Workplace-based Interventions Research Articles

ASSOCIATION OF HEALTHY LIFESTYLE INDEX AND ANTIHYPERTENSIVE MEDICATION USE WITH BLOOD PRESSURE CONTROL AMONG EMPLOYEES WITH HYPERTENSION IN CHINA

Objective: We examined the association of antihypertensive medication use and HLI with BP control among employees with hypertension in China based on a workplace-based multicomponent intervention program. Design and method: A cluster randomized clinical trial of a workplace-based multicomponent intervention program was conducted in 60 workplaces across 20 urban areas in China. Workplaces were randomly divided into intervention (n = 40) and control (n = 20) groups. Basic information on employees at each workplace was collected by trained professionals, including sociodemographic characteristics, medical history, family history, lifestyle behaviors, medication status and physical measurements. After baseline, the intervention group received a 2-year intervention to achieve BP control, which included:(1) a workplace wellness program for all employees; (2) a guidelines-oriented hypertension management protocol. HLI including nonsmoking, nondrinking, adequate physical activity, weight within reference range and balanced diet, were coded on a 5-point scale (range, 0-5, with higher score indicating a healthier lifestyle). Antihypertensive medication use was defined as taking drug within the last 2 weeks. Changes in HLI, antihypertensive medication use and BP control from baseline to 24 months were measured after the intervention. Results: After 24 months of the intervention, there was a significant improvement in lifestyle [smoking (0.65, 95% CI, 0.43∼0.99; P=0.045), drinking (OR=0.52, 95% CI, 0.40∼0.68; P<0.001), regular exercise (OR=3.10, 95% CI, 2.53∼3.78; P<0.001), excessive intake of fatty food (OR=0.17, 95% CI, 0.06∼0.52; P=0.002), restrictive use of salt (OR=0.26, 95% CI, 0.12∼0.56; P=0.001)]. Compare to employees with a deteriorating lifestyle after the intervention, those with an improved lifestyle had a higher BP control. In the intervention group, compared with employees not using antihypertensive medication, those who consistent used (OR, 2.34; 95% CI, 1.16∼4.72; P=0.017) or changed from not using to using antihypertensive medication (OR, 2.24; 95% CI, 1.08∼4.62; P=0.030) had higher BP control. Those who used antihypertensive medication and had a high HLI had the highest BP control (OR, 1.88; 95% CI, 1.32∼2.67, P<0.001). Conclusions: These findings suggest that adherence to antihypertensive medication treatment and healthy lifestyle were associated with a significant improvement in BP control among employees with hypertension.

Association Between the Improvement of Knowledge, Attitude and Practice of Hypertension Prevention and Blood Pressure Control-A Cluster Randomized Controlled Study.

Hypertension-related knowledge, attitude and practice (KAP) of hypertensive patients can affect the awareness, treatment and control of hypertension. However, little attention has been paid to the association between the change of hypertension preventive KAP and blood pressure (BP) control in occupational population using longitudinal data. We assess the effectiveness of a workplace-based multicomponent hypertension intervention program on improving the level of KAP of hypertension prevention, and the association between improvement in KAP and BP control during intervention. From January 2013 to December 2014, workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20) using a cluster randomized control method. All employees in each workplace were asked to complete a cross-sectional survey to screen for hypertension patients. Hypertension patients in the intervention group were given a 2-year workplace-based multicomponent hypertension intervention for BP control. The level of hypertension prevention KAP and BP were assessed before and after intervention in the two groups. Overall, 3331 participants (2658 in the intervention group and 673 in the control group) were included (mean [standard deviation] age, 46.2 [7.7] years; 2723 men [81.7%]). After 2-year intervention, the KAP qualified rate was 63.2% in the intervention groups and 50.1% in the control groups (odds ratio = 1.65, 95% CI, 1.36∼2.00, P < .001). Compared with the control group decreased in the qualified rate of each item of hypertension preventive KAP questionnaire, all the items in the intervention group increased to different degrees. The increase of KAP score was associated with the decrease of BP level after intervention. For 1 point increase in KAP score, systolic blood pressure (SBP) decreased by .28mmHg and diastolic blood pressure (DBP) decreased by .14mmHg [SBP: β = -.28, 95%CI: -.48∼-.09, P = .004; DBP: β = -.14, 95%CI: -.26∼-.02, P = .024]. SBP and DBP was significantly in manual labor workers (SBP: β = -.34, 95%CI: -.59∼-.09, P = .008; DBP: β = -.23, 95%CI: -.38∼-.08, P = .003), workers from private enterprise, state-owned enterprise (SOE) (SBP: β = -.40, 95%CI: -.64∼-.16, P = .001; DBP: β = -.21, 95%CI: -.36∼-.06, P = .005) and a workplace with an affiliated hospital (SBP: β = -.31, 95%CI: -.52∼-.11, P = .003; DBP: β = -.16, 95%CI: -.28∼-.03, P = .016). The improvement of knowledge (SBP: β = -.29, 95%CI: -.56∼-.02, P = .038; DBP: β = -.12, 95%CI: -.29∼.05, P = .160), as well as attitude (SBP: β = -.71, 95%CI: -1.25∼-.18, P = .009; DBP: β = .18, 95%CI: -.23∼.59, P = .385) and behavior (SBP: β = -.73, 95%CI: -1.22∼-.23, P = .004; DBP: β = -.65, 95%CI: -.97∼-.33, P < .001) was gradually strengthened in relation to BP control. This study found that workplace-based multicomponent hypertension intervention can effectively improve the level of hypertension preventive KAP among employees, and the improvement of KAP levels were significantly associated with BP control. Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641.

Exploring the Role of Sickness Absence Coordinators in Implementing Interventions to Reduce Sickness Absence in Public Sector Workplaces in Denmark.

In 2019, an initiative to reduce sickness absence in public sector workplaces in Denmark was introduced. The initiative involved appointing a sickness absence coordinator (SA coordinator) to oversee the implementation of workplace-based sickness absence interventions. Since the role of the SA coordinator is a novel concept introduced as part of the initiative, this study investigates the responsibilities of SA coordinators and the challenges they experienced in fulfilling this role during the implementation process. Semi-structured interviews with and observations of SA coordinators from four public sector workplaces were carried out. We collected the first four interviews and observations during the implementation process with follow-up interviews collected at the end of the process. The data were analyzed using thematic analysis. The SA coordinators all experienced challenges in terms of lack of commitment among the line managers to participate in the intervention. They experienced being seen as a burden rather than a helping hand, and felt that the line managers might have difficulty recognizing the value of the SA coordinators. Potential ways to improve the collaboration between the SA coordinators and the line managers include considering hiring the SA coordinator in-house and incorporation of intervention components into existing activities to accommodate the busyness of the line managers. To support the SA coordinators in carrying out their role and responsibilities, this study suggests that it is important to ensure commitment to the role, especially among the line managers in order to enhance good working relationships.

A systematic review of programs and interventions for reduction of sickness absence in nursing staff with work-related musculoskeletal disorders.

Negative consequences of musculoskeletal pain and injuries on the nurses' health and well-being can increase job dissatisfaction and impose high costs on healthcare centers due to lost workdays and compensation claims. This study aimed to identify policies, programs, and interventions that might be effective in the prevention and reduction of sickness absence and improvement of work outcomes in nursing staff with these problems. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Electronic databases were searched up to November 9-23, 2022. The keywords "musculoskeletal disorders", "nurse", "return to work", "sickness absence", and "sick leave" and their equivalents were combined using Boolean operators OR/AND. Reference lists of eligible literatures were also screened to identify related studies. In this study, a total of 3365 records were retrieved. After two rounds of screening, 15 studies were selected for qualitative synthesis. These studies included seven randomized controlled trial, five pre-post studies, two cohort, and one cross-sectional. Six types of interventions identified including back college, early workplace-based intervention, physical activity/training, psychosocial education, multifaceted intervention, and ergonomics program. There is insufficient evidence to identify effective interventions in preventing and reducing sickness absence, and improvement of work outcomes in nursing personnel with work-related musculoskeletal disorders. Numerous factors affected the occurrence of such disorders, and their consequences, therefore comprehensive strategy tailored to the injured person's needs should be considered.

Implementation and evaluation of a multi-level mental health promotion intervention for the workplace (MENTUPP): study protocol for a cluster randomised controlled trial

BackgroundWell-organised and managed workplaces can be a source of wellbeing. The construction, healthcare and information and communication technology sectors are characterised by work-related stressors (e.g. high workloads, tight deadlines) which are associated with poorer mental health and wellbeing. The MENTUPP intervention is a flexibly delivered, multi-level approach to supporting small- and medium-sized enterprises (SMEs) in creating mentally healthy workplaces. The online intervention is tailored to each sector and designed to support employees and leaders dealing with mental health difficulties (e.g. stress), clinical level anxiety and depression, and combatting mental health-related stigma. This paper presents the protocol for the cluster randomised controlled trial (cRCT) of the MENTUPP intervention in eight European countries and Australia.MethodsEach intervention country will aim to recruit at least two SMEs in each of the three sectors. The design of the cRCT is based on the experiences of a pilot study and guided by a Theory of Change process that describes how the intervention is assumed to work. SMEs will be randomly assigned to the intervention or control conditions. The aim of the cRCT is to assess whether the MENTUPP intervention is effective in improving mental health and wellbeing (primary outcome) and reducing stigma, depression and suicidal behaviour (secondary outcome) in employees. The study will also involve a process and economic evaluation.ConclusionsAt present, there is no known multi-level, tailored, flexible and accessible workplace-based intervention for the prevention of non-clinical and clinical symptoms of depression, anxiety and burnout, and the promotion of mental wellbeing. The results of this study will provide a comprehensive overview of the implementation and effectiveness of such an intervention in a variety of contexts, languages and cultures leading to the overall goal of delivering an evidence-based intervention for mental health in the workplace.Trial registrationPlease refer to Item 2a and registration ISRCTN14104664. Registered on 12th July 2022.

O.1.3-7 Hungarian Active Lifestyle (HEPA) Strategy 2033

Abstract Inactivity and obesity crisis is getting serious in Hungary in the last decade. According to the latest Eurobarometer studies (2022) 59% of the population are inactive and do not meet the WHO minimum physical activity recommendations. Besides, research shows that nearly 60% of Hungarian adults are overweight or obese, and every fifth child as well. As a respond to these challenges in 2023 the first ever Hungarian Active Leisure (HEPA) strategy has been prepared. As a first step we have created a sectoral map and interviewed potential action partners, including all the most recognized stakeholders from the recreation, sport, health and education sector. After a deep overview of the relevant literature, international guidelines and best practices the team of experts chose the OECD/WHO ‘Policy options to increase PA intervention’ model to follow (2023) as theoretical framework for future interventions. The major focus areas of interventions such as School-based interventions, Workplace-based interventions, Interventions of the Healthcare settings, Interventions in the sports sector and Information and communication policies must have been extended with three more areas: Urban design and transport policies, Natural environment and at last Seniors and Socially and economically disadvantaged citizens. A number of programs have already been piloted (just like Active School Program, Sport Clubs for Health, Workplace interventions or Senior - Pre-school children’s recreational-sport activities together) with great results. Indicators are not only the growing numbers of participants but also successful pilot programs are spreading and more and more work-places, local communities and sport clubs open up to follow these examples all over the country. Hopefully, in the medium and long term both physical activity rates will increase and health and well-being benefits are going to be significant too. Sources: https://sport.ec.europa.eu/news/new-eurobarometer-on-sport-and-physical-activity https://read.oecd-ilibrary.org/social-issues-migration-health/step-up-tackling-the-burden-of-insufficient-physical-activity-in-europe_540a3e56-en#page1

A qualitative exploration of the experiences of shift workers participated in a low-calorie meal replacement dietary intervention

ObjectivesShift work is associated with various health challenges, including obesity and metabolic disturbances. To address these concerns, a randomised controlled clinical trial was conducted to evaluate the efficacy of a...

Promoting employee wellbeing and preventing non-clinical mental health problems in the workplace: a preparatory consultation survey

BackgroundSmall and medium-sized enterprises (SMEs) face major financial losses due to mental health issues affecting employees at all levels but seldom apply programs to promote wellbeing and prevent mental health issues among employees. To support the development of a multi-country workplace-based mental health intervention for SMEs (MENTUPP), a multinational consultation study was conducted. The study aimed to examine the experiences and needs of SMEs concerning the promotion of employee wellbeing, and the prevention and management of non-clinical mental health problems in workplaces.MethodsA survey consisting of open and closed questions was designed to assess key informants’ opinion about the acceptability, the use, and the implementation of interventions to promote wellbeing and prevent mental health issues in the workplace. Academic experts and representatives of SME organisations, specific sector organisations, labour or advocacy groups, and occupational health organisations across the nine MENTUPP intervention countries (eight European countries and Australia) were invited to complete the survey. Data were collected via the online platform Qualtrics. Sixty-five of 146 informants responded, representing a 44.5% response rate. Descriptive statistics were used to analyse the quantitative data and qualitative data were analysed through thematic analysis.ResultsMeasures to create mentally healthy workplaces were most used in SMEs, while more specific mental health interventions, such as training staff on how to promote wellbeing, were hardly used. Managers lack resources to implement mental health interventions and are concerned about employees spending too much time on these interventions during working hours. Receiving information about the economic benefits of mental health interventions and hearing successful testimonials from other SMEs can persuade managers otherwise. Employees have concerns about confidentiality, discrimination and stigma, and career opportunities when using such interventions.ConclusionsThe study identifies a variety of challenges, needs and possibilities related to implementing mental health interventions in SMEs. Employers need to be convinced that investing in mental health in the workplace is worth their time and money. This requires more studies on the (cost-)effectiveness of mental health interventions. Once employers are engaged, their knowledge and competencies about how to implement such interventions should be increased and privacy concerns of employees to participate in them should be addressed.

Workplace-based primary prevention intervention reduces incidence of hypertension: a post hoc analysis of cluster randomized controlled study

BackgroundA workplace-based primary prevention intervention be an effective approach to reducing the incidence of hypertension (HTN). However, few studies to date have addressed the effect among the Chinese working population. We assessed the effect of a workplace-based multicomponent prevention interventions program for cardiovascular disease on reducing the occurrence of HTN through encouraging employees to adopt a healthy lifestyle.MethodsIn this post hoc analysis of cluster randomized controlled study, 60 workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20). All employees in each workplace were asked to complete a baseline survey after randomization for obtaining sociodemographic information, health status, lifestyle, etc. Employees in the intervention group were given a 2-year workplace-based primary prevention intervention program for improving their cardiovascular health, including (1) cardiovascular health education, (2) a reasonable diet, (3) tobacco cessation, (4) physical environment promotion, (5) physical activity, (6) stress management, and (7) health screening. The primary outcome was the incidence of HTN, and the secondary outcomes were improvements of blood pressure (BP) levels and lifestyle factors from baseline to 24 months. A mix effect model was used to assess the intervention effect at the end of the intervention in the two groups.ResultsOverall, 24,396 participants (18,170 in the intervention group and 6,226 in the control group) were included (mean [standard deviation] age, 39.3 [9.1] years; 14,727 men [60.4%]). After 24 months of the intervention, the incidence of HTN was 8.0% in the intervention groups and 9.6% in the control groups [relative risk (RR) = 0.66, 95% CI, 0.58 ~ 0.76, P < 0.001]. The intervention effect was significant on systolic BP (SBP) level (β = − 0.7 mm Hg, 95% CI, − 1.06 ~ − 0.35; P < 0.001) and on diastolic BP (DBP) level (β = − 1.0 mm Hg, 95% CI, − 1.31 ~ − 0.76; P < 0.001). Moreover, greater improvements were reported in the rates of regular exercise [odd ratio (OR) = 1.39, 95% CI, 1.28 ~ 1.50; P < 0.001], excessive intake of fatty food (OR = 0.54, 95% CI, 0.50 ~ 0.59; P < 0.001), and restrictive use of salt (OR = 1.22, 95% CI, 1.09 ~ 1.36; P = 0.001) in intervention groups. People with a deteriorating lifestyle had higher rates of developing HTN than those with the same or improved lifestyle. Subgroup analysis showed that the intervention effect of BP on employees with educational attainment of high school above (SBP: β = − 1.38/ − 0.76 mm Hg, P < 0.05; DBP: β = − 2.26/ − 0.75 mm Hg, P < 0.001), manual labor workers and administrative worker (SBP: β = − 1.04/ − 1.66 mm Hg, P < 0.05; DBP: β = − 1.85/ − 0.40 mm Hg, P < 0.05), and employees from a workplace with an affiliated hospital (SBP: β = − 2.63 mm Hg, P < 0.001; DBP: β = − 1.93 mm Hg, P < 0.001) were significantly in the intervention group.ConclusionsThis post hoc analysis found that workplace-based primary prevention interventions program for cardiovascular disease were effective in promoting healthy lifestyle and reducing the incidence of HTN among employees.Trial registrationChinese Clinical Trial Registry No. ChiCTR-ECS-14004641.

Lymphatic filariasis endgame strategies: Using GEOFIL to model mass drug administration and targeted surveillance and treatment strategies in American Samoa.

American Samoa underwent seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006, but subsequent surveys found evidence of ongoing transmission. American Samoa has since undergone further rounds of MDA in 2018, 2019, and 2021; however, recent surveys indicate that transmission is still ongoing. GEOFIL, a spatially-explicit agent-based LF model, was used to compare the effectiveness of territory-wide triple-drug MDA (3D-MDA) with targeted surveillance and treatment strategies. Both approaches relied on treatment with ivermectin, diethylcarbamazine, and albendazole. We simulated three levels of whole population coverage for 3D-MDA: 65%, 73%, and 85%, while the targeted strategies relied on surveillance in schools, workplaces, and households, followed by targeted treatment. In the household-based strategies, we simulated 1-5 teams travelling village-to-village and offering antigen (Ag) testing to randomly selected households in each village. If an Ag-positive person was identified, treatment was offered to members of all households within 100m-1km of the positive case. All simulated interventions were finished by 2027 and their effectiveness was judged by their 'control probability'-the proportion of simulations in which microfilariae prevalence decreased between 2030 and 2035. Without future intervention, we predict Ag prevalence will rebound. With 3D-MDA, a 90% control probability required an estimated ≥ 4 further rounds with 65% coverage, ≥ 3 rounds with 73% coverage, or ≥ 2 rounds with 85% coverage. While household-based strategies were substantially more testing-intensive than 3D-MDA, they could offer comparable control probabilities with substantially fewer treatments; e.g. three teams aiming to test 50% of households and offering treatment to a 500m radius had approximately the same control probability as three rounds of 73% 3D-MDA, but used < 40% the number of treatments. School- and workplace-based interventions proved ineffective. Regardless of strategy, reducing Ag prevalence below the 1% target threshold recommended by the World Health Organization was a poor indicator of the interruption of LF transmission, highlighting the need to review blanket elimination targets.

Workplace-Based Interventions for Mental Health in Africa: A Scoping Review.

Mental health problems are one of the leading contributors to the global burden of disease. Workplaces provide a valuable and accessible setting for interventions to improve worker health. However, little is known about mental health interventions on the African continent, particularly those based in the workplace. This review aimed to identify and report on the literature about workplace-based interventions for mental health in Africa. This review followed the JBI and PRISMA ScR guidelines for scoping reviews. We searched 11 databases for qualitative, quantitative and mixed-methods studies. The grey literature was included, and no language or date limits were applied. Title and abstract screening and full text review, were completed independently by two reviewers. A total of 15 514 titles were identified, of which, 26 titles were included. The most common study designs were qualitative studies (n = 7) and pre-experimental, single-group, pre-test, post-test studies (n = 6). Workers with depression, bipolar mood disorder, schizophrenia, intellectual disability, alcohol and substance abuse, stress and burnout were included in the studies. The participants were mostly skilled and professional workers. A wide variety of interventions were offered, of which, most were multi-modal. There is a need to develop multi-modal interventions in partnership with stakeholders, particularly for semi-skilled and unskilled workers.

Validitas Skor Faktor Pola Makan Modern untuk Mengidentifikasi Obesitas pada Pekerja Dewasa di Indonesia

As the prevalence of obesity continues to rise, including in adult workers, workplace-based interventions are needed to promote a healthy diet and prevent obesity. Valid measurement of dietary patterns is necessary to monitor and evaluate the effectiveness of these interventions. Therefore, this study analyzed the validity of the Modern Dietary Pattern Factor Score (MDP-FS) as a proxy indicator of obesity among Indonesian adult workers. This cross-sectional study used the fifth wave of the Indonesia Family Life Survey (IFLS) for sociodemographic, dietary, and anthropometric measures. The receiver operating characteristic (ROC) curve analysis was used to assess the ability of MDP-FS to detect obesity. The Area Under the Curve (AUC) of MDP-FS was 87% (95%CI 86-88.1%). At the MDP-FS cut-off of 5.2, the sensitivity and specificity of MDP-FS to indicate obesity were 74% and 76%, respectively. MDP-FS have good accuracy as a proxy indicator for measuring obesity of adult workers in Indonesia.

Providing quality improvement workplace-based professional development to Australian general practice clinical educators: findings from a feasibility study

ABSTRACT In Australia, doctors undertaking advanced training to become general practitioners work under the supervision of clinical educators. Primarily clinicians, these clinical educators participate in one day of teaching-related professional development annually, generally a workshop. Shortcomings with this form of professional development led to the development of a quality improvement focused intervention that is facilitated in the workplace and based on the clinical educator’s self-identified concerns. Drawing on teacher action research and feasibility study methodologies we explored this novel form of professional development by asking ‘Can this intervention work?’ We employed an embedded multiple case study design, trialling the intervention in four settings. The intervention’s constituent activities were acceptable to participants; including a preparedness to experience discomfort for the purpose of improving their teaching practices. They perceived the intervention as convenient and the workload manageable. Participants were motivated to experiment with new teaching behaviours, but measuring outcomes was challenging. Medical educators facilitating the intervention perceived their tasks as cognitively ‘hard work’. The findings provide support for this workplace-based intervention as a feasible form of professional development, which should be implemented on a larger scale and evaluated for impact.

S-23-3: EFFECT OF A WORKPLACE-BASED PRIMARY PREVENTION INTERVENTION FOR CARDIOVASCULAR DISEASE ON INCIDENCE OF HYPERTENSION - A CLUSTER RANDOMIZED CONTROLLED TRIAL

Objective: A workplace-based primary prevention intervention for cardiovascular disease could be an effective approach to encourage employees to adopt a healthy lifestyle and control the occurrence of hypertension. Our objective is to assess the effect of a workplace-based, multicomponent primary intervention strategy for cardiovascular disease on controlling the incidence of hypertension. Methods: A cluster randomized clinical trial was conducted from January 2013 to December 2014 in 60 workplaces across 20 urban regions in China. Workplaces were randomized to either the intervention group (n = 40) or control group (n = 20). All employee participants in each workplace were asked to complete standard questionnaire surveys and physical examinations. Employees in the intervention group were given a two-year workplace wellness intervention program, while those in the control group only maintained the existing health management measures in the workplace and did not receive additional intervention. The incidence of hypertension in baseline non-hypertensive patients in the intervention and control groups, as well as changes in blood pressure levels and lifestyle factors were assessed at the end of the trial. Results: Overall, 21,667 participants (16,488 in the intervention group and 5,179 in the control group) were included (mean [SD] age, 39.2 [9.0] years; 13,207 men [61.0%]). After 24 months of the intervention, the incidence of hypertension in baseline non-hypertensive patients was 7.2% in the intervention group and 8.2% in the control group (RR = 0.88, 95% CI,0.79 to 0.98, P = 0.012). The intervention effect was significant on systolic BP level (beta = -0.42, 95% CI, -0.80 to -0.05; P = 0.027) and on diastolic BP level (beta = -0.37, 95% CI, -0.67 to -0.07; P = 0.014). Moreover, greater improvement was reported in healthy lifestyle, such as the rates of smoking (-1.6%; 95% CI, -2.5% to -0.6%; P &lt; 0.001), drinking (-3.1%; 95% CI, -4.0% to -2.2%; P &lt; 0.001), regular exercise (10.9%; 95% CI, 9.8% to 11.9%; P &lt; 0.001), perceived stress (-5.7%; 95% CI, -6.6% to -4.7%; P = 0.025), fatty food intake (-9.0%; 95% CI, -10.1% to -7.9%; P &lt; 0.001) and excessive use of salt (-5.5%; 95% CI, -6.3% to -4.6%; P &lt; 0.001). Conclusion: This trial found that workplace-based primary prevention interventions for cardiovascular disease appeared to be effective in reducing the prevalence of hypertension, leading to measurable benefits such as lower blood pressure and adoption of healthy lifestyle habits. The intervention can therefore be considered for large-scale use or inclusion in workplaces health promotion programs in China and other countries.

Wiedereingliederung nach Depression – Eine vergleichende Studie mit Betriebsärztinnen und -ärzten sowie betroffenen Beschäftigten

Sustainable return to work after depression – a comparative study among occupational physicians and affected employees Introduction: The number of sick days taken from work due to depression is steadily rising. A successful return to work (WE) is essential for sustainable reintegration. This study aims to identify factors to optimise WE and to investigate approaches for a sustainable WE after a depressive episode. Methods: Semi-structured expert interviews with senior occupational physicians (BÄ, n = 5) served to develop two surveys among BÄ (n = 180) and employees after a depressive episode (n = 192). Predictors of WE rating, workplace-based WE interventions and sustainable WE interventions were analysed using multiple hierarchical regression, chi-square difference and t-tests. Results: For BÄ, employee training on mental illness prevention was found to be the strongest predictor of overall WE rating, whereas understanding and appreciation in conversations and stigmatisation were the strongest predictors of overall WE rating by the employees. Compared to the employees, BÄ reported significantly more availability of workplace-based interventions. To prevent relapse, the employees prioritised sufficient time and financial security during the WE process more than BÄ. Conclusions: The study identified facilitating and hindering factors that can inform further research and practice to improve WE after depressive episodes. To redress the awareness gap about the availability of workplacebased interventions, regular contact between BÄ and employees is crucial. Several factors were considered to be of varying importance for relapse prevention by the two groups. Multiple perceptions and needs ought to be taken into account when planning the WE. Keywords: depression – return to work – sick leave – workplace – occupational medicine

Managing work-related lateral elbow tendinopathy: Australian hand therapist's experiences with workplace-based interventions.

Lateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal conditions. Current treatments for LET focus mainly on the physiological symptoms of pain, grip strength, and function. Recently, a novel workplace-based hand therapy educational intervention, Working Hands-ED, was developed based on the Person-Environment-Occupation- Performance model, International Classification of Functioning, Disability and Health framework and the Australian Clinical Framework for the Delivery of Health Services. Combining a hand therapist's specialised knowledge and skills in upper limb rehabilitation with an approach that considers injured workers' occupations and work environments may provide a more holistic approach to managing work-related LET. To the best of our knowledge, no previous studies have investigated the experiences of hand therapists who perform workplace-based educational interventions for the management of LET. An exploratory, descriptive qualitative design using semi-structured interviews was used with hand therapists who delivered the novel hand therapy intervention Working Hands-ED. Ten occupational therapists working in hand therapy were interviewed. Three main themes and eight subthemes were identified from interview data: Person-centred approach, opportunity for therapists to provide enhanced service, and improved stakeholder engagement in the return-to-work process. Logistical challenges such as the costs and time spent away from the clinical setting were identified. All hand therapists reported delivering Working Hands-ED when managing work-related LET was a positive experience for them. They believed that the novel intervention could provide a more holistic approach to care that added value to their service delivery; however, there were some logistical factors to consider including the additional time and costs associated with the intervention.

Development and optimisation of a multi-component workplace intervention to increase cycling for the Cycle Nation Project.

The Cycle Nation Project (CNP) aimed to develop, test the feasibility of and optimize a multi-component individual-/social-level workplace-based intervention to increase cycling among office staff at a multinational bank (HSBC UK). To do this, we first explored barriers to cycling in a nationally-representative survey of UK adults, then undertook focus groups with bank employees to understand any context-specific barriers and ways in which these might be overcome. These activities led to identification of 10 individual-level, two social-level, and five organizational-level modifiable factors, which were mapped to candidate intervention components previously identified in a scoping review of cycling initiatives. Interviews with HSBC UK managers then explored the practicality of implementing the candidate intervention components in bank offices. The resultant pilot CNP intervention included 32 core components across six intervention functions (education, persuasion, incentivisation, training, environmental restructuring, enablement). Participants received a loan bike for 12-weeks (or their own bike serviced), and a 9-week cycle training course (condensed to 6 weeks for those already confident in basic cycling skills), including interactive information sharing activities, behavior change techniques (e.g., weekly goal setting), bike maintenance training, practical off-road cycling skill games and on-road group rides. Sessions were delivered by trained bank staff members who were experienced cyclists. The CNP pilot intervention was delivered across three sites with 68 participants. It was completed in two sites (the third site was stopped due to COVID-19) and was feasible and acceptable to both women and men and across different ethnicities. In addition, the CNP intervention was successful (at least in the short term) in increasing cycling by 3 rides/week on average, and improving perceptions of safety, vitality, confidence, and motivation to cycle. Following minor modifications, the long-term effectiveness and cost-effectiveness of the CNP intervention should be tested in a full-scale randomized controlled trial.

Evaluation of a workplace alcohol prevention program targeted on managers' inclination to initiate early alcohol intervention.

Alcohol interventions targeting the adult population are often conducted in healthcare settings, while preventive interventions often target adolescents or young adults. The general working population is often overlooked. A workplace-based intervention, consisting of development and implementation of an organizational alcohol policy, and skills development training for managers (APMaT) was carried out in order to prevent and reduce alcohol-related harms by identifying hazardous consumers at an early stage. This study aims to evaluate APMaT by focusing on managers' inclination to initiate early alcohol intervention. In a cluster randomized design, data were obtained from 187 managers (control: n = 70; intervention: n = 117). Inclination to initiate early alcohol intervention was measured using three items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Changes in managers' inclination to intervene were analyzed by applying multilevel ordered logistic regression. Predictors included in the model were group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group×time). Significant increase in inclination to intervene against hazardous alcohol consumption among managers in the intervention group compared to managers in the control group was observed. Specifically, a 50% increase of confidence to initiate an intervention was observed among managers in the intervention group. APMaT seems effective to increase managers' inclination to intervene early against hazardous consumption in the workplace. The effectiveness of APMaT at the employee level should be explored in prospective studies.

Sustainable return to work after depression - A comparative study among occupational physicians and affected employees.

IntroductionThe number of sick days taken from work due to depression is steadily rising. A successful return to work (RTW) is essential for sustainable reintegration. This study aims to identify factors to optimize RTW and to investigate approaches for sustainable RTW (sRTW) after depressive episodes.MethodsSemi-structured expert interviews with senior occupational physicians (OPs, N = 5) served to develop two surveys among OPs (N = 180) and employees after depressive episode (N = 192). Predictors of RTW rating, workplace-based RTW interventions and sRTW interventions were analyzed using multiple hierarchical regression, chi-square difference and t-tests.ResultsFor OPs, employee training on mental illness prevention was found to be the strongest predictor of overall RTW rating, whereas understanding and appreciation in conversations and stigmatization were strongest predictors of overall RTW rating by the employees. Compared to the employees, OPs reported significantly more availability of workplace-based interventions. To prevent relapse, the employees prioritized sufficient time and financial security during the RTW process more than OPs.ConclusionsThe study identified facilitating and hindering factors that can inform further research and practice to improve RTW after depressive episodes. To redress the awareness gap about the availability of workplace-based interventions, regular contact between OPs and employees is crucial. Several factors were considered to be of varying importance for relapse prevention by the two groups. Multiple perceptions and needs ought to be taken into account during RTW.

Workplace-based Interventions to Increase Mammography Screening in Islamic Countries: A Systematic Review and Narrative SummaryWorkplace-based Interventions to Increase Mammography Screening in Islamic Countries: A Systematic Review and Narrative Summary

Introduction: Breast cancer is a contributing factor to women’s death. Mammography screening uptake is low in Islamic countries compared to non-Islamic countries. In Saudi Arabia, a first step is to develop an appropriate intervention at workplace to increase mammography screening rates, this review was conducted to update current knowledge on the effectiveness of existing workplace interventions to enhance mammography screening uptake in Saudi Arabia. Methods: A systematic review and narrative syntheses was conducted. All studies that assessed the effectiveness of workplace interventions to increase mammography screening uptake among female employees were included. This review was registered on PROSPERO with the number CRD42021281744. Results: Three studies were included. All the studies evaluated a workplace educational intervention aiming to increase mammography screening uptake. It was found that workplace-based interventions increase breast mammography screening uptake while the effectiveness of the existing workplace intervention remains questionable and further research is warranted to improve our understanding of how we can successfully improve mammography screening among women in Islamic countries. Conclusion: This review has demonstrated that the effectiveness of the existing workplace interventions to increase mammography screening uptake remains unclear. It was also found that no studies about workplace interventions in Islamic countries.