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Lundmark R, Agrell A, Abildgaard JS, Wahlström J, Tafvelin S. A joint training of healthcare line managers and health and safety representatives in facilitating occupational health interventions: a feasibility study protocol for the Co-pilot project. Front Psychol 2024; 15:1340279. [PMID: 38860038 PMCID: PMC11163036 DOI: 10.3389/fpsyg.2024.1340279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Healthcare employees are experiencing poor wellbeing at an increasing rate. The healthcare workforce is exposed to challenging tasks and a high work pace, a situation that worsened during and after the COVID-19 pandemic. In turn, exposure to these high demands contributes to poor health, increased turnover, reduced job satisfaction, reduced efficacy, and reduced patient satisfaction and safety. Therefore, it is imperative that we identify measures to mitigate this crisis. One piece of this puzzle is how to implement sustainable tools and processes to improve the work environment of healthcare organizations. In this paper, we present the study protocol for the outlining and piloting of a joint training for pairs of healthcare line managers and their associated health and safety representatives in a Swedish healthcare organization. The objective of the training is to aid and advance the implementation of interventions to improve the work environment at the unit level. Following recommendations in the literature, the training is based on a stepwise approach that considers the specific context and focuses on the involvement of employees in creating interventions based on their needs. A central component of the training is the development of the pairs' collaboration in prioritizing, developing, implementing, and evaluating the interventions. The training is based on an on-the-job train-the-trainer approach in which participants are progressively trained during four workshops in the steps of a participatory intervention process. Between these workshops, the pairs follow the same progressive steps together with their employees to develop and implement interventions at their unit. The pilot will involve four pairs (i.e., eight participants) representing different parts and functions of the organization and will be conducted over a period of three months. We will use a mixed method design to evaluate preconditions, the process, and proximal transfer and implementation outcome factors of the training. The overall aim of the pilot is to appraise its feasibility and be able to adjust the training before a potential scale-up.
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Affiliation(s)
- Robert Lundmark
- Department of Psychology, Umeå University, Umeå, Sweden
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Alexander Agrell
- Department of Psychology, Umeå University, Umeå, Sweden
- Industrial Doctoral School for Research and Innovation, Umeå University, Umeå, Sweden
| | - Johan Simonsen Abildgaard
- Department of Organization, Copenhagen Business School, Copenhagen, Denmark
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Lundmark R. A power-sharing perspective on employees' participatory influence over organizational interventions: conceptual explorations. Front Psychol 2023; 14:1185735. [PMID: 37519376 PMCID: PMC10372622 DOI: 10.3389/fpsyg.2023.1185735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
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.
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Roodbari H, Nielsen K, Axtell C, Peters SE, Sorensen G. Testing middle range theories in realist evaluation: a case of a participatory organisational intervention. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-12-2021-0219] [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
PurposeRealist 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/approachQualitative data from 89 process tracking documents and 24 post-intervention, semi-structured interviews with intervention stakeholders were analysed using template analysis.FindingsThe 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/valueThis paper contributes to the understanding of “what works for whom in which circumstances” regarding participation in organisational interventions.
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Roodbari H, Nielsen K, Axtell C, Peters SE, Sorensen G. Developing Initial Middle Range Theories in Realist Evaluation: A Case of an Organisational Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8360. [PMID: 34444110 PMCID: PMC8394353 DOI: 10.3390/ijerph18168360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/28/2021] [Accepted: 08/05/2021] [Indexed: 12/04/2022]
Abstract
(1) Background: Realist evaluation is a promising approach for evaluating organisational interventions. Crucial to realist evaluation is the development and testing of middle range theories (MRTs). MRTs are programme theories that outline how the intervention mechanisms work in a specific context to bring about certain outcomes. To the best of our knowledge, no organisational intervention study has yet developed initial MRTs. This study aimed to develop initial MRTs based on qualitative evidence from the development phase of an organisational intervention in a large multi-national organisation, the US food service industry. (2) Methods: Data were collected through 20 semi-structured interviews with the organisation's managers, five focus groups with a total of 30 employees, and five worksite observations. Template analysis was used to analyse data. (3) Results: Four initial MRTs were developed based on four mechanisms of participation, leadership commitment, communication, and tailoring the intervention to fit the organisational context to formulate 'what may work for whom in which circumstances?' in organisational interventions; (4) Conclusions: Our findings provide insights into 'how' and 'which' initial MRTs can be developed in organisational interventions.
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Affiliation(s)
- Hamid Roodbari
- Institute for Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 2TN, UK; (K.N.); (C.A.)
| | - Karina Nielsen
- Institute for Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 2TN, UK; (K.N.); (C.A.)
| | - Carolyn Axtell
- Institute for Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield S10 2TN, UK; (K.N.); (C.A.)
| | - Susan E. Peters
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (S.E.P.); (G.S.)
- Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Glorian Sorensen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (S.E.P.); (G.S.)
- Dana-Farber Cancer Institute, Boston, MA 02215, USA
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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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Cedstrand E, Nyberg A, Sanchez-Bengtsson S, Alderling M, Augustsson H, Bodin T, Mölsted Alvesson H, Johansson G. A Participatory Intervention to Improve the Psychosocial Work Environment and Mental Health in Human Service Organisations. A Mixed Methods Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3546. [PMID: 33805501 PMCID: PMC8037176 DOI: 10.3390/ijerph18073546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/18/2022]
Abstract
Work-related stress is a global problem causing suffering and economic costs. In Sweden, employees in human service occupations are overrepresented among persons on sick leave due to mental health problems such as stress-related disorders. The psychosocial work environment is one contributing factor for this problem, making it urgent to identify effective methods to decrease stress at the workplace. The aim of the study is to evaluate a participatory intervention to improve the psychosocial work environment and mental health using an embedded mixed methods design. The study is a controlled trial with a parallel process evaluation exploring fidelity and participants' reactions to the intervention activities, experiences of learning and changes in behaviours and work routines. We collected data through documentation, interviews and three waves of questionnaires. Our results show small changes in behaviours and work routines and no positive effects of the intervention on the psychosocial work environment nor health outcomes. One explanation is end-users' perceived lack of involvement over the process causing the intervention to be seen as a burden. Another explanation is that the intervention activities were perceived targeting the wrong organisational level. A representative participation over both content and process can be an effective strategy to change psychosocial working conditions and mental health.
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Affiliation(s)
- Emma Cedstrand
- Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden; (A.N.); (M.A.); (T.B.); (G.J.)
| | - Anna Nyberg
- Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden; (A.N.); (M.A.); (T.B.); (G.J.)
- Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden
| | - Sara Sanchez-Bengtsson
- Center of Occupational and Environmental Medicine, Stockholm Region, 113 65 Stockholm, Sweden;
| | - Magnus Alderling
- Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden; (A.N.); (M.A.); (T.B.); (G.J.)
- Center of Occupational and Environmental Medicine, Stockholm Region, 113 65 Stockholm, Sweden;
| | - Hanna Augustsson
- Medical Management Centre, Procome Research Group, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Theo Bodin
- Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden; (A.N.); (M.A.); (T.B.); (G.J.)
- Center of Occupational and Environmental Medicine, Stockholm Region, 113 65 Stockholm, Sweden;
| | | | - Gun Johansson
- Institute for Environmental Medicine, Karolinska Institutet, Unit of Occupational Medicine, 171 77 Stockholm, Sweden; (A.N.); (M.A.); (T.B.); (G.J.)
- Center of Occupational and Environmental Medicine, Stockholm Region, 113 65 Stockholm, Sweden;
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