Education as a Workplace Intervention: An Economic Evaluation

TLDR

Initiatives with an education component have been found across diverse contexts to improve outcomes for workplace health as seen in a range of indicators, demonstrated by various research studies as highlighted in this article.

Abstract

Quality data is crucial when it comes to successfully evaluating health-based workplace interventions; ideally sourcing contextually specific data directly from the organization. By starting with larger themes present in systematic reviews, it can be determined if an intervention may be suitable for a given organization by then honing the search to ensure sourced data is applicable to the intended context. In this case, the broader evidence for education as a health initiative with economic value led to narrowing in on data which may suggest this intervention holds significant value for application. Across a variety of contexts, it has been demonstrated within research that education provides holistic economic benefits to organizations, holding strong merit as a health-based workplace intervention. Improvement to working conditions, mitigating sickness-related costs, supporting mental health, and significant reduction to new and active lost-time workers’ compensation claims, as presented in research highlighted within this article, suggest a holistic benefit to mental health, physical injury, and chronic health which are common concerns across sectors. Given that education can be adapted to the needs and objectives of the organization, it is an intervention component that has the potential to produce significant value across a variety of organizational needs and contexts.

Introduction

When it comes to evaluation of health-based workplace interventions, quality of data is extremely important. While it may be important for an organization to do their research in terms of existing peer-reviewed and grey literature, it is also critical to consider how this information applies to the context and circumstances of the organization (PCU-WHS, 2021). If at all possible, it is preferable to source internal data directly from the organization that will be implementing or improving an intervention process (PCU-WHS, 2021). Sourcing quality data, whether externally or internally, can be a challenge and must look to both qualitative and quantitative information in order to create a holistic bigger-picture (PCU-WHS, 2021).

Systematic-literature reviews often point to the need for further quality research on effects of workplace interventions; in particular, research which would illuminate economic factors of interest to employers, such as evaluating impact to costs and productivity (Wagner, et al., 2016; Tompa et al., 2008; Akerstrom, et al., 2021). It can be difficult to measure the impact of such factors, so the professional exploring or planning initiatives must carefully consider what data is needed to make a compelling and relevant case. An important question to reflect on as pertains to the business case for interventions in the workplace: is the available data applicable and replicable in this particular instance?

Background

Foundational Research

In order to make a compelling and relevant case for a given organization, it would be wise to look to a broader picture such as that revealed in systematic reviews before narrowing in on more specific research expounding the selected intervention of interest. This approach first seeks to determine which interventions are efficacious on the whole, and given this information looks more closely to reveal if a potential intervention might be applicable to the present context and circumstances.

The article, A Systematic Review of Disability Management Interventions with Economic Evaluations concludes there exists moderate evidence in favour of workplace interventions with an education component (Tompa et al., 2016). This led to choosing a direction for this article by prompting literature search of workplace interventions including an educational component. Of note, this turned up a handful of studies which mostly centered on elucidating the impact of training to prepare front-line supervisors and managers to respond to health needs of workers. A relevant and recent article, Can Working Conditions and Employees’ Mental Health be Improved via Job Stress Interventions Designed and Implemented by Line Managers and Human Resources on an Operational Level? was referenced to scope out potentially updated information on which direction to look in pursuit of research which presents quality evidence of the economic case for workplace interventions that include an educational component (Akerstrom et al., 2021).

Context Within Economic Evaluation

The article by Akerstrom et al. once again emphasized the importance of looking to the context within the organization in order to effectively and holistically evaluate intervention results (2021). Furthermore, this article pointed to a statistically significant effect on working conditions, motivation and health for employees who stated in a survey that they clearly understand what is expected of them in their job role (Akerstrom, et al., 2021). Additionally, the findings also suggested that it is critically important for frontline-managers to have adequate knowledge and training in order to plan and implement effective interventions (Akerstrom, et al., 2021).

Potential of Interventions with an Education Component

From the literature reviewed so far, there is evidence in favour of the potential for education to lead to positive outcomes in workplace interventions across multiple circumstances, from worker clarity on job role to adequate managerial role-related training. This information could suggest that having necessary information at work may help across the multiple levels needed for interventions to be successful. The article, Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews elicits that that multi-component mental health interventions are among the interventions with strongest evidence of efficacy (Wagner et al., 2016). This article outlines that some relevant details are not present within this review, such as more information on what comprises the multi-component mental health interventions (Wagner et al., 2016). It is possible that integrating an education component as a facet of a multi-component intervention might increase the likelihood of success. Taking into consideration some key points from the articles as mentioned above, further research was reviewed.

Integrity of Data

Qualitative

The journal publication, Supervisors and Presenteeism: How do Supervisors Accommodate and Support Skilled Workers with Chronic Health Concerns? proposes that relevant training for supervisors and managers mitigates sickness related costs (Nelson et al., 2016). While this study offers little quantitative data, it provides qualitative data in the form of looking at how costs can be reduced, rather than how much the costs were reduced. Another study that looks to qualitative data, A New Online Mental Health Training Program for Workplace Managers: Pre-Post Pilot Study Assessing Feasibility, Usability, And Possible Effectiveness submits that a particular standardized online training program may be a “feasible, acceptable, and efficient method of training managers in best workplace practices to help support the mental health needs of their staff” (Gayed et al., 2018, p. 2). Once again, this study focuses on how results were achieved rather than demonstrating how those results translate to typically desired organizational outcomes such as reducing costs or promoting productivity.

Quantitative

 By contrast, the review entitled, A Controlled Case Study of Supervisor Training to Optimize Response to Injury in the Food Processing Industry states, “Workers’ compensation claims data in the 7 months before and after the workshop showed a 47% reduction in new claims and an 18% reduction in active lost-time claims versus 27% and 7%, respectively, in the control group” (Shaw et al., 2006, p. 107). This level of detail on reduction to new and active lost-time claims provides a more quantitative perspective on measuring the impact of training for frontline supervisors. While there is value in looking to the quantitative information, this study had a narrow focus for the outcomes and missed out on painting a more complete picture of the overall intervention effects that would have been achieved if they had taken more outcomes into consideration or measured other impacts which are a relevant part of the picture in an economic evaluation of interventions.

Summary

• Qualitative Data: Studies indicate that relevant training for supervisors can mitigate sickness-related costs. For example, an online mental health training program was found to be a feasible method for training managers to support their staff's mental health needs.

• Quantitative Data: In a controlled study, training supervisors led to a 47% reduction in new workers’ compensation claims and an 18% reduction in active lost-time claims. While these quantitative results are promising, they highlight the need for a more comprehensive evaluation of overall intervention effects.

Issue Addressed by the Intervention

The studies presented cover a wide range of workplace issues such as mental health, physical injury, and chronic health which are common concerns across sectors.

Nature of the Intervention

This paper highlights a handful of studies with a common thread of successful interventions that include an education component.

Findings from the Studies

A spectrum of positive effects was outlined throughout the selected literature with a significant amount of diversity in the nature of findings. While only looking at a single study provides a limited perspective, taking into account the findings from study-to-study cultivates a bigger picture concept that may be applicable for a given organization.

Assessment of the Quality of the Studies

While the studies all had their drawbacks, for the most part they did a good job at detailing this and taking it into account their respective limitations for the discussion, conclusions, and presentation of data. All the studies seemed to point to the idea that education can be a powerful workplace intervention, the effects of which can be demonstrated and measured in a multitude of ways. The consistency of findings throughout different settings and formats suggests that this success may be applicable and replicable across a spectrum of workplace circumstances and contexts. These are all clues which assist in determining the quality of data being presented in each of the studies.

Overall Synthesis of the Impact of the Intervention

The information presented in this article suggests that interventions with an education component have the potential to positively influence the success of workplace intervention outcomes. The studies presented demonstrate that when education is tailored to the context and circumstances, it has the power to positively impact the outcomes for workers as well as the organization. Further, education is a flexible intervention which can readily be adapted to the needs and objectives of the organization. One common thread between all the included studies was the need for further research to determine a more complete picture of the workplace effects.

Conclusion

On many levels of implementing workplace interventions, education may prove useful, from the managerial and supervisory to the worker level. This article has presented a range of data from qualitative to quantitative which makes a case for education as an intervention which facilitates a range of effects such as minimizing workers compensation claims and reducing costs associated with health-related absences. Education has the potential to be most effective when it is customized to the needs presented by the environment, as this allows the employees to better act in accordance with their role as appropriate within that organizational context. It would be prudent for a given organization to do research of existing external literature followed by internal research and data analysis in order to determine if the proposed intervention would be applicable and replicable within the context and circumstances present.

References

Akerstrom, M., Corin, L., Severin, J., Jonsdottir, I. H., & Bjork, L. (2021). Can working conditions and employees’ mental health be improved via job stress interventions designed and implemented by line managers and human resources on an operational level? International Journal of Environmental Research and Public Health, 18(4). https://doi.org/10.3390/ijerph18041916

Gayed, A., LaMontagne, A. D., Milner, A., Deady, M., Calvo, R. A., Christensen, H., Mykletun, A., Glozier, N., & Harvey, S. B. (2018). A new online mental health training program for workplace managers: Pre-post pilot study assessing feasibility, usability, and possible effectiveness. JMIR Mental Health, 5(3). https://doi.org/10.2196/10517

Nelson, C. C., Shaw, W., & Robertson, M. (2016). Supervisors and presenteeism: How do supervisors accommodate and support skilled workers with chronic health concerns? Employment Responsibilities and Rights Journal, 28, 209–223. https://doi.org/10.1007/s10672-015-9275-4

Pacific Coast University for Workplace Health Sciences (PCU-WHS). (2021). Session 4 study guide: Evaluating intervention effectiveness. WHDM 404 Economics of Workplace Health Initiatives. PCU-WHS.

Shaw, W. S., Robertson, M. M., McLellan, R. K., Verma, S., & Pransky, G. (2006). A controlled case study of supervisor training to optimize response to injury in the food processing industry. Work, 26(2), 107-114.

Tompa, E., Oliveira, C., Dolinschi, R., & Irvin, E. (2008). A systematic review of disability management interventions with economic evaluations. Journal of Occupational Rehabilitation, 18. https://doi.org/10.1007/s10926-007-9116-x

Wagner, S. L., Koehn, C., White, M. I., Harder, H. G., Shultz, I. Z., Williams-Whitt, K., Warje, O., Dionne, C. E., Koehoorn, M., Pasca, R., Hsu, V., McGuire, L., Shulz, W., Kube, D., & Wright, M. D. (2016). Mental health interventions in the workplace and work outcomes: A best-evidence synthesis of systematic reviews. International Journal of Occupational and Environmental Medicine, 7(1). https://www.theijoem.com/ijoem/index.php/ijoem/article/view/607/677