Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.
BMC Public Health. 2022 May 11;22(1):947. doi: 10.1186/s12889-022-13230-9.
Sedentary behavior is associated with an increased risk of morbidity and mortality. To reduce occupational sitting time of office workers, the multi-component intervention 'Dynamic Work' was implemented in a Dutch insurance company. Although the results showed no significant reductions in sitting time, associations were found between higher levels of implementation and reductions in sitting time. Building upon these findings, this qualitative study aimed to identify barriers and facilitators from an organizational perspective for the implementation of Dynamic Work. In addition, we explored differences in barriers and facilitators between departments with a low, middle and high level of implementation.
In total, eighteen semi-structured interviews were conducted with two Dynamic Work coordinators, three occupational physiotherapists who delivered the intervention, and thirteen department managers. All participants were purposively sampled. The data was coded in Atlas.ti and a thematic analysis was performed guided by The Integrated Checklist of Determinants (TICD).
Implementation factors were related to the organization; working culture and financial support facilitated implementation. Factors related to the implementing department mainly hindered implementation, i.e. lack of information at start of the project, late delivery of Dynamic Work equipment, large group sizes, employee's workload and work tasks, and an ongoing reorganization. The facilitating role of managers was experienced as both enabling and hindering. The pre-existing familiarity of the occupational physiotherapists with the departments and alignment amongst the three implementers facilitated implementation. Yet, the non-obligatory nature of the intervention as well as limited availability and technical problems of equipment did not support implementation.
Various barriers and facilitators influenced the implementation of the Dynamic Work intervention, where the key role of the department manager, late delivery of dynamic work equipment and groups sizes varied between low and high implementing departments. These results can contribute to developing and improving implementation strategies in order to increase the effectiveness of future occupational health interventions.
The study protocol was registered on April 14, 2017 in the ClinicalTrials.gov Protocol Registration and Results System under registration number NCT03115645 .
久坐行为与发病率和死亡率的增加有关。为了减少上班族的职业久坐时间，多组分干预措施“动态工作”在一家荷兰保险公司实施。尽管结果显示久坐时间没有显著减少，但在更高的实施水平与减少久坐时间之间存在关联。基于这些发现，本定性研究旨在从组织角度确定“动态工作”实施的障碍和促进因素。此外，我们还探讨了在实施水平较低、中等和较高的部门之间，障碍和促进因素的差异。
总共对两位“动态工作”协调员、三位实施干预措施的职业理疗师和 13 位部门经理进行了 18 次半结构化访谈。所有参与者均采用目的抽样法选取。数据在 Atlas.ti 中进行编码，并根据《综合决定因素清单》（TICD）进行主题分析。
实施因素与组织有关；工作文化和财务支持促进了实施。与实施部门相关的因素主要阻碍了实施，即项目启动时信息缺乏、“动态工作”设备延迟交付、员工工作量和工作任务大，以及正在进行的重组。经理的促进作用被认为既有促进作用，也有阻碍作用。职业理疗师对部门的预先熟悉程度以及三位实施者之间的一致性促进了实施。然而，干预措施的非强制性性质以及设备的有限可用性和技术问题并没有支持实施。
各种障碍和促进因素影响了“动态工作”干预措施的实施，其中部门经理的关键作用、“动态工作”设备的延迟交付以及群体规模在低实施部门和高实施部门之间存在差异。这些结果可以为制定和改进实施策略提供参考，以提高未来职业健康干预措施的效果。
该研究方案于 2017 年 4 月 14 日在 ClinicalTrials.gov 协议注册和结果系统中注册，注册编号为 NCT03115645。
