Abstract
ObjectivesTo investigate the feasibility of recruitment, adherence and likely effectiveness of an e-learning intervention for managers to improve employees’ well-being and reduce sickness absence.MethodsThe GEM Study (guided e-learning for managers) was a mixed methods pilot cluster randomised trial. Employees were recruited from four mental health services prior to randomising three services to the intervention and one to no-intervention control. Intervention managers received a facilitated e-learning programme on work-related stress. Main outcomes were Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), 12-item GHQ and sickness absence <21 days from human resources. 35 in-depth interviews were undertaken with key informants, managers and employees, and additional observational data collected.Results424 of 649 (65%) employees approached consented, of whom 350 provided WEMWBS at baseline and 284 at follow-up; 41 managers out of 49 were recruited from the three intervention clusters and 21 adhered to the intervention. WEMWBS scores fell from 50.4–49.0 in the control (n=59) and 51.0–49.9 in the intervention (n=225), giving an intervention effect of 0.5 (95% CI −3.2 to 4.2). 120/225 intervention employees had a manager who was adherent to the intervention. HR data on sickness absence (n=393) showed no evidence of effect. There were no effects on GHQ score or work characteristics. Online quiz knowledge scores increased across the study in adherent managers. Qualitative data provided a rich picture of the context within which the intervention took place and managers’ and employees’ experiences of it.ConclusionsA small benefit from the intervention on well-being was explained by the mixed methods approach, implicating a low intervention uptake by managers and suggesting that education alone may be insufficient. A full trial of the guided e-learning intervention and economic evaluation is feasible. Future research should include more active encouragement of manager motivation, reflection and behaviour change.Trial Registration numberISRCTN58661009.
Highlights
There is empirical evidence including several meta-analyses, showing that the psychosocial work environment in terms of job strain, low social support at work from managers and colleagues, effort-reward imbalance, organisational injustice and job insecurity impacts on employee well-being and risk of sicknessStansfeld SA, et al BMJ Open 2015;5:e007981. doi:10.1136/bmjopen-2015-007981absence.[1,2,3,4] There is a consensus that employees’ health is a public health priority and the responsibility of employers and employees as well as health services.[5 6]
A review of studies of workplace reorganisation involving increasing skill discretion, team working and decision latitude in diverse occupational groups showed that team working interventions improved the work environment, by increasing support.[11]
The clusters were services belonging to one National Health Service (NHS) Mental Health Trust
Summary
Absence.[1,2,3,4] There is a consensus that employees’ health is a public health priority and the responsibility of employers and employees as well as health services.[5 6] So far, evaluations of organisational interventions for workplace stressors are limited. A review of studies of workplace reorganisation involving increasing skill discretion, team working and decision latitude in diverse occupational groups showed that team working interventions improved the work environment, by increasing support.[11] At the organisational level, team working interventions have tended to demonstrate improvements in the work environment by increasing support[12] and some studies of training and organisational approaches to increase participation, decision-making, and work support and communication have reduced sickness absence.[13]
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