Implementation of the participatory approach for supervisors to prevent sick leave: a process evaluation

To perform a process evaluation of a multifaceted strategy to implement the participatory approach for supervisors to prevent sick leave in three organisations. The implementation strategy incorporated a working group meeting with stakeholder representatives, supervisor training, and optional supervisor coaching. Context, recruitment, reach, dose delivered, dose received, fidelity, and satisfaction with the strategy were assessed at organisational and supervisor level using questionnaires and registration forms. At least 4 out of 6 stakeholders were represented in the working group meetings, and 11 % (n = 116) of supervisors could be reached. The working group meetings and supervisor training were delivered and received as planned and were well appreciated within all three organisations. Three supervisors made use of coaching. At 6-month follow-up, 11 out of 41 supervisors (27 %) indicated that they had applied the participatory approach at least one time. The implementation strategy was largely carried out as intended. However, reach of both supervisors and department managers should be improved. Future studies should consider targeting employees with the strategy

Does social support at home moderate the association between social support at work and work functioning among cancer patients?

PURPOSE: The aims of this study were to examine (1) the longitudinal associations of supervisor and colleague social support with work functioning in cancer patients who have returned to work and (2) the moderating role of social support at home.METHODS: Data from the longitudinal Work Life after Cancer study were used (n = 384). Work functioning (low versus moderate to high work functioning) was measured with the validated Work Role Functioning Questionnaire 2.0. Social support at work was measured from both supervisor and colleagues with the Copenhagen Psychosocial Questionnaire. Social support at home was measured with the Social Support List-Discrepancies. Logistic generalized estimating equations were used to analyse associations between supervisor and colleague social support and work functioning, and to examine the possible moderating effect of social support at home.RESULTS: More supervisor (OR: 1.21; 95% CI: 1.10, 1.32) and colleague (1.13; 1.03, 1.24) social support were significantly associated with moderate to high work functioning. The association between colleague social support and work functioning was attenuated for those who did not experience enough social support at home but remained almost significant for supervisor social support (1.17; 1.00, 1.37).CONCLUSIONS: Supervisor social support is associated with better work functioning regardless of social support at home, while colleague social support is only associated with better work functioning when cancer patients experience enough social support at home.IMPLICATIONS FOR CANCER SURVIVORS: Occupational physicians may play a key role in creating awareness that social support at work and at home are beneficial for cancer patients' work functioning.</p

The association between fast-food outlet proximity and density and Body Mass Index:Findings from 147,027 Lifelines cohort study participants

Unhealthy food environments may contribute to an elevated Body Mass Index (BMI), which is a chronic disease risk factor. We examined the association between residential fast-food outlet exposure, in terms of proximity and density, and BMI in the Dutch adult general population. Additionally, we investigated to what extent this association was modified by urbanisation level. In this cross-sectional study, we linked residential addresses of baseline adult Lifelines cohort participants (N = 147,027) to fast-food outlet locations using geo-coding. We computed residential fast-food outlet proximity, and density within 500 m(m), 1, 3, and 5 km(km). We used stratified (urban versus rural areas) multilevel linear regression models, adjusting for age, sex, partner status, education, employment, neighbourhood deprivation, and address density. The mean BMI of participants was 26.1 (SD 4.3) kg/m2. Participants had a mean (SD) age of 44.9 (13.0), 57.3% was female, and 67.0% lived in a rural area. Having two or more (urban areas) or five or more (rural areas) fast-food outlets within 1 km was associated with a higher BMI (B = 0.32, 95% confidence interval (CI):0.03,0.62; B = 0.23, 95% CI:0.10,0.36, respectively). Participants in urban and rural areas with a fast-food outlet within <250 m had a higher BMI (B = 0.30, 95% CI:0.03,0.57; B = 0.20, 95% CI:0.09,0.31, respectively). In rural areas, participants also had a higher BMI when having at least one fast-food outlet within 500 m (B = 0.10, 95% CI:0.02,0.18). In conclusion, fast-food outlet exposure within 1 km from the residential address was associated with BMI in urban and rural areas. Also, fast-food outlet exposure within 500 m was associated with BMI in rural areas, but not in urban areas. In the future, natural experiments should investigate changes in the fast-food environment over time

The association between the presence of fast-food outlets and BMI:the role of neighbourhood socio-economic status, healthy food outlets, and dietary factors

BACKGROUND: Evidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake. METHODS: In this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants' residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value < 0.10 or improved model fit (∆AIC ≥ 2), we conducted stratified analyses. We used causal mediation methods to assess mediation. RESULTS: Participants with one fast-food outlet within 1 km had a higher BMI than participants with no fast-food outlet within 1 km (B = 0.11, 95% CI: 0.01, 0.21). Effect sizes for at least two fast-food outlets were larger in low NSES areas (B = 0.29, 95% CI: 0.01, 0.57), and especially in low NSES areas where at least two healthy food outlets within 1 km were available (B = 0.75, 95% CI: 0.19, 1.31). Amount of fat intake, but not frequency of fast-food consumption, explained this association for 3.1%. CONCLUSIONS: Participants living in low SES neighbourhoods with at least two fast-food outlets within 1 km of their residential address had a higher BMI than their peers with no fast-food outlets within 1 km. Among these participants, healthy food outlets did not buffer the potentially unhealthy impact of fast-food outlets. Amount of fat intake partly explained this association. This study highlights neighbourhood socio-economic inequalities regarding fast-food outlets and BMI

Childhood Socioeconomic Status and Depressive Symptom Trajectories in the Transition to Adulthood in the United States and Canada

Purpose: We examined whether young people in the U.S. and Canada exhibit similar depressive symptom trajectories in the transition to adulthood and compared the effect of childhood socioeconomic status on trajectory membership. Methods: We used the American National Longitudinal Survey of Youth 1979 Child/Young Adult (n = 6,315) and the Canadian National Longitudinal Survey of Children and Youth (n = 3,666). Depressive symptoms were measured using five items from the Center for Epidemiological Studies on Depression scale. Latent trajectories of depressive symptoms from ages 16–25 years were identified using growth mixture models. We estimated the effect of childhood family income, parental education, and parental unemployment on trajectory membership using multivariable Poisson regression models with robust variances. Results: We identified four similar trajectories in the two countries: (1) low stable; (2) mid-peak; (3) increasing; and (4) decreasing. Relatively more Americans were in the low-stable trajectory group than Canadians (77.6% vs. 64.9%), and fewer Americans were in the decreasing group (7.1% vs. 19.1%). In the U.S., childhood family income in the bottom two quartiles was related to higher rates of increasing trajectory membership compared with income in the top quartile (incidence rate ratios: 1.59–1.79, p <.05), but not in Canada. In the U.S., parental education at a high school level was associated with higher rates of decreasing trajectory membership compared with higher education (incidence rate ratio = 1.45, confidence interval: 1.10–1.91; p =.01), but not in Canada. Conclusions: Depressive symptoms may take a similar course in the transition to adulthood within these two countries. Country differences may modify the degree to which childhood socioeconomic status determines trajectory membership

Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations

Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14?16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change. Electronic supplementary material The online version of this article (doi:10.1007/s10926-016-9664-z) contains supplementary material, which is available to authorized users

Investigating young adults' mental health and early working life trajectories from a life course perspective:the role of transitions

BACKGROUND: Many young adults leave the labour market because of mental health problems or never really enter it, through early moves onto disability benefits. Across many countries of the Organisation for Economic Co-operation and Development, between 30% and 50% of all new disability benefit claims are due to mental health problems; among young adults this moves up to 50%-80%. OUTLINE: We propose a research agenda focused on transitions in building young adults' mental health and early working life trajectories, considering varying views for subgroups of a society. First, we briefly review five transition characteristics, then we elaborate a research agenda with specific research questions. RESEARCH AGENDA: Our research agenda focuses on transitions as processes, in time and place and as sensitive periods, when examining young adults' mental health and early working life trajectories from a life course perspective. As more and more childhood and adolescent cohorts mature and facilitate research on later life labour market, work and health outcomes, transition research can help guide policy and practice interventions. FUTURE CROSS-DISCIPLINARY RESEARCH: In view of the many challenges young adults face when entering the changing world of work and labour markets, future research on transitions in young adults related to their mental health and early working life trajectories will provide ample opportunities for collaborative cross-disciplinary research and stimulate debate on this important challenge

Fast-food environments and BMI changes in the Dutch adult general population:the Lifelines cohort

OBJECTIVE: This study investigated cross-sectional and longitudinal associations of fast-food outlet exposure with BMI and BMI change, as well as moderation by age and genetic predisposition.METHODS: This study used Lifelines' baseline (n = 141,973) and 4-year follow-up (n = 103,050) data. Participant residential addresses were linked to a register with fast-food outlet locations (Nationwide Information System of Workplaces [Dutch: Landelijk Informatiesysteem van Arbeidsplaatsen, LISA]) using geocoding, and the number of fast-food outlets within 1 km was computed. BMI was measured objectively. A weighted BMI genetic risk score was computed, representing overall genetic predisposition toward elevated BMI, based on 941 single-nucleotide polymorphisms genome-wide significantly associated with BMI for a subsample with genetic data (BMI: n = 44,996; BMI change: n = 36,684). Multivariable multilevel linear regression analyses and exposure-moderator interactions were tested.RESULTS: Participants with ≥1 fast-food outlet within 1 km had a higher BMI (B [95% CI]: 0.17 [0.09 to 0.25]), and those with ≥2 fast-food outlets within 1 km increased more in BMI (B [95% CI]: 0.06 [0.02 to 0.09]) than participants with no fast-food outlets within 1 km. Effect sizes on baseline BMI were largest among young adults (age 18-29 years; B [95% CI]: 0.35 [0.10 to 0.59]) and especially young adults with a medium (B [95% CI]: 0.57 [-0.02 to 1.16]) or high genetic risk score (B [95% CI]: 0.46 [-0.24 to 1.16]).CONCLUSIONS: Fast-food outlet exposure was identified as a potentially important determinant of BMI and BMI change. Young adults, especially those with a medium or high genetic predisposition, had a higher BMI when exposed to fast-food outlets.</p

Associations of Genetic Factors, Educational Attainment, and Their Interaction With Kidney Function Outcomes

Both genetic predisposition and low educational attainment (EA) are associated with higher risk of chronic kidney disease. We examined the interaction of EA and genetic risk in kidney function outcomes. We included 3,597 participants from the Prevention of Renal and Vascular End-Stage Disease Cohort Study, a longitudinal study in a community-based sample from Groningen, the Netherlands (median follow-up, 11 years; 1997-2012). Kidney function was approximated by obtaining estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C. Individual longitudinal linear eGFR trajectories were derived from linear mixed models. Genotype data on 63 single-nucleotide polymorphisms, with known associations with eGFR, were used to calculate an allele-weighted genetic score (WGS). EA was categorized into high, medium, and low. In ordinary least squares analysis, higher WGS and lower EA showed additive effects on reduced baseline eGFR; the interaction term was nonsignificant. In analysis of eGFR decline, the significant interaction term suggested amplification of genetic risk by low EA. Adjustment for known renal risk factors did not affect our results. This study presents the first evidence of gene-environment interaction between EA and a WGS for eGFR decline and provides population-level insights into the mechanisms underlying socioeconomic disparities in chronic kidney disease