Health-Promoting Leadership: Concept, Measurement, and Research Framework

Preventive behaviors against COVID-19 among health care providers in Iran: A cross-sectional study

Background and Aim

During outbreaks of infectious diseases, if healthcare providers do not follow the principles of prevention, the risk of personal infection increases and they become a source of infection spread. This study aimed to determine the factors related to the preventive health behaviors of COVID-19 among Iranian healthcare providers based on protection motivation theory (PMT).

Methods

This analytical cross-sectional study included 346 healthcare providers. Data was collected by an online researcher-made questionnaire based on PMT. To analyze the data, independent T tests, analysis of variance (ANOVA), Spearman correlation coefficient, multiple linear regression, and SPSS 22 software were used. α was considered as 0.05.

Results

85.3% of the healthcare providers would always wear masks, 80.7% would always refuse to kiss and touch hands with others, and 34.7% sometimes would exercise at home. The preventive behaviors were significantly correlated with protection motivation (r = 0.84), self-efficacy (r = 0.51), response efficiency (r = 0.43), perceived severity (r = 0.41) Fear (r = 0.21), perceived susceptibility (r = 0.11), response cost (r = -0.14), and reward (r = -0.15). PMT constructs were able to predict 77% of the variance of the behaviors and the protection motivation construct was the strongest predictor (β = 0.806). Income above 300 Dolars per month was significantly related to the decrease in the mean score of preventive behaviors against COVID-19. The female sex and the individual or family history of infectious diseases were significantly related to increasing the mean score of COVID-19 preventive behaviors.

Conclusion

Based on the study results, it is suggested that some educational interventions be designed and implemented with a focus on this construct and the perceived severity construct and that more attention be given to the education of health care providers with high-income levels, male providers, and the individuals without a history of corona infection in themselves or their family members.

Does Organizational Commitment to Mental Health Affect Team Processes? A Longitudinal Study

Purpose

Team processes, such as reflexivity and participation, are critical for organizational sustainability, especially in high-reliability professions such as healthcare. However, little is known about health-related predictors of team processes. Basing our hypotheses on the Input-Process-Output (IPO) model, this study investigates the influence of perceived organizational commitment to mental health (OCMH) on healthcare workers' team reflexivity and participation via mental health-specific leadership (MHsL) and team autonomy.

Patients and Methods

The study involved 82 participants (ie, physicians, nurses, healthcare assistants, healthcare technicians, and physiotherapists) working in the Medicine, Emergency, and Neurological Departments at a large public healthcare organization in Italy. Data was gathered at 2-time points, 14 months apart.

Results

The results suggest that healthcare workers' perception of their organization's support for mental health at T1 significantly impacts team participation at T2 through MHsL and team autonomy. Likewise, the indirect effect of OCMH through MHsL and team autonomy was also significant in the model predicting team reflexivity. However, in both models, no direct relationship of OCMH on the dependent variables was found.

Conclusion

The findings highlight the importance of a mental health-supportive environment and leadership to foster team autonomy and, subsequentially, team processes, which are fundamental for performance and patient care.

Factors Associated with Depression, Anxiety, and Somatic Symptoms among International Salespeople in the Medical Device Industry: A Cross-Sectional Study in China

BACKGROUND

The physical and mental health of corporate employees is equally important, especially for international salespeople in the in vitro diagnostic (IVD) medical device industry. The rapid growth of the IVD market is driven by the increasing prevalence of chronic and infectious diseases. This study aims to determine the prevalence of depression, anxiety, and somatic symptoms among international salespeople in China's IVD industry and identify the association of socio-demographic, occupational, organizational, and psychosocial factors with mental health outcomes for depression, anxiety, and somatic symptoms in Chinese IVD international salespeople.

METHODS

The study was a cross-sectional survey of international salespeople (ISs) in IVD companies officially registered in China. An online survey was designed to collect data through email contact with IVD companies and social media between August 2022 and March 2023. Measured factors included effort-reward imbalance (ERI), health-promoting leadership (HPL), health climate (HC), inner strength (IS), and perceived social support (PSS). Mental health outcomes assessed using the Core Symptom Index (CSI) were depression, anxiety, and somatic symptoms.

RESULTS

A total of 244 salespeople responded to the survey. CSI scores indicated that 18.4% (n = 45) and 10.2% (n = 25) of the respondents had symptoms of major depression and anxiety, respectively. ERI was positively correlated, while the IS and PSS were negatively correlated with major depression, anxiety, and somatic symptoms (p < 0.01). The health climate was negatively correlated with major depression (p < 0.05). Education background was associated with somatic symptoms (p < 0.05). ERI, IS, and gender were significant predictors of major depression, anxiety, and somatic symptoms (p < 0.05).

CONCLUSION

The prevalence of depression and anxiety in China's IVD international salespeople was considered low compared with the prevalence in Chinese populations during COVID-19 but higher than those before the pandemic. Effort-reward imbalance, inner strength, and gender were significant factors in major depression, anxiety, and somatic symptoms among IVD international salespeople.

How job demands and job resources contribute to our overall subjective well-being

Objectives

How the work environment contributes to employees' overall subjective well-being remains inadequately explored. Building upon the seminal Job Demands-Resources model, this study aims to test a complex model that combines leadership, job demands, and job resources, as factors contributing either indirectly (via job satisfaction) or directly to employees' subjective well-being (SWB).

Methods

The cross-sectional data (N = 1,859) of the Belgian National happiness study (2020) were used. Leadership (satisfaction with leadership; perceived supervisor support), job demands (role conflict; job insecurity; work-private conflict; perceived working conditions), job resources (autonomy; relatedness; competence; skill utilization; personal growth), job satisfaction and subjective well-being (life evaluation; positive affect; negative affect) were assessed via self-report questionnaires. The proposed model investigates the direct impact of job demands and resources on SWB, as well as the indirect impact with job satisfaction as mediating factor, and was tested using the Structural Equation Modeling technique.

Results

Findings supported the proposed model. Both job demands and job resources have a direct relationship with SWB. Job resources are positively related to overall SWB, whereas job demands negatively affected SWB. Moreover, job resources are more strongly related to SWB compared to job demands. The demands and resources also indirectly contribute to employee's SWB via job satisfaction as job satisfaction appeared to mediate these relationships.

Conclusion

The current study shows that both job demands and resources directly and indirectly contribute to employees' SWB. Creating a supportive and healthy work environment is thus of paramount importance in order to foster employees' SWB. In particular, investing in improving job resources may be a fruitful approach to promote employees' overall subjective well-being.

Capturing the impact employees have on their coworkers and leaders: a holistic approach on health-specific support behavior from employees

Support is a valuable resource for ensuring employee health in the workplace. However, research on health-specific support behavior (i.e., support specifically targeting concrete health aspects) has only concentrated on either leader behavior (e.g., healthy leadership styles) or support provided by employees for specific health issues (e.g., healthy eating or smoking cessation). Although the importance of employee health has been well established, the examination of a wider range of potential health-specific support behaviors from employees provided for their colleagues and leaders has been neglected. To understand employee health-specific support behavior, we adapted an existing health-oriented leadership questionnaire to cover support for colleagues (PeerCare) and their leaders (LeaderCare). Capturing the employee perspective with a sample of 347 employees, the results confirmed a delineation of health-oriented scales (factor, convergent, and discriminant validity). By testing health-specific support behavior processes at work, the positive effects of PeerCare on general health were demonstrated. Contrary to expectations, existing health effects are outweighed when leaders provide health-specific support behavior to their employees (StaffCare). However, the results imply that the health-specific support behavior practices of different actors reinforce each other: the effects of StaffCare and PeerCare enhance each other, and StaffCare has a strong influence on LeaderCare. Remarkably, SelfCare has a key role in this process. The open questions and implications regarding the effects of the different health-specific support behavior measurements are discussed.

The Influence of Leadership on Employees' Work-nonwork Interface and Wellbeing: A Scoping Review

Many current working conditions are characterized by increasing blurred boundaries between work and nonwork with spillover that impact employees' and recovery processes and wellbeing. Research, although emerging, considers these processes in the leadership-wellbeing relationship insufficiently. The main aim of this study, therefore, was to enhance our understanding of the role of leadership on employee's work-nonwork interface and wellbeing. To address these processes adequately, longitudinal research is most appropriate. To our best knowledge, no review exists that could inform longitudinal studies on the leadership-employee wellbeing relationship with a focus on spillover and recovery processes. Following the PRISMA Extension for Scoping Reviews, we apply a narrative synthesis of 21 identified studies to organize the research landscape. We make three main contributions: First, we adopt an integrated resource-demands based process perspective and expand the leadership-employee wellbeing relationship by including spillover and recovery. Second, we map the used theoretical approaches and analyzed research gaps. Third, we offer a list of the issues and potential remedies of applied methodologies to orient further research. Results show, that while work-nonwork research is predominantly approached from a negative conflict-based view, research focused more on positive than on negative leadership. We identify two broad categories of investigated mechanisms, namely bolstering/hampering mechanisms, and buffering/strengthening mechanisms. Findings also highlight the importance of personal energy resources and therefore call for more attention to affect-driven theories. The identified predominance of the IT and healthcare sectors and of working parents warrants more representative research. We offer recommendations to advance future research both theoretically and methodologically.

The process of overcoming conflicts among teachers in the implementation of comprehensive sexuality education at ordinary public senior high schools in Mataram City, Indonesia: a qualitative study

BACKGROUND

Comprehensive sexuality education (CSE), which aims to help young people make responsible choices and acquire scientific knowledge and skills, has been promoted by UNESCO. Teachers experience conflicts in implementing CSE when teaching sexual topics in the local context, especially as the delivery of sexual knowledge and contraceptive methods is often prohibited by religious and traditional cultural norms. It was reported that there were multiple challenges in the implementation of sex education due to the religious and cultural background of societies and communities in Islamic countries. This study aimed to clarify the process of overcoming the conflicts, explore teachers' recognition and perception related to the implementation of CSE, and to suggest recommendations for promoting CSE in Islamic areas.

METHODS

This qualitative study combined the methods of focus group discussions (FGDs) and in-depth interviews (IDIs) to explore the conflict among teachers. Ten ordinary public senior high schools in Mataram City, Indonesia, agreed to participate, and in total, 59 participants were involved in this study. FGDs were conducted with teachers (n = 49), and IDIs were focused on school principals (n = 10) in each school. The collected interview data were analyzed using a deductive thematic analysis and the findings triangulated for both the FGDs and IDIs.

RESULTS

Overall, the teachers experienced conflicts in relation to religion, cultural background, and gender inequality in implementing CSE. The present study revealed the mutual recognition among teachers and acceptance of diverse backgrounds in the implementation of CSE at ordinary public senior high schools in Mataram City. Despite teachers reporting multiple conflicts, they made efforts to overcome these conflicts through mutual recognition and provided comprehensive guidance. The present findings indicated that teachers adapted CSE to follow multiple religions and cultural backgrounds.

CONCLUSIONS

The teachers accepted diverse backgrounds and provided CSE by collaborating with related educational subjects and external institutions to overcome conflicts. To provide more specialized education, it would be necessary to advocate a formal policy that might be accepted by diverse societies. Further research is necessary to apply the findings and recommendations for CSE implementation globally in the contexts of different countries.

How and When Health-Promoting Leadership Facilitates Employee Health Status: The Critical Role of Healthy Climate and Work Unit Structure

Health-promoting leadership has attracted a lot of attention from scholars in recent years. However, majority studies focused on theoretical arguments rather than empirical examination. Not only that, extant research often theorizes health-promoting leadership as a combination of a series of direct and explicit health-related behaviors, neglecting the potential social information it may convey to employees. Based on social information processing theory, this study empirically examines how and when health-promoting leadership can facilitate employees’ health status. Using a time-lagged data of 370 employees (i.e., matched to 51 leaders), we found that health-promoting leadership has a significant and positive influence on employees’ health status, and healthy climate acts as a linking pin. In addition, work unit structure moderates the relationship between health-promoting leadership and healthy climate. Specifically, compared with mechanic work unite structure, employees rely more on social information conveyed by health-promoting leadership when working at an organic work unite structure. This study not only extends current knowledge about the effect of health-promoting leadership, but also provides useful guidance for practitioners.

Cross-level effects of health-promoting leadership on nurse presenteeism: The mediation and moderation effect of workload and performance pressure

This study examines the cross-level influence mechanism of leaders’ health-promoting leadership on subordinates’ presenteeism among nursing industry. A multilevel mediated moderation model was hypothesized to explore whether health-promoting leadership is associated with subordinates’ presenteeism via the workload of subordinates, and how leader’s performance pressure plays the role in the model. Questionnaires were distributed to 110 nursing teams, which including 110 chief nurses and 660 subordinate nurses. Our findings showed that although health-promoting leadership has no direct impact on presenteeism, health-promoting leadership has an indirect impact on presenteeism via workload, and workload acts as a complete mediator. Meanwhile, performance pressure moderated the relationship between health-promoting leadership and workload. With an increase in performance pressure of leaders, the negative impact of health-promoting leadership on nurse workload gradually weakened. In this multilevel mediated moderation model, the mediated moderating effect of performance pressure was significant and the moderating effect was completely mediated, which means that the interaction between health-promoting leadership and performance pressure can affect presenteeism through workload. When leaders were under high performance pressure, the protective effect of health-promoting leadership on workload would be inhibited. These findings contribute to enriching the research on presenteeism, providing insight into how the health development of employees and performance demands of leaders may be balanced, and affording fresh thoughts for effective prevention and treatment of nurse presenteeism.

Business Leadership from a Gender Perspective and Its Impact on the Work Environment and Employee's Well-Being in Companies in the Basque Country

If the workplace environment is good, the health and well-being of employees will be good too. This research aims to distinguish whether there are differences when it comes to being directed by a man or a woman and whether this affects employees. An ad hoc questionnaire was applied, collecting personal information and including the MLQ-6 S. It was sent by mail and answered by 549 employees of 16 companies in the Basque Country, Spain. A total of 277 (50.5%) men and 272 (49.5%) women participated, among whom there were 63 managers. The methodology shows a double perspective of how employees understand and perceive the differences between male and female business leaders and how managers see themselves exercising this leadership. No significant differences have been perceived. Both men and women believe they make their employees feel good about exercising leadership (M = 42.11%, W = 48.00%) quite often. Employed women consider it more challenging to become leaders and reconcile their work-life. Men do not think so. Communication is the tool that women managers know best how to handle and where men seem to fail more. Working on it could achieve more business success and better health in employees.

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.