A Context Analysis with Stakeholders' Views for Future Implementation of Interventions to Prevent Health Problems Among Employees with a Lower Socioeconomic Position.

Purpose Health problems among employees with a lower socioeconomic position (SEP) often result from an interplay of problems on multiple life domains. Contextual factors greatly affect implementation of interventions that aim to solve these type of problems. The aim of this study was to gain insight into the organizational and socio-political context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Methods In total 16 semi-structured interviews were conducted with stakeholders at organizational level, occupational health service (OHS) level, and at socio-political macro level. Thematic analysis was performed to identify themes that describe the perceptions of stakeholders about the impact of contextual factors on implementation. Results The following themes were identified: (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. Conclusions Implementation of preventive interventions considering multiple life domains among lower SEP employees is challenging, due to various contextual factors. To improve the feasibility, many different stakeholders both in- and outside occupational health practice need to be involved, collaborate, and need to be convinced of the added value to prevent problems on multiple life domains among employees with a lower SEP.

Espaço multipics: a utilização das práticas integrativas e complementares como estratégia de cuidado na atenção à saúde do trabalhador / Multipics Space: the use of integrative and complementary practices as a strategy of care in the care of workers' health / Espacio multipics: el uso de prácticas integradoras y complementarias como estrategia de atención en el cuidado de la salud de los trabajadores

Introdução:As Práticas Integrativas e Complementares em Saúde foram regulamentadas no Sistema Único de Saúde,através da portaria nº 971/2006 que aprova a implantação da Política Nacional de Práticas Integrativas e Complementares, com o objetivo de garantir cuidado continuado,humanizado e integral em saúde,com ênfase na atenção primária. Objetivo:Relatar a experiência vivenciada por uma equipe de Residentes Multiprofissionais em Saúde, através do espaço de Práticas Integrativas e Complementares de uma Unidade Hospitalar na região do Seridó, Rio Grande do Norte. Metodologia:Trata-se de um estudo descritivo com abordagem quantitativa e qualitativa do tipo relato de experiência,desenvolvido a partir da vivência de uma equipe de Residentes em Atenção Básica da Universidade Federal do Rio Grande do Norte, atuantes no município de Caicó, em parceria com o Hospital Regional do Seridó. As ações foram realizadas durante os meses de março e abril de 2021. As práticas desenvolvidas foram ventosaterapia, musicoterapia, arteterapia, meditação guiada e aromaterapia. Após as práticas foi aplicado um questionário semi-estruturado, sobre seu conhecimento sobre tais práticas exercidas, nível de satisfação e uma descrição subjetiva da experiência e estado atual pós-prática. Resultados:Participaram das ações propostas 57 profissionais, dentre eles (84,21%) mulheres e (15,79%) homens, de vários setores da unidade hospitalar. 10,53% relataram desconhecer as práticas de um modo geral e 89,47% relataram não conhecer as práticas que foram ofertadas. De acordo com a pesquisa de satisfação, 98,25% dos profissionais relataram sentir-se "muito satisfeitos" e "satisfeitos", enquanto somente 1,75% consideraram as práticas "neutras". Os profissionais referiram, também, sensação de harmonia, bem-estar e de paz interior. Conclusões:Por meio da atuação foi possível ofertar um momento de relaxamento no ambiente de trabalho. Obteve-se após a prática um feedback positivo dos participantes sobre os resultados dessa atuação acerca do seu bem-estar (AU).

Introduction:Integrative and Complementary Health Practices were regulated in the Unified Health System, through Ordinance No. 971/2006 that approves the implementation of the National Policy of Integrative and Complementary Practices, with the objective of ensuring continued, humanized and comprehensive health care, with emphasis on primary care. Objective:To report the experience experienced by a team of Multiprofessional Health Residents, through the space of Integrative and Complementary Practices in a Hospital Unit in the Seridó region, Rio Grande do Norte. Methodology:This is a descriptive study with a quantitative and qualitative approach to the type of experience report,developed from the experience of a team of Residents in Primary Care of Federal University of Rio Grande do Norte, working in the municipality of Caicó in partnership with the Regional Hospital of Seridó. The actions were carried out during the months of March and April 2021. The practices developed were suction cup therapy, music therapy, art therapy, guided meditation and aromatherapy. After the practices, a semi-structured questionnaire was applied about their knowledge about the practices, level of satisfaction and a subjective description of the experience and current state after practice. Results:57 professionals participated in the proposed actions, including (84.21%) women and (15.79%) men, from various sectors of the hospital unit. 10.53% reported not knowing the practices in general and 89.47% reported not knowing the practices that were offered. According to the satisfaction survey, 98.25% of the professionals reported feeling "very satisfied" and "satisfied", while only 1.75% considered the practices "neutral". The professionals also mentioned a sense of harmony, well-being and inner peace. Conclusions:Through the performance it was possible to offer a moment of relaxation in the work environment. After the practice, positive feedback from the participants on the results of this performance about their well-being was obtained after practice.

Introducción:Las Prácticas de Salud Integradoras y Complementarias fueron reguladas en el Sistema Único de Salud, con el objetivo de garantizar una atención de salud continúa, humanizada e integral, con énfasis en la atención primaria. Objetivo: Relatar la experiencia experimentada por un equipo de Residentes de Salud Multiprofesional, a través del espacio Prácticas Integradoras y Complementarias en una Unidad Hospitalaria en la región del Seridó, Rio Grande do Norte. Metodología: Estudio descriptivo, cuantitativo y cualitativo,desarrollado a partir de la experiencia de un equipo de Residentes en Atención Primaria de la Universidad Federal do Rio Grande do Norte, trabajando en el Hospital Regional de Seridó. Las actuaciones se llevaron a cabo durante los meses de marzo y abril de 2021 a través del espacio. Las prácticas desarrolladas fueron terapia de ventosas, musicoterapia, arteterapia, meditación guiada y aromaterapia. Después de las prácticas, se aplicó un cuestionario semiestructurado sobre sus conocimientos sobre las praticas, el nivel de satisfacción y una descripción subjetiva de la experiencia y el estado actual después de la práctica. Resultados: 57 profesionales participaron en las acciones propuestas, entre ellas (84,21%) mujeres y (15,79%) hombres, de diversos sectores de la unidad hospitalaria. 10,53% reportaron no conocer las prácticas en general y 89,47% reportaron no conocer las prácticas que se ofrecieron. Según la encuesta de satisfacción, 98,25% de los profesionales dijeron sentirse "muy satisfechos" y "satisfechos", mientras que sólo 1,75% consideraron las prácticas "neutras". Los profesionales también mencionaron una sensación de armonía, bienestar y paz interior. Conclusiones:A través de la actuación fue posible ofrecer un momento de relajación en el ambiente de trabajo. Después de la práctica, se obtuvo retroalimentación positiva de los participantes sobre los resultados de este desempeño sobre su bienestar después de la práctica (AU).

Prevalence and utilization of company integration management in Germany: Results of the 2018 BiBB/BAuA survey of employed persons.

OBJECTIVES: This secondary analysis aims to investigate the implementation of the legally required company integration management ("BEM") in case of an incapacity for work of at least six weeks and to identify predictors. METHODS: Database is the representative randomized 2018 BIBB/BAuA Employment Survey of 20 012 employed persons in Germany. RESULTS: Of the 1367 employees entitled to company integration management, 40% received an offer from their employer and 27% accepted it. In the public sector, half of those who were entitled reported an offer. Among those entitled to company integration management, employees under the age of 30, at risk of dismissal, or with fixed-term employment contract received an offer particularly rarely. Entitled employees with disabilities or in companies with works/staff councils received disproportionately often an offer of company integration management. Logistic regression analyses reveal strong associations between company integration management offer and the duration of incapacity to work. The probability of receiving an offer is almost halved for those entitled in medium-sized compared to small companies. The higher the level of educational qualification, the higher are odds ratios for an offer. In companies in which employees were less or not satisfied with their work overall, the chance of a company integration management offer is significantly reduced almost by half. The chance of an offer is more than three times higher in companies with workplace health promotion compared to those without. CONCLUSIONS: Only a minority of eligible employees received an offer that is closely associated with health-promoting corporate culture and job satisfaction.

Effectiveness of Combining Antiobesity Medication With an Employer-Based Weight Management Program for Treatment of Obesity: A Randomized Clinical Trial.

Importance: The clinical efficacy of antiobesity medications (AOMs) as adjuncts to lifestyle intervention is well characterized, but data regarding their use in conjunction with workplace wellness plans are lacking, and coverage of AOMs by US private employers is limited. Objective: To determine the effect of combining AOMs with a comprehensive, interdisciplinary, employer-based weight management program (WMP) compared with the WMP alone on weight loss, treatment adherence, and work productivity and limitations. Design, Setting, and Participants: This 1-year, single-center, open-label, parallel-group, real-world, randomized clinical trial was conducted at the Cleveland Clinic's Endocrinology and Metabolism Institute in Cleveland, Ohio, from January 7, 2019, to May 22, 2020. Participants were adults with obesity (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared] ≥30) enrolled in the Cleveland Clinic Employee Health Plan. Interventions: In total, 200 participants were randomized 1:1, 100 participants to WMP combined with an AOM (WMP+Rx), and 100 participants to WMP alone. The WMP was the Cleveland Clinic Endocrinology and Metabolism Institute's employer-based integrated medical WMP implemented through monthly multidisciplinary shared medical appointments. Participants in the WMP+Rx group initiated treatment with 1 of 5 US Food and Drug Administration-approved medications for chronic weight management (orlistat, lorcaserin, phentermine/topiramate, naltrexone/bupropion, and liraglutide, 3.0 mg) according to standard clinical practice. Main Outcomes and Measures: The primary end point was the percentage change in body weight from baseline to month 12. Results: The 200 participants were predominately (177 of 200 [88.5%]) women, had a mean (SD) age of 50.0 (10.3) years, and a mean (SD) baseline weight of 105.0 (19.0) kg. For the primary intention-to-treat estimand, the estimated mean (SE) weight loss was -7.7% (0.7%) for the WMP+Rx group vs -4.2% (0.7%) for the WMP group, with an estimated treatment difference of -3.5% (95% CI, -5.5% to -1.5%) (P < .001). The estimated percentage of participants achieving at least 5% weight loss was 62.5% for WMP+Rx vs 44.8% for WMP (P = .02). The rate of attendance at shared medical appointments was higher for the WMP+Rx group than for the WMP group. No meaningful differences in patient-reported work productivity or limitation measures were observed. Conclusions and Relevance: Clinically meaningful superior mean weight loss was achieved when access to AOMs was provided in the real-world setting of an employer-based WMP, compared with the WMP alone. Such results may inform employer decisions regarding AOM coverage and guide best practices for comprehensive, interdisciplinary employer-based WMPs. Trial Registration: ClinicalTrials.gov Identifier: NCT03799198.

Health service use and health outcomes among international migrant workers compared with non-migrant workers: A systematic review and meta-analysis.

OBJECTIVES: The review aimed to synthesise recent evidence on health service use and health outcomes among international migrant workers, compared with non-migrant workers. METHODS: A search was carried out in MEDLINE, PubMed, Embase, and CINAHL for studies published between Jan 1, 2010, and Feb 29, 2020. Included outcomes were: occupational health service use, fatal occupational injury, HIV, and depression. Two authors independently screened records, extracted data, assessed risk of bias and judged quality of evidence. We meta-analysed estimates and conducted subgroup analyses by sex, geographical origin, geographical destination, and regularity of migration. RESULTS: Twenty-one studies were included comprising >17 million participants in 16 countries. Most studies investigated regular migrant workers in high-income destination countries. Compared with non-migrant workers, migrant workers were less likely to use health services (relative risk 0·55, 95% confidence interval 0·41 to 0·73, 4 studies, 3,804,131 participants, I2 100%, low quality of evidence). They more commonly had occupational injuries (1·27, 95% confidence interval 1·11 to 1·45, 7 studies, 17,100,626 participants, I2 96%, low quality of evidence). Relative risks differed by geographical origin and/or destination. There is uncertainty (very low quality of evidence) about occupational health service use (0 studies), fatal occupational injuries (5 studies, N = 14,210,820), HIV (3 studies, N = 13,775), and depression (2 studies, N = 7,512). CONCLUSIONS: Migrant workers may be less likely than non-migrant workers to use health services and more likely to have occupational injuries. More research is required on migrant workers from and in low- and middle-income countries, across migration stages, migrating irregularly, and in the informal economy.

Diseño de dietas alimentarias para soldadores y paileros a partir de su gasto energético / Design of food diets for welders and smiths based on their energy expenditure

RESUMEN Introducción: el desempeño laboral en algunos puestos de trabajo, determina un alto nivel de carga física por parte de los trabajadores, por lo que se impone la necesidad de disponer de una adecuada dieta alimentaria para mantener la salud física y mental. Objetivo: se desarrolló una investigación para diseñar una dieta alimentaria para soldadores y paileros a partir del gasto energético en actividades laborales. Materiales y métodos: se realizó un estudio de campo que partió de una muestra no probabilística de soldadores y paileros de la Empresa Industrial Ferroviaria José Valdés Reyes. Se ejecutó un procedimiento que permitió la determinación de la dieta alimentaria de los trabajadores a partir del gasto energético de las actividades que desarrollan. Se aplicaron ciertas técnicas de observación directa, entrevistas, tormenta de ideas, medición directa de variables fisiológicas y ecuaciones para el cálculo del gasto energético. Resultados: se diseñaron tres variantes de dietas ajustadas al gasto energético de tres puestos de trabajo de la mencionada empresa. Conclusiones: se espera que la aplicación de las dietas diseñadas contribuya a mantener una buena salud de los trabajadores de esos puestos de trabajo (AU).

ABSTRACT Introduction: the working performance of certain jobs determines a high level of physical load from the part of the workers, for what the necessity is imposed of having an appropriate food diet to preserve the physical and mental health. Objective: to design a food diet for welders and smiths starting from the energy expense in working activities. Materials and methods: a field study was carried out starting from a probabilistic sample of welders and smiths from the Industrial Railroad Enterprise Jose Valdes Reyes. A procedure was performed allowing to determine the energy expenditure of the activities they develop. Several techniques like direct observation, interviews, brain storm, direct measure of physiological variable and equations were used to calculate the energy expenditure. Results: three diet variants were designed adjusted to the energy expenditure of the three working places of the before mentioned enterprise. Conclusions: it is expected the application of the designed diets will contribute to keeping good health of the workers in those working places (AU).

Factors contributing to the distress, concerns, and needs of UK Neuroscience health care workers during the COVID-19 pandemic.

COVID-19 research from China suggests health care workers are at risk of distress, have specific concerns, and need support. It remains unknown whether findings are applicable to UK health care staff and whether psychological support based on generic approaches is effective. We administered an online survey at a leading neuroscience hospital in the UK to examine how individual staff characteristics contribute to distress, concerns, and interventions most valued during the COVID-19 pandemic. We found a high incidence of distress, particularly in females and staff with previous mental health history. Concerns fell into three factors: 'risk of infection', 'work challenges', and 'social change', and were affected by professional role and contact with COVID-19 patients. These three factors predicted distress. Psychological support and clear updates were deemed most useful, with specific needs affected by age, professional role, and contact with COVID-19 patients. This is the first documentation of a high incidence of psychological distress predicted by three types of concerns in health care workers of a neuroscience hospital. Distress, concerns, and interventions most valued were all affected by individual staff characteristics. These findings highlight the importance of providing stratified, one to one support interventions, tailored to professional group, and background, rather than more generic approaches. PRACTITIONER POINTS: The COVID-19 pandemic has resulted in a high incidence of psychological distress in UK health care staff. Distress, concerns, and interventions most valued are influenced by individual staff characteristics. Stratified, one-to-one support interventions, tailored to professional group, and background, rather than more generic approaches for stress reduction and resilience, are crucial.

Factors Influencing Implementation of a Workplace Tobacco Cessation Intervention in India: A Qualitative Exploration.

BACKGROUND: Tobacco use is projected to cause more than 8 million deaths annually worldwide by 2030 and is currently linked to 1 million annual deaths in India. Very few workplaces provide tobacco cessation as a part of occupational health in India. In this study, we examined promoters and barriers to implementing an evidence-based tobacco cessation program in a workplace setting in India. METHODS: In-depth interviews were conducted with all facilitators (two program coordinators and four counselors) of a workplace tobacco cessation intervention covering implementation efforts in five organizations, including three manufacturing units and two corporate settings. FINDINGS: The identified promoters for implementation of the program were as follows: (a) workplaces that provided access to many individuals, (b) high prevalence of tobacco use that made the intervention relevant, (c) core components (awareness sessions, face-to-face counseling and 6-months follow-up) that were adaptable, (d) engagement of the management in planning and execution of the intervention, (e) employees' support to each other to quit tobacco, (f) training the medical unit within the workplace to provide limited advice, and (g) efforts to advocate tobacco-free policies within the setting. Barriers centered around (a) lack of ownership from the workplace management, (b) schedules of counselors not matching with employees, (c) nonavailability of employees because of workload, and (d) lack of privacy for counseling. CONCLUSION/IMPLICATIONS FOR PRACTICE: This study provided practical insights into the aspects of planning, engaging, executing and the process of implementation of a tobacco cessation intervention in a workplace setting. It provided guidance for an intervention within occupational health units in similar settings.

Economic analyses of mental health and substance use interventions in the workplace: a systematic literature review and narrative synthesis.

Mental illness and substance use disorders in the workplace have been increasingly recognised as a problem in most countries; however, evidence is scarce on which solutions provide the highest return on investment. We searched academic and grey literature databases and additional sources for studies that included a workplace intervention for mental health or substance abuse, or both, and that did an economic analysis. We analysed the papers we found to identify the highest yielding and most cost-effective interventions by disorder. On the basis of 56 studies, we found moderate strength of evidence that cognitive behavioural therapy is cost-saving (and in some cases cost-effective) to address depression. We observed strong evidence that regular and active involvement of occupational health professionals is cost-saving and cost-effective in reducing sick leave related to mental health and in encouraging return to work. We identified moderate evidence that coverage for pharmacotherapy and brief counselling for smoking cessation are both cost-saving and cost-effective. Addressing mental health and substance misuse in the workplace improves workers' wellbeing and productivity, and benefits employers' bottom line (ie, profit). Future economic analyses would benefit from the consideration of subgroup analyses, examination of longer follow-ups, inclusion of statistical and sensitivity analyses and discussion around uncertainty, and consideration of potential for bias.

Cost-Effectiveness of a Problem-Solving Intervention Aimed to Prevent Sickness Absence among Employees with Common Mental Disorders or Occupational Stress.

The cost-benefit and cost-effectiveness of a work-directed intervention implemented by the occupational health service (OHS) for employees with common mental disorders (CMD) or stress related problems at work were investigated. The economic evaluation was conducted in a two-armed clustered RCT. Employees received either a problem-solving based intervention (PSI; n = 41) or care as usual (CAU; n = 59). Both were work-directed interventions. Data regarding sickness absence and production loss at work was gathered during a one-year follow-up. Bootstrap techniques were used to conduct a Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA) from both an employer and societal perspective. Intervention costs were lower for PSI than CAU. Costs for long-term sickness absence were higher for CAU, whereas costs for short-term sickness absence and production loss at work were higher for PSI. Mainly due to these costs, PSI was not cost-effective from the employer's perspective. However, PSI was cost-beneficial from a societal perspective. CEA showed that a one-day reduction of long-term sickness absence costed on average €101 for PSI, a cost that primarily was borne by the employer. PSI reduced the socio-economic burden compared to CAU and could be recommended to policy makers. However, reduced long-term sickness absence, i.e., increased work attendance, was accompanied by employees perceiving higher levels of production loss at work and thus increased the cost for employers. This partly explains why an effective intervention was not cost-effective from the employer's perspective. Hence, additional adjustments and/or support at the workplace might be needed for reducing the loss of production at work.

Need and Capacity of a Toolkit for Occupational Health Nurses to Promote a New or Enhanced Drug-Free Workplace Program.

Background: A drug-free workplace program (DFWP) has been shown to be effective in reducing workers' drug misuse. The purpose of this project was to determine the need and capacity for a new or enhanced DFWP in a large health system. If determined to be needed, the next step would be to develop, implement, and evaluate a toolkit to assist occupational health nurses to promote a new or enhanced DFWP. Methods: A strategic prevention framework was used to assess the need and capacity for a toolkit to prepare occupational health nurses to promote a new or enhanced DFWP. The project was conducted in the occupational health services department at a large health system in the Midwest U.S. occupational health nurses and employee assistance counselors in the hospital system completed a survey assessing the need and capacity for a new or enhanced DFWP. Findings: A gap was identified in the perceived effectiveness of training about DFWP and current DFWP components. The findings reflect the need and capacity for a DFWP toolkit. Optimally, a DFWP toolkit would include evidence-based drug and alcohol screening tools. We found that a toolkit for occupational health nurses to promote a new or enhanced DFWP in the project site was warranted. Conclusion/Application to practice: A DFWP can be an effective method of promoting workplace health and safety. Occupational health nurses can contact state and national representatives to encourage monitoring of drug-related work injuries to provide evidence to influence health policies to support effective DFWPs.

External validation of a prediction model and decision tree for sickness absence due to mental disorders.

PURPOSE: A previously developed prediction model and decision tree were externally validated for their ability to identify occupational health survey participants at increased risk of long-term sickness absence (LTSA) due to mental disorders. METHODS: The study population consisted of N = 3415 employees in mobility services who were invited in 2016 for an occupational health survey, consisting of an online questionnaire measuring the health status and working conditions, followed by a preventive consultation with an occupational health provider (OHP). The survey variables of the previously developed prediction model and decision tree were used for predicting mental LTSA (no = 0, yes = 1) at 1-year follow-up. Discrimination between survey participants with and without mental LTSA was investigated with the area under the receiver operating characteristic curve (AUC). RESULTS: A total of n = 1736 (51%) non-sick-listed employees participated in the survey and 51 (3%) of them had mental LTSA during follow-up. The prediction model discriminated (AUC = 0.700; 95% CI 0.628-0.773) between participants with and without mental LTSA during follow-up. Discrimination by the decision tree (AUC = 0.671; 95% CI 0.589-0.753) did not differ significantly (p = 0.62) from discrimination by the prediction model. CONCLUSION: At external validation, the prediction model and the decision tree both poorly identified occupational health survey participants at increased risk of mental LTSA. OHPs could use the decision tree to determine if mental LTSA risk factors should be explored in the preventive consultation which follows after completing the survey questionnaire.

Are workplace health promotion programmes effective for all socioeconomic groups? A systematic review.

Decreasing socioeconomic health inequalities is considered an important policy priority in many countries. Workplace health promotion programmes (WHPPs) have shown modest improvements in health behaviour. This systematic review aims to determine the presence and magnitude of socioeconomic differences in effectiveness and the influence of programme characteristics on differential effectiveness of WHPPs. Three electronic databases were searched for systematic reviews published from 2013 onwards and for original studies published from 2015 onwards. We synthesised the reported socioeconomic differences in effectiveness of WHPPs on health behaviours, and calculated effectiveness ratios by dividing the programme effects in the lowest socioeconomic group by the programme effects in the highest socioeconomic group. Thirteen studies with 75 comparisons provided information on the effectiveness of WHPPs across socioeconomic groups. Ten studies with 54 comparisons reported equal effectiveness and one study with 3 comparisons reported higher effectiveness for lower socioeconomic groups. Quantitative information on programme effects was available for six studies with 18 comparisons, of which 13 comparisons showed equal effectiveness and 5 comparisons showed significantly higher effect sizes among workers in low socioeconomic position. The differential effectiveness of WHPPs did not vary across programme characteristics. In this study no indications are found that WHPPs increase socioeconomic inequalities in health behaviour. The limited quantitative information available suggests that WHPPs may contribute to reducing socioeconomic inequalities. Better insight is needed on socioeconomic differences in effectiveness of WHPPs to develop strategies to decrease socioeconomic inequalities in health in the workforce.

Development and Assessment of a Social Network Service-Based Lifestyle-Modification Program for Workers at High Risk of Developing Cardiovascular Disease.

Cardiovascular disease is a leading cause of mortality in the United States. This study examined the cardiovascular disease risk factors and health beliefs of workers for the purpose of developing a social network service (SNS)-based (e.g., Facebook and KakaoTalk) lifestyle-modification program for workers. Participants included 68 hospital workers (aged 25-60 years), with more than two metabolic syndrome or cardiovascular disease risk factors. Participants were randomly assigned to one of three groups: SNS intervention group (n = 23), education-only intervention group (n = 19), or nonintervention group (n = 26). Data were collected to compare changes in risk indicators according to the intervention method and time and analyzed using repeated-measures analyses of variance. Compared to the education and nonintervention groups, the SNS intervention group demonstrated significant improvements in waist circumference, body mass index, total cholesterol, low-density lipoprotein cholesterol, health promotion behaviors, and self-efficacy. This type of program has potential for allowing occupational health professionals to work with workers to improve lifestyle behaviors that promote health and reduce the risk of cardiovascular disease.

A group randomized control trial to test the efficacy of the Road to Mental Readiness (R2MR) program among Canadian military recruits.

BACKGROUND: Despite increased interest in workplace mental health interventions, the evidence for beneficial effects is mixed. Furthermore, many existing studies lack methodological rigor. We report results from a group randomized control trial to test the efficacy of a vastly popular intervention in Canada, the Road to Mental Readiness (R2MR) program, which has been widely disseminated in military, first responder, and civilian settings. METHODS: The trial took place among Canadian Armed Forces military recruits completing their basic military qualification (BMQ) training, and randomized 65 platoons (N = 2831) into either (a) an Intervention (R2MR at week 2 of BMQ), or (b) a delayed Intervention Control (R2MR at week 9 of BMQ) condition. The principal investigator, participants, and data collection staff were blinded to platoon condition. Individual-level psychological functioning, resilience, mental health service use attitudes, intentions, and behaviours, and additional covariates were assessed with questionnaires around week 2 (a day or two before Intervention platoons received R2MR), at week 5, and at week 9 (a day or two before the Control platoons received R2MR). Military performance outcomes were obtained from administrative databases. RESULTS: The full trial results were mixed; for some outcomes (psychological functioning, resilience, and military performance), we saw no evidence of beneficial effects; where we did see benefits (mental health service use attitudes, intentions, behaviours), the effects were very small, or disappeared over time. Analyses among two subsamples (Group 1: Intervention platoons with a Fidelity Check and their Controls, and Group 2: Intervention platoons without Fidelity Check and their Controls) indicated that for some outcomes (attitudes and help-seeking), under high fidelity conditions, the beneficial effects of R2MR were increased and better sustained; Conversely, under poor fidelity conditions, decreased beneficial effects or even iatrogenic effects were observed. Analyses across three training divisions indicated the larger organizational climate further influences efficacy. CONCLUSIONS: Our findings paint a very complex picture in which it is made evident that sensible, evidence-informed workplace mental health interventions such as R2MR may work under high fidelity conditions, but may yield no discernable benefit or even inadvertent iatrogenic effects if implemented poorly or without sufficient consideration to the larger organizational context. TRIAL REGISTRATION: ISRCTN 52557050 Registered 13 October 2016.

Factors influencing ergonomists' use of observation-based risk-assessment tools.

BACKGROUND: Several observation-based risk-assessment tools have been developed in recent decades. Studies reporting their use often focus only on the user, the ergonomist. The influence of context and the attributes of the tools may also affect the use but are factors that are seldom considered. OBJECTIVE: The aim of the present study was to explore the process of risk-assessment assignments and to identify factors influencing the use of research-based observation-based risk-assessment tools among Swedish ergonomists, with a background as reg. physiotherapists, employed in Occupational Health Services (OHS). METHODS: A web-based questionnaire (n = 70) was combined with semi-structured interviews (n = 12). RESULTS: There was limited use of several observation-based risk-assessment tools. Furthermore, the results showed that ergonomics risk-assessment assignments are most commonly initiated reactively and that interventions were seldom evaluated. Factors that influence use are related both to the ergonomist and to the attributes of the tools as well as to contextual factors assigned to authorities, and internal organisations both within occupational health service companies and client companies. CONCLUSION: There was a lack of systematic approaches in ergonomics risks assessment and low use and knowledge of risk-assessment tools. This indicates that there is a need to support OHS companies in implementing systematic tools in their practice.

Assessment of Objective Symptoms of Depression in Occupational Health Examination.

OBJECTIVE: The aim of the study was to assess early symptoms of depression in regular occupational health examination using the objective measures based on electroencephalographic (EEG) signal analysis. METHODS: The study was performed on 125 volunteer participants. The resting-state EEG signal was recorded for 7 minutes. The spectral asymmetry index (SASI) and Higuchi fractal dimension (HFD) were calculated in EEG channel Pz. Parallel, the participants were subjected to two psychological tests, observer-rated HAM-D and self-rated EST-Q-D. RESULTS: The SASI revealed depressive symptoms for 64.8%, HFD for 55.2%, HAM-D for 44.8%, and EST-Q-D for 28.8% of participants. Combination of two different measures indicated depression symptoms up to 78.4% of participants. CONCLUSION: The results of this study confirm the feasibility of indication of early symptoms of depression applying EEG-based objective measures.