1. |
- Elling, Devy L., et al.
(author)
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Effects of a multi-component alcohol prevention program in the workplace on hazardous alcohol use among employees
- 2023
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In: BMC Public Health. - : Springer Nature. - 1471-2458. ; 23
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Journal article (peer-reviewed)abstract
- Background: The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees.Methods: Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness.Results: No statistically significant difference was observed in the odds of hazardous alcohol use, although employees in the intervention group showed a larger decrease compared to the control group. This remained even after adjusting for several factors, including the sociodemographic factors and policy awareness.Conclusions: The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions.
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2. |
- Elling, Devy L., et al.
(author)
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Effects of a multi-component alcohol prevention programme in the workplace on hazardous alcohol use among employees
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Other publication (other academic/artistic)abstract
- Background: The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees.Methods: Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs intervention), time (baseline vs 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness.Results: Employees in the intervention group showed a larger decrease in the odds of hazardous alcohol use compared to the control group. However, this difference was not statistically significant, even after adjusting for several factors, including the sociodemographic factors and policy awareness.Conclusions: The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions. Trial registration: ISCRTN: ISRCTN17250048.
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3. |
- Elling, Devy L., et al.
(author)
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Evaluation of a workplace alcohol prevention program targeted on managers’ inclination to initiate early alcohol interventions
- 2022
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In: Work. - 1051-9815 .- 1875-9270. ; 73:2, s. 517-526
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Journal article (peer-reviewed)abstract
- Background: Alcohol interventions targeting the adult population are often conducted in healthcare settings, while preventive interventions often target adolescents or young adults. The general working population is often overlooked. A workplace-based intervention, consisting of development and implementation of an organizational alcohol policy, and skills development training for managers (APMaT) was carried out in order to prevent and reduce alcohol-related harms by identifying hazardous consumers at an early stage. Objective: This study aims to evaluate APMaT by focusing on managers’ inclination to initiate early alcohol intervention.Methods: In a cluster randomized design, data were obtained from 187 managers (control: n = 70; intervention: n = 117). Inclination to initiate early alcohol intervention was measured using three items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Changes in managers’ inclination to intervene were analyzed by applying multilevel ordered logistic regression. Predictors included in the model were group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time).Results: Significant increase in inclination to intervene against hazardous alcohol consumption among managers in the intervention group compared to managers in the control group was observed. Specifically, a 50% increase of confidence to initiate an intervention was observed among managers in the intervention group.Conclusions: APMaT seems effective to increase managers’ inclination to intervene early against hazardous consumption in the workplace. The effectiveness of APMaT at the employee level should be explored in prospective studies.
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4. |
- Elling, Devy Lysandra, 1992-
(author)
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Intervening in a social world : An evaluation of an alcohol prevention programme in a Swedish workplace context
- 2022
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Doctoral thesis (other academic/artistic)abstract
- A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels.Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions.Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage.Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alcohol use within the given follow-up time.Given the mixed support for the effectiveness provided by Studies II and III, Study IV described managers’ perceived barriers in the dissemination of their organisational alcohol policy. This dissemination was an important component of APMaT because all managers were expected to facilitate its implementation throughout the workplace. Uncertainties and a variety of perceived organisational obstacles were reported by the managers to have hindered the dissemination of the organisational alcohol policy.This thesis highlights the complexity of delivering and implementing an intervention in a complex and dynamic setting, such as the workplace. The findings suggested that the investigated intervention, APMaT, might be effective in changing attitudes among managers, whereas no concrete effects on employees’ hazardous alcohol use could be demonstrated. Nevertheless, the studies contributed with knowledge to the development of prospective workplace prevention programmes.
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5. |
- Sundqvist, Kristina, 1973-, et al.
(author)
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Problem gambling and anxiety disorders in the general swedish population : a case control study
- 2022
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In: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 38, s. 1257-1268
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Journal article (peer-reviewed)abstract
- Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.
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6. |
- Sundqvist, Kristina, 1973-, et al.
(author)
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The Association Between Problem Gambling and Suicidal Ideations and Attempts : A Case Control Study in the General Swedish Population
- 2022
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In: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 38:2, s. 319-331
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Journal article (peer-reviewed)abstract
- The association between problem gambling and suicidal behaviours is well established in treatment seeking populations, but less explored among sub-clinical problem gamblers in the general population. The aim of this study was to examine the association between problem gambling (including moderate risk gambling) and suicidal ideations/suicide attempts, in the general Swedish population. Another aim was to compare problem gamblers with and without suicide ideation/attempts. A case-control study nested in the Swelogs cohort was used. Both ideations and attempts were about twice as frequent among the cases compared to the controls. After controlling for socio-economic status and life-time mental health problems, suicidal ideation, but not attempts, remained significantly higher among the cases compared to the controls. The largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators. Problem gambling severity (PGSI 8+) resulted in the smallest difference, compared to the other variables, between attempters and non-attempters. Even though no conclusion regarding the casual relationship can be drawn in this type of study, it seems like sub-clinical levels of problem gambling might have an impact on suicidal ideations whereas for suicide attempts to occur, other factors need to be present. In addition to mental health issues, financial difficulties may be such factors.
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7. |
- Wilson Martinez, Martina, 1991, et al.
(author)
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Swedish Managers’ and HR-Officers’ Experiences and Perceptions of Participating in Alcohol Prevention Skills Training : A Qualitative Study
- 2022
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In: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 13
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Journal article (peer-reviewed)abstract
- Objective: The objective of this study was to explore Swedish managers’ and HR-officers’ experiences and perceptions of skills training including a development and implementation of an alcohol policy.Methods: Semi-structured interviews were conducted with Swedish managers (n = 44) and HR-officers (n = 9) from nine different organizations whom had received skills training and an organizational policy implementation. The interviews were analyzed using thematic analyses.Results: In total, nine themes were identified as: The prevalence of alcohol problems: a wake-up call; a reminder to intervene immediately; an altered view of the responsibility of the employer; initiating conversations about alcohol: a useful toolbox; an imprecise, yet positive, memory; increased awareness of issues related to alcohol culture; I have not heard a word about a new alcohol policy; the alcohol policy: a mere piece of paper; and alcohol problem prevention: hardly a low-hanging fruit. Participants’ experiences of the skills training were positive overall.Conclusion: Various aspects of the skills training were appreciated by managers and HR-officers, including insight of prevalence statistics and employer responsibilities. Participants emphasized the value of repeated skills training occasions for retaining knowledge. Future research may investigate further in what way skills training may affect managers’ willingness to engage in workplace alcohol prevention. Since the implementation of any policy had gone unnoticed to participants, a reason for which could be related to the notion of the existing policy as “good enough” in its current condition, implementation and organizational issues, or a reluctance to address alcohol-related matters unless necessary; future research may focus on investigating in what manner alcohol policies are in fact utilized within organizations.
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8. |
- Elling, Devy L., et al.
(author)
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Perceived barriers in the dissemination of an organisational alcohol policy as part of implementing an alcohol prevention programme among managers
- 2022
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In: Drugs, Habits and Social Policy. - 2752-6739. ; 23:2, s. 128-139
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Journal article (peer-reviewed)abstract
- Purpose - An alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation because of the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers. Design/methodology/approach - A cross-sectional survey (n = 193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n = 18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers. Findings - Sixty-five per cent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace's approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers. Practical implications - A thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention. Originality/value - This study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.
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9. |
- Elling, Devy L., et al.
(author)
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Perceived barriers in the dissemination of and organisational alcohol policy as a part of implementing an alcohol prevention programme among managers
-
Other publication (other academic/artistic)abstract
- Purpose: An alcohol prevention programme, consisting of the implementation of an organisational alcohol policy and skills development training for managers, was delivered in Swedish workplaces. Previous findings revealed challenges in policy implementation due to the lack of dissemination amongst managers. This study aims to describe perceived dissemination barriers of the organisational alcohol policy by managers.Methodology: A cross-sectional survey (n=193 managers) was performed to identify common dissemination barriers in the workplace and complementary case illustrations derived from semi-structured interviews (n=18 managers) were used to understand the dissemination barriers of the organisational alcohol policy. Frequency distributions were presented to describe common perceived barriers.Findings: Sixty-five percent of managers reported that their workplace had not changed their approach to addressing alcohol-related issues compared to their usual practice before programme delivery. Various organisational factors, such as deprioritisation of programme dissemination, lack of communication, and inadequate strategies were some of the common barriers perceived by managers. Moreover, managers reported uncertainties regarding any changes concerning the workplace’s approach for addressing alcohol-related issues. Increased efforts in disseminating the organisational alcohol policy can reduce uncertainties among managers. Practical implications: A thorough process evaluation to understand processes in programme delivery and implementation is necessary to ensure the uptake of the intervention. Originality/value: The study highlighted the complexity of disseminating an alcohol policy in a dynamic setting, such as the workplace, and provided the importance of addressing organisational obstacles.
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10. |
- Flowers, Sarah A., et al.
(author)
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Decrease of core 2 O-glycans on synovial lubricin in osteoarthritis reduces galectin-3 mediated crosslinking
- 2020
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In: Journal of Biological Chemistry. - 0021-9258 .- 1083-351X. ; 295:47, s. 16023-16036
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Journal article (peer-reviewed)abstract
- The synovial fluid glycoprotein lubricin (also known as proteoglycan 4) is a mucin-type O-linked glycosylated biological lubricant implicated to be involved in osteoarthritis (OA) development. Lubricin's ability to reduce friction is related to its glycosylation consisting of sialylated and unsialylated Tn-antigens and core 1 and core 2 structures. The glycans on lubricin have also been suggested to be involved in crosslinking and stabilization of the lubricating superficial layer of cartilage by mediating interaction between lubricin and galectin-3. However, with the spectrum of glycans being found on lubricin, the glycan candidates involved in this interaction were unknown. Here, we confirm that the core 2 O-linked glycans mediate this lubricin-galectin-3 interaction, shown by surface plasmon resonance data indicating that recombinant lubricin (rhPRG4) devoid of core 2 structures did not bind to recombinant galectin-3. Conversely, transfection of Chinese hamster ovary cells with the core 2 GlcNAc transferase acting on a mucin-type O-glycoprotein displayed increased galectin-3 binding. Both the level of galectin-3 and the galectin-3 interactions with synovial lubricin were found to be decreased in late-stage OA patients, coinciding with an increase in unsialylated core 1 O-glycans (T-antigens) and Tn-antigens. These data suggest a defect in crosslinking of surface-active molecules in OA and provide novel insights into OA molecular pathology.
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