Workplace Health Promotion in German Social Firms—Offers, Needs and Challenges from the Perspectives of Employees, Supervisors and Experts

On the general labor market, social firms provide 30–50% of people with different types of disabilities the opportunity to gain employment. However, the topic of workplace health promotion (WHP), needs for improvement and accompanied challenges are neglected in the current research and were the focus of the present study. Therefore, data triangulation was used between July and December 2020 by combining three focus groups with employees (n = 14 employees) with 16 interviews with supervisors from several social firms in Northern Germany (e.g., from catering, cleaning or bicycle repair sectors). 17 semi-structured telephone interviews with experts in the field of WHP or social firms were added. All approaches were audio-taped, transcribed and anonymized. To analyze the data, Mayring’s qualitative content analysis was used. The results indicated that several offers for WHP, including sport, nutrition and relaxation, were offered, as well as those on smoking cessation, cooperation with external organizations or training and education offers. Needs for improvement were stated referring to additional sport offers, support for implementing a healthy diet, offers for relaxation, financial incentives or collaborations with external organizations. A low take-up of offers; a lack of resources, structures or management support; compatibility of offers with work time and organization; challenges with available trainings or the consideration of individual needs and capacities were highlighted as challenges. Overall, there is a need for further interventional and longitudinal research on WHP in social firms.

Ecological Momentary Assessment: A Meta-Analysis on Designs, Samples, and Compliance Across Research Fields

Ecological Momentary Assessments (i.e., EMA, repeated assessments in daily life) are widespread in many fields of psychology and related disciplines. Yet, little knowledge exists on how differences in study designs and samples predict study compliance and dropout—two central parameters of data quality in (micro-)longitudinal research. The current meta-analysis included k = 477 articles (496 samples, total N = 677,536). For each article, we coded the design, sample characteristics, compliance, and dropout rate. The results showed that on average EMA studies scheduled six assessments per day, lasted for 7 days, and obtained a compliance of 79%. Studies with more assessments per day scheduled fewer assessment days, yet, the number of assessments did not predict compliance or dropout rates. Compliance was significantly higher in studies providing financial incentives. Otherwise, design or sample characteristics had little effects. We discuss the implications of the findings for planning, reporting, and reviewing EMA studies.

Is it possible to recruit HIV self-test users for an anonymous phone-based survey using passive recruitment without financial incentives? Lessons learned from a pilot study in Côte d’Ivoire

Background Due to the discreet and private nature of HIV self-testing (HIVST), it is particularly challenging to monitor and assess the impacts of this testing strategy. To overcome this challenge, we conducted a study in Côte d’Ivoire to characterize the profile of end users of HIVST kits distributed through the ATLAS project (AutoTest VIH, Libre d’Accéder à la connaissance de son Statut). Feasibility was assessed using a pilot phone-based survey. Methods The ATLAS project aims to distribute 221300 HIVST kits in Côte d’Ivoire from 2019 to 2021 through both primary (e.g., direct distribution to primary users) and secondary distribution (e.g., for partner testing). The pilot survey used a passive recruitment strategy—whereby participants voluntarily called a toll-free survey phone number—to enrol participants. The survey was promoted through a sticker on the HIVST instruction leaflet and hotline invitations and informal promotion by HIVST kit-dispensing agents. Importantly, participation was not financially incentivized, even though surveys focussed on key populations usually use incentives in this context. Results After a 7-month period in which 25,000 HIVST kits were distributed, only 42 questionnaires were completed. Nevertheless, the survey collected data from users receiving HIVST kits via both primary and secondary distribution (69% and 31%, respectively). Conclusion This paper provides guidance on how to improve the design of future surveys of this type. It discusses the need to financial incentivize participation, to reorganize the questionnaire, the importance of better informing and training stakeholders involved in the distribution of HIVST, and the use of flyers to increase the enrolment of users reached through secondary distribution.

Making doctors stay: Rethinking doctor retention policy in a contracted-out primary healthcare setting in urban Bangladesh

Background “Contracting Out” is a popular strategy to expand coverage and utilization of health services. Bangladesh began contracting out primary healthcare services to NGOs in urban areas through the Urban Primary Health Care Project (UPHCP) in 1998. Over the three phases of this project, retention of trained and skilled human resources, especially doctors, proved to be an intractable challenge. This paper highlights the issues influencing doctor’s retention both in managerial as well as service provision level in the contracted-out setting. Methodology In this qualitative study, 42 Key Informant Interviews were undertaken with individuals involved with UPHCP in various levels including relevant ministries, project personnel representing the City Corporations and municipalities, NGO managers and doctors. Verbatim transcripts were coded in ATLAS.ti and analyzed using the thematic analysis. Document review was done for data triangulation. Results The most cited problem was a low salary structure in contrast to public sector pay scale followed by a dearth of other financial incentives such as performance-based incentives, provident funds and gratuities. Lack of career ladder, for those in both managerial and service delivery roles, was also identified as a factor hindering staff retention. Other disincentives included inadequate opportunities for training to improve clinical skills, ineffective staffing arrangements, security issues during night shifts, abuse from community members in the context of critical patient management, and lack of job security after project completion. Conclusions An adequate, efficient and dedicated health workforce is a pre-requisite for quality service provision and patient utilization of these services. Improved career development opportunities, the provision of salaries and incentives, and a safer working environment are necessary actions to retain and motivate those serving in managerial and service delivery positions in contracting out arrangements.