A process evaluation of individual and organizational occupational stress and health interventions

There is reason to believe that many health and stress interventions fail due to inattention to the effects of intervention implementation processes, but evaluations of these processes are found only rarely in the literature. The objective of the present study was to explore the issue of obstacles to implementation that may occur when stress and health interventions are introduced in work organizations. The study was conducted as a process evaluation of seven different individual and organizational interventions. Interviews were conducted in 22 post offices, 12 organizational units (such as care homes and local administrative units) of a Norwegian municipality, and in 10 shops in a shopping mall. The interviews took place before and after the interventions. The following key process factors were identified: (1) the ability to learn from failure and to motivate participants; (2) multi-level participation and negotiation, and differences in organizational perception; (3) insight into tacit and informal organizational behaviour; (4) clarification of roles and responsibilities, especially the role of middle management; and (5) competing projects and reorganization. For improved studies of interventions in the future we recommend that qualitative and quantitative methods be combined, that researchers build more on natural interventions that occur naturally within the organization, and that a pilot study be undertaken in order to investigate the cultural maturity of the organization.