title: Improving work functioning and mental health of health care employees using an e-mental health approach to workers' health surveillance: pretest-posttest study.
abstract: BACKGROUND
  Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants.
  
  
  METHODS
  We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes.
  
  
  RESULTS
  One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26).
  
  
  CONCLUSIONS
  The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Ketelaar
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Karen
authors.initials: K
authors.lastname: Nieuwenhuijsen
authors.affiliation: Department of Public Mental Health, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Linda
authors.initials: L
authors.lastname: Bolier
authors.affiliation: Innovation Center of Mental Health and Technology (I.COM), Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Odile
authors.initials: O
authors.lastname: Smeets
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
keywords: health personnel; internet self-help; mental health; occupational health; work functioning