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Purpose: To determine needs, expectations, facilitators, and barriers of insurance physicians (IPs) for using eHealth in their work. Also, we investigated differences between age groups., Materials and Methods: All insurance physicians employed at the Dutch Social Security Institute (SSI) received an online anonymous survey in July 2020., Results: Three hundred and fifteen IPs (31%) responded. According to these IPs, the most important need for using eHealth was to collect medical information more effectively and efficiently (71%).Main facilitators were that eHealth could make IPs' work more effectively and efficiently (61%) and more future-proof (60%). Main barriers were losing human interaction (54%) and security issues (51%). Younger IPs saw more options for using eHealth, compared to older IPs., Conclusions: The majority of IPs (in particular younger IPs) had a positive view towards using eHealth in their daily work. Nevertheless, differences in needs, expectations, facilitators and barriers between the age groups should be taken into account for the successful development and implementation of interventions using eHealth in insurance medicine.

Background: This study aimed to explore the experiences and needs of (ex-)welfare benefit recipients from a large urban municipality in the Netherlands regarding their welfare-to-work services and their case workers., Methods: Quantitative data from a client satisfaction survey that was filled out by 213 people (response rate 11%) who received welfare-to-work services was combined with results from four group interviews with a total of 15 people receiving welfare-to-work services. Verbatim transcripts from the interviews were analysed using inductive thematic analysis., Results: The survey results showed that most clients were reasonably satisfied with the welfare-to-work services they received. Four main themes emerged from the interviews: (1) experiences and needs related to the interactions between case workers and benefit recipients; (2) the need for tailored services; (3) the complicating role of the system the case workers operate within; and (4) the existence of differences between case workers regarding how strict they followed the rules and to what extent they connected with their clients on a personal level., Conclusions: Our findings show that clients were reasonably satisfied with the welfare-to-work services provided by their municipality but that there is still room for improvement. Case workers should have good social skills to build a trusting relationship with the client, welfare-to-work services should be tailored to the individual, and clear concise information should be given to welfare benefit recipients, especially with regard to what benefit recipients can expect of the municipality and the case workers, given their dual role in supporting (re-)integration to work and monitoring benefit eligibility., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Sit-stand workstations have shown to reduce sitting time in office workers on a group level. However, movement behaviour patterns might differ between subgroups of workers. Therefore, the objective of this study was to examine sitting, standing and stepping outcomes between habitual users and non-users of sit-stand workstations. From an international office population based in the Netherlands, 24 users and 25 non-users of sit-stand workstations were included (all had long-term access to these workstations). Using the ActivPAL, sitting, standing and stepping were objectively measured during and outside working hours. Differences in outcomes between users and non-users were analysed using linear regression. During working hours, users sat less (-1.64; 95% IC= -2.27--1.01 hour/8 hour workday) and stood more (1.51; 95% IC= 0.92-2.10 hour/8 hour workday) than non-users. Attenuated but similar differences were also found for total sitting time over the whole week. Furthermore, time in static standing bouts was relatively high for users during working hours (median= 0.56; IQR = 0.19-1.08 hour/8 hour workday). During non-working hours on workdays and during non-working days, no differences were found between users and non-users. During working hours, habitual users of their sit-stand workstation sat substantially less and stood proportionally more than non-users. No differences were observed outside working hours, leading to attenuated but similar differences in total sitting and standing time between users and non-users for total days. This indicated that the users of sit-stand workstations reduced their sitting time at work, but this seemed not to be accompanied by major carry-over or compensatory effects outside working hours., Competing Interests: . One of the authors (ES) is affiliated with a commercial occupational health and safety service (Arbo Unie). For ES, time to work on this manuscript was provided by Arbo Unie in the form of salary. The funder did not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Another author (AvdB) is performing paid advisory work for the spin-off company Evalua Nederland B.V., which has no relationship whatsoever with the present manuscript.

Objective: Prolonged sitting, which is highly prevalent in office workers, has been associated with several health risks. The aim of this study was to evaluate the Dynamic Work intervention by determining its effect on total sitting time at the 8-month follow-up in comparison to the control., Methods: This two-arm pragmatic cluster randomised controlled trial included 244 office workers from 14 different departments of a large, Dutch insurance company. The Dynamic Work intervention was a real-life, worksite intervention that included environmental components (i.e. sit-stand workstations), organisational components (i.e. group sessions), and individual components (e.g. activity/sitting trackers). Outcomes were assessed at baseline, 4-month follow-up, and 8-month follow-up. The primary outcome was total sitting time per day, objectively assessed using the activPAL activity monitor at 8-month follow-up. Secondary outcomes included other total and occupational movement behaviour outcomes, health-related outcomes, and work-related outcomes. Data analyses were performed using linear and logistic mixed models., Results: Total sitting time did not differ between the intervention and control group at the 8-month follow-up. Secondary outcomes also showed no difference between the intervention and control group at either the 4-month or at 8-month follow-up, with the exception of number of occupational steps, which showed a statistically significant effect at 4-month follow-up (but not at 8-month follow-up) of 913 (95% CI = 381-1445) steps/8-h working day., Conclusions: This study evaluated the effectiveness of a real-life worksite intervention to reduce sitting time and showed little to no effect. This may be due to the relatively low intensity of the intervention, i.e. that it only involved the replacement of 25% of sitting workstations with sit-stand workstations. Future research should focus on the evaluation of more intensive real-life worksite interventions that are still feasible for implementation in daily practice. CLINICALTRIALS., Gov, Registration Number: NCT03115645., Competing Interests: Declaration of competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare no conflicts of interest. This work was supported by Achmea, Interne Diensten N.V. (Handelsweg 2 Zeist, The Netherlands), which also provided the study population and co-developed the Dynamic Work intervention with the research team. Achmea had no influence on or role in the study design, data collection, analyses and interpretation of the data, the writing of this paper, and the decision to submit the paper for publication., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives Weighted regression procedures can be an efficient solution for cohort studies that involve rare events or diseases, which can be difficult to predict, allowing for more accurate prediction of cases of interest. The aims of this study were to (i) predict changes in work ability at one year after approval of the work disability benefit and (ii) explore whether weighted regression procedures could improve the accuracy of predicting claimants with the highest probability of experiencing a relevant change in work ability. Methods The study population consisted of 944 individuals who were granted a work disability benefit. Self-reported questionnaire data measured at baseline were linked with administrative data from Dutch Social Security Institute databases. Standard and weighted multinomial logit models were fitted to predict changes in the work ability score (WAS) at one-year follow-up. McNemar's test was used to assess the difference between these models. Results A total of 208 (22%) claimants experienced an improvement in WAS. The standard multinomial logit model predicted a relevant improvement in WAS for only 9% of the claimants [positive predictive value (PPV) 62%]. The weighted model predicted significantly more cases, 14% (PPV 63%). Predictive variables were several physical and mental functioning factors, work status, wage loss, and WAS at baseline. Conclusion This study showed that there are indications that weighted regression procedures can correctly identify more individuals who experience a relevant change in WAS compared to standard multinomial logit models. Our findings suggest that weighted analysis could be an effective method in epidemiology when predicting rare events or diseases.

Background: Large volumes of sitting time have been associated with multiple health risks. To reduce sitting time of office workers working for a Dutch insurance company, the Dynamic Work intervention was developed. The primary objective of this paper is to describe the study protocol of the Dynamic Work study, which aims to evaluate if this multicomponent intervention is (cost-)effective in reducing total sitting time on the short-term (≈3 months) and longer-term (≈12 months) compared to usual practice., Methods/design: This two-arm cluster randomized controlled trial will recruit 250 desk-based office workers working at different locations of an insurance company in the Netherlands. After baseline measurements, departments will be matched in pairs and each pair will be randomly assigned to the control or intervention condition. The multicomponent intervention contains organizational (i.e. face to face session with the head of the department), work environmental (i.e. the introduction of sit-stand desks and cycling workstations), and individual elements (i.e. counselling and activity/sitting tracker with a self-help program booklet). The counselling involves two group intervention sessions and four on-site department consultations with an occupational physiotherapist. Sitting time (primary outcome), upright time and step counts will be assessed objectively using the activPAL activity monitor at baseline, short-term (approximately 3 months) and longer-term (12 months). Other outcomes will include: self-reported lifestyle behaviours, anthropometrics, work-related outcomes (i.e. absenteeism, presenteeism, work performance, work-related stress), health-related outcomes (i.e. vitality, musculoskeletal symptoms, need for recovery, quality of life), and costs from both company and societal perspective. The study will include economic and process evaluations., Discussion: This study will assess the longer-term (cost-) effectiveness of a multicomponent workplace intervention aimed at reducing sitting time in comparison with usual practice. Furthermore, the process evaluation will provide insights in factors associated with successful implementation of this intervention., Trial Registration: ClinicalTrials.gov NCT03115645 ; Registered 13 April 2017. Retrospectively registered.

Purpose: To investigate the influence of high job demands, low job control, and high social support on need for recovery (NFR) among computer workers., Methods: Data was obtained from a longitudinal cohort study, including 5 consecutive measurements, with an in-between period of 6 months. General estimating equations analyses were performed to assess the risk for high NFR 6 months later. Odds ratios (ORs) for high NFR were calculated for high job demands, low job control and low social support, separately. Likewise, ORs were calculated for combinations of job demands and job control, as well as for combinations of job demands, job control and social support., Results: High job demands resulted in an increased risk for high NFR 6 months later, particularly in older workers. Low social support showed also an increased risk for future high NFR, but this was not the case for low job control. Furthermore, a combination of high job demands and low job control, as well as a combination of high job demands, low job control and low social support demonstrated an increased risk for future high NFR where older workers showed higher risks., Conclusion: This study demonstrated that adverse psychosocial work characteristics predicted future NFR among computer workers.

Purpose: To identify the risk factors for the onset of arm-wrist-hand and neck-shoulder symptoms among office workers and to estimate the relative contribution of these risk factors by calculating Population Attributable Fractions (PAFs)., Methods: A prospective cohort study was conducted among 1951 office workers with a follow-up duration of 2 years. Data on self-reported risk factors were collected at baseline and after 1 year of follow-up. Every 3 months, the occurrence of upper extremity symptoms was assessed using questionnaires. PAFs for individual risk factors were estimated based on Rate ratios (RRs) obtained from Poisson regression using Generalized Estimation Equations., Results: Previous disabling symptoms were identified as the most important risk factor for the onset of arm-wrist-hand and neck-shoulder symptoms. Modifiable risk factors for arm-wrist-hand symptoms with relatively large PAFs were: at least 4 h per day of self-reported computer use at work, high level of overcommitment, and low task variation and for neck-shoulder symptoms: supporting the arms during keyboard use and at least 4 h per day of self-reported mouse use at work. Compared to having 0 or 1 risk factor, the RR for arm-wrist-hand symptoms increased to 6.2 (95% CI 3.7-10.5) for having 5-7 potentially modifiable risk factors and for neck-shoulder symptoms to 3.0 (95% CI 2.1-4.4) for having 4 or 5 potentially modifiable risk factors., Conclusion: Preventive interventions at the population level should be aimed at changing modifiable risk factors with large PAFs. At the individual level, preventive interventions should be aimed at changing multiple modifiable risk factors simultaneously.

This study investigated the effects of non-obtrusive feedback on continuous lifted hand/finger behaviour, task performance and comfort. In an experiment with 24 participants the effects of two visual and two tactile feedback signals were compared to a no-feedback condition in a computer task. Results from the objective measures showed that all types of feedback were equally effective to reduce lifted hand/finger behaviour (effectiveness) compared to absence of feedback, while task performance was not affected (efficiency). In contrast to objective measures, subjective user experience was significantly different for the four types of feedback signals. Continuous tactile feedback appeared to be the best signal; not only the effectiveness and efficiency were rated reasonable, it also scored best on perceived match between signal and required action. This study shows the importance of including user experiences when investigating usability of feedback signals. Non-obtrusive feedback embedded in products and environments may successfully be used to support office workers to adopt healthy, productive and comfortable working behaviour., (Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

Objectives: In both science and media, the adverse effects of a long duration of computer use at work on musculoskeletal health have long been debated. Until recently, the duration of computer use was mainly measured by self-reports, and studies using more objective measures, such as software-recorded computer duration, were lacking. The objective of this study was to examine the association between duration of computer use at work, measured with software and self-reports, and the onset of severe arm-wrist-hand and neck-shoulder symptoms., Methods: A 2-year follow-up study was conducted between 2004 and 2006 among 1951 office workers in The Netherlands. Self-reported computer duration and other risk factors were collected at baseline and at 1-year follow-up. Computer use at work was recorded continuously with computer software for 1009 participants. Outcome questionnaires were obtained at baseline and every 3 months during follow-up. Cases were identified based on the transition within 3 months of no or minor symptoms to severe symptoms., Results: Self-reported duration of computer use was positively associated with the onset of both arm-wrist-hand (RR 1.9, 95% CI 1.1 to 3.1 for more than 4 h/day of total computer use at work) and neck-shoulder symptoms (RR 1.5, 95% CI 1.1 to 2.0 for more than 4 h/day of mouse use at work). The recorded duration of computer use did not show any statistically significant association with the outcomes., Conclusions: In the present study, no association was found between the software-recorded duration of computer use at work and the onset of severe arm-wrist-hand and neck-shoulder symptoms using an exposure window of 3 months. In contrast, a positive association was found between the self-reported duration of computer use at work and the onset of severe arm-wrist-hand and neck-shoulder symptoms. The different findings for recorded and self-reported computer duration could not be explained satisfactorily.

The study was designed to determine the effect of joystick handle size and (display-control) gain at two levels of required task precision on performance and physical load on crane operators. Eight experienced crane operators performed a simulated crane operation task on a computer by use of a joystick with either a short or a large handle. The task was performed at three gain levels and at two levels of required precision. Task performance, wrist and forearm postures, upper extremity muscle activity, perceived exertion and perceived comfort were measured.Task performance improved when using the joystick with the short handle and when working at a higher gain, while physical load decreased or remained the same. An increased level of required task precision was associated with a lower performance, but physical load was not affected. External validity of the simulated crane task seemed sufficient enough to extrapolate the results to practice.A joystick with a short handle is recommended, as this leads to an increased performance whilst the operator's physical load decreases or remains the same. Further optimization of performance and physical load can be achieved by optimizing gain settings of the joystick in relation to the task and type of joystick used.