues with cancer survivors, (b) whether cancer survivors experience these conversations as helpful, and (c) the possible financial implications for cancer survivors of (not) discussing their work early on. Methods The Dutch Federation of Cancer Patient Organizations developed and conducted a cross‐sectional online survey, consisting of 27 items, among cancer survivors in the Netherlands. Results In total, 3500 survivors participated in this study (71% female; mean age (SD) 56 (11) years). Thirty‐two percent reported to have had a conversation about work‐related issues with a healthcare professional in the hospital. Fifty‐four percent indicated that this conversation had been helpful to them. Conversations about work‐related issues took place more frequently with male cancer survivors, those aged 55 years or below, those diagnosed with gynecological, prostate, breast, and hematological or lymphatic cancer, those diagnosed ≤2 years ago, or those who received their last treatment ≤2 years ago. There was no statistically significant association between the occurrence of conversations about work‐related issues and experiencing the financial consequences of cancer and/or its treatment as burdensome. Conclusions Although conversations about work‐related issues are generally experienced as helpful by cancer survivors, early access to work‐related psychosocial cancer care in the hospital setting is not yet systematically offered.
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Affiliation(s)
- Amber D Zegers
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mirjam van Belzen
- Dutch Federation of Cancer Patients Organizations (Nederlandse Federatie van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Vivian Engelen
- Dutch Federation of Cancer Patients Organizations (Nederlandse Federatie van Kankerpatiëntenorganisaties, NFK), Utrecht, The Netherlands
| | - Carol Richel
- Dutch Breast Cancer Organization (Borstkankervereniging Nederland, BVN), Utrecht, The Netherlands
| | - Desiree J S Dona
- Department of Human Resources, Radboud university medical center, Nijmegen, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland, IKNL), Utrecht, The Netherlands
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36
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Middeldorp M, Loef B, van der Beek AJ, van Baarle D, Proper KI. Sickness absenteeism, work performance, and healthcare use due to respiratory infections for shift and non-shift workers. Chronobiol Int 2020; 37:1325-1334. [PMID: 33050768 DOI: 10.1080/07420528.2020.1825468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study aimed to compare sickness absenteeism, work performance, and healthcare use due to respiratory infections, as well as general sickness absenteeism and work performance between shift and non-shift workers. In this study, 589 shift and non-shift workers employed in hospitals were included. For 6 months, participants kept a daily record of their influenza-like illness/acute respiratory infection (ILI/ARI) symptoms using a diary application. After an episode of ILI/ARI symptoms ended, participants (n = 531) were questioned about their sickness absenteeism (occurrence and duration in hours), work performance (on a 10 point scale), and healthcare use during the ILI/ARI episode. At the end of the 6 months follow-up, participants (n = 498) were also asked about general sickness absenteeism and work performance in the past 4 weeks. Mixed-model and regression analyses were used to compare absenteeism, work performance, and healthcare use between shift and non-shift workers. No differences were found in sickness absenteeism [Odds Ratio (OR) = 1.00 (95%‒Confidence Interval (CI): 0.61‒1.64)] and work performance [Regression coefficient (B) = -0.19 (95%‒CI: -0.65‒0.26)] due to ILI/ARI between shift and non-shift workers. In addition, healthcare use due to ILI/ARI was similar between shift and non-shift workers. Furthermore, similar general sickness absenteeism rates and work performance levels were found between shift and non-shift workers. As this is the first study that examined the associations with shift work due to ILI/ARI, further studies are needed to confirm our findings.
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Affiliation(s)
- Marit Middeldorp
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Bette Loef
- Centre for Nutrition,Prevention and Health Services, 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
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Debbie van Baarle
- Centre for Immunology of Infectious Diseases and Vaccins, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Department of Immunology, Laboratory for Translational Immunology, University Medical Center Utrecht, Utrecht University, The Netherlands
| | - Karin I Proper
- Centre for Nutrition,Prevention and Health Services, 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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37
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Straker L, Holtermann A, Lee IM, van der Beek AJ, Stamatakis E. Privileging the privileged: the public health focus on leisure time physical activity has contributed to widening socioeconomic inequalities in health. Br J Sports Med 2020; 55:bjsports-2020-103356. [PMID: 33004406 DOI: 10.1136/bjsports-2020-103356] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Andreas Holtermann
- Department of Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - I-Min Lee
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Allard J van der Beek
- Public and Occupational Health, Amsterdam UMC - VUMC Campus, Amsterdam, The Netherlands
| | - Emmanuel Stamatakis
- School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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van Leeuwen LM, Tamminga SJ, Ravinskaya M, de Wind A, Hahn EA, Terwee CB, Beckerman H, Boezeman EJ, Hoving JL, Huysmans MA, Nieuwenhuijsen K, de Boer AGEM, van der Beek AJ. Proposal to extend the PROMIS® item bank v2.0 'Ability to Participate in Social Roles and Activities': item generation and content validity. Qual Life Res 2020; 29:2851-2861. [PMID: 32488684 PMCID: PMC7561593 DOI: 10.1007/s11136-020-02540-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Previous research indicated that the Patient-Reported Outcomes Measurement Information System (PROMIS®) item bank v2.0 'Ability to Participate in Social Roles and Activities' may miss subdomains of social participation. The purpose of this study was to generate items for these missing subdomains and to evaluate their content validity. METHODS A three-step approach was followed: (1) Item generation for 16 International Classification of Functioning Disability and Health subdomains currently not covered by the item bank; (2) Evaluation of content validity of generated items through expert review (n = 20) and think-aloud interviews with a purposeful sample of people with and without (chronic) health conditions (n = 10), to assess item comprehensibility, relevance, and comprehensiveness; and 3) Item revision based on the results of step 2, in a consensus procedure. RESULTS First, 48 items were generated. Second, overall, content experts indicated that the generated items were relevant. Furthermore, based on experts' responses, items were simplified and 'participation in social media' was identified as an important additional subdomain of social participation. Additionally, 'participating in various social roles simultaneously' was identified as a missing item. Based on the responses of the interviewed adults items were simplified. Third, in total 17 items, covering 17 subdomains, were proposed to be added to the original item bank. DISCUSSION The relevance, comprehensibility and comprehensiveness of the 17 proposed items were supported. Whether the proposed extension of the item bank leads to better psychometric properties of the item bank should be tested in a large-scale field study.
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Affiliation(s)
- Lisette M van Leeuwen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan, 1081 BT, Amsterdam, Netherlands.
| | - Sietske J Tamminga
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Margarita Ravinskaya
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Astrid de Wind
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Elisabeth A Hahn
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL, USA
| | - Caroline B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Heleen Beckerman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Edwin J Boezeman
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Jan L Hoving
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Maaike A Huysmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Angela G E M de Boer
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
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Coenen P, Robroek SJW, van der Beek AJ, Boot CRL, van Lenthe FJ, Burdorf A, Oude Hengel KM. Socioeconomic inequalities in effectiveness of and compliance to workplace health promotion programs: an individual participant data (IPD) meta-analysis. Int J Behav Nutr Phys Act 2020; 17:112. [PMID: 32887617 PMCID: PMC7650284 DOI: 10.1186/s12966-020-01002-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This individual patient data (IPD) meta-analysis aimed to investigate socioeconomic inequalities in effectiveness on healthy behavior of, and compliance to, workplace health promotion programs. METHODS Dutch (randomized) controlled trials were identified and original IPD were retrieved and harmonized. A two-stage meta-analysis was conducted where linear mixed models were performed per study (stage 1), after which individual study effects were pooled (stage 2). All models were adjusted for baseline values of the outcomes, age and gender. Intervention effects were assessed on physical activity, diet, alcohol use, and smoking. Also, we assessed whether effects differed between participants with low and high program compliance and. All analyses were stratified by socioeconomic position. RESULTS Data from 15 studies (n = 8709) were harmonized. Except for fruit intake (beta: 0·12 [95% CI 0·08 0·15]), no effects were found on health behaviors, nor did these effects differ across socioeconomic groups. Only participants with high compliance showed significant improvements in vigorous and moderate-to-vigorous physical activity, and in more fruit and less snack intake. There were no differences in compliance across socioeconomic groups. CONCLUSIONS Workplace health promotion programs were in general not effective. Neither effectiveness nor compliance differed across socioeconomic groups (operationalized by educational level). Even though stronger effects on health behavior were found for participations with high compliance, effects remained small. The results of the current study emphasize the need for new directions in health promotion programs to improve healthy behavior among workers, in particular for those in lower socioeconomic position.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Work, Health and Technology, Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 79-86, 2316, Leiden, The Netherlands
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40
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Louwerse I, van Rijssen HJ, Huysmans MA, van der Beek AJ, Anema JR. Predicting Long-Term Sickness Absence and Identifying Subgroups Among Individuals Without an Employment Contract. J Occup Rehabil 2020; 30:371-380. [PMID: 32030546 PMCID: PMC7406482 DOI: 10.1007/s10926-020-09874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Today, decreasing numbers of workers in Europe are employed in standard employment relationships. Temporary contracts and job insecurity have become more common. This study among workers without an employment contract aimed to (i) predict risk of long-term sickness absence and (ii) identify distinct subgroups of sick-listed workers. Methods 437 individuals without an employment contract who were granted a sickness absence benefit for at least two weeks were followed for 1 year. We used registration data and self-reported questionnaires on sociodemographics, work-related, health-related and psychosocial factors. Both were retrieved from the databases of the Dutch Social Security Institute and measured at the time of entry into the benefit. We used logistic regression analysis to identify individuals at risk of long-term sickness absence. Latent class analysis was used to identify homogenous subgroups of individuals. Results Almost one-third of the study population (n = 133; 30%) was still at sickness absence at 1-year follow-up. The final prediction model showed fair discrimination between individuals with and without long-term sickness absence (optimism adjusted AUC to correct for overfitting = 0.761). Four subgroups of individuals were identified based on predicted risk of long-term sickness absence, self-reported expectations about recovery and return to work, reason of sickness absence and coping skills. Conclusion The logistic regression model could be used to identify individuals at risk of long-term sickness absence. Identification of risk groups can aid professionals to offer tailored return to work interventions.
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Affiliation(s)
- Ilse Louwerse
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands.
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands.
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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Koopman E, Heemskerk M, van der Beek AJ, Coenen P. Factors associated with caregiver burden among adult (19-64 years) informal caregivers - An analysis from Dutch Municipal Health Service data. Health Soc Care Community 2020; 28:1578-1589. [PMID: 32207221 PMCID: PMC7496310 DOI: 10.1111/hsc.12982] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/23/2020] [Accepted: 03/04/2020] [Indexed: 05/25/2023]
Abstract
Due to the ageing population and the rising prevalence of chronic diseases, it is expected that the demand on informal caregivers will increase. Many informal caregivers experience burden, which can have negative consequences for their own health and that of the care recipient. To prevent caregiver burden, it is important to investigate factors associated with this burden. We aimed to identify factors associated with caregiver burden in adult informal caregivers. Among a sample of adult informal caregivers (n = 1,100) of the Dutch region of Zaanstreek-Waterland, perceived caregiver burden, demographic factors, caregiving situation, health-related factors and socio-financial factors were measured as part of the national Health Survey in 2016. Using univariate and multivariate logistic regression analysis, for which a backward selection method was applied, associations with caregiver burden were studied. In the multivariate model, time spent providing informal care was significantly associated with perceived caregiver burden, with an odds ratio (OR) [95% confidence interval] of 7.52 [3.93-14.39] for those spending >16 hr compared to 1-2 hr on informal care. Also providing care to their child(ren) (OR: 2.55 [1.51-4.31]), poor perceived health (OR: 1.80 [1.20-2.68]) and loneliness of the caregiver (OR: 2.05 [1.41-2.99]) were significantly associated with caregiver burden. To possibly prevent and reduce informal caregiver burden, factors associated with such burden should be intervened on. As such, special attention should be paid to caregivers who provide many hours of care or provide care to their child(ren), as well as those who have a poor perceived health themselves and/or experience feelings of loneliness.
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Affiliation(s)
- Emma Koopman
- Public Health Service Zaanstreek‐WaterlandZaanstadThe Netherlands
| | | | - Allard J. van der Beek
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Pieter Coenen
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
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de Wind A, Sewdas R, Hoogendijk EO, van der Beek AJ, Deeg DJH, Boot CRL. Occupational Exposures Associated with Life Expectancy without and with Disability. Int J Environ Res Public Health 2020; 17:ijerph17176377. [PMID: 32882992 PMCID: PMC7503628 DOI: 10.3390/ijerph17176377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 01/05/2023]
Abstract
Policies to extend working lives often do not take into account potentially important health inequalities arising from differences in occupational exposures. Little is known about which occupational exposures are associated with these inequalities. This study aims to examine differences in life expectancy without and with disability by occupational exposures. Longitudinal data (1992–2016) on disability and physical and psychosocial work demands and resources of 2513 (former) workers aged ≥55 years participating in the Longitudinal Aging Study Amsterdam were used. Gender specific life expectancies without and with disability by occupational exposures were calculated using multistate survival models. Women aged 55 years with high physical work demands had a lower life expectancy without disability than those with low exposure (1.02–1.57 years), whereas there was no difference for men. Men and women with high psychosocial work demands and resources had a longer life expectancy without disability than those with low exposure (1.19–2.14 years). Life expectancy with disability did not significantly differ across occupational exposures. Workers with higher psychosocial demands and resources and lower physical demands can expect to live more disability-free years. Information on occupational exposure helps to identify workers at risk for lower life expectancy, especially without disability, who may need specific support regarding their work environment.
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Affiliation(s)
- Astrid de Wind
- Behavioural Science Institute, Radboud University, 6500 Nijmegen, The Netherlands
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, 1081 Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
- Correspondence: ; Tel.: +31-(0)20-566-3279
| | - Ranu Sewdas
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
| | - Emiel O. Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (E.O.H.); (D.J.H.D.)
| | - Allard J. van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
| | - Dorly J. H. Deeg
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (E.O.H.); (D.J.H.D.)
| | - Cécile R. L. Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, 1081 Amsterdam, The Netherlands; (R.S.); (A.J.v.d.B.); (C.R.L.B.)
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Klaver KM, Duijts SFA, Geusgens CAV, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Internet-based cognitive rehabilitation for WORking Cancer survivors (i-WORC): study protocol of a randomized controlled trial. Trials 2020; 21:664. [PMID: 32690067 PMCID: PMC7372808 DOI: 10.1186/s13063-020-04570-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/02/2020] [Indexed: 01/19/2023] Open
Abstract
Background Cognitive problems are common in non-central nervous system cancer survivors. These problems are perceived as an important contributor to decline in work performance and work ability. Various interventions for cognitive problems have been proposed, but effectiveness regarding work-related outcomes has not yet been established. Effective treatment options to alleviate the adverse influence of cognitive problems on work performance are needed for working cancer survivors. In this paper, we will describe the design of a randomized, controlled, multicenter trial that evaluates the (cost-)effectiveness of an Internet-based cognitive rehabilitation program for occupationally active cancer survivors confronted with cognitive problems. Methods/ design A three-armed randomized controlled trial will be conducted, including two intervention groups (i.e., basic and extensive cognitive rehabilitation program) and one waitlist control group. In total, 261 cancer survivors (18–65 years) who have returned to work and who experience cognitive problems will be recruited. Patients with and without cognitive impairment as established in a neuropsychological assessment will be eligible; stratification will take place based on the presence of this cognitive impairment. The extensive intervention arm will contain a comprehensive training program (including psycho-education, fatigue management, and cognitive strategy training) with individual guidance (blended intervention). The basic intervention arm will contain a brief cognitive training program (including psycho-education and fatigue management) without individual guidance. The primary outcome will be accomplishment of an individually defined work-related treatment goal. Secondary outcomes include, among others, subjective cognitive functioning, work functioning, and quality of life. Primary and secondary outcomes will be measured at baseline (T0) and at 12 weeks (T1) and 26 weeks (T2) post-randomization. Discussion About 40–50% of the cancer patients worldwide are of working age at time of diagnosis. Many of the occupationally active cancer survivors experience cognitive problems. Both from an individual and a societal perspective, it is important to sustain cancer survivors’ employability. An effective treatment to alleviate the impact of cognitive decline and to improve work ability might help cancer survivors to sustain employability. Trial registration ClinicalTrials.gov NCT03900806. Registered on 03 April 2019 (current status: ongoing).
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Affiliation(s)
- Kete M Klaver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | | | - Maureen J B Aarts
- Department of Medical Oncology, Maastricht University MC, Maastricht, The Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology/School of Mental Health and Neurosciences (MHeNS), Maastricht University MC, Maastricht, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Brain and Cognition group, University of Amsterdam, Amsterdam, The Netherlands
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Bakker EJM, Kox JHAM, Boot CRL, Francke AL, van der Beek AJ, Roelofs PDDM. Improving mental health of student and novice nurses to prevent dropout: A systematic review. J Adv Nurs 2020; 76:2494-2509. [PMID: 32538480 PMCID: PMC7540364 DOI: 10.1111/jan.14453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 01/03/2023]
Abstract
Aims To provide: (a) an overview of interventions aimed at improving mental health of student or novice nurses; and (b) an evaluation of their effectiveness on dropout‐related outcomes. Design Systematic review. Data sources Research papers published between January 1971–February 2019 were identified from the following databases: Embase, Medline, PsycInfo, CINAHL, ERIC, the Cochrane Library, Web of Science, and Google Scholar. Review methods We followed the procedures recommended by the Editorial Board of the Cochrane Collaboration Back Review Group. We included peer‐reviewed articles with a quantitative research design, examining interventions aimed at improving mental health of student and novice nurses and their effect on dropout‐related outcomes. The large variation in studies prohibited statistical pooling and a synthesis without meta‐analysis of studies was performed. Results We identified 21 studies with three areas of focus: managing stress or stressors (N = 4); facilitating the transition to nursing practice (N = 14); and a combined approach (N = 3). Five studies showed a statistically significant effect on dropout‐related outcomes. The overall risk of bias was high. Conclusion A wide range of interventions are available, but the evidence for their effectiveness is limited. There is a need for high‐quality studies in this field, preferably with a randomized controlled design.
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Affiliation(s)
- Ellen J M Bakker
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos H A M Kox
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of General Practice, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,NIVEL Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Holtermann A, Straker L, Lee IM, van der Beek AJ, Stamatakis E. Long overdue remarriage for better physical activity advice for all: bringing together the public health and occupational health agendas. Br J Sports Med 2020; 54:1377-1378. [PMID: 32376672 DOI: 10.1136/bjsports-2019-101719] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Andreas Holtermann
- Department of musculoskeletal disorders and physical workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital and Harvard Medical School; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, Netherlands
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Loef B, van der Beek AJ, Hulsegge G, van Baarle D, Proper KI. The mediating role of sleep, physical activity, and diet in the association between shift work and respiratory infections. Scand J Work Environ Health 2020; 46:516-524. [PMID: 32255192 PMCID: PMC7737798 DOI: 10.5271/sjweh.3896] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Shift work may be associated with an increased incidence of respiratory infections. However, underlying mechanisms are unclear. Therefore, our aim was to examine the mediating role of sleep, physical activity, and diet in the association between shift work and respiratory infections. Methods: This prospective cohort study included 396 shift and non-shift workers employed in hospitals. At baseline, sleep duration and physical activity were measured using actigraphy and sleep/activity diaries, sleep quality was reported, and frequency of meal and snack consumption was measured using food diaries. In the following six months, participants used a smartphone application to report their influenza-like illness/acute respiratory infection (ILI/ARI) symptoms daily. Mediation analysis of sleep, physical activity, and diet as potential mediators of the effect of shift work on ILI/ARI incidence rate was performed using structural equation modeling with negative binomial and logistic regression. Results: Shift workers had a 23% [incidence rate ratio (IRR) 1.23, 95% CI 1.01–1.49] higher incidence rate of ILI/ARI than non-shift workers. After adding the potential mediators to the model, this reduced to 15% (IRR 1.15, 95% CI 0.94–1.40). The largest mediating (ie, indirect) effect was found for poor sleep quality, with shift workers having 29% more ILI/ARI episodes via the pathway of poorer sleep quality (IRR 1.29, 95% CI 1.02–1.95). Conclusions: Compared to non-shift workers, shift workers had a higher incidence rate of ILI/ARI that was partly mediated by poorer sleep quality. Therefore, it may be relevant for future research to focus on perceived sleep quality as an underlying mechanism in the relation between shift work and increased infection susceptibility.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment; P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
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Coenen P, Huysmans MA, Holtermann A, Krause N, van Mechelen W, Straker LM, van der Beek AJ. Towards a better understanding of the ‘physical activity paradox’: the need for a research agenda. Br J Sports Med 2020; 54:1055-1057. [DOI: 10.1136/bjsports-2019-101343] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 11/04/2022]
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Renaud LR, Jelsma JGM, Huysmans MA, van Nassau F, Lakerveld J, Speklé EM, Bosmans JE, Stijnman DPM, Loyen A, van der Beek AJ, van der Ploeg HP. Effectiveness of the multi-component dynamic work intervention to reduce sitting time in office workers - Results from a pragmatic cluster randomised controlled trial. Appl Ergon 2020; 84:103027. [PMID: 31987512 DOI: 10.1016/j.apergo.2019.103027] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/15/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Prolonged sitting, which is highly prevalent in office workers, has been associated with several health risks. The aim of this study was to evaluate the Dynamic Work intervention by determining its effect on total sitting time at the 8-month follow-up in comparison to the control. METHODS This two-arm pragmatic cluster randomised controlled trial included 244 office workers from 14 different departments of a large, Dutch insurance company. The Dynamic Work intervention was a real-life, worksite intervention that included environmental components (i.e. sit-stand workstations), organisational components (i.e. group sessions), and individual components (e.g. activity/sitting trackers). Outcomes were assessed at baseline, 4-month follow-up, and 8-month follow-up. The primary outcome was total sitting time per day, objectively assessed using the activPAL activity monitor at 8-month follow-up. Secondary outcomes included other total and occupational movement behaviour outcomes, health-related outcomes, and work-related outcomes. Data analyses were performed using linear and logistic mixed models. RESULTS Total sitting time did not differ between the intervention and control group at the 8-month follow-up. Secondary outcomes also showed no difference between the intervention and control group at either the 4-month or at 8-month follow-up, with the exception of number of occupational steps, which showed a statistically significant effect at 4-month follow-up (but not at 8-month follow-up) of 913 (95% CI = 381-1445) steps/8-h working day. CONCLUSIONS This study evaluated the effectiveness of a real-life worksite intervention to reduce sitting time and showed little to no effect. This may be due to the relatively low intensity of the intervention, i.e. that it only involved the replacement of 25% of sitting workstations with sit-stand workstations. Future research should focus on the evaluation of more intensive real-life worksite interventions that are still feasible for implementation in daily practice. CLINICALTRIALS. GOV, REGISTRATION NUMBER NCT03115645.
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Affiliation(s)
- Lidewij R Renaud
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands.
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Maaike A Huysmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam UMC, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Global Geo Health Data Center, Utrecht University, Utrecht, the Netherlands
| | - Erwin M Speklé
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands; Arbo Unie, Occupational Health Service, Utrecht, the Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, the Netherlands
| | - Dominique P M Stijnman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pediatrics, Amsterdam Cardiovascular Sciences Institute, the Netherlands
| | - Anne Loyen
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, Bilthoven, the Netherlands
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Hidde P van der Ploeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, the Netherlands
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Hulsegge G, Loef B, Benda T, van der Beek AJ, Proper KI. Shift work and its relation with meal and snack patterns among healthcare workers. Scand J Work Environ Health 2020; 46:143-151. [DOI: 10.5271/sjweh.3829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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50
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Louwerse I, Huysmans MA, van Rijssen JHJ, Schaafsma FG, Weerdesteijn KHN, van der Beek AJ, Anema JR. Predicting future changes in the work ability of individuals receiving a work disability benefit:
weighted analysis of longitudinal data. Scand J Work Environ Health 2020; 46:168-176. [DOI: 10.5271/sjweh.3834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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