***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: Objective : Workplace cancer prevention initiatives have been least successful with blue-collar workers . This study assesses whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables , compared to a st and ard health promotion intervention , for workers overall and for blue-collar workers in particular . Methods : A r and omized controlled design was used , with 15 manufacturing worksites assigned to a  health promotion ( HP )  or a health promotion plus occupational health and safety intervention ( HP/OHS ) , and compared from baseline ( 1997 ) to final ( 1999 ) . The response rates to the survey were 80 % at baseline ( n = 9019 ) and 65 % at final ( n = 7327 ) . Both groups targeted smoking and diet ; the HP/OHS condition additionally incorporated reduction of occupational exposures . Results : Smoking quit rates among  blue-collar  workers in the HP/OHS condition more than doubled relative to those in the HP condition ( OR = 2.13 , p = 0.04 ) , and were comparable to quit rates of white-collar workers . No statistically significant differences between groups were found for mean changes in fruits and vegetables . Conclusions : Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers BACKGROUND Environmental influences on health and health behavior have an important place in research on worksite health promotion . We tested the validity and internal consistency of a new measure of organizational health and safety climate that was used in a large r and omized trial of a worksite cancer prevention program ( the Working Well Trial ) . The result ing scales then were applied to assess intervention effects . METHODS This study uses data from a subset of 40 worksites in the Working Well Trial . Employees at 20 natural gas pipeline worksite and 20 rural electrical cooperatives completed a cross-sectional question naire at baseline and 3-year follow-up . RESULTS A factor analysis of this self-report instrument produced a two-factor solution . The result ing health and safety climate scales had good internal consistency ( Cronbach 's alpha = 0.74 and 0.82 , respectively ) and concurrent validity . The health climate scale was correlated more highly with organizational measures that were indicative of a supportive health climate than those indicating supportive safety climate , while the reverse was true of the safety climate scale . Changes in health climate were associated with the number of smoking and smokeless tobacco programs offered at the worksites at the time of the 3-year follow-up ( r = 0.46 and 0.42 , respectively ) . The scales were not correlated with most employee health behaviors . The health climate scores increased at intervention worksites , compared with scores at control worksites ( F[1,36 ] = 7.57 , P = 0.009 ) . CONCLUSIONS The health and safety climate scales developed for this study provide useful instruments for measuring organizational change related to worksite health promotion activities . The Working Well Intervention result ed in a significant improvement in worksite health climate AIM This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints , and increase coping in a population of nursing personnel . BACKGROUND . The work group in Norway with most sick leave is healthcare workers . More than 50 % of the sick leave is because of subjective health complaints . Work place physical exercise interventions have a documented positive effect on sick leave . METHOD After baseline screening , employees who had agreed to participate ( n=40 ) were r and omized to an intervention or control group . The intervention group participated in an Integrated Health Programme twice weekly during working hours . The programme consisted of physical exercise , stress management training , health information and an examination of the participants ' workplace . The control group was offered the same intervention after the project was finished . This study was carried out from 2001 to 2002 . FINDINGS There were no statistically significant effects on sick leave or health-related quality of life . The intervention group reported fewer neck complaints compared to the control group , but otherwise there were no effects on subjective health complaints . However , the subjective effects were large and highly statistically significant , the intervention group reporting improvement in health , physical fitness , muscle pain , stress management , maintenance of health and work situation . CONCLUSION The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints , but may be of use to employers wanting to increase employee job satisfaction and well-being According to prior reports , blue-collar workers are less likely to participate in worksite health promotion programs than are white-collar workers . This study examined worker participation in the WellWorks worksite cancer prevention intervention , which integrated health promotion and health protection . Analyses were conducted to assess relationships among participation in health promotion and health protection programs , and workers ' perceptions of management changes to reduce potential occupational exposures . Results indicate that blue-collar workers were less likely to report participating in health promotion activities than white-collar workers . A significant association was observed between participation in nutrition- and exposure-related activities , suggesting that participation in programs to reduce exposures to occupational hazards might contribute to blue-collar workers ' participation in health promotion activities . Furthermore , when workers were aware of changes their employer had made to reduce exposures to occupational hazards , they were more likely to participate in both smoking control and nutrition activities , even when controlling for job category . These findings have clear implication s for future worksite cancer prevention efforts OBJECTIVES We examined the efficacy of a cancer prevention intervention design ed to improve health behaviors among working-class , multiethnic population s employed in small manufacturing businesses . METHODS Worksites were r and omly assigned to an intervention or minimal-intervention control condition . The intervention targeted fruit and vegetable consumption , red meat consumption , multivitamin use , and physical activity . RESULTS Employees in the intervention group showed greater improvements for every outcome compared with employees in the control group . Differences in improvement were statistically significant for multivitamin use and physical activity . Intervention effects were larger among workers than among managers for fruit and vegetable consumption and for physical activity . CONCLUSIONS The social- context model holds promise for reducing disparities in health behaviors . Further research is needed to improve the effectiveness of the intervention PROBLEM STATEMENT Nurses have one of the highest rates of work-related musculoskeletal injury of any profession . Over the past 30 years , efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful . SPECIFIC AIMS The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care . Our first objective was to design and implement a multifaceted program that successfully integrated evidence -based practice , technology , and safety improvement . The second objective was to evaluate the impact of the program on injury rate , lost and modified work days , job satisfaction , self-reported unsafe patient h and ling acts , level of support for program , staff and patient acceptance , program effectiveness , costs , and return on investment . INTERVENTION The intervention included six program elements : ( 1 ) Ergonomic Assessment Protocol , ( 2 ) Patient H and ling Assessment Criteria and Decision Algorithms , ( 3 ) Peer Leader role , " Back Injury Re source Nurses " , ( 4 ) State-of-the-art Equipment , ( 5 ) After Action Review s , and ( 6 ) No Lift Policy . METHODS A pre-/post design without a control group was used to evaluate the effectiveness of a  patient care ergonomics program  on 23 high risk units ( 19 nursing home care units and 4 spinal cord injury units ) in 7 facilities .  Injury rates , lost work days , modified work days , job satisfaction , staff , and patient acceptance , program effectiveness , and program costs/savings were compared over two nine month periods : pre-intervention ( May 2001-January 2002 ) and post-intervention ( March 2002-November 2002 ) . Data were collected prospect ively through surveys , weekly process logs , injury logs , and cost logs . RESULTS The program elements result ed in a statistically significant decrease in the rate of musculoskeletal injuries as well as the number of modified duty days taken per injury . While the total number of lost workdays decreased by 18 % post-intervention , this difference was not statistically significant . There were statistically significant increases in two subscales of job satisfaction : professional status and tasks requirements . Self-reports by nursing staff revealed a statistically significant decrease in the number of ' unsafe ' patient h and ling practice s performed daily . Nurses ranked program elements they deemed to be " extremely effective " : equipment was rated as most effective ( 96 % ) , followed by No Lift Policy ( 68 % ) , peer leader education program ( 66 % ) , ergonomic assessment protocol ( 59 % ) , patient h and ling assessment criteria and decision algorithms ( 55 % ) , and lastly after action review s ( 41 % ) . Perceived support and interest for the program started at a high level for managers and nursing staff and remained very high throughout the program implementation . Patient acceptance was moderate when the program started but increased to very high by the end of the program . Although the ease and success of program implementation initially varied between and within the facilities , after six months there was strong evidence of support at all levels . The initial capital investment for patient h and ling equipment was recovered in approximately 3.75 years based on annual post-intervention savings of over $ 200,000/year in workers ' compensation expenses and cost savings associated with reduced lost and modified work days and worker compensation . CONCLUSIONS This multi-faceted program result ed in an overall lower injury rate , fewer modified duty days taken per injury , and significant cost savings . The program was well accepted by patients , nursing staff , and administrators . Given the significant increases in two job satisfaction subscales ( professional status and task requirements ) , it is possible that nurse recruitment and retention could be positively impacted Objective Blue-collar workers are difficult to reach and less likely to successfully quit smoking . The objective of this study was to test a training site-based smoking cessation intervention . Methods This study is a r and omized-controlled trial of a smoking cessation intervention that integrated occupational health concerns and was delivered in collaboration with unions to apprentices at 10 sites ( n = 1,213 ) . We evaluated smoking cessation at 1 and 6 months post-intervention . Results The baseline prevalence of smoking was 41 % . We observed significantly higher quit rates in the intervention versus control group ( 26 % vs. 16.8 % ; p = 0.014 ) 1 month after the intervention . However , the effects diminished over time so that the difference in quit rate was not significant at 6 month post-intervention ( 9 % vs. 7.2 % ; p = 0.48 ) . Intervention group members nevertheless reported a significant decrease in smoking intensity ( OR = 3.13 ; 95 % CI : 1.55–6.31 ) at 6 months post-intervention , compared to controls . Conclusion The study demonstrates the feasibility of delivering an intervention through union apprentice programs . Furthermore , the notably better 1-month quit rate results among intervention members and the greater decrease in smoking intensity among intervention members who continued to smoke underscore the need to develop strategies to help reduce relapse among blue-collar workers who quit smoking This study is a prospect i ve multicentre cohort study entitled Work and Health in the Processing and Engineering Industries , the AHA Study ( AHA is the Swedish abbreviation for the study ) . Four large workplaces in Sweden participated during the years from 2000 to 2003 . The present report has two objectives : ( 1 ) to present a comprehensive occupational health intervention programme and ( 2 ) to evaluate this programme with a focus on lifestyle ( smoking and exercise ) , health related quality of life ( HRQoL ) and sick leave . Interventions were provided on an individual and group level , including evidence -based methods for four health/focus areas ( individual level ) and a group intervention based on a survey-feedback methodology . The analyses in this report were exclusively employed at an organizational level . The proportion of smokers decreased at three companies and the course of the HRQoL was advantageous at two of the companies as compared to a gainfully employed reference group . A significant decrease in sick leave was revealed at one company , whereas a break in an ascending sick-leave trend appeared at a second company as compared to their respective corporate groups . This comprehensive workplace intervention programme appears to have had positive effects on smoking habits , HRQoL and sick leave Disparities in chronic disease risk by occupation call for newapproaches to health promotion . Well Works-2 was a r and omized , controlled study comparing the effectiveness of a health promotion/occupational health program ( HP/OHS ) with a st and ard intervention ( HP ) . Interventions in both studies were based on the same theoretical foundations . Results from process evaluation revealed that a similar number of activities were offered in both conditions and that in the HP/OHS condition there were higher levels of worker participation using three measures : mean participation per activity ( HP : 14.2 % vs. HP/OHS : 21.2 % ) , mean minutes of worker exposure to the intervention/site ( HP : 14.9 vs. HP/OHS : 33.3 ) , and overall mean participation per site ( HP : 34.4 % vs. HP/ OHS : 45.8 % ) . There were a greater number of contacts with management ( HP : 8.8 vs. HP/OHS : 24.9 ) in the HP/ OHS condition . Addressing occupational health may have contributed to higher levels of worker and management participation and smoking cessation among blue-collar workers Objective : PHLAME ’s ( Promoting Healthy Lifestyles : Alternative Models ’ Effects ) objective was to assess and compare two means to promote healthy lifestyles . Methods : Prospect i ve trial among 599 firefighters r and omized by station to 1 ) team-centered curriculum , 2 ) one-on-one motivational interviewing ( MI ) , and 3 ) controls .  Assessment included dietary behavior , physical activity , weight , 
    Output:
    
Effective interventions were most of those aim ed at improving employee physical or mental health .
Less consistent results were reported from integrated interventions targeting occupational health and safety management , injury prevention , or organizational cost savings .
Integrated approaches have been posed as comprehensive solutions to complex issues .