A study protocol of the adaptation and evaluation by means of a cluster-RCT of an integrated workplace health promotion program based on a European good practice

Abstract

Background An integrated workplace health promotion program (WHPP) which targets multiple lifestyle factors at different levels (individual and organizational) is potentially more effective than a single component WHPP. The aim of this study is to describe the protocol of a study to tailor a European good practice of such an integral approach to the Dutch context and to evaluate its effectiveness and implementation. Methods This study consists of two components. First, the five steps of the Map of Adaptation Process (MAP) will be followed to tailor the Lombardy WHP to the Dutch context. Both the employers and employees will be actively involved in this process. Second, the effectiveness of the integrated Dutch WHPP will be evaluated in a clustered randomized controlled trial (C-RCT) with measurements at baseline, 6 months and 12 months. Clusters will be composed based on working locations or units - dependent on the organization’s structure and randomization within each organization takes place after baseline measurements. Primary outcome will be a combined lifestyle score. Secondary outcomes will be the separate lifestyle behaviors targeted, stress, work-life balance, need for recovery, general health, and well-being. Simultaneously, a process evaluation will be conducted. The study population will consist of employees from multiple organizations in different industry sectors. Organizations in the intervention condition will receive the integrated Dutch WHPP during 12 months, consisting of an implementation plan and a catalogue with activities for multiple lifestyle themes on various domains: 1) screening and support; 2) information and education; 3) adjustments in the social, digital or physical environment; and 4) policy. Discussion The MAP approach provides an appropriate framework to systematically adapt an existing WHPP to the Dutch context, involving both employers and employees and retaining the core elements, i.e. the catalogue with evidence-based activities on multiple lifestyle themes and domains enabling an integrated approach. The following process and effect evaluation will contribute to further insight in the actual implementation and effectiveness of the integrated WHP approach. Trial registration NTR (trialregister.nl), NL9526. Registered on 3 June 2021.

Evaluating the Impact of Digital Health Interventions on Workplace Health Outcomes: A Systematic Review

“…Simons et al's (2015) study from the Netherlands may offer a more controlled setting with its RCT involving Delft University employees, while Kowalski et al's (2024) Swedish study shines through its large sample of 1267 healthcare workers, who partook in a mHealth stress-management study. The Dutch protocol of study by Smit et al (2022) cut across sectors, where employees working in organizations that were completely unrelated to each other engaged with a workplace health promotion program. Appraising the EMPOWER intervention in their protocols of studies, Olaya et al (2022) Therefore, the varying layers of employment, as well as sectors and even national contexts indicated by these sets of characteristics, demonstrate the potential capacity for digital health interventions but also underline both their likely appeal to a broad audience on the basis of the problems they help solve and the particular adaptability such solutions are expected to possess in order to conform to a wide range of occupational health needs.…”

“…Simons et al (2015) created a clear RCT structure with the effect that this reduces likely attrition, though self-selection issues combined with reliance on self-reporting may have skewed dropout rates. Smit et al (2022) and Olaya et al (2022) conducted research on the workplace health promotion program evaluation and assessment of eHealth intervention effectiveness without reporting details of attrition, which are often overlooked in the reports published. Thomson et al (2023) reported recruitment participation from 24 organizations and data received from 224 line managers for analysis, indicating reasonable participation rates, but the attrition rates were not specified.…”

Barriers and facilitators for participation in workplace health promotion programs: results from peer-to-peer interviews among employees

“…The integrated WHPP to be implemented exists of (1) a catalogue with health promoting activities on multiple levels (individual and organizational) and multiple lifestyle themes (physical activity, nutrition, relaxation, smoking, work-life balance, alcohol consumption, stress and sleep) and (2) an implementation plan to support successful implementation (Smit et al 2022). The choice for these lifestyle themes was based on relevance according to both employers and employees.…”

“…This study was embedded in a larger study in which an integrated WHPP will be developed, implemented and evaluated (Smit et al 2022). Organizations that will participate in the cluster randomized controlled trial (c-RCT) to evaluate the integrated WHPP were recruited trough the network of the research team, co-workers and branch specific networks and platforms.…”

“…This study was conducted during the development of an integrated WHPP in which a good example of a successful integrated WHPP, the Lombardy WHP Network (LWHPN), was tailored to the Dutch context (Smit et al 2022). The LWHPN is recognized as a good practice in the occupational setting in the European Joint Action CHRODIS because of its integrated approach and successful implementation (CHRODIS 2014;Coppola et al 2016;Public Health Best Practice Portal 2020).…”