Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity.

Abstract:

BACKGROUND:Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES:To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS:We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA:Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS:Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS:We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS:Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.

authors

Wolfenden L,Goldman S,Stacey FG,Grady A,Kingsland M,Williams CM,Wiggers J,Milat A,Rissel C,Bauman A,Farrell MM,Légaré F,Ben Charif A,Zomahoun HTV,Hodder RK,Jones J,Booth D,Parmenter B,Regan T,Yoong SL

doi

10.1002/14651858.CD012439.pub2

subject

Has Abstract

pub_date

2018-11-14 00:00:00

pages

CD012439

issn

1469-493X

journal_volume

11

pub_type

杂志文章,meta分析
  • Interventions for increasing acceptance of local anaesthetic in children and adolescents having dental treatment.

    abstract:BACKGROUND:Delivery of pain-free dentistry is crucial for reducing fear and anxiety, completion of treatment, and increasing acceptance of future dental treatment in children. Local anaesthetic (LA) facilitates this pain-free approach but it remains challenging. A number of interventions to help children cope with deli...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011024.pub2

    authors: Monteiro J,Tanday A,Ashley PF,Parekh S,Alamri H

    更新日期:2020-02-27 00:00:00

  • Radioisotopes for metastatic bone pain.

    abstract:BACKGROUND:Bone metastases manifest through pain, which can arise even before the injury is radiologically detected. Pain occurs as a result of bone destruction and, as more destruction ensues, more pain can be experienced. Radiculopathies, plexopathies and shrinkage of spinal nerves due to tumour growth and fractures ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003347

    authors: Roqué M,Martinez MJ,Alonso P,Català E,Garcia JL,Ferrandiz M

    更新日期:2003-01-01 00:00:00

  • Vitamin C for preventing and treating tetanus.

    abstract:BACKGROUND:Tetanus is a severe infection that can be prevented by vaccination. In developing countries vaccination coverage is not always high and in developed countries cases may still occur, particularly in elderly people owing to their reduced immunoprotection. It has been estimated that there are about one million ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006665.pub2

    authors: Hemilä H,Koivula TT

    更新日期:2008-04-16 00:00:00

  • Specialist epilepsy nurses for treating epilepsy.

    abstract:BACKGROUND:Epilepsy is the most common serious neurological condition after stroke, with a 0.5 per cent prevalence, and a two to three per cent life time risk of being given a diagnosis of epilepsy in the developed world. As a result of the perceived deficiencies and suggestions to improve the quality of care offered t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001907

    authors: Bradley P,Lindsay B

    更新日期:2001-01-01 00:00:00

  • Exercise for depression.

    abstract:BACKGROUND:Depression is a common and important cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychological therapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004366.pub6

    authors: Cooney GM,Dwan K,Greig CA,Lawlor DA,Rimer J,Waugh FR,McMurdo M,Mead GE

    更新日期:2013-09-12 00:00:00

  • Treatment for amphetamine withdrawal.

    abstract:BACKGROUND:Amphetamine withdrawal has been less studied although it is a common problem with a prevalent rate of 87% among amphetamine users. Its symptoms, in particular intense craving, may be a critical factor leading to relapse of amphetamine use. In clinical practice, treatment for cocaine withdrawal has been recom...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003021

    authors: Srisurapanont M,Jarusuraisin N,Kittirattanapaiboon P

    更新日期:2001-01-01 00:00:00

  • WITHDRAWN: Zinc for the common cold.

    abstract:BACKGROUND:Of the eight trials conducted since 1984 investigating the use of zinc in the treatment of the common cold, four have shown some benefit while the remainder have shown no benefit. Treatment masking and reduced bioavailability of zinc from some formulations have been claimed to influence the results reported....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001364.pub2

    authors: Marshall I

    更新日期:2007-07-18 00:00:00

  • Drugs for preventing red blood cell dehydration in people with sickle cell disease.

    abstract:BACKGROUND:Sickle cell disease is an inherited disorder of hemoglobin, resulting in abnormal red blood cells. These are rigid and may block blood vessels leading to acute painful crises and other complications. Recent research has focused on therapies to rehydrate the sickled cells by reducing the loss of water and ion...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD003426.pub6

    authors: Nagalla S,Ballas SK

    更新日期:2018-10-19 00:00:00

  • Pharmacotherapy for social phobia.

    abstract:BACKGROUND:Social phobia (SP), or social anxiety disorder, is a prevalent and disabling disorder. There is growing evidence that SP is mediated by specific neurobiological factors, and increased interest in the use of medication in its treatment. OBJECTIVES:To assess the effects of pharmacotherapy for Social Phobia, a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001206.pub2

    authors: Stein DJ,Ipser JC,Balkom AJ

    更新日期:2004-10-18 00:00:00

  • Push versus gravity for intermittent bolus gavage tube feeding of premature and low birth weight infants.

    abstract:BACKGROUND:Many small, sick and premature infants are unable to coordinate sucking, swallowing and breathing, and therefore, require gavage feeding. In gavage feeding, milk feeds are delivered through a tube passed via the nose or mouth into the stomach. Intermittent bolus milk feeds may be administered using a syringe...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005249.pub2

    authors: Dawson JA,Summan R,Badawi N,Foster JP

    更新日期:2012-11-14 00:00:00

  • Interventions for non-oliguric hyperkalaemia in preterm neonates.

    abstract:BACKGROUND:Non-oliguric hyperkalaemia of the newborn is defined as a plasma potassium level > 6.5 mmol/L in the absence of acute renal failure. Hyperkalaemia is a common complication in the first 48 hours of life in very low birth weight (birth weight < 1500 g) and/or very preterm newborns (< 32 weeks gestational age)....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005257.pub2

    authors: Vemgal P,Ohlsson A

    更新日期:2007-01-24 00:00:00

  • Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation.

    abstract:BACKGROUND:Chronic pulmonary infection is one of the hallmarks of lung disease in cystic fibrosis. Infections dominated by organisms of the Burkholderia cepacia complex, a group of at least 17 closely-related species of gram-negative bacteria, are particularly difficult to treat. These infections may be associated with...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009529.pub2

    authors: Horsley A,Jones AM

    更新日期:2012-10-17 00:00:00

  • Ocriplasmin for symptomatic vitreomacular adhesion.

    abstract:BACKGROUND:Symptomatic vitreomacular adhesion (sVMA) is a recognised cause of visual loss and by tradition has been managed by pars plana vitrectomy (PPV). A less invasive alternative to surgery in some people is enzymatic vitreolysis, using an intravitreal injection of ocriplasmin. OBJECTIVES:To assess the efficacy a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011874.pub2

    authors: Neffendorf JE,Kirthi V,Pringle E,Jackson TL

    更新日期:2017-10-17 00:00:00

  • Aspirin with or without an antiemetic for acute migraine headaches in adults.

    abstract:BACKGROUND:This is an updated version of the original Cochrane review published in Issue 4, 2010 (Kirthi 2010). Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter anal...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008041.pub3

    authors: Kirthi V,Derry S,Moore RA

    更新日期:2013-04-30 00:00:00

  • Chinese medicinal herbs to treat the side-effects of chemotherapy in breast cancer patients.

    abstract:BACKGROUND:Short term side-effects of chemotherapy include fatigue, nausea, vomiting, mucositis and myelosuppression or neutropenia. These occur during the course of treatment and generally resolve within months of completion of chemotherapy. A variety of Chinese medicinal herbs have been used for managing these side e...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004921.pub2

    authors: Zhang M,Liu X,Li J,He L,Tripathy D

    更新日期:2007-04-18 00:00:00

  • Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy.

    abstract:BACKGROUND:Chronic inflammatory demyelinating polyradiculoneuropathy is a peripheral neuropathy caused by peripheral nerve inflammation probably due to autoimmunity and would be expected to benefit from corticosteroids. Non-randomised studies suggest that corticosteroids are often beneficial. OBJECTIVES:To evaluate th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002062

    authors: Mehndiratta MM,Hughes RA

    更新日期:2002-01-01 00:00:00

  • Driving assessment for maintaining mobility and safety in drivers with dementia.

    abstract:BACKGROUND:Demographic changes are leading to an increase in the number of older drivers: as dementia is an age-related disease, there is also an increase in the numbers of drivers with dementia. Dementia can impact on both the mobility and safety of drivers, and the impact of formal assessment of driving is unknown in...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006222.pub2

    authors: Martin AJ,Marottoli R,O'Neill D

    更新日期:2009-01-21 00:00:00

  • Sclerotherapy versus sham or no intervention for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis.

    abstract:BACKGROUND:Portal hypertension commonly accompanies advanced liver disease and often gives rise to life-threatening complications, including bleeding (haemorrhage) from oesophageal and gastrointestinal varices. Variceal bleeding commonly occurs in children with chronic liver disease or portal vein obstruction. Therefor...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011573.pub2

    authors: Gattini D,Cifuentes LI,Torres-Robles R,Gana JC

    更新日期:2020-03-05 00:00:00

  • Oral water soluble contrast for the management of adhesive small bowel obstruction.

    abstract:BACKGROUND:Adhesions are the leading cause of small bowel obstruction. Gastrografin transit time may allow for the selection of appropriate patients for non-operative management. Some studies have shown when the contrast does not reach the colon after a designated time it indicates complete intestinal obstruction that ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004651.pub3

    authors: Abbas S,Bissett IP,Parry BR

    更新日期:2007-07-18 00:00:00

  • Hyperbaric oxygen therapy for the adjunctive treatment of traumatic brain injury.

    abstract:BACKGROUND:Traumatic brain injury is common and presents a health problem with significant effect on quality of life. Hyperbaric oxygen therapy (HBOT) has been suggested to improve oxygen supply to the injured brain and, therefore, to reduce the volume of brain that will ultimately perish. It is postulated that the add...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004609.pub2

    authors: Bennett MH,Trytko B,Jonker B

    更新日期:2004-10-18 00:00:00

  • Universal school-based prevention for illicit drug use.

    abstract:BACKGROUND:Drug addiction is a chronic, relapsing disease. Primary interventions should aim to reduce first use or to prevent the transition from experimental use to addiction. School is the appropriate setting for preventive interventions. OBJECTIVES:To evaluate the effectiveness of universal school-based interventio...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003020.pub3

    authors: Faggiano F,Minozzi S,Versino E,Buscemi D

    更新日期:2014-01-01 00:00:00

  • Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia.

    abstract:BACKGROUND:Neutropenia is a potentially serious side effect of chemotherapy and a major risk factor for infection, which can be life-threatening. It has been hypothesised that a low bacterial diet (LBD) can prevent infection and (infection-related) mortality in cancer patients receiving chemotherapy that causes episode...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006247.pub3

    authors: van Dalen EC,Mank A,Leclercq E,Mulder RL,Davies M,Kersten MJ,van de Wetering MD

    更新日期:2016-04-24 00:00:00

  • Decision aids for people facing health treatment or screening decisions.

    abstract:BACKGROUND:Decision aids are interventions designed to help people make specific and deliberative choices among options (including status quo) by providing (at a minimum) information on the options and outcomes relevant to a person's health status. A systematic review is needed to summarize what is known about their ef...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001431

    authors: O'Connor AM,Stacey D,Rovner D,Holmes-Rovner M,Tetroe J,Llewellyn-Thomas H,Entwistle V,Rostom A,Fiset V,Barry M,Jones J

    更新日期:2001-01-01 00:00:00

  • T-tube drainage versus primary closure after open common bile duct exploration.

    abstract:BACKGROUND:Between 5% and 11% of people undergoing cholecystectomy have common bile duct stones. Stones may be removed at the time of cholecystectomy by opening and clearing the common bile duct. The optimal technique is unclear. OBJECTIVES:The aim is to assess the benefits and harms of T-tube drainage versus primary ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005640.pub3

    authors: Gurusamy KS,Koti R,Davidson BR

    更新日期:2013-06-21 00:00:00

  • Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension.

    abstract:BACKGROUND:Hypertension is a modifiable cardiovascular risk factor. Although it is established that low-dose thiazides reduce mortality as well as cardiovascular morbidity, the dose-related effect of thiazides in decreasing blood pressure has not been subject to a rigorous systematic review. It is not known whether ind...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003824.pub2

    authors: Musini VM,Nazer M,Bassett K,Wright JM

    更新日期:2014-05-29 00:00:00

  • Education for contraceptive use by women after childbirth.

    abstract:OBJECTIVES:Postpartum education on contraceptive use is a routine component of discharge planning in many different countries with a wide variety of health care systems. This education is based on assumptions concerning women's receptivity to contraceptive education during the postpartum period and their presumed lack ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001863

    authors: Hiller JE,Griffith E

    更新日期:2000-01-01 00:00:00

  • Public stewardship of private for-profit healthcare providers in low- and middle-income countries.

    abstract:BACKGROUND:Governments use different approaches to ensure that private for-profit healthcare services meet certain quality standards. Such government guidance, referred to as public stewardship, encompasses government policies, regulatory mechanisms, and implementation strategies for ensuring accountability in the deli...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009855.pub2

    authors: Wiysonge CS,Abdullahi LH,Ndze VN,Hussey GD

    更新日期:2016-08-11 00:00:00

  • Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures.

    abstract:BACKGROUND:Surgical site infection and other hospital-acquired infections cause significant morbidity after internal fixation of fractures. The administration of antibiotics may reduce the frequency of infections. OBJECTIVES:To determine whether the prophylactic administration of antibiotics in people undergoing surgi...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000244.pub2

    authors: Gillespie WJ,Walenkamp GH

    更新日期:2010-03-17 00:00:00

  • Early surfactant administration with brief ventilation vs selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome.

    abstract:BACKGROUND:Both prophylactic and early surfactant replacement therapy, compared with later selective surfactant administration, reduce mortality and pulmonary complications in ventilated infants with respiratory distress syndrome (RDS). However, continued post-surfactant intubation and ventilation are risk factors for ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003063.pub2

    authors: Stevens TP,Blennow M,Soll RF

    更新日期:2004-01-01 00:00:00

  • Antithrombotic drugs for carotid artery dissection.

    abstract:BACKGROUND:Extracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes, and the second leading cause of stroke in patients younger than 45 years of age. Antithrombotic agents (heparin, ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000255

    authors: Lyrer P,Engelter S

    更新日期:2000-01-01 00:00:00