The effect of the stress autism mate app on perceived stress, coping, and resilience in adults with autism: a single-case experimental design.

Introduction: The mobile health application "Stress Autism Mate" (SAM) was designed to support adults with autism in identifying and managing daily stress. SAM measures stress four times daily, provides a daily and weekly stress overview, and provides personalised stress reduction advice. This study aimed to assess the effectiveness of SAM over four weeks in reducing perceived stress and internalised stigma, and enhancing coping self-efficacy, quality of life, and resilience among adults with autism. Methods: Using an A1-B-A2 single-case experimental design, the effect of using SAM on adults with autism was assessed. The phases consisted of A1; treatment as usual (TAU), B; introducing SAM, and finally A2; follow-up with TAU and without the use of SAM. Each phase lasted four weeks, and data were collected via questionnaires before and after each phase. Linear mixed models were used for data analysis. Results: Results show significant reductions in perceived stress levels, increased coping self-efficacy, and improved perceived health and psychological well-being after using SAM. Furthermore, increased resilience, and decreased internalised stigma were reported after follow-up. Discussion: In conclusion, this study highlights SAM as a valuable tool for empowering adults with autism to reduce stress and internalised stigmaand to improve coping self-efficacy, psychological well-being, and resilience.

Process Evaluation of a Work Stress Prevention Approach in Primary Education: Exploring the Added Value of Real-Time Feedback During Implementation.

OBJECTIVE: Participatory organizational-level interventions carry a risk of implementation failure. The current study evaluates the implementation of a work stress prevention approach in primary education and reflects on the use of real-time feedback as implementation strategy to prevent this risk. METHODS: The process evaluation was conducted at four primary schools in the Netherlands. A framework for evaluating organizational-level interventions was applied using mixed methods. RESULTS: Results show the implementation level varied between schools and was hindered by the intervention context, school size, and planning of the approach. Management commitment and employee involvement seemed important factors for successful implementation. Real-time feedback seemed valuable to further improve implementation, but not to prevent implementation failure. CONCLUSIONS: Collecting data on implementation factors before the active phase of the approach, may provide the possibility to anticipate on implementation problems earlier.

Effects of a participatory work stress prevention approach for employees in primary education: results of a quasi-experimental study.

OBJECTIVE: Work stress is a serious problem for employees in primary education. This study evaluates the effects of a work stress prevention approach on emotional exhaustion and work stress determinants (job crafting behavior, quantitative and emotional demands, leadership, support, autonomy, team culture and feelings of competence), and the impact of implementation success (management commitment, employee involvement, communication during implementation) on these outcomes. METHODS: A quasi-experimental study was conducted with an intervention group (4 schools, N=102 employees) and a control group (26 schools, N=656 employees) using questionnaires at baseline (T0), one-year (T1) and two-year (T2) follow-up. Multilevel mixed model analyses were performed to test effects of condition and implementation success on changes in emotional exhaustion and work stress determinants between T0 and T2 in the intervention and control group. RESULTS: No effect were found for emotional exhaustion. Improvement of quality of leadership between T0 and T2 was significantly larger in the intervention compared to the control group. Additionally, implementation success was associated with a decrease in unnecessary demands and an increase in quality of leadership, team culture and job crafting behavior. CONCLUSIONS: This study shows no direct effect of the approach on emotional exhaustion, but it does show beneficial effects on quality of leadership. Additionally, results suggest that, when successfully implemented, the approach also has beneficial effects on other work stress determinants (ie, job crafting behavior, unnecessary demands and team culture). Results indicate that - if implemented successfully - the organizational-level intervention has the potential to improve the psychosocial work context.

Design of the DISCovery project: tailored work-oriented interventions to improve employee health, well-being, and performance-related outcomes in hospital care.

BACKGROUND: It is well-known that health care workers in today's general hospitals have to deal with high levels of job demands, which could have negative effects on their health, well-being, and job performance. A way to reduce job-related stress reactions and to optimize positive work-related outcomes is to raise the level of specific job resources and opportunities to recover from work. However, the question remains how to translate the optimization of the balance between job demands, job resources, and recovery opportunities into effective workplace interventions. The aim of the DISCovery project is to develop and implement tailored work-oriented interventions to improve health, well-being, and performance of health care personnel. METHODS/DESIGN: A quasi-experimental field study with a non-equivalent control group pretest-posttest design will be conducted in a top general hospital. Four existing organizational departments will provide both an intervention and a comparison group. Two types of research methods are used: (1) a longitudinal web-based survey study, and (2) a longitudinal daily diary study. After base-line measures of both methods, existing and yet to be developed interventions will be implemented within the experimental groups. Follow-up measurements will be taken one and two years after the base-line measures to analyze short-term and long-term effects of the interventions. Additionally, a process evaluation and a cost-effectiveness analysis will be carried out. DISCUSSION: The DISCovery project fulfills a strong need for theory-driven and scientifically well-performed research on job stress and performance interventions. It will provide insight into (1) how a balance between job demands, job resources, and recovery from work can be optimized, (2) the short-term and long-term effects of tailored work-oriented effects, and (3) indicators for successful or unsuccessful implementation of interventions.

Individual Workplace Well-Being Captured into a Literature- and Stakeholders-Based Causal Loop Diagram.

This study demonstrates an innovative approach to capture the complexity of individual workplace well-being, improving our understanding of multicausal relationships and feedback loops involved. The literature shows that a high number of interacting factors are related to individual workplace well-being. However, many studies focus on subsets of factors, and causal loops are seldomly studied. The aim of the current study was, therefore, to capture individual workplace well-being in a comprehensive conceptual causal loop diagram (CLD). We followed an iterative, qualitative, and transdisciplinary systems-thinking approach including literature search, group model building sessions, retrospective in-depth interviews with employees, and group sessions with human resource professionals, managers, job coaches, and management consultants. The results were discussed with HR and well-being officers of twelve organizations for their critical reflection on the recognizability and potential of the developed CLD. The final result, a conceptual individual workplace well-being CLD, provides a comprehensive overview of multiple, measurable key factors relating to individual workplace well-being and of the way these factors may causally interact over time, either improving or deteriorating workplace well-being. In future studies, the CLD can be translated to a quantitative system dynamics model for simulating workplace well-being scenarios. Ultimately, these simulations could be used to design effective workplace well-being interventions.

Design of a Participatory Organizational-Level Work Stress Prevention Approach in Primary Education.

Background: Work stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation. Methods: The approach consists of five steps: (1) preparation: installing an advisory board and working groups, (2) risk assessment: inventory of work stress risks (questionnaires and focus groups). In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, (3) action planning: conducting an action plan with appropriate measures (focus groups), (4) implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and (5) evaluation: effects of the approach are studied in a controlled trial with measurements at baseline (T0), 1 year (T1), and 2 years (T2) follow-up. A process evaluation is carried out using quantitative (questionnaires and real-time monitoring data) and qualitative (interviews and data logs) data to study the implementation process of all steps of the work stress approach. Discussion: We believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education. Clinical Trial Registration: The study is registered in Netherlands Trial Register (ClinicalTrials.gov #NL9797, October 18, 2021).

Promoting Employees' Recovery During Shift Work: Protocol for a Workplace Intervention Study.

BACKGROUND: Shift work can be demanding owing to disturbances in the biological and social rhythms. This can cause short-term negative effects in employees, such as increased fatigue and reduced alertness. A potential way to counteract these negative effects is to enhance employees' recovery from work during working hours. OBJECTIVE: The aim of this study is to develop and implement an intervention that focuses on promoting "on-job" recovery of shift workers. METHODS: This study is performed in 2 department units with shift workers at a multinational company in the steel industry. For each department, an intervention will be developed and implemented through an iterative process of user-centered design and evaluation. This approach consists of various sessions in which employees and a project group (ie, researchers, line managers, human resource managers, and occupational health experts) provide input on the intervention content and implementation. Intervention effects will be evaluated using pretest and posttest web-based surveys. Digital ecological momentary assessment will be performed to gain insight into the link between the intervention and daily within-person processes. The intervention process and participants' perception of the interventions will be assessed through a process evaluation. Intervention results will be analyzed by performing mixed model repeated measures analyses and multilevel analyses. RESULTS: This study is supported by the Netherlands Organization for Applied Scientific Research Work and Health Research Program, which is funded by the Ministry of Economic Affairs and supported by the Dutch Ministry of Social Affairs and Employment, program number 19.204.1-3. This study was approved by the institutional review board on February 7, 2019. From June to August 2019, baseline data were collected, and from November to December 2019, the first follow-up data were collected. The second follow-up data collection and data analysis are planned for the first two quarters of 2020. Dissemination of the results is planned for the last two quarters of 2020. CONCLUSIONS: A strength of this study design is the participatory action approach to enhance the stakeholder commitments, intervention adherence, and compliance. Moreover, since the target group will be participating in the development and implementation of the intervention, the proposed impact will be high. In addition, the short-term as well as the long-term effects will be evaluated. Finally, this study uses a unique combination of quantitative and qualitative evaluation methods. A limitation of this study is that it is impossible to randomly assign participants to an intervention or control group. Furthermore, the follow-up period (6 months) might be too short to establish health-related effects. Lastly, the results of this study might be specific to the department, organization, or sector, which limits the generalizability of the findings. However, as workplace intervention research for shift workers is scarce, this study might serve as a starting point for future research on shift work interventions.

Work Stress Interventions in Hospital Care: Effectiveness of the DISCovery Method.

Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care.

Construction and Validation of the Perceived Opportunity to Craft Scale.

We developed and validated a scale to measure employees' perceived opportunity to craft (POC) in two separate studies conducted in the Netherlands (total N = 2329). POC is defined as employees' perception of their opportunity to craft their job. In Study 1, the perceived opportunity to craft scale (POCS) was developed and tested for its factor structure and reliability in an explorative way. Study 2 consisted of confirmatory analyses of the factor structure and reliability of the scale as well as examination of the discriminant and criterion-related validity of the POCS. The results indicated that the scale consists of one dimension and could be reliably measured with five items. Evidence was found for the discriminant validity of the POCS. The scale also showed criterion-related validity when correlated with job crafting (+), job resources (autonomy +; opportunities for professional development +), work engagement (+), and the inactive construct cynicism (-). We discuss the implications of these findings for theory and practice.