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Health-Promoting Leadership: A Study of the Concept and Critical Conditions forImplementation and Evaluatio
Nordic Council of Ministers, Nordic School of Public Health NHV.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: This thesis aims to describe and analyse the concept of health-promoting leadership, including criticalconditions for implementation and evaluation of such leadership.

Methods: Three case studies and one conceptual analysis were conducted using qualitative methods, including interviews, observations and document analysis. The qualitative data material in study III was supplementedwith quantitative material from a leadership survey. Study I was a qualitative case study of a Swedish industrial company characterized by a low sickness rate, a structure of self-managed teams and an organisational culturethat aimed to develop employee skills and influence. Study II was a phenomenograpic study of health-promoting leadership, as described by 20 individuals employed in Swedish municipalities. Study III was a case study of anintervention programme for the development of health-promoting leadership conducted in four city districts of Gothenburg, Sweden. Study IV was a case study on collaboration in workplace health promotion between municipalities in a Swedish region.

Results: Study I illustrates how a company leader developed and influenced organisational culture, including the employees’ control over their work situation, participation and personal development. The results of this study emphasise the importance of considering contextual factors when evaluating the role of leadership in promotinghealth at work. Study II describes health-promoting leadership in three different ways: organising health promoting activities, supportive leadership style, and developing a health-promoting workplace. Interviewees frequently linked good leadership in general with good employee health. Study III shows the importance ofregarding the development of health-promoting leadership as a contribution to building organisational capacityfor a health-promoting workplace. The intervention programme was implemented in an existing managementgroup already producing action plans for workplace health promotion. Such integration is an important part ofbuilding organisational capacity for creating and sustaining a health-promoting workplace. Study IV shows thatcollaborative health-promoting leadership is viewed as a strategy to reduce the sickness rate amongmunicipalities in a region. The study implies that collaborative workplace health promotion should be organisedinitially on a small scale, giving participants the time and opportunities to develop mutual trust. Moreover, StudyIV demonstrates the importance of including participants with differing levels of knowledge and experienceabout workplace health promotion.

Conclusions: Health-promoting leadership can be defined as leadership that works to create a culture for healthpromotingworkplaces and values, to inspire and motivate employee participation in such a development. Healthpromotingleadership can also be viewed as a critical part of organisational capacity for health promotion,including managerial knowledge and skills as well as organisational policies and structures that support a healthpromotingworkplace. Therefore, leadership involvement in the systematic development of both the physical andpsychosocial work environment is important.

Abstract [sv]

Syfte: Det övergripande syftet med denna avhandling är att beskriva och analysera begreppet hälsofrämjandeledarskap, vilket även inkluderar förutsättningar för utveckling och utvärdering av ett sådant ledarskap.

Metoder: Kvalitativa metoder har tillämpats i avhandlingens alla studier, inklusive intervjuer, observationer ochdokumentanalys. I studie III har det kvalitativa datamaterialet kompletterats med kvantitativa data från enledarskapsundersökning. Tre fallstudier och en konceptuell analys genomfördes. Studie I var en kvalitativfallstudie av ett svenskt industriföretag med låg sjukfrånvaro och med en arbetsorganisation som syftade till attutveckla medarbetarnas kompetens och inflytande i sitt arbete. Studie II var en fenomenografisk studie av hurhälsofrämjande ledarskap beskrevs bland 20 personer anställda i svenska kommuner. Studie III var en fallstudieav ett interventionsprogram för utveckling av hälsofrämjande ledarskap i fyra stadsdelar i Göteborg. Studie IVvar en kvalitativ fallstudie av samverkan mellan kommuner i en svensk region kring att skapa hälsofrämjandearbetsplatser.

Resultat: Studie I visar hur en företagsledare har utvecklat och påverkat en företagskultur som främjar deanställdas kontroll över arbetssituationen, samt deras delaktighet och personlig utveckling. Resultaten visar påvikten av att ta hänsyn till kontextuella faktorer vid utvärdering av vilken betydelse ledarskapet har för att främjahälsa på arbetsplatsen. Hälsofrämjande ledarskap beskrivs i studie II på tre olika sätt: att organiserahälsofrämjande aktiviteter, en stödjande ledarskapsstil, samt att utveckla en hälsofrämjande arbetsplats.Konceptet användes ofta bland intervjupersonerna för att länka idéer om ett gott ledarskap i allmänhet till deanställdas hälsa. Studie III visar på vikten av att se ledarskap som ett bidrag till utvecklingen av enhälsofrämjande arbetsplats. Programmet genomfördes i befintliga ledningsgrupper som tog fram handlingsplanerför en hälsofrämjande verksamhetsutveckling. Denna typ av integration är ett viktig led i att utveckla denorganisatoriska kapaciteten för att vara en hälsofrämjande arbetsplats. I studie IV sågs samverkan kringhälsofrämjande ledarskap som en strategi för att minska sjukskrivningar bland kommunerna i regionen. Studienpekar på vikten av att till en början organisera samverkan kring utveckling av hälsofrämjande arbetsplatser imindre skala för att ge samverkansparterna tid och möjligheter att utveckla ett ömsesidigt förtroende förvarandra. Studien visar också att det är viktigt att involvera olika samverkansparter med kompletterande kunskaper och erfarenheter om arbetshälsa.

Slutsatser: Hälsofrämjande ledarskap kan definieras som ett ledarskap som arbetar för att skapa enhälsofrämjande arbetsplatskultur. En sådan kultur innefattar värderingar som inspirerar och motiverar deanställda att delta i utvecklingen mot en hälsofrämjande arbetsplats. Hälsofrämjande ledarskap kan också sessom en viktig del av den organisatoriska kapaciteten för att främja hälsa, det vill säga chefers kunskaper ochfärdigheter såväl som riktlinjer och strukturer i organisationen som understödjer en hälsofrämjande arbetsplats.Det är därför viktigt med ett ledarskapsengagemang i den systematiska utvecklingen av både den fysiska ochpsykosociala arbetsmiljön.

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden , 2011. , 68 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2011:6
Keyword [en]
Health promotion, leadership, workplace health, evaluation, collaboration, case study
Keyword [sv]
hälsofrämjande arbete, ledarskap, hälsa på arbetsplatsen, utvärdering, samarbete, fallstudie
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3731ISBN: 978-91-86739-18-8 (print)OAI: oai:DiVA.org:norden-3731DiVA: diva2:786453
Public defence
2011-12-02, Nordic School of Public Health NHV, Göteborg, Sweden, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-02-09 Created: 2015-02-05 Last updated: 2015-02-09Bibliographically approved
List of papers
1. Development of health promoting leadership – experiences of a training programme
Open this publication in new window or tab >>Development of health promoting leadership – experiences of a training programme
2010 (English)In: Health Education, ISSN 0965-4283, E-ISSN 1758-714X, Vol. 11, no 2, 506-515 p.Article in journal (Refereed) Published
Abstract [en]

Purpose – The purpose of this paper is to describe and analyse the experiences of an intervention programme for development of health promoting leadership in Gothenburg in Sweden. The more specific purpose is to identify critical aspects of such a programme as part of the development of a health promoting workplace.Design/methodology/approach – A programme supporting managers in health promoting leadership was studied. The study was performed as a holistic case study design. In total, 17 semi‐structured interviews were conducted, supplemented with data from a leadership survey. The material was coded according to the principles of content analysis, resulting in the three main categories: comprehensiveness, integration and participation.Findings – The results show the importance of regarding the development of health promoting leadership as a contribution to the building of organisational capacity for health promoting workplaces. This requires a comprehensive approach, including both individual and structural aspects, as well as an integration of programme ideas into the practice of management. Moreover, a wide participation in the planning and design of the programme is desirable. The concrete outcomes of this programme were action plans for workplace health promotion developed during the programme. For the participating managers a positive part of the programme was also the possibilities for reflecting and sharing experiences.Originality/value – This study contributes knowledge and experiences that can be applied in the development of health promoting leadership. There is, however, a need for clearer health promoting goals and sub‐goals in order to assess the health outcomes of such a leadership programme.

Keyword
Leadership development, Health education, Workplace learning, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3729 (URN)10.1108/09654281011022441 (DOI)
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2015-02-09Bibliographically approved
2. Health promoting leadership - different views of the concept.
Open this publication in new window or tab >>Health promoting leadership - different views of the concept.
2011 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 40, no 1, 75-84 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe and analyse different views of health promoting leadership among actors involved in workplace health promotion in eight Swedish municipalities.

METHODS: Twenty individuals were interviewed and their views were analysed according to the methodology of phenomenograpic research, exploring how health promoting leadership was described, what motives were expressed, and what critical conditions were perceived for developing such leadership.

RESULTS: The informants described health promoting leadership in three ways: organising health promoting activities, having a supportive leadership style, and developing a health promoting workplace. The motives mentioned for developing health promoting leadership were instrumental motives and improved health. The critical conditions for health promoting leadership were organisational conditions, characteristics of individual managers, and support to managers.

CONCLUSIONS: It seems that the concept of health promoting leadership was often used to link ideas about good leadership to the health of employees. Organisational goals and management trends may also have influenced the motives as well as the conditions for development of health promoting leadership.

Keyword
Workplace health promotion, leadership, Swedish municipalities, middle managers, phenomenography
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3728 (URN)10.3233/WOR-2011-1208 (DOI)21849750 (PubMedID)
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2015-02-09Bibliographically approved
3. Collaboration in workplace health promotion: – a case study
Open this publication in new window or tab >>Collaboration in workplace health promotion: – a case study
2012 (English)In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 5, no 3, 181-193 p.Article in journal (Refereed) Published
Abstract [en]

Purpose– The aim of this article is to describe and analyze a case of interorganizational andintersectoral collaboration on workplace health promotion involving nine municipalities in a Swedishregion.Design/methodology/approach– A holistic case study design was chosen. The work of a projectgroup responsible for developing plans for collaboration in the target area of health promotingleadership was studied. Observations at project meetings, interviews with project members, andwritten project documents were analyzed by qualitative methods.Findings– Collaboration on health promoting leadership was seen as a strategy to reduce thesickness rate among the employees in the municipalities. The best way to develop such leadership wasconsidered to be through supporting good leadership in general and improving the general workingconditions of managers in the municipalities. Moreover, it was regarded as a critical condition to havestructural arrangements and resources to continue this collaboration.Practical implications– An implication of the study is that collaboration on workplace healthpromotion should be organized initially on a small scale, giving time and opportunities for theparticipants to develop mutual trust with one another. It is also important to involve participants withdifferent knowledge and experiences in the field. Thus, it may be possible to develop strategies forhealth-promoting leadership contributing to the overall aim of a decreased sickness rate.Originality/value– There is limited research on barriers and facilitating factors forinterorganizational and intersectoral collaboration on workplace health promotion. This study contributesan analysis of important conditions for this kind of collaboration.

Keyword
Health promotion, Leadership, Workplace health, Collaboration, Workplace, Health care, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3727 (URN)10.1108/17538351211268836 (DOI)
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2015-02-09Bibliographically approved
4. Leadership, organization and health at work: a case study of a Swedish industrial company.
Open this publication in new window or tab >>Leadership, organization and health at work: a case study of a Swedish industrial company.
2008 (English)In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 23, no 2, 127-33 p.Article in journal (Refereed) Published
Abstract [en]

The application of knowledge on organization and leadership is important for the promotion of health at workplace. The purpose of this article is to analyse the leadership and organization, including the organizational culture, of a Swedish industrial company in relation to the health of the employees. The leadership in this company has been oriented towards developing and actively promoting a culture and a structure of organization where the employees have a high degree of control over their work situation. According to the employees, this means extensive possibilities for personal development and responsibility, as well as good companionship, which makes them feel well at work. This is also supported by the low sickness rate of the company. The results indicate that the leadership and organization of this company may have been conducive to the health of the employees interviewed. However, the culture of personal responsibility and the structure of self-managed teams seemed to suit only those who were able to manage the demands of the company and adapt to that kind of organization. Therefore, the findings indicate that the specific context of the technology, the environment and the professional level of the employees need to be taken into consideration when analysing the relation between leadership, organization and health at work.

Keyword
health at work leadership organization
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3730 (URN)10.1093/heapro/dan015 (DOI)18344562 (PubMedID)
Available from: 2015-02-05 Created: 2015-02-05 Last updated: 2015-02-09Bibliographically approved

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