Evaluating the Effectiveness of Multifaceted Implementation Strategies for Implementing a Guideline for the Prevention of Common Mental Disorders at the Workplace in Schools

Not Applicable

Completed

• Conditions: Common Mental Disorders
• Interventions: Behavioral: Single implementation strategy; Behavioral: Multifaceted implementation strategies

• Registration Number: NCT03322839
• Lead Sponsor: Karolinska Institutet

Brief Summary

Given today's high prevalence of common mental disorders and related sick leave among teachers an urgent need exists for a more sustainable working life for this professional group. One way of doing this is by improving schools' social and organizational risk management. Recent reports have shown that many schools in Sweden however lack a structured approach to the management of social and organizational risks. In 2015, we launched the first Swedish occupational health guideline to support a structured prevention of social and organizational risks at the workplace with the aim of preventing common mental disorders. The long-term goal of this study is to support the implementation of this guideline within schools in order to improve social and organizational risk management and in doing so reduce risk factors for mental ill-health and related sick days. The objective of the study is to fill the current research-to-practice gap by conducting a cluster-randomized controlled trial that compares the effectiveness of two implementation strategies for implementing the guideline in schools. The strategies that will be compared are training (ARM 1) versus training in combination with implementation teams and workshops (ARM 2). Our hypothesis for the study is that schools that receive support in implementing the guideline through combined strategies are more responsive to working in a structured and systematic manner with the management of social and organizational risks than schools that only receive training. The trial will be conducted in 20 primary schools in two municipalities in Sweden. All schools have agreed to participate. The primary outcomes are adherence to the guideline (implementation effectiveness) and self-reported exhaustion among schools personnel (intervention effectiveness); the secondary outcomes are risk factors for mental ill-health and absenteeism. Data will be collected at baseline, 6, 12 and 24 months by mixed methods (i.e. survey, focus-group interviews, observation, and register-data).

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2017-09-12
• Study First Submitted: 2017-09-19
• Study First Submitted QC: 2017-10-23
• Study First Posted: 2017-10-26
• Primary Completion: 2019-10-30
• Study Completion: 2019-12-31
• Status Verified: 2020-09
• Last Update Submitted: 2020-09-10
• Last Update Posted: 2020-09-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 732

Inclusion Criteria

• all individuals who are employed by the participating schools

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Exclusion Criteria

• individuals employed by the participating municipalities and not by the participating schools, for example cleaning personal. Individuals on sick-leave

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Single implementation strategy	Single implementation strategy	The control-schools will only receive training to the school-management.
Multifaceted implementation strategies	Multifaceted implementation strategies	The school-management will participate in a one-day training. In addition each intervention school will form an implementation team that is responsible for the implementation of the guideline within their school. The implementation teams will participate in 4-5 workshops in order to support the implementation process.

Primary Outcome Measures

Name	Time	Method
Exhaustion (intervention effectiveness)	At baseline and 6, 12 and 24 months after baseline	Change from baseline in personnel's self-reported exhaustion during 6, 12 and 24 months follow. We hypothesize that adherence to the recommendations of the guideline will affect school personnel's self-reported exhaustion assessed with the Oldenburg Burnout Inventory (response format 1-4).
Guideline adherence (implementation effectiveness)	At baseline and 6, 12 and 24 months after baseline	Change from baseline in adherence to the recommendations of the guideline during 6, 12 and 24 months follow-up period. We will use a questionnaire directed at the school management and a questionnaire directed at the school personnel. The questionnaires contain statements related to the recommendations in the guideline, such as "at our school we have clear and practical policies for preventing mental ill-health among our employees".

Secondary Outcome Measures

Name	Time	Method
Commitment to the workplace	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported commitment as assessed by 3 items of the Copenhagen Psychosocial Questionnaire (response-form 1-5)
Social support superior	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported social support from superior as assessed by 3 items of the Copenhagen Psychosocial Questionnaire (response-form 1-5)
Recovery	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported recovery as assessed with 1 item (response-form 1-5)
Self-reported sickness absenteeism	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported sickness absenteeism as assessed by 2 items
Barriers	Assessed during the 24 month study period	Information will be collected on possible barriers that may have influenced the implementation process. This data will be assessed by documentation.
Psychosocial safety climate	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported psychosocial safety climate as assessed by the 11-items of the Psychosocial Safety Climate Scale (response format 1-5)
Job demands	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported job-demands as assessed by 11 items of the Copenhagen Psychosocial Questionnaire (response form 1-5)
Possibilities for development	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported possibilities for development as assessed by 4 items of the Copenhagen Psychosocial Questionnaire (response-form 1-5)
Work engagement	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported engagement as assessed by 3 items of the Utrecht Work Engagement Scale (response-form 1-7)
Work performance impairment due to problems in the work environment	At baseline and 6, 12 and 24 months after baseline	Change from baseline in work performance as assessed by a question based on one item from the Work Productivity Activity Impairment - General Health Questionnaire (response format from 0-10)
Recognition (reward)	At baseline and 6, 12 and 24 months after baseline	Change from baseline self-reported collaboration and leadership as assessed by 3-items of Copenhagen Psychosocial Questionnaire (response-format 1-5)
Influence at work	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported influence at work as assessed by 4 items of the Copenhagen Psychosocial Questionnaire (response-form 1-5)
Social support colleagues	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported social support as assessed by 3 items of the Copenhagen Psychosocial Questionnaire (response-form 1-5)
Self-reported stress	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported stress as assessed with a single question (response-form 1-5)
Work-family conflict	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-reported work-family conflict as assessed with 4 items of the Copenhagen Psychosocial Questionnaire (response-form 1-4)
Work performance impairment due to health problems	At baseline and 6, 12 and 24 months after baseline	Change from baseline in work performance as assessed by a question based on one item from the Work productivity Activity impairment - General Health Questionnaire (response format 0-10)
Facilitators	Assessed during the 24 month study period	Information will be collected on possible facilitators that may have influenced the implementation process. This data will be assessed by documentation.
Self-perceived health	At baseline and 6, 12 and 24 months after baseline	Change from baseline in self-perceived health as assessed with a single question (response-form 1-5)
Registered sickness absenteeism	12 months prior to baseline, and during 24 months after baseline	Change in total sick-leave due to common mental disorders in days, register data (sickness benefit and disability pension).
Self-reported stress (SMS)	Measured every 4th week over 12 months from baseline	Change from baseline in self-reported stress as assessed by one item sent by text-message by mobile-phone
Process evaluation data	Assessed during the 24 month study period.	Process data will be collected over the 24 months. This data will be assessed by documentation.

Trial Locations

Locations (1)

Unit for Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute; 🇸🇪 Stockholm, Sweden