What is actually measured in process evaluations for worksite health promotion programs: a systematic review

Abstract

BackgroundNumerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process.MethodsPubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years.ResultsOf the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program.ConclusionsProcess evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components.

Process variables in organizational stress management intervention evaluation research: a systematic review

“…The specific components are listed in table 1. Process variables were coded using a list of concepts derived from process evaluation literature (9,11,13,15,17). During coding, the researchers used the list of concepts as a frame of reference, as a starting point.…”

“…Intervention characteristics were adapted from Murta and colleagues (15). The process evaluation methods components were adapted from Wierenga and colleagues (17). The specific components are listed in table 1.…”

Unifying and diversifying workplace-based efforts for promoting health and preventing disability

“…The body of knowledge assessing WHPP's effectiveness is increasing [4][5][6]. A systematic review found more than 300 trials of WHPP published between 2000 and 2012 [5].…”

“…A systematic review found more than 300 trials of WHPP published between 2000 and 2012 [5]. Still, the effectiveness of such interventions is for several of the targeted lifestyle changes inconclusive or non-consistent [5][6][7][8]. One review even found that high-quality trials tended to report smaller effects than low-quality trials [8].…”

“…The body of knowledge assessing WHPP's effectiveness is increasing [4][5][6]. A systematic review found more than 300 trials of WHPP published between 2000 and 2012 [5]. Still, the effectiveness of such interventions is for several of the targeted lifestyle changes inconclusive or non-consistent [5][6][7][8].…”