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Objectives

Systematic reviews of organisational health interventions (OHI) show that processes, contexts, stakeholder roles and implementation often are poorly reported in OHI studies. However, this knowledge is a valuable complement to outcome-related knowledge and can contribute to a deeper understanding of the OHI, its effects or failures. The present study aims to analyse how line and middle managers describe enablers and barriers in the implementation of a health-promoting leadership programme in municipal organisations.

Methods

A qualitative case study design was applied to examine a health-promoting leadership programme as a case of OHI implementation. The leadership programme was implemented in two municipal organisations with the intention to change leaders’ behaviours’ into more health-promoting ones by providing on-the-job leadership training (based on transformational leadership and the Job Demands–Resources Model) aiming to improve leadership behaviours’ and employee health. Semi-structured interviews with line and middle managers were conducted (n=11). Interviews with senior managers (n=5), meeting notes, and action plans were used as supplementary data. The interview data were analysed using a thematic analysis.

Results

The line and middle managers describe the leadership programme as a new approach in leadership training as it address employee participation. Similarly, they describe employee involvement as a crucial enabler in the implementation of the leadership programme. Other enablers include action plans with clear goals, experiences of organisational change among employees, and integration of programme content into existing routines and structures. The line and middle managers also point out barriers in the programme implementation, and describe high workload, lack of senior management support, weak programme intensity, competing projects and organisational change as such barriers.

Conclusion

The enablers and barriers found in this study needs to be considered in relation to the organisational context. Especially, the organisational conditions for line and middle managers needs to be given attention. Taken together, these conditions are important in order to facilitate managers acting as drivers of change. The study contributes to the understanding of OHI implementation in public organisations, including lessons learned for both researchers designing and managers being involved in the implementation of OHIs.