Dalgaard Vita Ligaya, Kirkegaard Tanja, Wåhlin-Jacobsen Christian Dyrlund, Aust Birgit, Jaspers Sofie, Jønsson Thomas Faurholt, Winding Trine Nøhr
Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark.
Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark.
BMC Public Health. 2025 Jan 30;25(1):384. doi: 10.1186/s12889-024-20801-5.
Organizational multilevel interventions have been called for as a means to improve psychosocial working conditions, reduce stress, and enhance wellbeing in organizations. However, these types of interventions are highly complex to implement and evaluate, and they remain scarce in the literature. In this study, we present the evaluation of a multilevel intervention conducted in a municipality setting.
The intervention was based on a train-the-trainer principle and participatory risk assessment workshops on all organizational levels. Action plans were subsequently developed at the team level, and identified risks, which could not be addressed at the team level, were reported to the management for further action planning or escalation to the next management level. Using a pre-post study design, we evaluated changes in proximal outcomes related to the psychosocial working environment, and distal outcomes related to stress and job satisfaction. Changes over time in outcome measures were analyzed using linear mixed models. A quantitative process evaluation was used to examine the degree of implementation of the intervention.
Small improvements over time were observed with regard to quantitative demands, overall perception of the psychosocial work environment, job satisfaction, and the psychosocial safety climate. We also observed an increase in empowering leadership. Positive tendencies were also found for predicatability at work, possibilities for solving work tasks and support from closest manager. The effect sizes were small in all cases. No improvements in perceived stress or stress symptoms were found. The study revealed several practical and methodological challenges in conducting and implementing this type of multilevel intervention in a municipal setting.
Overall, our study suggests that the intervention was associated with small positive changes in certain aspects of the working environment but no improvements were observed in stress outcomes. The study highlights a number of challenges in relation to implementing this type of multilevel intervention in a municipal setting.
The study was prospectively registered at ISRCTN84940247 on April 23, 2019.
组织层面的多层次干预措施被视为改善心理社会工作条件、减轻压力以及提升组织内员工幸福感的一种方式。然而，这类干预措施的实施和评估极为复杂，且在文献中仍较为少见。在本研究中，我们展示了对在一个市政机构环境中开展的多层次干预措施的评估。
该干预措施基于培训培训师原则以及在组织各层级开展的参与式风险评估研讨会。随后在团队层面制定行动计划，对于团队层面无法解决的已识别风险，则上报给管理层以进行进一步的行动计划制定，或升级至更高一级管理层。采用前后对照研究设计，我们评估了与心理社会工作环境相关的近端结果以及与压力和工作满意度相关的远端结果的变化。使用线性混合模型分析结果指标随时间的变化。采用定量过程评估来检查干预措施的实施程度。
在定量需求、心理社会工作环境的总体认知、工作满意度以及心理社会安全氛围方面，随着时间推移观察到了小幅改善。我们还观察到赋能型领导有所增加。在工作可预测性、解决工作任务的可能性以及来自直属经理的支持方面也发现了积极趋势。所有情况下效应量都较小。未发现感知压力或压力症状有所改善。该研究揭示了在市政环境中开展和实施这类多层次干预措施时存在的若干实际和方法学挑战。
总体而言，我们的研究表明该干预措施与工作环境某些方面的小幅度积极变化相关，但在压力结果方面未观察到改善。该研究凸显了在市政环境中实施这类多层次干预措施所面临的一些挑战。
该研究于2019年4月23日在ISRCTN84940247进行了前瞻性注册。
