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BACKGROUND: Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organisations is needed.

OBJECTIVE: The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organisations.

METHODS: A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis.

RESULTS: The management of WHP was described as a set of components that together contribute to the organisation’s capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components.

CONCLUSIONS: The WHP management approach needs to be broadened to include work environment and organisational factors. Further integration with occupational health and safety and the general management system in the organisations is also needed. 

Keywords: integration, management, occupational health and safety, public sector organisation, workplace health

The aim of this study was to analyze how line and middle managers experience and describe barriers and enablers in the implementation of a health-promoting leadership program in municipal organizations. A qualitative case study design was applied to examine the leadership program in a case involving implementation of an organizational health intervention. Data were mainly collected using semi-structured interviews with line and middle managers participating in the leadership program. Interviews with senior managers, notes from meetings/workshops, and written action plans were used as complementary data. The interview data were analyzed using a thematic analysis, and the complementary data using a summative content analysis. The findings show that the interviewed line and middle managers experienced this leadership program as a new approach in leadership training because it is based primarily on employee participation. Involvement and commitment of the employees was considered a crucial enabler in the implementation of the leadership program. Other enablers identified include action plans with specific goals, earlier experiences of organizational change, and integration of the program content into regular routines and structures. The line and middle managers described several barriers in the implementation process, and they described various organizational conditions, such as high workload, lack of senior management support, politically initiated projects, and organizational change, as challenges that limited the opportunities to be drivers of change. Taken together, these barriers interfered with the leadership program and its implementation. The study contributes to the understanding of how organizational-level health interventions are implemented in public sector workplaces.

Aim

The aim of this explorative study was to investigate the employers’ management characteristics, their provision of workplace health promotion (WHP) measures, and employee satisfaction with WHP in relation to employee health in Swedish municipal social care organizations.

Subjects and methods

A cross-sectional design was used, and questionnaires were sent to top managers (representing the employer) and employees in a nationwide random sample of 60 of the 290 municipal organizations for the social care of elderly and disabled people in Sweden. The questionnaire data from the 60 managers were linked to aggregated employee data concerning self-rated health and satisfaction with WHP from a representative sample of 8,082 employees in the same organizations. All analyses were performed at the organizational level using independent t-test, Spearman’s rank correlation and multiple linear regression analysis.

Results

In the multivariate analysis, the organizational WHP index (i.e. local WHP projects and WHP coordinators), individual WHP index (i.e. health profile assessment, fitness activities and medical check-up), and the level of employees’ satisfied with WHP were associated with employee health (F = 9.64, p < 0.001, adjusted R² = 0.48). General organizational and management characteristics were, however, not statistically related to employee health.

Conclusion

The results suggest that the provision of individual-directed and organizational-directed health-specific measures were related to employee health in Swedish municipal social care organizations and, therefore, can be part of a comprehensive approach to address WHP.

Purpose - The purpose of this paper is to investigate general psychosocial work conditions and specific workplace health promotion (WHP) measures in relation to employee health and sickness absence in Swedish municipal social care organizations. Design/methodology/approach - In a random sample of 60 out of the 290 municipalities in Sweden, 15,871 municipal social care employees working with elderly and disabled clients were sent a questionnaire concerning psychosocial work environment, WHP, and self-rated health. The responses (response rate 58.4 per cent) were complemented by register data on sickness absence (&amp;gt;14 days). All data were aggregated to employer level. Findings - A structural equation modelling analysis using employer-level data demonstrated that employers with more favourable employee ratings of the psychosocial work conditions, as well as of specific health-promoting measures, had better self-rated health and lower sickness absence level among employees. Practical implications - The results from this representative nationwide sample of employers within one sector indicate that employers can promote employee health both by offering various health-specific programmes and activities, such as work environment education, fitness activities, and lifestyle guidance, as well as by forming a high-quality work environment in general including developmental and supportive leadership styles, prevention of role conflicts, and a supportive and comfortable social climate. Originality/value - This study with a representative nationwide sample demonstrates: results in line with earlier studies and explanations to the challenges in comparing effects from specific and general WHP interventions on health.

En jämförande studie inom vård och omsorg i ett representativt urval av 60 av Sveriges 290 kommuner visar att det finns tydliga samband mellan arbetsgivarens sätt att leda och organisera verksamheten och medarbetarnas hälsa och sjukfrånvaro. Både specifika hälsofrämjande åtgärder, ledarskap och socialt klimat har betydelse. Externa strukturella områdesfaktorer, som sociodemografi och arbetsmarknad samt attityder till när det är acceptabelt att sjukskriva sig, har också betydelse dock utan att reducera sambandet med de interna organisationsfaktorerna. Det finns alltså goda skäl för arbetsgivaren att bedriva ett målmedvetet och aktivt hälsofrämjande arbete både genom direkta individinriktade insatser och genom organisatoriskt stöd för hälsoarbetet. Detsamma gäller ett mer allmänt utvecklingsinriktat och stödjande ledarskap.

A comparative study of the social care organizations in a representative sample of 60 out the 290 municipalities in Sweden demonstrates significant associations between the employer’s way of organizing the work and the employees’ health and sickness absence. Specific workplace health promotion measures, as well as leadership styles and social climate are of importance. External structural regional factors such as sociodemography and labour market, as well as sickness absence culture have influence too, however without reducing the association to the internal factors concerning workplace health promotion, leadership and social climate. Accordingly, there are good reasons for employers to engage in health promotion activities both by individual-directed measures and by organizational support. The same is true for a more general developmental and supportive leadership style.

There is abundant documentation in research about the significant relationship between physical activity and mental health, but there is still more to be learned about what can enhance motivation to become more physically active. Fourteen persons with psychiatric disabilities were interviewed about their experiences of being physically active, and data was analyzed using a phenomenologicalhermeneutic method. Five themes emerged: Capability for Living, Liberation from a Heavy Mind, Companionship in Being in Motion, Longing for Living One’s Life, and Struggling with Limitations. The interpreted meaning of being physically active was to be moving toward reclaiming one’s life.

The aim of the study was to survey the self-reported health and physical activity in a sample of community mental healthcare users in a city of Sweden. The study was conducted through a cross-sectional design with participants requested to fill out a self-report questionnaire. Participants (n =103) were persons with psychiatric disabilities living in residential psychiatric settings and/or participating in daily activities provided by community mental healthcare services. The results showed that the group is affected with serious risk factors, such as high body mass index, low rated extent and frequency of physical activity and low self-estimated general state of health. Even though some difficulties associated with the answering process of this questionnaire emerged, these self-reported results clearly confirm the fact that persons with psychiatric disabilities constitute a vulnerable group in need for health-promoting caring activities and interventions.