Division Materials and Production, Research Institutes of Sweden (RISE), Gothenburg, Sweden.
Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
Front Public Health. 2020 Dec 22;8:579197. doi: 10.3389/fpubh.2020.579197. eCollection 2020.
According to policy and theory, there is need for organizational workplace health promotion (WHP) to strengthen working conditions for all employees. However, earlier studies show it is hard to implement in practice. The aim was to critically analyze and identify interacting mechanisms and obstacles behind failures of organizational WHP projects from system perspectives. A holistic case study was performed, to critically analyze data from an organizational WHP project approach at a public health care organization. The qualitative data was collected over 5 years and included interviews with key actors ( = 80), focus groups ( = 59 managers), structured observations ( = 250 hours), continuous field observations and documents ( = 180). Questionnaires to employees ( = 2,974) and managers ( = 140) was complementing the qualitative-driven mixed method approach. The analysis shows obstructing paradoxes of alignment and distribution of empowerment during the process of implementation into practice. The obstacles were interacting over system levels and were identified as: and . The following premises can be formulated regarding successful organizational WHP programs. Consider (1) the uncertainty a distributed empowerment to all system levels may create; (2) the distributed impact to define the target and allow broader areas to be included in WHP; and (3) the integration into other development processes and not reducing the organizational WHP to the form of a project.
根据政策和理论，有必要进行组织职场健康促进（WHP），以加强所有员工的工作条件。然而，早期的研究表明，在实践中很难实施。本研究旨在从系统的角度批判性地分析和识别组织 WHP 项目失败背后的相互作用机制和障碍。采用整体案例研究方法，对公共医疗保健组织中组织 WHP 项目方法的数据进行批判性分析。定性数据是在 5 年内收集的，包括对主要参与者（=80 人）的访谈、焦点小组（=59 名管理人员）、结构观察（=250 小时）、持续的现场观察和文件（=180 份）。对员工（=2974 人）和管理人员（=140 人）的问卷调查是对定性驱动的混合方法的补充。分析表明，在实施过程中，授权的一致性和分配存在矛盾。这些障碍在系统层面上相互作用，并被确定为：[障碍 1]、[障碍 2]和[障碍 3]。关于成功的组织 WHP 计划，可以提出以下前提。考虑到：(1) 将授权分散到所有系统层面可能带来的不确定性；(2) 将目标定义为分散影响，以允许更广泛的领域纳入 WHP；以及 (3) 将其整合到其他发展过程中，而不是将组织 WHP 简化为项目形式。
