Workplace health promotion participation in German companies – revisiting a theoretical approach using empirical enrichment
Year: 2024
Type: dissertation
Abstract: Background: International declarations emphasize that the workplace is a crucial setting to strengthen the health and well-being of the working population. However, participation rates in workplace health promotion (WHP) measures typically remain low. While empirical evidence exists for factors of WHP participation, the disparity between WHP offers and participation in Germany, specifically the role of organizational characteristics, is not fully understood yet. This calls for a theory-driven approach and investigation of workplace actors’ perceptions to better understand conditions of and reasons for WHP participation in companies. Objectives: In light of the research state, this cumulative dissertation aims at investigating perceived underlying factors of WHP participation in German companies and integrating them into an overarching theoretical approach. More specifically, Andersen’s Behavioral Model of Health Services Use is employed and supplemented by Schwarzer’s Health Action Process Approach (HAPA) to integrate and discuss empirical findings. Methods: Knowledge is generated using three empirical studies. (1) First, qualitative crosssectional interviews with eight occupational physicians are content-analyzed to explore their perspectives on factors of employee participation in WHP. Interviews with occupational physicians resulted from the process evaluation of a musculoskeletal measure in 22 companies. (2) Second, quantitative and qualitative cross-sectional data of an online mixedmethod survey with managers (n=179) of a large Information and Communications Technologies (ICT)-company are analyzed that address managers’ WHP participation and their own reasons for not participating in WHP. (3) Third, implications resulting from findings of a quasi-experimental pre-post-comparison of a workplace mindfulness training with ICTmanagers of the same company (n=56) are integrated to discuss how WHP participation can be promoted in general (3). Results: Framed by Andersen’s model, organizational and individual factors of WHP participation emerge from the empirical findings. Organizational factors such as tailored, target-oriented implementation of WHP measures, financial compensation, and an established collaborating WHP network appear as conducive for participation, while variable working locations/times and high workload appear as impeding for participation. On the individual level, conducive factors of WHP participation include perceived WHP availability, social support, and favorable benefit expectation, while impeding factors include individual time conflicts, no perceived need for WHP or severe health conditions. In the subsequent combination of Andersen’s model with the HAPA, empirical outcomes, workplace barriers and resources for the maintenance of learned health-promoting behavior following WHP participation emerge. Theoretical implications stemming from the models’ combination are discussed in light of facilitating (re-)use of WHP and maintaining beneficial organizational outcomes. Conclusion: The findings affirm certain organizational and individual factors of WHP participation identified in the research state, while more differentiated factors are contributed from the perspectives of occupational physicians and ICT-managers. Aside from the empirical findings, the overarching perspective of Andersen’s model combined with the HAPA generates further theoretical implications for the promotion of WHP participation. Thus, the dissertation contributes an empirically enriched theoretical approach that can be used by researchers and practitioners for further investigation and practical promotion of WHP participation in companies.
Author: Schubin, Kristina
Institution: University of Cologne
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Award: G7453130917
OpenAlex ID: W7063084403