Jonathan Houdmont

Evaluating organizational-level work stress interventions: Beyond traditional methods

Abstract Since the early 1990s, there has been a growing literature on organizational-level interventions for work-related stress, and associated calls for such interventions to be evaluated. At the same time, doubts have been expressed about the adequacy of traditional scientific research methods in applied psychology (the natural science paradigm) in providing an effective framework for such evaluations. This paper considers some of the philosophical and methodological issues raised by evaluation research in relation to organizational-level interventions for work-related stress. Four key issues are discussed: the concept of a study being “fit for purpose” in relation to research designs and the nature of acceptable evidence; the issue of control of research conditions in real-world studies; the need to evaluate process as well as outcome, including the interrelated nature of process and outcome; and the interpretation of imperfect evidence sets. The starting point of this paper is the reality of organizational life, which is complex and continually changing. Its main objective is not to offer an alternative to a scientific approach but to argue for a more broadly conceived and eclectic framework for evaluation that acknowledges the limitations of the traditional approach. It espouses an approach that is reflective of the reality of organizational life and in which the methods used for evaluating an intervention are fit for purpose. The paper concludes by offering an outline framework for this broader approach to the evaluation of interventions.

Testing a Model of Officer Intentions to Quit The Mediating Effects of Job Stress and Job Satisfaction

Voluntary turnover among law enforcement personnel is a significant concern. However, few studies have considered potential intermediate linkages in the relationship between working conditions and officers’ quit/stay intentions. Utilizing a large cross-sectional sample of U.K.-based officers (n = 1,789, response rate = 25%), a mediational model of officer turnover intentions was tested. Findings indicated that a number of key psychosocial conditions specified in the U.K. Health and Safety Executive Management Standards Indicator Tool (e.g., job demands, role clarity) were associated with officer intentions to leave; however, when job stress and job satisfaction were entered into the model, these relationships were either reduced, or no longer significant. Findings indicated that task-oriented conditions were more strongly associated with job stress while relational or socially oriented conditions were stronger predictors of job satisfaction. These results highlight that monitoring stress and satisfaction may be a valuable component of officer retention efforts, and could offer early-warning of impending turnover among staff.

Organisational psychosocial hazard exposures in UK policing: Management standards indicator tool reference values

Purpose: There is a paucity of contemporary evidence on the organizational (as opposed to operational) psychosocial hazard (OPH) exposures of UK police officers. The purpose of this study is to report on OPH exposures measured via an instrument developed by the UK government - the Management Standards Indicator Tool - among police officers sampled from an entire UK force. The study provides reference values for UK police officers’ OPH exposures, considers these in relation to government exposure targets, and examines the association between officers’ OPH exposures and perceived work-related stress. Design/methodology/approach: Police officers (n = 1,729) completed the Management Standards Indicator Tool which measures perceived exposure to seven psychosocial work environment dimensions: demands, control, managerial support, peer support, relationships, role, and change. In addition, a single-item measure of perceived work-related stress was applied. Findings: Sector-specific reference values were generated by job role and rank on each of the seven dimensions assessed by the Indicator Tool. Scores on all seven dimensions were below government target levels (indicating that scores fell below the 80th percentile in relation to benchmark data). 46% of police officers reported their work to be very or extremely stressful. A significant positive correlation (p < .01) was found between scores on each of the seven psychosocial work characteristics and perceived work-related stress. Originality/value: This study is the first to report on the assessment of UK police officers’ OPH exposure using the Management Standards Indicator Tool. It provides reference values that UK forces will find useful for benchmarking and intervention-targeting purposes, and against which progress in reducing OPH exposures can be assessed.

Work-related stress case definitions and prevalence rates in national surveys

BACKGROUND There is concern about lack of consistency in the design of case definitions used to measure work-related stress in national workforce surveys and the implications of this for the reliability and validity of prevalence estimates as well as for developments in policy and practice on tackling work-related stress. AIMS To examine associations between case definitions used for the measurement of work-related stress in nationally representative workforce surveys and the prevalence rates generated. METHODS The study focused on 18 nationally representative workforce surveys conducted between 1995 and 2008 that involved British samples. The published report from each survey was scrutinized for evidence of the case definition used to measure work-related stress and the associated prevalence rate. RESULTS Several types of case definition were identified that differed in terms of their theoretical basis, structure, and content. Each was associated with a unique range of prevalence rates. CONCLUSIONS The results illustrate the challenge presented to the production of valid and reliable estimates of the scale of work-related stress by inconsistent case definition design. The imperative for theory-based consistency in the design of case definitions used for the measurement of work-related stress in national workforce surveys is highlighted.

The Management Standards Indicator Tool and the estimation of risk

BACKGROUND The Health & Safety Executives (HSE) Indicator Tool offers a measure of exposure to psychosocial work conditions that may be linked to stress-related outcomes. The HSE recommends that Indicator Tool data should be used as a basis for discussions concerned with the identification of psychosocial work conditions that might warrant prioritization for intervention. However, operational constraints may render discussions difficult to convene and, when they do take place, the absence of information on harms associated with exposures can make it difficult to identify intervention priorities. AIMS To examine (i) the utility of the Indicator Tool for the identification of a manageable number of psychosocial work conditions as intervention candidates and (ii) whether administration of a measure of stress-related outcomes alongside the Indicator Tool can facilitate the identification of intervention priorities. METHODS One thousand and thirty-eight employees in the London region of the Her Majestys Prison Service completed the Indicator Tool and a measure of psychological well-being. Odds ratios were calculated to estimate the risk of impairment to well-being associated with exposure to psychosocial work conditions. RESULTS The Indicator Tool identified 34 psychosocial work conditions as warranting improvement. Intervention priority was given to those working conditions that were both reported to be poor by ≥50% of respondents and associated with risk of impairment to well-being. This method allowed for the identification of four areas. CONCLUSIONS Augmentation of the Indicator Tool with a measure of stress-related outcomes and the calculation of simple risk estimation statistics can assist the prioritization of intervention candidates.

Overweight and obesity in UK firefighters

BACKGROUND Obesity among firefighters can present a hindrance to operational effectiveness. In North American studies, 80% of US firefighters are overweight or obese. No studies have explored obesity among firefighters in the UK, and it is unclear whether obesity is a problem among UK firefighters. AIMS To establish the prevalence of obesity among a large sample of firefighters in the UK and to explore changes in body mass index (BMI) over a 3-year period. METHODS The BMI and body composition of 735 male firefighters from a UK county fire and rescue service were assessed in 2008 and 2011. RESULTS In 2008, 65% of the firefighters were either overweight (54%) or obese (11%). In 2011, slightly fewer firefighters were overweight (53%), but the proportion classified as obese increased significantly to 13%. Those classified as normal weight in 2008 were more likely to have gained weight by 2011 in comparison with those categorized as obese at baseline. A lower proportion of firefighters were classified as high risk for obesity based on their waist circumference in 2008. CONCLUSIONS The proportion of firefighters who are either overweight or obese is lower in this UK sample than that found in US studies. Nevertheless, the proportion of UK firefighters classed as overweight was higher than that found in the general population samples from England. Given the negative implications of obesity for performance, there is a need for further investment in theory-based, sector-specific health promotion research and practice.

Psychosocial risk assessment in organizations: Concurrent validity of the brief version of the Management Standards Indicator Tool

The Management Standards Indicator Tool (MSIT) is a 35-item self-report measure of the psychosocial work environment designed to assist organizations with psychosocial risk assessment. It is also used in work environment research. Edwards and Webster presented a 25-item version of the MSIT based on the deletion of items having a factor loading of < .65. Stress theory and research suggest that psychosocial hazard exposures may result in harm to the health of workers. Thus, using data collected from three UK organizations (N = 20,406) we compared the concurrent validity of the brief and full versions of the MSIT by exploring the strength of association between each version of the instrument and a measure of psychological wellbeing (GHQ-12 and Maslach Burnout Inventory). Analyses revealed that the brief instrument offered similar but not always equal validity to that of the full version. The results indicate that use of the brief instrument, which would be less disruptive for employees, would not elevate the risk of false negative or false positive findings in risk assessment.

The impact of two workplace-based health risk appraisal interventions on employee lifestyle parameters, mental health and work ability: results of a randomized controlled trial

Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental health and work ability in a UK context. A total of 180 employees were randomized into one of three groups: Group A (HRA augmented with health promotion and education activities), Group B (HRA only) and Group C (control, no intervention). After 12 months, changes in mean scoring in 10 lifestyle, mental health and work ability indices were compared, Groups A and B demonstrated non-significant improvements in 70% and 80%, respectively, compared with controls (40%). Odds ratios revealed that, compared with the control group, Group A was 29.2 (95% CI: 9.22-92.27) times more likely to report a perceived change in lifestyle behaviour; Group B 4.4 times (95% CI: 1.65-11.44). In conclusion, participation in the HRA was associated with a higher likelihood of perceived lifestyle behaviour change which was further increased in the augmented HRA group, thereby providing preliminary evidence that HRA and augmented HRA in particular may help UK employees make positive healthy lifestyle changes.

Occupational health professionals’ knowledge, understanding and use of work ability

Background The concept of work ability (WA) has a 30-year history in Finland, where it has been used extensively in occupational health (OH) research and practice. The extent to which WA has been integrated into UK OH practice is unclear. Aims (i) To compare knowledge, understanding and use of WA among OH nurses and physicians in the UK and Finland and (ii) to identify factors that influence the use of WA in Finnish OH practice. Methods An online questionnaire administered to OH practitioners in the UK and Finland. Results A total of 436 UK and 97 Finnish OH practitioners completed the questionnaire. Though familiarity with the term ‘work ability’ was similar among Finnish and UK respondents, substantial differences were found in understanding of the term. Ninety-five per cent (Finland) and 7% (UK) of respondents reported using the Work Ability Index (WAI), a validated measure of WA, in their practice. Finnish respondents indicated that they used the WAI results primarily for individual case management, understanding population health trends, health promotion and determining WA across age groups. UK respondents primarily attributed failure to use the WAI to lack of training. Primary factors influencing use of WA in Finland included it being considered common practice and an effect ive system by which to conduct individual assessments. Conclusions There are large differences between Finland and the UK in the assessment of WA in OH practice. Differences may reflect contrasting OH legislative frameworks.

Rail safety in Britain: An occupational health psychology perspective

As occupational health psychology matures, it will become involved in a more detailed way in areas ofspecific concern, and it will outgrow its recent over-dependence on a small number of very generalconcerns such as work stress and burnout. One example of all area of potential interest andopportunity is that afforded by rail safety. This paper discusses the position in Britain. It outlines thehistory and nature of safety management in the rail industry following privatisation in the 1990s. Itthen describes recent changes in safety thinking that could represent a mini-paradign shift and thatopen the door to the more active involvement of occupational health psychologists.