Managing Workplace Health Promotion in Municipal Organizations

The workplace is a suitable setting for health promotion, not least due to the amount of time employees spend at work. Previous research indicates large variations in employers' handling of workplace health promotion (WHP) efforts. However, more empirical knowledge of how WHP is handled in public sector organizations is needed. The overall aim of the thesis was to explore how WHP is managed and implemented in municipal organizations. The thesis draws on health promotion as the point of departure, further accompanied with concepts related to organizational change and implementation research. The thesis is based on three studies using different empirical materials. Both quantitative and qualitative research designs were used. In the first study, questionnaires were sent to both top managers and employees in a nationwide random sample of 60 of the 290 municipal social care organizations in Sweden. Data were analysed at the organizational level, linking WHP measures provided by the employer to employee health. In the second study, interviews concerning the management of WHP were carried out with senior managers representing various departments in two municipalities. The third study analysed the implementation of a health-promoting leadership programme, and the interviews made, concerned the experiences of line and middle managers participating in the programme. The results show that the provision of individualand organizational-directed WHP measures was associated to employee health at the organizational level. Furthermore, the senior managers described WHP management as components contributing to the organization's capacity for WHP. However, they mainly described WHP as providing healthy lifestyle activities, and mapping working conditions and employee health. In the study analysing the implementation of the leadership programme, line and middle managers described employee involvement as an enabling factor, whereas high workload and lack of senior management support were barriers described. Recurrent organizational changes and other politically-initiated projects and routines were also pointed out as competing events in the implementation process. From this thesis, it can be concluded that WHP management is dominated by measures directed towards the individual employee and needs to include more of psychosocial and organizational measures. Finally, the varied organizational conditions for municipal managers as well as the support from senior management and human resources staff needs to be considered and ensured as part of an active and continuous WHP practice. ISBN 978-91-7485-183-0 ISSN 1651-4238 Abstract The workplace is a suitable setting for health promotion, not least due to the amount of time employees spend at work. Previous research indicates large variations in the ways that employers provide and manage workplace health promotion (WHP) efforts and programmes. To understand these variations, further empirical knowledge of how WHP is managed in public sector organizations is needed. To assist in this effort, this thesis aimed to explore how WHP is managed and implemented in municipal organizations. Drawing on health promotion as a point of departure, this thesis also identified and applied concepts related to organizational change and implementation research. Using both quantitative and qualitative research designs, three studies were conducted using different empirical approaches. In the first study, questionnaires were sent to both the top managers and employees of a nationwide random sample of 60 of the 290 municipal social care organizations in Sweden. The collected data were analysed at the organizational level to investigate the associations between WHP measures offered and employee health. In the second study, interviews concerning the management of WHP were conducted with senior managers representing various departments in two municipalities. In the third study, interviews were conducted with line and middle managers participating in a health-promoting leadership programme to analyse its implementation in two municipal organizations. The findings of the studies revealed that individualand organizationaldirected WHP measures are associated with better employee health at the organizational level. In the second study, senior managers mainly described WHP as providing healthy lifestyle activities, and mapping working conditions and employee health. In the third study, which examined the implementation of the leadership programme, line and middle managers described employee involvement as an enabling factor and, high workload and lack of senior management support as barriers. They also described recurrent organizational changes and other politically initiated projects and routines as competing events in the implementation process.