***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Both low back pain ( LBP ) and neck pain ( NP ) are major occupational health problems . In the workplace , participatory ergonomics ( PE ) is frequently used on musculoskeletal disorders . However , evidence on the effectiveness of PE to prevent LBP and NP obtained from r and omised controlled trials ( RCTs ) is scarce . This study evaluates the process of the Stay@Work participatory ergonomics programme , including the perceived implementation of the prioritised ergonomic measures . Methods This cluster- RCT was conducted at the departments of four Dutch companies ( a railway transportation company , an airline company , a steel company , and a university including its university medical hospital ) . Directly after the r and omisation outcome , intervention departments formed a working group that followed the steps of PE during a six-hour working group meeting . Guided by an ergonomist , working groups identified and prioritised risk factors for LBP and NP , and composed and prioritised ergonomic measures . Within three months after the meeting , working groups had to implement the prioritised ergonomic measures at their department . Data on various process components ( recruitment , reach , fidelity , satisfaction , and implementation components , i.e. , dose delivered and dose received ) were collected and analysed on two levels : department ( i.e. , working group members from intervention departments ) and participant ( i.e. , workers from intervention departments ) . Results A total of 19 intervention departments ( n = 10 with mental workloads , n = 1 with a light physical workload , n = 4 departments with physical and mental workloads , and n = 4 with heavy physical workloads ) were recruited for participation , and the reach among working group members who participated was high ( 87 % ) . Fidelity and satisfaction towards the PE programme rated by the working group members was good ( 7.3 or higher ) . The same was found for the Stay@Work ergocoach training ( 7.5 or higher ) . In total , 66 ergonomic measures were prioritised by the working groups . Altogether , 34 % of all prioritised ergonomic measures were perceived as implemented ( dose delivered ) , while the workers at the intervention departments perceived 26 % as implemented ( dose received ) . Conclusions PE can be a successful method to develop and to prioritise ergonomic measures to prevent LBP and NP . Despite the positive rating of the PE programme the implementation of the prioritised ergonomic measures was lower than expected . Trial registration Current Controlled Trials IS RCT In web-based health promotion programs , large variations in participant engagement are common . The aim was to investigate determinants of high use of a  worksite self-help web-based program for  stress management . Two versions of the program were offered to r and omly selected departments in IT and media companies . A static version of the program including health screening tool , diary and information about stress was offered to the control group . Additional material s , i.e. interactive , cognitive-based and classical stress management exercises and a chat room , were offered to the intervention group . Baseline data regarding participants ' demographics , health ( self-ratings and biological measures ) , lifestyle , work-related factors and group membership were analyzed to study determinants of employees ' participation in the program during a period of 12 months . Multiple logistic regression analysis was used and found intervention group membership , being a woman , having at most a secondary education , regular physical exercise habits and having positive expectations of the program were significant predictors of high use . The findings demonstrate that the interactivity of a web-based program is an important factor for determining participation in a web-based worksite stress management  program . Implication s for those developing and implementing future web-based health promotion activities are discussed OBJECTIVE To evaluate the effectiveness of a lifestyle intervention for male workers in the construction industry at risk of cardiovascular disease ( CVD ) . METHODS In a r and omized controlled trial performed in the Netherl and s between 2007 and 2009 , usual care was compared to 6 months of individual counseling using motivational interviewing techniques , delivered face to face and by telephone . Participants aim ed at improving energy balance-related behavior or smoking cessation . Linear regression analyses were performed to determine the effects . RESULTS Body weight had significantly decreased at 6 ( β=-1.9 , 95 % CI -2.6 ; -1.2 ) and 12 months ( β=-1.8 , 95%CI -2.8 ; -1.1 ) . The intervention effects were also significant for diastolic blood pressure at 6 months ( β=-1.7 , 95 % CI -3.3 ; -0.1 ) . Among participants who had aim ed at energy balance , the intervention had a significant favorable effect on body weight at 6 ( β=-2.1 , 95 % CI -2.9 ; -1.3 ) and 12 months ( β=-2.2 , 95 % CI -3.1 ; -1.3 ) and at HDL cholesterol ( β=0.05 , 95 % CI 0.01 ; 0.10 ) and HbA1c ( β=-0.06 , 95%CI -0.12 ; -0.001 ) at 12 months , although there was no intervention effect on these variables over time . CONCLUSION Individual-based counseling result ed in significant beneficial long-term effects on body weight . This is an important finding for occupational health , considering the rising prevalence of obesity and CVD BACKGROUND This study explored the experiences of university employees recruited to a 10-week r and omized controlled trial ( n = 64 ) . The trial compared " walking routes " with " walking-while-working " on daily step totals , showing that , compared with controls , interventions result ed in around 1000 extra steps per day . METHODS A sub sample of 15 academic and administrative employees from intervention groups completed interviews at the end of intervention . Interviews were transcribed verbatim and subject to inductive coding within the major themes of benefits /positives and problems/barriers . FINDINGS Both interventions benefited employee health and work productivity but were difficult to implement in the workplace . Involvement in walking routes was challenged by the difficulties of managing time pressures , and individuals assigned to walking-while-working had to deal with local management subcultures favoring physical presence and inactivity . CONCLUSIONS Findings highlight the need for further research , advocate the value of walking at work , and provide insights into the challenges that face staff in workplace interventions Background Only a few workplace initiatives among cleaners have been reported , even though they constitute a job group in great need of health promotion . The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain , work ability and sickness absence among cleaners . Methods A cluster-r and omised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training ( PCT ) , cognitive behavioural training ( CBTr ) or a reference group ( REF ) .  Question naires about musculoskeletal pain and work ability were completed at baseline and after one year 's intervention . Sickness absence data were obtained from the managers ' records . Analyses were performed according to the intention-to-treat-principle ( ITT ) . Results No overall reduction in musculoskeletal pain , work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses . However , explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT . People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF ( p = 0.05 ) . Conclusions The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners . It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence . Trial registration IS RCT N : IS RCT Background Low back pain ( LBP ) and neck pain ( NP ) are common among workers .  Participatory Ergonomics ( PE ) is used as an implementation strategy to prevent these symptoms . By following the steps of PE , working groups composed and prioritised ergonomic measures , and developed an implementation plan . Working group members were responsible to implement the ergonomic measures in their departments . Little is known about factors that hamper ( barriers ) or enhance ( facilitators ) the implementation of ergonomic measures . This study aim ed to identify and underst and the possible barriers and facilitators that were perceived during implementation . Methods This study is embedded in a cluster r and omised controlled trial that investigated the effectiveness of PE to prevent LBP and NP among workers . For the purpose of the current study , question naires were sent to 81 working group members . Their answers were used to make a first inventory of possible barriers and facilitators to implementation . Based on the question naire information , 15 semi-structured interviews were held to explore the barriers and facilitators in more detail . All interviews were audio taped , transcribed verbatim , and analysed according to a systematic approach . Results All possible barriers and facilitators were obtained from question naire data , indicating that the semi-structured interviews did not yield information about new factors . Various barriers and facilitators were experienced . The presence of implementation plans for ergonomic measures  that were already approved by the management facilitated implementation before the working group meeting . In these cases , PE served as a strategy to improve the implementation of the approved measures . Furthermore , the findings showed that the composition of a working group ( i.e. , including decision makers and a worker who led the implementation process ) was important . Moreover , stakeholder involvement and collaboration were reported to considerably improve implementation . Conclusions This study showed that the working group as well as stakeholder involvement and collaboration were important facilitating factors . Moreover , PE was used as a strategy to improve the implementation of existing ergonomic measures . The results can be used to improve PE programmes , and thereby may contribute to the prevention of LBP and NP.Trial registration numberIS RCT Background : Environmental interventions directed at portion size might help consumers to reduce their food intake . Objective : To assess whether offering a smaller hot meal , in addition to the existing size , stimulates people to replace their large meal with a smaller meal . Design : Longitudinal r and omized controlled trial assessing the impact of introducing small portion sizes and pricing strategies on consumer choices . Setting / participants : In all , 25 worksite cafeterias and a panel consisting of 308 consumers ( mean age=39.18 years , 50 % women).Intervention : A small portion size of hot meals was offered in addition to the existing size . The meals were either proportionally priced ( that is , the price per gram was comparable regardless of the size ) or value size pricing was employed . Main outcome measures : Daily sales of small and the total number of meals , consumers ’ self-reported compensation behavior and frequency of purchasing small meals . Results : The ratio of small meals sales in relation to large meals sales was 10.2 % . No effect of proportional pricing was found B=−0.11 ( 0.33 ) , P=0.74 , confidence interval ( CI ) : −0.76 to 0.54 ) . The consumer data indicated that 19.5 % of the participants who had selected a small meal often-to-always purchased more products than usual in the worksite cafeteria . Small meal purchases were negatively related to being male ( B=−0.85 ( 0.20 ) , P=0.00 , CI : −1.24 to −0.46 , n=178 ) . Conclusion : When offering a small meal in addition to the existing size , a percentage of consumers that is considered reasonable were inclined to replace the large meal with the small meal . Proportional prices did not have an additional effect . The possible occurrence of compensation behavior is an issue that merits further attention Objectives To study the effect of a participatory ergonomics intervention on psychosocial factors  among kitchen workers . Design A cluster r and omised controlled trial . Setting Four cities in Finl and , 2002–2005 . Participants 504 workers in 119 municipal kitchens . Intervention Kitchens were r and omised to intervention ( n=59 ) and control ( n=60 ) groups . The intervention lasted 11–14 months and was based on the workers ' active participation in work analysis , planning and implementing the ergonomic changes aim ed at decreasing the physical and mental workload . Main outcome measures Mental stress , mental strenuousness of work , hurry , job satisfaction , job control , skill discretion , co-worker relationships and supervisor support . Data were collected by question naire at baseline , at the end of the intervention , and at a 12-month follow-up ( PI12 ) . Results At the end of the intervention , the OR of job dissatisfaction for the intervention group as compared with the control group was 3.0 ( 95 % CI 1.1 to 8.5 ) , of mental stress 2.3 ( 1.2 to 4.7 ) and of poor co-worker relationships 2.3 ( 1.0 to 5.2 ) . At the PI12 , the OR of job dissatisfaction was 3.0 ( 1.2 to 7.8 ) . Analysis of the independent and joint effects of the intervention and unconnected organisational reforms showed that adverse changes were accentuated among those with exposure to both . Conclusions No favourable effects on psychosocial factors at work were found . The adverse changes were due to a joint effect of the intervention and the unconnected organisational reforms . The findings do not support the usefulness of this kind of intervention in changing unsatisfactory psychosocial working conditions BACKGROUND Smoking is the leading preventable cause of premature death in the United States . Previous studies of financial incentives for smoking cessation in work setting s have not shown that such incentives have significant effects on cessation rates , but these studies have had limited power , and the incentives used may have been insufficient . METHODS We r and omly assigned 878 employees of a multinational company based in the United States to receive information about smoking-cessation programs ( 442 employees ) or to receive information about programs plus financial incentives ( 436 
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The most frequently reported facilitator was strong management support .
Conclusions Process evaluations are not systematic ally performed alongside effectiveness studies for WHPPs .
The quality of the process evaluations is mostly poor to average , result ing in a lack of systematic ally measured barriers/facilitators .
The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation .