Lydia Nadine Kwak

Lydia Nadine Kwak

Lektor | Docent
E-postadress: lydia.kwak@ki.se
Telefon: +46852487129
Besöksadress: Nobels väg 7, 17165 Solna
Postadress: C6 Institutet för miljömedicin, C6 IIR Kwak, 171 77 Stockholm
Del av:

Om mig

  • My research area is intervention and implementation research within the field of worker health. I have been an associate professor since 2017, and a senior lecturer in health promotion since 2019. In 2019, I become head of the unit for Intervention and Implementation Research for worker health at the Institute of Environmental Medicine. I am also assistant study director of the doctoral education at the Institute of Environmental Medicine and involved in several teaching activities. 
    I have a master’s degree in health sciences, specializing in Health Education and Promotion, and Biological Health Sciences, from Maastricht University in the Netherlands. In 2007, I defended my doctoral thesis at Maastricht University with the title: the NHF-NRG-In Balance-project: development, implementation and evaluation of a weight gain prevention program. In 2007, I moved to Sweden and started my research-career at Karolinska Institutet as a post-doctor.  

Forskningsbeskrivning

  • My research area is intervention and implementation research within the field of worker health. This means that I conduct research on how the health of the working population can be promoted at the workplace and how ill-health can be prevented. This research encompasses a broad range of research activities including gaining knowledge on determinants of health and health behaviour through observational studies, testing the effectiveness of methods targeting these determinants through intervention studies, and gaining knowledge on how effective interventions can be most effectively implemented into practice through implementation research studies.

    I am currently leading a large cluster randomized controlled trial financed by Forte among four municipalities and over 50 public schools in Sweden. The implementation research trial is the third step in facilitating the implementation of evidence-based methods for the prevention of mental ill-health within the workplace. In step one, we developed the Guideline for prevention of mental ill-health in the workplace consisting of evidence-based recommendations describing how organizations can prevent mental ill-health at the workplace through the management of social and organizational risks. In step two, implementation strategies were developed aimed at enhancing the adoption and implementation of the guideline within organizations. The effectiveness of the developed implementation strategies was tested in a cluster-randomized controlled trial among twenty schools in two municipalities in Sweden. Schools were chosen as the setting for implementation given the high prevalence of mental ill-health among teachers and the lack of a structured approach to the management of social and organizational risks within schools. In the current trial, we are testing the implementation mechanisms through which the implementation strategies impact guideline adherence in the workplace. This knowledge will propel the implementation research field toward a better understanding of how, when, where, and why implementation strategies are effective in integrating evidence-based methods into practice. 


    I am also leading a new project with start June 2024 financed by AFA-insurance aimed at examining the implementation of support-staff in schools. To increase our understanding of how support staff can better support teachers, the overall aim of this project is to increase knowledge of both the effectiveness of support staff on teacher’s workload and stress, and how support staff are to be implemented and organized in schools. The project applies a mixed-methods design and focuses specifically on public compulsory schools. 

Undervisning

  • I am the assistant study director of the doctoral education at the Institute of Environmental Medicine. Moreover, I have since 2011 been course leader of the doctoral course Public Health Intervention and Implementation research, which has now be renamed into Implementation Research in health. In addition, I give lectures for undergraduate and graduate programmes on the topic of intervention and implementation research and supervise master-and doctaral students as main and co-supervisor. 

Artiklar

Alla övriga publikationer

Forskningsbidrag

  • Forte in collaboration with Swedish Social Insurance Agency
    1 December 2023 - 1 November 2026
  • Swedish Research Council for Health Working Life and Welfare
    1 December 2023 - 30 November 2027
    Research problem and specific questionsThe profession of publicly financed personal assistant provides opportunities for persons with disabilities (‘assistance users’) to participate fully in society. The profession has specific working conditions that make it essential to study from a health perspective: personal assistants work in various environments, they often work alone in the user’s home, under varying terms of employment depending on whether the assistance organizer is private, public, cooperative or the users themselves. Moreover, the profession has high levels of sickness absence, is female-dominated, low-waged, and requires no formal education. Therefore, research on how health and the work environment interact in this profession is necessary to ensure a sustainable working life. Previous research has highlighted the importance of employers (with responsibility for safety and health at work) in the return to work process.The aim is to examine personal assistants’ and their employers’ perceptions of facilitators and barriers for return to work after sickness absence due to common mental disorders (CMDs).Data and MethodThe project has a qualitative approach. Data will be collected through two semi-structured interviews three months apart with 20–25 personal assistants and 20–25 employers/ managers.Societal relevance and utilisationCMDs are common causes of sickness absence, and women have a higher risk of becoming sick-listed than men. The profession of personal assistants suffers from high sickness absence and various insecure working conditions. Knowledge should be translated into practical measures through collaboration, remain sensitive to the legal rights of assistance users, and be useful in employers’ occupational safety and health management.Plan for project realisationThe main costs consist of salaries for the projects’ researchers. Additional costs include fees for ethical review, transcription services, language review, and collaboration.
  • Swedish Research Council for Health Working Life and Welfare
    1 July 2020 - 30 June 2027
    There is an urgent need for more knowledge on effective implementation strategies, as two-thirds of implementation efforts fail to achieve the intended change, and half have no effect on outcomes of interest. These implementation failures are partly due to the limited understanding of how implementation strategies work—the mechanisms of change through which implementation strategies affect implementation. This project will fill this research-gap by incorporating mediation analyses into a cluster randomized controlled trial that compares the effectiveness of two implementation strategies for implementing the Guideline for the prevention of mental ill-health at the workplace in schools. Schools are chosen as the setting for implementation given the high prevalence of mental ill-health among teachers. Moreover, they lack a structured approach to the prevention of mental ill-health. The aim of the project is to investigate how implementation strategies affect the defined mechanisms and guideline implementation. The mechanisms of the following implementation strategies will be compared: a discrete strategy that includes an educational meeting (control group) and a multifaceted strategy (intervention group) that combines the educational meeting with workshops, implementation teams and evaluative and iterative strategies (e.g. Plan-Do-Study-Act cycles). Our hypothesis is that schools that receive the multifaceted implementation strategy will show a greater increase in guideline adherence at follow-up than schools that only participate in an educational meeting. Mechanisms that will be tested include hypothesized mediators originating from the individual behavior change theory COM-B. The project will be conducted in primary schools (n=50) in four municipalities in Sweden. Adherence to the guideline will be assessed at baseline and 6, 12- and 24-months follow-up, and mediators at baseline and 3, 6, 9, 12- and 24-months follow-up. Mixed methods will be used.
  • Swedish Research Council for Health Working Life and Welfare
    1 July 2020 - 30 June 2026
    The aim of IMPROVE is to test the scalability of the Healthy School Start Plus (HSSP) programme at the municipal level while maintaining positive effects on child health outcomes. Implementation strategies will be developed based on knowledge of barriers and facilitators and tested in a comparative effectiveness study with a hybrid type 3 design. HSSP is a family support programme in pre-school class in disadvantaged areas to prevent childhood overweight and obesity through improved diet and physical activity. It also includes a parental online test for risk of developing type 2 diabetes. The programme has been evaluated twice and shown effectiveness with regard to child dietary habits and some effect on obesity. A third intervention trial fully adapted to the school context ends in 2020. The aim of IMPROVE is to take the next step from research to practice and includes 3 work packages over 4 years. In WP1 stakeholder workshops will be held in municipalities with at least 20 participating schools each to collaboratively identify potential barriers and facilitators of implementation, guided by the Consolidated Framework for Implementation Research. Then, tailored implementation strategies will be developed, a basic bundle (Basic) and a basic and an additional bundle (Basic+) and schools will be randomized to either one. In WP2 effectiveness of the bundles will be compared after 1 and 2 years regarding intervention fidelity (primary outcome), acceptability, appropriateness, feasibility, penetration, organisational readiness, child weight status and parental risk of type 2 diabetes. In WP3 key stakeholders will be interviewed regarding what it would take to sustain the programme with high quality in the municipality and to establish a health data monitoring and feed-back system for professionals. The National Organisation for School Nurses has expressed interest in the HSSP indicating a strong implementation momentum and opportunity for long-term sustainability.
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2020 - 31 December 2024
  • Swedish Research Council for Health Working Life and Welfare
    1 July 2019 - 30 November 2023
  • Swedish Research Council for Health Working Life and Welfare
    1 September 2017 - 31 August 2020
  • Postdoc contribution: Determination factors for physical activity from childhood to youth and from adolescence to adulthood.
    Swedish Research Council for Health Working Life and Welfare
    1 January 2009 - 31 December 2010

Anställningar

  • Lektor, Hälsopromotion, Institutet för miljömedicin, Karolinska Institutet, 2019-

Examina och utbildning

  • Docent, Hälsofrämjande arbete, Karolinska Institutet, 2017

Handledning

  • Handledning till doktorsexamen

    • Elinor Forsheden Sidoli, Organisational and social work environment within the construction industry: which managing practices work?, 2024-

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