Which work environment challenges are top of mind among eldercare workers and how would they suggest to act upon them in everyday practice? Process evaluation of a workplace health literacy intervention.

The purpose of this study was to identify challenges and action plans from 2.497 structured communication sessions between employee and supervisor and to gain insight into the processes of a quasi-experimental stepped wedge clustered intervention, which implemented workplace health literacy for reducing musculoskeletal pain among eldercare workers. Most challenges concerned staffing (17%), organisation of tasks (15%) and team work (14%). Most action plans concerned communication (18%), team-work (16%) and handling residents (14%). Half of the plans were solved at another level in the organisation than the challenge appeared. Actions planned on the individual level had the highest implementation rate (52%). The results underline the advantages in considering solutions to work environment and health challenges broadly at all levels in the organisation and the relevance of involving both the employee and the organisation/management in identifying and implementing solutions.