We conducted this realist evaluation study of an organizational health intervention involving 421 low-skilled workers (50% female), half of whom were immigrants, in three companies over six months. Non-profit agencies implemented peer-mentoring and taught peer-mentors and line managers how to enhance social support in order to improve workers’ work situation in a participative way. We formulated five mechanisms of change: the company management encouragement mechanism, the role model mechanism, the peer-mentor support mechanism, the line manager support mechanism, and the participative work improvement mechanism. We combined realist evaluation with a quasi-experimental design and process evaluation in a multi-methods approach. Results of multiple group latent change models and qualitative research showed that intervention-group workers perceived increases in peer-mentor support but not in line manager support. Peer-mentors managed to initiate high-quality improvements at work. Intervention-group workers showed significant reductions in blood pressure. Control-group workers experienced more psychosomatic complaints over time in significant contrast to intervention-group workers. Our results suggest that peer-mentoring offers an effective way for low-skilled workers and immigrants to achieve better health. To improve such health effects, a greater focus on line managers’ work situations is needed to help them provide support.

In this study, the authors analyze leadership behaviors as potential health-promoting resources for low-skilled workers in a highly culturally diverse work setting. The authors hypothesize that subordinates' and supervisors' individual power distance orientations will moderate the effect of subordinates' perceptions of leadership behavior and the subsequent effects on their well-being. Multilevel modeling is used to analyze a sample of data from 474 low-skilled employees (50% immigrants) and 35 direct supervisors from three German companies. Supporting the hypotheses, social support, task-related communication, and positive feedback, as expressions of esteem, are found to positively impact subordinates' well-being, but individual consideration shows no significant effects. Furthermore, results confirm that supervisors' power distance orientation moderates employees' perceptions about supervisors' positive feedback and the subsequent well-being effects. The moderating effect fails to hold for employees' power distance orientation. Results indicate that supervisors can most effectively promote the health of low-skilled workers by showing esteem through positive feedback, but if the supervisor has high individual power distance orientation, the effect is attenuated.

About 16% of the German workforce is low skilled (Lyly-Yrjänäinen, 2008), including formally qualified employees who work in positions that do not require formal training. These educated employees in the low-skilled workforce are often immigrants with meager German language skills or workers who lack an occupational qualification that is accepted in Germany. Therefore, low-skilled workforces are characterized by a high proportion of immigrant workers (Hoppe, 2011;Seebaß & Siegert, 2011). On the other hand, workers who have completed their vocational educations are also often employed in low-skilled jobs due to poor employment opportunities in their regular professions. Low-skilled jobs have comparatively unfavorable general working conditions such as high physical demands, job insecurity, rotating shift work, and time pressure (e.g.,

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