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Akerstrom M, Severin J, Miech EJ, Wikström E, Roczniewska M. Reducing sickness absence among public-sector healthcare employees: the difference-making roles of managerial and employee participation. Int Arch Occup Environ Health 2024; 97:341-351. [PMID: 38409534 PMCID: PMC10944807 DOI: 10.1007/s00420-024-02048-0] [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: 09/05/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Evaluations of organizational-level interventions to prevent work-related illness have identified enabling factors, but knowledge of necessary and sufficient conditions for intervention success is needed. The aim was to identify difference-making factors that distinguish intervention groups with and without a positive intervention effect on sickness absence. METHODS An organizational-level intervention designed to decrease sickness absence by providing support from process facilitators was implemented at eight healthcare workplaces in Sweden between 2017 and 2018. We applied coincidence analysis (CNA) to analyze 34 factors and determine which factors were necessary and sufficient for a successful implementation of tailored interventional measures on an organizational level (dichotomous) and reduced sickness absence (trichotomous). RESULTS Two factors perfectly explained both the presence and absence of a successful implementation: "a high sense of urgency" and "good anchoring and participation from the strategic management". The presence of either of these factors alone was sufficient for successful implementation, whereas the joint absence of both conditions was necessary and sufficient for the absence of successful implementation and an intervention effect. In addition, high employee participation was both necessary and sufficient for a high intervention effect. For organizations without high employee participation, successful implementation led to a medium-effect size. CONCLUSIONS This study identified participation as a difference-maker in the implementation process. Participation from different stakeholders turned out to be important in different phases. When implementing organizational-level interventions, high participation from both strategic management and employees appears to be crucial in terms of the intervention's effect on sickness absence.
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Affiliation(s)
- M Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Carl Skottbergs Gata 22B, 413 19, Gothenburg, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - J Severin
- Region Västra Götaland, Institute of Stress Medicine, Carl Skottbergs Gata 22B, 413 19, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - E J Miech
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - E Wikström
- Department of Business Administration, School of Business, Economics and Law, University of Gothenburg, Gothenburg, Sweden
| | - M Roczniewska
- Procome Research Group, Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
- Institute of Psychology, SWPS University, Sopot, Poland
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Taubman DS, Parikh SV. Understanding and Addressing Mental Health Disorders: a Workplace Imperative. Curr Psychiatry Rep 2023; 25:455-463. [PMID: 37589777 DOI: 10.1007/s11920-023-01443-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE OF REVIEW This article seeks to provide a broad overview of the workplace mental health literature, highlight practical implications of current research, and formulate key recommendations for stakeholders. Various aspects of disability related to mental health disorders, their associated financial costs, and the impact of stigma are covered. This article also discusses key strategies for assessing mental health problems among employees and reviews different types of interventions in the workplace. RECENT FINDINGS Workplace mental health is an evolving area, particularly in the wake of the pandemic. While established national workplace mental health standards do not currently exist, mental illness continues to have a severe impact on the health of organizations, employees, and the economy. Additional research is needed to fully understand and address the diversity of mental health needs among the broad range of employees and organizations across the USA. Employers have a responsibility and an opportunity to create workplaces that support the whole person, not just the employee. While research in the area has increased in the last decade, there is still much to learn in terms of the most effective ways to support our workforce.
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Schmidt JM, Epel ES, Jacobs LM, Mason AE, Parrett B, Pickett AM, Mousli LM, Schmidt LA. Controlled trial of a workplace sales ban on sugar-sweetened beverages. Public Health Nutr 2023; 26:2130-2138. [PMID: 37465952 PMCID: PMC10564602 DOI: 10.1017/s1368980023001386] [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: 11/01/2022] [Revised: 05/16/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors. DESIGN A controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban n 315; control n 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban. SETTING Sutter Health, a large non-profit healthcare delivery system in Northern California. PARTICIPANTS Full-time employees at Sutter Health screened for heavy SSB consumption. RESULTS Participants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI -4·9, -0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI -8·4, -0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption. CONCLUSIONS Workplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.
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Affiliation(s)
- Jamey M Schmidt
- Sutter Health California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Laurie M Jacobs
- Philip R Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA
| | - Ashley E Mason
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Bethany Parrett
- Sutter Health California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Amanda M Pickett
- Sutter Health California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - Leyla M Mousli
- Philip R Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA
| | - Laura A Schmidt
- Philip R Lee Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California at San Francisco, San Francisco, CA94143, USA
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Tsantila F, Coppens E, De Witte H, Arensman E, Amann B, Cerga-Pashoja A, Corcoran P, Creswell-Smith J, Cully G, Toth MD, Greiner B, Griffin E, Hegerl U, Holland C, Leduc C, Leduc M, Ni Dhalaigh D, O'Brien C, Paterson C, Purebl G, Reich H, Ross V, Rugulies R, Sanches S, Thompson K, Van Audenhove C. Outcome assessment of a complex mental health intervention in the workplace. Results from the MENTUPP pilot study. Int Arch Occup Environ Health 2023; 96:1149-1165. [PMID: 37452149 PMCID: PMC10504212 DOI: 10.1007/s00420-023-01996-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Multicomponent interventions are recommendable to achieve the greatest mental health benefits, but are difficult to evaluate due to their complexity. Defining long-term outcomes, arising from a Theory of Change (ToC) and testing them in a pilot phase, is a useful approach to plan a comprehensive and meaningful evaluation later on. This article reports on the pilot results of an outcome evaluation of a complex mental health intervention and examines whether appropriate evaluation measures and indicators have been selected ahead of a clustered randomised control trial (cRCT). METHODS The MENTUPP pilot is an evidence-based intervention for Small and Medium Enterprises (SMEs) active in three work sectors and nine countries. Based on our ToC, we selected the MENTUPP long-term outcomes, which are reported in this article, are measured with seven validated scales assessing mental wellbeing, burnout, depression, anxiety, stigma towards depression and anxiety, absenteeism and presenteeism. The pilot MENTUPP intervention assessment took place at baseline and at 6 months follow-up. RESULTS In total, 25 SMEs were recruited in the MENTUPP pilot and 346 participants completed the validated scales at baseline and 96 at follow-up. Three long-term outcomes significantly improved at follow-up (p < 0.05): mental wellbeing, symptoms of anxiety, and personal stigmatising attitudes towards depression and anxiety. CONCLUSIONS The results of this outcome evaluation suggest that MENTUPP has the potential to strengthen employees' wellbeing and decrease anxiety symptoms and stigmatising attitudes. Additionally, this study demonstrates the utility of conducting pilot workplace interventions to assess whether appropriate measures and indicators have been selected. Based on the results, the intervention and the evaluation strategy have been optimised.
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Affiliation(s)
- Fotini Tsantila
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium.
| | - Evelien Coppens
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
| | - Hans De Witte
- Research Group Work, Organisational and Personnel Psychology (WOPP-O2L), KU Leuven, Louvain, Belgium
- Optentia Research Unit, Vaal Campus, North-West University, Vanderbijlpark, South Africa
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Benedikt Amann
- Centre Fòrum Research Unit, Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain
- Mental Health Institute Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
- Universitat Pompeu Fab, Barcelona, Spain
| | - Arlinda Cerga-Pashoja
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Corcoran
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Grace Cully
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Monika Ditta Toth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Birgit Greiner
- School of Public Health, University College Cork, Cork, Ireland
| | - Eve Griffin
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Ulrich Hegerl
- European Alliance against Depression e.V., Leipzig, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt Am Main, Germany
| | - Carolyn Holland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Cliodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Charlotte Paterson
- University of Stirling, Nursing, Midwifery and Allied Health Professionals Research Unit, Stirling, Scotland, UK
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Hanna Reich
- German Depression Foundation, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sarita Sanches
- Phrenos Center of Expertise for Severe mental illness, Utrecht, The Netherlands
- Altrecht Mental Health Care, Utrecht, The Netherlands
| | | | - Chantal Van Audenhove
- Centre for Care Research and Consultancy, LUCAS, KU Leuven, Louvain, Belgium
- Academic Center for General Practice, KU Leuven, Louvain, Belgium
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Dahlqvist I, Ståhl C, Severin J, Akerstrom M. Shifting from an individual to an organizational perspective in work environment management - a process evaluation of a six-year intervention program within the Swedish public sector. BMC Public Health 2023; 23:1108. [PMID: 37291519 PMCID: PMC10248951 DOI: 10.1186/s12889-023-16059-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/06/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Working systematically with the work environment, particularly the organizational and psychosocial work environment entails several challenges for employers. There is a lack of knowledge on how to best undertake this work. Thus, the aim of this study is to evaluate the process of a six-year organizational-level intervention program where workplaces could apply for additional funds to implement preventive intervention measures, with the intention of improving working conditions and reducing sickness absence within the Swedish public sector. METHODS The program management process was studied using a mixed-method approach combining qualitative document and content analyses based on process documentation produced between 2017 and 2022 (n = 135), interviews with internal occupational health services professionals in 2021 (n = 9) and quantitative descriptive analyses of submitted applications with decisions from 2017 to 2022 (n = 621). RESULTS Qualitative analyses of the process documentation revealed concerns from the project group regarding access to sufficient competence and resources among stakeholders and participating workplaces, and role conflicts and ambiguities between the program and everyday operations. To address these challenges, the application process was developed over time using the knowledge gained from previous years. A change in the mental models in work environment management, from an individual to an organizational perspective, was seen among the project group and the internal occupational health services responsible for implementing most of the granted intervention measures. In addition, the proportion of granted intervention measures on an organizational level increased throughout the years from 39% in 2017 to 89% in 2022. The changes in the application process were believed to be the main contributor to the change among the applying workplaces. CONCLUSIONS Results indicate that a long-term organizational-level workplace intervention program may be used, by the employer, as a tool for shifting from an individual- to an organizational perspective in the work environment management. However, additional measures on multiple levels need to be implemented to secure a sustainable shift in perspective within the organization.
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Affiliation(s)
- I Dahlqvist
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
| | - C Ståhl
- Department of Behavioural Sciences and Learning, Division of Education and Sociology, Linköping University, Linköping, Sweden
| | - J Severin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottbergs gata 22B, Gothenburg, 413 19, Sweden.
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Kotagi P, Angolkar M, Koppad R. Comparison of work efficiency in factory workers: pre & post covid lockdown - a cross sectional study. BMC Public Health 2023; 23:939. [PMID: 37226216 DOI: 10.1186/s12889-023-15886-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/12/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic's impact on economies worldwide has caused changes in work patterns, reduced productivity, and job losses, particularly affecting factory workers. Lockdown measures have also led to reduced physical activity levels, which is a significant risk factor for chronic diseases. This study aims to investigate efficiency of factory workers pre and post lockdown periods. The findings will contribute to identifying evidence-based strategies to minimize the negative impact of lockdown measures on factory workers' productivity and health. MATERIALS AND METHODS A cross-sectional study was conducted to assess the work performance of employees in a medicine manufacturing unit. Data was collected from factory workers online and study period was January 2021 to April 2022. Survey includes close ended questions regarding work performance of employees before lockdown period (Before 20/03/2020) and performance after lockdown period (After August 2020). The sample size of 196 employees selected through simple random sampling. A questionnaire consisting of demographic factors, work details, and work performance was prepared using pretested standard tools, including the Individual Work Performance Questionnaire (IWPQ), the World Health Organization Health and Work Performance Questionnaire (HPQ), and the Stanford Presenteeism Scale (SPS-6). The collected data was analysed using descriptive statistics and a paired t-test. RESULTS The study found that prior to lockdown, 99% of employees consistently had higher performance, with 71.4% ranking in the top 10. However, after lockdown, the percentage of employees with high performance decreased to 91.8%, with only 63.3% ranking in the top 10. These differences were statistically significant, indicating a decrease in work efficiency of 8.1%. Before lockdown, employees worked longer hours, including on off days, while after lockdown, a small proportion missed work due to various reasons, resulting in better quality work. CONCLUSION In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the work efficiency of factory workers. The findings indicate a decrease in work efficiency after the lockdown, coupled with an increase in employee stress. This suggests that the pandemic has brought about unique challenges for factory workers that need to be addressed to maintain their well-being and productivity. This study emphasizes the importance of creating a supportive work environment that prioritizes the mental and physical health of employees, especially during times of crisis.
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Affiliation(s)
- Prathamesh Kotagi
- Department of Public Health, J. N. Medical College, KLE Academy of Higher Education & Research, Belgavi, Karnatka, India.
| | - Mubashir Angolkar
- Department of Public Health, J. N. Medical College, KLE Academy of Higher Education & Research, Belgavi, Karnatka, India
| | - Rajashree Koppad
- Department of Public Health, J. N. Medical College, KLE Academy of Higher Education & Research, Belgavi, Karnatka, India
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Lu Z, Wang S, Li Y, Liu X, Olsen W. Who Gains Mental Health Benefits from Work Autonomy? The Roles of Gender and Occupational Class. Appl Res Qual Life 2023; 18:1-23. [PMID: 37359222 PMCID: PMC9990038 DOI: 10.1007/s11482-023-10161-4] [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] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/25/2023] [Indexed: 06/28/2023]
Abstract
In recent years, improving work autonomy as an important priority in the UK labour market has been shown to enhance employee mental health and well-being. However, previous theories and empirical studies have paid little attention to the intersectional inequalities in the mental health benefits of work autonomy, preventing us from gaining a comprehensive understanding of the mental consequences of work autonomy. By integrating literature from occupational psychology, gender and social class, this study develops theoretical hypotheses regarding whether and how the mental health benefits of work autonomy vary alongside the intersectional axes of gender and occupational class and tests these hypotheses using long-term panel data in the UK (2010-2021). Overall, we find that those from higher occupational class and male employees acquire significantly more mental health benefits from high work autonomy compared with those from lower occupational class and female employees. Moreover, further analyses show significant intersectional inequalities of gender and occupational class. While male employees from all occupational classes gain significant mental health benefits from work autonomy, only female employees from higher (but not lower) occupational classes benefit from work autonomy. These findings contribute to the literature in the sociology of work by demonstrating the intersectional inequalities in mental health consequences of work autonomy, especially for women in the lower occupational class, highlighting the need for a more gender- and occupation-sensitive design in future labour market policies.
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Affiliation(s)
- Zhuofei Lu
- Department of Social Statistics, University of Manchester, HBS Building, Oxford Road, Manchester, M13 9PL UK
| | - Senhu Wang
- Department of Sociology, National University of Singapore, 11 Arts Link, #03-06 AS1, Singapore, 117573 Singapore
| | - Yaojun Li
- Department of Sociology and Cathie Marsh Institute for Social Research, University of Manchester, HBS Building, Oxford Road, Manchester, M13 9PL UK
| | - Xiyuan Liu
- Department of Sociology, University of Manchester, Arthur Lewis Building, Oxford Road, Manchester, M13 9PL UK
| | - Wendy Olsen
- Department of Social Statistics and Cathie Marsh Institute for Social Research, University of Manchester, HBS Building, Oxford Road, Manchester, M13 9PL UK
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Bauer H, Gewurtz R. Demand-side Employment Interventions for Individuals with Common Mental Disorders: a Scoping Review. J Occup Rehabil 2022; 32:629-636. [PMID: 35579666 DOI: 10.1007/s10926-022-10034-x] [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] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 06/15/2023]
Abstract
Traditional approaches to vocational rehabilitation tend to focus on improving worker skills and competencies rather than addressing barriers and inequities in existing workplace structures. The purpose of this scoping review is to provide an overview of current demand-side employment interventions that are aimed at building inclusive hiring and retention practices for persons living with common mental disorders (CMD). Methods Using the method advanced by Arksey and O'Malley (2005), and furthered by Levac et al., (2010), we carried out a scoping review to identify the range and breadth of literature exploring demand-side employment interventions for individuals with CMD. One rater screened titles and abstracts and two independent raters evaluated full-text articles against a set of inclusion/exclusion criteria. A descriptive analysis was conducted to highlight the state of the literature in this area. Results A total of 10 articles were retrieved, including six empirical papers and four theoretical papers. Three broad themes were extracted from the literature: (1) Workplaces as a determinant of worker health; (2) Unique interventions are needed for different work sectors; and (3) Individualistic perspectives embedded in demand-side interventions. Conclusions Demand-side employment interventions hold promise for building employer capacity to hire and retain people with CMD. There is a need for innovative approaches to engage workplace stakeholders in developing and evaluating innovative solutions to build inclusive workplaces.
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Thørrisen MM, Sadeghi T, Bonsaksen T, Graham ID, Aas RW. Working with alcohol prevention in occupational health services: "knowing how" is more important than "knowing that" - the WIRUS OHS study. Addict Sci Clin Pract 2022; 17:54. [PMID: 36183127 PMCID: PMC9526525 DOI: 10.1186/s13722-022-00335-0] [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: 12/09/2021] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels' levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity. METHODS In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses. RESULTS OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η2 = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, β = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units. CONCLUSIONS Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.
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Affiliation(s)
- Mikkel Magnus Thørrisen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway. .,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Talieh Sadeghi
- Work Research Institute, Centre for Welfare and Labour Research, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Tore Bonsaksen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Ian D Graham
- Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Randi Wågø Aas
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway. .,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
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10
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van Hees SGM, Carlier BE, Blonk RWB, Oomens S. Strengthening supervisor support for employees with common mental health problems: developing a workplace intervention using intervention mapping. BMC Public Health 2022; 22:1146. [PMID: 35676640 PMCID: PMC9174917 DOI: 10.1186/s12889-022-13545-7] [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: 03/13/2022] [Accepted: 05/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study presents the development of a workplace intervention to strengthen supervisor’s support for employees with common mental health problems (CMHP). CMHP have been increasing over the last years, resulting into negative work outcomes, such as absenteeism or reduced work performance. To date, organisational interventions have been promising in preventing these negative work outcomes, however it is yet unknown in what way the role of workplace stakeholders, in particular supervisors, can be strengthened. This study contributes to the literature of interventions on an organizational level which uses a preventative approach by promoting stay at work among employees with CMHP through supervisor support. Methods we applied the intervention mapping (IM) approach, by actively involving workplace stakeholders (employees with CMHP, supervisors and occupational health professionals) through the development process and the use of Integrated model of behaviour prediction for employers. All six steps of IM are followed and thematic analysis was used to analyse interviews and focus groups. Results Based on a comprehensive needs assessment, the intervention resulted in an online guideline, with five step-wise themes on how to support employees with CMHP to stay at work (SAW). The guideline addressed the most important and changeable actions using the Integrated model of behaviour prediction. The guideline presents how to signal and address problems in the workplace and find solutions by stimulating autonomy of employees, explore job accommodations and ask for occupational support. In addition, basic conditions on how to create mentally healthy workplaces were presented. Coaching sessions by occupational health professionals, that include practical strategies using the best available evidence, were identified by the stakeholders. Conclusions This SAW-Supervisor Guideline-intervention responds to the need of supervisors to be supported in their role, responsibility and ways to support employees with mental health issues, through a behaviour-oriented, preventative approach. Intervention mapping provided a systematic process to identify, structure and prioritize factors of supervisor support, resulting in a novel workplace intervention. The active involvement of workplace stakeholders throughout the process resulted into a well-received intervention. The theoretical framework provided practical ways to induce supportive behaviour of supervisors, bridging theory with practice.
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Affiliation(s)
- Suzanne G M van Hees
- Occupation and Health Research Group, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands. .,Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Bouwine E Carlier
- Occupation and Health Research Group, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - Roland W B Blonk
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.,TNO, Leiden, The Netherlands.,Optentia, North West University, Vanderbijlpark, South Africa
| | - Shirley Oomens
- Occupation and Health Research Group, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.,Department of Primary and Community Care, Nijmegen School of Occupational Health, Radboudumc, Nijmegen, The Netherlands
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11
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Ståhl C, Gustavsson IN, Jonsdottir IH, Akerstrom M. Multilevel, risk group-oriented strategies to decrease sickness absence in the public sector: evaluation of interventions in two regions in Sweden. Int Arch Occup Environ Health 2022; 95:1415-1427. [PMID: 35451629 PMCID: PMC9273540 DOI: 10.1007/s00420-022-01864-6] [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: 11/02/2021] [Accepted: 04/01/2022] [Indexed: 11/05/2022]
Abstract
Purpose Sickness absence has been identified as needing to be addressed through multilevel interventions, but knowledge regarding optimal design and implementation of such interventions is scarce. The aim of this study was to evaluate the implementation and effects of a large-scale multilevel intervention in the public sector in Sweden. Methods The overall effect of the intervention was assessed using mixed-effect models. Sickness absence data (before, and 6 or 12 months after the intervention) for 90 intervention groups and 378 reference groups was retrieved from administrative personnel systems from the two participating regional councils. The implementation processes were evaluated using qualitative content analysis of qualitative interviews conducted at two timepoints. Results The results show that the vast majority of implemented measures were on an individual level and the integration of the intervention differed between the two regions. The reception and perception of the intervention activities seem to have been influenced by the implementation process, and how well the interventions were communicated and integrated, both regarding the integration of the different interventions and their integration into the discrete context and existing routines. No short-term overall effects on sickness absence were found. Conclusions The results point to the many challenges in implementing complex interventions, especially where organizational measures are involved—including adequate participation by, and communication between, the involved actors, as well as sufficient resources. The results indicate potential learning effects regarding the awareness of organizational factors in sick leave, after implementing and integrating multilevel strategies.
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Affiliation(s)
- Christian Ståhl
- Department of Behavioral Sciences and Learning, Linköping University, 581 83, Linköping, Sweden. .,HELIX Competence Center, Linköping University, 581 83, Linköping, Sweden.
| | - Isa Norvell Gustavsson
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83, Linköping, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Region Västra Götaland, 413 19, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, 405 30, Gothenburg, Sweden
| | - Magnus Akerstrom
- The Institute of Stress Medicine, Region Västra Götaland, 413 19, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, 405 30, Gothenburg, Sweden
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12
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Vilar-Compte M, Hernández-Cordero S, Ancira-Moreno M, Burrola-Méndez S, Ferre-Eguiluz I, Omaña I, Pérez Navarro C. Breastfeeding at the workplace: a systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women. Int J Equity Health 2021; 20:110. [PMID: 33926471 PMCID: PMC8082937 DOI: 10.1186/s12939-021-01432-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [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: 01/28/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
Background Breastfeeding can be affected by maternal employment. This is important considering that in 2019, 47.1% of women globally participated in the labor force. The aim of this study was to review workplace interventions to promote, protect and support breastfeeding practices among working mothers globally. Methods A systematic review was conducted following the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Observational, experimental and qualitative peer-reviewed studies in English and Spanish, published between 2008 and 2019 were included. The review focused on working women who were pregnant, breastfeeding or who recently had a child, and women’s working environments. The outcomes of interest included breastfeeding intentions, initiation, exclusivity and duration, confidence in breastfeeding or breastmilk extraction, and perceived support at workplace. Quality was assessed according to National Institute for Health and Care Excellence (NICE) checklist for systematic reviews. It was registered on PROSPERO (#140624). Results Data was extracted from 28 quantitative and 9 qualitative studies. The most common interventions were designated spaces for breastfeeding or breastmilk extraction (n = 24), and the support from co-workers (n = 20). The least common interventions were providing breast pumps (n = 4) and giving mothers the flexibility to work from home (n = 3). Studies explored how interventions affected different breastfeeding outcomes including breastfeeding duration, breastfeeding exclusivity, confidence in breastmilk expression, and breastfeeding support. The evidence suggests that workplace interventions help increase the duration of breastfeeding and prevent early introduction of breastmilk substitutes. Having a lactation space, breastmilk extraction breaks, and organizational policies are key strategies. However, to achieve equitable working conditions for breastfeeding mothers, organizational and interpersonal changes need to occur as well. Conclusions The systematic review revealed that interventions at the workplace are important in protecting, promoting and supporting breastfeeding among working mothers. To achieve equitable work environments and fair nutritional opportunities for infants of working mothers, interventions should focus at the three ecological layers – individual, interpersonal, and organizational. The quality of studies can be improved. There is a need for studies assessing impacts of workplace interventions on infant feeding practices, mothers’ self-esteem and outcomes such productivity and abstentionism.
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Affiliation(s)
- Mireya Vilar-Compte
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Sonia Hernández-Cordero
- Department of Health, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico.
| | - Mónica Ancira-Moreno
- Department of Health, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Soraya Burrola-Méndez
- Department of Health, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Isabel Ferre-Eguiluz
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Isabel Omaña
- Department of Health, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Cecilia Pérez Navarro
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico.,Department of Health, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
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13
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Akerstrom M, Severin J, Imberg H, Jonsdottir IH, Björk L, Corin L. Methodological approach for measuring the effects of organisational-level interventions on employee withdrawal behaviour. Int Arch Occup Environ Health 2021; 94:1671-1686. [PMID: 33772378 PMCID: PMC8384822 DOI: 10.1007/s00420-021-01686-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022]
Abstract
Background Theoretical frameworks have recommended organisational-level interventions to decrease employee withdrawal behaviours such as sickness absence and employee turnover. However, evaluation of such interventions has produced inconclusive results. The aim of this study was to investigate if mixed-effects models in combination with time series analysis, process evaluation, and reference group comparisons could be used for evaluating the effects of an organisational-level intervention on employee withdrawal behaviour. Methods Monthly data on employee withdrawal behaviours (sickness absence, employee turnover, employment rate, and unpaid leave) were collected for 58 consecutive months (before and after the intervention) for intervention and reference groups. In total, eight intervention groups with a total of 1600 employees participated in the intervention. Process evaluation data were collected by process facilitators from the intervention team. Overall intervention effects were assessed using mixed-effects models with an AR (1) covariance structure for the repeated measurements and time as fixed effect. Intervention effects for each intervention group were assessed using time series analysis. Finally, results were compared descriptively with data from process evaluation and reference groups to disentangle the organisational-level intervention effects from other simultaneous effects. Results All measures of employee withdrawal behaviour indicated statistically significant time trends and seasonal variability. Applying these methods to an organisational-level intervention resulted in an overall decrease in employee withdrawal behaviour. Meanwhile, the intervention effects varied greatly between intervention groups, highlighting the need to perform analyses at multiple levels to obtain a full understanding. Results also indicated that possible delayed intervention effects must be considered and that data from process evaluation and reference group comparisons were vital for disentangling the intervention effects from other simultaneous effects. Conclusions When analysing the effects of an intervention, time trends, seasonal variability, and other changes in the work environment must be considered. The use of mixed-effects models in combination with time series analysis, process evaluation, and reference groups is a promising way to improve the evaluation of organisational-level interventions that can easily be adopted by others.
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Affiliation(s)
- M Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden. .,Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - J Severin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
| | - H Imberg
- Department of Mathematical Sciences, Chalmers University of Technology and The University of Gothenburg, Gothenburg, Sweden
| | - I H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden.,Social Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - L Björk
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden.,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - L Corin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden.,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
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14
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Paterson C, Leduc C, Maxwell M, Aust B, Amann BL, Cerga-Pashoja A, Coppens E, Couwenbergh C, O’Connor C, Arensman E, Greiner BA. Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol. Syst Rev 2021; 10:41. [PMID: 33509258 PMCID: PMC7844910 DOI: 10.1186/s13643-020-01570-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. METHODS AND ANALYSIS A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall's model of organisational-level interventions and Moore's sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. DISCUSSION This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base. SYSTEMATIC REVIEW REGISTRATION Research Registry ( reviewregistry897 ).
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Affiliation(s)
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | | | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Benedikt L. Amann
- Centro Forum Research Unit, Institut de Neuropsiquiatria i Addicions (INAD), Parc de Salut Mar, Hospital del Mar Medical Research Institute (IMIM), Autonomous University Barcelona, CIBERSAM, Barcelona, Spain
| | | | - Evelien Coppens
- Centre for Health Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Cliodhna O’Connor
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Research, Griffith University, Mount Gravatt, Australia
- International Association for Suicide Prevention (IASP), Washington, DC USA
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15
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Mänttäri S, Oksa J, Lusa S, Korkiakangas E, Punakallio A, Oksanen T, Laitinen J. Interventions to promote work ability by increasing physical activity among workers with physically strenuous jobs: A scoping review. Scand J Public Health 2020; 49:206-218. [PMID: 32515284 PMCID: PMC7917572 DOI: 10.1177/1403494820917532] [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] [Indexed: 11/16/2022]
Abstract
Aims: The potential benefits of workplace physical activity (PA)
interventions are in improving both health and important workplace outcomes.
Despite the differences in PA level between physically strenuous and inactive
work, the literature reporting the effectiveness of the interventions does not
usually differentiate physically active and inactive jobs. The aim of the
current study was therefore to collect and synthesise research evidence on
workplace PA interventions to promote work ability specifically among workers in
physically strenuous jobs by means of a scoping review.
Methods: The databases Medline, Cochrane Central and Scopus
were used to identify interventions to promote work ability by increasing PA
among workers in physically strenuous jobs. An iterative method was used to
obtain an overview of the study elements and to extract details on the study
design, sample, intervention, outcomes and effectiveness.
Results: A total of 47 studies evaluating eight categories
of interventions were found. Out of these, 18 reported significant effects on
work ability. Positive results came from a range of different interventions,
including aerobic exercise, strength training, combined aerobic exercise and
strength training, stretching, yoga, consultation and tailored physical exercise
programmes. Conclusions: Few interventions were effective
in promoting work ability by increasing PA among workers in physically
strenuous jobs. In particular, trials based on the demands of work,
multimodal interventions and applying wearable technology are
needed.
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Affiliation(s)
| | - Juha Oksa
- Finnish Institute of Occupational Health, Finland
| | - Sirpa Lusa
- Finnish Institute of Occupational Health, Finland
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16
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Al Badri FM, Baatjies R, Jeebhay MF. Assessing the health impact of interventions for baker's allergy and asthma in supermarket bakeries: a group randomised trial. Int Arch Occup Environ Health 2020; 93:589-599. [PMID: 31927662 DOI: 10.1007/s00420-019-01511-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To assess the impact of an intervention for baker's allergy and asthma in supermarket bakeries. METHODS A group randomised trial conducted in 31 bakeries (n = 337 bakers) that were randomly assigned to one of two intervention groups (n = 244 bakers) and a control group (n = 93 bakers). Health data collected prior to and 1-year after the intervention included information obtained from an ECRHS questionnaire; tests for atopy and serum-specific IgE to cereal flours; fractional exhaled nitric oxide (FeNO). Data from the two intervention groups were combined to form one intervention group for purposes of the statistical analysis. RESULTS At 1 year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO > 25 ppb) was similar in both intervention and control groups. The mean FeNO difference was also similar across both groups (2.2 ppb vs 1.7 ppb, p = 0.86). In those with FeNO > 25 ppb at baseline, the decline was greater in the intervention compared to control group (16.9 ppb vs 7.7 ppb, p = 0.24). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO > 25 ppb) did not demonstrate an appreciable FeNO decline (≥ 10%) in the intervention compared to control group. However, stratification by the presence of work-related ocular-nasal symptoms in bakers at baseline demonstrated a significant FeNO decline (≥ 10%) in the intervention compared to the control group (OR 3.73, CI 1.22-11.42). CONCLUSION This study demonstrates some evidence of an intervention effect on FeNO 1 year after an intervention, particularly in bakers with work-related ocular-nasal symptoms.
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Affiliation(s)
- F M Al Badri
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4. 45, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town, 7925, South Africa.,Occupational Medicine Department, Armed Forces Medical Services, Muscat, Oman
| | - R Baatjies
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4. 45, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town, 7925, South Africa.,Department of Environmental and Occupational Studies, Cape Peninsula University of Technology (CPUT), Cape Town, South Africa
| | - Mohamed F Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Room 4. 45, Fourth Level, Falmouth Building, Anzio Road, Observatory, Cape Town, 7925, South Africa.
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17
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Hulls PM, Richmond RC, Martin RM, de Vocht F. A systematic review protocol examining workplace interventions that aim to improve employee health and wellbeing in male-dominated industries. Syst Rev 2020; 9:10. [PMID: 31918756 PMCID: PMC6953289 DOI: 10.1186/s13643-019-1260-9] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 12/18/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The workplace environment potentially provides access to a large population who are employed, and it is an employer's responsibility to provide appropriate conditions for its employees. Whilst the aetiology of cardiovascular disease is multifactorial, it is generally acknowledged that working conditions, gender and age are involved in its development. Male-dominated industries (comprising > 70% male workers, e.g., agriculture, construction, manufacturing, mining, transport and technology) have a higher prevalence of health risk behaviours than other population subgroups. Working in a gender-dominated industry can impact an employee's health and wellbeing, particularly for the opposite sex. This systematic review examines workplace interventions that address the health and wellbeing of employees in male-dominated industries. METHODS We will include randomised controlled trials and studies with non-randomised intervention groups. The interventions must aim to improve employee physical and/or mental health and wellbeing implemented in the workplace in male-dominated industries. There will be no limits on date. The following electronic databases will be searched for published studies: Web of Science, Embed, MedLine, PsycInfo and the Cochrane Database. The search strategy will include free-text terms and MeSH vocabulary, including 'male-dominated industries', 'workplace interventions', 'occupational stress', 'mental health', 'cardiovascular disease', 'blood pressure', 'body mass index' and 'exercise'. Two authors will independently select, review and extract data from studies that meet the inclusion criteria. The Cochrane's Risk of Bias tool will be used to assess risk of bias. We will perform structured summaries of the included studies and, if possible, conduct meta-analyses or construct an Albatross plot. DISCUSSION There are an increasing number of interventions designed to improve employee health and wellbeing in the workplace, but no prior review that systematically evaluates their effectiveness. A systematic review is required to prioritise the future implementation of those interventions found to be most effective. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019161283.
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Affiliation(s)
- Paige M. Hulls
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Rebecca C. Richmond
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Richard M. Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR School for Public Health Research, University of Bristol, Bristol, UK
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18
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Reynolds JP, Kosīte D, Rigby Dames B, Brocklebank LA, Pilling M, Pechey R, Hollands GJ, Marteau TM. Increasing the proportion of healthier foods available with and without reducing portion sizes and energy purchased in worksite cafeterias: protocol for a stepped-wedge randomised controlled trial. BMC Public Health 2019; 19:1611. [PMID: 31791299 PMCID: PMC6889705 DOI: 10.1186/s12889-019-7927-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/08/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Overconsumption of energy from food contributes to high rates of overweight and obesity in many populations. A promising set of interventions tested in pilot studies in worksite cafeterias, suggests energy intake may be reduced by increasing the proportion of healthier - i.e. lower energy - food options available, and decreasing portion sizes. The current study aims to assess the impact on energy purchased of i. increasing the proportion of lower energy options available; ii. combining this with reducing portion sizes, in a full trial. METHODS A stepped-wedge randomised controlled trial in 19 worksite cafeterias, where the proportion of lower energy options available in targeted food categories (including main meals, snacks, and cold drinks) will be increased; and combined with reduced portion sizes. The primary outcome is total energy (kcal) purchased from targeted food categories using a pooled estimate across all sites. Follow-up analyses will test whether the impact on energy purchased varies according to the extent of intervention implementation. DISCUSSION This study will provide the most reliable estimate to date of the effect sizes of two promising interventions for reducing energy purchased in worksite cafeterias. TRIAL REGISTRATION The study was prospectively registered on ISRCTN (date: 24.05.19; TRN: ISRCTN87225572; doi: https://doi.org/10.1186/ISRCTN87225572).
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Affiliation(s)
- James P Reynolds
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Daina Kosīte
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Brier Rigby Dames
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | | | - Mark Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Rachel Pechey
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK.
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19
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Thørrisen MM, Skogen JC, Kjeken I, Jensen I, Aas RW. Current practices and perceived implementation barriers for working with alcohol prevention in occupational health services: the WIRUS OHS study. Subst Abuse Treat Prev Policy 2019; 14:30. [PMID: 31242911 PMCID: PMC6595559 DOI: 10.1186/s13011-019-0217-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/22/2019] [Accepted: 06/18/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Alcohol is associated with detrimental health and work performance outcomes, and one to three out of ten employees may benefit from interventions. The role of occupational health services (OHS) in alcohol prevention has received little attention in research. The primary aims of this study were to explore current practices of alcohol prevention targeting employees in occupational health settings, and examine whether and which perceived implementation barriers were associated with alcohol prevention activity. The secondary aim was to explore whether barriers were differentially associated with primary, secondary and tertiary prevention activities. METHODS In this cross-sectional study, survey data were collected from 295 OHS professionals in Norway in 2018. Data were analysed by means of descriptive statistics, one-way analysis of variance, paired samples t-tests, and multivariate linear regression analyses. RESULTS Overall, seven out of ten OHS professionals worked with alcohol-related cases less than monthly, while only one out of ten did so on a weekly basis. Their activities were more focused on tertiary prevention than on primary and secondary prevention. Physicians, psychologists and nurses reported to handle alcohol-related issues more often than occupational therapists and physical therapists. Higher levels of implementation barriers internal to the OHS' organisation (competence, time and resources) were associated with lower alcohol prevention activity. Barriers external to the OHS' organisation (barriers concerning employers and employees) were not. This pattern was evident for primary, secondary and tertiary prevention activities. A majority of OHS professionals agreed that employees' alcohol consumption constitute a public health challenge, and that OHS' should focus more on alcohol prevention targeting employees. CONCLUSIONS Occupational health settings at workplaces may be particularly serviceable for alcohol prevention programmes since the majority of the population is employed and the majority of employees consume alcohol. An increase in overall prevention activity, and a shift from mainly focusing on tertiary prevention to an increased emphasis on primary and secondary prevention, may both hinge on increased training of OHS professionals, emphasising knowledge on the importance of working with alcohol prevention, and training in administering alcohol prevention programmes. Making alcohol prevention a priority may also require increased allocation of time and resources.
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Affiliation(s)
- Mikkel Magnus Thørrisen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, PO box 4 St. Olavs plass, NO-0130 Oslo, Norway
- Presenter – Making Sense of Science, PO box 8118, NO-4068 Stavanger, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, PO box 973, NO-5808 Bergen, Norway
- Center for Alcohol & Drug Research, Stavanger University Hospital, PO box 8100, NO-4068 Stavanger, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PO box 8600, Forus, NO-4036 Stavanger, Norway
| | - Ingvild Kjeken
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, PO box 4 St. Olavs plass, NO-0130 Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, PO box 23, Vindern, NO-0319 Oslo, Norway
| | - Irene Jensen
- Institute of Environmental Medicine, Division of Intervention and Implementation Research for Worker Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Randi Wågø Aas
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, PO box 4 St. Olavs plass, NO-0130 Oslo, Norway
- Presenter – Making Sense of Science, PO box 8118, NO-4068 Stavanger, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, PO box 8600, Forus, NO-4036 Stavanger, Norway
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Vasiljevic M, Fuller G, Pilling M, Hollands GJ, Pechey R, Jebb SA, Marteau TM. What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias. Appetite 2019; 141:104304. [PMID: 31152762 PMCID: PMC8161726 DOI: 10.1016/j.appet.2019.05.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 01/07/2019] [Revised: 04/29/2019] [Accepted: 05/28/2019] [Indexed: 11/18/2022]
Abstract
Background Calorie labelling may help to reduce energy consumption, but few well-controlled experimental studies have been conducted in real world settings. In a previous randomised controlled pilot trial we did not observe an effect of calorie labelling on energy purchased in worksite cafeterias. In the present study we sought to enhance the effect by making the labels more prominent, and to address the operational challenges reported previously by worksites. Methods Three worksite cafeterias were randomised in a stepped wedge design to start the intervention at one of three fortnightly periods between March and July 2018. The intervention comprised introducing prominent calorie labelling for all cafeteria products for which calorie information was available (on average 87% of products offered across the three sites were labelled). Calorie content was displayed in bold capitalised Verdana typeface with a minimum font size of 14 e.g.120 CALORIES. Feasibility and acceptability were assessed using post-intervention surveys with cafeteria patrons and semi-structured interviews with managers. Effectiveness was assessed using total daily energy (kcal) purchased from intervention items across the three sites, analysed using semi-parametric GAMLSS models. Results Recruitment and retention of worksite cafeterias proved feasible: all three randomised sites successfully completed the study. Post-intervention feedback suggested high levels of intervention acceptability: 87% of responding patrons wanted calorie labelling to remain in place. No effect of the intervention on daily energy purchased was observed: −0.6% (95%CI -2.5 to 1.2, p = .487). By-site analyses showed similar null effects at each of the three sites, all ps > .110. Conclusions There was no evidence that prominent calorie labelling changed daily energy purchased across three English-based worksite cafeterias. The intervention was feasible to implement and acceptable to patrons and managers.
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Affiliation(s)
- Milica Vasiljevic
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK; Department of Psychology, Durham University, Durham, UK.
| | - Georgia Fuller
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
| | - Mark Pilling
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
| | - Rachel Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
| | - Susan A Jebb
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
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21
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Stevens ML, Boyle E, Hartvigsen J, Mansell G, Søgaard K, Jørgensen MB, Holtermann A, Rasmussen CDN. Mechanisms for reducing low back pain: a mediation analysis of a multifaceted intervention in workers in elderly care. Int Arch Occup Environ Health 2018; 92:49-58. [PMID: 30173369 DOI: 10.1007/s00420-018-1350-3] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/28/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE A multifaceted workplace intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) has shown effectiveness for reducing low back pain (LBP). However, the mechanisms of action underlying these intervention components are not well understood. METHODS This was a mediation analysis of a cluster-randomised controlled trial of a multifaceted intervention in 420 workers in elderly care. Mediation analysis was carried out via structural equation modelling. Potential mediators investigated were: fear-avoidance beliefs, perceived muscle strength, use of assistive devices at work and perceived physical exertion at work. LBP outcomes assessed were: days with LBP, LBP intensity and days with bothersome LBP. RESULTS There were no significant indirect effects of the intervention on LBP outcomes. There were significant effects of the intervention on both fear-avoidance measures [β = - 0.63, 95% CI (1.23, 0.03); β = - 1.03, 95% CI (- 1.70, - 0.34)] and the use of assistive devices [β = - 0.55, 95% CI (- 1.04, - 0.05)], but not on perceived muscle strength [β = - 0.18, 95% CI (- 0.50, 0.13)] or physical exertion [β = - 0.05, 95% CI (- 0.40, 0.31)]. The only potential mediator with a significant effect on LBP outcomes was physical exertion, which had a significant effect on LBP intensity [β = 0.14, 95% CI (0.04, 0.23)]. CONCLUSIONS A multifaceted intervention consisting of participatory ergonomics, physical training, and CBT was able to decrease fear-avoidance beliefs and increase use of assistive devices in the workplace. However, these changes did not explain the effect of any of the intervention components on days with LBP, LBP intensity and days with bothersome LBP.
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Affiliation(s)
- Matthew L Stevens
- Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Sydney, NSW, 2050, Australia.
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Gemma Mansell
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Marie B Jørgensen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The National Research Centre for the Working Environment, Copenhagen, Denmark
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22
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Hollands GJ, Cartwright E, Pilling M, Pechey R, Vasiljevic M, Jebb SA, Marteau TM. Impact of reducing portion sizes in worksite cafeterias: a stepped wedge randomised controlled pilot trial. Int J Behav Nutr Phys Act 2018; 15:78. [PMID: 30115084 DOI: 10.1186/s12966-018-0705-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reducing the portion sizes of foods available in restaurants and cafeterias is one promising approach to reducing energy intake, but there is little evidence of its impact from randomised studies in field settings. This study aims to i. examine the feasibility and acceptability, and ii. estimate the impact on energy purchased, of reducing portion sizes in worksite cafeterias. METHODS Nine worksites in England were recruited to reduce by at least 10% the portion sizes of foods available in their cafeterias from targeted categories (main meals, sides, desserts, cakes). In a stepped wedge randomised controlled pilot trial, each site was randomised to a date of implementation, staggered fortnightly, following a baseline period of four weeks. Impact on energy purchased was analysed using generalised linear mixed modelling. We also assessed feasibility, acceptability, and fidelity of intervention implementation. RESULTS Data from six of the nine randomised sites were analysed, with three sites excluded for not providing sufficient data and/or not implementing the intervention. The extent to which the intervention was implemented varied by site, with between 6 and 49% of products altered within targeted categories. Feedback following the intervention suggested it was broadly acceptable to customers and cafeteria staff. For the primary outcome of daily energy (kcal) purchased from intervention categories, there was no statistically significant change when data from all six sites were pooled: percentage change - 8.9% (95% CI: -16.7, - 0.4; p = 0.081). Each of these six sites showed reductions in energy purchased, ranging from - 15.6 to - 0.3%, which were borderline statistically significant at two sites (respective percentage changes (95% CIs): - 15.6% (- 26.7, - 2.8); - 14.0% (- 25.0, - 1.2)). Secondary outcome data are suggestive of a compensatory increase in energy purchased from food categories not targeted by the intervention, with no overall effect observed on energy purchased across all categories. CONCLUSIONS The results of this pilot trial suggest that reducing portion sizes could be effective in reducing energy purchased and consumed from targeted food categories, and merits investigation in a larger trial. Future studies will need to address factors that prevented optimal implementation including site dropout and application across a limited range of products. TRIAL REGISTRATION ( ISRCTN52923504 ). Registered on 20th September 2016.
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Brown SA, García AA, Zuñiga JA, Lewis KA. Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence. Patient Educ Couns 2018; 101:1036-1050. [PMID: 29339040 DOI: 10.1016/j.pec.2018.01.001] [Citation(s) in RCA: 20] [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: 07/21/2017] [Revised: 12/16/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. METHODS Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. RESULTS The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive. CONCLUSION The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes. PRACTICE IMPLICATIONS Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered.
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24
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Vasiljevic M, Cartwright E, Pilling M, Lee MM, Bignardi G, Pechey R, Hollands GJ, Jebb SA, Marteau TM. Impact of calorie labelling in worksite cafeterias: a stepped wedge randomised controlled pilot trial. Int J Behav Nutr Phys Act 2018; 15:41. [PMID: 29754587 PMCID: PMC5950179 DOI: 10.1186/s12966-018-0671-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 10/20/2017] [Accepted: 03/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For working adults, about one-third of energy is consumed in the workplace making this an important context in which to reduce energy intake to tackle obesity. The aims of the current study were first, to identify barriers to the feasibility and acceptability of implementing calorie labelling in preparation for a larger trial, and second, to estimate the potential impact of calorie labelling on energy purchased in worksite cafeterias. METHODS Six worksite cafeterias were randomised to the intervention starting at one of six fortnightly periods, using a stepped wedge design. The trial was conducted between August and December 2016, across 17 study weeks. The intervention comprised labelling all cafeteria products for which such information was available with their calorie content (e.g. "250 Calories") displayed in the same font style and size as for price. A post-intervention survey with cafeteria patrons and interviews with managers and caterers were used to assess the feasibility and acceptability of the intervention. Intervention impact was assessed using generalised linear mixed modelling. The primary outcome was the total energy (kcal) purchased from intervention items in each cafeteria each day. RESULTS Recruitment and retention of worksite cafeterias proved feasible, with post-intervention feedback suggesting high levels of intervention acceptability. Several barriers to intervention implementation were identified, including chefs' discretion at implementing recipes and the manual recording of sales data. There was no overall effect of the intervention: -0.4% (95%CI -3.8 to 2.9, p = .803). One site showed a statistically significant effect of the intervention, with an estimated 6.6% reduction (95%CI -12.9 to - 0.3, p = .044) in energy purchased in the day following the introduction of calorie labelling, an effect that diminished over time. The remaining five sites did not show robust changes in energy purchased when calorie labelling was introduced. CONCLUSIONS A calorie labelling intervention was acceptable to both cafeteria operators and customers. The predicted effect of labelling to reduce energy purchased was only evident at one out of six sites studied. Before progressing to a full trial, the calorie labelling intervention needs to be optimised, and a number of operational issues resolved. TRIAL REGISTRATION ISRCTN52923504 ; Registered: 22/09/2016; retrospectively registered.
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Affiliation(s)
- Milica Vasiljevic
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.
| | - Emma Cartwright
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Mei-Man Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Giacomo Bignardi
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Rachel Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Gareth J Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Susan A Jebb
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Theresa M Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
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Hugh-Jones S, Rose S, Koutsopoulou GZ, Simms-Ellis R. How Is Stress Reduced by a Workplace Mindfulness Intervention? A Qualitative Study Conceptualising Experiences of Change. Mindfulness (N Y) 2018; 9:474-87. [PMID: 29599850 DOI: 10.1007/s12671-017-0790-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Mindfulness-based interventions are effective as curative and preventative approaches to psychological health. However, the mechanisms by which outcomes are secured from such interventions when delivered in the workplace, and to a stressed workforce, are not well understood. The aim of the present study was to elicit and analyse accounts from past participants of a workplace mindfulness intervention in order to generate a preliminary model of how positive benefits appear to be secured. In-depth, semi-structured interviews were completed with 21 employees of a higher education institution who had completed an eight-week intervention based on Mindfulness-Based Stress Reduction, adapted for the workplace. Interviews invited participants to recount their experiences of the intervention and its impact, if any, on their work life. Aspects of the interview data that pertained to intervention experience and positive benefits were analysed using a version of grounded theory, leading to the generation of a provisional model of how positive change occurred. The model suggests that discrete, temporal experiences build on each other to generate multiple, positive benefits. As anticipated in mindfulness-based interventions, enhanced attentional capacity was important, but our provisional model also suggests that resonance, self-care, detection of stress markers, perceiving choice, recovering self-agency and upward spiralling may be central mechanisms that lead to positive outcomes. Understanding mechanisms of change may help support participant engagement and trust in work-based mindfulness programmes, and enhance participants’ ability to apply mindfulness in their work life.
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26
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Vasiljevic M, Cartwright E, Pechey R, Hollands GJ, Couturier DL, Jebb SA, Marteau TM. Physical micro-environment interventions for healthier eating in the workplace: protocol for a stepped wedge randomised controlled pilot trial. Pilot Feasibility Stud 2017; 3:27. [PMID: 28616251 PMCID: PMC5465576 DOI: 10.1186/s40814-017-0141-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 05/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An estimated one third of energy is consumed in the workplace. The workplace is therefore an important context in which to reduce energy consumption to tackle the high rates of overweight and obesity in the general population. Altering environmental cues for food selection and consumption-physical micro-environment or 'choice architecture' interventions-has the potential to reduce energy intake. The first aim of this pilot trial is to estimate the potential impact upon energy purchased of three such environmental cues (size of portions, packages and tableware; availability of healthier vs. less healthy options; and energy labelling) in workplace cafeterias. A second aim of this pilot trial is to examine the feasibility of recruiting eligible worksites, and identify barriers to the feasibility and acceptability of implementing the interventions in preparation for a larger trial. METHODS Eighteen worksite cafeterias in England will be assigned to one of three intervention groups to assess the impact on energy purchased of altering (a) portion, package and tableware size (n = 6); (b) availability of healthier options (n = 6); and (c) energy (calorie) labelling (n = 6). Using a stepped wedge design, sites will implement allocated interventions at different time periods, as randomised. DISCUSSION This pilot trial will examine the feasibility of recruiting eligible worksites, and the feasibility and acceptability of implementing the interventions in preparation for a larger trial. In addition, a series of linear mixed models will be used to estimate the impact of each intervention on total energy (calories) purchased per time frame of analysis (daily or weekly) controlling for the total sales/transactions adjusted for calendar time and with random effects for worksite. These analyses will allow an estimate of an effect size of each of the three proposed interventions, which will form the basis of the sample size calculations necessary for a larger trial. TRIAL REGISTRATION ISRCTN52923504.
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Affiliation(s)
- Milica Vasiljevic
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Emma Cartwright
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Rachel Pechey
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Gareth J. Hollands
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
| | | | - Susan A. Jebb
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Theresa M. Marteau
- Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK
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27
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Bjørnstad S, Patil GG, Raanaas RK. Nature contact and organizational support during office working hours: Benefits relating to stress reduction, subjective health complaints, and sick leave. Work 2017; 53:9-20. [PMID: 26684700 DOI: 10.3233/wor-152211] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Improving social support, and providing nature contact at work are potential health promoting workplace interventions. OBJECTIVE The objective was to investigate whether nature contact at work is associated with employee's health and participation, and to study whether the possible associations between nature contact and health can be explained by perceived organizational support. METHOD Data were collected through a web-based, cross-sectional survey of employees in seven public and private office workplaces in Norway (n = 707, 40% response rate). Multiple linear and logistic regression analysis were performed on 565 participants fulfilling inclusion criteria. RESULTS A greater amount of indoor nature contact at work was significantly associated with less job stress (B = -0.18, CI = -0.318 to -0.042), fewer subjective health complaints (B = -0.278, CI = -0.445 to -0.112) and less sickness absence (B = -0.061, CI = -0.009 to -0.002). Perceived organizational support mediated the associations between indoor nature contact and job stress and sickness absence, and partly mediated the association with subjective health complaints. Outdoor nature contact showed no reliable association with the outcomes in this study. CONCLUSIONS Extending nature contact in the physical work environment in offices, can add to the variety of possible health-promoting workplace interventions, primarily since it influences the social climate on the workplace.
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28
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Williams-Whitt K, Bültmann U, Amick B, Munir F, Tveito TH, Anema JR. Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations. J Occup Rehabil 2016; 26:417-433. [PMID: 27614465 PMCID: PMC5104758 DOI: 10.1007/s10926-016-9664-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.
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Affiliation(s)
- Kelly Williams-Whitt
- University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Ute Bültmann
- University Medical Center Groningen, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - Benjamin Amick
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Institute for Work and Health, Toronto, Canada
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Torill H Tveito
- Uni Research Health, Bergen, Norway
- Department of Health Promotion, University College of Southeast Norway, Horten, Norway
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. J Occup Rehabil 2016; 26:448-464. [PMID: 27796914 PMCID: PMC5104783 DOI: 10.1007/s10926-016-9677-7] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
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Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Borovoy A, Roberto CA. Japanese and American public health approaches to preventing population weight gain: A role for paternalism? Soc Sci Med 2015; 143:62-70. [PMID: 26344124 DOI: 10.1016/j.socscimed.2015.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 07/08/2015] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 11/25/2022]
Abstract
Controlling population weight gain is a major concern for industrialized nations because of associated health risks. Although Japan is experiencing rising prevalence of obesity and overweight, historically they have had and continue to maintain a low prevalence relative to other developed countries. Therefore, Japan provides an interesting case study of strategies to curb population weight gain. In this paper we explore Japanese approaches to obesity and diet through observational and ethnographic interviews conducted between June 2009 and September 2013. Nineteen interviews were conducted at four companies and three schools in Tokyo, as well as at a central Tokyo community health care center and school lunch distribution center. Interviewees included physicians, a Ministry of Health bureaucrat, human resources managers, welfare nurses employed by health insurance organizations, school nurses (also government employees), school nutritionists, and a school counselor. We highlight the role of culture and social norms in encouraging healthful behavior in Japan, focusing on the Ministry of Health, Labor, and Welfare's metabolic syndrome screening program (implemented in 2005) and the Japanese national school lunch program. The Japanese government prescribes optimal body metrics for all Japanese citizens and relies on institutions such as schools and health insurance organizations that are in some instances closely affiliated with the workplace to carry out education. Japan's socio-cultural approach leads us reflect on the cultural and social conditions that make different policy prescriptions more politically feasible and potentially effective. It also provokes us to question whether limited behavioral modifications and "nudging" can lead to broader change in an environment like the United States where there are fewer broadly shared socio-cultural norms regarding acceptable health behavior.
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Affiliation(s)
- Amy Borovoy
- East Asian Studies Department, 211 Jones Hall, Princeton University, Princeton, NJ, 08544-1008, USA.
| | - Christina A Roberto
- Department of Social and Behavioral Sciences, Department of Nutrition, Harvard University School of Public Health, USA
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