Organizational Interventions Research Articles

Validation of the Intervention Preparedness Tool: a short measure to assess important precursors for successful implementation of organisational interventions

ABSTRACT Process evaluation enables us to gain insights into the complex organisational intervention processes, but has mostly taken place post intervention, thus failing to support implementation. Using the theory of planned behaviour, we developed and validated a 7-item process evaluation questionnaire (the Intervention Preparedness Tool) that aims to evaluate the preparatory phases of the intervention and may be used to optimise the intervention process. The study was conducted in two Italian hospitals participating in an organisational intervention (N = 1,654 healthcare workers). We conducted exploratory factor analysis (EFA) on one half of the sample and cross-validated the best factor structure identified through confirmatory factor analysis (CFA) on the other half of the sample. Results showed that the Intervention Preparedness Tool composed of 7 items has a three-factor structure (readiness for change, intervention-context fit, and communication). To perform nomological validation, we correlated the Intervention Preparedness Tool with seven psychosocial working conditions (demand, control, peer support, supervisor support, roles, relationships, changes) and job satisfaction. We found that the dimensions of the Intervention Preparedness Tool were significantly related to these working conditions and job satisfaction suggesting that the organisational context may be related to participants’ appraisals of the early phases of participatory interventions.

The structured ambulatory post-stroke care program for outpatient aftercare in patients with ischaemic stroke in Germany (SANO): an open-label, cluster-randomised controlled trial

Patients with ischaemic stroke are at risk of recurrent stroke. In this study, we aimed to compare the effect of a structured ambulatory post-stroke care programme versus usual care on recurrent vascular events and death and control of cardiovascular risk factors. We did a prospective, open-label, cluster-randomised controlled trial (SANO) at stroke centres in regions of Germany. A cluster was defined as a region in which acute stroke care is provided by a participating stroke centre. Patients were eligible for participation if they were aged 18 years or older, had no severe disabilities before the index stroke (modified Rankin scale 0-1), had at least one modifiable cardiovascular risk factor, and presented within 14 days of symptom onset of their first ischaemic stroke. The participating regions were randomly assigned (1:1) to the intervention and control group (usual care) by the statistician using block randomisation (block sizes of six), stratified by rural and urban regions. In intervention regions, a cross-sectoral multidisciplinary network was established to provide a 1-year organisational and patient-centred intervention. Due to the type of intervention, masking of participants and study physicians was not possible. Endpoint adjudication was performed by an independent endpoint adjudication committee who were masked to cluster allocation. The primary endpoint was a composite of recurrent stroke, myocardial infarction, and all-cause death within 12 months after baseline assessment, assessed in the modified intention-to-treat (mITT) population, which included all patients who did not withdraw consent and completed the primary endpoint assessment at 12 months. This study was registered with the German Clinical Trials Register, DRKS00015322. Between Jan 1, 2019 and Dec 22, 2020, 36 clusters were assessed for eligibility, of which 30 were randomly assigned to the intervention group (n=15 clusters) or control group (n=15 clusters). No clusters dropped out of the study. 1203 (86%) of 1396 enrolled patients in the intervention group and 1283 (92%) of 1395 enrolled patients in the control group were included in the mITT population. The primary endpoint was confirmed in 64 (5·3%) of 1203 patients in the intervention group and 80 (6·2%) of 1283 patients in the control group (unadjusted odds ratio [OR] 0·80 [95% CI 0·49-1·30]; adjusted OR [aOR] 0·95 [95% CI 0·54-1·67]). All-cause deaths occurred in 31 (2·4%) of 1203 patients in the intervention group and 12 (1·0%) of 1283 patients in the control group. The incidence of serious adverse events was higher in the intervention group (266 [23·1%] of 1151) than the control group (106 [9·2%] of 1152). Falls (134 [11·4%] of 1203 patients in the intervention group; 39 [3·3%] of 1152 patients in the control group), hypertensive crisis (55 [4·7%]; 34 [2·8%]), and diagnosis of depression (51 [4·3%]; 13 [1·1%]) were the most frequent adverse events in both groups. No differences were identified in the rate of readmission to hospital between groups. No differences were identified between patients with ischaemic stroke in the intervention group and control group with regard to the incidence of vascular events 1 year after baseline assessment, despite positive effects with regard to the control of some cardiovascular risk factors. Longer-term effects and other potentially favourable effects on stroke-related sequelae and quality of life require further evaluation. Innovation Fund of the Federal Joint Committee.

A power-sharing perspective on employees' participatory influence over organizational interventions: conceptual explorations.

A participatory approach is widely recommended for organizational interventions aiming to improve employee well-being. Employees' participatory influence over organizational interventions implies that managers share power over decisions concerning the design and/or implementation of those interventions. However, a power-sharing perspective is generally missing in organizational intervention literature. The aim of this paper is therefore broaden the picture of the mechanisms that influence, more or less, participatory processes by conceptually exploring this missing part to the puzzle. These conceptual explorations departs from both an empowerment and a contingency perspective and results in six propositions on what to consider in terms of power-sharing strategies, reach, amount, scope, culture and capacity. Implications for research, as well as for organizations and practitioners interested in occupational health improvements, are then discussed. Especially, the importance of aligning power-sharing forms with the needs of the participating employees, and taking factors that can facilitate or hinder the power-sharing process into consideration, are stressed. The importance of training managers in power-sharing practices and supporting a participatory process is also highlighted.

Burnout among public sector pharmacy staff two years into the COVID-19 pandemic.

This study aimed to determine the prevalence and factors contributing to burnout among public sector pharmacy staff in Sarawak, Malaysia, two years into the COVID-19 pandemic. Impact of burnout on their lives and their coping strategies were also examined. A cross-sectional online survey was carried out among all pharmacy staff in public healthcare facilities throughout Sarawak. Burnout was measured using the Copenhagen Burnout Inventory. Multiple logistic regression analysed demographic and work characteristics associated with burnout. Open-ended replies on burnout causes, impact, coping strategies and employer's role were coded and thematically analysed. A total of 329 responses were received. The prevalence of personal, work and patient-related burnout was 54.7, 47.1 and 35.3%, respectively. Respondents facing problems with child support were 8.26 and 3.62 times more likely to suffer from personal and work-related burnout. Working in areas with potential exposure to COVID-19 patients increased the odds of patient and work-related burnout by 2.80 and 1.86 times, respectively. Burnout symptoms affected their quality of life; nevertheless, self-reported coping strategies were mostly positive. Respondents emphasised the need for organisational interventions, including increased resource allocation, better workload distribution and promotion of work-life balance, to mitigate burnout. A significant percentage of public sector pharmacy staff continue to experience burnout two years into the pandemic. Regular well-being assessments and supportive policies are recommended to help them cope with increased stress. Additional training for supervisors may be necessary to effectively manage staff and workload during a pandemic.

Police burnout and organizational stress: job and rank associations

PurposeBurnout is an issue affecting not only individual officers, but also the agencies they work for and the communities they serve. Despite its prevalence, there is limited evidence for effective interventions that address officer burnout. This study aims to advance this area of study by identifying organizational factors associated with police burnout. By identifying these factors, stakeholders interested in officer wellness will have more clearly defined targets for intervention.Design/methodology/approachSelf-report data were gathered from US police officers partitioned into command staff (n = 125), detective (n = 41), and patrol officer (n = 191) samples. Bootstrapped correlations were calculated between 20 organizational stressors and officer burnout.FindingsFindings revealed several shared organizational stressors associated with burnout regardless of role (command staff, detective, patrol officer), as well as several role-specific organizational stressors strongly associated with burnout. Together, these findings suggest utility in considering broad-based organizational interventions and role-specific interventions to affect burnout amidst varying job duties.Research limitations/implicationsPrimary limitations to consider when interpreting these results include sample homogeneity, unequal subsample sizes, cross-sectional data limitations, and the need for implementation of interventions to test the experimental effects of reducing identified organizational stressors.Practical implicationsThis study may provide command staff and consulting parties with targets to improve departmental conditions and officer burnout.Originality/valueThis represents the first study to evaluate organizational stressors by their strength of association with burnout across a stratified police sample.

Connecting the Concepts of Frugality and Inclusion to Appraise Business Practices in Systems of Food Provisioning: A Kenyan Case Study

Small and medium size business enterprises (SMEs) are the linchpin in systems of food provisioning in sub-Saharan Africa. These businesses occupy the middle of the agri-food chain and face a food security conundrum: they must ensure that smallholder producers of limited means can operate under fair terms while low-income consumers are supplied with affordable and nutritious food. This task becomes even more challenging when resources are scarce. This paper explores how resource-constrained SMEs arrange the terms on which both farmers and consumers are included in agri-food chains. To this end, it combines the concept of inclusion with that of frugality. We use the case of a Kenyan SME to demonstrate how a focus on frugality can advance our understanding of how business practices create thriving business relationships with smallholders while simultaneously ensuring access to affordable food for consumers. We additionally identify what conditions for inclusion emerge from this type of dynamic business practices. Our perspective departs from assessing induced organisational interventions, such as contract farming or cooperatives, which deliberately shorten the agri-food chain, thereby overlooking the skilful practices being employed by business actors in the middle of the chain.

Evaluation of an organisational-level monetary incentive to promote the health and wellbeing of workers in small and medium-sized enterprises: A mixed-methods cluster randomised controlled trial.

We conducted an independent evaluation on the effectiveness of an organisational-level monetary incentive to encourage small and medium-sized enterprises (SMEs) to improve employees' health and wellbeing. This was A mixed-methods cluster randomised trial with four arms: high monetary incentive, low monetary incentive, and two no monetary incentive controls (with or without baseline measurements to examine 'reactivity' The consequence of particpant awareness of being studied, and potential impact on participant behavior effects). SMEs with 10-250 staff based in West Midlands, England were eligible. We randomly selected up to 15 employees at baseline and 11 months post-intervention. We elicited employee perceptions of employers' actions to improve health and wellbeing; and employees' self-reported health behaviours and wellbeing. We also interviewed employers and obtained qualitative data. One hundred and fifty-two SMEs were recruited. Baseline assessments were conducted in 85 SMEs in three arms, and endline assessments in 100 SMEs across all four arms. The percentage of employees perceiving "positive action" by their employer increased after intervention (5 percentage points, pp [95% Credible Interval -3, 21] and 3pp [-9, 17], in models for high and low incentive groups). Across six secondary questions about specific issues the results were strongly and consistently positive, especially for the high incentive. This was consistent with qualitative data and quantitative employer interviews. However, there was no evidence of any impact on employee health behaviour or wellbeing outcomes, nor evidence of 'reactivity'. An organisational intervention (a monetary incentive) changed employee perceptions of employer behaviour but did not translate into changes in employees' self-reports of their own health behaviours or wellbeing. Trial registration: AEARCTR-0003420, registration date: 17.10.2018, retrospectively registered (delays in contracts and identfying a suitable trial registry). The authors confirm that there are no ongoing and related trials for this intervention.

2023—A Pivotal Year in Climate Risk Disclosure and ESG Fund Requirements

In 2022, disclosure and reporting requirements were proposed in both the European Union and the United States for Environmental, Social and Governance (ESG) metrics, but primarily for greenhouse gas (GHG) and climate‐related risks. Since the release of these proposals, many industry, non‐governmental organization (NGO), and public and governmental positions and interventions have surfaced to promote or counter these proposals. The primary concerns surrounding these proposals focus on the intent and cost of disclosure together with the availability, accuracy, and duplication of Scope 3 data. The schedule to finalize these proposals will make 2023 a pivotal year regarding climate risk disclosure and ESG fund requirements.

Hope during the COVID-19 lockdown – the role of organization interventions

PurposeThe study aims to investigate organization interventions experienced by employees during the lockdown for Coronavirus disease-2019 (COVID-19), and the effect of these organization interventions on hope.Design/methodology/approachThe respondents for the study were employees in full-time white-collar or professional job positions; they performed their job roles by way of work from home (WFH) in Sri Lanka during the COVID-19 lockdown. Structural equation modelling was used to analyse the data.FindingsResults showed that employees maintained high levels of hope while working from home. The study identified four organization interventions that (a) promote collaborative and coordinated work, (b) promote meaningful goals and a sense of social support, (c) alleviate psychological strain and (d) assist in maintaining physical health. These four organization interventions increased hope during the COVID-19 lockdown while working from home.Originality/valueThe literature calls for research on intervention studies explaining the promotion of hope. The present study was built on the theories of positive organizational behaviour, conservation of resources theory and hope theory. The findings support that these three traditional theories have lasting theoretical resonance in explaining present-day phenomena with unique applications.

Informal E-waste recycling practices and environmental pollution in Africa: What is the way forward?

Globally, e-waste is the fastest growing and most valuable waste-stream. While countries worldwide are increasingly acknowledging the e-waste problem and introducing policies and regulations that deal with e-waste, large quantities of e-waste still go undocumented. Much of these global e-wastes are accumulating in open-dumpsites and landfills in African-countries where they are recycled informally resulting in significant environmental and public-health concerns. Although, there is a plethora of studies on e-waste management and disposal, only a few-studies have focused on African-countries who are major recipients of e-waste. Moreover, despite the attempts to mitigate the problem of e-waste in African-countries, e-waste has remained a major-concern and there are currently very limited workable solutions. This study examines informal e-waste recycling, environmental pollution and the extent of environmental and health impacts in major countries of concern including Ghana, Nigeria, Egypt, Kenya and South Africa. The global e-waste Waste Atlas Report, 2020 identified these countries as major recipients of e-waste. To achieve the aims of this research, previous studies from 2005 to 2022 are collected from various databases and analyzed. Accordingly, this study focuses on environmental pollution and public-health impacts resulting from e-waste dumping and informal recycling practices, illegal transboundary shipment of e-waste to the selected countries, and the interventions of governments and international organizations in reducing the impact of e-waste pollution and informal recycling practices in Africa. Based on the outcomes of this study, practical approaches on the way-forward are recommended. The findings of this study contribute to a growing-body of research on informal e-waste recycling practices in Africa to document that individuals working within e-waste sites and residents in nearby communities are exposed to a number of toxic-substances, some at potentially concerning levels.

Healthcare worker burnout during the first COVID-19 lockdown in Italy: experiences from an intensive neurological rehabilitation unit.

The study aim was to investigate the prevalence of behavioral symptoms and burnout in healthcare workers in an intensive neurological rehabilitation unit in Messina, Italy, during the first COVID-19 lockdown in Italy. Forty-seven healthcare workers (including neurologists, physiatrists, nurses and rehabilitation therapists) were enrolled in this cross-sectional study from February 2020 to June 2020. Participants were administered the following psychometric tests to investigate burnout and related symptoms: the Maslach Burnout Inventory, which measures emotional exhaustion, depersonalization and reduced personal accomplishment; the Zung Self-Rating Depression Scale (SDS); the Pre-Sleep Arousal Scale (PSAS); the Dyadic Adjustment Scale; and the Buss-Perry Aggression Questionnaire (BPAQ). We found several correlations between test scores and burnout subdimensions. Emotional exhaustion was correlated with SDS (r = 0.67), PSAS-Cognitive (r = 0.67) and PSAS-Somatic (r = 0.70) scores, and moderately correlated with all BPAQ dimensions (r = 0.42). Depersonalization was moderately correlated with SDS (r = 0.54), PSAS-Cognitive (r = 0.53) and PSAS-Somatic (r = 0.50) scores. During the first COVID-19 lockdown in Italy, healthcare workers were more exposed to physical and mental exhaustion and burnout. Research evaluating organizational and system-level interventions to promote psychological well-being at work for healthcare workers are needed.

Work-Family Conflict, Resilience, And Well-Being of Community Pharmacists: A Conceptual Paper

COVID-19 has manifested as a global epidemic, with significant patient presentations for treatment and increased human resource workloads. Pharmacists are front-line healthcare professionals who play a critical role in medication management during the COVID-19 pandemic, and they play a unique function in the healthcare system. Due to staff shortages and increased demand for services both before and after the epidemic, pharmacists' workloads have become unsustainable, putting them under additional stress. Hence, it is expected that many pharmacists would be suffering from the daily unpredictable workload which might worsen their level of employee well-being. Ensuing from this finding, a comprehensive framework concerning the connection between work-family conflict, resilience, and employee well-being is proposed. This paper is a conceptual paper that aims to draw attention to the current change of work nature and the effect of work-family conflict on the resilience and well-being of community pharmacists. The target respondents are community pharmacists located in Greater Kuala Lumpur. Primary data will be collected by distributing questionnaires and subsequently the data will be empirically tested with structural equation modelling by using partial least squares analysis (SEM-PLS). The expected output of this study is a comprehensive theoretical framework for employee well-being that involves the connection between work-family conflict and resilience. This study will contribute significantly to the improvement of community pharmacists' well-being and will prompt the search for organizational intervention strategies to address the issue of pharmacists' well-being.

Learning to Be a Leader Worth Following

ABSTRACT Leading human service agencies has always been challenging, but recent political, financial, public health, and racial tensions in the U.S. have added further turbulence and complexity to those in CEO and Executive Director positions tasked with providing steady leadership of agencies serving the most vulnerable in our society. Though numerous books and journal articles examining leadership are published every year, there is something valuable about learning from experiences of leaders in the field. This article shares the perspective of one such leader, whose leadership approach is grounded on the principles of The Sanctuary Model, an evidence-supported, trauma-informed, organizational change intervention.

Cardiology in a Digital Age: Opportunities and Challenges for e-Health: A Literature Review.

To date, mortality rates associated with heart diseases are dangerously increasing, making them the leading cause of death globally. From this point of view, digital technologies can provide health systems with the necessary support to increase prevention and monitoring, and improve care delivery. The present study proposes a review of the literature to understand the state of the art and the outcomes of international experiences. A reference framework is defined to develop reflections to optimize the use of resources and technologies, favoring the development of new organizational models and intervention strategies. Findings highlight the potential significance of e-health and telemedicine in supporting novel solutions and organizational models for cardiac illnesses as a response to the requirements and restrictions of patients and health systems. While privacy concerns and technology-acceptance-related issues arise, new avenues for research and clinical practice emerge, with the need to study ad hoc managerial models according to the type of patient and disease.

Perceived Overqualification Among Therapists: An Experimental Study

The goal of the current study was to experimentally manipulate perceived overqualification (POQ) among a sample of therapists and assess this manipulation’s effect on task meaningfulness, positive affect, and negative affect. To conduct the experiment, we had participants read a clinical case vignette and then randomly assigned them to answer questions using their specialized clinical skills (control group) or using simple recall and transcription (perceived overqualification group). The POQ group reported significantly greater perceived overqualification and significantly less task meaningfulness than the control group. Perceived overqualification also mediated the relation between the experimental condition and task meaningfulness. The groups did not differ on positive or negative affect. Results support previous research and theory suggesting that perceived overqualification can have deleterious effects on job attitudes, which has implications for organizational and individual interventions.

The work-family conflict: Dyadic view of Brazilian couples

Several changes have occurred in the family setting over the last few decades: the insertion of women into the labor market, the growth of dual-career couples, and changes in the traditional and non-traditional structures of men's and women's societal roles. In this context, the Work-Family Conflict (WFC) is a construct of work interference in the family (WIF) and family interference in work (FIW). This study's central objective was to explore the conflict between family and work in a Brazilian context according to the dyadic scope. The study with a survey design was conducted with a Brazilian sample of 65 adult couples (130 individuals). Results showed differences between men and women concerning variables that influence the WFC. Stress at work was the central aspect of WFC. The results contribute to the advancement of knowledge on the issues of WFC in Brazil, dyadic analysis procedures, family and organization interventions.

Empowering leadership questionnaire: Brazilian adaptation and validation

ObjetivoO presente estudo tem o objetivo de apresentar a adaptação e validação do Questionário de Liderança Empoderadora (QLE) para uma amostra de trabalhadores brasileiros (N = 827).Design/método/abordagemForam realizados os procedimentos de tradução, adaptação e retroversão dos itens do instrumento original. A recolha de dados foi realizada utilizando o método bola de neve. Os dados foram avaliados com a Análise Fatorial Confirmatória (AFC).ResultadosOs resultados mostraram que a estrutura fatorial se manteve como nas versóes portuguesa e inglesa (original). A validade convergente foi testada com a aplicação do Questionário de Liderança Ética no Trabalho (QLET). As análises realizadas mostraram que a medida possui boas qualidades psicométricas, bons índices de confiabilidade e bons resultados de validade convergente com o QLET.Originalidade/valorA utilização do QLE pode representar uma importante ferramenta para o desenvolvimento teórico e prático dos estudos da liderança empoderadora com amostras brasileiras.Implicações da pesquisaO QLE ainda pode ser utilizado para identificar a presença da liderança empoderadora (fase diagnóstica) e contribuir para proposição de intervenções que levem a criação de ambientes de trabalho mais saudáveis e produtivos. Sua validade convergente com a liderança ética sugere que os gestores podem aplicar os dois tipos de liderança, complementarmente, de modo a criar interações de qualidade entre líderes e liderados que aumentem a autonomia dos trabalhadores e permitam que respondam prontamente aos desafios organizacionais.

Organizational intervention to improve access to retinopathy screening for patients with diabetes mellitus: health care service improvement project in a tertiary public hospital

IntroductionThe aim of this study was to improve the access to diabetic retinopathy (DR) screening with retinographies in a tertiary care center through a process conducted by an interdisciplinary group driven by a nurse. Materials and methodsThis is a quality improvement study that evaluated the flow for DR screening conducted by an interdisciplinary group using the Plan-Do-Study-Act methodology. As a result measure, we assessed the quantity of retinographies performed after the project implementation, the proportion of patients who presented abnormal retinographies, and the proportion of patients referred to a specialist. ResultsThe new patient screening flow and the reinforcement of available human resources led to an increase in the number of retinographies performed and screened patients. A total of 1184 retinographies were conducted, and it was possible to observe DR alterations in 37.8 % patients, of which only 6 % needed to be referred to the DR reference center. ConclusionsThis study showed a significant increase in the number of retinographies performed. The Plan-Do-Study-Act methodology was an important tool to improve the flow of patient access to fundus images, helping to consistently and continuously improve these processes.

What Works for whom in which Circumstances? An Integrated Realist Evaluation Model for Organisational Interventions

Realist evaluation is a recommended approach to evaluate organisational interventions. It examines how specific intervention mechanisms work in a given context to produce certain outcomes through developing and testing Context-Mechanism-Outcome (CMO) configurations. Inspired by realist evaluation, the five-phase model was developed by Nielsen and Abildgaard (2013). However, this model (1) does not include some crucial intervention components that should be evaluated in each intervention phase, and (2) does not follow the full realist evaluation cycle. In this article, we address these limitations of the five-phase model. First, we integrate the contents of the RE-AIM framework into the five-phase model to include crucial intervention components. Then, we explain how to follow a realist evaluation cycle, provide guidance on when, why, and how to develop and test CMO configurations for intervention components, and develop examples of CMO configurations for intervention components. In doing so, we develop an Integrated Realist Evaluation Model for Organisational Interventions (IREMOI). As such, this article demonstrates how working with CMO configurations systematically in an intervention may improve the understanding of ‘what works for whom in which circumstances’ and thereby the likelihood of intervention success.

All inside our heads? A critical discursive review of unconscious bias training in the sciences

AbstractIn response to persistent systemic gendered and racial exclusions in the sciences, unconscious or implicit bias training is now widely established as an organizational intervention in Higher Education (HE). Recent systematic reviews have considered the efficacy of unconscious bias training (UBT) but not the wider characteristics and effects of the interventions themselves. Guided by feminist scholarship in critical psychology and post‐structuralist discourse theory, this article critically examines UBT across STEMM and in HE institutions with a discursive analysis of published studies. Drawn from systematic searches in 4 databases, we identify three types of UBT reported in 22 studies with considerable variation in intervention types, target groups, and evaluation methods. Guided by limited cognitive problematizations of unconscious bias as a problem located inside individual minds, interventions follow established patterns in neoliberal governmentality and make available specific feeling rules and subject positions. These current Equality, Diversity & Inclusion practices present a new technology of power through which organizations may regulate affect and behavior but leave structural inequalities and barriers to inclusion intact.