Background

Workers in home care have high sick leave rates, predominantly because of musculoskeletal pain. The Goldilocks Work Principle proposes that health should be promoted by a “just right” composition of work tasks. Weekly workloads differ substantially between home care workers, suggesting that certain workers may have workloads that are too high, impacting their musculoskeletal health. The aim of this study was to evaluate the effectiveness of a “GoldiCare” intervention redistributing weekly workloads to become more equal among the homecare workers. Outcomes were pain in the neck/shoulder and lower back, and the implementation of the intervention was also evaluated. 

Methods

A 16-week cluster randomized controlled trial was conducted with 125 workers from 11 home care units, divided into six intervention units and five control units. The operation coordinators of each intervention unit were educated in the Goldilocks Work Principle and provided with a planning tool to facilitate an even distribution of high care need clients. The control group continued their usual work. Primary outcomes were pain intensity in the neck/shoulder and lower back (0 to 10). Secondary outcomes included fatigue (0 to 10), composition of physical behaviors and postures (accelerometers), adherence to the intervention (weekly usage rates of the planning tool), and performance of the intervention (percentage of workers with an even distribution of workload). 

Results

The analysis showed no difference between the intervention and control groups in change in lower back pain (0.07, 95%CI[-0.29;0.43]), neck/shoulder pain (-0.06, 95%CI[-0.49;0.36]) or fatigue (0.04, 95%CI[-0.52;0.61]. No significant changes were observed in the composition of physical behaviors (p=0.067) or postures (p=0.080-0.131) between the two groups. The intervention was succesfully implemented in three units of the six, with adherence ranging from 82-100% across the intervention period. The remaining three units had an adherence of 0-47%. No improvement in performance was observed.

Conclusion

No significant intervention effects were observed on musculoskeletal pain, fatigue, or the composition of physical behaviors and postures. The findings suggest that the intervention was not adequately implemented within the organization. Consequently, we cannot discern whether the lack of positive results were due to poor implementation or an ineffective intervention. Results thus highlight the need for a more comprehensive understanding of organizational structures within home care to facilitate more effective implementations. The hypothetical effectiveness of a fully implemented intervention remains unknown.

Introduction. Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared to permanent workers, but this has been largely understudied.

Aim. To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers.

Methods. Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors.

Results. 1076 permanent and 675 temporary workers received the survey and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers.

Conclusion. Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

We evaluated differences in work environment conditions and health by gender and place of birth in a commercial laundromat prior to (baseline) and at the end of the first wave of the COVID-19 pandemic (follow-up). Using survey data, including dimensions from the Copenhagen Psychosocial Questionnaire, from forty-one workers, we assessed work environment conditions and health at baseline, follow-up and in change scores between baseline and follow-up. At baseline, men and women reported similar scores, while foreign-born (FB) workers reported better work environment conditions than Swedish-born (SB) workers. During the pandemic, conditions generally declined for all workers, but FB reported smaller declines than SB. A consistent inequality hierarchy across the 4 groups was not clear at baseline, follow-up or in change scores between time points. The study suggests potential cultural differences may exist in how work environment conditions are experienced. This should be considered in future studies and when managing future crises

Objective Poor cardiorespiratory fitness and health is common among childcare workers. We designed “Goldilocks-games” according to the Goldilocks Work principle to provide high-intensity physical activity for childcare workers. We investigated the effectiveness of this Goldilocks Work intervention in increasing occupational high-intensity physical activity and improving work-related health.

Methods In a two-arm cluster randomized trial, 16 childcare institutions with 142 workers were randomly allocated to either an 8-week Goldilocks Work intervention or a control group. The primary outcome was occupational time in high-intensity physical activity. Secondary outcomes were occupational time in active physical behaviors, heart rate during sleep, pain, physical exhaustion, energy at work, work productivity, and need for recovery. 

Results The intervention was successfully delivered and received. Both groups had a low amount of occupational high-intensity physical activity at baseline, and the intervention group reported playing the games 3.1 (SD 1.5) times/week for a duration of 112.2 (SD 175.0) min/week. However, the intervention did not increase high-intensity physical activity or the secondary outcomes, except for energy at work, measured on a scale from 0-10, increasing 0.65 (95% CI, 0.08-1.21), and need for recovery, measured on a scale from 1-5, decreasing -0.32 (95% CI, -0.54- -0.09).

Conclusion The intervention was successfully delivered and received, but did not increase high-intensity physical activity. The intervention group increased their energy at work and decreased their need for recovery, but not the other health-related outcomes. Research on how to design and implement health-promoting work environment interventions in childcare are needed.

Introduction: Industrial workers with physically demanding work have increased risk of musculoskeletal pain. The present 12-week Goldilocks Work intervention aimed to organize work among industrial workers to comprise a ‘just right’ ergonomic balance of physical behaviors (i.e., sit, stand and active) intended to promote musculoskeletal health. The paper investigates the effectiveness of the intervention in reducing low back pain after work.         

Methods: 83 workers across 28 workteams in a biotech organization were recruited. Workteams were randomly allocated to receive the intervention or work as usual (control). Intervention workteams implemented the Goldilocks Work planning tool to organize their work tasks towards a predefined ‘just right’ ergonomic balance (i.e., composition of 60% sitting, 30% standing, 10% active work and hourly task alternation). The primary outcome was low back pain intensity. Secondary outcomes were bodily pain, fatigue, physical exertion, productivity and energy after work measured in the survey, and composition and alternations of physical behaviors measured using wearable sensors.  

Results: The intervention was delivered almost as planned, with good quality and high adherence among most workteams. However, the intervention did not change physical behaviors towards the intended ‘just right’ ergonomic balance. No significant reduction in low back pain (0.07, CI 95%: -0.68; 0.82), bodily pain (0.10, CI 95%: -0.57; 0.76), tiredness (-0.53, CI 95%: -1.24; 0.19), physical exertion (-0.18, CI 95%: -0.83; 0.48), or improvement in energy (0.39, CI 95%: -1.02; 0.23) or productivity (-0.03, CI 95%: -0.77; 0.72) were found. 

Conclusion: This Goldilocks Work intervention did not promote musculoskeletal health among industrial workers, and did not change physical behaviors as intended. Thus, more research is needed into implementation strategies to change physical behaviors during productive work towards an evidence-based ‘just right’ ergonomic balance.

Background: Flexible work arrangements (FWA) are common, but knowledge on how to organize flexible work to reduce negative consequences and preserve positive aspects is currently sparse, which hampers organizational initiatives.  

Purpose: This study aimed at determining the extent to which work strategies, work-related ICT use outside regular working hours (i.e., use of laptop, tablet, or smartphone, to handle information and facilitate communication), productivity, expectations of availability, and clarity of expectations about availability, had changed among office-based employees with FWA two and four months after a participative two-step workplace intervention.

Methods: An intervention group (n=97) was compared to a control group working as usual (n=70). The intervention, initiated and approved by the top management of the organization, included individual education intended to change work strategies, and workshops developing common rules and routines for FWA within the work group.

Results: Participants were satisfied with the intervention and reported larger changes than the control group in work strategies. No statistically significant effects were, however, found on ICT use, productivity, or expectations of availability.

Conclusions: This participative workplace intervention was successful in changing employees work strategies but may not be effective in influencing ICT use outside regular working hours, productivity, expectations of availability, and clarity of expectations about availability.

Background: 

Digital transformation has resulted in extensive use of information and communication technology (ICT) for occupational work in various domains (i.e. workplace, home, elsewhere). A better understanding of how ICT-use for work influence 24-h physical behaviors is needed for developing policy recommendations to promote health in a large fraction of the working population, including hybrid and teleworkers.

Purpose:

To examine the association of ICT-use and telework from home with 24-h physical behaviors in different domains among office workers in Sweden.

Methods:

We analyzed cross-sectional data from a Swedish cohort on flexible work (FLOC 2020-2025). Office workers (n=250) wore a thigh-worn accelerometer to assess physical behaviors and sleep over 7 days. Time spent working using ICT (minutes: computer, tablet, phone) and work domain (office, hybrid, telework from home) were self-reported. Linear mixed models were used to determine associations of ICT-use and work domain with 24-h compositions of sedentary, low, moderate-vigorous, and sleep behaviors, with adjustment for covariates. 

Results:

Results indicated that more ICT-use for work was significantly associated with more total sedentary time relative to physical activity of different intensities (p=0.01, R2= 0.096), but not with sleep relative to wake time. Hybrid and telework from home were significantly associated with more sedentary time relative to physical activity (p<0.05) and longer sleep relative to wake time (p<0.1).

Conclusions:

Using digital technology for work may contribute to more sedentary behavior in office workers, especially for hybrid and teleworkers.

Practical implications:

Interventions to reduce sedentary behavior may focus on reducing ICT-use and target both office, hybrid, and teleworkers.

Funding: The Swedish Research Council for Health, Working life and Welfare, FORTE (2019–01257).

Background Achieving work-life balance in flexible work arrangements is a challenge for both individuals and organizations, but intervention studies are sparse. We aimed to investigate the extent to which work-life balance, work-home interference, and home-work interference changed among office workers with flexible work arrangements after a workplace intervention. 

Methods Together with a large governmental agency in Sweden, we co-created an intervention with a focus on work strategies and common rules for flexible work in two steps: 1) an education to change individual work strategies and 2) a workshop to develop common rules and routines for flexible work within the workgroup. Two comparable departments participated, with 97 workers in the group receiving the intervention and 70 in a control group. Work-life balance and work-home/home-work interference were measured using questionnaires before the intervention (baseline), after the education (6-month follow-up), and after the workshop (12-month follow-up); and analyzed using linear mixed models with adjustments for covariates. 

Results We found no marked effects of the intervention on work-life balance, work-home interference, and home-work interference, with statistically non-significant effect estimates at both 6- and 12-months follow-ups. 

Conclusions Further studies are needed to evaluate whether other initiatives could be more effective in promoting work-life balance among office workers with flexible work arrangements. 

Background. The demand for home care workers (HCWs) is increasing, but home care services face challenges in recruiting and retaining skilled workers, partly due to hazards in the work environment. Transportation to client visits is an important part of HCWs' working conditions, with various modes (e.g., walking, cycling, driving) being utilized. However, these modes are often implemented without considering HCWs' perceptions of their use. Therefore, our study aimed to understand HCWs’ perceptions and experiences of using different transportation modes at work, and how they may influence health. 

Methods. Fourteen HCWs from a home care unit in Trondheim (Norway) participated in focus group interviews. The interviews were analyzed using a reflexive thematic analysis approach including reflexive journaling. The analytical process was guided by a biopsychosocial understanding of health. 

Results. The analysis showed that when different transportation modes were assigned, predictability of the assignment was important for the HCWs. Both walking and driving were regarded to have both positive and negative health impacts. When walking, informants thought that getting fresh air outdoors and doing physical activity was health-promoting, while bad weather conditions and too much walking could be negative for their health. When driving a car, informants talked about privacy and getting physical rest as positive for their health, while traffic and parking conditions could be stressful. Individual factors such as age, physical health, and strong preferences were highlighted as important to consider when planning HCWs’ transportation modes in an occupational health perspective.

Conclusions. Walking now and then between client visits was generally believed by the HCWs to lead to positive health effects compared to only driving a car. Introducing planning of various transportation modes in advance, so that they are predictable, seems important to reduce stress among HCWs. In addition, some individual factors should be considered in the planning, and it should be realized that the planning likely represents a trade-off between promoting the psychosocial work environment when driving a car and potentially enhancing long-term physical health when using active transportation. Thus, biopsychosocial aspects of health should be considered when planning the mode of transport between client visits for HCWs.