Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest-Posttest Study

BACKGROUND: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. METHODS: We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. RESULTS: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). CONCLUSION: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

EBM E-learning: Feasible and Effective for Occupational Physicians in Different Countries

OBJECTIVES: Although evidence-based medicine (EBM) is a useful method for integrating evidence into the decision-making process of occupational physicians, occupational physicians lack EBM knowledge and skills, and do not have the time to learn the EBM method. In order to enable them to educate themselves at the time and place they prefer, we designed an electronic EBM course. We studied the feasibility and utility of the course as well as its effectiveness in increasing EBM knowledge, skills, and behaviour. METHODS: Occupational physicians from various countries were included in a within-subjects study. Measurements were conducted on participants' EBM knowledge, skills, behaviour, and determinants of behaviour at baseline, directly after finishing the course and 2 months later (n = 36). The feasibility and utility of the course were evaluated directly after the course (n = 42). RESULTS: The course is applicable as an introductory course on EBM for occupational physicians in various countries. The course is effective in enhancing EBM knowledge and self-efficacy in practising EBM. No significant effect was found on EBM skills, behaviour, and determinants of behaviour. After the course, more occupational physicians use the international journals to solve a case. CONCLUSION: An electronic introductory EBM course is suitable for occupational physicians. Although it is an effective method for increasing EBM knowledge, it does not seem effective in improving skills and behaviour. We recommend integrating e-learning courses with blended learning, where it can be used side by side with other educational methods that are effective in changing behaviour.