The effectiveness of workplace nutrition and physical activity interventions in improving productivity, work performance and workability : a systematic review

Background Healthy lifestyles play an important role in the prevention of premature death, chronic diseases, productivity loss and other social and economic concerns. However, workplace interventions to address issues of fitness and nutrition which include work-related outcomes are complex and thus challenging to implement and appropriately measure the effectiveness of. This systematic review investigated the impact of workplace nutrition and physical activity interventions, which include components aimed at workplace’s physical environment and organizational structure, on employees’ productivity, work performance and workability. Methods A systematic review that included randomized controlled trials and or non-randomized controlled studies was conducted. Medline, EMBASE.com, Cochrane Library and Scopus were searched until September 2016. Productivity, absenteeism, presenteeism, work performance and workability were the primary outcomes of our interest, while sedentary behavior and changes in other health-related behaviors were considered as secondary outcomes. Two reviewers independently screened abstracts and full-texts for study eligibility, extracted the data and performed a quality assessment using the Cochrane Collaboration Risk-of-Bias Tool for randomized trials and the Risk-of-Bias in non-randomized studies of interventions. Findings were narratively synthesized. Results Thirty-nine randomized control trials and non-randomized controlled studies were included. Nearly 28% of the included studies were of high quality, while 56% were of medium quality. The studies covered a broad range of multi-level and environmental-level interventions. Fourteen workplace nutrition and physical activity intervention studies yielded statistically significant changes on absenteeism (n = 7), work performance (n = 2), workability (n = 3), productivity (n = 1) and on both workability and productivity (n = 1). Two studies showed effects on absenteeism only between subgroups. Conclusions The scientific evidence shows that it is possible to influence work-related outcomes, especially absenteeism, positively through health promotion efforts that include components aimed at the workplace’s physical work environment and organizational structure. In order to draw further conclusions regarding work-related outcomes in controlled high-quality studies, long-term follow-up using objective outcomes and/or quality assured questionnaires are required. Trial registration Registration number: PROSPERO CRD42017081837

Experiences of participating in a problem-solving intervention with workplace involvement in Swedish primary health care:a qualitative study from rehabilitation coordinator's, employee's, and manager's perspectives

BACKGROUND: Work-directed interventions that include problem-solving can reduce the number of sickness absence days. The effect of combining a problem-solving intervention with involvement of the employer is currently being tested in primary care in Sweden for employees on sickness absence due to common mental disorders (PROSA trial). The current study is part of the PROSA trial and has a two-fold aim: 1) to explore the experiences of participating in a problem-solving intervention with workplace involvement aimed at reducing sickness absence in employees with common mental disorders, delivered in Swedish primary health care, and 2) to identify facilitators of and barriers to participate in the intervention. Both aims targeted rehabilitation coordinators, employees on sickness absence, and first-line managers.METHODS: Data were collected from semi-structured interviews with participants from the PROSA intervention group; rehabilitation coordinators (n = 8), employees (n = 13), and first-line managers (n = 8). Content analysis was used to analyse the data and the Consolidated Framework for Implementation Research was used to group the data according to four contextual domains. One theme describing the participation experiences was established for each domain. Facilitators and barriers for each domain and stakeholder group were identified.RESULTS: The stakeholders experienced the intervention as supportive in identifying problems and solutions and enabling a dialogue between them. However, the intervention was considered demanding and good relationships between the stakeholders were needed. Facilitating factors were the manual and work sheets which the coordinators were provided with, and the manager being involved early in the return-to-work process. Barriers were the number of on-site meetings, disagreements and conflicts between employees and first-line managers, and symptom severity.CONCLUSIONS: Seeing the workplace as an integral part of the intervention by always conducting a three-part meeting enabled a dialogue that can be used to identify and address disagreements, to explain CMD symptoms, and how these can be handled at the workplace. We suggest allocating time towards developing good relationships, provide RCs with training in handling disagreements, and additional knowledge about factors in the employee's psychosocial work environment that can impair or promote health to increase the RCs ability to support the employee and manager.</p

Changes in skinfold thickness and waist circumference after 12 and 24 months resulting from the NHF-NRG In Balance-project

<p>Abstract</p> <p>Background</p> <p>More knowledge is needed regarding the effectiveness of weight gain prevention programmes. The present study tested the 12-and 24-month effectiveness of the 'Netherlands Research programme weight Gain prevention' (NHF-NRG)-In Balance-project, a worksite-based intervention aimed at the prevention of weight gain.</p> <p>Methods</p> <p>Twelve worksites (n = 553 participants) were matched and assigned to either intervention or control group. The worksites and employees of the intervention group received individual (i.e. pedometer, computer-tailored advice) and environmental (i.e. changes in worksite canteen) interventions, directed at physical activity and food intake over 1-year. Differences between the intervention and control group in changes in body weight, BMI, skinfold thickness and waist circumference at 12 and 24 months were examined using multilevel linear regression analyses adjusting for various baseline characteristics (age, gender, BMI, marital status, education and smoking status).</p> <p>Results</p> <p>A significant greater reduction in skinfold thickness was found in the intervention group than in the control group, both after 12-and 24 months (Unstandardized regression coefficients (B) = -2.52, 95% C.I. -4.58, -0.45; p = 0.018; B = -4.83, 95% C.I. 6.98, -2.67; p < 0.001 respectively). Significant differences were also observed for changes in waist circumferences both at 12 months (B = -1.50, 95% C.I. -2.35, -0.65; p < 0.001) and at 24 months (B = -1.30, 95% C.I. -2.18, -0.42; p = 0.005). No significant changes were observed for weight and BMI.</p> <p>Conclusions</p> <p>The project was effective with regard to changes in skinfold thickness and waist circumference both at 12 and 24 months. It supports the usefulness of worksite-based prevention, especially regarding maintenance of behavioral changes.</p

Person-Centered Practice as Anchor and Beacon: Pandemic Wisdom from the NCAPPS Community

Objective: This article summarizes the individual, systemic, and collective challenges and opportunities presented by the COVID-19 pandemic, based on 16 videos solicited by the National Center on Advancing Person-Centered Practices and Systems (NCAPPS) and submitted by NCAPPS collaborators during the first six months of the pandemic. Method: Informed by participatory action approaches and content analysis, we describe common themes in a series of 16 videos solicited by NCAPPS from subject matter experts with professional and lived experience of disability and human services systems. Results: The team organized the findings to identify both specific factors within each of the levels and the complex interplay between each of the factors at four levels: (1) individual disabled people and their/our spouses, family, and friends; (2) person-centered strategies; (3) system, services, and providers; and (4) society. Discussion: Practices such as person-centered planning, peer support, and self-direction enable us to respond to and cope with the traumas caused by the pandemic. Systems-level themes reveal clear opportunities for abandoning outdated practices and rebuilding the service system in a more person-centered manner. Commentators argued that a society that strives for collective responsibility and well-being and leaves no one behind will generate the interdependence necessary to weather disasters like the COVID-19 pandemic. Conclusion: Person-centered practices are both an anchor for weathering the pandemic and a beacon for rebuilding lives, service systems, and communities

Study protocol of a cluster randomised controlled trial investigating the effectiveness of a tailored energy balance programme for recent retirees

BACKGROUND: People in transitional life stages, such as occupational retirement, are likely to gain weight and accumulate abdominal fat mass caused by changes in physical activity and diet. Hence, retirees are an important target group for weight gain prevention programmes, as described in the present paper. METHODS/DESIGN: A systematic and stepwise approach (Intervention Mapping) is used to develop a low-intensity energy balance intervention programme for recent retirees. This one-year, low-intensity multifaceted programme aims to prevent accumulation of abdominal fat mass and general weight gain by increasing awareness of energy balance and influencing related behaviours of participants' preference. These behaviours are physical activity, fibre intake, portion size and fat consumption. The effectiveness of the intervention programme is tested in a cluster randomised controlled trial. Measurements of anthropometry, physical activity, energy intake, and related psychosocial determinants are performed at baseline and repeated at 6 months for intermediate effect, at 12 months to evaluate short-term intervention effects and at 24 months to test the sustainability of the effects. DISCUSSION: This intervention programme is unique in its focus on retirees and energy balance. It aims at increasing awareness and takes into account personal preferences of the users by offering several options for behaviour change. Moreover, the intervention programme is evaluated at short-term and long-term and includes consecutive outcome measures (determinants, behaviour and body composition)

Does physical activity buffer insomnia due to back and neck pain?

Musculoskeletal pain is highly prevalent and a burden to society, recurrent and persistent low back pain (LBP) and neck pain (NP) being the most common conditions. They are associated with other poor health outcomes such as sleep problems. Physical activity (PA) prevents LBP and NP, but the direct effect on sleep is unclear. This study explored the effect of pain on insomnia, and examined if adherence to moderate-to-high intensity levels of PA influenced this relationship.In this prospective observational study, 1821 workers were followed over 3 years. Data included self-rated measures of LBP and NP, insomnia and level and amount of PA. Pain variables were used in a "risk profile" for future sick-listing, insomnia was categorized into those with and without such problems, and adherence to PA was defined as reporting moderate-to-high levels in two consecutive years. In Poisson regression models, individuals with pain risk profiles were analysed according to PA adherence for the outcome insomnia. Repeated measurements allowed control for prior pain.In this mainly male working population, individuals with a risk profile for LBP and NP had a significant increased risk (RR = 1.5) of developing insomnia one year later when not adhering to moderate-to-high levels of PA. Among those not reporting prior pain, the risk was even larger (RR = 2.5). Generalizability may be restricted to relatively healthy males. The individuals who reported a pain risk profile two consecutive years did not get the buffer effect from adhering to moderate-to-high levels of PA in terms of developing insomnia

Developing a practice guideline for the occupational health services by using a community of practice approach: a process evaluation of the development process

Abstract Background One way to facilitate the translation of research into the occupational health service practice is through clinical practice guidelines. To increase the implementability of guidelines it is important to include the end-users in the development, for example by a community of practice approach. This paper describes the development of an occupational health practice guideline aimed at the management of non-specific low back pain (LBP) by using a community of practice approach. The paper also includes a process evaluation of the development providing insight into the feasibility of the process. Methods A multidisciplinary community of practice group (n = 16) consisting of occupational nurses, occupational physicians, ergonomists/physical therapists, health and safety engineers, health educators, psychologists and researchers from different types of occupational health services and geographical regions within Sweden met eleven times (June 2012–December 2013) to develop the practice guideline following recommendations of guideline development handbooks. Process-outcomes recruitment, reach, context, satisfaction, feasibility and fidelity were assessed by questionnaire, observations and administrative data. Results Group members attended on average 7.5 out of 11 meetings. Half experienced support from their workplace for their involvement. Feasibility was rated as good, except for time-scheduling. Most group members were satisfied with the structure of the process (e.g. presentations, multidisciplinary group). Fidelity was rated as fairly high. Conclusions The described development process is a feasible process for guideline development. For future guideline development expectations of the work involved should be more clearly communicated, as well as the purpose and tasks of the CoP-group. Moreover, possibilities to improve support from managers and colleagues should be explored. This paper has important implications for future guideline development; it provides valuable information on how practitioners can be included in the development process, with the aim of increasing the implementability of the developed guidelines

Implementation of highly challenging balance training for Parkinson’s disease in clinical practice : a process evaluation

CITATION: Leavy, B., et al. 2021. Implementation of highly challenging balance training for Parkinson’s disease in clinical practice : a process evaluation. BMC Geriatrics, 21:96, doi:10.1186/s12877-021-02031-1.The original publication is available at https://bmcgeriatr.biomedcentral.comBackground: Process evaluations provide contextual insight into the way in which interventions are delivered. This information is essential when designing strategies to implement programs into wider clinical practice. We performed a process evaluation of the HiBalance effectiveness trial investigating the effects of a 10-week of highly challenging and progressive balance training for mild-moderate Parkinson’s disease (PD). Study aims were to investigate i) the quality and quantity of intervention delivery and ii) barriers and facilitators for implementation. Methods: Process outcomes included; Fidelity; Dose (delivered and received) Recruitment and Reach. Investigation of barriers and facilitators was guided by the Consolidated Framework for Implementation Research. Program delivery was assessed across four neurological rehabilitation sites during a two-year period. Data collection was mixed-methods in nature and quantitative and qualitative data were merged during the analysis phase. Results: Thirteen program trainers delivered the intervention to 12 separate groups during 119 training sessions. Trainer fidelity to program core components was very high in 104 (87%) of the sessions. Participant responsiveness to the core components was generally high, although adherence to the home exercise program was low (50%). No significant context-specific differences were observed across sites in terms of fidelity, dose delivered/ received or participant characteristics, despite varying recruitment methods. Facilitators to program delivery were; PD-specificity, high training frequency and professional autonomy. Perceived barriers included; cognitive impairment, absent reactional balance among participants, as well a heterogeneous group in relation to balance capacity. Conclusion: These findings provide corroborating evidence for outcome evaluation results and valuable information for the further adaptation and implementation of this program. Important lessons can also be learned for researchers and clinicians planning to implement challenging exercise training programs for people with mildmoderate PD.https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-02031-1Publisher's versio