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Background: To date, mental health problems and mental workload have been increasingly related to long-term sick leave and disability. However, there is, as yet, no structured protocol available for the identification and application of an intervention for stress-related mental health problems at the workplace. This paper describes the structured development, implementation and planning for the evaluation of a return-to-work intervention for sick-listed employees with stressrelated mental disorders (SMDs). The intervention is based on an existing successful return-towork intervention for sick-listed employees with low back pain. Methods: The principles of Intervention Mapping were applied to combine theory and evidence in the development, implementation and planning for the evaluation of a participatory workplace intervention, aimed at an early return-to-work for sick-listed employees with SMDs. All stakeholders were involved in focus group interviews: i.e. employees recently sick-listed with SMDs, supervisors and occupational health professionals. Results: The development of the participatory workplace intervention according to the Intervention Mapping principles resulted in a structured return-to-work intervention, specifically tailored to the needs of sick-listed employees with SMDs. Return-to-work was proposed as a behavioural change, and the Attitude - Social influence - self-Efficacy model was identified as a theoretical framework. Stakeholder involvement in focus group interviews served to enhance the implementation. The cost-effectiveness of the intervention will be evaluated in a randomised controlled trial. Conclusion: Intervention Mapping was found to be a promising method to develop interventions tailored to a specific target group in the field of occupational health. [ABSTRACT FROM AUTHOR]

Objective: To study changes in lifestyle in relation to changes in body weight and waist circumference associated with occupational retirement in men.Design: A prospective cohort study with 5 years of follow-up. At baseline and at follow-up, questionnaires were completed and body weight and waist circumference were measured.Setting: The Doetinchem Cohort Study, consisting of inhabitants of Doetinchem, a town in a rural area of The Netherlands.Subjects: In total 288 healthy men aged 5065 years at baseline, who either remained employed or retired over follow-up.Results: The effect of retirement on changes in weight and waist circumference was dependent on type of former occupation. Increase in body weight and waist circumference was higher among men who retired from active jobs (0.42?kg?year-1 and 0.77?cm?year-1, respectively) than among men who retired from sedentary jobs (0.08?kg?year-1 and 0.23?cm?year-1, respectively). Weight gain and increase in waist circumference were associated with a decrease in fruit consumption and fibre density of the diet, with an increase in frequency of eating breakfast, and with a decrease in several physical activities, such as household activities, bicycling, walking and doing odd jobs.Conclusion: Retirement was associated with an increase in weight and waist circumference among those with former active jobs, but not among those with former sedentary jobs. Retirement may bring opportunities for healthy changes in diet and physical activity, which could be used in health promotion programmes. [ABSTRACT FROM AUTHOR]

Background. Physical activity promotion in general practice is advocated though not incorporated into daily practice. Several barriers must be overcome to develop a feasible and acceptable programme.Objective. The aim of this study was to conduct a process evaluation of a physical activity promotion programme in general practice (PACE), in which patients visited their provider (GP or practice nurse) twice.Methods. Process evaluation was conducted by means of telephone-administered, semi-structured interviews with providers and practice assistants. The main topics of the interviews were overall impression of PACE, PACE training, content and usability of the intervention materials, counselling, implementation of the intervention, and opportunities for future use.Results. In the 15 participating general practices, a total of 17 providers and 12 practice assistants were interviewed. The overall impression of the PACE programme was positive. Most providers experienced the provided material and training as helpful. Some problems concerning the number of forms used and patients having difficulties completing the forms were mentioned. Most providers (70.6%) spend 10 min or more discussing PACE during the first consultation. The second consultation mostly was completed within 10 min. Patients overestimating their level of physical activity was mentioned as the main barrier in providing the counselling. PACE was evaluated as suitable for implementation in Dutch general practice, and 60% of the providers actually intended using PACE in the future.Conclusion. The PACE programme was evaluated as being both acceptable and feasible in a selection of Dutch general practices. Positive adaptations will be made in order to implement PACE successfully in general practice at a wider scale. [ABSTRACT FROM AUTHOR]

Background The association between low birthweight and increased blood pressure in later life has repeatedly been confirmed. Increased arterial stiffness may be an underlying mechanism for this phenomenon. This study investigated whether birthweight was related to blood pressure and local and regional arterial stiffness.Methods In 281 subjects (161 women), with a mean age of 36, blood pressure was measured. The diameter, distension, and local pulse pressure of three large arteries were measured simultaneously using ultrasound imaging. Local and regional arterial compliance and distensibility were calculated. Information on birthweight was retrieved with a questionnaire.Results Linear regression analyses showed a 3.3 mmHg lower systolic blood pressure (SBP) and a 1.8 mmHg lower diastolic blood pressure (DBP), per 1kg higher birthweight. These associations were statistically significant after adjustment for adult weight. Birthweight was significantly and positively related to carotid arterial compliance (P = 0.050), but less so to brachial (P = 0.114) and femoral arterial compliance (P = 0.058). However, after adjustment for adult height, the strength of these associations decreased. Birthweight was not related to arterial distensibility. The association between birthweight and arterial compliance could only partly explain the association between birthweight and blood pressure.Conclusions Lower birthweight is related to increased blood pressure, and increased arterial stiffness. However, the latter relationship can only partly explain the association between birthweight and blood pressure. Therefore, mechanisms other than arterial stiffness contribute to the birthweight—blood pressure relationship. [ABSTRACT FROM AUTHOR]