The Association between Fear of Crime, Educational Attainment, and Health.

Fear of crime is an important public health problem that impacts people's quality of life, health, and wellbeing, and causes mental health ailments (e.g., anxiety). This study aimed to determine whether there was an association between fear of crime, educational attainment, and self-rated health and anxiety among women residing in a county in east-central Sweden. A sample (n = 3002) of women aged 18-84 years surveyed in the Health on Equal Terms survey carried out in 2018 was included in the study. Bivariate and multivariate regression analysis was performed on the relationship between the composite variables fear of crime, educational attainment, and self-rated health and anxiety. Women with primary education or similar who reported fear of crime had increased odds of poor health (odds ratio (OR) 3.17; 95% confidence interval (CI) 2.40-4.18) compared with women with primary education/similar and no fear of crime (OR 2.90; CI 1.90-3.20). A statistically significant relationship persisted in the multivariate analysis after controlling for other covariates, although the odds were reduced (OR 1.70; CI 1.14-2.53 and 1.73; CI 1.21-2.48, respectively). Similarly, in the bivariate analysis, women who reported fear of crime and who only had primary education had statistically significant odds of anxiety (OR 2.12; CI 1.64-2.74); the significance was removed, and the odds were reduced (OR 1.30; CI 0.93-1.82) after adjusting for demographic, socioeconomic, and health-related covariates. Women with only primary education or similar who reported fear of crime had higher odds of poor health and anxiety compared with those with university education or similar, with and without fear of crime. Future studies (including longitudinal ones) are warranted-on the one hand, to understand possible mechanisms of the relationship between educational attainment and fear of crime and its consequences to health, and on the other, to explore low-educated women's own perceptions regarding factors underlining their fear of crime (qualitative studies).

Individual determinants of satisfaction with the work environment after relocation to activity-based workplaces: A prospective study.

Relocation to activity-based workplaces influences work environment satisfaction, but individual determinants of changes in satisfaction remain unknown. The aim of the present study was to determine whether age, gender, education, occupational position, or office type before relocation can predict work environment satisfaction among employees and managers relocated to activity-based offices. Respondents (n = 422) rated work environment satisfaction three months before and nine months after relocation. The findings indicate that, on average, satisfaction decreased after relocation, while for some workers it increased. Occupational position and office type at baseline predicted changes in satisfaction with the work environment; specifically, managers and those working in open-plan offices before relocation reported a smaller decline in satisfaction after relocation, compared to those relocating from private offices. Participants with no university education were more satisfied with the physical and psychosocial work environment in activity-based workplaces than those with a university degree.

Interpersonal Violence Is Associated with Self-Reported Stress, Anxiety and Depression among Men in East-Central Sweden: Results of a Population-Based Survey.

Background and Objectives: Interpersonal violence is a social and public health problem globally, and though it is related to poor health outcomes across all genders, most research has been directed towards violence against women. As a result, the health consequences of men's victimization may be underreported and unaddressed. The purpose of this study was to assess the relationship between interpersonal violence and the psychological health outcomes of self-reported stress, anxiety, and depression among men. Materials and Methods: The study used data from the male sample (n = 2597) of the 2018 Health on Equal Terms Survey conducted in Gävleborg County in East-Central Sweden. Regression analysis was carried out to study the relationship between interpersonal violence and self-reported stress, anxiety, and depression. Results: The bivariate analysis showed that there was a statistically significant association between interpersonal violence and self-reported stress (OR 2.35; CI 1.45-3.81), anxiety (OR 1.54; CI 1.06-2.25), and depression (OR 2.30; CI 1.48-3.57). Controlling for other variables in the multivariate analysis removed the statistically significant relationship and reduced the odds ratios for stress (OR 1.46; CI 0.57-3.74), anxiety (OR 0.86; 0.40-1.84), and depression (OR 1.40; CI 0.67-3.32) respectively. Conclusions: The study found that interpersonal violence among men was associated with stress, anxiety and depression which was largely explained by demographic, socioeconomic, and health/behavior-related factors. The findings suggest the need for longitudinal studies to assess causal links between male victimization and psychological health outcomes at the county level.

Ameliorating Child poverty through Connecting Economic Services with child health Services (ACCESS): study protocol for a randomised controlled trial of the healthier wealthier families model in Sweden.

BACKGROUND: Sweden is often held up as an example of a country with low child deprivation; yet, rates of relative deprivation are rising. Every municipality in Sweden is required to provide free, timely and accessible budget and debt counselling under the Social Services Act. The services have been encouraged to perform preventative practice with families; however, this has not been realised. The Healthier Wealthier Families (HWF) model embeds universal screening for economic hardship into child health services and creates a referral pathway to economic support services. Given the universal child health system in Sweden, which is freely available and has excellent coverage of the child population, implementation of the HWF model has potential to support families to access the freely available municipal budget and debt counselling and ultimately improve rates of child deprivation in Sweden. METHODS/DESIGN: We will conduct a two-arm randomised waitlist-control superiority trial to examine the effectiveness and cost-effectiveness of the HWF model in the Sweden. A longitudinal follow-up with the cohort will explore whether any effects are maintained in the longer-term. DISCUSSION: HWF is a collaborative and sustainable model that could maximise the effectiveness of current services to address child deprivation in Sweden. The study outlined in this protocol is the first effectiveness evaluation of the HWF model in Sweden and is a crucial step before HWF can be recommended for national implementation within the child health services. TRIAL REGISTRATION: Clinicaltrials.gov; NCT05511961. Prospectively registered on 23 August 2022. https://clinicaltrials.gov/ct2/show/NCT05511961.

Implementation of Activity-Based Workplaces (ABW)-The Importance of Participation in Process Activities.

Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees' extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.

A complex challenge with unclear improvement: the need for involvement, contextualization and facilitation when managers implement a leadership model.

PURPOSE: Management and leadership in health care are described as complex and challenging, and the span of control is known to be a key component in the manager's job demands. The implementation of change can be a challenge in health care, and managers often have roles as implementation leaders. Little attention has been given to how managers perceive the process of implementation. Thus, this study aims to explore second-line managers' perceptions of, prerequisites for and experiences from the implementation of changes in their manager's work conditions. DESIGN/METHODOLOGY/APPROACH: A grounded theory-based qualitative design was used. Data were collected from a purposive sample of nine second-line managers by individual semi-structured interviews. The three stages of initial coding, focus codes and axial coding were used in data analysis. FINDINGS: Three thematic areas were identified: engagement, facilitation and achievement. The second-line managers' descriptions suggest that the change work entails a complex challenge with an unclear result. Involvement, consideration for the context and facilitation are needed to be able to conduct a cohesive implementation process. ORIGINALITY/VALUE: This study findings outline that to succeed when implementing change in complex organizations, it is crucial that managers at different levels are involved in the entire process, and that there are prerequisites established for the facilitation and achievement of goals during the planning, implementation and follow-up.

Relocation to Activity-Based Workplaces (ABW)-Importance of the Implementation Process.

Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient-and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.

Sense of Coherence and Lean-based leadership and alterations in sick leave and productivity at a steel wire manufacturing unit.

BACKGROUND: Managers have an important role in the creation of workplace conditions that prevent sick leave and lead to high performance. In Lean, the assumption is that people are the source for continuous improvements. There is a need for more knowledge about what kind of leadership can help managers in a Lean context to create workplace conditions for less sick leave and higher performance. OBJECTIVE: The purpose of this study was to examine how productivity and rate of sick leave changed at a stainless wire manufacturing unit after implementing a new leadership approach based on Sense of Coherence theory (SOC) and Lean philosophy. METHODS: In this case study, interventions coupled with productivity, quality and sick leave evaluations through the company's key performance indicators were performed. The follow-up was also based on narrative descriptions from the management team in the course of four meetings during the intervention. Notes were taken and analyzed regarding perceived outcomes of the intervention. RESULTS: The results showed that leadership based on SOC and Lean philosophy is positively correlated with productivity per worker, as was the amount of yearly production that met the quality specifications. The amount of sick leave decreased during the period of the intervention compared to before the intervention. CONCLUSIONS: Changes in management contribute to productivity. Combining Lean tools and Lean philosophy with the Sense of Coherence theory (SOC) as a base for leadership can influence productivity and decrease the rate of sick leave.

Readiness of Allied Professionals to Join the Mental Health Workforce: A Qualitative Evaluation of Trained Lay Trauma Counsellors' Experiences When Refugee Youth Disclose Suicidal Ideation.

The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors' experiences of procedures upon URM's disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: "Importance of safety structures", "Collaboration is key", "Let sleeping dogs lie" and "Going the extra mile". Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

Sense of Coherence, Health, Well-Being, and Work Satisfaction before and after Implementing Activity-Based Workplaces.

Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC-meaningfulness, manageability and comprehensibility-are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018-2019). Questionnaires were administered before (n = 536), 3 months (n = 409) and 9 months (n = 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physical p < 0.001; psychosocial p < 0.001), and minor changes in health and occupational well-being during relocation (p > 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p < 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p < 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.

Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden.

RATIONALE, AIM, AND OBJECTIVES: More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. METHODS: Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. RESULTS: A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. CONCLUSIONS: The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

Fear of crime and its relationship to self-reported health and stress among men.

BACKGROUND: Fear of crime is a growing social and public health problem globally, including in developed countries such as Sweden. This study investigated the impact of fear of crime on self-reported health and stress among men living in Gävleborg County. DESIGN AND METHODS: The study used data collected from 2993 men through a cross sectional survey in the 2014 Health in Equal Terms survey. Descriptive and logistic regression analyses were carried out to study the relationship between fear of crime and self-reported health and stress. RESULTS: There was a statistically significant association between fear of crime and self-reported poor health and stress among men residing in Gävleborg County. In the bivariate analysis, men who reported fear of crime had odds of 1.98 (CI 1.47-2.66) and 2.23 (CI 1.45-3.41) respectively. Adjusting for demographic, social and economic variables in the multivariate analysis only reduced the odds ratio for self-reported poor health to 1.52 (CI 1.05-2.21) but not for self-reported stress with odds of 2.22 (1.27-3.86). CONCLUSIONS: Fear of crime among men was statistically significantly associated with self-reported poor health and stress in Gävleborg County. However, the statistically significant relationship remained even after accounting for demographic, social and economic factors, which warrants further research to better understand the role played by other variables.

Perceptions of work environment priorities: Are there any differences by company size? An ecological study.

BACKGROUND: Earlier studies suggest that the quality of handling occupational health and safety (OHS) activities differs between companies of different sizes. Company size is a proxy variable for other variables affecting OHS performance. OBJECTIVE: The objective of this study was to investigate if there is an association between company size and perceptions of work environment prioritizations. METHODS: Data from 106 small- and medium-sized Swedish manufacturing companies was collected. One manager and one safety delegate at each company rated different aspects of their companies' work environment prioritizations with a 43-item questionnaire. Ratings were aggregated to a summary statistic for each company before analysis. RESULTS: No significant differences in perceptions of priority were found to be associated with company sizes. This is in contrast to earlier studies of objective differences. The respondents in small companies, however, showed significantly greater consensus in their ratings. CONCLUSIONS: Company size does not appear to be associated with perceptions of work environment prioritizations. Company size is an important proxy variable to study in order to understand what factors enable and obstruct safe and healthy workplaces. The work presented here should be viewed as an initial exploration to serve as direction for future academic work.

Explicit and implicit theories of change when designing and implementing preventive ergonomics interventions--a systematic literature review.

OBJECTIVE: In contrast to several previous papers dealing with the structure and effects of ergonomics interventions, this systematic literature review focuses on the theories concerning change processes upon which these interventions--implicitly or explicitly--have been based. METHODS: In a systematic search of 13 literature databases, 30 peer-reviewed intervention studies published between 2000-2007 were identified that provided sufficient information for the change process theory to be identified. RESULTS: Thirteen studies referred to an explicit theory of change, the most common being participatory theory, while in 17 studies, the change theory could only be discerned indirectly from the described intervention strategy. Twenty-five studies explained the reason for choosing their strategy, with a clear reference to theory or previous research, whereas five provided only a weak background. Four categories of intervention strategies for change were identified: (i) changes targeting the individual, (ii) changes focusing on the work environment, (iii) changes relying on interactions between people, and (iv) structural and organizational changes. CONCLUSIONS: A strikingly small proportion of ergonomics intervention studies have explained the theory behind the expected change process. A better awareness of the assumptions about change processes embedded in intervention strategies--whether implicit or explicit--may help in identifying and examining those ideas and processes that promote or restrict successful implementation. Such knowledge, in turn, can contribute to the development of interventions that are thoughtfully designed and effectively implemented.

Case study of a healthy eating intervention for Swedish lorry drivers.

Professional drivers, i.e. lorry, truck, bus and taxi drivers, have been identified as a particular health risk group. An intervention to study the efficacy of a series of educational programmes, involving improved nutritional balance in meals served, food preparation routines and carrying out personal health profiles on staff, was implemented at a Swedish truck stop in order to target this specific hard-to-reach risk group. Professional drivers were targeted through an information campaign, healthier 'Today's Special' choices and by using staff as proxy health promoters. A campaign emblem on the menu notice board indicated healthier food choice menu items. Drivers choosing healthier alternatives were given lottery tokens. The intervention was evaluated through nutritional analyses, field observations, questionnaires and interviews. Positive staff-level outcomes included increased nutritional awareness, personal health empowerment and, most crucially, overwhelming staff support for a health-promoting role. Nutritional analysis of pre- and post-intervention 'Today's Specials' showed a better balance of fat, calories, carbohydrates and protein (per 100 g) content in the dishes tested. At management level there were economic benefits in terms of time savings and reduced use of cooking fat in food preparation. Drivers tended to choose healthier alternatives and there was increased awareness of the healthier alternatives on offer. The case study showed that using truck stop staff as proxy health promoters offers a viable intervention strategy.