Dataset Information

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

ABSTRACT: Introduction:Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. Methods:We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15?months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Results:Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (-0.39) and interventions sites (-0.29) from baseline to 15?months, while context did not change for either. Only wellness program effort at 15?months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15?months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Discussion:Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.

SUBMITTER: Helfrich CD

PROVIDER: S-EPMC5925216 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

Helfrich Christian D CD Kohn Marlana J MJ Stapleton Austin A Allen Claire L CL Hammerback Kristen Elizabeth KE Chan K C Gary KCG Parrish Amanda T AT Ryan Daron E DE Weiner Bryan J BJ Harris Jeffrey R JR Hannon Peggy A PA

Frontiers in public health 20180423

<h4>Introduction</h4>Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time.<h4>Methods</h4>We analyzed two waves of readiness-to-change survey data collected as p ...[more]

PMID: 29740572

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Project description:Background:Small construction businesses (SCBs) account for a disproportionate share of occupational injuries, days lost, and fatalities in the US and other modern economies. Owner/managers of SCBs confront risks associated with their own and workers' safety and business survival, and their occupational safety and health (OSH) related values and practices are key drivers of safety and business outcomes. Given owner/mangers are the key to understanding and affecting change in smaller firms, as well as the pressing need for improved OSH in small firms particularly in construction, there is a critical need to better understand SCB owners' readiness to improve or adopt enhanced OSH activities in their business. Unfortunately, the social expectation to support safety can complicate efforts to evaluate owners' readiness. Objectives:To get a more accurate understanding of the OSH values and practices of SCBs and the factors shaping SCB owners' readiness and intent to implement or improve safety and health programming by comparing their discourse on safety with their self-rated level of stage of change. Methods:In-depth, semi-structured interviews were conducted with 30 SCB owner managers. Respondents were asked to self-rate their safety program activity on a 5-point scale from unaware or ignorant ('haven't thought about it at all') to actively vigilant ('well-functioning safety and health program for at least 6 months'). They were also asked to discuss the role and meaning of OSH within their trade and company, as well as attitudes and inclinations toward improving or enhancing business safety practices. Analysis and results:Respondents' self-rating of safety program activity was compared and contrasted with results from discourse analysis of their safety talk, or verbal descriptions of their safety values and activities. Borrowing from normative and stage theories of safety culture and behavioral change, these sometimes contradictory descriptions were taxonomized along a safety culture continuum and a range of safety cultures and stages of readiness for change were found. These included descriptions of strong safety cultures with intentions for improvement as well as descriptions of safety cultures with more reactive and pathological approaches to OSH, with indications of no intentions for improvement. Some owner/managers rated themselves as having an effective OSH program in place, yet described a dearth of OSH activity and/or value for OSH in their business. Conclusion:Assessing readiness to change is key to improving OSH performance, and more work is needed to effectively assess SCB OSH readiness and thus enable greater adoption of best practices.

Project description:This study aims to intensively evaluate the effectiveness of mindfulness-based intervention (MBI) on mental illness risks (including psychological distress, prolonged fatigue, and perceived stress) and job strain (job control and job demands) for employees with poor mental health.A longitudinal research design was adopted. In total, 144 participants were randomized to the intervention group or the control group. The intervention group participated in MBI for eight weeks. Measurements were collected for both groups at five time points: at pre-intervention (T1), at mid-intervention (T2), at the completion of intervention (T3), four weeks after intervention (T4), and eight weeks after intervention (T5). Data were analyzed according to the intention-to-treat principle. A linear mixed model with two levels was employed to analyze the repeated measurement data.Compared with the control group, the intercepts (means at T3) for the intervention group were significantly lower on psychological distress, prolonged fatigue, and perceived stress when MBI was completed. Even with the demographic variables controlled, the positive effects remained. For growth rates of prolonged fatigue and perceived stress, participants in the intervention group showed a steeper decrease than did the participants in the control group. Regarding job strain, although the intercept (mean at T3) of job demands showed a significant decline when BMI was completed, the significance disappeared when the demographic variables were controlled. Moreover, the other results for job control and job demands did not show promising findings.As a workplace health promotion program, the MBI seems to have potential in improving mental illness risks for employees with poor mental health. However, there was insufficient evidence to support its effect on mitigating job strain. Further research on maintaining the positive effects on mental health for the long term and on developing innovative MBI to suit job strain are recommended.ClinicalTrials.gov NCT02241070.

Project description:ObjectivesTo describe trends in caesarean sections and facilities performing caesareans over time in Tanzania and examine the readiness of such facilities in terms of infrastructure, equipment and staffing.DesignNationally representative, repeated cross-sectional surveys of women and health facilities.SettingTanzania.ParticipantsWomen of reproductive age and health facility staff.Main outcome measuresPopulation-based caesarean rate, absolute annual number of caesareans, percentage of facilities reporting to perform caesareans and three readiness indicators for safe caesarean care: availability of consistent electricity, 24?hour schedule for caesarean and anaesthesia providers, and availability of all general anaesthesia equipment.ResultsThe caesarean rate in Tanzania increased threefold from 2% in 1996 to 6% in 2015-16, while the total number of births increased by 60%. As a result, the absolute number of caesareans increased almost fivefold to 120?000 caesareans per year. The main mechanism sustaining the increase in caesareans was the doubling of median caesarean volume among public hospitals, from 17 caesareans per month in 2006 to 35 in 2014-15. The number of facilities performing caesareans increased only modestly over the same period. Less than half (43%) of caesareans in Tanzania in 2014-15 were performed in facilities meeting the three readiness indicators. Consistent electricity was widely available, and 24?hour schedules for caesarean and (less systematically) anaesthesia providers were observed in most facilities; however, the availability of all general anaesthesia equipment was the least commonly reported indicator, present in only 44% of all facilities (34% of public hospitals).ConclusionsGiven the rising trend in numbers of caesareans, urgent improvements in the availability of general anaesthesia equipment and trained anaesthesia staff should be made to ensure the safety of caesareans. Initial efforts should focus on improving anaesthesia provision in public and faith-based organisation hospitals, which together perform more than 90% of all caesareans in Tanzania.

Dataset Information

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

Publications

Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.

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