Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China.
Front Public Health. 2022 Jul 11;10:772632. doi: 10.3389/fpubh.2022.772632. eCollection 2022.
While the effectiveness of several occupational healthcare interventions has been demonstrated, successful implementation of such programs among internal migrant workers (IMWs) in small and medium-sized enterprises (SMEs) has been limited. This study aimed to evaluate the implementation of a three-arm cluster randomized controlled trial promoting respiratory protective equipment (RPE) use among IMWs exposed to organic solvents in SMEs and to assess the association between participants' compliance and effectiveness of intervention.
A total of 60 SMEs were randomly allocated to a low- or high-intensive intervention group, or a control group that did not receive any intervention. The low-intensive intervention group was subjected to both traditional and mHealth occupational health education. The high-intensive intervention group was subjected to the low-intensive group activities and peer education. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide implementation evaluation of this 6-months intervention. Generalized linear mixed models (GLMMs) were used to evaluate the effects of participants' compliance with the intervention on the primary outcomes, regarding the appropriate use of RPE.
Of 4,527 potentially eligible participants, 1,211 individuals were enrolled, with a reach rate of 26.8%. Sixty of the 66 SMEs approached (90.9%) SMEs adopted the intervention. Fidelity to traditional education (100.0%) and mHealth intervention (97.5%) was higher than fidelity to peer education (20.0%). Peer leaders cited inconvenient time and unfamiliarity with peers as two major barriers to delivering peer education. Compared with the control group, IMWs who complied with the interventions in both groups were more likely to wear RPE appropriately [low-intensive group: adjusted odds ratio (aOR) = 2.58, 95% confidence interval (CI): 1.56-4.28; high-intensive group: aOR = 7.52, 95% CI: 3.72-15.23]. Most participants (95.8%) were satisfied with the program and 93.1% stated that they would maintain the use of RPE in the future.
A multi-component occupational health intervention to promote the use of RPE among IMWs in SMEs was feasible and acceptable. Peer education had great potential to enhance the occupational health behavior of IMWs, and thus strategies to improve participants' adherence to this component warrant further investigation.
http://www.chictr.org.cn, identifier: ChiCTR-IOR-15006929.
虽然已经证明了几种职业保健干预措施的有效性，但在中小企业 (SMEs) 中的内部移民工人 (IMWs) 中成功实施这些计划的效果有限。本研究旨在评估一项三臂群组随机对照试验的实施情况，该试验旨在促进接触 SME 中有机溶剂的 IMW 使用呼吸保护设备 (RPE)，并评估参与者的依从性与干预效果之间的关联。
总共 60 家中小企业被随机分配到低或高密集干预组，或不接受任何干预的对照组。低密集干预组接受传统和移动健康职业健康教育。高密集干预组接受低密集组活动和同伴教育。采用扩展、有效性、采纳、实施和维持 (RE-AIM) 框架来指导这 6 个月干预的实施评估。使用广义线性混合模型 (GLMM) 评估参与者对干预的依从性对主要结果的影响，主要结果是关于适当使用 RPE。
在 4527 名潜在合格参与者中，有 1211 人入选，覆盖率为 26.8%。接触的 66 家中小企业中的 60 家 (90.9%) 中小企业采用了干预措施。传统教育 (100.0%) 和移动健康干预 (97.5%) 的保真度高于同伴教育 (20.0%)。同伴领袖指出，时间不方便和不熟悉同伴是开展同伴教育的两个主要障碍。与对照组相比，两组中遵守干预措施的 IMW 更有可能正确佩戴 RPE[低密集组：调整后的优势比 (aOR)=2.58，95%置信区间 (CI)：1.56-4.28；高密集组：aOR=7.52，95%CI：3.72-15.23]。大多数参与者 (95.8%) 对该计划表示满意，93.1% 表示将来会继续使用 RPE。
一项针对中小企业中 IMW 促进使用 RPE 的多组分职业健康干预措施是可行且可接受的。同伴教育有可能增强 IMW 的职业健康行为，因此进一步研究提高参与者对这一组成部分的依从性的策略是值得的。
