title: Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.
abstract: OBJECTIVE
  To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence).
  
  
  METHODS
  Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%).
  
  
  RESULTS
  There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity.
  
  
  CONCLUSIONS
  Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.
authors: From the Medical Management Centre (Dr von Thiele Schwarz, Ms Augustsson, and Dr Hasson); and Department of Learning, Informatics, Management and Ethics (Dr Stenfors-Hayes), Karolinska Institutet, Stockholm, Sweden.
authors: Ulrica
authors: U
authors: von Thiele Schwarz
authors: Hanna
authors: H
authors: Augustsson
authors: Henna
authors: H
authors: Hasson
authors: Terese
authors: T
authors: Stenfors-Hayes
mesh_terms: D000328:Adult; D004526:Efficiency; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006766:Hospitals, County; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D010564:Personnel, Hospital; D058996:Quality Improvement; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013548:Sweden; D018511:Systems Integration; D013997:Time Factors; D014938:Work Capacity Evaluation