© PRIMA-EF Consortium 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 work- related stress in different occupational sectors, worker groups, enterprise sizes and EU countries was conducted © PRIMA-EF Consortium

Best Practice Inventory - Development –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 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 . Interviews Participants were briefed Aims and objectives of project and ethics were outlined Interviews were recorded Results Interviews were transcribed Thematic Analysis © PRIMA-EF Consortium

Participants Total Interviews N=34 Primary-Level Interventions N= 10 Secondary-Level Interventions N=12 Tertiary Level Interventions N=10 Organisational Representatives N=2 UKFinland Netherlands NorwayDenmark SpainSwitzerland GermanySweden UKFinland Netherlands International PortugalSweden PolandGermany BelgiumNorway UKFinland Netherlands NorwayItaly GermanySweden UKNorway © PRIMA-EF Consortium

Success Factors for Interventions for Work-related Stress 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 user- friendly format Comprehensive stress management approach Competency building skills development. © PRIMA-EF Consortium

Success Factors for Interventions for Work-related Stress Intervention Design: –Evaluation of intervention: 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 Intervention Context: –implementation success factors: 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 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 –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 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 –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 “…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: 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 –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. However, the challenge knowing how to address these issues more directly, and adapt and tailor interventions; whilst not introducing problems –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 –Gender intrinsically linked to the larger issues surrounding diversity © PRIMA-EF Consortium

Special Issues: SME’s –Majority of interventions discussed had predominantly been used in large scale and medium sized companies. Few used in micro or small sized –Participants emphasized the need to adapt tools and methods for SME’s, this was seen as priority for interventions for WRS –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 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: 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