To facilitate evaluation of complex, organisational health interventions (OHIs), this paper aims at developing a context, process, and outcome (CPO) evaluation model. It builds on previous model developments in the field and advances them by clearly defining and relating generic evaluation categories for OHIs. Context is defined as the underlying frame that influences and is influenced by an OHI. It is further differentiated into the omnibus and discrete contexts. Process is differentiated into the implementation process, as the time-limited enactment of the original intervention plan, and the change process of individual and collective dynamics triggered by the implementation process. These processes lead to proximate, intermediate, and distal outcomes, as all results of the change process that are meaningful for various stakeholders. Research questions that might guide the evaluation of an OHI according to the CPO categories and a list of concrete themes/indicators and methods/sources applied within the evaluation of an OHI project at a hospital in Switzerland illustrate the model's applicability in structuring evaluations of complex OHIs. In conclusion, the model supplies a common language and a shared mental model for improving communication between researchers and company members and will improve the comparability and aggregation of evaluation study results.

This field study evaluates the process and outcome of an organizational-level stress management intervention (SMI) in eight companies, taking into account the lessons learned from previous evaluation research. It utilizes the RE-AIM evaluation framework to capture the Reach and Adoption of the intervention in the companies, the appraisal of the Implementation process and the project's Effectiveness and Maintenance with a range of qualitative and quantitative methods. It applies an adapted research design in the context of a field study involving entire organizations, retrospectively assigning study participants to comparison groups. The results of a longitudinal analysis (n = 1400) showed that the SMI had a positive impact on the participants' job demands and resources, when controlled for baseline levels. Qualitative data analysis revealed that the companies had built capacities for ongoing health promotion and showed what issues must be borne in mind when implementing such projects. The study also showed that participation in such interventions alone does not suffice to achieve the desired impact, but that the individual participants' appraisal of the intervention and the collective involvement of the teams must be further researched to fully understand how change occurs.

This study investigates the relationship between outcome expectancy for an individual stress management course and the total perceived impact of a comprehensive stress management intervention (SMI). It is based on data from three different measurement points from a longitudinal SMI in Switzerland. Individual and organizational outcome expectancies for stress management courses were captured with two newly developed items (SMI outcome expectancy) immediately after course completion. Perceived individual and organizational impacts of the overall intervention captured with two items of a retrospective impact assessment scale (perceived SMI impact) at the two-year follow-up survey were used as the outcome measurement. Baseline individual and organizational change commitments (as rated by participants) were included in the analyses as possible moderators. Regression analyses show that individual and organizational outcome expectancies in respect of stress management courses can to some extent predict the perceived impact of the intervention as a whole. At the individual level, an intervention will be perceived as most successful when participants already have a high individual change commitment and develop high outcome expectancies during stress management courses.Keywords: stress management intervention, process evaluation, change process, outcome expectancy, change commitment OUTCOME EXPECTANCY IN COMPREHENSIVE SMI 2 2 Outcome expectancy as a process indicator in comprehensive worksite stress management interventions In recent years, various studies have shown that work-related stress is associated with physical and social health problems for employees and with negative economic consequences for organizations (cf. Bond, Flaxman, & Loivette, 2006;van der Hek & Plomp, 1997). This insight has prompted an increase in worksite stress management interventions (SMIs) addressing psychosocial job-stress factors and coping strategies, and in studies assessing the impact of such interventions. Initially, most SMIs were conducted at the individual level (Giga, Noblet, Faragher, & Cooper, 2003)-that is, focusing on changing the individual's perception of stress and teaching participants how to cope with stress, which should ideally lead to experiencing reduced stress. At the organizational level, however, SMIs that aim at promoting organizational change processes-such as reducing organizational stressors or enhancing resources-and comprehensive SMIs involving a combined focus on both the individual and the organization are gaining increased attention (LaMontagne, Keegel, Louie, Ostry, & Landsbergis, 2007).Diverse meta-analyses (e.g., Richardson & Rothstein, 2008;van der Klink, Blonk, Schene, & van Dijk, 2001) and reviews (e.g., Bambra, Egan, Egan, 2013;Egan et al., 2007;Giga et al., 2003;LaMontagne et al., 2007;Murphy, 1996) have sought a) to investigate whether worksite SMIs are effective in general and b) to identify the most promising types of worksite SMIs. These reviews and metaanalyses report generally positive...

Purpose The purpose of this paper is to investigate whether intervention participants’ process appraisals relate to change in well-being and lean outcomes of entire teams. For this purpose, the study focussed on two main characteristics of a lean implementation process – workshop quality and outcome expectancy – and their interaction with the participation rate, and examined their association with leaner work processes and affective well-being in nursing teams. Design/methodology/approach Data were collected from a lean implementation project within 29 nursing wards of a university hospital. Employee surveys covering lean work processes and affective well-being at work were conducted before the implementation of four-day lean workshops in each nursing ward and six months after. The participating employee representatives evaluated the workshop quality and outcome expectancy of the workshops. Findings Multilevel analyses indicated that workshop quality did not relate to leaner work processes, but was associated with enhanced affective well-being after six months. By contrast, outcome expectancy was associated with leaner work processes, but did not relate to well-being. No moderation effects with participation rate were found. Practical implications The study shows the importance of monitoring process indicators in the early stages of implementation and optimising workshop contents and formats accordingly to ensure positive outcomes for entire teams. Originality/value The present study considers intervention participants’ process appraisals of workshop quality and outcome expectancy as good indicators of future change in lean work processes and the well-being of entire teams.