Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice

de Lange, A. and Teoh, Kevin and Fleuren, B. and Medisauskaite, Asta and Løvseth, L. and Reig-Botella, A. and Brulin, E. and Innstrand, S. and Lundmark, R. and van Dorssen, P. and Bååthe, F. and Heijkants, C. and Furunes, T. and Correia, I. (2024) Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice. Work & Stress: An International Journal of Work, Health & Organisations , ISSN 0267-8373.

Abstract

Extant research suggests the effectiveness of Occupational Health Psychology (OHP) interventions depends on their design in the broader organizational context. While the field recognizes that pre- and posttest evaluation do not sufficiently capture the complex dynamics around OHP interventions, complex multi-level OHP interventions are still scarce in the literature. As established intervention implementation frameworks suggest, it remains difficult to address this complexity in practice. The present position paper re-evaluates lessons learned from two complex European OHP intervention projects, by applying the Integrated Process Evaluation Framework (IPEF) and related theories to bridge the gap between the theoretically recognized complexity and practical challenges. The re-evaluations emphasize that program-multilevel theories rooted in OHP-perspectives contribute to adequately hypothesizing around systemic factors and mechanisms relevant to OHP interventions. Concretely, middle range theories that outline how an intervention’s mechanisms work within a specific context to produce certain outcomes are crucial. Additionally, strategically and actively involving key stakeholders at all levels of the system and across the different intervention phases improves the embedding of OHP interventions in organizations. We elaborate on these insights with seven concrete recommendations for complex OHP intervention research.

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