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. 2019 Apr 27;16(9):1494.
doi: 10.3390/ijerph16091494.

Prospective Evaluation of Fidelity, Impact and Sustainability of Participatory Workplace Health Teams in Skilled Nursing Facilities

Rajashree Kotejoshyer  1 , Yuan Zhang  2 , Marian Flum  3 , Jane Fleishman  4 , Laura Punnett  5
Affiliations

Prospective Evaluation of Fidelity, Impact and Sustainability of Participatory Workplace Health Teams in Skilled Nursing Facilities

Rajashree Kotejoshyer et al. Int J Environ Res Public Health. .

Abstract

Organizational features of work often pose obstacles to workforce health, and a participatory change process may address those obstacles. In this research, an intervention program sought to integrate occupational safety and health (OSH) with health promotion (HP) in three skilled nursing facilities. Three facilities with pre-existing HP programs served as control sites. The intervention was evaluated after 3-4 years through focus groups, interviews, surveys, and researcher observations. We assessed process fidelity in the intervention sites and compared the two groups on the scope of topics covered (integration), program impact, and medium-term sustainability. The intervention met with initial success as workers readily accepted and operationalized the concept of OSH/HP integration in all three intervention facilities. Process fidelity was high at first but diminished over time. At follow-up, team members in two intervention sites reported higher employee engagement and more attention to organizational issues. Two of the three control facilities remained status quo, with little OSH/HP integration. The intervention had limited but positive impact on the work environment and health climate: staff awareness and participation in activities, and organizational factors such as decision-making, respect, communication, and sharing of opinions improved slightly in all intervention sites. Resources available to the teams, management support, and changing corporate priorities affected potential program sustainability.

Keywords: integration; occupational safety and health; participatory workplace program; process fidelity; program impact; sustainability; workplace health promotion.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Timeline of the participatory intervention process and impact evaluation. HP, health promotion; PIP, participatory intervention program; CPH-NEW, Center for the Promotion of Health in the New England Workplace.
Figure 2
Figure 2
Participatory Intervention Design within Centers.
See this image and copyright information in PMC

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