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Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions.

ABSTRACT: Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.

SUBMITTER: van Heijster H

PROVIDER: S-EPMC9791441 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions.

van Heijster Hanneke H van Berkel Jantien J Boot Cécile Rl CR Abma Tineke T de Vet Emely E

BMJ open 20221222 12

<b>Background:</b> Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional e ...[more]

PMID: 36549731

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Project description:BackgroundWorkplace health programs (WHPs) may improve adult health but very little evidence exists on multi-level WHPs implemented at-scale and so the relationship between program implementation factors and outcomes of WHPs are poorly understood. This study evaluated Get Healthy at Work (GHaW), a state-wide government-funded WHP in Australia.MethodsA mixed-method design included a longitudinal quasi-experimental survey of businesses registered with GHaW and a comparison group of businesses surveyed over a 12-month period. Semi-structured interviews and focus groups with key contacts and employees of selected intervention group businesses and the service providers of the program were conducted to assess program adoption and adaptation.ResultsPositive business-level changes in workplace culture were observed over time among GHaW businesses compared with the control group. Multilevel regression modelling revealed perceptions that employees were generally healthy (p = 0.045 timeXgroup effect) and that the workplace promoted healthy behaviours (p = 0.004 timeXgroup effect) improved significantly while the control group reported no change in work culture perceptions. Changes in perceptions about work productivity were not observed; however only one third of businesses registered for the program had adopted GHaW during the evaluation period. Qualitative results revealed a number of factors contributing to program adoption: which depended on program delivery (e.g., logistics, technology and communication channels), design features of the program, and organisational factors (primarily business size and previous experience of WHPs).ConclusionsEvaluation of program factors is important to improve program delivery and uptake and to ensure greater scalability. GHaW has the potential to improve workplace health culture, which may lead to better health promoting work environments. These results imply that government can play a central role in enabling prioritisation and incentivising health promotion in the workplace.

Project description:BackgroundThe workplace provides an ideal setting for health promotion, as adults spend most of their day at work. Middle managers hold a strategic position to lead workplace health promotion. This study evaluates the outcomes of an intensive intervention training middle managers to promote health in the workplace.MethodsA workshop was designed and conducted to train female middle management employees to construct, implement, and evaluate a health promotion program in their workplace. Semi-structured interviews were carried out post-intervention to assess workplace health promotion outcomes according to the RE-AIM framework, and identify variables contributing to success. Additionally, questionnaires were distributed pre and post-program assessing personal health and self-efficacy changes.ResultsEighteen participants from 13 government offices, who serve 19,560 employees, completed the training course. Nine workplaces had workplace health promotion programs in progress 12 months after the course had ended, of which 8 made health promotion changes in organizational policy. Workplace RE-AIM scores showed that 8 workplaces were high or partial performers, and 5 were low or non-performers. Factors that increased the likelihood of successful interventions included management support, steering committee, comprehensive programming, conducting a needs assessment and flexibility in program implementation in the presence of challenges. Post course, participants reported increased health knowledge related to workplace health promotion (p < 0.001), and increased health promotion self-efficacy (p < 0.05).ConclusionsTraining and continued guidance of middle managers resulted in the design and successful implementation of workplace health promotion interventions. A RE-AIM based assessment was found to be an effective method for evaluating multi-content workplace health promotion programs. Registered at ClinicalTrials.gov, https://www.clinicaltrials.gov , registration number: NCT03295136, registration date: 24/09/2017.

Project description:ObjectiveTo gain insight into 1) the degree of implementation of an integrated workplace health promotion program (WHPP) 2) the perceptions of employers and employees regarding an integrated WHPP and 3) the contextual factors that hindered or enhanced implementation.MethodsData were collected by means of questionnaires, interviews among 19 employees, supervisors and HR-professionals, monitoring charts and observations at 6-10 months after the start of the implementation of the integrated WHPP. To evaluate the implementation process, ten process indicators from the evaluation frameworks of Nielsen & Randall and Wierenga were assessed. Descriptive analyses were performed for the process indicators as measured by questionnaires, monitoring charts and observations. Interviews with employers and employees were recorded, transcribed and then coded by two researchers independently by means of thematic coding.ResultsThe results cover the following topics: implemented activities, the working group, engagement of employees, the role of management and policy and organizational preconditions. Although the criteria of the WHPP were not completely met, various activities were implemented in all participating organizations. Working groups consisting of Human Resources professionals, supervisors and employees, who selected and implemented activities, were composed within each organization. 22% of the employees did not feel involved in the implementation process. The absence of organizational policies regarding WHP hampered implementation. Organizations had the intention to continue with the integrated WHPP, which requires sufficient time and budget.ConclusionsThe implementation of the integrated WHPP appeared to be challenging and complex. Working groups indicated that they made the first important steps in integrating WHP in their organization and had the intention to continue with the implementation. However, to increase the impact, employers and employees should have the opportunity to implement and participate in WHP. Hence, organizational policies regarding WHP and active support of higher management are expected to be essential.

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Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions.

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Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions.

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