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Background The workplace is an important setting for reaching potentially large numbers of smokers. Aims To review the evidence about smoking cessation in the workplace. Methods Literature review including a synthesis of findings from recent systematic reviews and meta-analyses of workplace smoking cessation programmes, a separate review of the qualitative evidence, case studies and an expert panel assessment. Results We found advantages, identified or confirmed from the mixed methods used in this work to holding smoking cessation programmes in the workplace. These included: (i) easy access to large numbers of worker populations for large workplaces, (ii) the potential improved recruitment to such programmes given this, (iii) the opportunity to access young men, traditionally difficult to achieve, (iv) access to occupational health and other staff who can assist with support and delivery and (v) ability for workers to attend relatively easily. Evidence on the importance of developing peer support at work was mixed. The simple provision or availability of programmes and interventions was unlikely to provide any beneficial behaviour change. Interventions should target workers that actively want to stop smoking, use elements that workers have identified as useful or focus on altering beliefs about smoking and the need to stop. Conclusions Smoking cessation programmes at work can provide useful support for workers wishing to stop smoking. They are only likely to be effective if participants have moved beyond the contemplation stage regarding smoking cessation, so that stopping smoking is a personal priority.

Objectives. The aim of this paper is to describe the development and refinement of nine measures of perceived work characteristics for use in studies of the psychological wellbeing of health services employees. The constructs measured are: autonomy/control, feedback, influence, leader support, professional compromise, role clarity, role conflict, peer support and work demands. Design. The study was a large scale cross-sectional survey. Methods. National Health Service Trust staff were selected from seven major occupational groups (nurses, doctors, administrative staff, managers, professions allied to medicine, professional and technical staff, and ancillary staff) within a sample of Trusts chosen to be representative of those in England. Questionnaires incorporating the scale items were completed by over 9,000 staff. The fit with the a priori nine-dimensional measurement model was tested using confirmatory factor analysis. Scale internal reliabilities and norms were calculated, and aspects of construct validity were examined. Results. The findings show a good fit to the measurement model for the sample as a whole and across occupational groups. All the scales exhibit acceptable internal reliabilities; and normative data is provided for all seven occupations (with norms for more specific job categories available on request). Analyses suggest good construct validity, showing the scales discriminate as anticipated across occupational groups and job categories, and they have the expected relationships with job satisfaction and psychological strain. Conclusions. The measures developed are usable for research purposes across the major occupational groups, with the possible exception of ancillary staff. Further work is desirable to confirm the measurement properties and extend the normative database.

Psychiatric interviews were carried out to validate the General Health Questionnaire-12 (GHQ-12; Goldberg, 1972) for use with staff of England's National Health Service (NHS), and to determine the appropriate threshold score to identify probable cases. In a sample of 551 NHS staff, the correlation between the GHQ-12 and the Clinical Interview Schedule-Revised (CIS-R) was found to be .70. The receiver operating characteristic showed that a 3/4 threshold, higher than used in all but one previous study, gave the best conservative estimate of minor psychiatric morbidity. This threshold gave an estimated sensitivity of the GHQ-12 of.69 and specificity of.88. It reduced case rates by between 8% and 17% as compared with lower possible thresholds. Convergent and discriminant validation of the GHQ-12 was demonstrated through comparison with other measures of mental and physical health.

A self-completion questionnaire survey was carried out, resulting in a sample of 675 white collar public sector employees. The survey examined the frequency of occurrence of work-based stressors and perceived control, and included a general measure of job satisfaction. The results revealed that higher levels of job satisfaction were reported by employees in higher grades. It was also observed that higher grades perceived more control within their working environment. No gender differenccs were found concerning reported stress problems, although significant differences were observed across grades in relation to role differentiation. Multivariate analyses revealed that grade effects were largely accounted for by differences in perceived control. Perceived control, role-based and organizational stressors as well as gender were the strongest contributors in predicting reported job satisfaction.

A self-completion questionnaire survey of coping behaviours and associated perceptions amongst 675 white collar public sector employees is reported. In addition to identifying underlying dimensions of coping behaviour, the relationship between reported use of coping strategies and perceptions related to work stress, general mental well-being, and job satisfaction were explored. From the responses concerning frequency of use of various coping methods, five dimensions of coping strategy were identified: problem-focused, health and leisure-oriented, social support seeking, avoidant, and formal relaxation. It was found that use of avoidant coping methods was significantly associated with perceived problems with coping at work, with lower job satisfaction, and with poorer levels of general mental health. Higher reported use of problem-focused methods was significantly associated with fewer problems with coping at work, higher job satisfaction, and better levels of general mental health.

RCTs are critical to evidence-based medicine, but recruitment is routinely problematic. Robust tests of recruitment methods, where alternative approaches are compared within RCTs, are rare. The MRC funded START programme aims to test the feasibility of routinely nesting recruitment interventions in host RCTs. This will rapidly extend the evidence base, allow promising recruitment interventions to be tested across multiple trials, and improve our understanding of the impact of contextual factors on recruitment. Newly commissioned or recruiting trials were identified via PCRN and HTA portfolios. A total of 225 PIs were sent a flyer describing the MRC START programme with a covering email (from PCRN or HTA) inviting them to contact the team if they would like to know more about the study. Preliminary discussions were held with interested trials to screen them for suitability. Formal agreements were then put in place and trial specific intervention content was developed. Nearly a third (32%) of PIs approached expressed an interest in the study. Just over half (52%) were excluded, reasons included incompatible recruitment strategies, timetable issues or trial size. Reaction to the additional burden placed on trials has so far been positive. Documentation has been found fit for purpose and the process of implementation supported by a ‘can do' culture and complex research skills in trial managers. This presentation will: • (a) describe START and report on progress to date, • (b) discuss early findings in relation to feasibility and host trial experience, • (c) present materials to support the recruitment of host trials.