Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: a qualitative study.
Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: a qualitative study.
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DOI：
10.1186/s43058-022-00268-4
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发表时间：
2022-03-02
影响因子：
--
通讯作者：
Shimazu T
中科院分区：
文献类型：
--
作者：
Saito J;Odawara M;Takahashi H;Fujimori M;Yaguchi-Saito A;Inoue M;Uchitomi Y;Shimazu T
大公司和中小企业（SME）在实施循证干预措施（EBI）方面存在巨大差异。以往的文献揭示了中小企业在实施过程中面临的各种障碍，例如缺乏时间、可及性和资源。然而，很少有研究从多层面全面考察这些影响因素。本研究旨在利用实施研究综合框架（CFIR）确定影响中小企业实施非传染性疾病预防活动（烟草、酒精、饮食、体力活动和健康检查）的因素。我们对 15 家员工少于 300 人的企业的健康管理者和/或雇主进行了 15 次半结构化访谈，并对日本四个县支持中小企业的健康保险公司的公共卫生护士/营养师进行了 4 个焦点小组的访谈。通过演绎定向方法进行定性内容分析。由两名独立研究人员将访谈笔录文本编码到构建的 CFIR 框架中后，每个企业对编码结果进行比较和修改，直至达成一致。在 39 个 CFIR 结构中，25 个对中小企业工作场所健康促进实施有促进作用，7 个有抑制作用，涵盖个人、内部和外部层面。特别是，雇主在实施工作场所健康促进活动中的领导参与被认为是可能影响其他促进因素的基本因素，包括组织层面的“知识和信息的获取”、“相对优先级”、“学习氛围”以及健康管理者层面的“自我效能”。主要障碍是雇主/经理认为“健康管理是自己的责任”。确定了影响中小企业非传染性疾病预防活动实施的多层次因素。在资源匮乏的环境中，雇主的大力认可和支持以及积极反馈对于健康管理者和雇员的积极性以及促进或参与健康促进非常重要。未来的研究需要根据已确定的障碍和促进因素制定针对具体情况的策略，并对它们进行实证评估，这将有助于缩小不同公司规模在工作场所健康促进实施方面的差异。在线版本包含可在 10.1186/s43058-022-00268-4 获取的补充材料。
There is an immense difference between large companies and small and medium-sized enterprises (SMEs) in implementation of evidence-based interventions (EBIs). Previous literature reveals various barriers that SMEs face during implementation, such as a lack of time, accessibility, and resources. However, few studies have comprehensively examined those influential factors at multi-levels. This study aims to identify the factors influencing the implementation of non-communicable disease prevention activities (tobacco, alcohol, diet, physical activity, and health check-up) in SMEs using Consolidated Framework for Implementation Research (CFIR). We conducted 15 semi-structured interviews with health managers and/or employers in 15 enterprises with less than 300 employees, and four focus groups among public health nurses/nutritionists of health insurers who support SMEs in four prefectures across Japan. A qualitative content analysis by a deductive directed approach was performed. After coding the interview transcript text into the CFIR framework constructs by two independent researchers, the coding results were compared and revised in each enterprise until an agreement was reached. Of the 39 CFIR constructs, 25 were facilitative and 7 were inhibitory for workplace health promotion implementation in SMEs, which were across individual, internal, and external levels. In particular, the leadership engagement of employers in implementing the workplace health promotion activities was identified as a fundamental factor which may influence other facilitators, including “access to knowledge and information,” “relative priority,” “learning climate,” at organizational level, and “self-efficacy” at the health manager level. The main barrier was the beliefs held by the employer/manager that “health management is one’s own responsibility.” Multi-level factors influencing the implementation of non-communicable diseases prevention activities in SMEs were identified. In resource-poor settings, strong endorsement and support, and positive feedback from employers would be important for health managers and employees to be highly motivated and promote or participate in health promotion. Future studies are needed to develop context-specific strategies based on identified barriers and facilitative factors, and empirically evaluate them, which would contribute to narrowing the differences in worksite health promotion implementation by company size. The online version contains supplementary material available at 10.1186/s43058-022-00268-4.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1097/jom.0000000000000629
发表时间：
2016-02-01
影响因子：
3.2
作者：
Kent, Karen;Goetzel, Ron Z.;Freundlich, Naomi
通讯作者：
Freundlich, Naomi
影响因子：
2.7
作者：
Linnan, Laura A.;Cluff, Laurie;Leff, Maija S.
通讯作者：
Leff, Maija S.
影响因子：
2.6
作者：
Gill, P.;Stewart, K.;Chadwick, B.
通讯作者：
Chadwick, B.