Skip to main content

Table 3 Reported barriers (B) and/or facilitators (F) in the studies included in this review

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

Main categories Description of the determinants for implementation B/F
Characteristics of the socio-political context 1. Compatibility of program with societal developments (attention for health in society) [74] F
2. Competitive business environment[53] B
Characteristics of the organization 3. Organizational reorganization: reorganization due to take over by another company [68] B
4. Lack of resources: financial, personnel, material (e.g., equipment, facilities) resources or lack of space or facilities [54, 57, 66, 72, 74] B
5. Organizational culture:  
(a) Senior leaders emphasized the need to implement the intervention keeping the organizational culture in mind [53] F
(b) Intervention did not fit the organizational culture [55, 72] B
(c) The organizational culture emphasized goal setting and tracks progress towards achieving goals [53] F
(d) Worksite culture supported social interaction among workers and between workers and managers [55] F
6. Organizational size:  
(a) In a large organization (1000+ employees) there were numerous competing priorities and it was challenging to maintain visibility [60] B
(b) In a small organization (<500 employees) it is challenging to assemble a critical mass of potential participants for participation in the intervention [60] B
(c) Small organizations tend to receive more intervention components per employee than larger organizations [61] F
7. Amount of company locations: Different company locations at which the intervention needs to be delivered [74] B
8. Organizations awareness of perceived benefits of investment [74], and awareness of relevance and economics of health and employee wellness [53, 60] F
9. Company image: the program gives the organization a positive image since it shows that the organization cares about their employees [66] F
10. Perceived responsibility of employer towards workers health and wellbeing [74] F
11. High staff turnover rate among employees made it difficult to provide adequate exposure to the intervention [68, 69] B
12. Good collaboration between persons/ structures/ services/ collaborative partners within or outside departments and organizations [54, 66, 72] F
13. Conflicting relationship between management and researchers[68] B
14. General good organizational support for health promotion [53] F
15. Poor psychosocial work environment consisting of the following the subcomponents: influence at work, work pace quantitative work demands, interpersonal relations [70] B
16. History of social interaction: Worksite has a history of bringing employees together for social activities and a history of positive social interaction between worker and management [55] F
17. Management support:  
(a) Strong (upper) management support for intervention and general health promotion efforts at the organization [55, 60, 68, 72, 73] F
(b) Unbalanced management support for intervention [55, 68] B
(c) Managers encouraging workers to attend intervention [55] F
(d) Experienced management support are different for junior employees and senior employees [64] B
(e) formal approval of upper management before start of intervention [57] F
(f) Lack of perceived management support by implementers on site [74] B
(h) Management commitment and willingness to provide employees with release time from their usual duties to attend intervention [55] F
18. Management participation and engagement:  
(a) Active management participation and involvement alongside and with workers [55, 73] F
(b) Active management engagement in planning [55] F
19. Relationship between management and employees: Respectful relationship between management and worker [55]  
Characteristics of the implementer 20. Job position of implementer: [74]  
(a) Self-employed (advantage of managing his or her own time) F
(b) Internal position (facilitating in scheduling appointments) F
(c) external position  
21. (Perceived) Support for implementers: [74] B
(a) Poor support from co- implementers B
  (b) Support for implementers to change their routines (applicable when implementer is an occupational physician) [74] F
22. Collaboration between implementers: lack of possibility to exchange experiences between implementers [74] B
23. Available time of implementer:  
(a) Sufficient time available to implement intervention [56, 66, 72, 74] F
(b) The intervention involved extra work on top of the heavy workload of the regular duties of the implementer [66] B
(c) planning difficulties of implementers with planning al contacts in the intervention period [59] B
24. Expectations of implementer: implementers expectations were met [74] F
25. Absence of a project leader/ leading person/ ambassador[72] B
26. Implementerscompliance with intervention protocol [52] F
27. Staff turnover among implementers: drop out of implementers (without replacing them) [69, 72] B
28. Absence of decision maker among implementers: among the implementers there lacked a person who was entitled to make decision at department level [72] B
29. High perceived Level of control for intervention delivery by provider/implementer [60] F
30. Low level of engagement of implementers in planning, promoting and providing feedback on intervention activities [55] B
31. Personnel characteristics of implementer: sufficient skills, knowledge and competence to implement guideline or intervention correctly [55, 59, 74] F
Characteristics of the intervention program 32. Degree of rewards: either financial reimbursement or other incentives [53, 68] F
33. Compatibility and alignment of intervention with:  
(a) organizations mission statement/business goals/ institutional policy change [53, 60, 68, 74] F
(b) policy, culture, norms and current practices of organization [56, 58, 66, 72] F
(c) Ease of integration of intervention in working live [64] F
34. The intervention fit implementers current work [74] F
35. Intervention is part of the worksites integral health policy and seen as a pilot for future health promotion policy instead of independent project [57] F
36. Relative advantage: intervention is advantageous compared to the current situation and no negative consequences were observed and the company, managers, implementers and participants benefit from participation [54, 56, 66, 72, 74] F
37. Time: Project took more time than expected due to high workload of administration and planning [74] B
38. Complexity: Intervention was not too difficult or complex to implement and execute [56, 59, 72, 74] F
39. Observability of positive results of the intervention [74] F
40. Risk and uncertainty level/Triability: the degree to which an innovation can be adopted/implemented with minimal risk [56] F
41. Conflicting interest between worksite and intervention [66] B
42. Timing of intervention activities: intervention activities coincide with scheduled breaks [68] F
43. Technical problems (e.g., equipment breaks down) [54, 69] B
44. Degree of incorporation of program communication and interventions into already established communication channels or existing worksite events/meetings [53, 55] F
45. Presence of advisory board: well-functioning advisory board [55] F
46. Ease of access to the program by bringing the program to participants and making participation free or inexpensive [53] F
Characteristics of the participant 47. Needs of participants:  
(a) Positive personal preferences for program [63] F
(b) No need for intervention (e.g., already being healthy) [74] B
(c) Positive program expectation [71] F
(d) Prior failed attempts to maintain a healthy lifestyle [62] B
48. Current workload and work structure/schedules: volume of daily tasks, overtime work, shift work, part-time work, irregular work schedules, shifts of different lengths, time-pressures [53, 60, 64, 68] B
49. Work demands: Workers were unable to participate since they could not leave their work due to work demands, obligations and limited free time and flexibility to leave immediate work area [55, 57, 60, 64] B
50. Time constraints of participants: lack of time, time constraints and willingness to make time to participate at work [53, 54, 57, 62, 63, 74] B
51. Amount of peer leaders: Few peer leaders due to geographically separated worksites made it difficult to establish group cohesion [68] B
52. Lack of social support:  
(a) No interaction with the entire workforce to build worksite-wide social norms and social support) [68] B
(b) Peer support: difficult to engage in behavior not considered normal by peers [64] B
53. Lack of motivation of workers to participate in intervention [54] B
54. Participants self-efficacy: Low to medium self-efficacy is a barrier for participation [70] B