Effects of web-based supervisor training on job stressors and psychological distress among workers: a workplace-based randomized controlled trial

Using workplaces as a unit for randomization, a randomized controlled trial was conducted to determine the effects of web-based supervisor training on the subject of worksite mental health on job stressors, supervisor support and psychological distress among subordinate workers. A total of eight workplaces of a sales and service company were randomly assigned to either training workplaces or non-training workplaces. Supervisors (n=23) at the training workplaces participated in web-based self-learning training on worksite mental health; supervisors (n=23) at the non-training workplaces did not. A total of 81 subordinate workers under the trained supervisors (the intervention group) and 108 subordinate workers under the non-trained supervisors (the control group) completed the Brief Job Stress Questionnaire (BJSQ) at baseline and at a three-month follow-up. No significant intervention effect was observed for any scale of the BJSQ measuring job stressors, supervisor or coworker support, or psychological distress among subordinate workers (p<0.05). The item score of work autonomy changed very little in the intervention group, while it decreased in the control group during the follow-up period, yielding a significant intervention effect (p=0.02). The item score for a friendly atmosphere in the workplace increased in the intervention group, while the score remained stable in the control group, yielding a significant intervention effect (p=0.02). While the present study failed to show any clear effect of the web-based training of supervisors on reduction of job stressors, it may be useful for maintaining worker autonomy and improving the friendliness of the worksite atmosphere.     

Reducing occupational psychological distress: a randomized controlled trial of a mailed intervention

There are increasing levels of psychological distress among general practitioners (GPs). The purpose of this study is to evaluate the effectiveness of a mailed intervention to reduce distress among 'at-risk' GPs. A questionnaire was sent to 1356 GPs from eight Divisions of General Practice. Out of 819 (60%) who responded, 233 GPs were recruited with scores indicative of psychological distress. These GPs were randomized to intervention (n = 120) or control (n = 113). The intervention consisted of a simple letter feeding back and interpreting the psychological score together with a self-help sheet. During the study, an educational program was offered to GPs by Divisions of General Practice. The main outcome measure used was changes in psychological distress (General Health Questionnaire 12) score after 3 months. Significance was set at P < 0.05. Initial analysis of the data showed borderline significance (P = 0.05). However, analysis of the data post hoc excluding GPs who participated in the educational program showed a significant reduction in psychological distress (P = 0.03). It appears that there may have been a dilution of the intervention effect. Mailed interventions are a cost-effective way of reaching at-risk GPs and may contribute to a reduction in psychological morbidity.     

Effects of the job stress education for supervisors on psychological distress and job performance among their immediate subordinates: a supervisor-based randomized controlled trial

As job stress is now one of the biggest health-related problems in the workplace, several education programs for supervisors have been conducted to reduce job stress. We conducted a supervisor-based randomized controlled trial to evaluate the effects of an education program on their subordinates' psychological distress and job performance. The subjects were 301 employees (46 supervisors and 255 subordinates) in a Japanese sake brewery. First, we randomly allocated supervisors to the education group (24 supervisors) and the waiting-list group (22 supervisors). Then, for the allocated supervisors we introduced a single-session, 60-min education program according to the guidelines for employee mental health promotion along with training that provided consulting skills combined with role-playing exercises. We conducted pre- and post-intervention (after 3 months) surveys for all subordinates to examine psychological distress and job performance. We defined the intervention group as those subordinates whose immediate supervisors received the education, and the control group was defined as those subordinates whose supervisors did not. To evaluate the effects, we employed a repeated measures analysis of variance (ANOVA). Overall, the intervention effects (time x group) were not significant for psychological distress or job performance among both male (p=0.456 and 0.252) and female (p=0.714 and 0.106) subordinates. However, young male subordinates engaged in white-collar occupations showed significant intervention effects for psychological distress (p=0.012) and job performance (p=0.029). In conclusion, our study indicated a possible beneficial effect of supervisor education on the psychological distress and job performance of subordinates. This effect may vary according to specific groups.     

Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial

Purpose

The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders (WUEMSDs) among computer workers.

Methods

Four hundred computer workers answered a questionnaire on work-related upper extremity musculoskeletal symptoms (WUEMSS). Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospective, randomized controlled 6-month intervention. Body posture and workstation layouts were assessed by the Ergonomic Questionnaire. We used the Visual Analogue Scale to assess the intensity of WUEMSS. The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities. Health-related quality of life was assessed with the Short Form-36. After baseline assessment, those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions, an ergonomic training brochure, and workplace visits with workstation adjustments. Follow-up assessment was conducted after 6 months.

Results

In the intervention group, body posture (p < 0.001) and workstation layout (p = 0.002) improved over 6 months; furthermore, intensity (p < 0.001), duration (p < 0.001), and frequency (p = 0.009) of WUEMSS decreased significantly in the intervention group compared with the control group. Additionally, the functional status (p = 0.001), and physical (p < 0.001), and mental (p = 0.035) health-related quality of life improved significantly compared with the controls. There was no improvement of work day loss due to WUEMSS (p > 0.05).

Conclusions

Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs.     

Promoting uptake of influenza vaccination among health care workers: a randomized controlled trial

In a randomized controlled trial, an intensive promotional campaign failed to increase the uptake of vaccination against influenza among health care workers. The uptake of vaccination was low.     

Effects of web-based psychoeducation on self-efficacy, problem solving behavior, stress responses and job satisfaction among workers: a controlled clinical trial

This study examined effects of web-based psychoeducation on self-efficacy, problem solving behavior, stress responses and job satisfaction. The program was based on social cognitive theory and was primarily aimed at increasing knowledge of stress, self-efficacy, and the use of problem solving behavior. A total of 225 employees were invited to participate in the study. Participants were assigned to an intervention (n=112) or waiting list control group (n=113). Those in the intervention group were asked to access the website and to complete learning within 1 month. To investigate the intervention effect, the change score in the outcome variable was calculated by subtracting the score at pre-intervention from that at post-intervention (1 week after completion of the learning period). Then, the difference in the scores between groups was examined using analyses of covariance (ANCOVA) with the pre-intervention score as the covariate. We detected a marginally significant difference between groups in changes in job satisfaction from pre- to post-intervention (p=0.081). Participants in the intervention group showed an increase in job satisfaction score, while those in the waiting list control group showed a decrease in it. No significant differences were detected between groups in the other indicators (p>.10). We detected significant or marginally significant intervention effects on self-efficacy, problem solving behavior, stress responses, and job satisfaction among males and younger individuals, and those who had initially higher job strain and higher interest in managing stress. Further research is required with longer time periods (controlled follow-up) and a broader sample to fully determine the intervention effect.     

Effects of exercise training on physical activity in older people: a randomized controlled trial

BACKGROUND: Recent randomized controlled trials indicated that exercise training for elderly significantly increased their physical fitness. However, very few studies have examined changes in physical activity after exercise training. The purpose of this study was to investigate whether six-month exercise training for older adults can increase and maintain their physical activity in daily life. METHODS: Sixty-two men and women aged 60 to 81 years (mean age 67.1 years), living in communities, were randomly allocated into an exercise group (n = 32) or a control group (n = 33). The intervention started in April 1998 and lasted for 25 weeks. The exercise regimen consisted of endurance training and resistance exercises in a two-hour class conducted at least twice a week. The subjects completed a physical activity diary at each pre-intervention (March 1998), post-intervention (September 1998) and follow-up (April 1999) measurement of physical activity. Physical activity, expressed as total daily energy expenditure, was calculated by multiplying the amount of time spent in each activity and the corresponding METs. RESULTS: Total daily energy expenditure significantly increased from 40.8 kcal/kg/day to 43.5 kcal/kg/day in the exercise group (p = 0.03), but did not change in the control group. At the follow-up measurement, the mean total daily energy expenditure in the exercise group remained significantly higher, by 1.7 kcal/kg/day, than that at the pre-intervention (p = 0.05). CONCLUSIONS: This randomized controlled trial indicated that exercise training for elderly was effective in increasing physical activity in daily life.     

Nurse-led adherence support in hypertension: a randomized controlled trial

BACKGROUND: Lack of medication adherence is a common reason for poor control of blood pressure in the community, increasing the risk of heart attacks and strokes. OBJECTIVE: To evaluate the effect of nurse-led adherence support for people with uncontrolled high blood pressure compared with usual care. METHODS: We recruited 245 women and men with uncontrolled hypertension (> or = 150/90 mmHg) from 21 general practices in Bristol, UK. Participants were randomized to receive nurse-led adherence support or usual care alone. Main outcome measures were adherence to medication ('timing compliance') and blood pressure. RESULTS: Mean baseline timing compliance (+/- SD) was high in both the intervention (90.8 +/- 15.6%) and the control group (94.5 +/- 7.6%). There was no evidence of an effect of the intervention on timing compliance at follow-up (adjusted difference in means -1.0%; 95% confidence interval (CI) -5.1 to 3.1). There was also no difference at follow-up between the groups with regard to systolic blood pressure (-2.7 mmHg; 95% CI -7.2 to 1.8) or diastolic blood pressure (0.2 mmHg; 95% CI -1.9 to 2.3). Projected costs for the primary care sector per consultation were 6.60 pound sterling for the intervention compared with 5.08 pound sterling for usual care. CONCLUSION: In this study, adherence to blood pressure medication was much higher than previously reported. There was no evidence of an effect of nurse-led adherence support on medication adherence or blood pressure compared with usual care. Nurse-led adherence support was also more expensive from a primary care perspective.     

Effects of a brief worksite stress management program on coping skills, psychological distress and physical complaints: a controlled trial

Objectives: To examine the effects of single-session, small-group stress management program on knowledge about stress, coping skills, and psychological and physical distress. Methods: A total of 300 employees from a company in western Japan were invited to participate in the study. Those who consented to enter the study were assigned to an intervention (n=149) or waiting list control group (n=151). Participants in the intervention group received a small-group stress management program. The program was primarily aimed at increasing knowledge about stress and improving coping skills. To investigate the intervention effect, change scores in outcome variables were calculated by subtracting the scores at pre-intervention from those at post-intervention (8 weeks after the pre-intervention survey). Next, the difference in the scores between groups was examined using analyses of covariance (ANCOVA) with the pre-intervention score as the covariate. Results: Favorable intervention effects were found on knowledge about stress and on coping skills (P<0.001 and P=0.012, respectively) and adverse effects on psychological distress (P=0.022). However, this adverse effect on psychological distress did not exist among those who initially perceived higher levels of job control. Conclusion: The single-session stress management program was effective on improving knowledge about stress, and coping skills, where job control moderated the effect of the program on psychological distress.     

Myofeedback training and intensive muscular strength training to decrease pain and improve work ability among female workers on long-term sick leave with neck pain: a randomized controlled trial

Abstract  

The theoretical framework is that muscle tension in the neck is related to insufficient muscular rest and is a risk factor for chronic pain and reduced work ability. Promoting muscle strength and muscle rest may increase work ability and reduce neck pain.     

Effects of sleep hygiene education and behavioral therapy on sleep quality of white-collar workers: a randomized controlled trial

Because poor sleep quality can reduce quality of life and increase prevalence of illness in workers, interventions are becoming increasingly important for businesses. To evaluate how sleep quality is affected by one-on-one behavioral modification when combined with group education, we conducted a randomized, controlled trial among day-shift white-collar employees working for an information-technology service company in Japan. Participants were randomly allocated to groups receiving either sleep hygiene group education (control group), or education combined with individual sleep modification training (one-on-one group). Occupational health professionals carried out both procedures, and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). PSQI scores were obtained before and after the intervention period, and changes in scores were compared across groups after adjustments for age, gender, job title, smoking and drinking habits, body-mass index, and mental health as assessed using K6 scores. The average PSQI score for the control group decreased by 0.8, whereas that of the one-on-one group decreased by 1.8 (difference of 1), resulting in a significantly greater decrease in score for the one-on-one group (95% confidence interval: 0.02 to 2.0). These results show that, compared to sleep hygiene group education alone, the addition of individual behavioral training significantly improved the sleep quality of workers after only three months.     

Service learning in medical and nursing training: a randomized controlled trial

The purpose of this study was to explore the long term effect of a service learning project on medical and nursing students' knowledge in aging and their attitudes toward older adults. A total of 124 students were recruited and then randomized to intervention group (IG) and control group (CG). A pre-and-post-intervention design measured students' knowledge in aging (using modified Palmore's Fact on Aging Quiz) and attitudes toward older adults (using Kogan's Old People Scale). A total of 103 students completed all the activities and questionnaires. After the intervention, there were significant differences between the IG and CG on Palmore's mental health (MH) (P = .04), Palmore's total score (P = .02) and Kogan's negative attitudes toward older adults (P = .001). All students increased their positive attitude toward older adults after the intervention. However, both the IG and CG showed a decrease in positive attitudes 1 month after the interventon, and such decrease varied, depending on the programme which students attended. The current study showed that the 10-week service learning activities significantly increased medical and nursing students' overall knowledge of aging and their understanding of mental health needs in old age, and reduced their negative attitudes toward older adults. However, the effect is not long-lasting. On the other hand, its effect on positive attitudes toward older adults cannot be concluded. Periodic contacts with older adults via service learning activities may be needed to sustain attitude change toward older adults.     

Effects of mailed advice on stress reduction among employees in Japan: a randomized controlled trial.

We conducted a randomized controlled trial (RCT) to examine the effects of mailed advice on reducing psychological distress, blood pressure, serum lipids, and sick leave of workers employed in a manufacturing plant in Japan. Those who indicated higher psychological distress (defined as having GHQ scores of three or greater) in the baseline questionnaire survey (n = 226) were randomly assigned to an intervention group or a control group. Individualized letters were sent to the subjects of the intervention group, informing them of their stress levels and recommending an improvement in daily habits and other behaviors to reduce stress. Eighty-one and 77 subjects in the intervention and control groups, respectively, responded to the one-year follow-up survey. No significant intervention effect was observed for the GHQ scores, blood pressure, serum lipids, or sick leave (p > 0.05). The intervention effect was marginally significant for changes in regular breakfasts and daily alcohol consumption (p = 0.09). The intervention effect was marginally significant for the GHQ scores among those who initially did not eat breakfast regularly (p = 0.06). The study suggests that only sending mailed advice is not an effective measure for worksite stress reduction. Mailed advice which focuses on a particular subgroup (e.g., those who do not eat breakfast regularly) may be more effective.     

Two-year outcome of coping skills training, group support and information for spouses of alcoholics: a randomized controlled trial

AIM: To evaluate three different intervention programmes for spouses of alcoholics. METHODS: 39 spouses of alcoholics (36 women and 3 men) with an average age of 47 years (ranging from 23 to 60 years) were randomly assigned to one of the three interventions: Coping Skills Training, Group Support, and Information. Follow-up interviews were conducted 12 and 24 months after completing the programme. Coping Behaviour Scale, Symptom Checklist 90 (SCL-90), Hardship Scale and AUDIT at admission and at follow-up were compared. 38 of the 39 spouses completed the 24-month follow-up examination. RESULTS: Improvements of coping behaviour, psychiatric symptoms and hardship noted at the 12-month follow-up examination were still evident in all groups at the 24-month follow-up examination. The three groups scored similarly at 24 months on the four scales. CONCLUSIONS: A post hoc examination of subjects with SCL-90 scores above general population means, showed less improvement in the Information group than the two therapy groups combined (P < 0.05).