Developing a framework for evaluation: a Theory of Change for complex workplace mental health interventions

Background There is a gap between the necessity of effective mental health interventions in the workplace and the availability of evidence-based information on how to evaluate them. The available evidence outlines that mental health interventions should follow integrated approaches combining multiple components related to different levels of change. However, there is a lack of robust studies on how to evaluate multicomponent workplace interventions which target a variety of outcomes at different levels taking into account the influence of different implementation contexts. Method We use the MENTUPP project as a research context to develop a theory-driven approach to facilitate the evaluation of complex mental health interventions in occupational settings and to provide a comprehensive rationale of how these types of interventions are expected to achieve change. We used a participatory approach to develop a ToC involving a large number of the project team representing multiple academic backgrounds exploiting in tandem the knowledge from six systematic reviews and results from a survey among practitioners and academic experts in the field of mental health in SMEs. Results The ToC revealed four long-term outcomes that we assume MENTUPP can achieve in the workplace: 1) improved mental wellbeing and reduced burnout, 2) reduced mental illness, 3) reduced mental illness-related stigma, and 4) reduced productivity losses. They are assumed to be reached through six proximate and four intermediate outcomes according to a specific chronological order. The intervention consists of 23 components that were chosen based on specific rationales to achieve change on four levels (employee, team, leader, and organization). Conclusions The ToC map provides a theory of how MENTUPP is expected to achieve its anticipated long-term outcomes through intermediate and proximate outcomes assessing alongside contextual factors which will facilitate the testing of hypotheses. Moreover, it allows for a structured approach to informing the future selection of outcomes and related evaluation measures in either subsequent iterations of complex interventions or other similarly structured programs. Hence, the resulting ToC can be employed by future research as an example for the development of a theoretical framework to evaluate complex mental health interventions in the workplace

Implementation and evaluation of a multi-level mental health promotion intervention for the workplace (MENTUPP): study protocol for a cluster randomised controlled trial

Background Well-organised and managed workplaces can be a source of wellbeing. The construction, healthcare and information and communication technology sectors are characterised by work-related stressors (e.g. high workloads, tight deadlines) which are associated with poorer mental health and wellbeing. The MENTUPP intervention is a flexibly delivered, multi-level approach to supporting small- and medium-sized enterprises (SMEs) in creating mentally healthy workplaces. The online intervention is tailored to each sector and designed to support employees and leaders dealing with mental health difficulties (e.g. stress), clinical level anxiety and depression, and combatting mental health-related stigma. This paper presents the protocol for the cluster randomised controlled trial (cRCT) of the MENTUPP intervention in eight European countries and Australia. Methods Each intervention country will aim to recruit at least two SMEs in each of the three sectors. The design of the cRCT is based on the experiences of a pilot study and guided by a Theory of Change process that describes how the intervention is assumed to work. SMEs will be randomly assigned to the intervention or control conditions. The aim of the cRCT is to assess whether the MENTUPP intervention is effective in improving mental health and wellbeing (primary outcome) and reducing stigma, depression and suicidal behaviour (secondary outcome) in employees. The study will also involve a process and economic evaluation. Conclusions At present, there is no known multi-level, tailored, flexible and accessible workplace-based intervention for the prevention of non-clinical and clinical symptoms of depression, anxiety and burnout, and the promotion of mental wellbeing. The results of this study will provide a comprehensive overview of the implementation and effectiveness of such an intervention in a variety of contexts, languages and cultures leading to the overall goal of delivering an evidence-based intervention for mental health in the workplace

Offshore wind turbines: An overview of the effects on the marine environment

none7siThe wind energy industry is growing worldwide. Recently, a number of physical and numerical modeling studies have been carried out in Europe to implement the offshore wind turbine technology, as well as the wind resource. Accordingly, the consideration of the possible environmental impacts of this technology on the marine environment, already affected by several anthropogenic pressures (e.g. fishery, maritime traffic) becomes increasingly important. Main goal of this paper is to provide an overview of the offshore wind farm developments and the associated environmental impacts at European level. The Italian state of the art is also presented.Riefolo, L.; Lanfredi, C.; Azzellino, A.; Tomasicchio, G.R.; D'Alessandro, F.; Penchev, V.; Vicinanza, D.Riefolo, Luigia; Lanfredi, Caterina; Azzellino, Arianna; Tomasicchio, G. R.; D'Alessandro, F.; Penchev, V.; Vicinanza, D

"Io sono un uomo di mondo...". Incroci di linguaggi e culture nell'arte comica di Totò

Immaginare l’uscita di un nuovo titolo su Antonio de Curtis, in arte Totò, può essere un’operazione affascinante, ma al tempo stesso rischiosa. La bibliografia fino a oggi prodotta per investigare i molteplici tratti del suo profilo umano e artistico – la vita privata, le sue ascendenze nobiliari, le sue caratteristiche di attore teatrale e cinematografico, le sue funamboliche acrobazie linguistiche, le sue apparizioni televisive, il suo talento comico, la sua produzione poetica e le sue composizioni in veste di autore e interprete di canzoni – è talmente vasta che diventerebbe impresa ardua individuare aspetti e dimensioni di questa popolare icona della comicità non ancora attraversati da uno sguardo critico. Il volume curato da Paolo Sommaiolo, però, non si sottrae a questa sfida, proponendo i contributi di due Giornate di Studio, tenutesi il 28 e il 29 aprile 2017 all’Università degli Studi di Napoli “L’Orientale”, nel corso delle quali alcuni docenti hanno dato vita a un vivace e stimolante dibattito da cui sono emerse interessanti prospettive per esplorare il “fenomeno Totò” da inconsuete angolature. L’intento era quello di sollecitare uno sguardo plurimo e una varietà di approcci tra la vocazione multiculturale degli insegnamenti impartiti all’“Orientale” e la multiforme vena umoristica della maschera di Totò, anch’essa connotata da una forte impronta multiculturale. Nelle tre sezioni di “Io sono un uomo di mondo…” si scopriranno insoliti intrecci, seguendo le tracce di Totò in contatto con modelli di culture straniere, in versioni della sua comicità doppiate o sottotitolate per la circolazione all’estero dei suoi film, in rapporto con gli eventi cruciali della storia del Novecento. La prospettiva d’indagine si allarga alle implicazioni filosofiche e di natura etico-politica che si possono trarre dalle sue interpretazioni attoriche e alle sue prove di scrittura, provando a rintracciare le dinamiche della sua recitazione e le prerogative che hanno determinato il successo della sua maschera comica

Implementation and evaluation of a multi-level mental health promotion intervention for the workplace (MENTUPP): study protocol for a cluster randomised controlled trial

Abstract Background Well-organised and managed workplaces can be a source of wellbeing. The construction, healthcare and information and communication technology sectors are characterised by work-related stressors (e.g. high workloads, tight deadlines) which are associated with poorer mental health and wellbeing. The MENTUPP intervention is a flexibly delivered, multi-level approach to supporting small- and medium-sized enterprises (SMEs) in creating mentally healthy workplaces. The online intervention is tailored to each sector and designed to support employees and leaders dealing with mental health difficulties (e.g. stress), clinical level anxiety and depression, and combatting mental health-related stigma. This paper presents the protocol for the cluster randomised controlled trial (cRCT) of the MENTUPP intervention in eight European countries and Australia. Methods Each intervention country will aim to recruit at least two SMEs in each of the three sectors. The design of the cRCT is based on the experiences of a pilot study and guided by a Theory of Change process that describes how the intervention is assumed to work. SMEs will be randomly assigned to the intervention or control conditions. The aim of the cRCT is to assess whether the MENTUPP intervention is effective in improving mental health and wellbeing (primary outcome) and reducing stigma, depression and suicidal behaviour (secondary outcome) in employees. The study will also involve a process and economic evaluation. Conclusions At present, there is no known multi-level, tailored, flexible and accessible workplace-based intervention for the prevention of non-clinical and clinical symptoms of depression, anxiety and burnout, and the promotion of mental wellbeing. The results of this study will provide a comprehensive overview of the implementation and effectiveness of such an intervention in a variety of contexts, languages and cultures leading to the overall goal of delivering an evidence-based intervention for mental health in the workplace. Trial registration Please refer to Item 2a and registration ISRCTN14104664. Registered on 12th July 2022

Implementing a complex mental health intervention in occupational settings: process evaluation of the MENTUPP pilot study

Background According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices.Objectives This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace.Method The Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance.Results Factors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19.Conclusions The results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity.Trial registration number ISRCTN14582090