Erasmus MC, Department of Epidemiology - Na2818, Postbus 2040, 3000 CA, -Rotterdam, The Netherlands.
Scand J Work Environ Health. 2018 Jul 1;44(4):414-422. doi: 10.5271/sjweh.3716. Epub 2018 Feb 13.
Objectives This study aims to evaluate the effectiveness of a "blended" workplace health-promotion intervention, alongside identification of key components beneficial for future implementation strategies. Methods Within a cluster randomized controlled trial, 491 employees at increased risk of cardiovascular disease were allocated to the limited (N=217; 9 clusters) or extensive (N=274; 8 clusters) intervention. The extensive intervention consisted of motivational interviewing (MI) within the framework of a web-based health risk assessment (HRA), a blended care approach. The limited intervention received solely the web-based HRA. Occupational health physicians (N=21) within three organizations delivered the intervention. Implementation components investigated included: HRA (reach and participation), newsletters (percentage read), and MI sessions (number and quality). MI quality was determined by scoring audiotaped MI sessions, using the MI treatment integrity code. After 6 and 12 months, effects on participation in health-promotion activities and its associations with components of implementation were determined by mixed-effects models. Results Over 80% of employees participated in health-promotion activities, with an additional 8% in the extensive compared to the limited group. In the extensive intervention, those with more or better quality MI sessions were more likely to participate in health-promotion activities. Increased MI quality was associated with sustained participation. Conclusions This study suggests that participation in health-promotion activities can be increased by adding MI to a web-based approach and improving the quality of the MI delivered. Interventions with MI should include optimized delivery and quality of MI sessions.
目的 本研究旨在评估“混合”工作场所健康促进干预的有效性，并确定对未来实施策略有益的关键组成部分。
方法 在一项集群随机对照试验中，491 名心血管疾病风险增加的员工被分配到有限（N=217；9 个群组）或广泛（N=274；8 个群组）干预组。广泛的干预措施包括在基于网络的健康风险评估（HRA）框架内进行动机访谈（MI），这是一种混合保健方法。有限的干预仅接受基于网络的 HRA。3 家机构的 21 名职业健康医生提供了干预措施。调查的实施内容包括：HRA（覆盖范围和参与度）、通讯（阅读百分比）和 MI 会议（次数和质量）。使用 MI 治疗完整性代码对录音 MI 会议进行评分，以确定 MI 质量。在 6 个月和 12 个月后，通过混合效应模型确定对健康促进活动参与度的影响及其与实施内容的关联。
结果 超过 80%的员工参与了健康促进活动，而广泛组比有限组多 8%。在广泛的干预中，接受更多或更好质量的 MI 会议的人更有可能参与健康促进活动。MI 质量的提高与持续参与有关。
结论 本研究表明，通过在基于网络的方法中添加 MI 并提高 MI 的质量，可以增加员工参与健康促进活动的积极性。具有 MI 的干预措施应包括优化 MI 会议的交付和质量。
