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Evaluation of Best Practice
Interventions for Work-related Stress
© PRIMA-EF Consortium
Aim of Study
• To conduct a comprehensive review and
analysis of case studies of evidence-based, best
practice interventions for:
– work-related stress
– bullying and harassment at work and customer
violence
• In a variety of different occupational sectors,
worker groups, enterprise sizes and European
countries
– with a special focus on gender and SMEs
© PRIMA-EF Consortium
Best Practice Inventory
•
A comprehensive literature review of
case studies of psychosocial risk
management interventions for workrelated stress in different occupational
sectors, worker groups, enterprise sizes
and EU countries was conducted
© PRIMA-EF Consortium
Best Practice Inventory - Development
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Using the PRIMA-EF framework, best practice
criteria was formulated and outlined
Evaluation criterion for interventions:
– Sector specificity
– usable with different enterprise sizes
– gender
– Theory based
– Adaptability
– CSR and Social Dialogue
– Quality control
– Evaluation (including process issues,
outcomes and sustainability)
– Benefits (including cost effectiveness)
© PRIMA-EF Consortium
Best Practice Inventory Review
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The inventory was sent to a number of
organizations and researchers/experts
across the EU with extensive expertise
in interventions
These individuals were asked to review
and evaluate the inventory.
Appropriate feedback integrated into
the further development of the
inventory
© PRIMA-EF Consortium
Interviews
•
Complementary data was collected through
semi-structured interviews with experts who
have developed, implemented, and evaluated
interventions.
– With a special focus on work-related stress
and workplace violence and bullying.
– Primary, secondary, tertiary- level
interventions
– In a variety of occupational sectors, size of
enterprise and from various European
countries.
© PRIMA-EF Consortium
Interview: Methodology
Interview
schedule
development
• Inventory
template used
as a general
framework of
schedule
Participants
Identified &
recruited
• Identified by
conducting a
systematic review of
literature on
interventions
(primary, secondary,
tertiary level) from
across Europe.
•Interventions
meeting best
practice criteria
were short-listed,
and author recruited
for participation via
email.
Interviews
•Participants
were briefed
•Aims and
objectives of
project and
ethics were
outlined
•Interviews
were recorded
© PRIMA-EF Consortium
Results
•Interviews
were
transcribed
•Thematic
Analysis
Participants
Total Interviews
N=34
Organisational
Representatives
N=2
UK
Primary-Level
Interventions
N= 10
Secondary-Level
Interventions
N=12
UK
UK
Finland
Netherlands
Norway
Denmark
Spain
Switzerland
Germany Sweden
Norway
Tertiary Level
Interventions
N=10
Finland
Netherlands
International
Portugal
Sweden
Poland
Germany
Belgium
Norway
© PRIMA-EF Consortium
UK
Finland
Netherlands
Norway
Italy
Germany Sweden
Success Factors for Interventions for
Work-related Stress
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Intervention Content:
Aspects and elements of design of intervention
• Theory-based intervention and evidence-based
practice
• Conducting a proper risk assessment
• Tailored-focus/ adaptable approach
• Systematic and stepwise approach
• Accessible to all key stakeholders and userfriendly format
• Comprehensive stress management approach
• Competency building skills development.
© PRIMA-EF Consortium
Success Factors for Interventions for
Work-related Stress
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Intervention Design:
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Evaluation of intervention:
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Strong study design with control
Planned systematic evaluation as part of intervention design
Intervention evaluation should be linked to intervention aims,
goals, and identified problems
Use of a variety of outcomes measures and evaluative approaches
(including process evaluation)
Short-term and long-term follow-up up over several time points
Comparative analysis across groups and sub-groups within
intervention
© PRIMA-EF Consortium
Success Factors for Interventions for
Work-related Stress
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Intervention Context:
– implementation success factors:
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Top-down and bottom-up approach
Facilitate dialogue and communication among key
stakeholders
Raising awareness on psychosocial issues and their
management within organisation
Accessibility and usability of tools, methods and
procedures across all members of the organisation
© PRIMA-EF Consortium
Challenges and Barriers in Interventions for
Work-related Stress Management and
Prevention
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Intervention Context
– Level of organisational readiness to change and the degree of
organisational resistance to change
– Generating achievable and realistic solutions to the identified
problems and cultivating and spurring action to implementing
intervention in a systematic manner
– Retaining and recruiting
» management and organisational support across the intervention
process
» Participation, involvement and engagement of workers
throughout intervention process
– Individual-level
» find suitably trained individuals to implement program
– Organisational level
» Adequately and effectively developing skills, abilities and
sufficient dialogue with management and in the organisation; to
promote the continuous improvement cycle
» Developing and maintaining trust and dialogue between the
various stakeholders throughout the process
© PRIMA-EF Consortium
Challenges and Barriers in Interventions for
Work-related Stress Management and
Prevention
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Intervention Content
– Initiating and designing tools that could be used by
management that are understandable,
comprehensive, user-friendly, and responsive to the
needs of organisation/ work group
– At the level of the individual
» Developing an intervention that while it
remains focused and tailored, also addresses a
large variety of problems and wide spectrum of
ill health, distress and illness
» Knowing when to intervene (i.e., not too early,
not too late)
– Comprehensive stress management and prevention
» Due to a lack of “… research examining and
evaluating of these types of interventions”
(Primary, Netherlands)
© PRIMA-EF Consortium
Challenges and Barriers in Interventions for
Work-related Stress Management and
Prevention
Intervention Design: issues surrounding evaluation
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Attaining a strong research design
• Meeting the defined best practice scientific standards
(i.e., control group & randomization)
Using reliable/valid measurement, especially when
tailoring instruments
Sustainability: adequate period for follow up assessment
to observe ‘real’ changes
• Giving intervention time “to root”
• Attrition rates/ drop out rates
• Maintaining organisational support and access
• Rapidly changing nature of the organisational context
and the impact of turn-over rates
© PRIMA-EF Consortium
Challenges and Barriers in Interventions for
Work-related Stress Management and
Prevention
Intervention Design: issues surrounding evaluation
• Economic Evaluation
• How to accomplish in a systematic way
• Process Evaluation
• Emphasized as important and integral assessing
interventions
• Selection bias
• “worried well”. People that volunteer to participate in
interventions are often not the ones in direct need
• Limitations of natural science paradigm in intervention
evaluation.
• Challenge of systematically evaluating the
effectiveness of interventions within the continuously
changing context of organisations
© PRIMA-EF Consortium
Corporate Social Responsibility
– The majority of experts did not link the
use of psychosocial risk management
to the promotion of responsible
business practices
– however several experts spoke of
promoting the health and wellbeing of
workers as an integral element of
responsible business practice
– Challenge: how to engage companies
that do not demonstrate responsible
business practice
© PRIMA-EF Consortium
Social Dialogue
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Social dialogue at enterprise level seen as
success factor
Several experts spoke of the importance of
extending SD from the enterprise to the
policy level
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“…social dialogue is a valuable tool to make things
happen. You can’t start talking about empowering
people to deal with their own stress if you have
social partners that don’t understand what is going
on. Social dialogue is the key”
Challenge:
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The lack of awareness in the various social partners
in regard to work-related stress and psychosocial
issues in the workplace and negotiating conflicting
political agendas
© PRIMA-EF Consortium
Special Issues: Gender
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Many interventions discussed did not directly address gender
issues in the design of the intervention
• However, gender issues were indirectly addressed during
the implementation of the intervention: i.e., if a problem
was identified
Many experts and practitioners agreed that gender was an
important issue in regards to the prevention and
management of work-related stress.
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However, the challenge knowing how to address these issues
more directly, and adapt and tailor interventions; whilst not
introducing problems
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Key gender issues in relation to the management and
prevention of work-related stress were: work-life balance,
issues surrounding discrimination, career development and
unequal pay
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Gender intrinsically linked to the larger issues surrounding
diversity
© PRIMA-EF Consortium
Special Issues: SME’s
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Majority of interventions discussed had
predominantly been used in large scale and
medium sized companies.
• Few used in micro or small sized
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Participants emphasized the need to adapt
tools and methods for SME’s, this was seen
as priority for interventions for WRS
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Challenge: getting SME’s involved, engaged,
and actively participating in psychosocial risk
management
© PRIMA-EF Consortium
Key Priorities for Action
Developing Capacity Building Programmes to support continuous improvement cycle
Evaluating and researching process issues and mechanisms that underpin
Interventions
Developing the knowledge base on preventative approaches for work-related stress
Research into practice
Developing a framework on guidance and standards for work-related management and
prevention and in their evaluation
Movement towards increased multidisciplinary research and practice
Awareness raising on psychosocial issues in workplace and work-related stress at the
level of the employee and the organisation
Building the business case for psychosocial risk management
More research examining and evaluating comprehensive management interventions
More high quality intervention research and evaluation examining long term effects
Developing and maintaining social dialogue among stakeholders
Increased research and evaluation for organisational level intervention with a complex
system
© PRIMA-EF Consortium
Conclusions
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Observed conceptual overlap between success
factors, challenges and barriers and key priorities
for action in the management and prevention of
work-related stress
Highlighting a increased need to translate
knowledge into practice
Important future direction:
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Need to distinguish and outline best practice criteria
for the evaluation of interventions tailored to the
perspective of the practitioner
© PRIMA-EF Consortium
Thank you for your attention!
Questions?
© PRIMA-EF Consortium