Figure 2.

Trial profile. After assessing the payroll (n = 1699) for eligible participants, we excluded 625 who were not eligible (not belonging to the target job groups [ie, nurses' aides, kitchen and cleaning personnel, or janitors], no longer employed, long-term sick-listed, or not being permanently employed). Of the 1074 eligible employees, 594 were randomised in 4 groups in accordance with the stepped wedge design. Each of the 4 groups beginning the intervention at 4 time points 3 months apart consisted of 4 to 5 clusters and 12 to 15 working teams. The study comprised 4 steps, each lasting 3 months. Within each step, information about dropouts is given. The most frequent reason for dropping out of the study was no longer being employed (53 participants, 37%). Other reasons were due to time of the intervention activities interfering with their work tasks (31 participants, 22%), withdrawal of consent to participate (29 participants, 20%), sickness absence or leave (20 participants, 14%), and private reasons (10 participants, 7%). In the end, 586 participants were included in the analyses because 8 were never included in the text message system.