Search

The overall aim of this thesis is to address the importance of improving the health and sustainable employability of workers in a vulnerable position, more specifically of workers with a lower SEP and workers with a work disability, and to investigate how workers with a lower SEP and with problems on multiple life domains can be adequately supported by OHPs, and how workers with a work disability can be adequately supported by supervisors at the workplace. The specific aims are: 1. To investigate the differences of exit from work on health between workers with a low SEP and workers with a high SEP. 2. To develop and evaluate a preventive intervention for OHPs to improve the health and sustainable employability of workers with a lower SEP and with problems on multiple life domains, and to explore facilitators and barriers for implementation of these types of preventive interventions in occupational health practice. 3. To explore the needs of workers with a work disability with respect to the guidance of supervisors in relation to their sustainable employability, and to evaluate an intervention for supervisors to improve the sustainable employability of workers with a work disability.

Background The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees. Methods Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness. Results No statistically significant difference was observed in the odds of hazardous alcohol use, although employees in the intervention group showed a larger decrease compared to the control group. This remained even after adjusting for several factors, including the sociodemographic factors and policy awareness. Conclusions The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions.

Purpose: To describe how managers of employees on sick-leave, due to chronic pain conditions, experience participating in a three-party meeting using the Demand and Ability Protocol (DAP) in the return-to-work process. Materials and methods: This study is based on individual semi-structured interviews with 17 managers of employees with chronic pain. Interviews were conducted after participating in a three-party meeting including the employee, manager, and a representative from the rehabilitation team. The data were analyzed using thematic analysis with an inductive approach. Results: Two main themes were identified–“to converse with a clear structure and setup” and “to be involved in the employee’s rehabilitation.” The first theme describe experiences from the conversation, and the second theme reflected the managers’ insights when being involved in the employee’s rehabilitation. The themes comprise 11 sub-themes describing how the DAP conversation and the manager′s involvement in the rehabilitation may influence the manager, the manager-employee relationship, and the organization. Conclusions: This study show, from a manager's perspective, how having a dialogue with a clear structure and an active involvement in the employee’s rehabilitation may be beneficial for the manager-employee relationship. Insights from participating in the DAP may also be beneficial for the organization. IMPLICATIONS FOR REHABILITATION * A structured dialogue between the employee, employer, and rehabilitation supports the return to work (RTW) process * A structured dialogue and collaboration may strengthen the relationship between the manager and employee * An active engagement of managers in the employeès RTW process is beneficial for the manager-employee relationship, and for the organisation * Healthcare professionals should collaborate with the workplace to promote participation of managers. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Objectives: Workplace exercise has been demonstrated to improve health outcomes and productivity. Hospital staffs may have a large potential to benefit from workplace exercise; however, implementation of workplace exercise faces the challenges of the workflow in hospitals. This study aimed to explore the economic and productivity consequences of a 12-week exercise intervention for hospital health care providers in a Danish hospital department. Methods: The outcome measures included the costs of providing the intervention, sick leave, self-reported quality of life (EQ-5D-5 L), work engagement (Utrecht Work Engagement Scale), and employees’ workplace social capital. Ordinary Least Squares and Generalized Linear Models were employed to assess whether the extent of participation in the intervention was associated with the outcome measures. Results: A total of 80 participants completed an average of 9 sessions during the 12-week study period, at an estimated mean cost of €77 per person. Increasing number of exercise sessions was associated with improvements on the pain domain of the EQ-5D-5 L (mean (SD) -0.2570 (0.723), p = 0.0049), and with improved work engagement (by 4.6%) over the intervention period. We found no significant associations between exercise session participation and the other outcome measures. Conclusions: The pilot study demonstrates relatively high acceptance of a worksite exercise program at a hospital, at a relatively low cost, with several important directions in outcomes. Further work should explore whether these results can be replicated in a larger, randomized trial.

Abstract Background A large proportion of staff working in hospital settings are overweight or obese, have poor dietary habits and low physical activity levels. The workplace is a priority setting for health promotion. This systematic review will describe dietary and physical activity workplace interventions that have aimed to improve the health of staff in hospital settings; and the barriers and enablers of implementing these interventions. Methods A systematic search retrieved 551 studies from 2004 to 2020 using the following databases CINAHL Complete, MEDLINE Complete, Academic Search Complete, Global Health, Health Source Nursing/Academic Edition and PsycINFO. Studies were included if they: (1) took place in a hospital setting; (2) employed a physical activity or dietary intervention to improve the well-being of staff; (3) the intervention duration was 12 weeks or over; (4) used a control group. The Integrated quality Criteria for the Review of Multiple Study designs (ICROMS) and National Institute of Health’s National Heart Lung and Blood Institute Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies tools were used to assess quality of included studies. A narrative review was conducted. Results Quality analysis identified six studies of high quality, nine moderate quality, and three low quality. Of these 18 studies, 15 reported at least one positive health outcome. The evidence revealed that multi-component strategies, financial incentives and motivational strategies were the most effective approaches to improve health behaviours of hospital staff. Conclusion Hospital-based dietary and physical activity workplace interventions show promise as an effective strateg

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

Objective: The objective of this study was to explore Swedish managers’ and HR-officers’ experiences and perceptions of skills training including a development and implementation of an alcohol policy. Methods: Semi-structured interviews were conducted with Swedish managers (n = 44) and HR-officers (n = 9) from nine different organizations whom had received skills training and an organizational policy implementation. The interviews were analyzed using thematic analyses. Results: In total, nine themes were identified as: The prevalence of alcohol problems: a wake-up call; a reminder to intervene immediately; an altered view of the responsibility of the employer; initiating conversations about alcohol: a useful toolbox; an imprecise, yet positive, memory; increased awareness of issues related to alcohol culture; I have not heard a word about a new alcohol policy; the alcohol policy: a mere piece of paper; and alcohol problem prevention: hardly a low-hanging fruit. Participants’ experiences of the skills training were positive overall. Conclusion: Various aspects of the skills training were appreciated by managers and HR-officers, including insight of prevalence statistics and employer responsibilities. Participants emphasized the value of repeated skills training occasions for retaining knowledge. Future research may investigate further in what way skills training may affect managers’ willingness to engage in workplace alcohol prevention. Since the implementation of any policy had gone unnoticed to participants, a reason for which could be related to the notion of the existing policy as “good enough” in its current condition, implementation and organizational issues, or a reluctance to address alcohol-related matters unless necessary; future research may focus on investigating in what manner alcohol policies are in fact utilized within organizations., Alkoholpreventiva insatser i arbetslivet

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

Purpose - An alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation because of the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers. Design/methodology/approach - A cross-sectional survey (n = 193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n = 18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers. Findings - Sixty-five per cent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace's approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers. Practical implications - A thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention. Originality/value - This study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.

Objectives This pilot study tested the use of an exercise offer to hospital employees during working hours and changes in work and health parameters. Methods Employees (n = 214) from a medical department on a Danish hospital were invited to 30 minutes' exercise training twice weekly for 12 weeks. Outcomes included health- and work-related parameters. Results Eighty employees (mean age, 44.4 [SD, 10.7] years; 81.3% women) completed the study. Intervention adherence was 36.3% (SD, 25.1%). Aerobic capacity increased from 34.6 (95% confidence interval [CI], 32.3 to 36.9) to 36.7 (95% CI, 34.1 to 39.4) mL O2/min per kilogram, P = 0.004. Blood pressure decreased from 120 (95% CI, 117 to 123)/79 (95% CI, 76 to 81) to 116 (95% CI, 112 to 120)/76 (95% CI, 74 to 79) mm Hg, P = 0.003. Waist circumference and musculoskeletal pain decreased. Well-being, social capital, and quality of life increased. Conclusions Despite low training adherence, completers improved outcomes related to metabolic and self-rated health.

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.

The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability. © 2022 by the authors.

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

Background: Sedentary Behaviour (SB) gets an increasing attention from ergonomics and public health due to its associated detrimental health effects. A large number of studies record SB with ActiGraph counts-per-minute cut-points, but we still lack valid information about what the cut-points tell us about office work. This study therefore analysed the concurrent and discriminant validity of commonly used cut-points to measure SB, activity level, and posture. Methods: Thirty office workers completed four office tasks at three workplaces (conventional chair, activity-promoting chair, and standing desk) while wearing two ActiGraphs (waist and wrist). Indirect calorimetry and prescribed posture served as reference criteria. Generalized Estimation Equations analysed workplace and task effects on the activity level and counts-per-minute, and kappa statistics and ROC curves analysed the cut-point validity. Results: The activity-promoting chair (p < 0.001, ES ≥ 0.66) but not the standing desk (p = 1.0) increased the activity level, and both these workplaces increased the waist (p ≤ 0.003, ES ≥ 0.63) but not the wrist counts-per-minute (p = 0.74) compared to the conventional chair. The concurrent and discriminant validity was higher for activity level (kappa: 0.52–0.56 and 0.38–0.45, respectively) than for SB and posture (kappa ≤0.35 and ≤ 0.19, respectively). Furthermore, the discriminant validity for activity level was higher for task effects (kappa: 0.42–0.48) than for workplace effects (0.13–0.24). Conclusions: ActiGraph counts-per-minute for waist and wrist placement were – independently of the chosen cut-point – a measure for activity level and not for SB or posture, and the cut-points performed better to detect task effects than workplace effects. Waist cut-points were most valid to measure the activity level in conventional seated office work, but they showed severe limitations for sit-stand desks. None of the placements was valid to detect the increased activity on

A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels. Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions. Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage. Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alc, En betydande andel av riskkonsumenter av alkohol finns i arbetskraften vilket tyder på att arbetsplatsen kan ge möjligheter att förebygga och minska riskkonsumtion av alkohol i ett tidigt skede. Ett alkoholförebyggande program med flera komponenter, s.k. ‘APMaT’ (engelsk förkortning för alkoholpolicy och utbildningstillfällen för chefer), designades och levererades av Alna, en organisation som tillhandahåller förebyggande insatser kring riskbeteende. Denna avhandling är en utvärdering av APMaT kring dess effektivitet genom att använda enkätdata både på chefs- och medarbetarnivåer. Studie I beskrev de sociodemografiska, arbets- och hälsorelaterade faktorerna bland chefer avseende deras benägenhet att genomföra insatser och deras kunskaper kring alkoholpolicy. Dessutom undersöktes sambandet mellan benägenhet att genomföra tidiga insatser och kunskaperna kring alkoholpolicy. Antalet underanställda hade ett starkt samband med både chefers benägenhet att genomföra insatser och kunskaperna kring alkoholpolicy, och att ett positivt graderat samband konstaterats mellan chefers benägenhet att genomföra tidiga insatser och deras alkoholpolicykunskap. Resultaten tyder på att chefers individuella faktorer kan ha betydelse för potentiella handlingar att genomföra tidiga insatser. Studie II utvärderade effektiviteten av APMaT genom att fokusera på förändringar i benägenhet att genomföra tidiga insatser bland chefer vid ettårsuppföljningstid. Resultaten tyder på att APMaT är effektiv till en viss del för att öka benägenhet att genomföra insatser genom ökat självförtroende att påbörja ett samtal med sina medarbetare, vilket kan öka sannolikheten att genomföra tidiga insatser i ett tidigt skede. Studie III utvärderade effektiviteten av APMaT ytterligare genom att undersöka förändringar i riskkonsumtionen av alkohol bland medarbetare vid ettårsuppföljningstid. Denna studie gav inte en stark empirisk evidens för att stödja effektiviteten av APMaT gällande riskkonsumtion av alkohol med

Context/purposeObservational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity.MethodsSix electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6–25 interventions analysed).ResultsInterventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ −0.6 kg), waist circumference (≈ −0.7 cm), percentage body fat (≈ −0.3 %), systolic blood pressure (≈ −1.1 mm Hg), insulin (≈ −1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I2=0.0–72.9).ConclusionsOur review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. Ther

Purpose: Snacks at work are often of poor dietary quality. The main objective of the current study is to examine the effect of making vegetable snacks available at workplace meetings on consumption. Design/methodology/approach: In three between-subjects field experiments conducted at a hospital and three ministries in the Netherlands, with meeting as the unit of condition assignment, attendees were exposed to an assortment of vegetables, varying in vegetable variety and presence of promotional leaflet in study 1 (N = 136 meetings), serving container in study 2 (N = 88 meetings) and additional presence of cookies in study 3 (N = 88 meetings). Consumption of vegetables and cookies was measured at meeting level to assess grams consumed per person. Findings: Across the three studies, average consumption per meeting attendee was 74 g (SD = 43) for study 1; 78 g (SD = 43) for study 2 and 87 g (SD = 35) for study 3. In the first study, manipulation of perceived variety and information leaflets did not affect intake. In the second study, significantly more vegetables were eaten when they were offered in single sized portions (M = 97 g, SD = 45) versus in a shared multiple portions bowl (63 g, SD = 38) (p < 0.001). In the third study, no effect was found of the additional availability of cookies on vegetable consumption during the meeting. Practical implications: The present studies show how availability of vegetables at unconventional occasions makes meeting attendants consume considerable portions of vegetables on average. As such, offering healthy snacks at the workplace may be a valuable part of workplace health promotion programs and positively change the “office cake culture”. Originality/value: Vegetable intake is less than recommended in many countries worldwide. Many snacking occasions are at work, which makes office meetings a potential consumption occasion to encourage vegetable intake. Hence, the aim of this study is to examine whether free availability of vegeta

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process., Published online: 31 July 2020

The purpose of this thesis was to deepen the understanding of recovery during the workday and its importance for employee health. Workplace intervention as a tool to promote employees’ experience of recovery was also evauated.The studies were carried out in a primary health care setting in one health care district in Sweden between 2013 and 2019, together with the employees working at the 26 participating centres. Both quantitative and qualitative methods were applied during the process. Two separate questionnaires were used and analysed with multivariate linear or logistic regression analyses. Also, focus group interviews were conducted for two different data collections, bothanalysed inspired by systematic text condensation.The findings indicate that experiencing recovery is the most significant predictor of self-rated health. The results also identified three factors of importance for perceived recovery during the workday: variation, companionship, andmanageability. Since these factors appeared to be prerequisites for recovery, they became the basis for planning and implementing a workplace intervention with various recovery activities addressed to primary health care employees.Consideration was also given to each workplace’s own abilities, needs, and wishes. An evaluation after intervention ending showed a significant increase in experienced recovery during the workday among the participating employees,which was mainly explained by the possibility for reflection. When exploring the intervention process further, four promoting factors for the successful outcome emerged: support, legitimacy, customization, and simplicity. Also, three areas were positively affected by the intervention. These upward spirals were work climate, employee well-being, and recovery awareness.The results of this thesis contribute to work recovery research by establishing that recovery is essential for self-rated health, and that interventions can be used to enhance employees’ experience of

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process., Published online: 31 July 2020

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.

Purpose: To explore if and how a dialogue-based workplace intervention with a convergence dialogue meeting can support a return to work process from the managers' perspective. Methods: Individual interviews were conducted with 16 managers (10 women and 6 men) who had an employee on sick leave because of stress-induced exhaustion disorder. The manager and employee participated in a dialogue-based workplace intervention with a convergence dialogue meeting that was guided by a healthcare rehabilitation coordinator. The intervention aimed to facilitate dialogue and find concrete solutions to enable return to work. The interviews were analyzed by the Grounded Theory method. Results: A theoretical model was developed with the core category enhancing managerial capacity to act in a complex return to work process,where the managers strengthened their agential capacity in three levels (categories). These levels werebuilding competence, making adjustments, andsharing responsibilitywith the employee. The managers also learned to navigate in multiple systems and by balancing demands, control and support for the employee and themselves. An added value was that the managers began to take preventive measures with other employees. When sick leave was caused only by personal or social issues (not work), workplace actions or interventions were difficult to find. Conclusions: From the managers' perspective, dialogue-based workplace interventions with a convergence dialogue meeting and support from a rehabilitation coordinator can strengthen managerial competence and capacity to act in a complex return to work process.

While smoking is widely acknowledged to be a social activity, limited evidence exists on the extent to which friends influence each other during worksite-based tobacco cessation interventions. Drawing on data from adult smokers (N = 1823) in a large, cluster randomized controlled trial in worksites in Thailand, this study examines the presence of social spillovers in the decision to abstain from smoking. We leverage a unique aspect of social network structure in these data-the existence of non-overlapping friendship networks-to address the challenge of isolating the effects of peers on smoking behavior from the confounding effects of endogenous friend selection and bidirectional peer influence. We find that individuals with workplace friends who have abstained from smoking during the trial are significantly more likely to abstain themselves. Instrumental variables estimates suggest that abstinence after 3 and 12 months increases 26 and 32 percentage points, respectively, for each additional workplace friend who abstains. These findings highlight the potential for workplace interventions to use existing social networks to magnify the effect of individual-level behavior change, particularly in low- and middle-income countries where tobacco cessation support tends to be limited.

Background: High alcohol consumption poses risks to individual health and society. Previous alcohol interventions have mainly focused on high-risk consumers or young adults in school-based settings. Since the majority of the adult population is in the workforce, the workplace can be considered a favorable arena for implementing interventions. Objective: This protocol describes a project aimed at increasing knowledge of the effectiveness of combining the implementation of an organizational alcohol policy with skills training for managers as a workplace alcohol prevention program, by evaluating the intervention and exploring managers’ perceptions of the intervention. Methods: Organizations with at least 100 employees were invited to take part in the project. A total of 11 organizations (744 managers and 11,761 employees) were included in the project. Data are collected through self-administered online surveys at baseline, 12 months, and 24 months. The primary outcome is managers’ inclination to initiate an early alcohol intervention (eg, by initiating a dialogue) when concern regarding employees’ hazardous alcohol consumption arises. The secondary outcomes of interest are managers’ and employees’ organizational alcohol policy knowledge and changes in alcohol consumption, as measured using the Alcohol Use Disorder Identification Test (AUDIT) score. A linear mixed-model framework will be used to model variability on different levels. Primary analysis will follow an intention-to-treat approach. Additionally, managers’ responses from semistructured interviews will be analyzed using thematic analysis to explore managers’ experiences regarding the prevention program. Results: This study is ongoing. The overall study start was on January 2018, and the study is planned to end in December 2020. Baseline and 12-month follow-up measurements have been collected. Conclusions: This project is designed to evaluate the effectiveness of an alcohol prevention program regarding higher i, This work was supported by the Public Health Agency of Sweden, which provides economic support for developmental projects in the areas of alcohol, narcotics, tobacco, and doping (grant no: 02781-2017; 03333-2018). This project is sponsored by the Department of Public Health Sciences, Stockholm University.

Quitting smoking is easier if you receive a reward for it. This research shows that employees refrained from smoking better if they received a reward in combination with quit-smoking training at work. The research involved 604 smokers who wanted to stop smoking from 61 companies in the Netherlands. Half of the smokers participated in a group training only (control group) and the other half participated in the group training and received a reward (intervention group). The reward consisted of gift certificates totalling €350. After the training, those who had stopped smoking received €50, after three months another €50, after six months again €50 and after 12 months €200. After a year, some people had started smoking again, but there was a large different between the intervention and control groups (41% vs. 26%). This demonstrates that a quit-smoking group training at work will be more successful if combined with a reward in the form of gift certificates. The results of this research have been published in the leading scientific journal The Lancet Public Health, among others. Funded by KWF Kankerbestrijding, ZonMw

While smoking is widely acknowledged to be a social activity, limited evidence exists on the extent to which friends influence each other during worksite-based tobacco cessation interventions. Drawing on data from adult smokers (N = 1823) in a large, cluster randomized controlled trial in worksites in Thailand, this study examines the presence of social spillovers in the decision to abstain from smoking. We leverage a unique aspect of social network structure in these data-the existence of non-overlapping friendship networks-to address the challenge of isolating the effects of peers on smoking behavior from the confounding effects of endogenous friend selection and bidirectional peer influence. We find that individuals with workplace friends who have abstained from smoking during the trial are significantly more likely to abstain themselves. Instrumental variables estimates suggest that abstinence after 3 and 12 months increases 26 and 32 percentage points, respectively, for each additional workplace friend who abstains. These findings highlight the potential for workplace interventions to use existing social networks to magnify the effect of individual-level behavior change, particularly in low- and middle-income countries where tobacco cessation support tends to be limited.

This study aimed to assess the effect of systematic self-observation, hetero-observational feedback, and feedforward and intrinsic feedback (SsObserWork components) on workers’ knowledge and behaviour of a manual material handling (MMH) technique in the industrial sector. Blue-collar workers recruited from a food processing company in Catalonia (Spain) were randomized into SsObserWork (N = 31) and control (N = 30) groups. SsObserWork group members participated individually in two sessions and a three-week follow-up between sessions where they received the SsObserWork components. The control group participated individually in two sessions where they received a standard MMH training. An ad hoc instrumentcalled the MMH-SsObserWork instrument was used to assess the MMH behaviour, and an adaption of the instrument was done to assess the workers’ knowledge. Significant differences were found between groups for the identification of recommended back positions in the first session and also on comparing both sessions. However, no differences were found for the rest of the criteria. There also were significant differences between groups in the score changes of the back, knee joints, elbow joints, and interaction criterion, indicating that the SsObserWork group improved the MMH performance in these criteria (behaviour). SsObserWork intervention showed a positive effect on improving the knowledge and behaviour of the MMH technique, specifically on back posture.

This study aimed to assess the effect of systematic self-observation, hetero-observational feedback, and feedforward and intrinsic feedback (SsObserWork components) on workers’ knowledge and behaviour of a manual material handling (MMH) technique in the industrial sector. Blue-collar workers recruited from a food processing company in Catalonia (Spain) were randomized into SsObserWork (N = 31) and control (N = 30) groups. SsObserWork group members participated individually in two sessions and a three-week follow-up between sessions where they received the SsObserWork components. The control group participated individually in two sessions where they received a standard MMH training. An ad hoc instrumentcalled the MMH-SsObserWork instrument was used to assess the MMH behaviour, and an adaption of the instrument was done to assess the workers’ knowledge. Significant differences were found between groups for the identification of recommended back positions in the first session and also on comparing both sessions. However, no differences were found for the rest of the criteria. There also were significant differences between groups in the score changes of the back, knee joints, elbow joints, and interaction criterion, indicating that the SsObserWork group improved the MMH performance in these criteria (behaviour). SsObserWork intervention showed a positive effect on improving the knowledge and behaviour of the MMH technique, specifically on back posture.

This study aimed to assess the effect of systematic self-observation, hetero-observational feedback, and feedforward and intrinsic feedback (SsObserWork components) on workers’ knowledge and behaviour of a manual material handling (MMH) technique in the industrial sector. Blue-collar workers recruited from a food processing company in Catalonia (Spain) were randomized into SsObserWork (N = 31) and control (N = 30) groups. SsObserWork group members participated individually in two sessions and a three-week follow-up between sessions where they received the SsObserWork components. The control group participated individually in two sessions where they received a standard MMH training. An ad hoc instrumentcalled the MMH-SsObserWork instrument was used to assess the MMH behaviour, and an adaption of the instrument was done to assess the workers’ knowledge. Significant differences were found between groups for the identification of recommended back positions in the first session and also on comparing both sessions. However, no differences were found for the rest of the criteria. There also were significant differences between groups in the score changes of the back, knee joints, elbow joints, and interaction criterion, indicating that the SsObserWork group improved the MMH performance in these criteria (behaviour). SsObserWork intervention showed a positive effect on improving the knowledge and behaviour of the MMH technique, specifically on back posture.

Quitting smoking is easier if you receive a reward for it. This research shows that employees refrained from smoking better if they received a reward in combination with quit-smoking training at work. The research involved 604 smokers who wanted to stop smoking from 61 companies in the Netherlands. Half of the smokers participated in a group training only (control group) and the other half participated in the group training and received a reward (intervention group). The reward consisted of gift certificates totalling €350. After the training, those who had stopped smoking received €50, after three months another €50, after six months again €50 and after 12 months €200. After a year, some people had started smoking again, but there was a large different between the intervention and control groups (41% vs. 26%). This demonstrates that a quit-smoking group training at work will be more successful if combined with a reward in the form of gift certificates. The results of this research have been published in the leading scientific journal The Lancet Public Health, among others. Funded by KWF Kankerbestrijding, ZonMw

Background: Despite extensive efforts, issues like obesity and poor physical capacity remain challenges for a healthy work life in several occupations. The Goldilocks work principle offers a new approach, encouraging design of productive work to promote physical capacity and health. This paper presents the protocol for the Goldilocks-childcare study, a randomised controlled intervention trial aiming to evaluate the effectiveness of implementing the Goldilocks work principle in childcare. The primary aim of the intervention is to increase time in moderate to vigorous physical activity (MVPA) by having the childcare workers act as active role models for children in daily playful physical activities, and thereby improve cardiorespiratory fitness and health of the workers. Methods: The study is a cluster-randomised trial with a usual-practice wait-list control group. The 10-week intervention consists of two phases. In the first, the childcare workers will participate in two participatory workshops aiming to a) develop playful physical activities ('Goldilocks-games') for children in which childcare workers participate as active role models at MVPA intensity, and b) develop action plans for implementation of the Goldilocks-games in daily work routines. In the second phase, childcare institutions will implement the Goldilocks-games. The primary outcome is working time spent in MVPA, and secondary outcomes are cardiorespiratory fitness, sleeping heart rate, perceived need for recovery, and productivity. Primary outcome and process evaluation will be based on direct measurements of physical activity and heart rate, determination of cardiorespiratory fitness, and questionnaires. Discussion: If proven effective, the Goldilocks work principle has a large potential for promoting sustainable health and working lives of childcare workers. Trial registration: ISRCTN, ISRCTN15644757, Registered 25th December 2019

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. To determine the effectiveness of workplace interventions and the most effective methodological design for the improvement of employee productivity, work ability, and absenteeism. A meta-analysis of randomized controlled trials (RCTs) of workplace interventions was conducted (PROSPERO, CRD42018094083). The PubMed, Scopus, PsycINFO, and Cochrane databases were searched. RCTs from 2000 to 2017 and with employees (18–65 years) were selected. Then, intervention characteristics and work-related outcomes data were extracted. A total of 47 RCTs were included in the systematic review, and 19 RCTs (11 absenteeism, 7 productivity, and 5 work ability) were included in the meta-analysis. The meta-analysis showed that the effectiveness of workplace interventions for absenteeism was −1.56 (95% CI, −2.67 to −0.44) and −2.65 (95% CI, −4.49 to −0.81) considering only moderate quality RCTs. In contrast, only a few studies of workplace interventions for productivity and work ability were included, which was insufficient for determining the effectiveness and best design for improving these work outcomes. The workplace is an interesting environment to reduce absenteeism, and individualized and counseling interventions with <10 sessions/total were the most effective workplace intervention methodological design for reducing the absenteeism of employees. Future high-quality RCTs that also consider health risks should be implemented to strengthen the results.

Objective: Evaluate the effect of the Quebec Healthy Enterprise Standard (QHES) on adverse physical and psychosocial work factors and work-related musculoskeletal problems (WMSP). Methods: Workers of ten organizations completed questionnaires before (n=2849) and 2-3 years following (n=2560) QHES implementation. Outcomes were assessed using validated instruments. Results: Workers exposed to adverse physical and psychosocial work factors had a higher prevalence of WMSP. After interventions, the prevalences of one adverse physical and three adverse psychosocial work factors were lower among workers exposed to interventions. Among men exposed to physical and psychosocial interventions, the lower prevalence of neck WMSP is compatible with a beneficial intervention effect. Other results generally showed few effects on WMSP. Conclusions: Results suggest that QHES implementation lead to a decrease in some adverse physical and psychosocial factors. Few effects were observed on WMSP.

Workplace health promotion programs (WHPPs) refer to a set of health promotion and protection strategies implemented at a worksite and designed to meet the health and safety needs of employees. One important question for WHPPs is how middle management experience their participation in a WHPP. This study aims to explore this question further by applying a qualitative content analysis to interviews with thirteen managers and ten human resource officers participating in a WHPP focusing on problem gambling. The WHPP consisted of two components: policy implementation and skills-development training. The participants were interviewed about their experiences of these two components and the implementation process. The qualitative content analysis resulted in six themes: (1) Expectations of the skills-development training, (2) Experiences of and prior beliefs about problem gambling, (3) A good foundation, (4) The difficult conversation, (5) Appreciated aspects of the training sessions, and (6) Remaining obstacles. The results suggest that the presentation of cases, facts, and general knowledge was appreciated by most participants. However, participants also expressed that they would benefit from tailored interventions, more support in the policy implementation process, and following up on the results., The current research project was funded by Alna, the non-profit organization providing workplace interventions focused on harmful use in this study. Alna received their funding from the Public Health Agency of Sweden to evaluate the intervention. However, neither Alna nor the Public Health Agency of Sweden was involved in the analysis or preparation of the manuscript.

Purposes Intervention mapping (IM) is a protocol for developing effective behavior change interventions. It has been used for 10 years to develop work disability prevention (WDP) interventions, but it is not known to what extent and with what success. The main objective of this study was to review the effectiveness of these interventions. Secondary objectives were to review their fidelity to the IM protocol, their theoretical frameworks and their content. Methods A search strategy was conducted in MEDLINE, Web of Science, PsycINFO, Pascal, Francis, and BDSP. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by two reviewers blinded to each other. Results Eight WDP interventions were identified aimed at return to work (RTW; n = 6) and self-management at work (n = 2). RTW interventions targeted workers with stress-related mental disorders (n = 1), low back pain (n = 1), musculoskeletal disorders (n = 1), cancer (n = 2) and gynecological surgery (n = 1). The fidelity to the IM protocol was weaker for the participatory planning group. Matrices of change, change methods, and applications were systematically reported. The main theoretical frameworks used were the attitude-social influence-self efficacy model (n = 4) and the theory of planned behavior (n = 2). Half of the interventions included a workplace component (n = 4). Two interventions were reported as effective, and one partially effective. Conclusion The IM protocol is used in WDP since 2007. The participative dimension appears underused. Few theoretical frameworks were used. Implications are to better consider the stakeholders involvement, and mobilize theoretical frameworks with greater attempts to intervene on the work environment.

OBJECTIVES: To assess the cost-effectiveness of workplace-delivered interventions designed to reduce sitting time as primary prevention measures for cardiovascular disease (CVD) in Australia. METHODS: A Markov model was developed to simulate the lifetime cost-effectiveness of a workplace intervention for the primary prevention of CVD amongst office-based workers. An updated systematic review and a meta-analysis of workplace interventions that aim to reduce sitting time was conducted to inform the intervention effect. The primary outcome was workplace standing time. An incremental cost-effectiveness ratio (ICER) was calculated for this intervention measured against current practice. Costs (in Australia dollars) and benefits were discounted at 3% annually. Both deterministic (DSA) and probabilistic (PSA) sensitivity analyses were performed. RESULTS: The updated systematic review identified only one new study. Only the multicomponent intervention that included a sit-and-stand workstation showed statistically significant changes in the standing time compared to the control. The intervention was associated with both higher costs ($6820 versus $6524) and benefits (23.28 versus 23.27, quality-adjusted life year, QALYs), generating an ICER of $43,825/QALY. The DSA showed that target age group for the intervention, relative risk of CVD relative to the control and intervention cost were the key determinants of the ICER. The base case results were within the range of the 95% confidence interval and the intervention had a 85.2% probability of being cost-effective. CONCLUSIONS: A workplace-delivered intervention in the office-based setting including a sit-and-stand desk component is a cost-effective strategy for the primary prevention of CVD. It offers a new option and location when considering interventions to target the growing CVD burden.

Purposes Intervention mapping (IM) is a protocol for developing effective behavior change interventions. It has been used for 10 years to develop work disability prevention (WDP) interventions, but it is not known to what extent and with what success. The main objective of this study was to review the effectiveness of these interventions. Secondary objectives were to review their fidelity to the IM protocol, their theoretical frameworks and their content. Methods A search strategy was conducted in MEDLINE, Web of Science, PsycINFO, Pascal, Francis, and BDSP. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by two reviewers blinded to each other. Results Eight WDP interventions were identified aimed at return to work (RTW; n = 6) and self-management at work (n = 2). RTW interventions targeted workers with stress-related mental disorders (n = 1), low back pain (n = 1), musculoskeletal disorders (n = 1), cancer (n = 2) and gynecological surgery (n = 1). The fidelity to the IM protocol was weaker for the participatory planning group. Matrices of change, change methods, and applications were systematically reported. The main theoretical frameworks used were the attitude-social influence-self efficacy model (n = 4) and the theory of planned behavior (n = 2). Half of the interventions included a workplace component (n = 4). Two interventions were reported as effective, and one partially effective. Conclusion The IM protocol is used in WDP since 2007. The participative dimension appears underused. Few theoretical frameworks were used. Implications are to better consider the stakeholders involvement, and mobilize theoretical frameworks with greater attempts to intervene on the work environment.

Introduction: Physical activity has a positive impact on physical and psychological well-being (Delisle, Werch, Wong, Bian, & Weiler, 2010), as well as social relations and skills development (Lamu & Olsen, 2016; Perkins & Williamon, 2014). Adopting a “healthy organization” culture through health programs, with strong senior and middle management support, and using interventions can promote health at workplaces (Rajaratnam et. al., 2014). We, therefore, consider it relevant to have physical activity, social relations and skill development as the starting point in a tabletennis intervention at the workplace. Aim: The aim was to develop, implement, and evaluate an intervention for improving health and wellbeing in the workplace by introducing table tennis. Methods and results: The intervention design consisted of two workshops and five table tennis sessions. Thirteen employees from a warehouse within the retail sector participated in the intervention. The participants had various backgrounds in table tennis and sport in general, different motives to participate, and came from different groups of employees (management and stock). After an introductory workshop, two table tennis coaches held one training session a week over the fiveweek intervention period. The employees were divided in to two groups and each group had a 45-minute session. The evaluation is in progress at present. Pre- and post-measurement has been conducted using health questionnaires Short Form 36 Health Survey (SF-36) and International Physical Activity Questionnaire (IPAQ). These will be analysed using a Bayesian paired t-test analysis. Based on the results of the questionnaire focus group interviews will be conducted with participants. Three focus groups of 4-5 participants in each group. The questions will focus on 24 experiences of the intervention and reflections on future directions for table-tennis and wellbeing activities at the workplace. Finally, there will be a workshop pointin