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Begtrup LM, Brauer C, Jensen JH, Søgaard Tøttenborg S, Flachs EM, Hammer PEC, Malmros PÅ, Bonde JPE. Impact of a manager-oriented intervention on occupational exposures and well-being among pregnant hospital and day-care employees: A cluster randomised trial. Scand J Public Health 2023; 51:188-196. [PMID: 34120525 DOI: 10.1177/14034948211018387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pregnancy can make it difficult to cope with demands at work and may affect women's well-being. We investigated if a manager-targeted educational intervention reduced demanding occupational exposures and improved the psychosocial work environment and well-being among pregnant employees. METHODS Data came from a cluster randomised trial in Danish hospitals and day-care institutions. Work units were assigned randomly and were non-blinded to the intervention, where managers were either invited to participate in a three-hour seminar addressing job adjustment in pregnancy or assigned to a control group undertaking their usual practice. Self-reported outcomes by pregnant employees at the work units were the proportion of pregnant employees with demanding occupational exposures, good psychosocial work environment and good well-being. Mixed logistic regression was applied in the population of responders and in intention-to-treat analyses using multiple imputations. RESULTS We included 915 pregnant employees: 451 in the intervention group and 464 in the control group. Of 216 invited managers, 103 (48%) participated in the seminar. A total of 339 (37%) pregnant employees answered the questionnaire. The proportion of pregnant employees who had demanding occupational exposures, good psychosocial work environment and good well-being in the intervention versus the control group were 36% versus 39% (odds ratio (OR)=0.90, 95% confidence interval (CI) 0.57-1.44), 56% versus 59% (OR=1.01, 95% CI 0.60-1.71) and 77% versus 73% (OR=1.13, 95% CI 0.68-1.87), respectively. CONCLUSIONS This manager-targeted educational intervention did not reduce demanding occupational exposures and did not improve the psychosocial work environment or the well-being among pregnant employees in hospital and day-care settings. Comprehensive and participatory interventions may be considered in future studies.
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Affiliation(s)
- Luise Mølenberg Begtrup
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Paula Edeusa Cristina Hammer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Per Åkesson Malmros
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
| | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg and Frederiksberg Hospital, Denmark
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Hazelzet E, Houkes I, Bosma H, de Rijk A. How a steeper organisational hierarchy prevents change-adoption and implementation of a sustainable employability intervention for employees in low-skilled jobs: a qualitative study. BMC Public Health 2022; 22:2373. [PMID: 36528559 PMCID: PMC9759045 DOI: 10.1186/s12889-022-14754-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adoption and implementation are prerequisites for the effectiveness of organisational interventions, but successful implementation is not self-evident. This article provides insights into the implementation of the organisational intervention 'Healthy Human Resources' (HHR). HHR is developed with Intervention Mapping and aims at improving sustainable employability (SE) of employees in low-skilled jobs. METHODS Qualitative data on adoption and implementation were collected by interviews with three employees and seven middle managers in five Dutch organisations and by extensive notes of observations and conversations in a logbook. Data triangulation was applied and all data were transcribed and analysed thematically using the qualitative analysis guide of Leuven (QUAGOL). RESULTS All organisations adopted HHR, but three failed during the transition from adoption to implementation, and two implemented HHR only partially. The steepness of the organisational hierarchy emerged as an overarching barrier: steeper hierarchical organisations faced more difficulties with implementing HHR than flatter ones. This was reflected in middle managers' lack of decision-making authority and being overruled by senior management. Middle managers felt incapable of remedying the lack of employees' voice. Subsequently, 'us-versus-them' thinking patterns emerged. These power imbalances and 'us-versus-them' thinking reinforced each other, further strengthening the hierarchical steepness. Both processes could be the result of wider socio-political forces. CONCLUSIONS This study improved the understanding of the difficulties to adopt and implement such organisational intervention to contribute to the sustainable employability of employees in low-skilled jobs. Practical implications are given for future implementation of organisational interventions.
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Affiliation(s)
- Emmelie Hazelzet
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands.
| | - Inge Houkes
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Angelique de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
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Helland E, Christensen M, Innstrand ST, Nielsen K. Line managers' middle-levelness and driving proactive behaviors in organizational interventions. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2021. [DOI: 10.1108/ijwhm-08-2020-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper explores line managers' proactive work behaviors in organizational interventions and ascertains how their management of their middle-levelness by aligning with the intervention, or not, influences their proactive work behaviors.Design/methodology/approachThe authors’ findings are based on thematic analysis of 20 semi-structured interviews of university heads of departments responsible for managing organizational interventions.FindingsThe authors found that line managers engaged in a range of proactive work behaviors to implement the organizational intervention (i.e. “driving proactive behaviors”). Furthermore, line managers tended to engage in driving proactive behaviors when they aligned with the organizational intervention, but not to when unconvinced of the intervention's validity.Practical implicationsThese findings highlight the importance of senior management and HR investing sufficient time and quality in the preparation phase to ensure all actors have a shared understanding of the organizational interventions' validity.Originality/valueThis is the first study to explore line managers' proactive work behaviors to implement an organizational intervention, and how the line managers' management of their middle-levelness influence these proactive work behaviors.
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Nielsen K, Christensen M. Positive Participatory Organizational Interventions: A Multilevel Approach for Creating Healthy Workplaces. Front Psychol 2021; 12:696245. [PMID: 34262513 PMCID: PMC8273334 DOI: 10.3389/fpsyg.2021.696245] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/28/2021] [Indexed: 11/20/2022] Open
Abstract
In the following perspective paper, we argue for the importance of conducting research on positive participatory organizational interventions. We propose that these types of interventions are important because they not only focus on eliminating or reducing adverse job demands but focus also on developing job resources. To achieve the best effects, actions should be taken to address demands and resources at the individual, group, leader and organizational levels. We furthermore suggest that the participatory intervention process itself may also build resources at these four levels.
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Affiliation(s)
- Karina Nielsen
- Institute of Work Psychology, The University of Sheffield, Sheffield, United Kingdom
- Norwegian University of Science and Technology, Trondheim, Norway
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Begtrup LM, Malmros P, Brauer C, Soegaard Toettenborg S, Flachs EM, Hammer PEC, Bonde JP. Manager-oriented intervention to reduce absence among pregnant employees in the healthcare and daycare sector: a cluster randomised trial. Occup Environ Med 2021; 78:oemed-2020-106794. [PMID: 33436380 DOI: 10.1136/oemed-2020-106794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/23/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim was to test if targeting managers with an educational intervention reduces absence among pregnant employees. METHODS The study was a non-blinded cluster randomised trial conducted in hospitals and daycare institutions from two administrative Danish Regions and two Danish municipalities. Clusters (work units) were assigned randomly and non-blinded to either (1) intervention, where all managers were invited to participate in a 3-hour seminar addressing needs and options for adjustment of work in pregnancy, or (2) control, with practice as usual. The primary outcome based on payroll data was long-term pregnancy-related absence, defined as ≥12.5% cumulated absence during pregnancy weeks 1-32. Intention-to-treat analysis was applied using mixed logistic regression. RESULTS Ninety work units were included (56 hospital departments and 34 daycare units) with 451 pregnant employees in the intervention group and 464 in the control group. Work units had on average 11 pregnant employees with no difference between the groups. 103 of the 216 invited managers (48%) participated in a the 3-hour seminar. In the intervention group, 154 (34%) had long-term pregnancy-related absence during pregnancy weeks 1-32 vs 166 (36%) in the control group. Relative odds of having long-term pregnancy-related absence, when being in the intervention group, was 1.06 (95% CI 0.71 to 1.58), with an interclass correlation coefficient of 0.07. CONCLUSION An educational intervention targeting managers did not reduce pregnancy-related absence among pregnant employees. TRIAL REGISTRATION NUMBER NCT03002987.
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Affiliation(s)
- Luise Moelenberg Begtrup
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Per Malmros
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Sandra Soegaard Toettenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Paula Edeusa Cristina Hammer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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De Angelis M, Giusino D, Nielsen K, Aboagye E, Christensen M, Innstrand ST, Mazzetti G, van den Heuvel M, Sijbom RB, Pelzer V, Chiesa R, Pietrantoni L. H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8035. [PMID: 33142745 PMCID: PMC7662282 DOI: 10.3390/ijerph17218035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022]
Abstract
The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.
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Affiliation(s)
- Marco De Angelis
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Davide Giusino
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Karina Nielsen
- Institute of Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 FL, UK;
| | - Emmanuel Aboagye
- Institute of Environmental Medicine, Karolinska Institute, 171 65 Stockholm, Sweden;
| | - Marit Christensen
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Siw Tone Innstrand
- Department of Psychology, Norwegian University of Science and Technology, N-7941 Trondheim, Norway; (M.C.); (S.T.I.)
| | - Greta Mazzetti
- Department of Education Studies, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy;
| | - Machteld van den Heuvel
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Roy B.L. Sijbom
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Vince Pelzer
- Department of Work and Organizational Psychology, University of Amsterdam, 1018 WS Amsterdam, The Netherlands; (M.v.d.H.); (R.B.L.S.); (V.P.)
| | - Rita Chiesa
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
| | - Luca Pietrantoni
- Department of Psychology, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy; (D.G.); (R.C.); (L.P.)
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