Employees' and line managers' active involvement in participatory organizational interventions: Examining direct, reversed, and reciprocal effects on well-being

A power-sharing perspective on employees' participatory influence over organizational interventions: conceptual explorations

A participatory approach is widely recommended for organizational interventions aiming to improve employee well-being. Employees' participatory influence over organizational interventions implies that managers share power over decisions concerning the design and/or implementation of those interventions. However, a power-sharing perspective is generally missing in organizational intervention literature. The aim of this paper is therefore broaden the picture of the mechanisms that influence, more or less, participatory processes by conceptually exploring this missing part to the puzzle. These conceptual explorations departs from both an empowerment and a contingency perspective and results in six propositions on what to consider in terms of power-sharing strategies, reach, amount, scope, culture and capacity. Implications for research, as well as for organizations and practitioners interested in occupational health improvements, are then discussed. Especially, the importance of aligning power-sharing forms with the needs of the participating employees, and taking factors that can facilitate or hinder the power-sharing process into consideration, are stressed. The importance of training managers in power-sharing practices and supporting a participatory process is also highlighted.

Further psychometric evaluation of the Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire: Practical implications in healthcare settings

BACKGROUND

Scientific research has identified a lack of psychometrically well-tested methods for evaluation of the work environment in healthcare settings. The Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire has been evaluated and has shown good content validity, as well as intra-rater and test-retest reliability. There are, however, still unknowns regarding the psychometric properties. If the SMET questionnaire is to be used in practical occupational health service (OHS) work and scientific research in healthcare settings, further psychometric evaluation is needed.

OBJECTIVE

The aim of this study was to gain further understanding of the psychometric properties of the SMET questionnaire when used in research and clinical OHS practice in healthcare settings.

METHODS

The psychometric evaluation was conducted using classical test theory (Cronbach's alpha, explorative factor analysis) and Rasch analysis (measurement targeting, category threshold order, person separation index) on data previously collected in development projects within the healthcare sector.

RESULTS

The results support the use of the SMET questionnaire as a psychometrically well-tested method for evaluation of the work environment in healthcare settings. They support the use of the initial 1-10 scale since all 10 steps are used. The results also support the trichotomization procedure since the trichotomized scale captures the construct of the work environment with good measurement targeting and good category threshold order.

CONCLUSION

The results of this study support the use of the SMET questionnaire as a psychometrically well-tested method for a broad multifactorial evaluation of the work environment in healthcare settings.

Leadership and well-being of employees in the Nordic countries: A literature review

BACKGROUND: There is a need for more knowledge regarding the importance of managerial leadership for fostering well-being in the workplace and how context has been accounted for in previous research. OBJECTIVE: To carry out a literature review of previous research that empirically examines the importance of leadership for well-being in a Nordic working life context. METHODS: A rapid literature review was conducted with narrative analysis in 5 steps; establish focus, research questions, and inclusion criteria; literature search; relevance screening; quality assessment; data analysis. The search identified 4566 unique studies where 35 quantitative and five qualitative met the relevance and quality criteria. RESULTS: Findings from quantitative and qualitative studies are presented. Transformational and supportive leadership are recurrently associated with employee well-being, although the qualitative studies also highlight adaptive leadership and leaders being available and providing space. Some connections are made to the Nordic context in the reviewed studies, but these connections are not fully elaborated. CONCLUSION: Leadership is related to employee well-being, although this relationship seems to be indirect, mediated by other factors in the working environment. The review identifies the need for more well-designed studies addressing the contextual factors of this relationship, and how leadership should be exercised in practice.

Testing middle range theories in realist evaluation: a case of a participatory organisational intervention

Purpose

Realist evaluation seeks to answer the question of “what works for whom in which circumstances?” through developing and testing middle range theories (MRTs). MRTs are programme theories that outline how certain mechanisms of an intervention work in a specific context to bring about certain outcomes. In this paper, the authors tested an initial MRT about the mechanism of participation. The authors used evidence from a participatory organisational intervention in five worksites of a large multi-national organisation in the US food service industry.

Design/methodology/approach

Qualitative data from 89 process tracking documents and 24 post-intervention, semi-structured interviews with intervention stakeholders were analysed using template analysis.

Findings

The operationalised mechanism was partial worksite managers’ engagement with the research team. Six contextual factors (e.g. high workload) impaired participation, and one contextual factor (i.e. existing participatory practices) facilitated participation. Worksite managers’ participation resulted in limited improvement in their awareness of how working conditions can impact on their employees’ safety, health, and well-being. Based on these findings, the authors modified the initial MRT into an empirical MRT.

Originality/value

This paper contributes to the understanding of “what works for whom in which circumstances” regarding participation in organisational interventions.

A framework for participatory work environment interventions in home care - success factors and some challenges

Background

Home care is beset with work environment issues and high staff turnover, while research concerned with interventions to improve the work environment is sparse. Few of the existing interventions apply a participative approach, despite this being associated with more positive outcomes and sustainable change. This paper presents a framework, rooted in action research and action learning, for participatory work environment interventions in home care, and demonstrates how this framework has been implemented in four Swedish home care organizations.

Methods

The framework has three phases (pre-intervention, intervention planning and intervention implementation) and consists of cycles of action and reflection in three constellations: a group of researchers, a reference group with labour market organization representatives and home care managers, and intervention work groups in the home care organizations. The work was documented and analysed with focus on the realization of the framework and challenges that were met on the way. The interventions were evaluated using a pre-/post-test questionnaire design.

Results

Parts of the framework were successfully implemented. The pre-intervention phase and the intervention planning phase, with intervention work groups, worked well. All four groups identified one intervention relevant to their own context. However, only two of the proposed interventions were fully implemented and evaluated. The high staff and management turnover, and the high rate of organizational changes made it impossible to evaluate the interventions statistically. Yet, data from open-ended questions in the post questionnaire showed that the two implemented interventions were perceived as successful.

Conclusions

The participatory framework, presented in this paper, seems promising for work environment interventions in home care. The framework was designed to reduce the risk of known disturbances affecting the process in unstable organizations. Despite this, it proved challenging to execute the framework, and especially the interventions, due to changes happening at high speed. In the two cases where organizational changes were not dominating, the interventions were implemented successfully. While the prerequisites for participation and successful implementation could be improved somewhat, the main issue, the instability of the organizational context, is hard for researchers or the individual home care units to tackle alone.

Development and Pilot Test of an Online Training to Engage Managers to Support Workplace Wellness

OBJECTIVE

To contribute to a broader understanding of effective implementation strategies to help managers engage employees in workplace wellness.

METHODS

We beta-tested an online training at four Washington state agencies (two test, two control). We administered a post-training evaluation, re-administered an online manager survey and conducted additional interviews with wellness leads.

RESULTS

Training participation rate was high. The two test agencies experienced a significant increase in the percentage of managers who: agreed that they received training on employee wellness; agreed their agency's culture supports employee wellness; and encouraged their employees to participate in wellness activities. Approximately 80% of managers who received the training agreed they could apply information learned to support employee wellness.

CONCLUSIONS

If proven effective, the training could be administered at a low cost and disseminated to improve employee health.

Using intervention mapping to develop 'Healthy HR' aimed at improving sustainable employability of low-educated employees

BACKGROUND

The perspectives of low-educated employees are often neglected when designing sustainable employability (SE) interventions. As a result, the interventions offered by the employer do often not align with the needs of low-educated employees. This particular group should therefore be actively involved in the process of developing and implementing SE interventions in their work organizations. The current paper describes the development process of a web-based intervention for HR managers and direct supervisors aimed at improving the SE of low-educated employees. This intervention is specifically designed to involve low-educated employees.

METHODS

The first four steps of the Intervention Mapping (IM) approach were used to systematically develop the intervention with the active involvement of stakeholders. Step 1 comprised a needs assessment including a literature review, empirical evidence, scoping search and several focus group interviews with employees and with representatives of employers. Step 2 formulated the intervention objective. During step 3, suitable theoretical methods were selected and translated to practical applications. Step 4 involved the development of a web-based intervention by integrating all information from the preceding steps.

RESULTS

The needs assessment indicated that the employees' active involvement and employees-employer genuine dialogue should be essential characteristics of an SE intervention for low-educated employees. The online toolkit 'Healthy HR' (HHR) was developed, which contains eight steps. Each step consists of one or more tasks helping the employer and employees with developing and implementing SE interventions themselves. One or more dialogue-based tools support each task. The leading principle providing structure within HHR was Adapted Intervention Mapping.

CONCLUSION

Principles of IM appeared to be useful to develop the intervention HHR systematically. This development process resulted in a practical online toolkit that supports employers in the development and implementation of local SE interventions tailored to the needs of low-educated employees. These employees should be actively involved in the process through a dialogue-based approach. By using IM principles, HHR is expected to increase the effectiveness in bettering the health and well-being of low-educated employees.

Implementing practices focused on workplace health and psychological wellbeing: A systematic review

RATIONALE

Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. Thus, implementation should be evaluated to improve the effectiveness of WHWPs.

OBJECTIVE

We conducted a systematic review to identify critical success factors for WHWP implementation and gaps in the evidence. Doing so provides a platform for future theoretical development.

METHODS

We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (e.g., work redesign, 37 studies; and health behavior change, 8 studies), secondary (e.g., mindfulness training, 11 studies), tertiary (e.g., focused on rehabilitation, 9 studies), and multifocal (e.g., including components of primary and secondary, 9 studies).

RESULTS

Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance.

CONCLUSIONS

The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656].

Does Dialogue Improve the Sustainable Employability of Low-Educated Employees? A Study Protocol for an Effect and Process Evaluation of "Healthy HR"

Background: There is a need to develop sustainable employability (SE) interventions that are better aligned to the needs of low-educated employees. This group needs to get a voice in intervention development and implementation. In this study, a dialogue-based approach is proposed consisting of an online step-by-step support toolkit for employers, "Healthy Human Resources" (HHR). When intervening, this toolkit enables and stimulates employers to have a continuous dialogue with their low-educated employees. By improving the employees' job control, HHR is aimed at cost-beneficially improving SE. This paper describes the protocol of the evaluation study to evaluate the effectiveness and implementation process of HHR on the SE of low-educated employees. Methods: The protocol of the evaluation study consists of: (1) an effect evaluation with a pretest-posttest design with a 1-year follow-up in five work organizations in the Netherlands deploying low-educated employees and with SE as the primary outcome and job control as the secondary outcome. The effect evaluation is expanded with a budget impact analysis; (2) a mixed-method process evaluation at 6 and 12 months after the start of HHR to evaluate the whole implementation process of HHR. This includes the experiences with HHR of various stakeholders, such as employees, human resource managers, and line managers. Discussion: The effect evaluation will give insight into the effects of HHR on the SE of low-educated employees. The process evaluation will provide insight into the underlying mechanisms of the (in) effectiveness of HHR. By improving dialogue, we hypothesize that HHR, through enhancing job control, will strengthen the SE of low-educated employees. Also for helping with tackling the socioeconomic health gap, if proven effective, the implementation of HHR on a wider scale can be recommended.

How to design, implement and evaluate organizational interventions for maximum impact: the Sigtuna Principles

Research on organizational interventions needs to meet the objectives of both researchers and participating organizations. This duality means that real-world impact has to be considered throughout the research process, simultaneously addressing both scientific rigour and practical relevance. This discussion paper aims to offer a set of principles, grounded in knowledge from various disciplines that can guide researchers in designing, implementing, and evaluating organizational interventions. Inspired by Mode 2 knowledge production, the principles were developed through a transdisciplinary, participatory and iterative process where practitioners and academics were invited to develop, refine and validate the principles. The process resulted in 10 principles: 1) Ensure active engagement and participation among key stakeholders; 2) Understand the situation (starting points and objectives); 3) Align the intervention with existing organizational objectives; 4) Explicate the program logic; 5) Prioritize intervention activities based on effort-gain balance; 6) Work with existing practices, processes, and mindsets; 7) Iteratively observe, reflect, and adapt; 8) Develop organizational learning capabilities; 9) Evaluate the interaction between intervention, process, and context; and 10) Transfer knowledge beyond the specific organization. The principles suggest how the design, implementation, and evaluation of organizational interventions can be researched in a way that maximizes both practical and scientific impact.

Business Results and Well-Being: An Engaging Leadership Intervention Study

The present quasi-experimental study tested the business impact of a leadership development program focusing on psychological well-being through the satisfaction of basic psychological needs. Based on the concept of engaging leadership and self-determination theory, the 8-month program targeted midlevel team leaders of the customer fulfilment center of a health systems multinational organization. The program was designed in co-creation between senior leadership and the team leaders that participated in the program. Outcomes showed positive business results through significant increases in a preselected key performance indicator and decreased employee absenteeism. Through changes in autonomy satisfaction and intrinsic motivation, the team leaders (N = 14) benefitted in a moderate to very large extent relative to a similar control group (N = 52). In contrast, team members (N = 148) displayed no such benefits. Specifically, higher levels of autonomy satisfaction are said to lead to higher levels of psychological well-being and motivation. Still, the link with business performance is absent in most organizational studies within self-determination theory, making the present study one of the first to fill this gap. The study discloses the program design, compares the effects to a relevant control group, evaluates the lessons learned, and provides practical suggestions.

Improving Working Conditions and Job Satisfaction in Healthcare: A Study Concept Design on a Participatory Organizational Level Intervention in Psychosocial Risks Management

This paper contributes to the literature on organizational interventions on occupational health by presenting a concept study design to test the efficacy of a Participatory Organizational-level Intervention to improve working conditions and job satisfaction in Healthcare. The Participatory Organizational-level Intervention is developed using the Italian methodology to assess and manage psychosocial risks tailored to Healthcare. We added an additional step: evaluation, aiming to examine how the intervention works, what worked for whom and in which circumstances. This ongoing study is conducted in collaboration with two large Italian hospitals (more than 7000 employees). The study design comprises a quasi-experimental approach consisting of five phases and surveys distributed pre- and post-intervention aiming to capture improvements in working conditions and job satisfaction. Moreover, to evaluate the efficacy of the Intervention in terms of process and content, we use a realist evaluation to test Context-Mechanisms-Outcome (CMO) configurations. We collect contextual factors at baseline and during and post-intervention process data on the key principles of line manager support and employees participation. This study is expected to provide insights on methods and strategies to improve working conditions and employees’ job satisfaction and on national policies in the occupational health framework.