Mindfulness Coaching

Discuss the design, implementation, and evaluation of participatory work redesign interventions for managing job stress

Introduction

Importance is placed on exploring possible interventions to perform organisational changes at the workplace to alleviate job stress, which can contribute to adverse health conditions along with poor productivity/performance, increased absenteeism, and high staff turnover (UK HSE, 2007; Backé et al., 2012; Theorell et al., 2015; Sara et al., 2018). Participatory work redesign interventions are trusted to tackle job stress (ILO, 2001; UK HSE, 2007; EU-OSHA, 2016). However, it is a naïve assumption that if you change how work is designed, organised and managed (i.e. work practices, procedures and policies), it runs as planned and is seamlessly implemented (Nielsen & Randall, 2013). Nielsen and Miraglia (2016) argued that a randomised, controlled trial design shows whether the intervention worked and is unsuitable for evaluating such complex interventions. Attempting to open the black box of how and why, and for whom in which circumstances such interventions succeed or fail to bring about intended outcomes can be achieved by building and testing models (Nielsen et al., 2016).

Intervention model

Nielsen, Randall, Holten et al. (2010) proposed a revised five-phase intervention model: initiation, screening, action planning, implementation and evaluation. Three fundamental principles go through all five phases: participation, management support and intervention fit.

Participation

Direct employee participation in the design and implementation is central to successful work redesign interventions for purposeful activities that fit the local context, safeguarding intervention ownership and increasing management/employee collaboration (Nielsen & Randall, 2012; Abildgaard et al., 2018). A suggested minimum level for a participatory intervention is initiatives where employees have moderate influence over the content and process (Abildgaard et al., 2018). However, it may increase complexity in specific contexts by involving too many stakeholders with competing ideas and motivations and straining resources (Axtell & Holman, 2018). Employee representatives could be sufficient because they gather additional input from the broad employee group as required (Framke & Sorensen, 2015).

Management support

A lack of support from management can cause difficulties in developing and maintaining the intervention (Montano et al., 2014). Interventions are typically voluntary and purposely driven by, and importance placed on, senior management and line managers. (Mellor et al., 2013; Biron & Karanika-Murray, 2014; Framke et al., 2015). Management should be open to critique and dialogue to pursue progress and ensure changes happen (Jenny et al., 2014). The philosophy of senior management on psychosocial safety climate is an essential predictor of success requiring support, especially at the early stages, through participation, communication and consultation (Dollard, 2012; Biron et al., 2014). However, obtaining senior management support is not alone; over time, it may lessen if progress does not match expectations (Nielsen & Abildgaard, 2013). There is interdependence whereby senior management needs to show support, act as positive role models, and allocate sufficient resources, autonomy and empowerment to line managers and employees (Lingard et al., 2012; Nielsen & Randall, 2013; Greasley & Edwards, 2014). Line managers can make or break an intervention as they are passed the responsibility to make it happen by providing a vision and prioritising as drivers of change (Hasson et al., 2014; Ipsen et al., 2015).

Intervention fit

Research supports that interventions should fit into the organisational context, people, culture, and existing structures (Albertsen et al., 2014; Nielsen & Randall, 2015). The benefits of aligning the intervention with existing objectives may include creating engagement, reducing unintended side effects, and increasing post-intervention sustainability (von Thiele Schwarz et al., 2020). Still, a high level of process flexibility can result in participants perceiving a lack of structure (Jenny et al., 2014).

Initiation

Research suggests establishing a steering committee early in the process with a mixed group (i.e. employees, senior/line managers, key stakeholders, HR & OH functions) with different perspectives working best (Mellor et al., 2011, 2013; Weigl et al., 2013; Jenny et al., 2014; Dollard & Zadow, 2018). Readiness for change can be supported by equipping participants directly involved and engaged with the necessary training to go through this complex decision-making process (Biron et al., 2014). Training line managers to implement and manage teams resulted in employees reporting better intervention implementation, working conditions and well-being (Nielsen, Randall & Christensen, 2010; Nielsen et al., 2017). Furthermore, if line managers return to a context where employees are motivated to work in teams, they can experience increased well-being (Nielsen & Daniels, 2012). A clear communication strategy for managers and employees on roles and responsibilities can lead to better health and well-being outcomes (Augustsson et al., 2015). Internal project champions that are skilled and trusted may be beneficial; if key stakeholders’ responsibilities and alignments are not agreed upon upfront, it can cause inertia (Hasson et al., 2014; Ipsen et al., 2015). Consultants are also vital to ensure activities such as meetings are happening (Framke et al., 2015).

Screening

Identifying problem areas to change provides the contextual development and baseline measurement for evaluating outcomes (Nielsen & Abildgaard, 2013). An appropriate mixed methods design in data collection where qualitative data can show depth and detail complements quantitative data showing breath and representativeness (Abildgaard et al., 2016). Risk assessment is a best practice tool (Dollard et al., 2018). The items within tailored questionnaires capture the local context, develop detailed action plans and create ownership as it is specific to the organisation and real experienced problems (Nielsen et al., 2014). Nevertheless, local context may not allow for specific approaches (i.e. tailored questionnaires) due to resources, and other methods may be more suitable (i.e. cognitive mapping interviews, walkarounds). Support in delivering results, such as providing space and time for employee feedback (i.e. everybody summits) and time-lapse (i.e. short questionnaires on mobile phones), may avoid losing momentum (Jenny et al., 2014). To validate and generate ideas for change, data feedback to the steering committee and employee focus groups is appropriate (Bond et al., 2008).

Action Planning

Typically developed in focus groups or workshops, it can be seen as time-consuming and lacking success if senior management develops action plans as they are further from acute problems than employees (Mellor et al., 2013). Agreement, engagement and positive effects (sense of community) can improve by increasing employee participation in workshops and without senior management to reveal significant problems (Ipsen et al., 2015; Poulsen et al., 2015; Saksvik et al., 2015). Important here to prioritise the resources for action plans on effect-gain balance, and encouraging participants to include some “quick wins” can create momentum and motivation (Axtell et al., 2018; von Thiele Schwarz et al., 2020). Improvement boards can facilitate the development and follow-up of action plans in teams with regular meetings at fixed times and all action plans displayed (Wåhlin-Jacobsen, 2018).

Implementation

Senior and line managers are instrumental in keeping a focus on implementing and following up on action plans (Augustsson et al., 2015; Mellor et al., 2013). Discussions in team meetings need to highlight, are we doing what we agreed to do (Mellor et al., 2011). Barriers may form when line managers are not equipped with available time and resources by senior management (Aust et al., 2010). Action plans implemented and perceived (rated) as improving conditions can result in improved working conditions compared to the baseline and improve well-being, too (Hasson et al., 2014). Changes in teamwork procedures show an improvement in autonomy and direct improvement in well-being (Nielsen & Randall, 2012).

Evaluation

Nielsen and Randall (2013) proposed a process evaluation model with three intervention components that can impact outcomes. Firstly, focusing on the intervention process includes documenting the stakeholders’ motivations, the communication, the action plans developed and implemented, and the substance and nature of change versus the intervention target. Moreover, to explain outcome variations in stress and well-being may benefit from subgroup analysis to verify what participant groups benefited most and the mechanism through which the change occurred can explain variation (Biron et al., 2014).

Secondly, identifying factors that may facilitate or hinder the intervention effects are diverse and multifaceted. Omnibus context focuses on the organisation’s preintervention healthiness, past use of and experiences affecting well-being outcomes, and these include the maturity of work culture, readiness for change, working conditions, and employee health and well-being. Discrete context focuses on concurrent changes occurring during the intervention period. The possibility that different stakeholders will use different/multiple criteria when evaluating stress intervention success should be considered (Biron et al., 2014).

Thirdly, evaluating the participants’ mental models as organisational actors and key stakeholders may have diverse and conflicting agendas that can influence how they behave and react to an intervention. People working closely together may develop similar mental models and react similarly when introduced to an intervention. Conversely, a lack of development of shared mental models may result in conflicting agendas and hinder effective implementation. Measuring the change in participants’ mental models from the intervention is an essential aspect of sustainability. Information at meetings or through newsletters too can substantially impact the mental models and subsequently drive the behaviours of actors (Nielsen & Abildgaard, 2013).

Collecting data throughout the process is essential to avoid retrospective sensemaking as elements of the process, and key stakeholders may change, although this may require more resources and expertise, especially in pressured contexts (Nielsen & Randall, 2013). Although timeline guidance is lacking, a compromise could be to start mid-way using mixed methods with appropriate follow-up times. Other methods include using chronicle workshops and observing the chain of effects in action plans leading to well-being through changing the work conditions (Nielsen & Abildgaard, 2013; Poulsen et al., 2015; Holman & Axtell, 2015).

Conclusion

Implications for practice to consider are to fit the intervention to the organisation context by developing a tailored strategy, the importance of management, both senior and line managers, and participation for using expertise and creating ownership. For the five phases, involvement through steering committees and developing communication plans for preparation, tailoring the screening yet keeping it simple, involving the employees for action planning to turn into tangible changes, managing and monitoring action plans during implementation, and integrating the evaluation into existing practices and developing sustainable changes for future problems.

References

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