Making workplace health promotion work: translation, implementation and evaluation of an integrated approach and European good practice

PROBLEM With the rising number and the substantial societal impact of chronic diseases, the promotion of a healthy lifestyle is of crucial importance. The workplace is an important setting to promote health among workers. Integrated approaches targeting multiple lifestyle factors at both the individual and environmental level are considered most effective, but are scarce. The integrated Lombardy Workplace Health Promotion (WHP) Network is recognized as good practice in the European Best Practice Portal. INTERVENTION APPROACH This proposal builds upon the Lombardy WHP Network, consisting of an integrating approach: the employer can choose the health promotion interventions to implement. To meet the Lombardy WHP Network criteria and receive a logo as an organization, the employer needs to implement at least four different lifestyle interventions per year at both the individual and at the environmental level. OBJECTIVE The aim of the proposed project is to tailor the integrated Lombardy WHP Network to the Dutch context, and to evaluate implementation on process measures and effectiveness. More specifically, SUBOBJECTIVES are: 1. To tailor the Lombardy WHP Network to the Dutch context, in co-creation with employers, employees and other stakeholders from policy and practice. 2. To evaluate the implementation of the Dutch WHP program on process measures to understand the success or failure of the implementation of the interventions. 3. To evaluate the effectiveness of the Dutch WHP program on health, well-being, and lifestyle behaviors. 4. To disseminate the results to contribute to a wider implementation of the Dutch WHP program in various occupational sectors. BOTTOM UP APPROACH In all phases of the project, from the tailoring of the WHP Network to the Dutch context to the dissemination of the results, we will apply a bottom-up approach with active involvement and input of relevant stakeholders. An advisory board including employers, employees, occupational health and prevention professionals, national policy, the Center Work Health, and the RIVM Center for Healthy Living will provide advice on the process and results of the project during the entire duration. A practice group including employees, employers, HR staff and facility management in each of the participating organizations will support implementation of the Dutch WHP program. PHASES OF PROJECT STUDY 1: TAILORING THE LOMBARDY WHP NETWORK TO THE DUTCH CONTEXT The stepwise and systematic approach of the Map of the Adaptation Process (MAP) will be followed to tailor the Lombardy WHP Network to the Dutch context and to identify the motivating and impeding factors for successful implementation. In doing so, five steps will be followed starting with an assessment to decide upon the main health promotion areas for the Dutch WHP program and preconditions for implementation, and ending up with a pilot test and implementation of the Dutch WHP program in the participating organizations. Participating organizations will already be involved in study 1. STUDY 2: PROCESS EVALUATION OF THE DUTCH WHP PROGRAM A systematic evaluation of the implementation process of the Dutch WHP program will be conducted to understand the success or failure of the implementation. The recruitment, reach, dose delivered, dose received, fidelity, maintenance, satisfaction, implementation strategy, participants’ mental models, and context will be evaluated. Data will be collected quantitatively and qualitatively by questionnaires for employees, interviews with managers and employees, and systematic observations in the workplace. STUDY 3: EFFECT EVALUATION OF THE DUTCH WHP PROGRAM The effectiveness of the WHP program will be evaluated in a cluster Randomized Controlled Trial (RCT) with two arms: an intervention group, receiving the Dutch WHP program and a control condition. A calculated sample size of 312 employees is feasible based on the interest and verbal commitment of 3 organizations (employing over 12000 employees) and 3 organizations who already signed a letter of consent for participation (N=752 employees). The organizations are diverse in occupational sector and will provide a diverse study population with regard to age, sex, educational level, and type of work. The primary outcome of this study is perceived health measured by the general health scale of the SF-36. Secondary outcomes are well-being and the targeted lifestyle behaviors. Measurements take place by questionnaire at baseline, 6 and 12 months and objective measures of physical activity are performed in a subsample of the study population. STUDY 4: COMMUNICATION AND DISSEMINATION OF THE RESULTS Based on the extensive networks of the project group and the societal advisory board, the results will be widely disseminated to employees and labor unions, employers and sector organizations in various work sectors, occupational health professionals and students, national policy makers, and scientists within the Netherlands and abroad.