Effects of a workplace health promotion programme on work- and health-related outcomes: a quasi-experimental trial

This thesis explores the research gap in salutogenic factors promoting workforce health and well-being generated by top management of small and medium-sized enterprises (SMEs) in East-Westphalia Lippe (EWL), in Germany. The workplace health promotion (WHP) is, and will be, a relevant area of research because the growing absenteeism, the reduced work performance and the increased turnover rates in businesses are believed to be some of the major challenges of the 21st-century. It is well documented that WHP has many advantages for SMEs but only a few recognise the necessity of WHP. The thesis chooses a new way in WHP in SMEs while using salutogenesis as a theoretical framework in order to give the thesis a special focus on employees’ well-being. In addition, salutogenesis is successfully used in various professional fields for example medicine and nursing. But there is a research gap in implementing salutogenesis in SMEs. The originality consists of connecting the salutogenesis (SoC model) with a current study about health promoting factors by Bruch et al. (2013) which were used as salutogenic factors and tested for usability in SMEs. Consequently, the thesis implements the theoretical premise of salutogenesis to SMEs and explores how, or to what extent, applicable the concept of salutogenesis is in SMEs in EWL. The primary question is: What salutogenic factors can be generated by top management to support the promotion of health and well-being of the workforce? The second research question meets the important role of the top manager as the decision maker of WHP: How can SMEs develop top management awareness to keep their staff healthy? The third key research question is: How can SMEs in EWL/Germany integrate health promoting and well-being factors? The research methodology is based on the literature review and the empirical research based on focus- group discussions of top managers and employees of SMEs in EWL. A critical realist prejudice was developed as a foundation for an Applied Thematic Analysis (ATA). A reflection group was used to compare the authors’ interpretation. The core findings are: The findings from the small-scale research suggest: The salutogenic factors can be mainly found in the quality of the relationship of top managers with their employees. The thesis delivers the new findings to WHP research: ‘the importance of the quality of the relationship’, and the ‘importance of the capacity of older top managers to reflect’. The latter is at the same time the surprising finding of this thesis. Whether the higher age of top managers has significant influences on WHP has to be explored in future research. For salutogenic WHP in SMEs, it seems to be optimal for the top managers to act in a relationship-oriented sense with the capacity to reflect themselves. SMEs that implement salutogenic factors are headed in the right direction to be fit for the future, by taking into account the needs of employees in the sense of salutogenesis and thus keeping their most important resource, the workforce, healthy. Further additional research is needed about experiences of implementation of the SoC in SMEs.

BackgroundRural and urban areas hold different health challenges and resources for resident small and medium-sized enterprises (SMEs) and their employees. Additionally, residents of urban and rural areas differ in individual characteristics. This study aims at investigating potential rural-urban differences (1) in the participation rate in workplace health promotion (WHP) and (2) in the relationship of WHP and health relevant outcomes in residents living in rural or urban German areas and working in SMEs.MethodsData of a large German Employee Survey in 2018 were used and analyzed by chi-square and t-tests and regression analyses regarding job satisfaction, sick days, and psychosomatic complaints. A total of 10,763 SME employees was included in analyses (23.9% living in rural, 76.1% living in urban areas).ResultsAnalyses revealed higher participation rates for SME employees living in rural areas. SME employees living in urban areas reported more often the existence of WHP. Results showed (a) significance of existence of WHP for psychosomatic complaints and (b) significance of participation in WHP for job satisfaction in SME employees living in urban but not for those living in rural areas.ConclusionThe revealed disparities of (1) higher participation rates in SME employees living in rural areas and in (2) the relationship of WHP aspects with health relevant outcomes are of special interest for practitioners (, e.g. human resource managers), politicians, and researchers by providing new indications for planning and evaluating WHP measures.

BackgroundPeople with inflammatory rheumatic diseases (iRD), such as rheumatoid arthritis (RA) and spondyloarthritis (SpA), experience restrictions in work participation. In times of crisis, such as the coronavirus disease 2019 (COVID19)...

BackgroundImproved work participation is an important goal in rehabilitation, and has important socio-economic benefits. Despite this, there is limited knowledge about how rehabilitation impacts work ability across different diagnostic groups.ObjectivesTo...

ObjectiveTo examine 5-year prospective associations between working conditions and work ability among employees in Germany.MethodsA cohort study (2011/2012–2017), based on a random sample of employees in employments subject to payment of social contributions aged 31–60 years (Study on Mental Health at Work; S-MGA; N = 2,078), included data on physical and quantitative demands, control (influence, possibilities for development, control over working time), relations (role clarity and leadership quality) and work ability (Work Ability Index, WAI; subscale ‘subjective work ability and resources’). Data were analysed using linear regression.ResultsPhysical demands and control were associated with small 5-year changes in work ability (ΔR2 = 1%). Among the subgroup of employees with ≥ 25 sickness days, possibilities for development, control and quality of leadership were associated with changes in work ability (ΔR2 = 8%).ConclusionsThe impact of working conditions on long term changes in work ability seems to be negligible. However, in vulnerable subpopulations experiencing poor health, working conditions may be associated to a larger extent to work ability over this time span.

Introduction: Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in work ability is still limited. We hypothesized that self-reported work ability improves in response to surgery-induced weight loss and sociodemographical variables (e.g., age, sex, and marital status), and that psychosocial characteristics (e.g., depressive symptoms and dysfunctional eating) may have predictive value as to patients’ work ability. Methods: A total of 200 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. They completed several self-report measures at the preoperative examination (t1) and at 6- (t2) and 12 months (t3) after bariatric surgery. A repeated-measures analysis of variance was calculated to detect any changes in the work ability and body mass index (BMI) among the 3 time points. Further, a hierarchical multiple regression analysis was used to determine whether any demographical and psychosocial characteristics at (t1) would predict work ability at (t3). Results: Participants (82% of whom were women) were middle-aged and showed a BMI of nearly 46 at the preoperative medical examination. Excess weight loss at (t2) and at (t3) was 49 and 66%, respectively. Work ability increased toward a moderate level after weight-loss surgery. Work ability and dysfunctional eating at (t1) showed significant predictive value with respect to work ability at (t3). Discussion: The results suggest that weight-loss surgery has a positive impact on work ability, and indicate a predictive value for the extent of weight loss and dysfunctional eating behavior. Against our hypothesis and in contrast to former research, a predictive value for depressive symptoms and age was not revealed. Further research must show how interventions can support and maintain improvements in work ability after bariatric surgery, in order to reduce sick leave and unemployment in patients with preoperative morbid obesity.

PurposeThis study aims to examine the influence of employee performance appraisal (PA) formalization on changes to one component of the employee–leadership social exchange relationship within the context of small and medium-sized enterprises (SMEs). Specifically, it builds upon extant research on human resource management within SMEs, performance appraisals and social exchange theory to consider the role of performance appraisal formalization in effecting change in the level of trust employees have in their leaders.Design/methodology/approachTo test study hypotheses, this study analyzes responses to two survey waves completed by employees of a US-based SME operating within the commercial construction industry. This SME formalized the PA process in between the administration of the first and second surveys. Study data were analyzed using hierarchical ordinary least squares regression.FindingsThe results of this study suggest that the formalization of PA has a positive effect on change in trust in leadership (TIL). Study results also suggest that employee perceptions of PA utility, procedural justice and satisfaction with the PA process are positively related to changes in TIL. This study also found that the effects of employee perceptions of PA utility and procedural justice on changes in TIL are mediated by employee satisfaction with the PA process.Research limitations/implicationsAs a consequence of study design, the results found in this study may be limited with respect to their external validity. Researchers and practitioners are encouraged to use caution before generalizing study findings to other contexts.Practical implicationsThis study suggests that PA formalization represents a means of increasing employee trust. Moreover, study results suggest that SME leaders hoping to increase employee TIL should be thoughtful about how they implement the PA process, paying particular attention to the usefulness of the feedback they provide and ensuring that the process of PA is viewed as being fair by employees. In doing so, SME leaders will enhance their employees’ satisfaction with the PA process, thereby increasing the trust they place in SME leadership.Originality/valueThis study extends research by considering the consequences of PA formalization with respect to changes in SME employee TIL. In doing so, this study heeds calls for additional research on the consequences of PA within SMEs, as well as sheds light on how PA formalization shapes the relationship between SME employees and leaders.

Background: Benefits of comprehensive workplace health promotion (WHP) programs and organizational support are well documented. However, few workplaces offer WHP programs. This study used mixed-methods analysis to examine the benefits of WHP and organizational support at small, rural workplaces. Methods: Kentucky workplaces with fewer than 500 full time employees and located in rural counties were surveyed. Results: Most workplaces did not offer comprehensive WHP programs or elements of organizational support. Cost, time, workplace size, location and lack of expertise were all identified barriers to implementation of WHP programs and organizational support. Conclusion: Identification of barriers to WHP and organizational support is needed to develop and facilitate more effective WHP programs at small, rural businesses.

Corporate sponsorship is often used to develop positive attitudes towards a brand or a firm, among its customers and/or potential customers. Depending on the size of the organisation, corporate sponsorship may involve high-profile entities (such as the Olympics), or smaller local groups or individuals, but the prominence of large entities means that sponsorships by large organisations attract most media and research attention. A less commonly studied effect of sponsorship is the effect on the attitudes of the sponsoring organisations’ own employees. In this area, as with consumer-focused sponsorship, large organisations are likely to have substantial advantages. Large firms have the resources to leverage their sponsorship both internally and externally. Large organisations also have the expertise to effectively communicate their sponsorship-relationship to internal audiences. Yet smaller organisations may also be successful in engaging employees by sponsoring local entities at far lower cost, and providing opportunities for employee participation in the sponsorship. This research compares sponsorship-linked attitudes of 405 employees at small and medium-sized enterprises (SMEs) and large organisations. Despite large organisations’ bigger budgets, sponsorship-linked attitudes were not significantly lower among SME employees. For one measure, sponsorship-linked organisational identification, SME employees rated significantly higher than employees of large organisations. The findings suggest that sponsorship can result in positive employee attitudes, even in SMEs—and may in fact be even more cost-effective for SMEs. These results may be due to increased communication within SMEs, or because SME employees may have stronger affiliations with sponsored entities. Implications for research and practice are discussed.

In Portugal, little is known about the work ability profiles of municipal workers and their changes during working life. In order to characterize and understand the changes in work ability among municipal workers, a prospective study was designed to begin in 2015 in the municipality of Sintra, in the surroundings of Lisbon, and to collect data every two years. The present paper aims at characterizing the changes in the work ability of those workers between 2015 and 2017 and to identify the main predictors. Data collection was based on a questionnaire that encompassed socio-demographic data, the Copenhagen Psychosocial Questionnaire II (COPSOQ II), the Nordic questionnaire adapted, and the Work Ability Index (WAI). In this two-year period, the work ability of municipal workers decreased and the main predictive factors were age, lower-back pain, negative health perception, the presence of burnout, and making manual efforts. Still, there were factors that act as positive predictors of an excellent work ability, such as having training in the previous two years, a good sense of community at work, and a favorable meaning of work. In summary, the intervention strategies in the work field should take into consideration the main predictors of work ability that are relevant for each organization.

Work ability (WA) is an important concept in occupational health research and for over 30 years assessed worldwide with the Work Ability Index (WAI). In recent years, criticism of the WAI is increasing and alternative instruments are presented. The authors postulate that theoretical and methodological issues need to be considered when developing alternative measures for WA and conclude that a short uni-dimensional measure is needed that avoids conceptual blurring. The aim of this contribution is to validate the short and uni-dimensional WAI components WAI 1 (one item measuring “current WA compared with the lifetime best”) and WAI 2 (two items assessing “WA in relation to the [mental/physical] demands of the job”). Cross-sectional and 12-month follow-up data of two large samples was used to determine construct validity of WAI 1 and WAI 2 and to relate this to respective results with the WAI. Data sources comprise nurses in Europe investigated in the European NEXT-Study (Sample A; Ncross-sectional = 28,948 and NLongitudinal = 9462, respectively) and nursing home employees of the German 3Q-Study (Sample B) where nurses (N = 786; 339, respectively) and non-nursing workers (N = 443; 196, respectively) were included. Concurrent and predictive validity of WAI 1 and WAI 2 were assessed with self-rated general health, burnout and considerations leaving the profession. Spearman rank correlation (ρ) with bootstrapping was applied. In all instances, WAI 1 and WAI 2 correlated moderately, and to a similar degree, with the related constructs. Further, WAI 1 and 2 correlated with WAI moderately to strongly with ρ ranging from 0.72–0.76 (WAI 1) and 0.70–0.78 (WAI 2). Based on the findings and supported by theoretical and methodological considerations, the authors confirm the feasibility of the short measures WAI 1 and WAI 2 for replacing WAI at least in occupational health research and employee surveys.

The study focused on assessing the growth challenges and opportunities of small and medium-sized enterprises (SMEs) in Chipata District, Zambia. The specific objectives were to examine the nature of challenges and opportunities faced by SMEs, investigate the factors leading to the failure of start-ups within five years, and develop a practical framework to guide SMEs in Chipata District. The study employed a mixed-methods approach, integrating qualitative and quantitative research approaches. The descriptive survey design was adopted, targeting a finite population of 85 SMEs, SME employees, and industry experts. Using Yamane’s formula with a 5% margin of error, a sample size of 70 respondents was derived. A sample of 70 participants was selected, comprising 60 SME employees chosen through random sampling and 10 experts, including local authority officials and SME owners, selected via purposive sampling. Data were collected through structured questionnaires and interview guides. Quantitative data were analyzed using the Statistical Package for Service Solutions (SPSS) to produce descriptive statistics, while qualitative data were subjected to content analysis to extract key themes. The findings revealed that SMEs face numerous challenges, including a highly competitive environment, financial constraints, outdated technology, insufficient government support, and lack of strategic knowledge. Opportunities were identified in leveraging government programs and local market demand. Start-up failures were attributed to inadequate capital, limited managerial competencies, and difficulties in retaining skilled employees. To address these issues, a framework was proposed, focusing on harmonizing regulatory frameworks, improving access to financing, building managerial and technological skills, and establishing innovation hubs to enhance product development and competitiveness. The study concludes that SMEs’ success depends on fostering managerial skills, embracing innovation, ensuring access to capital and infrastructure, and developing a committed workforce. Sustainable SME operations require enabling regulatory policies, strategic market linkages, and capacity-building initiatives. Recommendations included streamlining regulations, enhancing access to government programs, fostering mentorship initiatives, and creating innovation hubs. Policymakers are advised to prioritize a conducive regulatory environment, improve financing mechanisms, and invest in capacity-building initiatives for SMEs to thrive.

ObjectivesThis study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties.Methods435 German hospital residents in medical...

Changes in work ability and work interest (meaning) after the participation in a health promotion program were perceived and evaluated. Drivers of the Munich Transport Authority (n=122) of an average age of 50 years participated in 20 health days during working time over 1 year. The evaluation instruments of the health promotion program were the Work Ability Index (WAI) developed by the Finnish Institute of Occupational Health (FIOH) and the Effect Typology developed by the Institute of Occupational Health Promotion (IBG Austria). No changes were found in the WAI score. The Effect Typology evaluated the optimal effect ''evolution,'' i.e., psychological and noetic (mental) changes, for 50% of the participants. A variance analysis of the WAI pre-post differences according to the effect classes of the Effect Typology showed significant differences, namely an increase in the WAI in the evolution group and a drop in the recovery group. The Effect Typology is suitable for the evaluation of occupational health promotion and for the further understanding and development of the WAI.

BackgroundWork-related physical activity (PA) and work ability are of growing importance in modern working society. There is evidence for age- and job-related differences regarding PA and work ability. This study analyses work ability and work-related PA of employees in a medium-sized business regarding age and occupation.MethodsThe total sample consists of 148 employees (116 men—78.38 % of the sample—and 32 women, accounting for 21.62 %; mean age: 40.85 ± 10.07 years). 100 subjects (67.57 %) are white-collar workers (WC), and 48 (32.43 %) are blue-collar workers (BC). Work ability is measured using the work ability index, and physical activity is obtained via the Global Physical Activity Questionnaire.ResultsWork ability shows significant differences regarding occupation (p = 0.001) but not regarding age. Further, significant differences are found for work-related PA concerning occupation (p < 0.0001), but again not for age. Overall, more than half of all subjects meet the current guidelines for physical activity.ConclusionWork ability is rated as good, yet, a special focus should lie on the promotion during early and late working life. Also, there is still a lack of evidence on the level of work-related PA. Considering work-related PA could add to meeting current activity recommendations.