Clinical trial NCT04386135: DESVELA. Personal Skills as Determinants of Morbidity, Lifestyles, Quality of Life, Use of Services and Mortality.
Official title: DESVELA Cohort. Analysis of the Role of Personal Skills as Determinants of Incidence of Morbidity, Lifestyles, Quality of Life, Use of Services and Mortality.
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: General Population
Health Knowledge, Attitudes, Practice
Empowerment
Health Care Utilization
Life Style
Self Efficacy
Activation, Patient
Locus of Control
Quality of Life
Keywords: Primary Health Care
Health Promotion
Quality of Life
Life Style
Health Literacy
Empowerment
Locus of Control
Personality
Self Efficacy
Lead sponsor: Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
Sponsor class: OTHER
Collaborators: name: Preventive Services and Health Promotion Research Network
name: Instituto de Salud Carlos III
name: Parc Sanitari Sant Joan de Déu
name: Servei de Salut de les Illes Balears
name: Institut Català de la Salut
name: Servicio Aragones De Salud
name: Osakidetza
name: Andaluz Health Service
name: Castilla-La Mancha Health Service
name: Biocruces Bizkaia Health Research Institute
name: Fundació Sant Joan de Déu
name: Fundación Instituto de Estudios de Ciencias de la Salud de Castilla y León
name: Universidad Loyola Andalucia
name: University of Castilla-La Mancha
name: Instituto de Investigación Sanitaria Aragón
name: Fundació d'investigació Sanitària de les Illes Balears
name: Fundacin Biomedica Galicia Sur
name: Public Health Service of Galicia
First posted: 2020-05-13
Enrollment: 3260
Sex: ALL
Minimum age (years): 35
Maximum age (years): 74
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Population adscrited to Primary Health Centres in Spain

Brief summary: Quantitative study: The main objective is to analyze whether personal skills related to behaviours are independently associated with the incidence of morbidity. Study with quantitative and qualitative methodology. Multicenter project (10 teams) for the creation of a cohort of 3083 people aged 35 to 74 years of 9 Autonomous Communities (AACC). The personal variables that will be evaluated are: self-efficacy, activation, health literacy, resilience, locus of control and personality traits. Socio-demographic covariates, social capital and community health assets will be recorded. As a secondary objective, it will be analyzed whether personal skills are independently associated with lower all cause mortality, better adoption of healthy lifestyles, higher quality of life and less utilization of health services in follow-up. A physical examination, a blood analytical and a cognitive evaluation will be carried out. The incidence of morbidity will be analyzed with a Cox model for each of the six independent variables (objective 1); and mortality from all causes and from the other dependent variables (objective 2). The models will be adjusted by the indicated covariables. The possible heterogeneity between (AACC) will be estimated by introducing random effects into the model.

Qualitative study: To deepen in the opinions and experiences of the population on the relationship between personal skills with their perception of health, their lifestyles and their quality of life. The research will be carried out from a phenomenological perspective. The number of discussion groups needed to reach the saturation of speeches will be made. There will be an analysis of thematic content that will be triangulated between members of the research team. The meanings will be interpreted and an explanatory framework will be created with the contributions of each type of informant.


Eligibility criteria: Inclusion Criteria:

- Population ascribed to Primary Health Centres in Spain.

Exclusion Criteria:

* Illness at terminal phase.
* Institutionalization.
* Intellectual disability.
* Dementia.
* Idiomatic difficulties

Primary outcomes:
measure: Incidence of morbidity.
timeFrame: Five years
measure: Incidence of morbidity.
timeFrame: Ten years
measure: Mortality from all causes
timeFrame: Five years
measure: Mortality from all causes
timeFrame: Ten years
measure: Self-reported adherence to Mediterranean diet (PREDIMED scale)
timeFrame: Five years
measure: Self-reported adherence to Mediterranean diet (PREDIMED scale)
timeFrame: Ten years
measure: Self-reported physical activity (Validated questionnaire)
timeFrame: Five years
measure: Self-reported physical activity (Validated questionnaire)
timeFrame: Ten years
measure: Tobacco Consumption
timeFrame: Five years
measure: Tobacco Consumption
timeFrame: Ten years
measure: Alcohol consumption
timeFrame: Five years
measure: Alcohol consumption
timeFrame: Ten years
measure: Insomnia assessment
timeFrame: Five years
measure: Insomnia assessment
timeFrame: Ten years
measure: Self-reported quality of of life
timeFrame: Five years
measure: Self-reported quality of of life
timeFrame: Ten years
measure: Health service use
timeFrame: Five years
measure: Health service use
timeFrame: Ten years
Secondary outcomes:
Other outcomes:
Locations:
city: Dos Hermanas
country: Spain
facility: Centro de Salud Olivar de Quintos.
state: Andalucía
city: Ferreries
country: Spain
facility: Centro de Salud de Ferreries, Bisbe Severo, 3.
state: Balears
city: Manacor
country: Spain
facility: Centro de Salud de Manacor, C/d'En Simó Tort, 19.
state: Balears
city: Cornellà de Llobregat
country: Spain
facility: CAP Cornellà SDPI, La Gavarra. Carrer de Bellaterra, 41.
state: Barcelona
city: Cornellà de Llobregat
country: Spain
facility: CAP Sant Ildefons. Avinguda de la República Argentina, S/N.
state: Barcelona
city: Gavà
country: Spain
facility: CAP Dr. Bartomeu Fabrés Anglada Gava 2. Carrer de la Riera de les Parets, 7.
state: Barcelona
city: L'Hospitalet de Llobregat
country: Spain
facility: CAP Alhambra. Carrer de l'Alhambra, 20.
state: Barcelona
city: Bilbao
country: Spain
facility: Centro de Salud de Deusto, Luis Power, 18.
state: Bizkaia
city: Leiro
country: Spain
facility: Centro de Salud de Leiro, C/Gabino Bugallal S/N.
state: Orense
city: Vigo
country: Spain
facility: Centro de Salud Beiramar, AV. da Beiramar, 51.
state: Pontevedra
city: Guijuelo
country: Spain
facility: Centro de Salud Guijuelo. C/ Teso de La Feria, S/N.
state: Salamanca
city: Linares de Riofrío.
country: Spain
facility: Centro de Salud Linares de Riofrío. Ctra. de Guijuelo, S/N.
state: Salamanca
city: Peñafiel.
country: Spain
facility: Centro de Salud Peñafiel. Carrer Cruz Roja, S/N.
state: Valladolid
city: Tudela De Duero.
country: Spain
facility: Centro de Salud Tudela de Duero. C/ María Zambrano, S/N.
state: Valladolid
city: Valladolid.
country: Spain
facility: Centro de Salud San Pablo. C/ Cardenal Torquemada, S/N.
state: Valladolid
city: Daroca
country: Spain
facility: CS Daroca. C/Luchente S/N
state: Zaragoza
city: Cuenca
country: Spain
facility: Centro de Salud Cuenca 1, Calle Colón 2.
city: Girona
country: Spain
facility: Unidad de Investigación en Atención Primaria de Girona, IDIAP Jordi Gol, Institut Català de la Salut
city: Salamanca
country: Spain
facility: Centro de Salud San Juan. Avda. de Portugal, 83-89.
city: Zaragoza
country: Spain
facility: CS Arrabal, C/Andador Aragüés del Puerto, 3.
Study officials:
affiliation: IDIAP JORDI GOL
name: Bonaventura Bolíbar
role: STUDY_CHAIR
affiliation: IDIAP JORDI GOL
name: Rafel Ramos, PhD
role: STUDY_DIRECTOR
affiliation: IDIAP JORDI GOL
name: Ruth Martí-Lluch, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Mounce LTA, Campbell JL, Henley WE, Tejerina Arreal MC, Porter I, Valderas JM. Predicting Incident Multimorbidity. Ann Fam Med. 2018 Jul;16(4):322-329. doi: 10.1370/afm.2271.
citation: Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Licence CC BY-NC-SA 3.0 IGO.
citation: World Health Organization (WHO). Global status report on noncommunicable diseases 2014. Ginebra; 2014. ISBN 978 92 4 156422 8. [Internet]. Disponible en: http://www.who.int/nmh/publications/ncd_report_full_en.pdf.
citation: Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, Ustun TB, Wang PS. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiol Psichiatr Soc. 2009 Jan-Mar;18(1):23-33. doi: 10.1017/s1121189x00001421.
citation: O'Neil A, Jacka FN, Quirk SE, Cocker F, Taylor CB, Oldenburg B, Berk M. A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control. BMC Psychiatry. 2015 Feb 5;15:15. doi: 10.1186/s12888-015-0394-0.
citation: Carta de Ottawa para la Promoción de la Salud, OMS, Ginebra, 1986. Who.int. (2015). WHO. [internet] Disponible en: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html.
citation: Gol i Gurina J. Els Grans Temes D'un Pensament I D'una Vida. Barcelona: La llar del llibre; 1986
citation: Rosenzveig A, Kuspinar A, Daskalopoulou SS, Mayo NE. Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Medicine (Baltimore). 2014 Nov;93(22):e120. doi: 10.1097/MD.0000000000000120.
citation: Declaración de Yakarta, YAkarta, 1997. WHO. [internet] Disponible en: http://www.who.int/healthpromotion/conferences/previous/jakarta/en/hpr_jakarta_declaration_sp.pdf
citation: Estrategia de promoción de la salud y prevención en el SNS. Madrid, 2013. MSSSI. Disponible en: https://www.msssi.gob.es/profesionales/saludPublica/prevPromocion/Estrategia/estrategiaPromocionyPrevencion.htm
citation: Dahlgren G, Whitehead M. Policies and strategies to promote social equity in health. Stockholm: Institute for future studies; 1991. [internet]. Disponible en: https://core.ac.uk/download/pdf/6472456.pdf.
citation: Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Promotion International. 1996;11:11-18.
citation: Marmot M. 2004. The Status Syndrome: How Social Standing Affects Our Health and Longevity. New York: Henry Holt.
citation: Atkins L, Francis J, Islam R, O'Connor D, Patey A, Ivers N, Foy R, Duncan EM, Colquhoun H, Grimshaw JM, Lawton R, Michie S. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implement Sci. 2017 Jun 21;12(1):77. doi: 10.1186/s13012-017-0605-9.
citation: Rammstedt B, John OP. Measuring personality in one minute or less: A 10-item short version of the Big Five Inventory in English and German. J Res Pers. 2007; 41:203 -12.
citation: Goodwin RD, Friedman HS. Health status and the five-factor personality traits in a nationally representative sample. J Health Psychol. 2006 Sep;11(5):643-54. doi: 10.1177/1359105306066610.
citation: Chapman BP, Fiscella K, Kawachi I, Duberstein PR. Personality, socioeconomic status, and all-cause mortality in the United States. Am J Epidemiol. 2010 Jan 1;171(1):83-92. doi: 10.1093/aje/kwp323. Epub 2009 Dec 4.
citation: Jokela M, Pulkki-Raback L, Elovainio M, Kivimaki M. Personality traits as risk factors for stroke and coronary heart disease mortality: pooled analysis of three cohort studies. J Behav Med. 2014 Oct;37(5):881-9. doi: 10.1007/s10865-013-9548-z. Epub 2013 Nov 8.
citation: Jokela M, Batty GD, Nyberg ST, Virtanen M, Nabi H, Singh-Manoux A, Kivimaki M. Personality and all-cause mortality: individual-participant meta-analysis of 3,947 deaths in 76,150 adults. Am J Epidemiol. 2013 Sep 1;178(5):667-75. doi: 10.1093/aje/kwt170. Epub 2013 Aug 1.
citation: Hengartner MP, Kawohl W, Haker H, Rossler W, Ajdacic-Gross V. Big Five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community. J Psychosom Res. 2016 May;84:44-51. doi: 10.1016/j.jpsychores.2016.03.012. Epub 2016 Mar 24.
citation: Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monogr. 1966;80(1):1-28. No abstract available.
citation: Berglund E, Lytsy P, Westerling R. The influence of locus of control on self-rated health in context of chronic disease: a structural equation modeling approach in a cross sectional study. BMC Public Health. 2014 May 23;14:492. doi: 10.1186/1471-2458-14-492.
citation: Sturmer T, Hasselbach P, Amelang M. Personality, lifestyle, and risk of cardiovascular disease and cancer: follow-up of population based cohort. BMJ. 2006 Jun 10;332(7554):1359. doi: 10.1136/bmj.38833.479560.80. Epub 2006 May 10.
citation: Moreno-Peral P, Conejo-Ceron S, Fernandez A, Berenguera A, Martinez-Andres M, Pons-Vigues M, Motrico E, Rodriguez-Martin B, Bellon JA, Rubio-Valera M. Primary care patients' perspectives of barriers and enablers of primary prevention and health promotion-a meta-ethnographic synthesis. PLoS One. 2015 May 4;10(5):e0125004. doi: 10.1371/journal.pone.0125004. eCollection 2015.
citation: Wilski M, Chmielewski B, Tomczak M. Work locus of control and burnout in Polish physiotherapists: The mediating effect of coping styles. Int J Occup Med Environ Health. 2015;28(5):875-89. doi: 10.13075/ijomeh.1896.00287.
citation: Poortinga W, Dunstan FD, Fone DL. Health locus of control beliefs and socio-economic differences in self-rated health. Prev Med. 2008 Apr;46(4):374-80. doi: 10.1016/j.ypmed.2007.11.015. Epub 2007 Dec 4.
citation: Mautner D, Peterson B, Cunningham A, Ku B, Scott K, LaNoue M. How Multidimensional Health Locus of Control predicts utilization of emergency and inpatient hospital services. J Health Psychol. 2017 Mar;22(3):314-323. doi: 10.1177/1359105315603468. Epub 2016 Jul 10.
citation: Henninger DE, Whitson HE, Cohen HJ, Ariely D. Higher medical morbidity burden is associated with external locus of control. J Am Geriatr Soc. 2012 Apr;60(4):751-5. doi: 10.1111/j.1532-5415.2012.03904.x. Epub 2012 Mar 28.
citation: Keedy NH, Keffala VJ, Altmaier EM, Chen JJ. Health locus of control and self-efficacy predict back pain rehabilitation outcomes. Iowa Orthop J. 2014;34:158-65.
citation: Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The Self-Efficacy Scale: Construction and Validation. Psychol Rep. 1982;51:663 -71.
citation: Groffen DA, Bosma H, Tan FE, van den Akker M, Kempen GI, van Eijk JT. Material vs. psychosocial explanations of old-age educational differences in physical and mental functioning. Eur J Public Health. 2012 Aug;22(4):587-92. doi: 10.1093/eurpub/ckr063. Epub 2011 Jun 6.
citation: Windsor TD, Anstey KJ. A longitudinal investigation of perceived control and cognitive performance in young, midlife and older adults. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2008 Nov;15(6):744-63. doi: 10.1080/13825580802348570. Epub 2008 Sep 11.
citation: Zahodne LB, Nowinski CJ, Gershon RC, Manly JJ. Which psychosocial factors best predict cognitive performance in older adults? J Int Neuropsychol Soc. 2014 May;20(5):487-95. doi: 10.1017/S1355617714000186. Epub 2014 Mar 31.
citation: Bardach SH, Schoenberg NE, Howell BM. What Motivates Older Adults to Improve Diet and Exercise Patterns? J Community Health. 2016 Feb;41(1):22-9. doi: 10.1007/s10900-015-0058-5.
citation: Olsson I, Dahl AA. Avoidant personality problems--their association with somatic and mental health, lifestyle, and social network. A community-based study. Compr Psychiatry. 2012 Aug;53(6):813-21. doi: 10.1016/j.comppsych.2011.10.007. Epub 2011 Dec 5.
citation: Dolores Serrano-Parra M, Garrido-Abejar M, Notario-Pacheco B, Bartolome-Gutierrez R, Solera-Martinez M, Martinez-Vizcaino V. [Validity of the Connor-Davidson resilience scale (10 items) in a population of elderly]. Enferm Clin. 2013 Jan-Feb;23(1):14-21. doi: 10.1016/j.enfcli.2012.11.006. Epub 2013 Jan 23. Spanish.
citation: Notario-Pacheco B, Solera-Martinez M, Serrano-Parra MD, Bartolome-Gutierrez R, Garcia-Campayo J, Martinez-Vizcaino V. Reliability and validity of the Spanish version of the 10-item Connor-Davidson Resilience Scale (10-item CD-RISC) in young adults. Health Qual Life Outcomes. 2011 Aug 5;9:63. doi: 10.1186/1477-7525-9-63.
citation: Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008 Mar;41(1-2):127-50. doi: 10.1007/s10464-007-9156-6.
citation: Davydov DM, Stewart R, Ritchie K, Chaudieu I. Resilience and mental health. Clin Psychol Rev. 2010 Jul;30(5):479-95. doi: 10.1016/j.cpr.2010.03.003. Epub 2010 Mar 25.
citation: Lang FR, Heckhausen J. Perceived control over development and subjective well-being: differential benefits across adulthood. J Pers Soc Psychol. 2001 Sep;81(3):509-23. doi: 10.1037//0022-3514.81.3.509.
citation: Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. doi: 10.1111/j.1475-6773.2004.00269.x.
citation: Vernooij RW, Willson M, Gagliardi AR; members of the Guidelines International Network Implementation Working Group. Characterizing patient-oriented tools that could be packaged with guidelines to promote self-management and guideline adoption: a meta-review. Implement Sci. 2016 Apr 14;11:52. doi: 10.1186/s13012-016-0419-1.
citation: Blakemore A, Hann M, Howells K, Panagioti M, Sidaway M, Reeves D, Bower P. Patient activation in older people with long-term conditions and multimorbidity: correlates and change in a cohort study in the United Kingdom. BMC Health Serv Res. 2016 Oct 18;16(1):582. doi: 10.1186/s12913-016-1843-2.
citation: Moreno-Chico C, Gonzalez-de Paz L, Monforte-Royo C, Arrighi E, Navarro-Rubio MD, Gallart Fernandez-Puebla A. Adaptation to European Spanish and psychometric properties of the Patient Activation Measure 13 in patients with chronic diseases. Fam Pract. 2017 Sep 1;34(5):627-634. doi: 10.1093/fampra/cmx022.
citation: Sorensen K, Pelikan JM, Rothlin F, Ganahl K, Slonska Z, Doyle G, Fullam J, Kondilis B, Agrafiotis D, Uiters E, Falcon M, Mensing M, Tchamov K, van den Broucke S, Brand H; HLS-EU Consortium. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015 Dec;25(6):1053-8. doi: 10.1093/eurpub/ckv043. Epub 2015 Apr 5.
citation: Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004 Dec;19(12):1228-39. doi: 10.1111/j.1525-1497.2004.40153.x.
citation: Dennis S, Williams A, Taggart J, Newall A, Denney-Wilson E, Zwar N, Shortus T, Harris MF. Which providers can bridge the health literacy gap in lifestyle risk factor modification education: a systematic review and narrative synthesis. BMC Fam Pract. 2012 May 28;13:44. doi: 10.1186/1471-2296-13-44.
citation: Stringhini S, Carmeli C, Jokela M, Avendano M, Muennig P, Guida F, Ricceri F, d'Errico A, Barros H, Bochud M, Chadeau-Hyam M, Clavel-Chapelon F, Costa G, Delpierre C, Fraga S, Goldberg M, Giles GG, Krogh V, Kelly-Irving M, Layte R, Lasserre AM, Marmot MG, Preisig M, Shipley MJ, Vollenweider P, Zins M, Kawachi I, Steptoe A, Mackenbach JP, Vineis P, Kivimaki M; LIFEPATH consortium. Socioeconomic status and the 25 x 25 risk factors as determinants of premature mortality: a multicohort study and meta-analysis of 1.7 million men and women. Lancet. 2017 Mar 25;389(10075):1229-1237. doi: 10.1016/S0140-6736(16)32380-7. Epub 2017 Feb 1.
citation: Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P; Consortium for the European Review of Social Determinants of Health and the Health Divide. WHO European review of social determinants of health and the health divide. Lancet. 2012 Sep 15;380(9846):1011-29. doi: 10.1016/S0140-6736(12)61228-8. Epub 2012 Sep 8.
citation: Reblin M, Uchino BN. Social and emotional support and its implication for health. Curr Opin Psychiatry. 2008 Mar;21(2):201-5. doi: 10.1097/YCO.0b013e3282f3ad89.
citation: Moore S, Kawachi I. Twenty years of social capital and health research: a glossary. J Epidemiol Community Health. 2017 May;71(5):513-517. doi: 10.1136/jech-2016-208313. Epub 2017 Jan 13.
citation: Villalonga-Olives E, Kawachi I. The dark side of social capital: A systematic review of the negative health effects of social capital. Soc Sci Med. 2017 Dec;194:105-127. doi: 10.1016/j.socscimed.2017.10.020. Epub 2017 Oct 21.
citation: Poortinga W. Social relations or social capital? Individual and community health effects of bonding social capital. Soc Sci Med. 2006 Jul;63(1):255-70. doi: 10.1016/j.socscimed.2005.11.039. Epub 2006 Jan 19.
citation: Kim D, Subramanian SV, Kawachi I. Bonding versus bridging social capital and their associations with self rated health: a multilevel analysis of 40 US communities. J Epidemiol Community Health. 2006 Feb;60(2):116-22. doi: 10.1136/jech.2005.038281.
citation: House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988 Jul 29;241(4865):540-5. doi: 10.1126/science.3399889.
citation: Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010 Jul 27;7(7):e1000316. doi: 10.1371/journal.pmed.1000316.
citation: Ehsan AM, De Silva MJ. Social capital and common mental disorder: a systematic review. J Epidemiol Community Health. 2015 Oct;69(10):1021-8. doi: 10.1136/jech-2015-205868. Epub 2015 Jul 15.
citation: Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, Peter R. The measurement of effort-reward imbalance at work: European comparisons. Soc Sci Med. 2004 Apr;58(8):1483-99. doi: 10.1016/S0277-9536(03)00351-4.
citation: Rugulies R, Aust B, Madsen IE, Burr H, Siegrist J, Bultmann U. Adverse psychosocial working conditions and risk of severe depressive symptoms. Do effects differ by occupational grade? Eur J Public Health. 2013 Jun;23(3):415-20. doi: 10.1093/eurpub/cks071. Epub 2012 Jun 8.
citation: Rugulies R, Aust B, Madsen IE. Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies. Scand J Work Environ Health. 2017 Jul 1;43(4):294-306. doi: 10.5271/sjweh.3632. Epub 2017 Mar 17.
citation: Fahlen G, Knutsson A, Peter R, Akerstedt T, Nordin M, Alfredsson L, Westerholm P. Effort-reward imbalance, sleep disturbances and fatigue. Int Arch Occup Environ Health. 2006 May;79(5):371-8. doi: 10.1007/s00420-005-0063-6. Epub 2005 Dec 13.
citation: Dragano N, Siegrist J, Nyberg ST, Lunau T, Fransson EI, Alfredsson L, Bjorner JB, Borritz M, Burr H, Erbel R, Fahlen G, Goldberg M, Hamer M, Heikkila K, Jockel KH, Knutsson A, Madsen IEH, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Pentti J, Rugulies R, Salo P, Schupp J, Singh-Manoux A, Steptoe A, Theorell T, Vahtera J, Westerholm PJM, Westerlund H, Virtanen M, Zins M, Batty GD, Kivimaki M; IPD-Work consortium. Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals. Epidemiology. 2017 Jul;28(4):619-626. doi: 10.1097/EDE.0000000000000666.
citation: Burgel BJ, White MC, Gillen M, Krause N. Psychosocial work factors and shoulder pain in hotel room cleaners. Am J Ind Med. 2010 Jul;53(7):743-56. doi: 10.1002/ajim.20832.
citation: Siegrist J, Li J. Work Stress and Altered Biomarkers: A Synthesis of Findings Based on the Effort-Reward Imbalance Model. Int J Environ Res Public Health. 2017 Nov 10;14(11):1373. doi: 10.3390/ijerph14111373.
citation: Van Bortel T, Wickramasinghe ND, Morgan A, Martin S. Health assets in a global context: a systematic review of the literature. BMJ Open. 2019 Feb 3;9(2):e023810. doi: 10.1136/bmjopen-2018-023810.
citation: Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, Glynn L, Muth C, Valderas JM. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One. 2014 Jul 21;9(7):e102149. doi: 10.1371/journal.pone.0102149. eCollection 2014.
citation: Le Reste JY, Nabbe P, Lingner H, Kasuba Lazic D, Assenova R, Munoz M, Sowinska A, Lygidakis C, Doerr C, Czachowski S, Argyriadou S, Valderas J, Le Floch B, Deriennic J, Jan T, Melot E, Barraine P, Odorico M, Lietard C, Van Royen P, Van Marwijk H. What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice? BMC Fam Pract. 2015 Sep 17;16:125. doi: 10.1186/s12875-015-0337-3.