Process Evaluation of an Operational-Level Job Stress Intervention Aimed at Decreasing Sickness Absence among Public Sector Employees in Sweden

Abstract

Work-related sickness absence carries large societal costs, and interventions aimed at decreasing sickness absence need to be performed in an effective way. This study evaluated the implementation process of an operational-level job stress intervention, implemented between 2017 and 2018 in the public sector, by assessing the extent to which the allocated resources reached the intended target group, if the planned measures could be expected to address the relevant work environmental challenges, and if the planned measures were implemented. Data were collected from applications for funding in the intervention (n = 154), structured interviews (n = 20), and register data on sickness absence (n = 2,912) and working conditions (n = 1,477). Thematic analysis was used to classify the level of the work environmental challenges, the level and perspective of the suggested measures, and the “measure-to-challenge correspondence”. Overall, participating workplaces (n = 71) had both higher sickness absence (p = 0.01) and worse reported working conditions compared to their corresponding reference groups. A measure-to-challenge correspondence was seen in 42% of the measures, and individual-level measures were mostly suggested for organisational-level work environment challenges. Almost all planned measures (94%) were ultimately implemented. When performing operational-level interventions, managers and their human resource partners need support in designing measures that address the work environmental challenges at their workplace.

Cost–Benefit Evaluation of an Organizational-Level Intervention Program for Decreasing Sickness Absence among Public Sector Employees in Sweden

“…This difference in economic benefits between the approaches could be explained by the higher intervention effect in the FSA compared to that in the MSA, where the process evaluation of the two approaches showed that line managers and HR using the MSA needed support with designing interventions that corresponded to the workplace challenges they were facing. Only half of the interventions in the MSA were considered to fit the workplace challenges [ 22 ]; by contrast, there was a high correspondence between implemented interventions and the workplace challenges for the FSA [ 21 ]. The importance of fitting interventions to the context and workplace challenges has been addressed in previous literature [ 26 , 27 ].…”

“…There was, however, a difference in sickness absence between the participating workplaces with lower total sickness absence in the MSA, suggesting that the potential for impacts was smaller. Interestingly, a previous evaluation showed that the intervention groups with this approach had a significantly higher sickness absence than their respective reference groups, and a higher sickness absence compared to the mean sickness absence in the region [ 22 ], implying a potential to reduce sickness absence for workplaces in both approaches.…”

“…However, the program was implemented within the same organization, where workplaces mostly in the health care sector participated. Additionally, participation was based on having high rates of sickness absence and work environment challenges [ 22 ].…”

“…Almost exclusively, applications described organizational-level work environment challenges, such as staff shortages, high workload, and unclear goals or tasks. Interventions of all types were implemented, including workshops, physical activity, team building, work environmental analyses, manager support, and structural changes [ 22 ].…”

“…In 2017, an organizational-level workplace program with the purpose to decrease sickness absence was implemented in a public sector organization in Sweden, using two different approaches. The implementation process and the effects of this program have previously been evaluated, showing differences in effects on sickness absence for the two approaches [ 21 , 22 , 23 ]. The aim of the current study is to conduct an economic evaluation comparing the costs and benefits of this program.…”