title: Process evaluation of a participatory ergonomics programme to prevent low back pain and neck pain among workers.
abstract: 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 randomised 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 randomisation 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.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN27472278.
authors.affiliation: Body@Work TNO VUmc, Research Center Physical Activity, Work and Health, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. h.anema@vumc.nl.
authors.forename: Maurice T
authors.initials: MT
authors.lastname: Driessen
authors.forename: Karin I
authors.initials: KI
authors.lastname: Proper
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
authors.forename: Paulien M
authors.initials: PM
authors.lastname: Bongers
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek