Factors That Impact the Success of Interorganizational Health Promotion Collaborations: A Scoping Review.

OBJECTIVE: To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology. DATA SOURCE: A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. STUDY INCLUSION AND EXCLUSION CRITERIA: To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause. DATA EXTRACTION: Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success. DATA SYNTHESIS: NVivo 10 was used to code article content into the thematic categories identified in the data extraction. RESULTS: Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population. CONCLUSION: In general, the findings were consistent with previous reviews; however, additional novel themes did emerge.

Healthy Eating and Active Living: Rural-Based Working Men's Perspectives.

There is a pressing need for health promotion programs focused on increasing healthy eating and active living among "unreached" rural-based men. The purpose of the current study was to describe rural-based working men's views about health to distil acceptable workplace approaches to promoting men's healthy lifestyles. Two focus group interviews included 21 men who worked and lived in northern British Columbia, Canada. Interviews were approximately 2 hours in duration; data were analyzed using thematic analysis. Themes inductively derived included (a) food as quick filling fuels, (b) work strength and recreational exercise, and (c) (re)working masculine health norms. Participants positioned foods as quick filling fuels both at work and home as reflecting time constraints and the need to bolster energy levels. In the theme work strength and recreational exercise, men highlighted the physical labor demands pointing to the need to be resilient in overcoming the subarctic climate and/or work fatigue in order to fit in exercise. In the context of workplace health promotion programs for men, participants advised how clear messaging and linkages between health and work performance and productivity and cultivating friendly competition among male employees were central to reworking, as well as working, with established masculine health norms. Overall, the study findings indicate that the workplace can be an important means to reaching men in rural communities and promoting healthy eating and active living. That said, the development of workplace programs should be guided by strength-based masculine virtues and values that proactively embrace work and family life.

Changes in Men's Physical Activity and Healthy Eating Knowledge and Behavior as a Result of Program Exposure: Findings From the Workplace POWERPLAY Program.

BACKGROUND: The purpose of this study was to examine changes in physical activity and healthy eating knowledge and behaviors associated with the level of exposure to POWERPLAY, a men-centered workplace health promotion program. METHODS: This study is based on a quasi-experimental prepost design. Using a computer assisted telephone interview survey, data regarding program exposure and physical activity and health eating knowledge and behaviors were collected from men (N = 103) in 4 workplaces. RESULTS: Exposure scores were calculated and participants were categorized as having low (n = 54) or high exposure (n = 49) to POWERPLAY. Compared with the low exposure group, those reporting high exposure scored significantly higher on physical activity knowledge (F (1, 99) =14.17, P < .001, eta2 = .125) and health eating knowledge (F (1, 99) =14.37, P = .001, eta2 = .111). The high exposure group also reported significantly more minutes walked place to place (F (2, 206) = 3.91, P = .022, eta2 = .037) and on minutes walked for leisure (F (2, 230) = 3.08, P = .048, eta2 = .026). CONCLUSIONS: POWERPLAY shows significant promise as a workplace health promotion approach and may have an even greater impact when program exposure is augmented with environmental and policy changes.

A Men's Workplace Health Intervention: Results of the POWERPLAY Program Pilot Study.

OBJECTIVE: To explore physical activity and eating behaviors among men following the implementation of a gender-sensitive, workplace health promotion program. METHODS: Using a pre-post within-subjects design, computer-assisted telephone interviewing (CATI) was used to collect health-related information along with physical activity and fruit/vegetable intake at baseline and after 6 months. RESULTS: At baseline, participants (N = 139) consumed 3.58 servings of fruit and vegetables/day and engaged in an average of 229.77 min/week moderate-vigorous physical activity (MVPA). At 6 months, daily fruit/vegetable intake did not increase, whereas MVPA increased by 112.3 min/week. CONCLUSIONS: The POWERPLAY program successfully increased weekly MVPA. Engaging men in health promotion can be a challenge; here, the workplace served as a valuable environment for achieving positive change.

The POWERPLAY workplace physical activity and nutrition intervention for men: Study protocol and baseline characteristics.

Many health promotion programs hold little "manly" appeal and as a consequence fail to influence men's self-health practices. That said, the workplace can provide an important delivery point for targeted health promotion programs by supporting positive aspects of masculinity. The purpose of this article is to, a) describe the intervention design and study protocol examining the feasibility of a gender-sensitive workplace health promotion intervention focusing on physical activity and healthy eating in male-dominated rural and remote worksites, and b) report baseline findings. This study is a non-randomized quasi-experimental intervention trial examining feasibility and acceptability, and estimated intervention effectiveness. The POWERPLAY program was developed through consultations with men and key workplace personnel, and by drawing on a growing body of men's health promotion research. The program includes masculine print-based messaging, face-to-face education sessions, friendly competition, and self-monitoring concerning physical activity and healthy eating. Male participants (N=139) were recruited from four worksites in northern British Columbia, Canada. Baseline data were collected via computer assisted telephone interview (CATI) survey which assessed physical activity, dietary behavior and workplace environment. This protocol will also be used to collect follow-up data at 6months. A process evaluation, using semi-structured interviews, will be undertaken to assess feasibility and acceptability among participants and worksites. Study outcomes will guide intervention refinement and further testing in a sufficiently powered randomized control trial.

A study of a rural community's readiness for telehealth.

A qualitative approach was used to explore the readiness of a rural community for the implementation of telehealth services. There were four domains of interest: patient, practitioner, public and organization. Sixteen semistructured telephone interviews (three to five in each domain) were carried out with key informants and recorded on audio-tape. Two community awareness sessions were held, which were followed by five audio-taped focus groups (with five to eight people in each) in the practitioner, patient and public domains. In addition, two in-depth interviews were conducted with community physicians. Analysis of the data suggested that there were four types of community readiness: core, engagement, structural and non-readiness. The level of readiness varied across domains. There were six main themes: core readiness; structural readiness; projection of benefits; assessment of risk; awareness and education; and intra-group and inter-group dynamics. The results of the study can be used to investigate the readiness of rural and remote communities for telehealth, which should improve the chance of successful implementation.

A readiness model for telehealth is it possible to pre-determine how prepared communities are to implement telehealth?

Telehealth "readiness" can be defined as the degree to which users, health care organizations, and the health system itself are prepared to participate and succeed in its application. This project developed a readiness model for rural/remote locations in Canada. Specifically defined groups or communities with shared characteristics within a rural geographical community (i.e. practitioners, patients, the public, and health care organizations) participated in key informant interviews, awareness sessions, focus groups, and face-to-face interviews. The data were examined and organized keeping in mind Weiss' Program's Theory of Change. This approach allowed concrete and abstract factors to be considered. The model that emerged suggests that there are four types of readiness for each of the defined communities: core, engagement, structural, and non-readiness. The "communities" share some readiness factors and risks, but also exhibit unique elements. This finding is critical to acknowledge when the goal is to implement a useful, effective, and sustainable telehealth system within remote settings. Study results hold a key to understanding why technology systems have failed in the past, in spite of dedicating considerable human and financial resources towards their implementation. Notations of these findings will be helpful in future telehealth implementations within rural and isolated areas.

The essence of telehealth readiness in rural communities: an organizational perspective.

This paper examines telehealth readiness from an organizational perspective and explores the essence of telehealth readiness among four domains, namely, patients, practitioners, the public, and organizations in rural Canadian communities. Because readiness is a necessary requirement for the successful implementation of an innovation, it is important to identify and ensure core factors of readiness before costly investments are made. The findings presented here derive from a qualitative phenomenological research approach involving semistructured telephone interviews with four key informants (respondents). The data identified four categories of readiness in an organizational setting: core readiness, engagement, structural readiness, and nonreadiness. Understanding organizational readiness within rural and remote communities is an important step for the successful implementation of telehealth services into existing systems of health care.