Karin Ingeborg Proper

Objective: Although the impact of menopausal symptoms at work is increasingly recognized, it remains unclear to what extent and with whom menopausal symptoms that limit work functioning are discussed. We examined this and explored associations with taboo, symptom severity, and need for recovery. Methods: Cross-sectional data of 9,977 perimenopausal and postmenopausal women from the Dutch Lifelines cohort were used. In 2024, participants reported on experiencing and discussing menopausal symptoms that limit work functioning, perceived taboo, and the need for recovery. Descriptive statistics were used to examine how often symptoms were discussed and with whom (colleagues, supervisors, [occupational] professionals), and regression analyses were used to explore associations with taboo, symptom severity, and need for recovery. Results: In total, 36.7% of women reported limitations in work functioning due to menopausal symptoms. Among them, 45.5% did not discuss their symptoms at work. Women with limitations who did not discuss their symptoms were more likely to perceive talking about menopause at work as taboo than women without limitations, particularly those who felt the need to talk about it but did not (odds ratio: 5.12, 95% confidence interval: 3.54-7.41). This last subgroup, together with women with limitations who discussed their symptoms with an (occupational) professional, experienced the highest symptom severity and need for recovery. Conclusions: Of perimenopausal and postmenopausal women who report work limitations due to menopausal symptoms, nearly half did not discuss these symptoms at work. The perceived taboo among women who did not discuss symptoms highlights the importance of an open workplace culture and accessible support to promote work participation during menopause.

Healthcare workers (HCWs) report burnout complaints more often than the general workforce, leading to reduced quality of life and delivered care, high abse

Objectives: To support occupational physicians (OPs) in the execution of preventive tasks, a peer coaching intervention was developed and implemented in existing peer groups. The aim of this study was to examine the effects of the intervention on OPs’ execution of preventive tasks in practice. Methods: A total of 41 peer groups, including 231 OPs, participated in this cluster randomised controlled trial, of which 21 groups were assigned to the intervention group (N=106) and 20 to the control group (N=125). The intervention consisted of three peer coaching meetings aimed to promote the execution of preventive tasks. Data regarding the execution of preventive tasks, measured as percentage of their working time and hours allocated to specific preventive tasks, were collected at baseline, 6-month and 12-month follow-up. The effect of the intervention was examined by linear multilevel analysis. Results: Both the intervention and control group increased the percentage of working time allocated to prevention, from 14% at baseline to 17% at 12-month follow-up, but no significant differences between the study groups were found. For specific preventive tasks, the intervention group increased their time allocated to giving secondary prevention advice by 5 monthly hours compared with baseline. Conclusions: The intervention was found not to have an effect on the percentage of working time allocated to prevention, possibly due to contextual factors. However, intervention effects were found for giving secondary preventive advice. Future studies should focus on the willingness of employers and occupational health and safety to invest in prevention and refinement of the intervention under study. Trial registration number: ISRCTN15394765 .

This systematic review examined the impact of unemployment and re-employment on mental health problems (depression, anxiety and psychological distress) among working-age adults. We searched MEDLINE, Embase, APA PsycINFO and Web of Science (January 2012–March 2024) and included studies from a prior meta-analysis (1990–2012). Risk of bias was assessed using the Newcastle-Ottawa Scale. We conducted random-effects meta-analyses and narrative synthesis and evaluated the certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Of 9328 search records, 38 prospective longitudinal studies met the inclusion criteria (27 from 2012–2024 and 11 from 1990–2012). A pooled standardised mean difference (SMD, Cohen’s d) of 0.19 (95% CI 0.08 to 0.30, I²=88.7%) indicated increased symptom levels among the unemployed compared with those regularly employed. Similarly, pooled effect estimates indicated reduced symptoms after re-employment, with a stronger effect observed in between-group difference-in-difference analyses (SMD=−0.27, 95% CI −0.35 to −0.20, I²=40.1%) than within-group analyses (SMD=−0.19, 95% CI −0.29 to −0.10, I²=84.3%). The certainty of evidence for all outcomes based on our GRADE evaluation was low. Our systematic review and meta-analysis suggest that unemployment increases the risk of mental health problems, while re-employment may reduce this risk. However, due to the lack of high-certainty evidence, further longitudinal studies with multiple follow-ups are needed to strengthen causal inferences and better clarify mental health trajectories before and after re-employment.

Objectives: This study aimed to evaluate the process of implementation of a peer coaching intervention program for occupational physicians (OPs) to improve the execution of preventive tasks. Specifically, the evaluation seeks to: (1) describe the reach and uptake of the intervention program; (2) determine the extent to which the program was implemented as intended; (3) provide insights into experiences of OPs, and (4) identify factors influencing the implementation. Methods: This study employed a mixed-methods design. To address the four research aims, seven process indicators were used: acceptability, adoption, appropriateness, feasibility, fidelity, penetration and sustainability. Data were collected between March and June 2024 by means of an online questionnaire (N = 98), and 17 semi-structured interviews with group coordinators and OPs. The questionnaire included questions on attendance and reasons for non-attendance, experiences, and ratings of several aspects of the intervention program. Interviews focused on why and how OPs participated, experiences with the intervention program and how it can be improved, and how attention to prevention can be sustained. Results: Reach and uptake: 20 out of 21 groups allocated to the intervention program participated in the intervention and 98 out of 115 participants (85%) filled in the questionnaire. Three-quarters of the participants completed the entire program. Implementation as intended: 96% of the OPs successfully discussed barriers to the execution of preventive tasks, and 83% were able to formulate strategies for these barriers. Barriers and facilitators: Most participants managed to implement their formulated goals in practice. When they were unable to do so, time constraints and resistance from employers and their occupational health services often played a role. Participants’ experiences: OPs valued the program’s structure, interaction with colleagues, and the increased awareness it generated. Discussion and conclusion: The peer coaching group program was well-implemented and positively evaluated by OPs. The program can be improved by allocating more time to it, for instance by integrating it into the educational curriculum, and by paying more attention to the specific working conditions of OPs, such as the different sectors in which they are employed. Trial registration: ISRCTN registry; ISRCTN15394765. Registered on 27 June 2023.

Purpose: A stepped care approach, beginning with a low-intensity e-Health program followed by a high-intensity Participatory Approach led by a return-to-work (RTW) coordinator is a promising intervention to promote RTW of employees on sick leave with distress. As this approach is new, determinants of its successful implementation remain unknown. This study aimed to identify the potential facilitators and barriers for a stepped care approach to promote RTW of employees with distress, from the perspective of employees, employers, and occupational physicians. Methods: A qualitative study was performed consisting of individual semi-structured interviews with 10 employees, 5 supervisors, and two focus groups with 15 occupational physicians. The verbatim transcripts were inductively thematically coded. The Consolidated Framework for Implementation Research (CFIR) was applied to classify themes within its domains. Results: Themes were constructed belonging to either the implementation or the content of the stepped care approach, falling within the CFIR domains “innovation,” “outer setting,” “inner setting,” and “characteristics of the individual.” From all three stakeholder groups, identified facilitators were the tailored program, enabling task adjustments, and the RTW coordinator to stimulate a good communicative relationship between employee and supervisor. Barriers identified were the timing of the stepped care approach, integrating the approach in the current RTW system, and low digital skills. Conclusion: Both facilitators and barriers were found for the implementation of the stepped care approach. This underlines the importance of an adaptive implementation strategy that takes into account workplace dynamics and tailored approaches to support the stakeholder groups’ needs. Trial Registration: ISRCTN: 90663076. Registered on October 5, 2023.

Objective: While prevention is key in preventing work-related health problems, it is unclear how much time Dutch occupational physicians (OPs) dedicate to preventive tasks. This study aimed to assess OPs' attitudes, social influence, and self-efficacy (ASE) regarding preventive tasks and the association with time allocated to these tasks. Methods: In this cross-sectional study, questionnaire data on ASE determinants and time allocated to preventive tasks were collected from 227 OPs and analysed using multivariable linear regression, adjusted for demographic and organizational characteristics. Results: OPs spent about 10% of their time on preventive tasks, had a positive attitude but low self-efficacy, and experienced varying social support. No association was found between ASE determinants and time spent on preventive tasks. Conclusion: Future studies should focus on factors influencing prevention and the role of different stakeholders in this regard.

Background: Hybrid work is the new modus operandi for many office workers, leading to more sedentary behavior than office-only working. Given the potential of digital interventions to reduce sedentary behavior and the current lack of studies evaluating these interventions for home office settings, it is crucial to develop digital interventions for such contexts involving all stakeholders. Objective: This study aimed to reach expert consensus on the most feasible work strategies and the most usable digital elements as a delivery method to reduce sedentary behavior in the home office context. Methods: A modified Delphi study including 3 survey rounds and focus groups was conducted to achieve consensus. The first Delphi round consisted of two 9-point Likert scales for assessing the feasibility of work strategies and the potential usefulness of digital elements to deliver the strategies. The work strategies were identified and selected from a scoping review, a systematic review, and 2 qualitative studies involving managers and employees. The median and mean absolute deviation from the median for each item are reported. The second round involved 2 ranking lists with the highly feasible strategies and highly useful digital elements based on round 1 responses to order the list according to experts’ preferences. The weighted average ranking for each item was calculated to determine the most highly ranked work strategies and digital elements. The third round encompassed work strategies with a weight above the median from round 2 to be matched with the most useful digital elements to implement each strategy. In total, 4 focus groups were additionally conducted to gain a greater understanding of the findings from the Delphi phase. Focus groups were analyzed using the principles of reflexive thematic analysis. Results: A total of 27 international experts in the field of occupational health participated in the first round, with response rates of 86% (25/29) and 66% (19/29) in rounds 2 and 3, respectively, and 52% (15/29) in the focus groups. Consensus was achieved on 18 work strategies and 16 digital elements. Feedback on activity progress and goal achievement; creating an action plan; and standing while reading, answering phone calls, or conducting videoconferences were the most feasible work strategies, whereas wrist-based activity trackers, a combination of media, and app interfaces in smartphones were the most useful digital elements. Moreover, experts highlighted the requirement of combining multiple levels of strategies, such as social support, physical environment, and individual strategies, to enhance their implementation and effectiveness in reducing sedentary behavior when working from home. Conclusions: This expert consensus provided a foundation for developing digital interventions for sedentary behavior in home office workers. Ongoing interventions should enable the evaluation of feasible strategies delivered via useful digital elements in home office or hybrid contexts.

Many organizations are faced with growing numbers of employees who combine their jobs with informal caregiving responsibilities. To support working caregivers in maintaining a good balance between work, private life and informal care, a workplace participatory approach (PA) intervention was implemented in four Dutch organizations. This study’s aims were to evaluate the degree of PA implementation, contextual factors influencing implementation, and stakeholder experiences with the PA. A mixed methods process evaluation was conducted alongside a randomized controlled trial among three stakeholder groups: caregiving employees, their supervisors, and trained occupational professionals who acted as PA process facilitators. The implementation frameworks of Steckler and Linnan (2002) and Carrol et al. (2007) were applied to evaluate recruitment, reach, dosage, fidelity and context, as well as stakeholders’ satisfaction, experiences and perceived intervention outcomes. Data were collected after PA implementation (4–7 months) using questionnaires, semi-structured interviews, checklists and research logs. Of the 57 caregivers in the intervention group, 48 participated in the stepwise intervention. Among them, 20 (42%) completed all seven steps of the PA, and 30 (63%) involved their supervisors. PA implementation and supervisor involvement varied based on personal factors (e.g. a need for balance-related improvements; preference to keep caregiving private), interpersonal factors (e.g. caregiver-supervisor relationship quality), and organizational factors (high work demands; a supportive workplace culture for caregivers). Caregivers, supervisors, and process facilitators reported positive experiences with the PA, finding it valuable for addressing informal caregiving, receiving support and working on balance-related changes in multiple life domains. Some caregivers, however, needed more than the standard 3 PA meetings to identify key issues and implement solutions. Stakeholders found the PA helpful in addressing working caregivers’ work-life balance, but PA implementation can be further stimulated by creating a supportive organizational culture in which it is encouraged and safe to discuss informal care. Moreover, to better support working caregivers in the long term, the PA should be viewed as an ongoing and iterative process taking into account their evolving balance and circumstances. Current Controlled Trials ISRCTN15363783 (Registration date 21 November 2022; Retrospectively registered).