title: Implementation of physical coordination training and cognitive behavioural training interventions at cleaning workplaces--secondary analyses of a randomised controlled trial.
abstract: This study evaluates the implementation of physical coordination training (PCT) and cognitive behavioural training (CBTr) interventions in a randomised controlled trial at nine cleaners' workplaces. Female cleaners (n = 294) were randomised into a PCT, a CBTr or a reference (REF) group. Both 12-week interventions were performed in groups guided by an instructor. Records were kept on intervention dose (adherence) unanticipated events at the work place (context) and quality of intervention delivery (fidelity). Participant adherence was 37% in the PCT and 49% in the CBTr interventions. Optimal implementation was reached by only 6% in PCT and 42% in the CBTr. Analysis of the barriers to successful implementation indicated that the intervention process is sensitive to unanticipated events. In order to succeed in improving the health of high-risk populations such as cleaners and to correctly interpret intervention effects, more research on implementation is needed.
  
  
  BACKGROUND
  ISRCTN96241850.
  Both physical coordination training and cognitive behavioural training are potential effective workplace interventions among low educated job groups with high physical work demands. However, thorough consideration should be given to feasibility in the design of interventions. The optimal intervention should be tailored to closely match the implementation context and be robust and flexible to minimise susceptibility to changes in work organisation.
authors.affiliation: The National Research Centre for the Working Environment, Copenhagen, Denmark. mbj@nrcwe.dk
authors.forename: Marie B
authors.initials: MB
authors.lastname: Jørgensen
authors.forename: Anne
authors.initials: A
authors.lastname: Faber
authors.forename: Tobias
authors.initials: T
authors.lastname: Jespersen
authors.forename: Klaus
authors.initials: K
authors.lastname: Hansen
authors.forename: John
authors.initials: J
authors.lastname: Ektor-Andersen
authors.forename: Jørgen V
authors.initials: JV
authors.lastname: Hansen
authors.forename: Andreas
authors.initials: A
authors.lastname: Holtermann
authors.forename: Karen
authors.initials: K
authors.lastname: Søgaard
mesh_terms: D000704:Analysis of Variance; D003071:Cognition / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011594:Psychometrics; D011597:Psychomotor Performance; D058992:Social Participation; D013223:Statistics as Topic; D017132:Workplace / Q000523:psychology