| 1. |
- Blom, Victoria, 1975-
(författare)
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Striving for self-esteem : Conceptualizations and role in burnout
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- When self-esteem is dependent on competence individuals invest a great deal of effort in their accomplishments in order to validate themselves. The aim of the present thesis was to develop a theoretically sound and valid concept and measure of contingent self-esteem dependent on competence, and examine its vulnerable implications and role in burnout. In Study I a concept and measure of contingent self-esteem dependent on competence, termed competence-based self-esteem (CBSE), was developed. Confirmatory factor analyses showed its distinctiveness from other sources of self-esteem and revealed two dimensions comprising behaviors referring to: i) Self-esteem conditional upon competence and ii) Frustrated self-critical strivings. The new scale showed high reliability and gained both convergent and discriminative validity through different methods in different samples. Study II set out to experimentally test the vulnerable implications of CBSE in a performance situation. The results showed that high, as compared to low, scorers on the scale exhibited stronger physiological reactivity and momentary exertion coupled with frustrated mood. Study III focused on the role of self-esteem contingent on competence in the burnout process and its association with work- and private-life stressors over time in working women and men. The analyses showed that contingent self-esteem was a predictor of burnout. In addition, women scored higher on both contingent self-esteem and burnout and reported higher general life stress than did men, whereas men showed stronger associations between work stressors and burnout. The results of the three studies suggest that contingent self-esteem, where outcomes of one’s acts and performance serve to compensate an impoverished basic self-worth, facilitates the understanding of stress-related vulnerability and ill-health.
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| 2. |
- Larisch, Lisa-Marie
(författare)
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Movement behavior and mental health in office workers : Associations and intervention effects
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mental disorders pose a significant global health challenge. To effectively address this challenge, mental health promotion must be included in various sectors, including workplaces. Various strategies for promoting mental health in the workplace have been suggested, including interventions aimed at improving movement behavior, i.e., sitting less and moving more. Physical activity (PA) and sedentary behavior (SED) are established determinants of mental health. However, there are aspects of the relationship between movement behavior and mental health that are not well understood, for example, the combined effects of all movement behaviors occurring throughout the daily 24-hour cycle, i.e., time in bed, SED, light-intensity physical activity, and moderate to vigorous physical activity (MVPA), on mental health. In addition, only a few well-designed workplace interventions for improving movement and mental health outcomes have been tested. Office workers often spend extensive amounts of time being sedentary and might particularly benefit from such interventions. The aims of this thesis were (1) to investigate cross-sectional associations between 24-hour movement behavior and mental health among office workers and (2) to evaluate the efficacy, acceptability, feasibility, and fidelity of two cluster randomized controlled trial (RCT) interventions for improving movement behavior and mental health using quantitative and qualitative methods.In Paper I, we investigated cross-sectional associations between 24-hour movement behavior and mental health outcomes (symptoms of depression and anxiety, burnout, mental wellbeing, and stress) among office workers (N=345-370). Movement behavior was measured using accelerometers and sleep diaries. Mental health outcomes were assessed using validated questionnaires. Only the proportion of time spent in MVPA, relative to all other behaviors, was positively associated with mental wellbeing. Papers II-IV were based on a three-armed cluster RCT among office workers (N=263). During the 6-month intervention period, the iSED intervention group focused on reducing SED, and the iPA intervention group focused on increasing MVPA compared to a wait-list control group. The multi-level interventions were designed based on ecological models of health behavior, addressing the individual office workers as well as their physical, social, and organizational work environment. Paper II investigated intervention effects on accelerometer-measured 24-hour movement behavior and cardiorespiratory fitness. We considered overall 24-hour movement behavior and movement behavior during work versus non-work time. No intervention effects were found. Paper III was based on a qualitative study that was embedded in the RCT. It investigated the acceptability, feasibility, and fidelity of intervention components that addressed the individual, environmental and organizational level. Interviews and focus group discussions were performed with 38 key stakeholders after the 6-month intervention period. The study included office workers who received the interventions, health coaches who delivered counseling sessions, team leaders who were responsible for implementing group activities, and human resource and higher management staff who provided support at the organizational level. In general, the interventions were well appreciated, and components seemed to work as intended when delivered as intended. Many office workers experienced improvements in movement behavior and wellbeing and ascribed those to the interventions. Acceptability, feasibility, and fidelity of individual-level components were high but reduced for components depending on team leaders, mainly due to challenges associated with recruiting managers as team leaders and forming teams. Manager and team support were considered crucial for promoting more PA and less SED, yet many participants reported a lack of such support. Thus, identified challenges with these components might have reduced overall intervention efficacy. Paper IV investigated intervention effects on mental health outcomes (symptoms of depression or anxiety, mental wellbeing, and stress). In addition, we explored whether changes in mean PA intensity mediated or moderated intervention effects. The interventions improved mental wellbeing for the combined intervention groups and the iSED group but not for the iPA group compared to the control group. The interventions improved mean PA intensity, but mean PA intensity did not mediate intervention effects on any outcome. Mean PA intensity moderated intervention effects on mental wellbeing. Participants who reduced mean PA intensity reduced mental wellbeing compared to participants who did not change mean PA intensity. This highlights the importance of maintaining high levels of PA for mental wellbeing.This thesis contributes to existing knowledge by applying a rigorous investigation of cross-sectional associations between 24-h movement behavior and mental health among office workers and by conducting a comprehensive analysis of intervention effects. It offers valuable insights and considerations that may inform occupational health practitioners, employers, policy makers, and researchers and may contribute to developing future effective interventions.
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| 3. |
- Larisch, Lisa-Marie, et al.
(författare)
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Changing movement behavior for improving mental health among office workers: A qualitative study on acceptability, feasibility and fidelity of two RCT interventions
- 2022
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Konferensbidrag (refereegranskat)abstract
- Background: Behavior change research suggests that interventions addressing not only the individual, but also the environmental and organizational level might be more effective than those addressing only one. However, few RCTs have tried to change movement behavior among office workers with the aim of improving mental health outcomes, using multi-component interventions that address several levels. Above that, researchers seldomly assess acceptability, feasibility and fidelity of such complex interventions, even though they are considered important moderators of study outcomes. Purpose: This study aims at determining aspects of intervention acceptability, feasibility and fidelity of two multi-component cluster RCT interventions among office workers (N=263). Specifically, we want to answer: 1. How did participants experience specific intervention components as facilitating or hindering a movement behavior change? 2. Which factors in the work and non-work context did participants experience as facilitating or hindering a movement behavior change? 3. Were intervention components implemented and perceived as intended? Methods The interventions addressed the individual level (counseling sessions based on cognitive behavior therapy and motivational interviewing), the environmental level (e.g. walking meetings or lunch walks organized by team leaders) and the organizational level (participation during work time, employers encouraging participation). One intervention focused on reducing sedentary behavior, the other on increasing physical activity, compared to a wait-list control group. After completion of the 6-month intervention period, audio-recorded interviews and focus group discussions were performed with participants, health coaches delivering the counseling sessions, team leaders and Human Resource staff). Verbatim transcribed data will be analyzed using thematic analysis (Braun&Clarke 2006). An initial codebook based on a-priori themes of interest will be created. Two researchers will apply it to a subset of transcripts, in an inductive fashion whilst allowing for new themes to emerge. Once agreement on a final version of the codebook will be achieved, remaining transcripts will be analyzed accordingly. Implications: We expect that the results of this study may help to understand and interpret the results of the quantitative effectiveness evaluations. This study may generate valuable knowledge that can inform future similar studies or workplace health promotion efforts and make their conduct more efficient.
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| 4. |
- Larisch, Lisa-Marie, et al.
(författare)
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Effectiveness of two randomized and controlled multi-component interventions on 24-h movement behavior and mental health outcomes among office workers
- 2022
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Konferensbidrag (refereegranskat)abstract
- Background: To date it is unknown whether movement behavior change interventions among office workers are effective for improving mental health. Therefore, we designed a multi-component cluster RCT among office workers (N=263). One intervention group focused on reducing sedentary behavior (SED), the other on increasing moderate to vigorous physical activity (MVPA) compared to a wait-list control group. Based on ecological models of health behavior, intervention components addressed the individual (counseling using cognitive behavioral therapy (CBT) and motivational interviewing (MI)), the environmental (group activities such as lunch walks), and the organizational level (companies promoting the interventions internally). Primary outcomes were changes in accelerometer-measured and self-reported SED and MVPA, secondary outcomes were depression and anxiety symptoms, burnout, stress and mental well-being, assessed via validated, web- based questionnaires. Previous analyses using a compositional data analysis (CoDA) approach did not find intervention effects on 24-h movement behavior, i.e., SED, light intensity, moderate or vigorous physical activity. Purpose: This study aims at investigating intervention effects on mental health, i.e., depression and anxiety symptoms, burnout, stress and mental well-being. Secondary aims are to describe those participants that achieved a significant change in accelerometer- and device-measured SED and MVPA in comparison to those that did not, and to investigate whether changes in movement behavior were associated with changes in mental well-being. Methods: Linear mixed model analysis will be performed to analyze effects on mental health, according to the published study protocol. Performing exploratory analyses, quartiles of participants, based on changes in MVPA and SED, will be described on demographic characteristics and compared across quartiles. Change change analyses will investigate whether changes in SED or MVPA are associated with changes in mental well-being. CoDA will be applied, taking the co-dependence of 24-h movement behaviors into account. Implications: High sedentariness and sick-leave due to mental illness are challenges associated with office work. This RCT is the first among office workers that applies a multi-component approach to address several levels of health behavior, and that includes CBT and MI techniques. Results may inform occupational health and researcher efforts aiming at addressing the burden of sedentariness and its related consequences on mental health.
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| 5. |
- Larisch, Lisa-Marie, et al.
(författare)
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Improving movement behavior in office workers : effects of two multi-level cluster-RCT interventions on mental health
- 2024
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Ingår i: BMC Public Health. - : Springer. - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: We have previously reported on the design and efficacy of two cluster-randomized multi-level workplace interventions, attempting to decrease sedentary behavior (SED) or increase moderate to vigorous physical activity (MVPA) among office workers to improve mental health outcomes. The aim of this study was to investigate intervention effects on mental health outcomes, i.e., mental wellbeing, depression or anxiety symptoms, and stress immediately after the 6-month intervention period.Methods: Teams of 263 office workers were cluster-randomized to one of two interventions or a waitlist control group. The PA intervention (iPA) focused on increasing MVPA and the SED intervention (iSED) on reducing SED. Both multi-level interventions targeted individual office workers and their social, physical, and organizational work environment, incorporating counseling based on cognitive behavioral therapy and motivational interviewing. Mental health outcomes were assessed using validated questionnaires before and immediately after the intervention. Intervention effects were analyzed using linear mixed effects models.Results: Participants were mostly female and highly educated, with a mean age of 42 years and had favorable levels of mental health at baseline. Mental wellbeing improved for the iSED group (β = 8, 95% CI 1 to 15, p = 0.030) but not for the iPA group (β = 6, 95% CI -1 to 12, p = 0.072) compared to the control group. No effects were found for depression or anxiety symptoms or stress.Conclusions: The multi-level interventions improved mental wellbeing among this population of office workers, reaching statistical significance in the iSED group. The size of the effect can be regarded meaningful, considering favorable mental health and high PA level at baseline. Thus, workplace interventions that provide support on multiple levels appear to have potential for improving mental wellbeing, but not reducing ill-health variables, among healthy office workers. More research is needed to understand the mechanisms through which such improvements can be achieved and to identify the most effective intervention components.
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| 6. |
- Larisch, Lisa-Marie, et al.
(författare)
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"It depends on the boss" - a qualitative study of multi-level interventions aiming at office workers' movement behaviour and mental health
- 2023
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This embedded qualitative study explored the acceptability, feasibility, and fidelity of two multi-level RCT interventions among office workers, aiming at improving movement behaviour to enhance mental health and cognition. The interventions addressed the organizational, environmental, and individual level.Methods: Semi-structured interviews and focus group discussions were conducted with 38 stakeholders after completion of the interventions. Data were analysed using reflexive thematic analysis.Results: The interventions were well appreciated, and office workers attributed improvements in movement behaviour and wellbeing to the interventions. Especially the cognitive behavioural therapy (CBT) based counselling and free gym access were appreciated, feasible and delivered as planned. Participants described existing workplace norms as barriers to more activity, particularly for reducing sitting. Support from managers and team support were considered crucial components. However, delivering these components was difficult.Conclusions: The findings support the design of the multi-level interventions for changing movement behaviour. Results highlight the potential of CBT for this target group and the importance of manager and team support. Desired effects of similar multi-level interventions, including CBT, might be achieved in future studies that carefully address the issues with feasibility and acceptability and the resulting low fidelity of some intervention components that were identified in this study.
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