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Open Access 01-12-2022 | Study protocol

Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions

Authors: Miriam Engels, Leif Boß, Judith Engels, Rebekka Kuhlmann, Johanna Kuske, Sarah Lepper, Lutz Lesener, Valeria Pavlista, Mathias Diebig, Thorsten Lunau, Sascha A. Ruhle, Florian B. Zapkau, Peter Angerer, Jörg Hoewner, Dirk Lehr, Christian Schwens, Stefan Süß, Ines C. Wulf, Nico Dragano

Published in: BMC Public Health | Issue 1/2022

Abstract

Background

Workplace-related stress is a major risk factor for mental and physical health problems and related sickness absence and productivity loss. Despite evidence regarding the effectiveness of different workplace-based interventions, the implementation of stress prevention interventions is rare, especially in micro and small-sized enterprises (MSE) with fewer than 50 employees. The joint research project “PragmatiKK”⁺ aims to identify and address the specific barriers to the implementation of stress prevention interventions in MSE. This study protocol describes a mixed method study design to evaluate the effectiveness of adapted stress prevention interventions and the implementation process via an integrated web-based platform (“System P”) specifically targeted at MSE.

Methods

First, we develop a web-based intervention, which accounts for the specific working conditions in MSE and addresses stress prevention at a structural and behavioral level. Second, we use common methods of implementation research to perform an effect and process evaluation. We analyze the effectiveness of the web-based stress prevention interventions by comparing depressive symptoms at baseline and follow-up (after 6 months and 12 months). Indicators for a successful implementation process include acceptability, adoption, feasibility, reach, dose, and fidelity, which we will measure with quantitative web-based questionnaires and qualitative interviews. We will also analyze the accumulated usage data from the web-based platform.

Discussion

Collecting data on the implementation process and the effectiveness of a web-based intervention will help to identify and overcome common barriers to stress prevention in MSE. This can improve the mental health of employees in MSE, which constitute more than 90% of all enterprises in Germany.

⁺ Full Project Name: „PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben “(= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises).

Trial registration

German Register of Clinical Studies (DRKS): DRKS00026154, date of registration: 2021-09-16.

Available only for authorised users

Wedegaertner F, Arnhold-Kerri S, Sittaro N-A, Bleich S, Geyer S, Lee WE. Depression- and anxiety-related sick leave and the risk of permanent disability and mortality in the working population in Germany: a cohort study. BMC Public Health. 2013;13(1): 145:[10.1186/1471-2458-13-145]. [PMID: 23413800]

Koopmans PC, Bültmann U, Roelen CAM, Hoedeman R, van der Klink JJL, Groothoff JW. Recurrence of sickness absence due to common mental disorders. Int Arch Occup Environ Health. 2011;84(2):193–201. https://doi.org/10.1007/s00420-010-0540-4. [PMID: 20449605]CrossRefPubMed

Ahola K, Virtanen M, Honkonen T, Isometsä E, Aromaa A, Lönnqvist J. Common mental disorders and subsequent work disability: a population-based Health 2000 Study. J Affect Disord. 2011;134(1–3):365–72. https://doi.org/10.1016/j.jad.2011.05.028. [PMID: 21664696]CrossRefPubMed

Theorell T, Hammarstrom A, Aronsson G, et al. A systematic review including meta-analysis of work environment and depressive symptoms. BMC Public Health. 2015;15:738. https://doi.org/10.1186/s12889-015-1954-4. [PMID: 26232123]CrossRefPubMedPubMedCentral

Madsen IEH, Nyberg ST, Magnusson Hanson LL, et al. Job strain as a risk factor for clinical depression: Systematic review and meta-analysis with additional individual participant data. Psychol Med. 2017;47(8):1342–56. https://doi.org/10.1017/S003329171600355X. [PMID: 28122650]CrossRefPubMedPubMedCentral

Beck D, Lenhardt U, Schmitt B, Sommer S. Patterns and predictors of workplace health promotion: cross-sectional findings from a company survey in Germany. BMC Public Health. 2015;15:343. https://doi.org/10.1186/s12889-015-1647-z. [PMID: 25886159]CrossRefPubMedPubMedCentral

Health and Safety Executive (HSE). Risk assessment: A brief guide to controlling risks in the workplace. Sudbury: Health and Safety Executive; 2014.

Janetzke H, Ertel M. Psychosocial Risk Management in a European Comparison. Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA). 2017; Available from: URL: http://www.baua.de/dok/8565216. Accessed 19 Oct 2021.

Klenke B. Psychische Gefährdungsbeurteilungen in deutschen Unternehmen – Anforderungen, aktueller Stand und Vorgehensweisen. In: Ghadiri A, Ternès A, Peters T, editors. Trends im Betrieblichen Gesundheitsmanagement: Ansätze aus Forschung und Praxis. Wiesbaden: Springer Gabler; 2016. p. 17–26.

10.

Beck D, Richter G, Ertel M, Morschhäuser M. Gefährdungsbeurteilung bei psychischen Belastungen in Deutschland: Verbreitung, hemmende und fördernde Bedingungen. Praev Gesundheitsf. 2012;7(2):115–9. https://doi.org/10.1007/s11553-011-0326-x.CrossRef

11.

van Stolk C, Staetsky L, Hassan E, Woo C. Management of psychosocial risks at work: An analysis of the findings of the European Survey of Enterprises on New And Emerging Risks (ESENER) ; European Risk Observatory report. Luxembourg: Publ. Office of the Europ. Union; 2012.

12.

Harris JR, Hannon PA, Beresford SAA, Linnan LA, McLellan DL. Health promotion in smaller workplaces in the United States. Annu Rev Public Health. 2014;35:327–42. https://doi.org/10.1146/annurev-publhealth-032013-182416. [PMID: 24387086]CrossRefPubMed

13.

Wulf IC, Süß S, Diebig M. Akteure der Gefährdungsbeurteilung psychischer Belastung – Perspektiven und Konflikte im betrieblichen Arbeits- und Gesundheitsschutz. Z Arb Wiss. 2017;71(4):296–304. https://doi.org/10.1007/s41449-017-0085-4.CrossRef

14.

Pavlista V, Angerer P, Diebig M. Barriers and drivers of psychosocial risk assessments in German micro and small-sized enterprises: a qualitative study with owners and managers. BMC Public Health. 2021;21(1):1–12. https://doi.org/10.1186/s12889-021-11416-1.CrossRef

15.

Cunningham TR, Sinclair R, Schulte P. Better understanding the small business construct to advance research on delivering workplace health and safety. Small Enterp Res. 2015;21(2):148–60. https://doi.org/10.1080/13215906.2014.11082084.CrossRef

16.

Beck D, Lenhardt U. Consideration of psychosocial factors in workplace risk assessments: findings from a company survey in Germany. Int Arch Occup Environ Health. 2019;92(3):435–51. https://doi.org/10.1007/s00420-019-01416-5. [PMID: 30756179]CrossRefPubMedPubMedCentral

17.

da Silva SLC, Amaral FG. Critical factors of success and barriers to the implementation of occupational health and safety management systems: A systematic review of literature. Saf Sci. 2019;117:123–32. https://doi.org/10.1016/j.ssci.2019.03.026.CrossRef

18.

Heber E, Ebert DD, Lehr D, et al. The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis. J Med Internet Res. 2017;19(2):e32. https://doi.org/10.2196/jmir.5774. [PMID: 28213341]CrossRefPubMedPubMedCentral

19.

Havermans BM, Boot CR, Brouwers EP, et al. Effectiveness of a digital platform-based implementation strategy to prevent work stress in a healthcare organization: A 12-month follow-up controlled trial. Scand J Work Environ Health. 2018;44(4):613–21. https://doi.org/10.5271/sjweh.3758. [PMID: 30033477]CrossRefPubMed

20.

Diebig M, Dragano N, Körner U, Lunau T, Wulf IC, Angerer P. Development and Validation of a Questionnaire to Measure Psychosocial Work Stressors in Modern Working Environments. J Occup Environ Med. 2020;62(3):185–93. https://doi.org/10.1097/JOM.0000000000001779. [PMID: 31790057]CrossRefPubMed

21.

Dragano N, Wulf IC, Diebig M. digitale Gefährdungsbeurteilung psychischer Belastung. In: Fehlzeiten-Report 2019. Berlin: Springer; 2019. p. 111–25.

22.

Phillips EA, Gordeev VS, Schreyögg J. Effectiveness of occupational e-mental health interventions: a systematic review and meta-analysis of randomized controlled trials. Scand J Work Environ Health. 2019; https://doi.org/10.5271/sjweh.3839. [PMID: 31184758]

23.

Ebert DD, Kählke F, Buntrock C, et al. A health economic outcome evaluation of an internet-based mobile-supported stress management intervention for employees. Scand J Work Environ Health. 2018;44(2):171–82.PubMed

24.

Carolan S, Harris PR, Cavanagh K. Improving Employee Well-Being and Effectiveness: Systematic Review and Meta-Analysis of Web-Based Psychological Interventions Delivered in the Workplace. J Med Internet Res. 2017;19(7):e271. https://doi.org/10.2196/jmir.7583. [PMID: 28747293]CrossRefPubMedPubMedCentral

25.

Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: What it is and how to do it. BMJ. 2013;347:f6753. https://doi.org/10.1136/bmj.f6753.CrossRefPubMed

26.

Nielsen K, Randall R. Opening the black box: Presenting a model for evaluating organizational-level interventions. Eur J Work Organ Psychol. 2013;22(5):601–17. https://doi.org/10.1080/1359432X.2012.690556.CrossRef

27.

Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76. https://doi.org/10.1007/s10488-010-0319-7. [PMID: 20957426]CrossRefPubMed

28.

Davis FD. User Acceptance of Information Technology: System Characteristics, User Perceptions and Behavioral Impacts. Int J Man-Machine Stud. 1993;38:475–87.CrossRef

29.

Rabin BA, Brownson RC, Haire-Joshu D, Kreuter MW, Weaver NL. A glossary for dissemination and implementation research in health. J Public Health Manag Pract. 2008;14(2):117–23. https://doi.org/10.1097/01.PHH.0000311888.06252.bb. [PMID: 18287916]CrossRefPubMed

30.

Karsh B-T. Beyond usability: designing effective technology implementation systems to promote patient safety. Qual Saf Health Care. 2004;13(5):388–94. https://doi.org/10.1136/qshc.2004.010322. [PMID: 15465944]CrossRefPubMedPubMedCentral

31.

Stiles PG, Boothroyd RA, Snyder K, Zong X. Service penetration by persons with severe mental illness: how should it be measured? J Behav Health Serv Res. 2002;29(2):198–207. https://doi.org/10.1007/BF02287706. [PMID: 12032977]CrossRefPubMed

32.

Pluye P, Potvin L, Denis J-L. Making public health programs last: conceptualizing sustainability. Eval Program Plan. 2004;27(2):121–33. https://doi.org/10.1016/j.evalprogplan.2004.01.001.CrossRef

33.

McCoy K, Stinson K, Scott K, Tenney L, Newman LS. Health promotion in small business: a systematic review of factors influencing adoption and effectiveness of worksite wellness programs. J Occup Environ Med. 2014;56(6):579–87. https://doi.org/10.1097/JOM.0000000000000171. [PMID: 24905421]CrossRefPubMedPubMedCentral

34.

Gemeinsame Deutsche Arbeitsschutzstrategie. Empfehlungen zur Umsetzung der Gefährdungsbeurteilung psychischer Belastung. Berlin: Arbeitschutz in der Praxis; 2017. Available online at: https://www.gda-psyche.de/SharedDocs/Downloads/DE/empfehlungen-zur-umsetzung-der-gefaehrdungsbeurteilung-psychischer-belastung.pdf?__blob=publicationFile&v=1. Last retrieved on 19 Oct 2021.

35.

Diebig M, Angerer P. Description and application of a method to quantify criterion-related cut-off values for questionnaire-based psychosocial risk assessment. Int Arch Occup Environ Health. 2021;94(3):475–85. https://doi.org/10.1007/s00420-020-01597-4. [PMID: 33140836]CrossRefPubMed

36.

Heber E, Lehr D, Ebert DD, Berking M, Riper H. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial. J Med Internet Res. 2016;18(1):e21. https://doi.org/10.2196/jmir.5112. [PMID: 26818683]CrossRefPubMedPubMedCentral

37.

Ebert DD, Lehr D, Heber E, Riper H, Cuijpers P, Berking M. Internet-and mobile-based stress management for employees with adherence-focused guidance: Efficacy and mechanism of change. Scand J Work Environ Health. 2016;42(5):382–94.CrossRefPubMed

38.

Ebert DD, Heber E, Berking M, et al. Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial. Occup Environ Med. 2016;73(5):315–23. https://doi.org/10.1136/oemed-2015-103269. [PMID: 26884049]CrossRefPubMed

39.

Nixon P, Boß L, Heber E, Ebert DD, Lehr D. A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention. BMC Public Health. 2021;21(1):1511. https://doi.org/10.1186/s12889-021-11504-2. [PMID: 34353294]CrossRefPubMedPubMedCentral

40.

D'Zurilla TJ, Nezu AM. Problem-solving therapies. In: Dobson KS, editor. Handbook of cognitive-behavioral therapies. 3rd ed. New York: Guilford Press; 2010. p. 211–45.

41.

Berking M, Whitley B. Affect Regulation Training: A Practitioners’ Manual. New York: Springer New York; 2014.CrossRef

42.

Heber E, Ebert DD, Lehr D, Nobis S, Berking M, Riper H. Efficacy and cost-effectiveness of a web-based and mobile stress-management intervention for employees: design of a randomized controlled trial. BMC Public Health. 2013;13(1):655. https://doi.org/10.1186/1471-2458-13-655. [PMID: 23855376]CrossRefPubMedPubMedCentral

43.

Cooper A, Reimann R, Cronin D. About Face 3: The Essentials of Interaction Design. Hoboken: Wiley; 2007.

44.

Holden RJ, Kulanthaivel A, Purkayastha S, Goggins KM, Kripalani S. Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure. Int J Med Inform. 2017;108:158–67. https://doi.org/10.1016/j.ijmedinf.2017.10.006. [PMID: 29132622]CrossRefPubMedPubMedCentral

45.

Serio CD, Hessing J, Reed B, Hess C, Reis J. The effect of online chronic disease personas on activation: within-subjects and between-groups analyses. JMIR Res Protoc. 2015;4(1):e20. https://doi.org/10.2196/resprot.3392. [PMID: 25720676]CrossRefPubMedPubMedCentral

46.

Landes SJ, Mcbain SA, Curran M. Reprint of : An introduction to effectiveness-implementation hybrid designs. Psychiatry Res. 2019;(March):112630. https://doi.org/10.1016/j.psychres.2019.112630.CrossRef

47.

Hamilton AB, Finley EP. Qualitative methods in implementation research: An introduction. Psychiatry Res. 2019:280. https://doi.org/10.1016/j.psychres.2019.112516.

48.

Chan A-W, Tetzlaff JM, Gøtzsche PC, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586. https://doi.org/10.1136/bmj.e7586. [PMID: 23303884]CrossRefPubMedPubMedCentral

49.

European Commission. Commission Recommendation of 6 May 2003 concerning the definition of micro, small and medium-sized enterprises; 2003.

50.

Statistisches Bundesamt (Destatis). Kleine und mittlere Unternehmen; 2021 [cited 2021 June 16] Available from: URL: https://www.destatis.de/DE/Themen/Branchen-Unternehmen/Unternehmen/Kleine-Unternehmen-Mittlere-Unternehmen/_inhalt.html;jsessionid=2DF8779B9BB68114C815B8892DECA138.live741#sprg475846. Accessed 19 Oct 2021.

51.

Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord 2009; 114(1–3): 163–73 [https://doi.org/10.1016/j.jad.2008.06.026][PMID: 18752852].

52.

Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring Depression Treatment Outcomes with the Patient Health Questionnaire-9. Medical care. 2004;42(12):1194–201.CrossRefPubMed

53.

Phillips R, Schneider J, Molosankwe I, et al. Randomized controlled trial of computerized cognitive behavioural therapy for depressive symptoms: effectiveness and costs of a workplace intervention. Psychol Med. 2014;44(4):741–52. https://doi.org/10.1017/S0033291713001323. [PMID: 23795621]CrossRefPubMed

54.

Warttig SL, Forshaw MJ, South J, White AK. New, normative, English-sample data for the Short Form Perceived Stress Scale (PSS-4). J Health Psychol. 2013;18(12):1617–28. https://doi.org/10.1177/1359105313508346. [PMID: 24155195]CrossRefPubMed

55.

Dollard MF. The PSC-4; A Short PSC Tool. In: Dollard MF, Dormann C, Awang Idris M, editors. Psychosocial Safety Climate: A New Work Stress Theory. Cham: Springer International Publishing; 2019. p. 385–409.CrossRef

56.

Otto W, Neuert C, Meitinger K, Beitz C, Schmidt R, Stiegler A. Psychosocial Safety Climate - Weiterentwicklung und Validierung eines Instrumentes für die Erfassung der Handlungsbereitschaft zum Schutz der psychischen Gesundheit der Beschäftigten auf organisationaler Ebene. Kognitiver Pretest. GESIS Projektbericht. Mannheim. Version: 1.0. GESIS - Pretestlabor. Text. 2016. Available online at: https://doi.org/10.17173/pretest38.

57.

Berthelsen H, Muhonen T, Bergström G, Westerlund H, Dollard MF. Benchmarks for Evidence-Based Risk Assessment with the Swedish Version of the 4-Item Psychosocial Safety Climate Scale. Int J Environ Res Public Health. 2020;17(22):8675. https://doi.org/10.3390/ijerph17228675. [PMID: 33266458]CrossRefPubMedCentral

58.

Mohr G, Rigotti T, Müller A. Irritation - ein Instrument zur Erfassung psychischer Beanspruchung im Arbeitskontext. Skalen- und Itemparameter aus 15 Studien. Zeitschrift für Arbeits- und Organisationspsychologie A&O. 2005;49(1):44–8. https://doi.org/10.1026/0932-4089.49.1.44.CrossRef

59.

Kristensen TS, Hannerz H, Høgh A, Borg V. The Copenhagen Psychosocial Questionnaire--a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Environ Health. 2005;31(6):438–49. https://doi.org/10.5271/sjweh.948. [PMID: 16425585]CrossRefPubMed

60.

Nübling M, Stößel U, Hasselhorn H-M, Michaelis M, Hofmann F. Measuring psychological stress and strain at work - Evaluation of the COPSOQ Questionnaire in Germany. Psychosoc Med. 2006;3:Doc05. [PMID: 19742072]PubMedPubMedCentral

61.

Bouwmans C, Jong K de, Timman R, et al. Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P). BMC Health Serv Res 2013; 13(1): 217. [https://doi.org/10.1186/1472-6963-13-217]. [PMID: 23768141].

62.

Sasaki N, Obikane E, Vedanthan R, et al. Implementation Outcome Scales for Digital Mental Health (iOSDMH): Scale Development and Cross-sectional Study. JMIR Form Res. 2021;5(11):e24332. https://doi.org/10.2196/24332.CrossRefPubMedPubMedCentral

63.

Hoek RJA, Havermans BM, Houtman ILD, et al. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial. BMC Public Health. 2018;18(1):26. https://doi.org/10.1186/s12889-017-4585-0. [PMID: 28716117]CrossRef

64.

Minge M, Thüring M, Wagner I, Kuhr CV. The meCUE Questionnaire: A Modular Tool for Measuring User Experience. In: Soares M, Falcão C, Ahram TZ, editors. The meCUE Questionnaire: A Modular Tool for Measuring User Experience. Cham: Springer International Publishing; 2016. p. 115–28.

65.

Wessel D, Attig C, Franke T. ATI-S - An Ultra-Short Scale for Assessing Affinity for Technology Interaction in User Studies. In: Alt F, Bulling A, Döring T, editors. ATI-S - An Ultra-Short Scale for Assessing Affinity for Technology Interaction in User Studies. New York: The Association for Computing Machinery, Inc; 2019. p. 147–54.

66.

Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91. https://doi.org/10.3758/BF03193146. [PMID: 17695343]CrossRefPubMed

67.

Cook JA, Julious SA, Sones W, et al. DELTA2 guidance on choosing the target difference and undertaking and reporting the sample size calculation for a randomised controlled trial. Trials. 2018;19(1):606. https://doi.org/10.1186/s13063-018-2884-0. [PMID: 30400926]CrossRefPubMedPubMedCentral

68.

Lorenz E, Köpke S, Pfaff H, Blettner M. Cluster-Randomized Studies. Dtsch Arztebl Int. 2018;115(10):163–8. https://doi.org/10.3238/arztebl.2018.0163. [PMID: 29587960]CrossRefPubMedPubMedCentral

69.

Beck D. Psychische Belastung als Gegenstand des Arbeitsschutzes. Arbeit. 2019;28(2):125–47. https://doi.org/10.1515/arbeit-2019-0009.CrossRef

70.

Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–15. https://doi.org/10.1111/j.1365-2648.2007.04569.x. [PMID: 18352969]CrossRefPubMed

71.

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. https://doi.org/10.1186/1748-5908-4-50. [PMID: 19664226]CrossRefPubMedPubMedCentral

72.

Podsakoff PM, Organ DW. Self-Reports in Organizational Research: Problems and Prospects. J Manag. 1986;12(4):531–44. https://doi.org/10.1177/014920638601200408.CrossRef

73.

Wheat K, Brohan E, Henderson C, Thornicroft G. Mental illness and the workplace: conceal or reveal? J R Soc Med. 2010;103(3):83–6. https://doi.org/10.1258/jrsm.2009.090317. [PMID: 20200178]CrossRefPubMedPubMedCentral

74.

Jones AM. Disclosure of Mental Illness in the Workplace: A Literature Review. American Journal of Psychiatric Rehabilitation. 2011;14(3):212–29. https://doi.org/10.1080/15487768.2011.598101.CrossRef

Title: Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions
Authors: Miriam Engels
Leif Boß
Judith Engels
Rebekka Kuhlmann
Johanna Kuske
Sarah Lepper
Lutz Lesener
Valeria Pavlista
Mathias Diebig
Thorsten Lunau
Sascha A. Ruhle
Florian B. Zapkau
Peter Angerer
Jörg Hoewner
Dirk Lehr
Christian Schwens
Stefan Süß
Ines C. Wulf
Nico Dragano
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-022-12921-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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