An exploration of the role of management controls in the selection and implementation of health promotion programs in Australian universities

Abstract

This research examines the role of management controls on the selection and implementation of health promotion programs (HPPs) in the university sector. HPPs, which include any set of activities implemented to improve employee health (Potvin & Goldberg, 2012), have been shown to improve employee productivity and performance and thus to provide beneficial organisational outcomes (Grossmeier et al., 2016). However, research investigating the benefits of HPP implementation within different workplaces and contexts has produced mixed results (Caloyeras, Liu, Exum, Broderick, & Mattke, 2014; Liu et al., 2013). The mixed results reported in the literature are attributable to several factors such as the complexity of HPPs and the diverse agendas and contexts for their implementation (Bilodeau & Potvin, 2016). These implementation challenges have prompted calls for future research on HPPs to be based on proven implementation experiences and an understanding of the implementation context (Dooris, Wills, & Newton, 2014). Several challenges are associated with implementing suitable HPPs for different managerial contexts. Prior management control studies have shown that organisations influence employee health using specific management controls such as health statements that provide measures of a workforce’s health (Almqvist, Backlund, Sjoblom, & Rimmel, 2007). Further research is required to examine how a broader range of management controls and systems influence the ways that HPPs are implemented within organisations (Larsson, Akerlind, & Sandmark, 2016). Therefore, the research question examined in this study is: what is the role of management controls in the selection and implementation of HPPs? To address the research question, the first of two research objectives investigates the type of HPPs implemented in the university sector. A broad understanding of the institutional context in which HPPs are implemented is developed: which health issues and health risk factors are being targeted, which activities appear to be prioritised and managed, and which are not being used by a sample of Australian universities. Following this investigation, the second research objective examines the managerial contexts for HPP implementation. In particular, this objective is to examine the influence of management controls on the selection and implementation of HPPs. A broad range of management controls used by universities in the process of implementing HPPs is examined. The research is undertaken in two phases. The first phase includes a content analysis of publicly available website documentation from eight Australian universities. This phase provides an understanding of the types of HPPs being implemented by sampled universities to promote employee health. The second phase is a case study conducted to explore the role of management controls in one Australian university’s attempts to select and implement HPPs. This phase identifies how a single Australian university gains control of HPP implementation by satisfying the interests of diverse stakeholders. Actor-network theory (ANT) is drawn upon to interpret how management controls influence HPP implementation. ANT provides an analytical lens for examining how HPPs are strategically implemented to suit diverse interests and objectives for promoting health, such as senior management and academic employee concerns. The four moments of translation (e.g. problematisation, interessement, enrolment and mobilisation) developed by Callon (1986) are used as an analytical device to make sense of the complex roles that management controls perform in implementing HPPs and to report on their benefits. Findings from the research show that Australian universities target a diverse range of health issues and health risk factors that are known to be a risk to employee health. The most prominent health issues targeted are cancer, cardiovascular disease, diabetes and mental health. The most prominent health risk factors found include alcohol and substance abuse, discrimination and harassment, and social determinants. Various health-promoting activities, such as clinics and centres, courses and training, and extrinsic motivation, are used to provide employees with access to services for managing illnesses and improving health. Management controls were used to mobilise a network of people and mechanisms, such as expert opinions, surveys, tracking tools, and participation measures, to capture relations between universities, employees and their health. This research concludes that Australian universities aim to improve employee health through HPPs that are selected based on their ability to be effectively promoted as opposed to their providing desired health outcomes. No single best-practice approach to implementation appears to exist. Rather, these findings show that HPPs emerge in relation to managerial contexts such as the mix of administrative, cultural, planning, measurement, and rewards and compensation controls used by universities. The health issues and health risk factors targeted, along with the courses of action taken by sampled universities to address these concerns, are influenced by the measures available to monitor implementation outcomes.