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Promoting mental health in small-medium enterprises: An evaluation of the "Business in Mind" program


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Martin, AJ, Sanderson, Kristy, Scott, JL and Brough, P 2009 , 'Promoting mental health in small-medium enterprises: An evaluation of the "Business in Mind" program' , BMC Public Health, vol. 9, no. 239 , doi: 10.1186/1471-2458-9-239.

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Background: Workplace mental health promotion (WMHP) aims to prevent and effectively manage the social and
economic costs of common mental illnesses such as depression. The mental health of managers and employees within
small-medium enterprises (SMEs) is a neglected sector in occupational health research and practice, despite the fact that
this sector is the most common work setting in most economies. The availability and propensity of SME staff to attend
face-to-face training/therapy or workshop style interventions often seen in corporate or public sector work settings is a
widely recognised problem. The 'Business in Mind' program employs a DVD mode of delivery that is convenient for SME
managers, particularly those operating in regional and remote areas where internet delivery may not be optimal. The
objective of the intervention program is to improve the mental health of SME managers, and examine whether employees
of managers' whose mental health improves, report positive change in their psychosocial work environment. The
mechanisms via which we aim to improve managers' mental health are through the development of their psychological
capital (a higher order construct comprised of hope, self efficacy, resilience and optimism) and their skills and capacities
for coping with work stress.
Methods/Design: The effectiveness of two versions of the program (self administered and telephone facilitated) will be
assessed using a randomised trial with an active control condition (psychoeducation only). We aim to recruit a minimum
of 249 managers and a sample of their employees. This design allows for 83 managers per group, as power analyses
showed that this number would allow for attrition of 20% and still enable detection of an effect size of 0.5. The
intervention will be implemented over a three month period and postal surveys will assess managers and employees in
each group at baseline, intervention completion, and at 6 month follow up. The intervention groups (managers only) will
also be assessed at 12 and 24 month follow-up to examine maintenance of effects. Primary outcomes are managers' levels
of psychological capital (hope, resilience, self-efficacy and optimism), coping strategies, anxiety and depression symptoms,
self-reported health, job satisfaction and job tension. Secondary outcomes are participating managers subordinates'
perceptions of manager support, relational justice, emotional climate and job tension. In order to provide an economic
evaluation of the intervention, both employees and manager rates of absenteeism and presenteeism will also be assessed.
Discussion: The intervention being trialled is expected to improve both primary and secondary outcomes. If proven
efficacious, the intervention could be disseminated to reach a much larger proportion of the business community.
Trial registration: Current controlled trials ISRCTN 62853520

Item Type: Article
Authors/Creators:Martin, AJ and Sanderson, Kristy and Scott, JL and Brough, P
Journal or Publication Title: BMC Public Health
ISSN: 1471-2458
DOI / ID Number: 10.1186/1471-2458-9-239
Additional Information:

© 2009 Martin et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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