Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada.
Compr Psychiatry. 2024 Nov;135:152524. doi: 10.1016/j.comppsych.2024.152524. Epub 2024 Aug 12.
Public safety personnel (PSP) such as firefighters, paramedics, and police are exposed to traumatic situations, which increase their risk for mental health issues. However, many PSP do not seek help in a timely manner. Peer support interventions have the potential to decrease stigma and increase treatment-seeking behaviours among PSP. However, little is known regarding how the organizational culture of public safety organizations (PSOs) affects the implementation of a peer-based intervention. This study aims to understand the extent to which organizational culture, including masculinity contest cultures (MCC), within Canadian PSOs could affect implementation of PeerOnCall, a new peer support app for PSP.
A qualitative multiple case study design was adopted, integrating semi-structured interviews with organizational champions from five PSOs. One to three champions from each PSO acted as key informants regarding their organizations. Interviews explored champions' perceptions of how organizational culture might shape implementation. Interview data were analyzed using inductive thematic analysis.
Three themes were identified in analysis of the champion interviews. The first theme focused on external drivers and the second theme focused on internal drivers of organizational culture shift. The third theme focused on how culture can create resistance to implementation. Importantly, the MCC norm of show no weakness was described as a source of potential resistance when implementing the app.
Each PSO had a unique and changing culture. Understanding how champions anticipate the role of culture in shaping implementation of an app-based intervention like PeerOnCall can guide the creation of contextually relevant strategies that optimize implementation within PSOs. Recommendations for optimizing implementation and areas for further study are provided.
公共安全人员（PSP），如消防员、护理人员和警察，会接触到创伤性的情况，这增加了他们心理健康问题的风险。然而，许多 PSP 并没有及时寻求帮助。同伴支持干预有可能减少 PSP 中的污名化并增加寻求治疗的行为。然而，对于公共安全组织（PSO）的组织文化如何影响基于同伴的干预措施的实施，知之甚少。本研究旨在了解加拿大 PSO 中的组织文化（包括男子汉气概竞争文化（MCC））在多大程度上可能影响 PeerOnCall 的实施，PeerOnCall 是一种新的 PSP 同伴支持应用程序。
采用定性多案例研究设计，将来自五个 PSO 的组织拥护者的半结构化访谈结合起来。每个 PSO 的一到三名拥护者作为其组织的主要信息来源。访谈探讨了拥护者对组织文化如何影响实施的看法。使用归纳主题分析对访谈数据进行分析。
对拥护者访谈的分析确定了三个主题。第一个主题侧重于外部驱动力，第二个主题侧重于组织文化转变的内部驱动力。第三个主题侧重于文化如何产生对实施的抵制。重要的是，描述了男子汉气概竞争文化的不示弱规范，作为实施该应用程序时潜在抵制的来源。
每个 PSO 都有独特且不断变化的文化。了解拥护者如何预测应用程序等基于应用程序的干预措施实施中文化的作用，可以指导制定与上下文相关的策略，从而在 PSO 内部优化实施。提供了优化实施的建议和进一步研究的领域。
