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

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

Workplace-based rehabilitation with garment workers: A multiple case study.

BACKGROUND: Garment workers are at risk of developing work-related upper limb disorders (WRULD) due to the highly repetitive nature of their work. Workplace-based rehabilitation (WBR) facilitates improvement in work performance by providing intervention at the worker's place of work. OBJECTIVE: This study aims to determine the documented outcomes of workplace-based occupational therapy rehabilitation of garment workers with upper limb conditions. METHODS: A multiple case study design was used through a retrospective record review. All garment workers with upper limb conditions who were treated at a student occupational therapy practice in Cape Town, South Africa, with pre- and post-intervention outcome assessment, were included in the study (n = 7). Data were extracted from occupational therapy and medical files. RESULTS: 70% of the cases (n = 5) improved after WBR while 30% of cases showed no improvement or deterioration. Participants received 3- 5 individual WBR sessions of approximately 30 minutes each, over a period of 4 to 6 weeks. Interventions included workstation adaptations, job rotation, psychoeducation, work task modification, assistive technology and exercise programmes. Outcome measures most commonly used were the RULA, DASH, Boston Carpal Tunnel Questionnaire and pain intensity using the VAS. CONCLUSION: Workplace-based occupational therapy can be effective at improving upper limb function, pain and ergonomic risk amongst garment workers with upper limb conditions.

A systematic review of work-related interventions for breast cancer survivors: Potential contribution of occupational therapists.

BACKGROUND: A high number of breast cancer survivors need to resume work. Therefore, interventions aimed at effective work-related transitions are important. OBJECTIVE: A systematic review to determine what occupational therapy interventions are effective in work-related transitions of breast cancer survivors. METHODS: Multiple databases were searched for studies on work-related interventions within the scope of occupational therapy. Studies were included if 70% or more study participants were working age (> 18 years) breast cancer survivors, and work-related transition outcome measures were used. RESULTS: The search yielded 2 872 articles, of which 12 met the inclusion criteria. When classified according to the International Classification of Function Framework, quantitative sources focussed on Body Structures and Functions component and Multicomponents (consists of the Body Structures and Functions Component and the Activities Component) showed positive effects on improving the work-related transitions of BC survivors, however, the effects were statistically insignificant and the strength of evidence was moderate. Participants in a qualitative source reported that after they underwent a physical exercise programme their work performance improved. A Multicomponents intervention study showed statistically significant improvements on self-reported work-related outcomes of BC survivors. Low evidence was found for implementing a vocational rehabilitation case management programme targeting the Activities component, which showed positive effects in reducing the sick leave days of BC survivors, but the effects were statistically insignificant. No evidence was found for programmes focussed on restoring the Participation component. CONCLUSION: The evidence included in this systematic review were insufficient to recommend occupational therapy interventions that are effective (showing statistically significant improvements) for work-related transitions of BC cancer survivors.

Workplace-based occupational therapy for mental health in Africa: a scoping review protocol.

INTRODUCTION: Although mental health at work is a pressing and growing concern, mental healthcare accounts for less than 2% of global healthcare, with marked inequality across continents. Africa has the smallest proportion of mental health service providers, and the highest rate of out-of-pocket expenditure for mental health service users. Poor mental health at work results in costs to workers, employers and the economy. This review aims to collaborate with stakeholders to identify literature on workplace-based occupational therapy interventions supporting the mental health of workers in Africa. METHODS AND ANALYSIS: We will search Medline (PubMed), EBSCOhost (Academic Search Premier, AfricaWide Information, CINAHL, Health Source: Nursing/Academic), Scopus, Web of Science, Sabinet, Cochrane and OTSeeker for qualitative and quantitative primary research studies. Grey literature will be searched via Sabinet and ProQuest. No language or date restrictions will be applied. Title and abstract screening as well as full-text screening will be done independently by two reviewers. Data extracted will include information about the articles, characteristics of studies and interventions, and findings. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines will be used for reporting results. Three groups of stakeholders will be consulted during the review process: service users/workers, employers and service providers/occupational therapists. ETHICS AND DISSEMINATION: This scoping review does not require ethics approval. Findings of the review will be disseminated through stakeholder engagements, peer-reviewed publications and conference presentations.

Maternal perinatal mental health and infant and toddler neurodevelopment - Evidence from low and middle-income countries. A systematic review.

BACKGROUND: There is extensive lack of awareness of maternal mental health and its impact on child development in low- and middle-income countries (LAMICs). The aim of this systematic review was to analyze evidence for various maternal perinatal mental health disorders and their association with different domains of infant and toddler neurodevelopment during the first two postnatal years in LAMICs. METHODS: A comprehensive literature search was conducted within six databases from Jan 1990-April 2019. All included studies were narratively synthesized. RESULTS: Twenty-four studies, nine cross sectional and 15 longitudinal cohort studies, were included. Three studies were conducted in low-income, 11 in lower-middle-income and ten in upper-middle-income countries. The majority of studies assessed maternal mental health postnatally and 14 of these 22 studies found a significant association with infant and toddler neurodevelopment. Five of the ten studies reporting on exposure to prenatal mental health found a significant association. The most common maternal mental health disorder studied was depression, while the main neurodevelopmental outcomes assessed were motor, cognitive and language development. LIMITATIONS: Meta-analysis could not be conducted due to the variability in the reported maternal mental health disorders and the different times of assessment of exposures and outcomes. CONCLUSIONS: Maternal perinatal mental health disorders and their association with different domains of neurodevelopment in LAMICs is still inconclusive due to a limited number of papers. Mother-infant dyads in LAMICs are exposed to multiple and cumulative risk factors and causal pathways between maternal mental health and infant neurodevelopment are still poorly understood.

Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review.

Purpose The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes. Methods We searched Medline, Cochrane Library, Scopus, Web of Science, Academic Search Premier, Africa-Wide Information, CINAHL, OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Results Initial search located 1071 articles, of which 80 were full text reviewed. Twenty-eight articles were included, reporting on various outcomes relating to a total of seventeen studies. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n = 3), ergonomic training and workstation adjustments (n = 4), exercise and resistance training (n = 6), clinic-based versus workplace-based work hardening (n = 1), nurse case manager training (n = 1), physiotherapy versus Feldenkrais (n = 1), and ambulant myofeedback training (n = 1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion While there is substantial evidence for workplace exercise programs, other workplace-based interventions require further high quality research. Systematic review registration PROSPERO CRD42017059708.