Implementing workplace health promotion – role of middle managers

Exercise Prescription for the Work-Life Population and Beyond

The background for this paper concerns a high frequency of work-related disorders that may result from physical exposure at work being highly sedentary, repetitive-monotonous, or physically demanding. This may result in levels of physical inactivity or strenuous activity impairing health. The aim is to present an evidence-based exercise prescription for the work-life population and beyond. The exercise program is designed to be feasible for use at the workplace and/or during leisure time and to improve health, workability, productivity, sickness absence, etc. The specific concept of Intelligent Physical Exercise Training, IPET, includes the assessment of several health-related variables, including musculoskeletal disorders, physical capacity, and physical exposure at work and/or daily life activity. An algorithm with cut-points for prescribing specific exercises is provided. Exercise programs in praxis are addressed through descriptions of precise executions of various prescribed exercises and possible alternatives to optimize variation and adherence. Finally, perspectives on the significance of introducing IPET and the ongoing, as well as future lines of development, are discussed.

Physical activity in the workplace: a cost or a benefit for organizations? A systematic review

Purpose

Most adults do not follow the minimum requirements for physical activity despite the benefits such activity can provide toward improving quality of life. On average, an adult spends 60% of daily hours in the workplace, making it essential to create working environments that are favorable to avoiding harmful effects on the health of workers. Toward this end, the application of physical activity programs in a work context is one of the possible interventions. This study aims to carry out a systematic review of the literature to identify the impact of physical activity programs applied in the workplace, on employee wellness and organizational productivity.

Design/methodology/approach

The search for reports was carried out in two databases, namely, Thomson Reuters Web of Science and Scopus, according to several inclusion and exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was applied to ensure the quality of the study. Microsoft Excel 2016 was used to organize the database to support the data analysis.

Findings

The sample comprised 64 reports published in international journals between 1986 and 2019. From these studies, six thematic clusters were formed: Workplace Physical Activity Interventions, Workplace Wellness, Physical Activity and Organizational Performance, Barriers to Developing Physical Activity Programs in the Workplace, Physical Activity and Sedentary Occupations and Workplace Physical Activity Incentives. The analysis of these clusters confirmed that the implementation of physical activity programs in this context could represent beneficial effects for workers and the organizational system by contributing to a reduction in the rates of absenteeism and presenteeism. However, there are still many organizations that do not implement such programs.

Originality/value

The results of this study are essential for managers of organizations to be able to implement physical activity programs in a work context, similarly to the application of a strategy of corporate social responsibility in an intra-organizational environment. This research may also be useful for professionals in the areas of sports and physical exercise, who want to build their business around physical exercise programs applied to a work context.

Swedish managers' experience of yearly staff development dialogues, aiming for employee development, performance, and well-being

BACKGROUND

Societal development and a competitive corporate climate have resulted in increased emphasis on performance management (PM) but also sustainability and health challenges in working life. Opportunities for employee well-being, development and performance are thus highly relevant for organisations and society. PM includes a manager-employee dialogue process and is identified as a complex challenge when combined with employee development and well-being. Managers have a key role in PM, and research in collaboration with practitioners in specific contexts is needed. An exploratory study, focusing on managers' experience of dialogues between managers and employees in practice, was therefore conducted in collaboration with an inter-municipal corporation company in southern Sweden.

METHODS

A qualitative study with an inductive design, supported by semi-structured focus group interviews, was chosen based on the exploratory character of the study. Thirty-five managers were approached in the company and 15, of varying age and managerial experience, agreed to participate. Staff Development Dialogues (SDD) were used in the company PM model to facilitate employee development, performance, and well-being. Data was analysed using conventional qualitative content analysis to obtain new insights without using pre-set classifications.

RESULTS

The analysis resulted in three categories of SDD experiences: SDD in a business context; Managers in relation to SDD; and Employees in relation to SDD. The findings revealed varying SDD experiences as well as approaches, and analytical themes were considered in relation to the organisational context and the specific SDD content and process. The study showed the importance of SDD adaptation and a well-being perspective in the dialogues was related to relational aspects and the manager-employee approach to SDDs.

DISCUSSION

The findings confirm the complexity and challenges of PM including development and well-being. Adaptation to specific departments as well as employees is important, and using the same PM strategy throughout an organisation can be questioned. The identified link between a relational approach and a well-being perspective indicates a missed opportunity for systematic workplace health promotion. Strengthening the well-being perspective can, thus, improve the quality of an SDD model, which in turn can facilitate the creation of sustainable workplaces and better fulfilment of employers' health-related obligations for systematic work environment management.

Perceived Supervisor Support for Health Affects Presenteeism: A Cross-Sectional Study

We investigated the relationship between perceived supervisor support for health (PSSH) and presenteeism by adjusting for psychological distress and employee work engagement. These are the mediators of the two paths shown in the job demands-resources model. A cross-sectional study was conducted using a questionnaire survey among 15,158 non-managerial employees from seven companies in Japan considered to have relatively high perceived organizational support for health (POSH). PSSH was evaluated with a single question, “My supervisor supports employees to work vigorously and live a healthy life”, on a four-point scale. Presenteeism was estimated using the quantity and quality method. Multilevel logistic regression analyses nested by company were conducted. Lower PSSH was more likely to be associated with presenteeism, but after adjusting for psychological distress evaluated by K6 and for work engagement, the relationship between PSSH and presenteeism weakened. Our results suggested that lower PSSH is linked to presenteeism through both psychological states because of its role as a resource, and other independent factors, even with relatively high POSH. Increased PSSH could act as a measure against presenteeism in the workplace. To achieve this, it is important to create an environment where supervisors can easily encourage employees to improve their health.

Remote workers' experiences with electronic monitoring during Covid-19: implications and recommendations

Purpose

This conceptual article outlines the known effects of employee monitoring on employees who are working remotely. Potential implications, as well as practitioner suggestions, are outlined to identify how practitioners can create more supportive employee experiences as well as apply these to workplace health management scenarios.

Design/methodology/approach

This overview is based on a selective and practically oriented review of articles that hitherto considered the health implications of remote workers being monitored electronically over the last two years. This overview is subsequently complemented by a discussion of more recent findings that outline the potential implications of monitoring for remote employees, employees' work experience and workplace health management.

Findings

Several practitioner-oriented suggestions are outlined that can pave the way to a more supportive employee experience for remote workers, who are monitored electronically by their employers. These include the various health and social interventions, greater managerial awareness about factors that influence well-being and more collaboration with health professionals to design interventions and new workplace policies. Organizations would also benefit from using audits and data analytics from monitoring tools to inform their interventions, while a rethink about work design, as well as organizational reviews of performance and working conditions further represent useful options to identify and set up the right conditions that foster both performance as well as employee well-being.

Originality/value

The article outlines practitioner-oriented suggestions that can directly and indirectly support employee well-being by recognizing the various factors that affect performance and experience.

Association of Organizational Factors With the Proportion of Healthy Behaviours and Control of Blood Pressure at a Company Level

OBJECTIVES

The study examined a relationship between organizational factors and the health outcomes (health behaviors and blood pressure control) at a company level.

METHODS

This cross-sectional study using data from listed corporations on a stock exchange with 1000 to 30,000 employees that completed the health and productivity management survey of Japan in 2019.

RESULTS

We analyzed 886 companies. The presence of occupational health staff was associated with good health behaviors (no smoking and healthy body mass index) and good control of blood pressure. Implementation of education for manager was associated with low smoking rates.

CONCLUSION

The implementation of organizational factors by corporations may improve the lifestyle behaviors and disease management of their employees.

How Human Resources Index, Relational Justice, and Perceived Productivity Change after Reorganization at a Hospital in Sweden That Uses a Structured Support Model for Systematic Work Environment Management

To facilitate systematic work environment management, which should be a natural part of business development, a structured support model was developed. The Stamina model has previously been used in Swedish municipalities, showing positive results. The aim was to study how the Human Resources Index (HRI), relational justice, short-term recovery and perceived productivity changed in a recently reorganised perioperative setting in a hospital in Sweden that uses a structured support model for systematic work environment management. A longitudinal design that took measurements at four time points was used in a sample of 500 employees in a perioperative hospital department. The results for the overall sample indicated a positive trend in the HRI (Mt1 = 48.5, SDt1 = 22.5; Mt3 = 56.7, SDt1 = 21.2; p < 0.001). Perceived health-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 3; p < 0.001) and perceived work environment-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 4; p < 0.001) showed major improvements. Short-term recovery showed a minor improvement (Mt1 = 2.61, SDt1 = 1.33; Mt3 = 2.65, SDt3 = 1.22; p = 0.872). In conclusion, the implementation of the Stamina model, of which the HRI constitutes an important part, seems to be a helpful tool to follow-up on work environment processes, and minimise production losses due to health and work environment-related issues.

How Managers Perceive and (Do Not) Participate in Health Promotion Measures-Results from a Cross-Sectional Mixed-Methods Survey in a Large ICT Company

Managers often face stress and high work demands. Yet they have received limited attention as targets of workplace health promotion measures (HPMs). This study’s primary objective (1) is to examine managers’ self-reported participation in HPMs and factors associated with HPM participation. The secondary objective (2) is to examine managers’ perceptions of their working conditions. A cross-sectional mixed-methods online survey was conducted with a nonrandom sample of 179 managers in a large German ICT company. Stepwise logistic regression and qualitative content analysis were used for data analysis. Quantitative findings revealed that 57.9% of managers had not participated in HPMs yet. “Workload relief through digital tools” resulted as a significant predictor of managers’ previous HPM participation (OR: 2.84, 95% CI: 1.42–5.66). In qualitative findings, workload, time, lack of knowledge, and lack of demand were reported as participation barriers (1). Managers reported that work facility traits, workload, social support, and corporate culture should be improved to make their working conditions more health-promoting (2). These findings suggest that providing adequate organizational working conditions may help improve managers’ HPM participation rates and their perception of health-promoting work.

Identifying opportunities and barriers for introducing a workplace nutrition and health program for employees: Findings from formative research

BACKGROUND: The work style of employees engaged in the Information Technology (IT) and Business Process Outsourcing (BPO) sector in India is dominantly sedentary exposing them to detrimental obesogenic environments with unhealthy diets, increasing the risk of non-communicable diseases (NCDs). Workplace health interventions have been reported to have the potential of reducing NCDs and related risk factors among the employees and thus reduce cost of absenteeism and improve productivity. OBJECTIVE: This formative research study aims to explore the opportunities and barriers of the development and implementation of a Workplace Health Programme (WHP). METHODS: In this study, a mixed method including qualitative and quantitative approaches were used. Focus group discussions (FGDs) were conducted with employees and senior managers in employers of IT/BPO companies of different sizes in Hyderabad, India. The food and physical activity environment in the workplaces were explored using a checklist and ground truthing approach. A Knowledge, Attitudes and Practices (KAP) questionnaire was developed to assess health, nutrition and physical activity of the employees. RESULTS: Through this formative research, the required areas for nutrition, physical activity and health education were identified. The scopes of utilising existing facilities for physical activity and modifying the food environment was explored. We noted optimistic bias among the junior employees who did not consider themselves at risk of developing NCDs. CONCLUSIONS: The identified opportunities and barriers will help in developing strategic WHPs suitable to individual workplaces. The qualitative methods, ground truthing approach, checklist and KAP tools used here can assess the company environment and employee health and nutrition status.

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.

A mixed-method approach to tailor the implementation of a participatory Total Worker Health® program

Purpose –

Total Worker Health^® (TWH) programs, which represent a holistic approach for advancing worker safety, health and well-being, require an employer to adapt programmatic coordination and employee involvement in program design and delivery. Organizational readiness for such measures requires competencies in leadership, communication, subject expertise and worker participation. In the absence of documented methods for TWH readiness assessment, the authors developed a process to prospectively identify implementation facilitators and barriers that may be used to strengthen organizational competencies and optimize the organizational "fit" in advance.

Design/methodology/approach –

The mixed-method baseline assessment instruments comprised an online organizational readiness survey and a key leader interview; these were administered with key organizational and labor leaders in five US healthcare facilities. Findings about organizational resources, skills available and potential implementation barriers were summarized in a stakeholder feedback report and used to strengthen readiness and tailor implementation to the organizational context.

Findings –

The research team was able to leverage organizational strengths such as leaders' commitment and willingness to address nontraditional safety topics to establish new worker-led design teams. Information about program barriers (staff time and communication) enabled the research team to respond with proactive tailoring strategies such as training on participant roles, extending team recruitment time and providing program communication tools and coaching.

Originality/value –

A new method has been developed for prospective organizational readiness assessment to implement a participatory TWH program. The authors illustrate its ability to identify relevant organizational features to guide institutional preparation and tailor program implementation.

Health-promoting university: the implementation of an integrated guidance post for non-communicable diseases (Posbindu PTM) among university employees

Non-communicable diseases (NCDs) remain a challenge globally and in Indonesia. Workplace environments may place employees at risk for NCD behavioral factors. This study aimed to develop an integrated guidance post for NCD (in Indonesian, 'pos pembinaan terpadu penyakit tidak menular' [Posbindu PTM] early detection among employees in one of the Indonesian universities. Posbindu PTM is a community-based program oriented towards promotive and preventive efforts to control NCDs where the community acted as change agents. We conducted a process evaluation based on a quantitative approach through a survey (n = 313) and a qualitative method using in-depth interviews (n = 12) to support our findings that Posbindu PTM was acceptable and feasible to implement in a university context. High participation in Posbindu PTM showed that the program could encourage the university employees to join NCD prevention strategies from early detection to counseling and referral. All participants positively accepted Posbindu PTM for its benefits to health, the flexibility of the program, and the quality service provided by cadres. A need-based program planning, commitment from university leaders, adequate human resources and facilitation, and cooperation between departments, the clinic, and local primary health center and health department determined the success of Posbindu PTM implementation. In contrast, external activities negatively affected participants to join Posbindu PTM. There is a need for more routine scheduling and online-based application to enhance the program's performance. Posbindu PTM is essential for engaging employees with their health and may serve as a model for NCD prevention and control in similar settings. With Posbindu PTM implementation's success, a further stage is required to empower and sustain the Posbindu PTM program towards health-promoting universities.

Truckies and the Australian transport industry: Managers' perspectives about enablers and inhibitors to workplace health promotion

BACKGROUND

There is little published research about managers' views about implementing and embedding workplace health promotion interventions.

OBJECTIVE

To shed light on research-to-practice challenges in implementing workplace health promotion interventions in the Australian road transport industry.

METHODS

In this Participatory Action Research project, managers from small-to-midsized companies in the Australian road transport industry were asked their views about enablers and barriers to implementing nutrition and physical activity interventions in their workplace.

RESULTS

Managers identified practical assistance with resources, ideas, and staffing as being key enablers to implementation. Barriers included time restraints, worker age and lack of interest, and workplace issues relating to costs and resources.

CONCLUSION

Manager perspectives add new insights about successful implementation of workplace health promotion. A Participatory Action Research approach allows managers to develop their own ideas for adapting interventions to suit their workplace. These findings add to a small body of knowledge about managers' views regarding implementing workplace health promotion in small-to-midsized road transport companies - a relatively unexplored group. Managers highlight the importance of time constraints and worker availability when designing interventions for the road transport industry. Managers require a good understanding of the workplaces' socio-cultural context for successful health promotion and health behaviour change.

Factors influencing the implementation of workplace health promotion in companies in rural areas

Purpose

Workplace health promotion (WHP) is becoming increasingly important due to the ageing workforce and a shortage of skilled workers. Nevertheless, too few companies have reacted to the demographic change and introduced health-promoting measures. This paper aims to identify which factors influence the implementation of WHP, especially in small and medium-sized enterprises (SMEs) in rural areas.

Design/methodology/approach

253 companies in a rural area in the federal state of Saxony (Germany) were surveyed using a standardised questionnaire via a computer-assisted telephone interview. Bivariate analyses and logistic regression models were carried out. The focus was on the relationship between the status of WHP and the size of the company, pressure of demographic change, health-related attitude and organisational capacity factors.

Findings

It was shown that, in addition to the control variables company size and pressure of the shortage of skilled workers, a company's attitude regarding health promotion, financial capacity and planning and development capacity has a relevant influence on the status of WHP.

Practical implications

Based on the results, targeted measures can be developed and converted to implement WHP, particularly in SMEs in rural regions. The focus should be on sensitisation, knowledge transfer and capacity development.

Originality/value

The present paper reveals the relationship between company size, pressure of demographic change, health-related attitude and organisational capacities regarding the status of health-promoting measures in SMEs in a rural region.

First-Line Managers' Experiences of Working with a Structured Support Model for Systematic Work Environment Management

Background: This paper describes the experiences of first-line managers when working with a structured support model for systematic work environment management in their work groups. First-line managers play a key part in influencing the work environment. Methods: In this study, a sample of managers implementing a structured support model, the Stamina model, in Swedish municipalities were interviewed. A total of 31 (n = 31) interviews were conducted at two time points during a one-year period. The collected data were analysed using a qualitative thematic approach. Results: The results showed that managers experienced discomfort when giving the responsibility of working with work environmental issues to employees. However, managers also experienced and were impressed by how well it worked in allowing employees to take on work environmental issues. Managers found that they balanced between being quiescent and, at the same time, actively monitoring progress in the work groups. Conclusions: The results from this study implicate that managers need to be sensitive to the needs and capacity of their work groups. The oracle in Delphi stated know yourself. We conclude: Know your group!

How management groups’ reason when deciding to use a model focusing on systematic work environment management

Purpose

The purpose of this paper is to explore and describe the perspective of the management group regarding how they reasoned when deciding to engage in a model focussing on systematic work environment management, and what motives that influenced their decision.

Design/methodology/approach

This qualitative study with semi-structured interviews includes 18 representatives from the management groups in 18 Swedish municipalities. Data were analysed with a constant comparative method.

Findings

The participants described two aspects that were of importance when making the decision; establishing commitment before making the decision and establishing strategies to legitimise the decision. Furthermore, they expressed motives that were linked both to their individual expectations and wishes and to policies and facts in their organisations. The participants experienced the model as a valuable tool in their organisations to increase employee participation and to provide structured support to their first-line managers.

Practical implications

The managers’ motives were linked to individual expectations and external directives. These were often intertwined and influenced their decisions. When implementing this type of model, it is important to discuss decisions in a larger group to avoid building an organisational initiative on one person’s expectations. Furthermore, it is important to support the management’s work to establish commitment for the model in the municipal organisation.

Originality/value

This study adds to knowledge of the complexity of deciding and implementing models to support systematic work environment management in organisations.

Implementation strategies, and barriers and facilitators for implementation of physical activity at work: a scoping review

Background

Inactivity and sedentary lifestyle have led experts to recommend an increase in structured, workplace-based physical activity (PA) initiatives. Previous studies on workplace-based PA have only shown moderate and short-term effects. This has been attributed to the lack of clear implementation strategies and understanding of factors that may hinder or enable uptake of PA. To ensure long-term, sustainable outcomes, there is a need for a better understanding of implementation strategies, and barriers and facilitators to workplace-based PA.

Method

A scoping review of studies investigating implementation approaches and factors affecting uptake of workplace-based PA was conducted. Qualitative and quantitative articles published in MEDLINE, Embase, Scopus, or PsycINFO between 2008 and 2018 evaluating the implementation of PA were included. Data on study characteristics, evaluation, and implementation methods applied were systematically extracted. Two reviewers extracted, coded, and organised factors affecting uptake using the Theoretical Domains Framework (TDF).

Results

After dual, blinded screening of titles and abstracts, 16 articles reporting on eight studies were included in the review. Several different methods of implementation were applied, including information meeting, kick-off events, and "change agents" as the most common. A total of 109 factors influencing implementation were identified, consisting of 57 barriers and 52 facilitators. Barriers most often related to the TDF domains Environmental Context and Resources (n = 34, 36.2%), Social influences (n = 13, 13.8%), and Social/Professional Role and Identity (n = 8, 8.5%). Likewise, facilitators most often related to the TDF domains Social influences (n = 17, 19.5%), Environmental Context and Resources (n = 16, 18.4%), and Social/Professional Role and Identity (n = 9, 10.3%).

Conclusion

Our review has highlighted the multilevel factors affecting the uptake of workplace-based PA and underpins the complexities in implementation of such initiatives. The published literature predominantly provides details from the employees' perspectives on factors that need to be addressed and a lack of attention to these factors will cause them to hamper uptake of PA. The analysis of barriers and facilitators provides a theoretical foundation to guide future intervention design. However, further research is needed to fully understand the success or failure of implementation processes.

Workplace health in wellness – a study of Swedish spa-hotels

Purpose

In previous research, quality management practices have been found to be related to better health for employees. Dimensions of health-promoting quality leadership have been defined. The purpose of this study was to identify dimensions of workplace health in the wellness industry and relate them to the dimensions of health-promoting quality leadership.

Design/methodology/approach

An empirical study involving seven leading spa-hotels in Sweden has been carried out. The first part of the study consisted of quality cafés carried out at each of the hotels. The quality café is a novel method, which has the World Café-method as its basis, combined with quality management techniques. Based on the findings from the quality cafés, an employee survey was developed.

Findings

The findings from the study include a definition of five major health dimensions for the employees, namely, happiness, kinship, respect, physical health conditions and control. The dimensions were found to be statistically consistent and correlated with the self-reported health of the respondents.

Research limitations/implications

The findings are related to health promotion theory and the dimensions of health-promoting quality leadership. A framework for health leadership in the wellness industry is proposed. The study was only carried out in one country.

Practical implications

The framework and the findings should be useful for managers, particularly in the wellness sector, when designing their operations and health promotion activities.

Originality/value

Workplace health in the wellness sector, which is growing worldwide, is very scarcely researched.

Study protocol of an effect and process evaluation of the Stamina model; a Structured and Time-effective Approach through Methods for an Inclusive and Active working life

BACKGROUND

The working environment should be a naturally integrated part of business development. Provisions are in place that address the employer's obligations to investigate, carry out and follow up activities in such a way that ill health and accidents at work are prevented and a satisfactory working environment is achieved. Still, there are organizations that not properly perform systematic work environment management. In order to improve adherence, interventions and models focused on these issues need to be easy to understand and provide rapid feedback of results in order to be implemented. The Stamina model has recently been implemented in Sweden. The model is a participatory organizational systematic model facilitating the work environment, productivity and quality. It is a support model that provides structured and recurrent feedback in the systematic work environment management. The aim of the present paper is to thoroughly describe the Stamina model and the studies that are designed to investigate the effect, to increase the understanding of how and why the model was or was not effective, and to identify factors that facilitate implementation.

METHODS

The paper presents a project consisting of two related evaluation parts. Part one is an effect evaluation with an active group applying the Stamina model and a control group. This part investigate effects on proxy outcomes that are relevant for health and productivity. Part two is a process evaluation with a qualitative design. This part will be based on semi-structured interviews with various stakeholders, such as employees, first line managers, project managers, facilitators and representatives from the management group, in the organizations.

DISCUSSION

Many interventions found to be effective in research projects fail to translate into meaningful outcomes across multiple contexts. In this project a participatory approach will be adopted, including the possibility to modify the model according to organizational needs and preconditions. Valuable knowledge regarding the design and implementation of the model will be generated in order to develop a model that is suitable and sustainable in organizations.