Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.
Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
BMC Public Health. 2021 Oct 16;21(1):1869. doi: 10.1186/s12889-021-11937-9.
Many organizational interventions aim to improve working conditions to promote and protect worker safety, health, and well-being. The Workplace Organizational Health Study used process evaluation to examine factors influencing implementation of an organizational intervention. This paper examines the extent to which the intervention was implemented as planned, the dose of intervention implemented, and ways the organizational context hindered or facilitated the implementation of the intervention.
This proof-of-concept trial was conducted with a large, multinational company that provides food service through contractual arrangements with corporate clients. The 13-month intervention was launched in five intervention sites in October 2018. We report findings on intervention implementation based on process tracking and qualitative data. Qualitative data from 25 post-intervention interviews and 89 process tracking documents were coded and thematically analyzed.
Over the 13-month intervention, research team representatives met with site managers monthly to provide consultation and technical assistance on safety and ergonomics, work intensity, and job enrichment. Approximately two-thirds of the planned in-person or phone contacts occurred. We tailored the intervention to each site as we learned more about context, work demands, and relationships. The research team additionally met regularly with senior leadership and district managers, who provided corporate resources and guidance. By assessing the context of the food service setting in which the intervention was situated, we explored factors hindering and facilitating the implementation of the intervention. The financial pressures, competing priorities and the fast-paced work environment placed constraints on site managers' availability and limited the full implementation of the intervention.
Despite strong support from corporate senior leadership, we encountered barriers in the implementation of the planned intervention at the worksite and district levels. These included financial demands that drove work intensity; turnover of site and district managers disrupting continuity in the implementation of the intervention; and staffing constraints that further increased the work load and pace. Findings underscore the need for ongoing commitment and support from both the parent employer and the host client.
This study was retrospectively registered with the Clinical Trials. Gov Protocol and Results System on June 2, 2021 with assigned registration number NCT04913168 .
许多组织干预措施旨在改善工作条件，以促进和保护工人的安全、健康和福祉。工作场所组织健康研究采用过程评估来研究影响组织干预措施实施的因素。本文探讨了干预措施按计划实施的程度、实施的干预措施剂量以及组织环境阻碍或促进干预措施实施的方式。
这项概念验证试验是在一家大型跨国公司进行的，该公司通过与企业客户的合同安排提供餐饮服务。2018 年 10 月，该 13 个月的干预措施在五个干预地点启动。我们根据过程跟踪和定性数据报告干预实施情况的结果。对 25 次干预后访谈和 89 份过程跟踪文件中的定性数据进行了编码和主题分析。
在 13 个月的干预期间，研究团队代表每月与现场经理会面，就安全和人体工程学、工作强度和工作丰富度提供咨询和技术援助。大约三分之二的计划中的面对面或电话联系得以进行。我们根据对工作场所的服务环境的了解，对干预措施进行了调整，以了解更多的工作需求和关系。研究团队还定期与高级领导和地区经理会面，他们提供了公司资源和指导。通过评估干预措施所处的餐饮服务环境的背景，我们探讨了阻碍和促进干预措施实施的因素。财务压力、优先事项的竞争以及快节奏的工作环境限制了现场经理的可用性，并限制了干预措施的全面实施。
尽管得到了企业高层领导的大力支持，但我们在工作场所和地区层面实施计划中的干预措施时遇到了障碍。这些障碍包括推动工作强度的财务需求；现场和地区经理的更替扰乱了干预措施的实施连续性；以及人员配备限制，进一步增加了工作负荷和工作节奏。这些发现强调了雇主和托管客户都需要持续的承诺和支持。
这项研究于 2021 年 6 月 2 日在临床试验。 Gov 协议和结果系统中进行了回顾性注册，分配的注册编号为 NCT04913168。
