Abstract
BackgroundWorksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. Nevertheless, broad scale and successful implementation of WHPPs in daily practice often fails. In the present study, called BRAVO@Work, a 7-step implementation strategy was used to develop, implement and embed a WHPP in two different worksites with a focus on multiple lifestyle interventions.This article describes the design and framework for the formative evaluation of this 7-step strategy under real-time conditions by an embedded scientist with the purpose to gain insight into whether this this 7-step strategy is a useful and effective implementation strategy. Furthermore, we aim to gain insight into factors that either facilitate or hamper the implementation process, the quality of the implemented lifestyle interventions and the degree of adoption, implementation and continuation of these interventions.Methods and designThis study is a formative evaluation within two different worksites with an embedded scientist on site to continuously monitor the implementation process. Each worksite (i.e. a University of Applied Sciences and an Academic Hospital) will assign a participating faculty or a department, to implement a WHPP focusing on lifestyle interventions using the 7-step strategy. The primary focus will be to describe the natural course of development, implementation and maintenance of a WHPP by studying [a] the use and adherence to the 7-step strategy, [b] barriers and facilitators that influence the natural course of adoption, implementation and maintenance, and [c] the implementation process of the lifestyle interventions. All data will be collected using qualitative (i.e. real-time monitoring and semi-structured interviews) and quantitative methods (i.e. process evaluation questionnaires) applying data triangulation. Except for the real-time monitoring, the data collection will take place at baseline and after 6, 12 and 18 months.DiscussionThis is one of the few studies to extensively and continuously monitor the natural course of the implementation process of a WHPP by a formative evaluation using a mix of quantitative and qualitative methods on different organizational levels (i.e. management, project group, employees) with an embedded scientist on site.Trial RegistrationNTR2861
Highlights
Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees
Since we aim to study the natural course of implementation, not the researchers but the representatives (SG, project group (PG), working group (WG)) from both participating worksites themselves are set in the lead and made responsible for performing all actions needed according to the 7 steps
The rising call to improve the translation of research into daily practice has created a need for a shift in focus towards the evaluation of the implementation process of interventions, rather than the current focus on effect evaluations
Summary
Worksite health promotion programs (WHPPs) offer an attractive opportunity to improve the lifestyle of employees. In order to improve the implementation of WHPPs into daily practice, it is important to shift the focus from effect evaluations to the evaluation of the implementation process. Key determinants of success and failure could be obtained and addressed in future implementation For this purpose, traditional evaluation designs (i.e. randomized controlled trials) that focus on effect evaluations are not sufficient. A formative evaluation is an assessment that focuses on “the internal dynamics and actual operations of a program in order to understand its strengths and weaknesses and changes that occur in it over time” [18,20] It gives researchers insight into program implementation over time and employs a mix of qualitative and quantitative techniques. Investing time in effectiveness studies that are not used in daily practice and only include a posterior process evaluation that does not give insight into the important aspects of the implementation process, is a waste of money
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