ABSTRACT
Purposes Intervention mapping (IM) is a protocol for developing effective behavior change interventions. It has been used for 10 years to develop work disability prevention (WDP) interventions, but it is not known to what extent and with what success. The main objective of this study was to review the effectiveness of these interventions. Secondary objectives were to review their fidelity to the IM protocol, their theoretical frameworks and their content. Methods A search strategy was conducted in MEDLINE, Web of Science, PsycINFO, Pascal, Francis, and BDSP. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by two reviewers blinded to each other. Results Eight WDP interventions were identified aimed at return to work (RTW; n = 6) and self-management at work (n = 2). RTW interventions targeted workers with stress-related mental disorders (n = 1), low back pain (n = 1), musculoskeletal disorders (n = 1), cancer (n = 2) and gynecological surgery (n = 1). The fidelity to the IM protocol was weaker for the participatory planning group. Matrices of change, change methods, and applications were systematically reported. The main theoretical frameworks used were the attitude-social influence-self efficacy model (n = 4) and the theory of planned behavior (n = 2). Half of the interventions included a workplace component (n = 4). Two interventions were reported as effective, and one partially effective. Conclusion The IM protocol is used in WDP since 2007. The participative dimension appears underused. Few theoretical frameworks were used. Implications are to better consider the stakeholders involvement, and mobilize theoretical frameworks with greater attempts to intervene on the work environment.
Subject(s)
Occupational Health , Return to Work , Sick Leave , Disabled Persons , Humans , Randomized Controlled Trials as Topic , Self Efficacy , Workplace/organization & administrationABSTRACT
The qualitative-quantitative study investigates the co-existence of barriers and levers to FOBT screening in 5894 individuals reluctant to be screened, identifying operational motivational patterns that may increase screening compliance. Co-occurrence analysis was performed according to three motivational conditions (barriers, levers, or both).Cluster analysis then identified motivational predictors of effective screening. One quarter of the individuals who had refused screening nevertheless expressed at least one motivation towards FOBT. As such, co-existence of barriers and levers within the same individual demonstrates ambivalence tendencies. Intrinsic motivations appear to be the most likely to increase FOBT compliance. This study finds that certain factors well-known to improve CRC screening compliance generally, may not have much impact on reluctant individuals due to ambivalence and contextual nuances. Several practical recommendations to encourage screening participation are offered, such as focusing on levers rather barriers, providing tailored education to improve awareness and readiness, and fostering intrinsic motivation with relevant approaches.
Subject(s)
Decision Making , Early Detection of Cancer , Motivation , Occult Blood , Patient Compliance/psychology , Aged , Colorectal Neoplasms/diagnosis , Female , Humans , Male , Mass Screening/methods , Mass Screening/psychology , Middle Aged , Patient Education as TopicABSTRACT
BACKGROUND: Health promotion programs are expected to improve population health and reduce social inequalities in health. However, their theoretical foundations are frequently ill-defined, and their implementation faces many obstacles. The aim of this article is to describe the intervention mapping protocol in health promotion programs planning, used recently in several countries. METHODS: The challenges of planning health promotion programs are presented, and the six steps of the intervention mapping protocol are described with an example. Based on a literature review, the use of this protocol, its requirements and potential limitations are discussed. RESULTS: The intervention mapping protocol has four essential characteristics: an ecological perspective (person-environment), a participative approach, the use of theoretical models in human and social sciences and the use of scientific evidence. It comprises six steps: conduct a health needs assessment, define change objectives, select theory-based change techniques and practical applications, organize techniques and applications into an intervention program (logic model), plan for program adoption, implementation, and sustainability, and generate an evaluation plan. This protocol was used in different countries and domains such as obesity, tobacco, physical activity, cancer and occupational health. Although its utilization requires resources and a critical stance, this protocol was used to develop interventions which efficacy was demonstrated. CONCLUSION: The intervention mapping protocol is an integrated process that fits the scientific and practical challenges of health promotion. It could be tested in France as it was used in other countries, in particular to reduce social inequalities in health.
Subject(s)
Geographic Mapping , Health Plan Implementation , Health Promotion/methods , Health Promotion/organization & administration , Program Development , Program Evaluation , France , Health Plan Implementation/methods , Health Plan Implementation/organization & administration , Health Plan Implementation/standards , Humans , Needs Assessment , Program Development/methods , Program Development/standards , Program Evaluation/methods , Program Evaluation/standardsABSTRACT
OBJECTIVES: The pre-return-to-work medical consultation during sick leave for low back pain (LBP) aims at assessing the worker's ability to resume working without risk for his/her health, and anticipating any difficulties inherent to returning to work and job retention. This article summarizes the good practices guidelines proposed by the French Society of Occupational Medicine (SFMT) and the French National Health Authority (HAS), and published in October 2013. METHODS: Good practices guidelines developed by a multidisciplinary and independent task force (24 experts) and peer review committee (50 experts) based on a literature review from 1990 to 2012, according to the HAS methodology. RESULTS: According to the labour regulations, workers can request a medical consultation with their occupational physician at any time. The pre-return-to-work consultation precedes the effective return-to-work and can be requested by the employee regardless of their sick leave duration. It must be scheduled early enough to: (i) deliver reassuring information regarding risks to the lower back and managing LBP; (ii) evaluate prognostic factors of chronicity and prolonged disability in relations to LBP and its physical, social and occupational consequences in order to implement the necessary conditions for returning to work; (iii) support and promote staying at work by taking into account all medical, social and occupational aspects of the situation and ensure proper coordination between the different actors. CONCLUSION: A better understanding of the pre-return-to-work consultation would improve collaboration and coordination of actions to facilitate resuming work and job retention for patients with LBP.
Subject(s)
Low Back Pain/rehabilitation , Practice Guidelines as Topic , Return to Work , Work Capacity Evaluation , Consensus , Humans , Referral and ConsultationABSTRACT
OBJECTIVES: To describe and evaluate prescriptions of sick leave by urology surgeons for different kinds of interventions. METHODS: Between January and April 2006, a web-based survey was completed by urology surgeons on a voluntary basis. The analyzed data pertained to personal characteristics of the surgeons, mean duration of sick leave for 15 interventions and the type of job of the patient (strenuous or not). Analyses were performed with software SAS™ version 9.2. Descriptive analyses were performed and Kruskal-Wallis test was used to search for statistically significant differences between variables (p<0,05). RESULTS: One hundred and forty-eight surgeons were involved and 145 answers could be analyzed. Mean age of the surgeons was 46,3±9,4years. Urology surgeons were in the public sector (n=73/140; 52%), in private practice (n=43/140; 31%) or both (n=24/140; 17%). Kruskal-Wallis test showed that all patients who had a job considered as strenuous had significantly longer sick leave prescriptions. Younger surgeons (under 40) used to prescribe shorter sick leaves than their older counterparts. CONCLUSION: Sick leave prescriptions of the urology surgeons were globally homogeneous in this survey. Only a few interventions were the occasion of discordant prescriptions depending upon the age or practice (public/private) of the surgeons. Several hypotheses could be further explored as regard the source of variation in sick leave prescriptions. These results are usable for those stakeholders who are interested in continuous medical education and evaluation.
Subject(s)
Practice Patterns, Physicians' , Sick Leave/statistics & numerical data , Urology , France , Humans , Middle Aged , Surveys and QuestionnairesABSTRACT
Among the causes of mortality observed in the elderly population between 65 years and 80 years, the specific mortality rate related to AAA has been rising for several years. The interest of screening programs has been demonstrated and elective surgery is likely to reduce the incidence of rupture in at risk patients. This prospective study will allow us to know the prevalence of AAA in our country. A screening program will be set up with general practitioners and elective surgery will be proposed according to the diameter of the aorta. Cost-effectiveness of this program will be assessed. Improvement of life expectancy will be measured.
