Simple roads to failure, complex paths to success: An evaluation of conditions explaining perceived fit of an organizational occupational health intervention

Abstract

Organizational occupational health interventions (OOHIs) that are perceived by employees as relevant for their workplace are more likely to be implemented successfully, yet little is known about the conditions that produce such perceptions. This study identifies the conditions that create a perception among employees that an intervention fits their organization as well as the conditions that result in low levels of perceived fit. We used two‐wave data from 40 Danish preschools that underwent a quasi‐experimental OOHI. Perceived fit was assessed through employee ratings at follow‐up, while survey responses from implementation team members at five time points were used to assess four context and 14 process factors. The results of a coincidence analysis showed that high levels of perceived fit were achieved through two paths. Each path consisted of a lack of co‐occurring changes together with either very high levels of managerial support (path_1) or a combination of implementation team role clarity, staff involvement, and team learning (path_2). In contrast, low levels of perceived fit were brought about by single factors: limited leader support, low degree of role clarity, or concurrent organizational changes. The findings reveal the complexity involved in implementing OOHIs and offer insights into reasons they may fail.

Reducing sickness absence among public-sector healthcare employees: the difference-making roles of managerial and employee participation

“…In the analysis, the steps outlined in Whitaker et al ( 2020 ) along with using the “msc” routine for factor selection were followed (Roczniewska et al 2023 ). In the first step, the outcomes and predictors, derived from the qualitative process evaluation and the quantitative effect evaluation, were calibrated, i.e., assigned categorical values to each case for each variable.…”

“…Because the number of cases was relatively small compared to the number of factors, the second step in our preparatory analyses involved data reduction using a configurational approach described in detail in prior literature (Damschroder et al 2022 ; Miech et al 2022 ; Rich et al 2022 ; Roczniewska et al 2023 ; Yakovchenko et al 2020 ). Specifically, we applied the minimally sufficient conditions (msc) routine within the “cna" package in R across the entire dataset to identify specific configurations of conditions strongly linked to the outcomes of interest (i.e., having a successful implementation process and the intervention effect on sickness absence).…”

“…Previous process evaluations of organizational-level interventions have shown that several factors are important to achieve the desired outcomes of the intervention (for instance, see Herrera-Sánchez et al 2017 ; von Thiele Schwarz et al 2021 ), such as having support from the management (Härenstam et al 2019 ; LaMontagne et al 2012 ), ensuring high participation from the target group (Nielsen and Christensen 2021 ), and fitting the intervention to the organizational context (Ipsen et al 2015 ). The later has been identified as an important factor for the success of organizational-level interventions and the absence of co-occurring changes in combination with managerial support or a combination of role clarity, employee participation, and team learning has been associated with increased intervention fit, while limited leader support, low degree of role clarity, or concurrent organizational changes have been associated with decreased intervention fit (Roczniewska et al 2023 ). While multiple factors that may facilitate or hamper successful interventions have been identified, it is unclear which of them that are sufficient (i.e., enough by themselves but not the only path to the outcome), which are necessary (i.e., always must be present), and which are both necessary and sufficient to produce the desired intervention effect.…”